Measles in HIV-infected children in southern Africa

In recent years, southern Africa has experienced a widespread measles outbreak. Given the high human immunodeficiency virus (HIV) prevalence in the region, the particular features of measles in HIV-infected individuals are of interest to clinicians, especially as regards children, as are measles immunisation strategies for this population. This review discusses a case ofsevere measles in an HIV-infected child in Botswana, focusing on its implications for clinical case management in Botswana and similar settings and for policies on measles immunisation

Early identification of the opposition shot taker characterises elite goalkeepers' ability to read the game

Researchers investigating expertise in soccer goalkeepers have overwhelmingly focused on anticipating penalty kicks and identifying kinematic cues that are used to anticipate action outcomes. In this study, we took a novel approach to exploring 'game reading' skills in soccer goalkeepers. Specifically, we investigated whether and by what point during an attacking sequence in open play, elite goalkeepers can identify the opposition shot taker, a skill that is likely to facilitate organisation of the defensive line and interception of forward creative attacking passes. We used a moving window temporal occlusion paradigm to present elite, sub-elite, and amateur goalkeepers with 11-vs-11 attacking sequences that were divided into progressive segments. After viewing each segment, participants identified the player they thought would shoot at goal at the end of the attacking sequence. Elite goalkeepers identified the opposition shot taker earlier and more accurately than sub-elite and amateur participants. Findings suggest that elite goalkeeping is underpinned not only by anticipation of action outcomes but also game-reading skill that enables identification of the player most likely to carry out those actions

A Snapshot of the International Views of the Treatment of Rectal Cancer Patients, a Multi-regional Survey: International Tendencies in Rectal Cancer

BACKGROUND: Management of rectal cancer has a number of potentially appropriate alternatives for each patient. Despite acceptance of standards, practices may vary among regions. There is significant paucity of data in this area. The objective was to create a snapshot of the regional differences. DESIGN: This online survey included 10 questions. Enquiries focused on controversial topics, on surgeon and hospital volume, surgical margins, appropriateness of surgical approaches and techniques, watch-and-wait strategies, and total neoadjuvant therapy. Major colorectal surgery societies around the world were asked to invite their members to complete the survey. OUTCOME MEASURES: Frequency of responses across regions within each question was compared by Fisher's exact test. RESULTS: Seven hundred and fifty-three participants from 60 countries responded. Eight regions were identified, and four had sufficient representation for comparisons. Similarities and differences in the therapies among these regions were identified. Robotic surgery penetrance is higher in North America, and watch and wait is more accepted in South America. Patients in Oceania are more likely to be diverted; Europe has more usage of taTME. DISCUSSION: This online survey was practical as a mean to provide a rapid assessment of the international picture on consistency and variability of rectal cancer patients' care, and to potentially identify opportunities to standardized care to patients. Medical surveys have inherent limitations; pertinence to our study is selection bias. CONCLUSIONS: The management of rectal cancer varies among different regions. Identification of differences is important when considering global efforts to improve management and interpret data

Regional expression of the MAPT gene is associated with loss of hubs in brain networks and cognitive impairment in Parkinson disease and progressive supranuclear palsy.

Abnormalities of tau protein are central to the pathogenesis of progressive supranuclear palsy, whereas haplotype variation of the tau gene MAPT influences the risk of Parkinson disease and Parkinson's disease dementia. We assessed whether regional MAPT expression might be associated with selective vulnerability of global brain networks to neurodegenerative pathology. Using task-free functional magnetic resonance imaging in progressive supranuclear palsy, Parkinson disease, and healthy subjects (n = 128), we examined functional brain networks and measured the connection strength between 471 gray matter regions. We obtained MAPT and SNCA microarray expression data in healthy subjects from the Allen brain atlas. Regional connectivity varied according to the normal expression of MAPT. The regional expression of MAPT correlated with the proportionate loss of regional connectivity in Parkinson's disease. Executive cognition was impaired in proportion to the loss of hub connectivity. These effects were not seen with SNCA, suggesting that alpha-synuclein pathology is not mediated through global network properties. The results establish a link between regional MAPT expression and selective vulnerability of functional brain networks to neurodegeneration.Medical Research Council (Grant IDs: G1100464, MR/K020706/1, G0700503), Wellcome Trust (Grant ID: 103838), National Institute for Health Research Cambridge Biomedical Research Centre, Beverley Sackler fellowship scheme, NARSAD Young Investigator Award, Isaac Newton TrustThis is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.neurobiolaging.2016.09.00

Comparing ‘Twitter’ polls results with an online survey on surgeons perspectives for the treatment of rectal cancer

