Atmospheric new particle formation (NPF) and growth significantly influences climate by supplying new seeds for cloud condensation and brightness. Currently, there is a lack of understanding of ...whether and how marine biota emissions affect aerosol-cloud-climate interactions in the Arctic. Here, the aerosol population was categorised via cluster analysis of aerosol size distributions taken at Mt Zeppelin (Svalbard) during a 11 year record. The daily temporal occurrence of NPF events likely caused by nucleation in the polar marine boundary layer was quantified annually as 18%, with a peak of 51% during summer months. Air mass trajectory analysis and atmospheric nitrogen and sulphur tracers link these frequent nucleation events to biogenic precursors released by open water and melting sea ice regions. The occurrence of such events across a full decade was anti-correlated with sea ice extent. New particles originating from open water and open pack ice increased the cloud condensation nuclei concentration background by at least ca. 20%, supporting a marine biosphere-climate link through sea ice melt and low altitude clouds that may have contributed to accelerate Arctic warming. Our results prompt a better representation of biogenic aerosol sources in Arctic climate models.
To compare the rates of revision surgery for symptomatic neuromas in patients undergoing primary transtibial amputations with and without targeted muscle reinnervation (TMR).
Retrospective cohort ...study.
Level I trauma hospital and tertiary military medical center.
Adult patients undergoing transtibial amputations with and without TMR.
Transtibial amputation with targeted muscle reinnervation.
Reoperation for symptomatic neuroma.
During the study period, there were 112 primary transtibial amputations performed, 29 with TMR and 83 without TMR. Over the same period, there were 51 revision transtibial amputations performed, including 23 (21%) in the patients undergoing primary transtibial amputation at the study institution. The most common indications for revision surgery were wound breakdown/dehiscence (42%, n = 25), followed by symptomatic neuroma 18% (n = 9/51) and infection/osteomyelitis (17%, n = 10) as the most common indications. However, of the patients undergoing primary amputation at the study's institution, there was no difference in reoperation rates for neuroma when comparing the TMR group (3.6%, n = 1/28) and no TMR group (4.0%, n = 3/75) (
= 0.97).
Symptomatic neuroma is one of the most common reasons for revision amputation; however, this study was unable to demonstrate a difference in revision surgery rates for neuroma for patients undergoing primary transtibial amputation with or without targeted muscle reinnervation.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Background:
Osteochondral lesions of the talus (OLTs) are common injuries in young, active patients. Microfracture is an effective treatment for lesions less than 150 mm2 in size. Most commonly ...employed postoperative protocols involve delaying weightbearing for 6 to 8 weeks (DWB), though one study suggests that early weightbearing (EWB) may not be detrimental to patient outcomes. The goal of this research is to compare outcomes following EWB and DWB protocols after microfracture for OLTs.
Methods:
We performed a prospective, randomized, multicenter clinical trial of subjects with unilateral, primary, unifocal OLTs treated with microfracture. Thirty-eight subjects were randomized into EWB (18 subjects) and DWB (20 subjects) at their first postsurgical visit. The EWB group began unrestricted WB at that time, whereas the DWB group were instructed to remain strictly nonweightbearing for an additional 4 weeks. Primary outcome measures were the American Academy of Orthopaedic Surgery (AAOS) Foot and Ankle score and numeric rating scale (NRS) pain score.
Results:
The EWB group demonstrated significant improvement in AAOS Foot and Ankle Questionnaire scores at the 6-week follow-up appointment as compared to the DWB group (83.1 ± 13.5 vs 68.7 ± 15.8, P = .017). Following this point, there were no significant differences in AAOS scores between groups. At no point were NRS pain scores significantly different between the groups.
Conclusions:
EWB after microfracture for OLTs was associated with improved AAOS scores in the short term. Thereafter and through 2 years’ follow-up, no statistically significant differences were seen between EWB and DWB groups.
Level of Evidence:
Level II, prospective randomized trial.
