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Background: Exogenous artifacts can interfere with accurate histologic tissue evaluation on frozen sections during Mohs micrographic surgery (MMS). Mohs surgeons should be aware of these anomalies to avoid potential misdiagnoses., Objective: To review exogenous artifacts encountered in frozen tissue pathology during MMS., Methods: A literature search was conducted in PubMed to identify studies reporting on exogenous artifacts encountered during MMS and a list of previously described exogenous artifacts was compiled. A retrospective examination of frozen histology slides from recent Mohs cases at the authors' institution was performed to obtain illustrative examples of these artifacts, supplemented by formalin-fixed paraffin-embedded samples when frozen examples could not be found., Results: Exogenous artifacts represent foreign bodies that have been externally introduced into the skin or artifacts resulting from other external factors. If frozen section evaluation is inaccurate, overdiagnosis can occur during MMS, resulting in unnecessary layers, larger margins, and more complex reconstructions. These exogenous tissue changes can mimic inflammatory processes and melanocytic or keratinocyte malignancies on histology., Conclusion: Exogenous artifacts are common findings during margin assessment in Mohs micrographic surgery. The resulting histological findings can be confusing but correlating them with the clinical and surgical history often reassures surgeons. Recognizing these artifacts facilitates accurate diagnosis and promotes optimal patient care., (Copyright © 2024 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background: Patients are often advised to keep the initial postoperative dressings dry and undisturbed for 24 to 72 hours. However, these requirements may result in significant disruption of patients' activities of daily living, such as bathing, leisure, and exercise., Objective: Compare standard management of keeping wounds dry and covered (48 hours) with early (6 hours) postoperative water exposure., Methods: Investigator-blinded, randomized (1:1), controlled trial evaluating rate of infection and additional outcomes of interest., Results: Overall, 437 patients were randomized to either the early (6-hour) water exposure (n = 218) intervention group or the standard cohort (n = 219). The incidence of culture-proven infection in the intervention group (1.8%) was similar to the standard group (1.4%) (P > .99). There was also no difference in rates of bleeding or bruising. Scar assessment using the Patient and Observer Scar Assessment Scale revealed similar scar outcomes., Limitations: Single site, academic center., Conclusion: Surgical wounds can be allowed to get wet in the immediate postoperative period with no increased incidence of infection or other complications and with similar cosmesis., Competing Interests: Conflicts of interest Dr Kirby has served as a consultant for AbbVie, Incyte, Janssen, Novartis, and UCB; has received honoraria from AbbVie, Incyte, InsMed, and Viela Bio; and has served on the speakers bureau for AbbVie., (Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Conflicts of interest None.

Mycosis fungoides (MF) is a slowly progressive form of cutaneous T-cell lymphomas (CTCL). MF is classified into 4 subtypes including folliculotropic MF (FMF). Infiltration of both hair follicles and eccrine glands is included in the FMF classification and designated as syringotropic MF (STMF), an exceedingly rare form of CTCL. We report an additional case of STMF. The clinical course of syringotropic CTCL is more benign than FMF, suggesting that despite similar clinical presentations, they are molecularly distinct diseases. Clinical characteristics can help differentiate STMF from FMF. Skin-directed therapies are less effective in STMF than FMF. With distinct clinical characteristics, histopathologic findings, and disease course, syringotropic CTCL should be considered a subtype entity in the spectrum of adnexotropic MF. J Drugs Dermatol. 2022;21(12):1362-1364. doi:10.36849/JDD.6779.

In the past two decades, endovascular aortic repair (EVAR) of abdominal aortic aneurysm (AAA) has become the first line treatment for infrarenal AAA repair in many countries. While short-term results are good, concerns have been raised about long-term durability. Changes in aortoiliac anatomy, especially at the landing zones, could play a role in EVAR failure over time. The current study aimed to determine certain morphological changes in the distal iliac landing zone after EVAR implantation, as well aspossible risk factors associated with iliac sealing failure. In a retrospective analysis of a tertiary single-centre registry, including patients treated with EVAR between January 2008 and July 2018, clinical follow-up data were assessed, and computer tomography (CT) imaging was evaluated regarding morphological changes in the iliac anatomy during follow-up. For clinical analysis all patients with a minimum follow-up of one year were included; for morphological analysis of iliac anatomy all patients with available CT follow-up of a minimum of one year and a minimum of two CT scans were included. Overall, 127 out of 241 treated patients (92.1% male) were included in the clinical follow-up. Complete CT imaging of 99 iliac arteries in 55 patients was available for morphological analysis. Median postoperative follow-up (FU) for these patients was 33 months (IQR 31; min−max: 12−124). Incidence of type 1b endoleak was 3% but iliac limb detachment from the vessel wall was seen in 18.2% of the target vessels. There was a significant difference in oversizing in iliac limbs with detachment (median 13.9%, IQR 23.1) vs. without detachment (median 23.1%, IQR 19.1) (p = 0.034). Iliac arteries at the landing zone showed a significant diameter increase independent of an endoleak presence (overall cohort median diameter increase at one year 23.1 mm; at two years 0 mm; at three years 4.9 mm). Iliac arteries with detachment (median 14.4%; IQR 23.9) showed a significantly higher diameter increase at the landing zone after four years compared to arteries without detachment (median 5.3%; IQR 9) (p = 0.042). Oversizing correlated positively with an iliac diameter increase at the landing zone over time (3 m: p= 0.001; one year: p < 0.001; two years: p < 0.001; three years: p = 0.006). Older patients showed a significantly lower diameter increase at the distal landing zone over time than younger patients in the first two years after EVAR (p < 0.001/r = −0.606 after two years). In the current study, iliac limb oversizing was associated with increased dilatation of the distal landing zone during a three-year follow-up, while iliac limb detachment was observed less often. An older age was inversely associated to the iliac diameter increase. Future studies should clarify the association between stent graft oversizing, age, and changes in the iliac anatomy in order to identify parameters that affect EVAR durability.

