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Purpose: The purpose of this study was to survey practitioners’ use and perceptions of psychopathy assessments in Canadian forensic psychiatric settings. Psychopathy assessments are widely used in forensic settings to inform decisions about sentencing, placement, rehabilitation and parole. Recent empirical evidence suggests that the utility of psychopathy assessments might be overestimated, leading to a debate about their legal and ethical justification. However, one shortcoming of these discussions is that they rely heavily on anecdotal evidence about how exactly psychopathy assessments influence forensic decisions, due to a general lack of survey data on field uses. Some data are available in European and American contexts, but little is known about Canadian clinical practice. Design/methodology/approach: To address this shortcoming in the literature, the authors conducted a pilot study of practitioners in forensic psychiatric units in Ontario (N= 18), evaluating their use of psychopathy assessments, reporting habits and their perceptions of psychopathic offenders. Findings: Practitioners reported that they primarily used the Hare Psychopathy Checklist-Revised (PCL-R) as a risk assessment tool, often in combination with other tools. Most clinicians reported using psychopathy assessments infrequently, that there was a low base rate of psychopathic offenders and their attitudes and beliefs about psychopathy were generally consistent with the empirical literature. Originality/value: This pilot study provides novel insights into the use of psychopathy assessments in Canadian forensic psychiatry with the potential to inform current debates.

Sarcomas are rare and heterogeneous malignancies. Owing to their low prevalence and limited capacity to conduct large-scale clinical trials, understanding the molecular mechanisms of sarcomagenesis has become important in determining appropriate treatment. The Cancer Genome Atlas soft tissue sarcoma (STS) project (TCGA-SARC) was the largest and most comprehensive attempt to profile the genomics of multiple STS subtypes. TCGA-SARC made huge contributions to disease understanding. Since the publication of TCGA-SARC, numerous studies have used molecular profiling to assess STS biology. Herein molecular profiling studies in STS are reviewed and future directions with regard to omics profiling in STS research are discussed.

Gait analysis in the pediatric and adult orthopedic patient populations can adjunct the diagnosis and treatment of a multitude of musculoskeletal conditions. Understanding of normal and abnormal gait biomechanics is an important aspect of orthopedic residency; yet, there is great variability in the time residency programs dedicate to gait analysis education. The purpose of this study was to investigate if formal gait analysis education during residency improves an orthopedic resident’s understanding of normal and pathologic gait. Five residency programs consisting of 81 resident subjects were surveyed at the beginning of the 2016–2017 academic year. The residents were divided into those with formal gait analysis education (group A) and those without (group B). Each resident was sent an online survey with 11 questions from former orthopedic in-training exams (OITE) regarding gait pattern analysis. The average number of correct questions was compared between the two groups with Student’s t-test. Fifty-three of the 81 surveys sent out were completed. There were 23 subjects in group A and 30 in group B. All five programs and all postgraduate years (PGYs) were represented (PGY1: 10, PGY2: 12, PGY3: 12, PGY4: 6, PGY5 12). The average score for all residents was 5.6 out of 11 correct (51%). The residents from group A averaged a significantly higher score (6.3) than group B (5.0) (P= 0.017). Understanding gait biomechanics is a critical skill for orthopedic surgeons, and residency training often lacks sufficient training in their curriculum. A good understanding of gait analysis allows orthopedic surgeons to analyze gait disturbances and develop patient-specific treatment plans in adult and pediatric populations. This study found improved knowledge of gait patterns amongst orthopedic residents with formal education. Even though the residents with formal education fared better than their counterparts, the overall percent correct was still low (51%). Evidence: Level 3: Prospective Cohort Study.

Experimental in vitro models that capture pathophysiological characteristics of human tumours are essential for basic and translational cancer biology. Here, we describe a fully synthetic hydrogel extracellular matrix designed to elicit key phenotypic traits of the pancreatic environment in culture. To enable the growth of normal and cancerous pancreatic organoids from genetically engineered murine models and human patients, essential adhesive cues were empirically defined and replicated in the hydrogel scaffold, revealing a functional role of laminin–integrin α3/α6signalling in establishment and survival of pancreatic organoids. Altered tissue stiffness—a hallmark of pancreatic cancer—was recapitulated in culture by adjusting the hydrogel properties to engage mechano-sensing pathways and alter organoid growth. Pancreatic stromal cells were readily incorporated into the hydrogels and replicated phenotypic traits characteristic of the tumour environment in vivo. This model therefore recapitulates a pathologically remodelled tumour microenvironment for studies of normal and pancreatic cancer cells in vitro.

