The Role of Pelvic Neurophysiology Testing in the Assessment of Patients with Voiding Dysfunction

PURPOSE OF REVIEW: The role of pelvic neurophysiology testing in the evaluation of patients with lower urinary tract (LUT) symptoms is explored in this review. RECENT FINDINGS: Different neurophysiology tests such as sphincter EMG and pudendal somatosensory evoked potentials are useful in evaluating the sacral somatic afferent and efferent innervation. S2 and S3 dermatomal evoked potentials assess individual sacral roots and are feasible to perform using standard neurophysiology machines. SUMMARY: The innervation of the LUT has a substantial contribution from splanchnic and somatic nerves arising from the sacral segments. Pelvic neurophysiology tests, which assess somatic nerve functions, are therefore a useful tool in assessing sacral nerve functions in patients presenting with unexplained voiding dysfunction. In this review, the commonly performed neurophysiology studies that assess the S2, S3 and S4 sacral afferent and efferent pathways are outlined, and their clinical applications reviewed

Preliminary Evaluation of a 3H Imidazoquinoline Library as Dual TLR7/TLR8 Antagonists

Toll-like receptors (TLR) -7 and -8 are thought to play an important role in immune activation processes underlying the pathophysiology of HIV and several clinically important autoimmune diseases. Based on our earlier findings of TLR7-antagonistic activity in a 3H imidazoquinoline, we sought to examine a pilot library of 3H imidazoquinolines for dual TLR7/8 antagonists, since they remain a poorly explored chemotype. Two-dimensional NOE experiments were employed to unequivocally characterize the compounds. A quinolinium compound 12, bearing p-methoxybenzyl substituents on N3 and N5 positions was identified as a lead. Compound 12 was found to inhibit both TLR7 and TLR8 at low micromolar concentrations. Our preliminary results suggest that alkylation with electron-rich substituents on the quinoline N5, or conversely, elimination of the fixed charge of the resultant quaternary amine on the quinolinium may yield more active compounds

Correlation analysis of lidar derived optical parameters for investigations on thin cirrus features at a tropical station Gadanki(13.5ºN and 79.2ºE), India

The optical characterization of thin cirrus clouds is very important to understand its radiative effects. The optical parameters of cirrus clouds namely extinction

Elastic shape matching of parameterized surfaces using square root normal fields.

In this paper we define a new methodology for shape analysis of parameterized surfaces, where the main issues are: (1) choice of metric for shape comparisons and (2) invariance to reparameterization. We begin by defining a general elastic metric on the space of parameterized surfaces. The main advantages of this metric are twofold. First, it provides a natural interpretation of elastic shape deformations that are being quantified. Second, this metric is invariant under the action of the reparameterization group. We also introduce a novel representation of surfaces termed square root normal fields or SRNFs. This representation is convenient for shape analysis because, under this representation, a reduced version of the general elastic metric becomes the simple \ensuremathL2\ensuremathL2 metric. Thus, this transformation greatly simplifies the implementation of our framework. We validate our approach using multiple shape analysis examples for quadrilateral and spherical surfaces. We also compare the current results with those of Kurtek et al. [1]. We show that the proposed method results in more natural shape matchings, and furthermore, has some theoretical advantages over previous methods

Public health system integration of avoidable blindness screening and management, India.

In India, 73 million people have diabetes and 3.5 million infants are born preterm. Without timely screening, there is a risk of visual loss due to diabetic retinopathy and retinopathy of prematurity in these two groups, respectively. Both conditions are emerging causes of visual impairment in India but there is no public health programme for screening or management. Pilot projects were initiated in 2014 to integrate the screening and management of these conditions into existing public health systems, particularly in rural communities and their referral networks. The World Health Organization's health systems framework was used to develop the projects and strategies were developed with all stakeholders, including the government. Both projects involved hub-and-spoke models of care units around medical schools. For diabetic retinopathy, screening was established at primary health-care facilities and treatment was provided at district hospitals. For retinopathy of prematurity, screening was integrated into sick newborn care units at the district level and treatment facilities were improved at the closest publically funded medical schools. In the first two years, there were substantial improvements in awareness, screening, treatment and partnership between stakeholders, and changes in public health policy. By March 2018, diabetic retinopathy screening was established at 50 facilities in 10 states and treatment had been improved at 10 hospitals, whereas retinopathy of prematurity screening was established at 16 sick newborn care units in district hospital in four states and treatment had been improved at six medical schools. Advocacy within state governments was critical to the success of the initiative