Ligamentum flavum cyst in the lumbar spine: a case report and review of the literature

Degenerative changes in the lumbar spine can be followed by cystic changes. Most reported intraspinal cysts are ganglion or synovial cysts. Ligamentum flavum pseudocyst, as a cystic lesion in the lumbar spine, is a rare and unusual cause of neurologic signs and symptoms and is usually seen in elderly persons (due to degenerative changes). They are preferentially located in the lower lumbar region, while cervical localization is rare. Complete removal of the cyst leads to excellent results and seems to preclude recurrence. We report the case of a right-sided ligamentum flavum cyst occurring at L3–L4 level in a 70-year-old woman, which was surgically removed with excellent postoperative results and complete resolution of symptoms. In addition, we discuss and review reports in the literature

Effects of vitamin D and the antimicrobial peptide in asthma

Background: Vitamin D modulates a variety of processes and regulatory systems including host defense, inflammation, and immunity. A connection between Vitamin D status and asthma has been considered. Vitamin D mediates innate immunity, particularly through enhanced expression of the human cathelicidin antimicrobial peptide (LL-37). Increased levels of high sensitive-C reactive protein (Hs-CRP) were found to be significantly associated with respiratory function impairment. Objective: to evaluate the relation between serum vitamin D, Hs-CRP and LL-37 levels and asthma. Study design: Thirty children (15 males and 15 females) with proven diagnosis of asthma (ages ranged from 3-13 years) were studied; they attended the pediatric department of Zagazig University Hospital in the year 2011. In addition, 30 age and sex matched apparently healthy children served as a control group. All children were subjected to history taking, clinical examination, laboratory investigations (CBC, CRP, ESR), determination of serum level of 25-hydroxyvitamin D (25 OHD) and plasma LL-37. Results: The study revealed a highly significant decrease in 25 OHD, LL-37 and a highly significant increase in Hs-CRP in children with asthma than in control group. There were a highly significant positive correlation between vitamin D and LL37 in patients' and control groups and a significant negative correlation between both 25OHD and LL37 and Hs-CRP in patients' group. High WBC count (specially neutrophils and lymphocytes), Hs-CRP level and low levels of hemoglobin, 25OHD and LL 37 in patient group were considered risk factors of asthma. Conclusion: Inappropriate concentration of vitamin D decreases the ability of the immune system to defend against infection through lowering LL-37 and elevated Hs-CRP which leads to occurrence and precipitation of asthma.Keywords: Vitamin D- LL-37- asthmaEgypt J Pediatr Allergy Immunol 2012;10(2):101-10

Development and testing of the Active Temperature, Ozone and Moisture Microwave Spectrometer (ATOMMS) cm and mm wavelength occultation instrument

We present initial results from testing a new remote sensing system called the Active Temperature, Ozone and Moisture Microwave Spectrometer (ATOMMS). ATOMMS is designed as a satellite-to-satellite occultation system for monitoring climate. We are developing the prototype instrument for an aircraft to aircraft occultation demonstration. Here we focus on field testing of the ATOMMS instrument, in particular the remote sensing of water by measuring the attenuation caused by the 22 GHz and 183 GHz water absorption lines. Our measurements of the 183 GHz line spectrum along an 820 m path revealed that the AM 6.2 spectroscopic model provdes a much better match to the observed spectrum than the MPM93 model. These comparisons also indicate that errors in the ATOMMS amplitude measurements are about 0.3%. Pressure sensitivity bodes well for ATOMMS as a climate instrument. Comparisons with a hygrometer revealed consistency at the 0.05 mb level, which is about 1% of the absolute humidity. Initial measurements of absorption by the 22 GHz line made along a 5.4 km path between two mountaintops captured a large increase in water vapor similar to that measured by several nearby hygrometers. A storm passage between the two instruments yielded our first measurements of extinction by rain and cloud droplets. Comparisons of ATOMMS 1.5 mm opacity measurements with measured visible opacity and backscatter from a weather radar revealed features simultaneously evident in all three datasets confirming the ATOMMS measurements. The combined ATOMMS, radar and visible information revealed the evolution of rain and cloud amounts along the signal path during the passage of the storm. The derived average cloud water content reached typical continental cloud amounts. These results demonstrated a significant portion of the information content of ATOMMS and its ability to penetrate through clouds and rain which is critical to its all-weather, climate monitoring capability

Memaknai kebahagiaan: Analisis Kualitatif pada Komunitas Punker di Kota Banda Aceh

Fenomena Punk beberapa tahun terakhir sudah mulai muncul ke permukaan khususnya di daerah Kota Banda Aceh. Walaupun Kota Banda Aceh kota yang bersyariat Islam namun pertumbuhan Punkers dari tahun ketahun semakin meningkat, baik dari warga pendatang maupun warga Aceh. Penelitian ini bertujuan untuk mendiskripsikan kesejahteraan subjektif dari anak Punk dengan fokus mengungkap makna kebahagiaan dan dilema hidup dalam komunitas Punk. Partisipan dalam penelitian ini adalah 6 orang anak Punk yang kemudian terlibat dalam wawancara mendalam dan FGD di Peunayong, Banda Aceh. Hasil analisa kualitatif penelitian ini menggambarkan beberapa alasan mereka bertahan dalam komunitas Punk, diantaranya kebersamaan dan kekeluargaan yang dirasakan antara sesama anggota komunitas ini begitu besar. Anak Punk memaknai kebahagiaan sebagai kebebasan dan mendapatkan kenyamanan dalam kelompok keluarga baru. Di sisi lain, partisipan dalam penelitian ini juga mengaku bahwa mereka tidak mendapatkan kebahagiaan dalam keluarga biologis mereka. Penelitian ini berkontribusi untuk mengungkap isu sensitif bagi kelompok Punk dan menemukan makna kesejahteraan bagi kehidupan kelompok Punk. Gambaran aspek-aspek kesejahteraan subjektif dan dilema kehidupan dalam dimensi yang lebih lengkap akan dijelaskan dengan rinci pada bagian hasil dan pembahasan penelitian ini

Rituximab versus cyclophosphamide as first steroid sparing agent in childhood frequently relapsing and steroid dependent nephrotic syndrome

Background: Approximately 50% of children with steroid-sensitive nephrotic syndrome (SSNS) will suffer from frequent relapses or steroid dependency, prompting the use of so-called steroid-sparing drugs. In this pilot study, we compare the efficacy and safety of rituximab to oral cyclophosphamide as first-line steroid-sparing medications. Methods: A prospective open-label non-randomized study of children with frequent relapsing or steroid-dependant SSNS. Exclusion criteria were steroid-resistant disease, prescription of immunosuppressive agents other than prednisolone or levamisole, evidence of impaired kidney function, leucopenia, or active infection. The recruited children were allocated either to the oral cyclophosphamide (3 mg/kg/day for 8 weeks) or intravenous rituximab treatment (two doses of 375 mg/m2/dose, 2 weeks apart) and were monitored for relapses and side effects for 12 months. Results: Forty-six subjects were included from two centers; 27 received cyclophosphamide and 19 received rituximab. One-year relapse-free survival was reached in 17 (58.6%) patients treated with cyclophosphamide compared to 16 (84.2%) with rituximab (adjusted HR 0.36; 95% CI 0.09–1.45; p = 0.151). The mean interval to relapse was 6.9 months in the cyclophosphamide group (N = 10) and 6.3 months in the rituximab group (N = 3). Both treatments were associated with a significant (p < 0.001) reduction in prescribed dose of oral alternate-day steroid from 1.02 to 0.36 mg/kg (cyclophosphamide) and 0.86 to 0.08 mg/kg (rituximab). Importantly, a significantly (p = 0.003) higher percentage of patients achieved complete withdrawal of steroid within 3 months of commencing study treatment in the rituximab (73.7%) versus cyclophosphamide (29.6%) group. Transient leucopenia was the most frequent adverse effect observed in the cyclophosphamide group (18.5%) and one patient (3.4%) had acute hepatotoxicity besides severe leucopenia and neutropenia in the 7th week of treatment with complete recovery with the withdrawal of cyclophosphamide and maintenance of remission. A minor infusion-related reaction in the form of a generalized macular skin rash was observed in one patient (5%) in the rituximab group. Conclusions: Rituximab is non-inferior to cyclophosphamide and safe as a first-line steroid-sparing agent in children with SSNS. A larger multicenter study is required to assess superiority over cyclophosphamide

Building Classroom and Organizational Structure Around Positive Cultural Values

The Compass Project is a self-formed group of graduate and undergraduate students in the physical sciences at UC Berkeley. Our goals are to improve undergraduate physics education, provide opportunities for professional development, and increase retention of students-especially those from populations typically underrepresented in the physical sciences. Compass fosters a diverse, collaborative student community by providing a wide range of services, including a summer program and fall/spring seminar courses. We describe Compass's cultural values, discuss how community members are introduced to and help shape those values, and demonstrate how a single set of values informs the structure of both our classroom and organization.We emphasize that all members of the Compass community participate in, and benefit from, our cultural values, regardless of status as student, teacher, or otherwise.Comment: 4 pages, to be submitted to PERC 2012 proceeding

The effect of the menstrual cycle on physical characteristics (speed, strength, and endurance) in women in Saudi Arabia

