Recommendations for Future Articles on Knowledge, Attitudes and Practices in IJMS

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Usefulness of ultrasound as neurolocalization technique for the anesthetic blockade of the pelvic limb in dogs

P?ginas 10-16Recurso Electr?nicoEn este estudio, se evalu? la utilidad de la ecograf?a como t?cnica de neurolocalizaci?n para el bloqueo anest?sico de los nervios perif?ricos ci?tico, femoral, y plexo lumbar en el perro. Las caracter?sticas de estas estructuras nerviosas fueron estudiadas mediante disecci?n anat?mica realizada en 12 cad?veres caninos. La utilidad de esta t?cnica ecoguiada para el bloqueo anest?sico de estos nervios fue evaluada en 27 cad?veres caninos mediante la inyecci?n de un colorante alrededor de estos nervios y la posterior evaluaci?n del patr?n de tinci?n obtenido. Adicionalmente, la efectividad de esta t?cnica ecoguiada para el bloqueo anest?sico de los nervios ci?tico y emoral fue evaluada en nueve Beagles experimentales, mediante la inyecci?n de un anest?sico local cerca a los nervios estudiados, y la posterior evaluaci?n del d?ficit motor obtenido en la extremidad bloqueada. Los resultados de este estudio validan la utilidad de la ecograf?a como t?cnica de neurolocalizaci?n con el fin de llevar a cabo el bloqueo anest?sico del nervio ci?tico en la cara lateral del muslo y para los nervios femoral y obturador mediante un abordaje ventral suprainguinal.ABSTRACT. This study evaluated the usefulness of ultrasound as a neurolocalization technique for the anesthetic blockade of peripheral nerves such as sciatic, femoral and lumbar plexus in the dog. The characteristics of these neural structures were studied by anatomical dissection performed in 12 canine cadavers. The usefulness of this ultrasound-guided technique for the anesthetic blockade of those nerves was evaluated in 27 dog cadavers by injecting of a staining solution around the nerves followed by evaluation of the staining pattern obtained. Additionally, the effectiveness of this ultrasound-guided technique for the sciatic and the femoral nerve blockade was evaluated in 9 experimental Beagles, by injecting local anesthetic closely to these nerves and the subsequent evaluation of motor deficit in the blocked limb. The results of this study validate the usefulness of ultrasound as a neurolocalization technique with the aim to carry out an anesthetic blockade of the sciatic nerve in the lateral aspect of the thigh and also for the femoral and obturator nerves through a ventral suprainguinal approach. Keywords: Dog, Femora

Transparency in the International Journal of Medical Students

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Poster Presentations: A Presenting Opportunity in Conferences for Medical Students

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Subcutaneous Immunoglobulin Replacement Therapy with Hizentra® is Safe and Effective in Children Less Than 5 Years of Age.

BACKGROUND:Hizentra® (IGSC 20%) is a 20% liquid IgG product approved for subcutaneous administration in adults and children 2 years of age and older who have primary immunodeficiency disease (PIDD). There is limited information about the use of IGSC 20 % in very young children including those less than 5 years of age. METHODS:A retrospective chart review involved 88 PIDD infants and children less than 5 years of age who received Hizentra®. RESULTS:The mean age at the start of Hizentra® was 34 months (range 2 to 59 months). IGSC 20 % was administered weekly to 86 infants (two additional infants received twice weekly and three times weekly infusions, respectively) and included an average of 63 infusions (range 6-182) for an observation period up to 45.5 months. Infusion by manual delivery occurred in 15 patients. The mean dose was 674 mg/kg/4 weeks. The mean IgG level was 942 mg/dL while on IGSC 20 %, compared to a mean trough IgG level of 794 mg/dL (p < 0.0001) during intravenous or subcutaneous IgG administration prior to IGSC 20 %. Average infusion time was 47 (range 5-120) minutes, and the median number of infusion sites was 2 (range 1-4). Local reactions were mostly mild and observed in 36/88 (41%) children. No serious adverse events were reported. A significant increase in weight percentile (7 % ± 19.2, p = 0.0012) among subjects was observed during IGSC 20% administration. The rate of serious bacterial infections was 0.067 per patient-year while receiving IGSC 20%, similar to previously reported efficacy studies. CONCLUSIONS:Hizentra® is effective in preventing infections, and is well tolerated in children less than age 5 years

Aging in an infinite-range Hamiltonian system of coupled rotators

We analyze numerically the out-of-equilibrium relaxation dynamics of a long-range Hamiltonian system of $N$ fully coupled rotators. For a particular family of initial conditions, this system is known to enter a particular regime in which the dynamic behavior does not agree with thermodynamic predictions. Moreover, there is evidence that in the thermodynamic limit, when $N\to \infty$ is taken prior to $t\to \infty$, the system will never attain true equilibrium. By analyzing the scaling properties of the two-time autocorrelation function we find that, in that regime, a very complex dynamics unfolds in which {\em aging} phenomena appear. The scaling law strongly suggests that the system behaves in a complex way, relaxing towards equilibrium through intricate trajectories. The present results are obtained for conservative dynamics, where there is no thermal bath in contact with the system. This is the first time that aging is observed in such Hamiltonian systems.Comment: Figs. 2-4 modified, minor changes in text. To appear in Phys. Rev.

