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Survivors of critical illness, including those with COVID-19, are likely to experience post-intensive care syndrome (PICS). PICS involves a constellation of physical, cognitive, and mental health problems that can occur following hospitalization in an intensive care unit (ICU). This focused review describes the impact of PICS on an individual's function, societal participation, and family. Specific evidence-based screening tools for in-home identification of the deficits associated with PICS are recommended. Recognition of PICS through early screening by home health care providers is crucial in order to assemble the physical rehabilitation, mental health, and community resources needed to mitigate the long-term effects of COVID-19 and other critical illnesses. This review concludes with further PICS resources for community-based providers to enhance their knowledge and expertise and to prepare them for caring for COVID-19 and other critical illness survivors. [ABSTRACT FROM AUTHOR]

Candida auris is an emerging drug‐resistant yeast responsible for hospital outbreaks. This statement reviews the evidence regarding diagnosis, treatment and prevention of this organism and provides consensus recommendations for clinicians and microbiologists in Australia and New Zealand. C. auris has been isolated in over 30 countries (including Australia). Bloodstream infections are the most frequently reported infections. Infections have crude mortality of 30–60%. Acquisition is generally healthcare‐associated and risks include underlying chronic disease, immunocompromise and presence of indwelling medical devices. C. auris may be misidentified by conventional phenotypic methods. Matrix‐assisted laser desorption ionisation time‐of‐flight mass spectrometry or sequencing of the internal transcribed spacer regions and/or the D1/D2 regions of the 28S ribosomal DNA are therefore required for definitive laboratory identification. Antifungal drug resistance, particularly to fluconazole, is common, with variable resistance to amphotericin B and echinocandins. Echinocandins are currently recommended as first‐line therapy for infection in adults and children ≥2 months of age. For neonates and infants <2 months of age, amphotericin B deoxycholate is recommended. Healthcare facilities with C. auris should implement a multimodal control response. Colonised or infected patients should be isolated in single rooms with Standard and Contact Precautions. Close contacts, patients transferred from facilities with endemic C. auris or admitted following stay in overseas healthcare institutions should be pre‐emptively isolated and screened for colonisation. Composite swabs of the axilla and groin should be collected. Routine screening of healthcare workers and the environment is not recommended. Detergents and sporicidal disinfectants should be used for environmental decontamination. [ABSTRACT FROM AUTHOR]

Modern consumption patterns lead to massive waste, which poses challenges in storage and highlights the urgent need for more sustainable product development. Customer feedback on products plays a crucial role in product design, yet previous studies overlooked these invaluable insights. In response, this study introduces a novel systematic methodology that integrates the strengths of text mining, Quality Function Deployment (QFD), and the Theory of Inventive Problem Solving (TRIZ). Text mining techniques are utilized to extract customer requirements from online platforms, while QFD is used to translate these requirements into technical specifications. By integrating the contradiction matrix from TRIZ theory with the triptych, technical conflicts are resolved. The design process for next-generation smart glasses is employed as an illustrative case to validate the proposed integrated innovation design approach. Analytical outcomes suggest that the introduced methodology can effectively address sustainable product design challenges and sets the stage for future advancements in smart glasses. [ABSTRACT FROM AUTHOR]

The switch from petro-diesel fuel to biodiesel blends for Compression Ignition engines have raised tribological performance concerns among major automobile manufacturers. Biodiesel dilution on engine lubricants could have adverse long-term effects on the engine efficiency, which will reduce the fuel economy, thus, leading to higher greenhouse gas emissions. Therefore, this study investigates the tribological impact of palm methyl ester (PME) diluted in SAE5W40 and SAE10W40 engine lubricants along different lubrication regimes under engine cold start condition. Through lubrication Stribeck curve analysis conducted using a pin-on-disc tribometer, coefficient of friction (CoF) for both engine lubricants showed parabolic maximum behaviour with increasing PME dilution. The CoF reduction beyond these peak values is attributed to the improved friction modifier effect from the now-dominant PME but with reduced load carrying capacity. An effective lubricant should possess both reasonable friction modifier effect and highest load carrying capacity in mitigating boundary friction. Hence, through the study, it could be deduced that the acceptable PME dilution threshold level for SAE5W40 is up to 17.5-vol%, while for SAE10W40 is between 28.0-vol% and 34.5-vol%. PME dilution levels beyond these thresholds could easily cause lubrication film rupture under high load, high shear rate conditions during application along the mixed to boundary lubrication regimes, inducing material wear. [ABSTRACT FROM AUTHOR]

