Orbital Exenteration for Eyelid Skin Carcinoma

Exenteration of the orbit is a disfiguring and destructive procedure; it is generally performed for orbital malignancies and often provides a significant reconstructive challenge. Our purpose was to evaluate the clinical indications for orbital exenteration in a tertiary referral center and to assess the reconstructive options employed. A retrospective nonrandomized analysis was performed, selecting all patients undergoing orbital exenteration over a 5-year period, between January 2005 and January 2010. Patient demographics, tumor characteristics, and reconstructive techniques used were evaluated. Twenty patients with a mean age of 76.5 years underwent total orbital exenteration. Basal cell carcinoma was the main operative indication (45%), followed by squamous cell carcinoma (15%). Reconstructive techniques included cover of the raw orbital cavity with a temporal muscular flap in all cases followed with split skin grafting (25%), bilaterally pedicle V-Y advancement flap (10%) and a fasciocutaneous island flap of the retroauricular region (65%). Twenty percent of patients had local complications and all were treated in a satisfactory fashion. Eyelid skin tumors remain an important cause of orbital exenteration. Temporal muscle flap is a reliable and stable reconstructive solution after orbital exenteration and additional aid is supplied with skin grafts or local flaps. This technique ensures a good aesthetic outcome and better situation for later complementary treatments and minimal associated donor site morbidity

Measuring and mapping the effectiveness of the European Air Quality Directive in reducing N and S deposition at the ecosystem level

To protect human health and the environment (namely ecosystems), international air quality protocols and guidelines, like the Gothenburg protocol (1999) and the 2001 EU Air Quality Directive (NECD), conveyed national emission ceilings for atmospheric pollutants (Directive 2001/81/EC), including the reduction of sulfur (S) and nitrogen (N) emissions by 2010. However, to what degree this expected reduction in emissions had reflections at the ecosystem level (i.e. pollutant levels reaching and impacting ecosystems and their organisms) remains unknown. Here, we used lichens as ecological indicators, together with reported air and precipitation pollutant concentrations, to determine and map the consequences of the S and N atmospheric emission's reduction, during the implementation of the 2001 Directive (in 2002 and 2011), due primarily to the industrial-sector. The study area is a mixed-land-use industrialized Mediterranean agroforest ecosystem, in southwest Europe. The reduction of S emissions (2002-2011) was reflected at the ecosystem level, as the same S-declining trend was observed in atmospheric measurement stations and lichens alike (-70%), indicating that most S deposited to the ecosystem had an industrial origin. However, this was not the case for N with a slight N-reduction near industrial facilities, but mostly N-deposition in lichens increased in areas dominated by agricultural land-uses. Taken together, these results highlight the importance of going beyond emissions estimation and modeling, to assess the success of the implementation of the NECD in lowering pollutant accumulation in living organisms and their environment. This can only be achieved by measuring pollutant deposition at the ecosystem level (e.g. living organisms). By doing so, we were able to show that the 2001 NECD was successful in reducing S concentrations from Industry, whereas N remains a challenge. Despite the small reduction in N-emissions, deposition into ecosystems did not reflect these changes as agriculture and transport sectors must reduce NH3 and NOx emissions. (C) 2018 Published by Elsevier B.V.The research was supported by project GISA [funded by private companies: GALP, Repsol, APS, AdSA, AICEP, CARBOGAL, EDP, EuroResinas, KIMAXTRA, REN and GENERG; and managed by local authorities: CCDRA, ARSA and Municipalities of Sines, Santiago do Cacem, Grandola, Alcacer do Sal and Odemira]; article preparation was supported by project NitroPortugal [European Union's Horizon 2020 research and innovation programme under grant agreement No 692331]. NitroPortugal is a co-financer for the project Towards INMS, implemented by UN Environment. Concentration of pollutants in precipitation available in the EBAS database has largely been funded by the UN-ECE CLRTAP (EMEP) and through NILU internal resources

Visualization and measurement of the cell-free layer (CFL) in a microchannel network

