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71, p = 0.047; Rs = -0.73, p = 0.04, respectively).Conclusions Our findings suggest that children with MMC who exhibit greater movement quality and trunk control are likely to be functional ambulators with more optimal spatiotemporal gait parameters.Introduction Vasectomy is a popular choice of contraception worldwide. In the UK, vasectomy reversal is not usually licensed under the NHS with reports on outcomes being limited. Microsurgical reversal is a technique commonly performed under the operating microscope. Loupe magnification, however, is emerging as a safe and reliable technique to perform microsurgery.Method Loupe-assisted microsurgical vasovasotomies were performed on 14 men in a 3-year period. Indications for the procedure were for fertility only. Semen analysis variables were measured against European Association of Urologists (EAU) guidelines at six weeks. Patients were followed-up at clinic in three months. Data were collated using operation notes and cytology results, and analysed using descriptive statistics. Pearson's correlation coefficient was used to compare years after vasectomy, and age to sperm count.Results The average sperm count in our group was 41.3 million per millilitre (median 29.95, range 2.7-107.8) at 6 weeks. Seventy-five per cent were found to have positive sperm motility, and all had acceptable sperm morphology at follow-up. A very low to weak correlation between time after vasectomy and age, with sperm count. Conclusion We have demonstrated that fertility and post-operative outcomes using a loupe-assisted microsurgical vasovasotomy approach are favourable as per EAU guidelines.Oxidative stress underlies a number of pathological conditions, including cancer, neurodegeneration, and aging. Antioxidant-rich foods help maintain cellular redox homeostasis and mitigate oxidative stress, but the underlying mechanisms are not clear. For example, sulforaphane (SFN), an electrophilic compound that is enriched in cruciferous vegetables such as broccoli, is a potent inducer of cellular antioxidant responses. NFE2L2/NRF2 (nuclear factor, erythroid 2 like 2), a transcriptional factor that controls the expression of multiple detoxifying enzymes through antioxidant response elements (AREs), is a proposed target of SFN. NFE2L2/NRF2 is a target gene of TFEB (transcription factor EB), a master regulator of autophagic and lysosomal functions, which we show here to be potently activated by SFN. SFN induces TFEB nuclear translocation via a Ca2+-dependent but MTOR (mechanistic target of rapamycin kinase)-independent mechanism through a moderate increase in reactive oxygen species (ROS). Activated TFEB thembrane protein 1; MCOLN1/TRPML1 mucolipin 1; ML-SA1 mucolipin-specific synthetic agonist 1; ML-SI3 mucolipin-specific synthetic inhibitor 3; MTOR mechanistic target of rapamycin kinase; MTORC1 mechanistic target of rapamycin kinase complex 1; NAC N-acetylcysteine; NFE2L2/NRF2 nuclear factor erythroid 2 like 2; NPC Niemann-Pick type C; PBS phosphate-buffered saline; PPP2/PP2A protein phosphatase 2; Q-PCR real time polymerase chain reaction; ROS reactive oxygen species; RPS6KB1/S6K1/p70S6K ribosomal protein S6 kinase B1; SFN sulforaphane; TFEB transcription factor EB; WT, wild-type.BACKGROUND Moral distress is an important and well-studied phenomenon among nurses and other healthcare providers, yet the conceptualization of parental moral distress remains unclear. OBJECTIVE The objective of this dimensional analysis was to describe the nature of family moral distress in serious pediatric illness. DESIGN AND METHODS A dimensional analysis of articles retrieved from a librarian-assisted systematic review of Scopus, CINAHL, and PsychInfo was conducted, focusing on how children, parents, other family members, and healthcare providers describe parental moral distress, both explicitly through writings on parental moral experience and implicitly through writings on parental involvement in distressing aspects of the child's serious illness. ETHICAL CONSIDERATIONS To promote child and family best interest and minimize harm, a nuanced understanding of the moral, existential, emotional, and spiritual impact of serious pediatric illness is needed. The cases used in this dimensional analysis come froON Parent moral distress is an important and complex phenomenon that requires further theoretical and empirical investigation. We provide an integrated definition and dimensional schematic model that may serve as a starting point for future research and dialogue.Background Observations of first trimester human trisomy 15 (T15) embryos have identified meromelic changes in the upper limbs. These changes are similar to those observed in animal studies investigating the effects of overexpression of Meis2, a signaling transcription factor expressed during forelimb development. Although it would be exceedingly difficult to assess MEIS2 expression in the human embryonic arm, MEIS2 has been reported as consistently expressed in first trimester placental villus stroma. Methods This study addresses whether gene dosage effect might underlie meromelia in T15 by comparing MEIS2 expression in placentas from T15 and euploid spontaneous abortions employing manual and automated assessment of MEIS2 immunohistochemical scoring. Results Average MEIS2 expression is increased in T15 first trimester placental tissue compared to euploid controls but that the difference is marginal. A1874 Manual and automated scoring showed moderately strong correlation. Conclusion Extrapolation of these results suggests MEIS2 overexpression may not be required for meromelia in T15.Objective Road traffic injuries (RTI) cause ∼1.2 million deaths and 50 million injuries annually, disproportionately occurring in low- and middle-income countries. Although policy changes and infrastructural developments have continued to contribute to the decrease in RTI-related deaths, limited studies have investigated the relationship between motorcycle taxi driver behaviors and RTIs in Rwanda. This study aims to describe the safety behaviors of commercial motorcyclists in Kigali, Rwanda.Methods We surveyed 609 commercial motorcyclists in January 2014 then conducted a cross-sectional analysis of the results, including descriptive and bivariate logistic regression analyses.Results We found that 38.7% of surveyed motorcycle drivers experienced a crash during their lifetime, of which, more than half (n = 134, 56.8%) suffered injuries. Of all injuries, 38.8% (n = 52) resulted in hospitalization, and 14.2% (n = 19) in disability. Among motorcyclists, 100% reported always wearing a helmet, 99% reported always wearing a chin strap, and 98.

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