In addition, exogenous stimulation consistently evoked this neoco

In addition, exogenous stimulation consistently evoked this neocortical-to-hippocampal sequence of activation. Finally, parahippocampal lesions that disrupted functional connections between the neocortex and hippocampus effectively disrupted the transmission of both spontaneous and evoked neocortical activity to the hippocampus. These findings suggest that sleep-related motor activity

contributes to the development of neocortical and hippocampal circuits and provides a foundation on which coordinated activity between these two forebrain structures develops.”
“Background: Pediatric 123 obesity is a growing problem affecting the health of our youth. We sought to identify the barriers to pediatric bariatric referral at a tertiary referral AC220 supplier center.\n\nMethods: We performed a Survey of pediatricians and family practitioners at a single institution to assess their perspectives oil pediatric obesity.\n\nResults: A total of 61 physicians completed the survey (response rate 46%). All believed pediatric obesity is a major problem, and 82.0% noted an increase in the incidence during

a mean period of 15 years (range Mocetinostat molecular weight 3-25). Of the 61 physicians. 88.5% used nonoperative weight loss techniques, with only 1.8% reporting satisfactory results. However, 42.6% had referred a patient (adult or pediatric) for a bariatric procedure. of whom 84.6% were satisfied with the operative outcomes. Despite the high satisfaction with bariatric procedures, 88.5% would be unlikely

or would never refer a child for a bariatric procedure, and 44.3% would be somewhat or very likely to refer all adolescent.\n\nConclusion: physicians caring for children recognize the growing problem of childhood and adolescent obesity. Despite the poor outcomes with nonoperative methods and the high satisfaction with the outcomes of bariatric procedures, physicians are still reluctant to refer children and adolescents for surgical weight loss procedures. (Surg Obes Relat Dis 2009;5:88-93.) (C) 2009 American Society for Metabolic and Bariatric surgery. All rights reserved.”
“Sinonasal aspergillosis is an uncommon, yet debilitating and often frustrating condition to treat in dogs despite years of research check details evaluating pathogenesis, diagnosis and treatment. The disease is most commonly caused by non-invasive fungal infection, thought to be secondary to altered innate and/or adaptive immune responses. Attempts to confirm this have however failed. A variety of conflicting opinions regarding the diagnosis and treatment of sinonasal aspergillosis exist. Often the use of a particular treatment protocol is based upon personal or regional preference. Evaluation of the veterinary literature demonstrates that the evidence base in support of individual treatment recommendations is weak.

Group 1 consisted of 8, group 2 of 17, and group

Group 1 consisted of 8, group 2 of 17, and group 3 of 14 patients. Dyspnea was present in 35 of the patients (90%) and cyanosis in 17 patients (44%). Preembolization Pao(2) was different between groups 1 (52.6 +/- 11.6 mm Hg) and 3 (70.7 +/- 14.1 mm Hg). Neurologic events were more frequently reported before treatment in group 1 (62.5%) than in group 2 (35%) or in group 3 (43%). Eighty percent of patients reported improvement in their dyspnea after embolization. Pao(2) levels improved more in group 2 than in groups I and 3. Eight ischemic or infectious Complications occurred

in 4 patients (10%) due to reperfusion of embolized PAVMs or enlargement of non-embolized PAVMs. Complete and partial treatment success was reported using CT scanning in 59% and 38% of cases, respectively.\n\nConclusion: Vorinostat Dyspnea and paradoxical embolism are frequently encountered in HHT patients with diffuse PAVMs. Prevention of complications and improvement of dyspnea can be achieved after successful embolization in most patients. Better improvement of Pao(2) can be achieved in group 2.”
“OBJECTIVES Prune belly syndrome (PBS) is a rare condition characterized by the congenital absence or deficiency of the abdominal

wall musculature, with associated abnormalities of the genitourinary tract, including hydronephrosis and cryptorchidism. Few population-based epidemiology or mortality data are available.\n\nMETHODS We retrospectively reviewed the Kids’ Inpatient Database to evaluate PBS among newborn infants during their initial hospitalization in 2000, find more 2003, and 2006. The International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify patients and to determine the comorbidity status. The PBS incidence, demographics, comorbid conditions,