The increasing participation of women in sports has raised interest in understanding how the menstrual cycle, specifically estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH), affects athletic performance. These hormones fluctuate throughout the menstrual cycle, which is divided into the early follicular phase, ovulatory period, and mid-luteal phase, each with distinct hormonal profiles. While estrogen is believed to have an anabolic effect on skeletal muscle and influence substrate metabolism, progesterone may have an antiestrogenic effect, potentially affecting physical performance. However, research on the impact of these hormone fluctuations on performance yields contradictory results. Some studies report improved performance during various menstrual cycle phases, while others find no significant differences. Additionally, the effects of oral contraceptives (OCPs) on muscle strength and function remain unclear. Menopause, characterized by a decline in skeletal muscle mass and bone density, is associated with reduced physical performance in women. More research is needed to understand the effects of estrogen and progesterone fluctuations on physical performance in women, emphasizing the importance of gender-specific research and guidelines for optimizing athletic performance.

Braille text entry on smartwatches : an evaluation of methods for composing the Braille cell

Smartwatches are gaining popularity on market with a set of features comparable to smartphones in a wearable device. This novice technology brings new interaction paradigms and challenges for blind users, who have difficulties dealing with touchscreens. Among a variety of tasks that must be studied, text entry is analyzed, considering that current existing solutions may be unsatisfactory (as voice input) or even unfeasible (as working with tiny QWERTY keyboards) for a blind user. More specifically, this paper presents a study on possible solutions for composing a Braille cell on smart-watches. Five prototypes were developed and different feedback features were proposed. These are confronted with seven specialists on an evaluation study that results in a qualitative analysis of which strategies can be more useful for blind users in a Braille text entry.Postprin

Optimal Cerebral Perfusion Pressure During Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage

OBJECTIVES: The recommendation of induced hypertension for delayed cerebral ischemia treatment after aneurysmal subarachnoid hemorrhage has been challenged recently and ideal pressure targets are missing. A new concept advocates an individual cerebral perfusion pressure where cerebral autoregulation functions best to ensure optimal global perfusion. We characterized optimal cerebral perfusion pressure at time of delayed cerebral ischemia and tested the conformity of induced hypertension with this target value. DESIGN: Retrospective analysis of prospectively collected data. SETTING: University hospital neurocritical care unit. PATIENTS: Thirty-nine aneurysmal subarachnoid hemorrhage patients with invasive neuromonitoring (20 with delayed cerebral ischemia, 19 without delayed cerebral ischemia). INTERVENTIONS: Induced hypertension greater than 180 mm Hg systolic blood pressure. MEASUREMENTS AND MAIN RESULTS: Changepoint analysis was used to calculate significant changes in cerebral perfusion pressure, optimal cerebral perfusion pressure, and the difference of cerebral perfusion pressure and optimal cerebral perfusion pressure 48 hours before delayed cerebral ischemia diagnosis. Optimal cerebral perfusion pressure increased 30 hours before the onset of delayed cerebral ischemia from 82.8 +/- 12.5 to 86.3 +/- 11.4 mm Hg (p < 0.05). Three hours before delayed cerebral ischemia, a changepoint was also found in the difference of cerebral perfusion pressure and optimal cerebral perfusion pressure (decrease from -0.2 +/- 11.2 to -7.7 +/- 7.6 mm Hg; p < 0.05) with a corresponding increase in pressure reactivity index (0.09 +/- 0.33 to 0.19 +/- 0.37; p < 0.05). Cerebral perfusion pressure at time of delayed cerebral ischemia was lower than in patients without delayed cerebral ischemia in a comparable time frame (cerebral perfusion pressure delayed cerebral ischemia 81.4 +/- 8.3 mm Hg, no delayed cerebral ischemia 90.4 +/- 10.5 mm Hg; p < 0.05). Inducing hypertension resulted in a cerebral perfusion pressure above optimal cerebral perfusion pressure (+12.4 +/- 8.3 mm Hg; p < 0.0001). Treatment response (improvement of delayed cerebral ischemia: induced hypertension(+) [n = 15] or progression of delayed cerebral ischemia: induced hypertension(-) [n = 5]) did not correlate to either absolute values of cerebral perfusion pressure or optimal cerebral perfusion pressure, nor the resulting difference (cerebral perfusion pressure [p = 0.69]; optimal cerebral perfusion pressure [p = 0.97]; and the difference of cerebral perfusion pressure and optimal cerebral perfusion pressure [p = 0.51]). CONCLUSIONS: At the time of delayed cerebral ischemia occurrence, there is a significant discrepancy between cerebral perfusion pressure and optimal cerebral perfusion pressure with worsening of autoregulation, implying inadequate but identifiable individual perfusion. Standardized induction of hypertension resulted in cerebral perfusion pressures that exceeded individual optimal cerebral perfusion pressure in delayed cerebral ischemia patients. The potential benefit of individual blood pressure management guided by autoregulation-based optimal cerebral perfusion pressure should be explored in future intervention studies