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The sternocleidomastoid can be used as a pedicled flap in head and neck reconstruction. It has previously been associated with high complication rates, likely due in part to the variable nature of its blood supply.
To provide clinicians with an up-to-date review of clinical outcomes of sternocleidomastoid flap surgery in head and neck reconstruction, integrated with a review of vascular anatomical studies of the sternocleidomastoid.
A literature search of the Medline and Web of Science databases was conducted. Complications were analysed for each study. The trend in success rates was analysed by date of the study.
Reported complication rates have improved over time. The preservation of two vascular pedicles rather than one may have contributed to improved outcomes.
The sternocleidomastoid flap is a versatile option for patients where prolonged free flap surgery is inappropriate. Modern vascular imaging techniques could optimise pre-operative planning.
Chemical bonding in native oxides of GaAs, before and after etching, is detected by X-Ray Photoelectron Spectroscopy (XPS). It is correlated with surface energy engineering (SEE), measured via Three Liquid Contact Angle Analysis (3LCAA), and oxygen coverage, measured by High Resolution Ion Beam Analysis (HR-IBA).
Before etching, GaAs native oxides are found to be hydrophobic with an average surface energy, γT, of 33 ± 1 mJ/m2, as measured by 3LCAA. After dilute NH4OH etching, GaAs becomes highly hydrophilic and its surface energy, γT, increases by a factor 2 to a reproducible value of 66 ± 1 mJ/m2. Using HR-IBA, oxygen coverage on GaAs is found to decrease from 7.2 ± 0.5 monolayers (ML) to 3.6 ± 0.5 ML. The 1.17 ratio of Ga to As, measured by HR-IBA, remains constant after etching.
XPS is used to measure oxidation of Ga and As, as well as surface stoichiometry on two locations of several GaAs(100) wafers before and after etching. The relative proportions of Ga and As are unaffected by adventitious carbon contamination. The 1.16 Ga:As ratio, measured by XPS, matches HR-IBA analysis. The proportions of oxidized Ga and As do not change significantly after etching. However, the initial ratio of As2O5 to As2O3, within the oxidized As, significantly decreases after etching from approximately 3:1 to 3:2.
Absolute oxygen coverage, as a function of surface processing, is determined within 0.5 ML by HR-IBA. XPS offers insight into these modifications by detecting electronic states and phase composition changes of GaAs oxides. The changes in surface chemistry are correlated to changes in hydro-affinity and surface energies measured by 3LCAA.
Specimens (n = 508) of eight species of owl (Aves: Strigiformes) collected from 1994 to 2017 in Manitoba, Canada, were weighed and examined for chewing lice (Phthiraptera: Amblycera, Ischnocera). The relationship between host body mass and infestation by 12 species of lice was examined. Host body mass explained 52% (P = 0.03) of the variation in mean intensity of louse infestation among hosts, due primarily to a high abundance of lice on the heaviest owl species. The relationship was due to the mean intensity of lice, and neither species richness nor the prevalence of lice was related to host body mass. For individual louse species, the relationship was due primarily to Kurodaia acadicae Price and Beer, Kurodaia magna Emerson, and an undetermined species of Kurodaia Uchida (Phthiraptera: Menoponidae) (R2 = 0.997), but not the nine Strigiphilus Mjöberg (Phthiraptera: Philopteridae) species (R2 = 0.27). Louse intensity did not increase with body size for individual birds of any of the owl species. Mean intensity is expected to increase in proportion with the size, specifically the surface area, of the host. Why that relationship holds only for one louse genus, and not for the most abundant genus of lice on owls, and weakly compared with other families of birds, has yet to be determined.
