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Functional diversity-i.e., the diversity of morphophysiological characteristics of species in a biological community-revolutionized ecology in recent decades, shifting the focus of the field from species to ecosystems. While its ecological applications are known, its adaptability to other disciplines, specifically music, is explored here. We retrieved fourteen characteristics of 12,944 songs by the top 100 artists of the 2010s decade on four streaming platforms. Then, we calculated the three main components of functional diversity-richness, evenness, and divergence-to each artist using probabilistic hypervolumes. Furthermore, we investigated to what extent functional diversity and the traits of an artist, its albums and songs has an effect on their popularity across streaming platforms such as Spotify. High functional richness, where an artist's songs differ greatly sonically, correlated with increased listens of up to 244,300,000. This would lead to estimated profit earnings exceeding $1,000,000 per richness gain. Danceable, highly-energetic, melodic, pop, and, notably, melancholic songs, albums, and artists are more listened to than their counterparts in streaming services. We captured how patterns in human song might reflects the social state of human societies in recent years and demonstrate the potential of applying functional diversity concepts and tools across scientific and economic domains, extending its relevance beyond ecology. By demonstrating applications of state-of-the-art functional diversity metrics using music as a case study, we intent to communicate the often-complex concepts of functional diversity using the familiar realm of music, which is an intrinsic trait of human cultures across the globe., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Colares et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: To compare the use of toluidine blue 1% eye drops with anterior segment optical coherence tomography (OCT) for the determination of tumour margins in patients with ocular surface squamous neoplasia (OSSN)., Methods: The study was conducted from July 2020 to June 2021 at the Ocular Oncology department at the Federal University of São Paulo, Brazil. Slit-lamp photographs after toluidine blue staining and OCT of the anterior segment were taken on the same day from patients with OSSN. Photographs and OCT images were analyzed quantitatively using the software ImageJ and IMAGEnet®, respectively. The agreement between techniques was evaluated qualitatively through the Bland-Altman graph and quantitatively through intraclass correlation (ICC)., Results: A total of 21 participants (71.43% males) with a clinical diagnosis of OSSN were included in the study. The average + SD diameter along the chosen axes was 4.43 ± 2.08 mm with OCT of 4.37 ± 2.03 mm with toluidine blue, a difference not statistically significant (p = 0.2891). The Bland-Altman analysis indicated a good qualitative agreement between the methods, with all cases inserted within the limits of agreement from -0.3217 to 0.4268. The ICC quantitative analysis showed an almost perfect agreement of 99.57% (95%CI: 98.96-99.83%; p < 0.001)., Conclusions: Our findings showed that OCT and toluidine eye drops are equivalent in determining margins for tumour measurements, which is particularly relevant in low-income settings where anterior segment OCT is not available. The use of toluidine blue 1% could be an useful alternative to quantify the size of the tumour, help to monitor tumour growth, and outline margins for surgical planning., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The relative age effect (RAE) suggests that, due to maturity, young athletes born in the first quartiles of the year may have advantages over those born in the last quartiles of the year. Thus, it is important to evaluate the RAE in different sports and to consider the particularities of the subdivisions of the sports categories., Objective: To analyze the RAE in the top 20 of the Brazilian rankings in different combat sports., Methods: Observational study that analyzed the national databases for the year 2019 (from categories U-11 to U-18) made publicly available by the Brazilian confederations of karate, taekwondo and fencing. We obtained data on date of birth, age category and body weight of all modalities, type of fencing competition weapon (Epee, Foie and Saber) and type of karate modality (kumite and kata) from the top 20 places in each ranking. The final sample consisted of 1,486 athletes (Age: 14.2 ± 2.3. Male-53.2%. Female-46.8%). To identify the RAE, we performed a contingency analysis and compared the results between the sexes within the same sport., Results: There was RAE in the U-11, U-12, U-15 and U-17 fencing categories ( p  < 0.05), being higher in the female categories ( p  < 0.05). The RAE was higher for males in the Epee test, and similar between the sexes for the Saber and Foie tests. In karate, RAE occurred in categories U-14 and U-16 ( p  < 0.05), being higher in males ( p  < 0.05). The RAE was similar between the sexes in the kumite modality ( p  < 0.05). There was no RAE for the kata modality in karate ( p  > 0.05) and for the Taekwondo categories ( p  > 0.05)., Conclusion: The results showed the existence of a relative age effect in elite athletes ranked (top 20 places in each ranking) only for the sport of fencing and karate kumite., Competing Interests: Competing interestsThe authors declare no competing interests.Conflict of interestNothing to declare., (© The Author(s), under exclusive licence to Springer-Verlag Italia S.r.l., part of Springer Nature 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Purpose: The central nervous system adapts strategies to compensate the decreased motor capacities of a fatigued muscle. However, data on neurophysiological adaptations of muscles other than those under fatigue are scarce. The present study was designed to evaluate the effects of submaximal fatiguing contraction (leading to a task failure) induced in ankle dorsiflexors muscles on the excitability of the Hoffmann reflex (H-reflex) of an ankle plantarflexor (soleus muscle)., Materials and Methods: Twenty-three physically active males (75.5 ± 8.3 kg; 1.77 ± 0.08 m; 27.0 ± 8.0 years) were asked to maintain the contraction level of the right ankle dorsiflexors at 60% of the maximal isometric voluntary contraction (MIVC). Task failure was defined when the force level dropped below 40% MIVC for 5 consecutive seconds. The input-output relation of the ascending limb of the recruitment curve of the soleus H-reflex was examined at 0 min, 5 min, 10 min, 15 min and 20 min after the task failure., Results: The amplitude parameter representing the first recruited motoneurons (threshold H-reflex - H@th) was significantly higher at 5 min, 10 min, 15 min and 20 min after task failure as compared to control (Hth) ( p  < 0.05). On the other hand, the parameter that represents the activation of the relatively higher threshold motoneurons (H@100) was reduced (as compared to control - H100), but only at 20 min after the task failure ( p  < 0.05)., Conclusions: These results suggest differential reflex modulation of the soleus H-reflex after fatigue of the ankle dorsiflexors, that probably reflects neuronal adaptations underlying motor control around the ankle joint.

