Aneurysms of the mid axillary artery in major league baseball pitchers—A report of two cases

AbstractTrue aneurysms of the axillary artery and its branches are rarely identified. Our recent experience with successful repairs of symptomatic aneurysms of the axillary arteries at the origin of the circumflex humeral arteries in 2 major league baseball pitchers suggests a condition that may be more common than recognized previously. We report this unique experience with baseball pitchers to focus attention on a condition that should be considered in all athletes with hand pain, numbness, or signs of digital ischemia. In addition, a schedule of rehabilitation and the timing of an appropriate return to competition is presented. (J Vasc Surg 1998;28:702-7.

The magnitude of educational disadvantage amongst indigenous minority groups in Australia.

Indigenous groups are amongst the most disadvantaged minority groups in the developed world. This paper examines the educational disadvantage of indigenous Australians by assessing academic performance at a relatively early age. We find that, by the age of 10, indigenous Australians are substantially behind non-indigenous Australians in academic achievement. Their relative performance deteriorates further over the next 2 years. School and locality do not appear to be important determinants of the indigenous to non-indigenous achievement gap. However, geographic remoteness, indigenous ethnicity and language use at home have a marked influence on educational achievement. A current focus of Australian indigenous policy is to increase school resources. Our results suggest that this will not eliminate indigenous educational disadvantage on its own

Frequency of Injuries from Line Entanglements, Killer Whales, and Ship Strikes on Bering-Chukchi-Beaufort Seas Bowhead Whales

We analyzed scarring data for Bering-Chukchi-Beaufort (BCB) Seas bowhead whales (Balaena mysticetus) harvested by Alaska Native hunters to quantify the frequency of line entanglement, ship strikes, and killer whale-inflicted injuries. We had 904 records in our database for whales landed between 1990 and 2012, and after data quality screening, we found 521 records containing information on scarring. Logistic regression was used to evaluate different combinations of explanatory variables (i.e., body length, sex, year, year-group) to develop a prediction model for each scar type. We also list bowhead whales that were harvested, found dead, or observed alive entangled in commercial line/fishing gear. Our findings suggest that about 12% of harvested bowheads show entanglement scars. Their frequency is highly correlated with body length and sex: about 50% of very large bowheads (> 17 m) show such scars, while whales under 9 m rarely do, and males show a significantly higher rate than females. Scars associated with ship strikes are infrequent and occur on ~2% of all harvested whales; body length, sex, and year were not significant factors. Scarring from attempted killer whale predation was evident on ~8% of landed whales. As with entanglement injuries, the frequency of killer whale scars was much higher (> 40%) on whales more than 16 m in length and statistically more frequent in the second half of the study (2002 – 12). Increased killer whale injuries in the recent decade are consistent with studies conducted on bowheads of the Eastern Canada-West Greenland population. The findings presented here reflect the most thorough analysis of injury rates from entanglement, ships, and killer whales for the BCB bowheads conducted to date. They indicate that (1) entanglement rates primarily from pot fishing gear (crab or cod or both) are relatively high for very large and presumably older bowheads, (2) collisions with ships are infrequent at present, and (3) scarring from killer whales is frequent on very large adult whales (> 17 m). Considering that bowhead habitat is changing rapidly (e.g., sea ice reduction), industrial ship traffic in the Arctic is increasing, and commercial fishing operations are expanding to the north, we strongly recommend that monitoring of scarring and injuries on harvested bowheads continue into the future as a means of documenting change.Nous avons analysé les données sur les cicatrices que portent les baleines boréales (Balaena mysticetus) des mers de Béring, des Tchouktches et de Beaufort capturées par des chasseurs autochtones de l’Alaska afin de quantifier la fréquence d’emmêlements dans des filets de pêche, de collisions avec des navires et de blessures infligées par des épaulards. Notre base de données contenait 904 enregistrements portant sur des baleines prises entre 1990 et 2012 et, après une sélection des données selon leur qualité, nous avons trouvé 521 enregistrements comptant de l’information sur des cicatrices. Une méthode de régression logistique a été utilisée pour évaluer différentes combinaisons de variables explicatives (longueur corporelle, sexe, année et année-groupe, par exemple) afin de concevoir un modèle prédictif pour chaque type de cicatrice. Nous énumérons également les baleines boréales retrouvées emmêlées dans des engins ou des filets de pêche commerciale qui ont été capturées, trouvées mortes ou observées vivantes. Nos découvertes suggèrent qu’environ 12 % des baleines boréales capturées portent des cicatrices causées par l’emmêlement. La fréquence des cicatrices est étroitement liée à la longueur corporelle et au sexe : environ 50 % des baleines boréales de très grande taille (> 17 m) montrent de telles cicatrices, tandis que les baleines mesurant moins de 9 m portent rarement de telles cicatrices. Par ailleurs, les mâles affichent beaucoup plus de cicatrices que les femelles. Les cicatrices reliées à des collisions avec des navires sont rares et n’apparaissent que sur environ 2 % de toutes les baleines capturées; la longueur corporelle, le sexe et l’année n’étaient pas des facteurs importants. Les cicatrices causées par des tentatives de prédation par les épaulards étaient apparentes sur environ 8 % des baleines prises. Comme pour les blessures causées par l’emmêlement, la fréquence des cicatrices causées par des épaulards était beaucoup plus élevée(> 40 %) sur les baleines mesurant plus de 16 m de longueur et statistiquement plus fréquente dans la deuxième partie de l’étude (2002–2012). L’augmentation des blessures causées par des épaulards au cours de la dernière décennie concorde avec les études réalisées sur la population des baleines boréales de l’est du Canada et de l’ouest du Groenland. Les résultats présentés dans cette étude reflètent l’analyse la plus profonde du taux de blessures causées par l’emmêlement, les navires et les épaulards sur les baleines boréales des mers de Béring, des Tchouktches et de Beaufort à avoir été réalisée jusqu’à présent. Les observations indiquent que : 1) le taux d’emmêlement découlant principalement des engins ou casiers de pêche (crabe ou morue ou les deux) est relativement élevé chez les baleines boréales de très grande taille et probablement plus vieilles, 2) les collisions avec les navires sont rares en ce moment, et 3) les cicatrices causées par des épaulards sont fréquentes chez les baleines adultes de très grande taille (> 17 m). Étant donné le changement rapide de l’habitat de la baleine boréale (diminution des glaces marines, par exemple), l’augmentation de la circulation maritime industrielle dans l’Arctique et l’intensification des opérations de pêche commerciale au nord, nous recommandons fortement de continuer de surveiller les cicatrices et les blessures des baleines boréales capturées afin de documenter les changements