Expectation of reward differentially modulates executive inhibition

Background: Inhibitory control, a key modulatory component of cognition guiding strategy and behaviour, can be affected by diverse contingencies. We explore here the effect of expectation of reward over behavioural adjustment in a Stop Signal Task modulated by reward. We hypothesize that cognitive control is modulated by different expectation of the reward. Methods: Participants were allocated to two groups differing in their degree of knowledge in what to expect from rewards. Expected Specific Reward participants (N = 21) were informed of the different monetary feedbacks they would receive after each successful inhibition. Unexpected Reward participants (N = 24) were only told that they would receive monetary reward after correct inhibitory trials, but not the amounts or differences. Results: Our results confirmed previous observations demonstrating a 'kick-start effect' where a high reward feedback at the beginning of the task increases response inhibition. The Expected Specific Reward condition seems also to improve inhibitory control -as measured by the stop signal reaction time (SSRT)-, compared to the Unexpected Reward group. Conclusions: Knowledge of reward magnitudes seems to play a role in cognitive control irrespective of feedback magnitude. The manipulation of reward expectation appears to trigger different strategies for cognitive control, inducing a bottom-up effect of external cues, or a top-down effect given by the anticipation of incoming rewards. This is an early exploration to unearth possible higher order modulators - expectation and motivation- of cognitive control. This approach aims to gain insight into diverse psychopathological conditions related to impulsivity and altered reward systems such as Attention Deficit Hyperactive Disorder (ADHD), personality disorders, substance abuse, pathological gambling and cognitive aspects of Parkinson Disease. © 2019 The Author(s)

Bilateral Lung Transplantation in a Patient with Humoral Immune Deficiency: A Case Report with Review of the Literature

Humoral immune deficiencies have been associated with noninfectious disease complications including autoimmune cytopenias and pulmonary disease. Herein we present a patient who underwent splenectomy for autoimmune cytopenias and subsequently was diagnosed with humoral immune deficiency in the context of recurrent infections. Immunoglobulin analysis prior to initiation of intravenous immunoglobulin (IVIG) therapy was notable for low age-matched serum levels of IgA (11 mg/dL), IgG2 (14 mg/L), and IgG4 (5 mg/L) with a preserved total level of IgG. Flow cytometry was remarkable for B cell maturation arrest at the IgM+/IgD+ stage. Selective screening for known primary immune deficiency-causing genetic defects was negative. The disease course was uniquely complicated by the development of pulmonary arteriovenous malformations (AVMs), ultimately requiring bilateral lung transplantation in 2012. This is a patient with humoral immune deficiency that became apparent only after splenectomy, which argues for routine immunologic evaluation prior to vaccination and splenectomy. Lung transplantation is a rare therapeutic endpoint and to our knowledge has never before been described in a patient with humoral immune deficiency for the indication of pulmonary AVMs

The new communication network for an internet of everything based security/safety/general management/visitor's services for the Papal Basilica and Sacred Convent of Saint Francis in Assisi, Italy

© 2017 IEEE.The Papal Basilica and the Sacred Convent of St. Francis in Assisi, Italy together represent a unique and specific cultural heritage site where the mortal remains of St. Francis have been housed since 1230 AD. Millions of pilgrims and visitors from all over the world visit this site each year. In 2000 AD, together with other Franciscan sites in the surrounding area, it achieved UNESCO World Heritage status. Unique and complex cultural heritage sites, such as this, require a significant effort to ensure visitor security and safety. Along with such needs are cultural heritage preservation and protection as well as accessibility for visitors, with particular reference to visitors with disabilities, and for personnel normally present for site management, including the Friar's community. These aims can be achieved using integrated systems and innovative technologies, such as Internet of Everything (IoE) which can connect people, things (mobile terminals, smart sensors, devices, actuators; wearable devices; etc.), data/information/knowledge and particular processes. The purpose of this paper is to illustrate the methodology and show the results obtained from the study and the design of a new communication network for Internet of Everything based security/safety/general management and visitors' services of the Papal Basilica and Sacred Convent of Saint Francis in Assisi