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Many surgical strategies aim to treat the symptomatic neuroma of the superficial branch of the radial nerve (SBRN). It is still difficult to treat despite many attempts to reveal a reason for surgical treatment failure. The lateral antebrachial cutaneous nerve (LACN) is known to overlap and communicate with SBRN. Our study aims to determine the frequency of spreading of LACN fibers into SBRN branches through a microscopic dissection to predict where and how often LACN fibers may be involved in SBRN neuroma. Eighty-seven cadaveric forearms were thoroughly dissected. The path of LACN fibers through the SBRN branching was ascertained using microscopic dissection. Distances between the interstyloid line and entry of LACN fibers into the SBRN and emerging and bifurcation points of the SBRN were measured. The LACN fibers joined the SBRN at a mean distance of 1.7 ± 2.5 cm proximal to the interstyloid line. The SBRN contained fibers from the LACN in 62% of cases. Most commonly, there were LACN fibers within the SBRN's third branch (59%), but they were also observed within the first branch, the second branch, and their common trunk (21%, 9.2%, and 22%, respectively). The lowest rate of the LACN fibers was found within the SBRN trunk (6.9%). The SBRN contains LACN fibers in almost 2/3 of the cases, therefore, the denervation of both nerves might be required to treat the neuroma. However, the method must be considered based on the particular clinical situation. [Display omitted] [ABSTRACT FROM AUTHOR]

The public health crisis of chronic pain has only increased in recognition since the Institute of Medicine's (IOM) Relieving Pain in America (2011) called for a cultural transformation in the way pain is viewed, treated, and put forward specific recommendations for action. The National Pain Strategy (NPS) provides a roadmap for putting these recommendations into practice. We implemented a program that placed nurses and behavioral specialists at the head of an interdisciplinary team utilizing best practices. In this program, nurses enacted the NPS recommendations to advance care for patients with persistent pain on long-term opioid treatment. This program promoted professional growth in nurses along with fostering success for patients. Compared with patients receiving usual care, patients in the program achieved greater reductions in pain severity, pain-related disability, and pain-related functional interference and reported greater satisfaction with pain-related care and primary care services. This article will detail the NPS-aligned practice approaches these nurses and their teams used, describe the training for the nurses, and speak to opportunities to enhance the nurse's capacity for this role in hopes of providing a model for the future implementation of an NPS-based approach by nurses. [ABSTRACT FROM AUTHOR]

The sural nerve is a somatosensory nerve that provides sensation to the posterolateral aspect of the lower leg and the lateral part of the ankle and foot. Due to its location and anatomical properties, it is often used as an autologous nerve graft. However, the nerve harvest can be complicated by the presence of side branches. The objective of this study was to investigate the anatomy of the sural nerve and to map its side branches. This information can be used to predict the localization of separate incisions during the stair-step incisions technique for nerve harvest, thereby reducing the risk of complications. The study involved the dissection of 50 adult cadaveric legs (25 left and 25 right) obtained from 27 Central European cadavers. The focus of the dissection was to identify the sural nerve, small saphenous vein, and surrounding anatomical structures. Detailed measurements were taken on the side branches of the sural nerve, tributaries of the small saphenous vein, and their interrelationship. The average number of sural nerve side branches in a single leg was 4.2±1.9. These side branches were categorized into six groups based on their location and course: mediodistal, medioproximal, lateroproximal, laterodistal, medial perpendicular, and lateral perpendicular. Specific patterns of combination of these side branches were also identified and described. The branching point of the sural nerve was found to be 5.8±2.7 cm proximal to the lateral malleolus, whereas the small saphenous vein branching point was located more distally, 4.5 ± 2.8 cm proximal to the lateral malleolus. The highest density of sural nerve side branches was found 2.1–6.0 cm above the lateral malleolus. This study presents valuable data about the relationship between the sural nerve and the surrounding anatomical structures in the distal part of the leg, including the identification of its side branches and their relevance during nerve harvest procedures. On the basis of the most frequent locations of side branches, a three-incision-technique for nerve harvest is proposed. • The average number of sural nerve side branches in a distal leg was 4.2 ± 1.9. • Three specific patterns of combination of these side branches were identified and described. • The branching point of the sural nerve was found to be 5.8 ± 2.7 cm proximal to the lateral malleolus. • The highest density of sural nerve side branches was found 2.1–6.0 cm above the lateral malleolus. • A three-incision-technique for the sural nerve harvest has been proposed. [ABSTRACT FROM AUTHOR]

• Exercise induces significant hemoconcentration. • Postexercise increase in hs-cTnI is due to hemoconcentration only. • NT-proBNP, MR-proANP, MR-proADM, and copeptin show exercise-induced changes independent of hemoconcentration. • Biomarker assessment immediately after exercise does not improve prognostic stratification. [ABSTRACT FROM AUTHOR]

• Proposing the ANN-based prediction model to forecast future blood glucose level given CGM as the single input. • Utilizing time-domain features as additional attributes for proposed prediction model to improve the prediction accuracy. • By integrating time-domain features as additional attributes, it has improved majority of performance of models. • Proposed model outperformed other ML models and other models from previous studies, especially for short term forecasting. Predicting future blood glucose (BG) levels for diabetic patients will help them avoid potentially critical health issues. We demonstrate the use of machine learning models to predict future blood glucose levels given a history of blood glucose values as the single input parameter. We propose an Artificial Neural Network (ANN) model with time-domain attributes to predict blood glucose levels 15, 30, 45 and 60 min in the future. Initially, the model's features are selected based on the previous 30 min of BG measurements before a trained model is generated for each patient. These features are combined with time-domain attributes to give additional inputs to the proposed ANN. The prediction model was tested on 12 patients with Type 1 diabetes (T1D) and the results were compared with other data-driven models including the Support Vector Regression (SVR), K-Nearest Neighbor (KNN), C4.5 Decision Tree (DT), Random Forest (RF), Adaptive Boosting (AdaBoost) and eXtreme Gradient Boosting (XGBoost) models. Our results show that the proposed BG prediction model that is based on an ANN outperformed all other models with an average Root Mean Square Error (RMSE) of 2.82, 6.31, 10.65 and 15.33 mg/dL for Prediction Horizons (PHs) of 15, 30, 45 and 60 min, respectively. Our testing showed that combining time-domain attributes into the input data resulted in enhanced performance of majority of prediction models. The implementation of proposed prediction model allows patients to obtain future blood glucose levels, so that the preventive alerts can be generated before critical hypoglycemic/ hyperglycemic events occur. [ABSTRACT FROM AUTHOR]

