Humean laws, explanatory circularity, and the aim of scientific explanation

Abstract

One of the main challenges confronting Humean accounts of natural law is that Humean laws appear to be unable to play the explanatory role of laws in scientific practice. The worry is roughly that if the laws are just regularities in the particular matters of fact (as the Humean would have it), then they cannot also explain the particular matters of fact, on pain of circularity. Loewer (Philoso Stud 160:115–137, 2012) has defended Humeanism, arguing that this worry only arises if we fail to distinguish between scientific and metaphysical explanations. However, Lange (Philoso Stud 165:255–261, 2013, Synthese 195:1337–1353, 2018) has argued that scientific and metaphysical explanations are linked by a transitivity principle, which would undercut Loewer's defense and re-ignite the circularity worry for the Humean. I argue here that the Humean has antecedent reasons to doubt that there are any systematic connections between scientific and metaphysical explanations. The reason is that the Humean should think that scientific and metaphysical explanation have disparate aims, and therefore that neither form of explanation is beholden to the other in its pronouncements about what explains what. Consequently, the Humean has every reason to doubt that Lange's transitivity principle obtains.

RECOTOX, a French initiative in ecotoxicology-toxicology to monitor, understand and mitigate the ecotoxicological impacts of pollutants in socioagroecosystems

Abstract

RECOTOX is a cross-cutting initiative promoting an integrated research to respond to the challenges of monitoring, understanding, and mitigating environmental and health impacts of pesticides in agroecosystems. The added value of RECOTOX is to develop a common culture around spatial ecotoxicology including the whole chain of pressure-exposure-impact, while strengthening an integrated network of in natura specifically equipped sites. In particular, it promotes transversal approaches at relevant socioecological system scales, to capitalize knowledge, expertise, and ongoing research in ecotoxicology and, to a lesser extent, environmental toxicology. Thus, it will open existing research infrastructures in environmental sciences to research programs in ecotoxicology of pesticides.

Hepatozelluläres Karzinom – Stellenwert von Resektion, Lebertransplantation und Immunsuppression

Zusammenfassung

Das hepatozelluläre Karzinom (HCC) kann im Stadium BCLC 0 und A (Barcelona Classification of Liver Cancer) sowohl mittels Resektion als auch mittels Lebertransplantation innerhalb der Mailand-Kriterien erfolgreich kurativ behandelt werden. Bei Patienten ohne Zirrhose sollte immer eine Resektion angestrebt werden. Problematisch bei der Beurteilung der Therapie mittels Resektion und Lebertransplantation ist die Vergleichbarkeit. Die Berücksichtigung der portalen Hypertension zur Indikationsstellung muss in der Risiko-Nutzen-Bewertung für die Resektion streng beachtet werden. Multiple Analysen zeigen, dass beide Verfahren zu ähnlichen Ergebnissen führen. Der Überlebensvorteil für die Transplantation ist allerdings erst nach 10 Jahren erreicht. Die Implementation der Werte für AFP (α-Fetoprotein) hilft bei der Risikoabschätzung. Bezüglich der immunsuppressiven Therapie scheint eine niedrig dosierte Langzeitimmunsuppression und die Gabe eines mTOR-Inhibitors (mTORi) positive Effekte auf das Langzeitüberleben zu haben.

Novel magnetic graphene oxide functionalized cyanopropyl nanocomposite as an adsorbent for the removal of Pb(II) ions from aqueous media: equilibrium and kinetic studies

