Risk assessment for uptake and accumulation of pharmaceuticals by baby leaf lettuce irrigated with reclaimed water under commercial agricultural activities.

The use of reclaimed water to irrigate agricultural crops has increased in recent years as a consequence of water shortage constituting a potential risk for human health. The main objective of this study was to evaluate the impact on the soil-plant system and determining the accumulation of carbamazepine (CBZ), diclofenac (DCF), ketoprofen (KTP) and naproxen (NPX) in the edible part of lettuce under commonly used agricultural practices in commercial production. For this purpose, red oak baby lettuce (Lactuca sativa L.) was irrigated with reclaimed water fortified with different concentrations of pharmaceuticals. The study was carried out in two different scenarios: soil and tray. The tray experiments were conducted with substrate and took place at three different seasons of the year. Lettuce tissue sampled from these experiments were analysed 3 times during the lettuce growing cycle (first, second and third harvest). The practices of first harvest regrowth were also evaluated. For all experiments, CBZ showed the highest accumulation in lettuce leaves of the pharmaceuticals tested, showing a correlation between irrigation exposure time and pharmaceutical uptake. Unexpectedly, DCF was the compound with the highest uptake levels after regrowth practices. Results suggested that pharmaceuticals uptake could be directly associated with the irrigation method and possible accumulation in soil and substrates, while concentration of pharmaceuticals in substrates were 10 times higher. Based on the concentration values detected in lettuce leaves, the risk assessment suggests that no compounds imply any risk to human health, except CBZ for those on vegetarian diets in the tray scenario. Although commercial agricultural practices are usually not considered with regards to risk reduction, in this experiment we demonstrated that climatic conditions are a key factor in pharmaceuticals uptake and different agricultural practices (soil cropping and drip irrigation) can limit the presence of pharmaceutical compounds in crops.

Penetration of sodium hypochlorite into root canal dentine: effect of surfactants, gel form and passive ultrasonic irrigation.

AIM: To assess the penetration of sodium hypochlorite (NaOCl) gel or NaOCl solutions with surfactants, and the effect of passive ultrasonic irrigation (PUI) on penetration into dentinal tubules. METHODOLOGY: Bovine incisor root canals were instrumented, the roots sectioned and the dentine blocks obtained were stained with crystal violet. Dentine blocks (n = 10 per group) were exposed to 3% NaOCl gel or 3% NaOCl solution for 10 and 20 min. Other dentine blocks (n = 10 per group) were exposed to Chlor-Extra (6% NaOCl + surfactant), 6% NaOCl, 2.5% NaOCl with 0.2% cetrimide and 2.5% NaOCl for 10 and 20 min. The penetration depth of irrigants into dentinal tubules was measured in micrometres by viewing the bleached crystal violet under a stereomicroscope. Additionally, bovine incisor root canals, instrumented and stained with crystal violet, were distributed into two groups (n = 10) and irrigated with 2.5% NaOCl with PUI or conventional syringe irrigation (CSI). The penetration depth of irrigants into dentinal tubules was assessed 3 and 7 mm from the apex. Statistical analysis was performed by ANOVA and Tukey tests (α = 0.05). RESULTS: There was significantly greater penetration of 3% NaOCl solution into dentinal tubules compared with the gel form (P < 0.05). There was no difference (P > 0.05) between 6% NaOCl and Chlor-Extra, and between 2.5% NaOCl and 2.5% NaOCl + cetrimide. PUI significantly increased the penetration depth of NaOCl into dentinal tubules when compared with CSI (P < 0.05). CONCLUSIONS: In extracted bovine incisors, NaOCl gel penetrated less into dentinal tubules than NaOCl solution. The addition of surfactants did not increase the penetration depth. The use of PUI significantly increased NaOCl penetration into dentinal tubules.

Oxygen-participated electrochemistry of new lithium-rich layered oxides Li3MRuO5 (M = Mn, Fe).