Most studies of Lake Michigan lake trout (Salvelinus namaycush) have focused on adults, with scant attention to juveniles (<400 mm). We explored the spatial distribution and diet of juvenile lake trout using U.S. Geological Survey September bottom trawl data (2015–2022) and stomach content information opportunistically collected since 2012 by various agencies using multiple gear types. Most juvenile lake trout in the September bottom trawl survey were caught at 37–64 m bottom depths. Length frequency data from the bottom trawl survey identified three size classes likely associated with wild juvenile lake trout age: < 85 mm (∼age-0), 85–170 mm (∼age-1) and > 170 mm (∼age-2+). Largest catches of wild lake trout < 170 mm occurred along a northeastern transect (near Frankfort, Michigan), whereas most > 170 mm were collected along southern transects. Mysis diluviana was the dominant prey for juvenile lake trout < 170 mm, and > 250 mm were primarily piscivorous, while 170–250 mm appeared to be a transitional period of switching from Mysis to fish. Species composition of prey fishes consumed by lake trout varied spatially and we found evidence of seasonal and annual diet variation within Grand Traverse Bay. Diporeia , once an important component of juvenile lake trout diet, appears to no longer be consumed by juvenile lake trout in Lake Michigan to any measurable degree. Continued research on the ecology of juvenile lake trout may provide insight into the effects of a changing ecosystem on juvenile lake trout diet and growth, thereby contributing to the effort to rehabilitate the Lake Michigan lake trout population. [ABSTRACT FROM AUTHOR]

The lateral antebrachial cutaneous nerve (LACN) is a somatosensory nerve coursing in the lateral portion of the forearm. The nerve is located in a close proximity to the cephalic vein (CV) all along its course with a danger of being injured during venipuncture. The LACN also overlaps and communicates with the superficial branch of the radial nerve (SBRN) in the distal forearm and hand, making the awareness of their relationship of great importance in the treatment of neuroma. The aim of the study was to observe the relationship of the LACN to surrounding structures as well as its branching pattern and distribution. Ninety-three cadaveric forearms embalmed in formaldehyde were dissected. The relationship of the LACN to surrounding structures was noted and photographed, and distances between the structures were measured with a digital caliper. The cross-sectional relationships of the LACN and SBRN to the CV were described using heatmaps. The emerging point of the LACN was found distally, proximally or at the level of the interepicondylar line (IEL). The LACN branched in 76 cases (81.7 %) into an anterior and posterior branch at mean distance of 47.8 ± 34.2 mm distal to the IEL. The sensory distribution was described according to the relationship of the LACN branches to the medial border of the brachioradialis muscle. The LACN supplying the dorsum of the hand was observed in 39.8 % of cases. The LACN and the SBRN intersected in 86 % of upper limbs with communications noticed in 71 % of forearms. The LACN was stated as the most frequent donor of the communicating branch resulting in neuroma located distal to the communication and being fed from the LACN. The relationship of the LACN and the CV showed that the IEL is the most appropriate place for the venipuncture due to maximal calibers of the CV and deep position of the LACN. The LACN was adjacent to the cubital perforating vein and the radial artery in all cases. The medial border of the brachioradialis muscle was observed less than 1.8 mm from the LACN. The study provides morphological data on the LACN distribution, branching pattern and relationship to surrounding structures in a context of clinical use in different spheres of medicine. The branching pattern of the LACN appears to be more constant compared to data provided by previous authors. We emphasized the meaning of cross-sectional relationship of the LACN to the CV to avoid venipuncture outside the cubital fossa if possible. The posterior branch of the LACN was predicted as appropriate donor of the graft for a digital nerve. The LACN appeared to be in a close proximity within the whole length of the brachioradialis muscle what the orthopedic surgeons must be concerned of. The meaning of the donor-nerve of the communicating branch in neuroma treatment was also introduced. • The lateral antebrachial cutaneous nerve is in close proximity to the brachioradialis muscle along the whole forearm. • Its anterior branch is proximally associated with the cephalic vein and distally with the radial artery. • Its posterior branch is associated with the cephalic vein along the whole forearm. • Its posterior branch is an appropriate donor of the graft for the digital nerve. • Donor nerve of the communicating branch in neuroma must be treated as well. [ABSTRACT FROM AUTHOR]

Ocean acidification (OA) and high light was found to negatively affect the Antarctic key species Phaeocystis antarctica , Fragilariopsis kerguelensis and Chaetoceros debilis. To unravel the underlying physiological response at the transcriptomic level, these species were grown under ambient and elevated pCO 2 combined with low or high light. RNA sequencing revealed that the haptophyte was much more tolerant towards OA than the two diatoms as only these showed distinct OA-dependent gene regulation patterns. Under ambient pCO 2 , high light resulted in decreased glycolysis in P. antarctica. Contrastingly, upregulation of genes related to cell division and transcription as well as reduced expression of both cata- and anabolic carbon related pathways were seen in C. debilis. OA in combination with low light led to reduced respiration, but also surprisingly to higher expression of genes involved in light protection, transcription and translation in C. debilis. Though not affecting P. antarctica , OA combined with high light caused also photosensitivity in both diatoms. As additional response reallocation of carbon to lipids was found in C. debilis under these conditions. Overall, we conclude that P. antarctica is better adapted than the two diatoms to OA and high light. [ABSTRACT FROM AUTHOR]

The application of tandem MALDI-TOF MS screening with 16S rRNA gene sequencing of selected isolates has been demonstrated to be an excellent approach for retrieving novelty from large-scale culturing. The application of such methodologies in different hypersaline samples allowed the isolation of the culture-recalcitrant Salinibacter ruber second phylotype (EHB-2) for the first time, as well as a new species recently isolated from the Argentinian Altiplano hypersaline lakes. In this study, the genome sequences of the different species of the phylum Rhodothermaeota were compared and the genetic repertoire along the evolutionary gradient was analyzed together with each intraspecific variability. Altogether, the results indicated an open pan-genome for the family Salinibacteraceae , as well as the codification of relevant traits such as diverse rhodopsin genes, CRISPR-Cas systems and spacers, and one T6SS secretion system that could give ecological advantages to an EHB-2 isolate. For the new Salinibacter species, we propose the name Salinibacter altiplanensis sp. nov. (the designated type strain is AN15 T = CECT 9105 T = IBRC-M 11031 T ). [ABSTRACT FROM AUTHOR]

Prior studies have shown disparities in utilization of primary and revision total hip arthroplasty (THA). However, little is known about patient population differences associated with elective and nonelective surgery. Therefore, the aim of this study was to explore factors that influence primary utilization and revision risk of THA based on surgery indication. Data were obtained from 7,543 patients who had a primary THA from 2014 to 2020 in a database, which consists of multiple health partner systems in Louisiana and Texas. Of these patients, 602 patients (8%) underwent nonelective THA. THA was classified as "elective" or "nonelective" if the patient had a diagnosis of hip osteoarthritis or femoral neck fracture, respectively. After multivariable logistic regression, nonelective THA was associated with alcohol dependence, lower body mass index (BMI), women, and increased age and number of comorbid conditions. No racial or ethnic differences were observed for the utilization of primary THA. Of the 262 patients who underwent revision surgery, patients who underwent THA for nonelective etiologies had an increased odds of revision within 3 years of primary THA (odds ratio (OR) = 1.66, 95% Confidence Interval (CI) = 1.06-2.58, P -value =.025). After multivariable logistic regression, patients who had tobacco usage (adjusted odds ratio (aOR) = 1.36, 95% CI = 1.04-1.78, P -value =.024), alcohol dependence (aOR = 2.46, 95% CI = 1.45-4.15, P -value =.001), and public insurance (OR = 2.08, 95% CI = 1.18-3.70, P -value =.026) had an increased risk of reoperation. Demographic and social factors impact the utilization of elective and nonelective primary THA and subsequent revision surgery. Orthopaedic surgeons should focus on preoperative counseling for tobacco and alcohol cessation as these are modifiable risk factors to directly decrease reoperation risk. • No racial or ethnic differences in utilization of elective or nonelective THA. • Black patients have decreased utilization rates of revision hip arthroplasty. • Hip fracture patients had higher odds of reoperation than elective THA cohort. • No differences in hip arthroplasty reoperation based on BMI. • Smoking and alcohol use are modifiable risk factors for revision surgery. [ABSTRACT FROM AUTHOR]

In teaching and learning human anatomy, anatomical autopsy and prosected specimens have always been indispensable. However, alternative methods must often be used to demonstrate particularly delicate structures. Corrosion casting of porcine organs with Biodur E20 ® Plus is valuable for teaching and learning both gross anatomy and, uniquely, the micromorphology of cardiovascular, respiratory, digestive, and urogenital systems. Assessments of casts with a stereomicroscope and/or scanning electron microscope as well as highlighting cast structures using color coding help students to better understand how the structures that they have observed as two-dimensional images actually exist in three dimensions, and students found using the casts to be highly effective in their learning. Reconstructions of cast hollow structures from (micro-)computed tomography scans and videos facilitate detailed analyses of branching patterns and spatial arrangements in cast structures, aid in the understanding of clinically relevant structures and provide innovative visual aids. The casting protocol and teaching manual we offer can be adjusted to different technical capabilities and might also be found useful for veterinary or other biological science classes. [ABSTRACT FROM AUTHOR]

Lumbrical muscles of the upper limb belong to the middle group of intrinsic hand muscles. Their anatomical variability has been extensively studied with heterogeneous findings. Therefore, the aim of this study is to provide a systematic review and a meta-analysis of the lumbrical muscles variations in the human hand. For this purpose, four major electronic databases were searched to identify eligible studies. Then, all relevant data were extracted, and statistical analysis performed. A new classification of lumbrical muscles variations is proposed to summarize and clearly define all described findings. We included 26 studies, making a total sample of 1340 dissected hands. The most common variations for each muscle were an accessory belly for the first lumbrical muscle, a variable origin for the second lumbrical muscle, a variable innervation for the third lumbrical muscle and a variable insertion for the fourth lumbrical muscle with the prevalence 3.8%; 7.7%; 12% and 5.8%, respectively. We believe that results of our statistical analysis are suitable for both hand surgeons and other medical professionals dealing with hand injuries or functional problems in their daily routine. • A systematic review and a meta-analysis of the lumbrical muscles variations was performed in 1340 dissected hands. • The most common variation of the first lumbrical muscle is an accessory belly (3.8%). • The most common variation of the second lumbrical muscle is a variable origin (7.7%). • The most common variation of the third lumbrical muscle is a variable innervation (12.0%). • The most common variation of the fourth lumbrical muscle is a variable insertion (5.8%). [ABSTRACT FROM AUTHOR]

