Orbital haematoma after orbital fracture repair using silicone, polytetrafluorethylene, and poly-L-lactic acid/hydroxyapatite implants.

The purpose of this paper was to report the incidence of orbital haematoma formation following the repair of orbital fractures with silicone, polytetrafluorethylene (PTFE), and poly-L-lactic acid/hydroxyapatite (PLLA/HA) implants. This retrospective review examined 234 patients (235 sides) who underwent repair of orbital wall fractures over a six-year period. Of these, 36 patients received a silicone sheet; 49 patients received a silicone sheet with superimposed PTFE implant; and 149 patients (150 sides) received PTFE with or without an underlying PLLA/HA implant. Orbital haematomas were documented in 13 out of 36 patients (36.1%) who underwent fracture repair with a silicone sheet; seven out of 49 patients (14.3%) who had a silicone sheet with a superimposed PTFE implant; and three out of 150 sides (2.0%) with PTFE with or without underlying PLLA/HA. The difference in incidence of orbital haematoma formation was significant among the groups (p < 0.001, Pearson's chi squared test). In the silicone sheet group, haematomas formed within two weeks of surgery in 11 patients (84.6%). In the silicone sheet with superimposed PTFE implant group, five patients (71.4%) developed orbital haematomas no earlier than after two weeks postoperatively. This study showed that the incidence of orbital haematoma formation following orbital fracture repair is different among the implant materials. The use of PTFE and PLLA/HA implants may minimise this complication.

Mars Extant Life: What's Next? Conference Report.

On November 5-8, 2019, the "Mars Extant Life: What's Next?" conference was convened in Carlsbad, New Mexico. The conference gathered a community of actively publishing experts in disciplines related to habitability and astrobiology. Primary conclusions are as follows: A significant subset of conference attendees concluded that there is a realistic possibility that Mars hosts indigenous microbial life. A powerful theme that permeated the conference is that the key to the search for martian extant life lies in identifying and exploring refugia ("oases"), where conditions are either permanently or episodically significantly more hospitable than average. Based on our existing knowledge of Mars, conference participants highlighted four potential martian refugium (not listed in priority order): Caves, Deep Subsurface, Ices, and Salts. The conference group did not attempt to reach a consensus prioritization of these candidate environments, but instead felt that a defensible prioritization would require a future competitive process. Within the context of these candidate environments, we identified a variety of geological search strategies that could narrow the search space. Additionally, we summarized a number of measurement techniques that could be used to detect evidence of extant life (if present). Again, it was not within the scope of the conference to prioritize these measurement techniques-that is best left for the competitive process. We specifically note that the number and sensitivity of detection methods that could be implemented if samples were returned to Earth greatly exceed the methodologies that could be used at Mars. Finally, important lessons to guide extant life search processes can be derived both from experiments carried out in terrestrial laboratories and analog field sites and from theoretical modeling.

The amino-terminal domain of ORF149 of koi herpesvirus is preferentially targeted by IgM from carp populations surviving infection.

Recombinantly expressed fragments of the protein encoded by ORF149 (pORF149), a structural protein from the common- and koi-carp-infecting cyprinid herpesvirus-3 (CyHV-3) that was previously shown to be antigenic, were used to obtain evidence that its amino-terminal part contains immunodominant epitopes in fish populations that survived the infection. To obtain such evidence, nonspecific binding of carp serum tetrameric IgM had to be overcome by a novel ELISA protocol (rec2-ELISA). Rec2-ELISA involved pre-adsorption of carp sera with a heterologous recombinant fragment before incubation with pORF149 fragments and detection with anti-carp IgM monoclonal antibodies. Only in this way was it possible to distinguish between sera from uninfected and survivor carp populations. Although IgM from survivors recognised pORF149 fragments to a lesser degree than whole virus, specificity was confirmed by correlation of rec2- and CyHV-3-ELISAs, inhibition of rec2-ELISA by an excess of frgIIORF149, ELISA using IgM-capture, Western blotting, and reduction of reactivity in CyHV-3-ELISA by pre-adsorption of sera with frgIIORF149. The similarity of IgM-binding profiles between frgIORF149 (amino acid residues 42-629) and frgIIORF149 (42-159) and their reactivities with previously described anti-CyHV-3 monoclonal antibodies confirmed that most pORF149 epitopes were localised in its amino-terminal part.

