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Isthmic progenitors, tissue-specific stem cells in the stomach corpus, maintain mucosal homeostasis by balancing between proliferation and differentiation to gastric epithelial lineages. The progenitor cells rapidly adopt an active state in response to mucosal injury. However, it remains unclear how the isthmic progenitor cell niche is controlled during the regeneration of damaged epithelium. We recapitulated tissue recovery process after acute mucosal injury in the mouse stomach. Bromodeoxyuridine incorporation was used to trace newly generated cells during the injury and recovery phases. To define the epithelial lineage commitment process during recovery, we performed single-cell RNA-sequencing on epithelial cells from the mouse stomachs. We validated the effects of amphiregulin (AREG) on mucosal recovery, using recombinant AREG treatment or AREG-deficient mice. We determined that an epidermal growth factor receptor ligand, AREG, can control progenitor cell lineage commitment. Based on the identification of lineage-committed subpopulations in the corpus epithelium through single-cell RNA-sequencing and bromodeoxyuridine incorporation, we showed that isthmic progenitors mainly transition into short-lived surface cell lineages but are less frequently committed to long-lived parietal cell lineages in homeostasis. However, mucosal regeneration after damage directs the lineage commitment of isthmic progenitors towards parietal cell lineages. During recovery, AREG treatment promoted repopulation with parietal cells, while suppressing surface cell commitment of progenitors. In contrast, transforming growth factor-α did not alter parietal cell regeneration, but did induce expansion of surface cell populations. AREG deficiency impairs parietal cell regeneration but increases surface cell commitment. These data demonstrate that different epidermal growth factor receptor ligands can distinctly regulate isthmic progenitor-driven mucosal regeneration and lineage commitment. [Display omitted] Lineage commitment of stomach isthmic progenitor cells is regulated by different ligands for the epidermal growth factor receptor. [ABSTRACT FROM AUTHOR]

Elements of field cancerization, including atrophic gastritis, metaplasia, and dysplasia, promote gastric cancer development in association with chronic inflammation. However, it remains unclear how stroma changes during carcinogenesis and how the stroma contributes to progression of gastric preneoplasia. Here we investigated heterogeneity of fibroblasts, one of the most important elements in the stroma, and their roles in neoplastic transformation of metaplasia. We used single-cell transcriptomics to evaluate the cellular heterogeneity of mucosal cells from patients with gastric cancer. Tissue sections from the same cohort and tissue microarrays were used to identify the geographical distribution of distinct fibroblast subsets. We further evaluated the role of fibroblasts from pathologic mucosa in dysplastic progression of metaplastic cells using patient-derived metaplastic gastroids and fibroblasts. We identified 4 subsets of fibroblasts within stromal cells defined by the differential expression of PDGFRA , FBLN2, ACTA2 , or PDGFRB. Each subset was distributed distinctively throughout stomach tissues with different proportions at each pathologic stage. The PDGFRα+ subset expanded in metaplasia and cancer compared with normal, maintaining a close proximity with the epithelial compartment. Co-culture of metaplasia- or cancer-derived fibroblasts with gastroids showing the characteristics of spasmolytic polypeptide-expressing metaplasia–induced disordered growth, loss of metaplastic markers, and increases in markers of dysplasia. Culture of metaplastic gastroids with conditioned media from metaplasia- or cancer-derived fibroblasts also promoted dysplastic transition. These findings indicate that fibroblast associations with metaplastic epithelial cells can facilitate direct transition of metaplastic spasmolytic polypeptide-expressing metaplasia cell lineages into dysplastic lineages. [Display omitted] Altered stromal fibroblasts in the precancerous gastric lining promote the transition of precancerous metaplastic cells into dysplasia, supporting the development of gastric cancer. [ABSTRACT FROM AUTHOR]