Background and Purpose. Telehealth is defined as the delivery of health-related services and information via telecommunication technologies. The purposes of this case report are: (1) to describe the development, implementation, and evaluation of a telehealth approach for meeting physical therapist supervision requirements in a skilled nursing facility (SNF) in Washington and (2) to explore clinical and human factors of physical therapist practice in an SNF delivered via telehealth. Case Description. In 2009, Infinity Rehab conducted a pilot program to determine whether telehealth could be used to meet physical therapist supervision requirements in an SNF. In 2011, language allowing telehealth physical therapy was approved by the Washington Board of Physical Therapy (Board). In 2014-2015, telehealth outcomes were evaluated in a 51-person sample at an Infinity Rehab SNF. Cost savings of telehealth implementation from 2011 to 2015 were estimated. Outcomes. The Board deemed the telehealth pilot program a success and subsequently established telehealth practice language for physical therapy. Both human factors and clinical outcomes were required to implement a successful telehealth practice. Clinical outcomes and user satisfaction in telehealth and nontelehealth groups were equivalent. Cost savings were identified. Discussion. Human factors, such as the need for provider education in appropriate bedside manner with a telehealth session, were identified. Since 2011, more than 1,000 telehealth physical therapy sessions were conducted at Infinity Rehab SNFs in Washington State. In the future, alternative payment models focused on valued-based clinical outcomes may facilitate wider telehealth adoption in physical therapy. Future research on efficacy and cost-effectiveness is needed to promote broader adoption of telehealth physical therapy in SNFs. This experience demonstrates that telehealth implementation in an SNF for the purpose of physical therapy re-evaluation is a feasible alternative to in-person encounters. [ABSTRACT FROM AUTHOR]

Background Mycosis fungoides ( MF), the commonest form of cutaneous T-cell lymphoma, is uncommon in childhood. Phototherapy is a common treatment for MF. Aim To retrospectively evaluate the efficacy and safety of narrow band ultraviolet B ( NB- UVB) phototherapy for the treatment of MF n children. Methods We performed a retrospective analysis of children of East Asian descent with a clinical and histological diagnosis of MF, who were treated with NB- UVB phototherapy at the National Skin Centre, Singapore over the 5-year period 2004-2008. Results We identified nine suitable patients (eight boys, one girl; age range 5-12 years). Mean time from disease onset to diagnosis was 21 months (range 4 months to 3 years). There were two patients with stage 1A disease, six with stage 1B disease and one with stage 2A disease. Body surface area involvement ranged from 10% to 60%, and none of the patients had systemic involvement. Eight patients attained complete response after phototherapy, but only three had sustained remission after a follow-up of 1-3 years. Five patients had recurrence of lesions after an mean of 13.8 months (range 4-36). Treatment was well tolerated. Conclusion Phototherapy using NB- UVB in the treatment of MF is efficacious and safe. We recommend it as first-line treatment in the management of early-stage MF in children. [ABSTRACT FROM AUTHOR]

The effect of recirculating the flue gas on the performance of a multi-cyclones unit as particulate collector in an actual plant scale was studied. The existing multi-cyclones unit was modified by connecting a recirculation duct between the inlet and outlet gas stream of the multi-cyclones attached with an external induced (ID) fan. The particulate samplings were done following the U.S. EPA method at boiler outlet (before multi-cyclones), stack (after multi-cyclones) and recirculation duct. Result shows that the amount of recirculated particulates increases with ID fan suction power. The collection efficiency increased slightly from 68% (0% or without recirculation) to 74% (at 11% recirculation) and dropped to 67% (at 17% recirculation). Moreover, the amount of the fine particulate size fraction emitted able to be reduced one fold at 11% recirculation flow rate. However, high amount of recirculated particulates results in re-entrainment of particulates into the outlet of the multi-cyclones, hence, results in increase of particulate emission in the stack. [ABSTRACT FROM PUBLISHER]

Highlights: [•] We describe Δ(dinB-yafN)883(::kan), a novel dinB allele, referred to as ΔdinB883, a deletion that sensitizes E. coli cells to UV irradiation. [•] This UV radiation sensitivity is most acute in the early logarithmic phase of culture growth. [•] This UV radiation sensitivity is completely dependent upon a functional umuDC operon. [•] Sequencing reveals ΔdinB883 retains the proximal 161 nucleotides, i.e., 54 amino acids, of the wild-type sequence. [•] The ΔdinB883 mutant is hypothesized to produce a peptide of 83 amino acids, DinB883, that compromises UmuDC function. [ABSTRACT FROM AUTHOR]

Polyacrylonitrile (PAN) based solid polymer electrolyte consisting lithium tetrafluoroborate (LiBF), ethylene carbonate (EC) and dimethyl phthalate (DMP) have been prepared using solution casting method. Comparative studies were done on unplasticized PAN-LiBF system and the PAN plasticized system with the novel binary plasticizers of EC and DMP in the ratio of 1:1 by the variation of LiBF concentration. The highest room temperature conductivity of electrolyte in PAN-LiBF system is 1.83 × 10 S cm while 1.08 × 10 S cm is obtained from PAN-EC-DMP-LiBF system. The complexation and structure of polymer electrolytes have been investigated as function of LiBF content at different weight percentages. The morphology and crystalline phase of polymer host is completely changed on the addition of salt and plasticizers. The fraction of free ions is greatly dependent on the amount of salt and the presence of plasticizers. [ABSTRACT FROM AUTHOR]

