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It has been assumed that connections between the postparotid terminal branches of the facial nerve are purely motor. However, the nature of their fibers remains unexplored. The aim of this study is to determine whether these connections comprise motor fibers exclusively. In total 17 connections between terminal facial nerve branches were obtained from 13 different facial nerves. Choline acetyltransferase antibody (ChAT) was used to stain the fibers in the connections and determine whether or not all of them were motor. All connections contained ChAT positive and negative fibers. The average number of fibers overall was 287 (84–587) and the average proportion of positive fibers was 63% (37.7%–91.5%). In 29% of the nerves, >75% of the fibers were ChAT+ (strongly positive); in 52.94%, 50%–75% were ChAT+ (intermediately positive); and in 17.65%

Aggression is one manifestation of behavioral disturbances in neurodegenerative disease with emerging literature suggesting a high prevalence in Parkinson's disease and related disorders (PDRD).Our aim was to describe characteristics, associated factors, and consequences of aggression towards caregivers in PDRD.This is a convergent mixed methods study, leveraging data from 296 PDRD patient-caregiver dyads in a clinical trial of palliative care and semi-structured interviews with a subgroup of 14 caregivers who reported aggression. The primary outcome was baseline caregiver-reported aggression. Using multivariate linear regression, baseline dyad characteristics (eg, measures of disease, psychosocial issues, caregiver strain) were examined to identify factors associated with aggression. Thematic analysis of interviews was used to augment these findings.Associated variables included disease duration (Aggression in PDRD is driven by diverse factors (eg, grief, fluctuations in cognition) with serious consequences for caregivers. Neurologists and movement specialists should consider screening for aggression while prioritizing caregiver education and wellbeing.

By the end of the first year of life, infants' discrimination abilities tune to frequently experienced face groups. Little is known about the exploration strategies adopted to efficiently discriminate frequent, familiar face types. The present eye-tracking study examined the distribution of visual fixations produced by 10-month-old and 4-month-old singletons while learning adult (i.e., familiar) and child (i.e., unfamiliar) White faces. Infants were tested in an infant-controlled visual habituation task, in which post-habituation preference measured successful discrimination. Results confirmed earlier evidence that, without sibling experience, 10-month-olds discriminate only among adult faces. Analyses of gaze movements during habituation showed that infants' fixations were centered in the upper part of the stimuli. The mouth was sampled longer in adult faces than in child faces, while the child eyes were sampled longer and more frequently than the adult eyes. At 10 months, but not at 4 months, global measures of scanning behavior on the whole face also varied according to face age, as the spatiotemporal distribution of scan paths showed larger within- and between-participants similarity for adult faces than for child faces. Results are discussed with reference to the perceptual narrowing literature, and the influence of age-appropriate developmental tasks on infants' face processing abilities.

Intravascular large B-cell lymphoma (IVLBCL) is a rare form of lymphomas with poor prognosis, characterized by atypical lymphocytes selectively growing within the lumen of small or medium-sized vessels. Here, we report a case of intracerebral IVLBCL in a 54-year-old man who died three months after symptom onset. The diagnosis was made by postmortem pathological examination, based on the identification of multiple ischemic lesions, with small or medium-sized vessels filled with malignant B-cells, in the cerebral hemispheres, cerebellum, midbrain, and medulla oblongata, including the external cuneate nucleus and trigeminal spinal tract nucleus. Apart from necrotic lesions, specific histopathological search for occluded vessels in the other brain stem structures permitted identification of significant involvement of the cuneate nucleus, solitary tract nucleus, hypoglossal nucleus, and inferior olivary complex. Small vessels affected by IVLBCL were also found in the trunks of the oculomotor, trigeminal, glossopharyngeal, vagal, and hypoglossal nerves. These histopathological findings were consistent with some cranial nerve symptoms/signs ascertained during hospitalization, such as diplopia, dysphonia, and asymmetry/hypomotility of the palatal veil. The case study presented here reports novel insights on radiological, anatomical, and clinical correlations of the IVLBCL, including the possible involvement of nuclei and trunks of multiple cranial nerves. The reported findings may help clinicians in the early identification of this rapidly progressive disease that can be easily misdiagnosed, through integrated neuroradiological, neurological and neuropathological approaches.

Embaràs i malaltia cardíaca; Resultats de l’embaràs; Transposició de les grans artèries Embarazo y enfermedad cardíaca; Resultados del embarazo; Transposición de las grandes arterias Pregnancy and cardiac disease; Pregnancy outcomes, Transposition of the great arteries Background In the past 3 decades, the arterial switch procedure has replaced the atrial switch procedure as treatment of choice for transposition of the great arteries. Although survival is superior after the arterial switch procedure, data on pregnancy outcomes are scarce and transposition of the great arteries after arterial switch is not yet included in the modified World Health Organization classification of maternal cardiovascular risk. Methods and Results The ROPAC (Registry of Pregnancy and Cardiac disease) is an international prospective registry of pregnant women with cardiac disease, part of the European Society of Cardiology EURObservational Research Programme. Pregnancy outcomes in all women after an arterial switch procedure for transposition of the great arteries are described. The primary end point was a major adverse cardiovascular event, defined as combined end point of maternal death, supraventricular or ventricular arrhythmias requiring treatment, heart failure, aortic dissection, endocarditis, ischemic coronary events, and thromboembolic events. Altogether, 41 pregnant women (mean age, 26.7±3.9 years) were included, and there was no maternal mortality. A major adverse cardiovascular event occurred in 2 women (4.9%): heart failure in one (2.4%) and ventricular tachycardia in another (2.4%). One woman experienced fetal loss, whereas no neonatal mortality was observed. Conclusions Women after an arterial switch procedure for transposition of the great arteries tolerate pregnancy well, with a favorable maternal and fetal outcome. During counseling, most women should be reassured that the risk of pregnancy is low. Classification as modified World Health Organization risk class II seems appropriate. Funding from “Zabawas Foundation” and “De Hoop Foundation” in addition to the support from EURObservational Research Programme (EORP) is greatly acknowledged. Since the start of EORP, the following companies have supported the program: Abbott Vascular Int (2011–2021), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2021), Bayer AG (2009–2018), Boehringer Ingelheim (2009–2019), Boston Scientific (2009–2012), The Bristol Myers Squibb and Pfizer Alliance (2011–2019), Daiichi Sankyo Europe GmbH (2011–2020), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2014–2017), Edwards (2016–2019), Gedeon Richter Plc (2014–2016), Menarini Int Op (2009–2012), MSD‐Merck & Co (2011–2014), Novartis Pharma AG (2014–2020), ResMed (2014–2016), Sanofi (2009–2011), SERVIER (2009–2021), and Vifor (2019–2022).

In Milieudefensie et al. v Royal Dutch Shell, the District Court in the Hague ordered the respondent company to cut its global carbon dioxide emissions by 45 percent by 2030, as compared with 2019 levels. The landmark judgement represents the first imposition of a specific mitigation obligation on a private company over and above reduction targets set by existing ‘cap-and-trade’ regulations and/or other governmental mitigation policies. In interpreting Royal Dutch Shell's duty of care under Dutch tort law, the Court referred extensively to international soft law, including the United Nations Guiding Principles on Business and Human Rights. This note considers the implications of this case for corporate responsibility for environmental and human rights.

Summary The frequent association between coronavirus disease 2019 (COVID‐19) and olfactory dysfunction is creating an unprecedented demand for a treatment of the olfactory loss. Systemic corticosteroids have been considered as a therapeutic option. However, based on current literature, we call for caution using these treatments in early COVID‐19–related olfactory dysfunction because: (1) evidence supporting their usefulness is weak; (2) the rate of spontaneous recovery of COVID‐19–related olfactory dysfunction is high; and (3) corticosteroids have well‐known potential adverse effects. We encourage randomized placebo‐controlled trials investigating the efficacy of systemic steroids in this indication and strongly emphasize to initially consider smell training, which is supported by a robust evidence base and has no known side effects.

Obesity, a rising public health burden, is a multifactorial disease with an increased risk for patients to develop several pathological conditions including type 2 diabetes mellitus, hypertension, and cardiovascular disease. Increasing evidence suggests a relationship between the human brain-derived neurotrophic factor (BDNF) Val66Met single-nucleotide polymorphism (SNP) and obesity, although the underlying mechanisms of this connection are still not completely understood. In the present study, we found that homozygous knock-in BDNFMet/Met mice were overweight and hyperphagic compared to wildtype BDNFVal/Val mice. Increased food intake was associated with reduction of total BDNF and BDNF1, BDNF4 and BDNF6 transcripts in the hypothalamus of BDNFMet/Met mice. In contrast, in the white adipose tissue total BDNF and Glut4 expression levels were augmented, while sirtuin 1 and leptin receptor (Ob-R) expression levels were reduced in BDNFMet/Met mice. Moreover, plasmatic leptin levels were decreased in BDNFMet/Met mice. However, BDNFVal/Val and BDNFMet/Met mice showed a similar response to the insulin tolerance test and glucose tolerance test. Altogether, these results suggest that BDNF Val66Met SNP strongly contributes to adipose tissue pathophysiology, resulting in reduced circulating leptin levels and hypothalamic expression of BDNF, which, in turn, promote increased food intake and overweight in BDNFMet/Met mice.