Abstract

This work presents the synthesis of the novel silica-cyanopropyl functionalized magnetic graphene oxide (MGO/SiO₂-CN) hybrid nanomaterial derived by sol–gel method as a cheap efficient magnetic sorbent for the removal of extremely hazardous lead ions from aqueous media. The integration of the magnetic property, the carbon substrate, and the nitrile (–C ≡ N) containing organic grafted silica matrix promoted the adsorption capability against lead ions along with its simple synthesis recovery and low cost. The prepared nanocomposite was comprehensively characterized by Fourier transform infrared spectroscopy, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. Adsorption of lead was found to be pH dependent because of the charged nature of both analyte and adsorbent surface. Adsorption experiments were conducted under the optimum conditions, and the obtained experimental data from atomic absorption spectroscopy were analyzed using the popular isothermal models namely Langmuir, Freundlich, and Dubinin–Radushkevich isotherms as well as kinetically studied and evaluated for adsorption standard free energy (E). The experimental results have demonstrated the enhanced adsorption capability of the proposed sorbent nanocomposite for lead ion removal with the maximum adsorption capacity of 111.11 mg/g at pH 5.0. The proposed mechanism of lead adsorption was mainly attributed to the complexation of lead positive ions with the grafted –C ≡ N bond. The synergistic effect of the combination of three components (i.e., the magnetic graphene oxide matrix, the triple bond containing organic moiety, and the inorganic porous silica framework) excelled the adsorption capability and proved to be a good candidate as adsorbent for the removal of lead ions.

Study on the removal effect and influencing factors of nitrobenzene reduction by iron carbonate precipitates

Abstract

To investigate the activity of iron carbonate precipitates produced by long-term operation of Fe⁰ permeable reactive barriers, three kinds of precipitates, namely Fe₆(OH)₁₂CO₃, Fe₂(OH)₂CO₃, and FeCO₃, were prepared to reduce the pollutant nitrobenzene. We studied the reduction effects of these iron carbonate precipitates on nitrobenzene by considering three factors, namely the initial nitrobenzene concentration, initial pH, and precipitate dosage, and established the kinetic degradation using pseudo-first-order kinetics model. The results showed that all three precipitates can reduce nitrobenzene, and the order of reducing capability is Fe₆(OH)₁₂CO₃ > Fe₂(OH)₂CO₃ > FeCO₃; moreover, the removal efficiency values of nitrobenzene are 68.08, 53.00, and 50.29%. A high initial nitrobenzene concentration and high pH value are beneficial to nitrobenzene reduction, and removal efficiency was increased when pH was increased from 4 to 9. In addition, the increased precipitate addition in the Fe₆(OH)₁₂CO₃ and Fe₂(OH)₂CO₃ systems increased removal efficiency. Furthermore, the dosage did not significantly influence the removal rate in the FeCO₃ system. Fe₆(OH)₁₂CO₃ and Fe₂(OH)₂CO₃ mainly relied on the precipitate itself with the structural Fe(II) to reduce nitrobenzene, and FeCO₃ mainly relied on the dissolved Fe²⁺. The reaction of all three precipitates in reducing nitrobenzene followed the first-order reaction kinetics.

Nonvisualization of Sentinel Lymph Nodes by Lymphoscintigraphy in Primary Cutaneous Melanoma – Incidence, Risk Factors, and a Review of Management Options

PURPOSE: Lymphoscintigraphy (LS) is often obtained prior to sentinel lymph node biopsy (SLNB), especially in areas likely to have multiple or aberrant drainage patterns. This study aims to determine the incidence and characteristics of melanoma patients with a negative LS and to review the management options and surgical recommendations. METHODS: This is a retrospective study of patients with primary cutaneous melanoma who underwent SLNB between 2005 and 2016. Patients with nonvisualized lymph nodes on preoperative LS were compared in a 1:4 ratio with a randomly selected unmatched cohort drawn from all melanoma patients who underwent preoperative LS within the time period of the study. Demographic, clinical and outcome data were compared between these groups. RESULTS: A negative LS was seen in 2.3% of all cases (25 in 1073). In both univariate and multivariate analyses, predictive patient and tumor-specific factors for negative LS included older age and head and neck location. Patients with a non-visualized SLN had significantly worse overall survival compared with patients who had a visualized SLN, but there was no difference in melanoma-specific survival. In 16 of the 25 cases (64%), at least one SLN was found intraoperatively despite the negative LS. CONCLUSION: Older patients with head and neck melanomas are more likely to experience nodal nonvisualization on LS. In patients who have nodal nonvisualization, the surgeon should attempt SLNB at the time of excision of the primary lesion since a SLN can still be found in a majority of cases, and it offers prognostic information. CONFLICTS OF INTEREST AND SOURCE OF FUNDING: None of the authors have a financial interest in or a commercial association with any of the products, devices, or drugs mentioned in this manuscript. There was no source of funding for this manuscript. CORRESPONDING AUTHOR: Dr. Deepak Narayan, Yale University School of Medicine, Section of Plastic Surgery, 330 Cedar Street, P.O. Box 208041, New Haven, CT, 06520-8041, United States. Phone number: (203) 785-2570, Fax number: (203) 785-5714, deepak.narayan@yale.edu ©2018American Society of Plastic Surgeons

