New surgical technique for endoscopic management of anterior glottic web.

In this study we report a new endoscopic technique for the management of anterior glottic web (AGW). Previously, various procedures with endoscopic or open surgical approaches have been described for the treatment of symptomatic AGW. We present an original, highly effective endoscopic technique that seems to have several advantages over traditional approaches.We used this novel technique in a preliminary series of four patients. Using a CO2 laser, a curvilinear mucosal flap based on the web is elevated from the superior surface of one vocal chord. The web is divided, and the flap is sutured at the inferior surface of the opposite vocal chord, ensuring that no raw surfaces will be left exposed on this side of the larynx. We accurately describe the technique, displaying diagrams of the surgical steps.In three cases, a restoration of the laryngeal airway, with complete resolution of the AGW, was achieved. A limited residual web persisted close to the anterior commissure in the fourth patient.The new endoscopic technique utilized in our preliminary series of patients is a simple, repeatable, and effective surgical procedure for managing AGW

Scaling fields in the two-dimensional abelian sandpile model

We consider the isotropic two-dimensional abelian sandpile model from a perspective based on two-dimensional (conformal) field theory. We compute lattice correlation functions for various cluster variables (at and off criticality), from which we infer the field-theoretic description in the scaling limit. We find a perfect agreement with the predictions of a c=-2 conformal field theory and its massive perturbation, thereby providing direct evidence for conformal invariance and more generally for a description in terms of a local field theory. The question of the height 2 variable is also addressed, with however no definite conclusion yet.Comment: 22 pages, 1 figure (eps), uses revte

Validation and data characteristics of methane and nitrous oxide profiles observed by MIPAS and processed with Version 4.61 algorithm

The ENVISAT validation programme for the atmospheric instruments MIPAS, SCIAMACHY and GOMOS is based on a number of balloon-borne, aircraft, satellite and ground-based correlative measurements. In particular the activities of validation scientists were coordinated by ESA within the ENVISAT Stratospheric Aircraft and Balloon Campaign or ESABC. As part of a series of similar papers on other species [this issue] and in parallel to the contribution of the individual validation teams, the present paper provides a synthesis of comparisons performed between MIPAS CH4 and N2O profiles produced by the current ESA operational software (Instrument Processing Facility version 4.61 or IPF v4.61, full resolution MIPAS data covering the period 9 July 2002 to 26 March 2004) and correlative measurements obtained from balloon and aircraft experiments as well as from satellite sensors or from ground-based instruments. In the middle stratosphere, no significant bias is observed between MIPAS and correlative measurements, and MIPAS is providing a very consistent and global picture of the distribution of CH4 and N2O in this region. In average, the MIPAS CH4 values show a small positive bias in the lower stratosphere of about 5%. A similar situation is observed for N2O with a positive bias of 4%. In the lower stratosphere/upper troposphere (UT/LS) the individual used MIPAS data version 4.61 still exhibits some unphysical oscillations in individual CH4 and N2O profiles caused by the processing algorithm (with almost no regularization). Taking these problems into account, the MIPAS CH4 and N2O profiles are behaving as expected from the internal error estimation of IPF v4.61 and the estimated errors of the correlative measurements

Spatial Asymmetric Two dimensional Continuous Abelian Sandpile Model

We insert some asymmetries in the continuous Abelian sandpile models, such as directedness and ellipticity. We analyze probability distribution of different heights and also find the field theory corresponding to the models. Also we find the fields associated with some height variables.Comment: 14 Pages, 11 Figure

The disruption of Celf6, a gene identified by translational profiling of serotonergic neurons, results in autism-related behaviors

The immense molecular diversity of neurons challenges our ability to understand the genetic and cellular etiology of neuropsychiatric disorders. Leveraging knowledge from neurobiology may help parse the genetic complexity: identifying genes important for a circuit that mediates a particular symptom of a disease may help identify polymorphisms that contribute to risk for the disease as a whole. The serotonergic system has long been suspected in disorders that have symptoms of repetitive behaviors and resistance to change, including autism. We generated a bacTRAP mouse line to permit translational profiling of serotonergic neurons. From this, we identified several thousand serotonergic-cell expressed transcripts, of which 174 were highly enriched, including all known markers of these cells. Analysis of common variants near the corresponding genes in the AGRE collection implicated the RNA binding protein CELF6 in autism risk. Screening for rare variants in CELF6 identified an inherited premature stop codon in one of the probands. Subsequent disruption of Celf6 in mice resulted in animals exhibiting resistance to change and decreased ultrasonic vocalization as well as abnormal levels of serotonin in the brain. This work provides a reproducible and accurate method to profile serotonergic neurons under a variety of conditions and suggests a novel paradigm for gaining information on the etiology of psychiatric disorders

Contralateral Regional Recurrence in Lateralized or Paramedian Early-Stage Oral Cancer Undergoing Sentinel Lymph Node Biopsy-Comparison to a Historic Elective Neck Dissection Cohort

Introduction: Nowadays, two strategies are available for the management of the clinically negative neck in early-stage (cT1-2N0) oral squamous cell carcinoma (OSCC): elective neck dissection (END) and sentinel lymph node biopsy (SLNB). SLNB stages both the ipsilateral and the contralateral neck in early-stage OSCC patients, whereas the contralateral neck is generally not addressed by END in early-stage OSCC not involving the midline. This study compares both incidence and hazard of contralateral regional recurrences (CRR) in those patients who underwent END or SLNB. Materials and Methods: A retrospective multicenter cohort study, including 816 lateralized or paramedian early-stage OSCC patients, staged by either unilateral or bilateral END (n = 365) or SLNB (n = 451). Results: The overall rate of occult contralateral nodal metastasis was 3.7% (30/816); the incidence of CRR was 2.5% (20/816). Patients who underwent END developed CRR during follow-up more often than those who underwent SLNB (3.8 vs. 1.3%; p = 0.018). Moreover, END patients had a higher hazard for developing CRR than SLNB patients (HR = 2.585; p = 0.030). In addition, tumor depth of invasion was predictive for developing CRR (HR = 1.922; p = 0.009). Five-year disease-specific survival in patients with CRR was poor (42%) compared to patients in whom occult contralateral nodal metastases were detected by SLNB or bilateral END (88%), although not statistically different (p = 0.066). Conclusion: Our data suggest that SLNB allows for better control of the contralateral clinically negative neck in patients with lateralized or paramedian early-stage OSCC, compared to END as performed in a clinical setting. The prognosis of those in whom occult contralateral nodal metastases are detected at an earlier stage may be favorable compared to those who eventually develop CRR, which highlights the importance of adequate staging of the contralateral clinically negative neck

VALIDATION OF ENVISAT-1 LEVEL-2 PRODUCTS RELATED TO LOWER ATMOSPHERE O3 AND NOy CHEMISTRY BY A FTIR QUASI-GLOBAL NETWORK

A coordinated action involving eleven stations of the ground-based Network for Detection of Stratospheric Change (NDSC) equipped with Fourier transform infrared (FTIR) instruments was conducted to contribute to the validation of the three atmospheric chemistry instruments onboard ENVISAT, that are MIPAS, SCIAMACHY and GOMOS. The target products for validation are total columns of O3, CH4, CO and some important NOy species (NO2, HNO3, NO) and the source gas N2O. Together the eleven stations cover the latitudes between 79 °N and 78°S, including polar, mid -latitude and subtropical and tropical locations. The goal is to contribute to the assessment of the data quality of the aforementioned ENVISAT instruments, from a quasi-global perspective. The period of intensive ground-based data collection for the benefit of the ENVISAT Validation Commissioning Phase that is dealt with in the present paper is July 15 to December 1, 2002. The FTIR network involved collected a data set corresponding to an equivalent of approximately 400 days of measurements; about three quarter of the data have already been submitted to the ENVISAT Calval database and are included in the present work. Unfortunately, the distribution of ENVISAT data has been slow and limited. Only a limited number of coincidences has been found for making data inter-comparisons. Therefore, the conclusions drawn in this paper are very preliminary and cover only a limited set of data products from SCIAMACHY only. Our findings up to now concerning the above mentioned target products are the following: (1) SCIAMACHY near infrared operational products (CO, CH4, N2O) have no scientific meaning yet, (2), the operational SCIAMACHY total vertical O3 column product derived in the ultraviolet window has undergone some improvements with changing versions of the processor(s) but it still underestimates the column by about 5 – 10 %, (3), the operational SCIAMACHY total vertical O3 column product derived in the visible window is unrealistically large, and (3), the operational NO2 total column product from SCIAMACHY seems to largely overestimate the real column, but very few coincidences and large dispersions of the data do inhibit any further conclusion at present. In a next phase, the same ground-based correlative data set will be exploited to further validate the ENVISAT data as soon as more and reprocessed data will be distributed

The prognosis of streptococcal prosthetic bone and joint infections depends on surgical management-A multicenter retrospective study

BACKGROUND: The optimal treatment of streptococcal prosthetic joint infections (PJIs) is unclear. METHODS: A cohort of streptococcal PJIs was reviewed retrospectively in seven reference centers for the management of complex bone and joint infections, covering the period January 1, 2010 to December 31, 2012. RESULTS: Seventy patients with monomicrobial infections were included: 47 had infections of total hip arthroplasty and 23 had infections of total knee arthroplasty. The median age was 77 years (interquartile range (IQR) 69-83 years), the median Charlson comorbidity score was 4 (IQR 3-6), and 15.6% (n=11) had diabetes. The most commonly identified streptococcal species were Streptococcus agalactiae and Streptococcus dysgalactiae (38.6% (n=27) and 17.1% (n=12), respectively). Debridement, antibiotics and implant retention (DAIR) was performed after a median time of 7 days (IQR 3-8 days), with polyethylene exchange (PE) in 21% of cases. After a minimum follow-up of 2 years, 27% of patients had relapsed, corresponding to 51.4% of DAIR treatment cases and 0% of one-stage (n=15) or two-stage (n=17) exchange strategy cases. Rifampicin or levofloxacin in combination therapy was not associated with a better outcome (adjusted p= 0.99). S. agalactiae species and DAIR treatment were associated with a higher risk of failure. On multivariate analysis, only DAIR treatment and S. agalactiae were independent factors of relapse. Compared to DAIR without PE, DAIR with PE was only associated with a trend towards a benefit (odds ratio 0.33, 95% confidence interval 0.06-1.96; adjusted p= 0.44). CONCLUSIONS: Streptococcal PJIs managed with DAIR have a poor prognosis and S. agalactiae seems to be an independent factor of treatment failure

Validation of OMPS Suomi NPP and OMPS NOAA‐20 Formaldehyde Total Columns With NDACC FTIR Observations

We validate formaldehyde (HCHO) vertical column densities (VCDs) from Ozone Mapping and Profiler Suite Nadir Mapper (OMPS-NM) instruments onboard the Suomi National Polar-orbiting Partnership (Suomi NPP) satellite for 2012–2020 and National Oceanic and Atmospheric Administration-20 (NOAA-20) satellite for 2018–2020, hereafter referred to as OMPS-NPP and OMPS-N20, with ground-based Fourier-Transform Infrared (FTIR) observations of the Network for the Detection of Atmospheric Composition Change (NDACC). OMPS-NPP/N20 HCHO products reproduce seasonal variability at 24 FTIR sites. Monthly variability of OMPS-NPP/N20 has a very good agreement with FTIR, showing correlation coefficients of 0.83 and 0.88, respectively. OMPS-NPP (N20) biases averaged over all sites are −0.9 (4) ± 3 (6)%. However, at clean sites (with VCDs 4.0 × 10$^{15}$ molecules cm$^{−2}$, negative biases of −15% ± 4% appear for OMPS-NPP, but OMPS-N20 shows smaller bias of 0.5% ± 6% due to its smaller ground pixel footprints. Therefore, smaller satellite footprint sizes are important in distinguishing small-scale plumes. In addition, we discuss a bias correction and provide lower limit for the monthly uncertainty of OMPS-NPP/N20 HCHO products. The total uncertainty for OMPS-NPP (N20) at clean sites is 0.7 (0.8) × 10$^{15}$ molecules cm$^{−2}$, corresponding to a relative uncertainty of 32 (30)%. In the case of HCHO VCDs > 4.0 × 10$^{15}$ molecules cm$^{−2}$, however, the relative uncertainty in HCHO VCDs for OMPS-NPP (N20) decreases to 31 (18)%