General principles of tendon transfers: The ten commandments.

Transferring a muscle's point of force application by modifying its distal insertion will modify its function. This is the basic principle of tendon transfers. Despite being less popular due to superior primary nerve repair results, hand surgeons must be familiar with them. When used according to the Ten Commandments we propose, they provide good and useful functional recovery. Obviously, it depends on the number of muscles available for transfer. Tendon transfer is useful not only in nerve trunk palsy and brachial plexus lesions but also in upper limb tetraplegia rehabilitation. Tendon transfers are active palliative treatments under voluntary command and can be combined with other palliative procedures (arthrodesis, tenodesis) to improve the functional result. Nevertheless, they are far from ideal, as they re-allocate the remaining forces of the limb but do not create new ones.

General scientific guidance for stakeholders on health claim applications (Revision 1).

[Table: see text] The general guidance for stakeholders on the evaluation of Article 13(1), 13(5) and 14 health claims was first published in March 2011. Since then, the Panel on Dietetic Products Nutrition and Allergies (NDA) has completed the scientific assessment of Article 13(1) claims except for claims put on hold by the European Commission, and has assessedadditional health claim applications submitted pursuant to Articles 13(5), 14 and also 19. In addition, comments received from stakeholders indicate that general issues that are common to all health claims need to be further clarified and addressed. This guidance document aims to explain the general scientific principles applied by the NDA Panel for the scientific assessmentof all health claims and outlines a series of steps for the compilation of applications. The general guidance document represents the views of the NDA Panel based on the experience gained to date with the scientific assessment of health claims, and it may be further updated, as appropriate, when additional issues are addressed.The document also aims to inform applicants of newprovisionsin the pre-submission phase and in the application procedure set out in the General Food Law, as amended by the Transparency Regulation. These new provisions are applicable to all applications submitted as of 27 March 2021. The version of this guidance published in 2016 remains applicable for applications submitted before 27 March 2021.

Preserving 40% forest cover is a valuable and well-supported conservation guideline: reply to Banks-Leite et al.

Banks-Leite et al. (2021) claim that our suggestion of preserving ≥ 40% forest cover lacks evidence and can be problematic. We find these claims unfounded, and discuss why conservation planning urgently requires valuable, well-supported and feasible general guidelines like the 40% criterion. Using region-specific thresholds worldwide is unfeasible and potentially harmful.

[Interpretation for the group standard of the General principles of description for pathogenic microorganism collection].

Pathogenic microorganism is an important national strategic resource, whose value is embodied in the physical object and its corresponding information and data resources. At present, China has basically completed the designation of national and provincial preservation centers and professional laboratories, and various preservation institutions have been put into operation and begun to play its role of preservation institutions. In order to standardize the data management of pathogenic microorganism preservation and improve the quality of pathogenic microorganism resources, China CDC took the lead in formulating and issuing the community standard of Chinese Preventive Medicine Association, the General principles of description for pathogenic microorganism collection (T/CPMA 011-2020). The standard puts forward the data fields and description principles of microorganism strain, including general data such as number, name, separation, hazard classification, transmission route, pathogenicity, and characteristic data such as virus, bacteria and fungi. The core of pathogenic microorganism resources lies in quality and the foundation lies in standards. Taking data standards as the starting point, it will play an important supporting role in promoting the transformation of pathogenic microorganism preservation work to quality improvement, improving resource sharing and utilization, and leading the sustainable development of preservation work.

Educational Case: Point-of-Care Testing.

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http://journals.sagepub.com/doi/10.1177/2374289517715040. 1.

Emergent Gene Expression Responses to Drug Combinations Predict Higher-Order Drug Interactions.

Effective design of combination therapies requires understanding the changes in cell physiology that result from drug interactions. Here, we show that the genome-wide transcriptional response to combinations of two drugs, measured at a rigorously controlled growth rate, can predict higher-order antagonism with a third drug in Saccharomyces cerevisiae. Using isogrowth profiling, over 90% of the variation in cellular response can be decomposed into three principal components (PCs) that have clear biological interpretations. We demonstrate that the third PC captures emergent transcriptional programs that are dependent on both drugs and can predict antagonism with a third drug targeting the emergent pathway. We further show that emergent gene expression patterns are most pronounced at a drug ratio where the drug interaction is strongest, providing a guideline for future measurements. Our results provide a readily applicable recipe for uncovering emergent responses in other systems and for higher-order drug combinations. A record of this paper's transparent peer review process is included in the Supplemental Information.

International cooperation in criminal proceedings involving assisted reproductive technologies.

OBJECTIVE: Introduction: The fact that Ukrainian legislation in the field of reproductive medicine is the most liberal in Europe leads plenty of foreigners to come to Ukraine for using surrogacy as a method of treatment and in such a way to avoid certain prohibitions of their domestic legislation. Subsequently, they face legal issues during the border-crossing with a newborn. Additionally, there are several problems with acquiring a nationality for child in its parents' country. Moreover, it could lead to initialization of criminal proceedings in Ukraine and other countries as during pre-qualification these actions formally are similar to human trafficking. International cooperation in criminal proceedings in cases involving assisted reproductive technologies is a way of resolving the moral and legal dispute of countries with different legal regulations on assisted reproductive technologies. The aim: To establish the optimal ways of solving problems arising from the use of assisted reproductive technologies by foreign citizens, who come to Ukraine from countries, where surrogacy is prohibited. Thus, the use of it in Ukraine triggered the urgent need for international cooperation in criminal proceedings. PATIENTS AND METHODS: Materials and methods: This study has been conducted in 2019. In this research as an empirical basis 2 decisions of the European Court of Human Rights (ECHR), 1 press-release of the ECHR, 4 cases> materials, and additionally 2 regulatory documents have been used. Methods of general science (synthesis, induction, system method) and specific scientific methods (legal comparative method, special-legal method) have been applied. CONCLUSION: Conclusions: According to the mentioned above, it follows that the problematics of the international cooperation in criminal proceedings involving ART application also lie outside the scope of criminal proceedings alone, resulting in waste of time, funds and human resources in some countries' proceedings. Moreover, European countries have accepted a unified approach, according to which ART is a method of treatment, and newborns are full-fledged citizens according to «jus sanguinis". However, it is essentially important to admit that material law is primary here. The optimal way to solve the issues of foreigners opting for surrogacy in Ukraine for the sake of avoiding criminal proceedings in Ukraine and abroad is to provide for all countries a unified approach to understanding that ART technology is a method of treatment. And that countries of Europe, where surrogate motherhood is prohibited, should freely recognize parental rights of individuals, who have used or applied method of surrogate motherhood, and the rights of newborns to adopt the citizenship of their parents.

Analysis and Suggestions for Parts of the Problem of"General Principles for Processing"in Chinese Phar-macopoeia / 中国药房

OBJECTIVE:To provide reference for standardizing the names and definitions for the processing methods of"gener-al principles for processing"in reprinted Chinese Pharmacopoeia. METHODS:Comparing with the Processing of Chinese Mate-ria,Beijing Processing Specification for TCM Decoction Pieces,Shennong Bencaojing and National Processing Specification for Chinese Herbal Medicine,parts of the name and definition problems for processing methods of"general principles for processing"in Chinese Pharmacopoeia (2015 edition,Vol Ⅳ) were analyzed,and suggestions were put forward. RESULTS:The definitions of partial items in the"general principles for processing"in Chinese Pharmacopoeia remained to be normalized and operability re-mained to be improved. For example,the definitions of stir-frying,stir-frying with wine,stir-frying with vinegar,stir-frying with salt and stir-frying with honey were not accurate,so as the steaming. The name of the processing method under the term of decoc-tion pieces was not identified,there was deviation in the scope of crystallizing definition,and amount of pharmaceutic adjuvant was not worthy to be generalized. CONCLUSIONS:When generalizing and defining the processing methods for all TCM decoction pieces,Chinese Pharmacopoeia should give consideration to the popularity,accuracy and universality.

