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Previous studies have examined the utility of bilateral DXA hip bone mineral density (BMD) scans. While most studies demonstrate an advantage of bilateral hip scanning, the studies have been limited by size, or have not included simultaneous lumbar spine scans. To analyse the utility of dual hip scans in a clinical environment, a large retrospective study was performed of DXA BMD of both hips, and lumbar spine, in 17,169 individuals assessed at one centre over 10 years. There was no clinically significant difference in the population mean femoral neck BMD of the left vs the right leg (0.878 vs 0.881g/cm2) or total proximal femoral BMD of the left vs the right leg (0.920 vs 0.919g/cm2). There were however discrepancies in individuals between hip t-scores. For the total hip 1,977 (11.5 %) and 147 (0.9 %) of subjects had absolute t score differences ≥ 0.50 or ≥ 1.00. respectively. For the femoral neck 3,320 (19.3%) and 337 (2.0%) of subjects had absolute t score differences ≥ 0.50 or ≥ 1.00. respectively. Of the total 17,169 individuals there were 2,776 subjects with osteoporosis (T≤ -2.5) using the lumbar spine and right hip, compared to 2,834 subjects using the lumbar spine and left hip. Using the lumbar spine and both hips identified 3,214 individuals with osteoporosis. Diagnosis based on use of the lumbar spine and right hip BMD, or lumbar spine and left hip BMD, therefore failed to identify 15.8%, or 13.4%, of osteoporotic subjects respectively. Additional scanning time required was assessed in 40 subjects prospectively. Performing lumbar spine and both hips, compared to lumbar spine and one hip, required an average additional scan time of 55 seconds. The recommendation of best practise for DXA BMD measurements should be reviewed to consider lumbar spine and dual hip DXA as standard of care.

OBJECTIVES The aim of this study is to propose a new wave protocol to identify low-frequency oscillations for evaluating resting energy expenditure (REE) and compare its performance with the 5-minute interval abbreviated protocol and standard protocol. RESEARCH METHODS & PROCEDURES Consecutive 20-minute indirect calorimetry (IC) was used to collect metabolic data from 23 women and 37 men (between 23 and 43 years old). Sliding window filter algorithms were used to eliminate noise. Three protocols were used to evaluate REE: averaging the data between two consecutive waves (wave protocol), averaging the second 5-minute intervals (interval protocol), and averaging the last 15-minute REE (standard protocol). RESULTS Based on 60 healthy participants' metabolic data, compared with the interval protocol, the wave protocol showed better consistency with the standard protocol. The mean bias (limits of agreement) using the wave protocol was 0.3458% (-7.817% to 8.509%), and that using the interval protocol was -1.720% (-16.06% to 12.62%). The time required to evaluate REE with the wave protocol and interval protocol was measured. The measurement time for the interval protocol was 10 minutes, while the average measurement time for the wave protocol was 9.75 minutes. CONCLUSIONS We recommend the wave protocol for estimating REE in healthy people. This abbreviated protocol can identify low-frequency oscillations and consider individual differences to more accurately reflect the baseline REE compared to the interval protocol. Compared with the standard protocol, the measurement time of the wave protocol was reduced by nearly half (from 20 minutes (standard protocol) to 9.75 minutes).

Platelet-rich plasma (PRP) is being used as a treatment modality for skin rejuvenation since the last decade. There has been a lot of ambiguity regarding the ideal protocol to be followed and the specific indications where its use should be promoted. The use of PRP as monotherapy for skin rejuvenation, acne scars, periorbital rejuvenation, lipofilling and in combination with fractional CO2 and other resurfacing modalities is increasing rapidly. In this article, we have reviewed the current scientific evidence available and the IADVL national task force for PRP has come up with standard recommendations for use of PRP in esthetics along with the grade of evidence and strength of recommendation for each indication. The aim of this review is to provide a standard protocol for use of PRP in esthetics, for clinicians and academicians, leading to excellent results with this promising treatment modality.