Regeneration after severe peripheral nerve injury is often poor. Knowledge of human nerve regeneration and the growth microenvironment is greatly lacking. We aimed to identify the regenerative proteins in human peripheral nerve by comparing the proteome before and after a transection injury. In a unique study design, we collected closely matched samples of naïve and injured sural nerve. Naïve and injured (two weeks after injury) samples were analyzed using mass spectrometry and immunoassays. We found significantly altered levels following the nerve injury. Mass spectrometry revealed that injury samples had 568 proteins significantly upregulated and 471 significantly downregulated compared to naïve samples (q-value ≤ 0.05 and Z ≥ |2| (log2)). We used Gene Ontology (GO) pathway overrepresentation analysis to highlight groups of proteins that were significantly upregulated or downregulated with injury-induced degeneration and regeneration. Significant protein changes in key pathways were identified including growth factor levels, Schwann cell de-differentiation, myelination downregulation, epithelial-mesenchymal transition (EMT), and axonal regeneration pathways. The proteomes of the uninjured nerve compared to the degenerating/regenerating nerve may reveal biomarkers to aid in the development of repair strategies such as infusing supplemental trophic factors and in monitoring neural tissue regeneration., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Chau et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The COVID-19 pandemic has shifted the dynamics of health care and neurosurgical practice. Elective surgeries were suspended for 8 weeks in Kentucky. Our objective was to determine if telehealth (TH) visits could be sustained as an alternative to in-person visits., Methods: Deidentified data on TH usage, in-person clinic visits, and inpatient and neurosurgical case volumes from March 2, 2020 to June 26, 2020 were obtained for retrospective analysis., Results: TH use increased soon after the case suspension started and then decreased to little usage. The number of in-person visits were significantly lower during elective case suspension compared with when cases were resumed. Twenty-five percent of all visits during the suspension were conducted using TH. Thirty-nine percent of TH-visit patients were new patients, 11% were preoperative, 10% were postoperative, and 39% were other existing patients. Forty-eight percent of TH visits resulted in a later in-person clinic visit. After the suspension, in-person visits rebounded to 98% of the prepandemic numbers and TH visits were low., Conclusions: TH visits were challenging due to the need for in-person physical examinations in neurosurgery. TH temporarily accommodated patient needs during the pandemic but could not totally replace in-person visits and was not sustained after 3.5 months of use. Video TH visits worked well for nonurgent issues, such as minor visual examinations. Our findings could help guide the implementation of TH should similar circumstances arise again., (Copyright © 2021. Published by Elsevier Inc.)

This article begins with an overview of the historical treatment of maternal subjectivity within psychology, psychoanalysis, and feminism, discussing the inroads that have been made to support the subject status of mothers themselves, as well as where these improvements are incomplete. Also considered are the invited papers appearing in this special issue of Psychoanalytic Perspectives and the ways in which they unfold new iterations of theorizing maternal subjectivity. Particularly, this paper introduces the concept of matrescence—the developmental process of becoming a mother—into the psychoanalytic lexicon. Doing so allows further discussion of how the mother's subject status can elaborate the lineage of the feminine and co-created, relational, and social aspects of identity. Recognizing the mother is not an individualistic pursuit, a competition between mother and baby for whose experience gets to matter; rather, recognizing maternal subjectivity is inherently a recognition of linking. It is essential to the development of relational psychoanalysis and, this paper argues, an essential link in considering the oft-neglected socio-cultural aspects of the psyche. [ABSTRACT FROM AUTHOR]

Background/Objectives: Antibiotic (AB) therapy is the first step in managing hidradenitis suppurativa (HS). Knowledge of the local patterns of antimicrobial resistance is paramount for the appropriate selection of antimicrobials. This study aimed to assess the occurrence of antibiotic resistance in patients with HS. Methods: A cross-sectional study was conducted on 103 patients with HS seen at the Dermatology Department at the University Hospital of Heraklion, Heraklion, Crete, Greece, from January 2019 to December 2023, who were not on any antibiotics in the last three months. Results: A total of 103 patients with HS participated in this study. Purulent material from 139 skin lesions of these patients was swabbed, and 79.86% (111/139) tested positive for bacteria. Gram-positive isolates accounted for 73%, whereas Gram-negative isolates comprised 27%. Among the isolates, 85.1% were aerobes, and 14.9% were anaerobic. The most common bacterial families isolated were Staphylococcaceae (48.27%), Enterobacteriaceae (14.94%), and Streptococcaceae (6.89%). The antibiogram profiles of bacterial cultures revealed a 57.1% resistance to levofloxacin and a 53.3% resistance to penicillin in Staphylococcus lugdunensis, whereas Staphylococcus aureus showed a 76.9% resistance to penicillin and a 58.3% resistance to fusidic acid. High resistance rates of 63.5% for tigecycline, 63.3% for ampicillin, and 40.5% for colistin were observed for Gram-negative isolates. Resistances of 62.5%, 61.5%, and 53.8% to erythromycin, clindamycin, and penicillin, respectively, were observed in the anaerobes. Conclusions: Patients with HS displayed considerable resistance to bacterial proliferation. The revised therapeutic guidelines for HS should incorporate the latest insights into bacterial antibiotic resistance. [ABSTRACT FROM AUTHOR]

