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Several cotton experiments have been conducted at the University of Arizona's Maricopa Agricultural Center from which datasets have been obtained documenting cotton responses to elevated CO2 concentrations, water supply, nitrogen fertilizer, and planting density. In particular, these experiments included FACE (free-air CO2 enrichment; CO2, water; 10 treatment-years), AgIIS (Agricultural Irrigation Imaging System, pronounced Ag Eyes; nitrogen fertilizer, water supply; 4 treatment-years), and FISE (FAO-56 Irrigation Scheduling Experiments; irrigation scheduling method, planting density, nitrogen fertilizer; 24 treatment-years). Besides achieving the experimental objectives of determining cotton's response to the several variables, as well as testing remote sensing techniques, the comprehensive datasets are suitable for validating plant growth models because they include weather, soils, management, growth, yield and other data.

BlueScreen HC is a mammalian cell-based assay for measuring the genotoxicity and cytotoxicity of chemical compounds and mixtures. The BlueScreen HC assay has been utilized at the Research Institute for Fragrance Materials in a safety assessment program as a screening tool to prioritize fragrance materials for higher-tier testing, as supporting evidence when using a read-across approach, and as evidence to adjust the threshold of toxicological concern. Predictive values for the BlueScreen HC assay were evaluated based on the ability of the assay to predict the outcome of in vitro and in vivo mutagenicity and chromosomal damage genotoxicity assays. A set of 371 fragrance materials was assessed in the BlueScreen HC assay along with existing or newly generated in vitro and in vivo genotoxicity data. Based on a weight-of-evidence approach, the majority of materials in the data set were deemed negative and concluded not to have the potential to be genotoxic, while only a small proportion of materials were determined to show genotoxic effects in these assays. Analysis of the data set showed a combination of high positive agreement but low negative agreement between BlueScreen HC results, in vitro regulatory genotoxicity assays, and higher-tier test results. The BlueScreen HC assay did not generate any false negatives, thereby providing robustness when utilizing it as a high-throughput screening tool to evaluate the large inventory of fragrance materials. From the perspective of protecting public health, it is desirable to have no or minimal false negatives, as a false-negative result may incorrectly indicate the lack of a genotoxicity hazard. However, the assay did have a high percentage of false-positive results, resulting in poor positive predictivity of the in vitro genotoxicity test battery outcome. Overall, the assay generated 100% negative predictivity and 3.9% positive predictivity. In addition to the data set of 371 fragrance materials, 30 natural complex substances were evaluated for BlueScreen HC, Ames, and in vitro micronucleus assay, and a good correlation in all three assays was observed. Overall, while a positive result may have to be further investigated, these findings suggest that the BlueScreen HC assay can be a valuable screening tool to detect the genotoxic potential of fragrance materials and mixtures.

Point of care ultrasound (POCUS) allows for rapid, real-time evaluation of cardiovascular and respiratory pathology. The advent of portable, handheld devices and increased recognition by accrediting bodies of the importance of POCUS in guiding clinical decision making has expanded its use across the hospital setting and within medical training programs. POCUS allows clinicians to begin immediate investigation into their differential diagnoses without waiting for a formal imaging study, enhancing the speed of clinical interpretation. In addition to its diagnostic utility, POCUS can also inform clinicians of patients’ response to interventions when serial exams are obtained. This review examines the role of POCUS in the context of frequently encountered patients and highlights the key clinical questions that can be readily answered by POCUS.

Additive manufacturing methods1–4 using static and mobile robots are being developed for both on-site construction5–8 and off-site prefabrication9,10. Here we introduce a method of additive manufacturing, referred to as aerial additive manufacturing (Aerial-AM), that utilizes a team of aerial robots inspired by natural builders11 such as wasps who use collective building methods12,13. We present a scalable multi-robot three-dimensional (3D) printing and path-planning framework that enables robot tasks and population size to be adapted to variations in print geometry throughout a building mission. The multi-robot manufacturing framework allows for autonomous three-dimensional printing under human supervision, real-time assessment of printed geometry and robot behavioural adaptation. To validate autonomous Aerial-AM based on the framework, we develop BuilDrones for depositing materials during flight and ScanDrones for measuring the print quality, and integrate a generic real-time model-predictive-control scheme with the Aerial-AM robots. In addition, we integrate a dynamically self-aligning delta manipulator with the BuilDrone to further improve the manufacturing accuracy to five millimetres for printing geometry with precise trajectory requirements, and develop four cementitious–polymeric composite mixtures suitable for continuous material deposition. We demonstrate proof-of-concept prints including a cylinder 2.05 metres high consisting of 72 layers of a rapid-curing insulation foam material and a cylinder 0.18 metres high consisting of 28 layers of structural pseudoplastic cementitious material, a light-trail virtual print of a dome-like geometry, and multi-robot simulations. Aerial-AM allows manufacturing in-flight and offers future possibilities for building in unbounded, at-height or hard-to-access locations.

AIM To investigate infused hematopoietic cell doses and their interaction with conditioning regimen intensity +/- total body irradiation (TBI) on outcomes after peripheral blood hematopoietic cell transplant (PBHCT). METHODS Our retrospective cohort included 247 patients receiving a first, T-replete, human leukocyte antigen-matched allogeneic PBHCT and treated between 2001 and 2012. Correlations were calculated using the Pearson product-moment correlation coefficient. Overall survival and progression free survival curves were generated using the Kaplan-Meier method and compared using the log-rank test. RESULTS Neutrophil engraftment was significantly faster after reduced intensity TBI based conditioning [reduced intensity conditioning (RIC) + TBI] and > 4 × 106 CD34+ cells/kg infused. A higher total nucleated cell dose led to a higher incidence of grade II-IV acute graft-versus-host disease in the myeloablative + TBI regimen group (P = 0.03), but no significant difference in grade III-IV graft-versus-host disease. A higher total nucleated cell dose was also associated with increased incidence of moderate/severe chronic graft-versus-host disease, regardless of conditioning regimen. Overall and progression-free survival were significantly better in patients with a RIC + TBI regimen and total nucleated cell dose > 8 × 108/kg (3 years, overall survival: 70% vs 38%, P = 0.02, 3 years, progression free survival: 64% vs 38%, P = 0.02). CONCLUSION TBI and conditioning intensity may alter the relationship between infused cell doses and outcomes after PBHCT. Immune cell subsets may predict improved survival after unmanipulated PBHCT.

Synovial sarcoma is the most common pediatric non-rhabdomyosarcoma soft tissue sarcoma and accounts for about 8–10% of all soft tissue sarcoma in childhood and adolescence. The presence of a chromosomal translocation-associated SS18-SSX-fusion gene is causally linked to development of primary synovial sarcoma. Metastases occur in approximately 50–70% of synovial sarcoma cases with yet unknown mechanisms, which led to about 70–80% mortality rate in five years. To explore the possibilities to investigate metastatic mechanisms of synovial sarcoma, we carried out the first genome-wide search for potential genetic biomarkers and drivers associated with metastasis by comparative mutational profiling of 18 synovial sarcoma samples isolated from four patients carrying the primary tumors and another four patients carrying the metastatic tumors through whole exome sequencing. Selected from the candidates yielded from this effort, we examined the effect of the multiple missense mutations of ADAM17, which were identified solely in metastatic synovial sarcoma. The mutant alleles as well as the wild-type control were expressed in the mammalian cells harboring the SS18-SSX1 fusion gene. The ADAM17-P729H mutation was shown to enhance cell migration, a phenotype associated with metastasis. Therefore, like ADAM17-P729H, other mutations we identified solely in metastatic synovial sarcoma may also have the potential to serve as an entry point for unraveling the metastatic mechanisms of synovial sarcoma.

The essential oil of peppermint and one of its natural constituents, (R)-(+)-pulegone, are approved flavorings added to food worldwide. (R)-(+)-Pulegone and peppermint oil were tested separately in two independent bacterial reverse mutation assays according to Organisation for Economic Co-operation and Development Guideline 471. Both flavorings did not produce any evidence of mutagenicity up to cytotoxic concentrations in either the presence or the absence of exogenous metabolic activation.

