Notes

Particle moves induce avalanche-like compaction within gentle colloid filtration system brownies.
A total of 77 coronary lesions were assessed. Average myocardial area at risk and ischemic burden for all lesions was 59% and 23%, respectively. Correlations for ≥50% and ≥70% stenosis based myocardial area at risk compared to ischemic burden were moderate (r=0.564; p<0.01) and good (r=0.708; p<0.01), respectively.

The relation between myocardial area at risk as calculated by using a Voronoi-based algorithm at CCTA and ischemic burden as assessed by CTP is dependent on stenosis severity.
The relation between myocardial area at risk as calculated by using a Voronoi-based algorithm at CCTA and ischemic burden as assessed by CTP is dependent on stenosis severity.
To evaluate the measurement reliability of the geometric features of tibiofemoral joint on conventional knee MRI and also identify the features associated with increased risk of ACL injury.

This retrospective case-control study included knee MRIs of 60 patients with ACL injury (34 men, 26 women; mean age 34±13.6SD) and 60 normal individuals (31 men, 29 women; mean age 36±11.4SD). Geometric features of distal femur (intercondylar notch width, transcondylar width, and intercondylar notch angle) and tibial plateau (medial tibial plateau slope, lateral tibial plateau slope, and medial tibial plateau depth) were independently measured by two radiologists for each of the patients. Intraclass correlation coefficient (ICC) values were calculated to assess the reliability of the measurements. Variables with acceptable ICC values were included in the final logistic regression model, but the remaining were only reported descriptively.

There was good to excellent agreement between the radiologist in the measurement of ICNW and TCW. However, the agreement between the radiologists was not acceptable for the rest of the variables. The univariate logistic regression model showed as ICNW decreases, the risk of ACL injury increases (OR = 0.12, 95% CI [0.02, 0.60], p=0.01).

Our results suggest that ICNW and TCW are the only geometric features of the tibiofemoral joint that can be reliably measured on conventional knee MRI. Moreover, decreased ICNW is associated with an increased risk of ACL injury.
Our results suggest that ICNW and TCW are the only geometric features of the tibiofemoral joint that can be reliably measured on conventional knee MRI. Moreover, decreased ICNW is associated with an increased risk of ACL injury.Mobilization of nurses' agency across healthcare sectors is needed to counter challenges associated with older adults' transitions between hospital and primary care. Based on Cultural Historical Activity theory and the Change Laboratory method, we developed a learning intervention with 16 nurses. The aim was to foster the nurses' transformative agency to improve care. Video-recording of nine learning sessions were transcribed and analyzed. Results demonstrated that shared transformative agency exhibited as an emergent phenomenon crossing sectoral boundaries as a prerequisite for change in transitional care. The nurses progressed from acting as individuals criticizing the current conditions to collectively forming a vision around a transitional care model. This was nurtured through the nurses' negotiations which included a recognition of sharing similar challenges deriving from the healthcare organization and related financial restrictions, and conflicting healthcare and nursing ideals across healthcare sectors. Selleck Entinostat The evolution of transformative agency was grounded in a professional nursing identity.We report on the clinical history of a young male laborer with Lichtman Stage II Kienbock disease, who underwent a scaphocapitate arthrodesis after a failed silicone lunate prosthesis. After 35 years of follow-up, no further surgical intervention has been warranted despite progression of radiocarpal and ulnocarpal arthritis.We introduce a treatment that combines the cross-leg free flap with the Masquelet technique and describe two cases using this method for bone and soft tissue reconstruction. Both patients were successfully treated and ambulatory. This novel method can be safely performed using the delay technique, indocyanine-green angiography and near-infrared spectroscopy.
Parkinson's disease (PD) is the second most common neurodegenerative disease with a lifetime risk of 1% to 3%. Treatment includes supplementation of central dopaminergic neurotransmission with levodopa preparations and dopamine agonists. Misprescribing and delayed administration of these medications on admission to hospital can result in increased morbidity and mortality.

We aimed to assess the accuracy of time-critical PD medication prescribing and administration during unplanned hospital admissions.

Patients admitted during a 15-month period with PD on time-critical PD medications were included. Their electronic patient records were compared with the pharmacist medication reconciliation to assess accuracy of admission prescribing. Accuracy of administration was assessed by comparing the time medications were administered to the time they were due. Statistical Package for Social Sciences software was used to perform statistical analysis in this study.

A total of 102 admissions of 70 patients (67% men) were included for analysis. These patients were on 1.6 ± 0.8 time-critical PD medications before admission, accounting for 4.1 ± 1.8 administrations per day. Time-critical medications were prescribed correctly on admission in 50% of admissions, with errors in medication timing most common (31.6%). Of all doses, 51.7% were administered >30minutes late, and 29.7% of doses were administered >1 hour late. Female sex, a higher number of medications, and more frequent administrations were significantly associated with the rate of medication error.

