Targeted muscle reinnervation: advances and opportunities

It is with interest, and some concern, that we read the recent letter from Messrs Nikkhah et al. (1). Targeted muscle reinnervation (TMR) is a surgical development for the rehabilitation community with enormous potential to improve the quality of life for amputees. However, their letter fails to clarify exactly what TMR is, and how it can benefit amputees. There are two aspects to TMR. Kuiken's first aim was to improve the control of a myoelectric prostheses and secondly to strive for "intuitive" manipulation of a prosthesis (2,3).

The split hypoglossal nerve versus the cross-face nerve graft to supply the free functional muscle transfer for facial reanimation: a comparative study

Long-standing cases of facial paralysis are currently treated with free functional muscle transfer. Several nerves are mentioned in the literature to supply the free muscle transfer. The aim of this study is to compare the split hypoglossal nerve and the cross-face nerve graft to supply the free functional muscle transfer in facial reanimation.Of 94 patients with long-standing, unilateral facial palsy, 49 were treated using the latissimus dorsi muscle supplied by the split hypoglossal nerve, and 45 patients were treated using the healthy contralateral buccal branch of the facial nerve.

Biochar alleviates the toxicity of imidacloprid and silver nanoparticles (AgNPs) to Enchytraeus albidus (Oligochaeta)

Abstract

The present study investigated the use of biochar for the alleviation of the toxic effects of a nanosilver colloidal dispersion and a chloronicotinyl insecticide. The survival and reproduction of the potworm Enchytraeus albidus were assessed after exposure to imidacloprid and silver nanoparticles (AgNPs). E. albidus was exposed to 0, 25, 50, 100, 200, and 400 mg imidacloprid/kg and 0, 5, 25, 125, and 625 mg Ag/kg for 21 days in 10% biochar amended and non-biochar amended OECD artificial soil. In both exposure substrates, the effects of imidacloprid on survival were significant in the two highest treatments (p < 0.01). No biochar effect was observed as survival was statistically similar in both soils after exposure to imidacloprid. In the case of AgNPs, significant mortality was only observed in the highest AgNP treatments in both the amended and non-amended soils (p < 0.05). Nevertheless, statistically greater survival occurred in the biochar-amended treatment (p < 0.05). Reproduction results showed a more pronounced biochar effect with an EC₅₀ = 22.27 mg imidacloprid/kg in the non-amended soil and a higher EC₅₀ = 46.23 mg imidacloprid/kg in the biochar-amended soil. This indicated a 2-fold decrease in imidacloprid toxicity due to biochar amendment. A similar observation was made in the case of AgNPs where a reproduction EC₅₀ = 166.70 mg Ag/kg soil in the non-amended soil increased to an EC₅₀ > 625 mg Ag/kg soil (the highest AgNP treatment) in the amended soil. This indicated at least a 3.7-fold decrease in AgNPs toxicity due to biochar amendment. Although more studies may be needed to optimize the easing effects of biochar on the toxicity of these chemicals, the present results show that biochar could be useful for the alleviation of the toxic effects of imidacloprid and silver nanoparticles in the soil.

Toxicity comparison of the shoreline cleaners Accell Clean® and PES-51® in two life stages of the grass shrimp, Palaemonetes pugio

Abstract

Oil spills are a significant source of coastal pollution. Shoreline cleaners, used to remove oil from surfaces during spill response and remediation, may also act as toxins. Adult and larval grass shrimp, Palaemonetes pugio, were tested for lethal and sublethal impacts from two shoreline cleaners, Accell Clean SWA® and PES-51®, alone and in combination with crude oil using Chemically Enhanced Water Accommodated Fractions (CEWAFs). Median lethal toxicity values determined for the individual cleaners were similar. However, when tested in mixture with oil as CEWAFs, Accell Clean SWA resulted in greater hydrocarbon concentrations in the water column and greater toxicity than PES-51. Increased glutathione levels were observed for adult shrimp exposed to Accell Clean SWA, and glutathione was elevated in shrimp exposed to both CEWAFs. Larval shrimp development was delayed after exposure to both CEWAFs. These findings may have implications for managing and mitigating oil spills.

