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Robotics not only contributes to the invention of rehabilitation devices, it can also enhance the quality of medical education. In recent years, the use of patient simulators and part-task trainers in the medical education field has brought meaningful improvements in the training of medical practitioners. Nevertheless, in the context of therapy training for upper limb disorders, trainee therapists still have to engage directly with the patients to gain experience of the rehabilitation of physical diseases. In this work, a high-fidelity part-task trainer that is able to reproduce the stiffness of spasticity and rigidity symptoms of the upper limb, such as those observed in post-stroke patients and Parkinson's disease patients, has been developed. Based on the evaluation carried out by two experienced therapists, the developed part-task trainer is able to simulate different patient cases and help trainee therapists gain preclinical experience in a safe and intuitive learning environment. [ABSTRACT FROM AUTHOR]

Objective: Undescended testis (UDT) affects 1-6% of males. Current recommendations are to correct maldescent by 1 year of age. We identify the population characteristics of children referred and managed for UDT, age at referral and orchidopexy, and patterns of referral. Design, setting and patients: Retrospective 5-year review of all patients operated for UDT from 2007 to 2011 in our institution. Patient demographics, neonatal diagnosis of UDT, age at referral, referral source and age at first orchidopexy were recorded. Data are reported as median (range). Results: There were 513 boys with 576 undescended gonads; 450 (88%) had unilateral UDT. Congenital (present at birth) UDT was diagnosed in 287 (56%) children. Seventy-nine (15%) were premature births, 41 (8%) had associated major genitourinary abnormalities. Median age at referral was 1.1 (0-16.2) years; median age at first orchidopexy was 1.6 (0-17.2) years. When corrected for age, those with a history of prematurity and associated major genitourinary malformations were referred and operated on earlier. There was no difference in age at referral and orchidopexy when comparing unilateral versus bilateral maldescent, and palpability of UDT. Of those with congenital UDT, 70% were operated at beyond 1 year of age. Those referred from public tertiary hospitals were younger than those referred from community clinics (p<0.0001) and private healthcare institutions ( p=0.003). Conclusions: Despite early diagnosis in many patients with UDT, most are referred and operated after 1 year of age, even in congenital UDT. Premature babies, those with major genitourinary anomalies, and those seen in public tertiary hospitals are referred earlier. Community health initiatives must emphasise prompt referral to allay the impact of delayed surgery. [ABSTRACT FROM AUTHOR]

Large cytoplasmic ribonucleoprotein germ granule complexes are a common feature in germ cells. In C. elegans these are called P granules and for much of the life-cycle they associate with nuclear pore complexes in germ cells. P granules are rich in proteins that function in diverse RNA pathways. Here we report that the C. elegans homolog of the eIF4E-transporter IFET-1 is required for oogenesis but not spermatogenesis. We show that IFET-1 is required for translational repression of several maternal mRNAs in the distal gonad and functions in conjunction with the broad-scale translational regulators CGH-1, CAR-1 and PATR-1 to regulate germ cell sex determination. Furthermore we have found that IFET-1 localizes to P granules throughout the gonad and in the germ cell lineage in the embryo. Interestingly, IFET-1 is required for the normal ultrastructure of P granules and for the localization of CGH-1 and CAR-1 to P granules. Our findings suggest that IFET-1 is a key translational regulator and is required for normal P granule formation. [ABSTRACT FROM AUTHOR]

The use of polymerization to solidify, strengthen and imprint liquid organic materials is the basis of ultraviolet (UV) nanoimprint lithography. In spite of these advantages, the use of polymerization to pattern materials in thermal nanoimprint lithography is almost non-existent. In this study, we demonstrate a facile and general method to directly imprint a host of unary metal oxides (Fe2O3, ZrO2, TiO2, Nb2O5and Ta2O5) at a very high resolution viain situthermal free radical co-polymerization of various metal methacrylates in the presence of cross-linker ethylene glycol dimethacrylate using a silicon mold. Polymerization during nanoimprinting rigidly shapes the patterns, traps the metal atoms, reduces the surface energy and strengthens the structures, thereby giving ∼100% yield after demolding. It was found that the higher oxidation state of metal resulted in excessive cracking of imprinted structures. This could be due to a higher degree of cross-linking of the precursor leading to shrinkage-related stress. Optimization of the resin composition by partially replacing ethylene glycol dimethacrylate with methyl methacrylate alleviated this problem. Heat-treatment of the imprinted structures resulted in the loss of organics, their subsequent shrinkage and converted the patterns to their corresponding metal oxides with line-widths as small as 25 nm. [ABSTRACT FROM AUTHOR]