This study demonstrates high rates of inaccurate prescribing and inaccurate administration of time-sensitive medication in a cohort of patients with PD admitted acutely to hospitals.
This study demonstrates high rates of inaccurate prescribing and inaccurate administration of time-sensitive medication in a cohort of patients with PD admitted acutely to hospitals.The MDS Video Challenge continues to be the one of most widely attended sessions at the International Congress. Although the primary focus of this event is the presentation of complex and challenging cases through videos, a number of cases over the years have also presented an unusual or important neuroimaging finding related to the case. We reviewed the previous Video Challenge cases and present here a selection of those cases which incorporated such imaging findings. We have compiled these "imaging pearls" into two anthologies. The first focuses on pearls where the underlying diagnosis was a genetic condition. This second anthology focuses on imaging pearls in cases where the underlying condition was acquired. For each case we present brief clinical details along with neuroimaging findings, the characteristic imaging findings of that disorder and, finally, the differential diagnosis for the imaging findings seen.
Life-space mobility (LSM) captures a broad spectrum of mobility in physical and social environments; however, it has not been extensively studied in Parkinson's disease. Using a multiple-methods approach, individual, social and environmental factors that impact LSM were explored in PD.

Two hundred twenty-seven participants with PD (n=113) and a comparative group without PD (n=114) were recruited from the community. Within a cross-sectional survey, LSM (University of Alabama Birmingham Life-Space Assessment, LSA) was compared in the two groups. Using multiple linear regression, socio-demographics, lifestyle behaviors, medical, mobility and social factors were examined to identify factors that explained LSM. A qualitative narrative inquiry was completed to augment the findings from the survey; 10 participants with PD were interviewed regarding facilitators and barriers to mobility.

The mean overall LSA-composite score for the PD group was 64.2 (SD=25.8) and 70.3 (SD=23.1) for the community comparative gro encourage the LSM of the PD population.We selected several "imaging pearls" presented during the Movement Disorder Society (MDS) Video Challenge for this review. While the event, as implicated by its name, was video-centered, we would like to emphasize the important role of imaging in making the correct diagnosis. We divided this anthology into two parts genetic and acquired disorders. Genetic cases described herein were organized by the inheritance pattern and the focus was put on the imaging findings and differential diagnoses. Despite the overlapping phenotypes, certain described disorders have pathognomonic MRI brain findings that would provide either the "spot" diagnosis or result in further investigations leading to the diagnosis. Despite this, the diagnosis is often challenging with a broad differential diagnosis, and hallmark findings may be present for only a limited time.Oculomotor assessment is an essential element of the neurological clinical examination and is particularly important when evaluating patients with movements disorders. Most of the brain is involved in oculomotor control, and thus many neurological conditions present with oculomotor abnormalities. Each of the different classes of eye movements and their features can provide important information that can facilitate differential diagnosis. This educational review presents a clinical approach to eye movement abnormalities that are commonly seen in parkinsonism, ataxia, dystonia, myoclonus, tremor, and chorea. In parkinsonism, subtle signs such as prominent square wave jerks, impaired vertical optokinetic nystagmus, and/or the "round the houses" sign suggest early progressive supranuclear gaze palsy before vertical gaze is restricted. In ataxia, nystagmus is common, but other findings such as oculomotor apraxia, supranuclear gaze palsy, impaired fixation, or saccadic pursuit can contribute to diagnoses such as ataxia with oculomotor apraxia, Niemann-Pick type C, or ataxia telangiectasia. Opsoclonus myoclonus and oculopalatal myoclonus present with characteristic phenomenology and are usually easy to identify. The oculomotor exam is usually unremarkable in isolated dystonia, but oculogyric crisis is a medical emergency and should be recognized and treated in a timely manner. Gaze impersistence in a patient with chorea suggests Huntington's disease, but in a patient with dystonia or tremor, Wilson's disease is more likely. Finally, functional eye movements can reinforce the clinical impression of a functional movement disorder.
Levodopa-carbidopa intestinal gel (LCIG) therapy is used in advanced Parkinson's disease (PD) and consists of continuous administration of levodopa directly into the jejunum through a percutaneous endoscopic gastro-jejunal (PEG-J) tube. Recently, the metabolism of levodopa by
(
) has been reported. Intestinal bacteria can also affect this therapy.

To investigate intestinal bacteria and examine its impact on levodopa blood concentration in patients with PD receiving LCIG therapy.

We enrolled 6 patients receiving LCIG therapy in our department. After PEG-J tube replacement, intestinal bacteria were collected from the tip of the tube and were identified using culture and polymerase chain reaction (PCR) tests. Moreover, the presence of tyrosine decarboxylase, which metabolizes levodopa, was also confirmed by PCR test. The ability of these bacteria to metabolize levodopa was confirmed in vitro. Levodopa blood concentrations were also examined before PEG-J tube replacement.

Bacteria were detected in all 6 patients.
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