Sleeping Beauty Goes to the Lab: The Psychology of Self-Locating Evidence

Abstract

Analyses of the Sleeping Beauty Problem are polarised between those advocating the "1/2 view" ("halfers") and those endorsing the "1/3 view" ("thirders"). The disagreement concerns the evidential relevance of self-locating information. Unlike halfers, thirders regard self-locating information as evidentially relevant in the Sleeping Beauty Problem. In the present study, we systematically manipulate the kind of information available in different formulations of the Sleeping Beauty Problem. Our findings indicate that patterns of judgment on different formulations of the Sleeping Beauty Problem do not fit either the "1/2 view" or the "1/3 view." Human reasoners tend to acknowledge self-locating evidence as relevant, but discount its weight significantly. Accordingly, self-locating information may trigger more cautious judgments of confirmation than familiar kinds of statistical evidence. We also discuss how these results can advance the debate by providing a more nuanced and empirically grounded account or explication of the evidential impact of self-locating information.

Contamination of estuaries from failing septic tank systems: difficulties in scaling up from monitored individual systems to cumulative impact

Abstract

Aquaculture in many coastal estuaries is threatened by diffuse sources of runoff from different land use activities. The poor performance of septic tank systems (STS), as well as runoff from agriculture, may contribute to the movement of contaminants through ground and surface waters to estuaries resulting in oyster contamination, and following their consumption, impacts to human health. In monitoring individual STS in sensitive locations, it is possible to show that nutrients and faecal contaminants are transported through the subsurface in sandy soils off-site with little attenuation. At the catchment scale however, there are always difficulties in discerning direct linkages between failing STS and water contamination due to processes such as effluent dilution, adsorption, precipitation and vegetative uptake. There is often substantial complexity in detecting and tracing effluent pathways from diffuse sources to water bodies in field studies. While source tracking as well as monitoring using tracers may assist in identifying potential pathways from STS to surface waters and estuaries, there are difficulties in scaling up from monitored individual systems to identify their contribution to the cumulative impact which may be apparent at the catchment scale. The processes which may be obvious through monitoring and dominate at the individual scale may be masked and not readily discernible at the catchment scale due to impacts from other land use activities.

Different calcification responses of two hermatypic corals to CO 2 -driven ocean acidification

Abstract

Understanding how calcification is influenced by the enhanced dissolution of CO₂ in the oceans is the key to evaluating the effects of ocean acidification (OA) on coral reefs. In this study, two branching hermatypic corals widely distributed in the South China Sea, Pocillopora damicornis and Seriatopora caliendrum, were used to study the calcification responses to CO₂-driven OA (7.77 ± 0.07 vs. 8.15 ± 0.12). Our results showed that the calcification rate (0.17 ± 0.04%/day to 0.21 ± 0.12%/day) in P. damicornis remained unchanged in the acidified seawaters, but that in S. caliendrum decreased significantly (0.62 ± 0.21%/day to 0.44 ± 0.11%/day). Our results suggested that reef corals with high calcification rates may be more susceptible to the enhanced dissolution of CO₂. Differential calcified response to elevated CO₂ may be closely attributed to coralline capacity of the upregulation at their site of calcification in acidified seawater.

LETTER TO THE EDITOR: Predictors of internal mammary vessel diameter: A computed tomographic angiography-assisted anatomic analysis. J Plast Reconstructive & Aesthetic Surgery 2016: 69:1340-8. Cook JA, Tholpady SS, Momeni A, Chu MW

We would like to congratulate Dr Cook and colleagues on their publication entitled "Predictors of internal mammary vessel diameter: A computed tomographic angiography-assisted anatomic analysis" 1 and take this opportunity to contrast their experience with ours. Our comments are based on a prospectively collected database of consecutive abdominal microvascular breast reconstructions performed by a single surgeon (CMM) using the total rib preservation technique of internal mammary vessel exposure.

Using the internal mammary artery as recipient artery in cervicofacial reconstruction by fibular flap

This study was designed to investigate the anatomy of the internal mammary to its use for mandibular reconstruction using a fibula free flap for patients without other recipient vessels in the neck. This technique could be an alternative to venous grafts in vascular desert cases.We dissected the internal mammary artery in 6 cadavers from the clavicle down to the 5th rib.The length of the artery once released was 11 to 13 cm, its distal diameter of 2 to 3 mm.We measured the distance separating the distal end of the liberated artery with the hyoid anatomical landmark for the vascular anastomoses of the mandibular fibula flap reconstructions, this distance varies from 0 to 15 mm, theoretically allowing the use of the internal mammary artery for complexes mandibular reconstructions.

