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Background: Early identification of child abuse is critical to prevent death and disability. Studies suggest implicit bias of providers may lead to overrepresentation of minority and impoverished children in child abuse reporting. At our institution, universal screening for sexual and physical abuse for all children under 18 years of age was implemented in 2016. A rigorous, objective evaluation protocol focusing on the mechanism of injury and exam findings to improve recognition and eliminate bias was implemented in 2019. Findings: Demographics and clinical characteristics of patients less than 18 years of age were abstracted by chart review (2014–2015) and from a forensic database (2016–2022). International Classification of Diseases codes 995.5 (version 9) and T76.12XA (version 10) were used to identify patients before the establishment of forensic database. Relative frequency and patient characteristics of the three time periods (pre universal screening: 2014–2015, post universal screening: 2016–2019, post protocol implementation: 2020–2022) were compared using Chi-square tests and modified Poisson regression. Universal screening significantly increased the number of cases identified. The demographic profile of potential victims by race significantly changed over the reporting periods with an increased number of white children identified, consistent with state demographics. The proportion of publicly insured patients trended down with universal screening and protocol implementation, despite a significant increase in the number of children publicly insured in the state during this time. Conclusion: These single institutional results lend support to objective, evidence-based protocols to help eliminate bias surrounding race and poverty. [ABSTRACT FROM AUTHOR]

Background: We recently developed a preliminary predictive model identifying clinical and radiologic factors associated with the need for surgery following blunt abdominal trauma (BAT) in children. Our aim in this study was to further validate the factors in this predictive model in a multi-institutional study. Methods: A retrospective chart review of pediatric patients from five pediatric trauma centers who experienced BAT between 2011 and 2020 was performed. Patients under 18 years of age who had BAT and computed tomography (CT) abdomen imaging were included. Children with evidence of pneumoperitoneum, and hemodynamic instability were excluded. Fisher's exact test was used for statistical analysis of the association between the following risk factors and need for laparotomy: abdominal wall bruising (AWB), abdominal pain/tenderness (APT), thoracolumbar fracture (TLF), presence of free fluid (FF), presence of solid organ injury (SOI). A predictive logistic regression model was then estimated employing these factors. Findings: Seven hundred thirty-four patients were identified in this multi-institutional dataset with BAT and abdominal CT imaging, and 726 were included. Of those, 59 underwent surgical intervention (8.8%). Univariate analysis of association between the studied factors and need for surgical management showed that the presence of TLF (p < 0.01), APT (p < 0.01), FF (p < 0.01), and SOI (p < 0.01) were significantly associated. A predictive model was created using the 5 factors resulting in an area under the curve (AUC) of 0.80. For the motor vehicle collisions (MVC) group, only FF, SOI, and TLF are significantly associated with the need for surgical intervention. The AUC for the MVC group was 0.87. Conclusions: A clinical and radiologic prediction rule was validated using a large multi-institutional dataset of pediatric BAT patients, demonstrating a high degree of accuracy in identifying children who underwent surgery. FF, SOI, and TLF are the most important factors associated with the need for surgical intervention. Level of evidence: Level III. [ABSTRACT FROM AUTHOR]

During the last glacial–interglacial cycle, Arctic biotas experienced substantial climatic changes, yet the nature, extent and rate of their responses are not fully understood1–8. Here we report a large-scale environmental DNA metagenomic study of ancient plant and mammal communities, analysing 535 permafrost and lake sediment samples from across the Arctic spanning the past 50,000 years. Furthermore, we present 1,541 contemporary plant genome assemblies that were generated as reference sequences. Our study provides several insights into the long-term dynamics of the Arctic biota at the circumpolar and regional scales. Our key findings include: (1) a relatively homogeneous steppe–tundra flora dominated the Arctic during the Last Glacial Maximum, followed by regional divergence of vegetation during the Holocene epoch; (2) certain grazing animals consistently co-occurred in space and time; (3) humans appear to have been a minor factor in driving animal distributions; (4) higher effective precipitation, as well as an increase in the proportion of wetland plants, show negative effects on animal diversity; (5) the persistence of the steppe–tundra vegetation in northern Siberia enabled the late survival of several now-extinct megafauna species, including the woolly mammoth until 3.9 ± 0.2 thousand years ago (ka) and the woolly rhinoceros until 9.8 ± 0.2 ka; and (6) phylogenetic analysis of mammoth environmental DNA reveals a previously unsampled mitochondrial lineage. Our findings highlight the power of ancient environmental metagenomics analyses to advance understanding of population histories and long-term ecological dynamics.A large-scale metagenomic analysis of plant and mammal environmental DNA reveals complex ecological changes across the circumpolar region over the past 50,000 years, as biota responded to changing climates, culminating in the postglacial extinction of large mammals and emergence of modern ecosystems. [ABSTRACT FROM AUTHOR]

