Challenges faced in establishing a pediatric liver transplant program in a lower-middle-income country with free healthcare service.

Background: Liver transplant is the cure for children with liver failure. Sri Lanka is a lower-middle-income country with a predominant free, state health system. Pediatric liver transplant program in Sri Lanka is still in the budding state where the initial experience of the program is yet to be documented.

A novel structure for online surgical undergraduate teaching during the COVID-19 pandemic.

Background: The Covid-19 pandemic necessitated the delivery of online higher education. Online learning is a novel experience for medical education in Sri Lanka. A novel approach to undergraduate surgical learning was taken up in an attempt to improve the interest amongst the students in clinical practice while maximizing the limited contact time.

Pedestrian wind comfort near a super-tall building with various configurations in an urban-like setting.

Pedestrian wind comfort near a 400 m super-tall building in high and low ambient wind speeds, referred to as Windy and Calm climates, is evaluated by conducting computational fluid dynamics (CFD) simulations. The super-tall building has 15 different configurations and is located at the center of 50 m medium-rise buildings in an urban-like setting. Pedestrian level mean wind speeds near the super-tall building is obtained from three-dimensional (3D), steady-state, Reynolds-Averaged Navier-Stokes (RANS)-based simulations for five incident wind directions ( = 0°, 22.

Integrating twisted wind profiles to Air Ventilation Assessment (AVA): The current status.

Twisted wind flows generated by the complex terrain of Hong Kong induce two types of complication to Air Ventilation Assessment (AVA), first, imposing a false boundary condition on the wind tunnel tests done for AVA and, second, creating an ambiguity in determining the approaching wind direction in calculating the probability of occurrence of winds. The latter issue is partially solved using correction methods in post-analysis of AVA but the accuracy of these methods is not yet accessed. This study employs two twisted wind profiles to test an urban area in a boundary layer wind tunnel to investigate the influence of twisted wind flows on the outcomes of AVA and to estimate the accuracy of three common correction methods: No-Shift, Threshold, and Proportional methods.

New inflow boundary conditions for modeling twisted wind profiles in CFD simulation for evaluating the pedestrian-level wind field near an isolated building.

The hilly topography of Hong Kong influences oncoming winds and gradually changes their wind directions along the profiles' height. The vertical variation in wind directions, or the twist effect, significantly influences the Pedestrian Level Wind (PLW) field in urban areas of Hong Kong, thus it is a topic demanding systematic investigations. In this study, a new set of inflow boundary conditions are proposed to model twisted wind flows in Computational Fluid Dynamic (CFD) simulations.

A wind tunnel study of effects of twisted wind flows on the pedestrian-level wind field in an urban environment.

The influence of twisted wind flows on the pedestrian-level wind (PLW) field of an urban area was evaluated by testing a typical urban site (Tsuen Wan, Hong Kong) in a boundary layer wind tunnel. Four twisted wind profiles with different magnitudes and directions of yaw angles were employed to investigate variations in wind speed with the properties of the twisted wind flows at the pedestrian level. An additional conventional wind profile with similar wind speeds and turbulence intensities to the twisted winds but with zero yaw angles was simulated for comparisons.

Evaluation of pedestrian wind comfort near 'lift-up' buildings with different aspect ratios and central core modifications.

Owing to the void space at lower heights, lift-up buildings have high building permeability at ground level and subsequently improve the air circulation in congested urban areas. Despite this advantage, the lift-up design has been sparsely adopted for buildings in urban areas partly because of the lack of understanding of the combined effects of building dimensions and lift-up design on the surrounding pedestrian level wind (PLW) field. Therefore, this study aims to investigate the influence of lift-up buildings with different aspect ratios (height/width) on the surrounding PLW field and pedestrian wind comfort level.

Homeostatic regulation of the endoneurial microenvironment during development, aging and in response to trauma, disease and toxic insult.

The endoneurial microenvironment, delimited by the endothelium of endoneurial vessels and a multi-layered ensheathing perineurium, is a specialized milieu intérieur within which axons, associated Schwann cells and other resident cells of peripheral nerves function. The endothelium and perineurium restricts as well as regulates exchange of material between the endoneurial microenvironment and the surrounding extracellular space and thus is more appropriately described as a blood-nerve interface (BNI) rather than a blood-nerve barrier (BNB). Input to and output from the endoneurial microenvironment occurs via blood-nerve exchange and convective endoneurial fluid flow driven by a proximo-distal hydrostatic pressure gradient.

The blood-nerve barrier: structure and functional significance.

The blood-nerve barrier (BNB) defines the physiological space within which the axons, Schwann cells, and other associated cells of a peripheral nerve function. The BNB consists of the endoneurial microvessels within the nerve fascicle and the investing perineurium. The restricted permeability of these two barriers protects the endoneurial microenvironment from drastic concentration changes in the vascular and other extracellular spaces.

Evidence of GLP-1-mediated neuroprotection in an animal model of pyridoxine-induced peripheral sensory neuropathy.

Pyridoxine (vitamin B6) intoxicated rodents develop a peripheral neuropathy characterized by sensory nerve conduction deficits associated with disturbances of nerve fiber geometry and axonal atrophy. To investigate the possibility that glucagon-like peptide-1 (7-36)-amide (GLP-1) receptor agonism may influence axonal structure and function through neuroprotection neurotrophic support, effects of GLP-1 and its long acting analog, Exendin-4 (Ex4) treatment on pyridoxine-induced peripheral neuropathy were examined in rats using behavioral and morphometric techniques. GLP-1 is an endogenous insulinotropic peptide secreted from the gut in response to the presence of food.

Schema-based learning of adaptable and flexible prey- catching in anurans II. Learning after lesioning.

The previous companion paper describes the initial (seed) schema architecture that gives rise to the observed prey-catching behavior. In this second paper in the series we describe the fundamental adaptive processes required during learning after lesioning. Following bilateral transections of the hypoglossal nerve, anurans lunge toward mealworms with no accompanying tongue or jaw movement.

Schema-based learning of adaptable and flexible prey-catching in anurans I. The basic architecture.

A motor action often involves the coordination of several motor synergies and requires flexible adjustment of the ongoing execution based on feedback signals. To elucidate the neural mechanisms underlying the construction and selection of motor synergies, we study prey-capture in anurans. Experimental data demonstrate the intricate interaction between different motor synergies, including the interplay of their afferent feedback signals (Weerasuriya 1991; Anderson and Nishikawa 1996).

Pyridoxine-induced toxicity in rats: a stereological quantification of the sensory neuropathy.

Excess ingestion of pyridoxine (vitamin B6) causes a severe sensory neuropathy in humans. The mechanism of action has not been fully elucidated, and studies of pyridoxine neuropathy in experimental animals have yielded disparate results. Pyridoxine intoxication appears to produce a neuropathy characterized by necrosis of dorsal root ganglion (DRG) sensory neurons and degeneration of peripheral and central sensory projections, with large diameter neurons being particularly affected.

GABA receptor-mediated inhibition of reflex deglutition in the cat.

In anesthetized cats, swallowing elicited by electrical stimulation of the superior laryngeal nerves (SLNs) was inhibited by the GABA-mimetic muscimol and by diazepam, an action that was reversed by picrotoxin and bicuculline. This inhibition supports the involvement of GABA receptors, specifically those of the GABAA subtype which both antagonists have been shown to block in various areas of the central nervous system. The inhibition of reflex swallowing and its reversal were unaltered by a transection of the brainstem at a midcollicular level.

Perineurial permeability to sodium during Wallerian degeneration in rat sciatic nerve.

In rat sciatic nerves, the effect of Wallerian degeneration on the rate of transperineurial passage of sodium between the endoneurium and the epineurial extracellular space was investigated. In nerves transected and ligated at the sciatic notch, an in situ technique was used to measure the permeability coefficient-surface area product (PS) of the mid-thigh portion of the perineurium to 22Na. Sampling times ranged from one day to sixteen weeks after the lesion.

Endoneurial blood flow in rat sciatic nerve during development.

1. Endoneurial blood flow (EBF) in the sciatic nerve of rats aged 2-12 weeks was studied using microelectrode H2 polarography. 2.

Responses of medullary neurons to moving visual stimuli in the common toad. I. Characterization of medial reticular neurons by extracellular recording.

The concept of coded 'command releasing systems' proposes that visually specialized descending tectal (and pretectal) neurons converge on motor pattern generating medullary circuits and release--in goal-specific combination--specific action patterns. Extracellular recordings from medullary neurons of the medial reticular formation of the awake immobilized toad in response to moving visual stimuli revealed the following main results. (i) Properties of medullary neurons were distinguished by location, shape, and size of visual receptive fields (ranging from relatively small to wide), by trigger features of various moving configural stimulus objects (including prey- and predator-selective properties), by tactile sensitivity, and by firing pattern characteristics (sluggish, tonic, warming-up, and cyclic).

Developmental changes in blood-nerve transfer of albumin and endoneurial albumin content in rat sciatic nerve.

The rate of entry of albumin into the endoneurial space and its content within that compartment during development were investigated by measuring the permeability coefficient-surface area product to 125I-albumin (PSA) of the blood-nerve interface (BNI), endoneurial residual plasma volume (Vp), blood-nerve interface index to albumin, and endoneurial water content in sciatic nerves of rats ranging in age from 1 to 24 weeks. There was a 30-fold reduction in PSA and a 4-fold decrease in Vp from 2 to 24 weeks, indicating that the endoneurial capillaries and perineurium become less permeable during development. On the other hand, the Alb-BNI index was relatively small at 1 week, increased to a peak value around 6-8 weeks, and then decreased to adult values by 13 weeks.

Physiological changes in the sciatic nerve endoneurium of lead-intoxicated rats: a model of endoneurial homeostasis.

The effects of inorganic lead (Pb) on peripheral nerves were studied by measuring the permeability coefficient-surface area product to albumin (PSA) of the blood-nerve interface (BNI), water and Pb content of endoneurium, and residual endoneurial plasma volume (Vp) of sciatic nerves of adult rats maintained on a 4% Pb diet for 2-12 weeks. Additionally, body weight, haematocrit, and blood Pb levels were also monitored. Within 1 week, both blood and endoneurial Pb levels had increased significantly above background levels and continued to increase up to the 6th week.

Patterns of change in endoneurial capillary permeability and vascular space during nerve regeneration.

In frog sciatic nerve crushed and allowed to regenerate, an in situ perfusion technique was used to measure the permeability coefficient-surface area product (PS) of endoneurial capillaries to [14C]sucrose and endoneurial vascular space (V) at intervals of 3 days to 12 weeks post-crush. Additionally, the amplitude and latency of the compound action potential (CAP) of the regenerating nerve were also monitored. There was a delayed increase of both PS and V which peaked at 2-3 weeks after the crush and then declined.

Blood-nerve transfer of albumin and its implications for the endoneurial microenvironment.

Blood-nerve transfer of plasma albumin was studied by measuring the permeability coefficient-surface area (PS) product of the blood-nerve barrier (BNB) to 125I-albumin in rat sciatic nerve using the i.v. bolus injection method.

Patterns of change in endoneurial capillary permeability and vascular space during Wallerian degeneration.

In degenerating frog sciatic nerves an in situ perfusion technique was used to measure the permeability coefficient-surface area product (PA) of endoneurial capillaries to [14C]sucrose, and the endoneurial vascular space (V). Both PA and V started to increase after the 3rd day of degeneration. The increase in PA peaked around the 14th day of degeneration and then declined to reach near normal levels at 6 weeks post-transection.