Chest wall soft tissue thickness is associated with humeral shaft non-union: A radiographic study.

Background: Anecdotally, upper truncal obesity and large breasts have often been associated with inferior outcomes from non-operative management of diaphyseal humerus fractures. However, this assertion is without basis in the literature.

Aims: To produce radiographic measurements of chest wall soft tissue thickness (STT) and determine association with non-union in diaphyseal humerus fractures.

Radiological outcomes following surgical fixation with wires versus moulded cast for patients with a dorsally displaced fracture of the distal radius: a radiographic analysis from the DRAFFT2 trial.

Aims: The primary aim of this study was to report the radiological outcomes of patients with a dorsally displaced distal radius fracture who were randomized to a moulded cast or surgical fixation with wires following manipulation and closed reduction of their fracture. The secondary aim was to correlate radiological outcomes with patient-reported outcome measures (PROMs) in the year following injury.

Methods: Participants were recruited as part of DRAFFT2, a UK multicentre clinical trial.

Stitching Locally Fitted T-Splines for Fast Fitting of Large-Scale Freeform Point Clouds.

Parametric splines are popular tools for precision optical metrology of complex freeform surfaces. However, as a promising topologically unconstrained solution, existing T-spline fitting techniques, such as improved global fitting, local fitting, and split-connect algorithms, still suffer the problems of low computational efficiency, especially in the case of large data scales and high accuracy requirements. This paper proposes a speed-improved algorithm for fast, large-scale freeform point cloud fitting by stitching locally fitted T-splines through three steps of localized operations.

Diagnostic Needle Arthroscopy of the Shoulder: A Validation Study.

Background: Diagnostic needle arthroscopy offers an alternative imaging modality to magnetic resonance imaging (MRI) for the diagnosis of intra-articular pathology.

Purpose: To compare the accuracy of a needle arthroscopy device (Mi-eye2) versus MRI in identifying intra-articular anatomic abnormalities in the glenohumeral joint, with formal arthroscopy as the gold standard.

Study Design: Cohort study; Level of evidence, 2.

Use of a mutation-specific genotyping method to assess for HIV-1 drug resistance in antiretroviral-naïve HIV-1 Subtype C-infected patients in Botswana.

HIV-1 drug resistance poses a major threat to the success of antiretroviral therapy. The high costs of available HIV drug resistance assays prohibit their routine usage in resource-limited settings. Pan-degenerate amplification and adaptation (PANDAA), a focused genotyping approach based on quantitative PCR (qPCR), promises a fast and cost-effective way to detect HIV drug resistance mutations (HIVDRMs).

PANDAA intentionally violates conventional qPCR design to enable durable, mismatch-agnostic detection of highly polymorphic pathogens.

Sensitive and reproducible diagnostics are fundamental to containing the spread of existing and emerging pathogens. Despite the reliance of clinical virology on qPCR, technical challenges persist that compromise their reliability for sustainable epidemic containment as sequence instability in probe-binding regions produces false-negative results. We systematically violated canonical qPCR design principles to develop a Pan-Degenerate Amplification and Adaptation (PANDAA), a point mutation assay that mitigates the impact of sequence variation on probe-based qPCR performance.

Anal Cancer Precursor Lesions in HIV-Infected Persons: Tissue Human Papillomavirus Type Distribution and Impact on Treatment Response.

Background: Data on tissue distribution of human papillomavirus types in anal high-grade squamous intraepithelial lesions are limited and the impact on treatment outcomes poorly understood.

Objective: We aimed to investigate potential predictors of treatment failure after electrocautery ablation, including human papillomavirus type(s) isolated from index lesions.

Design: This was a retrospective cohort study.

Prevalence of oncogenic human papillomavirus genotypes in patients diagnosed with anogenital malignancies in Botswana.

Background: Human papillomavirus (HPV) associated malignancies are the leading cause of cancer death in Botswana. We sought to determine causative HPV types in patients with anogenital malignancies in Botswana to inform vaccine strategy.

Methods: We used formalin-fixed and paraffin-embedded (FFPE) tissue blocks from patients diagnosed with anal, penile and vulvar squamous cell carcinomas between the years, 2014 and 2016.

Current Status of Point-of-Care Testing for Human Immunodeficiency Virus Drug Resistance.