INTRODUCTION: Traditional surveys (including phone, mail and online) can be valuable tools to obtain information from specific communities. Social media apps such as Twitter are being increasingly adopted for knowledge dissemination and research purposes. Twitter polls are a unique feature which allows for a rapid response to questions posed. Nonetheless Twitter does not constitute a validated survey technique. The objective was to compare the similarities of Twitter polls in describing practice patterns for the treatment of rectal cancer. METHODS: A survey on the management of rectal cancer was designed using modified Delphi methodology. Surgeons were contacted through major colorectal societies to participate in an online survey. The same set of questions were periodically posted by influencers on Twitter polls and the results were compared. RESULTS: A total of 753 surgeons participated in the online survey. Individual participation in Twitter ranged from 162 to 463 responses. There was good and moderate agreement between the two methods for the most popular choice (9/10) and the least popular choice (5/10), respectively. DISCUSSION: It is possible that in the future polls available via social media can provide a low-cost alternative and an efficient, yet pragmatic method to describe clinical practice patterns. This is the first study comparing Twitter polls with a traditional survey method in medical research. CONCLUSIONS: There is viable opportunity to enhance the performance of research through social media, however, significant refinement is required. These results can potentially be transferable to other areas of medicine

Vacuum Stability, Perturbativity, and Scalar Singlet Dark Matter

We analyze the one-loop vacuum stability and perturbativity bounds on a singlet extension of the Standard Model (SM) scalar sector containing a scalar dark matter candidate. We show that the presence of the singlet-doublet quartic interaction relaxes the vacuum stability lower bound on the SM Higgs mass as a function of the cutoff and lowers the corresponding upper bound based on perturbativity considerations. We also find that vacuum stability requirements may place a lower bound on the singlet dark matter mass for given singlet quartic self coupling, leading to restrictions on the parameter space consistent with the observed relic density. We argue that discovery of a light singlet scalar dark matter particle could provide indirect information on the singlet quartic self-coupling.Comment: 25 pages, 10 figures; v2 - fixed minor typos; v3 - added to text discussions of other references, changed coloring of figures for easier black and white viewin

Robot-assisted laparoscopic transperitoneal pelvic lymphadenectomy and metastasectomy for melanoma: initial report of two cases

Robotic pelvic lymphadenectomy is a well established procedure in the urologic and gynecologic literature. To our knowledge robotic pelvic lymphadectomy for metastatic melanoma has yet to be described. Herein we present the first report of robot-assisted pelvic lymphadenectomy in malignant melanoma. After placement of six laparoscopic ports (12 mm camera, three 8-mm robotic ports, 12-mm and 5-mm assistant ports) the DaVinci S robot (Intuitive Surgical, CA, USA) was docked in standard fashion with the patient in low lithotomy. In both cases the patients had enlarged pelvic lymph nodes on computed tomography and complete excision of these masses was accomplished along with complete lymphadenectomy extending from Cooper’s ligament to just below the hypogastric artery in case 1 and to level of the bifurcation of aorta in case 2. A PK Maryland Dissector and monopolar scissors were used for dissection. Both patients were discharged on postoperative day #1. Robotic pelvic lymphadenectomy can be safely used for management of patients with metastatic melanoma involving the pelvic lymph nodes. Compared with the standard open procedure, pelvic lymphadenectomy with robotic assistance is associated with excellent vision and minimum morbidity

Haemoglobin mass and running time trial performance after recombinant human erythropoietin administration in trained men

<p>Recombinant human erythropoietin (rHuEpo) increases haemoglobin mass (Hbmass) and maximal oxygen uptake (v˙ O2 max).</p> <p>Purpose: This study defined the time course of changes in Hbmass, v˙ O2 max as well as running time trial performance following 4 weeks of rHuEpo administration to determine whether the laboratory observations would translate into actual improvements in running performance in the field.</p> <p>Methods: 19 trained men received rHuEpo injections of 50 IUNkg21 body mass every two days for 4 weeks. Hbmass was determined weekly using the optimized carbon monoxide rebreathing method until 4 weeks after administration. v˙ O2 max and 3,000 m time trial performance were measured pre, post administration and at the end of the study.</p> <p>Results: Relative to baseline, running performance significantly improved by ,6% after administration (10:3061:07 min:sec vs. 11:0861:15 min:sec, p,0.001) and remained significantly enhanced by ,3% 4 weeks after administration (10:4661:13 min:sec, p,0.001), while v˙ O2 max was also significantly increased post administration (60.765.8 mLNmin21Nkg21 vs. 56.066.2 mLNmin21Nkg21, p,0.001) and remained significantly increased 4 weeks after rHuEpo (58.065.6 mLNmin21Nkg21, p = 0.021). Hbmass was significantly increased at the end of administration compared to baseline (15.261.5 gNkg21 vs. 12.761.2 gNkg21, p,0.001). The rate of decrease in Hbmass toward baseline values post rHuEpo was similar to that of the increase during administration (20.53 gNkg21Nwk21, 95% confidence interval (CI) (20.68, 20.38) vs. 0.54 gNkg21Nwk21, CI (0.46, 0.63)) but Hbmass was still significantly elevated 4 weeks after administration compared to baseline (13.761.1 gNkg21, p<0.001).</p> <p>Conclusion: Running performance was improved following 4 weeks of rHuEpo and remained elevated 4 weeks after administration compared to baseline. These field performance effects coincided with rHuEpo-induced elevated v˙ O2 max and Hbmass.</p&gt