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Abstract Background Lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) significantly impact quality of life among older men. Despite the prevalent use of the American Urological Association Symptom Index (AUA-SI) for BPH, this measure overlooks key symptoms such as pain and incontinence, underscoring the need for more comprehensive patient-reported outcome (PRO) tools. This study aims to integrate enhanced PROs into routine clinical practice to better capture the spectrum of LUTS, thereby improving clinical outcomes and patient care. Methods This prospective observational study will recruit men with LUTS secondary to BPH aged ≥ 50 years from urology clinics. Participants will be stratified into medical and surgical management groups, with PRO assessments scheduled at regular intervals to monitor LUTS and other health outcomes. The study will employ the LURN Symptom Index (SI)-29 alongside the traditional AUA-SI and other non-urologic PROs to evaluate a broad range of symptoms. Data on comorbidities, symptom severity, and treatment efficacy will be collected through a combination of electronic health records and PROs. Analyses will focus on the predictive power of these tools in relation to symptom trajectories and treatment responses. Aims are to: (1) integrate routine clinical tests with PRO assessment to enhance screening, diagnosis, and management of patients with BPH; (2) examine psychometric properties of the LURN SIs, including test-retest reliability and establishment of clinically meaningful differences; and (3) create care-coordination recommendations to facilitate management of persistent symptoms and common comorbidities measured by PROs. Discussion By employing comprehensive PRO measures, this study expects to refine symptom assessment and enhance treatment monitoring, potentially leading to improved personalized care strategies. The integration of these tools into clinical settings could revolutionize the management of LUTS/BPH by providing more nuanced insights into patient experiences and outcomes. The findings could have significant implications for clinical practices, potentially leading to updates in clinical guidelines and better health management strategies for men with LUTS/BPH. Trial registration This study is registered in ClinicalTrials.gov (NCT05898932).

Abstract Introduction Practicality of implementation and dosing of supplemental gait training in an acute stroke inpatient rehabilitation setting are not well studied but can have positive impact on outcomes. Objectives To determine the feasibility of early, intense supplemental gait training in inpatient stroke rehabilitation, compare functional outcomes and the specific mode of delivery. Design and setting Assessor blinded, randomized controlled trial in a tertiary Inpatient Rehabilitation Facility. Participants Thirty acute post-stroke patients with unilateral hemiparesis (≥ 18 years of age with a lower limb MAS ≤ 3). Intervention Lokomat® or conventional gait training (CGT) in addition to standard mandated therapy time. Main outcome measures Number of therapy sessions; adverse events; functional independence measure (FIM motor); functional ambulation category (FAC); passive range of motion (PROM); modified Ashworth scale (MAS); 5 times sit-to-stand (5x-STS); 10-m walk test (10MWT); 2-min walk test (2MWT) were assessed before (pre) and after training (post). Results The desired supplemental therapy was implemented during normal care delivery hours and the patients generally tolerated the sessions well. Both groups improved markedly on several measures; the CGT group obtained nearly 45% more supplemental sessions (12.8) than the Lokomat® group (8.9). Both groups showed greater FIM improvement scores (discharge – admission) than those from a reference group receiving no supplemental therapy. An overarching statistical comparison between methods was skewed towards a differential benefit (but not significant) in the Lokomat® group with medium effect sizes. By observation, the robotic group completed a greater number of steps, on average. These results provide some evidence for Lokomat® being a more efficient tool for gait retraining by providing a more optimal therapy “dose”. Conclusions With careful planning, supplemental therapy was possible with minimal intrusion to schedules and was well tolerated. Participants showed meaningful functional improvement with relatively little supplemental therapy over a relatively short time in study.