ABSTRACTIntroduction: The ubiquitously expressed 37 kDa/67 kDa high-affinity laminin receptor (laminin receptor precursor/laminin receptor, LRP/LR) is a protein found to play several roles within cells. The receptor is located in the nucleus, cytosol and the cell surface. LRP/LR mediates cell proliferation, cell adhesion and cell differentiation. As a result, it is seen to enhance tumor angiogenesis as well as invasion and adhesion, key steps in the metastatic cascade of cancer. Recent findings have shown that LRP/LR is involved in the maintenance of cell viability through apoptotic evasion, allowing for tumor progression. Thus, several patented therapeutic approaches targeting the receptor for the prevention and treatment of cancer have emerged.Areas covered: The several roles that LRP/LR plays in cancer progression as well as an overview of the current therapeutic patented strategies targeting LRP/LR and cancer to date.Expert opinion: Small molecule inhibitors, monoclonal antibodies and small interfering RNAs might act used as powerful tools in preventing tumor angiogenesis and metastasis through the induction of apoptosis and telomere erosion in several cancers. This review offers an overview of the roles played by LRP/LR in cancer progression, while providing novel patented approaches targeting the receptor as potential therapeutic routes for the treatment of cancer as well as various other diseases.

Urinary tract dilatation is commonly identified on antenatal ultrasound. It represents a wide range of aetiologies including obstructive uropathy. Antenatal diagnosis and a consistent, evidenced based approach to follow up is essential in reducing neonatal morbidity and mortality. We present a summary of the current literature and a practical guide to the management of obstructive uropathy, including the normal sonographic features of the developing fetal urinary tract, antenatal diagnostic criteria and the approach to postnatal investigation and management.

East of Sri Lanka, in the northern Indian Ocean, a cold dome, known as the Sri Lanka Dome (SLD), develops during southwest monsoon season (June–September). The SLD first forms around May, matures in July, and decays around September, in association with the strong cyclonic wind stress curl. In this study, the structure and dynamics of SLD in response to the climatic events such as the Indian Ocean Dipole (IOD) are examined. Our results reveal that these climatic events modulated the subsurface temperature variability in the thermocline at ∼100 m depth, whose signature was also evident in the satellite‐derived sea surface height (SSH) anomaly in the SLD region. We find that the mechanisms for the formation of SLD are consistent with previous research, and there is year‐to‐year variability in the SLD dynamics. This study also reveals that the atmospheric parameters including vertical wind shear and midtropospheric relative humidity are high over the SLD region and adjacent southern Bay of Bengal and show an upward (increasing) trend over the decades. This has impacted the atmospheric parameters over the northern Bay of Bengal over the decades and as a consequence the total number of monsoon depressions (June–September) decreased over the decades from 1980 to 2015, as reported by the India Meteorological Department, New Delhi. Thus, the new insight emerged from this study is the variability in the cyclogenesis and the occurrence of total number of monsoon depressions over northern Bay of Bengal over the decades is much related to the SLD dynamics. Decadal changes of atmospheric parameters over the dome existThe vertical wind shear over the SLD region has shown an upward trend over the decadesThe midtropospheric relative humidity over the SLD region has shown an upward trend over the decades

This article describes how molecular breast imaging can be used in clinical practice in conjunction with digital breast tomosynthesis, targeted US, and MR imaging for breast cancer screening and problem solving.

We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality. The registry identified 48 blunt renal injury patients. Median Injury Severity Score was higher and hospital length of stay was significantly longer in those with blunt renal injury when compared with those without blunt renal injury (P < 0.001). The majority of patients with blunt renal injury were managed nonoperatively. Mortality was three out of 48 patients (5%). Nine patients underwent exploratory laparotomy. These operations were always performed for reasons other than the renal trauma (e.g., splenic injury, free fluid, free air). No patient underwent invasive renal operation. Six patients were treated using angiography with embolization. Of the six, one patient died of pulmonary septic complications. We conclude that selective nonoperative management is the mainstay of treatment for blunt renal injury. Angiography with embolization is a useful modality for cases of ongoing bleeding, and is typically preferable to nephrectomy in our experience.

The Southwest Tropical Indian Ocean (SWTIO) is a key region for air‐sea interaction. Tropical cyclones (TCs) regularly form over the SWTIO and subsurface ocean variability influences the cyclogenesis of this region. Tropical cyclone days for this region span from November through April, and peak in January and February during austral summer. Past research provides evidence for more tropical cyclone days over the SWTIO during austral summer (December–June) with a deep thermocline ridge than in austral summer with a shallow thermocline ridge. We have analyzed the Argo temperature data and HYbrid Coordinate Ocean Model (HYCOM) outputs while focusing on the austral summer of 2012/2013 (a positive Indian Ocean Dipole (IOD) year and neutral El Niño Southern Oscillation (ENSO) year) when seven named tropical cyclones developed over the SWTIO region. This study reveals that the climatic events like the IOD and ENSO influence the cyclonic activity and number of TC days over the SWTIO. We ascertain that the IOD events have linkages with the Barrier Layer Thickness (BLT) in the SWTIO region through propagating Rossby waves, and further show that the BLT variability influences the cyclonic activity in this region. Positive IOD event in 2012 influenced the number of TC days through downwelling Rossby waves4–5 month lag correlation between Dipole Mode Index and number of TC days in the SWTIONegative correlation between Oceanic Niño Index of positive ENSO phase and TC activity in the SWTIO