Subglacial Lake Whillans microbial biogeochemistry: a synthesis of current knowledge.

Liquid water occurs below glaciers and ice sheets globally, enabling the existence of an array of aquatic microbial ecosystems. In Antarctica, large subglacial lakes are present beneath hundreds to thousands of metres of ice, and scientific interest in exploring these environments has escalated over the past decade. After years of planning, the first team of scientists and engineers cleanly accessed and retrieved pristine samples from a West Antarctic subglacial lake ecosystem in January 2013. This paper reviews the findings to date on Subglacial Lake Whillans and presents new supporting data on the carbon and energy metabolism of resident microbes. The analysis of water and sediments from the lake revealed a diverse microbial community composed of bacteria and archaea that are close relatives of species known to use reduced N, S or Fe and CH4 as energy sources. The water chemistry of Subglacial Lake Whillans was dominated by weathering products from silicate minerals with a minor influence from seawater. Contributions to water chemistry from microbial sulfide oxidation and carbonation reactions were supported by genomic data. Collectively, these results provide unequivocal evidence that subglacial environments in this region of West Antarctica host active microbial ecosystems that participate in subglacial biogeochemical cycling.

Review of brucellosis cases from laboratory exposures in the United States in 2008 to 2011 and improved strategies for disease prevention.

Five laboratory-acquired brucellosis (LAB) cases that occurred in the United States between 2008 and 2011 are presented. The Centers for Disease Control and Prevention (CDC) reviewed the recommendations published in 2008 and the published literature to identify strategies to further prevent LAB. The improved prevention strategies are described.

A two-part model for reference curve estimation subject to a limit of detection.

Reference curves are commonly used to identify individuals with extreme values of clinically relevant variables or stages of progression which depend naturally on age or maturation. Estimation of reference curves can be complicated by a technical limit of detection (LOD) that censors the measurement from the left, as is the case in our study of reproductive hormone levels in boys around the time of the onset of puberty. We discuss issues with common approaches to the LOD problem in the context of our pubertal hormone study, and propose a two-part model that addresses these issues. One part of the proposed model specifies the probability of a measurement exceeding the LOD as a function of age. The other part of the model specifies the conditional distribution of a measurement given that it exceeds the LOD, again as a function of age. Information from the two parts can be combined to estimate the identifiable portion (i.e. above the LOD) of a reference curve and to calculate the relative standing of a given measurement above the LOD. Unlike some common approaches to LOD problems, the two-part model is free of untestable assumptions involving unobservable quantities, flexible for modeling the observable data, and easy to implement with existing software. The method is illustrated with hormone data from the Third National Health and Nutrition Examination Survey.

Seasonal 25-hydroxyvitamin D changes in British postmenopausal women at 57 degrees N and 51 degrees N: a longitudinal study.

The UK has insufficient intensity of sunlight at wavelengths 290-315 nm to enable cutaneous synthesis of vitamin D from October to April. There are regional differences in UVB strength throughout the UK but whether this translates to differences in vitamin D status is not known. We have reported seasonal variations in a cross-sectional study of over 3000 Scottish women in Aberdeen. The aim of this longitudinal study was to compare the seasonal variation of serum 25-hydroxyvitamin D [25(OH)D] in postmenopausal women residing in Aberdeen (57 degrees N) and Surrey (51 degrees N). Women attended 3-monthly visits over 12 months, starting summer 2006. In Aberdeen, 338 Caucasian women (mean age+/-SD, 61.7+/-1.5 years); and at Surrey, 138 Caucasian women (61.4+/-4.5 years) and 35 Asian women (59.9+/-6.4 years) had serum 25(OH)D measured by IDS enzyme immunoassay. In winter/spring none of the Caucasian women living in Surrey had 25(OH)D<20 nmol/L, but nearly a quarter of women in Aberdeen were vitamin D-deficient. This number decreased to 4.2% in summer/autumn. For the Asian women 17.1% were vitamin D-deficient in summer, increasing to 58.1% in winter. Using higher 25(OH)D deficiency cut-offs, the percentage of women affected was much higher. These longitudinal data show clear differences in vitamin D status between the north and south of the UK, and marked ethnic differences. They are consistent with our previous data and with cross-sectional data from the 1958 birth cohort. The low vitamin D status may have implications for bone health and other health outcomes, which is currently being investigated in this publication group. The extent of vitamin D deficiency in Asian women residing in the South of England is of concern.