Purpose: To develop an equation to provide the peak power (PP) through a specific stimulus performed in an aquatic environment, as well as to correlate morphological, anthropometric and strength variables with rowing performance., Methods: The sample consisted of 16 elite young rowing athletes of both sexes (15.7 ± 1.21 years). The strength of upper limbs and lower limbs was verified. To analyze the PP, a 100-m Sprint test was performed on an indoor rowing type ergometer, and after a 72-hour wash-out, the test was repeated in an aquatic environment on a vessel equipped with a global position system. Body composition was analyzed by examining bone densitometry with an X-ray source and maturation was verified by anthropometry., Results: The tests for water sprint and indoor rowing showed significant reliability (ICC = 0.695; p = 0.0007). The PP aquatic showed reliability with that acquired in indoor rowing (ICC = 0.897; p<0.0001) and was related to maturation (p<0.05). The morphology, anthropometry and strength of the upper limbs were related to the sprint and peak strength in both tests (p<0.05)., Conclusion: The equation for the PP in aquatic environment presented by the present study is highly reliable with an indoor ergometer digital ergometer., Competing Interests: The authors have declared that no competing interests exist.

Objective: To compare complications of ultrasound-guided percutaneous renal biopsy using two needle gauges (16-G and 18-G)., Methods: A total of 238 individuals with renal biopsy indication were included and randomly separated into two groups: ultrasound-guided percutaneous renal biopsy procedure carried out with a 16-G or 18-G needle. The adequacy of biopsy samples and post-procedure complications were compared between the two groups., Results: The procedures carried out with a 16-G needle collected fragments with a mean of 22.1 ± 10.8 glomeruli, and those carried out with an 18-G needle had a mean of 17.5 ± 9.4 glomeruli. Patients submitted to renal biopsies with a 16-G needle had a higher likelihood of having a complication (OR5.1, 95% CI 1.7-15.4, P = 0.001). The overall mean volume of post-biopsy hematoma in patients with complications was significantly larger than those without complications (44 ± 56.1 mL vs 5.9 ± 6.6 mL; P < 0.001)., Conclusions: Renal biopsies carried out by ultrasonography using an 18-G needle provide adequate histological analysis, showing a lower amount of glomeruli but with similar clinical quality as a 16-G needle. Furthermore, it is associated with a lower risk of procedure-related complications., (© 2018 The Japanese Urological Association.)

Purpose: We aimed to evaluate the effects of oral propranolol for circumscribed choroidal hemangioma., Methods: In this prospective, longitudinal interventional study, we administered oral propranolol at a dosage of 1.5 mg/kg/day to five patients with circumscribed choroidal hemangioma. We then evaluated visual acuity, binocular indirect ophthalmoscopy, optical coherence tomography, optical coherence tomography angiography, fluorescein and indocyanine green angiography, and ocular ultrasonography at regular intervals and compared changes from the baseline assessments., Results: No clinical or diagnostic changes were observed in the sizes of the circumscribed choroidal hemangiomas during treatment. Complications due to the hemangioma were reduced in the first four months of treatment, followed by maintenance, before worsening in the subsequent three months., Conclusions: The study showed that oral propranolol at a dose of 1.5 mg/kg/day did not offer effective monotherapy in the treatment of circumscribed choroidal hemangioma.