Background The evidence of pelvic lymph node metastases after radical prostatectomy (RP) with pelvic lymph node dissection (PLND) is one of the strongest prognostic factors for poor oncologic outcome. The extent of PLND, although representing a crucial step in RP, is still controversial. Currently, there is a critical drawback in clinical practice due to the lack of congruence between the known lymphatic drainage and cancer dissemination despite defined management by a surgical approach. We hypothesized the existence of alternative pathways for the lymphatic drainage of the prostate currently not considered in clinical daily practice. Methods We carried out a literature review of the anatomic description of nodal drainage of prostate reported by online databases (MEDLINE/PubMed, EBSCO, Web of Science, Ovid, and Scopus) and the original texts since the 18th century, with an additional anatomical dissection on a human cadaver to confirm theoretical data. Results The anatomical dissection study converged with the historical anatomical treatises in describing three groups of lymphatics devoted to carrying out prostatic nodal drainage. Apart from the ascending ducts from the cranial gland leading to the external iliac nodes; the lateral ducts leading to the hypogastric nodes; small lymphatic vessels from the posterior surface of the prostate, directed to the pararectal lymphatic plexus, in the direction of the lateral sacral lymph nodes and those at the sacral promontory (ie, pararectal and presacral lymph nodes) were observed. Conclusions Our preliminary findings demonstrate that lymphatic drainage of the prostate extends beyond standard nodal templates actually considered in surgical daily practice, despite the knowledge reported by historical anatomical treatises. Further anatomical and experimental evidence are needed to investigate anatomical variability in humans, as well as to add more topographical details.

Aim To determine retrospectively the long-term radiographic outcome of root canal treatments and root canal retreatments with unintentional root canal overfilling. Methodology A total of 220 root canal treatments (143 primary/77 retreatments) with postoperative unintentional canal overfilling and performed by two endodontists during their 45 years of private practice were included in the study. Lateral condensation techniques and nine different sealers were used. Overfilling was confirmed with a postoperative periapical radiograph and patients were scheduled regularly for recall visits. Average recall time was 4.86 years (maximum = 30 years). Two calibrated observers evaluated the radiographs and determined the long-term outcome using the PAI score pooled in a 3-category scale. The persistence or resorption of the extruded material was registered. The Kappa coefficient (K) was calculated and a logistic regression was used for further analysis. Odds ratios and their 95% CI were estimated. Results The level of inter-observer agreement was 66.1%. Primary root canal treatments had a significantly (P = 0.015) greater rate of success (91.6%) than retreatments (81.8%). Tooth location (P = 0.019) was the only other factor that significantly affected the outcome. The type of extruded material, and its resorption or persistence did not relate to the outcome. Persistence of extruded material was significantly affected by tooth location and recall time after treatment. Conclusion The outcome of root canal treatment with unintentional canal overfilling was not associated with the type of extruded material or its resorption or persistence. The persistence of extruded material did not relate to a favourable or unfavourable outcome.

Thanks to collaborations with anatomists and the possibility of performing public dissections during the Renaissance period, artists started to represent the human body more accurately and objectively in their drawings. This cultural change provided the basis for subsequent advances in education and learning as well as the institution of an obligatory anatomy course in the Academies of Arts. The encounter in Pavia between the eclectic artist Leonardo Da Vinci (1452-1519) and the physician Marco Antonio Della Torre (1481-1511), Professor of Theoretical Medicine at the University of Padova, who near the end of his short life founded the "Anatomical School" of the University of Pavia, could be considered a perfect example of this collaboration. According to the historian Giorgio Vasari, while Della Torre practiced dissection, Leonardo made a book of drawings with red chalk annotated by pen. All these anatomical drawings by Leonardo, preserved at Windsor Castle as the property of the Queen of England, date from 1513, after the death of Della Torre. During the same period, Leonardo started his own dissections in the crypt of Santa Maria Nuova in Florence with his anatomical knowledge already mature and consolidated. The aim of the present study is to present the life of Della Torre, his intense scientific activity between Padova and Pavia, and his relationship with Leonardo Da Vinci. In particular, we found the only available manuscript of Della Torre in the Marciana library of Venice. Clin. Anat. 32:744-748, 2019. © 2019 Wiley Periodicals, Inc.

