Two challenging cases of anti-MDA-5 dermatomyositis with rapidly progressive interstitial lung disease.

Anti-MDA-5 dermatomyositis (DM) is a subtype of idiopathic inflammatory myopathy, commonly presenting as clinically amyopathic dermatomyositis. It is associated with rapidly progressive interstitial lung disease and a poor prognosis. Here, we present two cases of anti-MDA-5 DM and discuss the challenges associated with timely diagnosis, and the importance of early and aggressive treatment.

Cognitive and neural mechanisms of learning and interventions for improvement across the adult lifespan: A systematic review protocol.

BACKGROUND: There continues to be growing interest in the Science of Learning including identifying applications for findings from this work outside the laboratory to support learning. Presently, there exists a gap in our understanding of learning during healthy adulthood as well as effective ways in which that learning can be improved. Developing a more comprehensive understanding of learning during adulthood, and effective ways of improving that learning, are crucial goals given the impact of a rapidly aging global population. The main objective of the proposed systematic review is to identify and synthesize all recent cognitive and brain research investigating learning across the adult lifespan. METHODS: Searches will be performed across Scopus, Web of Science, and ProQuest databases. Both published and unpublished literature will be screened for inclusion. Included articles will be limited to research in healthy adult samples reporting measures of learning-related cognition, brain structure or function and their relationship with age, or the impact of interventions to improve learning. All steps of the review will be performed by three trained reviewers. Tabular, narrative, and quantitative syntheses will be provided based on the characteristics of included studies. DISCUSSION: Findings from the proposed review will contribute to our understanding of learning in adulthood. Additionally, this review will identify research gaps in need of further investigation and relevant findings for translation, informing the scope of future funding priorities in the Science of Learning.

AI and Aphasia in the Digital Age: A Critical Review.

Aphasiology has a long and rich tradition of contributing to understanding how culture, language, and social environment contribute to brain development and function. Recent breakthroughs in AI can transform the role of aphasiology in the digital age by leveraging speech data in all languages to model how damage to specific brain regions impacts linguistic universals such as grammar. These tools, including generative AI (ChatGPT) and natural language processing (NLP) models, could also inform practitioners working with clinical populations in the assessment and treatment of aphasia using AI-based interventions such as personalized therapy and adaptive platforms. Although these possibilities have generated enthusiasm in aphasiology, a rigorous interrogation of their limitations is necessary before AI is integrated into practice. We explain the history and first principles of reciprocity between AI and aphasiology, highlighting how lesioning neural networks opened the black box of cognitive neurolinguistic processing. We then argue that when more data from aphasia across languages become digitized and available online, deep learning will reveal hitherto unreported patterns of language processing of theoretical interest for aphasiologists. We also anticipate some problems using AI, including language biases, cultural, ethical, and scientific limitations, a misrepresentation of marginalized languages, and a lack of rigorous validation of tools. However, as these challenges are met with better governance, AI could have an equitable impact.

Adjustment and homesickness in hospitalised children: A systematic review.

Children can experience significant distress during hospitalisation, as a result of the treatment process and due to psychosocial factors impacting their adjustment to the hospital environment. Such factors can contribute to negative outcomes for the child. Despite this, limited research focus has been placed on understanding the psychosocial factors that contribute to a child's distress to inform support strategies that can improve the experience of hospitalisation across paediatric conditions. The objectives of this review were to synthesise the qualitative and quantitative literature on psychosocial factors associated with hospital adjustment and to identify risk and protective factors that influence the adjustment process. The literature search (1980 to February 2024: CINAHL / Embase / Medline / PsychINFO and Web of Science databases) identified thirty-four studies. Poor hospital adjustment, anxiety, depression and homesickness, were reported by the majority of hospitalised children. Several demographic and psychosocial factors were identified in the quantitative synthesis to contribute to poor adjustment. Child age, temperament, attachment style, past negative hospital experiences, homesickness and fear cognitions, were all associated with adjustment to the hospital environment. Homesickness was identified as a particularly understudied and important construct. Theoretical and methodological considerations are discussed, and recommendations made for future research that can further support inpatient children and their families.

Bulk osteochondral allograft for massive Hill-Sachs defect combined with Latarjet procedure for bipolar bone loss in anterior instability.

