Physiological and Biochemical Characteristics of Cinnamomum camphora in Response to Cu- and Cd-Contaminated Soil

Abstract

Copper (Cu) and cadmium (Cd) are ordinary heavy metals. Unreasonable development and utilization of these heavy metals will cause severe pollution to the soils and consequently bring damage to human health. Therefore, recovering soils polluted by heavy metals is crucial. An indoor pot experiment was carried out involving seven treatments, namely, low-concentration Cu stress (Cu1), high-concentration Cu stress (Cu2), low-concentration Cd stress (Cd1), high-concentration Cd stress (Cd2), low-concentration Cu–Cd combined stress (Cu1Cd1), and high-concentration Cu–Cd combined stress (Cu2Cd2), and an uncontaminated soil as a control. Results demonstrated that the net photosynthetic rate and chlorophyll content are approximately 8.36–72.51% and 7.22–36.50%, respectively, lower under the Cu, Cd, and Cu–Cd combined stresses than under the control. The net photosynthetic rates are higher under Cu2 and Cd2 than under Cu1 and Cd1; by contrast, the net photosynthetic rate of leaves is lower under Cu2Cd2 than under Cu1Cd1. The net photosynthesis rate of Cinnamomum camphora is significantly positively correlated with superoxide dismutase activity but is significantly negatively correlated with the total chlorophyll, malondialdehyde, soluble sugar, and proline contents. Young Cinnamomum camphora grows well under Cu, Cd, and Cu–Cd combined stresses and is applicable in ecologically restoring heavy metal–contaminated soils.

http://bit.ly/2C3LPDc

Asynchronous Structure from Motion at Scale

Abstract

Vision systems that provide a 360-degree view are becoming increasingly common in today's vehicles. These systems are generally composed of several cameras pointing in different directions and rigidly connected to each other. The purpose of these systems is to provide driver assistance in the form of a display, for example by building a Bird's eye view around the vehicle for parking assistance. In this context, and for reasons of cost and ease of integration, such cameras are generally not synchronized. If non-synchronization is not a problem when it comes to display only, it poses significant issues for more complex computer vision applications (3D reconstruction, motion estimation, etc.). In this article, we propose to use a network of asynchronous cameras to estimate the motion of the vehicle and to find the 3D structure of the scene around it (for example for obstacle detection). Our method relies on the use of at least three images from two adjacent cameras. The poses of the cameras are independently estimated by conventional visual odometry algorithms. Then we show that it is possible to find the absolute scale factor by hypothesizing that the motion of the vehicle is smooth. The results are then refined through a local bundle adjustment on the scale factor and 3D points only. We evaluated our method under real conditions on the KITTI database, and we showed that our method can be generalized to a larger network of cameras thanks to a system developed in our lab.

http://bit.ly/2VyoF0z

Obituary to an Eminent Member of AMI, Dr Dadarwal

http://bit.ly/2VC2EOi

Targeting Angiogenesis in Colorectal Carcinoma

Abstract

Neo-angiogenesis plays a key role in colorectal cancer, with the vascular endothelial growth factor family proteins and their receptors in particular triggering multiple signaling networks that result in endothelial cell survival, migration, mitogenesis, differentiation, and vascular permeability. Anti-angiogenic therapies have improved colorectal cancer prognosis within the past 15 years. Bevacizumab demonstrated efficacy in combination with chemotherapy under different conditions, including as first- and second-line therapies, and also as a maintenance treatment strategy. Other drugs targeting angiogenesis effectors (e.g., ramucirumab and aflibercept) were approved after bevacizumab failure, confirming the concept of "continuous anti-angiogenic blocking". Recently, a number of new orally available multiple receptor tyrosine kinase inhibitors have been tested in late-stage clinical trials, with modest efficacy. Due to the availability of several anti-angiogenic agents, we need well-designed prospective randomized trials to optimize therapeutic sequencing. The place of biosimilars in the therapeutic armamentarium remains unclear at the moment. Further research is warranted to identify robust predictive biomarkers of efficacy and innovative clinically meaningful anti-angiogenic drugs that are cost-efficient.

http://bit.ly/2LTpYCU

The Role of Fluoroquinolones in the Treatment of Tuberculosis in 2019

Abstract

The inability to use powerful antituberculosis drugs in an increasing number of patients seems to be the biggest threat towards global tuberculosis (TB) elimination. Simplified, shorter and preferably less toxic drug regimens are being investigated for pulmonary TB to counteract emergence of drug resistance. Intensified regimens with high-dose anti-TB drugs during the first weeks of treatment are being investigated for TB meningitis to increase the survival rate among these patients. Moxifloxacin, gatifloxacin and levofloxacin are seen as core agents in case of resistance or intolerance against first-line anti-TB drugs. However, based on their pharmacokinetics (PK) and pharmacodynamics (PD), these drugs are also promising for TB meningitis and might perhaps have the potential to shorten pulmonary TB treatment if dosing could be optimized. We prepared a comprehensive summary of clinical trials investigating the outcome of TB regimens based on moxifloxacin, gatifloxacin and levofloxacin in recent years. In the majority of clinical trials, treatment success was not in favour of these drugs compared to standard regimens. By discussing these results, we propose that incorporation of extended PK/PD analysis into the armamentarium of drug-development tools is needed to clarify the role of moxifloxacin, gatifloxacin and levofloxacin for TB, using the right dose. In addition, to prevent failure of treatment or emergence of drug-resistance, PK and PD variability advocates for concentration-guided dosing in patients at risk for too low a drug-exposure.

http://bit.ly/2sf4Yxk

Vascularized composite allograft rejection is delayed by infusion of IFN-γ-conditioned BMSCs through upregulating PD-L1

Abstract

Mesenchymal stromal cells (MSCs) have been applied in prevention from allograft rejection based on their immunomodulatory effects. However, conflicting results have been presented among recent studies, for which one possibility being acknowledged is that the exact effect is determined by the microenvironment when MSCs are applied in vivo. Using a hind limb composite tissue allograft model, we investigate the influence of IFN-γ-preconditioning on the immunomodulatory effects of MSCs and the subsequent allograft survival. Firstly, different doses of IFN-γ were respectively used to incubate with bone marrow–derived MSCs (BMSCs). We found that IFN-γ altered the expression of PD-L1, a major suppressor gene in the immune system during allograft rejection, in a strictly dose-dependent manner in BMSCs. Ten nanograms per milliliter IFN-γ-incubated BMSCs significantly stimulated PD-L1 expression and suppressed T cell proliferation and differentiation, while 50 ng/mL IFN-γ-incubated BMSCs sharply reduced PD-L1 expression. Moreover, we observed that, in contrast to the naive BMSC transplantation group, BMSCs pre-conditioned with 10 ng/mL IFN-γ (BMSCs-IFN-γ) significantly delayed the allograft rejection in vivo. In vitro mixed lymphocyte reaction (MLR) indicated that BMSCs-IFN-γ inhibited T lymphocyte proliferation and activation via PD-L1. Moreover, BMSCs-IFN-γ did not influence the proliferation and activation of T lymphocytes when PD-L1 protein was neutralized by the PD-L1 antibody. These data collectively reveal a role of recipient ongoing immune microenviroment in BMSC-based immunesuppressive therapy.

Graphical abstract

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http://bit.ly/2C8WNaj

Patients’ experiences of life review therapy combined with memory specificity training (LRT-MST) targeting cancer patients in palliative care

Abstract

Purpose

Life review therapy combined with memory specificity training (LRT-MST) is effective in cancer patients in palliative care, but the effect size is moderate. The aim of this qualitative study was to obtain more in-depth knowledge on motivation to start with LRT-MST, experiences with LRT-MST, and perceived outcomes of LRT-MST.

Methods

Semi-structured interviews were conducted with 20 cancer patients in palliative care who participated in a randomized controlled trial investigating the effect of LRT-MST. All interviews were digitally recorded and transcribed verbatim. Data were analyzed by means of thematic analysis independently by two coders and coded into key issues and themes.

