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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.
Background: SMA is a neurodegenerative disease caused by biallelic deletion/mutation of SMN1. Copies of a similar gene (SMN2) modify disease severity. In a phase 1 study, SMN GRT onasemnogene abeparvovec (AVXS-101) improved outcomes of symptomatic SMA patients with two SMN2 copies (2xSMN2) dosed ≤6 months. Because motor neuron loss can be insidious and disease progression is rapid, early intervention is critical. This study evaluates AVXS-101 in presymptomatic SMA newborns. Methods: SPR1NT is a multicenter, open-label, phase 3 study enrolling ≥27 SMA patients with 2–3xSMN2. Asymptomatic infants ≤6 weeks receive a one-time intravenous AVXS-101 infusion (1.1x1014 vg/kg). Safety and efficacy are assessed through study end (18 [2xSMN2] or 24 months [3xSMN2]). Primary outcomes: independent sitting for ≥30 seconds (18 months [2xSMN2]) or assisted standing (24 months [3xSMN2]). Results: From April–September 2018, 7 infants received AVXS-101 (4 female; 6 with 2xSMN2) at ages 8–37 days. Mean baseline CHOP-INTEND score was 41.7 (n=6), which increased by 6.8, 11.0, 18.0, and 22.5 points at day 14 (n=4), month 1 (n=3), 2 (n=3), and 3 (n=2). Updated data available at the time of the congress will be presented. Conclusions: Preliminary data from SPR1NT show rapid motor function improvements in presymptomatic SMA patients.
The main factors determining the shape of a supersonic aeroplane or missile are aerodynamic in origin. However, as always, a compromise with structural considerations must be achieved, zero wing thickness for supersonic aircraft being just as unattainable as infinite aspect ratio for subsonic ones.
This compromise is more far-reaching in the supersonic aircraft because of the much greater importance of aeroelasticity.
In addition, there are entirely new problems which arise from the high structural temperatures attained in supersonic flight.
The primary structure of an aeroplane usually consists basically of a set of tubular beams. The main structural box of the wing or tailplane is a well-known example: a semi-monocoque fuselage is another. For any given loading condition of the aircraft the material in the tube is stressed mainly in tension, in shear, or in compression, depending on its location in the tube cross section.
The aim of the designer is to make the material fulfil these three functions in the most economical manner. In tension, he is limited only by the quality of material available. In shear, this is again substantially the case, although it is well known that very light shear webs over great depths do not develop as high an effective failing stress as do more sturdy webs. This property of dependence on the intensity of loading is much more marked in the case of the compression structure, which is liable to instability in various ways.
A surface-to-air guided weapon system is the result of many years work by a large and diverse team and includes radars and fire control equipment as well as the actual missile. In the time available it is impossible to cover the whole weapon system and therefore no apology is made for concentrating on the development history of the missile itself. It must be remembered, however, that there are many parts of the Bloodhound weapon system, a major contribution to the whole, which will not be mentioned.
In the current issue of Jane's All the World's Aircraft, J. W. R. Taylor states that ‘It would be pleasing to see in the development of programmes like Airbus and Tornado the seeds of increasingly successful European collaboration in the aerospace business … ‘
The Management Studies Group of the Royal Aeronautical Society have, for many years, been concerned with improving the effectiveness of the aerospace industry, and saw in European collaboration great opportunities as well as problems to be overcome. It was felt that the time was right for a review which could indicate the way forward, and identify the best growing conditions for the seeds of successful European collaboration.
This paper was commissioned by the Management Studies Group to review published papers for quantitative data in order to help set the scene for the talks and discussion to follow.
In the 18th Mitchell Memorial Lecture given to the Southampton Branch of the Society on 3rd February 1971, Val Cleaver discussed the outlook for astronautics after Apollo.
In the light of participation in the rapidly evolving programme since that date, I shall discuss, in this lecture, the history of the Apollo project, its relation to the evolving objectives of the NASA space programme as a whole, the origins of ideas which led to the post Apollo system, the history of negotiations between the Americans and Europe on European participation in the programme, the current studies, and factors underlying possible European involvement.
The first American satellite weighed 30 lb and was launched in 1958. Since then the Americans have launched several million pounds of payload into low earth orbit and, in the Apollo programme, individual payloads into low earth orbit have a weight of 300 000 lb. NASA astronauts have spent more than 6000 hrs in space, safely flying more than 100 million miles. Eighteen American astronauts have orbited the moon, eight have left their footprints on the lunar surface.
Infantile haemangiopericytoma is a rare childhood vascular tumour of borderline malignancy and unpredictable clinical course. It can present a diagnostic challenge due to indeterminate clinical, radiological and pathological features. This report presents the case of a large congenital haemangiopericytoma of the neck in a neonate, and discusses diagnosis, imaging, pathology and surgical management.
A full-term neonate presented with a large posterior neck mass at birth. Pre-operative radiological appearances were suggestive of teratoma, but following surgical excision the diagnosis of infantile haemangiopericytoma was confirmed on histological analysis. There were no signs of recurrence at 12-month follow up.
Haemangiopericytoma can follow an aggressive course in adults, including local recurrence and metastasis. The infantile variant is rare but typically follows a distinct clinical course, and is associated with more benign behaviour compared with similar tumours in adults and children over one year. Congenital haemangiopericytoma can be effectively treated with surgery, without requiring adjuvant therapy.
