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Attention-deficit/hyperactivity disorder (ADHD) commonly co-occurs in autistic children. However, additional research is needed to explore the differences in motor skills and sensory features in autistic children with and without ADHD, as well as the impacts of these factors on daily living skills (DLS). This observational study sought to fill this gap with 67 autistic children (6.14-10.84 years-old), 43 of whom had ADHD. Autistic children with ADHD demonstrated higher sensory features and lower motor skills than autistic children without ADHD. In examining autism and ADHD features dimensionally, we found that overall sensory features, seeking, and hyporesponsiveness were driven by both autism and ADHD features, whereas motor skills, enhanced perception, and hyperresponsiveness were driven by only autism features. Additionally, in using these dimensional variables of autism and ADHD features, we found that differences in motor skills, sensory and autism features, but not ADHD features, impact DLS of autistic children, with autism features and motor skills being the strongest individual predictors of DLS. Together, these results demonstrate the uniqueness of motor skills and sensory features in autistic children with and without ADHD, as well as how autism features, sensory features, and motor skills contribute to DLS, emphasizing the importance of a comprehensive understanding of each individual and complexities of human development when supporting autistic children., Competing Interests: Declarations. Conflict of interest: This study was performed in line with the ethical standards of the institutional review board and the 1964 Declaration of Helsinki and later amendments. Approval was granted by the Institutional Review Board (#2016-0441, #2018-1067, #2022-0413).  Informed consent: Parents or legal guardians provided informed consent, and participants provided either verbal or written assent., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Electroencephalographic neurofeedback (EEG NF) can improve quality of life (QoL) and reduce distress by modifying the amplitude of selected brain frequencies. This study aims to investigate the effects of NF therapy on QoL and self-efficacy in cancer patients and to explore age-related reactions. In a waitlist control paradigm, psychometric data (EORTC QLQ-C30, General Self-Efficacy Scale) of 20 patients were collected at three different time points, each five weeks apart. An outpatient 10-session NF intervention (mobile) was conducted between the second and third measurement point. QoL and self-efficacy changed significantly over time (QoL: F(2,36) = 5.294, p < .05, η 2  = .227; Self-efficacy: F(2,26) = 8.178, p < .05, η 2  = .386). While QoL increased in younger patients, older patients initially showed a decrease in QoL, which then increased during intervention. Younger patients did not differ from older patients in QoL in both waitlist control (T0-T1) and intervention phase (T1-T2). QoL in older patients significantly differed between waitlist control and intervention phase (Z = - 2.023, p < .05, d = 1.085). Self-efficacy increased in both age categories. Younger and older patients did not differ in self-efficacy in waitlist control, but in intervention phase (F(1,16) = 7.014, p < .05, η 2  = .319). The current findings suggest that NF therapy is a promising treatment modality for improving QoL in cancer patients. Our study reveals NF being a tool to influence self-efficacy, which should receive more appreciation in clinical care. However, the effect of NF in different age groups as well as the influence on further cancer-related symptoms should be investigated in future research., (© 2022. The Author(s).)

A growing literature posits attention as a core component of working memory (Baddeley, European Psychologist, 7(2), 85-97, 2002), yet research exploring this relationship is scarce in the temporal attention domain. The present research provided further evidence that the magnitude of the attentional blink (AB) can be influenced by working memory load (WML; Akyürek et al., Memory & Cognition 35, 621-627, 2007). Additionally, we behaviorally tested Akyürek and colleagues' (Psychophysiology, 47(6), 1134-1141, 2010) conclusion that working memory influences attention at an early stage by systematically manipulating the timing of the first target in relation to the stimuli preceding and following it. In two experiments, we demonstrated that the AB effect increases as the temporal interval between the first target and the stimulus following it decreases. Importantly, this effect was observed only when WML was low, indicating that WM influences attending to a second target at an early stage of attentional processing., (© 2022. The Psychonomic Society, Inc.)

Objective: Soft tissue reconstruction of complex defects of the lower abdomen, groin, the perineum and the hip region present a reconstructive challenge. Besides free tissue transfer, pedicled flaps may also be utilized. Harvest of the vertical rectus abdominis flap causes a functional deficit by weakening the abdominal wall. Pedicled, perforator-based flaps minimize functional deficits by preserving muscle., Indications: Soft tissue defects with exposed vital structures, prosthetic devices or irradiated wound beds., Contraindications: Previous surgery at the donor site, peripheral vascular disease at the pelvic and thigh region, previous vascular interventions at the donor site., Surgical Technique: After preoperative localization of the perforators, a retrograde, intramuscular dissection of the pedicle allows sufficient length to be gained in order to transpose the flap into the defect. Tunneling of the flap beneath the rectus femoris muscle and Sartorius muscle is often required for tension-free inset., Postoperative Management: Five days of bed-rest postoperatively followed by ambulation., Results: No complete flap loss was encountered in 13 cases. In 2 cases a partial tip necrosis required secondary skin grafting., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