Background and Objectives A number of DNA-based methods to genotype the alleles coding for HNA have been described, but all require the separate amplification and analysis of each allele. The aim was to develop a DNA-based method for simultaneous detection of HNA-1, HNA-3, HNA-4 and HNA-5 alleles. Materials and Methods An allele-specific primer extension method was used in combination with magnetic beads from Luminex technology. PCR-sequence-specific primers ( SSP) was used to resolve the presence of the HNA-1b allele in samples assigned by the Luminex bead assay as HNA-1a/-1b/-1c or HNA-1b/-1c. HNA allele frequencies were determined in a panel of 140 randomly selected English Caucasoid blood donors. Results HNA allelic types were compared with historical results, and 100% concordance was found. Only eight of the 97 samples used in the validation required additional testing by PCR- SSP. Allele frequencies were determined in the blood donor population as follows: 0·318 for HNA-1a, 0·668 for HNA-1b, 0·014 for HNA-1c, 0·768 for HNA-3a, 0·232 for HNA-3b, 0·882 for HNA-4a, 0·118 for HNA-4b, 0·736 for HNA-5a and 0·264 for HNA-5b. Conclusion A multiplex Luminex bead assay for the simultaneous detection of HNA-1, HNA-3, HNA-4 and HNA-5 alleles is described that enables rapid typing of donors to support HNA alloimmunized patients who require HNA-compatible blood products. [ABSTRACT FROM AUTHOR]

Abstract: Flow diverters (FDs) are high density meshed stents designed to reduce blood flow into intra-cranial aneurysms. Though the FD is one of many intracranial aneurysm (IA) treatments, FD implantation may also result in the growth and rupture of residual aneurysms. The purpose of this research is to investigate the effect of FD implantation on IA hemodynamics. Computational fluid dynamics (CFD) was conducted to analyze dynamic and resistance forces after FD deployment. Simulation results for the successful case (patient A) showed that FD flow resistance force was higher than dynamic force. This indicated that the FD provided sufficient resistance to reduce flow into the aneurysm. As a result, flow velocity magnitude at the aneurysm neck was reduced by 95%. On the other hand, the flow velocity magnitude at the aneurysm neck was reduced by about 50% for the unsuccessful case (patient B). The reason was that the flow resistance force at the aneurysm neck section was calculated to be lower than the flow driving force. In order to completely occlude the aneurysm, a higher resistance FD stent is to be required to suppress the dynamic forces. Patient-specific hemodynamic simulations offer means of quantitative estimation FD treatment outcomes. [Copyright &y& Elsevier]

The article discusses the telehealth, the delivery of services and information related to health via telecommunications technologies. The definitions of telehealth according to the American Telemedicine Association (ATA) and the American Physical Therapy Association (APTA) are provided. A description of the telehealth development from a rehabilitation perspective is given. The barriers to the adoption of telehealth technology by physical therapists are also discussed.

Spreading of evaporative liquid drops in a thin porous layer has been studied. The entire spreading process can be divided into three distinct phases according to the change of the wetted porous region size. The first phase is characterized by the expansion of the wetted porous region and shrinking of the liquid drop. Contact line pinning is observed in the wetted porous region in the second phase even with the liquid drop totally absorbed into the porous layer. The third phase sees the shrinkage of the wetted porous region until it is not observable. Based on these observations, a model is devised to simulate the spreading of a liquid drop under the studied conditions. Partial differential equations are used to describe the relation between liquid drop volume and other important parameters of a fluid flow, including maximum wetted region diameter achieved, time taken to reach each spreading process phase, and evaporation rate. Calculated results are in good agreement with the experimental data. [ABSTRACT FROM AUTHOR]

Background The primary purpose of this study was to report on an evaluation of the perceptions and beliefs of service providers towards family-centred practices in 11 early intervention programmes for infants and young children in Singapore. Methods The Measure of Processes of Care for Service Providers (MPOC-SP) and Measure of Beliefs about Participation in Family-Centred Service (MBP-FCS) were administered to 213 service providers made up of teachers, therapists, psychologists and social workers providing centre-based therapy to children with special needs who were below the age of 6 years. Results Exploratory factor analyses were performed with both scales. Nineteen of the 27 MPOC-SP items were retained and supported the original four-factor structure model. The exploratory factor analyses on MBP-FCS provided a less satisfactory outcome. Fourteen of the 28 items were retained and these loaded onto four factors. The two factors relating to Beliefs about benefits of FCS and Beliefs about the absence of negative outcomes from FCS failed to emerge as separate factors. Further multiple regressions indicated that more direct work with families and positive self-efficacy in implementing FCS contributed significantly to explaining service providers' positive perception towards family-centred practice in service delivery. Conclusions This is the first time MPOC-SP and MBP-FCS were administered to a population in an Asian context. While MBP-FCS would benefit from further development work on its construct, MPOC-SP offered important insights into service providers' perspectives about family-centred practices that would have useful implications for professional and service development. [ABSTRACT FROM AUTHOR]

