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IHMCIF (github.com/ihmwg/IHMCIF) is a data information framework that supports archiving and disseminating macromolecular structures determined by integrative or hybrid modeling (IHM), and making them Findable, Accessible, Interoperable, and Reusable (FAIR). IHMCIF is an extension of the Protein Data Bank Exchange/macromolecular Crystallographic Information Framework (PDBx/mmCIF) that serves as the framework for the Protein Data Bank (PDB) to archive experimentally determined atomic structures of biological macromolecules and their complexes with one another and small molecule ligands (e.g., enzyme cofactors and drugs). IHMCIF serves as the foundational data standard for the PDB-Dev prototype system, developed for archiving and disseminating integrative structures. It utilizes a flexible data representation to describe integrative structures that span multiple spatiotemporal scales and structural states with definitions for restraints from a variety of experimental methods contributing to integrative structural biology. The IHMCIF extension was created with the benefit of considerable community input and recommendations gathered by the Worldwide Protein Data Bank (wwPDB) Task Force for Integrative or Hybrid Methods (wwpdb.org/task/hybrid). Herein, we describe the development of IHMCIF to support evolving methodologies and ongoing advancements in integrative structural biology. Ultimately, IHMCIF will facilitate the unification of PDB-Dev data and tools with the PDB archive so that integrative structures can be archived and disseminated through PDB.

Advances in computational tools for atomic model building are leading to accurate models of large molecular assemblies seen in electron microscopy, often at challenging resolutions of 3-4 Å. We describe new methods in the UCSF ChimeraX molecular modeling package that take advantage of machine-learning structure predictions, provide likelihood-based fitting in maps, and compute per-residue scores to identify modeling errors. Additional model-building tools assist analysis of mutations, post-translational modifications, and interactions with ligands. We present the latest ChimeraX model-building capabilities, including several community-developed extensions. ChimeraX is available free of charge for noncommercial use at https://www.rbvi.ucsf.edu/chimerax. This article is protected by copyright. All rights reserved.

El estudio tuvo como objetivo analizar el impacto de los ejercicios pliométricos en la optimización de la fuerza explosiva de los jugadores reserva de la Liga de Portoviejo. El problema identificado fue la falta de un programa de entrenamiento estructurado para desarrollar la fuerza explosiva, lo cual es esencial para mejorar el desempeño en el fútbol. La metodología fue de enfoque cuantitativo y experimental, utilizando pruebas estandarizadas de salto vertical, salto horizontal y velocidad de 50 metros. Se seleccionó una muestra de 20 jugadores, de entre 18 y 20 años, quienes realizaron estas pruebas antes y después de un programa de entrenamiento pliométrico. Los resultados revelaron que, tras la intervención, la distancia promedio en el salto horizontal aumentó de 1.90 metros a 2.03 metros, mejorando de la clasificación de “malo” a “normal” en la mayoría de los jugadores. En el salto vertical, el promedio pasó de 38.40 cm, clasificado como “pobre”, a 43.80 cm, alcanzando la categoría de “debajo de la media”. Además, en las pruebas de velocidad, el tiempo promedio mejoró de 7.79 segundos a 7.22 segundos, logrando que varios jugadores alcanzaran la clasificación de “normal” y uno incluso se posicionara como “muy bueno”. En conclusión, los ejercicios pliométricos resultaron ser efectivos para mejorar la fuerza explosiva y la velocidad de los jugadores, evidenciando un impacto positivo en su rendimiento físico. Sin embargo, algunos jugadores permanecieron en categorías más bajas, lo que sugiere la necesidad de realizar ajustes personalizados en el entrenamiento para maximizar los resultados individuales.