Campylobacter are zoonotic pathogens commonly associated with gastroenteritis. To assess the relevance of Campylobacter in Vietnam, an economically transitioning country in SE Asia, we conducted a survey of 343 pig and poultry farms in the Mekong delta, a region characterized by mixed species farming with limited biosecurity. The animal-level prevalence of Campylobacter was 31·9%, 23·9% and 53·7% for chickens, ducks and pigs, respectively. C. jejuni was predominant in all three host species, with the highest prevalence in pigs in high-density production areas. Campylobacter isolates demonstrated high levels of antimicrobial resistance (21% and 100% resistance against ciprofloxacin and erythromycin, respectively). Multilocus sequence type genotyping showed a high level of genetic diversity within C. jejuni, and predicted C. coli inter-species transmission. We suggest that on-going intensification of animal production systems, limited biosecurity, and increased urbanization in Vietnam is likely to result in Campylobacter becoming an increasingly significant cause of human diarrhoeal infections in coming years.
Non-typhoidal Salmonella are an important but poorly characterized cause of paediatric diarrhoea in developing countries. We conducted a hospital-based case-control study in children aged <5 years in Ho Chi Minh City to define the epidemiology and examine risk factors associated with Salmonella diarrhoeal infections. From 1419 diarrhoea cases and 571 controls enrolled between 2009 and 2010, 77 (5·4%) diarrhoea cases were stool culture-positive for non-typhoidal Salmonella. Salmonella patients were more likely to be younger than controls (median age 10 and 12 months, respectively) [odds ratio (OR) 0·97; 95% confidence interval (CI) 0·94–0·99], to report a recent diarrhoeal contact (8·1% cases, 1·8% controls; OR 5·98, 95% CI 1·8–20·4) and to live in a household with >2 children (cases 20·8%, controls 10·2%; OR 2·32, 95% CI 1·2–4·7). Our findings indicate that Salmonella are an important cause of paediatric gastroenteritis in this setting and we suggest that transmission may occur through direct human contact in the home.
The broad-necked root borer, Prionus laticollis (Drury), causes economic damage to apple orchards in the eastern United States by boring in the roots of apple trees. The insect has a 3- to 4-year life cycle. Eggs are deposited in the soil or on the soil surface in mid-summer, and larvae tunnel through the bark and may excavate the interior wood of living, weakened, or dead apple tree roots. Larvae leave the roots to pupate in the soil and have been found up to a depth of 84 cm below the soil surface. Prepupae occur in the soil during May and June and pupae in June and July. Adults live approximately 1 week after emergence and mate several times. A tachinid fly, several potential pathogenic microorganisms, larvae biting one another, and freezing temperatures were observed to be mortality factors.
Biologically relevant lipid bilayers supported on highly ordered pyrolytic graphite (HOPG) were probed both mechanically and electrically with a Conductive Atomic Force Microscope (C-AFM) capable of measuring ultra-low currents. Results show that these membranes undergo an elastic response up to 26 nN on average when compressed with an AFM tip. Measuring the films with a low contact force demonstrates that contact mode AFM can be used repeatedly to image without damaging the film. Based on current-voltage measurements made with the C-AFM, it is shown that apparently high resistances seen for the films could be the result of variable electrical contact between the tip and surface. As a result, the paper proposes that the deflection of the cantilever should always be measured in order to ensure knowledge of the location of the tip during all electrical measurements.
Most of the nearly zonal, multiple, alternating jets observed in the oceans are latent, that is, their amplitudes are weak relative to the ambient mesoscale eddies. Yet, relatively strong jets are often observed in dynamical simulations. To explore mechanisms controlling the degree of latency, we analyse solutions of an idealized, eddy-resolving and flat-bottom quasigeostrophic model, in which dynamically generated mesoscale eddies maintain and interact with a set of multiple zonal jets. We find that the degree of the latency is controlled primarily by the bottom friction: the larger the friction parameter, the more latent are the jets; and the degree of the latency is substantial for a realistic range of the oceanic bottom friction coefficient. This result not only provides a plausible explanation for the latency of the oceanic jets, but it may also be relevant to the prominent atmospheric multiple jets observed on giant gas planets, such as Jupiter. We hypothesize that these jets can be so strong because of the relative absence of the bottom friction. The mechanism controlling the latency in our solutions is understood in terms of the changes induced in the linear eigenmodes of the time–mean flow by varying the bottom friction coefficient; these changes, in turn, affect and modify the jets. Effects of large Reynolds numbers on the eddies, jets, and the latency are also discussed.
The apparent family clustering of avian influenza A/H5N1 has led several groups to postulate the existence of a host genetic influence on susceptibility to A/H5N1, yet the role of host factors on the risk of A/H5N1 disease has received remarkably little attention compared to the efforts focused on viral factors. We examined the epidemiological patterns of human A/H5N1 cases, their possible explanations, and the plausibility of a host genetic effect on susceptibility to A/H5N1 infection. The preponderance of familial clustering of cases and the relative lack of non-familial clusters, the occurrence of related cases separated by time and place, and the paucity of cases in some highly exposed groups such as poultry cullers, are consistent with a host genetic effect. Animal models support the biological plausibility of genetic susceptibility to A/H5N1. Although the evidence is circumstantial, host genetic factors are a parsimonious explanation for the unusual epidemiology of human A/H5N1 cases and warrant further investigation.
The role of event knowledge in early language acquisition was investigated. Thirteen two-year-olds were observed interacting with their mothers over a five-week period. During weekly observational sessions, dyads interacted in both a familiar-event context and an unfamiliar-event context. Events were represented by complex toys (e.g. airport, marina, etc.). In the familiar-event, dyads interacted with the same event-toy during each observation period. In the unfamiliar-event, these same dyads interacted with a different novel toy during each observation period. The results indicated that children's increasing event knowledge facilitated their language development. Specifically, children's lexical type use, action verb use, and MLU increased in the familiar-event, but remained unchanged in the unfamiliar-event. Event knowledge also facilitated children's lexical token use. Results are discussed in terms of the role of event knowledge in language acquisition.