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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.
Several grass and broadleaf weed species around the world have evolved multiple-herbicide resistance at alarmingly increasing rates. Research on the biochemical and molecular resistance mechanisms of multiple-resistant weed populations indicate a prevalence of herbicide metabolism catalyzed by enzyme systems such as cytochrome P450 monooxygenases and glutathione S-transferases and, to a lesser extent, by glucosyl transferases. A symposium was conducted to gain an understanding of the current state of research on metabolic resistance mechanisms in weed species that pose major management problems around the world. These topics, as well as future directions of investigations that were identified in the symposium, are summarized herein. In addition, the latest information on selected topics such as the role of safeners in inducing crop tolerance to herbicides, selectivity to clomazone, glyphosate metabolism in crops and weeds, and bioactivation of natural molecules is reviewed.
Building on the recent advances in next-generation sequencing, the integration of genomics, proteomics, metabolomics, and other approaches hold tremendous promise for precision medicine. The approval and adoption of these rapidly advancing technologies and methods presents several regulatory science considerations that need to be addressed. To better understand and address these regulatory science issues, a Clinical and Translational Science Award Working Group convened the Regulatory Science to Advance Precision Medicine Forum. The Forum identified an initial set of regulatory science gaps. The final set of key findings and recommendations provided here address issues related to the lack of standardization of complex tests, preclinical issues, establishing clinical validity and utility, pharmacogenomics considerations, and knowledge gaps.
OBJECTIVES/SPECIFIC AIMS: Objectives/goals: Describe the process used to develop leveled competencies and associated examples. Discuss the final leveled competencies and their potential use in clinical research professional workforce initiatives. METHODS/STUDY POPULATION: The revised JTFCTC Framework 2.0 has 51 competency statements, representing 8 domains. Each competency statement has now been refined to delineate fundamental, skilled or advanced levels of knowledge and capability. Typically, the fundamental level describes the competency for a professional that requires some coaching and oversight, but is able to understand and identify basic concepts. The skilled level of the competency reflects the professional’s solid understanding of the competency and use of the information to take action independently in most situations. The advanced level embodies high level thinking, problem solving, and the ability to guide others in the competency. The process for developing both the three levels and examples involved 5 workgroups, each chaired by a content expert and comprising of national/international clinical research experts, including representatives from research sites, professional associations, government, and industry and academic sponsors. RESULTS/ANTICIPATED RESULTS: The committee developed 51 specific competencies arrayed across 3 levels and examples of each to demonstrate an appropriate application of the competency. The competencies and examples, and potential utilization, will be described. DISCUSSION/SIGNIFICANCE OF IMPACT: The use of competencies in the context of workforce development and training initiatives is helping to create standards for the clinical research profession. These leveled competencies allow for an important refinement to the standards that can be used to enhance the quality and safety of the clinical research enterprise and guide workforce development.
Chemical constituents trapped within glacial ice provide a unique record of climate, as well as repositories for biological material such as pollen grains, fungal spores, viruses, bacteria and dissolved organic carbon. Past research suggests that the veins of polycrystalline ice may provide a liquid microenvironment for active microbial metabolism fueled by concentrated impurities in the veins. Despite these claims, no direct measurements of impurity concentration in ice veins have been made. Using micro-Raman spectroscopy, we show that sulfate and nitrate concentrations in the veins of glacial ice from Greenland (Greenland Ice Sheet Project 2) and Antarctic (Newall Glacier and a Dominion Range glacier) core samples were 104 and 105 times greater than the concentrations measured in melted (bulk) core water. Methanesulfonate was not found in the veins, consistent with its presence as particulate matter within the ice. The measured vein concentration of molecular anions implies a highly acidic (pH < 3) vein environment with high ionic strength (mM-M). We estimate that the vein volume provides 16.7 and 576 km3 of habitable space within the Greenland and Antarctic ice sheets, respectively, which could support the metabolism of organisms that are capable of growing in cold, high ionic strength solutions with low pH.
Although historians have often noted the disadvantages of St. Petersburg's location for the development of a major city and seaport, they have paid relatively little attention to one of its most serious handicaps, its lack of direct and easy access to the products of the Russian interior. From the founding of St. Petersburg in 1703 to the opening of the Mariinsk and Tikhvin canals in 1810–11, the difficulty of transporting goods from the provinces to St. Petersburg created serious problems for consumers, producers, and merchants as well as the imperial government. It affected important sectors of the national economy and influenced the domestic and foreign policies of the Russian government.
Part of the difficulty of supplying St. Petersburg stemmed from the seemingly insatiable demand for Russian goods that accompanied the development of that city.
Survey-based contingent valuation (CV) techniques are commonly used to value the potential effects of a policy change when market-based valuation of those effects is not possible. The results of these analyses are often intended to inform policy decisions, which are made within the context of formal policymaking institutions. These institutions are typically designed to reduce the large number of potential options for addressing any given policy problem to a binary choice between the continuation of current policy and a single, specified alternative. In this research we develop an approach for conducting CV exercises in a manner consistent with the decision structure typically faced by policymakers. The data generated from this approach allow for an estimate of willingness to pay (WTP) for a defined policy alternative, relative to leaving policy unchanged, which we argue is of direct interest to policymakers. We illustrate our approach within the context of policy governing the storage of used nuclear fuel in the United States. We value the policy option of constructing an interim storage facility relative to continuation of current policy, wherein used nuclear fuel is stored on-site at or near commercial nuclear generating plants. We close the paper with a discussion of the implications for future research and the role of CV in the policymaking process.
How does living in a battleground state during a presidential election affect an individual’s political engagement? We utilize a unique collection of 113 million Facebook status updates to compare users’ political discussion during the 2008 election. “Battleground” state users are significantly more likely to discuss politics in the campaign season than are users in uncompetitive “blackout” states. Posting a political status update—a form of day-to-day engagement with politics—mediates ∼20 percent of the relationship between exposure to political competition and self-reported voter turnout. This paper is among the first to use a massive quantity of social media data to explain the microfoundations of how people think, feel, and act on a daily basis in response to their political environment.
Illegal exploitation of resources is a cause of environmental degradation worldwide. The effectiveness of conservation initiatives such as marine protected areas relies on users' compliance with regulations. Although compliance can be motivated by social norms (e.g. peer pressure and legitimacy), some enforcement is commonly necessary. Enforcement is expensive, particularly in areas far from land, but costs can be reduced by optimizing enforcement. We present a case study of how enforcement could be optimized at Cocos Island National Park, Costa Rica, an offshore protected area and World Heritage Site. By analysing patrol records we determined the spatial and temporal distribution of illegal fishing and its relationship to patrol effort. Illegal fishing was concentrated on a seamount within the Park and peaked during the third year-quarter, probably as a result of oceanographic conditions. The lunar cycle in conjunction with the time of year significantly influenced the occurrence of incursions. The predictability of illegal fishing in space and time facilitates the optimization of patrol effort. Repeat offenders are common in the Park and we suggest that unenforced regulations and weak governance are partly to blame. We provide recommendations for efficient distribution of patrol effort in space and time, establishing adequate governance and policy, and designing marine protected areas to improve compliance. Our methods and recommendations are applicable to other protected areas and managed natural resources.