Ong C W, Kim L G, Kong H H, Low L Y, Wang T T, Supriya S, Kathiresan M, Soong R & Salto-Tellez M (2010) Histopathology 56, 523–529 Computer-assisted pathological immunohistochemistry scoring is more time-effective than conventional scoring, but provides no analytical advantage Aims: Interpretation of immunohistochemistry is primarily done through human visual scoring while computer-assisted scoring is relatively uncommon. This study aimed to examine (i) the level of agreement between human visual and computer-assisted pathological scoring of immunoreactivity expression in colorectal cancers, (ii) whether computer-assisted scoring affects the prognostic significance of biomarkers, and (iii) whether computer-assisted pathological scoring provides any time-saving or reproducibility advantages. Methods and results: Tissue microarray blocks were constructed from the primary colorectal adenocarcinoma specimens of 486 patients. Scoring of the six markers [cytokeratin (CK) 7, CK20, cyclooxygenase-2, Ki67, p27 and p53] was done independently by a qualified pathologist, a trained scientist and the Ariol SL-50 (Applied Imaging). Univariate analysis showed that human visual and computer-assisted scoring were strongly correlated (all κ values >0.8). Both human visual and computer-assisted pathological scoring identified the same set of biomarkers with significant association with survival. Computer-assisted pathological scoring was shown to be a time-effective means of scoring larger numbers of slides (for high-throughput studies). Conclusions: Our results suggest that computer-assisted pathological scoring can be a viable alternative to pathologist scoring in a manner that is more practical and time-effective, but, interestingly, providing no analytical advantage. [ABSTRACT FROM AUTHOR]

A simple and facile method for the preparation of copper sulfide dendritic structures in high yield under mild conditions is described. This new approach encompasses many advantages over the conventional solvothermal preparations of dendrites in terms of product quality (better morphology control, good monodispersity, and high yield), reaction conditions (lower temperatures and pressures), and shorter reaction time. In addition, temporal growth of the dendrites can be readily followed and manipulated in this preparation via time-resolved microscopic analysis. The crystalline nature of the dendrites was confirmed using high-resolution transmission electron microscopy and selected area electron diffraction. Several factors, including the reaction temperature, time, relative concentration between the reactants, and amine chain length, were identified to be important and investigated in detail. It was demonstrated that the dendritic structures are favored at high ethylenediamine (EDA) and low tributylphosphite (TBPT) concentrations in general. Unprecedented multilayer crystal growth originating from the dendritic core was observed through varying the ratios of the reagents. On the basis of these carefully controlled experiments, a plausible formation mechanism of the dendrites was suggested and discussed. To the best of our knowledge, this is the first report on making crystalline semiconductor dendrites with such full control and tunability of morphology and size. [ABSTRACT FROM AUTHOR]

As classical phase 11 detoxification enzymes, glutathione S-transferases (GSTs) have been implicated in insecticide resistance and may have evolved in response to toxins in the niche-defining feeding substrates of Drosophila species. We have annotated the GST genes of the 12 Drosophila species with recently sequenced genomes and analyzed their molecular evolution. Gene copy number variation is attributable mainly to unequal crossing-over events in the large δ and ϵ clusters. Within these gene clusters there are also GST genes with slowly diverging orthologs. This implies that they have their own unique functions or have spatial/temporal expression patterns that impose significant selective constraints. Searches for positively selected sites within the GSTs identified G171K in GSTD1, a protein that has previously been shown to be capable of metabolizing the insecticide DDT. We find that the same radical substitution (G171K) in the substrate-binding domain has occurred at least three times in the Drosophila radiation. Homology-modeling places site 171 distant from the active site but adjacent to an alternative DDT-binding site. We propose that the parallel evolution observed at this site is an adaptive response to an environmental toxin and that sequencing of historical alleles suggests that this toxin was not a synthetic insecticide. [ABSTRACT FROM AUTHOR]

A series of two-level hierarchical structures on polystyrene (PS) and poly(methyl methacrylate) (PMMA) were fabricated using sequential nanoimprinting lithography (NIL). The hierarchical structures consist of micrometer and sub-micrometer scale grating imprinted with varying orientations. Through water contact angle measurements, these surface hierarchical structures showed a wide range of anisotropic wettabilities on PMMA and PS, with PMMA having an anisotropic wettability from 6° to 54° and PS having an anisotropic wettability from 8° to 32°. At the same time, the water contact angle of PMMA and PS can be tuned to nearly 120° without modifying the surface chemistry. A tunable anisotropic wettability is beneficial for applications where controlling the direction of liquid flow is important, such as in microfluidic devices. [ABSTRACT FROM AUTHOR]

Meckel’s diverticulum (MD), a seemingly innocuous anomaly of the gastrointestinal tract, presents distinctive challenges to a clinician, as it is prone to varied complications that are frequently elusive to diagnosis with conventional diagnostic modalities. This case series illustrates the diverse presentations and advantages of laparoscopic-assisted management of Meckel’s diverticular complications in children. Between October 2002 and April 2006, 36 patients (27 males and 9 females) aged 1.5 to 16 years (median 10 years) underwent laparoscopic-assisted trans-umbilical Meckel’s diverticulectomy (LATUM). Sixteen (44.4%) patients presented with lower gastrointestinal bleeding (14 with painless bleed and 2 with perforated peptic ulcer in the ileum adjacent to the MD), six (16.7%) patients presented with intestinal obstruction (four due to a mesodiverticular band and one each due to intussusception and floppy giant cystic dilatation of MD causing intestinal compression) and four (11.1%) patients presented with features masquerading as appendicitis (one with Meckel’s diverticulitis and perforation, one with perforated peptic ulcer adjacent to MD and two with a torted and gangrenous MD). In ten (27.8%) patients, incidental MD with a narrow base was noted at laparoscopic exploration for suspected appendicitis. All patients underwent successful LATUM along with appendicectomy in 15 (41.7%) patients . The operative duration ranged from 72 to 266 min (mean 125.9 ± 48.4). There were no intra-operative complications and none required conversion to open surgery. The hospital stay was 3 to 9 days (mean 5.3 ± 1.2). There were three (8.3%) cases of postoperative adhesive intestinal obstruction; two underwent successful laparoscopic adhesiolysis and one necessitated conversion to suprapubic laparotomy to release the pelvic adhesions. There were no other complications during the follow-up (median 16 months). LATUM is a safe, effective and an esthetic procedure offering timely diagnosis and cure for diverse Meckel’s diverticular complications. The technique also allows palpation of the MD and avoids usage of expensive staplers. [ABSTRACT FROM AUTHOR]

Objectives: Kikuchi disease is a benign, self-limiting condition of unknown aetiology, often manifesting as cervical lymphadenopathy and fever. The disease usually manifests itself in adulthood and paediatric reports are uncommon. The aims of this study are to report the features of Kikuchi disease in the local paediatric population, and to raise the awareness of this entity among clinicians involved in treating these children. Methods: This is a retrospective series of nine paediatric cases of Kikuchi disease treated in KK Women's and Children's Hospital, Singapore. The clinical presentation, subsequent clinical course and laboratory findings of these patients were reviewed. Results: The patients ranged in age from 7 to 16 years, and included six males and three females. All nine patients presented with fever and cervical lymphadenopathy. Hepatosplenomegaly was present in one child. The erythrocyte sedimentation rate was raised to variable extents, but there was no other significant haematological, serological or microbiological abnormality. In all cases the diagnosis was made on the basis of histological findings. Conclusions: Kikuchi disease in the paediatric population is not as uncommon as previously thought, and should be considered in the differential diagnosis of any child with fever of unknown origin or cervical lymphadenopathy. Early recognition will minimize unnecessary investigations and prolonged empirical treatments. [ABSTRACT FROM AUTHOR]

A bilayer scaffold consisting of a thermoplastic and thermoset has been fabricated via duo-mold imprinting method. The molds used in this fabrication are with comparable surface energy. The preferential demolding between the two molds was achieved by utilizing the adhesion difference between the molds and the two polymers while the transfer of the polymers from the mold to the substrate was guided by the large contrast of surface energy between the mold and the substrate. The use of thermoset polymer imparts the thermal and mechanical stabilities into the imprinted structures so that a higher imprinting temperature is feasible. A higher imprinting temperature is found to facilitate the transfer of the imprinted polymer from the mold to the substrate by enhancing the wetting between the polymer and the substrate. [ABSTRACT FROM AUTHOR]

Purpose - The primary aim of this research is to investigate the application of open source geographic information system software, geographical resources analysis support system (GRASS) for landslide hazard assessment. Design/methodology/approach - Five parameters affecting landslide occurrence derived from topographical, geological and land use maps of Cameron highland were used for the assessment. Findings - The results showed that about 93 percent of the study area falls under zone II that is of low hazard, with less than 7 percent on zone III with moderate hazard and only less than 1 percent falls under zone IV, which is of high hazard. Research limitations/implications - The accuracy of the landslide hazard map needs to be assessed by cross-correlation with landslide occurrence in the field. Practical implications - The map produced showed the potential application of GRASS as a tool for producing landslide hazard assessment map. Originality/value - The major outcome of this research is the possible use of open source GIS software in the application of landslide hazard assessment. The capability of GRASS in performing such environmental assessment will certainly attract many researchers and organizations with limited budgets, especially in developing countries such as Malaysia. [ABSTRACT FROM AUTHOR]

Abstract Study objective We examined the effectiveness of an antimicrobial surface coating for continual disinfection of high touch-frequency surfaces in the emergency department (ED). Methods Following a preliminary observation identifying stretcher rails as the surface with highest touch-frequency in the ED, we conducted a pilot randomized controlled trial involving 96 stretcher rails. The stretchers were randomized to receive an antimicrobial surface coating or placebo coating. Routine cleaning of stretchers subsequently continued as per hospital protocol in both arms. Sampling for total aerobic, gram-positive halophilic, gram-negative and methicillin-resistant Staphylococcus aureus bacteria was performed pre- and post-treatment at 24 h, 7 days and 180 days. Individuals who applied the coating and outcome assessors were blinded to the allocated arms. The primary outcome is contamination of antimicrobial versus placebo rails measured as colony forming units per cm2(CFU/cm2). Results Baseline total aerobic bacteria was comparable between placebo and intervention arms (0.84 versus 1.32 CFU/cm2, P = 0.235). Total aerobic bacteria contamination was significantly lower on antimicrobial versus placebo rails at 24 h (0.61 versus 1.01 CFU/cm2, median difference 0.40 CFU/cm2, 95% confidence interval [CI] 0.01 to 1.01 CFU/cm2). There was a non-statistically significant tendency for contamination to be lower on antimicrobial versus placebo rails at 7 days (1.15 versus 1.50 CFU/cm2, median difference 0.35 CFU/cm2, 95% CI -0.64 to 1.28 CFU/cm2), but higher at 180 days (2.06 versus 1.84 CFU/cm2, median difference − 0.22 CFU/cm2, 95% CI -1.19 to 0.78 CFU/cm2). Conclusion This is the first double-blinded, placebo-controlled, randomized trial to evaluate an antimicrobial surface coating on high touch-frequency surfaces in the emergency department. Total aerobic bacteria found on antimicrobial-coated patient transport stretcher rails was significantly lower than placebo rails at 24 h.

A two-step fabrication technique based on nanoimprint lithography is described for the fabrication of three-dimensional micro- and nanostructures. By combining simple two-dimensional geometries from two molds, complex and useful three-dimensional structures are obtained. The careful selection of mold geometries constitutes a simplified and efficient approach toward building up desirable three-dimensional structures without resorting to the use of a sacrificial process or components. Three-dimensional structures fabricated for a variety of specific applications are presented using both thermoplastic and cross-linked polymer materials. [ABSTRACT FROM AUTHOR]

Aim: Elder abuse may result in serious injuries with significant psychological consequences, leading to increased use of emergency department (ED) for trauma-related presentations. We aimed to describe the utilization of healthcare resources by victims of elder abuse. Materials and Methods: This retrospective study was conducted. Victims of elder abuse that were 65 years or older and presented between August 2018 and December 2020 were included. Information on demographics, mode of arrival, place and mechanism of injury, sustained injuries, injury severity score (ISS), disposition, and length of stay were collected and analyzed. Results: There were 33 (0.3%) victims of elder abuse. The median age was 69-year old (interquartile range: 66 to 76) and 23 (68.8%) participants were female. Majority (n=32, 97.0%) of patients sustained blunt injuries, with contusions to the limbs and head being the most common. The injuries were mostly minor to moderate in severity (ISS 8 or less: n=32, 97.0%). The utilization of healthcare resources was low: only two (6.1%) required ambulance transport to the ED, one (3.0%) required activation of the trauma team, one (3.0%) required surgery, and one (3.0%) required transfusion of blood products. However, 12 (36.4%) patients were admitted to the hospital, and five (15.2%) were admitted to the observation unit of the ED. Conclusion: Utilization of healthcare resource for injuries related to elder abuse was low. However, identification remains a challenge, and it is crucial for teams in the ED to be cognizant of elder abuse, as management should go beyond treating the injuries by including case notification, psychosocial assessment, and caregiver support.

Purpose: There is no consensus regarding adjuvant therapies following Kasai portoenterostomy (KP) for biliary atresia (BA). This study aimed to analyze the effect of extended perioperative intravenous antibiotics (PI-Abx) and adjuvant corticosteroid on cholangitis and jaundice clearance rates in the 3 years post-KP in children with BA. Methods: Data of patients who underwent KP between 1999-2018 at a single center were retrospectively analyzed. Group A (1999-2010) received PI-Abx for 5 days, Group B (2010-2012) received PI-Abx for 5 days plus low-dose prednisolone (2 mg/kg), and Group C (2012-2017) received PI-Abx for 14 days plus high-dose prednisolone (5 mg/kg). Results: Fifty-four patients were included with groups A, B, and C comprising 25, 9, and 20 patients, respectively. The number of episodes of cholangitis was 1.0, 1.6, and 1.3 per patient (p=NS) within the first year and 1.8, 2.3, and 1.7 (p=NS) over 3 years in Groups A, B, and C, respectively. The jaundice clearance rate at 6 months was 52%, 78%, and 50% (p=NS), and the 3-year native liver survival (NLS) rate was 76%, 100%, and 80% (p=NS) in Groups A, B, and C, respectively. A near-significant association was observed between the incidence of cholangitis within the first year and decompensated liver cirrhosis/death at 3 years post KP (p=0.09). Persistence of jaundice at 6 months was significantly associated with decompensated cirrhosis/death at 3 years (p<0.001). Conclusion: The extended duration of PI-Abx and adjuvant corticosteroids was not associated with improved rates of cholangitis, jaundice clearance, or NLS in patients with BA. [ABSTRACT FROM AUTHOR]