Liposuction-assisted four pedicle based breast reduction (LAFPBR): A new safer technique of breast reduction for elderly patients

As older people increasingly care for their body image and remain active longer, the demand for reduction mammaplasty is increasing in this population. Only a few studies of reduction mammaplasty have specifically focussed on the outcomes in elderly women. We developed a new breast reduction technique: the Liposuction-Assisted Four Pedicles - Based Breast Reduction (LAFPBR) that is especially indicated for elderly patients.The aim of this paper was to describe the LAFPBR technique and to determine whether it could be considered a safer option for elderly patients compared to the superomedial pedicle (SMP) technique.

Influence of dressing application time after breast augmentation on cutaneous colonization: a randomized clinical trial

Concepts regarding the best way to treat a surgical wound vary, in literature, ranging from no dressing use to dressing maintenance for 24 to 48 hours or until suture removal. This study aimed to evaluate the influence of the length of dressing maintenance after breast augmentation with implants on cutaneous colonization and surgical site infection. This is a two-arm parallel group randomized clinical trial. Eighty patients who were candidates for augmentation mammoplasty with silicone implants were randomly allocated to two groups, in which the dressing was removed on postoperative day 1 (group A, n=40) or postoperative day 6 (group B, n=40).

Intraoperative imaging of lymphatic vessel using ultra high-frequency ultrasound

Lymphaticovenular anastomosis (LVA) is effective and minimally invasive treatment for refractory lymphedema.1-4 The lymphatic vessels become sclerotic over time after lymph flow obstruction, and lose their function to drain lymph fluid in peripheral lymphedema patient.2 Anastomosing the severely sclerotic lymphatic vessels leads to minimum therapeutic effect in LVA. Therefore, identification of functional lymphatic vessels is important for LVA.3,4 Hayashi et al. reported non-invasive ultrasound visualization of lymphatic vessels in a region masked by dermal backflow pattern of indocyanine green (ICG) lymphography.

Invited commentary on jpras-d-17-00269

This article describes the development of a breast reduction guideline. This is a major achievement, which represents the culmination of a large body of work: multiple systematic reviews, consensus building, and recommendation generation. It has the potential to provide considerable benefit if developed appropriately, and if it gains traction with its target audience.

Routine closure of the donor site with a second dorsal metacarpal artery flap to avoid the use of a skin graft after harvest of a first dorsal metacarpal artery flap

Closure of the donor site on the index finger after raising a first dorsal metacarpal artery (DMA) flap harvest is challenging. The conventional choice is to use a full-thickness skin graft. However, this procedure is associated with several complications and a second donor site to harvest the skin graft is inevitable. The aim of this study was to design a modified incision to allow harvest of a first DMA flap without skin graft.

USB Dermatoscope as an Oculoscopy tool

Demographics and Outcomes of Stage I-II Merkel Cell Carcinoma Treated with Mohs Micrographic Surgery Compared with Wide Local Excision in the National Cancer Data Base

The optimal surgical approach (wide local excision (WLE) vs. Mohs micrographic surgery (MOHS)) for treating Merkel cell carcinoma (MCC) is yet to be determined.

Use of Sterile Urine Cups as Sharps Containers During Mohs Stages

Using smooth forceps for assisting incision and drainage of an infected epidermoid cyst

Autoinflammatory keratinization diseases: an emerging concept encompassing various inflammatory keratinization disorders of the skin

Among the myriad diseases affecting the skin are a subset of disorders whose main pathobiology is inflammation, predominantly in the epidermis and the superficial dermis, that leads to hyperkeratosis, manifesting clinically as thickened scaly skin. These are designated as "inflammatory keratinization disorders". The category includes many conditions that are poorly defined, although some, including psoriasis and lichen planus, are better categorized.

A prospective study comparing patients with early and late relapsing pemphigus treated with rituximab

Rituximab (RTX) is an effective therapy for patients with pemphigus. However it does not prevent relapse.