The COVID-19 pandemic (and its aftermath) highlights a critical need to communicate health information effectively to the global public. Given that subtle differences in information framing can have meaningful effects on behavior, behavioral science research highlights a pressing question: Is it more effective to frame COVID-19 health messages in terms of potential losses (e.g., "If you do not practice these steps, you can endanger yourself and others") or potential gains (e.g., "If you practice these steps, you can protect yourself and others")? Collecting data in 48 languages from 15,929 participants in 84 countries, we experimentally tested the effects of message framing on COVID-19-related judgments, intentions, and feelings. Loss- (vs. gain-) framed messages increased self-reported anxiety among participants cross-nationally with little-to-no impact on policy attitudes, behavioral intentions, or information seeking relevant to pandemic risks. These results were consistent across 84 countries, three variations of the message framing wording, and 560 data processing and analytic choices. Thus, results provide an empirical answer to a global communication question and highlight the emotional toll of loss-framed messages. Critically, this work demonstrates the importance of considering unintended affective consequences when evaluating nudge-style interventions., Competing Interests: Conflict of InterestThe authors declare no conflict of interest., (© The Society for Affective Science 2022.)

Copper (Cu) plays an essential role in the development and function of the brain. In humans, genetic disorders of Cu metabolism may cause either severe Cu deficiency (Menkes disease) or excessive Cu accumulation (Wilson disease) in the brain tissue. In either case, the loss of Cu homeostasis results in catecholamine misbalance, abnormal myelination of neurons, loss of normal brain architecture, and a spectrum of neurologic and/or psychiatric manifestations. Several metabolic processes have been identified as particularly sensitive to Cu dis-homeostasis. This review focuses on the role of Cu in noradrenergic neurons and summarizes the current knowledge of mechanisms that maintain Cu homeostasis in these cells. The impact of Cu misbalance on catecholamine metabolism and functioning of noradrenergic system is discussed.

Human pluripotent stem cells (hPSCs) provide a source for the generation of defined kidney cells and renal organoids applicable in regenerative medicine, disease modeling, and drug screening. These applications require the provision of hPSC-derived renal cells by reproducible, scalable, and efficient methods. We established a chemically defined protocol by application of Activin A, BMP4, and Retinoic acid followed by GDNF, which steered hPSCs to the renal lineage and resulted in populations of SIX2 + /CITED1 + metanephric mesenchyme- (MM) and of HOXB7 + /GRHL2 + ureteric bud (UB)-like cells already by 6 days. Transcriptome analysis corroborated that the PSC-derived cell types at day 8 resemble their renal vesicle and ureteric epithelial counterpart in vivo, forming tubular and glomerular renal cells 6 days later. We demonstrate that starting from hPSCs, our in vitro protocol generates a pool of nephrogenic progenitors at the renal vesicle stage, which can be further directed into specialized nephronal cell types including mesangial-, proximal tubular-, distal tubular, collecting duct epithelial cells, and podocyte precursors after 14 days. This simple and rapid method to produce renal cells from a common precursor pool in 2D culture provides the basis for scaled-up production of tailored renal cell types, which are applicable for drug testing or cell-based regenerative therapies.

The reading of glycan-encoded signals by tissue lectins is considered a major route of the flow of biological information in many (patho)physiological processes. The arising challenge for current research is to proceed from work on a distinct protein to family-wide testing of lectin function. Having previously identified homodimeric galectin-1 and chimera-type galectin-3 as molecular switches in osteoarthritis progression, we here provide proof-of-principle evidence for an intra-network cooperation of galectins with three types of modular architecture. We show that the presence of tandem-repeat-type galectin-8 significantly correlated with cartilage degeneration and that it is secreted by osteoarthritic chondrocytes. Glycan-inhibitable surface binding of galectin-8 to these cells increased gene transcription and the secretion of functional disease markers. The natural variant galectin-8 (F19Y) was less active than the prevalent form. Genome-wide array analysis revealed induction of a pro-degradative/inflammatory gene signature, largely under control of NF-κB signaling. This signature overlapped with respective gene-expression patterns elicited by galectins-1 and -3, but also presented supplementary features. Functional assays with mixtures of galectins that mimic the pathophysiological status unveiled cooperation between the three galectins. Our findings shape the novel concept to consider individual galectins as part of a so far not realized teamwork in osteoarthritis pathogenesis, with relevance beyond this disease.