Unlabelled: In this large, sham-controlled, randomized trial, we examined the efficacy of the combination of standard treatment and paraspinous lidocaine injection compared with standard therapy alone in subjects with chronic low back pain. There is little research-based evidence for the routine clinical use of paraspinous lidocaine injection for low back pain. A total of 378 subjects with nonspecific chronic low back pain were randomized to 3 groups: paraspinous lidocaine injection, analgesics, and exercises (group 1, LID-INJ); sham paraspinous lidocaine injection, analgesics, and exercises (group 2, SH-INJ); and analgesics and exercises (group 3, STD-TTR). A blinded rater assessed the study outcomes at 3 time points: baseline, after treatment, and after 3 months of follow-up. There were increased frequency of pain responses and better low back functional scores in the LID-INJ group compared with the SH-INJ and STD-TTR groups. These effects remained at the 3-month follow-up but differed between all 3 groups. There were significant changes in pain threshold immediately after treatment, supporting the effects of this intervention in reducing central sensitization. Paraspinous lidocaine injection therapy is not associated with a higher risk of adverse effects compared with conventional treatment and sham injection. Its effects on hyperalgesia might correlate with changes in central sensitization., Clinical Trial Registration: NCT02387567., Perspective: There are few data to support paraspinous lidocaine injection use in patients with nonspecific chronic low back pain. Our results show that this therapy when combined with standard therapy significantly increases the number of responders versus standard treatment alone. Its effects on hyperalgesia might correlate with a change in central sensitization., (Copyright © 2016. Published by Elsevier Inc.)

Cratylia argentea (Desv.) Kuntze (Fabaceae) is a drought-tolerant, perennial legume found primarily in Brazil, Bolivia, and Peru. The shrub is well adapted to acid soils and exhibits high productivity and nutritional value, characteristics that would favor its use as a dry season animal forage supplement in semiarid regions. In plant improvement programs, the production of elite hybrids with superior traits is generally achieved by crossing parents that exhibit the highest level of genetic divergence. Therefore, the aim of the present study was to assess genetic diversity among 13 accessions of C. argentea from the same population maintained in the active germplasm bank of Embrapa Meio-Norte using inter-simple sequence repeat (ISSR) markers. Genetic similarities between C. argentea accessions were estimated from Jaccard coefficients, and a dendrogram was constructed using the unweighted pair group method with arithmetic average (UPGMA). The set of 15 primers selected for ISSR analysis generated a total of 313 loci of which 79.23% were polymorphic. The mean number of bands per primer was 20.87, and the amplicons ranged from 280 to 3000 bp in size. Primers UBC834 and UBC827 generated the largest number of polymorphic loci and exhibited 90.91 and 100% polymorphism, respectively. The coefficients of genetic similarity among accessions varied between 0.49 and 0.73. UPGMA cluster analysis allowed the identification of four genotypic groups and demonstrated the existence of considerable variability within the collection. Potential progenitors were selected that would offer good possibilities of obtaining unusual and favorable combinations of genes in a plant breeding program.