Forces generated by actin assembly assist membrane invagination during clathrin-mediated endocytosis (CME). The sequential recruitment of core endocytic proteins and regulatory proteins, and assembly of the actin network, are well documented in live cells and are highly conserved from yeasts to humans. However, understanding of CME protein self-organization, as well as the biochemical and mechanical principles that underlie actins role in CME, is lacking. Here, we show that supported lipid bilayers coated with purified yeast Wiskott Aldrich Syndrome Protein (WASP), an endocytic actin assembly regulator, and incubated in cytoplasmic yeast extracts, recruit downstream endocytic proteins and assemble actin networks. Time-lapse imaging of WASP-coated bilayers revealed sequential recruitment of proteins from different endocytic modules, faithfully replicating in vivo behavior. Reconstituted actin networks assemble in a WASP-dependent manner and deform lipid bilayers, as seen by electron microscopy. Time-lapse imaging revealed that vesicles are released from the lipid bilayers with a burst of actin assembly. Actin networks pushing on membranes have previously been reconstituted; here, we have reconstituted a biologically important variation of these actin networks that self-organize on bilayers and produce pulling forces sufficient to bud off membrane vesicles. We propose that actin-driven vesicle generation may represent an ancient evolutionary precursor to diverse vesicle forming processes adapted for a wide array of cellular environments and applications.

Introduction: Basal cell carcinoma (BCC) is the most common skin malignancy in the world. While most lesions are treated using surgical methods, others may present as locally advanced or metastatic disease and are not amenable to surgical therapy alone. Treatment with sonic hedgehog pathway inhibitors (vismodegib, sonidegib) is designed to inhibit key signaling proteins and gene pathways involved with BCC to reduce the uncontrolled proliferation of basal cells in complicated disease and can be invaluable in treating patients with advanced disease. Case Presentation: We describe the course of a 68-year-old man who presented with a 7.2 × 6 cm exophytic and ulcerated locally invasive BCC of his upper back. The patient was started on daily vismodegib treatment with the goal of eventual surgical resection. After 11 weeks of therapy, he had significant improvement in both wound size and appearance. After 18 weeks of therapy, he had achieved a near complete clinical response of the central aspect of lesion with three remaining small peripheral lesions. These lesions were biopsied, and two were found to be negative for malignancy, while a small inferior nodule was positive for squamous cell carcinoma (SCC). Vismodegib therapy was discontinued after a total of 26 weeks of therapy. Excision of the SCC was performed, and the patient remains disease free at 2 years. Conclusion: This case report shows the efficacy of hedgehog pathway inhibitor therapy in the treatment of a locally advanced BCC with complete pathologic response, not requiring surgical intervention.

Purpose: The purpose of the article is to present the results of the analysis of the Covid 19 pandemic on digital commerce in the Pacific Alliance – PA- during the first 12 months. Methodology: The study is characterized as a descriptive qualitative study, where 9 specialists were interviewed. Later, their perceptions were tabulated and processed using Nvivo software, and these findings are presented in word clouds. Findings: Different digital buying and selling transactions depend on internet access and logistic coverage, revealing that rural areas face more significant restrictions. Additionally, the influence of commercial companies during the purchase process was observed, using digital tools to enhance product knowledge and optimize transactions with strategic allies such as Amazon, Mercado Libre, and Facebook, ranked in accordance with consumer awareness levels. Practical implications: E-COMMERCE during the first year had a rapid development driven by the limitations imposed to stop the advance of the pandemic. Originality/value: the study provides first-hand verification of the current situation of e-commerce in the AP, from the point of view of marketing experts.

Leukemic cells often show high nitric oxide (NO) and reactive oxygen species (ROS) levels. These can lead to resistance to apoptosis and therapy and increased proliferation. Plant-derived extracts decrease chemoresistance in cancer cells. In this study, we evaluated the effects of the plant-derived extracts P2Et (Caesalpinia spinosa) and Anamu-SC (Petiveria alliacea) and their combination with chemotherapeutic agents on NO and ROS levels in leukemic cell lines K562 and Reh. NO and ROS were determined using the DAF-FM DA and H2DCFDA probes. The mean fluorescence intensity for each variable was measured by flow cytometry. The extracts showed an antioxidant effect on both cell lines leading to a significant decrease in ROS levels without decreasing cell viability. Anamu-SC also increased NO levels in K562 cells when combined with idarubicin. Both extracts reduced the number of leukemic cells after 12 hours of treatment. Further studies are necessary to evaluate their effect on primary human leukemia cells. These findings suggest the potential of P2Et and Anamu-SC as adjuncts in leukemia treatment.

Summary:. Symptomatic neuromas of the superficial radial nerve (SRN) can cause debilitating pain. Traditional surgical management options have demonstrated inconsistent outcomes prompting a search for alternatives. Recent reports have emerged on the use of targeted muscle reinnervation (TMR) for neuromas of the SRN using donors that are well established in hand surgery, such as the brachioradialis (BR) or extensor capri radialis longus or brevis. Use of the brachioradialis or extensor capri radialis longus motor targets can require surgery at or above the level of the antecubital fossa, and denervation of these muscle groups may be undesirable in cases of complex upper extremity injury where these donors may be needed for tendon or nerve transfer. The supinator is an expendable and often overlooked donor nerve that has not been assessed as a target for TMR of the SRN. In this case series, three patients with SRN neuromas whose conservative management failed and who did not have an SRN lesion amenable to reconstruction were managed with TMR to the nerves to supinator. At latest follow-up (9–22 months), no patients had deficits in supination or evident donor site morbidity. Two patients reported complete resolution of their SRN neuroma pain, and one patient reported partial improvement. This case series reports early results of TMR of the SRN using nerves to supinator in cases of SRN neuromas not amenable to reconstruction, demonstrating technical feasibility, improvements in neuroma pain, and no discernible donor morbidity.

Many business colleges offer specialized marketing majors in addition to the general marketing major. Given the extra resources needed to maintain multiple majors, in a time when higher education budgets are being strained, a need exists to understand how students make choices among these majors and what students perceive to be the advantages of general marketing majors versus specialized marketing majors. Using social cognitive theory, we examine how students make selections among choices in marketing-related majors, focusing on influence and compatibility factors. We surveyed 608 marketing majors representing one general and five specialized marketing majors. The findings indicate that, compared with general marketing majors, students' choice of a specialized major is significantly more likely to be influenced by faculty and other students in the major. Also, the results show that students rate specialized majors better than a general marketing major in terms of self-efficacy, culture, and professional fit. On the other hand, students rate the general marketing major better than specialized majors in flexibility. These results have implications for supporting the priorities of students in both general and specialized majors.

With the development of educational robotics, teachers of secondary and high school frequently request clear indications on which type of robot is most effective for strengthening students' mental schemes on the robot. This paper investigates whether using crafts and recycled materials or structured materials to build robots is more effective in terms of pupils' cognition in educational robotics. Some scholarship argues that using crafts and recycled materials to build a robot from scratch is more effective than using structured materials. The design of the educational research applied here, and in which we tested this hypothesis, included two different robotics activities, carried out in Italy with two classes of secondary school. In the first, we asked the students to build a robot from scratch using crafts and recycled materials, while in the other we asked the students to build a robot from structured materials. These two activities were preceded and followed by the completion, by students, of the same questionnaire about knowledge of mechanics, manual skills, conceptualization of robots, and beliefs about the robotization of everyday life machines, which were the learning outcomes identified in this study according to the concept of constructive alignment and outcome-based education. Results show that building a robot from scratch increases pupils' knowledge and manual skills, while building a robot with structured materials increases their awareness of the robotization of machines. Thus, current scholarship's approach is only partially confirmed. To conclude, although pupils' appreciation involves equally both these robotics activities, each of these outlines a specific educational outcome.

UCSF ChimeraX is the next-generation interactive visualization program from the Resource for Biocomputing, Visualization, and Informatics (RBVI), following UCSF Chimera. ChimeraX brings (a) significant performance and graphics enhancements; (b) new implementations of Chimera's most highly used tools, many with further improvements; (c) several entirely new analysis features; (d) support for new areas such as virtual reality, light-sheet microscopy, and medical imaging data; (e) major ease-of-use advances, including toolbars with icons to perform actions with a single click, basic "undo" capabilities, and more logical and consistent commands; and (f) an app store for researchers to contribute new tools. ChimeraX includes full user documentation and is free for noncommercial use, with downloads available for Windows, Linux, and macOS from https://www.rbvi.ucsf.edu/chimerax.

