Quantitative radiologic criteria for the diagnosis of lumbar spinal stenosis: a systematic literature review

Background: Beside symptoms and clinical signs radiological findings are crucial in the diagnosis of lumbar spinal stenosis (LSS). We investigate which quantitative radiological signs are described in the literature and which radilogical criteria are used to establish inclusion criteria in clincical studies evaluating different treatments in patients with lumbar spinal stenosis. Methods: A literature search was performed in Medline, Embase and the Cochrane library to identify papers reporting on radiological criteria to describe LSS and systematic reviews investigating the effects of different treatment modalities. Results: 25 studies reporting on radiological signs of LSS and four systematic reviews related to the evaluation of different treatments were found. Ten different parameters were identified to quantify lumbar spinal stenosis. Most often reported measures for central stenosis were antero-posterior diameter (< 10 mm) and cross-sectional area (< 70 mm2) of spinal canal. For lateral stenosis height and depth of the lateral recess, and for foraminal stenosis the foraminal diameter were typically used. Only four of 63 primary studies included in the systematic reviews reported on quantitative measures for defining inclusion criteria of patients in prognostic studies. Conclusions: There is a need for consensus on well-defined, unambiguous radiological criteria to define lumbar spinal stenosis in order to improve diagnostic accuracy and to formulate reliable inclusion criteria for clinical studies

Autophagy–physiology and pathophysiology

“Autophagy” is a highly conserved pathway for degradation, by which wasted intracellular macromolecules are delivered to lysosomes, where they are degraded into biologically active monomers such as amino acids that are subsequently re-used to maintain cellular metabolic turnover and homeostasis. Recent genetic studies have shown that mice lacking an autophagy-related gene (Atg5 or Atg7) cannot survive longer than 12 h after birth because of nutrient shortage. Moreover, tissue-specific impairment of autophagy in central nervous system tissue causes massive loss of neurons, resulting in neurodegeneration, while impaired autophagy in liver tissue causes accumulation of wasted organelles, leading to hepatomegaly. Although autophagy generally prevents cell death, our recent study using conditional Atg7-deficient mice in CNS tissue has demonstrated the presence of autophagic neuron death in the hippocampus after neonatal hypoxic/ischemic brain injury. Thus, recent genetic studies have shown that autophagy is involved in various cellular functions. In this review, we introduce physiological and pathophysiological roles of autophagy

Internalised Values and Fairness Perception: Ethics in Knowledge Management

This chapter argues for ethical consideration in knowledge management (KM). It explores the effect that internalised values and fairness perception have on individuals’ participation in KM practices. Knowledge is power, and organisations seek to manage knowledge through KM practices. For knowledge to be processed, individual employees—the source of all knowledge—need to be willing to participate in KM practices. As knowledge is power and a key constituent part of knowledge is ethics, individuals’ internalised values and fairness perception affect knowledge-processing. Where an organisation claims ownership over knowledge, an individual may perceive being treated unfairly, which may obstruct knowledge-processing. Through adopting ethical KM practices, individual needs are respected, enabling knowledge-processing. Implications point towards an ethical agenda in KM theory and practice

ESCRT-III-driven piecemeal micro-ER-phagy remodels the ER during recovery from ER stress

The endoplasmic reticulum (ER) produces about 40% of the nucleated cell’s proteome. ER size and content in molecular chaperones increase upon physiologic and pathologic stresses on activation of unfolded protein responses (UPR). On stress resolution, the mammalian ER is remodeled to pre-stress, physiologic size and function on activation of the LC3-binding activity of the translocon component SEC62. This elicits recov-ER- phagy, i.e., the delivery of the excess ER generated during the phase of stress to endolysosomes (EL) for clearance. Here, ultrastructural and genetic analyses reveal that recov-ER-phagy entails the LC3 lipidation machinery and proceeds via piecemeal micro- ER-phagy, where RAB7/LAMP1-positive EL directly engulf excess ER in processes that rely on the Endosomal Sorting Complex Required for Transport (ESCRT)-III component CHMP4B and the accessory AAA+ ATPase VPS4A. Thus, ESCRT-III-driven micro-ER- phagy emerges as a key catabolic pathway activated to remodel the mammalian ER on recovery from ER stress

Prosthodontic Treatment for Edentulous Patiens

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A Guide to Competencies, Educational Goals, and Learning Objectives for Teaching Human Embryology in an Undergraduate Medical Education Setting

With the rapidly changing course of medical education and ever-increasing time restrictions on basic biomedical science instruction, most educators have one question in common—what is the most relevant information for the next generation of physicians? The Liaison Committee for Medical Education (LCME) and the Commission on Osteopathic College Accreditation (COCA) support a list of learning objectives for medical students defined by faculty prior to any educational activities, regardless of pedagogy. The question remains—what ensures competency for medical students in a given subject area upon completion of the course? To accomplish the task to ensure competency in human clinical embryology, a 6-month interactive online collaboration was formed. The outcome is a set of competencies in human embryology that should be required of all medical students, with the goals and learning objectives required to achieve these competencies