In the past years, in vitro blood studies have revealed several significant hemodynamic phenomena that have played a key role in recent developments of biomedical microdevices for cells separation, sorting and analysis. However, the blood flow phenomena happening in complex geometries, such as microchannel networks, have not been fully understood. Thus, it is important to investigate in detail the blood flow behavior occurring at microchannel networks. In the present study, by using a high-speed video microscopy system, we have used two working fluids with different haematocrit (1% Hct and 15% Hct) and we have investigated the cell-free layer (CFL) in a microchannel network composed by asymmetric bifurcations. By using the Z Project method from the image analysis software ImageJ, it was possible to conclude that the successive bifurcations and confluences influence the formation of the CFL not only along the upper and lower wall of the microchannel but also at the region immediately downstream of the confluence apex.The authors acknowledge the financial support provided by the project POCI-01-0145 FEDER-016861 (with associated reference PTDC/QEQ-FTT/4287/2014), UID/EMS/00532/2013 and UID/CEC/00319/2013 funded by FCT (Foundation for Science and Technology), through national funds (PIDDAC), and FEDER through COMPETE2020 - Programa Operacional Competitividade e Internacionalização (POCI). D. Bento acknowledges the PhD scholarship SFRH/BD/91192/2012 granted by FCT. The authors also acknowledge the financial support provided by the project Nos. UID/EMS/00532/2013 and UID/EMS/04077/2013 and the project Nos. UID/EMS/00532/2013, UID/EMS/04077/2013, POCI-01-0145-FEDER-007043, UID/CEC/00319/2013info:eu-repo/semantics/publishedVersio

Frequency and genotypic distribution of GB virus C (GBV-C) among Colombian population with Hepatitis B (HBV) or Hepatitis C (HCV) infection

<p>Abstract</p> <p>Background</p> <p>GB virus C (GBV-C) is an enveloped positive-sense ssRNA virus belonging to the <it>Flaviviridae </it>family. Studies on the genetic variability of the GBV-C reveals the existence of six genotypes: genotype 1 predominates in West Africa, genotype 2 in Europe and America, genotype 3 in Asia, genotype 4 in Southwest Asia, genotype 5 in South Africa and genotype 6 in Indonesia. The aim of this study was to determine the frequency and genotypic distribution of GBV-C in the Colombian population.</p> <p>Methods</p> <p>Two groups were analyzed: i) 408 Colombian blood donors infected with HCV (n = 250) and HBV (n = 158) from Bogotá and ii) 99 indigenous people with HBV infection from Leticia, Amazonas. A fragment of 344 bp from the 5' untranslated region (5' UTR) was amplified by nested RT PCR. Viral sequences were genotyped by phylogenetic analysis using reference sequences from each genotype obtained from GenBank (n = 160). Bayesian phylogenetic analyses were conducted using Markov chain Monte Carlo (MCMC) approach to obtain the MCC tree using BEAST v.1.5.3.</p> <p>Results</p> <p>Among blood donors, from 158 HBsAg positive samples, eight 5.06% (n = 8) were positive for GBV-C and from 250 anti-HCV positive samples, 3.2%(n = 8) were positive for GBV-C. Also, 7.7% (n = 7) GBV-C positive samples were found among indigenous people from Leticia. A phylogenetic analysis revealed the presence of the following GBV-C genotypes among blood donors: 2a (41.6%), 1 (33.3%), 3 (16.6%) and 2b (8.3%). All genotype 1 sequences were found in co-infection with HBV and 4/5 sequences genotype 2a were found in co-infection with HCV. All sequences from indigenous people from Leticia were classified as genotype 3. The presence of GBV-C infection was not correlated with the sex (p = 0.43), age (p = 0.38) or origin (p = 0.17).</p> <p>Conclusions</p> <p>It was found a high frequency of GBV-C genotype 1 and 2 in blood donors. The presence of genotype 3 in indigenous population was previously reported from Santa Marta region in Colombia and in native people from Venezuela and Bolivia. This fact may be correlated to the ancient movements of Asian people to South America a long time ago.</p

TRY plant trait database - enhanced coverage and open access

Plant traits-the morphological, anatomical, physiological, biochemical and phenological characteristics of plants-determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait-based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits-almost complete coverage for 'plant growth form'. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait-environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty