Head and Neck Diseases by Alexandros G.Sfakianakis: 01/18/16

Δευτέρα 18 Ιανουαρίου 2016

How Should We Consider the Risk of Antineutrophil Cytoplasmic Antibody (ANCA)–Positive Small-Vessel Vascul itis Associated with Antithyroid Drug Therapy?

How Should We Consider the Risk of Antineutrophil Cytoplasmic Antibody (ANCA)–Positive Small-Vessel Vasculitis Associated with Antithyroid Drug Therapy?: Clinical Thyroidology Jan 2016, Vol. 28, No. 1: 18-21.

Author information

Jacques Orgiazzi
Balavoine AS, Glinoer D, Dubucquoi S, Wémeau JL. Antineutrophil cytoplasmic antibody-positive small-vessel vasculitis associated with antithyroid drug therapy: how significant is the clinical problem? Thyroid 2015;25:1273-81. Epub October 19 2015.

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Physiological and pathological impact of exosomes of adipose tissue

Abstract

Exosomes are nanovesicles that have emerged as a new intercellular communication system for transporting proteins and RNAs; recent studies have shown that they play a role in many physiological and pathological processes such as immune regulation, cell differentiation, infection and cancer. By transferring proteins, mRNAs and microRNAs, exosomes act as information vehicles that alter the behavior of recipient cells. Compared to direct cell-cell contact or secreted factors, exosomes can affect recipient cells in more efficient ways. In whole adipose tissues, it has been shown that exosomes exist in supernatants of adipocytes and adipose stromal cells (ADSCs). Adipocyte exosomes are linked to lipid metabolism and obesity-related insulin resistance and exosomes secreted by ADSCs are involved in angiogenesis, immunomodulation and tumor development. This review introduces characteristics of exosomes in adipose tissue, summarizes their functions in different physiological and pathological processes and provides the further insight into potential application of exosomes to disease diagnosis and treatment.

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Open-book Splitting of a Distally Based Peroneus Brevis Muscle Flap to Cover Large Leg and Ankle Defects

Background: Large soft-tissue defects in the lower leg and ankle are a major problem for plastic surgeons. Many local flaps that are either proximally or distally based have been previously described to cover small defects. Larger defects may require a distant flap that is either pedicled or free. The peroneus brevis muscle flap is a well-known distally based safe flap that is used to cover a small defect. Methods: Ten distally based peroneus brevis muscle flaps were elevated in 10 patients (8 males and 2 females) with major lower third leg and ankle defects that were 6–12 cm in length and 6–10 cm in width, with open-book splitting of the proximal portion of the muscle to cover these large defects. Results: Flap survival was excellent, and partial skin graft loss in two cases healed with dressing. The average flap length was 10 cm, ranging between 6 and 12 cm. The average flap width was 8 cm, ranging between 6 and 10 cm. The donor site also healed uneventful. Conclusions: Open-book splitting of the distally based peroneus brevis muscle flap is ideally suited for moderate to large defects in the distal third of the lower leg and ankle. This modification of the distally based peroneus brevis muscle flap offers a convincing alternative for covering large defects of up to 12 × 10 cm in the distal leg and ankle region.

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Development of a novel kinetic model for the analysis of PAH biodegradation in the presence of lead and cadmium co-contaminants.

Publication date: 15 April 2016
Source:Journal of Hazardous Materials, Volume 307
Author(s): Michael E. Deary, Chinedu C. Ekumankama, Stephen P. Cummings
We report on the results of a 40 week study in which the biodegradation of 16 US EPA polycyclic aromatic hydrocarbons (PAHs) was followed in microcosms containing soil of high organic carbon content (11%) in the presence and absence of lead and cadmium co-contaminants. The total spiked PAH concentration was 2166mg/kg. Mercury amendment was also made to give an abiotic control.A novel kinetic model has been developed to explain the observed biphasic nature of PAH degradation. The model assumes that PAHs are distributed across soil phases of varying degrees of bioaccessibility. The results of the analysis suggest that overall percentage PAH loss is dependent on the respective rates at which the PAHs (a) are biodegraded by soil microorganisms in pore water and bioaccessible soil phases and (b) migrate from bioaccessible to non-bioaccessible soil phases. In addition, migration of PAHs to non-bioaccessible and non-Soxhlet-extractable soil phases associated with the humin pores gives rise to an apparent removal process. The presence of metal co-contaminants shows a concentration dependent inhibition of the biological degradation processes that results in a reduction in overall degradation. Lead appears to have a marginally greater inhibitory effect than cadmium.

Graphical abstract

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Mechanism of Aloe Vera extract protection against UVA: shelter of lysosomal membrane avoids photodamage

Photochem. Photobiol. Sci., 2016, Accepted Manuscript
DOI: 10.1039/C5PP00409H, Paper
Daniela Rodrigues, Ana Claudia Viotto, Robert G Checchia, Andreza Barbosa Gomide, Rosangela Itri, Divinomar Severino, Mauricio S. Baptista, Waleska Kerllen Martins
The premature aging (photoaging) of skin characterized by wrinkles, leathery texture and mottled pigmentation is a well-documented consequence of exposure to sunlight. UVA is an important risk factor for human…
The content of this RSS Feed (c) The Royal Society of Chemistry

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Accuracy of instructor assessment of chest compression quality during simulated resuscitation

Research Articles
Erin E. Brennan, Robert C. McGraw, Steven C. Brooks
Canadian Journal of Emergency Medicine, FirstView Article(s), 7 pages