Blunt cerebrovascular injury (BCVI) is a rare finding in trauma patients. The previously validated BCVI (Denver and Memphis) prediction model in adult patients was shown to be inadequate as a screening option in injured children. We sought to improve the detection of BCVI by developing a prediction model specific to the pediatric population. The National Trauma Databank (NTDB) was queried from 2007 to 2015. Test and training datasets of the total number of patients (885,100) with complete ICD data were used to build a random forest model predicting BCVI. All ICD features not used to define BCVI (2268) were included within the random forest model, a machine learning method. A random forest model of 1000 decision trees trying 7 variables at each node was applied to training data (50% of the dataset, 442,600 patients) and validated with test data in the remaining 50% of the dataset. In addition, Denver and Memphis model variables were re-validated and compared to our new model. A total of 885,100 pediatric patients were identified in the NTDB to have experienced blunt pediatric trauma, with 1,998 (0.2%) having a diagnosis of BCVI. Skull fractures (OR 1.004, 95% CI 1.003–1.004), extremity fractures (OR 1.001, 95% 1.0006–1.002), and vertebral injuries (OR 1.004, 95% CI 1.003–1.004) were associated with increased risk for BCVI. The BCVI prediction model identified 94.4% of BCVI patients and 76.1% of non-BCVI patients within the NTDB. This study identified ICD9/ICD10 codes with strong association to BCVI. The Denver and Memphis criteria were re-applied to NTDB data to compare validity and only correctly identified 13.4% of total BCVI patients and 99.1% of non BCVI patients. The prediction model developed in this study is able to better identify pediatric patients who should be screened with further imaging to identify BCVI. Retrospective diagnostic study–level III evidence. [ABSTRACT FROM AUTHOR]

Background: Exogenous exposures collectively may contribute to chronic, low-grade inflammation and increase risks for major chronic diseases and mortality. We previously developed, validated, and reported a novel, FFQ-based and lifestyle questionnaire-based, inflammation biomarker panel-weighted, predominantly whole foods-based 19-component dietary inflammation score (DIS) and 4-component lifestyle inflammation score (LIS; comprising physical activity, alcohol intake, BMI, and current smoking status). Both scores were more strongly associated with circulating biomarkers of inflammation in 3 populations than were previously reported dietary inflammation indices. Associations of the DIS and LIS with mortality risk have not been reported.Objectives: To investigate separate and joint associations of the DIS and LIS with all-cause, all-cancer, and cardiovascular disease (CVD) mortality risks in the prospective Iowa Women's Health Study (1986-2012; n = 33,155 women, ages 55-69 years, of whom 17,431 died during follow-up, including 4379 from cancer and 6574 from CVD).Methods: We summed each study participant's scores' components, weighted by their published weights, to yield the participant's inflammation score; a higher score was considered more pro-inflammatory. We assessed DIS and LIS mortality associations using multivariable Cox proportional hazards regression.Results: Among participants in the highest relative to the lowest DIS and LIS quintiles, the adjusted HRs for all-cause mortality were 1.11 (95% CI: 1.05-1.16) and 1.60 (95% CI: 1.53-1.68), respectively; for all-cancer mortality were 1.07 (95% CI: 0.97-1.17) and 1.51 (95% CI: 1.38-1.66), respectively; and for CVD mortality were 1.12 (95% CI: 1.03-1.21) and 1.79 (95% CI: 1.66-1.94), respectively (all Ptrend values < 0.01). Among those in the highest relative to the lowest joint LIS/DIS quintiles, the HRs for all-cause, all-cancer, and all-CVD mortality were 1.88 (95% CI: 1.71-2.08), 1.82 (95% CI: 1.50-2.20), and 1.92 (95% CI: 1.64-2.24), respectively.Conclusions: More pro-inflammatory diets and lifestyles, separately but especially jointly, may be associated with higher all-cause, all-cancer, and all-CVD mortality risks among women. [ABSTRACT FROM AUTHOR]

In this paper we examine the failure of the zero carbon homes agenda in the UK and argue that it represents a case of policy dismantling, where a range of policies and programmes have been introduced, revised and then removed by government. We bring together the sustainability transitions literature with the literature on policy dismantling, regime resistance and regime detractors, and suggest that the zero carbon housing agenda in the UK offers useful insights into the politics of sustainability transitions. We identify three phases of policy change, from policy expansion, symbolic dismantling and eventual active policy dismantling. In the conclusions we offer some suggestions on processes of policy dismantling and what this might mean for future sustainability transitions given the significant contributions of buildings to greenhouse gas emissions and the urgent need for rapid low carbon transitions. [ABSTRACT FROM AUTHOR]

