Urethroscrotal fistula complicating large spermatocele in a male ketamine abuser: A case report.

Ketamine related urinary tract complications were first reported in Hong Kong since 2007. The current case report describes a 37 years old male with long history of ketamine abuse, renal impairment, hypertension and HCV hepatitis, presented to us with insidious onset of painful scrotal swelling post bilateral nephrectomy, prostate and seminal vesicle preserving cystectomy. Radiological imaging and intraoperative finding revealed that it was a large spermatocele with urethroscrotal fistula, which was likely due to urethra stricture. The review of literature showed no guidelines for treatment, a symptoms based and multidisciplinary team approach is recommended.

Open-source, machine and deep learning-based automated algorithm for gestational age estimation through smartphone lens imaging.

Gestational age estimation at time of birth is critical for determining the degree of prematurity of the infant and for administering appropriate postnatal treatment. We present a fully automated algorithm for estimating gestational age of premature infants through smartphone lens imaging of the anterior lens capsule vasculature (ALCV). Our algorithm uses a fully convolutional network and blind image quality analyzers to segment usable anterior capsule regions. Then, it extracts ALCV features using a residual neural network architecture and trains on these features using a support vector machine-based classifier. The classification algorithm is validated using leave-one-out cross-validation on videos captured from 124 neonates. The algorithm is expected to be an influential tool for remote and point-of-care gestational age estimation of premature neonates in low-income countries. To this end, we have made the software open source.

Cathodal Transcranial Direct Current Stimulation Over Left Dorsolateral Prefrontal Cortex Area Promotes Implicit Motor Learning in a Golf Putting Task.

BACKGROUND: Implicit motor learning is characterized by low dependence on working memory and stable performance despite stress, fatigue, or multi-tasking. However, current paradigms for implicit motor learning are based on behavioral interventions that are often task-specific and limited when applied in practice. OBJECTIVE: To investigate whether cathodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) area during motor learning suppressed working memory activity and reduced explicit verbal-analytical involvement in movement control, thereby promoting implicit motor learning. METHODS: Twenty-seven healthy individuals practiced a golf putting task during a Training Phase while receiving either real cathodal tDCS stimulation over the left DLPFC area or sham stimulation. Their performance was assessed during a Test phase on another day. Verbal working memory capacity was assessed before and after the Training Phase, and before the Test Phase. RESULTS: Compared to sham stimulation, real stimulation suppressed verbal working memory activity after the Training Phase, but enhanced golf putting performance during the Training Phase and the Test Phase, especially when participants were required to multi-task. CONCLUSION: Cathodal tDCS over the left DLPFC may foster implicit motor learning and performance in complex real-life motor tasks that occur during sports, surgery or motor rehabilitation.

Acrylic acid derivatives of group 8 metal carbonyls: a structural and kinetic study.

The synthesis, spectroscopic, and X-ray structural studies of acrylic acid complexes of iron and ruthenium tetracarbonyls are reported. In addition, the deprotonated η(2)-olefin bound acrylic acid derivative of iron as well as its alkylated species were fully characterized by X-ray crystallography. Kinetic data were determined for the replacement of acrylic acid, acrylate, and methylacrylate for the group 8 metal carbonyls by triphenylphosphine. These processes were found to be first-order in the concentration of metal complex with the rates for dissociative loss of the olefinic ligands from ruthenium being much faster than their iron analogues. However, the ruthenium derivatives afforded formation of primarily mono-phosphine metal tetracarbonyls, whereas the iron complexes led largely to trans-di-phosphine tricarbonyls. This difference in behavior was ascribed to a more stable spin crossover species (3)Fe(CO)4 which undergoes rapid CO loss to afford the bis phosphine derivative. The activation enthalpies for dissociative loss of the deprotonated η(2)-bound acrylic acid ligand were found to be larger than their corresponding values in the protonated derivatives. For example, for dissociative loss of the protonated and deprotonated acrylic acid derivatives of iron(0) the ΔH(‡) values determined were 28.0 ± 1.2 and 34.1 ± 1.5 kcal·mol(-1), respectively. Density functional theory (DFT) computations of the bond dissociation energies (BDEs) in these acrylic acids and closely related complexes were in good agreement with enthalpies of activation for these ligand substitution reactions, supportive of a dissociative mechanism for olefin displacement. Processes related to catalytic production of acrylic acid from CO2 and ethylene are considered.