The internet-based assessment of response time (RT) and error rate (ERR) has recently become a well-validated alternative to traditional laboratory-based assessment, because methodological research has provided evidence for negligible setting- and setup-related differences in RT and ERR measures of central tendency. However, corresponding data on potential differences in the variability of such performance measures are still lacking, to date. Hence, the aim of this study was to conduct internet-based mental chronometry in both poorly standardized domestic and highly standardized laboratory environments and to compare the variabilities of the corresponding performance measures. Using the Millisecond Inquisit4Web software, 127 men and women completed three different RT-based cognitive paradigms (i.e., go/no-go, two-back, and number-letter). Each participant completed all paradigms in two environments (i.e., at home and in the laboratory), with a time lag of seven days and in a counterbalanced order. Mixed-effects modeling was employed to estimate the between-setting variability across a comprehensive set of performance measures, including conventional measures of central tendency (i.e., mean RT and ERR) and further measures characterizing the joint distribution of RT/ERR. The latter measures were estimated using the diffusion model. The results suggested negligible differences between the domestic and laboratory settings. Thus, this study provides novel evidence suggesting that the statistical power of internet-based mental chronometry is commonly not compromised by increased environmental variance. The within- and between-session reliabilities were in a satisfactory range-that is, comparable to performance measures collected offline in laboratory settings. In consequence, our results support the broad applicability, robustness, and cost efficiency of mental chronometry assessment using the internet.

Streptomyces violaceoruber grown in co-culture with Streptomyces aburaviensis produces an about 17-fold higher volume of droplets on its aerial mycelium than in single-culture. Physical separation of the Streptomyces strains by either a plastic barrier or by a dialysis membrane, which allowed communication only by the exchange of volatile compounds or diffusible compounds in the medium, respectively, still resulted in enhanced droplet formation. The application of molecular sieves to bioassays resulted in the attenuation of the droplet-inducing effect of S. aburaviensis indicating the absorption of the compound. 1 H-NMR analysis of molecular-sieve extracts and the selective indophenol-blue reaction revealed that the volatile droplet-inducing compound is ammonia. The external supply of ammonia in biologically relevant concentrations of ≥8 mM enhanced droplet formation in S. violaceoruber in a similar way to S. aburaviensis. Ammonia appears to trigger droplet production in many Streptomyces strains because four out of six Streptomyces strains exposed to ammonia exhibited induced droplet production.

Multi-modality molecular imaging techniques have expanded the role of imaging biomarkers in the pharmaceutical industry and are beginning to streamline the drug discovery and development process. The World Molecular Imaging Society (WMIS) serves as a forum for discussing innovative and exploratory multi-modal, interdisciplinary molecular imaging research with a mission of bridging the gap between pathology and in vivo imaging. To formalize the role of the WMIS in pharmaceutical research efforts, members of the society have formed an interest group entitled Advancing Drug Discovery and Development using Molecular Imaging (ADDMI). The ADDMI interest group launched their efforts at the 2016 World Molecular Imaging Congress by hosting a session of invited lectures on translational positron emission tomography (PET) imaging in the central nervous system. This article provides a synopsis of those lectures and frames the role of translational imaging biomarker strategies in the drug discovery and development process.

Olfactory signals constitute an important mechanism in interspecific interactions, but little is known regarding their role in communication between predator species. We analyzed the behavioral responses of a mesopredator, the red fox ( Vulpes vulpes ), to an olfactory cue (scat) of an apex predator, the lynx ( Lynx lynx ) in Białowieża Primeval Forest, Poland, using video camera traps. Red fox visited sites with scats more often than expected and the duration of their visits was longer at scat sites than at control sites (no scat added). Vigilant behavior, sniffing and scent marking (including over-marking) occurred more often at scat sites compared to control sites, where foxes mainly passed by. Vigilance was most pronounced during the first days of the recordings. Red fox behavior was also influenced by foxes previously visiting scat sites. They sniffed and scent marked (multiple over-marking) more frequently when the lynx scat had been over-marked previously by red fox. Fox visits to lynx scats may be seen as a trade-off between obtaining information on a potential food source (prey killed by lynx) and the potential risk of predation by an apex predator.

Background/aims: Human peritoneal mesothelial cells (HPMC) secrete phosphatidylcholines (PC) which form a lipid bilayer lining the peritoneum. They prevent frictions and adhesions and act as a barrier to the transport of water-soluble solutes while permitting water flux. PC may play an essential role in peritoneal integrity and function, the role of PD induced HPMC senescence on PC homeostasis, however, is unknown., Methods: HPMC cell lines were isolated from four non-uremic patients. Expression of the three PC synthesis genes (rt-PCR), and cellular storage and secretion of PC (ESI-mass-spectrometry) were analyzed in young and senescent HPMC (>Hayflick-limit)., Results: Senescent cells displayed significantly altered morphology; flow cytometry demonstrated extensive staining for senescence-associated beta galactosidase. Nine different PC were detected in HPMC with palmitoyl-myristoyl phosphatidylcholine (PMPC) being most abundant. In senescent HPMC mRNA expression of the three key PC synthesis genes was 1.5-, 2.4- and 6-fold increased as compared to young HPMC, with the latter, phosphatidylcholine cytidylyltransferase, being rate limiting. Intracellular storage of the nine PC was 75-450 % higher in senescent vs. young HPMC, PC secretion rates were 100-300 % higher. Intracellular PC concentrations were not correlated with the PC secretion rates. Electron microscopy demonstrated lamellar bodies, the primary storage site of PC, in senescent but not in young cells., Conclusion: Senescent HPMC store and secrete substantially more PC than young cells. Our findings indicate a novel protective mechanism, which should counteract peritoneal damage induced by chronic exposure to PD fluids.

