Upper Eyelid Reconstruction With a Horizontal V-Y Myotarsocutaneous Advancement Flap

Upper eyelid tumours, particularly basal cell carcinomas, are relatively frequent. Surgical ablation of these lesions creates defects of variable complexity. Although several options are available for lower eyelid reconstruction, fewer surgical alternatives exist for upper eyelid reconstruction. Large defects of this region are usually reconstructed with two-step procedures. In 1997, Okada et al. described a horizontal V-Y myotarsocutaneous advancement flap for reconstruction of a large upper eyelid defect in a single operative time. However, no further studies were published regarding the use of this particular flap in upper eyelid reconstruction. In addition, this flap is not described in most plastic surgery textbooks. The authors report here their experience of 16 cases of horizontal V-Y myotarsocutaneous advancement flaps used to reconstruct full-thickness defects of the upper eyelid after tumour excision. The tumour histological types were as follows: 12 basal cell carcinomas, 2 cases of squamous cell carcinomas, 1 case of sebaceous cell carcinoma and 1 of malignant melanoma. This technique allowed closure of defects of up to 60% of the eyelid width. None of the flaps suffered necrosis. The mean operative time was 30 min. No additional procedures were necessary as good functional and cosmetic results were achieved in all cases. No recurrences were noted. In this series, the horizontal V-Y myotarsocutaneous advancement flap proved to be a technically simple, reliable and expeditious option for reconstruction of full-thickness upper eyelid defects (as wide as 60% of the eyelid width) in a single operative procedure. In the future this technique may become the preferential option for such defects

Necrosis of a Guinea Pig Stomach after Contact with Povidone-Iodine: a Case Report

Rodents are the most frequently used animals in surgical experimentation. It is estimated that guinea pigs in particular are the third most commonly used species in this context. To disinfect guinea pigs’ skin, either alcohol or surgical iodine are most often used. In the context of an animal research project, a Nissen operation was performed in an adult male guinea pig. Because of accidental contamination of the operative field, a 10% povidone-iodine cutaneous solution was applied to the serosa of the anterior wall of the stomach and to the gastric fundus. The guinea pig died 12 hours after surgery due to an acute necrotizing hemorrhagic gastritis. Although there have been a few reports of povidone-iodine toxicity in the guinea pig, as far as the authors could determine, this is the first time that such a serious abdominal complication is reported. The authors believe that the possibility of a similar event should be taken into consideration when planning, executing and interpreting experiments in the guinea pig

A Posterior Interosseous Nerve Syndrome Associated With Spontaneous Rupture of the Extensor Pollicis Longus Tendon

Posterior interosseous nerve entrapment syndrome and spontaneous rupture of the extensor pollicis longus tendon are rare conditions. The authors describe the bizarre combination of a spontaneous rupture of the extensor pollicis longus tendon in a 82-year-old lady with a posterior interosseous nerve syndrome. As far as the authors know, this is the first description of such an association in the literature. Surgical exploration revealed compression of the posterior interosseous nerve at the proximal portion of the supinator muscle and at Henry's leash. The nerve was freed, and the tendon of the extensor index proprius was transferred to the extensor pollicis longus. Six months after the procedure, the patient had resumed her daily activities, showing a good functional result

Distributing the burdens of climate change

Global climate change raises many questions for environmental political theorists. This article focuses on the question of identifying the agents that should bear the financial burden of preventing dangerous climate change. Identifying in a fair way the agents that should take the lead in climate mitigation and adaptation, as well as the precise burdens that these parties must bear, will be a key aspect of the next generation of global climate policies. After a critical review of a number of rival approaches to burden sharing, the paper argues that only a principled and philosophically robust reconciliation of three approaches to burden sharing (‘contribution to problem’, ‘ability to pay’ and ‘beneficiary pays’) can generate a satisfactory mix of theoretical coherence and practical application

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: a 15-Year Retrospective Study