This study was conducted to determine the effect of nitrogen (N) doses (0, 40, 80, 120, 160, 200, and 240 kg ha-1) and bacterial inoculation on macro- (N, P, K, Ca, Mg, and Na) and micro- (Fe, Cu, Zn, Mn, and B) element contents of the Halisbey peanut variety. The nutrient requirements, specific nutrient management strategies, and adaptation of the variety to the regions where it was grown were also assessed. According to the average results of the N applications, different doses affected the levels of N (240N+B: 1.76%) alongside the content of other macro-elements, as well as sodium (200N: 0.09 mg kg-1), iron (80N: 32.39 mg kg-1), and copper (40N: 14.11 mg kg-1) among the micro-elements. The bacterial application was not found to significantly increase N content (240N+B: 1.76%), calcium content (0.08%) and zinc content (49.68 mg kg-1). At the same time, (240N+B) bacteria and N application increased the N ratio.

Summary:. Sensate flaps are increasingly used in diverse areas of plastic surgery. Concurrently, modern techniques in neuroma prevention have emerged, such as regenerative peripheral nerve interface (RPNI). Despite increasing use of sensate flaps, the combined use of donor-site neuroma prevention techniques has yet to be described. We report on the use of primary donor-site RPNI at the time of sensate anterolateral thigh (ALT) reconstructions. In ALT flaps, the vastus lateralis muscle can be segmentally devascularized from perforator dissection. These segments of devascularized vastus lateralis muscle can easily be used and repurposed as the free muscle grafts needed for RPNI, providing a physiologic target for the regenerating neurons. Donor-site neuroma has not been shown to be a significant issue at standard ALT flap donor sites. Sensate ALT flaps involve harvest of the lateral femoral cutaneous nerve and/or additional femoral sensory branches at a more proximal location close to the level of the anterior superior iliac spine, where injury to the lateral femoral cutaneous nerve may be associated with pain. In this series, eight patients underwent senate ALT flaps with the use of primary RPNI at the sensate ALT donor site. At a mean follow-up of 16.3 months (range 5–25 months), there was minimal to no nerve pain and no clinical evidence of donor-site neuroma. As sensate flap reconstructions are increasingly performed in plastic surgery and data on neuroma prevention techniques continue to grow, we propose consideration of their combined use.

Force generation by actin assembly shapes cellular membranes. An experimentally constrained multiscale model shows that a minimal branched actin network is sufficient to internalize endocytic pits against membrane tension. Around 200 activated Arp2/3 complexes are required for robust internalization. A newly developed molecule-counting method determined that ~200 Arp2/3 complexes assemble at sites of clathrin-mediated endocytosis in human cells. Simulations predict that actin self-organizes into a radial branched array with growing ends oriented toward the base of the pit. Long actin filaments bend between attachment sites in the coat and the base of the pit. Elastic energy stored in bent filaments, whose presence was confirmed by cryo-electron tomography, contributes to endocytic internalization. Elevated membrane tension directs more growing filaments toward the base of the pit, increasing actin nucleation and bending for increased force production. Thus, spatially constrained actin filament assembly utilizes an adaptive mechanism enabling endocytosis under varying physical constraints.