Background: The pediatric patient's response to hemorrhage as a function of young age is not well understood. As a result, there is no consensus on optimal resuscitation strategies for hemorrhagic shock in pediatric patients, or on the identification of clinical triggers to prompt implementation. The study objective was to develop a model of pediatric hemorrhage using young pigs to simulate school-aged children, and determine clinical and laboratory indicators for significant hemorrhage.Materials and Methods: 29 non-splenectomized female pigs, aged 3 months, weighing 30-40 kg, were randomized into groups with varying degrees of hemorrhage. Bleeding occurred intermittently over 5 h while the animals were anesthetized but spontaneously breathing. Various physiologic and biochemical markers were used to monitor the piglets during hemorrhage.Results: Swine experiencing up to 50% hemorrhage survived without exception throughout the course of hemorrhage. 80% (4/5) of the animals in the 60% hemorrhage group survived. Need for respiratory support was universal when blood loss reached 50% of estimated blood volume. Blood pressure was not useful in classifying the degree of shock. Heart rate was helpful in differentiating between the extremes of blood loss examined. Arterial pCO2, pH, lactate, HCO3 and creatinine levels, as well as urine output, changed significantly with increasing blood loss.Conclusions: Young swine are resilient against hemorrhage, although hemorrhage of 50% or greater universally require respiratory support. In this animal model, with the exception of heart rate, vital signs were minimally helpful in identification of shock. However, change in select laboratory values from baseline was significant with increasing blood loss.Level Of Evidence: This was a level II prospective comparative study. [ABSTRACT FROM AUTHOR]

DNA-based snapshots of ancient vegetation have shown that the composition of high-latitude plant communities changed considerably during the late Quaternary. However, parallel changes in biotic interactions remain largely uninvestigated. Here we show how mutualisms involving plants and heterotrophic organisms varied during the last 50,000 years. During 50–25 ka BP, a cool period featuring stadial-interstadial fluctuations, arbuscular mycorrhizal and non-N-fixing plants predominated. During 25-15 ka BP, a cold, dry interval, the representation of ectomycorrhizal, non-mycorrhizal and facultatively mycorrhizal plants increased, while that of N-fixing plants decreased further. From 15 ka BP, which marks the transition to and establishment of the Holocene interglaciation, representation of arbuscular mycorrhizal plants decreased further, while that of ectomycorrhizal, non-mycorrhizal, N-fixing and wind-pollinated plants increased. These changes in the mutualist trait structure of vegetation may reflect responses to historical environmental conditions that are without current analogue, or biogeographic processes, such as spatial decoupling of mutualist partners. [ABSTRACT FROM AUTHOR]

Two sites within the boreal forest of interior Alaska shed light on the climate and vegetation of terminal marine isotope stage (MIS) 6 (ca. 140-130 kyr ago) and MIS 5e (125-116 kyr ago). The Birch Creek and Koyukuk localities are river-cut exposures with sediments dating from the penultimate glaciation (at least) to the present. Plant macrofossils, pollen, and beetles were analyzed at these sites. Terminal MIS 6-aged samples indicate a cooler than modern climate and the presence of shrub tundra. During MIS 5e, boreal forest grew at the sites and temperatures were similar to modern times. However, the forest may also have been more mesic than today, as indicated by relatively abundant ferns. Winters may have been warmer than today, as suggested by beetle-based climatic reconstructions as well as the presence of two extralimital taxa that today live in regions where winter temperatures are up to 15 °C warmer than at the site localities. [ABSTRACT FROM AUTHOR]

