Lidocaine inhibited proliferation, migration, invasion and induced differentiation of glioma cells in vitro. Lidocaine suppressed the expression of circEZH2, and circEZH2 was highly expressed in glioma tissues and cells. CircEZH2 overexpression partly inhibited the function of lidocaine. CircEZH2 was a sponge of miR-181b-5p, and miR-181b-5p was downregulated in glioma tissues and cells. Besides, miR-181b-5p restoration reversed the effects of circEZH2 overexpression to repress the malignant behaviors of glioma cells. In addition, lidocaine mediated the circEZH2/miR-181b-5p axis to inhibit tumor growth in vivo.
 
  Lidocaine suppressed glioma progression by modulating the circEZH2/miR-181b-5p pathway.
 Lidocaine suppressed glioma progression by modulating the circEZH2/miR-181b-5p pathway.
  Competent neurologic examination and clinical skills are essential components in the care for patients in acute hospital and rehabilitation settings. To enhance the evaluation and education of Physical Medicine and Rehabilitation residents, the authors developed an educational objective structured clinical examination, the Neurological Exam Assessment Competency Evaluation System, and gathered 2 yrs of baseline data. The Neurological Exam Assessment Competency Evaluation System consisted of nine 9-min examination stations, seven with written clinical scenario with instructions for junior residents to complete the appropriate examination (stations Altered Mental Status, Mild Traumatic Brain Injury, Dementia, Stroke, Falls, and the International Standards for Neurological Classification of Spinal Cord Injury Sensory and Motor Examinations). Examinees provided written responses to posed questions for the other two stations-Modified Ashworth Scale and brachial plexus. The assessment tools for this examination wns for junior residents to complete the appropriate examination (stations Altered Mental Status, Mild Traumatic Brain Injury, Dementia, Stroke, Falls, and the International Standards for Neurological Classification of Spinal Cord Injury Sensory and Motor Examinations). Examinees provided written responses to posed questions for the other two stations-Modified Ashworth Scale and brachial plexus. The assessment tools for this examination were designed for residency programs to evaluate the basic competencies as outlined by the Accreditation Council for Graduate Medical Education and Physical Medicine and Rehabilitation milestones. Based on the feedback received from the examinees and examiners, the Neurological Exam Assessment Competency Evaluation System can serve as an educational objective structured clinical examination for the improvement of trainee core competencies.
  Intramuscular Botulinum toxin A (BTX-A) is used in the management of focal spasticity in cerebral palsy (CP). We aimed to conduct a systematic review to assess current literature on the use of BTX-A in the management of mobility related outcomes among adult persons with spastic CP.
 
  All studies reporting on the use of BTX-A in the management of spastic CP among adult persons were identified by searching the following electronic databases PubMed, CINAHL, the Cochrane Library, and EMBASE.
 
  Six studies were included in the review. Most studies were conducted in mixed patient groups comprising patients with movement disorders, traumatic brain injury, cerebral palsy and other disorders requiring therapy for spasticity. BTX-A was shown to be effective in improving spasticity related outcomes among persons with CP but mixed results were shown for functional outcomes.
 
  More studies are required on exclusive CP cohorts using recommended and currently used scales, incorporating Quality of life and patient satisfaction scales. Results from long term follow up studies will be valuable for better evaluation of the effectiveness of BTX-A in the management of spasticity related outcomes among adult persons with CP.
 More studies are required on exclusive CP cohorts using recommended and currently used scales, incorporating Quality of life and patient satisfaction scales.  https://www.selleckchem.com/products/cc-930.html  Results from long term follow up studies will be valuable for better evaluation of the effectiveness of BTX-A in the management of spasticity related outcomes among adult persons with CP.Interest in global health is rising in graduate medical education. Trainees are increasingly seeking high quality, ethically sound, and educationally robust opportunities for global medical rotations. When based on best educational practices, these opportunities can provide a unique learning experience for residents in traditional Physical Medicine and Rehabiliation (PM&R) programs. This article describes the development of an international rotation in PM&R including specific competency-based PM&R global health learning objectives, predeparture training, rotation structure, and post-rotation feedback mechanisms. The aim is to present the development of the program as a resource for both residents and program directors to help create and maximize existing rotations at their own institutions. Learners must complete predeparture requirements that include completion of a musculoskeletal rotation and global health didactics intended to provide foundational knowledge in physiatry and global health. Postrotation requirements include the residency program's standardized evaluation form, resident survey, and self-reflection essay. Experience from a novel 4-week pilot rotation to Punta Gorda, Belize is described to exemplify ACGME based learning objectives as well as the benefits of a formalized rotation structure. Using this unique set of learning objectives and proposed rotation requirements, we believe that PM&R residency programs can develop valuable global health learning experiences.The American Board of Physical Medicine and Rehabilitation's revised mission and vision emphasize lifelong learning throughout its board certification processes. More formative approaches have been incorporated into both initial and continuing certification. These changes are based in adult learning theory and are supported by an ongoing board research endeavor. Board certification in the future is envisioned as a partnership with physicians to facilitate ongoing learning and positively impact patient outcomes.