Fully Automated Measurement of the Insall-Salvati Ratio with Artificial Intelligence.

Patella alta (PA) and patella baja (PB) affect 1-2% of the world population, but are often underreported, leading to potential complications like osteoarthritis. The Insall-Salvati ratio (ISR) is commonly used to diagnose patellar height abnormalities. Artificial intelligence (AI) keypoint models show promising accuracy in measuring and detecting these abnormalities.An AI keypoint model is developed and validated to study the Insall-Salvati ratio on a random population sample of lateral knee radiographs. A keypoint model was trained and internally validated with 689 lateral knee radiographs from five sites in a multi-hospital urban healthcare system after IRB approval. A total of 116 lateral knee radiographs from a sixth site were used for external validation. Distance error (mm), Pearson correlation, and Bland-Altman plots were used to evaluate model performance. On a random sample of 2647 different lateral knee radiographs, mean and standard deviation were used to calculate the normal distribution of ISR. A keypoint detection model had mean distance error of 2.57 ± 2.44 mm on internal validation data and 2.73 ± 2.86 mm on external validation data. Pearson correlation between labeled and predicted Insall-Salvati ratios was 0.82 [95% CI 0.76-0.86] on internal validation and 0.75 [0.66-0.82] on external validation. For the population sample of 2647 patients, there was mean ISR of 1.11 ± 0.21. Patellar height abnormalities were underreported in radiology reports from the population sample. AI keypoint models consistently measure ISR on knee radiographs. Future models can enable radiologists to study musculoskeletal measurements on larger population samples and enhance our understanding of normal and abnormal ranges.

24-hour Intraocular pressure monitoring: the way ahead.

Aim: Large diurnal intraocular pressure (IOP) fluctuation is a single most independent risk factor for glaucoma progression besides raised IOP. The major limitation of Goldman applanation tonometer (GAT) is its inability to measure night IOP without disturbing the patient's sleep. We discussed the methods available for the 24-hour IOP monitoring and its relevance in glaucoma. Methods: A PUBMED search was performed using the 24 Hour tonometry, newer tonometry devices, contact lens sensors, as keywords and all relevant articles were studied. Results and Conclusion: A number of methods are available for the 24 hour IOP monitoring. These devices allow home monitoring of IOP without affecting the daily routine. These devices, like Rebound tonometry, Contact lens sensor (CLS), etc., were briefly discussed. Triggerfish is one CLS device that has the capability to measure IOP without affecting the patient's sleep. Besides being safe and easily tolerable, it has shown reproducible results with other tonometry methods. Triggerfish has also been proven the device of choice in measuring IOP in different glaucoma subtypes and determining the efficacy of treatment in them, the only challenge being that it presently provides data on relative IOP rather than absolute IOP. With future research, triggerfish CLS can become an important device to measure the 24 hour IOP values especially in patients whose office measured IOPs seemingly fit in patient's target range but still the patients' disease shows glaucomatous progression. The utility of this device in relation to progressive vision loss is a matter of future study. Abbreviations: CCT = Central Corneal Thickness; CLS = Contact lens sensor; GAT = Goldmann Applanation Tonometer; IOP = Intraocular Pressure; NTG = Normal Tension Glaucoma; PACG = Primary angle closure glaucoma; POAG = Primary open angle glaucoma; VAS = Visual Analogue Score.

Quantifying the quantum gate fidelity of single-atom spin qubits in silicon by randomized benchmarking.

Building upon the demonstration of coherent control and single-shot readout of the electron and nuclear spins of individual (31)P atoms in silicon, we present here a systematic experimental estimate of quantum gate fidelities using randomized benchmarking of 1-qubit gates in the Clifford group. We apply this analysis to the electron and the ionized (31)P nucleus of a single P donor in isotopically purified (28)Si. We find average gate fidelities of 99.95% for the electron and 99.99% for the nuclear spin. These values are above certain error correction thresholds and demonstrate the potential of donor-based quantum computing in silicon. By studying the influence of the shape and power of the control pulses, we find evidence that the present limitation to the gate fidelity is mostly related to the external hardware and not the intrinsic behaviour of the qubit.

Case Report: A Neocystostomy Perforation Presenting as a Gallstone.

An 83-year-old man, with a surgical history of radical cystectomy with simultaneous construction of a neobladder 13 years ago, presented clinically and radiologically as acute cholecystitis. Upon emergent exploratory laparotomy for his acute deterioration, a perforated neobladder was identified with its spilled stones in the gallbladder fossa, mimicking acute cholecystitis. This is the first case report of this presentation. Neobladder perforations should be considered in any patient who has undergone orthotopic bladder substitution, no matter how long it has been since the original reconstruction.

Oral arginine metabolism may decrease the risk for dental caries in children.