“Anatomic Basis of the Gastroepiploic Vascularized Lymph Node Transfer: A Radiographic Evaluation Using Computed Tomography Angiography (CTA)”

PURPOSE: The omentum, nourished by the gastroepiploic vessels, has gained popularity as an option for vascularized lymph node transfer (VLNT). The anatomy of the gastroepiploic vessels, omentum, and lymph nodes (LN) has not been investigated. The purpose of this study is to describe the right gastroepiploic artery (GEA) and related structures by using computed tomography angiography (CTA). MATERIALS AND METHODS: A retrospective analysis was conducted on 34 patients who received CTA. Statistical models were applied to identify right GEA and LN anatomical characteristics. RESULTS: The right GEA was identified in 33 of 34 patients. It was found to have a diameter of 2.49mm at its origin (SD 0.66). The gastroduodenal artery length prior to right GEA takeoff was 3.09cm (SD 1.31). Twenty-five patients had lymph nodes in the right GEA lymphosome. There were 2.7 LNs identified per patient (SD 2.12). The distance from the right GEA origin to the most proximal LN was 3.99cm (SD 2.21). The distance from the GEA origin to the third LN was 9.12cm (SD 5.06). Each LN was within 7.00mm (SD 6.2) of the right GEA. CONCLUSIONS: When using the right GEA donor site for VLNT, the plastic surgeon should anticipate using a pedicle length of 4cm, a total flap length of 9cm with 3cm of surrounding tissue in order to obtain at least 3 lymph nodes for transfer. CTA is an effective imaging modality that can be used for patient-specific surgical navigation prior to vascularized lymph node transfer. Financial Disclosure Statement: Ketan Patel is a consultant for Novadaq Corp and receives textbook royalties from Elsevier Corp. All other authors have no disclosures. Corresponding Author: Ketan M. Patel, M.D., Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, 1510 San Pablo Street, Suite 415, Los Angeles, CA 90033, ketan.patel@med.usc.edu ©2018American Society of Plastic Surgeons

Comparison of Pediatric Intercalary Allograft Reconstructions With and Without a Free Vascularized Fibula

Introduction: Lower extremity intercalary allograft reconstruction has traditionally been used to facilitate limb salvage. Combing the allograft with a vascularized fibula graft (FVFG) has been described; however there is a paucity of data comparing the outcome of these reconstructions. Material and Methods: 29 pediatric patients (15 males, 14 females) underwent lower extremity limb salvage with the use of intercalary cadaveric allograft at a mean age of 12 years. The most common diagnosis was osteosarcoma (n=18). Patients were reconstructed with an allograft alone (n=11) or supplemented with a FVFG (n=18). Results: The mean time to union of the allograft was 11 months, with 10 patients requiring additional bone grafting. There was no difference in the need for an additional bone graft (OR 0.87, P=1.0) between patients with a FVFG and those without. The allograft was revised in 3 patients due to fracture (n=2) and fracture and infection (n=1). In all these patients the allograft was not supplemented with a FVFG (P

Correlation between Quantity of Transferred Lymph Nodes and Outcome in Vascularized Submental Lymph Node Flap Transfer for Lower Limb Lymphedema

