Radiological assessment of hip disease in children with cerebral palsy: development of a core measurement set.

Aims: Hip disease is common in children with cerebral palsy (CP) and can decrease quality of life and function. Surveillance programmes exist to improve outcomes by treating hip disease at an early stage using radiological surveillance. However, studies and surveillance programmes report different radiological outcomes, making it difficult to compare. We aimed to identify the most important radiological measurements and develop a core measurement set (CMS) for clinical practice, research, and surveillance programmes. Methods: A systematic review identified a list of measurements previously used in studies reporting radiological hip outcomes in children with CP. These measurements informed a two-round Delphi study, conducted among orthopaedic surgeons and specialist physiotherapists. Participants rated each measurement on a nine-point Likert scale ('not important' to 'critically important'). A consensus meeting was held to finalize the CMS. Results: Overall, 14 distinct measurements were identified in the systematic review, with Reimer's migration percentage being the most frequently reported. These measurements were presented over the two rounds of the Delphi process, along with two additional measurements that were suggested by participants. Ultimately, two measurements, Reimer's migration percentage and femoral head-shaft angle, were included in the CMS. Conclusion: This use of a minimum standardized set of measurements has the potential to encourage uniformity across hip surveillance programmes, and may streamline the development of tools, such as artificial intelligence systems to automate the analysis in surveillance programmes. This core set should be the minimum requirement in clinical studies, allowing clinicians to add to this as needed, which will facilitate comparisons to be drawn between studies and future meta-analyses.

Ionic Liquid-Reduced Graphene Oxide Membrane with Enhanced Stability for Water Purification.

There has been a growing interest in water purification by graphene oxide (GO) laminate membranes due to their exceptional hydrophilicity, high throughput, and extraordinary separation performance originating from their two-dimensional and well-defined nanostructure. However, the swelling and stability in an aqueous environment are areas of concern for the GO laminate membranes. Here, a novel methylimidazolium ionic liquid-reduced GO (mimG)-assembled GO laminate membrane (mimG-GO) with remarkable stability was fabricated by a vacuum-assisted strategy for water purification. Methylimidazolium-based ionic liquid-reduced graphene oxide (mimG) was prepared by a facile nucleophilic ring-opening mechanism. Fabricated membranes were thoroughly characterized for stability, structural, permeance, and rejection properties in an aqueous environment. A combination of cationic mimG and GO nanosheets improves membrane stability in the aqueous environment via cation-π interactions and creates nanofluidic channels for facile water transport while yielding significant enhancement in the salt and dye separation performance. The pore size and the number of nanofluidic channels were precisely controlled via material deposition and laminate thickness to remove salts from water. The mimG-GO laminate membrane containing 72.2 mg m-2 deposition showed a permeance of 14.9 LMH bar-1, 50% higher than 9.7 LMH bar-1 of the neat GO laminate membrane, in addition to an increase in Na2SO4 salt rejection from 46.6 to 77.4%, overcoming the flux-rejection trade-off. The mimG-GO laminate membrane also rejected various anionic dyes (i.e., 99.9% for direct red 80 (DR 80), 96.8% for reactive black 5 (RB 5), and 91.4% for methyl orange (MO)). The mimG-GO laminate membrane containing 361.0 mg m-2 deposition showed the highest rejection for Na2SO4 (92.1%) and 99.9% rejection for DR 80, 99.0% rejection for RB 5, and 98.1% rejection for MO dyes keeping a flux of 2.6 LMH bar-1. Partial reduction and covalent grafting of ionic liquid moieties on GO helped to enhance the cation-π interaction between GO laminates, which showed enhanced stability, frictionless water transport, with high salt and dye rejection. Moreover, a simultaneous improvement in water permeance and solute rejection reveals the great potential of ionic liquid-functionalized GO laminate membranes for water-based applications.

Benign versus malignant solid breast masses: US differentiation.

PURPOSE: To investigate the general applicability and interobserver variability of ultrasonographic (US) features in differentiating benign from malignant solid breast masses. MATERIALS AND METHODS: One hundred sixty-two consecutive solid masses with a tissue diagnosis were reviewed. Three radiologists reviewed the masses without knowledge of clinical history or histologic examination results. RESULTS: US features that most reliably characterize masses as benign were a round or oval shape (67 of 71 [94%] were benign), circumscribed margins (95 of 104 [91%] were benign), and a width-to-anteroposterior (AP) dimension ratio greater than 1.4 (82 of 92 [89%] were benign). Features that characterize masses as malignant included irregular shape (19 of 31 [61%] were malignant), microlobulated (four of six [67%] were malignant) or spiculated (two of three [67%] were malignant) margins, and width-to-AP dimension ratio of 1.4 or less (28 of 70 [40%] were malignant). If the three most reliable criteria had been strictly applied by each radiologist, the overall cancer biopsy yield would have increased (from 23% to 39%) by 16%. When US images and mammograms were available, the increase in biopsy yield contributed by US was not statistically significant (2%, P = .73). However, in independent reviews, one to three reviewers interpreted four carcinomas as benign at US. CONCLUSION: The data confirm that certain US features can help differentiate benign from malignant masses. However, practice and interpreter variability should be further explored before these criteria are generally applied to defer biopsy of solid masses.

Studies on rapid assessment methods in leprosy.

A study was undertaken in Pudukottai district, Tamilnadu, India to test rapid assessment methods: viz (i) sample surveys with lower coverages for clinical examination in estimating the disease problem in the community, (ii) utility of registered case prevalence for estimating the actual prevalence in a given area, (iii) leprosy in school-going children and its utility in estimating leprosy prevalence in the community, and (iv) information on disability and smear positivity in estimating leprosy prevalence; and develop correction factors for estimating leprosy situation. A sample of 23 clusters from 582 clusters of contiguous villages and hamlets was further divided into two random sub-samples for two surveys with differing coverages. One team covered nine clusters comprising 34 villages with a population of 17,562 and examined 15,596 with a population of 26,927 and examined 16,622 (62%) persons for leprosy. The results showed that: (i) leprosy sample surveys with lowered coverages would tend to miss valuable information, in terms of quality and quantity; (ii) from 'known case' registers, to estimate the true burden of leprosy disease and to monitor its trend over time is inadequate; (iii) school surveys are of limited value for estimating the disease burden in the community or to monitor its trend over time; (iv) the number of smear-positive cases is to small to serve as an indicator for the total case load in the community; and (v) the prevalence of active disease and that of grade 2 disability in the community are poorly correlated. Reliable methods other than those used here need to be developed for evaluation and monitoring of the disease burden particularly in the post-MDT era.

Effects of sexual behavioral manipulation on brain plasticity in adult rats.

The purpose of the present study was to determine the effects of sexual behaviorial manipulation on brain plasticity in adult male rats. Adult male Sprague-Dawley rats that copulated during male sexual behavior testing were divided into four groups: control male; gonadectomized (Gdx) male; sexually active male; and sexually nonactive male. Female animals were used as an additional control group. At the end of a 12-week experimental period, the animals were again tested for male sexual behavior and tested for sexual motivation. Sexual behavior manipulations over the 12-week period resulted in significant differences in mount latency, mount frequency, intromission latency, intromission frequency, ejaculation latency, and the postejaculation interval. In the motivation test, significant differences in the number of approaches, contacts, and crossings of an electrified grid separating the test animal from a receptive female were also observed. Sexually dimorphic nucleus of the preoptic area (SDN-POA) volumes in sexually nonactive males were significantly smaller than in control males or sexually active males. Anteroventral periventricular nucleus (AVPV) volumes in the male groups were not significantly altered by sexual behavioral manipulations, however, the nonactive AVPV vol. was the only vol. not significantly different from the control female vol. These data demonstrate that in the adult rat, sexual behavioral manipulations resulted in significant alterations in behavior and in the vol. of the SDN-POA and that the effect of sexual behavior on the AVPV needs to be further investigated.

Direct connection between myelinosomes, endoplasmic reticulum and nuclear envelope in mouse hepatocytes grown with the amphiphilic drug, quinacrine.

Mouse hepatocytes grown in 4 microM quinacrine had numerous myelinosomes which were directly connected to expanded cisternae of the rough endoplasmic reticulum (RER). The cisternae of the RER either subtended the electron transparent space of the myelinosome, expanded to form the outer membrane of the myelinosome or penetrated into it. Material of low electron density was frequently seen within the area where the cisternae penetrated into the electron transparent space of the myelinosome. Myelinosomes were also associated with the nuclear envelope in a pattern similar to that of the RER. Quinacrine appears to bind with the phospholipids of the membranes of the endoplasmic reticulum and nuclear envelope and this drug-lipid complex is then moved into myelinosomes effectively removing the drug from the cell.

Some recent advances in non-communicable diseases in the Tropics. 1. Hypertension: an emerging problem in tropical countries.

With increasing urbanization, hypertension and its complications are becoming major health problems in many tropical countries. In particular, hypertension is a major cause of illness in black Africans. There is good evidence that an increasing dietary salt intake is partly responsible for this rising incidence of hypertension and possibly restriction of salt may help in prevention. The public health requirements for the prevention, detection and management of hypertension are likely to consume scarce resources in countries where life expectancy is gradually rising due to improved control of communicable disease and malnutrition. Failure to address the problem of hypertension could have serious effects on morbidity and mortality of economically active individuals in developing countries.

The effect of short-term exposure to low-iron diets on the mucosal processing of ionic iron.

Short-term alterations in the amount of iron in the diets of rats caused substantial differences in the distribution of a test dose of radioiron between mucosal transferrin and mucosal ferritin, and also caused a change in the relative amounts of these two proteins in mucosal tissue without resulting in any detectable change in liver iron stores. These differences correlated with changes in the retention of radioiron by the intestinal mucosa and the transport of radioiron to the blood stream. These studies emphasize the importance of local changes in the intestinal mucosa in the regulation of dietary iron absorption.