Osteochondral Autograft Used to Treat Avascular Necrosis of Metacarpal Head

Avascular necrosis of the metacarpal head is a rare condition, documented in less than 50 patients since 1932 when it was first described (2). The disease most commonly associated with steroid use, trauma, autoimmune disease, or idiopathic, which characterizes Dieterich’s disease (3). The patient generally presents with MCP joint stiffness and pain, with possible loss of active range of motion. As the disease advances, the subchondral bone can collapse causing joint incongruity. When non-operative treatment has failed, proposed treatment options include: simple debridement, curettage with cancellous bone grafting, osteochondral auto graft, arthroplasty, flexion osteotomy, and arthrodesis (1).There has been non consensus on optimal treatment due to the rarity of the disease. This case presentation describes the treatment of chronic AVN of the metacarpal head in a 15 year old female using a previously documented osteochondral autograft transfer system (OATS) technique. An osteochondral autograft plug from the non–weight-bearing articular surface of the lateral femoral condyle was transferred and press-fit to the focal defect present in the ring metacarpal head, resurfacing the collapsed defect (1). The articular surface was restored which allowed for full range of motion of ring metacarpal joint without crepitance or clicking. The patient is 8 months post op and has resumed all baseline activities without pain or functional deficit. This case represents an exceedingly rare condition that has several surgical options, none of which have enough data to be recommended as the gold standard of care. We reproduced previously documented results that using an osteochondral autograft from the lateral femoral condyle provides an adequate match for the unique articular shape of the metacarpal head and provided full pain relief, full metacarpal joint range of motion, no loss of function, and no morbidity from the donor site.https://scholarlycommons.henryford.com/merf2019caserpt/1110/thumbnail.jp

Biochemical effects of mutations in the gene encoding the alpha subunit of eukaryotic initiation factor (eIF) 2B associated with Vanishing White Matter disease

BACKGROUND: Leukoencephalopathy with Vanishing White Matter (VWM) is an autosomal recessive disorder caused by germline mutations in the genes EIF2B1-5, which encode the 5 subunits of the eukaryotic translation initiation factor eIF2B. To date, analysis of the biochemical effects of mutations in the EIF2B2-5 genes has been carried out, but no study has been performed on mutations in the EIF2B1 gene. This gene encodes eIF2Bα, the smallest subunit in eIF2B which has an important role in both the structure and regulation of the eIF2B complex. METHODS: eIF2B subunits were overexpressed in HEK293 cells and isolated from the resulting cell lysates by affinity chromatography. Formation of the eIF2B complex and binding of its substrate, eIF2, was assessed by western blot. Assays of the guanine nucleotide exchange (GEF) activity were also carried out. RESULTS: Of the 5 eIF2Bα mutations studied, we found 3 that showed loss or reduction of binding of eIF2Bα to the rest of the complex, one with increased GEF activity, and one where no effects on activity or complex formation were observed. CONCLUSIONS: This is the first study on eIF2Bα VWM mutations. We show that some mutations cause expected decreases in GEF activity or complex formation, similar to a majority of observed VWM mutations. However, we also observe some unexpected changes which hint at other effects of these mutations on as yet undescribed functions of eIF2B.Noel C. Wortham, and Christopher G. Prou

Insights into the secondary fraction of the organic aerosol in a Mediterranean urban area: Marseille

