Reference ranges for bone densitometers adopted Australia‐wide: Geelong osteoporosis study

Bone densitometry reports a measure of fracture risk in comparison with young adults (T‐scores) and age‐matched peers (Z‐scores). To date, each manufacturer has provided its own reference range resulting in lack of uniformity. The Australia and New Zealand Bone and Mineral Society and Osteoporosis Australia have recognized the need to standardize the reference range and have recommended that data generated by the Geelong Osteoporosis Study (GOS) be used Australia‐wide. The GOS recruited a random, population‐based sample of adult women and measured bone mineral density (BMD) at the proximal femur and spine using a Lunar DPX‐L. These data were used to establish reference ranges for Lunar machines and, using conversion equations, for Norland and Hologic machines. The new standardized Australian reference ranges for BMD will enable consistent diagnosis of osteoporosis and categorization of fracture risk across different types of densitometers.     

A Year of Critical Care: The Changing Face of the ICU During COVID-19

During the SARS-CoV-2 pandemic, admissions to hospital intensive care units (ICUs) surged, exerting unprecedented stress on ICU resources and operations. The novelty of the highly infectious coronavirus disease 2019 (COVID-19) required significant changes to the way critically ill patients were managed. Houston Methodist’s incident command center team navigated this health crisis by ramping up its bed capacity, streamlining treatment algorithms, and optimizing ICU staffing while ensuring adequate supplies of personal protective equipment (PPE), ventilators, and other ICU essentials. A tele–critical-care program and its infrastructure were deployed to meet the demands of the pandemic. Community hospitals played a vital role in creating a collaborative ecosystem for the treatment and referral of critically ill patients. Overall, the healthcare industry’s response to COVID-19 forced ICUs to become more efficient and dynamic, with improved patient safety and better resource utilization. This article provides an experiential account of Houston Methodist’s response to the pandemic and discusses the resulting impact on the function of ICUs.     

An exercise on the feasibility of carrying out secondary economic analyses

Purchasers of health services need up to date information on cost-effectiveness of interventions to help in prioritising spending. But economists have not yet developed a formal methodology for reviewing and summing up evidence from individual economic evaluations which may have been conducted at different times and in different places, or indeed for assessing whether such systematic reviews are possible in this context. This paper discusses the problems of reviewing available economic information, using a body of literature on the economics of influenza vaccination to illustrate some relevant issues. First, the paper examines alternative methods for adjusting prices to take into account differences in currency and time periods: Retail Price Indices are compared with health specific inflation indices, and exchange rates are compared with Purchasing Power Parity (PPP) data. For the studies reviewed, the choice of conversion method made little practical difference. Secondly, the paper explores the possibility of summarising the results of a review in terms of quantities of resources used, rather than prices. This method is constrained by the available data, but could be more generally useful as it allows direct comparison of underlying technologies, and calculation of costs by attaching local unit costs to the resources associated with an intervention. These two exercises highlight many of the problems that arise in generalising from economic studies. Both methods need to be developed further if they are to be useful to decision makers.     

Differential depression at excitatory and inhibitory synapses in visual cortex

The function of cortical circuits depends critically on the balance between excitation and inhibition. This balance reflects not only the relative numbers of excitatory and inhibitory synapses but also their relative strengths. Recent studies of excitatory synapses in visual and somatosensory cortices have emphasized that synaptic strength is not a fixed quantity but is a dynamic variable that reflects recent presynaptic activity. Here, we compare the dynamics of synaptic transmission at excitatory and inhibitory synapses onto visual cortical pyramidal neurons. We find that inhibitory synapses show less overall depression than excitatory synapses and that the kinetics of recovery from depression also differ between the two classes of synapse. When excitatory and inhibitory synapses are stimulated concurrently, this differential depression produces a time- and frequency-dependent shift in the reversal potential of the composite postsynaptic current. These results indicate that the balance between excitation and inhibition can change dynamically as a function of activity.     

肿瘤细胞株和癌组织角蛋白19、20 mRNA表达及临床意义

目的　建立利用角蛋白检测外周血中循环癌细胞的方法 ,探讨角蛋白 19、2 0 (K19、K2 0 )在不同肿瘤细胞株和肿瘤组织中的表达。方法　采用定量逆转录多聚酶链反应 (RT PCR)方法检测11个肺癌、食管癌、膀胱癌、大肠癌肿瘤细胞株和 33例相对应的癌组织中特异性K19、K2 0mRNA的表达。结果　 4种肿瘤细胞株及 33例相对应的癌组织均表达K19mRNA ,但表达量有明显差别。同种癌组织之间K19mRNA的表达量相差在 1.7～ 10倍之间 ,表达量最低者仅为阳性对照的 12 %以下。肺癌和食管癌细胞株和癌组织中均未见K2 0mRNA的表达。 6例膀胱癌组织中 ,仅有 1例呈阳性 ;5例肠癌组织中 ,4例呈阳性 ,表达量为阳性对照的 41%～ 77%。膀胱癌细胞株EJ1和肠癌细胞株SW480未见K2 0mRNA的表达。结论　K19、K2 0可作为检测外周血中循环癌细胞的生物标志物。但个别癌组织中K19、K2 0的表达低下 ,有可能导致检测出现假阴性结果。     

Cervical headgear and function regulator effects in Class II,division 1 patients

This study investigated 40 growing patients with Angle‐Class II, division 1, treated with either a functional regulator (FR) or cervical headgear (HG) over a period of approximately 1 year. The objective was to evaluate dentoalveolar and skeletal reactions.
Both appliances significantly (p<0.001) improved distocclusion and reduced the overjet. Cephalometric analyses revealed that the effects of these two appliances on the skeleton differed. Also, in the FR group, the inclination of incisors was (p<0.05) altered as well as the maxillary plane angle and the Wits‐appraisal (p<0.05). The HG group showed a significant (p<0.001) reduction in both SNA and ANB angles. Both appliances appear to be sufficient for improvement in patients with Class II, division 1 occlusion, with the HG showing an additional skeletal effect in the maxilla.     

Normative values of visual evoked potential in adults

Purpose:Visual evoked potentials (VEP) are used to determine the function of visual pathway from the optic nerve to visual cortex. Various factors may affect VEP response, viz., technical and environmental. The aim of this study is to obtain the normative value of VEP latency and amplitude parameters in adulthood in Indonesia, as well as the relationship of height, weight, body mass index (BMI), head circumference, and visual acuity with the variety of latency and amplitude values of VEP parameters.Methods:It is a cross-sectional study on 120 healthy subjects consisting of 60 males and 60 females between 18 and 65 years old. Height, weight, BMI, head circumference, and visual acuity were measured and continued with VEP examination using a 26′ checkerboard pattern on the left and right eyes alternately. All data were collected and analyzed with the Shapiro–Wilk test using statistical software R version 3.5.2.Results:Mean value of P100 latency (interocular latency) of left and right eye were 104.6 ± 3.4 ms and 104.1 ± 3.4 ms, respectively, as well as 9.8 ± 4.7 μV and 10.3 ± 5.4 μV for the amplitude. There was no significant difference between the male and female group, as well as on the age group. Female significantly exhibited a higher P100 amplitude than male. The greater the age, the lower amplitude of P100 significantly.Conclusion:Gender and age do not affect the P100 latency value but only affect P100 amplitude. Height, weight, BMI, head circumference, and visual acuity also do not affect the P100 latency and amplitude.