Background: Testing for alloantibodies against human platelet antigens (HPAs) is essential for the clinical diagnosis of fetomaternal alloimmune thrombocytopenia (FMAIT), posttransfusion purpura, and platelet (PLT) refractoriness. Most of the methods currently used for HPA alloantibody detection rely on the availability of panels of HPA-typed PLTs and some rely on validated monoclonal antibodies (MoAbs) against the PLT glycoproteins. Recombinant β3 integrins displaying the HPA-1a (rHPA-1a) or HPA-1b (rHPA-1b) epitopes have been produced as an alternative source of antigen. The suitability of these integrin fragments was evaluated for the development of an HPA-1a alloantibody screening assay, using Luminex xMAP technology.Study Design and Methods: A 3-plex bead assay was developed by coupling biotinylated rHPA-1a, rHPA-1b, and recombinant glycoprotein VI to LumAvidin microspheres. Forty patient samples referred for FMAIT diagnostic testing, which were previously screened by the MoAb-specific immobilization of PLT antigens (MAIPA) assay, were used to assess the assay.Results: The rHPA-1a- and rHPA-1b-coupled beads were able to detect HPA-1a and HPA-1b alloantibodies in all patient samples tested that were previously confirmed to contain HPA-1-specific antibodies. Furthermore, HLA Class I antibodies did not cross-react with the coupled beads.Conclusion: The 3-plex bead assay can be used to detect HPA-1a antibodies with sufficient specificity and sensitivity for use in the clinical setting of FMAIT. The development of other recombinant integrin fragments with the use of Luminex xMAP technology may assist in providing more rapid HPA antibody detection, enabling prompt diagnosis of alloimmune PLT disorders. [ABSTRACT FROM AUTHOR]

Objective: MicroRNAs (miRNAs) have been shown to offer great potential in the diagnosis of cancer. We investigated whether plasma miRNAs could discriminate between patients with and without colorectal cancer (CRC). Methods: This study was divided into three phases: (1) marker discovery using real-time PCR-based miRNA profiling on plasma, corresponding cancerous and adjacent non-cancerous colonic tissues of five patients with CRC, along with plasma from five healthy individuals as controls; (2) marker selection and validation by real-time quantitative RT-PCR on a small set of plasma; and (3) independent validation on a large set of plasma from 90 patients with CRC, 20 patients with gastric cancer, 20 patients with inflammatory bowel disease (IBD) and 50 healthy controls. Results: Of the panel of 95 miRNAs analysed, five were upregulated both in plasma and tissue samples. All the five miRNAs were validated on the plasma of 25 patients with CRC and 20 healthy controls. Both miR-17-3p and miR-92 were significantly elevated in the patients with CRC (p<0.0005). The plasma levels of these markers were significantly reduced after surgery in 10 patients with CRC (p<0.05). Further validation with an independent set of plasma samples (n = 180) indicated that miR-92 differentiates CRC from gastric cancer, IBD and normal subjects. This marker yielded a receiver operating characteristic curve area of 88.5%. At a cut-off of 240 (relative expression in comparison to RNU6B snRNA), the sensitivity was 89% and the specificity was 70% in discriminating CRC from control subjects. Conclusion: MiR-92 is significantly elevated in plasma of patients with CRC and can be a potential non-invasive molecular marker for CRC screening. [ABSTRACT FROM AUTHOR]

Maturity-onset diabetes of the young (MODY) is a subtype of diabetes defined by an autosomal pattern of inheritance and a young age at onset, often before age 25. MODY is genetically heterogeneous, with 8 distinct MODY genes identified to date and more believed to exist. We resequenced 732 kb of genomic sequence at 8p23 in 6 MODY families unlinked to known MODY genes that showed evidence of linkage at that location. Of the 410 sequence differences that we identified, 5 had a frequency <1% in the general population and segregated with diabetes in 3 of the families, including the 2 showing the strongest support for linkage at this location. The 5 mutations were all placed within 100 kb corresponding to the BLK gene. One resulted in an Ala71Thr substitution; the other 4 were noncoding and determined decreased in vitro promoter activity in reporter gene experiments. We found that BLK—a nonreceptor tyrosine-kinase of the src family of proto-oncogenes—is expressed in β-cells where it enhances insulin synthesis and secretion in response to glucose by up-regulating transcription factors Pdx1 and Nkx6.1. These actions are greatly attenuated by the Ala71Thr mutation. These findings point to BLK as a previously unrecognized modulator of β-cell function, the deficit of which may lead to the development of diabetes. [ABSTRACT FROM AUTHOR]

Treatment and prognosis of 14 patients of posterior fossa arterial dissections (AD) and dissecting aneurysms (DA) in one institution was reviewed. Internal trapping of aneurysm was performed for six patients presenting with SAH (three Vertebral, one posterior cerebral, one posterior inferior cerebellar, one anterior inferior cerebellar DA). The patency of the parent arteries was preserved in four DA patients with SAH (two Vertebral, two Basilar DA), 1 incidental vertebral DA, and one DA patient with brainstem infarction using stents and coils (four patients) or coils only (two patient). Proximal occlusion of parent artery was performed in a vertebral DA with SAH. One patient with a superior cerebellar DA presented with a midbrain infarct developed SAH with spontaneous occlusion of the aneurysm two weeks later. Of the 14 cases, ten were angiographically stable or cured during a follow up period of four to 70 months. one spontaneously resolved and two recurred. There was one death. [ABSTRACT FROM AUTHOR]