Healthcare delivery has advanced due to the implementation of point-of-care testing, which is often performed within minutes to hours in minimally equipped laboratories or at home. Technologic advances are leading to point-of-care kits that incorporate nucleic acid-based assays, including polymerase chain reaction, isothermal amplification, ligation, and hybridization reactions. As a limited number of single-nucleotide polymorphisms are associated with clinically significant human immunodeficiency virus (HIV) drug resistance, assays to detect these mutations have been developed.

The Situation Awareness Weighted Network (SAWN) model and method: Theory and application.

We introduce a novel model and associated data collection method to examine how a distributed organisation of military staff who feed a Common Operating Picture (COP) generates Situation Awareness (SA), a critical component in organisational performance. The proposed empirically derived Situation Awareness Weighted Network (SAWN) model draws on two scientific models of SA, by Endsley involving perception, comprehension and projection, and by Stanton et al. positing that SA exists across a social and semantic network of people and information objects in activities connected across a set of tasks.

Image findings of bisphosphonate related osteonecrosis of jaws comparing with osteoradionecrosis.

Objectives: The aim of this study was to evaluate image characteristics of bisphosphonate-related osteonecrosis of the jaws (BRONJ) and compare these with osteoradionecrosis (ORN).

Methods: 34 patients with BRONJ and 16 patients with ORN were included in this study. We investigated the CT and dental panoramic radiograph (DPR) images for osteolysis, osteosclerosis, sequestration, periosteal reaction, pathological fracture and spread of soft tissue inflammation around the jaws.

Transmitted/Founder HIV-1 Subtype C Viruses Show Distinctive Signature Patterns in Vif, Vpr, and Vpu That Are Under Subsequent Immune Pressure During Early Infection.

Viral variants that predominate during early infection may exhibit constrained diversity compared with those found during chronic infection and could contain amino acid signature patterns that may enhance transmission, establish productive infection, and influence early events that modulate the infection course. We compared amino acid distributions in 17 patients recently infected with HIV-1C with patients with chronic infection. We found significantly lower entropy in inferred transmitted/founder (t/f) compared with chronic viruses and identified signature patterns in Vif and Vpr from inferred t/f viruses.

An unusual exostotic lesion of the maxillary sinus from Roman Lincoln.

This report provides a differential diagnosis of an exostotic bony lesion within the left maxillary sinus of a Romano-British (3rd to 4th century AD) adult male from Newport, Lincoln. Macroscopic, radiographic, and cone beam computed tomography (CBCT) analyses suggest that the lesion is likely of odontogenic origin. The overall size of the lesion and areas of sclerosis and radiolucency, together with its hypothesised odontogenic origin, suggest that the lesion represents a chronic exostotic osteomyelitic reaction to the presence of odontogenic bacteria.

Computed tomography as an aid to planning intubation in the difficult airway.

Patients having oral and maxillofacial operations often require nasal intubation, but limited mouth opening and unfavourable nasal anatomy can make it difficult. We aimed to find out whether there is an association between the prediction of difficult nasal intubation on computed tomography (CT) and actual problems. We retrospectively reviewed the imaging and anaesthetic records of 77 patients who had replacement of the temporomandibular joint (TMJ) as these patients often have limited mouth opening and have had a preoperative CT.

Changes in parotid gland morphology and function in patients treated with intensity-modulated radiotherapy for nasopharyngeal and oropharyngeal tumors.

Objective: To evaluate the morphological changes of the parotid glands in patients treated with intensity-modulated radiotherapy (IMRT) for nasopharyngeal and oropharyngeal tumors and the correlations with parotid function.

Methods: Ten patients with nasopharyngeal and oropharyngeal tumors treated with IMRT between May 2009 and January 2010 at Hokkaido University Hospital were included in this study. In the morphological assessment of the parotid glands, the sizes and computed tomography (CT) numbers of the bilateral parotid glands before and after IMRT with CT were calculated.

Immune activation markers in peripartum women in Botswana: association with feeding strategy and maternal morbidity.

