High baseline perivascular space volume in basal ganglia is associated with attention and executive function decline in Parkinson's disease.

BACKGROUND: Pathologic perivascular spaces (PVS), the fluid-filled compartments surrounding brain vasculature, may underlie cognitive decline in Parkinson's disease (PD). However, whether this impacts specific cognitive domains has not been investigated. OBJECTIVES: This study examined the relationship of PVS volume at baseline with domain-specific and global cognitive change over 2 years in PD individuals. METHODS: A total of 39 individuals with PD underwent 3T T1w magnetic resonance imaging to determine PVS volume fraction (PVS volume normalized to total regional volume) within (i) centrum semiovale, (ii) prefrontal white matter (medial orbitofrontal, rostral middle frontal, and superior frontal), and (iii) basal ganglia. A neuropsychological battery included assessment of cognitive domains and global cognitive function at baseline and after 2 years. RESULTS: Higher basal ganglia PVS at baseline was associated with greater decline in attention, executive function, and global cognition scores. CONCLUSIONS: While previous reports have associated elevated PVS volume in the basal ganglia with decline in global cognition in PD, our findings show such decline may affect the attention and executive function domains.

Algorithmic Approach to Antibiotic Prophylaxis for Traumatic Craniomaxillofacial Injuries.

ABSTRACT: Prophylactic antibiotics are commonly used in the management of traumatic injuries to the maxillofacial complex, yet there are no set guidelines for when and when not to prescribe. The purpose of this review is to present the evidence for antibiotic prophylaxis in different clinical scenarios and to propose algorithms to facilitate the decision making process with the ultimate goal of improving antibiotic prescribing practices. A number of databases were searched using a wide range of keywords to ensure the topic was fully encapsulated. The review is divided into 3 sections: soft tissue trauma, maxillofacial fractures, and ballistic injuries. The algorithms were constructed using the current evidence as well as pathophysiologic principles, especially when there were insufficient studies. This review found the literature on antibiotic prophylaxis to be highly varied and not standardized. Creating an algorithm for providers to follow will help to set a standard of care and decrease the misuse of antibiotics.

Morphological predictors of swimming speed performance in river and reservoir populations of Australian smelt Retropinna semoni.

Dam construction is a major driver of ecological change in freshwater ecosystems. Fish populations have been shown to diverge in response to different flow velocity habitats, yet adaptations of fish populations to river and reservoir habitats created by dams remains poorly understood. We aimed to evaluate divergence of morphological traits and prolonged swimming speed performance between lotic and lentic populations of Australian smelt Retropinna semoni and quantify the relationship between prolonged swimming speed performance and morphology. Prolonged swimming speed performance was assessed for 15 individuals from each of three river and two reservoir populations of R. semoni using the critical swimming speed test (Ucrit ). Body shape was characterized using geometric morphometrics, which was combined with fin aspect ratios and standard length to assess morphological divergence among the five populations. Best subsets model-selection was used to identify the morphological traits that best explain Ucrit variation among individuals. Our results indicate R. semoni from river populations had significantly higher prolonged swimming speed performance (Ucrit = 46.61 ± 0.98 cm s-1 ) than reservoir conspecifics (Ucrit = 35.57 ± 0.83 cm s-1 ; F1,74 = 58.624, Z = 35.938, P < 0.001). Similarly, R. semoni sampled from river populations had significantly higher fin aspect ratios (ARcaudal = 1.71 ± 0.04 and 1.29 ± 0.02 respectively; F(1,74) = 56.247, Z = 40.107, P < 0.001; ARpectoral = 1.85 ± 0.03 and 1.33 ± 0.02 respectively; F(1,74) = 7.156, Z = 4.055, P < 0.01). Best-subset analyses revealed Ucrit was most strongly correlated with pectoral and caudal fin aspect ratios (R2 adj = 0.973, AICc = 41.54). Body shape, however, was subject to a three-way interaction among population, habitat and sex effects (F3,74 = 1.038. Z = 1.982; P < 0.05). Thus sexual dimorphism formed a significant component of unique and complex variation in body shape among populations from different habitat types. This study revealed profound effects of human-altered flow environments on locomotor morphology and its functional link to changes in swimming performance of a common freshwater fish. While past studies have indicated body shape may be an important axis for divergence between lotic and lentic populations of several freshwater fishes, fin aspect ratios were the most important predictor of swimming speed in our study. Differences in body morphology here were inconsistent between river and reservoir populations, suggesting this aspect of phenotype may be more strongly influenced by other factors such as predation and sexual dimorphism.