Abstract

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Suitability of hair type for dermatophytes perforation and differential diagnosis of T. mentagrophytes from T. verrucosum

Summary

Most of the dermatophyte species have the ability to perforate hair structure and consume its contents of keratin through secretion of keratinase enzyme. Two clinical isolated species of dermatophytes were diagnosed as Trichophyton mentagrophytes var. granulosum and Trichophyton verrucosum. To determine the perforation ability, the isolated fungi were incubated with the hair of four different animals (rabbit, rat, cow and cat) and human hairs with three different colours (black, albino and bleached yellow) for different periods. Variable perforating ability of T. mentagrophytes was shown in rat hair and all types of human hair after 15 days, while other mammalian hairs exhibited resistance to this fungal activity. On the other hand, T. verrucosum was revealed a slow perforating ability, which needed a long time (60 days) for most of tested hairs. Perforation of human black hair could be considered a diagnostic test for differentiation between T. mentagrophytes and T. verrucosum. In conclusion, the treated or untreated human hair was considered more suitable to use as a source of keratin for the growth of dermatophytes than animal hairs. The human black hair was a best type of hair to use in the perforating test for differentiation between T. mentagrophytes and T. verrucosum.

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Global Retinoblastoma Pipeline Review Report for H2 2015 – SYS-CON Media (press release)

Global Retinoblastoma Pipeline Review Report for H2 2015
SYS-CON Media (press release)
Another newly published market research titled Salivary Gland Cancer – Pipeline Review, H2 2015 provides comparative analysis at various stages, therapeutics assessment by drug target, mechanism of action (MoA), route of administration (RoA) and …

and more »

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Molecular genetics of testicular cancer: What does the clinician need to know? https://t.co/2YzxaAYXRf

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Drug-drug interactions in older cancer patients: a report from the 15th meeting of #SIOG, November 2015 https://t.co/C7CrO3efdP @SIOGorg

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Langerhans cell histiocytosis masquerading as hidradenitis suppurativa

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Acquired epidermodysplasia verruciformis associated with human papillomavirus type 47 in a HIV-infected patient

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Wearable scanning photoacoustic brain imaging in behaving rats

A wearable scanning photoacoustic imaging (wPAI) system is presented for noninvasive brain study in behaving rats. This miniaturized wPAI system consists of four pico linear servos and a single transducer-based PAI probe. It has a dimension of 50 mm × 35 mm × 40 mm, and a weight of 26 g excluding cablings. Phantom evaluation shows that wPAI achieves a lateral resolution of ∼0.5 mm and an axial resolution of ∼0.1 mm at a depth of up to 11 mm. Its imaging ability is also tested in a behaving rat, and the results indicate that wPAI is able to image blood vessels at a depth of up to 5 mm with intact scalp and skull. With its noninvasive, deep penetration, and functional imaging ability in behaving animals, wPAI can be used for behavior, cognition, and preclinical brain disease studies.

A wearable scanning photoacoustic imaging (wPAI) system is presented for noninvasive brain study in behaving rats. The results indicate that wPAI is able to image blood vessels at a depth of up to 5 mm with intact scalp and skull. With its noninvasive, deep penetration, and functional imaging ability in behaving animals, wPAI can be used for behavior, cognition, and preclinical brain disease studies.

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Laser-induced capillary leakage for blood biomarker detection and vaccine delivery via the skin

Circulation system is the center for coordination and communication of all organs in our body. Examination of any change in its analytes or delivery of therapeutic drugs into the system consists of important medical practice in today's medicine. Two recent studies prove that brief illumination of skin with a low powered laser, at wavelengths preferentially absorbed by hemoglobin, increases the amount of circulating biomarkers in the epidermis and upper dermis by more than 1,000-fold. When probe-coated microneedle arrays are applied into laser-treated skin, plasma blood biomarkers can be reliably, accurately, and sufficiently quantified in 15∼30 min assays, with a maximal detection in one hr in a manner independent of penetration depth or a molecular mass of the biomarker. Moreover, the laser treatment permits a high efficient delivery of radiation-attenuated malarial sporozoites (RAS) into the circulation, leading to robust immunity against malaria infections, whereas similar immunization at sham-treated skin elicits poor immune responses. Thus this technology can potentially instruct designs of small, portable devices for onsite, in mobile clinics, or at home for point-of-care diagnosis and drug/vaccine delivery via the skin.

This review focuses on a modified form of selective photothermolysis and its potentials in point-of-care diagnosis and in delivering drugs into circulation via the skin. Capillary leakage, rather than rupture, is induced by low energy lasers that are preferably absorbed by hemoglobin, resulting in extravasation of circulating biomarkers and facilitating entrance of drugs into circulation. The extravasated biomarkers can be measured by probe-coated microneedle arrays in the skin.

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Materials, Vol. 9, Pages 57: Advanced Engineering Strategies for Periodontal Complex Regeneration

The regeneration and integration of multiple tissue types is critical for efforts to restore the function of musculoskeletal complex. In particular, the neogenesis of periodontal constructs for systematic tooth-supporting functions is a current challenge due to micron-scaled tissue compartmentalization, oblique/perpendicular orientations of fibrous connective tissues to the tooth root surface and the orchestration of multiple regenerated tissues. Although there have been various biological and biochemical achievements, periodontal tissue regeneration remains limited and unpredictable. The purpose of this paper is to discuss current advanced engineering approaches for periodontal complex formations; computer-designed, customized scaffolding architectures; cell sheet technology-based multi-phasic approaches; and patient-specific constructs using bioresorbable polymeric material and 3-D printing technology for clinical application. The review covers various advanced technologies for periodontal complex regeneration and state-of-the-art therapeutic avenues in periodontal tissue engineering.

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Sustainability, Vol. 8, Pages 43: Designing the Business Models for Circular Economy—Towards the Conceptual Framework

Switching from the current linear model of economy to a circular one has recently attracted increased attention from major global companies e.g., Google, Unilever, Renault, and policymakers attending the World Economic Forum. The reasons for this are the huge financial, social and environmental benefits. However, the global shift from one model of economy to another also concerns smaller companies on a micro-level. Thus, comprehensive knowledge on designing circular business models is needed to stimulate and foster implementation of the circular economy. Existing business models for the circular economy have limited transferability and there is no comprehensive framework supporting every kind of company in designing a circular business model. This study employs a literature review to identify and classify the circular economy characteristics according to a business model structure. The investigation in the eight sub-domains of research on circular business models was used to redefine the components of the business model canvas in the context of the circular economy. Two new components—the take-back system and adoption factors—have been identified, thereby leading to the conceptualization of an extended framework for the circular business model canvas. Additionally, the triple fit challenge has been recognized as an enabler of the transition towards a circular business model. Some directions for further research have been outlined, as well.

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Sensors, Vol. 16, Pages 113: Modeling Sensor Reliability in Fault Diagnosis Based on Evidence Theory

Sensor data fusion plays an important role in fault diagnosis. Dempster–Shafer (D-R) evidence theory is widely used in fault diagnosis, since it is efficient to combine evidence from different sensors. However, under the situation where the evidence highly conflicts, it may obtain a counterintuitive result. To address the issue, a new method is proposed in this paper. Not only the statistic sensor reliability, but also the dynamic sensor reliability are taken into consideration. The evidence distance function and the belief entropy are combined to obtain the dynamic reliability of each sensor report. A weighted averaging method is adopted to modify the conflict evidence by assigning different weights to evidence according to sensor reliability. The proposed method has better performance in conflict management and fault diagnosis due to the fact that the information volume of each sensor report is taken into consideration. An application in fault diagnosis based on sensor fusion is illustrated to show the efficiency of the proposed method. The results show that the proposed method improves the accuracy of fault diagnosis from 81.19% to 89.48% compared to the existing methods.

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Antioxidants, Vol. 5, Pages 4: Comparison of the Pulmonary Oxidative Stress Caused by Intratracheal Instillation and Inhalation of NiO Nanoparticles when Equivalent Amounts of NiO Are Retained in the Lung

NiO nanoparticles were administered to rat lungs via intratracheal instillation or inhalation. During pulmonary toxicity caused by NiO nanoparticles, the induction of oxidative stress is a major factor. Both intratracheal instillation and inhalation of NiO nanoparticles induced pulmonary oxidative stress. The oxidative stress response protein, heme oxygenase-1 (HO-1), was induced by the administration of NiO nanoparticles at both the protein and gene expression level. Additionally, certain oxidative-stress markers in the lung, such as 8-iso-prostaglandin F2α, thioredoxin, and inducible nitric oxide synthase were increased. Furthermore, the concentration of myeloperoxidase (MPO) in the lung was also increased by the administration of NiO nanoparticles. When the amount of NiO in the lung is similar, the responses against pulmonary oxidative stress of intratracheal instillation and inhalation are also similar. However, the state of pulmonary oxidative stress in the early phase was different between intratracheal instillation and inhalation, even if the amount of NiO in the lung was similar. Inhalation causes milder oxidative stress than that caused by intratracheal instillation. On evaluation of the nanoparticle-induced pulmonary oxidative stress in the early phase, we should understand the different states of oxidative stress induced by intratracheal instillation and inhalation.

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Sustainability, Vol. 8, Pages 87: Evaluation and Clustering Maps of Groundwater Wells in the Red Beds of Chengdu, Sichuan, China

Since the start of the 21st century, groundwater wells have been placed in red beds to solve the problem of scarce water resources in Southwest China and have rapidly expanded to other areas. By providing examples of cartography in Chengdu and Sichuan, China, and using the locations of groundwater in fractures and pores when monitoring and managing red sandstone and mudstone wells, a series of maps of groundwater wells at different scales in the red beds of Chengdu was obtained. Most of the wells located in red beds are located in Jintang, Dayi, and Qingbaijiang and exhibit different cluster features. The kernel density estimation and spatial cluster analysis classification methods were used based on the Density Based Spatial Clustering of Applications with Noise algorithm (DBSCAN) in three concentrated areas. This method describes the trends of the clustering results and the relationships between the locations of residents and red bed wells. The cartography results show that the groundwater wells in red beds are mainly distributed in hilly areas and partially correspond with the locations of villages and settlements, particularly their geological and topographic factors, which satisfy the maximum requirements of water use and recycling in Southwest China. The irrigation wells located in red beds are not only reliable and efficient but also replace inefficient water resources in the recharge-runoff-discharge groundwater process, which promotes the sustainable development of groundwater resources.