This study was conducted to determine the macro and micro element contents of fourteen peanuts in Turkey. Virginia (NC-7, Halisbey, Arıoğlu-2003, Sultan Flower-22, Osmaniye-2005, Brantley, Wilson, Batem-5025, Batem-Cihangir, NC V 11 and Polen) Runner (Georgia Green) and Spanish (Florispan) market types have been evaluated. The research was conducted for two years (2015 to 2016) under main crop conditions in the trial areas of belonging to the Oil Seed Research Institute. The highest nitrogen content is from the Florispan (4.56%) variety, the highest phosphorus and sodium content is from the Halisbey (0.10%) variety, the highest potassium content is from the Sultan (0.46%) variety, the highest calcium content is from the Flower-22 (0.07%) variety and the highest the magnesium content was taken from Arıoğlu-2003 (0.26%) variety. The highest iron content is in Batem-Cihangir (27.34 mg kg-1) variety, the highest copper content is in Flower-22 (7.08 mg kg-1), the highest zinc content is in Sultan (29.35 mg kg-1), the highest manganese content NC-7 (20.61 mg kg-1) variety, the highest boron content was found in Florispan (26.99 mg kg-1) variety. According to the results of this study, varieties with different chemical compositions can be used in food and breeding studies.

Context: Nasal packs are necessary after nasal surgery for hemostasis and internal stabilization of bony and cartilaginous structures. Aims: The study was done to compare the outcomes of conventional nasal packing and Merocel packing in terms of the middle ear pressure, mucociliary clearance, patient comfort, and complication. Settings and Design: A prospective study was conducted among 40 patients in a tertiary care center for 18 months. Subjects and Methods: The patients between 18 and 50 years and who underwent septal surgery were included in the study. The patients with any history of ciliary dysfunction, who underwent functional endoscopic sinus surgery with septoplasty, and any middle ear diseases were excluded from the study. The patients were divided into Group 1, which had conventional nasal pack and Group 2, which had Merocel postoperatively. All the patients were assessed with impedance audiometry and sacchrin test preoperatively and postoperatively at 1, 2 and 4 weeks and these were compared between the 2 groups. During pack removal, pain and bleeding and postoperative complications were also compared between the groups. Statistical Analysis Used: The difference between the two-group comparison student t-tests, the differences between the right and left sides of the same tests paired t-test. The association/difference between categorical variables Chi-square test was calculated at a 5% level of significance. Results: Group 1 and Group 2 had a mean age of 38.47 and 37.47, respectively. Gender predisposition in Group 2 is 1:1 and in Group 1 is 3:2. The middle ear pressure returns to normal by 2nd week in Group 2 compared to Group 1, which improved by 4th week (P < 0.05). The mucociliary clearance reverts to normal by 1st week in Group 2 and 4th week in Group 1 (P = 0.0001) was statistically significant. Group 2 had lesser pain scores assessed using visual analog scores (P = 0.0001) and less bleeding (P = 0.01), which was statistically significant. Group 2 has fewer postoperative complications. Conclusions: The conventional and Merocel packs were both effective packs. In terms of mucociliary clearance, the middle ear pressure Merocel packing was better, and conventional nasal packing had more incidence in terms of postoperative complications.

Structures of biomolecular systems are increasingly computed by integrative modeling. In this approach, a structural model is constructed by combining information from multiple sources, including varied experimental methods and prior models. In 2019, a Workshop was held as a Biophysical Society Satellite Meeting to assess progress and discuss further requirements for archiving integrative structures. The primary goal of the Workshop was to build consensus for addressing the challenges involved in creating common data standards, building methods for federated data exchange, and developing mechanisms for validating integrative structures. The summary of the Workshop and the recommendations that emerged are presented here.

AbstractBackground The introduction of portable and pocket ultrasound scanners has potentiated the use of ultrasound in primary care, whose many applications have been studied, analyzed and collected in the literature. However, its use is heterogeneous in Europe and there is a lack of guidelines on the necessary training and skills.Objectives To identify the fundamental applications and indications of ultrasound for family physicians, the necessary knowledge and skills, and the definition of a framework of academic and pragmatic training for the development of these competencies.Methods A modified 3-round Delphi study was carried out in Catalonia, with the participation of 65 family physicians experts in ultrasound. The study was carried out over six months (from September 2020 to February 2021). The indications of ultrasound for family physicians were agreed (the > = 75th percentile was considered) and prioritised, as was the necessary training plan.Results The ultrasound applications in primary care were classified into seven main categories. For each application, the main indications (according to reason for consultation) in primary care were specified. A progressive training plan was developed, characterised by five levels of competence: A (principles of ultrasound and management of ultrasound scanners); B (basic normal ultrasound anatomy); C (advanced normal ultrasound anatomy); D (pathologic ultrasound, description of pathological images and diagnostic orientation); E (practical skills under conditions of routine clinical practice).Conclusion Training family physicians in ultrasound may consider seven main applications and indications. The proposed training plan establishes five different levels of competencies until skill in real clinical practice is achieved.

The aberrant activation of Wnt/β-catenin signaling in tumor cells and immune cells in the tumor microenvironment (TME) promotes malignant transformation, metastasis, immune evasion, and resistance to cancer treatments. The increased Wnt ligand expression in TME activates β-catenin signaling in antigen (Ag)-presenting cells (APCs) and regulates anti-tumor immunity. Previously, we showed that activation of Wnt/β-catenin signaling in dendritic cells (DCs) promotes induction of regulatory T cell responses over anti-tumor CD4+ and CD8+ effector T cell responses and promotes tumor progression. In addition to DCs, tumor-associated macrophages (TAMs) also serve as APCs and regulate anti-tumor immunity. However, the role of β-catenin activation and its effect on TAM immunogenicity in TME is largely undefined. In this study, we investigated whether inhibiting β-catenin in TME-conditioned macrophages promotes immunogenicity. Using nanoparticle formulation of XAV939 (XAV-Np), a tankyrase inhibitor that promotes β-catenin degradation, we performed in vitro macrophage co-culture assays with melanoma cells (MC) or melanoma cell supernatants (MCS) to investigate the effect on macrophage immunogenicity. We show that XAV-Np-treatment of macrophages conditioned with MC or MCS significantly upregulates the cell surface expression of CD80 and CD86 and suppresses the expression of PD-L1 and CD206 compared to MC or MCS-conditioned macrophages treated with control nanoparticle (Con-Np). Further, XAV-Np-treated macrophages conditioned with MC or MCS significantly increased IL-6 and TNF-α production, with reduced IL-10 production compared to Con-Np-treated macrophages. Moreover, the co-culture of MC and XAV-Np-treated macrophages with T cells resulted in increased CD8+ T cell proliferation compared to Con-Np-treated macrophages. These data suggest that targeted β-catenin inhibition in TAMs represents a promising therapeutic approach to promote anti-tumor immunity.

Clinical persistence of Chlamydia trachomatis (Ct) sexually transmitted infections (STIs) is a major public health concern. In vitro persistence is known to develop through interferon gamma (IFN-γ) induction of indoleamine 2,3-dioxygenase (IDO), which catabolizes tryptophan, an essential amino acid for Ct replication. The organism can recover from persistence by synthesizing tryptophan from indole, a substrate for the enzyme tryptophan synthase. The majority of Ct strains, except for reference strain B/TW-5/OT, contain an operon comprised of α and β subunits that encode TrpA and TrpB, respectively, and form a functional αββα tetramer. However, trpA mutations in ocular Ct strains, which are responsible for the blinding eye disease known as trachoma, abrogate tryptophan synthesis from indole. We examined serial urogenital samples from a woman who had recurrent Ct infections over 4 years despite antibiotic treatment. The Ct isolates from each infection episode were genome sequenced and analyzed for phenotypic, structural, and functional characteristics. All isolates contained identical mutations in trpA and developed aberrant bodies within intracellular inclusions, visualized by transmission electron microscopy, even when supplemented with indole following IFN-γ treatment. Each isolate displayed an altered αββα structure, could not synthesize tryptophan from indole, and had significantly lower trpBA expression but higher intracellular tryptophan levels compared with those of reference Ct strain F/IC-Cal3. Our data indicate that emergent mutations in the tryptophan operon, which were previously thought to be restricted only to ocular Ct strains, likely resulted in in vivo persistence in the described patient and represents a novel host-pathogen adaptive strategy for survival.IMPORTANCEChlamydia trachomatis (Ct) is the most common sexually transmitted bacterium with more than 131 million cases occurring annually worldwide. Ct infections are often asymptomatic, persisting for many years despite treatment. In vitro recovery from persistence occurs when indole is utilized by the organism's tryptophan synthase to synthesize tryptophan, an essential amino acid for replication. Ocular but not urogenital Ct strains contain mutations in the synthase that abrogate tryptophan synthesis. Here, we discovered that the genomes of serial isolates from a woman with recurrent, treated Ct STIs over many years were identical with a novel synthase mutation. This likely allowed long-term in vivo persistence where active infection resumed only when tryptophan became available. Our findings indicate an emerging adaptive host-pathogen evolutionary strategy for survival in the urogenital tract that will prompt the field to further explore chlamydial persistence, evaluate the genetics of mutant Ct strains and fitness within the host, and their implications for disease pathogenesis.

