A critical analysis of the review on antimicrobial resistance report and the infectious disease financing facility

Over the past year, two major policy initiatives have been introduced focusing on stimulating antibiotic development for human consumption. The European Investment Bank has announced the development of the Infectious Disease Financing Facility (IDFF) and the British government commissioned the Review on Antimicrobial Resistance, led by Jim O’Neill. Each constitutes a major effort by the European community to address the evolving crisis of antimicrobial resistance. Though both have similar goals, the approaches are unique and worthy of consideration. This manuscript utilizes a previously published framework for evaluation of antibiotic incentive plans to clearly identify the strengths and weaknesses of each proposal. The merits of each proposal are evaluated in how they satisfy four key objectives: 1) Improve the overall net present value (NPV) for new antibiotic projects; 2) Enable greater participation of Small to Medium Sized Enterprises (SME); 3) Encourage participation by large pharmaceutical companies; 4) Facilitate cooperation and synergy across the antibiotic market. The IDFF seeks to make forgivable loans to corporations with promising compounds, while the O’Neill group proposes a more comprehensive framework of early stage funding, along with the creation of a stable global market. Ultimately, the proposals may prove complementary and if implemented together may form a more comprehensive plan to address an impending global crisis. Substantial progress will only be made on these efforts if action is taken at an international level, therefore we recommend consideration of these efforts at the upcoming G20 summit

Hand transplants, daily functioning, and the human capacity for limb regeneration

Unlike some of our invertebrate and vertebrate cousins with the capacity to regenerate limbs after traumatic loss, humans do not have the ability to regrow arms or legs lost to injury or disease. For the millions of people worldwide who have lost a limb after birth, the primary route to regaining function and minimizing future complications i

Future considerations in the diagnosis and treatment of compressive neuropathies of the upper extremity

Compressive neuropathies of the upper extremity are among the most common conditions seen by hand surgeons. The diagnoses of carpal tunnel syndrome and cubital tunnel syndrome have traditionally been made by a combination of history, physical examination, and electrodiagnostic testing. However, findings can be nonspecific and electrodiagnostic testing is invasive for the patient. The diagnosis of compressive neuropathies continues to evolve as technology advances, and newer diagnostic modalities predominantly focus on preoperative diagnostic imaging with ultrasound and magnetic resonance imaging/neurography. With the advent of cheaper, faster, and less invasive imaging, the future may bring a paradigm shift away from electrophysiology as the gold standard for the preoperative diagnosis of compressive neuropathies. Intraoperative imaging of nerve health is an emerging concept that warrants further investigation, whereas postoperative imaging of nerve recovery with ultrasound and magnetic resonance imaging currently has a limited role because of nonspecific findings and potential for misinterpretation. Advances in surgical treatment of compressive neuropathies appear to center around the use of imaging for less invasive neurolysis techniques and other adjunctive treatments with nerve decompression. The management of failed peripheral nerve decompressions and recurrent compressive neuropathies remains challenging

Characterization of the dorsal ulnar corner in distal radius fractures : implication for surgical decision making

Poster presented at the 2017 Health Sciences Research Day which was organized and sponsored by the University of Missouri School of Medicine Research Council and held on November 9, 2017.Conclusions: 3D segmentation software is effective in producing 3D distal radius fracture models that can be used for analysis. The study demonstrated a pattern in dorsal ulnar corner fragment shape, though the study population size should be increased to improve the power of the results. The data will improve understanding of the morphology and size of the dorsal ulnar corner fracture fragment, which is critical to understanding the optimal method of operative fixation. This information will also lead to development of more accurate intra-articularfracture models for biomechanical studies

Early expression of MMP-9 predicts recovery of tibialis anterior after sciatic nerve crush injury

Background: The purpose of this study was to assess the expression of molecular markers and epineural blood flow after differing degrees of nerve injury to identify potential tools to predict nerve recovery in a rat sciatic nerve model. Methods: A total of 72 rats were divided into nine groups. Each group was subjected to one of three crush injuries, created by applying one of three vascular clamps for 30 seconds. Vascularity was assessed with laser Doppler flowmetry before and after crush, and at nonsurvival surgery. Nonsurvival surgeries were performed 6 hours, 2 weeks, or 6 weeks later with nerve conduction studies and muscle strength testing. Expression of matrix metalloproteinase 9 (MMP-9) and matrix metalloproteinase 2 (MMP-2) in each nerve was quantified using with enzyme linked immunosorbent analysis. Results: Persistent hyperemia was noted in the zone of injury compared with baseline at 2 weeks and 6 weeks in the groups that displayed incomplete recovery. Expression of MMP-9 at 6 hours increased with increasing severity of crush and was inversely related to tibialis anterior muscle force recovery. The ratio of MMP-9:MMP-2 expression correlated well with recovery of compound nerve action potential amplitude at 6 weeks. Conclusions: Resolution of nerve hyperemia may correlate with nerve recovery from trauma, but early measures of nerve blood flow after injury are not prognostic of recovery. Ratio of MMP-9:MMP-2 expression 6 hours after injury correlates with recovery of compound nerve action potential at 6 weeks, while MMP-9 expression alone predicts tibialis anterior recovery. These findings together suggest that increased MMP-9 expression is a potentially useful marker of more severe nerve injury

Toward peripheral nerve mechanical characterization using Brillouin imaging spectroscopy

SIGNIFICANCE: Peripheral nerves are viscoelastic tissues with unique elastic characteristics. Imaging of peripheral nerve elasticity is important in medicine, particularly in the context of nerve injury and repair. Elasticity imaging techniques provide information about the mechanical properties of peripheral nerves, which can be useful in identifying areas of nerve damage or compression, as well as assessing the success of nerve repair procedures. AIM: We aim to assess the feasibility of Brillouin microspectroscopy for peripheral nerve imaging of elasticity, with the ultimate goal of developing a new diagnostic tool for peripheral nerve injury APPROACH: Viscoelastic properties of the peripheral nerve were evaluated with Brillouin imaging spectroscopy. RESULTS: An external stress exerted on the fixed nerve resulted in a Brillouin shift. Quantification of the shift enabled correlation of the Brillouin parameters with nerve elastic properties. CONCLUSIONS: Brillouin microscopy provides sufficient sensitivity to assess viscoelastic properties of peripheral nerves

On the nature of the compact sources in IRAS 16293-2422 seen in at centimeter to sub-millimeter wavelengths

We present multi-epoch continuum observations of the Class 0 protostellar system IRAS 16293-2422 taken with the Very Large Array (VLA) at multiple wavelengths between 7 mm and 15 cm (41 GHz down to 2 GHz), as well as single-epoch Atacama Large Millimeter/submillimeter Array (ALMA) continuum observations covering the range from 0.4 to 1.3 mm (700 GHz down to 230 GHz). The new VLA observations confirm that source A2 is a protostar driving episodic mass ejections, and reveal the complex relative motion between A2 and A1. The spectrum of component B can be described by a single power law ($S_\nu \propto \nu^{2.28}$) over the entire range from 3 to 700 GHz (10 cm down to 0.4 mm), suggesting that the emission is entirely dominated by dust even at $\lambda$ = 10 cm. Finally, the size of source B appears to increase with frequency up to 41 GHz, remaining roughly constant (at $0''.39$ $\equiv$ 55 AU) at higher frequencies. We interpret this as evidence that source B is a dusty structure of finite size that becomes increasingly optically thick at higher frequencies until, in the millimeter regime, the source becomes entirely optically thick. The lack of excess free-free emission at long wavelengths, combined with the absence of high-velocity molecular emission indicates that source B does not drive a powerful outflow, and might indicate that source B is at a particularly early stage of its evolution