Eleven of the 12 species of owls (Aves: Strigidae, Tytonidae) known to occur in Manitoba, Canada, were examined for chewing lice (Phthiraptera: Amblycera, Ischnocera) from 1976 to 2015: barn owl (Tyto alba (Scopoli); Aves: Tytonidae) (n = 2), snowy owl (Bubo scandiacus (Linnaeus); Aves: Strigidae) (n = 77), great horned owl (Bubo virginianus (Gmelin); Aves: Strigidae) (n = 262), great grey owl (Strix nebulosa Förster; Aves: Strigidae) (n = 142), barred owl (Strix varia Barton; Aves: Strigidae) (n = 10), northern hawk owl (Surnia ulula (Linnaeus); Aves: Strigidae) (n = 18), short-eared owl (Asio flammeus (Pontoppidan); Aves: Strigidae) (n = 74), long-eared owl (Asio otus (Linnaeus); Aves: Strigidae) (n = 67), eastern screech owl (Megascops aslo (Linnaeus); Aves: Strigidae) (n = 59), boreal owl (Aegolius funereus (Linnaeus); Aves: Strigidae) (n = 47), and northern saw-whet owl (Aegolius acadicus (Gmelin); Aves: Strigidae) (n = 44), a total of 802 owls. No lice were found infesting barn owl (Tyto alba (Scopoli); Aves: Tytonidae) or eastern screech owl (Megascops asio (Linnaeus); Aves: Strigidae). We collected a total of 113 810 lice of 12 species: Kurodaia Uchida (Phthiraptera: Menoponidae) – three species; and Strigiphilus Mjöberg (Phthiraptera: Philopteridae) – nine species. Overall prevalence of infestation ranged from 10.0% to 88.9%. Mean intensity for total lice ranged from 22.4 to 506.5. Infestation parameters for each louse–host combination are provided; prevalence and mean intensity were not related for louse–host species combinations. Distribution of louse infestations was highly aggregated. In all louse–host combinations but one, either females were more prevalent than males or there was no significant deviation from 50:50. Male Strigiphilus ceblebrachys Denny significantly outnumbered females in snowy owls. There was a tendency for louse species to co-occur on the same host specimen. Where sample sizes for owls were large enough, no seasonal patterns in abundance of lice were detected.
Replicate radiocarbon (14C) measurements of organic and inorganic control samples, with known Fraction Modern values in the range Fm = 0–1.5 and mass range 6 μg–2 mg carbon, are used to determine both the mass and radiocarbon content of the blank carbon introduced during sample processing and measurement in our laboratory. These data are used to model, separately for organic and inorganic samples, the blank contribution and subsequently “blank correct” measured unknowns in the mass range 25–100 μg. Data, formulas, and an assessment of the precision and accuracy of the blank correction are presented.
Open Strategy has drawn increasing attention in recent years. A growing number of studies have captured greater transparency and heightened inclusion in the strategic practices of contemporary organizations (e.g., Whittington et al., 2011; Hautz et al., 2017). It is often Information Technology (IT) that can facilitate involvement of a wider range of stakeholders in the generation of strategic content and knowledge (Chesbrough & Appleyard, 2007; Wulf & Butel, 2016), and in the practice of strategy (Whittington et al., 2011; Whittington, 2014). However, despite the widely recognized role of such technology as online platforms (Malhotra et al., 2017) and social media (Huang et al., 2013; Baptista et al., 2017) in enabling openness in strategy, literature with an explicit focus on IT has been surprisingly sparse to date (Tavakoli et al., 2015; 2017). Thus far, most papers have been published in Management and Strategic Management outlets (e.g., Whittington et al., 2011; Stieger et al., 2012; Seidl & Werle, 2017), including a special issue on Open Strategy in Long Range Planning (e.g., Hautz et al., 2017).
Clinical Enterobacteriacae isolates with a colistin minimum inhibitory concentration (MIC) ≥4 mg/L from a United States hospital were screened for the mcr-1 gene using real-time polymerase chain reaction (RT-PCR) and confirmed by whole-genome sequencing. Four colistin-resistant Escherichia coli isolates contained mcr-1. Two isolates belonged to the same sequence type (ST-632). All subjects had prior international travel and antimicrobial exposure.
Formally established in the fall of 1947, the Laboratory of Archaeology at the University of Georgia is an archaeological research and collection repository. It is considered one of the premier institutions for curation of archaeological collections from the American Southeast. For over 70 years, the Laboratory has served as a repository for objects and associated records generated from archaeological projects and research undertaken by faculty, students, CRM professionals, and state and federal agencies. The Laboratory curates over 20,000 cubic feet of artifacts as well as paper and digital archives. In addition, the Laboratory houses the Georgia Archaeological Site File and manages data from more than 59,000 archaeological sites, including over 11,500 archaeological reports. In this paper, we explore implementation procedures for bringing legacy collections up to modern curation standards. We also outline how we migrate the data on paper records into the digital realm, articulating them within a comprehensive framework.