A Síndroma de Stevens-Johnson (SSJ), a Síndroma de Sobreposição (SS) e a Necrólise Tóxica Epidérmica (NTE) são emergências médicas raras, mas com elevadas morbilidade e mortalidade. A literatura referente às características destas doenças em Portugal é muito escassa. Procedeu-se à análise dos registos clínicos dos 20 doentes internados na Unidade de Queimados (UQ) do Hospital de São José nos últimos 15 anos com o diagnóstico de SSJ, SS ou NTE. A maior parte das toxidermias foi do tipo NTE (65%), seguida do SS (25%) e do SSJ (10%). A idade média foi 57,1 ± 19,0 anos. A duração média do internamento foi de 12,6 ± 7,8 dias. A mortalidade foi de 50%, sendo significativamente maior que os 16,4% de mortalidade global registada na UQ no mesmo período (p < 0,01). A área de superfície corporal total envolvida foi de 43,9 ± 28,6 %. O agente causal mais frequentemente implicado foi o alopurinol (35%), seguido da exposição à luz ultravioleta e metoxipsoraleno (15%). Catorze doentes (70%) foram tratados com corticóides nos primeiros dias de internamento, enquanto seis doentes (30%) foram tratados conservadoramente. A mortalidade foi menor nos doentes tratados com corticóides (42,8% vs 66,7%), embora esta diferença não fosse estatisticamente significativa. As taxas de infecção também não diferiram significativamente nos dois grupos. O SCORTEN nas primeiras 24 horas demonstrou ser um bom preditor de mortalidade. São necessários mais estudos para tentar reduzir a mortalidade nestas doenças

Satellite-derived bathymetry in optically complex waters using a model inversion approach and Sentinel-2 data

This study presents an assessment of a model inversion approach to derive shallow water bathymetry in optically complex waters, with the aim of both understanding localised capability and contributing to the global evaluation of Sentinel-2 for coastal monitoring. A dataset of 12 Sentinel-MSI images, in three different study areas along the Irish coast, has been analysed. Before the application of the bathymetric model two atmospheric correction procedures were tested: Deep Water Correction (DWC) and Case 2 Regional Coastal Color (C2RCC) processor. DWC outperformed C2RCC in the majority of the satellite images showing more consistent results. Using DWC for atmospheric correction before the application of the bathymetric model, the lowest average RMSE was found in Dublin Bay (RMSE ¼ 1.60, bias ¼ \u100000 0.51), followed by Mulroy Bay (RMSE ¼ 1.66, bias ¼ 1.30) while Brandon Bay showed the highest average error (RMSE ¼ 2.43, bias ¼ 1.86). However, when the optimal imagery selection was considered, depth estimations with a bias less than 0.1 m and a spread of 1.40 m were achieved up to 10 m. These results were comparable to those achieved by empirical tuning methods, despite not relying on any in situ depth data. This conclusion is of particular relevance as model inversion approaches might allow future modifications in crucial parts of the processing chain leading to improved results. Atmospheric correction, the selection of optimal images (e.g. low turbidity), the definition of suitably limited ranges for the per-pixel occurrence of optical constituents (phytoplankton, CDOM, backscatter) and seabed reflectances, in combination with the understanding of the specifics characteristics at each particular site, were critical steps in the derivation of satellite bathymetry

Structural characterization of the Aspergillus niger citrate transporter CexA uncovers the role of key residues S75, R192 and Q196

Supplementary data associated with this article can be found in the online version at doi:10.1016/j.csbj.2023.04.025.The Aspergillus niger CexA transporter belongs to the DHA1 (Drug-H+ antiporter) family. CexA homologs are exclusively found in eukaryotic genomes, and CexA is the sole citrate exporter to have been functionally characterized in this family so far. In the present work, we expressed CexA in Saccharomyces cerevisiae, demonstrating its ability to bind isocitric acid, and import citrate at pH 5.5 with low affinity. Citrate uptake was independent of the proton motive force and compatible with a facilitated diffusion mechanism. To unravel the structural features of this transporter, we then targeted 21 CexA residues for site-directed mutagenesis. Residues were identified by a combination of amino acid residue conservation among the DHA1 family, 3D structure prediction, and substrate molecular docking analysis. S. cerevisiae cells expressing this library of CexA mutant alleles were evaluated for their capacity to grow on carboxylic acid-containing media and transport of radiolabeled citrate. We also determined protein subcellular localization by GFP tagging, with seven amino acid substitutions affecting CexA protein expression at the plasma membrane. The substitutions P200A, Y307A, S315A, and R461A displayed loss-of-function phenotypes. The majority of the substitutions affected citrate binding and translocation. The S75 residue had no impact on citrate export but affected its import, as the substitution for alanine increased the affinity of the transporter for citrate. Conversely, expression of CexA mutant alleles in the Yarrowia lipolytica cex1Δ strain revealed the involvement of R192 and Q196 residues in citrate export. Globally, we uncovered a set of relevant amino acid residues involved in CexA expression, export capacity and import affinity.This work was supported by the Strategic Programme UID/BIA/04050/2020 and the project LA/P/0069/2020 granted to the Associate Laboratory ARNET, both funded by Portuguese funds through the FCT-IP. J.A. acknowledges the FCT and the Doctoral Program in Applied and Environmental Microbiology for the PD/BD/150584/2020 PhD grant and a COST Action CA18113 Short-Term Scientific Mission grant (EuroMicropH). M.S.S. acknowledges the Norte2020 for the UMINHO/BD/25/2016 PhD grant with the re ference NORTE-08-5369-FSE-000060. I.S-S. was supported by the program contract FCTUMINHO/Norma transitória from the Legal Regime of Scientific Employment (RJEC)

Risk of introduction of lumpy skin disease in France by the import of vectors in animal trucks

BACKGROUND: The lumpy skin disease virus (LSDV) is a dsDNA virus belonging to the Poxviridae family and the Capripoxvirus genus. Lumpy skin diseases (LSD) is a highly contagious transboundary disease in cattle producing major economic losses. In 2014, the disease was first reported in the European Union (in Cyprus); it was then reported in 2015 (in Greece) and has spread through different Balkan countries in 2016. Indirect vector transmission is predominant at small distances, but transmission between distant herds and between countries usually occurs through movements of infected cattle or through vectors found mainly in animal trucks. METHODS AND PRINCIPAL FINDINGS: In order to estimate the threat for France due to the introduction of vectors found in animal trucks (cattle or horses) from at-risk countries (Balkans and neighbours), a quantitative import risk analysis (QIRA) model was developed according to the international standard. Using stochastic QIRA modelling and combining experimental/field data and expert opinion, the yearly risk of LSDV being introduced by stable flies (Stomoxys calcitrans), that travel in trucks transporting animals was between 6 x 10-5 and 5.93 x 10-3 with a median value of 89.9 x 10-5; it was mainly due to the risk related to insects entering farms in France from vehicles transporting cattle from the at-risk area. The risk related to the transport of cattle going to slaughterhouses or the transport of horses was much lower (between 2 x 10-7 and 3.73 x 10-5 and between 5 x 10-10 and 3.95 x 10-8 for cattle and horses, respectively). The disinsectisation of trucks transporting live animals was important to reduce this risk. CONCLUSION AND SIGNIFICANCE: The development of a stochastic QIRA made it possible to quantify the risk of LSD being introduced in France through the import of vectors that travel in trucks transporting animals. This tool is of prime importance because the LSD situation in the Balkans is continuously changing. Indeed, this model can be updated to process new information on vectors and the changing health situation, in addition to new data from the TRAde Control and Expert System (TRACES, EU database). This model is easy to adapt to different countries and to other vectors and diseases

Adapting to survive: How Candida overcomes host-imposed constraints during human colonization

Successful human colonizers such as Candida pathogens have evolved distinct strategies to survive and proliferate within the human host. These include sophisticated mechanisms to evade immune surveillance and adapt to constantly changing host microenvironments where nutrient limitation, pH fluctuations, oxygen deprivation, changes in temperature, or exposure to oxidative, nitrosative, and cationic stresses may occur. Here, we review the current knowledge and recent findings highlighting the remarkable ability of medically important Candida species to overcome a broad range of host-imposed constraints and how this directly affects their physiology and pathogenicity. We also consider the impact of these adaptation mechanisms on immune recognition, biofilm formation, and antifungal drug resistance, as these pathogens often exploit specific host constraints to establish a successful infection. Recent studies of adaptive responses to physiological niches have improved our understanding of the mechanisms established by fungal pathogens to evade the immune system and colonize the host, which may facilitate the design of innovative diagnostic tests and therapeutic approaches for Candida infections.Work at CBMA is supported by the Contrato-Programa UIBD/04050/2020 funded by Portuguese national funds through the FCT I.P. RA and CBA are recipients of FCT PhD fellowships (PD/BD/113813/2015 and PD/BD/135208/2017, respectively). Research stay of RA at KU Leuven was supported by Boehringer Ingelheim Fonds. Work at KU Leuven is supported by grants from the Fund for Scientific Research Flanders (FWO grant nr: G0F8519N) and by the Research Council of the KU Leuven (grant nr: C14/17/063). Work at the University of Exeter is funded by a programme grant from the UK Medical Research Council (MRC) [www.mrc.ac.uk: MR/M026663/1], by the MRC Centre for Medical Mycology, University of Exeter [MR/N006364/1], and by the Wellcome Trust [www.wellcome.ac.uk: 097377]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript