Hybrid Dorsal Preservation Rhinoplasty: How We Do It

Background: A difficult to correct dorsal K-area is a frequent cause of residual and/or recurrent dorsal hump in preservation rhinoplasty. Fragile osseocartilaginous elastic connections essential in static stability of nasal pyramid structure should be at least respected. A bulging of Upper Lateral Cartilage (ULC) caudally to this area are principal cause of cartilaginous hump, difficult to correct without damaging the stability. Aim: A hybrid method of a combination of structural surgery with preservation attitude was suggested. Methods and Material: Osseocartilaginous interconnection of DKA area (Dorsal K-Area) can be totally preserved with structural correction of the same area. An incision below of DKA interconnections, with high auto-spreader grafts instead of trimming the deformity was suggested. Conclusion: Septal T-segment could be freely excised as needed, sutured with high and low autospreader graft, as well with septum in desired position, without jeopardizing static stability of nasal pyramid. In our patients, no residual and/or recurrent hump was registered in immediate and as well in long term resultsinfo:eu-repo/semantics/publishedVersio

Deviated Nose: Partial Lateral Osteotomies in a New Preservation Rhinoplasty Concept

Background: A deviated nose continues to be a problem to solve in Rhinoplasty. Various techniques were presented as a possible solution of this aesthetic and functional nasal deformation. In the light of current trend of preservation of structures and function, a modification of osteotomies was presented. Goals: The goal of this paper is to present partial lateral osteotomies surgical technique performed with piezo-electric instruments. Methods and Results: Partial and incomplete osteotomies were introduced as method to avoid disinsertion of nasal pyramid of glabellar area and to avoid bony step in areas of osteotomy cut. Rhinosculpture in its extended mode was promoted for modulation of bony structure with obtaining immediate aesthetic and structural results, minoring a surgical trauma. Conclusion: An incomplete oblique transverse, lateral and intermediate osteotomies, facilitates the "slide-down" positioning of the bone edges, without the need of bone dessinsertion in glabellar region.info:eu-repo/semantics/publishedVersio

Extended Dorsal Preservation in a New Concept of Preservational Rhinoplasty

Background: A dorsal preservation rhinoplasty concept was discussed and the benefits vs. contraindications and limitations were presented. In specific cases of severe nasal septal deformations associated with necessity of major septoplasty, focused on perpendicular plate, a New Concept of Extended Dorsal Preservation Rhinoplasty is presented (New Extended PR-D). PR-D is based on septoplasty, rhinosculpture and partial osteotomies. Goals: The objective of this paper is to present a new approach in some cases of rhinoplasty named as extended dorsal preservation rhinoplasty. Methods and Results: Partial and incomplete osteotomies were introduced as method to avoid disinsertion of nasal pyramid of glabellar area and to avoid bony step in areas off osteotomy cut. Rhinosculpture in its extended mode was promoted for modulation of bony structure with obtaining immediate aesthetic and structural results, minoring a surgical trauma. Conclusion: The principles of Preservation Concept were respected in this New Extended PR-D Concept.info:eu-repo/semantics/publishedVersio

Aquaponics: the ugly duckling in european organic regulation

Aquaponics is an integrated closed-loop multi-trophic food production system that combines elements of a recirculating aquaculture system (RAS) and hydroponics (Endut et al., 2010; Goddek et al., 2015; Graber and Junge, 2009). Organic agriculture has in principle the same approach defined by the International Federation of Organic Agriculture Movements (IFOAM, September 2005) "Organic Agriculture is a production system that sustains the health of soils, ecosystems and people. It relies on ecological processes, biodiversity and cycles adapted to local conditions, rather than the use of inputs with adverse effects. Organic Agriculture combines tradition, innovation and science to benefit the shared environment and promote fair relationships and a good quality of life for all involved."N/

