Role of simulation-based training and assessment to improve brachytherapy competency among radiation oncology residents.

Simulation is a technique used in healthcare to replicate clinical scenarios and improve patient safety, efficacy, and efficiency. Simulation-based medical education facilitates training and assessment in healthcare without increasing risk to patients, supported by ample evidence from surgical/procedural specialties. Simulation in radiation oncology has been leveraged to an extent, with successful examples of both screen-based and hands-on simulators that have improved confidence and performance in trainees.

Single-cell-resolution transcriptome map of human, chimpanzee, bonobo, and macaque brains.

Identification of gene expression traits unique to the human brain sheds light on the molecular mechanisms underlying human evolution. Here, we searched for uniquely human gene expression traits by analyzing 422 brain samples from humans, chimpanzees, bonobos, and macaques representing 33 anatomical regions, as well as 88,047 cell nuclei composing three of these regions. Among 33 regions, cerebral cortex areas, hypothalamus, and cerebellar gray and white matter evolved rapidly in humans.

Musculoskeletal Simulation Tools for Understanding Mechanisms of Lower-Limb Sports Injuries.

Musculoskeletal simulation and dynamic modeling programs have been used to gain insight into lower-limb musculoskeletal injury mechanisms. In addition to the temporospatial, kinematic, and kinetic data obtained from motion analysis systems, musculoskeletal simulation programs also can provide information on joint contact and muscle forces, musculotendinous lengths and velocities, and muscle activation levels. Musculoskeletal simulation platforms may help in the assessment of risk factors for sports-related injuries.

Effects of special exercise programs on functional movement screen scores and injury prevention in preprofessional young football players.

To increase movement capacity and to reduce injury risk in young soccer players by implementing a special functional exercise program based on functional movement screen (FMS) and correctives. 67 young male athletes 14-19 years of age from a Super League Football Club Academy participated in the study. Functional movement patterns were evaluated with FMS assessment protocol.

Chitosan coatings with enhanced biostability in vivo.

In this article, we study the stability of chitosan coatings applied on glutaraldehyde-stabilized bovine pericardium when exposed to biodegradation in vivo in the course of model subcutaneous tests on rats. The coatings were deposited from carbonic acid solutions, that is, H O saturated with CO at high pressure. Histological sections of treated pericardium samples demonstrated that the structure of pericardial connective tissues was not significantly altered by the coating application method.

Formation of Easy-to-Recover Polystyrene--Poly(4-vinylpyridine) Micelles Decorated with Pd Nanoparticles in Solutions of Self-Neutralizing Carbonic Acid.

It was found out that block copolymers of polystyrene and poly(4-vinylpyridine) with comparable lengths of blocks could be dissolved in a high-pressure reactor containing water phase saturated with carbon dioxide under high pressure at room temperature. This rather effective dissolution occurs due to a protonation of P4VP nitrogen-containing groups together with a plasticization of the polymer material to be dissolved by a compressed dense CO being contained in the autoclave. The selected block copolymers form rather monodispersed micelles with well-defined and reproducible spherical geometry.

Fluid filtration and reabsorption across microvascular walls: control by oncotic or osmotic pressure? (secondary publication).

Aim: Relationships between hydrostatic and oncotic (colloid osmotic) pressures in both capillaries and interstitium are used to explain fluid filtration and reabsorption across microvascular walls. These pressures are incorporated in the Starling oncotic hypothesis of capillaries which fails, however, to explain fluid homeostasis when hydrostatic capillary pressure is high (in feet during orthostasis) and low (in lungs), or when oncotic plasma pressure is significantly decreased in experiments and some clinical states such as genetic analbuminaemia.

Methods: To explain fluid homeostasis we propose osmotic counterpressure hypothesis of capillaries which claims: 1) during water filtration across microvascular wall in arterial capillary, the plasma osmolytes are sieved (retained) so that plasma osmotic counterpressure is generated, 2) this osmotic counterpressure rises along the length of capillary and when it reaches capillary hydrostatic pressure the water filtration is halted, and 3) in venous capillaries and postcapillary venules where hydrostatic pressure is low, the osmotic counterpressure is instrumental in water reabsorption from interstitium what leads to dissipation of osmotic counterpressure.

The African variant of BKV in a Turkish renal transplant patient.

In renal transplant recipients, BK polyomavirus (BKV) is linked to nephropathy. BK virus genotypes have a strong geographic component. This paper presents the African variant of BKV in a Turkish renal transplant patient, which is a rare cause of infection in the Northern Hemisphere and, to our knowledge, the first case from Turkey.

Recent insights into a new hydrodynamics of the cerebrospinal fluid.

