Parent-child correlations for weight, height and head circumference on eight occasions between birth and 4 years were estimated within groups of 212 small-for-dates (SFD), 208 average-for-dates (AFD) and 221 large-for-dates (LFD) children. For mothers and fathers in the SFD and AFD groups, and fathers in the LFD group, correlations for weight were generally low in the first year, with moderate increases up to 4 years. No correlations for weight at any age were found between mothers and LFD children. There was a gradual rise in correlations for length in all three groups for both mothers and fathers between birth and 4 years. Head circumference correlations in the AFD and LFD groups were relatively high at birth and showed little change thereafter. Mother-child correlations for head circumference in the SFD group were absent at birth, but then rose sharply to a value comparable with the AFD parents' correlations at 18 months, with the little change thereafter. No SFD father-child correlations for head circumference were found at any age. Children's standards of weight and head circumference adjusted for mid-parental measures would, in some cases, be misleading.

Ethnopharmacological relevance: Shen-Fu Decoction (SFD), a classic Traditional Chinese paired herb formulation, has been widely used for the treatment of sepsis in China. This study was carried out to assess the effects of SFD in sepsis-induced intestinal permeability and intestinal epithelial tight junction damage in rats with sepsis.

Materials and methods: A rat model of sepsis was created by cecal ligation and puncture (CLP). Rats in Sham and CLP + vehicle groups received equal distilled water, while rats in SFD group were treated by gavage of SFD (3 mg/kg, twice a day) for 72h. Mortality, sepsis-induced peritoneal inflammation, intestinal and liver histopathology damage, intestinal permeability (serum FITC-dextran and D-lactate), serum LPS, serum inflammation (PCT, TNF-α, and IL-6), and liver function (AST and ALT) were evaluated. The levels of zonula occluden (ZO-1), Occludin, Claudin-1 were analyzed by Real-time quantitative PCR and Western blotting (WB) respectively. Vasodilator-stimulated phosphoprotein (VASP) and p-VASP in intestinal epithelium were analyzed by WB.

Results: Our study showed that SFD markedly reduced the mortality rate of CLP rats, prevented intestine and liver damage, relieved sepsis-induced intestinal permeability and inflammation elevation, ameliorated sepsis-induced impaired intestinal permeability by regulating the expression of ZO-1, Occludin, Claudin-1 and p-VASP.

Conclusions: The herbal formula SFD may be useful for reducing sepsis-induced organic damage and mortality by ameliorating the condition of sepsis-induced intestinal permeability by regulating tight junction proteins and p-VASP.

Keywords: Intestinal permeability; Organic damage; Sepsis; Shen-fu decoction; Tight junction proteins; p-VASP.

BACKGROUND

Curcumin known to have number of medicinal use and masked the fiber containing ukonan like active polysaccharide in turmeric and its pharmacological effect will be addressed on diabetic nephropathy particularly the glycoconjugates of extracellular components viz., glycoproteins and glycosaminoglycans - heparan sulfate (HS).

METHODS

Male Wistar rats were maintained on AIN-76 diet containing 10% spent turmeric and were grouped into control and STZ induced diabetes SFC/TFC and SFD/TFD, respectively. Diabetic status was monitored using blood and urine, and at the end, harvested kidneys were used to study the amelioration of glycoprotiens (collagen) and HS by enzymatic digestion, spectrophotometric, hydroxyproline and agarose electrophoretic methods.

RESULTS

In the present study spent turmeric (10%) fed diabetic rats showed improved glomerular filtration rate (50%), kidney enlargement (60%) and other glycoconjugate metabolism in kidney. Increased collagen content in diabetic group was observed by hydroxyproline estimation (24%) and periodic acid-Schiff's (PAS) staining. Furthermore, elevated activities of enzymes involved in the synthesis and degradation of glycosaminoglycans (GAGs) were significantly lowered in spent turmeric fed diabetic group. Improvement in total GAGs (43%) and sulfate content (18%) followed by fractionation of GAGs using specific enzymes led to HS (28%) in the spent turmeric fed diabetic group, when compared to starch fed diabetic group and was further confirmed by electrophoresis of GAG.

CONCLUSIONS

These results clearly indicate beneficial role of spent turmeric in controlling glycoconjugates such as glycoproteins and heparan sulfate related kidney complications during diabetes.