A proportion of patients with anterior glenohumeral instability present with bipolar bone loss comprising large Hill-Sachs lesions and substantial glenoid defect. These are surgically difficult cases to treat. We describe a novel surgical procedure of bulk size-matched osteochondral allograft reconstruction for massive Hill-Sachs lesions combined with the Latarjet procedure for these challenging cases.

Select Cover Crop Residue and Soil Microbiomes Contribute to Suppression of Fusarium Root and Crown Rot in Barley and Soybean.

Fusarium root and crown rot (FRCR) negatively impact several economically important plant species. Cover crops host different soil and residue microbiomes, thereby potentially influencing pathogen load and disease severity. The carryover effect of cover crops on FRCR in barley and soybean was investigated. Field trials were conducted in Prince Edward Island, Canada. Two cover crops from each plant group, including forbs, brassicas, legumes, and grasses, were grown in a randomized complete block design with barley and soybean planted in split plots the following year. Barley and soybean roots were assessed for FRCR through visual disease rating and Fusarium spp. were isolated from diseased tissue. Fungal and bacterial communities in cover crop residues were quantified using amplicon sequencing. The disease-suppressive effects of soil were tested in greenhouse studies. The results indicated that sorghum-sudangrass-associated microbiomes suppress Fusarium spp., leading to reduced FRCR in both barley and soybean. The oilseed radish microbiome had the opposite effect, consequently increasing FRCR incidence in barley and soybean. The results from this study indicate that cover crop residue and the associated soil microbiome influence the incidence and severity of FRCR in subsequent crops. This information can be used to determine cover cropping strategies in barley and soybean production systems.

The dynamics of vegetation diversity and biomass under traditional grazing in Ethiopia's Somali rangeland.

Traditional grazing management practices are central to rangeland productivity and biodiversity. However, the degradation of rangelands and loss of ecosystem services have raised concerns about the future of pastoralism as a form of land use. It is imperative to understand how these practices influence vegetation attributes, e.g., herbaceous species diversity and composition, growth forms (grass, forbs), life form (annuals, perennials), tree metrics (density, canopy cover, and biomass). This study evaluates vegetation shifts under three grazing management practices-enclosures, open grazing, and browsing lands-in the Somali pastoral ecosystem of Ethiopia. Enclosures exhibited the highest diversity in herbaceous species, with open grazing lands favoring forbs and annuals. Distinct compositional shifts in herbaceous species were observed across regimes, especially in grass and annuals. Enclosures had three times higher herbage biomass of open grazing and double that of browsing management practice. Conversely, browsing management practices presented optimal wood biomass, density, and canopy cover. The results highlight that a transition to combined enclosure and browsing practices can elevate plant production and diversity, benefiting the Somali rangeland economy. Consequently, dryland restoration should incorporate indigenous knowledge to ensure future rangeland sustainability and biodiversity preservation.

Relationship between deprivation, and the uptake and use of the common ailments service in community pharmacies in Wales.

OBJECTIVES: Since 2013 community pharmacies in Wales have been commissioned to provide a common ailments service (CAS), providing pharmacy medicine without charge to patients. In the first review of national pharmacy data, this study aimed to describe the relationship between provision of CAS and deprivation. METHODS: A retrospective observational study, using CAS claims data from April 2022 to March 2023 collected as part of routine service delivery. Consultation data were matched to the index of multiple deprivation (IMD) decile of the providing pharmacy. Linear regression was used to describe the correlation between CAS claims data and IMD deciles of the pharmacy postcode. KEY FINDINGS: In the study period, 239 028 consultations were recorded. More than twice as many consultations were carried out in pharmacies located in the most deprived decile (33 950) than in pharmacies in the least deprived decile (14 465). Linear regression demonstrated a significant correlation r(10) = -0.927, P < 0.001. There was a strong relationship between greater numbers of consultations and greater deprivation of the pharmacy postcode (R2 = 0.887). This significant correlation with deprivation was also found in the majority of individual conditions. There was no significant correlation between deprivation decile and the number of consultations per patient. CONCLUSIONS: Community pharmacies offer a key resource for tackling health inequalities. Patients in those areas with the greatest need are those most likely to use the CAS in pharmacies and receive the care they need. Commissioning services like this naturally supports deprived communities, through a combination of patient behaviours, location, and accessibility.