Background: Pneumothorax is one of the main complications of transbronchial lung cryobiopsy (TBLC). Chest ultrasound (CUS) is a radiation-free alternative method for pneumothorax detection. Objective: We tested CUS diagnostic accuracy for pneumothorax and assessed its role in the decision algorithm for pneumothorax management. Secondary objectives were to evaluate the post-procedure pneumothorax occurrence and risk factors. Methods: Eligible patients underwent TBLC, followed by chest X-ray (CXR) evaluation 2 h after the procedure, as our standard protocol. Bedside CUS was performed within 30 min and 2 h after TBLC. Pneumothorax by CUS was defined by the absence of lung sliding and comet-tail artefacts and confirmed with the stratosphere sign on M-mode. Pneumothorax size was determined through lung point projection on CUS and interpleural distance on CXR and properly managed according to clinical status. Results: Sixty-seven patients were included. Nineteen pneumothoraces were detected at 2 h after the procedure, of which 8 (42.1%) were already present at the first CUS evaluation. All CXR-detected pneumothoraces had a positive CUS detection. There were 3 discordant cases (κ = 0.88, 95% CI: 0.76–1.00, p < 0.001), which were detected by CUS but not by inspiration CXR. We calculated a specificity of 97.5% (95% CI: 86.8–99.9) and a sensitivity of 100% (95% CI: 87.2–100) for CUS. Pneumothorax rate was higher when biopsies were taken in 2 lobes and if histology had pleural representation. Final diagnosis was achieved in 79.1% of patients, with the most frequent diagnosis being hypersensitivity pneumonitis. Regarding patients with large-volume pneumothorax needing drainage, the rate of detection was similar between CUS and CRX. Conclusion: CUS can replace CXR in detecting the presence of pneumothorax after TBLC, and the lung point site can reliably indicate its size. This useful method optimizes time spent at the bronchology unit and allows immediate response in symptomatic patients, helping to choose optimal treatment strategies, while preventing ionizing radiation exposure.

Background and Objectives. The debonding procedures of brackets in orthodontics cause a different amount of time loss and enamel damage. The current research assesses and equates the time consumption for bracket debonding using four different techniques. Materials and Methods. A total of 80 human premolars were included in this study. The samples were first arranged following a standard protocol for bracketing and then debonded using the ultrasonic scaler (US), debonding plier (DP), ligature cutter (LC), and thermal method (TM). Depending on the technique applied for debonding, the specimens were randomly divided into four groups with 20 samples, each keeping a 1 : 1 ratio. During the debonding process, the time taken for each bracket removal was recorded using a stopwatch. To assess the difference in mean time required for debonding among the four techniques, one-way ANOVA test was applied along with Tukey’s HSD to compare the two methods. Results. The time range and the mean time required for the four techniques analyzed show that the DP method has the highest range of time needed for debonding with 0.97–2.56 seconds, while LC methods have the least time range taking 0.46 to 1.79 seconds. TM’s mean time to debond is the highest at 1.5880 seconds. LC method has the lowest mean debonding time of 0.9880 seconds. The one-way ANOVA test has shown the mean debonding time required by the four techniques to be significantly different ( p < 0.001 ). Tukey’s HSD multiple comparisons also show that the mean time to debond using the LC method is substantially less than the other three methods ( p < 0.001 ). Conclusion. The mean debonding time for the TM was substantially the highest, followed by the US and DP. Debonding with the LC technique required the least time. This study shows some limelight towards the effectiveness of the LC method as it is the least time-consuming technique.

Background Histological images show strong variance (e.g. illumination, color, staining quality) due to differences in image acquisition, tissue processing, staining, etc. This can impede downstream image analysis such as staining intensity evaluation or classification. Methods to reduce these variances are called image normalization techniques. Methods In this paper, we investigate the potential of CycleGAN (cycle consistent Generative Adversarial Network) for color normalization in hematoxylin-eosin stained histological images using daily clinical data with consideration of the variability of internal staining protocol variations. The network consists of a generator network GB that learns to map an image X from a source domain A to a target domain B, i.e. GB:XA→XB. In addition, a discriminator network DB is trained to distinguish whether an image from domain B is real or generated. The same process is applied to another generator-discriminator pair (GA,DA), for the inverse mapping GA:XB→XA. Cycle consistency ensures that a generated image is close to its original when being mapped backwards (GA(GB(XA))≈XA and vice versa). We validate the CycleGAN approach on a breast cancer challenge and a follicular thyroid carcinoma data set for various stain variations. We evaluate the quality of the generated images compared to the original images using similarity measures. In addition, we apply stain normalization on pathological lymph node data from our institute and test the gain from normalization on a ResNet classifier pre-trained on the Camelyon16 data set. Results Qualitative results of the images generated by our network are compared to original color distributions. Our evaluation indicates that by mapping images to a target domain, the similarity training images from that domain improves up to 96%. We also achieve a high cycle consistency for the generator networks by obtaining similarity indices greater than 0.9. When applying the CycleGAN normalization to HE-stain images from our institute the kappa-value of the ResNet-model that is only trained on Camelyon16 data is increased more than 50%. Conclusions CycleGANs have proven to efficiently normalize HE-stained images. The approach compensates for deviations resulting from image acquisition (e.g. different scanning devices) as well as from tissue staining (e.g. different staining protocols), and thus overcomes the staining variations in images from various institutions.The code is publicly available at https://github.com/m4ln/stainTransfer_CycleGAN_pytorch. The data set supporting the solutions is available at 10.11588/data/8LKEZF.