Results

Patients started LRT-MST for intrinsic (e.g., potential benefit for personal well-being) and extrinsic reasons (e.g., potential benefit for future patients). Patients indicated mainly positive experiences with the intervention. They appreciated sharing their memories and regaining memories with a specific focus on retrieving positive memories. Some disliked the fact that negative memories could not be addressed. Most patients perceived positive outcomes of the intervention belonging to the overarching themes "ego-integrity" and "psychological well-being" in the here and now, as well as in the nearby future (including end-of-life).

Conclusions

LRT-MST is of added value as a psychological intervention in palliative care. This study provided in-depth insight into reasons to start the intervention, and the experiences and outcomes, which are important to further tailor LRT-MST and for development or improvement of other psychological interventions targeting cancer patients in palliative care.

http://bit.ly/2FikekG

A rare cause of scalp swelling in infancy: delayed subaponeurotic fluid collections in five cases

Abstract

Subaponeurotic (subgaleal) fluid collection (DSFC) is a rare clinical entity of unknown etiology. We aimed to present our series of infants who were diagnosed with DSCF at Ankara University Children's Hospital. We retrospectively reviewed clinical findings, imaging studies, laboratory tests, management, and clinical courses of infants diagnosed with DSCF between June 2014 and June 2018. Five infants (4 males, 1 female), aged 5–14 weeks, were identified during the study period. All deliveries were non-progressive (3 normal deliveries, 2 cesarean sections) while instrumentation (vacuum extraction or forceps) was used in 2. History of recent trauma, concern for child abuse, and family or personal history of coagulopathy were negative for all patients. Conservative management with the spontaneous resolution was observed in 2 to 12 weeks in all infants. Although rare, DSFC should always be kept in mind in the differential diagnosis of scalp swelling in young infants. The diagnosis is primarily clinical, and current treatment is conservative.

http://bit.ly/2LW4h59

The Safety and Efficacy of Procedureless Gastric Balloon: a Study Examining the Effect of Elipse Intragastric Balloon Safety, Short and Medium Term Effects on Weight Loss with 1-Year Follow-Up Post-removal

Abstract

Introduction

The Ellipse intragastric balloon (EIGB) is a new swallowable balloon that does not require endoscopy at insertion or removal. The aim of this study is to investigate the safety of EIGB and its efficiency in weight reduction even after 1 year of expulsion.

Method

Prospective study on our initial experience with a consecutive group of patients who underwent the insertion of EIGB in the period between September 2016 and February 2017. The patients were followed up to assess pain, nausea, and vomiting after procedure. As well as, the time of balloon extraction, route of extraction, and weight loss.

Results

Total of 112 patients underwent EIGB placement. A 1-year follow-up was obtained on 85% of patients. Mean weight and BMI before the procedure 92.2 kg and 34.3 kg/m², respectively. One patient had small bowel obstruction. Six patients did not tolerate EIGB and three patients had early deflation. Total weight loss % (TWL%) 10.7, 10.9, and 7.9% at 3, 6, and at date of last follow-up. When data were stratified according to BMI into two groups: group 1 (BMI 27.5–34.9) and group 2 (BMI 35–49), the TWL% for group 1 at 3 months, 6 months, and last day of follow-up are as follows: 10.2%, 10.6%, and 8.8%, while it was 11.5%, 11.2%, and 6.6% for group 2.

Conclusion

EIGB are effective, safe, and feasible non-invasive method for weight loss.

http://bit.ly/2Ax6kZ8

Effects of IL-1β on MMP-9 Expression in Cementoblast-Derived Cell Line and MMP-Mediated Degradation of Type I Collagen

Abstract

It has been reported that matrix metalloproteinases (MMPs) are induced by many cytokines, and they are involved in various inflammatory processes, including periodontitis. However, the effects of interleukin-1β (IL-1β) on MMP-9 expression in cementoblasts, the cells responsible for cementum production, remain largely unknown. In this study, we used qPCR and gelatin zymogram analysis to show that IL-1β upregulated MMP-9 expression in cementoblast-derived cell line. Several signaling pathways, such as ERK1/2, JNK, p38, and AP-1 (c-Fos and ATF-2), were activated in response to IL-1β stimulation. Furthermore, enhancement of AP-1 activity by IL-1β was further confirmed by the AP-1 reporter assay and the electrophoretic mobility shift assay (EMSA). Pretreatment with specific inhibitors of ERK1/2 (U0126), JNK (SP600125), and AP-1 (tanshinone IIA) attenuated IL-1β-induced MMP-9 expression. In addition, inhibitors of ERK1/2 (U0126) and JNK (SP600125) attenuated IL-1β-enhanced AP-1 activity. This suggested that IL-1β stimulated AP-1 activation, at least partially, through ERK1/2 and JNK signaling pathways. Moreover, we found that IL-1β also upregulated the expression of MMP-13 and enhanced MMP-mediated degradation of type I collagen. Collectively, these results suggested that IL-1β induced MMP-9 expression by activation of AP-1 through the ERK1/2 and JNK signaling pathways in cementoblast-derived cell line and enhanced MMP-mediated collagen degradation possibly by MMP-13 and MMP-9.

http://bit.ly/2FdrfmZ

Dextrocardia and corrected transposition of the great arteries with rheumatic tricuspid stenosis: a unique association

Abstract

A 37-year-old lady presented with difficulty in breathing, which had progressively worsened in the last few months. Investigations revealed dextrocardia, congenitally corrected transposition of aorta, severe left atrioventricular valve stenosis with regurgitation, and right atrioventricular valve regurgitation. Left atrioventricular valve stenosis with thickening of leaflets and commissural fusion were suggestive of rheumatic valvular heart disease. She underwent left atrioventricular valve replacement and right atrioventricular valve repair with annuloplasty ring. This is a unique association of rheumatic valvular disease in corrected transposition of great arteries with dextrocardia. Morphology made surgical correction very challenging. Surgical correction of such case has not been reported in literature so far.

http://bit.ly/2s9XD28

Surgical management of diffusely diseased coronary arteries

Abstract

Purpose

To analyze the outcomes of long segment coronary anastomoses in patients with diffusely diseased coronary arteries and compare them with medically managed patients.

Methods

We retrospectively studied patients with diffusely diseased coronary arteries who underwent complete revascularization with long segment coronary reconstruction (> 2 cm in length) from February 2015 to November 2016. During the same time, patients who opted medical management for diffuse coronary artery disease were also studied.

Results

Forty-one patients underwent long segment coronary anastomoses for diffuse coronary artery disease with either left internal thoracic artery (LITA) or saphenous vein conduits. In 15 (36.58%) patients, the anastomosis length was more than 4 cm. In 41 patients, left anterior descending (LAD) artery had long segment anastomosis and in four patients, posterior descending artery (PDA) had long segment anastomosis. Twenty-one patients were operated off-pump and the rest were operated on cardiopulmonary bypass. The post-operative recovery of all the patients was uneventful. There were no procedural complications. There was one mortality due to cerebrovascular accident (2.43%). During the study period, 50 patients with diffuse coronary artery disease were under medical management. In the medically managed group, there were seven death during the follow-up, with mortality rate of 14%.

Conclusion

Patients with diffuse disease coronary diseases, who are surgically managed, have a better outcome when compared to the medically managed patients with acceptable morbidity and mortality.

http://bit.ly/2LYuXCs

Correction to: Abstracts of the MASCC/ISOO 2016 Annual Meeting

In the published Abstracts, the authorgroup of one abstract is incorrect. Matthew Kang was inadvertently deleted in abstract eP250, page 168. The correct authorgroup for eP250 is the the below

http://bit.ly/2CVGwHH

Response to the letter to the editor: Post-traumatic stress in head and neck cancer survivors and their partners

http://bit.ly/2FbPB1c

Web-based videoconferencing for rural palliative care consultation with elderly patients at home

Abstract

Purpose

Providing specialized palliative care support to elderly patients in rural areas can be challenging. The purpose of this study was to gain a preliminary understanding of the experience of using mobile web-based videoconferencing (WBVC) for conducting in-home palliative care consults with elderly rural patients with life-limiting illness.

