Modified transseptal approach in endoscopic transsphenoidal pituitary surgery.

OBJECTIVE: Transsphenoidal pituitary surgery is commonly performed via a direct transostial approach with a posterior septectomy. However, a technique via an endoscopic transseptal route has been described that avoids a posterior septectomy, but it comes with its own disadvantages. METHODS: This paper describes a modification, and discusses its pros and cons. RESULTS: The initial incision in the mucosa is placed level with the anterior middle turbinate. The mucoperichondrial flap is raised ipsilaterally until the sphenoid sinus ostium. An incision is made at the osseocartilaginous junction, and the contralateral mucoperichondrial flap is raised. The bony septum and posterior aspect of this flap is excised. The size and position of this window can be adapted. At the end of the operation, the lateralised intact mucoperichondrial flap is moved back to the midline. CONCLUSION: Excision or deflection of the cartilaginous septum is not required. It maintains an intact septal mucosa on one side and avoids a septal perforation.

Prevalence of Sexual Victimization Among Female and Male College Students: A Methodological Note With Data.

This study provides insight on how sample recruitment methods may affect reported rates of sexual victimization on college campuses. The study compares sexual victimization rates among students who complete surveys after initial requests with those who complete them only after multiple reminders. Using probability sampling methods, undergraduate students from 12 universities were invited to complete a survey on campus violence; initial invitations were followed with up to five reminders. Women (n = 1,008) and men (n = 344) who completed surveys were categorized as early, middle, or late responders based on the number of reminders required to convert them from non-responders to responders. About 24.2% of women and 15.6% of men reported sexual victimization in the previous two months. In initial analyses, female early and late responders did not differ on sexual victimization, but males did. Male late responders reported higher rates of sexual victimization than early responders. In sensitivity analyses that re-defined early and late responders, women who were early responders reported more sexual victimization than women who were late responders, while men who were early responders reported less sexual victimization than men who were late responders. These findings suggest that researchers may underestimate sexual victimization rates for male college students unless multiple attempts are made to solicit their participation. Researchers are encouraged to utilize multiple reminders to increase research participation.

Students in a Course-Based Undergraduate Research Experience Course Discovered Dramatic Changes in the Bacterial Community Composition Between Summer and Winter Lake Samples.

Course-based undergraduate research experience (CURE) courses incorporate high-impact pedagogies that have been shown to increase undergraduate retention among underrepresented minorities and women. As part of the Building Infrastructure Leading to Diversity program at the University of Detroit Mercy, a CURE metagenomics course was established in the winter of 2019. Students investigated the bacterial community composition in a eutrophic cove in Lake Saint Clair (Harrison Township, MI, United States) from water samples taken in the summer and winter. The students created 16S rRNA libraries that were sequenced using next-generation sequencing technology. They used a public web-based supercomputing resource to process their raw sequencing data and web-based tools to perform advanced statistical analysis. The students discovered that the most common operational taxonomic unit, representing 31% of the prokaryotic sequences in both summer and winter samples, corresponded to an organism that belongs to a previously unidentified phylum. This result showed the students the power of metagenomics because the approach was able to detect unclassified organisms. Principal Coordinates Analysis of Bray-Curtis dissimilarity index data showed that the winter community was distinct from the summer community [Analysis of Similarities (ANOSIM) r = 0.59829, n = 18, and p < 0.001]. Dendrograms based on hierarchically clustered Pearson correlation coefficients of phyla were divided into a winter clade and a summer clade. The conclusion is that the winter bacterial population was fundamentally different from the summer population, even though the samples were taken from the same locations in a protected cove. Because of the small class sizes, qualitative as well as statistical methods were used to evaluate the course's impact on student attitudes. Results from the Laboratory Course Assessment Survey showed that most of the respondents felt they were contributing to scientific knowledge and the course fostered student collaboration. The majority of respondents agreed or strongly agreed that the course incorporated iteration aspects of scientific investigations, such as repeating procedures to fix problems. In summary, the metagenomics CURE course was able to add to scientific knowledge and allowed students to participate in authentic research.

