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Introduction Uterine artery embolisation (UAE) is regarded as a safe and effective treatment for symptomatic uterine fibroids and/or adenomyosis. Dose reduction during UAE is critical for this reproductive‐age patient population to minimise the risks of radiation‐induced effects. The aim of this study was to identify the predictors of radiation dose which can be controlled and optimised for patients during UAE. Methods A total of 150 patients between June 2018 and August 2019 were included in this study. Demographic and clinical information such as age, body mass index (BMI), total number of fibroids, total fibroid volume, total uterus volume and dosimetric measurements on Dose Area Product (DAP), Air Kerma (AK) and fluoroscopy time were recorded. Total digital subtraction angiography (DSA), total conventional roadmap (CRM), total last‐image hold (LIH) and total fluoroscopy were calculated from the dose report. Multiple linear regression analysis was used to identify the independent predictor variables of total dose (DAP) using a regression model. Results Total DSA, total CRM and total LIH were identified as the determinants of dose for UAE (P, The predictors of patient radiation dose have been identified for the interventional radiology procedure known as uterine artery embolisation (UAE). A regression model entered and identified total digital subtraction angiography (DSA), total conventional roadmap (CRM) and total last‐image hold (LIH) as the determinants of dose over demographic and other angiographic variables. Control of these dose predictors can potentially minimise radiation dose exposure to this reproductive‐age patient population. Dose optimisation can be attained to reduce the risks of tissue effects and/or stochastic effects associated with irradiating the pelvis region.

Background Acquired brain injury (ABI), such as Parkinson's disease, dementia or stroke, can result in communication difficulties that lead to an impoverished ability to connect meaningfully with others. Choral singing is a complex task that uses multiple brain regions which are also responsible for language and communication skills. The potential therapeutic effects of group singing on communication-related outcomes across ABI aetiologies have not been systematically reviewed. Aims To examine whether participation in group singing over multiple sessions improves speech, voice, language and/or communication skills in individuals with ABI-related communication disorders. Methods & procedures A database search was undertaken according to the PRISMA guidelines. Search terms included: stroke OR Parkinson* OR dementia OR 'acquired brain injury' AND choir OR choral OR singing OR sing OR 'choral sing* ' OR group adj3 singing OR community adj3 singing AND speech OR language OR communication. Main contribution A total of 11 studies were included. Nine were quantitative, including one randomized and one non-randomized control trial, and two were mixed method. Nine studies were scored as level IV (uncontrolled) on the American Academy of Neurology (AAN) Classification of Evidence Matrix and two as level III (e.g., lack of blinded assessors). Eight examined speech and voice skills in Parkinson's disease, two functional communication skills in post-stroke aphasia and one communication between individuals with dementia and a significant other. One level III control trials provided evidence for a therapeutic effect of group singing on communication in individuals with Parkinson's disease. Conclusions & implications Currently, there is only one study providing support for using group singing to improve speech and voice skills in people with Parkinson's disease, and no studies of adequate quality indicating positive effects on language and functional communication abilities in ABI. Further research using more rigorous experimental designs is required to determine whether group singing can influence communication skills in ABI. What this paper adds What is already known on the subject Music activates widespread, bilateral cortical and subcortical brain regions. Group singing is increasingly understood to have positive benefits on quality of life and health-related well-being in both healthy and clinical populations. Given the crossover in neural networks between singing, speech and language, singing activities are also thought to have positive effect of communication impairments secondary to ABI. However, to date, the research evidence supporting the application of group singing for communication impairments in ABI has not been summarized. What this paper adds to existing knowledge A total of 11 studies have looked at communication outcomes after group singing in ABI. For most of these, the quality of evidence was low (AAN level IV). It also highlights that there is a bias in the literature towards the studying individuals with Parkinson's disease (i.e., nine of the 11 studies). What are the potential or actual clinical implications of this work? This review concludes that, currently, there is emerging evidence to support positive effects of a group singing for speech and voice symptoms in individuals with Parkinson's disease, when provided using the Tamplin protocol. However, there is not yet any evidence for communication benefits for individuals with aphasia or dementia.

INTRODUCTION: Biomarkers of disease severity in Charcot-Marie-Tooth disease (CMT) are required to evaluate early responses to treatment. In this study we used magnetic resonance imaging (MRI) to evaluate the relationship between muscle volume and intramuscular fat accumulation with weakness, disability, and impaired gait in affected children and adolescents. METHODS: Fifty-five participants underwent MRI of the anterior compartment of the lower leg. Muscle and fat volumes were calculated. Strength was measured using hand-held dynamometry, disability using the CMT Pediatric Scale, and 3-dimensional gait analysis using an 8-camera Vicon Nexus motion capture system. RESULTS: Lower muscle volume was significantly associated with reduced dorsiflexion strength, increased disability, impaired gait profile score, and foot drop. Intramuscular fat accumulation was associated with reduced dorsiflexion strength and impaired gait profile score. DISCUSSION: The MRI protocol described was feasible, reliable, and sensitive to the magnitude of weakness, disability, and walking difficulties in children with CMT. Muscle Nerve 59:213-217, 2019.

