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The rise of the mechanistic worldview in the seventeenth century had a major impact on views of biological generation. Many seventeenth century naturalists rejected the old animist thesis. However, the alternative view of gradual mechanistic formation in embryology didn't convince either. How to articulate the peculiarity of life? Researchers in the seventeenth century proposed both "animist" and mechanistic theories of life. In the eighteenth century again a controversy in biology arose regarding the explanation of generation. Some adhered to the view that life is a physical property of matter (e.g. Buffon), others saw living entities as the result of the development of pre-existing germs (e.g. Bonnet). Naturalists, lacked a convincing account that could guide their research. In interaction with leading naturalists of his time Immanuel Kant articulated an approach to explaining generation. Kant's account, delineated in his Kritik der Urteilskraft (Critique of the power of judgment) (1790), is a combination of Newtonian non-reductionist mechanism in explanation, and a concept of natural end comparable to Stahl's formal conception of organic bodies. It consists of two claims: a) in biology only mechanical explanation is explanatory, and b) living entities contain some original organisation, which is mechanically unexplainable. In the nineteenth century this approach influenced naturalists as Müller, Virchow, and Von Baer, in their physiological research. Dissatisfied with a sheer mechanistic or, on the other hand, a sheer teleological approach, they appreciated the Kantian account of mechanical explanation of natural ends. In Germany, in the second halve of the nineteenth century, Ernst Haeckel reopened the debate about abiogenesis, which still continuous., (© 2022. The Author(s).)

Introduction: The present study aimed to describe characteristics of patients with type 2 diabetes (T2D) in UK primary care initiated on dapagliflozin, post-dapagliflozin changes in glycated hemoglobin (HbA 1c ), body weight and blood pressure, and reasons for adding dapagliflozin to insulin., Methods: Retrospective study of patients with T2D in the Clinical Practice Research Datalink with first prescription for dapagliflozin. Patients were included in the study if they: (1) had a first prescription for dapagliflozin between November 2012 and September 2014; (2) had a Read code for T2D; (3) were registered with a practice for at least 6 months before starting dapagliflozin; and (4) remained registered for at least 3 months after initiation. A questionnaire ascertained reason(s) for adding dapagliflozin to insulin., Results: Dapagliflozin was most often used as triple therapy (27.7%), dual therapy with metformin (25.1%) or added to insulin (19.2%). Median therapy duration was 329 days [95% confidence interval (CI) 302-361]. Poor glycemic control was the reason for dapagliflozin initiation for 93.1% of insulin-treated patients. Avoiding increases in weight/body mass index and insulin resistance were the commonest reasons for selecting dapagliflozin versus intensifying insulin. HbA 1c declined by mean of 9.7 mmol/mol (95% CI 8.5-10.9) (0.89%) 14-90 days after starting dapagliflozin, 10.2 mmol/mol (95% CI 8.9-11.5) (0.93%) after 91-180 days and 12.6 mmol/mol (95% CI 11.0-14.3) (1.16%) beyond 180 days. Weight declined by mean of 2.6 kg (95% CI 2.3-2.9) after 14-90 days, 4.3 kg (95% CI 3.8-4.7) after 91-180 days and 4.6 kg (95% CI 4.0-5.2) beyond 180 days. In patients with measurements between 14 and 90 days after starting dapagliflozin, systolic and diastolic blood pressure decreased by means of 4.5 (95% CI -5.8 to -3.2) and 2.0 (95% CI -2.9 to -1.2) mmHg, respectively from baseline. Similar reductions in systolic and diastolic blood pressure were observed after 91-180 days and when follow-up extended beyond 180 days. Results were consistent across subgroups., Conclusion: HbA 1c , body weight and blood pressure were reduced after initiation of dapagliflozin in patients with T2D in UK primary care and the changes were consistent with randomized clinical trials., Funding: AstraZeneca.