Cardiopulmonary resuscitation (CPR) in patients with severe acute respiratory syndrome coronavirus-2-associated disease (coronavirus disease 2019) poses a unique challenge to health- care providers due to the risk of viral aerosolization and disease transmission. This has caused some centers to modify existing CPR procedures, limit the duration of CPR, or consider avoiding CPR altogether. In this review, the authors propose a procedure for CPR in the intensive care unit that minimizes the number of personnel in the immediate vicinity of the patient and conserves the use of scarce personal protective equipment. Highlighting the low likelihood of successful resuscitation in high-risk patients may prompt patients to decline CPR. The authors recommend the preemptive placement of central venous lines in high-risk patients with intravenous tubing extensions that allow for medication delivery from outside the patients' rooms. During CPR, this practice can be used to deliver critical medications without delay. The use of a mechanical compression system for CPR further reduces the risk of infectious exposure to health- care providers. Extracorporeal membrane oxygenation should be reserved for patients with few comorbidities and a single failing organ system. Reliable teleconferencing tools are essential to facilitate communication between providers inside and outside the patients' rooms. General principles regarding the ethics and peri-resuscitative management of coronavirus 2019 patients also are discussed.

Nematode flavin-containing monooxygenase-2 (fmo-2) is induced by dietary restriction and hypoxia, and is required for the longevity and health benefits of these pathways. It is also sufficient to confer these benefits when overexpressed. As FMOs are well-conserved across taxa, the fmo-2 mechanism has high translational potential. To determine the changes that occur following fmo-2 induction, we performed RNA-seq and untargeted metabolomics analyses. Our data reveal that one-carbon metabolism (OCM) is significantly altered by fmo-2 overexpression. OCM is a nexus for essential metabolic pathways, including transmethylation, transsulfuration, nucleotide synthesis, and amino acid metabolism. We hypothesized that fmo-2 confers longevity benefits by altering key metabolic processes within or downstream of OCM. To test this, we asked whether fmo-2 and OCM interact to regulate longevity by knocking down expression of genes involved with OCM and measuring lifespan and oxidative stress resistance. To understand the biological implications of these interactions, we generated a computational model using qPCR data of key OCM-related genes to predict changes in OCM metabolic flux. Our model predicts significant changes in OCM flux that are regulated by fmo-2 expression levels and are consistent with our RNAi and multi-omics results. We are now testing this model by knocking down genes downstream of OCM to determine their role in fmo-2-mediated benefits. Preliminary results support our hypothesis that changes in metabolic flux through OCM are involved downstream of fmo-2 expression, and may also implicate the UPRER in this pathway. Our future work will elucidate this mechanism and link stress perception and fmo-2-mediated longevity.

An organism’s ability to respond to stress is crucial for long-term survival. These stress responses are coordinated by distinct but overlapping pathways, many of which have been found to also regulate longevity in multiple organisms across species. Despite extensive effort, our understanding of these pathways and how they affect aging remains incomplete and thus is a key area of study in Geroscience. Our previous work identified flavin-containing monooxygenase-2 (fmo-2) as a key longevity-promoting gene downstream of at least three longevity promoting pathways, including the hypoxic response, the pentose phosphate pathway, and the dietary restriction pathway. Based on the commonalities of these pathways, we hypothesized that fmo-2, a classically annotated xenobiotic enzyme, might play a key endogenous role in responding to metabolic stress. Our resulting data, using metabolic profiling and further epistatic analysis, both support this hypothesis and link fmo-2’s mechanism to modifications to one-carbon metabolism (OCM), a key intermediate pathway between the nucleotide metabolism, methylation, and transsulfuration pathways. Using mathematical modeling and a novel metabolomics approach, we were able to further identify the likely mechanism of fmo-2-mediated metabolic effects, and connect them to both OCM and downstream components. We propose a model whereby nematode fmo-2 represents a class of enzymes that are able to modify large aspects of metabolism, similar to how transcription factors modify gene expression, and that fmo-2 is a key member of a conserved metabolic stress response.