The long term follow up studies on cases of cardiovascular diseases during pregnancy or delivery were reviewed in 181 patients administrated in our clinic. The results as follows: 1. An incidence of patients with cardiovascular disease during pregnancy was 1.46 per cent as a whole, and there was increasing tendency in congenital heart disease. 2. An accidental heart failure during pregnancy was seen in 7.7 per cent and all cases with NYHA III grade had an incidence of 100 per cent. 3. The occurrence of toxicosis and SFD pregnancy were more frequently seen in group of heart disease than in controls. But, no difference was observed in spontaneous abortion or neonatal asphyxia. 4. 28 patients with Starr-Edwards prosthetic heart valves became pregnant in our clinic. In these pregnancies, 5 cases receiving with warfarin therapy resulted in 3 anomalies of new born and in 2 spontaneous abortion. So, the use of warfarin seemed to have the risk to the fetus. But omission of the anticoagulant therapy on the other hand, increased the danger of systemic embolization to the mother. 5. The follow up study by mail in some cases revealed that, as a general, pregnancy and delivery may aggravate the condition of patients, especially who had mitral heart failures.

UNASSIGNED

Retrospective case series.

UNASSIGNED

To correlate functional outcomes with spinopelvic parameters in patients with high-grade spondylolisthesis (HGS) treated with instrumented in-situ surgery or reduction and fusion.

UNASSIGNED

Satisfactory functional outcomes are reported with reduction and in-situ fusion strategies in HGS. However, reasons for this are unclear. We hypothesize that following lumbosacral fusion, the L5 becomes part of the sacrum, which improves spinopelvic parameters, resulting in equivalent functional outcomes in both surgical methods.

UNASSIGNED

Twenty-six patients undergoing HGS (reduction group A, 13; in-situ group B, 13) were clinically evaluated using the Oswestry Disability Index (ODI), short form-12 (SF-12), and Visual Analogue Scale (VAS) scores. Spinopelvic parameters, including pelvic incidence, pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), lumbosacral kyphosis (LSK) angle, and sacrofemoral distance (SFD) were measured preoperatively from S1 and postoperatively from L5 as the new sacrum at 1 year follow-up. Sagittal alignment was assessed using the sagittal vertical axis.

UNASSIGNED

Both groups were comparable in terms of age, sex, severity of slip, and preoperative spinopelvic parameters (p>0.05). Postoperative VAS, SF-12, and ODI scores significantly improved in both groups (p<0.05). Compared with preoperative values, the mean postoperative PT, SFD, and LSK significantly changed in both groups. In reduction group, PT changed from 26.98° to 10.78°, SFD from 61.24 to 33.56 mm, and LSK from 74.76° to 109.61° (p<0.05). In in-situ fusion group PT changed from 26.78° to 11.08°, SFD from 62.9 to 36.99 mm, and LSK from 67.23° to 113.38° (p<0.05 for all). In both groups, SS and LL did not change significantly (p>0.05).

UNASSIGNED

After fusion, the L5 becomes the new sacrum and influences spinopelvic parameters to change favorably. This possibly explains why reduction and in-situ fusion achieve equivalent functional outcomes in HGS.

The MMPI-3 is an updated version of the MMPI-2-RF that provides enhanced coverage of constructs related to personality and psychopathology. A new Self-Importance (SFI) scale measures individuals' beliefs that they possess special qualities. Low SFI scores indicate that test-takers report lacking such attributes. The Self-Doubt (SFD) scale, which was revised from the MMPI-2-RF, also has a self-orientation and measures a lack of self-esteem. The current study used three college student samples to investigate whether MMPI-3 SFI and SFD measure distinct constructs; in other words, are beliefs about self-importance distinct from self-esteem? SFI and SFD scores were conversely but differentially associated with measures of positive valence, self-esteem, and grandiose and vulnerable narcissism. Dominance and regression analyses indicated that SFI scores generally dominated SFD scores in prediction of positive valence and grandiose narcissism (characterized by grandiosity, dominance, aggressiveness). SFD scores generally dominated SFI scores in prediction of self-esteem and vulnerable narcissism (characterized by negative affect, feelings of incompetence, inadequacy). The current findings indicated that self-importance and self-esteem are two distinct constructs and therefore appropriately measured by separate scales.