According to the traditional hypothesis, the cerebrospinal fluid (CSF) is secreted inside the brain ventricles and flows unidirectionally along subarachnoid spaces to be absorbed into venous sinuses across arachnoid villi and/or via paraneural sheaths of nerves into lymphatics. However, according to recent investigations, it appears that interstitial fluid (ISF) and CSF are formed by water filtration across the walls of arterial capillaries in the central nervous system (CNS), while plasma osmolytes are sieved (retained) so that capillary osmotic counterpressure is generated, which is instrumental in ISF/CSF water absorption into venous capillaries and postcapillary venules. This hypothesis is supported by experiments showing that water, which constitutes 99% of CSF and ISF bulk, does not flow along CSF spaces since it is rapidly absorbed into adjacent CNS microvessels, while distribution of other substances along CSF spaces depends on the rate of their removal into microvessels: faster removal means more limited distribution.

New experimental model of acute aqueductal blockage in cats: effects on cerebrospinal fluid pressure and the size of brain ventricles.

It is generally assumed that cerebrospinal fluid (CSF) is secreted in the brain ventricles, and so after an acute blockage of the aqueduct of Sylvius an increase in the ventricular CSF pressure and dilation of isolated ventricles may be expected. We have tested this hypothesis in cats. After blocking the aqueduct, we measured the CSF pressure in both isolated ventricles and the cisterna magna, and performed radiographic monitoring of the cross-sectional area of the lateral ventricle.

Dynamics of distribution of 3H-inulin between the cerebrospinal fluid compartments.

Since the distribution of substances between various cerebrospinal fluid (CSF) compartments is poorly understood, we studied (3)H-inulin distribution, over time, after its injection into cisterna magna (CM) or lateral ventricle (LV) or cisterna corporis callosi (CCC) in dogs. After the injection into CM (3)H-inulin was well distributed to cisterna basalis (CB), lumbar (LSS) and cortical (CSS) subarachnoid spaces and less distributed to LV. When injected in LV (3)H-inulin was well distributed to all CSF compartments.

Serial culture of murine primary airway epithelial cells and ex vivo replication of human rhinoviruses.

Human rhinoviruses (HRV) are the primary etiological agents in cold infections, and represent a serious risk to individuals with chronic respiratory disease such as asthma. In order to develop treatment options for HRV infections, murine models are a crucial component in the study of infection mechanisms due to the wide array of reagents and techniques available to study murine immunology. We present here a cell culture system for studying isolated murine epithelial cell responses to HRV.

Transventricular and transpial absorption of cerebrospinal fluid into cerebral microvessels.

It is generally accepted that volume of cerebrospinal fluid (CSF) is secreted in brain ventricles and flows to subarachnoid space to be absorbed into dural venous sinuses or/and into lymphatics via perineural sheats of cranial nerves. Since 99% of CSF volume is water, in experiments on cats 3H-water was slowly infused into lateral ventricle and found that it does not flow to subarachnoid space but that it is rapidly absorbed transventricularly into periventricular capillaries. When 3H-water was infused in cortical subarachnoid space, it was absorbed locally into cerebral capillaries via pia mater.

Effect of head position on cerebrospinal fluid pressure in cats: comparison with artificial model.

Aim: To demonstrate that changes in the cerebrospinal fluid (CSF) pressure in the cranial cavity and spinal canal after head elevation from the horizontal level occur primarily due to the biophysical characteristics of the CSF system, ie, distensibility of the spinal dura.

Methods: Experiments in vivo were performed on cats and a new artificial model of the CSF system with dimensions similar to the CSF system in cats, consisting of non-distensible cranial and distensible spinal part. Measurements of the CSF pressure in the cranial and spinal spaces were performed in chloralose-anesthetized cats (n = 10) in the horizontal position on the base of a stereotaxic apparatus (reference zero point) and in the position in which the head was elevated to 5 cm and 10 cm above that horizontal position.

The investigation of cerebrospinal fluid formation by ventriculo-aqueductal perfusion method in cats.

Objectives: The perfusion of cerebrospinal fluid (CSF) spaces by artificial CSF (aCSF) containing an indicator, is an indirect method used to calculate CSF formation. To evaluate this method, we have developed a ventriculo-aqueductal perfusion method, which enables a direct measurement of CSF formation in the ventricles.

Methods: In chloralose anaesthetized cats, the aqueduct of Sylvius was cannulated so that the outflow end of the plastic cannula was positioned extracranially.

Spinal contribution to CSF pressure lowering effect of mannitol in cats.

Objectives: After application of hyperosmolar mannitol the cerebrospinal (CSF) pressure is usually lowered within 30 min but this effect cannot be explained either by changes in intracranial blood volume and flow or by changes in brain volume. We assume that this effect of mannitol my be consequence of CSF volume decrease primarily in the spinal CSF due to high compliance of the spinal dura.

Methods: To explore such a possibility we planned to separate spinal and cerebral CSF.