Methods

This was a descriptive, exploratory, proof-of-concept study with a convenience sample of 10 WBVC visits. A palliative care clinical nurse specialist (PC-CNS), in the home with the patient/family and home care nurse (HC-N), used a laptop computer with webcam and speakerphone to connect to a distant palliative care physician consultant (PC-MD) over a secure Internet connection. Data was collected using questionnaires, interviews, and focus groups.

Results

Analysis of qualitative data revealed four themes: communication, logistics, technical issues, and trust. Participants reported they were comfortable discussing concerns by WBVC and felt it was an acceptable and convenient way to address needs. Audiovisual quality was not ideal but was adequate for communication. Use of WBVC improved access and saved time and travel. Fears were expressed about lack of security of information transmitted over the Internet.

Conclusions

Using WBVC for in-home palliative care consults could be an acceptable, effective, feasible, and efficient way to provide timely support to elderly rural patients and their families. Having a health care provider in the home during the WBVC is beneficial. WBVC visits have advantages over telephone calls, but limitations compared to in-person visits, suggesting they be an alternative but not replacement for in-person consultations.

http://bit.ly/2FhYMg1

Cancer survivorship care after curative treatment: Chinese oncology practitioners’ practices

Abstract

Purpose

To establish oncology practitioners' perceptions of responsibility, confidence levels, and frequency of survivorship care practice in relation to the post-treatment phase of survivorship care in Mainland China; to identify factors associated with oncology practitioners' perceptions of responsibility, confidence levels, and frequency of survivorship care practice; and to examine factors that impede the provision of quality survivorship care.

Methods

A cross-sectional survey of Chinese oncology practitioners was conducted using a test battery consisting of a self-developed information sheet, a 29-item survivorship care scale (29-SCS), and a 16-item impeding factors scale.

Results

There were 331 participants. Mean values of the four subscales (8.87, 61.82, 18.62, and 40.49) on perceptions of responsibility were relatively higher than those of the mean values of confidence levels and frequency of survivorship care practice. Participant characteristics, including professional discipline, highest educational qualification achieved, work status, work role, and work setting, were identified as factors associated with oncology practitioners' responsibility perceptions, confidence levels, and survivorship care practice frequency. The top three barriers to quality survivorship care perceived by participants were lack of time, an appropriate physical location, and evidence-based practice guidelines to inform survivorship care.

Conclusions

Findings of relatively high levels of perception of responsibility and low levels of confidence in survivorship care suggest that survivorship care is needed, with the aim of implementing oncology practitioners' responsibility and improving their confidence in providing survivorship care in cancer practice. Future multiple levels of cooperation for overcoming barriers and implementing quality survivorship care are highly recommended.

http://bit.ly/2FbPAua

Robotic Task Planning Using a Backchaining Theorem Prover for Multiplicative Exponential First-Order Linear Logic

Abstract

In this paper, we propose an exponential multiplicative fragment of linear logic to encode and solve planning problems efficiently in STRIPS domain, that we call the Linear Planning Logic (LPL). Linear logic is a resource aware logic treating resources as single use assumptions, therefore enabling encoding and reasoning of domains with dynamic state. One of the most important examples of dynamic state domains is robotic task planning, since informational or physical states of a robot include non-monotonic characteristics. Our novel theorem prover is using the backchaining method which is suitable for logic languages like Lolli and Prolog. Additionally, we extend LPL to be able to encode non-atomic conclusions in program formulae. Following the introduction of the language, our theorem prover and its implementation, we present associated algorithmic properties through small but informative examples. Subsequently, we also present a navigation domain using the hexapod robot RHex to show LPL's operation on a real robotic planning problem. Finally, we provide comparisons of LPL with two existing linear logic theorem provers, llprover and linTAP. We show that LPL outperforms these theorem provers for planning domains.

http://bit.ly/2VBT6TR

Electrocochleography: Cochlear Implants and the Return to the Operating Room

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Pitch and Duration Pattern Sequence Tests in 7- to 11-Year-Old Children: Results Depend on Response Mode

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Influence of Instantaneous Compression on Recognition of Speech in Noise with Temporal Dips

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Quality and Readability of English-Language Internet Information for Tinnitus

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The Effect of Test, Electrode, and Rate on Electrocochleography Measures

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Sentence Recognition in Steady-State Speech-Shaped Noise versus Four-Talker Babble

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Counseling in Pediatric Audiology: Audiologists’ Perceptions, Confidence, and Training

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Levels of Music Played by Caucasian and Filipino Musicians with and without Conventional and Musicians’ Earplugs

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Electrocochleography: Cochlear Implants and the Return to the Operating Room

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Pitch and Duration Pattern Sequence Tests in 7- to 11-Year-Old Children: Results Depend on Response Mode

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Influence of Instantaneous Compression on Recognition of Speech in Noise with Temporal Dips

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Quality and Readability of English-Language Internet Information for Tinnitus

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The Effect of Test, Electrode, and Rate on Electrocochleography Measures

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Sentence Recognition in Steady-State Speech-Shaped Noise versus Four-Talker Babble

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Counseling in Pediatric Audiology: Audiologists’ Perceptions, Confidence, and Training

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Levels of Music Played by Caucasian and Filipino Musicians with and without Conventional and Musicians’ Earplugs

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via IFTTT

Electrocochleography: Cochlear Implants and the Return to the Operating Room

from #Audiology via ola Kala on Inoreader http://bit.ly/2QrFxCy
via IFTTT

Pitch and Duration Pattern Sequence Tests in 7- to 11-Year-Old Children: Results Depend on Response Mode

from #Audiology via ola Kala on Inoreader http://bit.ly/2VrVADY
via IFTTT

Influence of Instantaneous Compression on Recognition of Speech in Noise with Temporal Dips

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Quality and Readability of English-Language Internet Information for Tinnitus

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The Effect of Test, Electrode, and Rate on Electrocochleography Measures

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Sentence Recognition in Steady-State Speech-Shaped Noise versus Four-Talker Babble

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Counseling in Pediatric Audiology: Audiologists’ Perceptions, Confidence, and Training

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Levels of Music Played by Caucasian and Filipino Musicians with and without Conventional and Musicians’ Earplugs

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Volume change pattern of decompression of mandibular odontogenic keratocyst

Abstract

Objectives

This study was aimed to analyze the reducing pattern of decompression on mandibular odontogenic keratocyst and to determine the proper time for secondary enucleation.

Materials and methods

Seventeen patients with OKC of the mandible were treated by decompression. Forty-five series of CT data were taken during decompression and measured by using InVivo software (Anatomage, San Jose, Calif) and were analyzed.

Results

The expected relative volume during decompression is calculated using the following formula: V(t) = V_initial × exp.(at + 1/2bt²) (t = duration after decompression (day)). There was no significant directional indicator in the rate of reduction between buccolingual and mesiodistal widths.

Conclusion

The volume reduction rate gradually decreased, and 270 days were required for 50% volume reduction following decompression of OKC. The surgeon should be aware of this pattern to determine the timing for definitive enucleation.

Clinical relevance

The volume reduction rate and pattern of decompression of the OKC can be predicted and clinicians should be considered when treating OKC via decompression.

http://bit.ly/2Quz21M

Clinical investigation of gustatory and neurosensory alterations following mandibular third molar surgery: an observational prospective study

Abstract

Objective

This study aimed to prospectively observe gustatory and neurosensory alterations following surgical removal of mandibular third molars.

Material and methods

A prospective clinical study was conducted with patients who required mandibular third molar extraction, recruited from the Division of Oral and Maxillofacial Surgery at the Federal University of Ceará (Brazil). Age, sex, and radiographic signs were recorded. The outcome variables were the presence or absence of gustatory and neurosensory alterations. The patients were observed preoperatively and at 7, 30, 90, and 180 days postoperatively by using gustatory and neurosensory tests.