A Novel Sensitive Immunoassay Targeting the 5-Methylthio-d-Xylofuranose-Lipoarabinomannan Epitope Meets the WHO's Performance Target for Tuberculosis Diagnosis.

The only currently commercialized point-of-care assay for tuberculosis (TB) that measures lipoarabinomannan (LAM) in urine (Alere LF-LAM) has insufficient sensitivity. We evaluated the potential of 100 novel monoclonal antibody pairs targeting a variety of LAM epitopes on a sensitive electrochemiluminescence platform to improve the diagnostic accuracy. In the screening, many antibody pairs showed high reactivity to purified LAM but performed poorly at detecting urinary LAM in clinical samples, suggesting differences in antigen structure and immunoreactivity of the different LAM sources. The 12 best antibody pairs from the screening were tested in a retrospective case-control study with urine samples from 75 adults with presumptive TB. The best antibody pair reached femtomolar analytical sensitivity for LAM detection and an overall clinical sensitivity of 93% (confidence interval [CI], 80% to 97%) and specificity of 97% (CI, 85% to 100%). Importantly, in HIV-negative subjects positive for TB by sputum smear microscopy, the test achieved a sensitivity of 80% (CI, 55% to 93%). This compares to an overall sensitivity of 33% (CI, 20% to 48%) of the Alere LF-LAM and a sensitivity of 13% (CI, 4% to 38%) in HIV-negative subjects in the same sample set. The capture antibody targets a unique 5-methylthio-d-xylofuranose (MTX)-dependent epitope in LAM that is specific to the Mycobacterium tuberculosis complex and shows no cross-reactivity with fast-growing mycobacteria or other bacteria. The present study provides evidence that improved assay methods and reagents lead to increased diagnostic accuracy. The results of this work have informed the development of a sensitive and specific novel LAM point-of-care assay with the aim to meet the WHO's performance target for TB diagnosis

Distribution quantitative morphological variation and preliminary molecular analysis of different growth forms of wild rooibos (Aspalathus linearis) in the northern Cederberg and on the Bokkeveld Plateau

Aspalathus linearis (Fabaceae) is endemic to the Cape Floristic Region in the Western Cape and Northern Cape Provinces of South Africa. The reddish leaves and stems, primarily of one cultivar, are used to make a commercially important tea which is marketed locally and internationally as ‘rooibos’ or ‘redbush’ tea. In historical times rooibos was collected in the wild. In the twentieth century cultivation of a single cultivar increasingly replaced wild harvest to meet growing demand. Recently, tea from wild forms of the species, which vary significantly in growth form and reproductive strategy, has been marketed by small-scale farmers in Wupperthal and on the Suid Bokkeveld plateau in the northern part of the species' distribution. Little information on the wild forms of this species has been published, although a rich body of knowledge exists amongst local harvesters and other land-users. In this study, we focus on the northern part of the species’ distribution area where wild rooibos is harvested for commercial sale to niche organic and fair-trade markets. We adopt a transdisciplinary approach to (1) document the different growth forms, (2) develop a bioclimatic model of the potential distribution of the species, (3) quantify the morphological variation that exists between growth forms relative to the established cultivar and (4) use molecular techniques to provide a preliminary insight into the infraspecific diversity of different wild A. linearis growth forms. Our results show that local land users in the region identify four main growth forms of wild A. linearis. These are an ‘erect form’ and a ‘prostrate form’ in the Wuppertal area, a ‘shrub form’ in the Suid Bokkeveld, and a ‘tree form’ that has been observed at specific sites at Wupperthal, Biedouw and the Suid Bokkeveld. The PCA analysis of seven morphological traits identified three growth forms, which support the land user descriptions except in the case of the 'tree' and 'erect' forms which co-occurred in coordinate space. Both shrub and prostrate forms are wider than they are taller and possess more stems closer to the ground than erect forms. While the stems of both shrub and prostrate forms lie relatively flat on the ground, stem thickness is significantly greater in shrub forms. The tree type, the erect form and the cultivar studied possess the highest harvestable biomass. Prostrate forms and shrub forms resprout after fire while erect and tree forms regenerate from seed only. Haplotypic variation was assessed using DNA sequences from a single chloroplast region and revealed strong genetic differences between the different growth forms. Although preliminary, there is some evidence that sprouting and nonsprouting forms of the species are genetically isolated. This has important taxonomic implications for the species. Additional chloroplast regions and a nuclear region were also identified as variable and potentially useful markers for a multi-locus molecular approach to studying taxonomic and ecological questions within the species