The subclavius muscle runs underneath the clavicle. However, there have been a few reports of a duplicated subclavius muscle which is commonly referred to as subclavius posticus muscle due to its orientation being posterior to the proper subclavius muscle. Its occurrence seems to potentially create a narrowing interval at the superior thoracic aperture as it crosses over the brachial plexus. It might also have functional influence on the shoulder girdle. To provide comprehensive gross anatomy description of the variant "subclavius posticus muscle" and to investigate its reported clinical implications with emphasis on its involvement in causing brachial plexus compression. A scoping review with meta-analysis of the gross anatomy of the subclavius posticus muscle was conducted along with investigating its correlation to the thoracic outlet syndrome. Forty-seven articles were pooled through two rounds of the selection process. The relevant information was extracted and meta-analyzed. The scoping review and meta-analysis of the 47 articles revealed a total prevalence of 11/2069 (4.9%); 10/1369 (5.1%) in cadaveric studies, and 1/700 (5.0%) in MRI studies. The subclavius posticus muscle is a short triangular muscle with an average length of 12 cm and an average width of 1 cm. It originates from the sternal end of the first rib in most cases with reported variants of one case originating from the costoclavicular ligament and one case where it was fused with the proper subclavius muscle. Its insertion is more variable: on the superior border of the scapula with variable length in 71.35%, on the coracoid process of the scapula in 25.42%, and on the clavicle in 0.90%. The subclavian nerve seems to be the dominant nerve supply with a 57.6% prevalence, while 25.8% are innervated by the suprascapular nerve. Other reported nerves were the nerve to the myolohyoid (4.5%), accessory phrenic nerve (4.5%), and a direct branch from the brachial plexus (2.0%). The blood supply was reported (only once) to be from the suprascapular artery. However, the venous drainage was not established at all. The subclavius posticus muscle is a variant muscle occurring with a reported overall prevalence of 4.9%. It can compress the brachial plexus as it runs across at the space of the superior thoracic aperture with exquisite contact, and this can lead to a neurogenic thoracic outlet syndrome. It also can be involved in the vascular thoracic outlet syndrome. Lastly, it is important not to omit its potential influence in shoulder joint instability to some extent. [Display omitted] [ABSTRACT FROM AUTHOR]

The 2013 American College of Cardiology/American Heart Association guidelines on cholesterol management have placed greater emphasis on high-intensity statin dosing for those with known cardiovascular disease or diabetes mellitus. Differences in risk of hepatotoxicity, new onset diabetes and rhabdomyolysis specifically between the high-intensity statins and the most common moderate-intensity statin, simvastatin, were not found to a significant degree in this review. Rather, baseline characteristics and drug-drug interactions (DDIs) appear to be more important regarding the risk of these adverse effects. Pharmacogenetic differences in statin metabolism may explain individual susceptibility, however genetic testing is not felt to be cost effective at this time. More importantly, statin choice should consider concomitant use of the many prevalent CYP3A4 inhibitors or inducers, and when present, rosuvastatin selection is recommended to reduce DDIs and risk of statin-induced adverse effects. [ABSTRACT FROM AUTHOR]

The anatomy of the brachial plexus has been a subject of interest to many researchers over time resulting in an inconsistent amount of data. Previously, our team had published two evidence-based studies on the anatomical variations involving the brachial plexus, therefore the aim of this study was to analyze the findings regarding the infraclavicular part of the brachial plexus with the use of meta-analytic techniques to complete the comprehensive series. Major scientific databases were extensively searched to compile anatomical studies investigating the morphology of the infraclavicular part of the brachial plexus. Extracted data were classified based on our proposed classification system and subsequently analyzed with the use of random effects meta-analysis to state the pooled prevalence estimates of the distinct variation patterns. A total of 75 studies (4772 upper limbs) were selected for the meta-analysis. The branches of the lateral cord, including the lateral pectoral nerve and musculocutaneous nerve, resembled their usual origin in 76.8% (95% CI 50–96%) and 98.8% (95% CI 98–100%), respectively. The medial pectoral nerve, medial brachial cutaneous nerves, medial antebrachial cutaneous nerve and ulnar nerve emerging from the medial cord were observed originating from their usual origins in 90.9% (95% CI 68–100%), 90.7% (95% CI 73–100%), 87.9% (95% CI 67–99%) and 97.7% (95% CI 94–100%), respectively. Lastly, nerves branching from the posterior cord, including the superior and inferior subscapular nerves, thoracodorsal nerve, axillary nerve and radial nerve, originated as per textbook description in 90.7% (95% CI 80–98%), 76.1% (95% CI 61–89%), 90.1% (95% CI 84–95%), 79.8% (95% CI 68–90%) and 99.0% (95% CI 96–100%), respectively. Moreover, the usual origin of the median nerve from the lateral and medial cord via the corresponding roots was encountered in 89.7% (95% CI 84–95%) of cases. The nerves originating from the infraclavicular part of the brachial plexus exhibit a wide spectrum of possible origins. However, the usual patterns were significantly the most common types present in more than three quarters of cases. Especially clinicians might profit from the enhanced understanding of the brachial plexus anatomy presented herein, since we offer a strong guide for handling the anatomically challenging pathologies in this specific area. [ABSTRACT FROM AUTHOR]

Efficient conservation management must be applied in protected areas in order to slow the loss of biodiversity in Europe. Regarding forests, a conservation approach based on minimal intervention prevails in most protected woodlands, thus facilitating the expansion of closed-canopy forests at the expense of open forests. To identify effective conservation strategies for protected forests, the minimal intervention or “hands-off” approach must be compared with active measures to support biodiversity. We carried out a study in the oak-dominated forests of Podyji National Park (Czech Republic), an historically managed area left for natural succession since 1950. Twelve experimental clearings were created in closed-canopy forests within the core zone of the park; six of these clearings were connected to forest edges and open meadows, the remaining six clearings were isolated from open habitats within closed forest. To assess the importance of minimal intervention and active management measures in protected forests, we compared the richness and composition of insects, reptiles, birds and vascular plants in the clearings and in four reference habitats, including closed forest, forest edge, open forest, and meadow, in the first season following the intervention. In comparison to closed-canopy forest, the clearings had higher species richness of butterflies, saproxylic and floricolous beetles, reptiles, and vascular plants but lower richness of moths and epigeic beetles, and similar richness of birds. For most groups, the species composition of clearings differed from that of closed forest or even the forest edge, indicating that the latter habitats cannot serve as a sufficient replacements for the conservation of open woodland species. The species richness of isolated clearings was generally lower than that of clearings connected to open habitats, and their communities contained a larger proportion of species associated with closed forest. Most threatened species were associated with clearings or open forest, closed forest and meadow hosted only a few. The creation of the clearings in closed-canopy forests had a positive effect on overall species richness and supported threatened species in most model groups. It is thus a valuable management tool in the conservation of temperate woodland biodiversity. Our results also point to the importance of connectivity of open habitats in wooded landscapes. Further surveys of the clearings are needed to ascertain the effect of such interventions to see how communities change throughout succession, or alternatively to what extent hindering succession by repeated cutting may alter communities. [ABSTRACT FROM AUTHOR]