Purpose We describe an alternative workup protocol for virtual surgical planning of orthognathic surgery using an intraoral fiducial marker, clinical photography, and the digital transfer of occlusal data. We also discuss our initial experience using this protocol in a series of patients. Patients and Methods A retrospective cohort study was performed of consecutive patients who had undergone combined maxillary and mandibular osteotomies for the correction of dentofacial deformities at 1 center. These patients underwent treatment planning using the modified virtual surgical planning protocol described in the present report. The primary outcome evaluated was the accuracy of the method, which was determined through superimposition of the surgical plan to the postoperative cone-beam computed tomography (CBCT) scan. The secondary outcomes included the accuracy of the natural head position readings and the adequacy of the CBCT scanned stone models for the fabrication of occlusal splints. Results The population included 25 patients. The root mean standard deviation (RMSD) from the preoperative plan to the postoperative scan at the maxillary cephalometric points was 1.2, 1.4, and 2.1 mm in the axial, sagittal, and coronal planes, respectively. The RMSD of the superimposed plan to the postoperative scan at the 3 mandibular cephalometric points was 1.2, 0.8, and 0.7 mm in the axial, sagittal, and coronal planes, respectively. The average variance from the axial, sagittal, and coronal planes for the natural head position was 0.05, 2.22, and 0.69 mm, respectively. All splints fabricated from the CBCT occlusal data fit the stone models and were used intraoperatively. In the subset of patients whose models were both digitally transferred and laser scanned, the superimposition of the laser scan data to the CBCT scanned data was found to have a maximum variation of 0.2 mm at the occlusal level. Conclusions The use of an intraoral fiducial marker changed the workflow for the data collection needed for virtual surgical planning of the correction of dentofacial deformities, while still obtaining accurate results. Because the device does not cause lip distortion, the possibility of virtually predicting a more expectant postoperative lip position exists without the need for additional scans. Furthermore, this work flow allows the transfer of data to be isolated to digital media.

A 2-protected cis-amino mitosene undergoes an irreversible acetone promoted isomerization and converts to the 1-isomer. Kinetic studies and DFT calculations of the reaction are reported. An organocatalytic mechanism is proposed, involving a covalent intermediate formed by reaction of the mitosene and acetone.

© 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim We report on the feasibility for color fine-tuning of optical materials using rational design principles based on chemical reasoning. For this purpose, a modular framework for the construction of symmetrical cap-linker-cap compounds, using triarylamine caps and oligothiophene linkers, is applied. The chosen structural scaffolds are heavily used in recent industrial applications and provide five possibilities for altering their electronic and steric properties: electron donor/acceptor groups, planarization/deplanarization, and modulation of the π-conjugation length. Permutation of the used building blocks leads to a set of 54 different molecules, out of which 32 are synthesized and characterized in solution as well as in example fabricated OLED devices. This setup allows for color fine-tuning in the range of 412 nm to 540 nm with typical steps of 4 nm. In addition, to further benefit from the large experimental data set the spectroscopic results are used to benchmark quantum chemical computations, which show excellent agreement thus highlighting the potential of these calculations to guide future syntheses.

We conducted a gene therapy trial in 10 patients with adenosine deaminase (ADA)–deficient severe combined immunodeficiency using 2 slightly different retroviral vectors for the transduction of patients' bone marrow CD34+ cells. Four subjects were treated without pretransplantation cytoreduction and remained on ADA enzyme-replacement therapy (ERT) throughout the procedure. Only transient (months), low-level (< 0.01%) gene marking was observed in PBMCs of 2 older subjects (15 and 20 years of age), whereas some gene marking of PBMC has persisted for the past 9 years in 2 younger subjects (4 and 6 years). Six additional subjects were treated using the same gene transfer protocol, but after withdrawal of ERT and administration of low-dose busulfan (65-90 mg/m2). Three of these remain well, off ERT (5, 4, and 3 years postprocedure), with gene marking in PBMC of 1%-10%, and ADA enzyme expression in PBMC near or in the normal range. Two subjects were restarted on ERT because of poor gene marking and immune recovery, and one had a subsequent allogeneic hematopoietic stem cell transplantation. These studies directly demonstrate the importance of providing nonmyeloablative pretransplantation conditioning to achieve therapeutic benefits with gene therapy for ADA-deficient severe combined immunodeficiency.

An ultra thin implantable system using flexible organic light emitting diodes (OLEDs) and organic photodetectors (OPDs) on parylene substrate shows biocompatibility and high conformability on any surface. This system was used to monitor variations in cerebral blood volume (CBV) corresponding to an epileptic seizure, along with baseline signals such as heartbeat, respiration and slow sinusoidal hemodynamic oscillations (SSHOs). As such, this system shows strong potential for implantable and/or wearable biosensors for continuous health monitoring.

This paper examines how the market may intentionally or unintentionally create barriers to green development practices. It also offers ideas and recommendations for those who build, finance, and ar...