Abstract Background To understand how suicide management occurs within the primary care setting in terms of follow-up assessments and referral practices. Methods At an initial primary care visit, adolescents (aged 12–20 years old) completed electronic screening. Data were focused on youth who endorsed a suicidal risk item while completing screening at two Midwestern primary care clinics. Data were collected through retrospective chart reviews to analyze actions taken by the primary care physician at the youth’s initial visit and follow-up visit within the next 12 months. Results At initial visits 200 adolescents endorsed a suicidal risk item and 39 (19.5%) were considered to be concerning by their primary care physician. The average age was 14.7 years old (SD ± 2.0). Seventy-two percent (n = 144) were female, and 65% (n = 129) identified as Black. At initial visits, significant differences between suicidal concern groups were found in reporting active suicidal ideation, past suicide attempts, those who were referred to behavioral health counseling, and those who had a diagnosis of depression. Interestingly, only 13% (n = 25) of all patients who endorsed the suicide item were asked whether or not there were weapons in their home and primary care providers asked only 7% (n = 13) of all patients whether they had a safety plan. Conclusions There was inconsistent follow-up for adolescents with a history of suicide concerns. At this time, national guidelines do not exist regarding primary care follow-up of youth with suicide concerns. Guidelines are a necessary precursor for practice improvement. Trial Registration Clinical Trials Registry: NCT02244138 . Registration date, September 1, 2014.

Background:. A key component of success of a nerve transfer is the innervation density, which is directly affected by the donor nerve axonal density and donor-to-recipient (D:R) axon ratio. Optimal D:R axon ratio for a nerve transfer is quoted at 0.7:1 or greater. In phalloplasty surgery, there are currently minimal data available to help inform selection of donor and recipient nerves, including unavailability of axon counts. Methods:. Five transmasculine people who underwent gender-affirming radial forearm phalloplasty had nerve specimens processed with histomorphometric evaluation to determine axon counts and approximate donor-to-recipient axon ratios. Results:. Mean axon counts for recipient nerves were 6957 ± 1098 [the lateral antebrachial (LABC)], 1866 ± 590 [medial antebrachial (MABC)], and 1712 ± 121 [posterior antebrachial cutaneous (PABC)]. Mean axon counts for donor nerves were 2301 ± 551 [ilioinguinal (IL)] and 5140 ± 218 [dorsal nerve of the clitoris (DNC)]. D:R axon ratios using mean axon counts were DNC:LABC 0.739 (0.61–1.03), DNC:MABC 2.754 (1.83–5.91), DNC:PABC 3.002 (2.71–3.53), IL:LABC 0.331 (0.24–0.46), IL:MABC 1.233 (0.86–1.17), and IL:PABC 1.344 (0.85–1.82). Conclusions:. The DNC is the more powerful donor nerve with greater than two times the axon count of the IL. The IL nerve may be under-powered to re-innervate the LABC based on an axon ratio consistently less than 0.7:1. All other mean D:R are more than 0.7:1. DNC axon counts may be excessive for re-innervation of the MABC or PABC alone with D:R of more than 2.5:1, potentially increasing risk of neuroma formation at the coaptation site.