Two-dimensional (2D) visible crystal-structure patterns analogous to the quantum harmonic oscillator (QHO) have been experimentally observed in the near- and far-fields of a self-frequency-doubling (SFD) microchip laser. Different with the fundamental modes, the localization of the SFD light is changed with the propagation. Calculation based on Hermite-Gaussian (HG) functions and second harmonic generation theory reproduces well the patterns both in the near- and far-field which correspond to the intensity distribution in coordinate and momentum spaces, respectively. Considering the analogy of wave functions of the transverse HG mode and 2D harmonic oscillator, we propose that the simple monolithic SFD lasers can be used for developing of new materials and devices and testing 2D quantum mechanical theories.

Studies of the phenotypic structure of Ixodes persulcatus (Schulze, 1930) populations in relation to their exoskeleton abnormalities are important in both theoretical and practical respects. The data on the species' population structure in Asiatic part of Russia are fragmentary. The goal of the study was to describe taiga tick population structure based on the pattern of females' exoskeleton abnormalities revealed in Asiatic part of Russia. A total of 3872 I. persulcatus females from 16 geographically remote sites of Far Eastern, Siberian, and Ural Federal Districts (FEFD, SFD, and UFD accordingly) were studied. It was demonstrated that all the populations possessed specimens with exoskeleton abnormalities. The «shagreen skin» abnormality was dominant in all these areas. At the same time, the percentage of abnormalities among the specimens collected to the north of 55°N is considerably higher (63.4 ± 3.39 %) than that of samples from the SFD southward territories (33.1 ± 3.43 %). The frequency of abnormalities in its turn is lower (24.4 ± 1.93 %) in the females from the territories with moderate monsoon and moderate continental climate (FEFD) than that in specimens from SFD and UFD areas with sharp continental climate. Thus, such polymorphism of the females' exoskeleton structure may reflect the natural phenogeographical variability of the character rather than the result of the anthropogenic impact. 403

We computationally study the effects of binding kinetics to the channel wall, leading to transient immobility, on the diffusive transport of particles within narrow channels, that exhibit single-file diffusion (SFD). We find that slow binding kinetics leads to an anomalously slow diffusive transport. Remarkably, the scaled diffusivity D[over ̂] characterizing transport exhibits scaling collapse with respect to the occupation fraction p of sites along the channel. We present a simple "cage-physics" picture that captures the characteristic occupation fraction p_{scale} and the asymptotic 1/p^{2} behavior for p/p_{scale}≳1. We confirm that subdiffusive behavior of tracer particles is controlled by the same D[over ̂] as particle transport.

Despite advances in techniques for contour acquisition, most patients are still contoured manually using lead wire. The lead wire method has unpredictable inherent inaccuracies due to the fact that the wire must be removed from the patient to obtain the contour. A simple radiographic method for a quick and accurate contour is presented that eliminates such an operator error. The technique requires that a thin lead wire be placed on the patient's skin in the desired plane as in the manual contouring process. With the wire still in place, the simulator table is rotated 90 degrees, and then the gantry is rotated to any reasonable angle (30-45 degrees) for a simple radiograph. The source-to-film distance (SFD) and gantry angle are noted. The radiograph of the lead wire contour is digitized on a personal computer (PC) and transformed from the film coordinates to the patient coordinates using the SFD and the gantry angle as input parameters. The accuracy and efficacy of this method were tested in four test cases: a square box, and contours in the head and neck, thoracic, and pelvic regions. The accuracy of the calculated contour was within +/- 4 mm for the large-gradient contours and +/- 3 mm in the other cases. A root mean square deviation of < 2 mm was observed between this method and the CT contour. This method can be used in any clinical setting where a simulator and a digitizer with a PC are available. The transformation code is simple and could be placed on any treatment planning computer system.

We report efficient, diode-pumped, self-frequency doubling (SFD) in the newly developed laser crystal Nd3+:Na3La9O3(BO3)8 (Nd:NLBO). More than 730 mW of fundamental output power at 1072 nm was achieved with a slope efficiency of 16.2%. With incident pump power of 8 W, 29 mW of green cw laser emission at 536 nm was observed with proper phase matching. This initial performance and the good optical properties of the crystalline host are encouraging for the development of a high power diode-pumped SFD visible light laser source.