Abstract Background Bimolecular fluorescence complementation (BiFC) is a novel technique to examine protein-protein interaction through the assembly of fluorescent proteins. In the present study, BiFC was used to study the assembly of the Epstein-Barr virus latent membrane protein 1 (LMP1) signaling complex within the membrane of mammalian cells. LMP1 signaling requires oligomerization, localization to lipid rafts, and association of the cytoplasmic domain to adaptor proteins, such as the tumor necrosis factor receptor associated factors (TRAFs). Methods LMP1-TRAF and LMP1-LMP1 interactions were assayed by BiFC using fluorescence microscopy and flow cytometry. Function of LMP1 BiFC contructs were confirmed by transformation assays and nuclear factor- κB (NF-κB) reporter assays. Results BiFC was observed between LMP1 and TRAF2 or TRAF3 and mutation of the LMP1 signaling domains reduced complementation. Fluorescence was observed in previously described LMP1 signaling locations. Oligomerization of LMP1 with itself induced complementation and BiFC. LMP1-BiFC constructs were fully functional in rodent fibroblast transformation assays and activation of NF-κB reporter activity. The BiFC domain partially suppressed some LMP1 mutant phenotypes. Conclusions Together these data suggest that BiFC is a unique and novel platform to identify and characterize proteins recruited to the LMP1-signaling complex.

Empowerment and development of job skills of rural youth has been proposed as one of the key strategies for the development of entrepreneurial activities in rural areas, the development of which depends on various factors. In the meantime, teamwork skills have a special place in empowerment and development of job skills. Accordingly, the present study was conducted in a descriptive-analytical manner with the aim of analyzing the role of teamwork skills on the capabilities of rural youth in Sanjabi rural district of Kermanshah. The research tool was a researcher-made questionnaire. The reliability of the questionnaire was obtained using Cronbach's alpha coefficient and the validity of the research tool was confirmed by a panel of expert. The statistical population was 15-35 years rural youth (N=4288). A sample of 351 people was selected by stratified multi-stage sampling technique. Based on results, the respondents had a moderate level of teamwork skills and a high level of job empowerment. Interpersonal communication level in the rural youth was higher than other dimensions of teamwork skills. The ability of young people in cooperative activities was above average. Based on correlation analysis there was a direct and significant relationship between teamwork skills and job empowerment. Based on the results of multiple regressions, adaptation, decision making, interpersonal communication, leadership and coordination explain 52.5% of the changes in youth job empowerment.

Reduction of systemic autoimmunity using TNF blockers may also reduce inflammatory diseases in other organs. Here, the authors use a patient database and scRNA-seq to link autoimmune diseases to benign prostatic hyperplasia (BPH), and demonstrate that prostatic hyperplasia is reduced by TNF blockers in humans and mice.

The validated 17-gene Oncotype DX Genomic Prostate Score® (GPS™) assay risk-stratifies prostate-cancer patients with localized disease. The assay has primarily been utilized in lower risk patients deciding between active surveillance versus definitive therapy. In this retrospective cohort study, we analyze the association of the GPS result with time to biochemical recurrence post-prostatectomy in patients with National Comprehensive Cancer Network® (NCCN) intermediate and higher risk prostate cancer. The 141 patients included in the study were from the NorthShore University HealthSystem diagnosed 2014-2019 with NCCN intermediate (n = 109) or higher risk (n = 32) prostate cancer, treated with radical prostatectomy 2015-2019. The association of GPS result with time to biochemical recurrence was evaluated using univariable and multivariable Cox proportional hazards models in 120 patients with unfavorable intermediate or higher risk. Median (interquartile range) follow-up time was 28 (20 to 38) months. The GPS result was significantly associated with time to biochemical recurrence as both a continuous and dichotomous variable in univariable (hazard ratio [HR] per 20 GPS units 2.36, 95% CI 1.45-3.80, p < 0.001; HR for GPS result 41-100 vs 0-40 3.28, 95% CI 1.61-7.19, p < 0.001) and in multivariable models accounting for NCCN risk group (HR per 20 GPS units 2.14, 95% CI 1.31-3.46, p = 0.003; HR for GPS result 41-100 vs 0-40 3.00, 95% CI 1.43-6.72, p = 0.003) or biopsy Gleason Score and diagnostic PSA or PSA density. These results indicate that the GPS assay was a strong predictor of biochemical recurrence after radical prostatectomy in this unfavorable intermediate and higher risk prostate cancer patient population.