Elimination of phenolsulfonphthalein from the cerebrospinal fluid via capillaries in central nervous system in cats by active transport.

It was recently proposed that organic anions, such as cerebral acidic metabolites and phenolsulfonphthalein (PSP), are eliminated from cerebrospinal fluid (CSF) by diffusion into the central nervous system (CNS) and further by active transport into capillaries. To test this hypothesis, PSP was injected into cisternal CSF and its distribution into various parts of the CNS was measured 1 and 3 h later in control cats and those pretreated with probenecid, which blocks active transport of organic anions into capillaries. PSP in tissue shows an intensive pink color when exposed to 1 N NaOH.

Homeostatic role of the active transport in elimination of [3H]benzylpenicillin out of the cerebrospinal fluid system.

Cerebral acidic metabolites and penicillin are organic anions which can be carried by active transport into capillaries of the central nervous system (CNS). However, it is generally believed that these metabolites are mainly delivered from CNS to cerebrospinal fluid (CSF) and eliminated by CSF circulation over cortex and its absorption into dural venous sinuses. To test this hypothesis we studied fate of penicillin ([3H]benzylpenicillin) in the CSF under control conditions and when its active transport was blocked by probenecid.

The mechanism of coupling of the organic anion exchange to Na(+)-dicarboxylate symport in basolateral membrane vesicles.

The rates of p-aminohippurate (PAH) and of uric acid uptake by basolateral membrane vesicles isolated from proximal tubules of rat kidney have been investigated. Accumulation of both substrates against the concentration gradient within the vesicles was shown to occur in the presence of alpha-ketoglutarate (alpha-KG) and Na+ gradient in the incubation medium. The mechanism of the coupling between Na(+)-dicarboxylate symport and organic anion transport is discussed based on the differences between the rates of PAH and of uric acid uptake.

Experimental hydrocephalus and hydromyelia: a new insight in mechanism of their development.

One group of cats had an acrylic screw implanted into the adqueduct of Sylvius, while the other group of animals received a solution of kaolin into the cisterna magna. Three weeks later the dye phenolsulphonphthalein was instilled into the lateral ventricle to ascertain communication between CSF compartments, and thereafter the brain was perfused with formalin. As shown by planimetry of brain ventricles both groups of experimental animals developed hydrocephalus, i.

[Monozygotic twins with centrotemporal spikes on the electroencephalogram--differences in clinical manifestations and the effect of valproate therapy].

Monozygotic twin sisters who had almost identical electroencephalographic abnormalities, but different clinical features and different response of this abnormalities to valproate at the age of 6 years are described. One twin was admitted to the hospital because of numerous brief myotonic seizures of sudden onset with corresponding abnormalities in the electroencephalogram. The seizures disappeared completely and the electroencephalogram became normal within a week of treatment with valproate.

Effect of active transport on distribution and concentration gradients of [3H]benzylpenicillin in the cerebrospinal fluid.

After application of [3H]benzylpenicillin ([3H]BP) in lateral brain ventricle in dogs, the distribution of [3H]BP to contralateral ventricle and cisterna magna was much higher when its active transport from cerebrospinal fluid (CSF) was blocked by probenecid than under control conditions. Analysis of [3H]BP concentrations in both lateral ventricles and cisterna magna over time indicates that active transport restricts distribution of substances along CSF spaces and contributes to the maintenance of their concentration gradients between CSF compartments. This suggests that biochemical changes in a part of the brain and the adjacent CSF compartment may not be reflected into remote compartments of CSF such as lumbar CSF if substances in question are removed from CSF by active transport.

Plasma level of dipropylacetamide and dipropylacetic acid and effect of these drugs on 5-hydroxytryptamine metabolism in mouse brain.

After intraperitoneal application of the antiepileptics dipropylacetamide (DPM, 200 mg/kg) and dipropylacetic acid (DPA, 200 mg/kg) in mice their concentration in plasma and their effects on 5-hydroxytryptamine (5-HT) metabolism in the brain were followed during 360 minutes. Peak plasma level of DPA and DPM was observed at 30 minutes, but level of DPM was only about 25% that of DPA. Plasma content of both drugs declined to low levels by 360 minutes.

Effect of valproic acid on 5-hydroxytryptamine turnover in mouse brain.

The effect of the antiepileptic drug valproic acid (di-n-propylacetic acid, 200 mg kg-1) on brain 5-hydroxytryptamine (5-HT) synthesis during monoamine oxidase inhibition by pargyline hydrochloride (120 mg kg-1) was studied in mice. Valproic acid increased 5-HT synthesis and elevated 5-hydroxyindoleacetic acid level in brain indicating that turnover of 5-HT is increased. The possible significance of this effect in relation to anticonvulsant action of valproic acid is discussed.