Fil: Macchi, Leandro. Universidad Nacional de Tucuman. Instituto de Ecologia Regional. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Tucuman. Instituto de Ecologia Regional; Argentina. Universitat zu Berlin; Alemania. Consejo Nacional de Investigaciones Cientificas y Tecnicas; Argentina

In coronavirus disease 2019 (COVID‐19), higher morbidity and mortality are associated with age, male gender, and comorbidities, such as chronic lung diseases, cardiovascular pathologies, hypertension, kidney diseases, diabetes mellitus, and obesity. All of the above conditions are characterized by increased sympathetic discharge, which may exert significant detrimental effects on COVID‐19 patients, through actions on the lungs, heart, blood vessels, kidneys, metabolism, and/or immune system. Furthermore, COVID‐19 may also increase sympathetic discharge, through changes in blood gases (chronic intermittent hypoxia, hyperpnea), angiotensin‐converting enzyme (ACE)1/ACE2 imbalance, immune/inflammatory factors, or emotional distress. Nevertheless, the potential role of the sympathetic nervous system has not yet been considered in the pathophysiology of COVID‐19. In our opinion, sympathetic overactivation could represent a so‐far undervalued mechanism for a vicious circle between COVID‐19 and comorbidities., Aging and comorbidities (lung, cardiovascular, kidney, and metabolic diseases) are characterized by sympathetic overactivity, which may exert detrimental effects on lungs, heart, vessels, kidney, metabolism, and/or immune system of coronavirus disease 2019 (COVID‐19) patients. COVID‐19 may furtherly increase sympathetic discharge, through hypoxia, angiotensin‐converting enzyme (ACE)1/ACE2 imbalance, immune/inflammatory factors, and emotional distress. Thus, sympathetic activation could represent a so‐far undervalued mechanism for a vicious circle between COVID‐19 and comorbidities.

Understanding how biodiversity responds to intensifying agriculture is critical to mitigating the trade‐offs between them. These trade‐offs are particularly strong in tropical and subtropical deforestation frontiers, yet it remains unclear how changing landscape context in such frontiers alters agriculture–biodiversity trade–offs. We focus on the Argentinean Chaco, a global deforestation hotspot, to explore how landscape context shapes trade‐off curves between agricultural intensity and avian biodiversity. We use a space‐for‐time approach and integrate a large field dataset of bird communities (197 species, 234 survey plots), three agricultural intensity metrics (meat yield, energy yield and profit) and a range of environmental covariates in a hierarchical Bayesian occupancy framework. Woodland extent in the landscape consistently determines how individual bird species, and the bird community as a whole, respond to agricultural intensity. Many species switch in their fundamental response, from decreasing occupancy with increased agricultural intensity when woodland extent in the landscape is low (loser species), to increasing occupancy with increased agricultural intensity when woodland extent is high (winner species). This suggests that landscape context strongly mediates who wins and loses along agricultural intensity gradients. Likewise, where landscapes change, such as in deforestation frontiers, the very nature of the agriculture–biodiversity trade–offs can change as landscapes transformation progresses. Synthesis and applications . Schemes to mitigate agriculture–biodiversity trade–offs, such as land sparing or sharing, must consider landscape context. Strategies that are identified based on a snapshot of data risk failure in dynamic landscapes, particularly where agricultural expansion continues to reduce natural habitats. Rather than a single, fixed strategy, adaptive management of agriculture–biodiversity trade–offs is needed in such situations. Here we provide a toolset for considering changing landscape contexts when exploring such trade‐offs. This can help to better align agriculture and biodiversity in tropical and subtropical deforestation frontiers. Instituto de Recursos Biológicos Fil: Macchi, Leandro. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto de Ecología Regional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tucumán; Argentina Fil: Decarre, Julieta. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Recursos Biológicos; Argentina Fil: Goijman, Andrea Paula. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Recursos Biológicos; Argentina Fil: Mastrangelo, Matias Enrique. Universidad Nacional de Mar del Plata. Facultad de Ciencias Agrarias. Grupo de Estudio de Agroecosistemas y Paisajes Rurales; Argentina. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina Fil: Blendinger, Pedro G. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto de Ecología Regional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tucumán; Argentina. Fil: Gavier Pizarro, Gregorio Ignacio. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Recursos Biológicos; Argentina Fil: Murray, Francisco. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria San Luis. Agencia de Extensión Rural San Luis; Argentina Fil: Piquer Rodriguez, María. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto de Ecología Regional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tucumán; Argentina Fil: Semper-Pascal, Asunción. Humboldt-University Berlin. Geography Department; Alemania Fil: Kuemmerle, Tobias. Humboldt-University Berlin. Geography Department; Alemania. Humboldt-University Berlin. Integrative Research Institute for Transformations in Human Environment Systems; Alemania

The field of stem cell biology is exciting because it provides researchers and clinicians with seemingly unlimited applications for treating many human diseases. Stem cells are a renewable source of pluripotent cells that can differentiate into nearly all human cell types. In this article we focus particularly on human embryonic stem (hES) cells, derived from the inner cell mass of the blastocyst and cultured for expansion while remaining undifferentiated, to explore their unique molecular personalities and clinical applications. The aim of this literature review is to reflect the interest in hES cells and to provide a resource for researchers and clinicians interested in the molecular characteristics of such cells. Clin. Anat. 32:354-360, 2019. © 2018 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.