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Sustainability, Vol. 8, Pages 82: Environmental Capabilities of Suppliers for Green Supply Chain Management in Construction Projects: A Case Study in Korea

Green supply chain management (GSCM) enhances a firm's competitiveness for sustainable growth. GSCM is especially important in the construction industry, a project-based business that often results in heavy environmental pollution. For the successful implementation of GSCM in the construction industry to occur, contractors should make the best use of suppliers' environmental capabilities based on shared understanding of the capabilities. This paper examines the shared understanding of suppliers' environmental management capabilities between the contractor and suppliers by assessing the consistency between the contractor's and suppliers' evaluations of the capabilities. This explorative case study investigates a supply chain comprised of a major construction firm and 106 suppliers in Korea. The results of the case analysis show that the suppliers' self-evaluation scores of environmental capability are higher than the contractor's evaluation scores. Furthermore, from both evaluators, suppliers received the lowest scores in the evaluation item rating the relationship with second-tier suppliers and the highest in the evaluation item rating the relationship with the contractor. The consistency between the suppliers' and contractor's evaluation is related to several characteristics of suppliers, such as industry type, firm size and partnership duration with the contractor. This study contributes to the literature of GSCM and strategic alignment amongst supply chain partners for the construction industry.

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Water, Vol. 8, Pages 21: New Insights on the Simultaneous Removal by Adsorption on Organoclays of Humic Acid and Phenol

The exploitation of thermal water as a heat source in houses and apartments (during winter) is a widely used alternative to natural gas. However, this type of water may contain organic contaminants, which must be removed before releasing the used water into rivers and lakes. Because of the presence of a wide range of pollutants (including phenolic compounds and humates), efficient, cheap removal processes are needed. In order to demonstrate their capability in thermal water cleaning, clay minerals were applied for the removal of phenol and humic acid via adsorption. To determine the most efficient removal strategy for the aforementioned pollutants, the following parameters were investigated: the type of the clay mineral, the organophilization strategy (in situ or pre-organophilization), and the individual or simultaneous removability of the model pollutants. The current study revealed that the applied low cost, in situ prepared clay mineral adsorbents are applicable in the removal of pollutants from thermal water.

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Sensors, Vol. 16, Pages 112: A Time-Aware Routing Map for Indoor Evacuation

Knowledge of dynamic environments expires over time. Thus, using static maps of the environment for decision making is problematic, especially in emergency situations, such as evacuations. This paper suggests a fading memory model for mapping dynamic environments: a mechanism to put less trust on older knowledge in decision making. The model has been assessed by simulating indoor evacuations, adopting and comparing various strategies in decision making. Results suggest that fading memory generally improves this decision making.

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Langerhans cell histiocytosis masquerading as hidradenitis suppurativa

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Acquired epidermodysplasia verruciformis associated with human papillomavirus type 47 in a HIV-infected patient

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IJERPH, Vol. 13, Pages 137: Using a Household Food Inventory to Assess the Availability of Traditional Vegetables among Resettled African Refugees

A cross-sectional sequential explanatory mixed methods study was conducted among household food preparers to examine the association between home availability and consumption of traditional vegetables among resettled African refugees living in Queensland, Australia. Home availability of traditional African vegetables was associated with age, having a vegetable garden, employment status, and having a supermarket in the local neighborhood. Food preparers from homes with low vegetable availability were less likely to consume the recommended number of vegetable servings. Barriers faced in the food environment included language, lack of availability of traditional vegetables and lack of transport. All of these aspects contributed to the study findings that both individual and food environment characteristics may play a role in access to and availability of food and vegetable consumption of resettled refugees. Consumption of traditional foods among the resettled refugees continues post resettlement.

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IJERPH, Vol. 13, Pages 136: Excess Medical Care Costs Associated with Physical Inactivity among Korean Adults: Retrospective Cohort Study

Physical inactivity is a major risk factor for chronic diseases and premature death. The increased health risks associated with physical inactivity may also generate a heavier economic burden to society. We estimated the direct medical costs attributable to physical inactivity among adultsusing data from the 2002–2010 Korean National Health Insurance Service-National Sample Cohort. A total of 68,556 adults whose reported physical activity status did not change during the study period was included for this study. Propensity scores for inactive adults were used to match 23,645 inactive groups with 23,645 active groups who had similar propensity scores. We compared medical expenditures between the two groups using generalized linear models with a gamma distribution and a log link. Direct medical costs were based on the reimbursement records of all medical facilities from 2005 to 2010. The average total medical costs for inactive individuals were $1110.5, which was estimated to be 11.7% higher than the costs for physically active individuals. With respect to specific diseases, the medical costs of inactive people were significantly higher than those of active people, accounting for approximately 8.7% to 25.3% of the excess burden. Physical inactivity is associated with considerable medical care expenditures per capita among Korean adults.

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Ue: si riunisce a Bruxelles il Consiglio Affari esteri, focus su Siria e Iraq – Agenzia Nova (Abbonamento)

Ue: si riunisce a Bruxelles il Consiglio Affari esteri, focus su Siria e Iraq
Agenzia Nova (Abbonamento)
I ministri discuteranno i recenti progressi nell'ambito delle iniziative diplomatiche per porre fine al conflitto interno al paese. Durante l'incontro si farà anche il punto dello stato dei rapporti tra Arabia Saudita e Iran, anche per cercare di …

and more »

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Behavioral Sciences, Vol. 6, Pages 4: A Longitudinal Study of Sexual Entitlement and Self-Efficacy among Young Women and Men: Gender Differences and Associations with Age and Sexual Experience

Many scholars have called for an increased focus on positive aspects of sexual health and sexuality. Using a longitudinal design with two assessments, we investigated patterns of entitlement to sexual partner pleasure and self-efficacy to achieve sexual pleasure among 295 young men and women aged 17–25 years attending one Australian university. We also tested whether entitlement and efficacy differed by gender, and hypothesized that entitlement and efficacy would be higher in older participants and those with more sexual experience. A sense of entitlement to sexual partner pleasure increased significantly over the year of the study, whereas, on average, there was no change in self-efficacy over time. At Time 1 (T1), young women reported more entitlement than young men. Age was positively associated with T1 entitlement, and experience with a wider range of partnered sexual behaviors was concurrently associated with more entitlement and efficacy and was also associated with increased entitlement to partner pleasure and increased self-efficacy in achieving sexual pleasure at T2 relative to T1. A group with the least amount of sexual experience was particularly low in entitlement and efficacy when compared to groups with a history of coital experience. There was no evidence that any association differed between young men and young women. Limitations of the study include a sample of predominantly middle class, Caucasian students at one university and the possibility that students more interested in sex and relationships, and with more sexual experience, chose to participate.

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Forests, Vol. 7, Pages 25: Synthesis and New Observations on Needle Pathogens of Larch in Northern Finland

Needle pathogens of larch (Larix spp.) in the Nordic countries are under-studied. Their incidence in Finland tends to be low and local, and this may be a function of enemy release, since species of larch were introduced to the region. Here, the ecology and incidence of larch needle pathogens and the abiotic factors that also affect larch in northern Finland are reviewed. Field observations and related laboratory analyses during the past 35 years have mainly been obtained near the Kivalo Research Area within the Arctic Circle, Finnish Lapland. The relatively recent introduction of Hypodermella laricis is a primary focus. This pathogen is not only new to Nordic countries, but can cause severe outbreaks, defoliation and crown-thinning in the canopies of all ages of most planted larch species worldwide. Symptoms of H. laricis clearly differ from those of Mycosphaerella laricina; the latter has affected Larix sibirica at high latitudes for decades. The effects of Meria laricis, Lophodermium laricinum, various rust fungi, and wind and frost are also discussed.

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Nutrients, Vol. 8, Pages 48: Cancer Prevention and Health Benefices of Traditionally Consumed Borago officinalis Plants

Nowadays, healthy eating is increasing the demand of functional foods by societies as sources of bioactive products with healthy qualities. For this reason, we tested the safety of the consumption of Borago officinalis L. and its main phenolic components as well as the possibility of its use as a nutraceutical plant to help in cancer prevention. The in vivo Drosophila Somatic Mutation and Recombination Test (SMART) and in vitro HL-60 human cell systems were performed, as well-recognized methods for testing genotoxicity/cytotoxicity of bioactive compounds and plant products. B. officinalis and the tested compounds possess antigenotoxic activity. Moreover, B. officinalis wild type cultivar exerts the most antigenotoxic values. Cytotoxic effect was probed for both cultivars with IC50 values of 0.49 and 0.28 mg·mL−1 for wild type and cultivated plants respectively, as well as their constituent rosmarinic acid and the assayed phenolic mixture (IC50 = 0.07 and 0.04 mM respectively). B. officinalis exerts DNA protection and anticarcinogenic effects as do its component rosmarinic acid and the mixture of the main phenolics presented in the plant. In conclusion, the results showed that B. officinalis may represent a high value plant for pleiotropic uses and support its consumption as a nutraceutical plant.

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Subcutaneous Tissue Expander Placement with Synthetic Titanium-Coated Mesh in Breast Reconstruction: Long-term Results

Summary: A subcutaneous, prepectoral, muscle-sparing approach has been recently described for implant-based breast reconstruction. This is a preliminary series of 2-stage breast reconstructions by means of tissue expander placed subcutaneously with the support of a titanium-coated polypropylene mesh. A pilot series of cases was started in 2012. Inclusion criteria were informed consent, age less than 80 years, normal body mass index (range, 18.5–24.9), no T4 and metastatic cancers, no comorbidities, and nonsmoking patients. Expander losses, infections, seromas, skin/nipple necrosis, wound dehiscence, and reinterventions were registered in follow-up visits. Furthermore, patients were followed up in second-stage procedures and for at least 1 year from implant positioning to collect any surgical complication, reinterventions, cosmetic outcome, and oncological data. Between June 2012 and March 2014, 25 cases were enrolled in the study. Expander/implant loss rate was 0%. Skin/nipple necrosis rate was 4%. Infections rate was 12% after first-stage and 4% after second-stage procedure. Seromas rate was 0%. Five (20%) fat graft procedures were performed over the expander before second-stage reconstruction, and no reinterventions were required after second stage. Patients mean score was 99 for cosmetic outcome satisfaction, in a 0–100 scale. Subcutaneous 2-stage reconstruction with synthetic mesh proved safe and feasible. Patients satisfaction is very good after 14 months median follow-up form definitive implant placement. Although the present study involved only a small number of cases, a tissue-expander subcutaneous reconstruction seems to have promising results. Whenever pectoralis major muscle can be spared, a conservative reconstruction might be an option.