Unanticipated Large-Scale Deletion in Fusarium graminearum Genome Using CRISPR/Cas9 and Its Impact on Growth and Virulence.

Fusarium graminearum, a filamentous fungus, and causal agent of Fusarium head blight (FHB) in wheat and other cereals, leads to significant economic losses globally. This study aimed to investigate the roles of specific genes in F. graminearum virulence using CRISPR/Cas9-mediated gene deletions. Illumina sequencing was used to characterize the genomic changes due to editing. Unexpectedly, a large-scale deletion of 525,223 base pairs on chromosome 2, comprising over 222 genes, occurred in two isolates. Many of the deleted genes were predicted to be involved in essential molecular functions, such as oxidoreductase activity, transmembrane transporter activity, hydrolase activity, as well as biological processes, such as carbohydrate metabolism and transmembrane transport. Despite the substantial loss of genetic material, the mutant isolate exhibited normal growth rates and virulence on wheat under most conditions. However, growth rates were significantly reduced under high temperatures and on some media. Additionally, wheat inoculation assays using clip dipping, seed inoculation, and head point inoculation methods were performed. No significant differences in virulence were observed, suggesting that these genes were not involved in infection or alternative compensatory pathways, and allow the fungi to maintain pathogenicity despite the extensive genomic deletion.

Does Language Distance Modulate the Contribution of Bilingualism to Cognitive Reserve in Seniors? A Systematic Review.

We report a systematic review and exploratory meta-regression investigating the hypothesis that the effects of bilingualism on cognitive reserve are modulated by the distance between the pair of languages a bilingual uses. An inclusive multiple database search was performed in order to identify all relevant published research conducted in bilingual seniors. A combination of qualitative and quantitative synthesis methods were used in order to investigate our research questions. Results suggest that healthy bilingual seniors speaking more distant language pairs show improved monitoring performance on cognitive tasks. Evidence regarding a modulatory influence of language distance (LD) on the age of dementia diagnosis was inconclusive due to the small number of published studies meeting our inclusion criteria. We recommend more detailed reporting of individual differences in bilingual experience to assess the impact of LD and other variables on typical cognitive aging and the development of dementia. Linguistic differences in samples should also be considered as a constraint on bilingual advantages in future studies. Preregistration: PROSPERO CRD42021238705; OSF DOI 10.17605/OSF.IO/VPRBU.

Fixation of Proximal Third Humeral Shaft Fractures in Older Patients.

Background: Humeral shaft fractures occur frequently in older patients. The more proximal end of the shaft is prone to non-union when compared with more distal fractures. We provide an overview of several key features of this significant patient group. Method: Our institutional fracture database was searched for all cases of proximal third humeral shaft fractures in patients over 60 years of age. Retrospective evaluation of patient demographics, management, length of stay and incidence of non-union was performed. Results: 75 patients (61 female) were analysed. 33 patients were 'frail' (Clinical Frailty Scores of >4). Non-union occurred in 19 of 45 non-surgically treated fractures and in 1 of 37 cases treated surgically. Mean length of stay was 5.9 days (non-operative) and 6.6 days (operative). Proximal extension into the humeral head is common. Conclusion: Non-surgical management of proximal third humeral shaft fractures is associated with an increased risk of non-union. We detail an operative technique and case example supporting early fixation of displaced proximal third humeral shaft fractures in older patients that can be utilized for both primary and delayed fixation. In view of the significant association of non-union a well-constructed prospective cohort study with outcome assessment would be of value to further characterize this emerging injury population.Level of Evidence: Level IV, retrospective case series.

Inhibitory control as a significant predictor of academic performance in Chinese high schoolers.

Studies investigating the relationship between cognitive function and academic performance have recently shifted focus from differences in intelligence to executive function. To date, these studies have focused disproportionately on samples recruited from Western countries, despite evidence in support of cultural differences in the development of executive function. To address this gap, the present study investigated whether differences in two dimensions of executive function, inhibitory and attentional control, could predict academic performance in a sample of Chinese adolescents (n = 42). Participants reported on demographic details and completed both the Simon task and Attention Network Test. Data were analyzed using multiple linear regression controlling for gender, age, SES, English language proficiency, processing speed, and fluid intelligence. Results showed that one index of inhibitory control derived from non-cue trials on the Attention Network Test explained a significant amount of unique variance in academic performance. Our findings provide evidence that executive function, specifically inhibitory control, plays a significant role in academic performance.