Objective: Reconstruction of the ruptured ulnar collateral ligament of the metacarpophalangeal (MP) joint of the thumb., Indications: Ruptured ulnar collateral ligament of the thumb MP joint with instability: joint opening of more than 30° in flexion and more than 20° in extension, Stener lesion, displaced avulsion fractures., Contraindications: Abrasions, wound-healing disturbance, skin disease, osteoarthritis., Surgical Technique: Curved skin incision dorsoulnar above the thumb MP joint. Protection of the branches of the superficial radial nerve. Incision of the adductor aponeurosis. Exposing the ulnar collateral ligament; opening and examination of the joint. Depending on the injury, primary suture repair, transosseous suture, repair with a bone anchor, osteosynthesis with K-wires or small screws in avulsion fracture, ligament reconstruction in chronic instability or older injury., Postoperative Treatment: Cast splint of the MP joint until swelling subsides; cast immobilization for 6 weeks; range-of-motion exercises, avoiding forced radial deviation of the MP joint for 3 months., Results: Complete joint stability 3 months postoperatively in all 34 patients with rupture of the ulnar collateral ligament.

We have determined refined multidimensional chemical shift ranges for intra-residue correlations ((13)C-(13)C, (15)N-(13)C, etc.) in proteins, which can be used to gain type-assignment and/or secondary-structure information from experimental NMR spectra. The chemical-shift ranges are the result of a statistical analysis of the PACSY database of >3000 proteins with 3D structures (1,200,207 (13)C chemical shifts and >3 million chemical shifts in total); these data were originally derived from the Biological Magnetic Resonance Data Bank. Using relatively simple non-parametric statistics to find peak maxima in the distributions of helix, sheet, coil and turn chemical shifts, and without the use of limited "hand-picked" data sets, we show that ~94% of the (13)C NMR data and almost all (15)N data are quite accurately referenced and assigned, with smaller standard deviations (0.2 and 0.8 ppm, respectively) than recognized previously. On the other hand, approximately 6% of the (13)C chemical shift data in the PACSY database are shown to be clearly misreferenced, mostly by ca. -2.4 ppm. The removal of the misreferenced data and other outliers by this purging by intrinsic quality criteria (PIQC) allows for reliable identification of secondary maxima in the two-dimensional chemical-shift distributions already pre-separated by secondary structure. We demonstrate that some of these correspond to specific regions in the Ramachandran plot, including left-handed helix dihedral angles, reflect unusual hydrogen bonding, or are due to the influence of a following proline residue. With appropriate smoothing, significantly more tightly defined chemical shift ranges are obtained for each amino acid type in the different secondary structures. These chemical shift ranges, which may be defined at any statistical threshold, can be used for amino-acid type assignment and secondary-structure analysis of chemical shifts from intra-residue cross peaks by inspection or by using a provided command-line Python script (PLUQin), which should be useful in protein structure determination. The refined chemical shift distributions are utilized in a simple quality test (SQAT) that should be applied to new protein NMR data before deposition in a databank, and they could benefit many other chemical-shift based tools.

Objective: Providing stability and reduction of the period of immobilisation of non- or minimally displaced scaphoid fractures using a minimally invasive technique., Indications: Scaphoid fractures of the types A2, B1 and B2 (Herbert's classification) with no or minimal displacement, along with a patient's request for early functional treatment., Contraindications: Relative contraindications: significant dislocation of the fracture, scaphoid cyst or a too proximal fracture, concomitant fractures of the wrist. Absolute contraindications: pseudoarthrosis, luxation fractures., Surgical Technique: Minimally invasive percutaneous screw fixation using a double threaded screw., Postoperative Management: Postoperative immobilisation in a plaster cast with a thumb inlay for 1-3 weeks until swelling and pain subside. Followed by active physiotherapeutic exercise, however no pressure on the hand for 6 weeks after surgery., Results: Seventy patients with a non- or a minimally displaced scaphoid fracture were treated between 2005 and 2011. We used percutaneous screw fixation as the therapy technique. A total of 57 patients (81%) presented for follow-up. Four patients (5.7%) had an unhealed fracture 6 months postsurgery confirmed. One patient needed revision surgery because of a screw that was too long. None of the patients had a postsurgical infection, haematoma or a complex regional pain syndrome. Smoking and putting pressure on the hand too early have been identified as possible risk factors for the unhealed fractures.