The development of new biomaterials and drug delivery systems necessitates animal experimentation to demonstrate biocompatibility and therapeutic efficacy. Reduction and replacement of the requirement to conduct experiment using full-grown animals has been achieved through utilising zebrafish embryos, a promising bridge model between in vitro and in vivo research. In this review, we consider how zebrafish embryos have been utilised to test both the biocompatibility of materials developed to interact with the human body and drug release studies. Furthermore, we outline the advantages and limitations of this model and review legal and ethical issues. We anticipate increasing application of the zebrafish model for biomaterial evaluation in the near future. This review aims to evaluate the potential application and suitability of the zebrafish model in the development of biomaterials and drug delivery systems. It creates scientific impact and interest because replacement models are desirable to the society and the scientific community. The continuous development of biomaterials calls for the need to provide solutions for biological testing. This review covers the topic of how the FET model can be applied to evaluate biocompatibility. Further, it explores the zebrafish from the wild-type to the mutant form, followed by a discussion about the ethical considerations and concerns when using the FET model. Image, graphical abstract [ABSTRACT FROM AUTHOR]

Describes a two-part study of the research needs of graduate students at Georgetown University. The first part, conducted in May 2010, consisted of an online survey about students' research practices and opinions about the library. The second part, conducted in May 2011, consisted of focus groups with particular subsets of graduate students. The goals of the study were to: 1) gain insight into students' research habits; 2) determine how they use and perceive the library; 3) determine any differences in responses between students in different disciplines; and 4) uncover distinctions between “scholarly” students (those intent on careers in academia) and “professional” students (those intent on careers outside of academia). Survey responses and focus group transcripts reflected three common broad themes: 1) Infrastructure (library building, furniture, designated space for graduate students); 2) Awareness & Scholarly Support (awareness of specialized library resources and services, tailored orientation and instruction); and fcase3) Access Services (availability of resources on and off campus, interlibrary and consortial lending, borrowing policies). Humanities students were much more familiar with library services and resources than social science students. Among social science students, we found few differences between the “scholarly” and “professional” groups. [Copyright &y& Elsevier]

• Programs can be distinguished by purpose, audience, methods, approach to uncertainty and assumptions, and more. • Programs' timeframes varied from <2 to 100 years, with many focused on the 20–40 year range. • Environmental futures programs are strengthened by using multiple methods and defining success in advance. • Seven practices can promote the successful uptake of environmental futures information by decision-makers. Environmental decision- and policy-making must contend with uncertainty about the future that can hinder proactive environmental decisions, forcing environmental managers into reactive postures. To help prevent this, a variety of methods exist for exploring potential environmental futures and associated uncertainties. Producing environmental futures benefits those involved by supporting a systems-level understanding and expanding thinking beyond "business as usual". We review select environmental and non-environmental futures programs that seek to inform decision-making. Review objectives are to: 1) identify and discuss key environmental futures program attributes, and 2) propose program attributes that support successful connection with decision processes. Attributes discussed include purpose and audience, methods, addressing uncertainty and assumptions, relationship to indicator programs, how program values and biases are addressed, the role of goals, and how success is measured and defined. We conclude with recommendations for how to conduct environmental futures programs to be more useful for environmental decisions. These include: combining multiple environmental futures methods to provide complementary insights or highlight inconsistencies in assumptions, including a schematic of assumptions and drivers, and defining success criteria, whenever possible. These practices can help increase the acceptance of environmental futures products in decision-making and increase their short-term and long-term contributions. [ABSTRACT FROM AUTHOR]

