Global aesthetic surgery statistics: a closer look.

INTRODUCTION: Obtaining quality global statistics about surgical procedures remains an important yet challenging task. The International Society of Aesthetic Plastic Surgery (ISAPS) reports the total number of surgical and non-surgical procedures performed worldwide on a yearly basis. While providing valuable insight, ISAPS' statistics leave two important factors unaccounted for: (1) the underlying base population, and (2) the number of surgeons performing the procedures. METHODS: Statistics of the published ISAPS' 'International Survey on Aesthetic/Cosmetic Surgery' were analysed by country, taking into account the underlying national base population according to the official United Nations population estimates. Further, the number of surgeons per country was used to calculate the number of surgeries performed per surgeon. RESULTS: In 2014, based on ISAPS statistics, national surgical procedures ranked in the following order: 1st USA, 2nd Brazil, 3rd South Korea, 4th Mexico, 5th Japan, 6th Germany, 7th Colombia, and 8th France. When considering the size of the underlying national populations, the demand for surgical procedures per 100,000 people changes the overall ranking substantially. It was also found that the rate of surgical procedures per surgeon shows great variation between the responding countries. CONCLUSION: While the US and Brazil are often quoted as the countries with the highest demand for plastic surgery, according to the presented analysis, other countries surpass these countries in surgical procedures per capita. While data acquisition and quality should be improved in the future, valuable insight regarding the demand for surgical procedures can be gained by taking specific demographic and geographic factors into consideration.

Patterns of Phylogenetic Diversity of Subtropical Rainforest of the Great Sandy Region, Australia Indicate Long Term Climatic Refugia.

Australia's Great Sandy Region is of international significance containing two World Heritage areas and patches of rainforest growing on white sand. Previous broad-scale analysis found the Great Sandy biogeographic subregion contained a significantly more phylogenetically even subset of species than expected by chance contrasting with rainforest on white sand in Peru. This study aimed to test the patterns of rainforest diversity and relatedness at a finer scale and to investigate why we may find different patterns of phylogenetic evenness compared with rainforests on white sands in other parts of the world. This study focussed on rainforest sites within the Great Sandy and surrounding areas in South East Queensland (SEQ), Australia. We undertook field collections, expanded our three-marker DNA barcode library of SEQ rainforest plants and updated the phylogeny to 95% of the SEQ rainforest flora. We sampled species composition of rainforest in fixed area plots from 100 sites. We calculated phylogenetic diversity (PD) measures as well as species richness (SR) for each rainforest community. These combined with site variables such as geology, were used to evaluate patterns and relatedness. We found that many rainforest communities in the Great Sandy area were significantly phylogenetically even at the individual site level consistent with a broader subregion analysis. Sites from adjacent areas were either not significant or were significantly phylogenetically clustered. Some results in the neighbouring areas were consistent with historic range expansions. In contrast with expectations, sites located on the oldest substrates had significantly lower phylogenetic diversity (PD). Fraser Island was once connected to mainland Australia, our results are consistent with a region geologically old enough to have continuously supported rainforest in refugia. The interface of tropical and temperate floras in part also explains the significant phylogenetic evenness and higher than expected phylogenetic diversity.

"Natural" human leukocyte antigen antibodies found in nonalloimmunized healthy males.

BACKGROUND: Human leukocyte antigen (HLA) antibodies were normally not found in subjects who have not been immunized by pregnancies, transfusions, or transplants. But with new methodology, we now see that HLA antibodies are often found in nonalloimmunized males. METHODS: The sera of 424 healthy male donors were tested with single antigen Luminex beads. RESULTS: Human leukocyte antigen antibodies were detected in 63% of 424 male blood donors when a fluorescent value of more than 1000 was used as the cutoff. Antibodies to class I was found in 42%, class II in 11% and both in 12%. Five males who were tested eight times over a 6-month period consistently had the same specificity at similar strength levels at each testing. The antibodies reacted with specificities that are rare in the general population: 18.9% had antibodies to A*3002; more than 10% had antibodies to A*3101, B76, B*8201, and Cw*1701. About half of the donors with antibodies had one or two specificities; the other half had three or more specificities. Among those with class II specificities, 20.5% had antibodies to DPA1*0201/DPB1*0101, and 10.8% to DQA1*0503/DQB1*0301. Because the above data were obtained by testing sera of 424 Mexican donors, as a check, 29 males in Los Angeles were tested and shown to have similar specificities at roughly similar frequencies. CONCLUSIONS: Normal males were found to have HLA antibodies to infrequent HLA specificities. It is likely that these HLA antibodies are produced to cross-reactive epitopes found in microorganisms, ingested proteins and allergens-making them natural antibodies.

Epitopes of HLA antibodies found in sera of normal healthy males and cord blood.

This chapter defines epitopes targeted by antibodies in the sera of two populations of healthy normal males and in cord blood samples from a third population. These epitopes are accessible for antibody binding on either the intact or dissociated forms of recombinant HLA class I single antigens. Sixty percent of these epitopes are defined by hidden amino acids, and are therefore designated as cryptic epitopes. All sera were tested in parallel, using single antigen beads that bore either intact or dissociated recombinant HLA antigens. Ninety-six HLA class I epitopes were characterized as epitopes of these antibodies. More than half were private epitopes, and the rest were shared by two-to-18 HLA antigens. Fifty-eight (60%) epitopes were accessible on dissociated HLA antigens. Of these, 41 were defined by hidden amino acids, 13 by at least one hidden amino acid in addition to exposed amino acids, and four were defined by exposed amino acids. Almost all epitopes were found exclusively on either A-, B-, or C-locus antigens--except for one inter-locus epitope. Antibodies with nearly identical specificities were found in all three of the tested populations. Most of these antibodies target epitopes that are accessible only on the dissociated forms of the HLA class I antigens. Specificities of such antibodies are unavoidably detected when testing for specificities of alloantibodies so it may be necessary to clearly differentiate the two forms of antibody. The relevance of these antibodies in transplantation is not yet known. But even if they are shown to be irrelevant to graft rejection, awareness of the newly identified epitopes could prove useful in avoiding unnecessary exclusion of potential transplant donors.

The influence of house construction on the indoor abundance of mosquitoes.

This study examined the potential effects of different house construction features on the indoor abundance of culicine mosquitoes in Trinidad (TT) and the Dominican Republic (DR) using xenomonitoring surveys. To assess these effects, a survey was taken of different homes in both countries alongside concurrent indoor resting mosquito collections to determine which features may be correlated with a greater abundance. Between June 2002 and April 2003 data were collected from 104 homes in TT and 121 homes in the DR. In TT, 61 (58.65%) of the homes were located in urban areas and 43 (41.35%) were located in rural villages, whereas in the DR 40 (33.06%) were located in rural areas, and 81 (66.94%) in the urban area. Overall, a total of 1,630 mosquitoes were collected in TT, of which 77% were Culex quinquefasciatus, whereas 459 mosquitoes were collected from the DR, of which 46% were Cx. quinquefasciatus. It was found that in TT and the DR the mean number of Cx. quinquefasciatus mosquitoes was greater in cement homes than in either wood or other poorer quality homes (TT cement 17.43, others 14.43; DR cement 4.24, others 3.41). In TT it was found that homes that had painted interiors were significantly more likely to have a high abundance of mosquitoes resting indoors compared to homes without painted interiors (OR 2.90, CI 1.09-8.72). Likewise, having a painted exterior was not significant, but only slightly so, in TT as having a detrimental effect (OR 2.14, CI 0.89-6.67). Similarly, having a painted interior or exterior was also found to be a predictor of a high abundance of indoor resting mosquitoes in the DR (interior OR 3.13, CI 1.41-6.92; exterior OR 1.97, CI .91-4.26). Reduced adult abundance in TT was correlated with homes being built on stilts, with more than four people sleeping in the home, and having a painted interior. In the DR, reductions were correlated with homes where residents slept under a bed net and with people who lived in a rural location. Changes in construction patterns in the Caribbean region could help prevent human-mosquito contact potentially reducing the transmission of certain vector-borne diseases in the population.

Interpreting satellite column observations of formaldehyde over tropical South America.

Space-borne column measurements of formaldehyde (HCHO), a high-yield oxidation product of volatile organic compounds (VOCs), represent important constraints for quantifying net regional fluxes of VOCs. Here, we interpret observed distributions of HCHO columns from the Global Ozone Monitoring Experiment (GOME) over tropical South America during 1997-2001. We present the first comparison of year-long in situ isoprene concentrations and fire-free GOME HCHO columns over a tropical ecosystem. GOME HCHO columns and in situ isoprene concentrations are elevated in the wet and dry seasons, with the highest values in the dry season. Previous analysis of the in situ data highlighted the possible role of drought in determining the elevated concentrations during the dry season, inferring the potential of HCHO columns to provide regional-scale constraints for estimating the role of drought on isoprene emissions. The agreement between the observed annual cycles of GOME HCHO columns and Along-Track Scanning Radiometer firecount data over the Amazon basin (correlations typically greater than 0.75 for a particular year) illustrates the potential of HCHO column to provide quantitative information about biomass burning emissions.

Histopathology and immunohistochemistry of the caecum in children with the Trichuris dysentery syndrome

Caecal biopsy specimens from Jamaican children with the Trichuris dysentery syndrome (TDS) and age matched Jamaican controls were investigated by immunohistochemistry and by light microscopy. Biopsy specimens from all children (with TDS and controls) showed a mild to moderate increase in inflamatory cells. Except in the vicinity of the worm, where the epithlium was flattened, there was no other epithelial abnormality. Compared with controls, children with TDS had increased IgM lamina propria plasma cells and decreased intaepithelial T cells. There was also an increase in crypt epithelial cells proliferation. Lamina propia T cells (both activated and non-activated) were no more common in children with the Trichuris syndrome than controls. Epithelial cell HLA-DR and VLA-1 expression (which are increased in other colitides) were the same in both groups. Despite the presence of large worm burdens and chronic dysentery, therefore, only minor changes were seen in the caecal mucosa of children with TDS. (AU)