The Emergence of New Psychoactive Substance (NPS) Benzodiazepines. A Survey of their Prevalence in Opioid Substitution Patients using LC-MS

Benzodiazepines have a wide range of clinical uses being among the most commonly prescribed medicines globally. The EU Early Warning System on new psychoactive substances (NPS) has over recent years detected new illicit benzodiazepines in Europe's drug market1. Additional reference standards were obtained and a multi-residue LCMS method was developed to test for 31 benzodiazepines or metabolites in urine including some new benzodiazepines which have been classified as New Psychoactive Substances (NPS) which comprise a range of substances, including synthetic cannabinoids, opioids, cathinones and benzodiazepines not covered by international drug controls. 200 urine samples from patients attending the HSE National Drug Treatment Centre (NDTC) who are monitored on a regular basis for drug and alcohol use and which tested positive for benzodiazepine class drugs by immunoassay screening were subjected to confirmatory analysis to determine what Benzodiazepine drugs were present and to see if etizolam or other new benzodiazepines are being used in the addiction population currently. Benzodiazepine prescription and use is common in the addiction population. Of significance we found evidence of consumption of an illicit new psychoactive benzodiazepine, Etizolam.

Continuous digital hypothermia prevents lamellar failure in the euglycaemic hyperinsulinaemic clamp model of equine laminitis.

BACKGROUND: Continuous digital hypothermia can prevent the development and progression of laminitis associated with sepsis but its effects on laminitis due to hyperinsulinaemia are unknown. OBJECTIVES: To determine the effects of continuous digital hypothermia on laminitis development in the euglycaemic hyperinsulinaemic clamp model. STUDY DESIGN: Randomised, controlled (within subject), blinded, experiment. METHODS: Eight clinically normal Standardbred horses underwent laminitis induction using the euglycaemic hyperinsulinaemic clamp model (EHC). At initiation of the EHC, one forelimb was continuously cooled (ICE), with the other maintained at ambient temperature (AMB). Dorsal lamellar sections (proximal, middle, distal) were harvested 48 h after initiation of the EHC and were analysed using histological scoring (0-3) and histomorphometry. Cellular proliferation was quantified by counting epidermal cell nuclei staining positive with an immunohistochemical proliferation marker (TPX2). RESULTS: Severe elongation and disruption of SEL with dermo-epidermal separation (score of 3) was observed in all AMB feet at one or more section locations, but was not observed in any ICE sections. Overall 92% of the AMB sections received the most severe histological score (grade 3) and 8% were grade 2, whereas ICE sections were classified as either grade 1 (50%) or grade 2 (50%). Relative to AMB feet, ICE sections were 98% less likely to exhibit grades 2 or 3 (OR: 0.02, 95% CI 0.001, 0.365; P<0.01). Histomorphometry measurements of total and nonkeratinised primary epidermal lamellar length were significantly increased (P<0.01) in AMB limbs compared with ICE. TPX2 positive cell counts were significantly increased (P<0.01) in AMB limbs compared with ICE. MAIN LIMITATIONS: Continuous digital hypothermia was initiated before recognition of laminitis and therefore the clinical applicability requires further investigation. CONCLUSIONS: Continuous digital hypothermia reduced the severity of laminitis in the EHC model and prevented histological lesions compatible with lamellar structural failure.

Pregabalin Abuse amongst Opioid Substitution Treatment Patients.

Pregabalin (Lyrica®) is used in treating epilepsy, nerve pain and anxiety. Pregabalin was initially thought to have a low misuse potential however there are emerging reports of Pregabalin being abused. A study was commenced at the National Drug Treatment Centre's (NDTC) Drug Analysis Laboratory to determine the level of usage of Pregabalin within the addiction services population in Ireland. A total of 498 urine samples representing samples from 440 individual opioid substitution patients, initially screened by immunoassay for drugs of abuse, were subjected to further analysis for Pregabalin by Liquid Chromatography/Mass Spectrometry (LC/MS). Of 440 patients tested, 39 tested positive for Pregabalin (9.2%). Only 10 patients from this group were prescribed this drug to our knowledge thus giving an estimated rate of misuse of 7.0%. Other drugs detected in the Pregabalin positive patients were Opiates (31.8%), Cocaine (11.4%), Benzodiazepines (79.5%) and Cannabis (77.8%). Our study confirms that Pregabalin abuse is taking place amongst the addiction services population. We believe that misuse of this prescription drug is a serious emerging issue which should be monitored carefully.