The utility of zebrafish is becoming more frequent due to lower costs and high similarities to humans. Zebrafish larvae are attractive subjects for drug screening and drug metabolism research. However, obtaining good quality zebrafish larvae sections for batch samples at designated planes, angles, and locations for comparison purposes is a challenging task. We report here the optimization of fresh frozen zebrafish larvae sectioning for mass spectrometry imaging. We utilized the gelatin solutions that were created at two different temperatures (50 and 85 °C) as embedding media. Gelatin-50 (gelatin created under 50 °C, solid gel under room temperature) was used to make a larvae-shaped mold and gelatin-85 (gelatin created under 85 °C, liquid under room temperature) was used to embed the larvae. H&E staining of sections shows well-preserved morphology and minimal histological interference. More importantly, the position of the larvae was well controlled resulting in more consistent sectioning of the larvae.

(1) Imaging of pharmaceutical compounds in tissue is an increasingly important subsection of Mass Spectrometry Imaging (MSI). Identifying proper target engagement requires MS platforms with high sensitivity and spatial resolution. Three prominent categories of drugs are small molecule drugs, antibody-drug conjugate payloads, and protein degraders. (2) We tested six common MSI platforms for their limit of detection (LoD) on a representative compound for each category: a Matrix-Assisted Laser Desorption/Ionization (MALDI) Fourier Transform Ion Cyclotron, a MALDI-2 Time-of-Flight (ToF), a MALDI-2 Trapped Ion Mobility Spectrometry ToF, a Desorption Electrospray Ionization Orbitrap, and 2 Atmospheric Pressure-MALDI Triple Quadrupoles. Samples were homogenized tissue mimetic models of rat liver spiked with known concentrations of analytes. (3) We found that the AP-MALDI-QQQ platform outperformed all 4 competing platforms by a minimum of 2- to 52-fold increase in LoD for representative compounds from each category of pharmaceutical. (4) AP-MALDI-QQQ platforms are effective, cost-efficient mass spectrometers for the identification of targeted analytes of interest.

Illustrated is the usefulness of keeping track of the directions of atomic orbitals in predicting the shapes of molecules. The application of this technique to all cumulenes and its use in the determination of aromaticity in cyclic systems is discussed. (KR)

Provides a set of instructions for writing Lewis octet structures which incorporates a simple rule called the "6N+2 Rule." Discusses the importance of these structures in elementary chemistry, biochemistry, and organic chemistry courses. Also discusses non-octet structures and how they are characterized. (JM)

Purpose Male urinary incontinence is thought to be infrequent. We sought to describe the prevalence of urinary incontinence in a male treatment seeking cohort enrolled in the LURN (Symptoms of Lower Urinary Tract Dysfunction Research Network). Materials and Methods Study inclusion and exclusion criteria, including men with prostate cancer or neurogenic bladder, were previously reported. LURN participants prospectively completed questionnaires regarding lower urinary tract symptoms and other clinical variables. Men were grouped based on incontinence type, including 1) no urinary incontinence, 2) post-void dribbling only and 3) urinary incontinence. Comparisons were made using ANOVA and multivariable regression. Results Of the 477 men 24% reported no urinary incontinence, 44% reported post-void dribbling only and 32% reported urinary incontinence. African American men and those with sleep apnea were more likely to be in the urinary incontinence group than in the no urinary incontinence group (OR 3.2, p = 0.02 and OR 2.73, p = 0.003, respectively). Urinary incontinence was associated with significantly higher bother compared to men without leakage (p <0.001). Compared to men without urinary incontinence and men with only post-void dribbling those with urinary incontinence were significantly more likely to report higher scores (more severe symptoms) on the PROMIS (Patient-Reported Outcomes Measurement Information System) questionnaires regarding bowel issues, depression and anxiety than men without urinary incontinence (p <0.01). Conclusions Urinary incontinence is common among treatment seeking men. This is concerning because the guideline recommended questionnaires to assess male lower urinary tract symptoms do not query for urinary incontinence. Thus, clinicians may be missing an opportunity to intervene and improve patient care. This provides a substantial rationale for a new or updated symptom questionnaire which provides a more comprehensive symptom assessment. [ABSTRACT FROM AUTHOR]