This study delves into the pathogenesis of virulent genotype VII strains of the Newcastle disease virus (NDV), focusing on experimentally infected birds. Predominant and consistent lesions observed include bursal atrophy and extensive depletion of all lymphoid tissues. Immunohistochemistry (IHC) analysis, targeting apoptosis (Caspase-3), necroptosis (MLKL), and NDV markers, indicates that bursal atrophy is linked to a non-apoptotic programmed cell death pathway known as “necroptosis”. Repair assisted damage detection (RADD) of the bursa reveal oxidative DNA damage patterns consistent with programmed cell death, aligning with MLKL expression. Contrastingly, in the spleen, our findings suggest that necrosis (non-programmed cell death) predominantly contributes to lymphoid depletion. This conclusion is supported by evidence of karyorrhexis, fibrinous inflammation, RADD analyses, and IHC. Moreover, in addition to being pathogenic in its own right, NDV caused extensive and rapid lymphoid depletion that should be expected to contribute to profound immunosuppression. The elucidation of necroptosis in NDV-infected chickens provides a good rationale to investigate this mechanism in other paramyxoviral diseases such as human measles.

Newcastle Disease Virus (NDV) genotype VII (GVII) is becoming the predominant strain of NDV in the poultry industry. It causes high mortality even in vaccinated chickens with a common NDV genotype II vaccine (GII-vacc). To overcome this, the killed GVII vaccine has been used to prevent NDV outbreaks. However, the debate about vaccine differences remains ongoing. Hence, this study investigated the difference in chickens’ responses to the two vaccines at the molecular level. The spleen transcriptomes from vaccinated chickens reveal that GVII-vacc affected the immune response by downregulating neuroinflammation. It also enhanced a synaptogenesis pathway that operates typically in the nervous system, suggesting a mechanism for the neurotrophic effect of this strain. We speculated that the down-regulated immune system regulation correlated with protecting the nervous system from excess leukocytes and cytokine activity. In contrast, GII-vacc inhibited apoptosis by downregulating PERK/ATF4/CHOP as part of the unfolded protein response pathway but did not affect the expression of the same synaptogenesis pathway. Thus, the application of GVII-vacc needs to be considered in countries where GVII is the leading cause of NDV outbreaks. The predicted molecular signatures may also be used in developing new vaccines that trigger specific genes in the immune system in combating NDV outbreaks.

Focuses on the nanoimprinting lithography processes developed by researchers from the Institute of Materials Research in Singapore. Components of a transistor; Next-generation lithography techniques; Applications of the nanoimprinting lithgraphy; Information on the nanoimprinting lithography processes.

Introduction: MicroRNAs (miRNAs) play a crucial role in regulating gene expression during key developmental processes, including fetal development. Brahman (Bos taurus indicus) and Angus (Bos taurus taurus) cattle breeds represent two major cattle subspecies with strikingly different phenotypes.Methods: We analyzed miRNA expression in liver samples of purebred and reciprocal crosses of Angus and Brahman to investigate breed and parent-of-origin effects at the onset of accelerated fetal growth.Results: We identified eight novel miRNAs in fetal liver samples and 14 differentially expressed miRNAs (DEMs) between purebred samples. Correlation of gene expression modules and miRNAs by breed and parent-of-origin effects revealed an enrichment of genes associated with breed-specific differences in traits such as heat tolerance (Brahman) and fat deposition (Angus). We demonstrate that genes predicted to be targets of DEMs were more likely to be differentially expressed than non-targets (p-value < 0.05). We identified several miRNAs (bta-miR-187, bta-miR-216b, bta-miR-2284c, bta-miR-2285c, bta-miR-2285cp, bta-miR-2419-3p, bta-miR-2419-5p, and bta-miR-11984) that showed similar correlation patterns as bta-miR-2355-3p, which has been associated with the glutamatergic synapse pathway, a key facilitator of heat tolerance. Furthermore, we report Angus-breed-specific miRNAs (bta-miR-2313-5p, btamiR-490, bta-miR-2316, and bta-miR-11990) that may be involved in fat deposition. Finally, we showed that the DEMs identified in fetal liver are involved in Rap1, MAPK, and Ras signalling pathways, which are important for fetal development, muscle development and metabolic traits such as fat metabolism.Conclusion: Our work sheds light on the miRNA expression patterns that contribute to gene expression differences driving phenotypic differences in indicine and taurine cattle.