The relevance of the topic under study is due to the fact that patients receiving large or repeated doses of corticosteroids often suffer from hypersensitivity reactions or side effects from taking this category of drugs. As a result, this poses a serious problem for healthcare authorities, as the scientific understanding of this phenomenon is still at an early stage. The purpose of study is to comprehensively disclose the various types of mechanisms underlying corticosteroid hypersensitivity, as well as to develop recommendations for more accurate methods of diagnosis, treatment, and prevention of this reaction. To achieve this goal, this theoretical study used various methods, including analysis, deduction, abstraction and generalization, and the method of synthesis. The results of the study underscore the broad spectrum of applications for corticosteroid drugs in medicine, highlighting their systemic effects and potential for side effects and hypersensitivity reactions across various bodily systems. These adverse reactions encompass hyperglycemia, hypertension, respiratory issues, visual impairments, skin conditions like contact dermatitis, bone tissue complications, and behavioral disorders, notably in children. Administering corticosteroids in COVID-19 treatment necessitates caution due to the potential for life-threatening immediate hypersensitivity reactions, which may be mistaken for disease progression. The results and conclusions of this study, which were formed using the above methods, may lead to a more accurate diagnosis of hypersensitivity to drugs such as corticosteroids, and may also contribute to the development of effective preventive measures. This study is of practical importance for dermatologists, allergists and immunologists, as well as researchers working in the field of rheumatology, allergology and immunology. [ABSTRACT FROM AUTHOR]

Appropriate animal models, mimicking conditions of both health and disease, are needed to understand not only the biology and the physiology of neurons and other cells under normal conditions but also under stress conditions, like nerve injuries and neuropathy. In such conditions, understanding how genes and different factors are activated through the well-orchestrated programs in neurons and other related cells is crucial. Knowledge about key players associated with nerve regeneration intended for axonal outgrowth, migration of Schwann cells with respect to suitable substrates, invasion of macrophages, appropriate conditioning of extracellular matrix, activation of fibroblasts, formation of endothelial cells and blood vessels, and activation of other players in healthy and diabetic conditions is relevant. Appropriate physical and chemical attractions and repulsions are needed for an optimal and directed regeneration and are investigated in various nerve injury and repair/reconstruction models using healthy and diabetic rat models with relevant blood glucose levels. Understanding dynamic processes constantly occurring in neuropathies, like diabetic neuropathy, with concomitant degeneration and regeneration, requires advanced technology and bioinformatics for an integrated view of the behavior of different cell types based on genomics, transcriptomics, proteomics, and imaging at different visualization levels. Single-cell-transcriptional profile analysis of different cells may reveal any heterogeneity among key players in peripheral nerves in health and disease. [ABSTRACT FROM AUTHOR]

Peripheral nerve injury (PNI) is associated with delayed repair of the injured nerves in elderly patients, resulting in loss of nerve function, chronic pain, muscle atrophy, and permanent disability. Therefore, the mechanism underlying the delayed repair of peripheral nerves in aging patients should be investigated. Schwann cells (SCs) play a crucial role in repairing PNI and regulating various nerve-repair genes after injury. SCs also promote peripheral nerve repair through various modalities, including mediating nerve demyelination, secreting neurotrophic factors, establishing Büngner bands, clearing axon and myelin debris, and promoting axon remyelination. However, aged SCs undergo structural and functional changes, leading to demyelination and dedifferentiation disorders, decreased secretion of neurotrophic factors, impaired clearance of axonal and myelin debris, and reduced capacity for axon remyelination. As a result, aged SCs may result in delayed repair of nerves after injury. This review article aimed to examine the mechanism underlying the diminished neural repair ability of aging SCs. [ABSTRACT FROM AUTHOR]

A 45‑year‑old married male presented with nonhealing, painless ulcers with purulent discharge over genitals for 3 months. He had molluscum contagiosum over genitalia and forehead. A tissue smear suggested a diagnosis of donovanosis. Biopsy suggested diagnosis of molluscum contagiosum and serology was positive for human immunodeficiency virus 1 and herpes simplex 2. The patient was started on acyclovir and doxycycline. Antiretroviral therapy was initiated. The patient responded slowly over a period of 8 weeks. Immunocompromised patients having nonhealing genital ulcers must be subjected to tissue smear to pick up the diagnosis of granuloma inguinale. [ABSTRACT FROM AUTHOR]