Evaluation of metallothionein formation as a proxy for zinc absorption in an in vitro digestion/Caco-2 cell culture model.

Caco-2 cell metallothionein (MT) formation was studied to determine if MT could be used as a proxy for zinc (Zn) absorption in a cell culture model. The MT intracellular concentration was determined using a cadmium/hemoglobin affinity assay. The cellular Zn uptake was determined by acid digests (5% HNO(3)) using inductively-coupled argon-plasma emission spectroscopy. The effect of phytic acid (PA) on cellular Zn and MT concentrations was also studied. Cells were treated with a media containing 0, 2, 5, 10, 25, 50, 75 µmol L(-1) Zn (ZnCl(2)). The effect of varying the Zn:PA molar ratios (1:0, 1:1, 1:5, 1:10, 1:20) on the Zn uptake and MT formation was determined. The results showed a positive linear correlation between Zn-media concentrations and cellular Zn uptake, and MT formation was observed. Zn and MT concentrations in the cells treated with increasing levels of Zn (>25 µmol L(-1) Zn) were elevated. The Zn and MT concentrations in the cells incubated with Zn (when <10 µmol L(-1)) were similar to the untreated cells. PA significantly lowered the cellular Zn and MT concentrations. When the Zn:PA molar ratios were >1:5, cellular MT concentrations were no different to untreated cells. When a combined in vitro digestion/cell model was used, the cellular MT concentrations in white or red beans and fish samples were no different to the cell baseline. This study suggests that measurements of cellular Zn and MT concentrations have some limitations (<10 µmol L(-1) Zn). PA was observed to be a potent inhibitor of Zn uptake. Under the conditions of this in vitro model, Caco-2 cell monolayers are not useful for evaluating the Zn availability from foods.

Meat and ascorbic acid can promote Fe availability from Fe-phytate but not from Fe-tannic acid complexes.

This study utilized an in vitro digestion/Caco-2 cell model to determine the levels of ascorbic acid (AA) and "meat factor" needed to promote Fe absorption from Fe complexed with phytic acid (PA) or tannic acid (TA). AA reversed the inhibition of Fe absorption by PA beginning at a molar ratio of 1:20:1 (Fe:PA:AA) but essentially had no effect on the Fe complexed with TA. Fish also reversed the inhibition of Fe uptake by PA but not by TA. TA and fish decreased total Fe solubility. Iron in the presence of PA was highly soluble. AA, but not fish, increased the percentage of soluble Fe as Fe2+ in the presence of both inhibitors. The results indicate that monoferric phytate is a form of Fe that can be available for absorption in the presence of uptake promoters. In contrast, a TA-Fe complex is much less soluble and unavailable in the presence of promoters.

Non-attendance at an orthopaedic and trauma specialist outpatient department of a regional hospital.

PURPOSE: To assess the extent of and reasons for non-attendance in the Orthopaedic and Trauma Specialist Outpatient Department. METHOD: The first stage was a retrospective survey and the second stage was a structured face-to-face interview. RESULTS: In stage 1, monthly statistics (12 months) were reviewed. There were no significant statistical differences between the attendance and default counts/rates and the seasons, except the default rate (F = 5.537 (3,8), P = 0.024). The mean default rate ranged from 17.6 to 20.62% over the four seasons. April-June had the lowest mean default rate. In stage 2, 50 subjects were recruited randomly; 25 had attended the clinic and 25 had not. There were no significant differences in the demographic characteristics between the two groups or in the ratings of the attitudes towards the various professional groups. However, those who did not attend the clinic expressed most dissatisfaction with the waiting time, the quality of consultation, and the facilities in the waiting area. DISCUSSION: Although the exact waiting time was not recorded, this did not stop us from evaluating the work process with the aim of shortening waiting time and improving the quality of that time. To develop measures that shorten waiting time, it was necessary to review the functional process of a consultation session. The quality of waiting time can be enhanced by rearranging the waiting areas, providing more chairs, improving the lighting, and ensuring the cleanliness of the toilet facilities. An education programme that adopts a behavioural approach is suggested to help clients appreciate the value of follow-ups.