Results

The response to sweet (p = 0.509) and sour (p = 0.078) stimulus did not alter significantly over time. The salty threshold significantly increased from the preoperative to 7- and 30-day postoperative periods, returning to baseline values at 90 days postoperatively (p = 0.038). The bitter threshold increased significantly from the preoperative to 7-day postoperative period, returning to baseline values at 30 days after surgery (p < 0.001). Regarding neurosensory evaluation, there was an altered response to stimulus at 7 days postoperatively in specific studied areas, returning to baseline values 30 days after surgery (p < 0.05).

Conclusion

The present study shows that mandibular third molar removal was associated with slight sensory disturbances related to mechanical, tactile, and gustatory perception. Regarding the recovery period, all patients returned to normal function without intervention, over a period ranging from 30 to 90 days.

Clinical relevance

This study highlighted the importance of a sensory evaluation following removal of third molars, notably regarding mechanical perception and gustatory threshold assessment.

http://bit.ly/2Azi4dA

The added value of orthotic management in the context of multi-level surgery in children with cerebral palsy

Publication date: Available online 6 January 2019

Source: Gait & Posture

Author(s): M Schwarze, J Block, T Kunz, M Alimusaj, DWW Heitzmann, C Putz, T Dreher, SI Wolf

Abstract

Background

Treatment of cerebral palsy includes an interdisciplinary concept and in more severe cases the well-established multi-level surgery (MLS). Different kinds of orthoses are typically part of postoperative treatment but there is a lack of knowledge about their additional benefit.

Research question

Do ankle foot orthoses lead to an additional, measurable improvement of gait after MLS?

Methods

20 children with bilateral spastic cerebral palsy (9 retrospective, 11 in a postoperative clinical routine) were included. All had a preoperative gait analysis before MLS. Postoperatively, they were fitted with different ankle foot orthoses (AFO), depending on their individual needs. Dynamic ankle foot orthoses (DAFO), combined DAFO with additional dynamic, elastic shank adaptation (DESA) and ground reaction force AFOs (GRAFO) were used. Patients underwent a second gait analysis 1.5 (± 0.6) years postoperatively barefoot and with orthoses. Data analysis included testing for normal distribution (Shapiro-Wilk-Test) and further nonparametric statistical testing on basis of a Wilcoxon Single-Rank Test.

Results

The operation produced changes in the hip, knee and ankle joint, and the pelvis. Spatiotemporal parameters showed significant changes due to additional use of the orthoses. Further, additional kinematic changes occurred at the hip, knee and ankle joint as well as the foot. The Gillette Gait Index (GGI) improved significantly by supplementary orthoses, but not by surgery alone. The Gait Profile Score (GPS) and Gait Deviation Index (GDI) rather showed changes due to the surgery.

Significance

MLS significantly improves GPS and GDI more than a year after surgery, which can be interpreted as an improvement in gait pattern. In contrast, the GGI is improved by additional postoperative orthotic treatment, which implies that walking ability itself has improved, rather than the gait pattern. Orthoses show a positive additional effect on surgical results at different anatomical levels. Spatiotemporal parameters are positively influenced solely by additional orthotic support.

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The added value of orthotic management in the context of multi-level surgery in children with cerebral palsy

Publication date: Available online 6 January 2019

Source: Gait & Posture

Author(s): M Schwarze, J Block, T Kunz, M Alimusaj, DWW Heitzmann, C Putz, T Dreher, SI Wolf

Abstract

Background

Treatment of cerebral palsy includes an interdisciplinary concept and in more severe cases the well-established multi-level surgery (MLS). Different kinds of orthoses are typically part of postoperative treatment but there is a lack of knowledge about their additional benefit.

Research question

Do ankle foot orthoses lead to an additional, measurable improvement of gait after MLS?

Methods

20 children with bilateral spastic cerebral palsy (9 retrospective, 11 in a postoperative clinical routine) were included. All had a preoperative gait analysis before MLS. Postoperatively, they were fitted with different ankle foot orthoses (AFO), depending on their individual needs. Dynamic ankle foot orthoses (DAFO), combined DAFO with additional dynamic, elastic shank adaptation (DESA) and ground reaction force AFOs (GRAFO) were used. Patients underwent a second gait analysis 1.5 (± 0.6) years postoperatively barefoot and with orthoses. Data analysis included testing for normal distribution (Shapiro-Wilk-Test) and further nonparametric statistical testing on basis of a Wilcoxon Single-Rank Test.

Results

The operation produced changes in the hip, knee and ankle joint, and the pelvis. Spatiotemporal parameters showed significant changes due to additional use of the orthoses. Further, additional kinematic changes occurred at the hip, knee and ankle joint as well as the foot. The Gillette Gait Index (GGI) improved significantly by supplementary orthoses, but not by surgery alone. The Gait Profile Score (GPS) and Gait Deviation Index (GDI) rather showed changes due to the surgery.

Significance

MLS significantly improves GPS and GDI more than a year after surgery, which can be interpreted as an improvement in gait pattern. In contrast, the GGI is improved by additional postoperative orthotic treatment, which implies that walking ability itself has improved, rather than the gait pattern. Orthoses show a positive additional effect on surgical results at different anatomical levels. Spatiotemporal parameters are positively influenced solely by additional orthotic support.

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The added value of orthotic management in the context of multi-level surgery in children with cerebral palsy

Publication date: Available online 6 January 2019

Source: Gait & Posture

Author(s): M Schwarze, J Block, T Kunz, M Alimusaj, DWW Heitzmann, C Putz, T Dreher, SI Wolf

Abstract

Background

Treatment of cerebral palsy includes an interdisciplinary concept and in more severe cases the well-established multi-level surgery (MLS). Different kinds of orthoses are typically part of postoperative treatment but there is a lack of knowledge about their additional benefit.

Research question

Do ankle foot orthoses lead to an additional, measurable improvement of gait after MLS?

Methods

20 children with bilateral spastic cerebral palsy (9 retrospective, 11 in a postoperative clinical routine) were included. All had a preoperative gait analysis before MLS. Postoperatively, they were fitted with different ankle foot orthoses (AFO), depending on their individual needs. Dynamic ankle foot orthoses (DAFO), combined DAFO with additional dynamic, elastic shank adaptation (DESA) and ground reaction force AFOs (GRAFO) were used. Patients underwent a second gait analysis 1.5 (± 0.6) years postoperatively barefoot and with orthoses. Data analysis included testing for normal distribution (Shapiro-Wilk-Test) and further nonparametric statistical testing on basis of a Wilcoxon Single-Rank Test.

Results

The operation produced changes in the hip, knee and ankle joint, and the pelvis. Spatiotemporal parameters showed significant changes due to additional use of the orthoses. Further, additional kinematic changes occurred at the hip, knee and ankle joint as well as the foot. The Gillette Gait Index (GGI) improved significantly by supplementary orthoses, but not by surgery alone. The Gait Profile Score (GPS) and Gait Deviation Index (GDI) rather showed changes due to the surgery.

Significance

MLS significantly improves GPS and GDI more than a year after surgery, which can be interpreted as an improvement in gait pattern. In contrast, the GGI is improved by additional postoperative orthotic treatment, which implies that walking ability itself has improved, rather than the gait pattern. Orthoses show a positive additional effect on surgical results at different anatomical levels. Spatiotemporal parameters are positively influenced solely by additional orthotic support.