Background: Vascularized lymph node transfer (VLNT) has shown promising results in the treatment of lower limb lymphedema, but little is known about the number of lymph nodes needed for the transfer to achieve optimal results. This study investigated the correlation between number of transferred lymph nodes in submental VLNT and outcomes regarding limb circumference reduction and cellulitis incidence. Methods: Thirty-five patients who had received submental VLNT to an ankle for lower limb lymphedema, post-gynecological cancer treatment, were included in the study. Limb circumference was determined via tape measurement pre- and postoperatively and was used to calculate the circumferential difference. Ultrasonography was performed postoperatively to determine the number of lymph nodes within the transferred flap. Patients were divided into groups A-C depending on the number of transferred lymph nodes: 1-2 (n=10), 3-4 (n=14) and 5-8 (n=11), respectively. Results: The mean age was 60.0 ± 9.2 years. All flaps survived. The mean improvement of circumferential difference for the whole cohort was 19.8 ± 9.2 %. Groups B and C both had significantly higher improvements in the circumferential difference than group A (p=0.04 and p=0.02, respectively), but when compared to each other, the difference was non-significant. All groups had significant reductions in cellulitis incidence postoperatively. Conclusions: Submental VLNT for lower limb lymphedema reduced the incidence of cellulitis, regardless of the number of transferred lymph nodes. The transfer of 3 or more lymph nodes provided significantly better outcome regarding limb circumference reduction than the transfer of 2 or fewer lymph nodes. FINANCIAL DISCLOSURE STATEMENT: The authors have nothing to disclose. No funding was received for this article. AUTHOR CONTRIBUTIONS: JG and MHC were responsible for the study idea, design and follow-through. JG, SYC and WHC were responsible for data collection. All authors were involved in the interpretation of results. JG and MHC were responsible for statistical analysis. All authors were involved in critical review and approval of the final result. IRB NUMBER: 101-3481B ACKNOWLEDGMENTS: The authors would like to thank Miffy Chia-yu Lin, M. Sc., for her assistance in the preparation of tables and figures for this manuscript. CORRESPONDING AUTHOR: Ming-Huei Cheng, MD, MBA, FACS, Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Center of Tissue Engineering, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No. 5 Fu-Hsing Street, Kweishan, Taoyuan 333, Taiwan , Telephone: +886 3 281200 ext. 2172, Fax: +886 3 3972681, E-mail: minghueicheng@gmail.com, minghuei@adm.cgmh.org.tw ©2018American Society of Plastic Surgeons

Extended Transconjunctival Lower Eyelid Blepharoplasty with Release of the Tear Trough Ligament and Fat Redistribution

No abstract available

Influence of Repaired Cleft Lip and Palate on Layperson Perception following Orthognathic Surgery

Background: Facial scarring and disharmony due to clefting is associated with psychosocial stress which may be improved by orthognathic surgery. The authors examine how a history of clefting influences change in layperson perception of a patient following orthognathic surgery. Methods: 1000 laypeople were recruited through Mechanical Turk to evaluate patient photographs pre- and post-orthognathic surgery. Nineteen patients – 5 with unilateral and 4 with bilateral clefting – were included. Respondents assessed 6 personality traits, 6 emotional expressions, and likelihood of 7 interpersonal experiences on a scale from 1-7. Results: Using Mann-Whitney U and independent samples t-tests, changes in all aspects of social perception post-procedure differed significantly between cleft vs. non-cleft cohorts (p

“Incidents of Mandibular Distraction Osteogenesis for Hemifacial Microsomia.”

Background: This article mainly focused on the safety and unexpected incidents of mandibular distraction osteogenesis in treating patients with hemifacial microsomia. Methods: Records of 71 patients with hemifacial microsomia treated by mandibular distraction osteogenesis from February 2010 to March 2015 were examined in this retrospective study. The modified mandibular osteotomy was conducted under the assistance of three-dimensional (3D) reconstruction, computer-aided design and rapid prototyping technique. Distraction was conducted 4-7 days postoperatively at a frequency of 1 mm/d; moreover, the distractor was kept in place for 4 to 13 months after the first operation before it was removed. The scope of distraction ranged from 20 to 40 mm. All incidents encountered during and following the mandibular distraction process were documented in the medical records of patients. The patients were followed up for an average of 34.4 months after the second-stage operation. Results: The overall rate of incidents was 36.6%. Of them, minor incidents, which could be resolved with or without noninvasive therapy, were observed in 18.3% of all procedures in this series. Meanwhile, the rate of moderate incidents necessitating invasive therapy was reported to be 12.7%, while that of major incidents that could not be resolved with invasive therapy was 5.6%. Conclusions: Mandibular distraction osteogenesis is a widely used procedure for treating patients with hemifacial microsomia. It is extremely important to be fully aware of variety of incidents occurring during and following the surgical procedure to minimize the incidence of such incidents. Financial Disclosure Statement: All authors has no financial conflict to disclose. The study was funder by Special Fund for Scientific Research in the Public Interest from National Health and Family Planning Commission of the People's Republic of China (No. 201502016), and 2015 Major Project of School/Institution of Plastic Surgery Hospital, Chinese Academic of Medical Sciences (No.Z2015008). Corresponding author: Zhiyong Shi, MD, Department of maxillofacial surgery, Plastic Surgery Hospital (Institude), Chinese Academy of Medical Sciences, Peking Union Medical College; No.33 Badachu Road, Shijingshan District, Beijing, 100144, China. zhangzy1011@163.com ©2018American Society of Plastic Surgeons

“Interposition Vein Grafting in Head and Neck Free Flap Reconstruction”

Background: Many surgeons are hesitant to use interposition vein grafting in head and neck microvascular free flap surgery due to concerns for elevated risk of flap loss. Methods: We conducted a review of patients who underwent head and neck free flap reconstruction between 2005 and 2015. The effect of vein grafts on flap compromise and flap loss were analyzed using univariate and multivariate models. Results: A total of 3240 free flaps were performed. Vein grafts were used in 241 flaps (7.4%). The free flap compromise rate was 14.5% with vein grafts and 3.4% without vein grafts (p

Long-term results in isolated metopic synostosis- the Oxford experience in 22 years.

Background: Metopic synostosis causing trigonocephaly is treated by fronto-orbital-advancement and remodelling to correct the deformity, cerebral distortion and to treat intracranial hypertension in a small number of cases. This study's aim was to evaluate complications, revisions and long-term outcomes. Methods: A retrospective chart review was performed on consecutive metopic craniosynostosis patients treated between February 1995 and February 2017 at the Oxford Craniofacial Unit. Results: 245 patients with isolated metopic synostosis were seen. 202 patients underwent fronto-orbital-advancement and remodelling. 50 (25%) female; 152 (75%) male. Mean age at surgery was 16.8 months. Mean weight preoperatively was 12kg. All patients received blood transfusion. Mean postoperative stay was 6 days. Average follow-up time was 8 years (range 0.5-22 years). There were 8 (4%) major complications. 6 (2.9%) patients required secondary calvarial-expansion for late raised intracranial pressure. 31 (15%) had other subsequent procedures including wire removal (8%) and forehead shape contouring (4%) with alloplastic onlay. Raised intracranial pressure prior to surgery was confirmed in 2 cases by intracranial pressure monitoring. Conclusion: Trigonocephaly is caused by metopic synostosis and is treated by fronto-orbital advancement and remodelling in order to restore both internal and external skull configuration. Following surgery, we identified a 2.9% risk of late raised intracranial pressure requiring a secondary calvarial-expansion, necessitating prolonged follow up in all cases. Temporal hollowing and forehead contour defects were not uncommon, resulting in a need for onlay recontouring in selected cases. This is the largest reported series of metopic synostosis. Financial disclosure statement: The authors have no financial disclosures. Presented at: 17th biennal congress of the International Society of Craniofacial Surgery (ISCFS), 24th-28th October 2017, Cancun, Mexico. Correspondence should be address to: Hamidreza Natghian M.D., Oxford Craniofacial Unit, Level LG1, West Wing, John Radcliffe Hospital, Headley Way, Headington, OX3 9DU, Oxford, United Kingdom. Email: Hamidreza.natghian@gmail.com ©2018American Society of Plastic Surgeons

“Targeted Muscle Reinnervation in the Lower Leg: An Anatomic Study.”