International audience; Mithilfe der numerischen Strömungsmechanik (Computational Fluid Dynamics; CFD) untersuchten wir die Ausbreitung von Gasen in und um einen Geflügelstall. Ein 3D- CFD-Modell berücksichtigt die natürliche Belüftung in Kombination mit von den Tieren erzeugten Wärme und Wasserdampf. Um dieses 3-D-CFD-Modell zu validieren, wurden während eines Produktionszyklus in einem Betrieb im Westfrankreichs im Frühjahr 2014 Daten erhoben. Zunächst erfolgte die Überprüfung des dreidimensionalen CFD-Modells auf der Basis des Raumklimas. In der zweiten Stufe sollte die Verteilung der Gase in der Umgebung untersucht werden. Dazu wurde der Wasserdampf räumlich und zeitlich genau im Gebäudeinnenbereich registriert, um die Fahnenentwicklung in der Umgebung des Gebäudes vorherzusagen.; Using Computational Fluid Dynamics (CFD), we investigated the spread of gases inside and around of a poultry house. A 3D CFD model takes account of the natural ventilation combined with heat and water vapour produced by the animals. In order to validate a 3D CFD model a cycle of production for experimental purposes located West of France during the spring, 2014 was used to retrieve data. In the first step, there is a validation of a 3D CFD model based on the interior climate. In the second step, the aim was to identify how the gases might be dispersed in the surrounding environment. Water vapour was accurately logged in space and time for the interior of the building, and then utilized to predict the plume development in the building’s surroundings.

UMR AGAP - équipe DAAV (Diversité, adaptation et amélioration de la vigne)139 auteurs : Ardlie KG, Deluca DS, Segrè AV, Sullivan TJ, Young TR, Gelfand ET, Trowbridge CA, Maller JB, Tukiainen T, Lek M, Ward LD, Kheradpour P, Iriarte B, Meng Y, Palmer CD, Esko T, Winckler W, Hirschhorn JN, Kellis M, MacArthur DG, Getz G, Shabalin AA, Li G, Zhou YH, Nobel AB, Rusyn I, Wright FA, Lappalainen T, Ferreira PG, Ongen H, Rivas MA, Battle A, Mostafavi S, Monlong J, Sammeth M, Melé M, Reverter F, Goldmann JM, Koller D, Guigó R, McCarthy MI, Dermitzakis ET, Gamazon ER, Im HK, Konkashbaev A, Nicolae DL, Cox NJ, Flutre T, Wen X, Stephens M, Pritchard JK, Tu Z, Zhang B, Huang T, Long Q, Lin L, Yang J, Zhu J, Liu J, Brown A, Mestichelli B, Tidwell D, Lo E, Salvatore M, Shad S, Thomas JA, Lonsdale JT, Moser MT, Gillard BM, Karasik E, Ramsey K, Choi C, Foster BA, Syron J, Fleming J, Magazine H, Hasz R, Walters GD, Bridge JP, Miklos M, Sullivan S, Barker LK, Traino HM, Mosavel M, Siminoff LA, Valley DR, Rohrer DC, Jewell SD, Branton PA, Sobin LH, Barcus M, Qi L, McLean J, Hariharan P, Um KS, Wu S, Tabor D, Shive C, Smith AM, Buia SA, Undale AH, Robinson KL, Roche N, Valentino KM, Britton A, Burges R, Bradbury D, Hambright KW, Seleski J, Korzeniewski GE, Erickson K, Marcus Y, Tejada J, Taherian M, Lu C, Basile M, Mash DC, Volpi S, Struewing JP, Temple GF, Boyer J, Colantuoni D, Little R, Koester S, Carithers LJ, Moore HM, Guan P, Compton C, Sawyer SJ, Demchok JP, Vaught JB, Rabiner CA, Lockhart NC, Ardlie KG, Getz G, Wright FA, Kellis M, Volpi S, Dermitzakis ET.; Understanding the functional consequences of genetic variation, and how it affects complex human disease and quantitative traits, remains a critical challenge for biomedicine. We present an analysis of RNA sequencing data from 1641 samples across 43 tissues from 175 individuals, generated as part of the pilot phase of the Genotype-Tissue Expression (GTEx) project. We describe the landscape of gene expression across tissues, catalog thousands of tissue-specific and shared regulatory expression quantitative trait loci (eQTL) variants, describe complex network relationships, and identify signals from genome-wide association studies explained by eQTLs. These findings provide a systematic understanding of the cellular and biological consequences of human genetic variation and of the heterogeneity of such effects among a diverse set of human tissues.