Consensus statement on terminology and management: disorders of sex development.

The recent consensus conference addressed several aspects of the care of patients with Disorders of Sex Development (DSD). Among these were proposals regarding a new terminology to classify patients, medical, surgical and psychological care and the decision regarding sex of rearing or gender assignment for those with the most severe forms of genital ambiguity. However, a basis was found to be lacking for the assignment of sex of rearing for many diagnoses as well as for some for whom no diagnosis could be made. Also, no consensus could be made concerning genital surgery, particularly in response to the call to defer all genital surgery until the age a child could decide. This in part involved the lack of a clear indication of the point when a person has arrived at a state of maturity enabling such a decision. However, consensus was reached that genital surgery should be performed for the infant with significant ambiguity, in spite of the lack of outcome data, when the parents unequivocally desire. It was clear that desired outcome data will not be available for decades, if ever. Also, blatantly lacking are adequate data concerning the impact of prenatal androgen on the fetal central nervous system regarding subsequent development of gender and sexual issues.

Local moment, itinerancy, and deviation from Fermi-liquid behavior in NaxCoO2 for 0.71< or = x < or =0.84.

Here we report the observation of Fermi surface (FS) pockets via the Shubnikov-de Haas effect in NaxCoO2 for x=0.71 and 0.84, respectively. Our observations indicate that the FS expected for each compound intersects their corresponding Brillouin zones, as defined by the previously reported superlattice structures, leading to small reconstructed FS pockets, but only if a precise number of holes per unit cell is localized. For 0.71< or = x < 0.75 the coexistence of itinerant carriers and localized S=1/2 spins on a paramagnetic triangular superlattice leads at low temperatures to the observation of a deviation from standard Fermi-liquid behavior in the electrical transport and heat capacity properties, suggesting the formation of some kind of quantum spin-liquid ground state.

Shubnikov-de Haas effect in the metallic state of Na0.3CoO2.

Shubnikov-de Haas oscillations for two well-defined frequencies, corresponding, respectively, to areas of 0.8 and 1.36% of the first Brillouin zone, were observed in single crystals of Na(0.3)CoO2. The existence of Na superstructures in Na0.3CoO2, coupled with this observation, suggests the possibility that the periods are due to the reconstruction of the large Fermi surface around the Gamma point. An alternative interpretation in terms of the long sought-after epsilon'(g) pockets is also considered but found to be incompatible with existing specific heat data.

Consensus statement on management of intersex disorders.

The birth of an intersex child prompts a long-term management strategy that involves a myriad of professionals working with the family. There has been progress in diagnosis, surgical techniques, understanding psychosocial issues and in recognizing and accepting the place of patient advocacy. The Lawson Wilkins Paediatric Endocrine Society (LWPES) and the European Society for Paediatric Endocrinology (ESPE) considered it timely to review the management of intersex disorders from a broad perspective, to review data on longer term outcome and to formulate proposals for future studies. The methodology comprised establishing a number of working groups whose membership was drawn from 50 international experts in the field. The groups prepared prior written responses to a defined set of questions resulting from an evidence based review of the literature. At a subsequent gathering of participants, a framework for a consensus document was agreed. This paper constitutes its final form.

Shubnikov-de Haas oscillations and the magnetic-field-induced suppression of the charge ordered state in Na(0.5)CoO2.