The incidence of tick-borne human diseases (TBD) in the Czech Republic (CZ) is on the increase, driven by infections increasingly acquired in residential locations, earlier in spring and later in autumn, and among children and the elderly. To interpret these trends, data on Lyme borreliosis (LB) incidence between 1997 and 2010 were analysed in the context of population migration flows registered in the CZ during the same period. Analysis showed that a migration stream of families with children, and of the elderly, flowed from more urbanized and densely populated localities to those more rural and less populated, where the chance of acquiring LB in the home vicinity was greater than in the urban settings. By contrast, a stream of people in the life phase between early adulthood and family formation flowed reversely, corresponding to a prominent absence of this age category from the patient spectrum. The data further showed that the more the residential exposure became prevalent, the more people were in year-round (rather than in summertime only) contact with ticks, which accounts for an extension of the cases’ seasonal distribution as well as for an overall increase in case numbers. Finally, the fact that majority of the urban-to-rural migrants could be categorised as wealthier people could explain the previously noticed lack of low-status people among TBD patients in the CZ. [ABSTRACT FROM AUTHOR]

Abstract: Recent rise in tick-borne diseases in many parts of Europe is a phenomenon in need of an explanation. We analyzed temporal trends in spatial distribution of a population at risk of Lyme borreliosis, tick-borne encephalitis, and as a control, also of a ‘non-tick-borne disease’ in the Czech Republic in 1997–2010. Analysis revealed that the population's exposure had been increasingly confined to the nearest surroundings of residences or in totally residential locations and that the incidence of the diseases depended in some causal way on how close to residences people exposed themselves to the risk. The rise in Lyme borreliosis and tick-borne encephalitis was solely due to infections acquired at or near patients’ homes (<5km), while the number of cases acquired further away was decreasing. The detected patterns in the data question some of the hypotheses which may be applicable in explaining the rise in disease incidences in the Czech Republic including the effect of climate change. Potentially causal factors are discussed. [Copyright &y& Elsevier]

Objective: This study aimed (1) to determine whether scanner arm rotation causes significant movement of the head restraint and (2) to measure patient movement and its variation during the scan. Study Design: The iCAT scanner and a high-speed camera were used. The 40 patients were divided into 2 groups: the open-eyed group and the blindfolded group. Results: The mean level of head restraint movement was 0.130 mm, with a significantly higher level at the beginning, probably owing to the accelerating arm. Mean movement of patients was 1.135 mm and 1.119 mm in the open-eyed and blindfolded groups, respectively. Patient movement was also significantly higher at the beginning of the scan, when noise and vibrations are likely to surprise the patient. Conclusions: Patient instruction and a dry-run scan should be done by clinicians. Manufacturers should consider separating the seat and head restraint from the rest of the scanner to avoid vibration transfer. [Copyright &y& Elsevier]

Abstract: Processing and interpreting the face is generally very important because one is often required to make rapid decisions in life on the basis of meagre information. Ninety-two volunteers used a computer-assisted test battery to assess 40 profiles of patients (8 skeletal Class II and 8 skeletal Class III patients, each pre- and postoperatively, with 8 skeletal Class I photographs serving as controls). On a 7-point Likert scale the raters were asked to evaluate aesthetics and a few relevant personality traits (e.g. unintelligent, inhibited, aggressive, brutal). The photographs of the two patient groups were rated significantly less attractive and intelligent prior to surgery than the photographs of the control group. In respect of personality traits, the photographs of the skeletal Class III group differed more strongly from normal ones. In respect of aesthetics and intelligence, both patient groups benefited markedly from surgery. For some personality traits, significant interactions were found between the two groups on pre–post comparison. The method underlying the study is useful for evaluating the outcome of orthognathic surgery, but also indicates the strongly generalized and unconscious processes involved in the estimation of people''s personality traits, especially when these concern deviations from the socially normal condition. [Copyright &y& Elsevier]

Abstract: Grading is the process of subdividing a diagnostic category to increase the amount of information in a histopathology report and so assist clinicians in making individual therapeutic decisions. A good grading system will have a high signal to noise ratio with good inter- and intra-observer agreement. Many grading systems in histopathology have been produced by a top-down design process which does not take into account the natural distribution of cases. Such systems may produce very poor results if the arbitrary boundaries of the grading system do not coincide with the natural boundaries of clusters of cases. This review examines the fundamental processes involved in grading and demonstrates bottom-up design processes which have the potential to produce effective grading systems. [Copyright &y& Elsevier]

The naturally occurring coumestan wedelolactone has been previously shown to reduce growth of various cancer cells. So far, the growth-suppressing effect of wedelolactone has been attributed to the inhibition of the NFκB transcription factor and/or androgen receptors. We found that wedelolactone suppressed growth and induced apoptosis of androgen receptor-negative MDA-MB-231 breast cancer cells at concentrations that did not inhibit the NFκB activity. The cells responded to wedelolactone by the S and G2/M phase cell cycle arrest and induction of the DNA damage signaling. Wedelolactone interacted with dsDNA and inhibited the activity of DNA topoisomerase IIα. We conclude that wedelolactone can act as growth suppressor independently of NFκB and androgen receptors. [ABSTRACT FROM AUTHOR]