Aging is one of the most important biological processes and is a known risk factor for many age-related diseases in human. Studying age-related transcriptomic changes in tissues across the whole body can provide valuable information for a holistic understanding of this fundamental process. In this work, we catalogue age-related gene expression changes in nine tissues from nearly two hundred individuals collected by the Genotype-Tissue Expression (GTEx) project. In general, we find the aging gene expression signatures are very tissue specific. However, enrichment for some well-known aging components such as mitochondria biology is observed in many tissues. Different levels of cross-tissue synchronization of age-related gene expression changes are observed, and some essential tissues (e.g., heart and lung) show much stronger “co-aging” than other tissues based on a principal component analysis. The aging gene signatures and complex disease genes show a complex overlapping pattern and only in some cases, we see that they are significantly overlapped in the tissues affected by the corresponding diseases. In summary, our analyses provide novel insights to the co-regulation of age-related gene expression in multiple tissues; it also presents a tissue-specific view of the link between aging and age-related diseases., National Cancer Institute (U.S.), National Human Genome Research Institute (U.S.), National Heart, Lung, and Blood Institute, National Institute on Drug Abuse (NIDA), National Institute of Mental Health (U.S.), National Institute of Neurological Disorders and Stroke (U.S.)

Almost 1% of human infants are born with urogenital abnormalities, many of which are linked to irregular connections between the distal ureters and the bladder. During development, ureters migrate by an unknown mechanism from their initial integration site in the Wolffian ducts up to the base of the bladder in a process that we call ureter maturation. Rara(-/-) Rarb2(-/-) mice display impaired vitamin A signaling and develop syndromic urogenital malformations similar to those that occur in humans, including renal hypoplasia, hydronephrosis and mega-ureter, abnormalities also seen in mice with mutations in the proto-oncogene Ret. Here we show that ureter maturation depends on formation of the 'trigonal wedge', a newly identified epithelial outgrowth from the base of the Wolffian ducts, and that the distal ureter abnormalities seen in Rara(-/-) Rarb2(-/-) and Ret(-/-) mutant mice are probably caused by a failure of this process. Our studies indicate that formation of the trigonal wedge may be essential for correct insertion of the distal ureters into the bladder, and that these events are mediated by the vitamin A and Ret signaling pathways.

Various signaling pathways rely on changes in cytosolic calcium ion concentration ([Ca 2+ ] i ). In plants, resting [Ca 2+ ] i oscillates diurnally. We show that in Arabidopsis thaliana , [Ca 2+ ] i oscillations are synchronized to extracellular Ca 2+ concentration ([Ca 2+ ] o ) oscillations largely through the Ca 2+ -sensing receptor CAS. CAS regulates concentrations of inositol 1,4,5-trisphosphate (IP 3 ), whichinturndirects release of Ca 2+ from internal stores. The oscillating amplitudes of [Ca 2+ ] o and [Ca 2+ ] i are controlled by soil Ca 2+ concentrations and transpiration rates. The phase and period of oscillations are likely determined by stomatal conductance. Thus, the internal concentration of Ca 2+ in plant cells is constantly being actively revised.

105:2440, 2000 11. Nisanci M, Turegun M, Er E, et al: Reconstruction of the middle and lower face with three simultaneous free flaps: Combined use of bilateral fibular flaps for maxillomandibular reconstruction. Ann Plast Surg 51:301, 2003 12. Zhang C, Zhang Z: Reconstruction of mandible with fibular flap and dental implant distractor: A new approach. Chin Med J 115:1877, 2002 13. Barton FE Jr, Spicer TE, Byrd HS: Head and neck reconstruction with the latissimus dorsi myocutaneous flap: Anatomic observations and a report of 60 cases. Plast Reconstr Surg 71:199, 1983 14. Hayden RE, Kirby SD, Deschler DG: Technical modifications of the latissimus dorsi pedicled flap to increase versatility and viability. Laryngoscope 110:352, 2000 15. Shigemitsu K, Naomoto Y, Haisa M, et al: A case of thyroid cancer involving the trachea: Treatment by partial tracheal resection and repair with a latissimus dorsi musculocutaneous flap. Jpn J Clin Oncol 30:235, 2000 16. Wu LY, Halim AS, Sain AH: Laminated pedicled latissimus dorsi myocutaneous flap for single-stage reconstruction of a composite anterior neck and tracheal defect. J Otolaryngol 34:69, 2005 17. Zbar RI, Funk GF, McCulloch TM, et al: Pectoralis major myofascial flap: A valuable tool in contemporary head and neck reconstruction. Head Neck 19:412, 1997 18. Liu R, Gullane P, Brown D, et al: Pectoralis major myocutaneous pedicled flap in head and neck reconstruction: A retrospective review of indications and results in 244 consecutive cases at Toronto General Hospital. J Otolaryngol 30:34, 2001 19. Vartanian JG, Carvalho AL, Carvalho SM, et al: Pectoralis major and other myofascial/myocutaneous flaps in head and neck cancer reconstruction: Experience with 437 cases at a single institution. Head Neck 26:1018, 2004 20. Wei FC, Chen HC, Chuang CC, et al: Fibular osteoseptocutaneous flap: Anatomic study and clinical application. Plast Reconstr Surg 78:191, 1986 21. Jones NF, Monstrey S, Gambier BA: Reliability of the fibular osteocutaneous flap for mandibular reconstruction: Anatomical and surgical confirmation. Plast Reconstr Surg 97:707, 1996 22. Ferri J, Piot B, Ruhin B, et al: Advantages and limitations of the fibula free flap in mandibular reconstruction. J Oral Maxillofac Surg 55:440, 1997 23. Chang YM, Santamaria E, Wei FC, et al: Primary insertion of osseointegrated dental implants into fibula osteoseptocutaneous free flap for mandible reconstruction. Plast Reconstr Surg 102:680, 1998