An epifluorescent attachment improves whole-plant digital photography of Arabidopsis thaliana expressing red-shifted green fluorescent protein.

BACKGROUND AND AIMS: Studies have shown that levels of green fluorescent protein (GFP) leaf surface fluorescence are directly proportional to GFP soluble protein concentration in transgenic plants. However, instruments that measure GFP surface fluorescence are expensive. The goal of this investigation was to develop techniques with consumer digital cameras to analyse GFP surface fluorescence in transgenic plants. METHODOLOGY: Inexpensive filter cubes containing machine vision dichroic filters and illuminated with blue light-emitting diodes (LED) were designed to attach to digital single-lens reflex (SLR) camera macro lenses. The apparatus was tested on purified enhanced GFP, and on wild-type and GFP-expressing arabidopsis grown autotrophically and heterotrophically. PRINCIPAL FINDINGS: Spectrum analysis showed that the apparatus illuminates specimens with wavelengths between ∼450 and ∼500 nm, and detects fluorescence between ∼510 and ∼595 nm. Epifluorescent photographs taken with SLR digital cameras were able to detect red-shifted GFP fluorescence in Arabidopsis thaliana leaves and cotyledons of pot-grown plants, as well as roots, hypocotyls and cotyledons of etiolated and light-grown plants grown heterotrophically. Green fluorescent protein fluorescence was detected primarily in the green channel of the raw image files. Studies with purified GFP produced linear responses to both protein surface density and exposure time (H(0): ß (slope) = 0 mean counts per pixel (ng s mm(-2))(-1), r(2) > 0.994, n = 31, P < 1.75 × 10(-29)). CONCLUSIONS: Epifluorescent digital photographs taken with complementary metal-oxide-semiconductor and charge-coupled device SLR cameras can be used to analyse red-shifted GFP surface fluorescence using visible blue light. This detection device can be constructed with inexpensive commercially available materials, thus increasing the accessibility of whole-organism GFP expression analysis to research laboratories and teaching institutions with small budgets.

Ultrasound in the selective screening of developmental dysplasia of the hip.

INTRODUCTION: Developmental dysplasia of the hip (DDH) can result in chronic pain, gait abnormalities and degenerative arthritis. Infants with a family history, Breech delivery or unstable/"clicking" of the hip on examination are at higher risk. The goal is to detect cases early enough for normal hip development and function by the end of adolescence, but clinical examination alone is ineffective. MATERIALS AND METHODS: All infants born at the West Middlesex University Hospital, Isle-worth, U.K., between 3/3/2005 and 21/10/2006 underwent prospective clinical screening to reveal risk factors of unstable hip on examination, family history of DDH and Breech delivery. Infants with risk factors underwent static and dynamic ultrasound of the hips (Harke's method with Terjesen measurements), performed by a consultant radiologist or sonographer. The infant was then examined by an Orthopaedic Surgeon who was blinded to the ultrasound findings until after creating a management plan. RESULTS: 5772 infants were born during the study period. 200 (3.5%) at-risk infants were identified, resulting in 400 hip ultrasounds. Following review of ultrasound findings, the majority of cases (163/200, 81.5%) lead to no change in management. Change in timing or type of clinical follow up occurred in 31 cases with normal ultrasounds and 20 cases with abnormal (immature hip) ultrasounds. Dysplasia was demonstrated in 6 infants (3%) on ultrasound, who were treated with Parvlik Harness. Of these, only 5 were detected on examination. Therefore, the ultrasound findings lead to 1 intervention with Parvlik Harness which would have otherwise gone undiagnosed from clinical examination. CONCLUSION: Whereas type and timing of follow up was adjusted in 18.5% of the at-risk infants, targeted screening of at-risk with ultrasound lead to only one intervention. This encourages discussion on the resource implication and viability of ultrasound screening, as only one from two hundred lead to an intervention.