The texture of a fabric can be perceived by the haptic and visual senses. Visual texture can be defined as a visual quality of a surface. It is an important phenomenon because it can be significant in many fields, such as textile design and e-commerce. At the same time, when we consider the semantics of the word, it is important to take into account that there are a variety of manifestations of fabrics (e.g., woven, knitted, etc.). The mechanism of visual texture perception of fabrics was investigated by measuring visual evaluation values. In our experiment, 12 textile samples with different surface textures are evaluated using thirty-four adjectives (Kansei words). For each visual texture, the adjectives with the highest mean ratings are extracted and analyzed. By using Hierarchical Cluster Analysis (HCA) and Principal Component Analysis (PCA), we aimed to discover and determine preferences for the visual texture of fabrics. The result is a semantic explanation of fabric texture with the adjectives proposed, which can help customers to evaluate the quality of the textile. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a major global impact on the treatment of hospitalized surgical patients. Our study retrospectively evaluates the impact of the COVID-19 pandemic at a neurosurgical reference center in Mexico City. We compared the number of neurosurgeries, the rate and type of postoperative infections, the causative microorganisms and in-hospital mortality rates in a 4-year period, from the pre-pandemic year 2019 until 2022. A total of 4150 neurosurgical procedures were registered. In 2020 the total number of surgeries was reduced by 36% compared to 2019 OR = 0.689 (95% CI 0.566–0.834) p ≤ 0.001, transnasal/trans sphenoidal pituitary resections decreased by 53%, and spinal surgeries by 52%. The rate of neurosurgical infections increased from 3.5% in 2019 to 5.6% in 2020 (p = 0.002). Regarding the microorganisms that caused infections, gram positive cocci accounted for 43.5% of isolates, Klebsiella spp. and Pseudomonas spp. caused one third of the infections. No significant differences were found for in-hospital mortality nor patterns of resistance to antibiotics. The number of surgeries increased in the last two years, although the infection rate has returned to pre-pandemic levels. We observed a lower impact from subsequent waves of COVID-19 and despite an increase in the number of surgeries, the surgeries have not amounted to the full pre-pandemic levels. [ABSTRACT FROM AUTHOR]

The true differences between barefoot and shod running are difficult to directly compare because of the concomitant change to a mid/forefoot footfall pattern that typically occurs during barefoot running. The purpose of this study was to compare isolated effects of footwear structure and cushioning on running mechanics in habitual mid/forefoot runners running shod (SHOD), barefoot (BF), and barefoot on a foam surface (BF+FOAM). Ten habitually shod mid/forefoot runners were recruited (male = 8, female = 2). Repeated measures ANOVA (α = 0.05) revealed differences between conditions for only vertical peak active force, contact time, negative and total ankle joint work, and peak dorsiflexion angle. Post hoc tests revealed that BF+FOAM resulted in smaller vertical active peak magnitude and instantaneous vertical loading rate than SHOD. SHOD resulted in lower total ankle joint work than BF and BF+FOAM. BF+FOAM resulted in lower negative ankle joint work than either BF or SHOD. Contact time was shorter with BF than BF+FOAM or SHOD. Peak dorsiflexion angle was smaller in SHOD than BF. No other differences in sagittal joint kinematics, kinetics, or ground reaction forces were observed. These overall similarities in running mechanics between SHOD and BF+FOAM question the effects of footwear structure on habituated mid/forefoot running described previously. [ABSTRACT FROM AUTHOR]

Footstrike angle (FSA) has been widely used to classify footstrike pattern (FSP). However, inconsistent FSA cut-off values were adopted in previous studies. This study aimed to validate the FSA cut-off values in runners. Stride index, the gold standard to determine FSP, and FSA were obtained when 15 experienced runners, 14 novice runners and 14 untrained individuals performed 3-min run on an instrumented treadmill at their preferred running speeds in habitual, rearfoot, midfoot and forefoot strike patterns. According to the receiver operating characteristic curve associated with the Youden index, the optimal FSA cut-off values were −0.8° (i.e., cut-off angle for forefoot strike) –7.4° (i.e., cut-off angle for rearfoot strike) for runners. We observed minor differences in the FSA cut-off values across runners with various running experience and a wider cut-off range for midfoot strikers when a modified strike index was utilized. This validation study established cut-off footstrike angles for runners' FSP classification. [ABSTRACT FROM AUTHOR]

Van Rijswijk et al. demonstrated that patients with a shrinking AAA, one year after EVAR, have better long-term survival compared to patients with a stable AAA size. Abdominal aortic surgery has witnessed significant paradigm shifts in recent years with the introduction of structured screening programs, as well as the evolution of endovascular aortic aneurysm repair (EVAR), which has allowed physicians to promptly identify and successfully treat an increasing number of patients, even including those previously considered unfit for open repair. Preoperative age, maximum AAA diameter, and infrarenal angle showed to be useful in preoperatively differentiating patients with a shrinking AAA at a one-year follow-up from those with a stable AAA diameter. The future of aortic surgery will be defined by our ability to identify the factors that are decisive for long-term success and thus enable us to tailor treatment modalities to individual patient characteristics. [Extracted from the article]

This prospective cohort study examined the impact of high anxiety levels on psychological state and gait performance during recovery in runners with lower body injuries. Recreational runners diagnosed with lower body injuries who had reduced running volume (N = 41) were stratified into groups using State Trait Anxiety Inventory (STAI) scores: high anxiety (H-Anx; STAI ≥40 points) and low anxiety (L-Anx; STAI <40 points). Runners were followed through rehabilitation to return-to-run using monthly surveys. Main outcome measures included kinesiophobia (Tampa Scale of Kinesiophobia, TSK-11), Positive and Negative Affect Schedule (PANAS; Positive and negative scores), Lower Extremity Function Scale (LEFS), running recovery (University of Wisconsin Running Injury and Recovery Index [UWRI]) and CDC Healthy Days modules for general health, days of anxiety/tension, disrupted sleep and work/usual activities. Running biomechanics were assessed at baseline and the final visit using 3D motion capture and a force-plated treadmill. The time to return-to-running for was 5.0±3.1 and 7.9±4.1 months for L-Anx and H-Anx, respectively and participants who withdrew (n = 15) did so at 7.7±6.2 months. L-Anx maintained low anxiety and H-Anx reduced anxiety from baseline to final visit (STAI = 31.5 to 28.4 points, 50.4 to 37.8 points, respectively), whereas the withdrawn runners remained clinically anxious at their final survey (41.5 to 40.3 points; p <.05). Group by time interactions were found for PANAS positive, LEFS UWRI, general health scores, and days feeling worry, tension and anxiety (all p <.05). Final running performance in L-Anx compared to H-Anx was most improved with cadence (8.6% vs 3.5%; p =.044), impact loading rate [-1.9% vs +8.9%] and lower body stiffness [+14.1% vs +3.2%; all p <.05). High anxiety may identify runners who will experience a longer recovery process, health-related functional disruptions, and less optimization of gait biomechanics during rehabilitation after a lower extremity injury. [ABSTRACT FROM AUTHOR]