Background There is a lot of debate on whether musical experience/training can affect cochlear filter characteristics and thereby enhance frequency resolution skills in musicians (Ms). Thus, the objective of the study was to compare between Ms and non-musicians (NMs) and correlate the frequency resolution skills with years of musical experience, the difference limen for frequency (DLF), and the Q10 values of psychophysical tuning curves (PTCs) measured at 2 characteristic frequencies (CFs), 1000 and 4000 Hz. The secondary objective was to find out whether spontaneous otoacoustic emissions (SOAEs) can be recorded among Ms more frequently than among NMs. Methods Thirty-six listeners with normal hearing participated in the study. They were 18 Ms with a minimum of 8 years of musical experience, and 18 NMs. Forward-masked PTCs and DLF tests were assessed for each listener in the right ear at 2 CFs, 1 and 4 kHz, and SOAEs were measured using standard protocol. Results The results obtained indicated that values of the psychophysical measures, DLF and Q10, were better among the Ms group. Statistically significant differences were seen when measurements were done at 1 KHz and 4 KHz. SOAEs were recorded in a higher number of Ms than NMs. Musical experience had a moderate positive correlation with PTC Q10 values at both 1 and 4 kHz, but not DLF values. Conclusion This study indicates that musical experience enhances peripheral filtering, and thereby betters cochlear frequency selectivity in Ms.

Young onset Parkinson’s disease (YOPD) is defined as idiopathic Parkinson’s disease (IPPD) affecting people between the ages of 21 and 40 years old; it makes up approx. 5% of all Parkinson’s Disease patients. The quicker onset of motor complications is what makes YOPD different than the later onset of Parkinson’s Disease. The quicker onset of the motor complications and progression of the disease are what make this disease have a very high morbidity rate. Technology and research have provided the ability to improve motor complications dramatically and extend the ability to maintain function and live a meaningful life. Due to the specificity of the progression of YOPD, nurses and medical staff need to base the care and treatment of the patient on the patient rather than follow a standard protocol for everyone. The University of California in San Francisco (UCSF) symptom management theory and the theory implication for persons with neurological disorders/diseases can provide the basis on how to effectively develop a care plan for these patients. Nurses can have a significant impact on how the disease can affect the patient on the long-term through education, support and advocacy. This case history documents the course of a YOPD patient with unusually severe motor complications. This case study is presenting a 38-year-old male patient that has developed rhabdomyolysis due to dyskinesia. This article aims to help provide context and information pertaining to the usage of simulations when educating both undergraduate and graduate nursing students. (JNNN 2021;10(2):71–76)

The ability to detect phenotypic similarity or kinship in third-parties’ faces is not perfect, but better than chance. Still, some humans are better than others at this task. Yet researchers in kinship detection have difficulties in building up large and diverse datasets of high-quality pictures of related persons. The current experiments tested a novel method for circumventing this difficulty by using morphing techniques in order to generate a wide array of stimuli derived from a limited number of individual pictures. Six experiments tested various stimuli (standard protocol, mirrored face, other-sex face, other-ethnicity face, other-expression face and antiface). Our benchmarks are the similarity or kinship scores achieved by participants when faced with pictures of real siblings. We show that all stimuli, except the antiface, elicit detection scores similar to those elicited by real pictures of actual siblings. In addition, by exploring different experiment parameters (simultaneous or sequential task, kinship or similarity task) and some individual characteristics, these experiments provide a better understanding of kinship detection in third parties. The validation of our new method will allow widening the range of available stimuli to the research community, and even to develop new ecologically relevant experimental protocols that are hardly or not feasible with veridical images.