Delayed Care and Mortality Among Women and Men with Myocardial Infarction

Background-Women with ST-segment-elevation myocardial infarction (STEMI) have higher mortality rates than men. We investigated whether sex-related differences in timely access to care among STEMI patients may be a factor associated with excess risk of early mortality in women. Methods and Results-We identified 6022 STEMI patients who had information on time of symptom onset to time of hospital presentation at 41 hospitals participating in the ISACS-TC (International Survey of Acute Coronary Syndromes in Transitional Countries) registry (NCT01218776) from October 2010 through April 2016. Patients were stratified into time-delay cohorts. We estimated the 30-day risk of all-cause mortality in each cohort. Despite similar delays in seeking care, the overall time from symptom onset to hospital presentation was longer for women than men (median: 270 minutes [range: 130-776] versus 240 minutes [range: 120-600]). After adjustment for baseline variables, female sex was independently associated with greater risk of 30-day mortality (odds ratio: 1.58; 95% confidence interval, 1.27-1.97). Sex differences in mortality following STEMI were no longer observed for patients having delays from symptom onset to hospital presentation of (odds ratio: 0.77; 95% confidence interval, 0.29-2.02). Conclusions-Sex difference in mortality following STEMI persists and appears to be driven by prehospital delays in hospital presentation. Women appear to be more vulnerable to prolonged untreated ischemia

Phytophagous hoverflies (Diptera Syrphidae) as indicators of changing landscapes

Spatial and temporal differences in landscape patterns are of considerable interest for understanding ecological processes. In this study, we assessed habitat quality by using the Syrph The Net database and data on decreasing species richness over a 25-year period for the two largest phytophagous hoverfly genera (Merodon and Cheilosia). Furthermore, within this time frame, we explored congruence between ecological responses (species richness and Biodiversity Maintenance Function for these two genera) and landscape structural changes through correlation analysis. Our results indicate that landscapes have experienced changes in aggregation, isolation/connectivity and landscape diversity, with these parameters being significantly correlated with Cheilosia species richness loss and habitat quality. We conclude that the genus Cheilosia is a good bioindicator that can highlight not only the current quality of an area but also temporal changes in landscape patterns.Peer reviewe

A T Cell-inducing influenza vaccine for the elderly: safety and immunogenicity of MVA-NP+M1 in adults aged over 50 years

Current influenza vaccines have reduced immunogenicity and are of uncertain efficacy in older adults. We assessed the safety and immunogenicity of MVA-NP+M1, a viral-vectored influenza vaccine designed to boost memory T cell responses, in a group of older adults.Thirty volunteers (aged 50-85) received a single intramuscular injection of MVA-NP+M1 at a dose of 1·5×10(8) plaque forming units (pfu). Safety and immunogenicity were assessed over a period of one year. The frequency of T cells specific for nucleoprotein (NP) and matrix protein 1 (M1) was determined by interferon-gamma (IFN-γ) ELISpot, and their phenotypic and functional properties were characterized by polychromatic flow cytometry. In a subset of M1-specific CD8(+) T cells, T cell receptor (TCR) gene expression was evaluated using an unbiased molecular approach.Vaccination with MVA-NP+M1 was well tolerated. ELISpot responses were boosted significantly above baseline following vaccination. Increases were detected in both CD4(+) and CD8(+) T cell subsets. Clonality studies indicated that MVA-NP+M1 expanded pre-existing memory CD8(+) T cells, which displayed a predominant CD27(+)CD45RO(+)CD57(-)CCR7(-) phenotype both before and after vaccination.MVA-NP+M1 is safe and immunogenic in older adults. Unlike seasonal influenza vaccination, the immune responses generated by MVA-NP+M1 are similar between younger and older individuals. A T cell-inducing vaccine such as MVA-NP+M1 may therefore provide a way to circumvent the immunosenescence that impairs routine influenza vaccination.ClinicalTrials.gov NCT00942071

Assessment of a polygenic hazard score for the onset of pre-clinical Alzheimer’s disease

Background: With a growing number of loci associated with late-onset (sporadic) Alzheimer’s disease (AD), the polygenic contribution to AD is now well established. The development of polygenic risk score approaches have shown promising results for identifying individuals at higher risk of developing AD, thereby facilitating the development of preventative and therapeutic strategies. A polygenic hazard score (PHS) has been proposed to quantify age-specific genetic risk for AD. In this study, we assessed the predictive power and transferability of this PHS in an independent cohort, to support its clinical utility. Results: Using genotype and imaging data from 780 individuals enrolled in the Australian Imaging, Biomarkers and Lifestyle (AIBL) study, we investigated associations between the PHS and several AD-related traits, including 1) cross-sectional Aβ-amyloid (Aβ) deposition, 2) longitudinal brain atrophy, 3) longitudinal cognitive decline, 4) age of onset. Except in the cognitive domain, we obtained results that were consistent with previously published findings. The PHS was associated with increased Aβ burden, faster regional brain atrophy and an earlier age of onset. Conclusion: Overall, the results support the predictive power of a PHS, however, with only marginal improvement compared to apolipoprotein E alone