Humeral shaft fractures (HSFs) represent 3% of the fractures of the locomotor apparatus, and the middle third of the shaft is the section most affected. In the majority of cases, it is treated using nonsurgical methods, but surgical indications in HSF cases are increasingly being adopted. The diversity of opinions makes it difficult to reach a consensus regarding the types of osteosynthesis, surgical technique and quantity and quality of synthesis materials that should be used. It would appear that specialists are far from reaching a consensus regarding the best method for surgical treatment of HSFs. We believe that less invasive methods, which favor relative stability, are the most appropriate methods, since the most feared complications are less frequent.

Objective: To evaluate shoulder functional results and the retear rate of arthroscopic repair of the rotator cuff augmented with platelet-rich plasma (PRP)., Methods: Prospective case series with single-row arthroscopic repair of the rotator cuff augmented with PRP. Only cases of isolated supraspinatus tears with retraction of less than 3 cm were included in this series. The PRP used was obtained by apheresis. It was applied on liquid consistency in its activated form, with the addition of autologous thrombin. Patients were evaluated after 12 months of the surgical procedure. The Constant-Murley, UCLA and VAS scales were used, and the retear rate was assessed using magnetic resonance imaging (MRI)., Results: Fourteen patients were evaluated (14 shoulders). The mean Constant-Murley score was 45.64 ± 12.29 before the operation and evolved to 80.78 ± 13.22 after the operation (p < 0.001). The UCLA score increased from 13.78 ± 5.66 to 31.43 ± 3.9 (p < 0.001). The patients' pain level decreased from a median of 7.5 (p25% = 6, p75% = 8) to 0.5 (p25% = 0, p75% = 3) (p = 0.0013) according to the VAS score. None of the patients presented complete retear. Three patients (21.4%) showed partial retear, without transfixation. Only one patient developed complications (adhesive capsulitis)., Conclusion: Patients submitted to arthroscopic rotator cuff repair augmented with PRP showed significant functional improvement and none of them had complete retearing.

Among members of the Fabaceae family, native to the Brazilian Caatinga, the species Poincianella pyramidalis and P. bracteosa exhibit particular potential as forage for cattle, sheep and goats. With the aim of establishing genetic relationships within Poincianella, random amplified polymorphic DNA analysis was performed on eight accessions of P. pyramidalis and two accessions of P. bracteosa, originating from the semiarid zone of the state of Piauí, northeastern Brazil, and present in the germplasm bank of Embrapa Meio Norte (Teresina, Piauí, Brazil). Amplification reactions using 11 selected arbitrary sequence primers generated 167 fragments with an overall polymorphism of 70.38%. Five monomorphic loci were generated exclusively in P. pyramidalis accessions, while three unique monomorphic loci were associated with P. bracteosa, and these represented potential species-specific markers. The similarity coefficients between Poincianella accessions were low (mean value 0.59) but with a wide variation (range 0.443 to 0.748). The similarity matrix and the dendrogram constructed using the unweighted pair group method allowed the separation of Poincianella accessions into two major clusters represented by the two distinct species, while the accessions of P. pyramidalis could be separated further into three subgroups. The high level of genetic diversity detected in the genus Poincianella could be used in future breeding programs to produce enhanced cultivars, although the variability could be better exploited if more specimens were collected from other locations within the semiarid region of northeastern Brazil.