Background: The use of Pre-exposure prophylaxis to prevent HIV infections has become widespread, so are concerns that PrEP leads to risky behaviour that can results into infections. While it is standard protocol for the healthcare personnel to conduct routine HIV screenings, no standardized procedure for educating people exists. PrEP gives an opportunity for adolescents and young adults to access a prevention option that respects their particularities and vulnerabilities.The objective of the study was to assess the Knowledge, Attitudes and Practices of students towards PrEP and if it is associated health risk behavior Methods: A cross sectional quantitative research design was used to determine the knowledge, attitudes and practices of students towards PrEP and its’ associated risk behaviour using a self-administered questionnaire. The data was analyzed using a computer Soft-Ware-Statistical Package for Social Sciences.The sample size was 367 students of Nkrumah University student in Central Province Results: There is an existing gap in comprehensively knowing and understanding PrEP and guidelines. About 36.8% of the respondents indicates they had poor knowledge on PrEP further, the results indicate 61% of the respondents had general negative attitude towards PrEP.Conclusion: More effort by government and stakeholders is needed to educate and inform students on PrEP. There is need to establish ways of dispelling myths and improve the perception towards PrEP thus reducing stigmatization.

Aim of the study: Using the example of a clinical case, to show the importance of dynamic observation by means of various diagnostic methods of intestinal imaging, in combination with a pathomorphological confirmation method for setting the correct clinical diagnosis. Materials and methods: The studies were performed on multislice computed tomographs Brilliance CT and ICT (Philips Medical Systems) and magnetic resonance imaging machines (GE), with intravenous contrast enhancement. We used special methods of contrasting the lumen of the intestine with gradual and retrograde filling it with water. The surgical material fixed in 10% neutral formuline for 10-24 hours. Tissue fragments were processed in a Leica TP1020 histoprocessor (Leica BioSystems, Germany) according to a standard protocol, after which it was embedded in paraffin blocks. Histological sections with a thickness of 3-5 μm were made by a Leica RM2245 microtome (Leica BioSystems, Germany). The prepared histological preparations were stained with hematoxylin and eosin in a Leica Autosteiner XL histostiner (Leica BioSystems, Germany). Results: From 2013 to 2020 patient K. underwent 4 colonoscopies, 5 esophagogastroduodenoscopies, 1 Х-ray examination with small bowel series, 3 MRI studies and 5 CT studies, including those with intravenous contrast enhancement, with a total radiation exposure of 187 mSv. The diagnosis was revised from ulcerative colitis, Crohn’s disease to NC. The final diagnosis was made by the pathologist’s analysis of materials. Conclusion: The clinical case presented by us clearly demonstrates the importance of dynamic observation by computed and magnetic resonance imaging, in combination with a pathomorphological confirmation method.

BackgroundRepetitive transcranial magnetic stimulation (rTMS) is a technique for stimulating brain activity using a transient magnetic field to induce an electrical current in the brain producing depolarization of focal groups of brain cells. TMS is a protocol approved by the U.S. Food and Drug Administration in routine clinical practice as a treatment for depression. A major limitation of rTMS is the large amount of time taken for a standard protocol (38 min a day for 20–30 working days). The optimal type and duration of TMS are still uncertain, as is the optimal strategy for continuing or changing the type of rTMS if there is a poor initial response.ObjectivesThe trial aims to assess whether a 1-week compressed course of left dorsolateral prefrontal (L DLPFC) 5 Hz accelerated rTMS (aTMS) treatment is as effective as an established 4-week course of non-accelerated rTMS and if additional 5 Hz L DLPFC aTMS treatments will be efficacious in non-responders as compared to 1 Hz right DLPFC aTMS treatment.MethodsA randomized, single-blind, delayed-start trial was planned to commence in Jan 2020. A total of 60 patients will be enrolled from the Institute of Mental Health Singapore within a 2-year period and randomized into the early or delayed-start phase of the trial. The primary outcome of the trial is the improvement of Montgomery-Asberg Depression Rating scale at the end of the active treatment phase.DiscussionIf this study protocol proves to be effective, the findings of this trial will be updated to the College of Psychiatrists, Academy of Medicine Singapore, as well as published in a peer-reviewed journal to enhance local and international TMS treatment guidelines.Trial registrationClinicalTrials.gov ID:NCT03941106