Star identification is a critical technology in the research of star sensors. Conventional star identification algorithms identify stars based only on the geometry position information. As a result, these algorithms are sensitive to positional noise or require a high number of imaged stars in the field of view (FOV). In this article, a star identification algorithm using color ratio information is proposed to solve this problem. An analytical model is developed to predict the performance of the proposed algorithm. In addition, an optimized strategy is proposed to reduce the identification time by selecting stars with the same color ratio information to construct the observation triangles. Experimental results on simulation and real sky images show that the proposed algorithm is robust to high-level position noise, and it requires three stars to find a unique match. Compared with the pyramid algorithm, the proposed algorithm uses fewer stars and achieves a higher star identification rate over the entire sky in a shorter time even under harsh conditions. [ABSTRACT FROM AUTHOR]

The guide star catalog is an important component of star identification algorithms for star sensors that indirectly determines their identification rate and other performance characteristics. Currently, star identification algorithms based on triangle features have high identification rates and strong anti-interference abilities. However, this type of method usually requires a large-size guide triangle catalog. Without proper construction, many triangles in the catalog are barely used in the pattern recognition process. In this paper, a guide triangle catalog generation method for star identification based on triangle density and utilization is proposed. First, a model of the star density and triangle density distribution in the celestial sphere is established. Then, considering factors such as the sizes and shapes of the triangles and the brightness levels of the stars, a triangle utilization model is established. Based on these models, a high-triangle-utilization, low-size guide triangle catalog is generated by eliminating low-utilization triangles to the greatest extent possible under the premise of ensuring a minimum triangle density. Some experiments were conducted to prove the performance of the proposed method. Compared with the existing methods under the same conditions, the size of the catalog constructed by the proposed method can be reduced by 70%–90%. Because the selected triangles are different, the proposed catalog exhibits a higher identification rate than other catalogs of the same size. [ABSTRACT FROM AUTHOR]

This study aimed to investigate differences in the isometric rate of force development (IRFD) for the early, late, and whole phases of the force-time curve during explosive leg extension among ball sports athletes and track and field athletes. Ninety-one athletes specializing in different ball sports (ball sports athletes group), 43 sprinters and jumpers (sprinters & jumpers group), 10 throwers (thrower group) and 14 endurance runners (endurance runners group) performed the isometric unilateral leg press with explosive force production. A custombuilt dynamometer was used to measure IRFDs during the isometric unilateral leg press with a knee angle of 115 deg. IRFDs for early phase (Early IRFD), late phase (Late IRFD) and overall force-time curve (Average IRFD) were obtained. relative IRFD that took individual body weight (IRFD/BW) were also derived. Differences in IRFDs among the various sport groups were analyzed by one-way ANOVA and multiple comparison. It was found that IRFDs other than Late IRFD/BW showed a significant main effect among the athlete groups (p < 0.05). The results suggested that the characteristics of IRFDs other than Late IRFD/BW might differ among athletes according to their specialization. For multiple comparison, the ball sports athletes group and the sprinters & jumpers group tended to show similar mean IRFD values. However, only mean values for the Early IRFD/BW of sprinters & jumpers group were significantly greater than those for the ball sports athletes group (p < 0.05). In the throwers group, the mean of any IRFD tended to be greater, and the mean values of Early IRFD, Late IRFD, and Average IRFD were significantly greater than in the other groups (p < 0.05). In contrast, the endurance runners group tended to show small mean values for any IRFDs. These present results suggest that the capacity for explosive force production is reflected in the differences of IRFDs other than the Late IRFD/BW among various sports. [ABSTRACT FROM AUTHOR]

One promising strategy in cell therapies for Parkinson's disease (PD) is to harness a patient's own cells to provide neuroprotection in areas of the brain affected by neurodegeneration. No treatment exists to replace cells in the brain. Thus, our goal has been to support sick neurons and slow neurodegeneration by transplanting living repair tissue from the peripheral nervous system into the substantia nigra of those with PD. Our group has pioneered the transplantation of transection-activated sural nerve fascicles into the brain of human subjects with PD. Our experience in sural nerve transplantation has supported the safety and feasibility of this approach. As part of a paradigm to assess the reparative properties of human sural nerve following a transection injury, we collected nerve tissue approximately 2 weeks after sural nerve transection for immunoassays from 15 participants, and collected samples from two additional participants for single nuclei RNA sequencing. We quantified the expression of key neuroprotective and select anti-apoptotic genes along with their corresponding protein levels using immunoassays. The single nuclei data clustered into 10 distinctive groups defined on the basis of previously published cell type-specific genes. Transection-induced reparative peripheral nerve tissue showed RNA expression of neuroprotective factors and anti-apoptotic factors across multiple cell types after nerve injury induction. Key proteins of interest (BDNF, GDNF, beta-NGF, PDGFB, and VEGF) were upregulated in reparative tissue. These results provide insight on this repair tissue's utility as a neuroprotective cell therapy. [ABSTRACT FROM AUTHOR]