A comprehensive aerosol characterization was conducted at Marseille during summer, including organic (OC) and elemental carbon (EC), major ionic species, radiocarbon (¹⁴C), water-soluble OC and HULIS (HUmic LIke Substances), elemental composition and primary and secondary organic markers. This paper is the second paper of a two-part series that uses this dataset to investigate the sources of Organic Aerosol (OA). While the first paper investigates the primary sources (El Haddad et al., 2010), this second paper focuses on the secondary fraction of the organic aerosol. <br><br> In the context of overall OC mass balance, primary OC (POC) contributes on average for only 22% and was dominated by vehicular emissions accounting on average for 17% of OC. As a result, 78% of OC mass cannot be attributed to the major primary sources and remains un-apportioned. Radiocarbon measurements suggest that more than 70% of this fraction is of non-fossil origin, assigned predominantly to biogenic secondary organic carbon (BSOC). Therefore, contributions from three traditional BSOC precursors, isoprene, $\alpha$-pinene and &beta;-caryophyllene, were considered. These were estimated using the ambient concentrations of Secondary Organic Aerosol (SOA) markers from each precursor and laboratory-derived marker mass fraction factors. <br><br> Secondary organic markers derived from isoprene photo-oxidation (ie: 2-methylglyceric acid and 2-methyltetrols) do not exhibit the same temporal trends. This variability was assigned to the influence of NO_x concentration on their formation pathways and to their potential decay by further processing in the atmosphere. The influence of changes in isoprene chemistry on assessment of isoprene SOC contribution was evaluated explicitly. The results suggest a 60-fold variation between the different estimates computed using different isoprene SOC markers, implying that the available profiles do not reflect the actual isoprene SOC composition observed in Marseille. <br><br> Using the marker-based approach, the aggregate contribution from traditional BSOC was estimated at only 4.2% of total OC and was dominated by α-pinene SOC accounting on average for 3.4% of OC. As a result, these estimates underpredict the inexplicably high loadings of OC. This underestimation can be associated with (1) uncertainties underlying the marker-based approach, (2) presence of other SOC precursors and (3) further processing of fresh SOC, as indicated by organosulfates (RSO₄H) and HUmic LIke Substances (HULIS) measurements

How Society Can Maintain Human-Centric Artificial Intelligence

Although not a goal universally held, maintaining human-centric artificial intelligence is necessary for society's long-term stability. Fortunately, the legal and technological problems of maintaining control are actually fairly well understood and amenable to engineering. The real problem is establishing the social and political will for assigning and maintaining accountability for artifacts when these artefacts are generated or used. In this chapter we review the necessity and tractability of maintaining human control, and the mechanisms by which such control can be achieved. What makes the problem both most interesting and most threatening is that achieving consensus around any human-centred approach requires at least some measure of agreement on broad existential concerns

HAGE (DDX43) is a biomarker for poor prognosis and a predictor of chemotherapy response in breast cancer

Background: HAGE protein is a known immunogenic cancer-specific antigen. Methods: The biological, prognostic and predictive values of HAGE expression was studied using immunohistochemistry in three cohorts of patients with BC (n=2147): early primary (EP-BC; n=1676); primary oestrogen receptor-negative (PER-BC; n=275) treated with adjuvant anthracycline-combination therapies (Adjuvant-ACT); and primary locally advanced disease (PLA-BC) who received neo-adjuvant anthracycline-combination therapies (Neo-adjuvant-ACT; n=196). The relationship between HAGE expression and the tumour-infiltrating lymphocytes (TILs) in matched prechemotherapy and postchemotherapy samples were investigated. Results: Eight percent of patients with EP-BC exhibited high HAGE expression (HAGEþ) and was associated with aggressive clinico-pathological features (Ps<0.01). Furthermore, HAGEþexpression was associated with poor prognosis in both univariate and multivariate analysis (Ps<0.001). Patients with HAGE+ did not benefit from hormonal therapy in high-risk ER-positive disease. HAGE+ and TILs were found to be independent predictors for pathological complete response to neoadjuvant-ACT; P<0.001. A statistically significant loss of HAGE expression following neoadjuvant-ACT was found (P=0.000001), and progression-free survival was worse in those patients who had HAGE+ residual disease (P=0.0003). Conclusions: This is the first report to show HAGE to be a potential prognostic marker and a predictor of response to ACT in patients with BC

Deweyan tools for inquiry and the epistemological context of critical pedagogy

This article develops the notion of resistance as articulated in the literature of critical pedagogy as being both culturally sponsored and cognitively manifested. To do so, the authors draw upon John Dewey\u27s conception of tools for inquiry. Dewey provides a way to conceptualize student resistance not as a form of willful disputation, but instead as a function of socialization into cultural models of thought that actively truncate inquiry. In other words, resistance can be construed as the cognitive and emotive dimensions of the ongoing failure of institutions to provide ideas that help individuals both recognize social problems and imagine possible solutions. Focusing on Dewey\u27s epistemological framework, specifically tools for inquiry, provides a way to grasp this problem. It also affords some innovative solutions; for instance, it helps conceive of possible links between the regular curriculum and the study of specific social justice issues, a relationship that is often under-examined. The aims of critical pedagogy depend upon students developing dexterity with the conceptual tools they use to make meaning of the evidence they confront; these are background skills that the regular curriculum can be made to serve even outside social justice-focused curricula. Furthermore, the article concludes that because such inquiry involves the exploration and potential revision of students\u27 world-ordering beliefs, developing flexibility in how one thinks may be better achieved within academic subjects and topics that are not so intimately connected to students\u27 current social lives, especially where students may be directly implicated

