James Mann, M.D. (1759-1832): Military Surgeon for the Second War of Independence .

The War of 1812 is remembered for the Burning of Washington, and Francis Scott Key’s “The Star Spangled Banner,” but little else. It was a poorly funded war of relatively short duration and nebulous resolution. Under such circumstances, it is understandable that the “Second War of Independence” failed to produce many notable military or medical advancements. However, one surgeon took it upon himself to recount his experiences in the field. For his dedication to the art and science of medicine, James Mann deserves recognition

Ditches show systematic impacts on soil and vegetation properties across the Swedish forest landscape

Novel mapping methods using AI have led to improved mapping of the extent of drainage systems, but the full scope of the effects of drainage on ecosystems has yet to be understood. By combining ditches mapped with remote sensing and AI methods with soil data from the Swedish Forest Soil Inventory, and vegetation data from the National Forest Inventory we identified 4 126 survey plots within 100 m of a ditch. The inventory data span across three biomes; the northern boreal zone, the hemiboreal zone, and the temperate zone. We explored if soils and vegetation close to ditches were indeed different from the surrounding landscape. The large number of plots spread widely across the Swedish forest landscape spanning different physiographic regions, climates, topography, soils, and vegetation made it possible to identify the general effect of drainage on soil properties, tree productivity, and plant species composition. We found a surprisingly large amount of ditches on mineral soils (50-70%, depending on the definition of peatlands). Forest growth was affected, with higher growth rates of trees closer to ditches, particularly Norway spruce. Sphagnum mosses - a key indicator of wet soils - were less common near ditches, where they were replaced by feather mosses. The soil bulk density was higher closer to ditches, as was the concentration of metals that are typically associated with organic matter (Al), while concentrations of metals with a lower affinity for organic material decreased toward ditches (Na, K, Mg). The results from mineral soils and peat soils often differed. For example, N and tree volume increased toward ditches, but on different levels for peat and mineral soils, while the thickness of the humus layer and Pleurozium schreberi cover showed opposite patterns for the different soils. Clearly, ditches have affected the entire Swedish forest landscape, driving it towards a drier, more spruce-dominated productive forested ecosystem and away from wetland ecosystems like mires and littoral areas along streams. Furthermore, the biogeochemistry of the soils and understory species cover near ditches have changed, potentially irreversibly, at least within human time frames, and have implications for restoration goals and the future of forestry

Moyamoya: A Review of the Disease and Current Treatments

INTRODUCTION Moyamoya disease is a rare progressive cerebrovascular disease characterized by bilateral stenosis of vasculature of the Circle of Willis, specifically the distal internal carotid arteries, that leads to extensive collateral circulation. These dilated collateral vessels are described as having a hazy “puff of smoke” appearance on angiography. “Moyamoya” is the Japanese word for this characteristic appearance. The disease was originally described in Japan in 1957 1 and introduced to the English literature in 1969.2 The disease is most known for its distribution in Asian populations, but recently there has been more research and attention given to moyamoya in Europe and North American Moyamoya disease presents clinically due to the ischemic and hemorrhagic complications of abnormal cerebral vascularity.3,4 Epidemiology Moyamoya disease was originally described in Japanese populations but is present in a variety of ethnicities.3,5,6 In Japan, the incidence per 100,000 patient years is between 0.35 to 0.943 with a male: female ratio of 1:1.87. In the US, incidence ranged from 0.05 to 0.17 per 100,000 patient years with a similar gender distribution.3,6 Other population studies have not been as robust but European studies show moyamoya statistics that are more similar to American findings than those of Asian moyamoya findings.4 There is a bimodal distribution of incidence: in early childhood and adulthood, but the doublepeaked incidence is less dramatic in the US and Europe.4,8 Children typically present with the ischemic symptoms and adults can present with either ischemic or hemorrhagic type, with the ischemic type predominating.5,9 Overall, the hemorrhagic type is more common in Asia than the U.S.9 The incidence has been increasing with time, which may be due to increased awareness.