and disposition were assessed.\n\nRESULTS A total of 133 newborn male infants diagnosed with PBS were identified of 1 420 991 live male births, for a weighted incidence estimate of 3.8 cases/100 000 live births. Of the newborns with PBS, 50% were white, 31% black, and 10% were Hispanic. In-hospital mortality was high (39 of 133, 29%). Of the 133 patients with PBS, 55 (41%) were discharged home and 39 (29%) required inpatient transfer or home nursing care. Fifty-seven patients (43%) were born premature; 56% of the PBS deaths occurred in premature infants. Mechanical ventilation was required in 64 newborns (48%), and 33 (24%) had coexisting congenital cardiovascular anomalies. Renal failure was uncommon, occurring in only 5 newborns (4%); none required dialysis. Only 13 patients (10%) underwent urinary diversion (vesicostomy or ureterostomy).\n\nCONCLUSIONS The incidence of PBS was 3.8 cases/100 000 live births. Despite advances in care for children with PBS, this condition continues to be associated with high perinatal mortality, likely related to the associated prematurity and pulmonary complications. Renal failure was rare, as was immediate urinary diversion. UROLOGY 76: 44-48, 2010.

L All rights reserved “
“Background: Non-motor symptoms (NM

L. All rights reserved.”
“Background: Non-motor symptoms (NMS) of Parkinson’s disease (PD) affect virtually every patient, yet they are under-recognized and under-treated. The NMS Questionnaire (NMSQuest) is a validated 30-item self-assessment instrument useful for NMS screening in clinic. Objective: Development of a straight forward grading classification of the burden of non-motor symptoms in PD based on the number of NMS as assessed by the NMS Questionnaire. Methods: In an observational, cross-sectional, international study of 383 consecutive patients distribution of the declared NMS as

per NMSQuest was analyzed according to previously published levels based on the Non-Motor Symptoms Scale and also the median and interquartile range (IR, percentiles 25 and 75) of the total NMSQuest scores. After post hoc checking, these values were proposed as cut-off points for estimating NMS burden based only on the accumulation of DMH1 symptoms. Results: Burden and number of NMS correlate closely (r bigger than = 0.80).

On the basis of this finding, five levels (0 = No NMS to 4 = Very severe) of NMSQuest grading were proposed after identification of their cut-offs by ordinal logistic regression and median and interquartile range distribution. These values coincided almost completely with those obtained by median and interquartile range selleck screening library in an independent sample. Concordance between this classification and HY staging was weak (weighted kappa = 0.30), but was 3 substantial (weighted kappa =

0.68) with the Non-Motor Symptoms Scale grading. Conclusion: Completion of NMSQuest and subsequent grading of the burden could allow the health care professional to approach the severity this website of NMS burden using the self completed NMSQuest in a primary care setting. (C) 2015 Elsevier Ltd. All rights reserved.”
“Autosomal recessive LPIN1 mutations have been recently described as a novel cause of rhabdomyolysis in a few families. The purpose of the study was to evaluate the prevalence of LPIN1 mutations in patients exhibiting severe episodes of rhabdomyolysis in infancy. After exclusion of primary fatty acid oxidation disorders, LPIN1 coding sequence was determined in genomic DNA and cDNA. Among the 29 patients studied, 17 (59%) carried recessive nonsense or frameshift mutations, or a large scale intragenic deletion. In these 17 patients, episodes of rhabdomyolysis occurred at a mean age of 21 months. Secondary defect of mitochondrial fatty oxidation or respiratory chain was found in skeletal muscle of two patients. The intragenic deletion, c. 2295-866_2410-30del, was identified in 8/17 patients (47%), all Caucasians, and occurred on the background of a common haplotype, suggesting a founder effect. This deleted human LPIN1 form was unable to complement Delta pah1 yeast for growth on glycerol, in contrast to normal LPIN1. Since more than 50% of our series harboured LPIN1 mutations, LPIN1 should be regarded as a major cause of severe myoglobinuria in early childhood.

In intact follicles and in theca cells, IGF-I and b-insulin had n

In intact follicles and in theca cells, IGF-I and b-insulin had no effect on HCG-stimulated testosterone production. HCG-stimulated 17 beta-estradiol production, however, was significantly increased by IGF-I and b-insulin. To clarify the mechanism of 17 beta-estradiol production by the ovarian follicles during vitellogenic CH5183284 research buy stage of carp, effects of IGF-I and b-insulin

either alone or in combination with HCG on aromatase activity (conversion of testosterone to 17 beta-estradiol) and cytochrome P450 aromatase (P450arom) gene expression were investigated in vitro. IGF-I and b-insulin alone stimulated aromatase activity and P450arom gene expression and significantly Cilengitide enhanced 432 HCG-induced enzyme activity and P450arom gene expression. Our results thus indicate that IGF-I and b-insulin alone can stimulate testosterone and 17 beta-estradiol production in vitellogenic follicles of C. carpio by stimulating aromatase activity and P450arom gene expression. Evidence also provided for

the modulation of HCG-induced aromatase activity and P450arom gene expression by IGF-I and b-insulin in such follicles. (C) 2009 Elsevier Ireland Ltd. All rights reserved.”
“OBJECTIVE: Although a dural or intramedullary arteriovenous fistula involving the conus medullaris and fed by the lateral sacral artery has been reported, a case of perimedullary fistula arising from an artery in the filum terminale has not been described in the literature. The authors report the first case of perimedullary arteriovenous fistula located in the filum terminale.\n\nCLINICAL PRESENTATION: A 61-year-old man presented with a 10-year history

of leg pain. Thoracolumbar magnetic resonance imaging scans revealed multiple perimedullary signal voids from T10 to L3. Angiography showed engorged perimedullary veins and a fistula fed by the anterior spinal artery from the right ninth segmental artery and by 2 branches of the left lateral sacral artery. The anterior spinal artery was also regarded as the artery of the filum terminale.\n\nINTERVENTION: Transarterial embolization was performed to occlude C59 Wnt mw the feeders from the left lateral sacral artery, and an L5 total laminectomy was subsequently performed to obliterate residual fistulous material from the artery of the filum terminale. The thickened, yellowish filum, surrounded by tortuous, engorged veins, was coagulated and resected. Postoperatively, the patient’s symptoms gradually resolved and were not aggravated during long periods of walking.\n\nCONCLUSION: It must be noted that a fistula can be located in the filum terminale and can be successfully treated using multidisciplinary approaches.

Methods We evaluated 59 asymptomatic adults consecutively for rep

Methods We evaluated 59 asymptomatic adults consecutively for repaired CoA with MR imaging between 2008 and 2012. Results Patients were aged 29 +/- 8(16-49) years; 34 males (58%) and 34 with bicuspid aortic valve (58%). Median age at the time of initial repair was two years. Surveillance MR imaging was performed 23 +/- 8 years post-procedure. The three most common interventions performed were subclavian-flap repair (25%), end-to-end repair (33%) and patch aortoplasty (33%). Re-intervention with balloon angioplasty or repeat surgery had been performed in 22%

of subjects. There were 28 cases of recoarctation (48%), of which seven were at least moderate in severity. Repair site and ascending GSI-IX aortic aneurysm occurred in eight (14%) and four (7%) subjects, respectively. Freedom VX-661 in vitro from any degree of recoarctation and other aortic complications was observed in eight subjects (14%). Conclusion MR imaging detected a high rate of aortic abnormalities in asymptomatic adults after CoA repair, including 27% with clinically

significant recoarctation and/or local aneurysm formation.”
“Phototrophic microbial mats are ideal model systems for ecological and evolutionary analysis of highly diverse microbial communities. Microbial mats are small-scale, nearly closed, and self-sustaining benthic ecosystems that comprise the major element cycles, trophic levels, and food webs. The steep and fluctuating physicochemical microgradients, that are the result of the ever changing environmental conditions and of the microorganisms’ own activities, give rise to a plethora of potential niches resulting in the formation of one of the most diverse microbial ecosystems known to date. For several decades, microbial mats have been studied extensively and more recently molecular biological techniques selleck inhibitor have been introduced that allowed

assessing and investigating the diversity and functioning of these systems. These investigations also involved metagenomics analyses using high-throughput DNA and RNA sequencing. Here, we summarize some of the latest developments in metagenomic analysis of three representative phototrophic microbial mat types (coastal, hot spring, and hypersaline). We also present a comparison of the available metagenomic data sets from mats emphasizing the major differences between them as well as elucidating the overlap in overall community composition.”
“A series of 3 ‘-aminoflavones 5,6,7,8-tetra- or 5,7-dioxygenated on the A-ring was synthesized from tangeretin or naringin, two natural Citrus flavonoids. These flavones were evaluated for antiproliferative activity, activation of 432 apoptosis, and inhibition of tubulin assembly. The most antiproliferative flavones exhibit a common 5-hydroxy-6,7,8-trimethoxy substitution pattern on the A-ring. (C) 2009 Elsevier Ltd. All rights reserved.”

2 +/- 10 3 years, which is the youngest, and with the largest pro

2 +/- 10.3 years, which is the youngest, and with the largest proportion of patients smaller than 40 years in the entire IH population. The overall population attributable risk (PAR) of the nine risk factors to AMI was higher in the

ME (97.5%) than 123 worldwide (90.4%). Elevated apolipoprotein (Apo)B/ApoA1 had the strongest association with AMI, with odds ratio (OR) of 3.43 and PAR of 57.1%, followed by smoking (OR 3.63 and PAR 45.6%). ApoB/ApoA1 had greater association than the 17DMAG supplier conventional low-density lipoprotein (LDL)/high-density lipoprotein (HDL) cholesterol ratio. Both diabetes (OR 3.42, PAR 16.4%) and hypertension (OR 1.89, PAR 10.7%) had greater association with AMI in women than men. Abdominal obesity (OR 2.12, PAR 26.1%) and depression (OR 1.97, PAR 45.3%), but not conventional BMI, were significantly associated with AMI (p smaller than 0.0001). Conclusion This is the largest prospective population study of risk factors associated with AMI in the ME. AMI occurs at younger age in the ME than all other regions. The PAR for the nine risk factors was higher in the ME (97.5%) than the rest of the world. These findings should guide serious prevention strategies.”

Unscheduled bleeding is the main side effect of continuous oral contraceptive pills (OCPs) and has been correlated with the up-regulation of matrix metalloprotineases (MMPs). The study objective was to determine if prophylactic administration of doxycycline (an MMP inhibitor at low subantimicrobial selleckchem doses) would prevent unscheduled bleeding during the initiation of a continuous OCP.\n\nStudy Design: Subjects using cyclic hormonal contraceptives (combined OCPs, patch or ring) without unscheduled bleeding were switched to continuous OCPs (20 mcg ethinyl cstradiol/100 mcg levonorgestrel). They were randomized to receive daily doxycycline [sustained-release subantimicrobial dose (40 mg daily)] or placebo for the first 84 days and then observed for Cediranib mouse an additional 28 days on the continuous OCP alone. The number of bleeding/spotting days and the time in days it took to achieve amenorrhea

were compared using a t test.\n\nResults: Sixty-five subjects were randomized. Although the use of doxycycline did not significantly decrease the number of mean bleeding/spotting days in the first 84 days of the study [doxycycline 14.75 (SE 2.30), placebo 17.78 (2.31), p=.36], women who received doxycycline had a significantly earlier onset of amenorrhea [mean last day of bleeding/spotting doxycycline 61.7 (7.7), placebo 85.2 (6.7), p=.03].\n\nConclusion: The coadministration of subantimicrobial-dose doxycycline during initiation of continuous OCPs results in a significant reduction in the length of time needed to achieve amenorrhea. (C) 2012 Elsevier Inc. All rights reserved.”
“S-1 is an oral antitumor agent that contains tegafur, which is converted to fluorouracil (5-FU) in the human body.

The concentrations of several nutritionally

desirable com

The concentrations of several nutritionally

desirable compounds (beta-lactoglobulin, Tariquidar omega-3 fatty acids, omega-3/omega-6 ratio, conjugated linoleic acid c9t11, and/or carotenoids) decreased with increasing feeding intensity (organic outdoor >= conventional outdoor >= conventional indoors). Milking system intensification (use of robotic milking parlors) had a more limited effect on milk composition, but increased mastitis incidence. Multivariate analyses indicated that differences in milk quality were mainly linked to contrasting feeding regimens and that milking system and breed choice also contributed to differences in milk composition between production systems.”
“Background: Bronchial 123 asthma is the most frequent chronic childhood disease and can have a marked impact on educational development,

activities and quality of life. The AIRMAG survey provides an opportunity to assess asthma and its impact in children in North Africa. Objective: To describe the prevalence, burden and management of asthma in children in the Maghreb.\n\nMethods: A general population sample was generated using a stratified sampling method based on randomly-generated lists of telephone numbers. The target sample consisted of 10 000 households in each country, which were contacted by telephone. A structured interview was proposed. Oligomycin A solubility dmso Two screening questions were asked to identify subjects with asthma. Children who met these criteria were then questioned in more detail. about their asthma.\n\nResults: Of 30350 households contacted, 1090 subjects with asthma were identified,

of whom 248 were aged under sixteen and interviewed by proxy. The prevalence of paediatric asthma ranged from RG-7112 in vitro 3.5% in Tunisia to 4.4% in Morocco. 22.8% of children were rated as severe persistent and 30.9% as intermittent. Asthma control was adequate in 7.6% of children and unacceptable in 46.2%. Control was best in Tunisia and worst in Morocco. 12.2% had been hospitalised for their asthma in the previous year and 32.9% had needed to attend an emergency department. Short-acting beta-agonists were used by 52.8% of children and prophylactic inhaled corticosteroids (atone or in association with long-acting beta-agonists) by 27.0%.\n\nConclusions: Asthma has a major impact on the lives of children with asthma in the Maghreb. This could be improved by offering more appropriate care as recommended in the GINA guidelines. (C) 2009 Published by Elsevier Ltd.”
“Algorithm-based exposure assessments based on patterns in questionnaire responses and professional judgment can readily apply transparent exposure decision rules to thousands of jobs quickly. However, we need to better understand how algorithms compare to a one-by-one job review by an exposure assessor.


analyses revealed an interaction betw


analyses revealed an interaction between MKRN1 and WNVCp. Domain analysis indicated that the C terminus of MKRN1 and the N terminus of WNVCp were required for the interaction. MKRN1 could induce WNVCp ubiquitination and degradation in a proteasome-dependent manner. Interestingly, the WNVCp mutant with amino acids 1 to 105 deleted WNVCp was degraded by MKRN1, whereas the mutant with amino acids 1 to 90 deleted was not. When three lysine sites at positions 101, 103, and 104 of WNVCp were replaced with alanine, MKRN1-mediated ubiquitination and degradation of the mutant were significantly inhibited, suggesting that these sites are required for the ubiquitination. Finally, U2OS cell lines stably expressing MKRN1 were resistant to cytotoxic effects

of WNV. In contrast, cells BTK inhibitor purchase depleted of MKRN1 were more susceptible to WNVCp cytotoxicity. Confirming this, overexpression of MKRN1 significantly reduced, but depletion of MKRN1 increased, WNV proliferation in 293T cells. Taken together, our results suggest that MKRN1 can protect cells from WNV by inducing WNVCp degradation.”
“Background. Adrenocortical carcinoma (ACC) is a rare, but aggressive, malignancy. Current American Association of Clinical Endocrinologists (AACE)/American Association of Endocrine Surgeons (AAES) guidelines recommend resection of nonfunctional adrenal neoplasms >= 4 cm. This study evaluates LY3023414 17-AAG ic50 the cost-effectiveness of this approach.\n\nMethods. A decision tree was constructed for patients with a nonfunctional, 4-cm adrenal incidentaloma with no radiographic

suspicion for ACC. Patients were randomized to adrenalectomy, surveillance per AACE/AAES guidelines, or no follow-up (“sign-off”). Incremental cost-effectiveness ratio (ICER) includes health care costs, including missed ACC. ICER (dollar/life-year-saved [LYS]) was determined from the societal perspective. Sensitivity analyses were performed.\n\nResults. In the base-case analysis, assuming a 2.0% probability of ACC for a 4-cm tumor, surgery was more cost-effective than surveillance (ICER $25,843/LYS). Both surgery and surveillance were incrementally more cost-effective than sign-off ($35 /LYS and $8/LYS, respectively). Sensitivity analysis demonstrated that the model was sensitive to patient age, tumor size, probability of ACC, mortality of ACC, and cost of hospitalization. The results of the model were stable across different cost and complications related to adrenalectomy, regardless of operative approach.\n\nConclusion. In our model, adrenalectomy was cost-effective for neoplasms >4 cm and in patients <65 years, primarily owing to the aggressiveness of ACC. Current AACE/AAES guideline recommendations for the resection of adrenal incidentalomas >= 4 cm seem to be cost-effective. (Surgery 2012;152:1125-32.)”
“Aims Hydrogen sulphide levels are reduced in many disease states, including diabetes and end-stage renal disease.