Beta cell dysfunction induced by bone morphogenetic protein (BMP)-2 is associated with histone modifications and decreased NeuroD1 chromatin binding

Insufficient insulin secretion is a hallmark of type 2 diabetes and has been attributed to beta cell identity loss characterized by decreased expression of several key beta cell genes. The pro-inflammatory factor BMP-2 is upregulated in islets of Langerhans from individuals with diabetes and acts as an inhibitor of beta cell function and proliferation. Exposure to BMP-2 induces expression of Id1-4, Hes-1, and Hey-1 which are transcriptional regulators associated with loss of differentiation. The aim of this study was to investigate the mechanism by which BMP-2 induces beta cell dysfunction and loss of cell maturity. Mouse islets exposed to BMP-2 for 10 days showed impaired glucose-stimulated insulin secretion and beta cell proliferation. BMP-2-induced beta cell dysfunction was associated with decreased expression of cell maturity and proliferation markers specific to the beta cell such as Ins1, Ucn3, and Ki67 and increased expression of Id1-4, Hes-1, and Hey-1. The top 30 most regulated proteins significantly correlated with corresponding mRNA expression. BMP-2-induced gene expression changes were associated with a predominant reduction in acetylation of H3K27 and a decrease in NeuroD1 chromatin binding activity. These results show that BMP-2 induces loss of beta cell maturity and suggest that remodeling of H3K27ac and decreased NeuroD1 DNA binding activity participate in the effect of BMP-2 on beta cell dysfunction

Oxidative potential apportionment of atmospheric PM₁: a new approach combining high-sensitive online analysers for chemical composition and offline OP measurement technique

Source apportionment models were widely used to successfully assign highly time-resolved aerosol data to specific emissions and/or atmospheric chemical processes. These techniques are necessary for targeting the sources affecting air quality and for designing effective mitigation strategies. Moreover, evaluation of the toxicity of airborne particulate matter is important since the classically measured particulate matter (PM) concentrations appear insufficient for characterizing the impact on human health. Oxidative potential (OP) measurement has recently been developed to quantify the capability of PM to induce an oxidative imbalance in the lungs. As a result, this measurement unit could be a better proxy than PM mass concentration to represent PM toxicity. In the present study, two source apportionment analyses were performed using positive matrix factorization (PMF) from organic aerosol (OA) mass spectra measured at a 15 min time resolution using a time-of-flight aerosol chemical speciation monitor (ToF-ACSM) and from 19 trace elements measured on an hourly basis using an online metal analyser (Xact 625i). The field measurements were carried out in summer 2018. While it is common to perform PMF studies individually on ACSMs and more recently on Xact datasets, here we used a two-step methodology leading to a complete PM1 source apportionment. The outputs from both OA PMF and Xact PMF, the inorganic species concentrations from the ACSM, and the black carbon (BC) fractions (fossil fuel and wood burning) measured using an Aethalometer (AE33) were gathered into a single dataset and subjected to a combined PMF analysis. Overall, eight factors were identified, each of them corresponding to a more precise source than performing single PMF analyses. The results show that besides the high contribution of secondary ammonium sulfate (28 %) and organic nitrate (19 %), about 50 % of PM1 originated from distinct combustion sources, including emissions from traffic, shipping, industrial activities, cooking, and biomass burning. Simultaneously, PM1 filters were collected during the experimental period on a 4 h sampling basis. On these filters, two acellular OP assays were performed (dithiothreitol; OPDTT and ascorbic acid; OPAA) and an inversion method was applied on factors issued from all PMFs to assess the contribution of the PM sources to the OP. This work highlights the sensitivity of OPAA to industrial and dust resuspension sources and those of OPDTT to secondary ammonium sulfate, shipping, and biomass burning.</p