Review of Concussion and Return-to-Play Guidelines in Sport

Concussion is a form of mild traumatic head injury (TBI) associated with a variety of neurologic signs and symptoms. While historically trivialized in its significance, significant progress has been made in the medical literature and lay understanding of concussion. Severe TBI, long the subject of extensive research, has come under increased scrutiny following experience with blast injuries during the wars in Afghanistan and Iraq. Such experience, grievously earned, has brought significant public attention and funding to the study of head injury. However, for the civilian population, concussion continues to be the most common form of traumatic brain injury, and athletics continues to be the single largest cause of concussion. Concussion in sports has come under substantial scrutiny as a result of widely publicized injuries in major American sports, particularly football and hockey. Media coverage has increased further as understanding of the related yet distinct syndrome of chronic traumatic encephalopathy (CTE), formerly known as dementia pugilistica or punch-drunk syndrome , and its proposed mechanism of repeated sub-concussive trauma has increased. While media attention has focused primarily on concussion in professional athletes, the majority of sports-related concussions occur in youth participants.1 With relative unavailability of physicians trained in on-field assessment of concussed athletes relative to professional sports teams, youth athletes are at significant risk for short- and long-term neurologic injury from concussion. This manuscript aims to outline the natural history of sports concussion and review recent updates in on-field assessment and return-to-play guidelines

An integrated genomic analysis of lung cancer reveals loss of DUSP4 in EGFR-mutant tumors.

To address the biological heterogeneity of lung cancer, we studied 199 lung adenocarcinomas by integrating genome-wide data on copy number alterations and gene expression with full annotation for major known somatic mutations in this cancer. This showed non-random patterns of copy number alterations significantly linked to EGFR and KRAS mutation status and to distinct clinical outcomes, and led to the discovery of a striking association of EGFR mutations with underexpression of DUSP4, a gene within a broad region of frequent single-copy loss on 8p. DUSP4 is involved in negative feedback control of EGFR signaling, and we provide functional validation for its role as a growth suppressor in EGFR-mutant lung adenocarcinoma. DUSP4 loss also associates with p16/CDKN2A deletion and defines a distinct clinical subset of lung cancer patients. Another novel observation is that of a reciprocal relationship between EGFR and LKB1 mutations. These results highlight the power of integrated genomics to identify candidate driver genes within recurrent broad regions of copy number alteration and to delineate distinct oncogenetic pathways in genetically complex common epithelial cancers

Microtextures of Laterites and Bauxites Capping Deccan Trap Basalts in Western India

Thirty-five samples of laterites and bauxites representing both the high-level (elevation \u3e 1000 m) and low-level (elevation \u3c 100 m) deposits in western India have been examined by scanning electron microscopy. Megascopically, laterites exhibit vesicular, spongy and pisolitic textures, whereas bauxites display pisolitic, massive and nodular textures. Laterites, as well as bauxites are commonly characterized by framework microtexture produced by a three dimensional arrangement of crystallites. Locally, the luterites and bauxites exhibit crystalline-webby microtexture formed by a web-like arrangement of stacks of lamellar crystals. The individual crystals in the matrix of laterites and bauxites display anhedral forms and they range in size from about 0.5 μm to 20 μm. Crystals larger than 20 μm in size generally occur as linings of the vugs, in channels and veins, and they are usually euhedral. Pisolites and nodules in laterites and bauxites are composed of material generally finer than the material in the matrix around them. Platy morphology is most common for the minerals in laterites and bauxites. Gibbsite occurs in various forms ranging from prismatic, stubby slab-like to lath-shaped crystals. Both high-level and low-level deposits of laterites are characterized by similar textures. The variations in textures of bauxites are also found to be independent of the elevation of the deposits

Grid-Adapted FUN3D Computations for the Second High Lift Prediction Workshop

Contributions of the unstructured Reynolds-averaged Navier-Stokes code FUN3D to the 2nd AIAA CFD High Lift Prediction Workshop are described, and detailed comparisons are made with experimental data. Using workshop-supplied grids, results for the clean wing configuration are compared with results from the structured code CFL3D Using the same turbulence model, both codes compare reasonably well in terms of total forces and moments, and the maximum lift is similarly over-predicted for both codes compared to experiment. By including more representative geometry features such as slat and flap brackets and slat pressure tube bundles, FUN3D captures the general effects of the Reynolds number variation, but under-predicts maximum lift on workshop-supplied grids in comparison with the experimental data, due to excessive separation. However, when output-based, off-body grid adaptation in FUN3D is employed, results improve considerably. In particular, when the geometry includes both brackets and the pressure tube bundles, grid adaptation results in a more accurate prediction of lift near stall in comparison with the wind-tunnel data. Furthermore, a rotation-corrected turbulence model shows improved pressure predictions on the outboard span when using adapted grids

Can creatine supplementation improve body composition and objective physical function in rheumatoid arthritis patients? A randomised controlled trial.