We have performed electrical transport measurements at low temperatures and high magnetic fields in Na(0.5)CoO2 single crystals. Shubnikov-de Haas oscillations corresponding to only 1% of the area of the orthorhombic Brillouin zone were clearly observed, indicating that most of the original Fermi surface vanishes at the charge-ordering (CO) transition. In-plane magnetic fields were found to suppress strongly the CO state. For fields rotated within the conducting planes, we observe angular magnetoresistance oscillations whose periodicity changes from twofold to sixfold at the transition.

Thermodynamic and transport measurements of superconducting Na0.3CoO2.1.3H2O single crystals prepared by electrochemical deintercalation.

Superconducting single crystal samples of Na0.3CoO2.1.3H(2)O have been produced using an electrochemical technique which dispenses with the usual bromine chemical deintercalation method. In fully hydrated crystals, susceptibility and specific heat measurements confirm that bulk superconductivity has been achieved. The extracted normal state density of states indicates Fermi-liquid behavior with strong mass enhancement and a modest Wilson ratio. Measurements of H(c2) for H parallel c and H parallel ab reveal significant anisotropy, and the extracted value for the coherence length is about 100 A, consistent with an extremely narrow bandwidth.

Characterization of nuclease-resistant ribozymes directed against hepatitis B virus RNA.

Hepatitis B virus (HBV) is responsible for > 350 million cases of chronic hepatitis B worldwide and 1.2 million deaths each year. To explore the use of ribozymes as a novel therapy for HBV infection, nuclease-resistant ribozymes that target highly conserved regions of HBV RNA were screened in cell culture. These synthetic ribozymes have the potential to cleave all four major HBV RNA transcripts and to block the HBV lifecycle by cleavage of the pregenomic RNA. A number of the screened ribozymes demonstrate activity in cell culture systems, as measured by decreased levels of HBV surface antigen, HBV e antigen and HBV DNA. In addition, a lead anti-HBV ribozyme maintains activity against a lamivudine-resistant HBV variant in cell culture. Treatment of HBV transgenic mice with lead anti-HBV ribozymes significantly reduced viraemia compared with saline-treated animals and was as effective as treatment with lamivudine. In conclusion, the therapeutic use of a ribozyme alone or in combination with current therapies (lamivudine or interferons) may lead to improved HBV therapy.

Laser in situ keratomileusis with a scanning excimer laser for the correction of low to moderate myopia with and without astigmatism.

PURPOSE: To evaluate the safety and effectiveness of and patient satisfaction with laser in situ keratomileusis (LASIK) performed with a scanning excimer laser by experienced surgeons to correct low and moderate levels of myopia and astigmatism. SETTING: Clinique Laservue, Montreal, Quebec, Canada. METHODS: A consecutive series of 125 patients (236 eyes) with myopia of -0.5 to -7.0 diopters (D) and cylinder less than 2.5 D were enrolled in this single-center prospective clinical trial. The patients were treated with LASIK and followed for 6 months. The System-ALK Automated Corneal Shaper microkeratome (Bausch & Lomb Surgical) with a 180 microm thickness plate and the Technolas 217 excimer laser (Bausch & Lomb Surgical) with PlanoScan software for the stromal ablation were used in all procedures. Since this version of PlanoScan tended to undercorrect, a mean of 14.7% was added to the standard nomogram. Patient satisfaction was assessed by questionnaires administered preoperatively and 1 and 6 months postoperatively. Retreatments for enhancement were not performed during the 6-month follow-up. RESULTS: Six months after LASIK (86.4% follow-up), the mean postoperative manifest spherical equivalent was +0.02 D +/- 0.64 (SD) compared with a preoperative mean of -4.01 +/- 1.59 D. The uncorrected visual acuity was 20/40 or better in 94.6% of eyes and 20/20 or better in 81.9%. A total of 91.2% were within +/-1.0 D of emmetropia and 73.0% were within +/-0.5 D. Only 2 eyes were overcorrected by >1.0 D. Of the eyes with astigmatic myopia, 86.8% were within +/-1.0 D of the intended cylinder correction (by vector analysis) and 73.0% were within +/-0.5 D. The refractions were generally stable after 1 month, and the change in refraction between postoperative examinations was within +/-0.5 D in 88.0% of eyes. A 1-line decrease in best spectacle-corrected visual acuity was seen in 11.3% of eyes, and no eye lost more than 1 line. An increase of 1 or 2 lines was seen in 45.1%. No intraoperative problems occurred, and the interface was clear in all eyes. At 6 months, most symptoms present significantly more frequently than preoperatively were "mild"; none were "marked" or "severe." A total of 90.5% of eyes were reported with marked to extreme improvement in the overall quality of vision, and 99.0% of patients said they would choose LASIK surgery again. CONCLUSIONS: Mild to moderate myopia, with and without astigmatism, was corrected safely, effectively, and predictably with a high degree of patient satisfaction using LASIK with a scanning excimer laser and the System-ALK Automated Corneal Shaper.