Many biological studies require the analysis of ultrastructural changes at the level of cell organelles and macromolecules. Since the resolution of modern confocal microscope is limited by the diffraction limit (200–300 nm), it is impossible to study such small objects using standard fluorescence microscopy. Ultra-high resolution microscopy methods require expensive equipment and are technically difficult in use, which in turn limits their widespread practical application. However, recently appeared methods make it possible to increase the resolution of microscopy not by improving the image registration system, but by physically isotropic expansion of a biological sample using a controlled chemical process. Due to this method, called expansion or expansive microscopy (ExM), it became possible to obtain three-dimensional images of samples with a resolution sufficient to study individual cell organelles using a conventional confocal microscope. This review covers the history of this method, its basic principles and examples of use in various fields of biology and medicine, as well as reflects future directions for improving this technology. The article discusses the methodological features of the ExM application in a study of brain tissue samples using the algorithm that allows adaptation of the standard protocol to the goals and objectives of a particular study.

The multi-country May Measurement Month (MMM) screening campaign aims to raise awareness on blood pressure (BP) and hypertension in individuals and communities, and measure BP, ideally, of those who had no BP measurement in the preceding year. We here report key findings from the Cameroon arm of MMM 2019. An opportunistic sample of adults (≥18 years) was included from 5 May to 5 June 2019 across 15 sites (markets, churches, homes, motor parks, workplaces, and hospitals/clinics). Data collection, cleaning, the definition of hypertension, and statistical analysis followed the standard protocol. The mean age of the 30 187 participants screened was 36.9 (SD: 14.9) years, 50.4% were female (5% of whom were pregnant), and 94.4% were screened out of the hospital/clinic settings. After multiple imputation of missing data, 6286 (20.8%) had hypertension, 24.0% were taking antihypertensive medication, and 705 (11.2%) of all participants with hypertension had controlled BP. In linear regression models adjusted for age, sex, and antihypertensive medicines use, a previous diagnosis of hypertension, a history of stroke, and use of antihypertensive medicines were significant predictors of systolic and diastolic BP levels. BPs were also significantly higher when measured in public outdoors, public indoors (diastolic BP only), workplaces, and other unspecified areas compared to hospitals/clinic settings. MMM19 is the largest ever BP screening campaign in a single month, in Cameroon and despite the limitations resulting from non-random sample selection, the opportunistic screening allows access to awareness and screening for hypertension out of the hospital/clinic settings.

The Philippine Society of Hypertension (PSH) took part again in the annual May Measurement Month 2019 (MMM19) blood pressure (BP) measurement campaign to raise awareness of hypertension especially in those who are not aware of their condition. The MMM19 standard protocol designed by the International Society of Hypertension was used during screening. These included the collection of basic data on demography, lifestyle, and environmental factors. Standardized sitting BP measurements were taken two to three times, using an automated BP apparatus and were inputted either in the MMM19 app or data were recorded in paper form and manually transferred to Excel spreadsheets by encoders supervised by the PSH. A total of 89 941 participated through opportunistic convenience sampling. After multiple imputation, a total of 47 925 (53.3%) participants had hypertension (≥140/90 mmHg or on antihypertensive medication). Of this number, 31 151 (65%) were aware that they had high BP and 30 120 (62.8%) were on antihypertensive medications. Of the 30 120 participants on antihypertensive medications, only 18 373 (61.1%) had controlled BP (

To measure the 24-h intraocular pressure (IOP) by Icare PRO rebound in healthy and primary open-angle glaucoma (POAG) eyes and compare it with non-contact tonometry (NCT). Thirty POAG patients, who were under IOP-lowering treatment, and 30 healthy subjects were included. Participants were hospitalized overnight for the 24-h IOP measurement. IOPs were measured by Icare PRO and NCT according to a standard protocol every 2 h during 24 h. The 24-h IOP curve and IOP-related parameters were compared between Icare PRO and NCT groups in POAG and healthy eyes. The IOPs measured by Icare PRO in habitual position increased notably at 22:00 in the normal group and at 20:00 in the POAG group, reached peak at 0:00, stayed high until 4:00, and then decreased in both groups (all p