Background Congenital melanocytic naevi (CMNs) can be associated with abnormalities of the cental nervous system (CNS) and/or with melanoma. Quoted incidences for these complications vary in the literature, as do recommendations for investigations and follow-up. Objectives To determine the incidence of complications, and to identify phenotypic features associated with a higher risk of complications. Methods We reviewed records of 224 patients with CMNs seen in Dermatology clinic between 1991 and 2007. Patients were excluded if they had a complication at the time of referral. Magnetic resonance imaging (MRI) of the CNS was offered on the basis of CMN phenotype. Follow up was in clinic and/or by postal questionnaires. Results One hundred and twenty patients (54 boys and 66 girls) who had MRI of the CNS were included in the analysis. Mean age at MRI was 2·46 years (median 1·20). Mean follow up was 8·35 years (median 7·86). Sixty-five per cent had naevi > 20 cm projected adult size or multiple CMNs (40% > 40 cm), and 83% had satellite lesions at birth. Outcome measures were MRI abnormality, clinical neurological abnormality, any tumour, malignant melanoma, and death. No complications were seen in the 16 patients with no satellite lesions at birth. MRI and/or clinical neurological abnormalities were found in 22 patients (18%) and were significantly associated with projected adult size of the CMN (particularly > 40 cm), and independently with male gender. Tumours occurred in five patients, two of which were malignant melanoma (1·7%). Due to small numbers there was no significant association between phenotype and occurrence of tumours. Three patients (2·5%) died (one from neuromelanosis and two from melanoma in patients with normal MRI scans). Death was significantly associated with CMN size > 40 cm. Importantly, there was no significant association between CMN distribution (including posterior axial location) and adverse outcomes. Conclusions This is the largest study of CNS imaging in patients with CMNs. We report a newly recognized association between male gender and neurological complications, dispute the previously reported association between CMN site and neurological complications, and quantify the associations between CMN size, satellite lesions and neurological complications. We make recommendations for the management of these patients. [ABSTRACT FROM AUTHOR]

Sarcoidosis is a systemic noncaseating granulomatous disorder of unknown origin involving multiple organ systems. There has been no report so far to describe the epidemiological pattern of cutaneous involvement in sarcoidosis in South-East Asia with diverse ethnic groups. A retrospective study examining the clinicopathological features of all patients diagnosed with sarcoidosis at a tertiary dermatology centre in Singapore from 1980 to 2003 was conducted. Cutaneous sarcoidosis was diagnosed in 25 patients: 13 were Indian, 11 were Chinese and one was Eurasian. Cutaneous manifestations included papules, nodules, plaques and scarring alopecia. Extracutaneous involvement of lymph nodes (four patients), lungs (eight patients) and eyes (two patients) was seen. Eight patients had abnormal chest radiographic findings. Histopathological examination of skin lesions revealed noncaseating, epithelioid granulomatous infiltration in the dermis without evidence of mycobacterial infection, deep fungal infection or polarizable birefringent material. Treatment modalities included corticosteroids, hydroxychloroquine, isotretinoin, methotrexate and surgical excision. Five patients had complete resolution of the cutaneous lesions. Cutaneous sarcoidosis is rare in Asia and indeed in Singapore. Extracutaneous involvement is not uncommon and a thorough clinical evaluation should be undertaken. [ABSTRACT FROM AUTHOR]

Noradrenergic inputs to the hypothalamic paraventricular nucleus (PVN) play important roles in the regulation of neuroendocrine and autonomic functions. Previous reports show that noradrenaline increases the frequency of spontaneous inhibitory postsynaptic currents (sIPSCs) in a subpopulation of type II neurones, acting via α1-adrenoceptors (ARs), but reduces this frequency in most type I and another subpopulation of type II neurones, via α2-ARs on presynaptic GABA neurones. Here, we identified the subtypes of α-ARs mediating noradrenaline-induced increases and decreases in the sIPSC frequency of PVN neurones, by using slice patch recordings from PVN neurones. In both type I and II neurones, the noradrenaline-induced decrease in sIPSC frequency was completely blocked by BRL44408 (α2A-AR antagonist) at 1-3 μM, which is approximately 1/100 of its equilibrium dissociation constant (pA2 = 8.0), but not by prazosin (20-100 μM, α2B/C-AR antagonist; pA2 = 7.5). The effect of noradrenaline was mimicked by guanfacine (α2A-AR agonist) with an EC50 of 0.1 μM. In type II neurones, the noradrenaline-induced increase in sIPSC frequency was not blocked by any of the following antagonists: RS17053 (10 μM, α1A-AR antagonist), BMY7378 (2 μM, α1D-AR antagonist), prazosin (0.1 μM, α1-AR antagonist; pA2 = 10.5), or chloroethylclonidine (10 μM, α1B/D-AR antagonist). However, the effect of noradrenaline was blocked by higher concentrations of prazosin (1 μM) or RS17053 (100 μM), suggesting the involvement of α1L-subtype, a low affinity form of α1A-ARs. Collectively, our results indicate that the α2A-, or α1L-ARs on the GABA neurones mediate the noradrenaline-induced decreases, or increases in the frequencies of the sIPSCs of PVN neurones, respectively. [ABSTRACT FROM AUTHOR]