Mechanical complications of acute myocardial infarction (AMI) are rare, but often fatal. Medical therapy does not provide adequate risk reduction, and surgical correction is recommended when feasible. Supplemental hemodynamic support utilizing intra-aortic counterpulsation with a balloon pump provides an improvement in morbidity and mortality when combined with a corrective surgical approach. We report a case of an elderly male with a progressive 2-week history of ischemic symptoms presenting with acute pulmonary edema, hypotension and an inferior wall ST-elevation MI. His hospital course was complicated by ischemic mitral regurgitation (MR) and cardiogenic shock, which resulted in a papillary muscle rupture/avulsion from the inferolateral myocardial wall, and a communication for blood from ventricle to pericardial space. Initial management included mechanical ventilation, pharmacologic inotropic support, percutaneous revascularization of the culprit lesion and intra-aortic balloon counterpulsation. The patient underwent further successful cardiovascular surgical correction of his incompetent mitral valve, free wall rupture and other obstructive coronary arteries, leading to discharge and survival. Mechanical complications from AMI and the role of intra-aortic balloon support are discussed.

Development of the metanephric kidney involves the establishment of discrete zones of induction and differentiation that are crucial to the future radial patterning of the organ. Genetic deletion of the forkhead transcription factor, Foxd1, results in striking renal abnormalities, including the loss of these discrete zones and pelvic fused kidneys. We have investigated the molecular and cellular basis of the kidney phenotypes displayed by Foxd1-null embryos and report here that they are likely to be caused by a failure in the correct formation of the renal capsule. Unlike the single layer of Foxd1-positive stroma that comprises the normal renal capsule, the mutant capsule contains heterogeneous layers of cells, including Bmp4-expressing cells, which induce ectopic phospho-Smad1 signaling in nephron progenitors. This missignaling disrupts their early patterning,which, in turn, causes mispatterning of the ureteric tree, while delaying and disorganizing nephrogenesis. In addition, the defects in capsule formation prevent the kidneys from detaching from the body wall, thus explaining their fusion and pelvic location. For the first time, functions have been ascribed to the renal capsule that include delineation of the organ and acting as a barrier to inappropriate exogenous signals, while providing a source of endogenous signals that are crucial to the establishment of the correct zones of induction and differentiation.

The process of comparative analysis involves inspecting mammograms for characteristic signs of potential cancer by comparing various analogous mammograms. Factors such as the deformable behavior of the breast, changes in breast positioning, and the amount/geometry of compression may contribute to spatial differences between corresponding structures in corresponding mammograms, thereby significantly complicating comparative analysis. Mammogram registration is a process whereby spatial differences between mammograms can be reduced. Presented in this paper is a nonrigid approach to matching corresponding mammograms based on a physical registration model. Many of the earliest approaches to mammogram registration used spatial transformations which were innately rigid or affine in nature. More recently algorithms have incorporated radial basis functions such as the Thin-Plate Spline to match mammograms. The approach presented here focuses on the use of the Cauchy-Navier Spline, a deformable registration model which offers approximate nonrigid registration. The utility of the Cauchy-Navier Spline is illustrated by matching both temporal and bilateral mammograms.