Objective To determine the rate of disease progression in a longitudinal natural history study of children with Charcot-Marie-Tooth (CMT) disease. Methods Two hundred six (103 female) participants aged 3 to 20 years enrolled in the Inherited Neuropathies Consortium were assessed at baseline and 2 years. Demographic, anthropometric, and diagnostic information were collected. Disease progression was assessed with the CMT Pediatric Scale (CMTPedS), a reliable Rasch-built linearly weighted disability scale evaluating fine and gross motor function, strength, sensation, and balance. Results On average, CMTPedS Total scores progressed at a rate of 2.4 ± 4.9 over 2 years (14% change from baseline; p

Sudomotor activity is modified by both warm and cold fluid ingestion during heat stress, independently of differences in core and skin temperatures, suggesting independent viscerally-mediated modification of thermoeffectors. The purpose of the present study was to determine whether visceral thermoreceptors modify shivering responses to cold stress. Ten males (27 ± 5y, 1.73 ± 0.06 m, 78.4 ± 10.7 kg) underwent whole-body cooling via 5 °C water perfusion-suit, on four occasions, to induce a steady-state shivering response, at which point two aliquots of 1.5 ml/kg (SML) and 3.0 ml/kg (LRG), separated by 20- min, of either 7°C, 22°C, 37°C or 52°C water were ingested. Rectal, mean skin and mean body temperature (Tb), electromyographic activity (EMG), metabolic rate (M) and whole-body thermal sensation on a visual analogue scale (WBTS) ranging from 0 mm [very cold] to 200 mm [very hot] were all measured throughout. Tb was not different between all fluid temperatures following SML (7°C:35.7 ± 0.5°C, 22°C:35.6 ± 0.5°C, 37°C:35.5 ± 0.4°C, 52°C:35.5 ± 0.4°C; P = 0.27) or LRG (7°C:35.3 ± 0.6°C, 22°C:35.3 ± 0.5°C, 37°C:35.2 ± 0.5°C, 52°C:35.3 ± 0.5°C; P = 0.99) fluid ingestion. With SML ingestion, greater metabolic rate and cooler thermal sensations were observed with 7°C (M:179 ± 55 W, WBTS:29 ± 21 mm) compared to 52°C (M:164 ± 34 W, WBTS:51 ± 28 mm; all P < 0.05) ingestion. With LRG ingestion, compared to shivering and thermal sensations with 37 °C ingestion (M:215 ± 47 W, EMG:3.9 ± 2.5%MVC, WBTS:33 ± 2 mm) values were different (all P < 0.05) following 7°C (M:269 ± 77 W, EMG:5.5 ± 0.9%MVC, WBTS:14 ± 12 mm), 22°C (M:270 ± 86 W, EMG:5.6 ± 1.0%MVC, WBTS:18 ± 19 mm) and 52°C (M:179 ± 34 W, EMG:3.3 ± 2.1%MVC, WBTS:53 ± 28 mm) ingestion. In conclusion, ingesting 52°C fluids decreased shivering and the sensation of coolness, whereas 22°C and 7°C fluids increased shivering and sensations of coolness to similar levels, independently of core and skin temperature.

The four "Shoulder Normalization Tests" were found previously to be a parsimonious set of isometric tests that produce maximal voluntary isometric contractions (MVIC) in the supraspinatus, infraspinatus, subscapularis, trapezius, serratus anterior, deltoid, latissimus dorsi, and pectoralis major [Boettcher et al. (2008). J Orthop Res 26:1591-1597]. However, these tests have not been validated for rhomboid major and teres major. In the current study, these Shoulder Normalization Tests were evaluated and compared to three other tests that could possibly elicit maximum activity in rhomboid major and teres major: abduction/extension in 90° abduction; adduction at 90° abduction; and extension in 30° abduction. No statistical difference was found in the mean activation of rhomboid major and teres major in these additional MVIC tests compared to the Shoulder Normalization Tests. However, the extension MVIC test produced maxima for at least 50% of subjects in rhomboid major, teres major, and latissimus dorsi. We concluded that the original Shoulder Normalization Tests should be expanded to include the extension MVIC test. The EMG normalization reference value for any of the above muscles would be the maximum EMG level generated across these Revised Shoulder Normalization Tests.