Therapeutic options for patients with castration-resistant prostate cancer (CRPC) remain limited. In a multicenter, Phase II study, 65 patients with histologically confirmed CRPC received a biomodulatory regimen during the six-month core study. Treatment comprised daily doses of imatinib mesylate, pioglitazone, etoricoxib, treosulfan and dexamethasone. The primary endpoint was prostate-specific antigen (PSA) response. Responders could enter an extension phase until disease progression or intolerable toxicity occurred. Mean PSA was 45.3 ng/mL at baseline, and 77 % of patients had a PSA doubling time <3 months. Of the 61 evaluable patients, 37 patients (60.6 %) responded or had stable disease and 23 of them (37.7 % of 61 patients) were PSA responders. Among the 23 responders mean PSA decreased from 278.9 ± 784.1 ng/mL at baseline to 8.8 ± 11.6 ng/mL at the final visit (week 24). The progression-free survival (PFS) was 467 days in the ITT population. Of the 947 adverse events, 57.6 % were suspected to be drug-related, 13.8 % led to dose adjustment or permanent discontinuation and 40.2 % required concomitant medication. This novel combination approach led to an impressive PSA response rate of 37.7 % in CRPC patients. The good PSA response and PFS rate combined with the manageable toxicity profile suggest an alternative treatment option.

The measurement of long-range distances remains a challenge in solid-state NMR structure determination of biological macromolecules. In 2D and 3D correlation spectra of uniformly (13)C-labeled biomolecules, inter-residue, inter-segmental, and intermolecular (13)C-(13)C cross peaks that provide important long-range distance constraints for three-dimensional structures often overlap with short-range cross peaks that only reflect the covalent structure of the molecule. It is therefore desirable to develop new approaches to obtain spectra containing only long-range cross peaks. Here we show that a relaxation-compensated modification of the commonly used 2D (1)H-driven spin diffusion (PDSD) experiment allows the clean detection of such long-range cross peaks. By adding a z-filter to keep the total z-period of the experiment constant, we compensate for (13)C T1 relaxation. As a result, the difference spectrum between a long- and a scaled short-mixing time spectrum show only long-range correlation signals. We show that one- and two-bond cross peaks equalize within a few tens of milliseconds. Within ~200 ms, the intensity equilibrates within an amino acid residue and a monosaccharide to a value that reflects the number of spins in the local network. With T1 relaxation compensation, at longer mixing times, inter-residue and inter-segmental cross peaks increase in intensity whereas intra-segmental cross-peak intensities remain unchanged relative to each other and can all be subtracted out. Without relaxation compensation, the difference 2D spectra exhibit both negative and positive intensities due to heterogeneous T1 relaxation in most biomolecules, which can cause peak cancellation. We demonstrate this relaxation-compensated difference PDSD approach on amino acids, monosaccharides, a crystalline model peptide, a membrane-bound peptide and a plant cell wall sample. The resulting difference spectra yield clean multi-bond, inter-residue and intermolecular correlation peaks, which are often difficult to resolve in the parent 2D spectra.

We introduce a Python-based program that utilizes the large database of (13)C and (15)N chemical shifts in the Biological Magnetic Resonance Bank to rapidly predict the amino acid type and secondary structure from correlated chemical shifts. The program, called PACSYlite Unified Query (PLUQ), is designed to help assign peaks obtained from 2D (13)C-(13)C, (15)N-(13)C, or 3D (15)N-(13)C-(13)C magic-angle-spinning correlation spectra. We show secondary-structure specific 2D (13)C-(13)C correlation maps of all twenty amino acids, constructed from a chemical shift database of 262,209 residues. The maps reveal interesting conformation-dependent chemical shift distributions and facilitate searching of correlation peaks during amino-acid type assignment. Based on these correlations, PLUQ outputs the most likely amino acid types and the associated secondary structures from inputs of experimental chemical shifts. We test the assignment accuracy using four high-quality protein structures. Based on only the Cα and Cβ chemical shifts, the highest-ranked PLUQ assignments were 40-60 % correct in both the amino-acid type and the secondary structure. For three input chemical shifts (CO-Cα-Cβ or N-Cα-Cβ), the first-ranked assignments were correct for 60 % of the residues, while within the top three predictions, the correct assignments were found for 80 % of the residues. PLUQ and the chemical shift maps are expected to be useful at the first stage of sequential assignment, for combination with automated sequential assignment programs, and for highly disordered proteins for which secondary structure analysis is the main goal of structure determination.

Prior investigations suggest that birth order position may be associated with the risk for developing a pervasive developmental disorder. This retrospective chart review examined the birth order status of 29 psychiatrically-referred patients with Asperger's Syndrome (AS). Eighty-six percent of the subjects were first born. The finding was statistically significant when compared to an expected random distribution of AS subjects χ(2) (1, N = 29) = 9.18, p < 0.01. The reasons for such an association are unclear though birth stoppage, obstetric complications, and immunological mechanisms may play a role.

Objective: Problematic tissue defects in the distal one-third of the lower leg represent a special challenge for the operative therapy. The distally based adipofascial sural artery flap is a safe and effective modification of the classical fasciocutaneous sural artery flap technique and makes the reconstruction in this problematic area more feasible. The surgical aim is soft tissue reconstruction with local tissue avoiding free tissue transfer., Indications: Complex or chronic wounds (maximum width of 8 cm) of the distal lower leg with exposed bone, joints, tendons, and/or neurovascular structures, especially in cases of missing skin perforators., Contraindications: Arterial vascular disease (stage III-IV), especially peroneal artery occlusion. Postthrombotic syndrome with occlusion of the small saphenous vein. Chronic lymphedema., Surgical Technique: Preparation of the vascular pedicle of the distally based flap (including small saphenous vein, sural artery and nerve), the adjacent crural fascia and the subcutaneous fat without a skin island. The pivot point is about 6 cm cranial to the malleolus lateralis. The flap can be raised proximally up to the heads of the gastrocnemius muscle. After harvesting the flap there will be a change in blood flow direction in the small saphenous vein. The donor site can be closed primarily. The flap is covered with meshed split skin graft at the end of surgery., Postoperative Management: Strict elevation of the extremity for 5 days, then flap conditioning., Results: Between 1997 and 2012, this technique was used in 104 consecutive patients with soft tissue defects in the distal one-third of the lower leg. Flap survival was achieved 91 patients. In 2 patients amputation of the lower leg was necessary at the mid tibia level. In 3 cases flap necrosis occurred, requiring free tissue transfer.

Objective: Reduction of pain and gain of functionality in symptomatic osteoarthritis of the first carpometacarpal joint., Indications: Idiopathic, rheumatic, or posttraumatic osteoarthritis of the first carpometacarpal joint. RELATIVE CONTRAINDICATIONS: Poor general condition, poor condition of the hand's soft tissue/skin, chronic regional pain syndrome, current or recent infections of the hand, heavy manual labor (decision on a by-case basis)., Surgical Technique: Supine position, hand pronated or slightly tilted. Upper arm tourniquet (Esmarch's method). Loupe magnification. Incision over the first extensor compartment. Exposure and incision of the thumb's basal joint. Resection of the trapezium. Exposure of the abductor pollicis longus (APL) tendon. Longitudinal split of the tendon harvesting the distally based ulnar part of the tendon. The split APL tendon is wrapped around the flexor carpi radialis (FCR) muscle tendon, suturing it to the tendon and back to itself. The rest of the split APL tendon is placed into the gap between the scaphoid and the first metacarpal bone, which is followed by wound closure., Postoperative Management: Plaster cast (thumb abduction splint) for 4 weeks. Stable commercially available wrist brace for at least 2 more weeks., Results: There were no significant differences between the FCR arthroplasty (Epping's method) and the APL arthroplasty (Wulle's technique) regarding pain (visual analog scale), disability/usability (DASH score), or range of motion. Patients who had undergone APL arthroplasty showed significantly better grip and pinch strength. Furthermore, the operating time was significantly shorter and scars were significantly smaller in APL arthroplasty.

Several techniques for spectral editing of 2D (13)C-(13)C correlation NMR of proteins are introduced. They greatly reduce the spectral overlap for five common amino acid types, thus simplifying spectral assignment and conformational analysis. The carboxyl (COO) signals of glutamate and aspartate are selected by suppressing the overlapping amide N-CO peaks through (13)C-(15)N dipolar dephasing. The sidechain methine (CH) signals of valine, lecuine, and isoleucine are separated from the overlapping methylene (CH(2)) signals of long-chain amino acids using a multiple-quantum dipolar transfer technique. Both the COO and CH selection methods take advantage of improved dipolar dephasing by asymmetric rotational-echo double resonance (REDOR), where every other π-pulse is shifted from the center of a rotor period t(r) by about 0.15 t(r). This asymmetry produces a deeper minimum in the REDOR dephasing curve and enables complete suppression of the undesired signals of immobile segments. Residual signals of mobile sidechains are positively identified by dynamics editing using recoupled (13)C-(1)H dipolar dephasing. In all three experiments, the signals of carbons within a three-bond distance from the selected carbons are detected in the second spectral dimension via (13)C spin exchange. The efficiencies of these spectral editing techniques range from 60 % for the COO and dynamic selection experiments to 25 % for the CH selection experiment, and are demonstrated on well-characterized model proteins GB1 and ubiquitin.