Educational neurotechnology: Where do we go from here?

Recent educational trends point to an interest in educational neurotechnology. While these tools have the potential to change education, little is known about whether their use improves educational outcomes. Additionally, their adoption may be negatively impacted by teachers' lack of knowledge about the brain. In this paper we outline the potential of educational neurotechnology including what we know, what we do not yet know, and additional considerations for the ethical, successful adoption of these tools in classrooms around the world. Special consideration is given to the training needs of pre- and in-service educators whose support will be essential to the successful adoption of educational neurotechnology.

Associations between neck circumference and markers of dysglycemia, non-alcoholic fatty liver disease, and dysmetabolism independent of Body Mass Index in an Emirati population.

Aim: Neck circumference (NC) is quick and easy to measure and may be a useful surrogate marker for body composition. We investigated NC as a potential marker of dysglycemia, MetS, and NAFLD. Methods: 674 individuals were recruited at the Imperial College London Diabetes Centre in a study of sleep apnea prevalence. Of these, 547 (Age 46 ± 11.4 years, Body Mass Index (BMI) 31 ± 6 kg/m2, 279 (51%) female, 113 normal glucose tolerance (NGT), 108 Prediabetes, 326 Type 2 diabetes (T2DM)) met all inclusion criteria for analysis. NC was measured at the thyroid cartilage, and collar size was recorded. Analysis was performed using univariate and multivariate linear regression. Results: Adjusted for BMI, sex, and age, NC was 0.65 ± 0.3 cm greater in prediabetes (p = 0.0331), and 1.07 ± 0.28 cm greater in T2DM, compared with NGT (p = 0.0002). Adjusting for BMI, sex, and glycemic status, 1-cm increase in NC was associated with a 1.04 ± 1.01 U/L (p <0.0001) increase in ALT and, additionally, correcting for statin use, a 0.03 ± 0.01 mmol/L reduction in HDL (p <0.0001) and a 0.1 ± 0.02 increase in TC : HDL. A 1 cm increase in NC was associated with a 1.15 ± 1.02% (p <0.0001) increase in 10-year AHA cardiovascular risk in individuals over 40 years old and a 0.16 ± 0.02 (p <0.0001) increase in NAFLD fibrosis score. The neck circumference was associated with the hazard of new onset of deranged ALT adjusted for age, sex, glycemic status, and BMI (hazard ratio 1.076 (95% CI 1.015-1.14, p = 0.0131) and with the incidence of Fatty Liver Index associated with high probability of NAFLD (hazard ratio 1.153 (95% CI 1.019-1.304), p = 0.0239). Conclusion: NC is associated with dysglycemia, components of the MetS, and factors predictive of NAFLD, but does not appear to independently predict subsequent progression to high risk of liver fibrosis in this predominantly diabetic population.

Imposing Compulsory Rugby Union on Schoolchildren: An Analysis of English State-Funded Secondary Schools.

Objective: To establish the extent to which Rugby Union was a compulsory physical education activity in state-funded secondary schools in England and to understand the views of Subject Leaders for Physical Education with respect to injury risk. Method: A cross-sectional research study using data obtained under the Freedom of Information Act (2000) from 288 state-funded secondary schools. Results: Rugby Union was delivered in 81% (n = 234 of 288) of state-funded secondary school physical education curricula, including 83% (n = 229 of 275) of state-funded secondary school boys' and 54% (n = 151 of 282) of girls' physical education curricular. Rugby Union was compulsory in 91% (n = 208 of 229) of state-funded secondary schools that delivered it as part of the boys' physical education curriculum and 54% (n = 82 of 151) of state-funded secondary schools that delivered contact Rugby Union as part of the girls' physical education curriculum. Subject Leaders for Physical Education also perceived Rugby Union to have the highest risk of harm of the activities they delivered in their school physical education curriculum. Conclusion: Notwithstanding discussions of appropriate measures (i.e., mandatory concussion training, Rugby Union specific qualifications and CPD) to reduce injury risk, it is recommended that Rugby Union should not be a compulsory activity given that it has a perceived high risk of injury and is an unnecessary risk for children in physical education.

A resting-state network for novelty: Similar involvement of a global network under rest and task conditions.