Neuroblastoma is a lethal childhood solid tumor of developing peripheral nerves. Two percent of children with neuroblastoma develop opsoclonus myoclonus ataxia syndrome (OMAS), a paraneoplastic disease characterized by cerebellar and brainstem-directed autoimmunity but typically with outstanding cancer-related outcomes. We compared tumor transcriptomes and tumor-infiltrating T and B cell repertoires from 38 OMAS subjects with neuroblastoma to 26 non-OMAS-associated neuroblastomas. We found greater B and T cell infiltration in OMAS-associated tumors compared to controls and showed that both were polyclonal expansions. Tertiary lymphoid structures (TLSs) were enriched in OMAS-associated tumors. We identified significant enrichment of the major histocompatibility complex (MHC) class II allele HLA-DOB∗01:01 in OMAS patients. OMAS severity scores were associated with the expression of several candidate autoimmune genes. We propose a model in which polyclonal auto-reactive B lymphocytes act as antigen-presenting cells and drive TLS formation, thereby supporting both sustained polyclonal T cell-mediated anti-tumor immunity and paraneoplastic OMAS neuropathology. [Display omitted] • OMAS-associated neuroblastomas contain more B and T cells than control neuroblastomas • OMAS-associated neuroblastoma B and T cell repertoires are diverse, with small clones • Tertiary lymphoid structures are enriched in OMAS-associated neuroblastomas • Gene expression correlated to neurological symptom severity nominates autoantigens Rosenberg et al. sought features of the systemic immune response underlying improved tumor outcomes and neurological dysfunction in patients with opsoclonus myoclonus ataxia syndrome (OMAS), an autoimmune disease caused by neuroblastoma. Diverse B and T cell lymphocytic infiltration organized in enriched tertiary lymphoid structures predominate in OMAS-associated tumors. [ABSTRACT FROM AUTHOR]

Climate change is predicted to contribute to the present wave of extinctions; however, these extinctions may not immediately follow temperature increases and other climate change effects. We examined how predator species composition and increased temperatures affected bacterivorous protist community extinction debt (the number of species that will go extinct) and relaxation time (the amount of time it takes for the extinction debt to be paid off). We found that neither affected relaxation time, but that the presence of a generalist predatory protist species increased extinction debt through its role as a keystone predator. Warming also significantly decreased how long it took communities to lose half of the species that were to eventually go extinct. That this half-relaxation time was shorter in warmed communities than in unwarmed communities in this system indicates that extinctions were front-loaded in the warmed communities compared to the unwarmed communities. Our findings suggest that even if increased temperature is not expected to increase extinction debt, it could still accelerate the rate at which those extinctions will occur. This in turn narrows the time window for taking actions to prevent a large portion of the extinction debt from being paid off. [ABSTRACT FROM AUTHOR]

Highly alkaline industrial residues (e.g., steel slag, bauxite processing residue (red mud) and ash from coal combustion) have been identified as stocks of potentially valuable metals. Technological change has created demand for metals, such as vanadium and certain rare earth elements, in electronics associated with renewable energy generation and storage. Current raw material and circular economy policy initiatives in the EU and industrial ecology research all promote resource recovery from residues, with research so far primarily from an environmental science perspective. This paper begins to address the deficit of research into the governance of resource recovery from a novel situation where re-use involves extraction of a component from a bulk residue that itself represents a risk to the environment. Taking a political industrial ecology approach, we briefly present emerging techniques for recovery and consider their regulatory implications in the light of potential environmental impacts. The paper draws on EU and UK regulatory framework for these residues along with semi-structured interviews with industry and regulatory bodies. A complex picture emerges of entwined ownerships and responsibilities for residues, with past practice and policy having a lasting impact on current possibilities for resource recovery. [ABSTRACT FROM AUTHOR]

This paper explores the interest by policy makers to encourage and develop a green economy, with a particular focus on UK government attempts to engender a shift in the mainstream building and construction sector towards adopting green building methods and techniques. The building sector has been the focus of endeavours to engender a shift towards greener ways of working and building, due to its high contribution to greenhouse gas emissions and associated concerns over enhanced global warming and climate change. The paper outlines the recent development of national UK policy on green building as exemplified in legislation for the Code for Sustainable Homes and in Building Regulations. These have given rise to a particular set of responses to green building requirements that favour technological solutions that can readily be accommodated by the existing system. In critiquing these developments we draw upon socio-technical sustainability transitions research, one strand of which has focused on the ways in which niche developments can challenge and disrupt existing regimes of practice. We do this empirically through our research into the green building sector which has involved in-depth interviews with a range of actors from the UK green building sector, including architects, building companies, materials suppliers and policy makers. Respondents from within the green building niche are critical of current UK legislation, and argue that its narrow conceptualisation fails to adequately encourage, or recognise, what they would consider to be green building forms that will contribute to substantial reductions in carbon emissions, nor does it respect locally appropriate building methods. [ABSTRACT FROM AUTHOR]

Abstract: The spectre of a food security crisis has raised important questions about future directions for agriculture and given fresh impetus to a long-standing debate about the potential contribution of agricultural biotechnology to food security. This paper considers the discursive foundations for promotion of agricultural biotechnology, arguing that notions of progress and ‘science-based’ risk assessment act as ‘anti-political’ strategies to remove consideration of genetically modified organisms (GMOs) from the cut and thrust of politics, while the concept of ‘food security’ reconstitutes agricultural biotechnology as a moral imperative. We argue that a debate ostensibly focussed on developing countries in fact largely arises from discordant views about the future of farming and rural areas in the developed countries where these arguments are taking place. These debates are examined through a comparative study of the UK and Australia. Whereas acceptance of GM crops and foods at government and industry level has not led to commercial adoption in the UK due to consumer resistance and the influence of EU regulations, Australian governments at federal and state level have increasingly embraced GM crops, potentially locking Australia into a food and farming trajectory based on agricultural biotechnology. [Copyright &y& Elsevier]

Abstract: This paper explores some of the key institutional transformations in livestock breeding associated with the increasing significance of genetic techniques, situating this within an assessment of an emerging agricultural bioeconomy. Focusing on beef cattle and sheep breeding in the United Kingdom, the paper examines how a move towards the involvement of international and corporate interests in livestock breeding is restructuring the network of institutional interests affecting the knowledge and decision making of individual breeders. The paper suggests that the structural transformation of beef cattle and sheep breeding is complicated by the need for negotiation between breeders’ ‘traditional’ knowledge-practices and the ‘geneticised’ techniques being made available to them. We are thus seeing the emergence of new and complex interactions between the major actors which are reconfiguring power relationships in the UK livestock breeding sector. [Copyright &y& Elsevier]

Cells are complex systems in which many functions are performed by different genetically defined and encoded functional modules. To systematically understand how these modules respond to drug or genetic perturbations, we develop a functional module states framework. Using this framework, we (1) define the drug-induced transcriptional state space for breast cancer cell lines using large public gene expression datasets and reveal that the transcriptional states are associated with drug concentration and drug targets, (2) identify potential targetable vulnerabilities through integrative analysis of transcriptional states after drug treatment and gene knockdown-associated cancer dependency, and (3) use functional module states to predict transcriptional state-dependent drug sensitivity and build prediction models for drug response. This approach demonstrates a similar prediction performance as approaches using high-dimensional gene expression values, with the added advantage of more clearly revealing biologically relevant transcriptional states and key regulators. [Display omitted] • FM states framework is developed to understand transcriptomic states • FM states are discovered for cancer cell lines before or after intervention • This tool facilitates drug and target prediction by integrating large data resources Qin et al. develop a functional module states framework to understand the transcriptomic states of samples. This approach reveals transcriptional states of cancer cell lines before or after treatment. It provides valuable and biologically interpretable features for drug sensitivity and target prediction. [ABSTRACT FROM AUTHOR]

Abstract: It is increasingly argued that we are entering into a “biotech century”, in which biotechnology promises major advances in agricultural productivity. The development of biotechnology is not a straightforward affair, however, and the advent of GMOs has led to public protest and consumer resistance. This paper draws upon a comparative Australian–UK project concerned with the role of regulation and governance in mediating the debates and managing the associated risks. Regulatory responses and the mediation of conflicts by the Australian and UK governments have been shaped by the institutional and policy environments in these two countries. The implications of these public debates and regulatory responses for the capture of competitive opportunities are considered. The fact that the two countries have broadly similar systems of governance and regulation reveals how alike the circumstances are in many respects. But at the same time there are important differences in both the style and the content of the policy debates. In both the UK and Australia, the respective central governments remain committed to a ‘biotechnology future’. Against this background, there is little doubt that the choices about biotechnology will play a defining role in shaping the future of rural places. [Copyright &y& Elsevier]

Abstract: This paper investigates whether eco-industrial parks (EIPs) offer possibilities to implement sustainable development policies. EIPs are based upon industrial ecology principles that suggest industrial systems can operate in a similar fashion to natural ecological systems. Drawing upon a survey of all identifiable EIPs in the USA and Europe and in-depth interview surveys of 16 EIPs, the research discovered few examples of networking between firms or processes using wastes and materials recycling. Most EIPs are at a very early stage of development, where linkages are potential rather than real. The problems encountered in developing EIPs from scratch suggests that a more fruitful approach is to build upon existing and potential linkages within a locality, assisted by a pro-active policy to encourage interchanges. [Copyright &y& Elsevier]

Abstract: Despite the widespread incorporation of sustainable development into policy discourses, actually achieving the ‘win–win–win’ scenario of economic, environmental and social development continues to be problematic. Advocates of industrial ecology suggest that by shifting the basis of industrial production from a linear to a closed loop system, these gains can be achieved. In recent years, concepts drawn from industrial ecology have been used to plan and develop eco-industrial parks (EIPs) that seek to increase business competitiveness, reduce waste and pollution, create jobs and improve working conditions. Despite a growing interest in EIPs, there have been few empirically informed studies that seek to explore the potential contribution such EIPs may make to sustainable development. This paper contributes to a developing sympathetic critique of industrial ecology by focusing on the key problems and dilemmas that arise in the course of developing eco-industrial parks, drawing upon empirical work conducted in the USA. The paper draws upon both an extensive survey of EIPs and in-depth interviews conducted with a range of stakeholders at ten US sites. As the paper reveals, EIPs in the USA are in their early stages and likewise their contribution to both economic development and environmental policy, let alone social policies, is complicated and inchoate. The empirical material reveals that key features of industrial ecology such as inter-firm networking and collaboration in the form of materials interchange and energy cascading are either absent or in the early planning stages. In each of the ten cases what is emerging is a form of EIP partly determined by the geographic setting and broader economic realities of the locality. While collaborative behaviour between firms is central to EIP development if the potential benefits of industrial ecology are to be realised, it is important to realise that such behaviour is difficult to develop from scratch through policy intervention. In conclusion, the paper suggests that expectations must be realistic for the community and location in question. As part of that realism, EIP projects must be designed to allow for a gradual approach, and each phase needs to be financially viable. [Copyright &y& Elsevier]

Abstract: Aims: To investigate if a lateral hip radiograph is always needed in the management of intra-capsular proximal femoral fractures. Furthermore, we sought to evaluate if a radiographer could accurately identify cases in which the lateral radiograph is not required. Methods: All patients who underwent surgical management of an intra-capsular proximal femoral fracture over a 3 month period at our unit were identified. Radiographs were reviewed by 6 observers: 2 consultant orthopaedic surgeons, 2 registrars, and 2 radiographers. Initially the observers viewed the AP radiographs alone and classified the fractures into displaced, undisplaced, or unclear categories. They were then shown the lateral view and asked for a diagnosis and management plan. Comparison of diagnosis and management based on AP views alone, and AP in-combination with a lateral view was made. Results: 90 patients were included; the mean age was 80.8 years with a range of 42–100 years. 73 underwent arthroplasty and 17 had internal fixation. All observers, including the radiographer were able to make a surgical decision in 90% of the cases based on AP views alone. Lateral radiographs improved the diagnostic accuracy by 6%. The availability of the lateral view did not alter the management in patients where the AP clearly demonstrated a displaced fracture. Conclusion: Elderly patients with a displaced intra-capsular fracture identifiable on the AP do not require a lateral radiograph. Such patients can be accurately identified by the radiographer. Patient discomfort experienced during positioning for the lateral view would be avoided, and a financial saving made. [Copyright &y& Elsevier]