We describe the synthesis, crystal structure and lithium deinsertion-insertion electrochemistry of two new lithium-rich layered oxides, Li3MRuO5 (M = Mn, Fe), related to rock salt based Li2MnO3 and LiCoO2. The Li3MnRuO5 oxide adopts a structure related to Li2MnO3 (C2/m) where Li and (Li0.2Mn0.4Ru0.4) layers alternate along the c-axis, while the Li3FeRuO5 oxide adopts a near-perfect LiCoO2 (R3[combining macron]m) structure where Li and (Li0.2Fe0.4Ru0.4) layers are stacked alternately. Magnetic measurements indicate for Li3MnRuO5 the presence of Mn(3+) and low spin configuration for Ru(4+) where the itinerant electrons occupy a π*-band. The onset of a net maximum in the χ vs. T plot at 9.5 K and the negative value of the Weiss constant (θ) of -31.4 K indicate the presence of antiferromagnetic superexchange interactions according to different pathways. Lithium electrochemistry shows a similar behaviour for both oxides and related to the typical behaviour of Li-rich layered oxides where participation of oxide ions in the electrochemical processes is usually found. A long first charge process with capacities of 240 mA h g(-1) (2.3 Li per f.u.) and 144 mA h g(-1) (1.38 Li per f.u.) is observed for Li3MnRuO5 and Li3FeRuO5, respectively. An initial sloping region (OCV to ca. 4.1 V) is followed by a long plateau (ca. 4.3 V). Further discharge-charge cycling points to partial reversibility (ca. 160 mA h g(-1) and 45 mA h g(-1) for Mn and Fe, respectively). Nevertheless, just after a few cycles, cell failure is observed. X-ray photoelectron spectroscopy (XPS) characterisation of both pristine and electrochemically oxidized Li3MRuO5 reveals that in the Li3MnRuO5 oxide, Mn(3+) and Ru(4+) are partially oxidized to Mn(4+) and Ru(5+) in the sloping region at low voltage, while in the long plateau, O(2-) is also oxidized. Oxygen release likely occurs which may be the cause for failure of cells upon cycling. Interestingly, some other Li-rich layered oxides have been reported to cycle acceptably even with the participation of the O(2-) ligand in the reversible redox processes. In the Li3FeRuO5 oxide, the oxidation process appears to affect only Ru (4+ to 5+ in the sloping region) and O(2-) (plateau) while Fe seems to retain its 3+ state.

Effectiveness of several solutions to prevent the formation of precipitate due to the interaction between sodium hypochlorite and chlorhexidine and its effect on bond strength of an epoxy-based sealer.

AIM: To evaluate the effectiveness of isopropyl alcohol, saline or distilled water to prevent the precipitate formed between sodium hypochlorite (NaOCl) and chlorhexidine (CHX) and its effect on the bond strength of an epoxy-based sealer in radicular dentine. METHODOLOGY: The root canals of 50 extracted human canines (n = 10) were instrumented. In G1, root canals were irrigated with 17% EDTA and 2.5% NaOCl; G2, as G1, except that 2% CHX was used as the final irrigant. In the other groups, intermediate flushes with isopropyl alcohol (G3), saline (G4) or distilled water (G5) were used between NaOCl and CHX. The specimens were submitted to SEM analysis to evaluate the presence of debris and smear layer, in the apical and cervical segments. In sequence, fifty extracted human canines were distributed into five groups (n = 10), similar to the SEM study. After root filling, the roots were sectioned transversally to obtain dentine slices, in the cervical, middle and apical thirds. The root filling was submitted to a push-out bond strength test using an electromechanical testing machine. Statistical analysis was performed using Kruskal-Wallis and Dunn's tests (α = 5%). RESULTS: All groups had similar amounts of residue precipitated on the canal walls (P > 0.05). The push-out bond strength values were similar for all groups, independently of the root third evaluated (P > 0.05). CONCLUSIONS: Isopropyl alcohol, saline and distilled water failed to prevent the precipitation of residues on canal walls following the use of NaOCl and CHX. The residues did not interfere with the push-out bond strength of the root filling.

Effects of maternal age and offspring sex on milk yield, composition and calf growth of red deer (Cervus elaphus).