A series of experiments was conducted to determine the effects of a fibrolytic enzyme preparation (enzyme 1; E1) on the in vitro fermentation of lucerne incubated with equine faecal inocula. In experiment 1, high-temperature-dried (HT) lucerne was treated with five levels of E1 (0 to 2.4 ml/g DM) and incubated at 50 degrees C for 20 h. Samples then received a simulated foregut digestion (SFD) treatment before DM and NSP analysis. In experiment 2, HT lucerne was treated with the same enzyme levels used in experiment 1. Samples were then split into two groups; plus or minus an SFD treatment before in vitro fermentation using an equine faecal inoculum. In experiment 3, fresh and wilted lucerne were treated with the same levels of E1 as experiments 1 and 2, incubated at 50 degrees C for 20 h, then fermented in vitro. For experiment 4, fresh and wilted lucerne were treated with low levels (0 to 0.008 ml/g DM) of E1 before fermentation. E1 significantly (P<0.05) enhanced DM and NSP losses from HT lucerne following SFD treatment compared with the control. High levels of E1 significantly (P<0.05) enhanced the rate, but not extent, of fermentation of HT, wilted and fresh lucerne; however, low levels of E1 were ineffective. At higher application levels, E1 appears to have considerable potential to enhance the nutritive value of lucerne for horses. Information on the fermentation kinetics of the substrates was valuable; all end-point measurements showed no effect of enzyme treatment.

Sorsby Fundus Dystrophy (SFD) is a rare autosomal dominant disease of the macula that leads to bilateral loss of central vision and is caused by mutations in the TIMP3 gene. However, the mechanisms by which TIMP3 mutations cause SFD are poorly understood. Here, we generated human induced pluripotent stem cell-derived retinal pigmented epithelial (hiPSC-RPE) cells from three SFD patients carrying TIMP3 p.(Ser204Cys) and three non-affected controls to study disease related structural and functional differences in the RPE. SFD-hiPSC-RPE exhibited characteristic RPE structure and physiology but showed significantly reduced transepithelial electrical resistance associated with enriched expression of cytoskeletal remodelling proteins. SFD-hiPSC-RPE exhibited basolateral accumulation of TIMP3 monomers, despite no change in TIMP3 gene expression. TIMP3 dimers were observed in both SFD and control hiPSC-RPE, suggesting mutant TIMP3 dimerization does not drive SFD pathology. Furthermore, mutant TIMP3 retained matrix metalloproteinase activity. Proteomic profiling showed increased expression of extracellular matrix proteins, endothelial cell interactions and angiogenesis-related pathways in SFD-hiPSC-RPE. By contrast, there were no changes in VEGF secretion. However, SFD-iPSC-RPE secreted higher levels of monocyte chemoattractant protein 1, platelet-derived growth factor, and angiogenin. Our findings provide a proof-of-concept that SFD patient-derived hiPSC-RPE mimic mature RPE cells and support the hypothesis that excess accumulation of mutant TIMP3, rather than an absence or deficiency of functional TIMP3, drives ECM and angiogenesis related changes in SFD. This article is protected by copyright. All rights reserved.

Keywords: Sorsby fundus dystrophy; human induced pluripotent stem cell; metalloproteinase inhibitor 3; retinal degeneration; retinal pigment epithelial cell.

Somatoform disorders (SFD) are defined as a syndrome characterized by somatic symptoms which cannot be explained by organic reasons. Chronic or recurrent forms of somatization lead to heavy emotional and financial burden to the patients and their families. However, the underlying etiology of SFD is largely unknown. The purpose of this study is to investigate the changed brain glucose metabolic pattern in SFD. In this study, 18 SFD patients and 21 matched healthy controls were enrolled and underwent an ¹⁸F-FDG PET scan. First, we explored the altered brain glucose metabolism in SFD. Then, we calculated the mean ¹⁸F-FDG uptake values for 90 AAL regions, and detected the changed brain metabolic connectivity between the most significantly changed regions and all other regions. In addition, the Pearson coefficients between the neuropsychological scores and regional brain ¹⁸F-FDG uptake values were computed for SFD patients. We found that SFD patients showed extensive hypometabolism in bilateral superolateral prefrontal cortex, insula, and regions in bilateral temporal gyrus, right angular gyrus, left gyrus rectus, right fusiform gyrus, right rolandic operculum and bilateral occipital gyrus. The metabolic connectivity between right insula and prefrontal areas, as well as within prefrontal areas was enhanced in SFD. And several brain regions were associated with the somatic symptoms, including insula, putamen, middle temporal gyrus, superior parietal gyrus and orbital part of inferior frontal gyrus. Our study revealed widespread alterations of the brain glucose metabolic pattern in SFD patients. Those findings might elucidate the neuronal mechanisms with glucose metabolism and shed light on the pathology of SFD.