Abstract: A marked increase in tick-borne encephalitis (TBE) incidence has been observed in Europe during the last 2 decades. Hypothetical causes include global climatic fluctuations, human-induced environmental changes, and socio-economic changes. These factors are thought to be disproportionately relevant in different geographical areas. To date, epidemiological studies of this phenomenon were based primarily on aggregated data, and little is known about TBE dynamics on the detailed geographical scale. This study is aimed at the subregional variations of incidence of TBE in the Czech Republic. The methodology of spatial statistics was applied. Over 13,000 cases of TBE, registered 1971–2007, were pinpointed on a GIS map and analysed for density variations in both time and space. Selected areas were studied in detail, using time series analysis. These analyses revealed that the incidence of TBE was highly variable both across the country and over the study period. Although the aggregate total of reported cases were generally increasing, local trends were divergent. A detailed study of one endemic area (that one with the highest case density level) showed that heterogeneities are detectable, even on a very fine geographical scale. There was no evident spatial coherence of the TBE trends; and some adjacent areas showed quite differing trends. However, countrywide coherence was demonstrated for quasi-octennial fluctuations in the TBE series, associable with the North Atlantic oscillation. The possible influences of both various climatic and population covariates upon TBE occurrence are discussed. However, the geographical heterogeneity of the disease trends, at such a fine spatial scale, cannot be explained satisfactorily by fluctuations in climatic or socio-economic conditions. [Copyright &y& Elsevier]

Background: Effective and safe access site closure is critical for clinical application of natural orifice transluminal endoscopic surgery. Objective: The current study evaluated a simple novel technique of gastrotomy closure. Design: Feasibility study with a survival animal model. Setting: Animal laboratory. Subjects: Ten female domestic pigs. Interventions: Endoscopic closure of a gastrotomy incision was evaluated in 10 pigs in a survival study. A standard double-channel endoscope was advanced into the peritoneal cavity through an incision made by a needle-knife and an 18-mm dilation balloon. After peritoneoscopy and salpingectomy, gastric closure was performed by using an endoscopic grasper and sequential application of 2 endoloops. After a follow-up period of 1 to 3 weeks, the pigs were killed for postmortem examination. Main Outcome Measurements: Feasibility, efficiency, and safety of a novel closure technique. Results: Correct positioning and delivery of endoloops was achieved in all animals in a median time of 17 minutes (range 13-25 minutes). All animals survived without complications. Postmortem examination demonstrated patent full-thickness gastric closure without any evidence of infection. Limitations: Feasibility study with a small number of subjects in a porcine model. Conclusion: Double endoloop technique represents a novel, simple, safe, and efficient means of gastric access site closure in natural orifice transluminal endoscopic surgery. [Copyright &y& Elsevier]

Abstract: We studied changes in the composition of butterfly and burnet fauna in 25 reserves of xeric grasslands within the city Prague, Czech Republic, based on a recent repetition of a survey conducted three decades ago. The past and recent survey detected 91 and 84 species, 12 species were lost and four were gained between the surveys. There was no significant change in mean numbers of species per reserve or in mean species incidences, even if the categories of the habitat association, mobility and body size were analysed separately. Contrary to these comparisons, ordination analyses indicated a significant shift in species composition in individual reserves. Species of short-sward xeric grasslands tended to be associated with the past survey, whereas species of taller grasslands and xeric scrub were associated with recent survey. These shifts were more prominent in large reserves with high proportion of natural (as opposed to urban) perimeter, connected with other reserves, having diverse topography and high plant and biotope richness. We interpret this by gradual successional changes which affect the reserves despite conservation management. Despite these changes, butterfly losses were lower than in comparable surveys recently conducted elsewhere in Central Europe, partly because major losses occurred long before the 1980s survey and partly owing to a high heterogeneity of the urban landscape surrounding the reserves. [Copyright &y& Elsevier]

Abstract: Reduction of cerebral blood flow by caffeine has been shown in multiple studies. However, the effect of this substance on pathologically dilated cerebral vessels is not clearly defined. The aim of this study was to investigate the effect of caffeine on an already dilated cerebral circulation and specify if these vessels are still able to constrict as a consequence of caffeine stimulation. A second aim of this study was to compare results of cerebral vasomotor CO2 reactivity testing with and without caffeine ingestion. Seventeen healthy adult volunteers had vasomotor reactivity tested before and thirty minutes after ingestion of 300 mg of caffeine. Each vasomotor reactivity test consisted of velocity measurements from both middle cerebral arteries using transcranial Doppler ultrasound during normocapnia, hypercapnia, and hypocapnia. Hemodynamic data and end-tidal CO2 (etCO2) concentration were also recorded. The vasomotor reactivity (VMR) and CO2 reactivity were calculated from a measured data pool. At a level of etCO2 =40 mmHg the resting velocity in the middle cerebral artery (VMCA) dropped from 70.7±22.8 cm/sec to 60.7 ± 15.4 cm/sec 30 minutes after caffeine stimulation (14.1% decrease, p <0.001). During hypercapnia of etCO2 =50 mmHg there was also a significant decline of VMCA from 103.1±25.4 to 91.4±21.8 cm/sec (11.3%, p <0.001). There was not a statistically significant reduction of VMCA during hypocapnia. Calculated VMR and CO2 reactivity before and after caffeine intake were not statistically significant. The presented data demonstrate a significant decrease in cerebral blood flow velocities after caffeine ingestion both in a normal cerebrovascular bed and under conditions of peripheral cerebrovascular vasodilatation. These findings support the important role of caffeine in regulation of CBF under different pathological conditions. Despite significant reactive vasodilatation in the brain microcirculation, caffeine is still able to act as a competitive antagonist of CO2 on cerebral microvessels. The fact that caffeine may decrease CBF despite significant pathological vasodilatation offers the possibility of therapeutic manipulation in patients with traumatic vasoparalysis. For routine clinical testing of CO2 reactivity it is not necessary to insist on pre-test dietary restrictions. [Copyright &y& Elsevier]