Objective: Reconstruction of the tip of the thumb using a neurovascular flap., Indications: Transverse defects of the thumb's tip or large defects of the palmar pulp (max. 2.0-2.5 cm) with exposure of bone and/or tendons., Contraindications: Extensive crush injury, heavy wound contamination, circulatory disorders, acute infection, very large defects (> 2.0-2.5 cm finger length), circumferential soft tissue defects, and previous defects/operations (relative)., Surgical Technique: Supine position, hand supinated, tourniquet, loupe magnification. Mid-lateral incisions along both sides of the finger running from the defect to the interphalangeal joint (small defect) or proceeding further proximally. Careful elevation of the flap including both neurovascular bundles leaving dorsal branches of the bundles (long fingers only) and the flexor tendon sheath intact. Suture of the flap in either flexion position (i.e., advancement flap) (Moberg) or by creating an island-flap through an additional transverse skin incision along the flap's base (O'Brien). Finally, closure of the defect at the flap's base using a full thickness skin graft, Z plasty, or V-Y plasty., Postoperative Management: Plaster cast (finger slightly flexed) for 2 weeks., Results: Reliable method. Good functional results with good sensibility and only minor reduction in range of motion.

Objective: Operative technique of propeller flap reconstruction of soft tissue defects in the distal lower extremity. Soft tissue reconstruction of the distal third of the lower extremity with local, reliable perforator flaps avoiding free tissue transfer., Indications: Complex wounds (maximum width of 6 cm) of the distal lower extremity with exposed bones, joints, tendons, and neurovascular structures., Contraindications: Arterial vascular disease (stage III or IV), diabetes mellitus, postthrombotic syndrome, venous ulcers, chronic lymphedema, contusion of adjacent soft tissue, previous radiation, and lack of perforators, Surgical Technique: The perforator represents the pivot point around which rotation of up to 180º of the subfascially harvested flap allows closure of the defect. The proximal donor site can be closed primarily up to a width of 6 cm., Postoperative Management: Strict elevation of the extremity for 5 days, then flap conditioning., Results: This technique was used for soft tissue reconstruction in 17 patients. In one patient with diabetes, complete flap necrosis occurred, requiring amputation of the extremity. One case of epidermolysis healed without further surgery.

Purpose: To explore feasibility, tolerability, dosimetry and probable efficacy of intravenous endoradiotherapy with carrier-added 4-[(131)I]iodo-L-phenylalanine (c.a. (131)I-IPA) in refractory high-grade glioma., Methods: Two male patients (45 and 50 years), with long-standing, extensively pre-treated gliomas and evidence of progression underwent single intravenous injections of 2 and 4 GBq of c.a. (131)I-IPA, respectively. Tumour targeting was verified by (131)I-IPA single-photon emission computed tomography (SPECT). Metabolic and morphological changes indicative of tumour response were assessed by sequential [(18)F]fluoroethyltyrosine ((18)F-FET) positron emission tomography (PET) and contrast-enhanced magnetic resonance imaging (MRI) following therapy. Further monitoring included clinical state, safety laboratory, quality of life and dosimetry. Absorbed mean organ and whole-body doses were determined according to the Medical Internal Radiation Dose (MIRD) scheme using OLINDAEXM based on serial planar scintigraphy., Results: Both patients tolerated the treatment well. No evidence of acute or delayed organ toxicity was observed. (131)I-IPA accumulated in the tumour recurrences identified by MRI/(18)F-FET. In patient 1, PET showed progressively decreasing maximum standardised uptake values (SUVmax) over 10 months, indicating metabolic response, paralleled by reduced contrast enhancement and tumour volume on MRI. Progression occurred 18 months after therapy. Treatment was repeated using 6.6 GBq of (131)I-IPA, to which no response was observed. Patient 2, followed-up for 3 months after therapy, showed stable disease on MRI and PET. Mean absorbed whole body doses ranged from 0.13 to 0.17 mSv/MBq, with the highest absorbed organ doses to kidneys, bladder and heart (0.86-1.23; 0.49-0.6 and 0.45-0.56 mSv/MBq)., Conclusion: Systemic endoradiotherapy using up to 6.6 GBq of c.a.(131)I-IPA is not associated with clinically detectable toxicity. Measurable anti-tumour effects in gliomas were observed. (131)I-IPA warrants further evaluation as glioma therapy.