In this article, we consider the problem of extracting star spots for traditional star sensors under highly dynamic conditions. Under this setting, it is difficult to effectively extract star spots with a low signal-to-noise ratio (SNR), resulting in a failure to estimate the attitude of star sensors. We propose a method named optimal directional connected component (ODCC) for this task. According to the dynamic characteristics of star sensors, we propose an image enhancement method that can adaptively estimate the directions of star spots and integrate the star image so that the SNR of the star spots is increased. This aids in searching for spots with a low SNR. According to the imaging characteristics of a star, we model the imaging region of a star as a rectangle and then creatively cast the problem of extracting spots into a problem of estimating the endpoints of the rectangle. A maximum likelihood estimation method based on the Gaussian mixture model is proposed to determine the region of the star spot. Experiments demonstrate the extraction capability and accuracy of the method. In conclusion, this method has a promising application value for improving the dynamic performance of traditional star sensors. [ABSTRACT FROM AUTHOR]

Exertion may alter running mechanics and increase injury risk. Effects of exertion following gait-retraining are unknown. Objectives: To determine how exertion effects load rates, footstrike, and cadence in runners following a transition to forefoot strike (FFS) or increased cadence (CAD) gait-retraining. Methods: 33 (9 M, 24 F) healthy rearfoot strike runners were randomized into CAD or FFS groups. All runners received strengthening exercises and gait-retraining. 3D kinetic and kinematic motion analysis with instrumented treadmill at self-selected speed was performed at baseline & 1-week post-intervention, including an exerted run. Exertion was ≥17 on Borg's Rating of Perceived Exertion scale or voluntary termination of running. Results: Within group comparisons between fresh and exerted running: Cadence not affected in either group. Foot angle at contact became less plantarflexed in FFS (−2.2°, ±0.4) and was unchanged in CAD. Both groups increased vertical average load rate (FFS +16.9%, CAD +13.6%). CAD increased vertical stiffness (+8.6 kN/m). FFS reduced ankle excursion (1.8°). (p ≤ 0.05 for all values listed). Conclusion: Both FFS and CAD exhibited increased load rates with exertion. Variables that may have increased load rates were different for each group. CAD runners had increased vertical stiffness while FFS runners had reduced plantarflexion at contact and reduced ankle dorsiflexion excursion. [ABSTRACT FROM AUTHOR]

Background. Sleeve gastrectomy is the most commonly performed bariatric procedure. Laparoscopic longitudinal gastrectomy (LLG) may be indicated for other indications. Patients and Methods. Two men and two women aged 67, 72, 77, and 80 years underwent LLG for nonbariatric indications with two having normal weight, one being cachectic, and one severely obese. Results. LLG was discussed with patients prior to surgery, but decision for LLG was made during surgery after contemplating other surgical options. A wide sleeve over a 42 French bougie was created with the staple line being oversewn with running 3-0 silk. Indications included a bleeding Dieulafoy lesion that failed endoscopic clipping, fundus gland polyposis found during paraesophageal hernia repair, fundus nodules suspected to be leiomyosarcoma metastases revealing splenosis on final pathology, and significant gastric dilatation associated with organoaxial gastric volvulus. Three patients had an uneventful recovery; the severely obese patient temporarily lost weight but died after two years from a stroke. The last patient developed dysphagia due to an alphaloop in the sleeve, which was managed by endoscopic stenting. The device subsequently migrated and was laparoscopically removed, with a side-side gastrogastrostomy performed to straighten the alpha-loop. The patient tolerated food better and with overnight PEG tube feeds gained weight but continued heavy smoking. He died after one year from COPD exacerbation. Conclusion. LLG seems to be an appropriate intervention for various gastric pathologies. Training of residents and fellows in the minimally invasive surgical steps of LLG is encouraged. [ABSTRACT FROM AUTHOR]

Impact loading plays a key role in the pathophysiology of running-related injuries. Providing real-time feedback may be an effective strategy to reduce impact loading; however, it is currently unclear what an effective training method to help runners achieve a habitual low loading rate is. We subjected 20 healthy non-runners to a structured sequence of direct and indirect biofeedback designed to facilitate broader exploration of neuro-mechanical workspace for potential movement solutions (indirect feedback on cadence and foot-strike angle) and to refine and converge upon an optimal sub-set of that space to match the task goal (direct feedback on loading rate). While indirect biofeedback on foot-strike angle yielded a lower impact load than providing direct biofeedback on loading rate, compared to indirect biofeedback on foot-strike angle, providing direct feedback on loading rate statistically increased (+58%, p = 0.007) the range of goal-relevant solutions participants used to lower their impact loading. Results showed that structured feedback was effective in increasing the range of input parameters that match the task goal, hence expanding the size of goal-relevant solutions, which may benefit running performance under changing environmental constraints. [ABSTRACT FROM AUTHOR]

