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Patients with adolescent idiopathic scoliosis undergoing corrective surgery are at risk for iatrogenic spinal cord injury and subsequent new neurologic deficits (NNDs). Intraoperative neurophysiologic monitoring (IONM) has been used to identify spinal cord injury; however, available data showing that IONM leads to improved clinical outcomes are inconclusive. This exploratory study aimed to examine the incidence of NNDs after idiopathic scoliosis surgery in two pediatric institutions in Canada with a focus on IONM use.

Charts of pediatric patients (10-18 yr) with adolescent idiopathic scoliosis who underwent scoliosis correction surgery were retrospectively identified from the operating room database. Data regarding incidence and severity (mild [isolated sensory deficit] vs severe [any motor deficit]) of NNDs as well as demographic and clinical characteristics were extracted.

Of 547 patients reviewed, 359 (66%) underwent IONM and 186 (34%) underwent wake-up test. Neuromonitoring data were missing in two tionable. As we were unable to adjust for confounding variables, further research is needed to determine the impact of IONM on NNDs.
The goal of this review is to provide an overview of the impact and underlying mechanism of oxidative stress on connexin channel function, and their roles in skeletal aging, estrogen deficiency, and glucocorticoid excess associated bone loss.

Connexin hemichannel opening is increased under oxidative stress conditions, which confers a cell protective role against oxidative stress-induced cell death. Oxidative stress acts as a key contributor to aging, estrogen deficiency, and glucocorticoid excess-induced osteoporosis and impairs osteocytic network and connexin gap junction communication. EI1 reviews the current knowledge for the role of oxidative stress and connexin channels in the pathogenesis of osteoporosis and physiological and pathological responses of connexin channels to oxidative stress. Oxidative stress decreases osteocyte viability and impairs the balance of anabolic and catabolic responses. Connexin 43 (Cx43) channels play a critical role in bone remodeling, mechanotransduction, and survve stress conditions, there is a consistent reduction of Cx43 expression, while the opening of Cx43 hemichannels protects osteocytes against cell injury caused by oxidative stress.Utilization of robust quality improvement methodology in conjunction with traditional interventions to enhance an Early Mobility program (EMP) in a tertiary pediatric intensive care unit (PICU).
EMP was implemented in our PICU in May 2017. The percentage of appropriate physical and occupational therapist consults were determined. We also evaluated the activity levels received by the patient and the levels for which they qualified based on their medical condition. Failure Modes and Effects Analysis (FMEA) was performed to identify potential complications related to the mobilization of critically ill children. We created 4 simulation scenarios based on FMEA prioritized results.

After the implementation of EMP, appropriate physical and occupational therapist consults significantly increased (
< 0.0001). However, most patients still failed to receive the optimal level of activity recommended by protocol. This failure was partly due to concern for safety events during mobilization. FMEA identified vital sign changes [Risk Priority Number (RPN) 97.8], staff injury (RPN 64), and pain/anxiety (RPN 60.5) as potential safety events. We performed various in-situ simulation sessions based on these potential events. #link# In post-simulation evaluations, 100% of participants agreed that the simulation experience would improve their performance in the actual clinical setting. Feedback from simulations led to the development of an EM patient safety checklist and clinical pathway.

We describe a novel technique of using FMEA to develop scenarios that simulate potential adverse events to optimize safe EM in PICU. An EM checklist and pathway can guide in the implementation of safe EMP.
We describe a novel technique of using FMEA to develop scenarios that simulate potential adverse events to optimize safe EM in PICU. An EM checklist and pathway can guide in the implementation of safe EMP.
During baseball pitching, a high amount of elbow varus torque in the arm cocking-to-acceleration phase is thought to be a biomechanical risk factor for medial elbow pain and injury. The biomechanics of the stride phase may provide preparation for the arm cocking-to-acceleration phase that follows it.

To determine the kinematic parameters that predict peak elbow varus torque during the stride phase of pitching.

Descriptive laboratory study.

Participants were 107 high school baseball pitchers (age range, 15-18 years) without shoulder or elbow problems. Whole-body kinematics and kinetics during fastball pitching were analyzed using 3-dimensional measurements from 36 retroreflective markers. A total of 26 kinematic parameters of the upper and lower limbs during the stride phase leading up to the stride foot contact were extracted for multiple regression analysis to assess their combined effect on the magnitude of peak elbow varus torque.

Increased wrist extension, elbow pronation, knee flexion on the leased peak elbow varus torque is expected to reduce the risk of elbow medial pain and injury.Reversible cutaneous hyperpigmentation often occurs in the setting of nutritional deficiencies and protein energy malnourishment, with atypical presentations arising from autoimmune disease. Here, we present a 52-year-old female with hypertension, type 1 diabetes, and Hashimoto's thyroiditis, under the diagnosis of polyglandular autoimmune syndrome type II, referred for evaluation of asymptomatic hyperpigmentation of the palms, soles, hard palate, and tongue for 6 months. The patient underwent a significant work-up, including esophagogastroduodenoscopy, which revealed hypertrophic gastropathy as well as evidence of acquired B12 deficiency secondary to pernicious anemia. The patient was initiated on B12 supplementation, with eventual resolution of mucocutaneous findings.
Currently, 6-month oxaliplatin-based chemotherapy has been recommended as the preferred adjuvant treatment against high-risk stage 2 and stage 3 colon cancer patients.