Fertility after unilateral cryptorchidism. Paternity, time to conception, pretreatment testicular location and size, hormone and sperm parameters.

OBJECTIVE: To further evaluate whether fertility is decreased among a cohort of men with previous unilateral cryptorchidism as compared with a control group of men. SUBJECTS AND METHODS: Formerly unilateral cryptorchid men who had undergone orchiopexy between the years of 1955 and 1975 at the Children's Hospital of Pittsburgh and a control group of men who were matched for age of an unrelated surgery at the same institution were evaluated by review of medical records and by completion of a questionnaire. 359 previously cryptorchid men were identified as having attempted paternity. Of these men, 320 had information concerning preoperative testicular location and 163 for preoperative testicular size. 106 of these men had levels of testosterone, inhibin B, FSH, and LH measured, while 95 of the men had semen analyses. RESULTS: Among men who had attempted paternity, there was no statistical difference in success of paternity between the previously unilateral group (89.7%) and the control group (93.7%). There was no difference in the mean time to conception (7.1 +/- 0.7 months for the unilateral group vs. 6.9 +/- 2.3 for the control group). Within the unilateral group in regard to success at paternity, no difference was found compared with the age of orchiopexy, preoperative testicular location, or preoperative testicular size. Inhibin B levels were lower among the unilateral group. FSH, LH, testosterone, sperm density, motility and morphology were not different, but considerable variation was noted within the cryptorchid group. CONCLUSIONS: In this continued evaluation of a cohort of previously cryptorchid men who had undergone unilateral orchiopexy, paternity does not appear to be significantly compromised after unilateral cryptorchidism. Unilateral cryptorchidism appears to be one of several factors contributing to infertility, similar to those found in the general population. No correlation was found between success at paternity and the age of orchiopexy, preoperative testicular size or preoperative testicular location. Inhibin B levels were lower while FSH, LH, T and sperm parameters did not differ.

Cultural predictors of self-esteem: a study of Chinese American female and male young adults.

This study examined how specific domains of cultural orientation (language, social affiliation, and cultural pride) related to self-esteem for a sample of 174 Chinese American male and 179 Chinese American female college students. Participants completed measures of cultural orientation (General Ethnicity Questionnaire; J.L. Tsai, Y.W. Ying, & P.A. Lee, 2000) and self-esteem (M. Rosenberg, 1965). Cultural orientation significantly predicted self-esteem, above and beyond the contribution of age, gender, grade point average, and socioeconomic status. Specifically, proficiency in English and Chinese languages and pride in Chinese culture were positively correlated with self-esteem, whereas affiliation with Chinese people was negatively correlated with selfesteem. The cultural predictors of self-esteem differed for Chinese American men and women. Whereas self-esteem was mainly related to pride in Chinese culture for Chinese American women, self-esteem was mainly related to English and Chinese language proficiency for Chinese American men. Implications of these findings for understanding Asian Americans are discussed.

Relationship of young adult Chinese Americans with their parents: variation by migratory status and cultural orientation.

To examine whether Chinese and American cultural orientations mediate the association between migratory status and parent relationship, 122 American-born, 121 early-immigrant, and 110 late-immigrant Chinese young adults were measured on cultural orientation and parent relationship. The poorest relationships were found in the early-immigrant group. Cultural orientation mediated the difference in parent relationship between early and late immigrant groups, but not between early-immigrant and American-born groups. Implications of the findings for research and practice are discussed.