The aim of this study is to evaluate the influence of intra-uterine growth retardation (IUGR), as well as it's types and severity on the development of respiratory distress among low-birth-weight infants. A total of 673 neonates were studied, the small-for-dates infants (SFD), 40% of total, were divided according to the type of IUGR, in proportionate and disproportionate, and according to the severity, in birth weight below 3rd and between 3rd and 10th percentile. Respiratory distress was more frequent among the appropriate for gestational age (57.3%) compared to the SFD infants (33.7%), (p < 0.0001), and among males (52.6%) compared to females (47.4%) (p = 0.01). There was an inverse relationship between gestational age, as well as birth weight and respiratory distress. It occurred in 90.6% of very-low-birth-weight infants and in 39% of the others, with a predominance among the appropriate for gestational age newborns. Respiratory distress occurred in 80% of neonates below 34 weeks of gestational age and in 26% of the neonates above it (p < 0.0001). Regarding to the small-for-dates infants, respiratory distress occurred more frequently among the disproportionate (42.5%), when compared to proportionate infants (28.1%) (p = 0.03). The severity of IUGR had no influence on these results. The authors concluded that among low birth weight infants, the groups with increased risk for respiratory distress are the appropriate for gestational age and, among small-for-dates and disproportionate infants, those weighing less than 1500 g.

58 small-for-date (SFD) aged 6 to 12 years, born between 1970 and 1975 were followed-up. Retardation of motor skills and speech during early infancy was found in 20-30%. At 6 to 12 years of age one third still had deficits in body weight und height. Neurological abnormalities in 17 children were usually mild, most often affecting fine motor function. Significant impairment of visuomotor perception on psychological testing was seen in 21 children, and EEG abnormalities in 20 cases. The results in neurological, psychological and EEG investigations for 23 children (group I) were normal. 24 patients (group II) showed one or two abnormal findings. In 9 children (group III) results of all three examinations were abnormal. The follow-up results were influenced by socioeconomic factors. Small-for-date babies showed on the whole encouraging results on follow-up during later childhood, with 40% of the children being normal, and mostly mild abnormalities in the remaining patients. Prognosis may be further improved by preterm delivery, i.e. early termination of intrauterine growth retardation.

Erroneous information from sensors affect process monitoring and control. An algorithm with multiple model identification methods will improve the sensitivity and accuracy of sensor fault detection and data reconciliation (SFD&DR). A novel SFD&DR algorithm with four types of models including outlier robust Kalman filter, locally weighted partial least squares, predictor-based subspace identification, and approximate linear dependency-based kernel recursive least squares is proposed. The residuals are further analyzed by artificial neural networks and a voting algorithm. The performance of the SFD&DR algorithm is illustrated by clinical data from artificial pancreas experiments with people with diabetes. The glucose-insulin metabolism has time-varying parameters and nonlinearities, providing a challenging system for fault detection and data reconciliation. Data from 17 clinical experiments collected over 896 hours were analyzed; the results indicate that the proposed SFD&DR algorithm is capable of detecting and diagnosing sensor faults and reconciling the erroneous sensor signals with better model-estimated values.

OBJECTIVE

Use compressed sensing (CS) for 3D biexponential spin-lattice relaxation time in the rotating frame (T1ρ ) mapping of knee cartilage, reducing the total scan time and maintaining the quality of estimated biexponential T1ρ parameters (short and long relaxation times and corresponding fractions) comparable to fully sampled scans.

METHODS

Fully sampled 3D-T1ρ -weighted data sets were retrospectively undersampled by factors 2-10. CS reconstruction using 12 different sparsifying transforms were compared for biexponential T1ρ -mapping of knee cartilage, including temporal and spatial wavelets and finite differences, dictionary from principal component analysis (PCA), k-means singular value decomposition (K-SVD), exponential decay models, and also low rank and low rank plus sparse models. Synthetic phantom (N = 6) and in vivo human knee cartilage data sets (N = 7) were included in the experiments. Spatial filtering before biexponential T1ρ parameter estimation was also tested.