Record retrieval was conducted in PubMed, Web of Science, Cochrane Central Register of Controlled Trials, American Society of Clinical Oncology and European Society for Medical Oncology meeting libraries from inception to November 2019. Regarding survival and tolerability, randomized controlled trials comparing different adjuvant systemic regimens against high-risk stage 2 and stage 3 colon cancer were eligible. Disease-free survival was primary endpoint. Network calculation was based on a random-effects model, and relative ranking of each node was numerically indicated by
score.

A total of 30 trials were included, corresponding to 54,109 patients. Regarding disease-free survival, none of the analyzed regimens displayed significant superiority against common comparator 6-month capecitabine plus oxaliplatin (XELOX), while 12-month [netw non-Asian countries.
The 3-month XELOX treatment could be an alternative option of the 6-month regimen among low-risk stage 3 patients. Among high-risk stage 3 patients, 6-month oxaliplatin-based regimens still seem more competitive. In addition, clinical application of 12-month capecitabine monotherapy should be cautious, despite its top rankings, especially among non-Asian countries.
Obesity is a risk factor for mood disorder (such as depression and anxiety). link2 We aimed to assess application of A Body Shape Index (ABSI) and abdominal volume index (AVI), as new indices of obesity to evaluate the relationship between obesity and depression/anxiety.

This cross sectional study was conducted on 307 overweight and obese women (249 females, 58 males) 20-60 years in Iran in 2017-2018. The anthropometric measures including weight, waist circumference, hip circumference, body fat and derived values of body mass index, waist-hip ratio, AVI and ABSI were evaluated. HADS questionnaire for depression and anxiety completed.

Prevalence of depression was 36.1% in women; men 24.1%; overweight 28.1%; obese 36.5 % and central obesity 33.7%. Anxiety was apparent in 27.1% of overweight 30.3 % obese and 29.6% central obesity. People with depression and anxiety had higher WC, BF and AVI. ABSI had no significant correlation with depression/anxiety. The odds of depression (1.06; 95% CI, 1.02-1.12) and anxiety (1.06; 95% CI, 1.01-1.11) were elevated with increase AVI.

Our results suggested that AVI as an indirect measure of abdominal obesity along with WC and BF could be useful in predicting the relationship between obesity and depression/anxiety.
Our results suggested that AVI as an indirect measure of abdominal obesity along with WC and BF could be useful in predicting the relationship between obesity and depression/anxiety.The adaptive evolution and coevolution of the ribulose-1,5-bisphosphate carboxylase/oxygenase large subunit (rbcL) gene in the genus Hildenbrandia were studied based on phylogenetic tree construction and the physicochemical properties and the secondary structures of protein encoded by rbcL (Rubisco large subunit) were analyzed. link3 The amino acids compositions and grand average of hydropathicity of freshwater H. rivularis and marine H. rubra were similar. Rubisco large subunit of Hildenbrandia was hydrophilic and the secondary structure was primarily composed of α-helixes and β-sheets, revealing the relatively stable structure of this protein. The predicted phosphorylation sites in H. rivularis and H. rubra were 33 and 36, respectively. No positive selection sites were detected in the genus Hildenbrandia, implying that rbcL gene evolved either neutrally or under purifying selection. A total of 41 coevolutionary groups were detected in the Rubisco large subunit of Hildenbrandia and the coevolving sites are in closer proximity in 3-dimensional structure of the protein. Despite the long evolutionary history, rbcL gene in genus Hildenbrandia under different environments is rather conservative.The SARS-CoV-2 spike (S) protein, a primary target for COVID-19 vaccine development, presents its receptor binding domain in two conformations, the receptor-accessible 'up' or receptor-inaccessible 'down' states. Here we report that the commonly used stabilized S ectodomain construct '2P' is sensitive to cold temperatures, and this cold sensitivity is abrogated in a 'down' state-stabilized ectodomain. Our findings will impact structural, functional and vaccine studies that use the SARS-CoV-2 S ectodomain.
The assessment of dental age is useful in the planning of orthodontic treatment, in pediatric dentistry, pediatric endocrinology, and forensic medicine. It is essential for a pediatric dentist to formulate treatment plan and it is a source of complementary information for pediatrician. Changes in the body proportion and composition are the essential elements of growth, especially maturation.

The present study was aimed to correlate the chronological age, dental age, and body height in children from Pune region of Maharashtra, India.

Four hundred and thirty-one panoramic radiographs of 177 boys and 254 girls in the age group of 4-14 years were obtained. Chronological age was assessed by recording date of birth. Dental age assessment was done using orthopantamogram following the method described by Demirjian. Body height was recorded using a measuring tape.

Chronological age and dental age showed significant positive correlation between male and female sample, i.e., r = 0.905 for males and r = 0.901 for females.
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