Mean ejection fraction was 32% and resting heart rate was 71 6 bp

Mean ejection fraction was 32% and resting heart rate was 71.6 bpm. Concomitant medications included beta-blockers (87%), renin-angiotensin system agents (89%), antithrombotic agents (94%), and lipid-lowering agents (76%). Conclusions:

Main results from BEAUTIFUL are expected in 2008, and should show whether ivabradine, on top of optimal medical treatment, reduces mortality and cardiovascular events in this population of high-risk patients. Copyright (c) 2007 S. Karger AG, Basel.”
“Grainyhead transcription factors play an evolutionarily conserved role in regulating epidermal terminal differentiation. One such factor, the mammalian Grainyhead-like epithelial transactivator (Get1/Grhl3), is important for epidermal barrier formation. In addition to a role in barrier formation, Grainyhead genes play roles selleck chemicals llc in closure of several structures such as the mouse neural CAL-101 datasheet tube and Drosophila wounds. Consistent with these observations, we found that Get1 knockout mice have an eye-open at birth phenotype. The failure of eyelid closure appears to be due to critical functions of Get1 in promoting F-actin polymerization, filopodia formation, and the cell shape 3 changes that are required for migration of the keratinocytes at the leading edge during eyelid closure: The expression of TGF alpha, a known regulator of leading

edge formation, is decreased in the eyelid tip of Get1(-/-) mice. Levels of phospho-EGFR and phospho-ERK are also decreased at the leading edge tip. Furthermore, in an organ culture model, TGF alpha can increase levels of phospho-EGFR and promote cell shape changes as well as leading edge formation in Get1(-/-) eyelids, indicating that in eyelid closure Get1 acts upstream of TGFa in the EGFR/ERK pathway. (C) 2008 Elsevier Inc. All rights

“Among the great amount of genes presented in microarray gene expression data, only a small fraction is effective for performing a certain diagnostic test. In this regard, mutual information has been shown to be successful for selecting a set of relevant and nonredundant genes from microarray data. However, information theory offers many more measures such as the f-information measures that may be suitable for selection of genes from microarray gene expression data. This paper presents different f-information measures as the evaluation criteria for gene selection problem. To compute the gene-gene redundancy (respectively, gene-class relevance), these information measures calculate the divergence of the joint distribution of two genes’ expression values (respectively, the expression values of a gene-and the class labels of samples) from the joint distribution when two genes (respectively, the gene and class label) are considered to be completely independent.

In conclusion, the negative results of cytotoxicity, genotoxicity

In conclusion, the negative results of cytotoxicity, genotoxicity and mutagenicity indicated that all the membranes can be employed for medical supplies, mainly in bone tissue engineering/regeneration, due to their osteoinductive properties.”
“The Central Nervous System (CNS) function was shown to be fueled exclusively by oxidative phosphorylation (OXPHOS). This is in line with the sensitivity

of brain to hypoxia, but less with the scarcity of the mitochondria in CNS. Consistently with the ectopic expression of FoF1-ATP synthase and the electron transfer chain in myelin, we have reported data demonstrating see more that isolated myelin vesicles (IMV) conduct OXPHOS. It may suggest that myelin sheath could be a site for the whole aerobic degradation of glucose.\n\nIn this paper, we assayed the functionality of glycolysis and of TCA cycle enzymes in IMV purified from bovine forebrain. We found the presence and activity of all of the glycolytic and TCA cycle enzymes, comparable to those in mitochondria-enriched Selleck GSK2126458 fractions, in the same experimental conditions. IMV also contain consistent carbonic anhydrase activity.\n\nThese data suggest

that myelin may be a contributor in energy supply for the axon, performing an extra-mitochondrial aerobic OXPHOS. The vision of myelin as the site of aerobic metabolism may shed a new light on many demyelinating pathologies, GW786034 that cause an a yet unresolved axonal degeneration and whose clinical onset coincides with myelin

development completion. (C) 2013 Elsevier Masson SAS. All rights reserved.”
“Background: The aim of this study was to determine whether immobilization of an arm has detrimental effects on driving performance.\n\nMethods: Thirty-six healthy officers-in-training were assigned a sequence of fiberglass splints (left and right-sided 3 above-the-elbow thumb spica and below-the-elbow splints) with use of a randomized higher-order crossover design. Runs were scored on a cone-marked driving course used for officer certification with predetermined passing requirements. Driving time, the number of cones hit per course section, and the cone-adjusted total time (a five-second penalty per hit cone) were recorded. A linear mixed-effect model with random environmental and learning effects for cone-adjusted time analysis was used. Participants rated perceived driving difficulty and safety with each splint, and ratings were compared with the Wilcoxon signed-rank test.\n\nResults: Thirty participants completed the entire set of runs. Analysis of total cone-adjusted time revealed a significant performance decrease with the left arm in an above-the-elbow thumb spica splint (average, 22.2 seconds; p < 0.001) and with the left arm in a below-the-elbow splint (average, 16.2; p = 0.007).