Arginine metabolism by oral bacteria via the arginine deiminase system (ADS) increases the local pH, which can neutralize the effects of acidification from sugar metabolism and reduce the cariogenicity of oral biofilms. To explore the relationship between oral arginine metabolism and dental caries experience in children, we measured ADS activity in oral samples from 100 children and correlated it with their caries status and type of dentition. Supragingival dental plaque was collected from tooth surfaces that were caries-lesion-free (PF) and from dentinal (PD) and enamel (PE) caries lesions. Regardless of children's caries status or type of dentition, PF (378.6) had significantly higher ADS activity compared with PD (208.4; p < .001) and PE (194.8; p = .005). There was no significant difference in the salivary arginolytic activity among children with different caries status. Mixed-model analysis showed that plaque caries status is significantly associated with ADS activity despite children's age, caries status, and dentition (p < .001), with healthy plaque predicting higher ADS activity compared with diseased plaque. Plaque arginine metabolism varies greatly among children and tooth sites, which may affect their susceptibility to caries.

One-particle measurement of the antiproton magnetic moment.

For the first time a single trapped antiproton (p) is used to measure the p magnetic moment µ(p). The moment µ(p)=µ(p)S/(ℏ/2) is given in terms of its spin S and the nuclear magneton (µ(N)) by µ(p)/µ(N)=-2.792 845±0.000 012. The 4.4 parts per million (ppm) uncertainty is 680 times smaller than previously realized. Comparing to the proton moment measured using the same method and trap electrodes gives µ(p)/µ(p)=-1.000 000±0.000 005 to 5 ppm, for a proton moment µ(p)=µ(p)S/(ℏ/2), consistent with the prediction of the CPT theorem.

New protocol to prevent TMJ reankylosis and potentially life threatening complications in triad patients.

The management of patients with the triad of temporomandibular joint (TMJ) ankylosis, micrognathia and obstructive sleep apnea syndrome is challenging for the oral and maxillofacial surgeon because it involves achieving the desired oral opening, correction of micrognathia, and correction of the obstructed airway. Seven of the authors' triad patients, in whom only the release of ankylosis was performed, developed bradycardia and respiratory distress during postoperative jaw physiotherapy, leading to their non-compliance for active jaw physiotherapy and subsequent reankylosis. This paper suggests a new surgical protocol for the management of patients with the triad, to achieve correction of the obstructed airway, relief of the respiratory distress symptoms, correction of micrognathia and restricted mouth opening. It also provides a logical reason for the occurrence of bradycardia following ankylosis release and its potential role in TMJ reankylosis. It emphasizes that the occurrence of bradycardia in triad patients during jaw exercises is dictated by the severity of their apnea-hypopnea index and the degree of narrowing of their posterior airway space. The recognition and prevention of this by the new protocol is discussed in 7 patients.

Trapped antihydrogen in its ground state.

Antihydrogen atoms (H¯) are confined in an Ioffe trap for 15-1000 s-long enough to ensure that they reach their ground state. Though reproducibility challenges remain in making large numbers of cold antiprotons (p¯) and positrons (e(+)) interact, 5±1 simultaneously confined ground-state atoms are produced and observed on average, substantially more than previously reported. Increases in the number of simultaneously trapped H¯ are critical if laser cooling of trapped H¯ is to be demonstrated and spectroscopic studies at interesting levels of precision are to be carried out.

Adiabatic cooling of antiprotons.

Adiabatic cooling is shown to be a simple and effective method to cool many charged particles in a trap to very low temperatures. Up to 3×10(6) p are cooled to 3.5 K-10(3) times more cold p and a 3 times lower p temperature than previously reported. A second cooling method cools p plasmas via the synchrotron radiation of embedded e(-) (with many fewer e(-) than p in preparation for adiabatic cooling. No p are lost during either process-a significant advantage for rare particles.

Change in dental caries status over 2 years in children of Panchkula, Haryana: A longitudinal study.

BACKGROUND: Despite credible scientific advances and the fact that it is preventable, dental caries continues to be a major public health problem in developing countries like India. The first step toward disease prevention at community level is assessment of the disease activity. AIM: Hence this study was conducted to evaluate the change in dental caries status over 2 years in children of Panchkula, Haryana. MATERIALS AND METHODS: 207 school children having mixed dentition (age 7-8 years) and 103 children (age 12-13 years) were assessed for change in their dmf/DMF status over 2 years. RESULTS AND CONCLUSION: Results revealed that 81% of 7-8-year-old children and 83 % 12-13-year-olds had caries. There was a statistically significant increase in DMFT score of children over 2 years; thus necessitating implementation of rigorous preventive strategies at community level.

Centrifugal separation of antiprotons and electrons.

Centrifugal separation of antiprotons and electrons is observed, the first such demonstration with particles that cannot be laser cooled or optically imaged. The spatial separation takes place during the electron cooling of trapped antiprotons, the only method available to produce cryogenic antiprotons for precision tests of fundamental symmetries and for cold antihydrogen studies. The centrifugal separation suggests a new approach for isolating low energy antiprotons and for producing a controlled mixture of antiprotons and electrons.

Dendrimers and their pharmaceutical applications--a review.