Imaging intestinal inflammation: As an alternative to ileocolonoscopy with biopsy required to diagnose and monitor inflammatory bowel diseases, Fournier et al. investigated the use of magnetic resonance imaging with microsized particles of iron oxide targeting mucosal vascular addressin cell adhesion molecule 1 on inflamed mucosal tissues. They showed that the contrast agent bound to activated endothelium in the gastrointestinal tract and could be used to visualize inflammation in mouse models of colitis. Therapeutic response to atorvastatin or anti-TNF antibody could also be monitored using the contrast agent. Results support use of the molecular imaging for noninvasive diagnosis and monitoring of mucosal inflammation. Mucosal tissues play critical roles in health and disease as the primary barrier between the external world and the inner body, lining the digestive, respiratory, urinary, mammary, and reproductive tracts. Clinical evaluation of mucosal tissues is currently performed using endoscopy, such as ileocolonoscopy for the intestinal mucosa, which causes substantial patient discomfort and can lead to organ damage. Here, we developed a contrast agent for molecular magnetic resonance imaging (MRI) that is targeted to mucosal vascular addressin cell adhesion molecule 1 (MAdCAM-1), an adhesion molecule overexpressed by inflamed mucosal tissues. We investigated the diagnostic performance of molecular MRI of MAdCAM-1 to detect mucosal inflammation in several models of acute and chronic intestinal inflammation in mice. We demonstrated that molecular MRI of MAdCAM-1 reveals disease activity and can evaluate the response to inflammatory treatments along the whole intestinal mucosa in clinically relevant models of inflammatory bowel diseases. We also provide evidence that this technique can detect low, subclinical mucosal inflammation. Molecular MRI of MAdCAM-1 has potential applications in early diagnosis, longitudinal follow-up, and therapeutic response monitoring in diseases affecting mucosal tissues, such as inflammatory bowel diseases. [ABSTRACT FROM AUTHOR]

Loading rates have been linked to running injuries, revealing persistent impact features that change direction among three-dimensional axes in different footwear and footstrike patterns. Extracting peak loads from ground reaction forces, however, can neglect the time-varying loading patterns experienced by the runner in each footfall. Following footwear and footstrike manipulations during laboratory-based overground running, we examined three-dimensional loading rate-time features in each direction (X, Y, Z) using principal component analysis. Twenty participants (9 M, 11 F, age: 25.3 ± 3.6 y) were analysed during 14 running trials in each of two footwear (cushioned and minimalist) and three footstrike conditions (forefoot, midfoot, rearfoot). Two principal components (PC) captured the primary loading rate-time features (PC1: 42.5% and PC2: 22.8% explained variance) and revealed interaction among axes, footwear, and footstrike conditions (PC1: F(2.1, 40.1) = 5.6, p = 0.007, η2 = 0.23; PC2: F(2.0, 38.4) = 62.3, p < 0.001, η2 = 0.77). Rearfoot running in cushioned footwear attenuated impact loads in the vertical direction, and forefoot running in minimalist footwear attenuated impact loads in the anterior-posterior and medial-lateral directions relative to forefoot running in cushioned shoes. Loading patterns depend on footwear and footstrike interactions, which require shoes that match the runner's footstrike pattern. [ABSTRACT FROM AUTHOR]

Unlike the traditional star pattern recognition algorithms that extract star features as a vector to be matched in a database, in this article, a spider-web image is constructed and a hierarchical convolution neural network (CNN) model is proposed to recognize this spider-web image. Stars are linked with different color lines based on the angle distance to enhance the discrimination of the spider-web images. A training dataset and testing dataset are constructed based on spider-web images for CNN model training. A hierarchical CNN model with two stages, which are designed to perform first step identification and recognize similar spider-web images, respectively, is proposed. Experiment results show that, compared with other algorithms, the proposed algorithm is more robust toward the position noise, magnitude noise, small numbers of stars in the field of view, and the presence of false stars. [ABSTRACT FROM AUTHOR]

Research has suggested that a high variability in foot strike pattern during downhill running is associated with lower neuromuscular fatigue of the plantar flexors (PF). Given the popularity of trail running, we designed an intervention study to investigate whether a strategy with regular changes in foot strike pattern during downhill running could reduce the extent of fatigue on neuromuscular, energetics and biomechanical parameters as well as increase an uphill time-to-exhaustion trial (TTE) performance. Fourteen experienced trail runners completed two interventional conditions (separated by 15 days) in a pseudo-randomised and counter-balanced order that consisted of 2.5-h of treadmill graded running with (switch condition) or without (control condition) a change between fore- and rear-foot strike pattern every 30 s during the downhill sections. Pre and Post, neuromuscular tests were performed to assess PF central and peripheral fatigue. Energy cost of running was assessed using an indirect calorimetry system and biomechanical gait parameters were acquired with an instrumented treadmill. TTE was performed after both the graded running conditions. There were not significant condition × time interactions (p ≥.085) for any of the variables considered, and TTE was not different between the two conditions (p =.755). A deliberate strategy to alternate between foot strike patterns did not reduce the extent of fatigue during prolonged graded running. We suggest that it is not the ability to switch between foot strike patterns that minimises fatigue; rather the ability to adapt foot strike pattern to the terrain and therefore a better running technique. [ABSTRACT FROM AUTHOR]