RESULTS

Most CS methods performed satisfactorily for an acceleration factor (AF) of 2, with relative median normalized absolute deviation (MNAD) around 10%. Some sparsifying transforms, such as low rank with spatial finite difference (L + S SFD), spatiotemporal finite difference (STFD), and exponential dictionaries (EXP) significantly improved this performance, reaching MNAD below 15% with AF up to 10, when spatial filtering was used.

CONCLUSIONS

Accelerating biexponential 3D-T1ρ mapping of knee cartilage with CS is feasible. The best results were obtained by STFD, EXP, and L + S SFD regularizers combined with spatial prefiltering. These 3 CS methods performed satisfactorily on synthetic phantom as well as in vivo knee cartilage for AFs up to 10, with median error below 15%.

Soil fugitive dust (SFD) is an important contributor to ambient particulate matter (PM), but most current SFD emission inventories are updated slowly or have low resolution. In areas where vegetation coverage and climatic conditions undergo significant seasonal changes, the classic wind erosion equation (WEQ) tends to underestimate SFD emissions, increasing the need for higher spatiotemporal data resolution. Continuous acquisition of precise bare soil maps is the key barrier to compiling monthly high-resolution SFD emission inventories. In this study, we proposed taking advantage of the massive Landsat and Sentinel-2 imagery data sets stored in the Google Earth Engine (GEE) cloud platform to enable the rapid production of bare soil maps with spatial resolutions of up to 10 m. The resulting improved spatiotemporal resolution of wind erosion parameters allowed us to estimate SFD emissions in Beijing as being ~5-7 times the level calculated by the WEQ. Spring and winter accounted for >85% of SFD emissions, while April was the dustiest month with SFD emissions of PM₁₀ exceeding 11,000 t. Our results highlighted the role of SFD in air pollution during winter and spring in northern China, and suggested that GEE should be further used for image acquisition, data processing, and compilation of gridded SFD inventories. These inventories can help identify the location and intensity of SFD sources while providing supporting information for local authorities working to develop targeted mitigation measures.

Keywords: Emission inventory; GEE; Particulate matter; Soil fugitive dust; Wind erosion.

Quantitative analysis using proton NMR (¹H qNMR) has been employed in various areas such as pharmaceutical analysis (e.g., dissolution study), vaccines, natural products analysis, metabolites, and macrolide antibiotics in agriculture industry. However, it is not routinely used in the quantification of saccharides in dry powder inhaler (DPI) formulations. The aim of this study was to develop a ¹H NMR method for the quantification of saccharides employed in DPI formulations. Dry powders as DPI carriers were prepared by spray drying (SD) and spray freeze drying (SFD) using three saccharides: namely D-mannitol, D-sorbitol and D-(+)-sucrose. The calibration curves constructed for all three saccharides demonstrated linearity with R² value of 1. The ¹H qNMR method produced accurate (relative error %: 0.184-3.697) and precise data with high repeatability (RSD %: 0.517-3.126) within the calibration curve concentration range. The ¹H qNMR method also demonstrated significant sensitivity with low values of limit of detection (0.058 mM for D-mannitol, 0.045 mM for D-(+)-sucrose, and 0.056 mM for D-sorbitol) and limit of quantitation (0.175 mM for D-mannitol, 0.135 mM for D-(+)-sucrose, and 0.168 mM for D-sorbitol). Pulmonary deposition via impaction experiments of the three saccharides was quantified using the developed method. It was found that SFD D-mannitol (68.99%) and SFD D-(+)-sucrose (66.62%) exhibited better delivered dose (total saccharide deposition in throat and all impactor stages) than SD D-mannitol (49.03%) and SD D-(+)-sucrose (57.70%) (p < 0.05). The developed ¹H qNMR methodology can be routinely used as an analytical method to assess pulmonary deposition in impaction experiments of saccharides employed as carriers in DPI formulations.

