Acute Primary Small Bowel Volvulus in a Male With Loeys-Dietz Syndrome.

Loeys-Dietz syndrome (LDS) is a connective tissue disorder with features including, but not limited to, aortic dissections, skeletal abnormalities, and craniofacial defects. However, considering its relatively recent discovery, there are still many unknowns about LDS. The extent of a connective tissue disorder like LDS is yet to be defined throughout the various organ systems, including the gastrointestinal system. Connective tissue disorders have been found to have higher associations with certain conditions, like constipation. In a similar manner, LDS may increase the propensity for developing uncommon gastrointestinal manifestations, like primary small bowel volvulus. A volvulus is defined as an abnormal rotation of the small bowel segment along the axis of its mesentery. Primary small bowel volvulus is differentiated from secondary small bowel volvulus by its nature of origin: primary small bowel volvulus occurs as an independent spontaneous occurrence, whereas secondary small bowel volvulus is secondary to the presence of adhesions, diverticular disease, or abdominal masses. In this case report, we highlight a potential gastrointestinal manifestation of LDS with the occurrence of a primary small bowel volvulus in a young adult male diagnosed with LDS. The patient experienced acute primary small bowel volvulus 14 days into his stay, which may have been influenced by this newfound connective tissue disorder.

Augmented Reality Based Interactive Cooking Guide.

Cooking at home is a critical survival skill. We propose a new cooking assistance system in which a user only needs to wear an all-in-one augmented reality (AR) headset without having to install any external sensors or devices in the kitchen. Utilizing the built-in camera and cutting-edge computer vision (CV) technology, the user can direct the AR headset to recognize available food ingredients by simply looking at them. Based on the types of the recognized food ingredients, suitable recipes are suggested accordingly. A step-by-step video tutorial providing details of the selected recipe is then displayed with the AR glasses. The user can conveniently interact with the proposed system using eight kinds of natural hand gestures without needing to touch any devices throughout the entire cooking process. Compared with the deep learning models ResNet and ResNeXt, experimental results show that the YOLOv5 achieves lower accuracy for ingredient recognition, but it can locate and classify multiple ingredients in one shot and make the scanning process easier for users. Twenty participants test the prototype system and provide feedback via two questionnaires. Based on the analysis results, 19 of the 20 participants would recommend others to use the proposed system, and all participants are overall satisfied with the prototype system.

Single incision fasciotomy for acute compartment syndrome of the leg: A systematic review of the literature.

Purpose: To review published literature assessing clinical outcomes and complication rates of single incision fasciotomy in fractures of the lower leg. Methods: We searched PubMed and EMBASE for articles published through July 5, 2021, using the terms "single incision fasciotomy", "acute compartment syndrome of the limbs", "compartment syndrome fasciotomy", and "(compartment syndrome fasciotomy) AND (incision)". The inclusion criteria were studies of Level I to IV evidence in English, published in 1970 or later, involving human subjects, reporting clinical outcomes of single incision fasciotomy performed in cases of acute compartment syndrome in lower leg fractures, including at least 1 patient. Results: Among the 3040 combined total results, 11 primary studies met our inclusion criteria. Adequate and safe compartment release was achieved with single-incision technique. No significant difference was found in terms of complications such as infection and non-union. Conclusions: The comparative efficacy and safety of single-incision fasciotomy is relatively equal to the two-incision techniques when evaluated in the literature. However, double-incision fasciotomy remains the predominant surgical technique, widely preferred by surgeons due to the familiarity with the technique and ease of full compartment release. In addition to the actual fasciotomy procedure, data suggests that operative timing, closure and fixation techniques can significantly impact patient outcomes. These findings may be used to guide the orthopedic community when determining the optimal incision-type to use in acute compartment syndrome emergencies for lower-extremity fracture cases in conjunction with closure and fixation techniques.

A lingering question addressed: Reading rate and most efficient listening rate are highly similar.

Is it possible that silent reading rate is the same as the most efficient listening rate? The hypothesis has been formulated in the past, but never got much traction because silent reading is almost twice as fast as typical speech. On the other hand, several studies have shown that listening comprehension retains high quality for spoken materials presented at speeds up to 275 words per minute (wpm), and a recent meta-analysis has also shown that reading rate is lower than often thought: 240-260 wpm on average. To address the question above, we ran a new study specifically comparing spontaneous silent reading rate with comprehension of speech presented at different rates within the same participants and using matched texts. We replicated the finding that listening comprehension was not hindered at the speech rate of 270 wpm but showed a steep decline at the rate of 315 wpm. Thus, the most efficient observed listening rate was on par with the spontaneous reading rate for the same texts (269 wpm on average). Therefore, we conclude that listening and reading follow the same time constraints. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mesenchymal stem cell-derived neural progenitors in progressive MS: Two-year follow-up of a phase I study.