The neurotoxin β-N-methylamino-L-alanine (BMAA) is suspected to play a role in Alzheimer's disease, Parkinson's disease and amyotrophic lateral sclerosis. Because BMAA seems to be produced by cyanobacteria, surface waters are screened for BMAA. However, reliable analysis of BMAA requires specialized and expensive equipment. In 2012, a commercial enzyme-linked immunosorbent assay (ELISA) for determination of BMAA in surface waters was released. This kit could enable fast and relatively cheap screening of surface waters for BMAA. The objective of this study was to determine whether the BMAA ELISA kit was suitable for the determination of BMAA concentrations in surface waters. We hypothesised that the recovery of spiked samples was close to 100% and that the results of unspiked sample analysis were comparable between ELISA and liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis. However, we found that recovery was higher than 100% in most spiked samples, highest determined recovery was over 400%. Furthermore, the ELISA gave a positive signal for nearly each tested sample while no BMAA could be detected by LC-MS/MS. We therefore conclude that in its current state, the kit is not suitable for screening surface waters for BMAA.

Filtrates from crushed Moringa oleifera seeds were tested for their effects on growth and Photosystem II efficiency of the common bloom-forming cyanobacterium Microcystis aeruginosa. M. aeruginosa populations exhibited good growth in controls and treatments with 4- and 8-mg crushed Moringa seeds per liter, having similar growth rates of 0.50 (+/-0.01) per day. In exposures of 20- to 160-mg crushed Moringa seeds L(-1), growth rates were negative and on average -0.23 (+/-0.05) .day(-1). Presumably, in the higher doses of 20- to 160-mg crushed seeds per liter, the cyanobacteria died, which was supported by a rapid drop in the Photosystem II efficiency (Phi(PSII)), while the Phi(PSII) was high and unaffected in 0, 4, and 8 mg L(-1). High-density populations of M. aeruginosa (chlorophyll-a concentrations of approximately 270 microg L(-1)) were reduced to very low levels within 2 weeks of exposure to >/=80-mg crushed seeds per liter. At the highest dosage of 160 mg L(-1), the Phi(PSII) dropped to zero rapidly and remained nil during the course of the experiment (14 days). Hence, under laboratory conditions, a complete wipeout of the bloom could be achieved. This is the first study that yielded evidence for cyanobactericidal activity of filtrate from crushed Moringa seeds, suggesting that Moringa seed extracts might have a potential as an effect-oriented measure lessening cyanobacterial nuisance.

The effect of filtration of medium through different kinds of filters (glass fiber, mixed esters of cellulose and nitrocellulose) on the morphology in the green alga Scenedesmus obliquus was examined. Several compounds potentially released from membrane filters were further investigated, and among them, two anionic surfactants were found to be morphologically active. Exposure to the anionic surfactants resulted within 2 d in the transformation of unicellular populations of Scenedesmus in populations dominated by colonies. Growth rates between control and surfactant-exposed populations were identical, and the morphological effect occurred at surfactant concentrations far below the reported no-observed-effect concentration for growth inhibition, stressing the need for inclusion of morphological appearance of Scenedesmus in algal toxicity testing to improve the assessment of ecological risks.

Various methods for the treatment of trigger digits exist. This study was designed to compare the results of an open surgical technique with those of a percutaneous surgical technique for the treatment of trigger digits. Ninety-six patients with 100 trigger digits were randomized to either open (n = 46) or percutaneous (n = 54) surgical release of the first annular pulley. Operation time, duration of postoperative pain, recovery of motor function, and surgical complications were assessed. Trigger digits were successfully treated in 98% of the cases using the open surgical technique and in 100% of the cases using the percutaneous technique. Mean operation time was significantly longer using the open technique. Mean duration of postoperative pain and time to recovery of motor function were significantly shorter for patients treated with the percutaneous method. No serious complications were observed in either group. We conclude that percutaneous correction of trigger digits is a quicker procedure, is less painful, and shows significantly better results in rehabilitation than open surgery.

We prospectively studied the accuracy of magnetic resonance imaging (MRI) and ultrasonography (US) for preoperative detection of rupture in 35 single-lumen implants filled with silicone gel in 18 patients. The positive predictive value of US for rupture of an implant was 70% and the negative predictive value 64%. Sensitivity and specificity were 44% and 87%, respectively. Accuracy, defined as the total true positive and true negative values divided by the total number of implants studied was 66%. The positive predictive value of MRI was 100% and the negative predictive value 90%. The corresponding sensitivity and specificity were 88% and 100% and the accuracy 94%. MRI offers significantly better diagnostic sensitivity (p = 0.02) and accuracy (p = 0.004), and should be regarded as the "gold standard" in the evaluation of rupture of breast implants filled with silicone gel. When MRI is not readily available, US is an acceptable alternative.