Systematic discovery of drug interaction mechanisms.

Drug combinations are increasingly important in disease treatments, for combating drug resistance, and for elucidating fundamental relationships in cell physiology. When drugs are combined, their individual effects on cells may be amplified or weakened. Such drug interactions are crucial for treatment efficacy, but their underlying mechanisms remain largely unknown. To uncover the causes of drug interactions, we developed a systematic approach based on precise quantification of the individual and joint effects of antibiotics on growth of genome-wide Escherichia coli gene deletion strains. We found that drug interactions between antibiotics representing the main modes of action are highly robust to genetic perturbation. This robustness is encapsulated in a general principle of bacterial growth, which enables the quantitative prediction of mutant growth rates under drug combinations. Rare violations of this principle exposed recurring cellular functions controlling drug interactions. In particular, we found that polysaccharide and ATP synthesis control multiple drug interactions with previously unexplained mechanisms, and small molecule adjuvants targeting these functions synthetically reshape drug interactions in predictable ways. These results provide a new conceptual framework for the design of multidrug combinations and suggest that there are universal mechanisms at the heart of most drug interactions.

Principios generales sobre la psicofarmacoterapia en niños y adolescentes. Una revisión

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Abstract: The work of Charles Bradley done in 1937, which reports the effects of Benzedrine in 30 pediatric patients that had behaviour problems, is a classic document considered by many as the beginning of child psychopharmacotherapy. In spite of a coordinated effort made by the National Institute of Mental Health in the United States carried out by a panel, called "Conferences on Infantile Research in Psychopharmacology", for many years this practice kept being inarticulate. Psychopharmacotherapy in adults with psychiatric diseases has had a different development. During the decade of 1950 substances such as chlorpromazine and tricycle antidepressives started to be used in clinical practice and between 1980 and 1990 new products were developed for treating schizophrenia, depression and mania. Even if there is no such as the "ideal drug", the new psychopharmacological developments have allowed patients to have a better quality of life. In pediatric population the difficulty to conduct controlled clinical tests has been a constant; for this reason the practice of child psychopharmacotherapy keeps facing challenges; also, in the United States several very strict norms have been dictated in order to endorse the security and efficacy of a product for infantile use. Other problems faced today in clinical practice are the excesive use of medications for minors prescribed by people without enough practice and academic information, and also the deficient therapeutic results provoked by wrong prescriptions. But the worst of all are the false promises made to relatives and patients, on the usage of products or substances that have not been tested by a rigorous scientific scrutiny, specially concerning diffused clinical problems such as the Attention Deficit Hyperac-tivity Disorder (ADHD) or Autism. These facts, most of all, determine the rejection and fear for medications and become an adverse variable that we must face continuously. The main objective of this work is to make a review about the general principles that are suggested for a good psychopharmaco-therapy on children and teen-agers, a practice that must always be part of a planned multimode treatment that follows an adequate paidopsychiatric evaluation. A right diagnose will always be important for the appropriate selection of the medication. The development of taxonomies such as those described in the Mental Disorders Statistics and Diagnostic Manual of the American Psychiatric Association or by the International Classification of Diseases of the World Health Organization, have allowed the existence of an order in the ela-boration of paidopsychiatric diagnosis, that even if being mainly descriptive, allow to make a more structured clinical work. The parameters for the psychiatric evaluation of children and teen-agers recommended by the American Academy of Child and Adolescent Psychiatry (AACAP) in 1997 is an example of the importance that proves the attention on minors, its objective is to give a guide without pretending to make it a golden standard. The selection of a medication must be based on two premises: a diagnose of the disorder itself, and on the other hand, the recognition of target symptoms. Considering this interrelation will allow a more acceptable evaluation on the risks and benefits of a phar-macological prescription for children and teenagers. Thus pediatric psychopharmacotherapy must be based on the correlation between the actions and effects of drugs and the biochemical and evolving aspects of the disorder, but it will also be necessary that the professional be aware of the changes that inevitably will take place in the dynamic of absorption, distribution and elimination of the medications according to the stage of the biological child's development. When someone deals with very small children, it is almost impossible for the child psychiatrist to get direct information as it is for children to understand the information that the expert would pretend to give them. This constrains to consider the cognitive and verbal realities proper of each stage of the development, so the direct evaluation of the small patient must be complemented with reports of a multi-informers system. It will be fundamental to consider also that small children have little differentiated emotions and that it must not be ignored that for them concepts such as time and space are difficult to understand. Clinical exploration through recreational activities will be a primordial tool in the daily work with children. It will also be recommendable that the plan of the treatment be organized jointly with the parents of the minor in order to inform them completely about the goals and objectives of the prescription of a drug; the participation of the small patient must be included too. It must not be forgotten that the pharmacological treatment is part of a more integral attention program in which other experts must participate, such as pedagogues, clinical psychologists or language therapists, a fact that will be more common than irregular. The therapeutic adherence is a variable that must be constantly checked. If it is carried out irregularly or the wrong dose of the recommended drug is taken, the presence of symptoms as a result of the abrupt interruption of the medication could be confused with the adverse collateral effects, which would make worse the clinical condition. Pediatric patients must have a complete medical history complemented by a physical and neurological evaluation, which must be included in the registry of vital constants as well as size and weight of the minor; other registers could be more convenient if they are considered to be needed. The support on laboratory surveys plays an important roll and at the present time the recommendation for making an electro-cardiography evaluation previous to the administration of some drugs is more accepted; in this sense it is undoubtedly important to consider the recommendations proposed by the American Association of Cardiology for monitoring the cardiovascular function of children and teen-agers who receive medications after prolonged periods of time. Polypharmacy is a common practice; due to this fact, the interaction between drug/ drug must be carefully valued. The child psychiatric evaluation must be made with the support of structured or semistructured interviews for the clinical diagnosis and with evaluation scales for measuring the severity of the specific symptoms or global clinical conditions. The strategy for choosing a plan of pharmacological treatment for the pediatric patient must be made individually; in this sense, the development of algorithms for the administration of medications on children and teenagers has been the result of many efforts in order to make prescriptions more rational and neat. The revision of controlled clinical tests on the efficacy and security of these agents in the pediatric population is fundamental for the election of a prescription. The responsibility of the professional that prescribes a medication devolves on structuring a plan of formal treatment and an individualized monitoring according to the stages of the treatment (beginning, maintenance and interruption ). As it is expected, the expert must reach the maximum therapeutic benefit in a child or an adolescent with the minimum of collateral effects, evaluating always the risk and the benefits. Some authors recommend the prescription of drugs on children and teen-agers only for short periods of time as the nondesirable effects in long terms are not quite well known. There are no specific times for stopping the administration of a drug. However, it is recommended that during the stages of the treatment, clinical changes in minors be watched and registered rigorously, in order to be able to reduce or stop the dose in the appropriate moment, even in cases of clinical conditions such as schizophrenia, depression or development generalized disorders. The main objective of this clinical work will be that the quality of life of the minor becomes optimum.

A Primary Study on the General Principles of Treatment and the Symptoms System Based on the Four-Season Model in Treatise on Febrile Disease / 浙江中医药大学学报

Based on the discuss of Yin-Yang in classics, five states method is reasoned,in which one of the states is indescribable,without no disbalance between Yin and Yang, and the rest could be named by more or less in Yinqi or Yangqi as pathologic states. To state the pathologic states, Zhang Zhongjing had established a six-disease system named by Yin-Yang which benefited from the Four-Season Model in Neijing Bible as reference. Therefore the general principle of treatments and the six-disease system in Treatise on Febrile Disease, such as “the patients in a state of Autumn unbalance sould be treated with cathartic while that in Summer unbalance treated with diaphoretic”, can be easily understood in the Four-Season Model.