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Background: One of the lesser recognized complications of diabetes mellitus are musculoskeletal (MSK) complications of the upper and lower extremity. No prevalence studies have been conducted in general practice. Thus, the aim of this study was to investigate the prevalence of upper extremity MSK disorders in patients with type 2 diabetes (T2DM) in the Netherlands. Methods: We conducted a cross-sectional study with two different approaches, namely a representative Dutch primary care medical database study and a questionnaire study among patients with T2DM. Results: In the database study, 2669 patients with T2DM and 2669 non-diabetes patients were included. MSK disorders were observed in 16.3% of patients with T2DM compared to 11.2% of non-diabetes patients (p < 0.001, OR 1.53, 95% CI 1.31, 1.80). In the questionnaire study, 200 patients with T2DM were included who reported a lifetime prevalence of painful upper extremity body sites for at least four weeks of 67.3%. Conclusion: We found that upper extremity MSK disorders have a high prevalence in Dutch patients with T2DM presenting in general practice. The prevalence ranges from 16% based on GP registered disorders and complaints to 67% based on self-reported diagnosis and pain. Early detection and treatment of these disorders may play a role in preventing the development of chronic MSK disorders.
Small-scale thermal upwellings under the northern East African Rift from S travel time tomography
(2016)
There is a long-standing debate over how many and what types of plumes underlie the East African Rift and whether they do or do not drive its extension and consequent magmatism and seismicity. Here we present a new tomographic study of relative teleseismic S and SKS residuals that expands the resolution from previous regional studies below the northern East African Rift to image structure from the surface to the base of the transition zone. The images reveal two low-velocity clusters, below Afar and west of the Main Ethiopian Rift, that extend throughout the upper mantle and comprise several smaller-scale (about 100 km diameter), low-velocity features. These structures support those of our recent P tomographic study below the region. The relative magnitude of S to P residuals is around 3.5, which is consistent with a predominantly thermal nature of the anomalies. The S and P velocity anomalies in the low-velocity clusters can be explained by similar excess temperatures in the range of 100–200°C, consistent with temperatures inferred from other seismic, geochemical, and petrological studies. Somewhat stronger VS anomalies below Afar than west of the Main Ethiopian Rift may include an expression of volatiles and/or melt in this region. These results, together with a comparison with previous larger-scale tomographic models, indicate that these structures are likely small-scale upwellings with mild excess temperatures, rising from a regional thermal boundary layer at the base of the upper mantle.
The species of the genus Enicospilus Stephens, 1835 in Saudi Arabia are reviewed. Six species have previously been recorded from Saudi Arabia: E. brevicornis (Masi, 1939), E. capensis (Thunberg, 1822), E. nervellator Aubert, 1966, E. perlatus Shestakov, 1926, E. psammus Gauld & Mitchell, 1978 and E. oculator Seyrig, 1935. Five new species are described and illustrated in this paper: Enicospilus arabicus Gadallah & Soliman sp. nov., E. mirabilis Soliman & Gadallah sp. nov., E. pseudoculator Gadallah & Soliman sp. nov., E. shadaensis Gadallah & Soliman sp. nov. and E. splendidus Rousse, Soliman & Gadallah sp. nov. Twelve species are newly recorded for the fauna of Saudi Arabia, thus raising the total number to 23 species: E. bicoloratus Cameron, 1912, E. divisus (Seyrig, 1935), E. dubius (Tosquinet, 1896), E. grandiflavus Townes & Townes, 1973, E. odax Gauld & Mitchell, 1978, E. oweni Gauld & Mitchell, 1976, E. pacificus (Holmgren, 1868), E. pallidus (Taschenberg, 1875), E. rundiensis Bischoff, 1915, E. senescens (Tosquinet, 1896), Enicospilus sp. 1 and Enicospilus sp. 2 cf. bicoloratus Cameron, 1912. The unknown male of E. odax is described for the first time. The COI barcodes of 17 specimens were sequenced, compared to the existing data and uploaded to the BOLD Systems database. An illustrated key and an annotated faunistic list of all species of Enicospilus in Saudi Arabia are also provided. Finally, we discuss the biogeographical and ecological significance of the Enicospilus fauna in Saudi Arabia.