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Mechanobiology and Mechanotherapy of Adipose Tissue-Effect of Mechanical Force on Fat Tissue Engineering

Summary: Our bodies are subjected to various mechanical forces, which in turn affect both the structure and function of our bodies. In particular, these mechanical forces play an important role in tissue growth and regeneration. Adipocytes and adipose-derived stem cells are both mechanosensitive and mechanoresponsive. The aim of this review is to summarize the relationship between mechanobiology and adipogenesis. PubMed was used to search for articles using the following keywords: mechanobiology, adipogenesis, adipose-derived stem cells, and cytoskeleton. In vitro and in vivo experiments have shown that adipogenesis is strongly promoted/inhibited by various internal and external mechanical forces, and that these effects are mediated by changes in the cytoskeleton of adipose-derived stem cells and/or various signaling pathways. Thus, adipose tissue engineering could be enhanced by the careful application of mechanical forces. It was shown recently that mature adipose tissue regenerates in an adipose tissue-engineering chamber. This observation has great potential for the reconstruction of soft tissue deficiencies, but the mechanisms behind it remain to be elucidated. On the basis of our understanding of mechanobiology, we hypothesize that the chamber removes mechanical force on the fat that normally impose high cytoskeletal tension. The reduction in tension in adipose stem cells triggers their differentiation into adipocytes. The improvement in our understanding of the relationship between mechanobiology and adipogenesis means that in the near future, we may be able to increase or decrease body fat, as needed in the clinic, by controlling the tension that is loaded onto fat.

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Open-book Splitting of a Distally Based Peroneus Brevis Muscle Flap to Cover Large Leg and Ankle Defects

Microvascular Staged Phalloplasty Preserving Original Glans in a Severe Hypospadias: A Case Report

Summary: Penile reconstruction is usually performed in patients with gender dysphoria; with penile loss because of trauma, infection, and tumors; and with congenital deformities like severe hypospadias, in which standard techniques do not achieve a good result. Hypospadias are one of the most common inherent genital anomalies in boys. Many surgical procedures have been published for total phallic reconstruction aiming at a functionally and aesthetically pleasing. We present a case of reconstruction of the penis in a severe hypospadias in a 40-year-old man by transferring the original glans to the forearm flap and a stiffening procedure with an osteocutaneous fibular flap 3 months after first surgery. Three months postoperatively, the final result was an acceptable sexual intercourse, normal voiding, and quite normal appearance. Microvascular staged phalloplasty preserving original glans in a severe hypospadia could be considered a surgical option for micropenis. Technical difficulties and microsurgical advanced skills are the main drawback of this approach.

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Primary Squamous Cell Carcinoma Arising from a Breast Implant Capsule

Summary: Primary squamous cell carcinoma (SCC) of the breast comprises less than 0.1% of all breast cancers. Literature review reveals only 1 reported case of an SCC arising from the capsule of a breast implant. The authors describe, herein, a primary SCC arising from the capsule of a long-standing silicone breast implant.

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Total Single-Stage Autologous Breast Reconstruction with Free Nipple Grafts

Summary: Outstanding results are difficult to achieve in postmastectomy reconstructions in obese ptotic patients. We describe an autologous single-stage reconstruction with free nipple grafts that is best suited for these difficult patients. This technique allows for delayed volume supplementation with implants or fat grafting but does not commit the patient to additional surgery. It avoids the common complications of immediate implant-based reconstructions. This technique is also an excellent option in patients with a known requirement for radiotherapy as it does not sacrifice a valuable autologous flap nor does it subject the patient to capsular contracture, infection, and extrusion. It also obviates the psychological trauma that many women suffer awaiting a reconstruction after radiotherapy. We believe it should be considered as a first-line reconstructive option.

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Technical Improvements to a Rat Brachial Plexus Avulsion Model via a Posterior Surgical Approach

No abstract available

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Free Pulp Transfer for Fingertip Reconstruction—The Algorithm for Complicated Allen Fingertip Defect

Background: We present a review of all the cases of free toe pulp transfer and an algorithm for application of free pulp transfer in complicated Allen fingertip defect. Methods: Seventeen patients underwent free toe pulp transfer for fingertip reconstruction by the senior author. Twelve cases were Allen type II with oblique pulp defect, 4 were Allen type III, and 1 patient had 2 fingertip injuries classified both as type IV. According to the algorithm presented, for the type III defects where the germinal matrix is still preserved, we use free pulp transfer and nail bed graft to preserve the nail growth instead of toe to hand transfer. For the type IV injuries with multiple defects, a combination of web flap from both big toe and second toe is possible for 1-stage reconstruction. Results: All pulp flaps survived completely. Static 2-point discrimination ranged from 6 to 15 mm (mean: 10.5 mm). No patient presented dysesthesia, hyperesthesia, pain at rest, or cold intolerance. The donor site did not present any nuisances apart from partial skin graft loss in 3 cases. Conclusions: We tried to classify and modify the defects' reconstruction according to Allen classification. Free toe pulp transfer is a "like with like" reconstruction that provides sensate, glabrous skin with good color and texture match for fingertip trauma, and minimal donor site morbidity compared with traditional toe to hand transfer.

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“Walk the Rim, Feel the Bone” Technique in Superior Sulcus Filling

Summary: Superior sulcus filler injection is a nonsurgical method to rejuvenate the upper face. Blindness and stroke are devastating complications of facial filler injection. This study describes an injection technique that minimizes the risk of blindness and includes a case study demonstrating the cosmetic benefits of this procedure. To avoid retrograde injection of filler embolus into the ophthalmic artery, we advocate a "'walk the rim, feel the bone" approach. Small boluses of hyaluronic acid filler are given in preperiosteal plane, avoiding the superior orbital foramen.

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Safety and Efficacy of Stabilized Hyaluronic Acid Gel for Breast Enhancement

Summary: Long-term follow-up data following 2 breast enhancement treatments with stabilized hyaluronic acid (HA) gel are limited. Although HA gel is no longer marketed for breast enhancement, there is a clinical need for information about follow-up of previously treated women. A multicenter, noncomparative study was conducted in women seeking breast enhancement. Subjects received 1 treatment of HA gel (maximum, 100 mL/breast); a subgroup underwent retreatment 9 months later. Follow-up was conducted for 24 months after last treatment; endpoints included magnetic resonance imaging for estimation of gel degradation, adverse events, breast examinations, Global Esthetic Improvement Scale, and satisfaction ratings. Seventy-one subjects received 1 treatment, with 22 (31%) receiving retreatment after 9 months. Twenty-four months after last treatment, the mean percentage of remaining gel was 17% in the single-treatment group and 21% in the retreatment group; complete degradation had not occurred in any subject. The most commonly reported treatment-related adverse events were implant-site nodules, medical device implantation events, capsular contracture associated with breast implant, and injection-site nodules; most were mild to moderate and required no intervention. Based on subject Global Esthetic Improvement Scale ratings, 36% of breasts in the single- treatment group and 50% of breasts in the retreatment group were improved 24 months after last treatment, but subject satisfaction had returned to baseline levels. Some gel remained in all subjects 24 months after last treatment. Although single treatment and retreatment were generally well tolerated, physicians need to be aware of common treatment-related complications to manage them adequately.

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Response to Video Capture of Plastic Surgery Procedures Using the GoPro HERO 3+: Patient Privacy and Compliance

No abstract available

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Subcutaneous Direct-to-Implant Breast Reconstruction: Surgical, Functional, and Aesthetic Results after Long-Term Follow-Up

Background: Direct-to-implant breast reconstruction can be achieved more easily by means of soft-tissue replacement devices such as dermal matrices and synthetic meshes. The feasibility of a subcutaneous approach has been recently investigated by some studies with different devices functioning as implant support. Aim of this study is to analyze the long-term results, both objective and subjective, of a previous nonrandomized trial comparing prepectoral (subcutaneous) and retropectoral breast reconstructions. Methods: Patients enrolled in a nonrandomized prospective trial, comparing the standard retropectoral reconstruction and the prepectoral subcutaneous approach, using a titanium-coated mesh in both techniques, were followed up and evaluated for long-term results. Cases were compared in terms of the causes and rate of reinterventions, of the postoperative BREAST-Q questionnaire results, and of an objective surgical evaluation. Results: The subcutaneous group had a rate of implant failure and removal of 5.1% when compared with 0% in the retropectoral group. Aesthetic outcome was significantly better for the subcutaneous group both at a subjective and at an objective evaluation. Capsular contracture rate was 0% in the subcutaneous group. Conclusions: A higher rate of implant failure and removal, although not significant, always because of skin flaps and wound problems, should be taken into account for a careful patients selection. The subcutaneous breast reconstruction shows good long-term results. A coherent subjective and objective cosmetic advantage of this approach emerges. Moreover, no capsular contracture is evident, albeit in a relatively limited number of cases.

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The Role of Embryologic Fusion Planes in the Invasiveness and Recurrence of Basal Cell Carcinoma: A Classic Mix-Up of Causation and Correlation

Background: The facial embryologic fusion planes as regions of mesenchymal and ectodermal fusion of the primordial facial processes during embryological development have been suggested to influence the spread, invasiveness, pathogenesis, and recurrence of cutaneous carcinoma. This study sought to establish whether basal cell carcinoma (BCC) originating in embryologic fusion planes has a greater propensity for earlier depth of invasion, leading to an increased rate of lesion recurrence. Methods: Facial BCCs excised in a single surgeon practice over 2 years were allocated into 2 anatomic domains according to their correlation with embryologic fusion planes. Lesion depth of invasion, surface area, and margins of excision were analyzed in conjunction with recurrence data over the following 70–80 months. Results: Of the 331 lesions examined, 70 were located in embryologic fusion planes. No difference was found in the mean surface area and depth of invasion for lesions located in the 2 domains (P > 0.05). Ten lesion recurrences were identified, none of which were located in embryologic fusion planes. Recurrent lesions were excised with a significantly greater percentage of close and incomplete excision margins (P

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Novel Principles and Techniques to Create a Natural Design in Female Hairline Correction Surgery

Background: Female hairline correction surgery is becoming increasingly popular. However, no guidelines or methods of female hairline design have been introduced to date. Methods: The purpose of this study was to create an initial framework based on the novel principles of female hairline design and then use artistic ability and experience to fine tune this framework. An understanding of the concept of 5 areas (frontal area, frontotemporal recess area, temporal peak, infratemple area, and sideburns) and 5 points (C, A, B, T, and S) is required for female hairline correction surgery (the 5A5P principle). The general concepts of female hairline correction surgery and natural design methods are, herein, explained with a focus on the correlations between these 5 areas and 5 points. Results: A natural and aesthetic female hairline can be created with application of the above-mentioned concepts. Conclusion: The 5A5P principle of forming the female hairline is very useful in female hairline correction surgery.

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A Prospective Study Assessing Complication Rates and Patient-Reported Outcomes in Breast Reconstructions Using a Novel, Deep Dermal Human Acellular Dermal Matrix

Background: The value proposition of an acellular dermal matrix (ADM) taken from the deep dermis is that the allograft may be more porous, allowing for enhanced integration and revascularization. In turn, this characteristic may attenuate complications related to foreign body reactions, seromas, and infection. However, this is juxtaposed against the potential loss of allograft structural integrity, with subsequent risk of malposition and extrusion. Despite the active use of novel, deep dermal ADMs, the clinical outcomes of this new technology has not been well studied. Methods: This is a prospective study to evaluate surgical and patient-reported outcomes using a deep dermal ADM, FlexHD Pliable. Surgical outcomes and BREAST-Q patient-reported outcomes were evaluated postoperatively at 2- and 6-month time points. Results: Seventy-two breasts (41 patients) underwent reconstruction. Complication rate was 12.5%, including 2 hematomas and 7 flap necroses. One case of flap necrosis led to reconstructive failure. Notably, there were no cases of infection, seroma, or implant extrusion or malposition. Average BREAST-Q scores were satisfaction with outcome (70.13 ± 23.87), satisfaction with breasts (58.53 ± 20.00), psychosocial well being (67.97 ± 20.93), sexual well being (54.11 ± 27.72), and physical well being (70.45 ± 15.44). Two-month postoperative BREAST-Q scores decreased compared with baseline and returned to baseline by 6 months. Postoperative radiation therapy had a negative effect on satisfaction with breasts (P = 0.004) and sexual well being (P = 0.006). Conclusions: Deep dermal ADM is a novel modification of traditional allograft technology. Use of the deep dermal ADM yielded acceptably low complication rates and satisfactory patient-reported outcomes.

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A Multisite Study of Oral Clefts and Associated Abnormalities in Thailand: The Epidemiologic Data

Background: This study aimed to obtain epidemiological data of birth incidences of cleft lips and/or cleft palates (CLP) in the Thai population with associated risk factors. Methods: The data were collected for a period of 12 months between 2003 and 2004 for infants' deliveries with CLP and associated risk factors in all hospitals of 6 provinces from 4 regions of Thailand. The birth incidence, related factors with cleft birth, and linkage with geographical area were analyzed by the geographic information system. Results: Phitsanulok, Saraburi, and Khon Kaen had higher birth incidences for CLP of 2.01, 1.69, and 1.66 per 1000 live births, respectively, and the overall birth incidence was 1.51 per 1000 live births. There were a total of 112 cleft births (61 males and 51 females) with 43 cleft lips, 18 cleft palates, and 51 cleft lips + cleft palates. The northeast region had infants with different gestational ages at birth and mothers with higher intakes of vitamins and a use of vitamin A supplement or retinoic acid than others. A use of folic acid supplement was low in all 4 regions. Conclusions: The varied incidence of CLP may reflect the incomplete accuracy of case ascertainment. A number of challenges were addressed. The geographic information system was helpful for more background investigation and planning of cleft care management. Our study enables future studies of etiological factors and future birth registries.

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Costal Grafting in Mandibular Reconstruction

Background: Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery, and free fibular flap is the gold standard for this indication. However, there are alternatives; nonvascular bone grafting is one of them, and we present the costal grafting for mandibular reconstruction, a classic technique that is reliable, efficient, and produced less morbidity than the technique of using composite free flaps. Method: A 9-year retrospective review of 54 patients treated surgically for mandibular reconstruction was performed. The criterion mainly analyzed was graft survival. The surgical technique was described in detail. Results: A total of 54 patients with mandibular bone defect were identified. Five symphysis, 46 corpus, and 20 ramus defects were considered. These patients underwent reconstruction by costal grafting, and the engrafting was successful in 92.6% of cases. Dental rehabilitation with dental implants was realized in 70% of cases. Conclusions: The approach described in this article allowed the authors to obtain good results with costal grafting for mandibular reconstruction and dental rehabilitation. Costal grafting is a good alternative for fibula free flap in specific indications. Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery. Since the 1980s, the gold standard for these defects is the use of free fibular flap.1 In some cases, this technique is contradicted; the surgeon then has several possibilities for the use of free osteomyocutaneous flaps (iliac crest, scapula, and serrato-costal flaps).2–8

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IJERPH, Vol. 13, Pages 137: Using a Household Food Inventory to Assess the Availability of Traditional Vegetables among Resettled African Refugees

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IJERPH, Vol. 13, Pages 136: Excess Medical Care Costs Associated with Physical Inactivity among Korean Adults: Retrospective Cohort Study

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Materials, Vol. 9, Pages 53: Bottom-Up Synthesis and Sensor Applications of Biomimetic Nanostructures

The combination of nanotechnology, biology, and bioengineering greatly improved the developments of nanomaterials with unique functions and properties. Biomolecules as the nanoscale building blocks play very important roles for the final formation of functional nanostructures. Many kinds of novel nanostructures have been created by using the bioinspired self-assembly and subsequent binding with various nanoparticles. In this review, we summarized the studies on the fabrications and sensor applications of biomimetic nanostructures. The strategies for creating different bottom-up nanostructures by using biomolecules like DNA, protein, peptide, and virus, as well as microorganisms like bacteria and plant leaf are introduced. In addition, the potential applications of the synthesized biomimetic nanostructures for colorimetry, fluorescence, surface plasmon resonance, surface-enhanced Raman scattering, electrical resistance, electrochemistry, and quartz crystal microbalance sensors are presented. This review will promote the understanding of relationships between biomolecules/microorganisms and functional nanomaterials in one way, and in another way it will guide the design and synthesis of biomimetic nanomaterials with unique properties in the future.

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