A day in the life of a doctor working at the Himalayan Rescue Association.

The Himalayan Rescue Association's (HRA) clinic in Pheriche, Nepal (4243m) is one of a number of high altitude medical posts where demands for services are increasing. Every year international doctors see over 1000 patients, assisting local people with basic health needs and providing emergency care for trekkers with both altitude-related and general illnesses and injuries. This article describes the work of the voluntary clinic and some of the challenges it faces.

Perpendicular spin torque in magnetic tunnel junctions.

A steady-state electrical current flowing in a magnetic heterostructure can exert a torque on the magnetization, and provides a means to control magnetization states and dynamics in spintronics structures. However, some components of the torque are difficult to measure and to calculate. We have determined the perpendicular spin torque in MgO magnetic tunnel junctions by measuring their lowest ferromagnetic resonance frequency and find that it decreases linearly with increasing bias voltage. Micromagnetic modeling shows that this decrease is caused by the perpendicular component of spin torque. We obtain a quantitative value for the perpendicular spin torque effective field as a function of bias voltage, and show that this effective field is a linear function in bias voltage and approximately equal in magnitude to the in-plane spin torque effective field.

Head shop compound abuse amongst attendees of the Drug Treatment Centre Board.

The use of "Head Shop" compounds has received much media attention lately. There is very little research in the current literature with regard to the extent of the usage of these substances amongst the drug using population in Ireland. We conducted a study to examine the extent of the usage of Mephedrone, Methylone and BZP amongst attendees of Methadone maintenance programs at the DTCB. Two hundred and nine samples in total were tested. The results showed significant usage of these compounds amongst this cohort of drug users, with 29 (13.9%) of samples tested being positive for Mephedrone, 7 (3.3%) positive for Methylone and 1 (0.5%) positive for BZP.

Al13H-: hydrogen atom site selectivity and the shell model.

Using a combination of anion photoelectron spectroscopy and density functional theory calculations, we explored the influence of the shell model on H atom site selectivity in Al(13)H(-). Photoelectron spectra revealed that Al(13)H(-) has two anionic isomers and for both of them provided vertical detachment energies (VDEs). Theoretical calculations found that the structures of these anionic isomers differ by the position of the hydrogen atom. In one, the hydrogen atom is radially bonded, while in the other, hydrogen caps a triangular face. VDEs for both anionic isomers as well as other energetic relationships were also calculated. Comparison of the measured versus calculated VDE values permitted the structure of each isomer to be confirmed and correlated with its observed photoelectron spectrum. Shell model, electron-counting considerations correctly predicted the relative stabilities of the anionic isomers and identified the stable structure of neutral Al(13)H.

First Report of a New Postharvest Disease of Pear Fruit Caused by Sphaeropsis pyriputrescens in Canada.

A survey of stored d'Anjou pears was conducted in British Columbia (BC), Canada in January 2006 to determine if Sphaeropsis rot was present in BC as had been reported previously for apples and pears in Washington (1,2). Sphaeropsis pyriputrescens Xiao & J.D. Rogers produces decay similar to Botrytis cinerea that originates from the stem or calyx end. Of 3,614 pears sampled, 55 (1.5%) had symptoms similar to those described for Sphaeropsis rot. Isolations were made from each infected pear onto acidified potato dextrose agar (APDA) dishes and incubated at 20°C for 5 to 7 days. Twenty-seven cultures resembling S. pyriputrescens were induced to produce pycnidia by exposing them to 12-h cycles of alternating light and dark periods at 20°C (1). Conidia extracted from pycnidia were then streaked onto PDA dishes and incubated at 20°C for 12 to 24 h from which single-spore cultures were made. These isolates developed a dense, white-to-cream mycelium that turned yellow over time; black pycnidia were formed on the culture dishes after 4 weeks. Conidia were brown, clavate to subglobose to irregular, and similar in size (16 × 10 µm) to previous descriptions (1). Identification of S. pyriputrescens was confirmed by using DNA sequence data from the ß-tubulin and ribosomal genes. Sequences from S. pyriputrescens from Washington (1) were compared with those from BC, Canada. Isolates from Canada shared 99 to 100% sequence homology with those from Washington. Two of the BC isolates (DAOM 238917 and 238918) were deposited in the Canadian Culture Collection, Ottawa, ON and their corresponding sequences were placed in the GenBank database (NCBI, Bethesda, MD) with accession nos. EU156037 and EU156040 (ribosomal gene) and EU156048 and EU 156050 (ß-tubulin gene), respectively. Five isolates from different locations in BC and two isolates from Washington were tested for pathogenicity on d'Anjou pears and four apple cultivars (Ambrosia, Fuji, Gala, and Granny Smith). Plugs (3 mm in diameter) removed from 2-week-old cultures were placed into two corresponding wounds on each of five fruit per cultivar. The fruit were then placed at 1 or 20°C for 22 or 7 days, respectively, when the diameters of the decay areas were recorded. All isolates were pathogenic on pears (P = <0.05). Decay lesion diameter was greater at 1°C, ranging from 46.8 to 57.9 mm, than at 20°C, ranging from 32.6 to 44.2 mm. All BC isolates were also pathogenic on the fruit of each apple cultivar (P = <0.05), although at 20°C, decay areas were smaller than on pears, and at 1°C, very little rot developed. Koch's postulates were completed by reisolating S. pyriputrescens from the inoculated pears and apples and identifying the isolates as above. Although S. pyriputrescens was only observed on pears in BC, research in Washington indicates that it is a more serious problem on apples (2). To our knowledge, this is the first documented report of the occurrence of S. pyriputrescens in Canada. References: (1) C. L. Xiao and J. D. Rogers. Plant Dis. 88:114, 2004. (2) C. L. Xiao et al. Plant Dis. 88:223, 2004.

Negative ions of nitroethane and its clusters.

Valence and dipole-bound negative ions of the nitroethane (NE) molecule and its clusters are studied using photoelectron spectroscopy (PES), Rydberg electron transfer (RET) techniques, and ab initio methods. Valence adiabatic electron affinities (EA(a)s) of NE, C(2)H(5)NO(2), and its clusters, (C(2)H(5)NO(2))(n), n=2-5, are estimated using vibrationally unresolved PES to be 0.3+/-0.2 eV (n=1), 0.9+/-0.2 eV (n=2), 1.5+/-0.2 eV (n=3), 1.9+/-0.2 eV (n=4), and 2.1+/-0.2 eV (n=5). These energies were then used to determine stepwise anion-neutral solvation energies and compared with previous literature values. Vertical detachment energies for (C(2)H(5)NO(2))(n)(-) were also measured to be 0.92+/-0.10 eV (n=1), 1.63+/-0.10 eV (n=2), 2.04+/-0.10 eV (n=3), and 2.3+/-0.1 eV (n=4). RET experiments show that Rydberg electrons can be attached to NE both as dipole-bound and valence bound anion states. The results are similar to those found for nitromethane (NM), where it was argued that the diffuse dipole state act as a "doorway state" to the more tightly bound valence anion. Using previous models for relating the maximum in the RET dependence of the Rydberg effective principle number n(max)(*), the dipole-bound electron affinity is predicted to be approximately 25 meV. However, a close examination of the RET cross section data for NE and a re-examination of such data for NM finds a much broader dependence on n(*) than is seen for RET in conventional dipole bound states and, more importantly, a pronounced [l] dependence is found in n(max)(*) (n(max)(*) increases with [l]). Ab initio calculations agree well with the experimental results apart from the vertical electron affinity value associated with the dipole bound state which is predicted to be 8 meV. Moreover, the calculations help to visualize the dramatic difference in the distributions of the excess electron for dipole-bound and valence states, and suggest that NE clusters form only anions where the excess electron localizes on a single monomer.