The warm, equable, and ice-free early Eocene Epoch permits investigation of ecosystem function and macro-ecological patterns during a very different climate regime than exists today. It also provides insight into what the future may entail, as anthropogenic CO2 release drives Earth toward a comparable hothouse condition. Studying plant–insect herbivore food webs during hothouse intervals is warranted, because these account for the majority of nonmicrobial terrestrial biodiversity. Here, we report new plant and insect herbivore damage census data from two floodplain sites in the Wind River Basin of central Wyoming, one in the Aycross Formation (50–48.25 Ma) at the basin edge (WRE) and the second in the Wind River Formation in the interior of the basin (WRI). The WRI site is in stratigraphic proximity to a volcanic ash that is newly dated to 52.416 ± 0.016/0.028/0.063 (2σ). We compare the Wind River Basin assemblages to published data from a 52.65 Ma floodplain flora in the neighboring Bighorn (BH) Basin and find that only 5.6% of plant taxa occur at all three sites and approximately 10% occur in both basins. The dissimilar floras support distinct suites of insect herbivores, as recorded by leaf damage. The relatively low-diversity BH flora has the highest diversity of insect damage, contrary to hypotheses that insect herbivore diversity tracks floral diversity. The distinctiveness of the WRE flora is likely due to its younger age and cooler reconstructed paleotemperature, but these factors are nearly identical for the WRI and BH floras. Site-specific microenvironmental factors that cannot be measured easily in deep time may account for these differences. Alternatively, the Owl Creek Mountains between the two basins may have provided a formidable barrier to the thermophilic organisms that inhabited the basin interiors, supporting Janzen's hypothesis that mountain passes appear higher in tropical environments.
Apolipoprotein E (APOE) E4 is the main genetic risk factor for Alzheimer’s disease (AD). Due to the consistent association, there is interest as to whether E4 influences the risk of other neurodegenerative diseases. Further, there is a constant search for other genetic biomarkers contributing to these phenotypes, such as microtubule-associated protein tau (MAPT) haplotypes. Here, participants from the Ontario Neurodegenerative Disease Research Initiative were genotyped to investigate whether the APOE E4 allele or MAPT H1 haplotype are associated with five neurodegenerative diseases: (1) AD and mild cognitive impairment (MCI), (2) amyotrophic lateral sclerosis, (3) frontotemporal dementia (FTD), (4) Parkinson’s disease, and (5) vascular cognitive impairment.
Genotypes were defined for their respective APOE allele and MAPT haplotype calls for each participant, and logistic regression analyses were performed to identify the associations with the presentations of neurodegenerative diseases.
Our work confirmed the association of the E4 allele with a dose-dependent increased presentation of AD, and an association between the E4 allele alone and MCI; however, the other four diseases were not associated with E4. Further, the APOE E2 allele was associated with decreased presentation of both AD and MCI. No associations were identified between MAPT haplotype and the neurodegenerative disease cohorts; but following subtyping of the FTD cohort, the H1 haplotype was significantly associated with progressive supranuclear palsy.
This is the first study to concurrently analyze the association of APOE isoforms and MAPT haplotypes with five neurodegenerative diseases using consistent enrollment criteria and broad phenotypic analysis.
To define optimal thromboprophylaxis strategy after stent implantation in superior or total cavopulmonary connections.
Stent thrombosis is a rare complication of intravascular stenting, with a perceived higher risk in single-ventricle patients.
All patients who underwent stent implantation within superior or total cavopulmonary connections (caval vein, innominate vein, Fontan, or branch pulmonary arteries) were included. Cohort was divided into aspirin therapy alone versus advanced anticoagulation, including warfarin, enoxaparin, heparin, or clopidogrel. Primary endpoint was in-stent or downstream thrombus, and secondary endpoints included bleeding complications.
A total of 58 patients with single-ventricle circulation underwent 72 stent implantations. Of them 14 stents (19%) were implanted post-superior cavopulmonary connection and 58 (81%) post-total cavopulmonary connection. Indications for stenting included vessel/conduit stenosis (67%), external compression (18%), and thrombotic occlusion (15%). Advanced anticoagulation was prescribed for 32 (44%) patients and aspirin for 40 (56%) patients. Median follow up was 1.1 (25th–75th percentile, 0.5–2.6) years. Echocardiograms were available in 71 patients (99%), and advanced imaging in 44 patients (61%). Thrombosis was present in two patients on advanced anticoagulation (6.3%) and none noted in patients on aspirin (p = 0.187). Both patients with in-stent thrombus underwent initial stenting due to occlusive left pulmonary artery thrombus acutely post-superior cavopulmonary connection. There were seven (22%) significant bleeding complications for advanced anticoagulation and none for aspirin (p < 0.001).
Antithrombotic strategy does not appear to affect rates of in-stent thrombus in single-ventricle circulations. Aspirin alone may be sufficient for most patients undergoing stent implantation, while pre-existing thrombus may warrant advanced anticoagulation.
Significant inter-centre variability in the intensity of endomyocardial biopsy surveillance for rejection following paediatric cardiac transplantation has been reported. Our aim was to determine if low-intensity biopsy surveillance with two scheduled biopsies in the first year would produce outcomes similar to published registry outcomes.
A retrospective study of paediatric recipients transplanted between 2008 and 2014 using a low-intensity biopsy protocol consisting of two surveillance biopsies at 3 and 12–13 months in the first post-transplant year, then annually thereafter. Additional biopsies were performed based on echocardiographic and clinical surveillance. Excluded were recipients that were re-transplanted or multi-organ transplanted or were followed at another institution.
A total of 81 recipients in the first 13 months after transplant underwent an average of 2 (SD ± 1.3) biopsies, 24 ± 6.8 echocardiograms, and 17 ± 4.4 clinic visits per recipient. During the 13-month period, 19 recipients had 24 treated rejection episodes, with the first at an average of 2.8 months post-transplant. The 3-, 12-, 36-, and 60-month conditional on discharge graft survival were 100%, 98.8%, 98.8%, and 90.4%, respectively, comparable to reported figures in major paediatric registries. At a mean follow-up of 4.7 ± 2.1 years, four patients (4.9%) developed cardiac allograft vasculopathy, three (3.7%) developed a malignancy, and seven (8.6%) suffered graft loss.
Rejection surveillance with a low-intensity biopsy protocol demonstrated similar intermediate-term outcomes and safety measures as international registries up to 5 years post-transplant.
This is a copy of the slides presented at the meeting but not formally written up for the volume.
The stress evolution during electrochemical deposition of metals on amorphous substrates was monitored by an in situ, real time cantilever curvature measurement technique. The technique used is similar to that employed for in situ stress measurements performed during physical vapor deposition of thin films, but has been modified for optimal use in an electrochemical system. The electrodeposited films displayed Volmer-Weber island growth behavior, and exhibited a compression-tension-compression stress development that could be correlated with discrete island formation, island-coalescence, and post-coalescence growth stages, respectively. Under constant current conditions, the voltage transient displayed a corresponding three-stage character. Atomic force microscopy images confirmed that the microstructures of the films underwent three-dimensional island nucleation and growth. In the post-coalescence regime, interruption of the deposition resulted in an exponentially decreasing stress relaxation. The overall stress behaviors during growth and after the growth interruption were found to be very similar to that observed during physical vapor deposition of films on amorphous substrates. The experimental results will be analyzed in terms of recently proposed stress generation mechanisms.
A design and manufacturing method is described for creating a motor tendon–actuated soft foam robot. The method uses a castable, light, and easily compressible open-cell polyurethane foam, producing a structure capable of large (~70% strain) deformations while requiring low torques to operate (<0.2 N·m). The soft robot can change shape, by compressing and folding, allowing for complex locomotion with only two actuators. Achievable motions include forward locomotion at 13 mm/s (4.3% of body length per second), turning at 9◦/s, and end-over-end flipping. Hard components, such as motors, are loosely sutured into cavities after molding. This reduces unwanted stiffening of the soft body. This work is the first demonstration of a soft open-cell foam robot locomoting with motor tendon actuators. The manufacturing method is rapid (~30 min per mold), inexpensive (under $3 per robot for the structural foam), and flexible, and will allow a variety of soft foam robotic devices to be produced.