OBJECTIVE: To determine the long-term safety and efficacy of repeated intrathecal (IT) administration of autologous mesenchymal stem cell-derived neural progenitors (MSC-NPs) in patients with progressive MS by evaluating subjects 2 years after treatment. METHODS: Twenty subjects were enrolled as part of a phase I, open-label single-arm study of 3 IT injections of MSC-NPs spaced 3 months apart. Subjects were evaluated for adverse events and disability outcomes including the Expanded Disability Status Scale (EDSS) and the timed 25-foot walk (T25FW). Long-term evaluation was conducted 2 years after the third treatment. CSF was collected before and 3 months after treatment. RESULTS: Eighteen of the 20 study participants completed the full 2-year follow-up protocol. There were no long-term adverse events associated with repeated IT-MSC-NP treatment. Seven subjects showed sustained improvement in EDSS after 2 years, although the degree of improvement was not maintained in 5 of the subjects. Three of the 10 ambulatory subjects showed sustained improvement in the T25FW after 2 years. CSF biomarker analysis revealed a decrease in C-C motif chemokine ligand 2 (CCL2) and an increase in interleukin 8, hepatocyte growth factor, and C-X-C motif chemokine ligand 12 (CXCL12) after treatment. CONCLUSIONS: Safety and efficacy of repeated IT-MSC-NP treatment was sustained for 2 years; however, the degree of disability reversal was not sustained in a subset of patients. CSF biomarkers altered in response to IT-MSC-NP treatment may reflect specific immunoregulatory and trophic mechanisms of therapeutic response in MS. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for patients with progressive MS, IT administration of MSC-NPs is safe and effective. The study is rated Class IV because of the absence of a non-IT-MSC-NP-treated control group. CLINICALTRIALSGOV IDENTIFIER: NCT01933802.

A national experiment reveals where a growth mindset improves achievement.

A global priority for the behavioural sciences is to develop cost-effective, scalable interventions that could improve the academic outcomes of adolescents at a population level, but no such interventions have so far been evaluated in a population-generalizable sample. Here we show that a short (less than one hour), online growth mindset intervention-which teaches that intellectual abilities can be developed-improved grades among lower-achieving students and increased overall enrolment to advanced mathematics courses in a nationally representative sample of students in secondary education in the United States. Notably, the study identified school contexts that sustained the effects of the growth mindset intervention: the intervention changed grades when peer norms aligned with the messages of the intervention. Confidence in the conclusions of this study comes from independent data collection and processing, pre-registration of analyses, and corroboration of results by a blinded Bayesian analysis.

Association of a Delayed Cord-Clamping Protocol With Hyperbilirubinemia in Term Neonates.

OBJECTIVE: To evaluate the implementation of a delayed cord-clamping protocol at an academic medical center, and its short-term associations on term neonates. METHODS: This was a retrospective cohort study of women aged 18 years or older delivering a term neonate at an academic medical center before and 5-7 months after implementation of a universal delayed cord-clamping protocol (October-December 2015 and October-December 2016, respectively). The primary outcome measure was the mean peak neonatal transcutaneous bilirubin level, with secondary outcome measures including mean initial transcutaneous bilirubin levels, mean serum bilirubin levels, number of serum bilirubin levels drawn, incidence of clinical jaundice, and phototherapy. RESULTS: Protocol adherence was 87.8%. Data are presented on 424 neonates. The mean peak neonatal transcutaneous bilirubin levels were significantly higher among neonates in the postprotocol group (10.0±3.4 mg/dL vs 8.4±2.7 mg/dL, P<.01). More neonates in the postprotocol group were diagnosed with jaundice (27.2% vs 16.6%; odds ratio [OR] 1.88; 95% CI 1.17-3.01) and required serum blood draws (43.7% vs 29.4%; OR 1.86; 95% CI 1.25-2.78). However, there were no differences in mean peak serum bilirubin levels between groups (9.7±3.0 mg/dL vs 9.1±3.1 mg/dL, P=.17) or need for phototherapy (5.2% vs 6.6%, OR 1.28; 95% CI 0.57-2.89). CONCLUSION: Implementation of a delayed cord-clamping protocol for term neonates was associated with significantly higher mean transcutaneous bilirubin levels, an increased number of serum blood draws, and more clinical diagnoses of jaundice, although there was no increase in the incidence of phototherapy.

