An electrophysiological and morphometric study of the effect of different methods of surgical repair in motor and mixed nerve: a comparison of the repair of the facial nerve and the median nerve in a large animal

The outcome of peripheral nerve injuries has been poorly documented. This is due to the heterogeneity of the injuries, the variety of surgeons from different surgical specialities performing the repairs and a lack of objective follow up. Anecdotal reports have suggested that injuries to purely motor nerves have a better outcome than those affecting mixed nerves.This aims of this work were to document the natural history of nerve injuries and their repair under controlled conditions in order to ascertain the outcome of different types of nerve injury and to compare the outcome of the same injuries in motor nerves and mixed nerves. A further objective was to determine which investigations would be useful in the assessment and follow up of peripheral nerve injuries both as predictors of outcome and in clinical practice.The sheep model was selected as its peripheral nerves are a similar size, and behave in a similar manner to, human peripheral nerves. A set of six standardised nerve injuries (normal control, neurapraxia, axonotmesis, neurotmesis and suture repair, neurotmesis and entubulation, and nerve graft) was created in both the facial (motor) nerve and the median (mixed) nerve. The function of the nerves and their target muscles was assessed using nerve conduction studies (maximum conduction velocity, distribution of conduction velocities, refractory period), single-fibre electromyography (jitter), target muscle tension and mass, and nerve fibre morphometry.In the carefully controlled conditions of the experiments, for both nerves the transection injuries had a poorer outcome than the non-transection injuries. This effect was more marked in the median nerve than in the facial nerve suggesting that the type of nerve affected the outcome of injury. Maximum conduction velocity was determined to be the most useful test for use in the clinical management of nerve injuries. Distribution of conduction velocities, a nerve conduction test based on collision theory, may be too sensitive to be of use in the management of mechanical nerve injury but may have a valuable role in the assessment of more subtle conditions such as neuropathies and Bell's palsy. Nerve fibre morphometry discriminated between the different injuries and remains a useful tool in a research setting

Biological Motivational Systems, Positive and Negative Partner Behavior, and Relationship Satisfaction

Relationship satisfaction has been associated with a variety of outcomes, including mental and physical health, suicide risk, and mortality. The present study investigated the association between the behavioral inhibition system (BIS) and behavioral activation system (BAS), positive and negative partner behavior, and relationship satisfaction. A sample of 113 married participants completed an online self-report survey. Two validated measures of positive and negative partner behavior were combined to create positive and negative composite variables. The positive partner behavior composite variable was positively associated with relationship satisfaction and the negative partner behavior composite variable was negatively associated with relationship satisfaction. BIS was negatively associated with relationship satisfaction, and BAS Drive and Reward Responsiveness were positively associated with relationship satisfaction. BAS Fun Seeking moderated the association between the positive partner behavior composite and relationship satisfaction: the strength of the association between the positive partner behavior composite and relationship satisfaction increased at higher levels of BAS Fun Seeking. The results suggest that BAS Fun Seeking is particularly sensitive to positive partner behavior. Results support the importance of integrating individual and relationship factors in future research on intimate relationship functioning.</p

Use of parent report in detecting developmental delays in preterm infants

The purpose of this study was to examine the utilization of parent report in detecting developmental delays using the Parents' Evaluation of Developmental Status (PEDS). An additional goal was to assess whether or not characteristics of preterm infants, such as birthweight, impact parental report. It was hypothesized that parents of preterm infants would be able to detect developmental delays across measures, with characteristics of preterm infants having an impact. Specifically, it was believed that with increased gestational age and birthweight parental report would be better able to detect developmental delay, while with increased stay in the Neonatal Intensive Care Unit and increased medical fragility parents would be less likely to detect developmental delays. A cohort of 36 parent-child dyads was recruited through the Duke University Medical Center's Special Infant Care Clinic. Participants were between the ages of 11 and 24 months and recruited from March 2009-July 2009. Parent participants were asked to complete the PEDS, and a few brief questionnaires prior to their child's developmental assessment. At the scheduled appointment, the child participants were administered the Bayley Scales of Infant and Toddler Development-Third Edition (BSID-III). The presence of significant concerns on the PEDS was compared to the presence of a developmental delay as measured by the BSID-III to determine parental reliability through the use of sensitivity and specificity. Logistic regression was used to examine the predictability of delay for individual PEDS questions as well as the influence of infant characteristics on parent response. No statistically significant correlations were found between individual PEDS question responses and developmental delays in preterm infants. Further, no statistically significant correlations were found between infant characteristics and parent response on the PEDS. Sensitivity did not meet acceptable standards. Specificity only met standards within the language domain. In conclusion, the results of this study suggest the PEDS may be insufficient for screening delay in preterm infants. While parents are clearly concerned about the development of their preterm infants, this study suggests that elicitation of these concerns in written format may not be a valid, efficient, or reliable method

Streaming induced by high amplitude acoustic pulses and its implications

SIGLEAvailable from British Library Document Supply Centre- DSC:DX93561 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Hydrogen Handler/Safety Course

This viewgraph presentation describes the process of handling hydrogen safely. It also gives a general description of hydrogen, its uses, hazards, and material incompatability

IPHE Regulations Codes and Standards Working Group - Type IV COPV Round Robin Testing

This manuscript presents the results of a multi-lateral international activity intended to understand how to execute a cycle stress test as specified in a chosen standard (GTR, SAE, ISO, EIHP...). The purpose of this work was to establish a harmonized test method protocol to ensure that the same results would be achieved regardless of the testing facility. It was found that accurate temperature measurement of the working fluid is necessary to ensure the test conditions remain within the tolerances specified. Continuous operation is possible with adequate cooling of the working fluid but this becomes more demanding if the cycle frequency increases. Recommendations for future test system design and operation are presented

Adjuvant radiation therapy in metastatic lymph nodes from melanoma

<p>Abstract</p> <p>Purpose</p> <p>To analyze the outcome after adjuvant radiation therapy with standard fractionation regimen in metastatic lymph nodes (LN) from cutaneous melanoma.</p> <p>Patients and methods</p> <p>86 successive patients (57 men) were treated for locally advanced melanoma in our institution. 60 patients (69%) underwent LN dissection followed by radiation therapy (RT), while 26 patients (31%) had no radiotherapy.</p> <p>Results</p> <p>The median number of resected LN was 12 (1 to 36) with 2 metastases (1 to 28). Median survival after the first relapse was 31.8 months. Extracapsular extension was a significant prognostic factor for regional control (p = 0.019). Median total dose was 50 Gy (30 to 70 Gy). A standard fractionation regimen was used (2 Gy/fraction). Median number of fractions was 25 (10 to 44 fractions). Patients were treated with five fractions/week. Patients with extracapsular extension treated with surgery followed by RT (total dose ≥50 Gy) had a better regional control than patients treated by surgery followed by RT with a total dose <50 Gy (80% vs. 35% at 5-year follow-up; p = 0.004).</p> <p>Conclusion</p> <p>Adjuvant radiotherapy was able to increase regional control in targeted sub-population (LN with extracapsular extension).</p