Although it is generally agreed that the Arctic flora is among the youngest and least diverse on Earth, the processes that shaped it are poorly understood. Here we present 50 thousand years (kyr) of Arctic vegetation history, derived from the first large-scale ancient DNA metabarcoding study of circumpolar plant diversity. For this interval we also explore nematode diversity as a proxy for modelling vegetation cover and soil quality, and diets of herbivorous megafaunal mammals, many of which became extinct around 10 kyr bp (before present). For much of the period investigated, Arctic vegetation consisted of dry steppe-tundra dominated by forbs (non-graminoid herbaceous vascular plants). During the Last Glacial Maximum (25-15 kyr bp), diversity declined markedly, although forbs remained dominant. Much changed after 10 kyr bp, with the appearance of moist tundra dominated by woody plants and graminoids. Our analyses indicate that both graminoids and forbs would have featured in megafaunal diets. As such, our findings question the predominance of a Late Quaternary graminoid-dominated Arctic mammoth steppe. [ABSTRACT FROM AUTHOR]

Opal, organic C and N contents, and organic δC and δN stable isotopes were analyzed on a sedimentary sequence spanning the past ~12,000 years from Dune Lake, a shallow groundwater-fed lake in the boreal forest region of central interior Alaska. The chronology, based on Pb and 15 AMS radiocarbon dates on terrestrial materials, indicates that 5 m of biogenic sediment accumulated following dune stabilization at ~10,000 cal yr BP. Previous studies on lake level and pollen were synthesized with these data to assess Holocene changes in hydrogeology and climate. Variability in groundwater level and flux has a strong control on lake level and are negatively correlated with the δC of organic matter produced within the lake. This relationship results from the input of groundwater with high pCO and with dissolved inorganic carbon depleted in C, which subsequently affects lake phytoplankton δC signatures. A rapid rise in lake level between ca. 11,000 and 9,500 cal yr BP coincided with stabilization of the dune field adjacent to the lake and expansion of vegetation around the lake, including white spruce. Organic δC values are relatively low and constant between about 10,000 and 6,000 cal yr BP, and then steadily increase until about 2,000 cal yr BP, suggesting a pattern of high followed by dropping lake levels generally consistent with results from core-transect studies. Higher-frequency fluctuations of 2-3 ‰ in δC are common, and suggest variability in aspects of the lake-carbon cycle over multi-decadal timescales. Recent trends in groundwater and lake level, river discharge, and precipitation suggest an important role for wintertime precipitation in the regional groundwater system. The unusual hydrology of this system relative to most other lakes studied for paleoclimate in this region provides a novel insight into different seasonal aspects of Alaskan paleoclimatology. The record is consistent with a general long-term decrease in wintertime precipitation, possibly accompanied by an increase in permafrost extent, over the Holocene. [ABSTRACT FROM AUTHOR]

The 'Perfect Storm' metaphor describes a combination of events that causes a surprising or dramatic impact. It lends an evolutionary perspective to how social-ecological interactions change. Thus, we argue that an improved understanding of how social-ecological systems have evolved up to the present is necessary for the modelling, understanding and anticipation of current and future social-ecological systems. Here we consider the implications of an evolutionary perspective for designing research approaches. One desirable approach is the creation of multi-decadal records produced by integrating palaeoenvironmental, instrument and documentary sources at multiple spatial scales. We also consider the potential for improved analytical and modelling approaches by developing system dynamical, cellular and agent-based models, observing complex behaviour in social-ecological systems against which to test systems dynamical theory, and drawing better lessons from history. Alongside these is the need to find more appropriate ways to communicate complex systems, risk and uncertainty to the public and to policy-makers. [ABSTRACT FROM AUTHOR]