The repairs strategy adopted is replacement of damaged materials without dealing with the real problems. Many engineers unintentionally attempt treating the symptoms, instead of dealing with the cause. Such an approach may offer a quick action with minimum inconvenience to the occupants. But in this process, there is a strong possibility that the source and cause for the distress remain unattended and continue to cause problem even after the superficial repairs have been executed. If structural defects are dealt with in this fashion, it remains only as defects camouflaged beneath finishes, which gives a false sense of safety to the occupants allowing the problem to continue without getting treated. A rational approach to any repair and rehabilitation work to consider the source of the problem and the symptoms together identified on a standard scale is needed. Repairs, maintenance , rehabilitation is an integral part during life span of the structure. Neglecting or avoiding the same results in a potential loss of structure which may ultimately result in loss of human life. Structural Audit is the most commonly used parameter/system which gives a detailed structural information regarding the actual insight of the structure. There are also detailed systems available as far as repairs or rehabilitation is concerned. There is a gap which needs to be bridged between the assessment and the actual repair process. There needs to be a standard system developed which will act as a protocol regarding assessment of the degree of deterioration of the structure.

Gastroenterology has been an early leader in bridging the gap between artificial intelligence (AI) model development and clinical trial validation, and in recent years we have seen the publication of several randomized clinical trials examining the role of AI in gastroenterology. As AI applications for clinical medicine advance rapidly, there is a clear need for guidance surrounding AI-specific study design, evaluation, comparison, analysis and reporting of results. Several initiatives are in the publication or pre-publication phase including AI-specific amendments to minimum reporting guidelines for clinical trials, society task force initiatives aimed at priority use cases and research priorities, and minimum reporting guidelines that guide the reporting of clinical prediction models. In this paper, we examine applications of AI in clinical trials and discuss elements of newly published AI-specific extensions to the Consolidated Standards of Reporting Trials and Standard Protocol Items: Recommendations for Interventional Trials statements that guide clinical trial reporting and development. We then review AI applications at the pre-trial level in both endoscopy and other subfields of gastroenterology and explore areas where further guidance is needed to supplement the current guidance available at the pre-trial level.

Preclinical cancer research increasingly demands sophisticated models for the development and translation of efficient and safe cancer treatments to clinical practice. In this regard, tumor-grafted chorioallantoic membrane (CAM) models are biological platforms that account for the dynamic roles of the tumor microenvironment and cancer physiopathology, allowing straightforward investigations in agreement to the 3Rs concept (the concept of reduction, refinement, and replacement of animal models). CAM models are the next advanced model for tumor biological explorations as well as for reliable assessment regarding initial efficacy, toxicity, and systemic biokinetics of conventional and emerging neoplasm treatment modalities. Here we report a standardized and optimized protocol for the production and biocharacterization of human papillomavirus (HPV)-negative head and neck chick chorioallantoic membrane models from a commercial cell line (SCC-25). Oral malignancies continue to have severe morbidity with less than 50% long-term survival despite the advancement in the available therapies. Thus, there is a persisting demand for new management approaches to establish more efficient strategies toward their treatment. Remarkably, the inclusion of CAM models in the preclinical research workflow is crucial to ethically foster both the basic and translational oncological research on oral malignancies as well as for the advancement of efficient cancer treatment approaches.

Cell-free mitochondrial DNA (cf-mtDNA) is a marker of inflammatory disease and a predictor of mortality, but little is known about cf-mtDNA in relation to psychobiology. A systematic review of the literature reveals that blood cf-mtDNA varies in response to common real-world stressors including psychopathology, acute psychological stress, and exercise. Moreover, cf-mtDNA is inducible within minutes and exhibits high intra-individual day-to-day variation, highlighting the dynamic regulation of cf-mtDNA levels. We discuss current knowledge on the mechanisms of cf-mtDNA release, its forms of transport ("cell-free" does not mean "membrane-free"), potential physiological functions, putative cellular and neuroendocrine triggers, and factors that may contribute to cf-mtDNA removal from the circulation. A review of in vitro, pre-clinical, and clinical studies shows conflicting results around the dogma that physiological forms of cf-mtDNA are pro-inflammatory, opening the possibility of other physiological functions, including the cell-to-cell transfer of whole mitochondria. Finally, to enhance the reproducibility and biological interpretation of human cf-mtDNA research, we propose guidelines for blood collection, cf-mtDNA isolation, quantification, and reporting standards, which can promote concerted advances by the community. Defining the mechanistic basis for cf-mtDNA signaling is an opportunity to elucidate the role of mitochondria in brain-body interactions and psychopathology.