Steerable "banana" cages have been posited to increase segmental lordosis in short-segment transforaminal lumbar interbody fusions (TLIF). The same is not necessarily true for straight "bullet" cages. Although increased lordosis is generally thought to be advantageous, a potential complication is decreased foraminal height. Here we evaluate for any association between cage type and change in foraminal height and clinical outcomes following short-segment TLIFs. We retrospectively reviewed consecutive 1- and 2-level TLIFs with bilateral facetectomies with minimum 1-year clinical and radiographic follow-up. Two cohorts were based on cage morphology: steerable "banana" cage or straight "bullet" cage. Patient reported outcome measures (PROMs), radiographic measurements, and revision rates were compared. A total of 46 patients with 53 straight and 95 patients with 131 steerable cage levels were included. Steerable cages showed increased segmental lordosis (9.1° vs. 13.5°, P < 0.001) and decreased foraminal height (20.3 vs. 18.5 mm, P < 0.001) after surgery. Straight cages demonstrated similar segmental lordosis (8.7° vs 8.1°, P = 0.30) and foraminal height (19.4 vs 20.0 mm, P < 0.065). Both cohorts showed improved PROMs at last follow-up (P ≤ 0.005). Subanalysis comparing patients who had increased or decreased foraminal height revealed similarly improved PROMs between cohorts. Revision rates at 1 year were similar between cohorts (4.3% for straight and 3.2% for steerable group, P = 0.72). Although the increased segmental lordosis afforded by placement of steerable cages may decrease foraminal height after short segment TLIF, clinical outcomes are not negatively affected by this association. [ABSTRACT FROM AUTHOR]

There are few objective measures for evaluating individual performance throughout surgical residency. Two commonly used objective measures are the case log numbers and written board examination scores. The objective of this study was to investigate possible correlations between these measures. We conducted a retrospective review of the American Board of Neurological Surgery (ABNS) written board scores and the Accreditation Council for Graduate Medical Education case logs of 27 recent alumni from neurologic surgery residency training programs at The Ohio State Wexner Medical Center and the University of Nebraska Medical Center. The number of spine cases logged was significantly correlated with the ABNS written examination performance in univariate linear regression (r 2 = 0.182, P = 0.0265). However, case numbers from all other neurosurgical subspecialties did not significantly correlate with ABNS written board performance (P > 0.1). Identifying which objective measures correlate most closely with resident education could help optimize the structure of residency training programs. We believe that early exposure to focused aspects of neurosurgery helps the young resident learn quickly and efficiently and ultimately score highly on standardized examinations. Therefore program directors may want to ensure focused exposure during the early years of residency, with particular attention to worthwhile rotations in spine neurosurgery. [ABSTRACT FROM AUTHOR]

Abstract: We present a rare case of female newborn that presented with atypical genitalia, vaginal atresia and a short segment rectal stenosis which was successfully managed in a minimally invasive fashion using urological endoscopic and balloon dilatation technology. We believe that this technique is safe and feasible for short rectal stenotic segments and might prevent the need for major reconstruction surgery. [Copyright &y& Elsevier]

Cementoplasty is a well-established intervention for symptomatic control of localized skeletal metastases; however, its use has never been reported for metastases in the foot. We report on a patient with symptomatic skeletal metastases throughout the foot in which cementoplasty, in conjunction with internal fixation, was used to alleviate pain and enable comfortable ambulation. [Copyright &y& Elsevier]

Recent controversy over the introduction of genetically modified crops and their subsequent incorporation into foods has led to major popular debate and discussion. Despite this, there has been relatively little academic discussion of the background to these developments. Inthis paper it is argued that such developments need to be seen in the context of restructuring activity within the new `biosciences industry' and closely linked to the globalization of such corporate activity and the drive for the liberalization of trade. By contrast, the reaction to genetically modified foods and seeds has typically been national or local in scope, and limited in its effectiveness. [ABSTRACT FROM AUTHOR]