In routine practice of neonatology, differentiating preterm premature new-born from small-for-date (SFD) new-born infant is an essential aspect to anticipate different clinical scenarios and monitor accordingly. Clinical assessment of new-born maturity is an invincible tool in resource poor areas for the purpose, without any prior investment. Over the past decades, clinical method for new-born infant maturity assessment has evolved intricately. From defining prematures with a mere statement of birth weight to clinical assessment of new-born maturity as per gestational age with a comprehensive scheme based on neural and physical maturity characteristics of new-born, clinical method for new-born maturity assessment has evolved over past decades to the present where we stand. Review on the evolutionary history of clinical method for new-born infant maturity assessment will enable researchers in this field to get acquainted with the trend of past research work in accordance to the recent advancement all over the world. In the process, the lacunas still present in this area of study can be spotted which will invite new research proposals.

Through this single-center consecutive prospective study, we evaluated the results of a combined approach for L5-S1 isthmic spondylolisthesis, using a polyetheretherketone (PEEK) interbody lordotic cage during anterior approach and pedicle screw-based posterior fixation. Between 2010 and 2014, 27 adult patients were treated for L5-S1 isthmic spondylolisthesis (high and low grades) by a combined approach with a minimum follow-up of one year. Clinical outcome was assessed before surgical treatment and at four months and one year after surgery by: VAS, Oswestry Index (ODI) and Rolland-Morris scores. Two observers evaluated the following radiological parameters: pelvic incidence, pelvic tilt, lumbar lordosis, segmental lordosis L5-S1, anterior and posterior disc height, spinal vertical axis (SVA), SVA/sacro-femoral distance (SFD) ratio. Fusion was evaluated on the CT scan at one-year follow-up. Blood loss, surgery time and complications were also collected. The mean age was 47.7 years (±16.9). The VAS, ODI and Rolland-Morris scores were significantly improved postoperatively, decreased from 7.5 (±1.45); 48 (±19.25); 15.3 (±4.67) before the surgery to 3.8 (±2.55); 28.7 (±19.58) and 7.76 (±7.21) respectively at one year after the surgery (P=0.05). The mean follow-up was 3.3 years. Mean surgery time was 193.7min (±37). Fusion was obtained in 100% of cases. Segmental lordosis L5-S1, pelvic tilt, slippage, anterior and posterior L5-S1 disc height were significantly improved postoperatively, they passed from 20.1; 22.6; 35.3%; 26.4%; 17.9% to 29.5; 20.6; 20.3%; 64.4%; 36.3% respectively. Combined surgical procedure meets the required goals of surgery in the treatment of adults L5-S1 isthmic spondylolisthesis.

OBJECTIVE

Because the small-radius photon beams shaped by cones in stereotactic radiosurgery (SRS) lack lateral electronic equilibrium and a detector's finite cross section, direct experimental measurement of dosimetric data for these beams can be subject to large uncertainties. As the dose calculation accuracy of a treatment planning system largely depends on how well the dosimetric data are measured during the machine's commissioning, there is a critical need for an independent method to validate measured results. Therefore, the authors studied the model-based calculation as an approach to validate measured off-axis ratios (OARs).

METHODS

The authors previously used a two-component analytical model to calculate central axis dose and associated dosimetric data (e.g., scatter factors and tissue-maximum ratio) in a water phantom and found excellent agreement between the calculated and the measured central axis doses for small 6 MV SRS conic beams. The model was based on that of Nizin and Mooij ["An approximation of central-axis absorbed dose in narrow photon beams," Med. Phys. 24, 1775-1780 (1997)] but was extended to account for apparent attenuation, spectral differences between broad and narrow beams, and the need for stricter scatter dose calculations for clinical beams. In this study, the authors applied Clarkson integration to this model to calculate OARs for conic beams. OARs were calculated for selected cones with radii from 0.2 to 1.0 cm. To allow comparisons, the authors also directly measured OARs using stereotactic diode (SFD), microchamber, and film dosimetry techniques. The calculated results were machine-specific and independent of direct measurement data for these beams.

RESULTS

For these conic beams, the calculated OARs were in excellent agreement with the data measured using an SFD. The discrepancies in radii and in 80%-20% penumbra were within 0.01 cm, respectively. Using SFD-measured OARs as the reference data, the authors found that the calculated OARs were more accurate than those measured with a microchamber or film dosimetry.

CONCLUSIONS

The model produces sufficiently accurate conic beam dosimetric data that can be used to validate direct measurement results for such beams.