Bromocriptine Use in Peripartum Cardiomyopathy: Review of Cases.

Objective This study is to review published cases of peripartum cardiomyopathy (PPCM) treated with bromocriptine and outline pros and cons of the treatment strategy. Data Sources Data were collected from PubMed/MedLine, ClinicalTrials.gov; the years 2007 to 2018 were searched for English-language articles. Search terms: "bromocriptine and peripartum cardiomyopathy", "bromocriptine and cardiomyopathy." Methods of Study Selection This search strategy yielded 171 articles. After excluding duplicates, 86 studies were reviewed. Sixty-one articles involving the treatment of PPCMP were included, and of these, 17 were case reports of patients with PPCMP treated with bromocriptine; these studies were included in this review. Tabulation, Integration, and Results Seventeen of these articles were case reports of patients with peripartum cardiomyopathy treated with bromocriptine that were included. Conclusion Bromocriptine seems to be a promising treatment, there is currently insufficient evidence for universal utilization of bromocriptine for all patients with PPCMP. Addition of bromocriptine to the standard heart failure therapy should be individualized.

Scalable 3D bicontinuous fluid networks: polymer heat exchangers toward artificial organs.

A scalable method for fabricating architected materials well-suited for heat and mass exchange is presented. These materials exhibit unprecedented combinations of small hydraulic diameters (13.0-0.09 mm) and large hydraulic-diameter-to-thickness ratios (5.0-30,100). This process expands the range of material architectures achievable starting from photopolymer waveguide lattices or additive manufacturing.

Splice variant specific modulation of CaV1.2 calcium channel by galectin-1 regulates arterial constriction.

RATIONALE: Ca(V)1.2 channels are essential for excitation-contraction coupling in the cardiovascular system, and alternative splicing optimizes its role. Galectin-1 (Gal-1) has been reported to regulate vascular smooth muscle cell (VSMC) function and play a role in pulmonary hypertension. We have identified Gal-1 multiple times in yeast 2-hybrid assays using the Ca(V)1.2 I-II loop as bait. OBJECTIVE: Our hypothesis is that Gal-1 interacts directly with Ca(V)1.2 channel at the I-II loop to affect arterial constriction. METHODS AND RESULTS: Unexpectedly, Gal-1 was found to selectively bind to the I-II loop only in the absence of alternatively spliced exon 9*. We found that the current densities of Ca(V)1.2(Δ9*) channels were significantly inhibited as a result of decreased functional surface expression due to the binding of Gal-1 at the export signal located on the C-terminus of exon 9. Moreover, the suppression of Gal-1 expression by siRNA in rat A7r5 and isolated VSMCs produced the opposite effect of increased I(Ca,L). The physiological significance of Gal-1 mediated splice variant-specific inhibition of Ca(V)1.2 channels was demonstrated in organ bath culture where rat MAs were reversibly permeabilized with Gal-1 siRNA and the arterial wall exhibited increased K(+)-induced constriction. CONCLUSION: The above data indicated that Gal-1 regulates I(Ca,L) via decreasing the functional surface expression of Ca(V)1.2 channels in a splice variant selective manner and such a mechanism may play a role in modulating vascular constriction.

Sensitivity of feedback-enhanced MRI contrast to macroscopic and microscopic field variations.

Nonlinear feedback interactions have been shown to amplify contrast due to small differences in resonance frequency arising from microscopic susceptibility variations. Determining whether the selectivity of feedback-based contrast enhancement for small resonance frequency variations remains valid even in the presence of macroscopic field inhomogeneity is important for transitioning this new methodology into in vivo applications in imaging systems with lower field strengths and poorer homogeneity. This work shows that contrast enhancement under the radiation damping (RD) feedback field is sensitive to microscopic intravoxel frequency variations. Feedback-enhanced contrast provides superior signal differentiation from voxels with distinct microscopic frequency distributions compared with T(2)*-weighted imaging, while remaining robust to macroscopic field gradients, which frequently give rise to artifacts by other frequency-sensitive methods. Applying multiple RF pulses during evolution under RD and actively adjusting the phase and amplitude of the feedback field are shown to further improve signal differentiation. Experimental results reveal that feedback-enhanced contrast can generate positive contrast, reflecting microscopic field variations induced by strong local dipole fields, such as those created by blood vessels and superparamagnetic iron oxide nanoparticles. Extensions to in vivo imaging at lower field strengths are discussed in the context of amplifying the RD field via active electronic feedback.