Hormone levels shift the immune state in HIV-uninfected pregnant and breastfeeding women away from Th1 responses and toward regulation to permit fetal tolerance. Limited data exist on inflammation during pregnancy or postpartum in HIV-infected women, though certain inflammatory markers are associated with adverse health outcomes among HIV-infected persons. We measured hsCRP, D-dimer, IFN-γ, IL-6, IL-10 and TNF-α at 34 weeks gestation and six months postpartum in HIV-infected women from the Botswana Mashi PMTCT trial who were randomized to breastfeeding or formula-feeding.

Recurrent parotitis of childhood or juvenile recurrent parotitis--a review and report of two cases.

Unlabelled: Recurrent parotitis of childhood is an uncommon condition which affects children of variable age. The condition may be misdiagnosed so delaying treatment. These two case reports highlight the variable signs and symptoms of this unusual condition and the value of ultrasound as an aid to diagnosis.

The TRACTISS protocol: a randomised double blind placebo controlled clinical trial of anti-B-cell therapy in patients with primary Sjögren's Syndrome.

Background: Primary Sjögren's Syndrome (PSS) mainly affects women (9:1 female:male ratio) and is one of the commonest autoimmune diseases with a prevalence of 0.1 - 0.6% of adult women.

The illusion of caries from anatomical variance: a case report.

This paper presents two examples of unusual radiolucencies caused by grossly distorted anatomy. In the circumstances these could easily have been misdiagnosed as caries. Some of the more common artefacts presenting as caries are discussed.

A pilot randomized controlled trial comparing bismuth iodine paraffin paste external ear pack and no ear pack after middle ear surgery.

To pilot a substantive randomized control trial comparing post-operative external ear canal pack with no ear pack after middle ear surgery, 32 adults undergoing primary posterior bony canal wall preserving middle ear surgery were randomized to have either a bismuth iodoform paraffin paste pack or no ear pack post-operatively. Outcome measures included clinician- and patient-recorded visual analogue scale scores for ear signs and symptoms at 3 weeks and 3 months and audiometric findings at 3 months post-operatively. There was no statistically significant inter-group difference in 3-week clinician and patient cumulative scores for ear signs and symptoms.

tat Exon 1 exhibits functional diversity during HIV-1 subtype C primary infection.

Human immunodeficiency virus type 1 (HIV-1) Tat is a mediator of viral transcription and is involved in the control of virus replication. However, associations between HIV-1 Tat diversity and functional effects during primary HIV-1 infection are still unclear. We estimated selection pressures in tat exon 1 using the mixed-effects model of evolution with 672 viral sequences generated from 20 patients infected with HIV-1 subtype C (HIV-1C) over 500 days postseroconversion.

Abacavir alters the transcription of inflammatory cytokines in virologically suppressed, HIV-infected women.

Background: Abacavir (ABC) may be associated with a small, increased risk of myocardial infarction in HIV-infected adults, possibly related to cytokine-mediated inflammation.

Methods: To evaluate the induction of inflammatory cytokine transcription by ABC, we used samples from women randomized to receive zidovudine/lamivudine/ABC (Trizivir) or lopinavir/ritonavir and zidovudine/lamividine (Kaletra/Combivir) from the third trimester through six-months postpartum for the prevention of mother-to-child transmission (PMTCT). Women were matched by CD4 count and baseline HIV RNA.

Prevalence of human papillomavirus genotypes and associated cervical squamous intraepithelial lesions in HIV-infected women in Botswana.

Human papillomaviruses (HPV) constitute one of the most prevalent sexually transmitted infections and are the etiological agents for invasive cervical cancer, the predominant cancer among women in Botswana. However, the prevalence of HPV genotypes in Botswana has yet to be reported. One hundred thirty-nine endocervical swabs were taken at baseline from HIV-1 infected, HSV-2 seropositive women enrolled in a longitudinal cohort study designed to assess the influence of herpes simplex virus-2 (HSV-2) infection on genital tract shedding of HIV-1.

Proximal humeral fracture classification systems revisited.

Hypothesis: This study evaluated several classification systems and expert surgeons' anatomic understanding of these complex injuries based on a consecutive series of patients. We hypothesized that current proximal humeral fracture classification systems, regardless of imaging methods, are not sufficiently reliable to aid clinical management of these injuries.

Materials And Methods: Complex fractures in 96 consecutive patients were investigated by generation of rapid sequence prototyping models from computed tomography Digital Imaging and Communications in Medicine (DICOM) imaging data.