Individuals with central nervous system injuries are a large and apparently rapidly expanding population-as suggested by 2013 statistics from the American Heart Association. Increasing survival rates and lifespans emphasize the need to improve the quality of life for this population. In persons with central nervous system injuries, mobility limitations are among the most important factors contributing to reduced life satisfaction. Decreased mobility and subsequently reduced overall activity levels also contribute to lower levels of physical health. Braces to assist walking are options for greater-functioning individuals but still limit overall mobility as the result of increased energy expenditure and difficulty of use. For individuals with greater levels of mobility impairment, wheelchairs remain the preferred mobility aid yet still fall considerably short compared with upright bipedal walking. Furthermore, the promise of functional electrical stimulation as a means to achieve walking has yet to materialize. None of these options allow individuals to achieve walking at speeds or levels comparable with those seen in individuals with unimpaired gait. Medical exoskeletons hold much promise to fulfill this unmet need and have advanced as a viable option in both therapeutic and personal mobility state, particularly during the past decade. The present review highlights the major developments in this technology, with a focus on exoskeletons for lower limb that may encompass the spine and that aim to allow independent upright walking for those who otherwise do not have this option. Specifically reviewed are powered exoskeletons that are either commercially available or have the potential to restore upright walking function. This paper includes a basic description of how each exoskeleton device works, a summation of key features, their known limitations, and a discussion of current and future clinical applicability. [ABSTRACT FROM AUTHOR]

Rocker bottom shoes have recently gained considerable popularity, likely in part because of the many purported benefits, including reducing joint loading and toning muscles. Scientific inquiry about these benefits has not kept pace with the increased usage of this shoe type. A fundamental premise of rocker bottom shoes is that they transform hard, flat, level surfaces into more uneven ones. Published studies have described a variety of such shoes—all having a somewhat rounded bottom and a cut heel region or a cut forefoot region, or both (double rocker). Despite the fundamentally similar shoe geometries, the reported effects of rocker bottom shoes on gait biomechanics have varied considerably. Ten healthy subjects agreed to participate in the present study and were given appropriately sized Masai Barefoot Technology (St. Louis, MO), Skechers ™ (Manhattan Beach, CA), and New Balance (Boston, MA) conventional walking shoes. After a 12-day accommodation period, the subjects walked wearing each shoe while 3-dimensional motion and force data were collected in the gait laboratory. The key findings included (1) increased trunk flexion, decreased ankle plantarflexion range, and reduced plantarflexion moment in the early stance; (2) increased ankle dorsiflexion and knee flexor moment in the midstance; (3) decreased peak ankle plantarflexion in the late stance; and (4) decreased ankle plantarflexion and decreased hip flexor and knee extensor moments in the pre-swing and into swing phase. The walking speed was unconstrained and was maintained across all shoe types. A biomechanical explanation is suggested for the observed changes. Suggestions for cautions are provided for using rocker bottom shoes in patients with neuromuscular insufficiency. [ABSTRACT FROM AUTHOR]

Broilers selected for increased body size and breast muscle have imposed stress on the skeletal system, resulting in poorer walking ability. Our objectives were to determine the relationship between bone mineralization and gait score in 4 crosses of commercial broilers and to ascertain if mineralization of the toe is correlated to the tibia. Three chickens per pen each with good (gait score of 0 or 1) or poorer (gait score of 3) walking ability were killed and weighed. The left humerus, the left middle toe, and both drumsticks were collected for determination of bone mineral density (BMD), bone mineral content, and bone size traits using dual-energy x-ray absorptiometry. The BMD and bone size traits were similar among the 4 crosses of commercial broilers at 6 wk of age. However, gait scores differed among genotypes, with cross C having better gait scores than crosses A and B, but did not differ from cross D. The bone mineral content and bone size traits did not differ between birds with good walking ability as compared with those broilers of poorer walking ability. However, birds with poorer walking ability had higher BMD (P < 0.05) and BW (P < 0.001) than males with good walking ability. Within a cross, the correlation between gait score and BMD was not significant except for cross D birds. Broilers of cross D with better walking ability had decreased bone mineralization (r = 0.19, P = 0.03). The stronger correlation between gait score and BW for all crosses of commercial broilers (r = 0.38, P < 0.0001) suggests that the low association between gait score and bone mineralization for cross D was mainly due to BW. The BMD of the left toe was correlated to the BMD of the left tibia (r = 0.91, P < 0.0001) and right tibia (r = 0.87, P < 0.0001). In conclusion, bone mineralization was similar among crosses of meat-type chickens, and it had little influence on the gait score of male broilers. [ABSTRACT FROM AUTHOR]