Introduction Collagenase Clostridium histolyticum (CCH) is an injectable agent used to treat Peyronie's disease (PD) by enzymatically degrading the interstitial collagen in plaques. CCH has been administered via multiple treatment protocols, in combination therapies, to patients with varying curvatures and in both the acute and stable phases of this condition. Objectives To review the current literature and provide an update on CCH as an injectable therapy for PD, as a singular therapy or in conjunction with combination therapies, and its associated complications. We provide a brief background of PD treatments, evaluate CCH efficacy in penile curvature reduction and subjective improvement in a variety of protocols, and compare combination therapies (penile traction, sildenafil), plaque location, and efficacy in both acute and stable diseases. Methods We performed a systematic review of the existing PubMed literature pertaining to CCH injection therapy in the treatment of PD and compared the effectiveness to different treatment modalities. Results CCH is a safe and effective injectable agent for all curvature directions in both acute and stable PD. It can be used in conjunction with multiple penile modeling techniques, in combination with sildenafil, and following a shortened administration protocol. Moderate to severe treatment-related adverse events occur at a rate of 9% and are typically managed conservatively. Conclusion Intralesional injections of CCH are FDA approved as a nonsurgical treatment for men with PD. The IMPRESS trials were instrumental in demonstrating the efficacy and safety of CCH and provided a standard protocol for administration. Additional studies are required to optimize treatment protocols and use in combination therapies. Further investigation of patients with ventral curvatures, hourglass deformities, and those in acute phase is needed. Natale C, McLellan D, Yousif A, et al. Review of Intralesional Collagenase Clostridium Histolyticum Injection Therapy and Related Combination Therapies in the Treatment of Peyronie's Disease (an Update). Sex Med 2021;9:340–349.

Purpose Postswallow residue is a clinical sign of swallow impairment and has shown a strong association with aspiration. Videofluoroscopy (videofluoroscopic study of swallowing [VFSS]) is commonly used to visualize oropharyngeal swallowing and to identify pharyngeal residue. However, subjective binary observation (present or absent) fails to provide important information on volume or location and lacks objectivity and reproducibility. Reliable judgment of changes in residue over time and with treatment is therefore challenging. We aimed to (a) determine the reliability of quantifying pharyngeal residue in children using the bolus clearance ratio (BCR), (b) determine associations between BCR and other timing and displacement measures of oropharyngeal swallowing, and (c) explore the association between BCR and penetration–aspiration in children. Method In this single-center retrospective observational study, we obtained a set of quantitative and descriptive VFSS measures from 553 children (0–21 years old) using a standard protocol. VFSS data were recorded at 30 frames per second for quantitative analysis using specialized software. Results Good interrater (ICC = .86, 95% CI [.74, .961], p < .001) and excellent intrarater reliability was achieved for BCR (ICC = .97, 95% CI [.91, 1.000], p = 001). Significant correlations between BCR and pharyngeal constriction ratio and total pharyngeal transit time were reported ( p < .05). Using binomial logistic regression modeling, we found BCR was predictive of penetration–aspiration in children, χ 2 (13) = 58.093, p < .001, 64.9%. Children with BCR of ≥ 0.1 were 4 times more likely to aspirate. Conclusion BCR is a reliable, clinically useful measure to quantify postswallow residue in children, which can be used to identify and treat children with swallow impairments, as well as to measure outcomes of intervention.

Evaluating the short tandem repeat (STR) in the field is important for the timely identification of a suspect. Several lines showed that the RapidHIT® ID system is reliable for DNA genotyping with buccal swabs and naked DNA. However, the application of this approach with blood samples has been poorly investigated. Because blood samples are among the most common forensic samples in our laboratory, further studies should be conducted. Here, we assessed the analytical performance of 19 STR loci with a newly developed RapidINTEL (RI) Sample Cartridge Kit by using the blood samples with known genotypes. Several commonly used substrates were included in the sensitivity study, and FTA cards proved to be the most promising sample carrier for blood storage and later identification. There was superior sensitivity and specificity with a 100% concordance rate for 0.5 μL of blood or 7 ng of genomic DNA. The performance for blood samples was comparable with that for the standard protocol. High success rate (90.57%) and high-concordance (100%) genotyping were automatically achieved over a wide range of operating conditions except for TH01. No contamination was observed throughout the study. Hematin, indigo, and humic acid had limited influence on the instrument system, while urea and melanin dramatically affected the genotyping results. Generally, the newly developed RI sample cartridge provided an alternative method for the STR genotyping of single-source blood samples over a wide range of operating conditions.