Shoe manufacturers launch running shoes with increased (e.g., maximalists) or decreased (e.g., minimalists) midsole thickness and claim that they may prevent running injury. Previous studies tested footwear models with different midsole thicknesses on the market but the shoe construct was not strictly comparable. Therefore, in the present study, we examined the effect of midsole thickness, from 1-mm to 29-mm, in a standard test shoe prototype on the vertical loading rates, footstrike angle and temporal spatial parameters in distance runners. Fifteen male habitual rearfoot strikers were recruited from local running clubs. They were asked to run on an instrumented treadmill in shoes with different midsole thicknesses. We found significant interactions between midsole thickness with vertical loading rates (p < 0.001), footstrike angle (p = 0.013), contact time (p < 0.001), cadence (p = 0.003), and stride length (p = 0.004). Specifically, shoes with thinner midsole (1- and 5-mm) significantly increased the vertical loading rates and shortened the contact time, when compared with thicker midsole shoes (25- and 29-mm). However, we did not observe any substantial differences in the footstrike angle, cadence and stride length between other shod conditions. The present study provides biomechanical data regarding the relationship between full spectrum midsole thicknesses and running biomechanics in a group of rearfoot strikers. [ABSTRACT FROM AUTHOR]

This paper introduces two new techniques for random number generation with any prescribed nonlinear distribution based on the $k$ k -vector methodology. The first approach is based on an inverse transform sampling using the optimal $k$ k -vector to generate the samples by inverting the cumulative distribution. The second approach generates samples by performing random searches in a pregenerated large database previously built by massive inversion of the prescribed nonlinear distribution using the $k$ k -vector. Both methods are shown to be suitable for massive generation of random samples. Examples are provided to clarify these methodologies. [ABSTRACT FROM AUTHOR]

The effect of textured insoles on kinetics and kinematics of overground running was assessed. 16 male injury-free-recreational runners attended a single visit (age 23 ± 5 yrs; stature 1.78 ± 0.06 m; mass 72.6 ± 9.2 kg). Overground 15-m runs were completed in flat, canvas plimsolls both with and without textured insoles at self-selected velocity on an indoor track in an order that was balanced among participants. Average vertical loading rate and peak vertical force (Fpeak) were captured by force platforms. Video footage was digitised for sagittal plane hip, knee and ankle angles at foot strike and mid stance. Velocity, stride rate and length and contact and flight time were determined. Subjectively rated plantar sensation was recorded by visual scale. 95% confidence intervals estimated mean differences. Smallest worthwhile change in loading rate was defined as standardised reduction of 0.54 from a previous comparison of injured versus non-injured runners. Loading rate decreased (−25 to −9.3 BW s−1; 60% likely beneficial reduction) and plantar sensation was increased (46-58 mm) with the insole. Fpeak (−0.1 to 0.14 BW) and velocity (−0.02 to 0.06 m s−1) were similar. Stride length, flight and contact time were lower (−0.13 to −0.01 m; −0.02 to−0.01 s; −0.016 to −0.006 s) and stride rate was higher (0.01-0.07 steps s−1) with insoles. Textured insoles elicited an acute, meaningful decrease in vertical loading rate in short distance, overground running and were associated with subjectively increased plantar sensation. Reduced vertical loading rate could be explained by altered stride characteristics. [ABSTRACT FROM AUTHOR]

Chronic use of opioid medications has been reported to cause altered sexual function. It is not known if non-opioid pain medications have similar effects. Assessment of this effect through the measurement of concentrations of free hormones is limited. Positivity of opioid medications (hydrocodone, oxycodone, morphine, methadone, tramadol and fentanyl) and non-opioid pain medications (gabapentin or pregabalin) in human serum and plasma samples from adult men and women were evaluated for association with concentrations of free testosterone (fTe) and free estradiol (fE2) measured using equilibrium dialysis-liquid chromatography-tandem mass spectrometry methods. Lower concentrations of fTe (p = 0.0253) were observed in samples positive for the hydrocodone, oxycodone and morphine group compared to age matched controls. The presence of methadone, tramadol, fentanyl and pregabalin had no effect on fTe. When compared with age-matched controls, women between 48-55 years of age showed reduced fE2 concentrations in samples positive for tramadol, fentanyl and gabapentin (p = 0.0243, 0.0045 and 0.0050, respectively). Particular opioid medications such as methadone, tramadol or fentanyl and non-opioid medications such as pregabalin or gabapentin may offer advantages over opioid medications for treating pain with fewer endocrinologic side effects. Measurement of free hormones in pain medication users could be important in determining their association with sexual function. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Body weight supported treadmill training is commonly used in clinical practice with broad applicability including gait and balance interventions with research supporting its' efficacy in rehabilitation in a wide variety of populations. Despite the popularity of unweighted locomotion within rehabilitation, little evidence is currently available evaluating the actual unweighting effects. The LightSpeed® was developed to serve as a financially feasible option for both patients and clients. Purpose: The primary purpose of this study was to determine the unweighting effects of a novel body weight support system (LightSpeed®) on plantar loading in healthy, young adults. Methods: Fifteen participants completed a trial of weighted/unweighted walking and running where resulting impact forces were recorded using pressure sensitive insole system. Results: The results showed a statistically significant reduction in ground reaction forces and pressures while in the bodyweight support system accounting for approximately 24% and 16% reduction in the impulse and 14.7% and 19.9% in the pressure time integral during walking and running respectively. Conclusion: The LightSpeed® unweighting device may serve as an effective rehabilitation gait intervention tool for rehabilitation specialists and clients. Further laboratory and intervention study is needed comparing various body weight support systems through basic and applied research studies to further assist the rehabilitation specialist when making decisions regarding appropriate applications. [ABSTRACT FROM AUTHOR]