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Biodegradation of malachite green by an endophytic bacterium Klebsiella aerogenes S27 involving a novel oxidoreductase

Abstract

Endophytic microorganisms can metabolize organic contaminants and assist in plant growth, thus facilitating the phytoremediation of polluted environments. An endophytic bacterium capable of decoloring malachite green (MG) was isolated from the leaves of the wetland plant Suaeda salsa and was identified as Klebsiella aerogenes S27. Complete decolorization of MG (100 mg/l) was achieved in 8 h at 30 °C and pH 7.0. Ultraviolet-visible spectroscopy and Fourier-transform infrared spectroscopy analyses indicated the degradation of MG by the isolate. The enzymic assays of the strain showed the triphenylmethane reductase (TMR) activity. A gene encoding putative TMR-like protein (named as KaTMR) was cloned and heterologously expressed in Escherichia coli. KaTMR showed only 42.6–43.3% identities in amino acids compared with well-studied TMRs, and it phylogenetically formed a new branch in the family of TMRs. The degraded metabolites by recombinant KaTMR were detected by liquid chromatography-mass spectrometry, showing differences from the products of reported TMRs. The biotransformation pathway of MG was proposed. Phytotoxicity studies revealed the less-toxic nature of the degraded metabolites compared to the dye. This study presented the first report of an endophyte on the degradation and detoxification of triphenylmethane dye via a novel oxidoreductase, thus facilitating the study of the plant-endophyte symbiosis in the bioremediation processes.

http://bit.ly/2saEi0N

Optimization of the Gal4/UAS transgenic tools in zebrafish

Abstract

The Gal4/UAS system provides a powerful tool to analyze the function of genes. The system has been employed extensively in zebrafish; however, cytotoxicity of Gal4 and methylation of UAS can hinder future applications of Gal4/UAS in zebrafish. In this study, we provide quantitative data on the cytotoxicity of Gal4-FF and KalTA4 in zebrafish embryos. A better balance between induction efficiency and toxicity was shown when the injection dosage was 20 pg for Gal4-FF and 30 pg for KalTA4. We tested the DNA methylation of UAS in different copies (3×, 5×, 7×, 9×, 11×, and 14×), and the results showed, for the first time, that the degree of UAS methylation increases with the increase in the copy number of UAS. We detected insertions of the Tol2-mediated transgene in the Gal4 line and found as many as three sites of insertion, on average; only about 20% of individuals contained single-site insertion in F1 generation. We suggested that the screening of Gal4 lines with single-site insertion is essential when Tol2-mediated Gal4 transgenic lines are created. Moreover, we designed a novel 5 × non-repetitive UAS (5 × nrUAS) to reduce the appeal of multicopy UAS as a target for methylation. Excitingly, the 5 × nrUAS is less prone to methylation compared to 5 × UAS. We hope the results will facilitate the future application of the Gal4/UAS system in zebrafish research.

http://bit.ly/2LS2Ncc

Tremorgenic and neurotoxic paspaline-derived indole-diterpenes: biosynthetic diversity, threats and applications

Abstract

Indole-diterpenes (IDTs) such as the aflatrems, janthitrems, lolitrems, paspalitrems, penitrems, shearinines, sulpinines, and terpendoles are biogenetically related but structurally varied tremorgenic and neurotoxic mycotoxins produced by fungi. All these metabolites derive from the biosynthetic intermediate paspaline, a frequently occurring IDT on its own right. In this comprehensive review, we highlight the similarities and differences of the IDT biosynthetic pathways that lead to the generation of the main paspaline-derived IDT subgroups. We survey the taxonomic distribution and the regulation of IDT production in various fungi and compare the organization of the known IDT biosynthetic gene clusters. A detailed assessment of the highly diverse biological activities of these mycotoxins leads us to emphasize the significant losses that paspaline-derived IDTs cause in agriculture, and compels us to warn about the various hazards they represent towards human and livestock health. Conversely, we also describe the potential utility of these versatile molecules as lead compounds for pharmaceutical drug discovery, and examine the prospects for their industrial scale manufacture in genetically manipulated IDT producers or domesticated host microorganisms in synthetic biological production systems.

http://bit.ly/2QmS0Y9

Interdural high signal on CISS sequence: an alternative CSF pathway?

Abstract

Purpose

The falx cerebri, falx cerebelli, and tentorial notch exhibit a peculiar morphology with a two-layered, dural leaf that protrudes into the cranial cavity with a free edge. However, there are few studies exploring this morphology using neuroimaging techniques. The present study aimed to explore these dural structures using magnetic resonance imaging.

Methods

A total of 65 outpatients were included in this study. Following initial examinations with conventional sequences, the constructive interference in steady-state (CISS) sequences were performed in thin-sliced, coronal sections.

Results

In 78% of the subjects, the interdural spaces presenting with high signal were identified in the falx cerebri. These spaces were located adjacent to the uppermost part of the falx, formed by two dural leaves and the superior sagittal sinus, and tapered downward where the leaves united to form the falx cerebri. At the tentorial notch, these spaces were found in 52% of the 65, most predominantly in the medial edge followed by the tentorium cerebelli-tentorial notch junctional region. Forty-one percent of patients had a dural opening into the cerebral cistern. The interdural spaces with high signal were not identified in the tentorium cerebelli in any of the subjects.

Conclusions

The falx cerebri and tentorial notch form the interdural spaces that may provide alternative cerebrospinal fluid pathways. The coronal CISS sequence is suitable for delineating such interdural spaces.

http://bit.ly/2F9H0fy

The first Korean case report with scaphocephaly as the initial sign of X-linked hypophosphatemic rickets

Abstract

Introduction

X-linked hypophosphatemic rickets (XLH) can occasionally cause premature fusion of cranial sutures through an increased level of fibroblast growth factor 23 (FGF-23), which leads to the dysregulation of phosphate and vitamin D metabolism. Secondary craniosynostosis has long been considered to present late after XLH has already been diagnosed either clinically or genetically.

Case presentation

We present observations of a male infant showing sagittal synostosis as the first sign of XLH. Our patient did not show any other skeletal deformities except macrocephaly with a long head shape. There is a family history of genetically unconfirmed hypophosphatemic rickets in his mother. Direct sequencing by genomic polymerase chain reaction revealed that the patient has a large deletion comprising exons 1–3 of the phosphate regulating endopeptidase homolog X-linked (PHEX) gene.

Conclusion

Our observations suggest that craniosynostosis secondary to rickets can develop in early infancy. Careful monitoring of head shape and growth is therefore critical for early detection of craniosynostosis in XLH.

http://bit.ly/2FdGNqS

Bariatric Surgery Outcomes in Appalachia Influenced by Surgery Type, Diabetes, and Depression

Abstract

Background

Most effective treatment for morbid obesity and its comorbidities is bariatric surgery. However, research is limited on weight loss and associated outcomes among patients in Appalachia. The objective of this study was to examine demographic and comorbidity influence on surgical outcomes of this population including age, sex, race, state of residence, education, marital status, body mass index (BMI kg/m²), excess body weight (EBW), percent excess weight loss (%EWL), blood pressure, diagnosed depression, diagnosed type 2 diabetes (T2D), Beck Depression Inventory-II (BDI-II), and laboratory values (i.e., hemoglobin A1c).

Methods

A retrospective electronic medical record (EMR) data extraction was performed on N = 582 patients receiving bariatric surgery (laparoscopic Roux-en-Y gastric bypass [RYGB] and laparoscopic sleeve gastrectomy [SG]) between 10/2013 and 2/2017.

Results

Patient population was 92.5% Caucasian, 79.3% female, 62.8% married, 45 ± 11.1 years, 75.8% received RYGB, and 24.2% received SG. Average %EWL from baseline to 1-year follow-up was 68.5 ± 18.4% (n = 224). In final descriptive models, surgery type, diagnosed T2D, HbA1c, and depressive symptoms were significant covariates associated with lower %EWL.

Conclusions

Findings suggest patients completing surgery within an Appalachian region have successful surgical outcomes at 1-year post-surgery, as indicated by significant reductions of > 50% EWL, regardless of other covariates. Results suggest that bariatric programs should consider paying special consideration to patients with T2D or depressive symptoms to improve outcomes. Results have potential to inform future prospective studies and aid in guiding specific interventions tailored to address needs of this unique population.

http://bit.ly/2TuvTkk

Efficacy of acetylleucine in vertigo and dizziness: a systematic review of randomised controlled trials

Abstract

Purpose

To assess the efficacy of acetylleucine to improve or stop an attack of vertigo and dizziness (vertigo/dizziness).

Methods

Systematic review by 2 independent reviewers. Consultation of the Medline, Cochrane and ClinicalTrials.gov databases until September 2018. Keywords used: Acetylleucine, Tanganil®, Acetyl-DL-leucine, Acetyl-leucine. Trial selection: randomised controlled trials (RCTs) comparing acetylleucine against placebo.

Results

Up until 2018, no RCTs have been published on the efficacy of acetylleucine in vertigo/dizziness.

Conclusion

There is no solid evidence of the efficacy of acetylleucine in vertigo/dizziness. Given its frequent prescription and the cost generated for the French social security system, high-quality randomised trials should be carried out to assess its efficacy.

http://bit.ly/2VzgNfa

The Impact of Roux-en-Y Gastric Bypass on Bone Remodeling Expressed by the P1NP/βCTX Ratio: a Single-Center Prospective Cohort Study

Abstract

Background

Bariatric surgery seems to decrease bone mineral density and increase the risk of fatigue fractures. P1NP (bone formation) and βCTX (bone resorption) were recently validated as reference bone turnover markers (BTM).

Objective

To assess changes in bone remodeling in severely obese patients undergoing Roux-en-Y gastric bypass (RYGB) by using a new composite biomarker, the P1NP/βCTX ratio.

Methods

We prospectively collected blood samples preoperatively, at 1 month and at 1 year from 114 consecutive RYGB patients from 12/2012 to 04/2014. Repeated measures ANOVA and multiple regression were used for data analysis. Cumulative incidence of fractures was assessed in 06/2018.

Results

The P1NP/βCTX ratio decreased significantly (P < 0.001) from baseline to 1 month and 1 year (180 ± 6.6, 110 ± 4.1, and 132 ± 5.4). The 1-year P1NP/βCTX ratio did not correlate with BMI or ΔBMI, but inversely correlated with age (r = − 0.23, P = 0.014) and with hsCRP (r = − 0.26, P = 0.009), even after adjustment for age, sex, BMI, and lifestyle, and linearly correlated with albumin (r = 0.2, P = 0.037). At baseline, none of these correlations were detectable. Serum for all time-points was available from > 94% of the patients. At a median follow-up of 4.7 years, 8 patients (7.3%) had a bone fracture, all of them traumatic.

Conclusion

Following RYGB, bone remodeling increases, with a shift toward degradation. This effect seems to be weight-loss independent and shows a correlation with age, with the level of systemic inflammation, and with nutritional state. The risk of fractures should be assessed systematically in bariatric patients and measures of prevention should be improved accordingly.

http://bit.ly/2CPOv8U

Human Biology

Health care: Where are we heading? Monali Amit Shah Advances in Human Biology 2019 9(1):1-1

The incidence of brain tumours in Iran: A systematic review and meta-analysis Soheil Hassanipour, Gholamreza Namvar, Mohammad Fathalipour, Mohammad Ghorbani, Elham Abdzadeh, Saber Zafarshamspour, Shirin Riahi, Abdollah Mohammadian-Hafshejani, Hamid Salehiniya Advances in Human Biology 2019 9(1):2-7 Background: Brain tumours (BTs) constitute approximately 88% of all central nervous system tumours. The present study aimed to determine the age-standardised rate (ASR) of BTs in Iran. Methods: A comprehensive search was conducted on all studies of BTs incidence using Medline/PubMed, Scopus, Embase, Google Scholar and Web of Sciences as international databases and Scientific Information Database, MagIran, IranMedex and IranDoc as Iranian databases until April 2018. This systematic review was done based on the preferred reporting items for systematic reviews and meta-analyses. Results: The primary search yielded 312 relevant studies. A total of 17 studies were included after more detailed retrieval. The results of the random-effect model were demonstrated the ASR of BTs was 4.16 (95% confidence interval [CI], 3.20–5.12) for males and 3.40 (95% CI, 2.67–4.13) for females. Conclusion: The incidence of BTs is lower in Iran compared to other parts of the world. The incidence of nervous system cancers is increasing base on region, geographical, and economic conditions in Iran. Hence, training programmes can be considered to reduce the risk factors, complications of nervous system cancers and early diagnosis of nervous tumors.

The effect of placenta abruption on the risk of intrauterine growth restriction: A meta-analysis Ensiyeh Jenabi, Salman Khazaei, Bita Fereidooni Advances in Human Biology 2019 9(1):8-11 There is a contradict findings on the effect of placenta abruption on the risk of intrauterine growth restriction (IUGR). Therefore, the objective of present meta-analysis was to identify all the eligible studies to assess the effect of placenta abruption on the risk of IUGR. The major electronic databases, including PubMed, Scopus and Web of Science, were searched to identify relevant published studies. The literature search included 551 articles until January 2018 with 35,201 participants. In the end, a total of seven references were remained for this meta-analysis. Two independent authors reviewed the retrieved the studies and extracted data. I2 statistics was used to assess of heterogeneity. The random effects model was conducted to assess pooled effects size. the results of study showed that placenta abruption has a significant effect on the risk of IUGR based on odds ratio results (2.06; 95% confidence interval: 1.57, 2.55). The result reported of the measure of effect was homogeneous (I2 = 0.0%). we presented based on reports in epidemiological studies that placenta abruption is a risk factor for IUGR.

Is breech presentation associated with autism spectrum disorders among children: A meta-analysis Ensiyeh Jenabi, Saeid Bashirian, Salman Khazaei Advances in Human Biology 2019 9(1):12-15 The meta-analysis of case–control and cohort studies was conducted to obtain the association between breech presentation and the risk of autism spectrum disorder (ASD) among children. The search for relevant studies in major electronic databases was performed including; Web of Science, PubMed and Scopus up to May 2018. The odds ratio (ORs) with 95% confidence intervals (CI) was extracted from eligible studies. The pooled estimate of OR was not indicated a significant association between breech presentation and risk of ASD among children (OR = 1.15, 95% CI = 0.93–1.37), but this association was significant in the unadjusted analysis (OR = 1.32, 95% CI = 1.05–1.58). Our findings were not showed that breech presentation is associated with increased risk of ASD among children.

The incidence of testicular cancer in Iran from 1996 to 2017: A systematic review and meta-analysis Soheil Hassanipour, Mohammad Ghorbani, Milad Derakhshan, Hamed Fouladseresht, Shokrollah Mohseni, Elham Abdzadeh, Shirin Riahi, Morteza Arab-Zozani, Hamed Delam, Hamid Salehiniya Advances in Human Biology 2019 9(1):16-20 Objective: Testicular cancer (TC), although it is one of the most unusual cancers, seems to be increasing. There is no accurate information on the incidence of this cancer in Iran. The present study is conducted to evaluate the incidence rates of TC in Iran. Methods: A systematic search was conducted on all published studies of TC incidence using Medline/PubMed, Scopus, Embase, Web of Science, Google Scholar and four Iranian databases (Scientific Information Database, MagIran, IranMedex and IranDoc) until June 2018. This systematic review was done according to the preferred reporting items for systematic reviews and meta-analyses. Result: The database searching yielded 132 potentially relevant studies. A total of 11 studies were included in the study. The results of the random-effects model were demonstrated that the age-standardised rate (ASR) of TC was 1.13, 95% confidence interval (0.97–1.29) among Iranian males. Conclusion: ASR for TC in Iran is lower than the world average; however, it has a higher incidence than other Asian countries.

Effect of cryopreservation on the structural and functional integrity of human periodontal ligament stem cells: A systematic review Rujuta Krishnakant Pandya, Monali Shah, Yesha Shroff, Mrugank Vyas Advances in Human Biology 2019 9(1):21-27 Aim: The aim of the present systematic review was to assess the effect of cryopreservation on the human periodontal ligament (PDL) stem cells and their ability for periodontal regeneration. Materials and Methods: An electronic search without time restrictions was conducted up to August 2017 in indexed databases using the combination of different keywords including cryopreservation, cryofixation, vitrification and human periodontal ligament stem cells. The exclusion criteria included reviews, commentaries, letters to the editor, interviews and updates. The relevant articles were included and data extraction was processed. Results: Dimethyl sulphoxide was used as a cryoprotectant in all the studies which yielded good results. The magnetic freezing proves to be better than the normal freezer. The cryopreserved cells showed no significant difference for viability, proliferation, and regenerative capacities as compared to the fresh human PDL stem cells (PDLSCs), in vitro as well as in vivo. Conclusion: Cryopreservation of the human PDLSCs would serve as an opportunity for future regenerative therapy for the periodontium.

The effect of diabetes on nerve–muscle conduction of tibial and peroneal nerve association with habit and habitat in Bikaner Region Ekta Soni, Priyanka Soni, Jitendra Kumar Acharya Advances in Human Biology 2019 9(1):28-31 Introduction: Diabetes is due to defect in Beta cell of islets of Langerhans, that is seen in pancreas. This defect is responsible for disturbance in blood glucose level. Other factors which are also responsible includes diet, hereditary, immunological factor, lack of exercise etc., The damage to nerves in DM has been assumed to be a result of the interaction of metabolic defects complicated by vasa nervorum abnormalities. Nerve conduction velocity, are standard measurement used to confirm the presence or absence of diabetic neuropathy. In Nerve conduction velocity study common nerves that are studied are common peroneal nerve, tibial nerve and sural nerve. Materials and Methods: The study was planned in Physiology Department in close collaboration with Department of Medicine (Diabetic Section), S.p.mc. Bikaner. A total of 100 subjects for study from diabetic centre, were selected. Institutional ethical clearance was taken before commencement of study from ethical committee of our institution. Results: In present study, maximum number of patients were non-smokers in both study and control groups (87% and 91% respectively) and this difference was found statistically insignificant (P > 0.05). We observed that the patients were vegetarian in both study and control groups and this difference was found statistically insignificant (P > 0.05). The mean peroneal nerve in study group was 42.26 ± 1.95 m/s and in control group it was 52.05 ± 4.78 m/s and the difference was found statistically highly significant (P < 0.001) and mean value of tibial nerve in study group was 41.71 ± 2.29 m/s and in control group it was 49.84 ± 2.67 m/s and the difference was found statistically highly significant (P < 0.001). Conclusion: In our study, we concluded that nerve conduction velocities decreases in tibial and common peroneal nerve in diabetic patients as compared to control. Nerve conduction velocities also decrease with increasing age, increased HbA1C >6.5%.

New insight into the role of electronic apex locators in detecting simulated horizontal root fractures: An In vitro study Mukti M Shah, Vaishali V Parekh, Nidhi J Patel, Parth V Dodiya, Dipak H Chauhan Advances in Human Biology 2019 9(1):32-36 Aim and Objectives: The aim of this study is to check the accuracy of two different electronic apex locators (EALs): Canal Pro and Root ZX – in locating simulated horizontal root fractures (HRFs). Materials and Methods: Forty-five recently extracted, single-rooted, human permanent teeth were selected for the study. Endodontic access cavity was prepared, and canal patency was checked using no. 10-K file. Horizontal fractures were simulated using 0.2-mm thick diamond disk in coronal, middle and/or apical third of root by operator one, until half of the canal was exposed circumferentially. Using both the apex locators, all the fractures were detected by the second operator to confirm the accuracy of EALs. The actual length of the fractures was then measured under ×2.5 magnification, and results were subjected to statistical analysis. Results: Results were analysed using the one-way analysis of variance and Tukey's post hoc test, and the differences between all the test samples were analysed. All the measurements were compared to the actual values separately. A statistically significant difference was determined at 95% confidence level (P ≤ 0.05). Conclusion: Investigated both the EAL are capable of detecting simulated HRF and that the Canal Pro showed a higher accuracy rate.

To determine the prevalence of glucose-6-phosphate dehydrogenase deficiency using a novel water-soluble tetrazolium-8 formazan method' for neonatal screening in region of Himachal Pradesh, India Seema Sharma, Milap Sharma Advances in Human Biology 2019 9(1):37-41 Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most significant enzyme defect in India with an incidence ranging from 2% to 27.9% in different communities. Prolonged neonatal jaundice and haemolytic crisis are known to occur in children with G6PD deficiency. Hence, screening of a population for G6PD deficiency is paramount. A Novel water soluble tetrazolium-8 (WST-8) Formazan Method has been used in this study for in-field mass-screening of G6PD in the region of Himachal Pradesh, India. Materials and Methods: In this prospective study, 5652 neonates were screened to assay G6PD activity using WST8/1-methoxy phenazine methosulphate method within the first 48 h of life. Orange colour at the end of the procedure indicated normal G6PD activity while pink or colourless appearance indicated G6PD deficiency. Results: After the screening of 5652 neonates, the prevalence of G6PD deficiency was 12.4%. 45 newborns (6%) had a severe G6PD deficiency. Males were more affected than females (70:30). Furthermore, males had higher prevalence of deficiency than females (64% [n = 29] and 16% [n = 16]). Conclusions: G6PD deficiency assessment by the method used for population screening in the study was easy to do and quite simple. Following this, the high prevalence of this deficiency was noted in Himachal Pradesh. This study highlights the need to do neonatal screening of G6PD deficiency in population so that untowards complications like haemolytic crisis, complications due to neonatal jaundice can be avoided.

Evaluation of the accessible level of iodine in marketed iodised salt in Iran: A comparison with standard recommended values Abolfazl Mohammadbeigi, Ali Salehi, Hamidreza Heidari, Mahdi Asadi-Ghalhari Advances in Human Biology 2019 9(1):42-45 Background: Iodine is one of the essential micronutrients for synthesise and secrete adequate amounts of thyroid gland hormones. Its deficiency is the most important threatening causes for human health. The aim of this study was to evaluate iodine concentration in marketed edible salt samples in Qom city and to compare with existing standards and offering solutions necessary to fix the probably problems. Materials and Methods: A cross-sectional, descriptive study was carried out on 60 samples of 20 brands of marketed edible salt in Qom during 2017. Iodine concentration was evaluated by the British Pharmacopoeia titration method. Results: According to the national standard of Iran during this study, iodine concentration in 51.67% of salt samples was in acceptable limits and 48.33% of samples were out of acceptable ranges. None of the tested samples had iodine content more than the standard limit. Conclusions: To improve salt fortification status and removing iodine deficiency in society, the following actions should be considered: enforcing producers to follow national and international standards, continuous monitoring the producers, necessary legal actions against offending manufacturers and appropriate measures by health ministry and relevant authorities.

Pediatric Neuropsychology

Review of Neurodevelopmental Disorders in Children and Adolescents

Investigating the BRIEF and BRIEF-SR in Adolescents with Mild Traumatic Brain Injury Abstract To date, limited research has investigated the Behavioral Rating Inventory of Executive Function (BRIEF) and BRIEF Self-Report (BRIEF-SR) in adolescents presenting exclusively with mild traumatic brain injuries (mTBI). The present study was retrospective and included 163 adolescents (43% male; M age = 14.80; M days since injury = 34.10) referred for neuropsychological evaluation after mTBI. Results revealed that mean BRIEF and BRIEF-SR clinical scale scores in the sample were generally similar to those in the standardization sample, commensurate with previous literature on the trajectory of cognitive and symptom recovery after mTBI. Adolescents reported significantly higher scores than their parents only on Emotional Control, with no differences emerging on other clinical scales. Confirmatory factor analyses indicated that the two-factor model of the BRIEF-SR (Metacognition and Behavioral Regulation; Comparative Fit Index (CFI) = 0.97) provided relatively and statistically significant better fit than a one-factor model extracted in exploratory analyses. Results also indicated that a three-factor model of the BRIEF capturing Metacognition, Behavioral Regulation, and Emotional Regulation (CFI = 0.98) provided relatively and significantly better fit than the two-factor model. These results suggested that adolescents in the post-acute phase of mTBI recovery may rate their own executive dysfunction in terms of metacognitive and behavioral difficulties, while their parents may observe executive dysfunction in these two dimensions in addition to emotional dysfunction. Relationships to previous literature, limitations of the present study, and implications for clinical practice are discussed.