Pityrocarpa moniliformis (Benth.) Luckow and Jobson, commonly known as angico-de-bezerro, is a forage legume that occurs naturally in the Caatinga of northeastern Brazil. This fast growing, vigorous, melliferous tree is well adapted to arid terrains and its branches and leaves possess high nutritional value. However, the scarcity of information regarding genetic variability within the species limits its possible exploitation as an animal forage. The aim of the study was to evaluate the genetic similarities of ten accessions of P. moniliformis available in the active germplasm collection of Embrapa Meio-Norte, using the RAPD markers to select those most suitable for cultivation and/or plant breeding. Polymerase chain reaction using ten selected RAPD primers generated 110 amplified loci, 106 (96.4%) of which were polymorphic. Primers A10 and M06 produced the largest number of polymorphic loci (18 and 13 bands, respectively), while primers B18 and K15 generated the smallest number (7 bands each). The dendrogram, constructed using the Jaccard coefficients and considering a cut-off point of 0.41 allowed the separation of the ten accessions into four genotypic groups. The highest genetic similarity coefficient (0.56) was observed between group I accessions BGFAB6 and BGFAB9 and BGFAB 7 and BGFAB 8, while the lowest coefficient (0.11) was observed between accessions BGFAB3 (group IV) and BGFAB10 (group III). The results revealed that genetic variability is present in the accessions of P. moniliformis.

Senna spectabilis (DC.) H.S. Irwin & Barneby (Fabaceae; Caesalpinioideae), commonly known as "canafístula" or "cassia", is widely used in the semi-arid region of northeastern Brazil as a source of forage and timber. The plant presents a high nutritional content in comparison with other forage species that are native to the Brazilian Caatinga; thus, it represents a valuable resource during periods of drought. The aim of this study was to evaluate the genetic variability among eight accessions of S. spectabilis available in the forage germplasm collection of Embrapa Meio-Norte using the random-amplified polymorphic DNA technique. The 15 primers selected for use in the analysis produced 107 bands, including 59 (55.14%) that were polymorphic. A similarity matrix was generated on the basis of Jaccard coefficients, and a dendrogram was constructed using the unweighted pair group method with arithmetic mean clustering technique. The mean value of the similarity coefficients was 0.73, and the cophenetic correlation coefficient was 83.76%. Accessions CAN. 4 and CAN. 5 presented the greatest genetic similarity, while CAN. 6 and CAN. 8 were the most divergent. The S. spectabilis accessions were classified into two main groups with group I including accessions CAN. 1, CAN. 2, CAN. 4, CAN. 5, CAN. 7, CAN. 8, and CAN. 9, and group II comprising the single accession CAN. 6. The results presented herein revealed that, although the germplasm collection is presently limited, there is sufficient genetic variability among the accessions to permit future breeding programs.

Purpose: Intensive scheduling in sports requires athletes to resume physical activity shortly after injury. The purpose of this study was to investigate early isokinetic muscle strength and knee function on bone-patellar tendon-bone (BPTB) ACL reconstruction with double femoral pin fixation or interference screw technique., Methods: A prospective study was conducted from 2008 to 2009, with 48 athletes who received femoral BPTB fixation with interference screw (n = 26) or double pin (n = 22). Clinical (IKDC objective score and hop test) and isokinetic muscle strength (peak torque (PT), PT/body weight and flexion/extension rate (F/E) in 60 and 240°/s) were analyzed at 6 months of follow-up., Results: Analysis at baseline showed no differences between groups before surgery related to age, gender, associated injury, Tegner or Lysholm score; thus showing that groups were similar. During follow-up, however, there were significant differences between the two groups in some of the isokinetic muscle strength: PT/BW 60°/s (Double Pin = 200% ± 13% vs. Interference Screw = 253% ± 16%*, *P = 0.01); F/E 60°/s (Double Pin = 89% ± 29%* vs. Interference Screw = 74% ± 12%, *P = 0.04). No statistical differences between groups were observed on IKDC objective score, hop test and complications., Conclusion: The significant muscle strength outcome of the interference screw group found in this study gives initial evidence that this fixation technique is useful for athletes that may need accelerated rehabilitation. Early return to sports ability signaled by isokinetic muscle strength is of clinical relevance as it is one of the main goals for athletes' rehabilitation.

