Selective dorsal rhizotomy in non-ambulant children with cerebral palsy: a multi-center prospective study.

Purpose: Assess the effects of selective dorsal rhizotomy (SDR) on motor function and quality of life in children with a Gross Motor Function Classification System (GMFCS) level of IV or V (non-ambulatory).

Methods: This is a prospective, observational study in three tertiary neurosurgery units in England, UK, performing SDR on children aged 3-18 with spastic diplegic cerebral palsy, and a GMFCS level of IV or V, between 2012 and 2019. The primary outcome measure was the change in the 66-item Gross Motor Function Measure (GMFM-66) from baseline to 24 months after SDR, using a linear mixed effects model.

Molecular Genetics and Targeted Therapies for Paediatric High-grade Glioma.

Brain tumours are the leading cause of paediatric cancer-associated death worldwide. High-grade glioma (HGG) represents a main cause of paediatric brain tumours and is associated with poor prognosis despite surgical and chemoradiotherapeutic advances. The molecular genetics of paediatric HGG (pHGG) are distinct from those in adults, and therefore, adult clinical trial data cannot be extrapolated to children.

Cytokine-based Cancer Immunotherapy: Challenges and Opportunities for IL-10.

Cancer immunotherapy is an evolving field of research. Cytokines have been conceptualized as an anticancer therapy for longer than most other cancer immunotherapy modalities. Yet, to date, only two cytokines are FDA-approved: IFN-α and IL-2.

The effect of GMFCS level, age, sex, and dystonia on multi-dimensional outcomes after selective dorsal rhizotomy: prospective observational study.

Purpose: Investigate the effect of age category (1-9 years vs 10-18 years), sex, Gross Motor Function Classification System (GMFCS) level, and presence of dystonia on changes in eight function test parameters 24 months after selective dorsal rhizotomy (SDR).

Methods: Prospective, single-center study of all children aged 3-18 years with bilateral cerebral palsy with spasticity who underwent SDR at a tertiary pediatric neurosurgery center between 2012 and 2019. A linear mixed effects model was used to assess longitudinal changes.

Soluble antigens in plasma allow mismatched transfusion without hemolysis.

Background: Universal plasma is a scarce resource when a massive transfusion protocol has been initiated. Previous studies have reported success using group A plasma in place of the universal plasma, group AB. It is unclear why there are not more reports of hemolytic reactions occurring from this practice.

Right Middle Lobe Collapse and Pleural Effusion in an 18-Year-Old Man.

An 18-year-old African American male subject presented to an acute care clinic with 3 days of productive cough, chills, pleuritic right chest pain, sore throat with hoarseness, congestion, and intermittent shortness of breath. He recently relocated to Texas from Georgia to undergo basic military training. He denied any other recent travel or contact with persons with pulmonary TB or other respiratory illnesses.

Bilateral Malar Reconstruction Using Patient-Specific Polyether Ether Ketone Implants in Treacher-Collins Syndrome Patients With Absent Zygomas.

The authors performed bilateral malar reconstruction using polyether ether ketone implants in 3 patients with Treacher-Collins syndrome with absent, as opposed to hypoplastic, zygomata. These patient-specific implants were fabricated using computed-aided design software reformatted from three-dimensional bony preoperative computed tomography images. The first time the authors performed this procedure the implant compressed the globe resulting in temporary anisocoria that was quickly recognized intraoperatively.

The Frequency of Truly Unknown/Undetermined Deaths: A Review of 452 Cases Over a 5-Year Period.

The forensic autopsy is often regarded as the final medical diagnosis and expert scientific opinion in matters of death investigation, usually in the legal setting, and sometimes in the clinical setting as well. There are however limitations to what the autopsy can answer, and sometimes the circumstances surrounding a death, despite our best efforts, are simply unable to be determined. Approximately 5% of cases reportedly remain unknown after a complete autopsy.

Optimizing Transfusion Ratios in Massive Transfusion Protocols: An Argument Against the 1:1:1 Dogma and Approach to Trauma Resuscitation.

We believe that the current practice of transfusing red blood cells (RBCs), plasma, and platelets in a 1:1:1 ratio is not optimal in massive transfusion protocols (MTPs) and is based on a simple yet profound misconception regarding the preparation of component blood products. This 1:1:1 approach ignores the additional fluids added for anticoagulation and preservation of the components and assumes that there is a one-size-fits-all ratio that must be used across all types of trauma. In this article, we explain the rationale behind our conclusion with supporting figures and suggest that although the 1:1:1 ratio might be within the range of hemostasis, it falls near the lower cusp of hemostasis, making it less than ideal.

Utility of reflexive gomori methenamine silver and Acid-fast bacillus staining on bronchoalveolar lavage specimens.

Objective: Reflexive testing of bronchoalveolar lavage (BAL) specimens with Gomori methenamine silver (GMS) and acid-fast bacillus (AFB) stains is not routinely performed by most institutions. Instead, these stains are usually ordered to evaluate for the presence of fungal elements and/or acid-fast organisms if initial histopathologic assessment suggests the presence of these pathogens. Our institution, however, performs these stains on all BAL specimens.

Anti-c (Little c) IgM: An Uncommonly Observed but Expected Phenomenon.

The c-antigen (little c) is part of the Rh blood group system and is found in approximately 80% of the United States population. Anti-c antibody develops in individuals sensitized through previous exposure and is associated with acute and delayed hemolytic transfusion reactions as well as hemolytic disease of the newborn (HDN). Most antibodies produced against Rh antigens are of the immunoglobulin (Ig) G type.

An information-theoretic approach to motor action decoding with a reconfigurable parallel architecture.

Methods for decoding movements from neural spike counts using adaptive filters often rely on minimizing the mean-squared error. However, for non-Gaussian distribution of errors, this approach is not optimal for performance. Therefore, rather than using probabilistic modeling, we propose an alternate non-parametric approach.

Incidence and epidemiology of cervical radiculopathy in the United States military: 2000 to 2009.

Study Design: Epidemiological review of a prospectively collected military database.

Objective: This investigation sought to determine the incidence of cervical radiculopathy and risk factors for its development within the population of the United States military from 2000 to 2009.

Summary Of Background Data: Currently, the epidemiology of cervical radiculopathy remains poorly understood and risk factors for its development have not been reliably defined.

Ultrahigh-birefringent squeezed lattice photonic crystal fiber with rotated elliptical air holes.

We report an experimental realization of a highly birefringent photonic crystal fiber as a result of compressing a regular hexagonal structure. The experimental measurements estimate a group birefringence of approximately 5.5x10(-3) at 1550 nm in good agreement with the numerical results.

Limitations of parallel global optimization for large-scale human movement problems.

Global optimization algorithms (e.g., simulated annealing, genetic, and particle swarm) have been gaining popularity in biomechanics research, in part due to advances in parallel computing.

Metallic mode confinement in microstructured fibres.

We report the first long, uniform, optical fibers in which visible light is guided in a single mode by metallic reflection. We describe the fabrication, experiment and characterization of these metallic optical fibers and compare them with theoretical calculations.