We investigated whether techniques developed to evaluate qualitative lake-level changes in the temperate zone can be used in sub-arctic and arctic Alaska. We focused on aquatic pollen records and sediment properties (loss-on-ignition and magnetic susceptibility) from centrally-located sediment-surface samples and cores, as these are the most commonly reported data in the literature. Modern aquatic pollen values are generally low (< 5%) and may be zero, even in lakes with abundant aquatic macrophytes. Greater diversity and higher values of aquatic pollen are likely at depths < 5 m, but pollen is found in depths up to 15 m. It is absent at depths > 20 m. Spores of Isoetes and Equisetum and Pediastrum cell-nets, when present, tend to be widely distributed, even in deep water. At Birch Lake, interior Alaska, trends in aquatic taxa and sediment characteristics for the last ca. 12,000 14C yrs recorded in a single, deep-water core reflect the same water-level changes as do transect-based lake-level reconstructions - if modern distributional characteristics of pollen and spores are taken into account. The lake rose from extremely low levels at ca. 12,000 14C yr B.P. After a period of fluctuation, it rose to a relatively high level by ca. 8000 14C yr B.P. and then stabilized. A preliminary survey of aquatic pollen trends from other lake-sediment records suggests that the period ca. 11,000-8000 14C yr B.P. may have seen relatively low lake levels in north-western and interior Alaska and high levels thereafter. Changes in aquatic pollen and sediments are evident in north-eastern interior lakes at the same time, but they are more difficult to interpret. Aquatic pollen productivity in Alaskan lakes may partly depend on factors other than water depth (e.g. temperature, pH, nutrient status, or length of the ice-free season). An Alaska-wide reconstruction of late-Quaternary lake levels based on extant single-core data would be best done after further study of contributing factors that may control sediment properties and aquatic pollen distribution. [ABSTRACT FROM AUTHOR]

Membrane-bound enzymes from developing legume-seed endosperms catalyse galactomannan biosynthesis in vitro from GDP-mannose and UDP-galactose. A mannosyltransferase [mannan synthase] catalyses the extension of the linear (1→4)-β-linked d-mannan backbone towards the non-reducing end. A specific α-galactosyltransferase brings about the galactosyl-substitution of the backbone by catalysing the transfer of a (1→6)-α- d-galactosyl residue to an acceptor mannosyl residue at or close to the non-reducing terminus of the growing backbone. Labelled galactomannans with a range of mannose/galactose (Man/Gal) ratios were formed in vitro from GDP-[C]mannose and UDP-[C]galactose using membrane-bound enzyme preparations from fenugreek ( Trigonella foenum-graecum L.), guar ( Cyamopsis tetragonoloba (L.) Taub.) and senna ( Senna occidentalis (L.) Link.), species which in vivo, form galactomannans with Man/Gal ratios of 1.1, 1.6 and 3.3 respectively. The labelled galactomannans were fragmented using a structure-sensitive endo-(1→4)-β- d-mannanase and the quantitative fragmentation data were processed using a computer algorithm which simulated the above model for galactomannan biosynthesis on the basis of a second-order Markov chain process, and also the subsequent action of the endo-mannanase. For each galactomannan data-set processed, the algorithm generated a set of four conditional probabilities required by the Markov model. The need for a second-order Markov chain description indicated that the galactomannan subsite recognition sequence of the galactosyltransferase must encompass at least three backbone mannose residues, i.e. the site of substitution and the two preceding ones towards the reducing end of the growing galactomannan chain. Data-sets from the three plant species generated three distinctly different sets of probabilities, and hence galactose-substitution rules. For each species, the maximum degree of galactose-substitution consistent with these rules was closely similar to that observed for the primary product of galactomannan biosynthesis in vivo. The data provide insight into the mechanism of action and the spatial organisation of membrane-bound polysaccharide synthases. [ABSTRACT FROM AUTHOR]

Galactomannan deposition was investigated in developing endosperms of three leguminous species representative of taxonomic groups which have galactomannans with high, medium and low galactose content. These were fenugreek ( Trigonella foenum-graecum L.; mannose/galactose (Man/Gal) = 1.1), guar ( Cyamopsis tetragonoloba (L.) Taub.; Man/Gal = 1.6) and Senna occidentalis (L.) Link. (Man/Gal = 3.3), respectively. Endosperms were analysed at different stages of seed development for galactomannan content and the levels, in cell-free extracts, of a mannosyltransferase and a galactosyltransferase which have been shown to catalyse galactomannan biosynthesis in vitro (M. Edwards et al., 1989, Planta 178, 41-51). There was a close correlation in each case between the levels of the biosynthetic mannosyl- and galactosyltransferases and the deposition of galactomannan. The relative in vitro activities of the mannosyl- and galactosyltransferases in fenugreek and guar were similar, and almost constant throughout the period of galactomannan deposition. In Senna the ratio mannosyltransferase/galactosyltransferase was always higher than in the other two species, and it increased substantially throughout the period of galactomannan deposition. In fenugreek and guar the galactomannans present in the endosperms of seeds at different stages of development had the Man/Gal ratios characteristic of the mature seeds. By contrast the galactomannan present in Senna endosperms at the earliest stages of deposition had a Man/Gal ratio of about 2.3. During late deposition this ratio increased rapidly, stabilising at about 3.3, the ratio characteristic of the mature seed. The levels of α-galactosidase in the developing endosperms of fenugreek and guar were low and remained fairly constant throughout the deposition of the galactomannan. In Senna, α-galactosidase activity in the endosperm was low during early galactomannan deposition, but increased subsequently, peaking during late galactomannan deposition. The developmental patterns of the α-galactosidase activity and of the increase in Man/Gal ratio of the Senna galactomannan were closely similar, indicating a cause-and-effect relationship. The endosperm α-galactosidase activity in Senna was capable, in vitro, of removing galactose from guar galactomannan without prior depolymerisation of the molecule. In fenugreek and in guar the genetic control of the Man/Gal ratio in galactomannan is not the result of a post-depositional modification, and must reside in the biosynthetic process. In Senna, the Man/Gal ratio of the primary biosynthetic galactomannan product is controlled by the biosynthetic process. Yet the final Man/Gal ratio of the galactomannan in the mature seed is, to an appreciable extent, the result of galactose removal from the primary biosynthetic product by an α-galactosidase activity which is present in the endosperm during late galactomannan deposition. [ABSTRACT FROM AUTHOR]

Sixteen patients with discitis from January 1980 through December 1983 underwent 18CT scans for initial evaluation. In six scans the study produced a false negative result (sensitivity 63%, 11/16). In three of these six the scan was performed at the wrong disc level, and in three the error was interpretive. During the same time period 6 patients had a CT diagnosis of discitis which proved incorrect (positive predictive value 63%), three of which had fractures, two had normal post discectomy changes, and one had a neuropathic arthropathy. These studies were reviewed in a blinded fashion along with 30 CT scans of post operative patients without clinical or laboratory evidence of discitis. The CT findings in the discitis patients were: (a( anterior paravertebral soft tissue swelling with obliteration of paravertebral fat planes, (b) fragmentation or erosions of vertebral end plates, and (c) paravertebral fluid collection (abscess). Both (a) and (b) were seen in 13/15 patients, (a) alone in 1/15, (b) alone in 1/15, and all three (a, b, c) in 2/15. The CT scan is diagnostic of discitis in those with all three findings. In those patients with only (a) or both (a) and (b), the CT can be suggestive of discitis in the proper clinical setting when correlated with plain film findings: however, these CT findings are also observed in other conditions. Involvement of the spinal canal by inflammatory mass was seen in 6/16 patients with discitis. Low attenuation (hypodensity) of the affected disc was not observed. [ABSTRACT FROM AUTHOR]