Eight isonitrogenous (46% crude protein) and isolipidic (14% crude lipid) diets were formulated for juvenile black sea bass Centropristis striata to replace menhaden fish meal (FM) protein (59.5% CP) ...by three cottonseed meal (CSM) proteins: a CSM prepared from glandless seed (GCSM, 50.4% CP), a CSM that had been solvent extracted with acidic ethanol to remove the gossypol (SCSM, 53.8% CP), and a CSM prepared from regular (glanded) cottonseed (RCSM, 45% CP). Three diets replaced 50, 75 and 100% of FM protein with GCSM, and three diets replaced 50, 75 and 100% of FM protein with SCSM. One diet replaced 100% FM protein with RCSM protein. A control diet (0% CSM) was formulated with high FM protein and other practical protein sources. l-methionine and l-lysine were supplemented to the diets to equal the control diet. Fifteen fish were stocked in each of twenty-four 75-L tanks, and each test diet was fed to triplicate groups of fish (mean initial weight=7.7±0.10g) for 56days at 22–24°C, 32–35 salinity, and ambient photoperiod conditions. Fish were fed twice per day to apparent satiation. Final (day 56) mean body weight (BW, 24.16–31.62g), body weight gain (BWG, 211.2–311.3%), specific growth rate (SGR, 1.70–2.18%/d), and feed intake (FI, 0.37–0.43g/fish/d) were not significantly different (P>0.05) among the control, GCSM or SCSM treatments, but were reduced (P<0.05) for the 100% RCSM treatment (20.09g, 159.5%, 1.45%/d, and 0.25g/fish/d, respectively). Lower palatability of the RCSM diet was attributable to the anti-nutrient compound gossypol. No significant differences in survival (84.1–97.8%), feed conversion ratio (FCR, 1.05–1.33), protein efficiency ratio (PER, 1.62–2.08), or whole body protein or lipid composition were observed among the fish fed the low-gossypol diets. Gossypol (25.9mg/kg) was only detectable in the livers of fish fed the high-gossypol RCSM diet. Fish whole body essential amino acid compositions did not differ significantly among treatments. Whole body n − 3 PUFAs decreased, while n−6 PUFAs increased with increasing CSM protein in the diets. The apparent digestibility coefficient of protein was high (83.1–87.1%) for all treatments. For juvenile black sea bass, 75% FM in the diet can be replaced with low-gossypol CSM protein prepared by solvent-extraction, and 100% of FM can be replaced with low-gossypol CSM protein prepared from glandless seed with no adverse effects on survival, growth or feed utilization.
Cotton seed flour is an inexpensive agricultural by-product. The results demonstrate successful replacement of fish meal protein with genetically-improved cottonseed flour protein in the diet of black sea bass. These findings may substantially lower aquafeed costs (a key operational cost) for finfish growout operations to boost profitability and accelerate expansion of commercial production of black sea bass and other finfish species.
•Reduced-gossypol cottonseed meal may allow higher inclusion rates in aquafeeds.•Eight diets (46% CP and 14% CL) replacing fish meal (FM) protein by low-gossypol cottonseed meal protein (CSM) prepared from glandless seed (0, 50, 75 and 100%), a CSM that had been solvent-extracted to separate the gossypol (50, 75 and 100%), and a CSM prepared from regular (glanded) high-gossypol cottonseed (100%), were fed to juvenile black sea bass Centropristis striata.•A maximum of 75% FM can be replaced with low-gossypol CSM protein produced by solvent extraction, and 100% of FM can be replaced with low-gossypol CSM protein prepared from glandless seed in the diet of juvenile black sea bass, with no adverse effects on survival, growth, feed utilization and apparent protein digestibility compared to a FM-based control diet.