Objectives: To identify Chlamydia trachomatis via polymerase chain reaction and a direct fluorescent antibody assay in patients with vernal keratoconjunctivitis while comparing the efficacies of both tests for detecting Chlamydia trachomatis in these conditions., Methods: Conjunctival scraping samples were obtained from 177 patients who were divided into two groups: a vernal keratoconjunctivitis group (group A) and a control group (group B). The polymerase chain reaction and a direct fluorescent antibody assay were performed. Sensitivity, specificity, receiver operating characteristic curves, and areas under the curve were calculated for both tests in groups A and B. Receiver operating characteristic curves were plotted using a categorical variable with only two possible outcomes (positive and negative)., Results: Statistical analysis revealed a significant association between vernal keratoconjunctivitis and Chlamydia trachomatis infection detected by a direct fluorescent antibody assay with high sensitivity and specificity. All patients in group A with positive polymerase chain reactions also presented with positive direct fluorescent antibody assays., Conclusion: The association between vernal keratoconjunctivitis and Chlamydia trachomatis infection was confirmed by positive direct fluorescent antibody assays in 49.4% of vernal keratoconjunctivitis patients and by positive polymerase chain reactions in 20% of these patients. The direct fluorescent antibody assay detected Chlamydia trachomatis in a higher number of patients than did the polymerase chain reaction. Although the diagnosis of trachoma is essentially clinical, the disease may not be detected in vernal keratoconjunctivitis patients. Due to the high frequency of chlamydial infection detected in patients with vernal keratoconjunctivitis, we suggest considering routine laboratory tests to detect Chlamydia trachomatis in patients with severe and refractory allergic disease.

Purpose: Toxoplasmosis is the most common cause of posterior infectious uveitis worldwide. It is often impossible to determine its congenital or acquired nature. Interleukin-2 (IL-2) in peripheral blood has been described as a possible marker for acquired toxoplasmosis. The purpose of this study is to evaluate the histopathological characteristics of ocular toxoplasmosis cases using CD25 as a marker for the expression of interleukin-2., Methods: Ten formalin-fixed, paraffin-embedded enucleated globes from ten immunocompetent patients with clinical diagnosis of toxoplasmosis were evaluated. Four patients had the acquired form of ocular toxoplasmosis (positive IgM) while six were IgM negative and IgG positive for toxoplasmosis. Histopathological slides were reviewed for the extension of the retinal necrosis, number of toxo cysts, the granulomatous inflammatory reaction, the presence of T and B cells within the choroid and the IL-2 expression. Immunohistochemistry using monoclonal antibodies was performed to observe the expression of CD4, CD8, CD20, CD25, and CD68., Results: The histopathological evaluation disclosed no differences between acquired and the other ocular toxoplasmosis cases regarding the characteristics studied. However, CD25 showed a higher expression of IL-2 on the 4 acquired cases of ocular toxoplasmosis compared to the remainders., Conclusions: To the best of our knowledge, this is the first report showing that the use of CD25 as a marker for interleukin-2 could differentiate acquired ocular toxoplasmosis.

Conclusion: The study shows that there are differences in the measurement of the action potentials with and without the stylet in the Nucleus Freedom Contour Advance that are higher in the apex than in the base of the cochlea., Objectives: To determine if there are differences in the intraoperative impedances and in the neural response telemetry threshold values in the Nucleus Freedom Contour Advance before and after stylet removal., Subjects and Methods: This was a prospective clinical study. Intraoperative impedances and neural response telemetry in users of the Freedom Contour Advance Cochlear Implant were measured before and after stylet removal., Results: There was a significant reduction in the impedance values of an average 1.5 kOmega+/-2.3 in common ground mode and 1.3 kOmega+/-2.3 for all monopolar modes after the stylet removal (p < 0.001). When analyzing the apical, medium, and basal electrodes, there was a statistically significant reduction in the neural response thresholds after stylet removal only in the apical electrodes (p = 0.001).