Particulate enzyme preparations were isolated from developing fenugreek ( Trigonella foenum-graecum L.) and guar ( Cyamopsis tetragonoloba [L.] Taub.) seed endosperms during the period of galactomannan deposition in vivo. These preparations catalysed the formation of polysacharide products from guanosine 5′-diphosphate (GDP)-mannose, from uridine 5′-diphosphate (UDP)-galactose and from mixtures of the two nucleotides. The products were analysed by solubility, by complete acid hydrolysis, and by selective enzymatic cleavage using pure enzymes of known specificity. With GDP-[U-C]- d-mannose as substrate and a divalent metal cation (Mg, Mn, or Ca) a highly efficient transfer of labelled d-mannosyl residues was obtained to give a product identified as linear (1→4)-β-linked d-mannan. No transfer of galactosyl residues was obtained when GDP-[U-C]- d-galactose was the only substrate, although very low and variable amounts of an unidentified product which released labelled glucose on acid hydrolysis were formed. In the presence of UDP-galactose, GDP-mannose and Mn ions, products were formed which have been characterised as galactomanans - a linear (1→4)-β- d-mannan backbone carrying d-galactopyranosyl substituents linked (1→6)-α to mannose. The degree of galactose substitution of the d-mannan backbone was manipulated in vitro by varying GDP-mannose concentrations at constant (saturating) UDP-galactose levels. The transfer of d-galactosyl residues from UDP-galactose to galactomannan was absolutely dependent upon the simultaneous transfer of D-mannosyl residues from GDP-mannose. d-Mannan sequences pre-formed in situ using the mannosyltransferase in the absence of UDP-galactose could not become galactose-substituted in a subsequent incubation either with UDP-galactose alone or with UDP-galactose plus GDP-mannose A model for the interaction of GDP-mannose mannosyltransferase and UDP-galactose galactosyltransferase in galactomannan biosynthesis is proposed. [ABSTRACT FROM AUTHOR]

The levels of cell-wall xyloglucan (amyloid) in nasturtium ( Tropaeolum majus L.) cotyledons were monitored during a 28-d period covering seed imbibition, germination and early seedling development. The activities of the following enzymes capable of hydrolysing the glycosidic linkages in the xyloglucan were assayed in cotyledon extracts over the same period: endo-(1→4)-β-glucanase (EC 3.2.1.4), β-glucosidase (EC 3.2.1.21), α-xylosidase and β-galactosidase (EC 3.2.1.23). The endo-β-glucanase was assayed viscometrically using xyloglucan as substrate, and the three glycosidases using appropriate p-nitrophenylglycosides. Alpha xylosidase and β-galactosidase, the enzymes which would be expected to hydrolyse the side-chains from the xyloglucan molecule, were also assyed using xyloglucan as substrate. Under our culture conditions, xyloglucan levels remained constant at 30 mg per cotyledon pair for 7 d, that is until 3 d after germination: thereafter, the amount of xyloglucan diminished to zero in a 12-d period. The most rapid period of depletion was between days 9 and 13. The mobilisation of all reserve substances from the cotyledons resulted in a weight-loss of 92 mg: xyloglucan, therefore, is an important storage substance, representing 33% by weight of the seed's substrate reserves. It is a cell-wall storage polysaccharide. Xyloglucan mobilisation was accompanied by a 17-fold increase in endo-β-glucanase activity, a 7-fold increase in β-galactosidase and an 8-fold increase in α-xylosidase activities, all determined using xyloglucan as substrate. All three activities began to increase at day 5, peaked at days 12-14 when the most rapid phase of xyloglucan breakdown was over, and had declined to zero by days 22-25. The levels of theses enzymes have been shown to be consistent with their being responsible for xyloglucan hydrolysis in vivo. Nitrophenyl-β-galactosidase activity increased up to day 3, remained constant and then increased again 2.5-fold from day 5, peaking at day 11. Nitrophenyl-β-glucosidase remained relatively constant up to day 16 and then decreased to zero by day 25. Nitrophenyl-α-xylosidase activity was not detected. [ABSTRACT FROM AUTHOR]