The variability of bone traits was assessed in purebred lines of meat-type chickens using dual-energy x-ray absorptiometry. Experiment 1 evaluated changes in bone mineralization and size traits of the tibia and humerus in 4 purebred lines from 6 to 24 wk of age. Experiment 2 compared the same traits of the tibia, radius, and ulna of 9 purebred lines at 6 wk of age. Differences in bone traits among purebred lines were apparent in both experiments. Of the 4 purebred lines compared in experiment 1, line C demonstrated the best phenotypic traits relative to bone quality. Even though line C had the longest tibia, one of the largest bone areas, one of the heaviest BW, and one of the highest bone mineral content (BMC) at 24 wk of age, the tibia of line C did not become less dense in mineral as this line of chickens approached sexual maturity as did the tibia of the other purebred lines of chickens. Specifically, its tibial bone mineral density (BMD) showed age-related increases unlike the other purebred lines of chickens, which showed little change in tibial BMD from 6 to 24 wk of age. In experiment 2, all bone traits as well as BW were different among purebred lines (P < 0.001). The 2 purebred lines (7 and 8) with the lightest 6-wk-old BW (2,033 and 2,055 g, respectively) had diverse skeletal traits. Birds of line 7 had the lowest BMD (0.1131 g/cm²), BMC (1.05 g), shortest bone length (69.2 mm), and smallest bone area (8.0 cm²); however, the other purebred line low in BW (line 8) showed the opposite trend in that bones from these birds were the highest in BMD (0.1276 g/cm²), BMC (1.38 g), bone length (74.6 mm), and area (9.2 cm²) when compared with all of the other lines. In conclusion, several purebred lines of meat-type chickens expressed large differences in bone traits, suggesting the potential to genetically select birds for increased BMD. [ABSTRACT FROM AUTHOR]

Life cycle changes in bone mineralization and bone size traits of the tibia and humerus were evaluated in commercial male and female broilers using dual-energy x-ray absorptiometry (DEXA). Experiment 1 evaluated weekly changes in bone traits from 2 to 7 wk of age, whereas experiment 2 compared the bone traits of 4 strains of commercial meat-type chickens from 4 to 8 wk of age. Birds Were restrained without anesthesia, and the humerus and tibia were scanned in vivo. After each scan, individual BW was determined. From the DEXA scans, bone mineral density (BMD), bone mineral content (BMC), as well as bone length, width, and area were determined. Bone mineralization and size traits were analyzed as an analysis of covariance with BW as the covariate. If BW was NS as a covariate, then an ANOVA was used. The BMD reached its peak at 4 wk of age. The BMC of the humerus changed little from 2 to 8 wk of age, whereas tibial BMC increased as the birds aged, especially in males (P < 0.0001). In experiment 1, bone length, width, and area also increased with age (P < 0.0001), with the tibia growing in length at a faster rate than the humerus. In experiment 2, the BMD did riot differ among the 4 strains of commercial broilers. Interactions with strain of chicken were also NS, indicating that all strains of chickens responded similarly with respect to age (4, 6, and 8 wk of age), sex, and type of bone (humerus vs. tibia). Coefficients of variation for BMD ranged from 15 to 16%, indicating a potential use of DEXA for selection to improve skeletal integrity. In conclusion, the tibia continued to grow, especially after the initiation of the growth spurt at 3 to 4 wk of age, as indicated by bone length, width, and BMC, but it did not become denser in mineral after 4 wk of age as its surface area increased. [ABSTRACT FROM AUTHOR]

Investigates the temporal-spatial characteristics of the gait of patients with traumatic brain injury (TBI). Methods of gait analysis which are in clinical use; Methodology; Conclusion.