Coagulase-positive staphylococci, which frequently colonize the mucosal surfaces of animals, also cause a spectrum of opportunistic infections including skin and soft tissue infections, urinary tract ...infections, pneumonia, and bacteremia. However, recent advances in bacterial identification have revealed that these common veterinary pathogens are in fact zoonoses that cause serious infections in human patients. The global spread of multidrug-resistant zoonotic staphylococci, in particular the emergence of methicillin-resistant organisms, is now a serious threat to both animal and human welfare. Accordingly, new therapeutic targets that can be exploited to combat staphylococcal infections are urgently needed. Enzymes of the methylerythritol phosphate pathway (MEP) of isoprenoid biosynthesis represent potential targets for treating zoonotic staphylococci. Here we demonstrate that fosmidomycin (FSM) inhibits the first step of the isoprenoid biosynthetic pathway catalyzed by deoxyxylulose phosphate reductoisomerase (DXR) in staphylococci. In addition, we have both enzymatically and structurally determined the mechanism by which FSM elicits its effect. Using a forward genetic screen, the glycerol-3-phosphate transporter GlpT that facilitates FSM uptake was identified in two zoonotic staphylococci, Staphylococcus schleiferi and Staphylococcus pseudintermedius. A series of lipophilic ester prodrugs (termed MEPicides) structurally related to FSM were synthesized, and data indicate that the presence of the prodrug moiety not only substantially increased potency of the inhibitors against staphylococci but also bypassed the need for GlpT-mediated cellular transport. Collectively, our data indicate that the prodrug MEPicides selectively and robustly inhibit DXR in zoonotic staphylococci, and further, that DXR represents a promising, druggable target for future development.
A regional climate model is used to evaluate dry deposition of ozone over the North East Atlantic. Results are presented for a deposition scheme accounting for turbulent and chemical enhancement of ...oceanic ozone deposition and a second non-chemical, parameterised gaseous dry deposition scheme. The first deposition scheme was constrained to account for sea-surface ozone-iodide reactions and the sensitivity of modelled ozone concentrations to oceanic iodide concentration was investigated. Simulations were also performed using nominal reaction rate derived from in-situ ozone deposition measurements and using a preliminary representation of organic chemistry. Results show insensitivity of ambient ozone concentrations modelled by the chemical-enhanced scheme to oceanic iodide concentrations, and iodide reactions alone cannot account for observed deposition velocities. Consequently, we suggest a missing chemical sink due to reactions of ozone with organic matter at the air-sea interface. Ozone loss rates are estimated to be in the range of 0.5–6 ppb per day. A potentially significant ozone-driven flux of iodine to the atmosphere is estimated to be in the range of 2.5–500 M molec cm−2 s−1, leading to a mixing-layer enhancement of organo-iodine concentrations of 0.1–22.0 ppt, with an average increase in the N.E. Atlantic of around 4 ppt per day.
CV following aneurysmal SAH is a significant cause of morbidity and mortality. We review our experiences using PTA and IA verapamil infusion for treating medically refractory cases.
We performed a ...retrospective review of patients with SAH admitted from July 2003 to January 2008.
Of 546 patients admitted within 72 hours of symptom onset, 231 patients (42%) developed symptomatic CV and 189 patients (35%) required endovascular therapy. A total of 346 endovascular sessions were performed consisting of 1 single angioplasty, 286 IA verapamil infusions, and 59 combined treatments. PTA was performed on 151 vessel segments, and IA verapamil was infused in 720 vessel segments. IA verapamil doses ranged from 2.0 to 30.0 mg per vessel segment and from 3.0 to 55.0 mg per treatment session. Repeat treatments were necessary in 102 patients (54%) for persistent, recurrent, or worsening CV. There were 6 treatment-related complications, of which 2 resulted in clinical worsening. No deaths were attributable to endovascular therapy. At follow-up, 115 patients (61%) had a good outcome and 55 patients (29%) had a poor outcome. Sixteen patients died from causes related to SAH, while 3 died from other medical complications.
Endovascular treatments are an integral part of managing patients with medically refractory CV. In our experience, PTA and IA verapamil are safe, with a low complication rate, but further studies are required to determine appropriate patient selection and treatment efficacy.
To determine if the dietary supplements, glucosamine and/or chondroitin, result in reduced joint space narrowing (JSN) and pain among people with symptomatic knee osteoarthritis.
A double-blind ...randomised placebo-controlled clinical trial with 2-year follow-up. 605 participants, aged 45-75 years, reporting chronic knee pain and with evidence of medial tibio-femoral compartment narrowing (but retaining >2 mm medial joint space width) were randomised to once daily: glucosamine sulfate 1500 mg (n=152), chondroitin sulfate 800 mg (n=151), both dietary supplements (n=151) or matching placebo capsules (n=151). JSN (mm) over 2 years was measured from digitised knee radiographs. Maximum knee pain (0-10) was self-reported in a participant diary for 7 days every 2 months over 1 year.
