An Online Mindfulness-Based Group Intervention for Tics: A Pilot Randomized Controlled Trial.

BACKGROUND: Current treatments for Tourette syndrome (TS) and persistent tic disorder (PTD) are often insufficiently effective, inaccessible, and frequently associated with adverse events. Thus, we must continue to develop and test effective, accessible, and safe treatment options. OBJECTIVE: We aimed to conduct a pilot randomized controlled trial (RCT) comparing a novel, videoconference-delivered group mindfulness-based intervention for tics (MBIT) to videoconference-delivered group psychoeducation, relaxation, and supportive therapy (PRST) for adults with TS or PTD. METHODS: Thirty-two adults with TS or PTD were randomly assigned to receive 8 weeks of either MBIT or PRST. Tic severity, tic-related impairment, and global improvement were assessed by a trained, independent evaluator who was masked to treatment condition at baseline (week 0), posttreatment (week 9), 1-month follow-up, and 6-month follow-up. All study procedures were conducted online via secure videoconferencing. RESULTS: Twenty-eight participants began treatment and were included in analyses. MBIT, relative to PRST, was associated with a significantly greater decline in tic severity (d = 0.85) and tic-related impairment (d = 0.99) from baseline to posttreatment. Treatment response was significantly higher in MBIT (69%) than in PRST (13%). Neither treatment resulted in serious adverse effects. The durability of treatment outcomes is also reported and discussed. CONCLUSIONS: The results from this pilot RCT suggest that videoconference-delivered group MBIT may be an efficacious, accessible, and safe intervention for adults with tics. Future research is necessary to confirm these preliminary findings. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Two-Year Clinical and Radiographic Evaluation of Scheker Prosthesis (Aptis) Distal Radioulnar Joint Arthroplasty.

PURPOSE: To evaluate the clinical and radiographic outcomes of patients who underwent semiconstrained distal radioulnar joint arthroplasty. METHODS: A retrospective analysis was performed on a series of patients who underwent distal radioulnar joint arthroplasty with more than a 23-month follow up. The quantitative outcome variables included the visual analog scale for pain; Disability of the Arm, Shoulder, and Hand (DASH) score; Patient-Rated Wrist Evaluation (PRWE); and Mayo wrist score. The range of motion, grip strength, torque, and lifting capacity were measured at final follow up and compared with that of the nonsurgical extremity. Complications related to the prosthesis were assessed. RESULTS: Twenty-one patients (mean age 57 years) were assessed at an average 41-month follow up (23-73 months). Fifteen underwent prior hand, wrist, or elbow procedures. Four patients required 5 reoperations. The postoperative median visual analog scale pain score was 0.6 at rest and 2.1 with activity. The median postoperative DASH score was 26.7, PRWE 41, and Mayo wrist score was 65. Upon comparing the supination torque of the operative and intact sides, the operative side was found to average 87% of the intact side on a work simulator and 77% on the simulator's D-ring. Eight of 20 patients had lysis around the collar of the ulnar component (40%), as detected using radiography. Three of 21 (14%) radial plates were malpositioned, with 2 resulting in a fracture. The overall complication rate was 29%. CONCLUSIONS: Distal radioulnar joint arthroplasty using the Scheker prosthesis demonstrated good patient pain scores and the restoration of supination strength. The collar lysis resulted in weaker supination and grip strength. Still, the patients experienced mild levels of pain and moderate disability. A moderate complication rate persisted, as reported by other authors. Accurate radial component placement is important. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Substantial P-Type Conductivity of AlN Achieved via Beryllium Doping.

Beryllium has long been predicted by first principle theory as the best p-type dopant for GaN and AlN. But experimental validation of these theories has not, until now, borne out the original predictions. A key challenge is the dopant-induced strain leading to Be rejection from substitutional sites in favor of interstitial sites, leading to self-compensation. More flexible growth methods like metal modulated epitaxy (MME) that can operate at substantially lower temperatures than traditional approaches, can more effectively place Be into the proper substitutional lattice sites. MME grown Be-doped AlN shows substantial p-type conductivity with hole concentrations in the range of 2.3 × 1015 -3.1 × 1018  cm-3  at room temperature. While others have achieved sizable carrier concentrations near surfaces via carbon doping or Si implantation, this is the only known demonstration of substantial bulk p-type doping in AlN and is a nearly 1000 times higher carrier concentration than the best previously demonstrated bulk electron concentrations in AlN. The acceptor activation energy is found to be ≈37 meV, ≈8 times lower than predicted in literature but on par with similar results for MME p-type GaN. Preliminary results suggest that the films are highly compensated. A p-AlN:Be/i-GaN:Be/n-GaN:Ge pin diode is demonstrated with substantial rectification.

Maintenance of column performance at scale.

Pack-in-place column packing methods were developed for Q Sepharose Big Beads at 40 cm I.D. and scaled up to 200 cm I.D. in Chromaflow columns. The efficiency and asymmetry of the packed bed were evaluated as a function of test velocity and sample volume. The performance of the packed beds at both scales approached the theoretical limits of column performance (Hred =2 and Af=1) expected in small analytical columns. The packing strategy was effective for scale up and the stability of the packed beds, the effectiveness of the column design with respect to the mobile phase distribution system and the stability of the media to the pack-in-place technology, are presented.

Growth-associated Protein-43 (GAP-43) Expression In Ganglionic and Aganglionic Colon.

Abstract Objectives: Because of its specificity for nerve fibers of the enteric nervous system, calretinin is an effective adjunctive marker in the assessment for Hirchsprung disease. Growth associated protein (GAP-43) has been shown to be expressed in nerve fibers within the intestinal lamina propria. No prior report compares GAP-43 expression in ganglionic versus aganglionic intestine. Methods: Six consecutive Hirschsprung endorectal pull through specimens were retrieved from our archives. In addition 3 controls were selected from colonic resections for reasons other than Hirschsprung Disease. Immunoperoxidase for GAP-43 was carried out on the ganglionic and aganglionic segments of all cases and controls. Submucosal ganglion soma positivity and nerve fiber positivity within the lamina propria were graded on a subjective scale of 1-3 that incorporated both strength and density. Data: GAP-43 strongly stained submucosal ganglion cells and nerve fibers within the lamina propria in 6/6 of the ganglionic segments and 3/3 of the normally innervated controls . GAP-43 did not show any ganglion cell body positivity within the aganglionic segments; however, all 6 aganglionic segment lamina propria were positive for nerve fiber staining. There was a small subjective increase in the amount of nerve fiber positivity for GAP-43 in ganglionic segments and controls versus aganglionic segments. Conclusion: GAP-43 marks mucosal nerve fibers in ganglionic intestine but also aganglionic intestine and thus is less useful than calretinin as a marker for Hirschsprung Disease. The abundant mucosal nerves highlighted by GAP-43 requires further characterization.

Nuclear transfer with apoptotic bovine fibroblasts: can programmed cell death be reprogrammed?

Cell death by apoptosis is considered to be irreversible. However, reports have indicated that its reversibility is possible if the cells have not yet reached the "point of no return." In order to add new information about this topic, we used cells at different moments of apoptotic process as nuclear donors in somatic cell nuclear transfer (SCNT) in order to test if programmed cell death can be reversed. Adult bovine fibroblasts were treated with 10 µM of staurosporine (STP) for 3 h and analyzed for phosphatidylserine externalization (Annexin assay) and presence of active caspase-9. Annexin-positive (Anx+) and Caspase-9-positive (Casp-9+) cells were isolated by FACS and immediately transferred into enucleated in vitro matured bovine oocytes. After STP treatment, 89.9% of cells were Anx+ (4.6% in control cells; p<0.01) and 24.9% were Casp-9+ (2.4% in control cells; p<0.01). Fusion and cleavage were not affected by the use apoptotic cells (p>0.05). Also, the use of Anx+ cells did not affect blastocyst production compared to control (26.4% vs. 22.9%, respectively; p>0.05). However, blastocyst formation was affected by the use of Casp-9+ cells (12.3%; p<0.05). These findings contribute to the idea of that apoptosis is reversible only at early stages. Additionally, we hypothesize that the "point of no return" for apoptosis may be located around activation of Caspase-9.

Endoscopically assisted ulnar neurolysis for cubital tunnel syndrome.

Controversy remains regarding the surgical treatment of cubital tunnel syndrome. Similar outcomes with ulnar nerve transposition, both subcutaneous and submuscular, and simple decompression have recently been reported. We describe an endoscopically assisted cubital tunnel release through a 2-cm incision using readily available standard equipment. Seventeen of 21 procedures successfully alleviated symptoms of cubital tunnel syndrome in these patients. Four patients who developed ulnar nerve subluxation intraoperatively who were treated with medial epicondylectomy failed to experience relief of symptoms and were successfully treated with anterior submuscular transposition. Patients with more profound motor weakness and/or electrodiagnostic studies had less complete relief of symptoms.

Herpes zoster virus vaccine.

Varicella zoster virus (VZV) is the etiologic agent of varicella and herpes zoster (HZ) in humans. Herpes zoster is the result of reactivation of VZV within certain sensory ganglia. The burden of illness from HZ and post-herpetic neuralgia (PHN) is high. Herpes-zoster vaccine contains live attenuated varicella-zoster virus in an amount approximately 14 times greater than that found in the varicella virus vaccine. Herpes zoster vaccine is approved for the prevention of shingles in appropriate persons aged 60 and older. The vaccine is administered in a single subcutaneous dose. Reported side effects are mild and generally limited to localized injection site findings. Herpes-zoster vaccine reportedly decreases the occurrence of herpes zoster by approximately 50 percent and prevents the development of PHN by two thirds. The vaccine appears to be minimally effective in those individuals over the age of 80 and is not recommended in this age group.