Abstract: While transfers of formerly coppiced or grazed woodlands into shady high forests cause severe declines of woodland butterflies across Europe, increasing numbers of wild ungulates contribute to maintaining stand openness. To disentangle the relative effects of management and ungulates, we studied butterfly assemblages in the Milovicky Wood, southeastern Czech Republic. After centuries of short-rotation coppicing, the wood was abandoned in the 1950s and two game parks, for deer and mouflon, were established there in the 1960s. Comparisons of historical and recent records show severe declines, but the wood still hosts 83 butterfly and burnet species, including 19 nationally endangered ones. Recording along fixed transects disentangled effects of game keeping and management. Stands situated in the mouflon park hosted fewer species than those in either the deer park or outside of the parks. Clearings, coppice, coppice with standards and rides hosted more species than closed forest. The strongest predictors of composition of butterfly assemblages were plant communities and stand management, followed by vegetation covers, plant species richness and kind of game (mouflon, deer, none). Both game and management exhibited independent effects. Past high game densities contributed to butterfly losses, but have maintained open structures absent from woods managed for timber. Under reduced densities, mouflon exhibit adverse effects on butterflies but deer do not. Recent plans to transfer the area to high forest are incompatible with conserving local butterflies and incur high costs of forest protection against the animals. In contrast, re-establishment of active coppicing for fuel wood production would be optimal for butterflies, compatible with game keeping. Finding a balance between game and traditional forms of management offers an opportunity for threatened biodiversity of European lowland forests. [Copyright &y& Elsevier]

The presence of procathepsin D, a zymogen of the soluble lysosomal aspartic proteinase cathepsin D, was detected in rat milk using Western blot analysis and assay of proteolytic activity in acidic buffers. No other forms of cathepsin D were found. Two different polyclonal anti-procathepsin D antibodies were used for immunochemical detection of procathepsin D. Both antibodies we found to recognize rat procathepsin D. Proteolytic activity in acidic buffers was detected using a fluorogenic substrate specific for cathepsin D and was abolished by pepstatin A, a specific inhibitor of aspartic proteinases. This study represents third demonstration of presence of procathepsin D in mammal breast milk. Potential sources and physiological functions are discussed. [Copyright &y& Elsevier]

The anatomy of the supraclavicular part of the brachial plexus is highly variable, therefore the aim of this study was to perform a systematic review and meta-analysis of the various origins of the long thoracic, dorsal scapular, suprascapular and subclavian nerves. Major electronic databases were searched to identify all cadaveric studies investigating the morphology of the supraclavicular part of the brachial plexus. Data on the origins of these nerves were extracted and classified. A random effects meta-analysis was performed to state the pooled prevalence estimates. A total of 26 studies, constituting a total of 1021 cases, were deemed eligible for inclusion into the meta-analysis. The usual origin of the long thoracic nerve from the C5, C6 and C7 roots was observed in 78.1% (95% CI 69.4–86.7%) of cases and 21.9% (95% CI 13.3–30.6%) had unusual origins. An accessory long thoracic nerve occurred in 0.3% (95% CI 0–0.7%) of cases. The overall prevalence of the dorsal scapular nerve arising from its usual origin the C5 root was found in 85.2% (95% CI 75.7–94.6%) of cases, while 14.8% (95% CI 5.4–24.3%) appeared abnormal. The suprascapular nerve emerged from its usual point on the superior trunk in 89.8% (95% CI 85.1–94.4%) of cases and in 10.2% (95% CI 5.6–14.9%) of cases had a variable origin. An accessory suprascapular nerve was present in 0.2% (95% CI 0–0.6%). Two possible sites of origin of the subclavian nerve were noted and the typical origin from the superior trunk was found in 98.3% (95% CI 96.3–100%) of cases and variable origin from the C5 root in 1.7% (95% CI 0–3.7%). All unusual origins of each nerve were much less common. The nerves emerging from the supraclavicular part of the brachial plexus express a wide spectrum of potential origins. Based on their various origins, a new classification system for all the nerves belonging to the supraclavicular part was proposed. Knowledge of these variations and their prevalence data is important to prevent iatrogenic injuries and to state useful landmarks for interventions in the axilla. [ABSTRACT FROM AUTHOR]

The brachial plexus is a complex anatomical structure that gives rise to all the nerves of the upper limb. Its variability is frequently observed and represents a challenge for interventions in the lower neck and axilla. The aim of this study was to present a comprehensive and evidence-based review with meta-analytic techniques on the variability of roots, trunks, divisions and cords of the brachial plexus. Major medical databases were searched to identify all anatomical studies investigating the variability in the formation of the brachial plexus. Data extracted consisted of demographic information, morphometric parameters, the arrangement of the brachial plexus at the level of the roots, trunks, divisions and cords and the relationship of the brachial plexus to the axillary artery and scalene muscles. The different configurations of the brachial plexus were put into a new classification, and the pooled prevalence of each case was calculated using a random effects model. A sub-analysis on age and geographical location was also performed. A total of 40 studies (3055 upper limbs) were included in the meta-analysis. The regular arrangement of roots forming trunks was identified in 84% (95% CI 79–89%) of cases. The overall prevalence of the prefixed and postfixed brachial plexus was 11% (95% CI 6–17%) and 1% (95% CI 0–1%), respectively and in less than 0.1% of cases the brachial plexus received a branch from both C4 and T2. For divisions forming cords, the regular arrangement was observed in 96% (95% CI 93–98%) of cases. Additional communicating branches between the components of the brachial plexus appeared in 5% (95% CI 3–7%) of cases. The relationship of the brachial plexus to the axillary artery and scalene muscles was considered regular in 96% (95% CI 89–100%) and 86% (95% CI 66–98%) of cases, respectively. Analysis of the morphometric parameters revealed the proportional consistency between the components forming the plexus during aging. Knowledge of anatomical variations of the brachial plexus is important for examinations and interventions in the lower neck and axilla. The variability was observed especially in the roots forming trunks, while divisions forming cords showed quite stable appearance. The results of this evidence-based review and meta-analysis can be applied in many different medical disciplines. [ABSTRACT FROM AUTHOR]

• Effect of coppice management on butterflies, moths and saproxylic beetles was tested. • There was a high turnover of communities between early and late stages of coppice. • Different stages of coppice support different functional/ecological groups. • Coppicing supports the existence of diversified communities of insects. Most European temperate woodlands are managed as high forests by clear-cutting or selective cutting. Such forests are shady environments, providing limited opportunities for light-demanding woodland associated organisms. Coppicing has been identified as a suitable tool for biodiversity conservation, because it leads to a spatially and temporally dynamic mosaic of open and closed-canopy successional stages. However, the number of studies on insects is still limited in this respect, and cross-taxon comparisons are needed. We analysed the effect of the successional stage of coppice (time since last felling of coppice layer) on butterflies, moths, and saproxylic beetles, in floodplain coppice-with-standards woods dominated by oak (Quercus robur) and ash (Fraxinus angustifolia) in Lower Austria. We compared species richness, community composition, and life-history traits of the target groups among four stages of coppice: (i) Freshly cut : stands in the first season after felling; (ii) Young coppice: stands 3–7 years after felling; (iii) Mid-aged : advanced stage in 10–15 years after felling with dense undergrowth and high canopy closure; and (iv) Mature : latest stage of coppice, 30–40 years old. We found differences in species richness of butterflies and moths among the stages. Butterfly richness peaked in young coppice and was lowest in dense mid-aged stage. Moth richness was higher in late stages (mid-aged and mature) than in early ones (freshly cut and young). There was no effect on richness of saproxylic beetles. Species compositions of moths and beetles, however, differed among the stages, with the most pronounced difference between early and late stages. The successional stage affected composition of life-history traits of all study groups, showing that the particular stages are exploited by species with different functional/ecological associations to their habitat or by different trophic guilds. The results show that the diversity of all three target groups profited from coppicing. The small-scale mosaic of successional stages created by coppicing supports the existence of diversified communities of insects with both light-demanding and shade-tolerant species. Conservation managers may set variable rotation lengths in order to support threatened species associated with particular stages. In order to further support diversity of saproxylic beetles, conservation management should prioritize maintaining coppice-with-standards woods over simple coppices, some of the standards should be retained to become potential veteran trees in the future, coppice stools should be kept relatively high, and some of the felled trees or larger branches may be left in place on the ground for decay. [ABSTRACT FROM AUTHOR]

Tree pruning is a labor and cost-intensive task. Still, it is a necessary activity that ensures a high yield of good quality products in horticulture and increases the overall health of trees in general. Extensive research has been done attempting to automate this labor-intensive procedure, lower the cost, and demand a skilled workforce. We introduce a new algorithm based on discrete differential evolution that simulates the pruning of virtual trees. Although pruning driven by differential evolution alone optimizes the overall tree light intake, it cannot maintain the distance between individual trees, nor can it shape trees into any of the growing forms. In the article, we show that adding additional steps into the pruning process, which is an initial trimming of the tree into a desired shape, can be improved significantly. We demonstrate our method by simulating the pruning of virtual trees and show that it provides results comparable to the results obtained by a human expert. By simulating the tree pruning over a few consecutive years, We show that our method is also capable of autonomous tree training toward the desired growing form. • Proper selection of branches for the removal is essential for automated pruning. • New two-step pruning algorithm is proposed, based on differential evolution (DE). • First step defines the initial shape of the tree, and DE optimizes the light intake. • Pruning optimization by DE is a good alternative to predefined set of pruning rules. • Virtual trees have been used for testing and comparison with the human pruning. [ABSTRACT FROM AUTHOR]

The relationships among the Aurearenophyceae, Phaeothamniophyceae, Phaeophyceae and Xanthophyceae lineages of the Heterokontophyta SI clade are not well known. By adding previously unexamined taxa related to these classes in a five gene phylogeny (SSU rRNA, atp B, psa A, psa B, rbc L), we recovered an assemblage of taxa previously unrecognized. We propose the class Phaeosacciophyceae class. nov., that includes Phaeosaccion collinsii, Phaeosaccion multiseriatum sp. nov., Phaeosaccion okellyi sp. nov., Antarctosaccion applanatum, Tetrasporopsis fuscescens, Tetrasporopsis moei sp. nov., and Psammochrysis cassiotisii gen. & sp. nov. We re-examine the literature for Chrysomeris , Nematochrysis , Chrysowaernella and the invalid name " Giraudyopsis " and conclude some taxa in previous studies are misidentified or misnamed, i.e. Chrysomeris and Chrysowaernella, respectively. We also show that Nematochrysis sessilis var. vectensis and Nematochrysis hieroglyphica may belong in the recently described class Chrysoparadoxophyceae. The phylogenetic relationships of Phaeobotrys solitaria and Pleurochloridella botrydiopsis are not clearly resolved, but they branch near the Xanthophyceae. Here we describe a new class Phaeosacciophyceae, a new order Phaeosacciales, a new family Tetrasporopsidaceae, a new genus Psammochrysis and four new species. [ABSTRACT FROM AUTHOR]

Background: Hip and knee arthroplasties are among the most commonly performed surgical procedures in the elderly. In this age group, uncertainty exists regarding the importance of mild to moderate chronic kidney disease (CKD), which is prevalent but often unrecognized in the perioperative setting. This study evaluates the association between mild to moderate CKD and adverse postoperative outcomes in patients 65 years or older METHODS: This retrospective study selected patients 65 years or older undergoing hip or knee arthroplasty between 2006 and 2016 from the National Surgical Quality Improvement Program database. We created logistic regression models to analyze the relationship between CKD stage and each of our coprimary outcomes. The primary outcomes were major complication and mortality occurring within 30 days of surgery.Results: Of the 193,747 included patients, 68,424 (35.3%) underwent hip and 125,323 (64.7%) knee arthroplasty. Within 30 days of surgery, 12,767 patients (6.6%) experienced a major complication and 352 (0.2%) died. Compared to patients with no kidney disease, patients with CKD stages 3b and 4 were at higher risk for both major complication (adjusted odds ratio [aOR] 1.28 [1.08-1.52], aOR 1.5 [1.13-1.98], respectively) and mortality (aOR 3.17 [1.23-8.14], aOR 3.93 [1.26-12.21], respectively) after hip arthroplasty, and for major complication (aOR 1.42 [1.23-1.63], aOR 1.52 [1.19-1.93], respectively) after knee arthroplasty.Conclusion: Among elderly patients, stage 3b and stage 4 CKD were associated with 30-day postoperative major complication after hip or knee arthroplasty, and with 30-day postoperative mortality after hip, but not knee, arthroplasty. Further research will be required to inform perioperative management decisions. [ABSTRACT FROM AUTHOR]