Much is being written today about the changing nature of the American workforce. This article summarizes 10 of these changes: (a) global competition; (b) the changing skills of work; (c) the declining impact of unions; (d) the altered human composition of the workforce; (e) the effects of continuous improvement, downsizing, and reengineering; (f) the growing use of part-time employees; (g) the widening income gap; (h) lessened employer and employee loyalty and commitment; (i) early retirement programs; and (j) telecommunications and virtual employees. Rather than just identifying and documenting these trends, this article discusses the ethical implications of such movements. In this article, employee relations ethics is defined as "treating employees properly, with respect and dignity." The term employee relations ethics is used both individually and collectively to analyze the negative human results from a moral rather than an economic perspective. The age-old clash between bottom-line mentality (economics) versus higher order thinking (ethics) is revisited with a focus on employees, not owners (old theory) or customers (new theory). [ABSTRACT FROM AUTHOR]

Hypoxia‐ischaemia (HI) can result in structural brain abnormalities, which in turn can lead to behavioural deficits in various cognitive and motor domains, in both adult and paediatric populations. Cardiorespiratory arrest (CA) is a major cause of hypoxia‐ischaemia in adults, but it is relatively rare in infants and children. While the effects of adult CA on brain and cognition have been widely studied, to date, there are no studies examining the neurodevelopmental outcome of children who suffered CA early in life. Here, we studied the long‐term outcome of 28 children who suffered early CA (i.e., before age 16). They were compared to a group of control participants (n = 28) matched for age, sex and socio‐economic status. The patient group had impairments in the domains of memory, language and academic attainment (measured using standardised tests). Individual scores within the impaired range were most commonly found within the memory domain (79%), followed by academic attainment (50%), and language (36%). The patient group also had reduced whole brain grey matter volume, and reduced volume and fractional anisotropy of the white matter. In addition, lower performance on memory tests was correlated with bilaterally reduced volume of the hippocampi, thalami, and striatum, while lower attainment scores were correlated with bilateral reduction of fractional anisotropy in the superior cerebellar peduncle, the main output tract of the cerebellum. We conclude that patients who suffered early CA are at risk of developing specific cognitive deficits associated with structural brain abnormalities. Research Highlights: Our data shed light on the long‐term outcome and associated neural mechanisms after paediatric hypoxia‐ischaemia as a result of cardiorespiratory arrest.Patients had impaired scores on memory, language and academic attainment.Memory impairments were associated with smaller hippocampi, thalami, and striatum.Lower academic attainment correlated with reduced fractional anisotropy of the superior cerebellar peduncle. [ABSTRACT FROM AUTHOR]

Growth inhibition caused by fluoride was further studied by analyzing free and bound ribosomes, and the ribosomal components in corn roots. Ribosomes were isolated by differential centrifugation. Ribosomal components were analyzed by column chromatography and electrophoresis. Fluoride reduces the amounts of both free and bound ribosomes. Fluoride also modifies the RNA to protein ratio of bound ribosomes more than that of free ribosomes. Fluoride does not affect base ratios of the ribosomal RNA, but reduces its content and changes the structure of the ribosomal protein moiety. [ABSTRACT FROM AUTHOR]

Eccrine syringofibroadenoma of Mascaro is a rare benign tumour. There are five subtypes, one of which is known to occur in reaction to inflammatory and neoplastic dermatoses. We describe a patient with previous lepromatous leprosy presenting with multiple flesh-coloured verrucous plaques over the right foot. Histology was consistent with eccrine syringofibroadenoma. To our knowledge, this is the first reported case of multiple eccrine syringofibroadenomata occurring in association with leprosy. The tumours in this case are most likely reactive in nature, subsequent to multiple traumatic events with tissue remodelling in an insensate foot affected by leprosy. It is less probable that the tumours are a result of scarring from recurrent infections. We also raise the possibility of a neuroeccrine interaction, with sympathetic neuropathy in leprosy as a contributing factor in the pathogenesis. [ABSTRACT FROM AUTHOR]

The article provides information about strokes. Stroke is an important pediatric illness and is one of the top ten causes of childhood death. At least two-thirds of children affected by ischaemic stroke have residual impairments spanning many domains of function and up to a fifth of them have a recurrence. Epidemiological studies have established that as many children are affected by stroke as by brain tumor. However, the collaborative networks established for the study and treatment of pediatric malignancies are only now evolving in the field of childhood stroke. The article also provides information about several types of strokes.

Myelin oligodendrocyte glycoprotein antibodies (MOG-Abs) are a well-recognized cause of acquired demyelinating syndromes in both adult and children. Despite basal ganglia involvement on imaging, movement disorder is not a cardinal feature. We describe a 2-year-9-month-old girl who presented with severe encephalopathy with aphasia, seizures and a complex movement disorder with dystonic posturing and tonic eye deviation. Neuroimaging revealed subtle asymmetrical predominantly white matter signal changes. MOG-Abs were positive in the serum. Other known pathogenic autoantibodies including N-methyl-D-aspartate receptor antibodies (NMDAR-Abs) were negative. The patient made a complete recovery following 2-week corticosteroid treatment. This case highlights the need for MOG-Ab testing in children with suspected autoimmune encephalopathies. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article about indeterminate results on the inferon- γ release assay for tuberculosis screening by Desai and company.

Presents a correction for the article entitled "Subtypes of alpha1 and alpha2-Adrenoceptors Mediating Noradrenergic Modulation of Spontaneous Inhibitory Postsynaptic Currents in the Hypothalamic Paraventricular Nucleus" appearing volume 16, 2004 issue of the "Journal of Neuroendocrinology."

Reviews the medical book `CNS magnetic resonance imaging in infants and children' edited by Eric N Faerber.

Objective: The objective of this study was to evaluate the effectiveness of PACH in reducing hospital readmissions and costs to the health system. Methodology: A retrospective non-randomised trial was designed to examine the costs and outcomes of PACH. All patients referred for PACH and met the programme inclusion criteria were included as the intervention group. Patients who declined PACH programme or were out of boundary formed the control group. The primary outcomes were the number of hospital readmissions and total health system costs at 3 and 6 months post-discharge. To account for uncertainty in mortality for the control group, patients who had not utilised any health services after 6 months were assumed to have died. Results: There were 409 patients in the PACH group and 201 patients in the control group. Both groups were similar in demographic and baseline characteristics. Multivariate analyses showed that hospital readmissions were 38% higher for patients in the PACH group after 6 months. Total healthcare costs at 3 months and 6 months showed no statistical differences. Enrolment in PACH was associated with lower mortality, higher hospital readmissions and no differences in costs. However, the results could be limited by incomplete data on health services utilisation and mortality. These findings reflect the challenges faced when conducting programme evaluation in the local setting. [ABSTRACT FROM AUTHOR]

The objective of this study is to investigate the biodiesel production from Calophyllum inophyllum -palm mixed oil. The C. inophyllum--palm biodiesel (C. inophyllum palm oil methyl ester, CPME) is first produced by mixing the crude oils at an equal ratio of 50:50 vol%, followed by degumming, acid-catalyzed esterification, purification, and, last, alkaline-catalyzed transesterification. With this systematic procedure, the acid value of the CPME is 0.4 mg KOH/g, resulting in a significant enhancement of oxidation stability (114.21 h). The results indicate that the fatty acid methyl ester composition of the CPME may be the reason for its larger higher heating value (39.4 MJ/kg) and lower kinematic viscosity (4.15 mm²/s). In short, CPME satisfied the ASTM D6751 and EN 14214 standards as a promising alternative fuel in the future. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate cerebral magnetic resonance imaging (MRI) scans of children with prenatal drug exposure in a clinical context. A hospital-based cohort of 10- to 14-year-old children, prenatally exposed to alcohol, opioids, and polysubstances, and a group of sex- and age-matched controls were examined with cerebral MRI. Scans obtained from 34 exposed children and 40 controls were scored based on the presence and degree of pathology by an experienced pediatric neuroradiologist blinded to the participants’ background. Overall visual detectable MRI pathology was found in 35% of the exposed children and 33% of the controls (odds ratio = 1.08; 95% confidence interval = 0.36-3.25). No specific imaging pattern following prenatal drug exposure was seen by the means of simple visual analysis of cerebral MRI scans. Although cerebral MRI is feasible, it is probably of limited value in the clinical assessment of children with prenatal drug exposure. [ABSTRACT FROM AUTHOR]

An analytical method based on statistical mechanics is proposed to predict ultra-thin adsorbed films of physical fluids with molecular diversity formed on smooth surfaces. The model is representative of molecular interactions at the smooth summits of surface asperities in the nano-scale. At this physical scale the constraining effect of the solid barriers promotes discretization of the fluid volume into molecular layers. These layers are usually ejected from the contact in a stepwise manner. The integrated effect of intermolecular forces as well as their interactions with the contiguous surfaces is responsible for the discontinuous drainage of the fluid. However, at the same time, the adsorption energy of the molecular species strives to form a molecular monolayer upon the boundary solids. The net result of these complex interactions is an ultra-thin adsorbed film, whose shear characteristics depends on a competition between the repulsive solvation pressure and the energy of molecular adsorption. It is shown that very thin low shear strength films are formed in this manner. This would depend on the molecular concentration and the wall adsorption energy. An important implication is that boundary adherent films should be viewed as a result of surface-fluid combination for which the choice of concentration and fraction content of particular species are crucial. [ABSTRACT FROM AUTHOR]

Background: TRNT1 (CCA-adding transfer RNA nucleotidyl transferase) enzyme deficiency is a new metabolic disease caused by defective post-transcriptional modification of mitochondrial and cytosolic transfer RNAs (tRNAs).Results: We investigated four patients from two families with infantile-onset cyclical, aseptic febrile episodes with vomiting and diarrhoea, global electrolyte imbalance during these episodes, sideroblastic anaemia, B lymphocyte immunodeficiency, retinitis pigmentosa, hepatosplenomegaly, exocrine pancreatic insufficiency and renal tubulopathy. Other clinical features found in children include sensorineural deafness, cerebellar atrophy, brittle hair, partial villous atrophy and nephrocalcinosis. Whole exome sequencing and bioinformatic filtering were utilised to identify recessive compound heterozygous TRNT1 mutations (missense mutation c.668T>C, p.Ile223Thr and a novel splice mutation c.342+5G>T) segregating with disease in the first family. The second family was found to have a homozygous TRNT1 mutation (c.569G>T), p.Arg190Ile, (previously published). We found normal mitochondrial translation products using passage matched controls and functional perturbation of 3' CCA addition to mitochondrial tRNAs (tRNA(Cys), tRNA(LeuUUR) and tRNA(His)) in fibroblasts from two patients, demonstrating a pathomechanism affecting the CCA addition to mt-tRNAs. Acute management of these patients included transfusion for anaemia, fluid and electrolyte replacement and immunoglobulin therapy. We also describe three-year follow-up findings after treatment by bone marrow transplantation in one patient, with resolution of fever and reversal of the abnormal metabolic profile.Conclusions: Our report highlights that TRNT1 mutations cause a spectrum of disease ranging from a childhood-onset complex disease with manifestations in most organs to an adult-onset isolated retinitis pigmentosa presentation. Systematic review of all TRNT1 cases and mutations reported to date revealed a distinctive phenotypic spectrum and metabolic and other investigative findings, which will facilitate rapid clinical recognition of future cases. [ABSTRACT FROM AUTHOR]

Background The incidence of skin cancers has been increasing in Singapore, owing to the country's location near the equator and its ageing population. Topical photodynamic therapy ( PDT) is a treatment method employing light and a topical photosensitizer to treat actinic keratosis ( AK). Most published data to date on PDT have been drawn from studies of patient with Fitzpatrick skin phototypes I and II. Aim To evaluate the effectiveness of PDT in the treatment of AK in patients with skin phototype IV in Singapore. Methods This was a retrospective analysis of 13 East Asian patients with AK treated with PDT at the National Skin Centre, Singapore, from 2006 to 2013. Results The overall clearance rate of AK at 3 months was 81.8% (9 of 11 patients; the other 2 were lost to follow-up). Mild to moderate pain during therapy was a common adverse event. Conclusions PDT is a useful treatment method for AK in East Asian patients with skin phototype IV. Further larger prospective studies will be needed to evaluate its overall efficacy in East Asian patients. [ABSTRACT FROM AUTHOR]

Background The main aims of the 16th ISBT Platelet Immunology workshop were as follows: (i) to test the ability of the laboratories in the identification of platelet alloantibodies, (ii) to compare the detection of HPA-1a alloantibodies in serum and plasma, (iii) to quantify HPA-1a alloantibodies, (iv) to measure platelet-bound HPA-1a alloantibodies in lysates, (v) to evaluate a new bead-based assay for anti- HPA-1a and anti- HPA-1b detection, (vi) to evaluate the efficiency of a human monoclonal antibody for HPA-5a phenotyping and (vii) to test the ability to genotype for HPA-1, HPA-2, HPA-3, HPA-4, HPA-5, HPA-6, HPA-9, HPA-12w, HPA-13w and HPA-15. Materials and methods Seven exercises were developed to encompass the aims of this workshop. All materials and procedures were distributed for 34 laboratories from 20 countries. Results The platelet alloantibodies identification exercise presented good results compared with previous workshops. Comparison between serum and plasma in titration study showed comparable results for HPA-1a and HPA-5b alloantibodies. For the quantitative determination of HPA-1a alloantibodies, most of the laboratories could reliably assign a similar concentration. It was also possible to identify bound anti- HPA-1a alloantibodies in cell lysates within 2 weeks. The bead assay demonstrated good reproducibility between laboratories although some anti- HPA-1a samples remain an issue. Phenotyping of HPA-5b showed high false-negative error (6%). DNA typing presented excellent results, demonstrating that DNA tests for HPA are very well established in all laboratories. Conclusions This workshop presented high complexity exercises with very good results achieved in most of the exercises and approximately 100% consensus among the participants. [ABSTRACT FROM AUTHOR]

Background: The Silk Vista Baby (SVB) flow diverter (FDS) is the only FDS deliverable via a 0.017 inch microcatheter and is specifically designed for the distal vasculature. We sought to evaluate the safety and efficacy of the SVB. Materials and Methods: We performed a retrospective review to identify SVB cases at 4 tertiary neurosurgical centres within the U.K. Clinical, procedural, angiographic and follow-up data were collected. Results: We identified 60 patients (35 female, 58%) of average age 54 ± 10.5 (range 30–72) with 61 aneurysms, 50 (81.9%) located in the anterior circulation. The majority of the aneurysms treated were unruptured (46, 75.4%) and saccular (46, 75.4%). Dome size was 6.2 ± 6.2 mm (range 1–36mm) and parent vessel diameter was 2.3 ± 0.4 mm (range 1.2-3.3 mm). An average number of 1.07 devices were implanted. Coils or other devices were implanted in 14 aneurysms (23.3%). At last angiographic follow-up (n = 55), 7.5 ± 4.2 months post-procedure, 32 aneurysms (57.1%) were graded as RRC I, 7 (12.5%) RRC II, and 17 RRC III (30.4%). Clinical complications, excluding death, were seen in 4 patients (6.8%) including 1 delayed aneurysm rupture and 3 symptomatic ischaemic events. Only one patient had permanent morbidity (mRS 1). 3 patients died during follow-up (5.1%); 2 deaths were related to the aneurysms (3.4%) – one ruptured dissecting MCA aneurysm, and one giant partially thrombosed posterior circulation aneurysm. 93% of patients were mRS ≤ 2 at last follow-up. Conclusion: The SVB has high rates of technical success and an acceptable safety profile. Distal aneurysms may occlude slower due to relative oversizing of the devices. [ABSTRACT FROM AUTHOR]