Czerny from Heidelberg is generally accepted to have performed the first augmentation mammaplasty in 1895. Since then, a variety of nonsilicone materials have been injected or implanted to augment or to reconstruct the hypoplastic female breast, including autologous tissues, intramammary- or submammary-injected alloplastic materials, and preformed alloplastic materials other than silicone. For various reasons outlined in this review, none was fully acceptable. The introduction of the medical-grade silicone bag prosthesis in the early 1960s improved the results of mammary augmentation dramatically and reduced the incidence of fibrous contracture and implant extrusion. Other methods of breast augmentation became obsolete.

Silicone gel leakage problems are central to the furor over the complications alleged to be caused by breast implants. Because clinical examination may not reveal confirmatory signs of gel bleed or rupture, radiologists are often requested by plastic surgeons to evaluate the integrity of the implant's envelope. The findings of the various imaging investigations are reported in terms such as "teardrop," "linguini," and "snowstorm." To interpret the radiologist's report correctly, the plastic surgeon should be familiar with these terms and the findings they represent. In this article, we present an explanation of the radiologists' vocabulary in these matters, as well as an indication as to the significance of the various signs.

Issues related to administering managed care in the teaching environment of an academic medical practice may be drastically different than the same types of issues in a typical medical practice. This paper is an overview of those specific discrepancies and how they must be dealt with.

The discussion on possible side effects of implanted silicone has resulted in a growing number of patients inquiring whether or not their mammary prostheses are intact and when failure of the prostheses is to be expected. Between November 1988 and May 1995, 182 patients had their silicone mammary prostheses replaced, repositioned, or removed one to three times. Capsular contraction, dislocation, pain paresthesia, and/or suspected rupture were common indications for surgery. To try and be able to provide an indication as to the correlation of implant age and integrity, we recorded the status of all 426 prostheses observed during secondary surgery. In this selected group of patients, approximately 50 percent of the mammary prostheses with an implant age of 7 to 10 years showed gel bleed or rupture. Applying the survival Kaplan-Meier curve, 50 percent of implants may be expected to bleed or be ruptured at the age of 15 years. Rupture was observed more frequently than gel bleed. It seems that there is no chronologic relation between gel bleed and rupture.

The usual reaction of the human body to implantation of a silicone prosthesis is formation of a fibrous capsule. Local reactions to silicone outside this fibrous capsule and distant migration of silicone particles have been described. So far, transcapsular migration of silicone particles from the mammary implant through the fibrous capsule of mammary prostheses has not been studied. In this prospective study 71 capsules found in 40 patients were histologically studied. The chi-squared test was applied to evaluate a possible correlation between silicone migration on the one hand and implant age and integrity of the prostheses on the other. The degree of silicone migration was discerned in four stages. Stage 1 represents no silicone particles in the capsule, stage 2 represents migration up to less than half of the capsule thickness, stage 3 shows migration confined to the outer half of the capsule thickness, and stage 4 means transcapsular silicone migration. In only 4 of 71 capsules no migration into or through the capsule was observed. The degree of silicone migration was significantly less in patients in whom the capsule was calcified and was significantly more in patients in whom implantation exceeded 12 years. There was no significant correlation between the status of the prosthesis (intact, bleeding, or ruptured) and the degree of silicone migration.

Silicone breast implants have been used since 1962. Reliable methods to detect rupture and silicone gel bleed are needed, even more so because of increasing concern about the possible hazards of silicone. In cases in which clinical examination is not conclusive, additional radiodiagnostic evaluation may be useful in diagnosing intracapsular and extracapsular rupture of mammary prostheses. In the series presented, combined ultrasound and mammography shows a sensitivity for prosthesis rupture of 64% and a specificity of 81%. Silicone gel bleed cannot be detected by means of clinical examination or by combined mammography and ultrasound.

Prolonged spasm in small vessels is a major problem after microsurgical procedures. Topical agents applied to resolve these spasms have been the subject of many experimental studies. In this model we studied the effectiveness of various concentrations of lidocaine in resolving microvascular spasms induced by anastomosing the ventral rat tail artery.

Various lidocaine hydrocholoride concentrations were used to measure the degree of resolution of ergotamine-induced vasospasm of the rat tail artery. Also further studies are indicated; 12% lidocaine seems to be as effective as 20% lidocaine. The widely used 2% lidocaine had little effect on the experimentally induced vasospasm.