At-grade stabilization structure impact on surface water quality of an agricultural watershed

Decades of farming and fertilization of farm land in the unglaciated/Driftless Area (DA) of southwestern Wisconsin have resulted in the build-up of P and to some extent, N, in soils. This build-up, combined with steep topography and upper and lower elevation farming (tiered farming), exacerbates problems associated with runoff and nutrient transport in these landscapes. Use of an at-grade stabilization structure (AGSS) as an additional conservation practice to contour strip cropping and no-tillage, proved to be successful in reducing organic and sediment bound N and P within an agricultural watershed located in the DA. The research site was designed as a paired watershed study, in which monitoring stations were installed on the perennial streams draining both control and treatment watersheds. Linear mixed effects statistics were used to determine significant changes in nutrient concentrations before and after installation of an AGSS. Results indicate a significant reduction in storm event total P (TP) concentrations (P = 0.01) within the agricultural watershed after installation of the AGSS, but not total dissolved P (P = 0.23). This indicates that the reduction in P concentration is that of the particulate form. Storm event organic N concentrations were also significantly reduced (P = 0.03) after the AGSS was installed. We conclude that AGSS was successful in reducing the organic and sediment bound N and P concentrations in runoff waters thus reducing their delivery to nearby surface waters

At-grade stabilization structure impact on surface water quality of an agricultural watershed

Decades of farming and fertilization of farm land in the unglaciated/Driftless Area (DA) of southwestern Wisconsin have resulted in the build-up of P and to some extent, N, in soils. This build-up, combined with steep topography and upper and lower elevation farming (tiered farming), exacerbates problems associated with runoff and nutrient transport in these landscapes. Use of an at-grade stabilization structure (AGSS) as an additional conservation practice to contour strip cropping and no-tillage, proved to be successful in reducing organic and sediment bound N and P within an agricultural watershed located in the DA. The research site was designed as a paired watershed study, in which monitoring stations were installed on the perennial streams draining both control and treatment watersheds. Linear mixed effects statistics were used to determine significant changes in nutrient concentrations before and after installation of an AGSS. Results indicate a significant reduction in storm event total P (TP) concentrations (P = 0.01) within the agricultural watershed after installation of the AGSS, but not total dissolved P (P = 0.23). This indicates that the reduction in P concentration is that of the particulate form. Storm event organic N concentrations were also significantly reduced (P = 0.03) after the AGSS was installed. We conclude that AGSS was successful in reducing the organic and sediment bound N and P concentrations in runoff waters thus reducing their delivery to nearby surface waters

Peripheral killer cells do not differentiate between asthma patients with or without fixed airway obstruction

Objective: The three main types of killer cells – CD8+ T cells, NK cells and NKT cells – have been linked to asthma and chronic obstructive pulmonary disease (COPD). However, their role in a small subset of asthma patients displaying fixed airway obstruction (FAO), similar to that seen in COPD, has not been explored. The objective of the present study was to investigate killer cell numbers, phenotype and function in peripheral blood from asthma patients with FAO, asthma patients without FAO, and healthy individuals. Methods: Peripheral CD8+ T cells (CD8+CD3+CD56−), NK cells (CD56+CD3−) and NKT-like cells (CD56+CD3+) of 14 asthma patients with FAO (post-bronchodilator FEV/FVC <0.7, despite clinician-optimised treatment), 7 asthma patients without FAO (post-bronchodilator FEV/FVC ≥0.7), and 9 healthy individuals were studied. Results: No significant differences were seen between the number, receptor expression, MAPK signalling molecule expression, cytotoxic mediator expression, and functional cytotoxicity of peripheral killer cells from asthma patients with FAO, asthma patients without FAO and healthy individuals. Conclusions: Peripheral killer cell numbers or functions do not differentiate between asthma patients with or without fixed airway obstruction