Association of retinal atrophy with cortical lesions and leptomeningeal enhancement in multiple sclerosis on 7T MRI.

Background: Retinal atrophy in multiple sclerosis (MS) as measured by optical coherence tomography (OCT) correlates with demyelinating lesions and brain atrophy, but its relationship with cortical lesions (CLs) and meningeal inflammation is not well known.

Objectives: To evaluate the relationship of retinal layer atrophy with leptomeningeal enhancement (LME) and CLs in MS as visualized on 7 Tesla (7T) magnetic resonance imaging (MRI).

Methods: Forty participants with MS underwent 7T MRI of the brain and OCT.

Developing a standardized list of entomological collection methods for use in databases.

The current natural history specimen databasing paradigm focuses on standardizing occurrence data: where and when a specimen was collected. In order to gather more information about a particular species, researchers also must know how to encounter, and possibly collect, the species. For entomological specimens, collection method terminology written on labels has not been standardized, and perhaps should not be; however, use of a broad-scale collection method framework may aid in communication among researchers especially within the context of public databases.

Individualized atrophy scores predict dementia onset in familial frontotemporal lobar degeneration.

Introduction: Some models of therapy for neurodegenerative diseases envision starting treatment before symptoms develop. Demonstrating that such treatments are effective requires accurate knowledge of when symptoms would have started without treatment. Familial frontotemporal lobar degeneration offers a unique opportunity to develop predictors of symptom onset.

Mechanical Model of Dexterous Continuum Manipulators with Compliant Joints and Tendon/External Force Interactions.

Dexterous continuum manipulators (DCMs) have been widely adopted for minimally- and less-invasive surgery. During the operation, these DCMs interact with surrounding anatomy actively or passively. The interaction force will inevitably affect the tip position and shape of DCMs, leading to potentially inaccurate control near critical anatomy.

Surgical options after Fontan failure.

Objective: The objective of this European multicenter study was to report surgical outcomes of Fontan takedown, Fontan conversion and heart transplantation (HTX) for failing Fontan patients in terms of all-cause mortality and (re-)HTX.

Methods: A retrospective international study was conducted by the European Congenital Heart Surgeons Association among 22 member centres. Outcome of surgery to address failing Fontan was collected in 225 patients among which were patients with Fontan takedown (n=38; 17%), Fontan conversion (n=137; 61%) or HTX (n=50; 22%).

Cohort for Tuberculosis Research by the Indo-US Medical Partnership (CTRIUMPH): protocol for a multicentric prospective observational study.

Introduction: Tuberculosis disease (TB) remains an important global health threat. An evidence-based response, tailored to local disease epidemiology in high-burden countries, is key to controlling the global TB epidemic. Reliable surrogate biomarkers that predict key active disease and latent TB infection outcomes are vital to advancing clinical research necessary to 'End TB'.

Effectiveness of a pay-for-performance intervention to improve maternal and child health services in Afghanistan: a cluster-randomized trial.

Background: A cluster randomized trial of a pay-for-performance (P4P) scheme was implemented in Afghanistan to test whether P4P could improve maternal and child (MCH) services.

Methods: All 442 primary care facilities in 11 provinces were matched by type of facility and outpatient volume, and randomly assigned to the P4P or comparison arm. P4P facilities were given bonus payments based on the MCH services provided.

Use of a Cumulative Risk Scale to Predict Poor Intellectual and Academic Outcomes in Childhood Epilepsy.

Discrete risk factors for poor outcomes in childhood epilepsy have been identified, but it is unclear whether the combined effect of several risk factors better predicts outcome. The Epilepsy Cumulative Risk Scale was developed to quantify cumulative risk for poor outcomes in childhood epilepsy. Participants included 156 clinic-referred children with epilepsy.

Variation of bilateral transverse ligament tubercles with age and gender in a large series of subjects on multidetector computed tomography.

Background: The transverse ligament tubercles play an important role in maintaining the stability of upper cervical spine, but the variation of these tubercles with aging has not been studied systematically.

Purpose: To evaluate the variation of the height of the transverse ligament tubercles with respect to age and gender, and assess side-to-side differences on multidetector computed tomography (MDCT).

Material And Methods: A consecutive series of 291 Chinese patients undergoing a head or neck MDCT were divided into eight age groups.

Risk Factors for Attention and Behavioral Issues in Pediatric Sickle Cell Disease.

Background: Children with sickle cell disease have an increased risk of neurodevelopmental disorders such as attention deficit hyperactivity disorder, intellectual disability, and specific learning disabilities. Little research has been done to characterize the sickle cell disease-related characteristics associated with neurodevelopmental disorders in the sickle cell disease population.

Methods: This study was a retrospective chart review involving the outpatient records of 2 medical centers, Kennedy Krieger Institute and Johns Hopkins Hospital.

Engaging staff to improve quality and safety in an austere medical environment: a case-control study in two Sierra Leonean hospitals.

Quality Problem Or Issue: Inadequate observance of basic processes in patient care such as patient monitoring and documentation practices are potential impediments to the timely diagnoses and management of patients. These gaps exist in low resource settings such as Sierra Leone and can be attributed to a myriad of factors such as workforce and technology deficiencies.

Initial Assessment: In the study site, only 12.

Diagnosis and treatment of cancer using genomics.

The field of cancer diagnostics is in constant flux as a result of the rapid discovery of new genes associated with cancer, improvements in laboratory techniques for identifying disease causing events, and novel analytic methods that enable the integration of many different types of data. These advances have helped in the identification of novel, informative biomarkers. As more whole genome sequence data are generated and analyzed, emerging information on the baseline variability of the human genome has shown the importance of the ancestral genomic background in patients with a potential disease causing variant.

Research design considerations for chronic pain prevention clinical trials: IMMPACT recommendations.

Although certain risk factors can identify individuals who are most likely to develop chronic pain, few interventions to prevent chronic pain have been identified. To facilitate the identification of preventive interventions, an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain. We present general design considerations for prevention trials in populations that are at relatively high risk for developing chronic pain.

Safety and postoperative adverse events in pediatric otologic surgery: analysis of American College of Surgeons NSQIP-P 30-Day outcomes.

Objectives: Describe safety and postoperative sequelae of pediatric otologic surgery and identify predictive factors for postoperative events.

Study Design: Retrospective cohort study of the American College of Surgeons National Surgery Quality Improvement Program-Pediatric (NSQIP-P) database.

Setting: Data pooled from the 2012 NSQIP-P public use file (50 institutions).

Improving the sensitivity of the Xpert MTB/RIF assay on sputum pellets by decreasing the amount of added sample reagent: a laboratory and clinical evaluation.

The Xpert MTB/RIF (Xpert) assay permits rapid near-patient detection of Mycobacterium tuberculosis in sputum; however, the test sensitivity remains suboptimal in paucibacillary specimens that are negative for acid-fast bacilli using smear microscopy. Xpert testing includes dilution with sample reagent, and when processed sputum pellets are tested, the recommended sample reagent/pellet ratio is 3:1. We evaluated whether a decreased sample reagent/pellet ratio of 2:1 increased Xpert sensitivity compared to the recommended 3:1.

Zebrafish as a model for apolipoprotein biology: comprehensive expression analysis and a role for ApoA-IV in regulating food intake.

Improved understanding of lipoproteins, particles that transport lipids throughout the circulation, is vital to developing new treatments for the dyslipidemias associated with metabolic syndrome. Apolipoproteins are a key component of lipoproteins. Apolipoproteins are proteins that structure lipoproteins and regulate lipid metabolism through control of cellular lipid exchange.

Racial-Ethnic Differences in Parental Body Image Perceptions of Preschoolers: Implications for Engaging Minority Parents in Weight-Related Discussions.

Parental misperception of minority preschoolers’ body image remains a major barrier to obesity prevention. Differences in child body image perception between Latino and African-American parents may inform etiologies to obesity disparities. Using pooled data from studies implementing validated child body sketches, frequency of parental misperception in these two populations are analyzed and associations with provider commentary and parental acculturation reported.

Spatial and Temporal Control Contribute to Step Length Asymmetry During Split-Belt Adaptation and Hemiparetic Gait.

Background: Step length asymmetry (SLA) is a common hallmark of gait poststroke. Though conventionally viewed as a spatial deficit, SLA can result from differences in where the feet are placed relative to the body (step position strategy), the timing between foot strikes (step time strategy), or the velocity of the body relative to the feet (step velocity strategy).

Objective: The goal of this study was to characterize the relative contributions of each of these strategies to SLA.

Geography, Race/Ethnicity, and Obesity Among Men in the United States.

The prevalence of obesity in the United States has increased significantly and is a particular concern for minority men. Studies focused at the community and national levels have reported that geography can play a substantial role in contributing to obesity, but little is known about how regional influences contribute to obesity among men. The objective of this study is to examine the association between geographic region and obesity among men in the United States and to determine if there are racial/ethnic differences in obesity within these geographic regions.

Acute upregulation of hedgehog signaling in mice causes differential effects on cranial morphology.

Hedgehog (HH) signaling, and particularly signaling by sonic hedgehog (SHH), is implicated in several essential activities during morphogenesis, and its misexpression causes a number of developmental disorders in humans. In particular, a reduced mitogenic response of cerebellar granule cell precursors to SHH signaling in a mouse model for Down syndrome (DS), Ts65Dn, is substantially responsible for reduced cerebellar size. A single treatment of newborn trisomic mice with an agonist of the SHH pathway (SAG) normalizes cerebellar morphology and restores some cognitive deficits, suggesting a possible therapeutic application of SAG for treating the cognitive impairments of DS.

Evaluation of hypoallergenicity of a new, amino acid-based formula.

Unlabelled: The American Academy of Pediatrics (AAP) defined a formula as hypoallergenic if it ensures with 95% confidence that 90% of infants with confirmed cow's milk allergy (CMA) will not react with defined symptoms under double-blind, placebo-controlled conditions. This study's objective was to determine whether a new amino acid-based formula (AAF) meets the AAP hypoallergenicity criteria.

Methods: Children with CMA were randomized to double-blind placebo-controlled food challenges (DBPCFC) with a new AAF and a commercial AAF in crossover fashion followed by an at-home open challenge with the new AAF.

Disparities in identification of comorbid diagnoses in children with ADHD.

Aims: This study explores disparities in identification of educationally relevant comorbidities and medication prescribing practices for children with attention-deficit hyperactivity disorder (ADHD) and either comprehensive neurodevelopmental evaluations or evaluations limited by insurance to behavior management with medication.

Methods: This study was a retrospective chart review of 5- to 10-year-old children with ADHD diagnosed at the initial evaluation. Data collected included demographics, rates of comorbid conditions, medication management, and educational interventions.

Effects of specified performance criterion and performance feedback on staff behavior: a component analysis.

The present study isolated the effects of frequently used staff training intervention components to increase communication between direct care staff and clinicians working on an inpatient behavioral unit. Written "protocol review" quizzes developed by clinicians were designed to assess knowledge about a patient's behavioral protocols. Direct care staff completed these at the beginning of each day and evening shift.

Research designs for proof-of-concept chronic pain clinical trials: IMMPACT recommendations.

Proof-of-concept (POC) clinical trials play an important role in developing novel treatments and determining whether existing treatments may be efficacious in broader populations of patients. The goal of most POC trials is to determine whether a treatment is likely to be efficacious for a given indication and thus whether it is worth investing the financial resources and participant exposure necessary for a confirmatory trial of that intervention. A challenge in designing POC trials is obtaining sufficient information to make this important go/no-go decision in a cost-effective manner.