The process of building bridges between theory and practice can be a difficult task, and instructional developers have only begun to attempt it. Specific ways in which instructional design theories can be applied within the context of an instructional development model are described in this article. The authors chronicle and analyze the development of a course in applied phonetics which is important both for its contribution to instruction in the field of phonetics and for the way in which it utilizes many different theories of instructional design in a real instructional setting. The authors also discuss how Elaboration Theory was applied, as well as other instructional strategies and evaluation techniques. The goal of Instructional Development is to create effective and efficient instruction. This is often achieved through systematic application of appropriate instructional theories and strategies in order to solve defined instructional problems. However, the application of theory and research to practice may be difficult. While researchers in the field of instructional design and development have been working steadily to build a theory base for themselves, practitioners continue to pragmatically develop curricula, courses, and instructional materials. In many ways, the field has worked deductively to establish rationales for its activities. Linkages between the broad, inclusive theories which contain only minimal strategies for implementation and the process of solving specific instructional problems have yet to be clearly established. This article provides one illustration of how such linkages can be established by chronicling and analyzing a specific instructional development project and identifying the various theories that were used as the project evolved. [ABSTRACT FROM AUTHOR]

The multiple forms of ATP-ase activity in maize root tips have been examined by separation and staining using polyacrylamide gel electrophoresis. The band pattern obtained using a whole homogenate supernatant fraction was compared with the pattern obtained from various cell organelle fractions. The kinetic properties of the ATP-ase activity in various fractions were also examined. The results support the view that ATP-ase activity exists in a number of molecular forms in the same tissue and that these forms may show specific intracellular localizations. [ABSTRACT FROM AUTHOR]

Attempts to explain the likelihood that a state would choose to participate in prison industry enhancement (PIE). Decline of prison production; Renewed interest in prison production; A public choice model; Econometric technique and data used in the study; Empirical results of the study; Conclusion drawn from the study.

Two cases of orbital pseudotumor are described with computed tomographic (CT) studies showing extension of the pseudotumor beyond the confines of the bony orbit. In one patient with orbital pseudotumor involving the medial rectus muscle, the pseudotumor extended through the medial wall of the orbit into the ethmoid sinus. A second patient had extension of orbital pseudotumor into the infraorbital fissure causing enlargement of the infraorbital fissure and foramen. Both lesions were confirmed by biopsy. [ABSTRACT FROM AUTHOR]

An unusual case of spontaneous rupture of the esophagus is reported in which the patient survived without surgical closure or drainage procedure. The site of perforation and subsequent closure are documented radiologically. [ABSTRACT FROM AUTHOR]

The timing of the seasonal freeze-thaw cycle of arctic lakes affects ecological processes and land-atmosphere energy fluxes. We carried out detailed ice-phenology mapping of arctic lakes, based on daily surface-reflectance time series for 2000-2013 from MODIS at 250 m spatial resolution. We used over 13,300 lakes, area >1 km2, in five study areas distributed evenly across the circumpolar Arctic - the first such phenological dataset. All areas showed significant trends towards an earlier break-up, stronger than previously reported. The mean shift in break-up start ranged from −0.10 days/year (Northern Europe) to −1.05 days/year (central Siberia); the shift in break-up end was between −0.14 and −0.72 days/year. Finally, we explored the effect of temperature on break-up timing and compared results among study areas. The 0 °C isotherm shows the strongest relationship (r = 0.56-0.81) in all study areas. If the trend in early break-up continues, rapidly changing ice phenology will likely generate significant, arctic-wide impacts. [ABSTRACT FROM AUTHOR]

