NFATc1 controls the cytotoxicity of CD8+ T cells

NFAT nuclear translocation has been shown to be required for CD8+ T cell cytokine production in response to viral infection. Here the authors show NFATc1 controls the cytotoxicity and metabolic switching of activated CD8+ T cells required for optimal response to bacteria and tumor cells

Quantitative research: Surveys/questionnaires

Surveys are a popular way to gather information about a group of people. The aim of this section is to explore what surveys are and to provide an introduction to the kinds of issues the researcher needs to ask when developing, administering and analysing the findings from a survey

Risk of urethral stricture recurrence increases over time after urethroplasty

ObjectiveTo report a single institutional experience with urethroplasty outcomes and success rates at long-term follow up. MethodsA retrospective review was carried out of all urethroplasties performed by a single surgeon from 2000 to 2010. A total of 347 patients underwent urethroplasty during this time period, of which 227 had minimum 1-year follow-up data available. Demographic, clinical, pathological and outcome data were reviewed. Recurrence was defined by patient reported urinary symptoms or need for subsequent intervention. Statistical analyses were carried out using SPSS statistical software. ResultsA total of 26% of all patients had a recurrence at a mean follow up of 62months (range 13-147months). The recurrence rate after anastomotic urethroplasty was 18%, as compared with 31% after substitution urethroplasty. Mean time to recurrence was 34months (range 5-87). On univariate analysis, use of abdominal skin graft, history of prior urethroplasty, lichen sclerosus and length of follow up were statistically significant predictors of recurrence. On multivariate analysis, only history of prior urethroplasty and length of follow-up time exceeding 48months were statistically significant predictors of recurrence. ConclusionsUrethroplasty for urethral stricture is the most durable treatment modality, regardless of surgical approach. However, there is an ongoing risk of recurrence with the passage of time. Patients should be counseled appropriately on the potential for late recurrence of stricture disease after urethroplasty

Characteristics of motor vehicle crashes associated with seizure: Car crash semiology

OBJECTIVE: To examine the characteristics of seizure-related vehicle crashes (SRC). METHOD: Using a nested case-control design, we identified and compared cases of SRC involving confirmed epilepsy patients with 137,126 non-seizure-related crash controls (NSRC) in the Australian state of Victoria. SRC were identified from approximately 20,000 epileptologist medical records by cross-referencing this source with the Victorian Police Traffic Incident database and the Road Crash Information System Database (RCISD). RESULTS: Seventy-one SRC involving 62 patients with epilepsy were identified. Thirty-seven SRC resulted in injury and could be identified in the RCISD and compared to NSRC. Seizure-related crashes typically involved a single vehicle (57% vs 29%, p < 0.001) carrying a sole occupant (95% vs 48%, p = 0.001). Most SRC began with an "out of control movement" (51% vs 10%, p < 0.001) and the subsequent collision type differed significantly between the groups (p < 0.001). The majority of SRC were a "collision with a fixed object" (54% vs 17%, p < 0.001) involving an "off path on straight" mechanism (48% vs 10%, p < 0.001). Regarding all 71 SRC, generalized as compared with focal epilepsy crashes involved younger drivers (p < 0.001), seizure-provoking factors (p = 0.033), and occurred earlier in the day (p = 0.004). CONCLUSIONS: Given the distinct SRC features, we propose that clinicians, crash investigators, and driver licensing authorities incorporate collision characteristics into the overall assessment of suspected SRC. Further research should examine restricting driving immediately after risk periods as a harm-minimization strategy

Impact of rigid and nonrigid registration on the determination of 18F-FDG PET-based tumour volume and standardized uptake value in patients with lung cancer

Purpose: Assessment of the metabolically active tumour tissue by FDG PET is evolving for use in the diagnosis of non-small-cell lung cancer (NSCLC), in the planning of radiotherapy, and in follow-up and response evaluation. For exact evaluation accurate registration of PET and CT data is required. The registration process is usually based on rigid algorithms; however, nonrigid algorithms are increasingly being used. The influence of the registration method on FDG PET-based standardized uptake value (SUVmax) and metabolic tumour volume (MTV) definition has not yet been evaluated. We compared intra- and interindividual differences in SUV and MTV between rigid- and nonrigid-registered PET and CT acquired during different breathing manoeuvres. Methods: The study group comprised 28 radiotherapy candidates with histologically proven NSCLC who underwent FDG PET acquisition and three CT acquisitions (expiration - EXP, inspiration - INS, mid-breath-hold - MID). All scans were re gistered with both a rigid (R) and a nonrigid (NR) procedure resulting in six fused datasets: R-INS, R-EXP, R-MID, NR-INS, NR-EXP and NR-MID. For the delineation of MTVs a contrast-oriented contouring algorithm developed in-house was used. To accelerate the delineation a semiautomatic software prototype was utilized. Results: Tumour mean SUVmax did not differ for R and NR registration (R 17.5±7, NR 17.4±7; p=0.2). The mean MTV was higher by 3±12 ml (p=0.02) in the NR group than in the R group, as was the mean tumour diameter (by 0. 1±0.2 cm; p<0.01). With respect to the three different breathing manoeuvres, there were no differences in MTV in the R group (p>0.7). In intraindividual comparison there were no significant differences in MTVs concerning the registration pairs R-EXP (68± 88 ml) vs. NR-EXP (69±85 ml) und R-MID (68±86 ml) vs. NR-MID (69±83 ml) (both p>0.4). However, the MTVs were larger after NR registration during inspiration (R-INS 68±82 vs. NR-INS 78±93 ml; p=0.02). Conclusion: The use

Policing services with mentally ill people: Developing greater understanding and best practice

Although it is now well known that there is a disproportionate number of people with mental illnesses in the criminal justice system, surprising little attention has been paid to the challenges faced by policing people with mental illnesses in the community. This article provides an overview of some of the key findings from a programme of research undertaken in Victoria to further understand and develop a best practice model at this interface. The areas covered will include the prevalence of psychiatric symptoms and mental illnesses among police cell detainees; the existing knowledge base and attitudes of police towards mentally ill people; the relationship between mental illness and offending; the frequency and nature of police apprehensions of mentally ill people under the Mental Health Act; the association among mental disorder, police shootings, and other injuries to people as a result of these encounters; and police interactions with victims of crime. The work highlights the need for ongoing improvements in policing people with mental illnesses, and particularly the need for improved inter-agency practices for dealing with them