Neuroimaging research provides converging evidence in support of functional networks active under rest conditions. While these networks are typically locally-distributed, a globally-distributed resting-state network (gRSN) was recently identified. The gRSN component is characterized by a scalp topography similar to that of the widely-studied P3 component of the event related potential, thought to represent the brain's response to novelty. In this study, we investigate similarities between the neural generators underlying these two networks to test the hypothesis that the gRSN is a resting-state network for novelty. By using the second-order blind identification (SOBI) algorithm, which works with temporal information, we show that (1) a resting-state component resembling the topography of the P3 can be recovered in all participants; (2) this gRSN component can be modeled with a set of ECDs with high goodness of fit; (3) ECD locations of the gRSN correspond to a network of globally-distributed brain structures overlapping heavily with the networking underlying the P3; and, (4) structures underlying these two networks are similarly involved during task and resting-state conditions. We interpret this as evidence in support of a resting-state network for detection and response to novelty.

A scoping review of research on neuroscience training for teachers.

BACKGROUND: Including neuroscience concepts in teacher training has continued to gain interest. While many studies advocate for this, little is known about currently published research. METHODS: The framework for a scoping review was followed in order to generate a more comprehensive understanding of current research on neuroscience training for teachers. The present study aims to: (1) describe the scope of existing research; (2) summarize findings; and (3) provide recommendations for future inquiry. RESULTS: Limited studies and methodological issues prevent strong conclusions from being drawn about the impact of this training although most results are promising. CONCLUSIONS: This scoping review provides the first comprehensive summary of the existing research on neuroscience training for teachers and discusses a number of considerations for improving future research in this area.

Tendon transfers for irreparable rotator cuff tears.

Symptomatic irreparable rotator cuff tears pose a challenge for shoulder surgeons. Whilst reverse polarity shoulder arthroplasty is an effective option for older symptomatic patients who have exhausted conservative management, the optimal treatment for younger patients remains controversial. In this article we outline the main tendon transfer options, including anatomical considerations, indications, contraindications, surgical technique, complications and a review of the evidence. Tendon transfers provide an alternative joint-preserving surgical option, but the evidence so far is limited, with a clear need for well-designed comparative studies to confirm their effectiveness.

Management of rotator cuff tears - Key historical landmarks.

The management of rotator cuff pathology has developed over hundreds of years. In this article, we take a journey from the early days, in order to understand how we have reached our modern-day practice. Initially our understanding of rotator cuff pathology was based on cadaveric anatomical findings and this has enhanced over the years by the development of radiological and surgical techniques. We discuss the historical debates over the pathogenesis of cuff dysfunction. This work describes the landmark publications by several clinicians who have made important contributions to our understanding of rotator cuff pathology and its management. We follow the trends of surgical management of rotator cuff tears, traditionally performed via an open technique, to an exponential rise in arthroscopic surgery in recent years. As new techniques emerge, a review of the historical rise and fall of techniques is a reminder for us to remain vigilant of surgical indications and rigorous outcome analysis.

Intra-abdominal desmoplastic small round cell tumour in a 56-year-old female: Case report of a very rare presentation of an unusual tumour.

INTRODUCTION: This case report discusses the rare diagnosis of intra-abdominal desmoplastic small round cell tumour (DSRCT) in a 56-year-old female. PRESENTATION OF CASE: An incidental intra-abdominal lesion was found during investigation of joint pain. Ultrasound-guided biopsy suggested desmoid tumour, after undergoing laparotomy and en-bloc excision of the tumour due to concerning radiological progression, the final histology was desmoplastic small round cell tumour. At six-week follow-up imaging, no recurrence or metastatic disease was noted. She declined chemotherapy and specialist follow-up, electing to have routine follow up with her General Practitioner only. DISCUSSION: Intra-abdominal DSRCT is rare and mainly seen in young males. To our knowledge, this is the only reported case of DSRCT in a female over the age of 50. CONCLUSION: There should be timely discussion between different surgical units to provide efficient care. Any disparity between radiological and histological appearance should prompt further review and investigation in order to ensure misdiagnosis is avoided and appropriate treatment is provided. Despite cytoreductive surgery, survival is dismal due to the aggressive nature of the tumour, and its low numbers limiting adequate study into post diagnosis care.