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The use of stereotactic headframes for neurosurgical procedures requiring targeted localization continues to grow with new advancements in technology and treatment modalities. A configuration of the Leksell stereotactic G frame with a straight front bar, useful in epilepsy and laser cases, almost completely obscures oral access and presents a significant airway challenge for the anesthetist. Although previous papers have suggested that the entire headframe should be removed during an airway emergency, we describe a novel method to remove only the front bar.

We performed an observational mannequin study. Anesthesia personnel from a single center were asked to intubate a mannequin with the Leksell frame fully in situ and again with the front bar removed. In addition, the time to remove the entire frame versus only the front bar was investigated.

Eighteen anesthesia personnel participated in the study as well as four neurosurgeons. The average time to intubate the mannequin in the frame was 23.5 (11.4) seconds and with the front bar removed, 10.9 (2.5) seconds (p < 0.001). The average time taken to remove just the front bar by the neurosurgeons was 35.4 (7.3) seconds compared to an average of 83.3 (18.6) seconds to remove the headframe entirely (p < 0.001).

Our study demonstrates that intubating with the Leksell front bar in situ is possible with videolaryngoscopy under an ideal situation. More importantly, the removal of just the front bar is a simpler more streamlined approach requiring statistically less time to secure an airway.

Our study demonstrates that intubating with the Leksell front bar in situ is possible with videolaryngoscopy under an ideal situation. More importantly, the removal of just the front bar is a simpler more streamlined approach requiring statistically less time to secure an airway.The study of language acquisition has a long and contentious history researchers disagree on what drives this process, the relevant data, and the interesting questions. Here, I outline the Starting Big approach to language learning, which emphasizes the role of multiword units in language, and of coarse-to-fine processes in learning. I outline core predictions and supporting evidence. In short, the approach argues that multiword units are integral building blocks in language; that such units can facilitate mastery of semantically opaque relations between words; and that adults rely on them less than children, which can explain (some of) their difficulty in learning a second language. The Starting Big approach is a theory of how children learn language, how language is represented, and how to explain differences between first and second language learning. I discuss the learning and processing models at the heart of the approach and their cross-linguistic implications.

Ventilation of the middle ear and mastoid air cells is believed to play an important role in the pathogenesis of chronic ear disease. Traditionally, ventilation is assessed by computed tomography. However, this exposes patients to cumulative radiation injury. In cases with a perforation in the tympanic membrane, tympanometry potentially presents a non-invasive alternative to measure the ventilated middle-ear and mastoid air cell volume. This study hypothesised that total tympanometry volume correlates with ventilated middle-ear and mastoid air cell volume.

Total tympanometry volume was compared with ventilated middle-ear and mastoid air cell volume on computed tomography scans in 20 tympanic membrane perforations.

There was a high correlation between tympanometry and computed tomography volumes (r = 0.78; p < 0.001). A tympanometry volume more than 2 ml predicted good ventilation on computed tomography.

These results may help reduce the need for pre-operative computed tomography in uncomplicated cases with tympanic membrane perforations.

These results may help reduce the need for pre-operative computed tomography in uncomplicated cases with tympanic membrane perforations.Despite several extensive and exhaustive efforts, search for potential therapy against leishmaniasis has not made much progress. In the present work, we have employed mining strategy to screen Leishmania donovani proteome for identification of promising vaccine candidate. We have screened 21 potential antigenic proteins from 7960 total protein of L. donovani, based on the presence of signal peptide, GPI anchor, antigenicity prediction and substractive proteomic approach. Secondly, we have also performed comprehensive immunogenic epitope prediction from the screened 21 proteins, using IEDB-AR tools. Out of the 21 antigenic proteins, we obtained 11 immunogenic epitopes from 9 proteins. The final results revealed that four predicted epitopes namely; YPAFAALVF, VAVAATVAY, AAAPTEAAL and MYPLVAVVF, have significantly better binding potential with respective alleles and could elicits immune responses. Docking analysis using PATCHDOCK server and molecular dynamic simulation using GROMACS revealed the potential of the sequences as immunogenic epitopes. In silico studies also suggested that the epitopes occupied almost same binding cleft with the respective alleles, when compared with the reference peptides. It is also suggested from the molecular dynamic simulation data that the peptides were intact in the pocket for longer periods of time. Our study was designed to select MHC class I restricted epitopes for the activation of CD8 T cells using immunoinformatics for the prediction of probable vaccine candidate against L. donovani parasites. Communicated by Ramaswamy H. Sarma.Galectin-1 (Gal-1) is the first member of galectin family, which has a carbohydrate recognition domain, specifically binds towards β-galactoside containing oligosaccharides. Auranofin Owing its association with carbohydrates, Gal-1 is involved in many biological processes such as cell signaling, adhesion and pathological pathways such as metastasis, apoptosis and increased tumour cell survival. The development of β-galactoside based inhibitors would help to control the Gal-1 expression. In the current study, we carried out molecular dynamics (MD) simulations to examine the structural and dynamic behaviour Gal-1-thiodigalactoside (TDG), Gal-1-lactobionic acid (LBA) and Gal-1-beta-(1→6)-galactobiose (G16G) complexes. The analysis of glycosidic torsional angles revealed that β-galactoside analogues TDG and LBA have a single binding mode (BM1) whereas G16G has two binding modes (BM1 and BM2) for interacting with Gal-1 protein. We have computed the binding free energies for the complexes Gal-1-TDG, Gal-1-LBA and Gal-1-G16G using MM/PBSA and are -6.