Introduction: Targeted muscle reinnervation (TMR) re-routes the ends of cut nerves to re-innervate small motor nerves of nearby muscles, with the goal of reducing neuroma pain and/or improving prosthesis function. Anatomical roadmaps for TMR have been established in the upper extremity and thigh, but not for the lower leg. Methods: The major branch points (MBPs) of motor nerves and the motor entry points (MEPs) to muscles of the leg were dissected in five cadaver specimens. Leg length was defined as distance from lateral femoral condyle to lateral malleolus. The distances from the lateral femoral condyle to MBPs and MEPs were recorded as a percentage of leg length to identify targets for TMR. Results: The tibialis anterior and extensor digitorum longus were both acceptable targets in the anterior compartment, with an average 4.4 MEPs within 10-80% and 3 MEPs within 20-80% leg length, respectively. The peroneus longus was the best target in the lateral compartment, with an average 5.8 MEPs within 20-70% leg length. The gastrocnemius and soleus were both acceptable targets in the superficial posterior compartment, with an average 4.4 MEPs within 0-40% and 6.2 MEPs within 20-80% leg length, respectively for each muscle. The flexor digitorum longus was the best target in the deep posterior compartment, with an average 6 MEPs within 30-90% leg length. Conclusions: TMR is technically feasible in the lower leg. This cadaveric study provides a roadmap for incision placement and identification of motor nerve targets. Financial Disclosure Statement: Dr. Ko is a speaker for Checkpoint Surgical, Cleveland OH. Dr. Dumanian is a speaker for Axogen, Inc. Alachua, FL. No funding was received for this article. Corresponding author: Gregory Dumanian, MD, ivision of Plastic Surgery, Northwestern Memorial Hospital, 675 N. St. Clair St, Suite19-250, Chicago, IL 60611 USA. email: gdumania@nm.org ©2018American Society of Plastic Surgeons

Sphenoid Dysplasia in Neurofibromatosis: Patterns of Presentation and Outcomes of Treatment

Introduction: Sphenoid wing dysplasia in patients with neurofibromatosis type 1 (NF-1) may result in challenging and significant changes, including ultimately vision loss. We describe the radiographic patterns of sphenoid dysmorphology with time and age, and the impact of surgical intervention on preservation of vision. Methods: A retrospective study was performed at a single pediatric hospital, identifying subjects with NF-1. Records were reviewed in their entirety for each subject, with attention to opthamalogic evaluation. Radiographic images were digitally analyzed and scored for sphenoid transformations on a grade of 0-3. Results: Fifty-two subjects were identified. On initial imaging, 42.31% had a normal sphenoid (grade 0), 32.69% had an abnormal contour (grade 1), 11.54% had thinning (grade 2), and 13.46% had a gross defect (grade 3). Among the 45 subjects with serial imaging, 55.56% demonstrated progression of the deformity of at least one grade. Deformity progression correlated with length of imaging interval. Enucleation was noted to occur more often in subjects with a gross sphenoid defect (p

Reply to Letter to the Editor by Dr. Innocenti et al. on our paper the Extended Transconjunctival Lower Eyelid Blepharoplasty with Release of the Tear Trough Ligament and Fat Redistribution

No abstract available

The association between autologous breast reconstruction and body mass index in breast oncology

No abstract available

Reply: The association between autologous breast reconstruction and body mass index in breast oncology

No abstract available

Prepectoral Breast Reconstruction

No abstract available