The movement of Aedes aegypti (L.) and Aedes albopictus (Skuse) females between sylvatic and urban environments was investigated by marking, releasing, and recapturing adults and by identifying rubidium (Rb)-marked eggs of females that were released after taking a bloodmeal containing RbCI. When released in the forest, Ae. albopictus females flew as far as 1000 m and reached houses within 1 wk. When Ae. albopictus were released close to houses, most females were recaptured near the release point, and Rb-marked eggs were found 1000 m away in the forest only once, 35 d after the release. These differing patterns of movement may suggest a preference of Ae. albopictus for the human-modified environment. Ae. aegypti, however, showed low tendency to disperse into the forest. The capacity of Ae. albopictus females to disperse from a sylvatic into a human-modified environment suggests that this species may play a role in the dissemination of forest-restricted pathogens, such as yellow fever virus.

The development of operative laparoscopic surgery is linked to advances in ancillary surgical instrumentation. Ultrasonic energy devices avoid the use of electricity and provide effective control of small- to medium-sized vessels. Bipolar computer-controlled electrosurgical technology eliminates the disadvantages of electrical energy, and a mechanical blade adds a cutting action. This instrument can provide effective hemostasis of large vessels up to 7 mm. Such devices significantly increase the cost of laparoscopic procedures, however, and the amount of evidence-based information on this topic is surprisingly scarce. This study compared the effectiveness of three different energy sources on the laparoscopic performance of a left colectomy. The trial included 38 nonselected patients with a disease of the colon requiring an elective segmental left-sided colon resection. Patients were preoperatively randomized into three groups. Group I had electrosurgery; vascular dissection was performed entirely with an electrosurgery generator, and vessels were controlled with clips. Group II underwent computer-controlled bipolar electrosurgery; vascular and mesocolon section was completed by using the 10-mm Ligasure device alone. In group III, 5-mm ultrasonic shears (Harmonic Scalpel) were used for bowel dissection, vascular pedicle dissection, and mesocolon transection. The mesenteric vessel pedicle was controlled with an endostapler. Demographics (age, sex, body mass index, comorbidity, previous surgery and diagnoses requiring surgery) were recorded, as were surgical details (operative time, conversion, blood loss), additional disposable instruments (number of trocars, EndoGIA charges, and clip appliers), and clinical outcome. Intraoperative economic costs were also evaluated. End points of the trial were operative time and intraoperative blood loss, and an intention-to-treat principle was followed. The three groups were well matched for demographic and pathologic features. Surgical time was significantly longer in patients operated on with conventional electrosurgery vs the Harmonic Scalpel or computed-based bipolar energy devices. This finding correlated with a significant reduction in intraoperative blood loss. Conversion to other endoscopic techniques was more frequent in Group I; however, conversion to open surgery was similar in all three groups. No intraoperative accident related to the use of the specific device was observed in any group. Immediate outcome was similar in the three groups, without differences in morbidity, mortality, or hospital stay. Analysis of operative costs showed no significant differences between the three groups. High-energy power sources specifically adapted for endoscopic surgery reduce operative time and blood loss and may be considered cost-effective when left colectomy is used as a model.