Management of head and neck pseudoaneurysms: a review of 33 consecutive cases.

Background. Endosaccular coiling, vessel occlusion, stenting, stent-assisted coiling, and flow diversion are all endovascular treatment options for pseudoaneurysms (PAs) of the head and neck. We explore different clinical situations in which these were selected for PA management at a single institution. Methods. Over a period of ten years, 33 patients presented to our hospital with PAs of the head and neck. Their outcomes and procedural complications are discussed. Results. We observed a complication rate of 18.2% (6 of 33), consisting predominantly of infarcts following vessel occlusion. As measured by the modified Rankin Scale, 25 (75.8%) patients had achieved favorable outcomes on discharge. A single patient who was treated with stent-assisted coiling expired following procedural complications. Conclusions. In our series, most patients with traumatic/iatrogenic PAs were successfully treated with parent vessel sacrifice. When parent vessel occlusion is not an option, stenting with or without coiling, or flow diversion, may also be safe and effective alternatives

O novo ensino médio no Espírito Santo: a implantação realizada nas escolas-piloto

Este artigo analisa a implantação do Novo Ensino Médio (NEM) em oito escolas-piloto do sistema estadual de ensino do Espírito Santo (ES). O estudo utiliza documentos legislativos e entrevistas realizadas com os/as diretores/as e os/as pedagogos/as das escolas-piloto, submetidas à análise de conteúdo. Conclui-se que a implantação no ES está em consonância com os princípios da reforma articulada aos mecanismos próprios da nova governamentabilidade neoliberal em ação, pois produz: responsabilização individualizada dos/as estudantes na sua trajetória escolar e adaptação ao novo modelo por meio do Projeto de Vida; redução da autonomia docente; flexibilização e desvalorização do trabalho docente transformando o fazer pedagógico em fazer administrativo e altruísmo dos/as gestores/as aos moldes do sistema privado

Psychophysical Evaluation of Achromatic and Chromatic Vision of Workers Chronically Exposed to Organic Solvents

The purpose of this paper was to evaluate achromatic and chromatic vision of workers chronically exposed to organic solvents through psychophysical methods. Thirty-one gas station workers (31.5 ± 8.4 years old) were evaluated. Psychophysical tests were achromatic tests (Snellen chart, spatial and temporal contrast sensitivity, and visual perimetry) and chromatic tests (Ishihara's test, color discrimination ellipses, and Farnsworth-Munsell 100 hue test—FM100). Spatial contrast sensitivities of exposed workers were lower than the control at spatial frequencies of 20 and 30 cpd whilst the temporal contrast sensitivity was preserved. Visual field losses were found in 10–30 degrees of eccentricity in the solvent exposed workers. The exposed workers group had higher error values of FM100 and wider color discrimination ellipses area compared to the controls. Workers occupationally exposed to organic solvents had abnormal visual functions, mainly color vision losses and visual field constriction

FIBROMA OSSIFICANTE PERIFÉRICO PÓS GESTAÇÃO: RELATO DE CASO CLÍNICO

O fibroma ossificante periférico é um crescimento gengival benigno relativamente comum de natureza reacional, correspondendo à evolução do granuloma piogênico. É uma das lesões não-neoplásicas mais freqüentes na gengiva, representando cerca de 9,6% dos exames submetidos à análise anátomo-patológica. Origina–se da membrana periostal/periodontal e a proliferação excessiva de tecido maduro representa uma resposta à irritação gengival causada por biofilme, cálculo subgengival, corpos estranhos no sulco gengival e restaurações mal adaptadas. Esta irritação crônica da membrana periostal/periodontal causaria metaplasia do tecido conjuntivo, resultando na calcificação distrófica com formação óssea. Acredita-se ainda que a maioria das lesões inicia-se como um granuloma piogênico, sofrendo maturação fibrosa e calcificação. O granuloma piogênico resulta de uma inflamação crônica desencadeada a partir de fatores locais, tais como placa ou cálculo dentais, e na mulher grávida, também é decorrente das alterações hormonais inerentes à gravidez. O objetivo deste trabalho é relatar um caso de evolução de um granuloma piogênico para um fibroma ossificante periférico. A lesão, de aspecto irregular, de base pediculada, com consistência elástica e superfície exibindo impressões da mordida e coloração parcialmente avermelhada, foi diagnosticada nove meses após o parto, presente entre os elementos dentários 11 e 12, em paciente melanoderma de 25 anos de idade, com queixa estética e de crescimento e sangramento gengivais desde o sétimo mês da gestação, quando foi orientada por um cirurgião-dentista que a lesão regrediria espontaneamente após o término da gravidez. O protocolo adotado remete a um diagnóstico inicial de granuloma piogênico, contudo a lesão não regrediu. Realizou–se terapia periodontal básica e excisão cirúrgica subperiosteal da lesão sob anestesia local e a peça foi submetida ao exame anátomo–patológico, que permitiu o diagnóstico conclusivo de fibroma ossificante periférico. A paciente foi submetida ao tratamento protocolado e após dois anos de acompanhamento não se observou sinal de recidiva da lesão

Trans-Arctic asymmetries, melting pots and weak species cohesion in the low-dispersal amphiboreal seaweed Fucus distichus

Amphiboreal taxa are often composed of vicariant phylogroups and species complexes whose divergence and phylogeographic affinities reflect a shared history of chronic isolation and episodic trans-Arctic dispersal. Ecological filters and shifting selective pressures may also promote selective sweeps, niche shifts and ecological speciation during colonization, but these are seldom considered at biogeographical scales. Here we integrate genetic data and Ecologic Niche Models (ENMs) to investigate the historical biogeography and cohesion of the polymorphic rockweed Fucus distichus throughout its immense amphiboreal range, focusing on trans-Arctic asymmetries, glacial/interglacial dynamics, and integrity of sympatric eco-morphotypes. Populations were sampled throughout the Pacific and the Atlantic, from southern rear-edges to the high-Arctic. They were genotyped for seven microsatellites and an mtDNA spacer, and genetic diversity and structure were assessed from global to local scales. ENMs were used to compare niche divergence and magnitude of post-glacial range shifts in Pacific versus Atlantic sub-ranges. Haplotypic and genotypic data revealed distinct and seemingly isolated Pacific vs Arctic/Atlantic gene-pools, with finer-scale regional sub-structuring pervasive in the Pacific. MtDNA diversity was highly structured and overwhelmingly concentrated in the Pacific. Regionally, Alaska showed the highest intra-population diversity but the lowest levels of endemism. Some sympatric/parapatric ecotypes exhibited distinct genotypic/ haplotypic compositions. Strikingly, niche models revealed higher Pacific tolerance to maximum temperatures and predicted a much more consolidated presence in the NE Atlantic. Glacial and modern ranges overlapped extensively in the Pacific, whereas the modern Atlantic range was largely glaciated or emerged during the Last Glacial Maximum. Higher genetic and ecogeographic diversity supports a primary Pacific diversification and secondary Atlantic colonization, also likely reflecting the much larger and more stable climatic refugia in the Pacific. The relic distribution and reduced ecological/morphological plasticity in the NE Atlantic are hypothesized to reflect functional trans-Arctic bottlenecks, recent colonization or competition with congeners. Within the Pacific, Alaska showed signatures of a post-glacial melting pot of eastern and southern populations. Genetic/ecotypic variation was generally not sufficiently discontinuous or consistent to justify recognizing multiple taxonomic entities, but support a separate species in the eastern Pacific, at the southern rear-edge. We predict that layered patterns of phylogeographic structure, incipient speciation and niche differences might be common among widespread low-dispersal amphiboreal taxa