We here describe a new Indian helicarionoidean genus, Varadia Bhosale & Raheem gen. nov., containing the single species Varadia amboliensis Bhosale, Thackeray, Muley & Raheem gen. et sp. nov. This new semi-slug is endemic to the northern and central Western Ghats and is primarily a forest-living species. We describe and figure the shell, reproductive system, radula, spermatophore and external morphology of this new species, and detail its known distribution. We explore its relationships to other helicarionoideans using phylogenetic analyses of DNA sequence data for part of the ribosomal RNA gene cluster and discuss the morphology of the new genus in relation to other, primarily South Indian, helicarionoidean taxa. Based on characters of the reproductive system, particularly the male genitalia and the gametolytic sac, we provisionally place Varadia gen. nov. in the Macrochlamydinae (Ariophantidae). This is consistent with the results of our molecular phylogenetic analyses. The combination of large size, broad, densely tuberculated shell lobes and a shell with ca 4 whorls and a disproportionately large body whorl makes V. amboliensis gen. et sp. nov. unique among the helicarionoidean taxa of the Western Ghats. The new semi-slug is also highly distinctive in the morphology of its male genitalia.
Background: Bone age (BA) assessment performed by artificial intelligence (AI) is of growing interest due to improved accuracy, precision and time efficiency in daily routine. The aim of this study was to investigate the accuracy and efficiency of a novel AI software version for automated BA assessment in comparison to the Greulich-Pyle method.
Methods: Radiographs of 514 patients were analysed in this retrospective study. Total BA was assessed independently by three blinded radiologists applying the GP method and by the AI software. Overall and gender-specific BA assessment results, as well as reading times of both approaches, were compared, while the reference BA was defined by two blinded experienced paediatric radiologists in consensus by application of the Greulich-Pyle method.
Results: Mean absolute deviation (MAD) and root mean square deviation (RSMD) were significantly lower between AI-derived BA and reference BA (MAD 0.34 years, RSMD 0.38 years) than between reader-calculated BA and reference BA (MAD 0.79 years, RSMD 0.89 years; p < 0.001). The correlation between AI-derived BA and reference BA (r = 0.99) was significantly higher than between reader-calculated BA and reference BA (r = 0.90; p < 0.001). No statistical difference was found in reader agreement and correlation analyses regarding gender (p = 0.241). Mean reading times were reduced by 87% using the AI system.
Conclusions: A novel AI software enabled highly accurate automated BA assessment. It may improve efficiency in clinical routine by reducing reading times without compromising the accuracy compared with the Greulich-Pyle method.
Objective: To assess the current medical practice in Europe regarding prenatal dexamethasone (Pdex) treatment of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency.
Design and methods: A questionnaire was designed and distributed, including 17 questions collecting quantitative and qualitative data. Thirty-six medical centres from 14 European countries responded and 30 out of 36 centres were reference centres of the European Reference Network on Rare Endocrine Conditions, EndoERN.
Results: Pdex treatment is currently provided by 36% of the surveyed centres. The treatment is initiated by different specialties, that is paediatricians, endocrinologists, gynaecologists or geneticists. Regarding the starting point of Pdex, 23% stated to initiate therapy at 4–5 weeks postconception (wpc), 31% at 6 wpc and 46 % as early as pregnancy is confirmed and before 7 wpc at the latest. A dose of 20 µg/kg/day is used. Dose distribution among the centres varies from once to thrice daily. Prenatal diagnostics for treated cases are conducted in 72% of the responding centres. Cases treated per country and year vary between 0.5 and 8.25. Registries for long-term follow-up are only available at 46% of the centres that are using Pdex treatment. National registries are only available in Sweden and France.
Conclusions: This study reveals a high international variability and discrepancy in the use of Pdex treatment across Europe. It highlights the importance of a European cooperation initiative for a joint international prospective trial to establish evidence-based guidelines on prenatal diagnostics, treatment and follow-up of pregnancies at risk for CAH.
Radiative transition of an excited baryon to a nucleon with emission of a virtual massive photon converting to dielectron pair (Dalitz decays) provides important information about baryon-photon coupling at low q2 in timelike region. A prominent enhancement in the respective electromagnetic transition Form Factors (etFF) at q2 near vector mesons ρ/ω poles has been predicted by various calculations reflecting strong baryon-vector meson couplings. The understanding of these couplings is also of primary importance for the interpretation of the emissivity of QCD matter studied in heavy ion collisions via dilepton emission. Dedicated measurements of baryon Dalitz decays in proton-proton and pion-proton scattering with HADES detector at GSI/FAIR are presented and discussed. The relevance of these studies for the interpretation of results obtained from heavy ion reactions is elucidated on the example of the HADES results.
In March 2019 the HADES experiment recorded 14 billion Ag+Ag collisions at √sNN = 2.55 GeV as a part of the FAIR phase-0 physics program. In this contribution, we present and investigate our capabilities to reconstruct and analyze weakly decaying strange hadrons and hypernuclei emerging from these collisions. The focus is put on measuring the mean lifetimes of these particles.