After adjusting for factors associated with structural disease progression (gender, body mass index (BMI), baseline structural disease severity and Heberden's nodes), allocation to the dietary supplement combination (glucosamine-chondroitin) resulted in a statistically significant (p=0.046) reduction of 2-year JSN compared to placebo: mean difference 0.10 mm (95% CI 0.002 mm to 0.20 mm); no significant structural effect for the single treatment allocations was detected. All four allocation groups demonstrated reduced knee pain over the first year, but no significant between-group differences (p=0.93) were detected. 34 (6%) participants reported possibly-related adverse medical events over the 2-year follow-up period.
Allocation to the glucosamine-chondroitin combination resulted in a statistically significant reduction in JSN at 2 years. While all allocation groups demonstrated reduced knee pain over the study period, none of the treatment allocation groups demonstrated significant symptomatic benefit above placebo.
NCT00513422; http://www.clinicaltrials.gov.
Few studies have evaluated inhaled corticosteroid (ICS)/long-acting beta(2)-adrenergic agonist combination therapy in asthmatic children. This study was designed to evaluate the safety (primary) and ...clinical benefits (secondary) of budesonide/formoterol pressurized metered-dose inhaler (pMDI) versus budesonide dry powder inhaler (DPI) in children with persistent asthma. This was a 26-week, multicenter, randomized, open-label U.S. study of 187 children 6-11 years of age previously receiving ICS. After 1 week of usual ICS therapy, subjects received twice-daily budesonide/formoterol pMDI 160/4.5 micrograms x 2 inhalations (320/9 micrograms; n = 124) or budesonide DPI 200 micrograms x 2 inhalations (400 micrograms 320 micrograms delivered ex-mouthpiece; n = 63). Budesonide/formoterol and budesonide were well tolerated with a similar incidence of adverse events (AEs) (84.6% and 85.7%, respectively), most of mild or moderate intensity. Treatment-related AE incidence was low (5.4%) and similar across groups (budesonide/formoterol, 4.9%; budesonide, 6.3%). No clinically important treatment differences were observed for 12-lead electrocardiograms, hematology, serum glucose and potassium, and 24-hour urinary cortisol. Compared with budesonide, budesonide/formoterol decreased health care use (urgent care visits and interference with daily activities child or work caregiver; p < or = 0.012) and improved health-related quality of life (Pediatric Asthma Quality of Life Questionnaire standardized and Pediatric Asthma Caregiver Quality of Life Questionnaire overall scores; p < or = 0.006) and pulmonary function (predose forced expiratory volume in 1 second and forced expiratory flow during the middle half of exhalation; p < or = 0.007). In this 26-week study of asthmatic children (6-11 years), safety profiles were similar and clinical benefits were greater with budesonide/formoterol than with budesonide.
Global investment in biomedical research has grown significantly over the last decades, reaching approximately a quarter of a trillion US dollars in 2010. However, not all of this investment is ...distributed evenly by gender. It follows, arguably, that scarce research resources may not be optimally invested (by either not supporting the best science or by failing to investigate topics that benefit women and men equitably). Women across the world tend to be significantly underrepresented in research both as researchers and research participants, receive less research funding, and appear less frequently than men as authors on research publications. There is also some evidence that women are relatively disadvantaged as the beneficiaries of research, in terms of its health, societal and economic impacts. Historical gender biases may have created a path dependency that means that the research system and the impacts of research are biased towards male researchers and male beneficiaries, making it inherently difficult (though not impossible) to eliminate gender bias. In this commentary, we - a group of scholars and practitioners from Africa, America, Asia and Europe - argue that gender-sensitive research impact assessment could become a force for good in moving science policy and practice towards gender equity. Research impact assessment is the multidisciplinary field of scientific inquiry that examines the research process to maximise scientific, societal and economic returns on investment in research. It encompasses many theoretical and methodological approaches that can be used to investigate gender bias and recommend actions for change to maximise research impact. We offer a set of recommendations to research funders, research institutions and research evaluators who conduct impact assessment on how to include and strengthen analysis of gender equity in research impact assessment and issue a global call for action.
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