Trochanteric Fractures in Young Children.

BACKGROUND: Isolated avulsion fractures of the greater and lesser trochanter are usually seen in adolescents prior to the fusion of the apophysis. Greater trochanter fractures in adults have a high incidence of intertrochanteric extension and lesser trochanter fractures are regarded as a pathognomonic sign of metastatic disease. These fractures are very rare among children. METHODS: We report five cases of trochanteric fractures in children of less than two years of age three of which were unrecognized initially in the accident and emergency department. RESULTS: Early and complete recovery ensued following immobilization and symptomatic treatment. Surgical intervention was not required. CONCLUSIONS: There needs to be a high index of suspicion to diagnose these fractures in children and plain radiographs need to be carefully examined when assessing a limping child. Our experience shows when correctly diagnosed these injuries can be treated successfully with supportive treatment and no need for surgical intervention. LEVEL OF EVIDENCE: IV Case series.

Fibrous Nanozyme Dressings with Catalase-Like Activity for H2O2 Reduction To Promote Wound Healing.

The concentrations of the redox pair hydrogen peroxide (H2O2) and oxygen (O2) can promote or decelerate the progression and duration of the wound healing process. Although H2O2 can reach critically high concentrations and prohibit healing, a sufficient O2 inflow to the wound is commonly desired. Herein, we describe the fabrication and use of a membrane that can contemptuously decrease H2O2 and increase O2 levels. Therefore, hematite nanozyme particles were integrated into electrospun and cross-linked poly(vinyl alcohol) membranes. Within the dual-compound membrane, the polymeric mesh provides a porous scaffold with high water permeability and the nanozymes act as a catalyst with catalase-like activity that can efficiently convert H2O2 into O2, as shown by a catalase assay. When comparing the growth of fibroblasts at an H2O2 concentration of 50 µM, the growth was largely enhanced when applying the nanozyme dressing. Thus, application of the nanozyme dressing can significantly reduce the harmful effect of higher H2O2 concentrations. The described catalytic membranes could be used in the future to provide an improved environment for cell proliferation in wounds and thus applied as advanced wound healing dressings.

Amine functionalized ZrO2 nanoparticles as biocompatible and luminescent probes for ligand specific cellular imaging.

Surface functionalized ZrO2 nanoparticles show strong photoluminescence and are a versatile tool for cellular targeting due to their chemical functionality. They are highly photostable, biocompatible and amenable to coupling with bioligands (e.g. secondary goat anti-rabbit antibody (GAR) and tri-phenyl phosphine (TPP)) via carbodiimide chemistry. Antibody (GAR) functionalized ZrO2 nanoparticles were used to image the nuclear protein Sirt6, whereas triphenyl phosphonium ion (TPP) functionalized ZrO2 nanoparticles specifically targeted the mitochondria. The versatility and easiness of the ZrO2 surface modification opens up new possibilities for designing non-toxic water dispersible and photostable photoluminescent NPs.

Traumatic pediatric olecranon injury: a report of suture fixation and review of the literature.

Elbow injuries make up to 3% to 4% of all emergency department presentations and are often difficult to diagnose. These injuries are often missed on radiographs because of the large cartilaginous component of the pediatric elbow resulting in malunion. Fractures around the elbow joint are one of the leading causes of litigation claim, and awareness of the pitfalls in diagnosis of these subtle injuries is necessary for a prompt diagnosis. Fracture of the olecranon epiphysis is rare and often being described around puberty and in association with osteogenesis imperfecta. Management using K-wire tension band fixation has been described in the past, which can lead to growth arrest in younger patients.We hereby present a missed rare sleeve-type open olecranon epiphyseal fracture in a young child, highlighting the pitfalls in the diagnosis of these injuries. This article also reviews various options to manage such a rare fracture and also suggests an alternative method of transosseous suture fixation with an excellent result.