OBJECTIVE: Rheumatoid cachexia (muscle wasting) in rheumatoid arthritis (RA) patients contributes to substantial reductions in strength and impaired physical function. The objective of this randomised control trial was to investigate the effectiveness of oral creatine (Cr) supplementation in increasing lean mass and improving strength and physical function in RA patients. METHOD: In a double-blind design, 40 RA patients, were randomised to either 12 weeks supplementation of Cr or placebo. Body composition (dual energy x-ray absorptiometry, DXA, and bioelectrical impedance spectroscopy, BIS), strength and objectively-assessed physical function were measured at: baseline, day 6, week 12 and week 24. Data analysis was performed by ANCOVA. RESULTS: Creatine supplementation increased appendicular lean mass (ALM; a surrogate measure of muscle mass) by 0.52 (± 0.13) kg (P = 0.004 versus placebo), and total LM by 0.60 (± 0.37) kg (P = 0.158). The change in LM concurred with the gain in intracellular water (0.64 ± 0.22 L, P = 0.035) measured by BIS. Despite increasing ALM, Cr supplementation, relative to placebo, failed to improve isometric knee extensor (P = 0.408), handgrip strength (P = 0.833), or objectively-assessed physical function (P's = 0.335 - 0.764). CONCLUSION: In patients with RA, creatine supplementation increased muscle mass, but not strength or objective physical function. No treatment-related adverse effects were reported suggesting that Cr supplementation may offer a safe and acceptable adjunct treatment for attenuating muscle loss; this treatment may be beneficial for patients suffering from severe rheumatoid cachexia. This article is protected by copyright. All rights reserved

Extraskeletal Chondrosarcoma of Labium Majus

Extraskeletal myxoid chondrosarcoma (ESMC) is a rare tumor seen more often in men. It is seen to arise from soft tissue of lower extremity or buttocks. We report a case of soft tissue swelling of left labium majus in a 66-year-old female. Patient underwent wide excision with uneventful postoperative course. Histopathology of specimen confirmed it to be ESMC. Patient refused adjuvant therapy. Followup of 1 year has shown her to be disease- and symptom- free. Only two cases arising from vulva have been reported in literature . This is the third case and first from Indian subcontinent. A brief review of clinical features, diagnosis, treatment, and outcome of patients with extraskeletal chondrosarcoma is presented

Deciphering plant richness using satellite remote sensing: a study from three biodiversity hotspots

The ‘spectral variation hypothesis (SVH)’ assumes spectral variability as a result of variation in species richness. In the present study, we explore the potential of satellite datasets in identifying the patterns in species richness in part of three global biodiversity hotspots falling in India viz., Himalaya, Indo-Burma, and Western Ghats. We used generalized linear models to correlate remote sensing based vegetation indices (VIs) and physiographic indices (PIs) with plant richness calculated using 1264, 1114, and 1004 field plots across 21 different forest vegetation classes in Himalaya, Indo-Burma, and Western Ghats respectively. Three different vegetation indices ranked highest in explaining the variance in plant richness in the three hotspots. The variance in species richness explained by models based on only VIs was highest (69%, P < 0.01) for Bamboo vegetation in Indo Burma hotspot with Normalized Difference Vegetation Index, followed by that for dry deciduous forest in Western Ghats (57%, P < 0.001) with Normalized Difference Water Index, and for grasslands (54%, P < 0.05) in Himalaya by Modified Soil Adjusted Vegetation Index. The explained variance increased with combined models that are based on PIs and VIs to up to 85% (P < 0.05). Overall, we observed very high correlation between VIs and plant richness in open canopy vegetation classes with low species richness such as grasslands, scrubs, and dry deciduous forests, followed by vegetation classes with moderately dense canopy. Our study provides crucial insights on utility of satellite datasets as a proxy for estimating plant richness for better conservation of diverse ecosystems

The landscape of somatic copy-number alteration across human cancers

available in PMC 2010 August 18.A powerful way to discover key genes with causal roles in oncogenesis is to identify genomic regions that undergo frequent alteration in human cancers. Here we present high-resolution analyses of somatic copy-number alterations (SCNAs) from 3,131 cancer specimens, belonging largely to 26 histological types. We identify 158 regions of focal SCNA that are altered at significant frequency across several cancer types, of which 122 cannot be explained by the presence of a known cancer target gene located within these regions. Several gene families are enriched among these regions of focal SCNA, including the BCL2 family of apoptosis regulators and the NF-κΒ pathway. We show that cancer cells containing amplifications surrounding the MCL1 and BCL2L1 anti-apoptotic genes depend on the expression of these genes for survival. Finally, we demonstrate that a large majority of SCNAs identified in individual cancer types are present in several cancer types.National Institutes of Health (U.S.) (Dana-Farber/Harvard Cancer Center and Pacific Northwest Prostate Cancer SPOREs, P50CA90578)National Institutes of Health (U.S.) (Dana-Farber/Harvard Cancer Center and Pacific Northwest Prostate Cancer SPOREs, R01CA109038))National Institutes of Health (U.S.) (Dana-Farber/Harvard Cancer Center and Pacific Northwest Prostate Cancer SPOREs, R01CA109467)National Institutes of Health (U.S.) (Dana-Farber/Harvard Cancer Center and Pacific Northwest Prostate Cancer SPOREs, P01CA085859)National Institutes of Health (U.S.) (Dana-Farber/Harvard Cancer Center and Pacific Northwest Prostate Cancer SPOREs, P01CA 098101)National Institutes of Health (U.S.) (Dana-Farber/Harvard Cancer Center and Pacific Northwest Prostate Cancer SPOREs, K08CA122833

Pseudosarcomatous myofibroblastic proliferations of the genitourinary tract are genetically different from nodular fasciitis and lack USP6, ROS1 and ETV6 gene rearrangements

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145266/1/his13526_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145266/2/his13526.pd