Background The PhageDx™Cronobacter Assay is based on the infection of Cronobacter spp. by specific bacteriophages and expression of a luciferase reporter gene. Results are generated in as little as 18.5 h for powdered infant formula (PIF). Objective An AOAC Performance Tested MethodsSM (PTM) study was conducted to validate the PhageDx Cronobacter Assay for the detection of Cronobacter in 10, 100, and 300 g milk- and soy-based PIF test portions. Method The performance of the PhageDx method was compared to the ISO 22964:2006/2017 Microbiology of the Food Chain—Horizontal Method for the Detection of Cronobacter spp. and the U.S. Food and Drug Administration (FDA) Bacteriological Analytical Manual (BAM) Chapter 29 Cronobacter: 2012. Inclusivity/exclusivity, product consistency and stability, and robustness testing also were conducted. Results There was no significant difference between the 10, 100, or 300 g test portions for the milk and soy PIF matrixes between the PhageDx Cronobacter Assay, the ISO 22964:2006/2017, and the FDA BAM Chapter 29 Cronobacter: 2012 methods. The reporter bacteriophages were specific for Cronobacter and infected 75 strains in inclusivity testing. They did not infect 35 non-Cronobacter bacteria in exclusivity testing. Robustness testing showed that the method performed well with specific deviations from the standard protocol. Consistency and stability testing demonstrated that the recombinant phage gave consistent results across three production lots and was stable when stored under appropriate conditions for at least 3 months. Conclusions Work in the submitting and independent laboratories demonstrated that the PhageDx Cronobacter Assay meets the qualifications for PTM status. Highlights The PhageDx Cronobacter Assay is a rapid, simple, and specific test that has shown equivalence to both the FDA BAM and ISO reference methods for detecting Cronobacter spp. in PIF.

Purpose The primary aim of this study was to obtain high-quality acoustic normative data in natural field environments for female voices. A secondary aim was to examine acoustic measurement variability in field environments. Method This study employed a within-subject repeated-measures experimental design that included 45 young female adults with normal voices. Participants were stratified by age (18–23, 24–29, and 30–35 years). After initial evaluation and instruction, participants completed voice recordings during seven consecutive days using a standard protocol, including both connected speech and sustained vowels. Thirty-two cepstral-, spectral-, and time-based acoustic measures were acquired using Praat and the Analysis of Dysphonia in Speech and Voice. Results Among the 958 total recordings, greater than 90% satisfied inclusion criteria based on protocol compliance, peak clipping, and signal-to-noise ratio. Significant differences were observed for age ( p < .05). For 19 acoustic measures, values improved significantly as signal-to-noise ratio increased. Cepstral- and spectral-based measures demonstrated less measurement variability as compared with time-based measures. Conclusions With adequate training, field audio recordings represent a viable option for clinical voice management. The significant age effects observed in this study support the need for more specific criteria when collecting and applying normative data. Cepstral- and spectral-based measures demonstrated the least measurement variability. This study provides additional evidence for multiparameter acoustic voice measurement, specifically toward ecologically valid sampling in natural environments. Future studies should expand on these findings in other populations with normal and disordered voices.

Background: Collagen crosslinking (CXL), used as a treatment modality in infectious keratitis, can be further studied for the prevention of recurrent infection in cases undergoing therapeutic penetrating keratoplasty (TPK). Purpose: To study the role of collagen crosslinking of the donor corneal tissue and the graft host junction during TPK in preventing recurrence of infection. Materials and Methods: This was a prospective, clinical, interventional pilot case study done from May 2017 to July 2018. Fifteen cases and 15 controls who had infectious keratitis and needed TPK were included. Pediatric patients, one eyed patients, perforated ulcers and those with any other significant comorbidity were excluded. In patients who were enrolled as cases, the donor corneal graft and the graft host junction were subjected to CXL using modified Dresden protocol just after the TPK. TPK was done as per standard protocol. The patients were followed up for at least four months duration and the recurrences in both the groups were recorded. Statistics: The Odds Ratio of the cases not developing a recurrent infection vis-a-vis the controls has been calculated along with the Confidence Interval using the SPSS Statistics software. Results: Recurrence of infection was found in one case and in four controls within one month of TPK. Conclusions: CXL done on donor corneal tissue and the graft host junction intra operatively, has a role in reducing recurrence of infection after TPK. Keywords: Collagen crosslinking, Donor corneal button, Graft-host junction, Infectious keratitis, Therapeutic penetrating keratoplasty.