Dendrimers are hyperbranched macromolecules having tree like structure, consisting of a core molecule and alternating layers of monomers. They can be synthesized by divergent and convergent growth methods. During synthesis, properties like dendrimer size, molecular mass, surface group can be controlled and configured to the desired need. The ability of dendrimers to encapsulate and bind the guest molecule can be used for solubility enhancement, sustained release and drug delivery applications. In this review we tried to delineate the properties, synthesis methods and expound potential pharmaceutical applications along with toxicological considerations of dendrimers.

Primary intraosseous meningioma.

Primary intraosseous meningioma of the skull is an uncommon lesion often confused preoperatively with a primary bone tumor of the skull. We report this rare tumor in a 19-year-old male who was radiographically diagnosed as osteoid osteoma.

Residues of DDT and HCH in wheat samples collected from different states of India and their dietary exposure: A multicentre study.

Under a multicentre study conducted by the Indian Council of Medical Research, 1712 samples of wheat grain/flour were collected from urban and rural areas in 11 states representing different geographical regions of India. These samples were analysed for residues of DDT (2,2-bis (p-chlorophenyl)-1,1,1-trichloro ethane) and different isomers of HCH (1,2,3,4,5,6-hexachloro cyclohexane, a mixture of isomers) by gas-liquid chromatography. Residues of DDT were detected in 59.4% of 1080 samples of wheat grain and in 78.2% of 632 samples of wheat flour. Different isomers of HCH were present in about 45-80% of the samples of wheat grain/flour. Medians of DDT and total HCH, respectively, for pooled samples of wheat grain were 0.013 and 0.035 mg kg(-1), while those for wheat flour were 0.01 and 0.02 mg kg(-1). Estimated daily intakes of DDT and different isomers of HCH through the consumption of wheat contaminated at their median and 90th percentiles constituted a small proportion of their acceptable daily intakes. Amongst the pesticide residues analysed, statutory maximum residue limits have been fixed only for gamma-HCH in wheat in India, as 0.1 mg kg(-1) in wheat grain and zero in wheat flour. Residue levels of gamma-HCH exceeded these maximum residue limits in five of 1080 samples of wheat grain and in 340 of 632 samples of wheat flour. The failure to meet the requirement of the gamma-HCH maximum residue limit in large number of wheat flour samples was attributed to the fixation of practically unachievable zero limit. Comparing the previous studies and the present one, the levels of residues of DDT and HCH in wheat were significantly decreased.

Psychomotor performance of psychiatric inpatients under therapy: assessment by paper and pencil tests.

Fifty psychiatric inpatients included in the study were diagnosed as having substance related disorder, schozophrenia, bipolar disorder, depressive disorder or anxiety disorder based on DSM-IV and ICD-10. All the patients were on multiple drug therapy for a minimum of 7 days in the hospital. The psychomotor performance score assessed with the help of the six letter cancellation test and the digit letter substitution test was compared with a matched group of 50 normal volunteers. The significantly low scores for patients may be considered indicative of the fact that prolonged therapy would be required to attain normal psychomotor status. Thus, simple paper and pencil tests may provide valuable information in assessment of psychomotor and cognitive functions of psychiatric patients during recovery.

Buccoadhesive erodible disk for treatment of oro-dental infections: design and characterisation.

Buccoadhesive erodible disks of cetylpyridinium chloride were prepared using different bioadhesive polymers along with excipients like mannitol. The purpose of designing the erodible disk was to obviate the need for removal of exhausted device. The optimized disk containing 5.0 mg of cetylpyridinium chloride, 2.0 mg of magnesium stearate and 6.0 mg of mannitol along with sodium carboxy methyl cellulose DVP and hydroxypropylmethylcellulose K4M in the ratio of 1:3 was found to release the drug for a period of over 6.0 h without getting dislodged. Maximum in vitro drug release was found to be 94.78% in 6.0-h study. In situ release characteristics were evaluated using a 'flow-through assembly', which simulated the conditions of the human buccal cavity. The drug concentrations in the in situ samples were found to be above minimum inhibitory concentration (MIC) of the drug. The bioadhesive performance and the surface pH of the disks were satisfactory. Cetylpyridinium chloride disks were tested against microorganisms commonly found in oro-dental infections namely Candida albicans, Staphylococcus aureus, Escherichia coli and Streptococcus mutans. The disk as well as the in situ samples showed inhibition of growth of microorganisms. Approval was taken from Jamia Hamdard Review Board (Ethical Board) to perform in vivo studies in healthy human volunteers. In vivo evaluation of buccoadhesive disks revealed adequate comfort, taste, and non-irritation and none of the volunteers reported severe dry mouth/severe salivation or heaviness at the place of attachment. Salivary concentrations were maintained above MIC for 8.0 h. Correlation was found between the drug concentration in situ and concentration of drug in saliva collected in healthy human volunteers. The correlation was found to be positive with a correlation coefficient of 0.9596. It was found to be statistically significant at 5% confidence level (P<0.05).