Purpose and Methods: In order to determine forces acting upon an articular joint during hand rehabilitation, a dynamic splint was built and connected to a dynamometer (capable of measuring forces in the range 0 - 600 gf). Through trigonometric calculation, the authors measured the flexing force in the proximal interphalangeal joint of the middle finger at 30 degrees, 45 degrees, 60 degrees, and 90 degrees of flexion. Measurements were obtained in a population of 40 voluntary adults, 20 females and 20 males, This flexing force was correlated with age, sex, and anthropometric measures., Results: Force in the flexing tendon is maximal at the start of flexion, and decreases as the angle of joint flexion increases. A relationship was observed between finger length and the magnitude of the force exerted on the tendon: the longer the finger, the greater the force exherted upon the tendon. Force is greater at all the measured angles, (except 30 degrees) in males and in individuals of higher stature, and bigger arm span., Conclusions: The flexing force can be effectively measured at all flexing angles, that it correlates with a number of different anthropometric parameters, and that such data are likely to open the way for future studies.

It is shown that bacterial activity, even of slowly growing species, can be detected by precise interferometric measurements of refractive index changes of the culture medium. The bacteria-containing sample is kept in an isothermal block together with a reference liquid without bacteria. The biological activity is obtained from the difference of the index changes of these samples. Experiments were performed with Bacilo Calmette-Guérin. The order of magnitude of the observed total refractive index change was compatible with theoretical estimates based on the amount of available oxygen. An unexpected positive index change during the lag phase was observed, which might permit fast diagnostics in medical applications. This technique may provide cheap and quick tests of bacterial susceptibility with respect to antibiotics.

Static and dynamic pedobarometric evaluations were performed on the feet of 100 normal adult white men aged from 20 to 49 years old (mean = 29.9 +/- 6.9), using version 3.848 of the F-SCAN system. All evaluations were performed using new pressure sensor insoles with standardized conditions. Maximum vertical forces and plantar peak pressure measurements were taken during 7.88 seconds each of walking in a straight line at subject's own pace and standing. Feet were separated based on their side and lower limb dominance. The means of three consecutive and three alternate tests provided quantitative data. Maximum static and vertical dynamic forces were found to be greater on the dominant side and were significantly correlated with body weight. There were significant differences between dominant and non-dominant sides in static plantar peak pressure evaluations at the forefoot and midfoot, and in the dynamic evaluations at the midfoot. There was a significant correlation between dynamic plantar peak pressures at the midfoot and body weight.

A total of 26 children (26 affected, 25 control hips) with Legg-Calvé-Perthes' disease (LCP) met the cooperation requirements for inclusion in the study using contrast-enhanced power Doppler sonography for assessment of changes in the revascularization flow. Sagittal sonograms were obtained before and at the peak effect of an intravenously injected microbubble-based contrast agent. Overall mean peak enhancement ratios were greater for children with later onset of disease (>5.8 years old) than for those with earlier onset (< or = 5.8) (p = 0.02). The use of ultrasound (US) contrast agents improved depiction of proximal femoral vascularity in all regions of the femoral head: epiphysis (n = 3, pre; n = 8, postcontrast), physis (n = 12, pre; n = 21, postcontrast) and metaphysis (n = 6, pre; n = 8, postcontrast) and resulted in a marked increase in the number of mean pixel intensity values within the physis (p = 0.02). In conclusion, contrast-enhanced power Doppler sonography is an effective method for demonstration of changes from the revascularization process in LCP, particularly within the physis.

Tumor necrosis factor (TNF)-alpha has been implicated as a key factor in inflammatory processes occurring in erythema nodosum leprosum (ENL). In the present study, the roles of soluble factors and contact-mediated interaction in the induction of enhanced TNF-alpha secretion in leprosy have been investigated. In vitro studies have demonstrated that Mycobacterium leprae per se is a poor stimulus for TNF-alpha production by purified monocytes obtained from normal subjects, although this could be enhanced by either exogenous interferon-gamma or cell contact with fixed activated T lymphocytes. Further investigations demonstrated that monocyte-T cell contact enhanced M. leprae-induced TNF-alpha production by peripheral blood mononuclear cells of ENL patients and was modulated by blocking antibodies to CD40L, CD69, and CD18. These results suggest that physical contact with T cells isolated from patients in a particular disease state (ENL) modulates monocyte function and may contribute to the secretion of proinflammatory cytokines described in ENL.