Abstract: Geographic differences in frequency and azole resistance among Candida glabrata may impact empiric antifungal therapy choice. We examined geographic variation in isolation and azole susceptibility of C. glabrata. We examined 23 305 clinical isolates of C. glabrata during ARTEMIS DISK global surveillance. Susceptibility testing to fluconazole and voriconazole was assessed by disk diffusion, and the results were grouped by geographic location: North America (NA) (2470 isolates), Latin America (LA) (2039), Europe (EU) (12 439), Africa and the Middle East (AME) (728), and Asia-Pacific (AP) (5629). Overall, C. glabrata accounted for 11.6% of 201 653 isolates of Candida and varied as a proportion of all Candida isolated from 7.4% in LA to 21.1% in NA. Decreased susceptibility (S) to fluconazole was observed in all geographic regions and ranged from 62.8% in AME to 76.7% in LA. Variation in fluconazole susceptibility was observed within each region: AP (range, 50–100% S), AME (48–86.9%), EU (44.8–88%), LA (43–92%), and NA (74.5–91.6%). Voriconazole was more active than fluconazole (range, 82.3–84.2% S) with similar regional variation. Among 22 sentinel sites participating in ARTEMIS from 2001 through 2007 (84 140 total isolates, 8163 C. glabrata), the frequency of C. glabrata isolation increased in 14 sites and the frequency of fluconazole resistance (R) increased in 11 sites over the 7-year period of study. The sites with the highest cumulative rates of fluconazole R were in Poland (22% R), the Czech Republic (27% R), Venezuela (27% R), and Greece (33% R). C. glabrata was most often isolated from blood, normally sterile body fluids and urine. There is substantial geographic and institutional variation in both frequency of isolation and azole resistance among C. glabrata. Prompt species identification and fluconazole susceptibility testing are necessary to optimize therapy for invasive candidiasis. [Copyright &y& Elsevier]

PHACE syndrome is the association of large segmental facial hemangiomas and congenital anomalies, such as posterior fossa malformations, cerebral arterial anomalies, coarctation of the aorta, eye anomalies, and sternal defects. To date, the reported cases of PHACE syndrome have been sporadic, suggesting that PHACE may have a complex pathogenesis. We report here genomic copy number variation (CNV) analysis of 98 individuals with PHACE syndrome as a first step in deciphering a potential genetic basis of PHACE syndrome. A total of 3,772 CNVs (2,507 duplications and 1,265 deletions) were detected in 98 individuals with PHACE syndrome. CNVs were then eliminated if they failed to meet established criteria for quality, spanned centromeres, or did not contain genes. CNVs were defined as 'rare' if not documented in the database of genomic variants. Ten rare CNVs were discovered (size range: 134-406 kb), located at 1q32.1, 1q43, 3q26.32-3q26.33, 3p11.1, 7q33, 10q24.32, 12q24.13, 17q11.2, 18p11.31, and Xq28. There were no rare CNV events that occurred in more than one subject. Therefore, further study is needed to determine the significance of these CNVs in the pathogenesis of PHACE syndrome. [ABSTRACT FROM AUTHOR]

Abstract: This single-arm phase II study evaluated the tumor-vascular disrupting agent ASA404 (vadimezan, 5,6-dimethylxanthenone-4-acetic acid/DMXAA) 1800mg/m2 plus standard therapy of carboplatin and paclitaxel in patients with advanced non-small cell lung cancer (NSCLC). This ASA404 dose is 50% higher than that used in previous phase II studies. Thirty patients with histologically confirmed stage IIIb or IV NSCLC previously untreated with chemotherapy received carboplatin AUC 6mg/mlmin plus paclitaxel 175mg/m2 plus ASA404 1800mg/m2 every 21 days for up to six cycles. The addition of ASA404 1800mg/m2 to standard therapy produced little change in the systemic exposure of either total or free carboplatin or paclitaxel, and was generally well-tolerated, with no cardiac serious adverse events or clinically relevant ophthalmic abnormalities. The best overall tumor response was partial response, which was seen in 37.9% of patients by independent assessment and in 46.7% by investigator assessment. Stable disease was seen in 48.3% of patients by independent assessment and in 43.3% by investigator assessment. Median time to tumor progression was 5.5 months by investigator assessment and median survival was 14.9 months. The data from this trial corroborate findings from a recent randomized phase II trial, which suggested improvements in efficacy variables, including survival, when ASA404 1200mg/m2 was added to standard therapy for advanced NSCLC. The manageable safety profile, lack of adverse pharmacokinetic interactions and efficacy outcomes seen in this single-arm study suggest that ASA404 1800mg/m2 is a viable dose for future combination studies. [Copyright &y& Elsevier]