Background and Objectives: An optimal vitamin and mineral supply may contribute to the enhancement of immune defenses and thus favorably influence the course and intensity of recurrent upper respiratory tract infections (URIs). ln the present study the dietary efficacy and benefits of a micronutrient combination in patients with recurrent URls was evaluated., Methods: 192 patients with recurrent URIs were enrolled in this randomized, placebo-controlled, double-blind multicenter trial for a study duration of 16 weeks. Efficacy variables were number, intensity and course of URIs (as assessed using a total common cold score [CCS]) and the alterations in micronutrient supply (vitamins C and D3, folic acid and selenium) during the study., Results: In subjects who initially had at least two common cold symptoms (N = 107) the symptoms improved in the active group (AG) significantly more than in the placebo group (PG; ACCS: AG -6.9 +/- 4.8; PG -5.4 +/- 4.5; p = 0.034). In patients with initially severe common cold (CC) episodes the symptoms improved in the AG to a statistically significant extent (ACCS: AG -93.8%, PG -91.2%, p = 0.043). In the age group below 45 years significantly fewer AG than PG patients were absent from their job during the second or third CC episode (AG: 14.3%, PG: 47.8%, p = 0.038). Patients with vitamin-D deficiency and/or insufficient vitamin-C supply reported significantly fewer CC episodes in AG than in PG. In the course of the trial, in AG vs. PG the serum vitamin C, folic acid and selenium levels increased (p < or = 0.001). The concentration of 25(OH)D3 decreased in both groups, but less so in the AG (AG -8.8%; PG-14%; p = 0.001)., Conclusion: Study results show the efficacy of a nutritional medical treatment with a special micronutrient combination in patients susceptible to infections and suffering from recurrent respiratory tract infections.

Background and Objectives: An optimal vitamin and mineral supply may contribute to the enhancement of immune defenses and thus favorably influence the course and intensity of recurrent upper respiratory tract infections (URIs). In the present study the dietary efficacy and benefits of a micronutrient combination in patients with recurrent URIs was evaluated., Methods: 192 patients with recurrent URIs were enrolled in this randomized, placebo-controlled, double-blind multicenter trial for a study duration of 16 weeks. Efficacy variables were number, intensity and course of URIs (as assessed using a total common cold score [CCS]) and the alterations in micronutrient supply (vitamins C and D3, folic acid and selenium) during the study., Results: In subjects who initially had at least two common cold symptoms (N = 107) the symptoms improved in the active group (AG) significantly more than in the placebo group (PG; ΔCCS: AG -6.9 ± 4.8; PG -5.4 ± 4.5; p = 0.034). In patients with initially severe common cold (CC) episodes the symptoms improved in the AG to a statistically significant extent (ΔCCS: AG -93.8%, PG -91.2%, p = 0.043). In the age group below 45 years significantly fewer AG than PG patients were absent from their job during the second or third CC episode (AG: 14.3%, PG: 47.8%, p = 0.038). Patients with vitamin-D deficiency and/or insufficient vitamin-C supply reported significantly fewer CC episodes in AG than in PG. In the course of the trial, in AG vs. PG the serum vitamin C, folic acid and selenium levels increased (p ? 0.001). The concentration of 25(OH)D3 decreased in both groups, but less so in the AG (AG -8.8%; PG -14%; p = 0.001)., Conclusion: Study results show the efficacy of a nutritional medical treatment with a special micronutrient combination in patients susceptible to infections and suffering from recurrent respiratory tract infections.

When animal ethicists deal with welfare they seem to face a dilemma: On the one hand, they recognize the necessity of welfare concepts for their ethical approaches. On the other hand, many animal ethicists do not want to be considered reformist welfarists. Moreover, animal welfare scientists may feel pressed by moral demands for a fundamental change in our attitude towards animals. The analysis of this conflict from the perspective of animal ethics shows that animal welfare science and animal ethics highly depend on each other. Welfare concepts are indispensable in the whole field of animal ethics. Evidence for this can be found by analyzing the structure of theories of animal ethics and the different ways in which these theories employ welfare concepts. Furthermore, the background of values underneath every welfare theory is essential to pursue animal welfare science. Animal ethics can make important contributions to the clarification of underlying normative assumptions with regard to the value of the animal, with regard to ideas about what is valuable for the animal, and with regard to the actions that should follow from the results of animal welfare science.

Mutations in the K+ channel gene KCNJ10 (Kir4.1) cause the autosomal recessive EAST syndrome which is characterized by epilepsy, ataxia, sensorineural deafness, and a salt-wasting tubulopathy. The renal salt-wasting pathology of EAST syndrome is caused by transport defects in the distal convoluted tubule where KCNJ10 plays a pivotal role as a basolateral K+ channel. This review on EAST syndrome outlines the molecular aspects of the physiology and pathophysiology of KCNJ10 in the distal convoluted tubule.

We describe a patient with MUTYH-associated polyposis diagnosed with colon cancer at 33 years of age, as well as gastric polyps at a later age. She was also diagnosed with papillary thyroid cancer at age 35. MUTYH-associated polyposis is an autosomal recessively inherited disease which has clinical overlap with Familial adenomatous polyposis and its attenuated form, in that it is associated with risk of colon cancer at a young age. Extra-intestinal cancers have also been reported in patients with MUTYH-associated polyposis; however the tumor spectrum is still evolving. National Comprehensive Cancer Network guidelines recommend screening for colon, duodenal and gastric polyps in individuals with MUTYH-associated polyposis. Screening for extra-intestinal cancers i.e. thyroid cancer is presently not part of these recommendations. These will likely continue to evolve as the MUTYH-associated polyposis tumor spectrum is better understood as a result of future case reports and research.