The article discusses a court case in the Court of Justice of the European Union (CJEU) which involved the right to use a foreign decoding device to screen Premier League soccer matches. The court held that the prohibition of soccer broadcasting outside the state of licensure is illegal and therefore not enforceable within the European Union (EU).

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: is the preservation of the phrenic nerve important after pneumonectomy? Altogether more than 49 papers were found using the reported search, of which four represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that care should be taken to preserve the integrity of the phrenic nerve wherever possible. The abnormal diaphragmatic motion which occurs as a consequence of phrenic nerve damage significantly reduces expiratory lung volumes, gas exchange and exercise capacity in already compromised patients. Phrenic nerve injury can also lead to a prolonged need for mechanical ventilation; this alone carries a risk of complication, such as infection. Plication of the paralyzed hemi-diaphragm has proved effective in reducing respiratory insufficiency after pneumonectomy. The aim of this is to fix and flatten the diaphragm, thus mimicking the role of a functioning phrenic nerve. Furthermore, the function of a preserved phrenic nerve remains normal for up to 11 years post pneumonectomy. Therefore, deterioration in function may highlight a recurrence in disease or a change in the post pneumonectomy space.

It is a common practice to secure both mesh and peritoneum using tacks when performing a transabdominal preperitoneal (TAPP) inguinal hernia repair. The use of tacks to secure the mesh is well documented and has been associated with postoperative chronic pain. Recently, fibrin glue has been used to secure the mesh in these repairs but not used to reapproximate the incised peritoneum. This study assessed the technical feasibility of using fibrin glue for fixation of both mesh and peritoneum.

SWATH-mass spectrometry (MS) enables accurate and reproducible proteomic profiling in multiple model organisms including the mouse. Here, we present a comprehensive mouse reference spectral library (MouseRefSWATH) that permits quantification of up to 10,597 proteins (62.2% of the mouse proteome) by SWATH-MS. We exploit MouseRefSWATH to develop an analytical pipeline for species-specific deconvolution of proteomic alterations in human tumour xenografts (XenoSWATH). This method overcomes the challenge of high sequence similarity between mouse and human proteins, facilitating the study of host microenvironment-tumour interactions from ‘bulk tumour’ measurements. We apply the XenoSWATH pipeline to characterize an intraductal xenograft model of breast ductal carcinoma in situ and uncover complex regulation consistent with stromal reprogramming, where the modulation of cell migration pathways is not restricted to tumour cells but also operates in the mouse stroma upon progression to invasive disease. MouseRefSWATH and XenoSWATH open new opportunities for in-depth and reproducible proteomic assessment to address wide-ranging biological questions involving this important model organism.

Larval erythraeid mites are common ectoparasites of harvestmen (Opiliones). However, interactions between these mites and hosts in tropical environments have received little attention. In this study, we examined the prevalence and intensity of mite infestations for Neotropical harvestmen from the Caribbean island of Trinidad. Overall, the prevalence of infestation was 9.9%, with significant interspecific variation in the intensity of mite infestation and significant differences in parasitism of hosts between habitats. Harvestmen collected from lowland, crappo-cocorite forest exhibited the highest infestation rates. In our samples, the intensity of infestation varied from 1 to 17 mites per host. Examination by scanning electron microscopy revealed that harvestmen were infested by two taxa of mites, a species of Leptus and another unidentified erythraeid species. Our observations represent the first host records for erythraeid mites parasitizing harvestmen from the families Cranaidae and Manaosbiidae. Mites were found to attach preferentially to the tibia and femur of the leg (175 of 178 observations). In general, the harvestmen of Trinidad exhibited mite parasitism in a fashion similar to temperate species with respect to site of attachment and prevalence and intensity of mite infestation. In the field, we also collected an adult Cynortula sp. (Cosmetidae) that was transporting 30 gravid adults of an oribatid mite (Acariformes, Oribatida, Mixonomata). Cases of mite phoresy upon harvestmen are rare, with our observation representing the first report of phoresy by an oribatid mite upon a harvestman and the first documentation of mite phoresy upon harvestmen in the Caribbean.