Test and Book Reviews in Pediatric Neuropsychology

Correction to: Automatized Sequences as a Performance Validity Test? Difficult If You Have Never Learned Your ABCs In the original article the name of author Allyson G. Harrison was misspelled. The original article has been updated and her name is correct here.

Pediatric Performance Validity Testing: State of the Field and Current Research

One-Minute PVT: Further Evidence for the Utility of the California Verbal Learning Test—Children's Version Forced Choice Recognition Trial Abstract Objective To replicate previous research on the forced choice recognition trial for the California Verbal Learning Test—Children's Version (FCR-C). Method Classification accuracy of the FCR-C was computed in 178 children referred for neuropsychological assessment to a tertiary care hospital. Results FCR-C ≤ 14 produced the best combination of sensitivity (.12–.42) and specificity (.88–.96). Unlike some of the criterion performance validity tests (PVTs), base rate of failure on the FCR-C was evenly distributed across age ranges. Conclusion The FCR-C is a quick and inexpensive PVT, unaffected by cognitive maturation, and highly specific to psychometrically defined invalid performance.

Automatized Sequences as a Performance Validity Test? Difficult If You Have Never Learned Your ABCs Abstract Accurate identification of symptom exaggeration is essential when determining whether or not data obtained in pediatric evaluations are valid or interpretable. Apart from using freestanding performance validity tests (PVTs), many researchers encourage use of embedded measures of test-related motivation, including the newly developed automatized sequences test (AST). Such embedded measures are based on identification of performance patterns that are implausible if the test taker is investing full effort; however, it is unclear whether or not persons with pre-existing cognitive difficulties such as specific learning disabilities (SLD) might be falsely accused of poor test motivation due to actual but impaired learning of basic sequences. This study examined the specificity of the AST by reviewing performance of 83 SLD adolescents. Anywhere from 22 to 41% of SLD adolescents investing good effort failed one or more of the tasks included in the AST, and those with lower intelligence scores had higher rates of failure. Clinicians should therefore be cautious if using this PVT with individuals who have a documented history of reading, learning, or intellectual problems.

Detecting Invalid Performance in Youth with Traumatic Brain Injury Using the Child and Adolescent Memory Profile (ChAMP) Lists Subtest Abstract Background Neuropsychological assessment must include determinants of validity. This study sought to develop an embedded performance validity indicator for the Child and Adolescent Memory Profile (ChAMP) Lists verbal memory subtest. Methods Children and adolescents (N = 103; mean age = 14.6 years, SD = 2.4, range = 8–18) who were on average 25 weeks (SD = 15.1) post-traumatic brain injury (TBI; 85% mild and 15% moderate-severe) were administered ChAMP Lists and two stand-alone performance validity tests (PVTs; Test of Memory Malingering; Medical Symptom Validity Test). Nineteen patients were deemed to have invalid performance defined as failure on both PVTs. Binary logistic regression and classification statistics were used to determine a cutoff score for invalid performance on ChAMP Lists using failure on two PVTs as the criterion. Results Invalid performance was not associated with demographics, injury type, or time since injury, but was significantly correlated with ChAMP Lists scaled scores. Only ChAMP Lists Recognition predicted validity grouping and had excellent discrimination (area under the curve of 93%). A cutoff scaled score of 7 or less on ChAMP Lists Recognition achieved sensitivity for invalid performance at 79% while maintaining specificity at 91%. A more stringent cutoff score of 5 or less on ChAMP Lists Recognition achieved sensitivity for invalid performance at 63% with specificity at 95%. Conclusion This study yields a promising embedded performance validity indicator for ChAMP Lists Recognition with good sensitivity and excellent specificity for detecting invalid performance in youth with TBI.

Why Children Fail the Test of Memory Malingering: Review of False Positive Performance in Pediatric Studies Abstract Rationale The Test of Memory Malingering (TOMM) is a commonly utilized performance validity test currently recommended for pediatric use with children as young as 5 years of age. Yet, a small sample of children struggles to pass the TOMM due to true cognitive difficulties. The systematic search and review identified the reported cases of false positive and overall failing TOMM performance in children. The goal of this project was to increase the understanding of the cognitive constructs and minimum cognitive abilities necessary for children to pass the TOMM. The secondary goal was to use the existing data to suggest clinical guidelines related to use of the TOMM with children. Methods and Results A comprehensive search of PubMed/MEDLINE, EMBASE, Web of Science, and PsycINFO was conducted, returning an initial 12,052 results. After duplicate articles were removed, 10,583 remained; 61 were evaluated for eligibility and 22 were included as our final sample. Results suggested that false positives were observed in children with low IQ, memory issues, complex medical presentation, and younger children. Conclusions Without relevant, quality validation and normative studies, the TOMM should not be used clinically with young children or children suspected of having significant cognitive issues. Failing performance on the TOMM does not necessarily indicate poor effort or invalidate the neuropsychological profile. Instead, it may be reflective of other factors, particularly in children below age 6, children with lower intellectual abilities (especially FSIQ ≤ 75), children with multiple diagnoses, or children with more severe neurological diagnoses. Clinical recommendations are also discussed.

The Rey-Osterrieth Complex Figure: a Useful Measure of Organizational Skills for Adolescents with ADHD? Abstract Deficits in organization, time management, and planning (OTMP) abilities are common in adolescents with attention-deficit/hyperactivity disorder (ADHD) and contribute to impairment. Assessment of these skills is vital, but few measures have been validated for youth with ADHD. The Rey-Osterrieth Complex Figure (ROCF) task is frequently used in research and clinical settings despite limited validity evidence. The present study evaluated whether ROCF performance, as scored via the Boston Qualitative Scoring System, exhibited validity as a measure of OTMP skills in a large (N = 285) sample of adolescents comprehensively diagnosed with ADHD. ROCF performance exhibited minimal associations with measures of OTMP, executive functioning, or aspects of academic impairment affected by OTMP abilities; all correlations were nonsignificant after accounting for the influence of intelligence. Further, ROCF task performance did not differ by ADHD presentation or medication status. Correlations with other variables that may be confounded with ROCF performance (anxiety symptoms, depressive symptoms, parent education) also demonstrated nonsignificant correlations with all BQSS scores. The ROCF may not adequately capture OTMP abilities of adolescents with ADHD; future directions for the assessment of OTMP skills are discussed.

Spinal myoclonus following neuraxial anesthesia: a literature review

Abstract

Spinal myoclonus (SM) is a rare neurologic movement disorder following neuraxial anesthesia (NA). SM following NA (SM-NA) has insufficient clinical information and its pathogenesis remains to be elucidated. The aim of this review article was to summarize the past cases and consider SM-NA pathophysiology. Based on our PubMed search, it was revealed that SM-NA develops within several hours after neuraxial local anesthetic (LA) administration and resolves in a day without leaving neurologic compilations. It occurs primarily in the lower extremities, but can sometimes spread upward and affect the upper extremities and trunk. Although statistical adjustments are indispensable, analysis of the previous cases provided important facts that seem to be related with the mechanism of SM-NA. The frequently used LAs for spinal anesthesia were hyperbaric. SM-NA occurrence was more frequent in women. After initiation of spinal anesthesia, intrathecal hyperbaric LA distributes cephalad. In the LA elimination process, the large concentration differences in intrathecal LA may induce the partially functioning spinal neurons, resulting in myoclonus generation. The morphological features of the lumbar spine in women can predispose to a higher LA concentration difference. SM-NA is an unpredictable and rare neural complication following NA and should be confirmed by basic experiments and large-scale researches.

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