Background: Tirbanibulin 1% ointment is a new treatment for actinic keratosis (AK) on the face or scalp. A health economic model was developed as part of a submission to the Scottish Medicines Consortium to evaluate the cost-effectiveness of tirbanibulin compared to the most frequently prescribed treatments.A decision tree approach was used to calculate the costs and benefits of different treatment strategies for AK on the face or scalp over a one-year time horizon. Data on the relative efficacy of treatments, which were based on the probability of complete clearance of AK, were obtained from a network meta-analysis. Sensitivity and scenario analyses were performed to determine the robustness of the model results.Tirbanibulin is estimated to be cost saving versus diclofenac sodium 3%, imiquimod 5% and fluorouracil 5%. Tirbanibulin remains cost saving when inputs are varied in sensitivity and scenario analyses. While the complete clearance rates are deemed similar across comparators, tirbanibulin is associated with a lower rate of severe local skin reactions, and a shorter treatment duration, which may improve treatment adherence.Tirbanibulin is a cost saving intervention for the treatment of AK from the perspective of the Scottish Healthcare System.Methods: Tirbanibulin 1% ointment is a new treatment for actinic keratosis (AK) on the face or scalp. A health economic model was developed as part of a submission to the Scottish Medicines Consortium to evaluate the cost-effectiveness of tirbanibulin compared to the most frequently prescribed treatments.A decision tree approach was used to calculate the costs and benefits of different treatment strategies for AK on the face or scalp over a one-year time horizon. Data on the relative efficacy of treatments, which were based on the probability of complete clearance of AK, were obtained from a network meta-analysis. Sensitivity and scenario analyses were performed to determine the robustness of the model results.Tirbanibulin is estimated to be cost saving versus diclofenac sodium 3%, imiquimod 5% and fluorouracil 5%. Tirbanibulin remains cost saving when inputs are varied in sensitivity and scenario analyses. While the complete clearance rates are deemed similar across comparators, tirbanibulin is associated with a lower rate of severe local skin reactions, and a shorter treatment duration, which may improve treatment adherence.Tirbanibulin is a cost saving intervention for the treatment of AK from the perspective of the Scottish Healthcare System.Results: Tirbanibulin 1% ointment is a new treatment for actinic keratosis (AK) on the face or scalp. A health economic model was developed as part of a submission to the Scottish Medicines Consortium to evaluate the cost-effectiveness of tirbanibulin compared to the most frequently prescribed treatments.A decision tree approach was used to calculate the costs and benefits of different treatment strategies for AK on the face or scalp over a one-year time horizon. Data on the relative efficacy of treatments, which were based on the probability of complete clearance of AK, were obtained from a network meta-analysis. Sensitivity and scenario analyses were performed to determine the robustness of the model results.Tirbanibulin is estimated to be cost saving versus diclofenac sodium 3%, imiquimod 5% and fluorouracil 5%. Tirbanibulin remains cost saving when inputs are varied in sensitivity and scenario analyses. While the complete clearance rates are deemed similar across comparators, tirbanibulin is associated with a lower rate of severe local skin reactions, and a shorter treatment duration, which may improve treatment adherence.Tirbanibulin is a cost saving intervention for the treatment of AK from the perspective of the Scottish Healthcare System.Conclusions: Tirbanibulin 1% ointment is a new treatment for actinic keratosis (AK) on the face or scalp. A health economic model was developed as part of a submission to the Scottish Medicines Consortium to evaluate the cost-effectiveness of tirbanibulin compared to the most frequently prescribed treatments.A decision tree approach was used to calculate the costs and benefits of different treatment strategies for AK on the face or scalp over a one-year time horizon. Data on the relative efficacy of treatments, which were based on the probability of complete clearance of AK, were obtained from a network meta-analysis. Sensitivity and scenario analyses were performed to determine the robustness of the model results.Tirbanibulin is estimated to be cost saving versus diclofenac sodium 3%, imiquimod 5% and fluorouracil 5%. Tirbanibulin remains cost saving when inputs are varied in sensitivity and scenario analyses. While the complete clearance rates are deemed similar across comparators, tirbanibulin is associated with a lower rate of severe local skin reactions, and a shorter treatment duration, which may improve treatment adherence.Tirbanibulin is a cost saving intervention for the treatment of AK from the perspective of the Scottish Healthcare System. [ABSTRACT FROM AUTHOR]

Presents an abstract of a study on the polymerase chain reaction for the detection and analysis of flue-cured tobacco or Nicotiana tabacum, expressing a Chitinase transgene.