Differential maternal allocation theory states that mothers will invest more heavily in the offspring sex that will secure higher reproductive output. Senescence theory is concerned with the gradual deterioration of physiological function with age. We analysed the offspring sex-dependent response of calf growth and milk traits to mother age in an Iberian population of captive red deer (Cervus elaphus) using a 22 year time series longitudinal data set. Previous studies revealed that there was little evidence for the differential allocation theory on milk traits and that most studies lacked proper control for confounding factors. Our results indicated that (i) calf growth was offspring male-biased, negatively affected by mother age and positively influenced by mother weight and parity, and (ii) there was no support for differential allocation offspring sex-dependence in milk traits (yield, energy density, fat, protein and lactose content). Our findings suggest that maternal allocation responds to offspring energy requirements, which are mainly driven by offspring body weight, and contingent on mother age and weight and previous maternal reproductive effort.

Fibronectin- and collagen-mimetic ligands regulate bone marrow stromal cell chondrogenesis in three-dimensional hydrogels.

Modification of tissue engineering scaffolds with bioactive molecules is a potential strategy for modulating cell behavior and guiding tissue regeneration. While adhesion to RGD peptides has been shown to inhibit in vitro chondrogenesis, the effects of extracellular matrix (ECM)-mimetic ligands with complex secondary and tertiary structures are unknown. This study aimed to determine whether collagen- and fibronectin-mimetic ligands would retain biologic functionality in three-dimensional (3D) hydrogels, whether different ECM-mimetic ligands differentially influence in vitro chondrogenesis, and if effects of ligands on differentiation depend on soluble biochemical stimuli. A linear RGD peptide, a recombinant fibronectin fragment containing the seven to ten Type III repeats (FnIII7-10) and a triple helical, collagen mimetic peptide with the GFOGER motif were covalently coupled to agarose gels using the sulfo-SANPAH crosslinker, and bone marrow stromal cells (BMSCs) were cultured within the 3D hydrogels. The ligands retained biologic functionality within the agarose gels and promoted density-dependent BMSC spreading. Interactions with all adhesive ligands inhibited stimulation by chondrogenic factors of collagen Type II and aggrecan mRNA levels and deposition of sulfated glycosaminoglycans. In medium containing fetal bovine serum, interactions with the GFOGER peptide enhanced mRNA expression of the osteogenic gene osteocalcin whereas FnIII7-10 inhibited osteocalcin expression. In conclusion, modification of agarose hydrogels with ECM-mimetic ligands can influence the differentiation of BMSCs in a manner that depends strongly on the presence and nature of soluble biochemical stimuli.

Remote ischemic postconditioning: does it protect against ischemic damage in percutaneous coronary revascularization? justification and design of a randomized placebo-controlled clinical trial.

OBJECTIVE: Myocardial damage that is associated with percutaneous coronary intervention (PCI) partially affects the results of the procedure, and is related to medium-term cardiovascular death. Remote postischemic conditioning might reduce the myocardial lesions that are associated with PCI, but perhaps less so in diabetics. The aim of this study was to evaluate the protective effect of remote postischemic conditioning in patients undergoing elective PCI for stable angina or non-ST elevation acute coronary syndrome with troponin <1 ng/ml at the time of randomization. METHODS: This randomized single-blinded single-center clinical trial involved 320 patients undergoing elective PCI who were randomized to either receive three 5-min cycles of ischemia by inflation of a cuff on the non-dominant arm to 200 mm Hg (remote postischemic conditioning) or to placebo (uninflated cuff). The primary outcome variable was the maximum increase in troponin in the first 24 h. The secondary outcome variable was readmission due to heart failure or cardiovascular mortality after 1 year of follow-up. In addition, a diabetic population was studied. CONCLUSIONS: This clinical trial evaluated the possible reduction in intervention-related myocardial damage that was attributable to remote postischemic conditioning.

Water sprinkling as a tool for heat abatement in farmed Iberian red deer: Effects on calf growth and behaviour.

Climatic models predict scenarios in which ambient temperature will continue increasing worldwide. Under these climatic conditions, fitness and animal welfare of many populations are expected to suffer, especially those that live in captive or semi-natural conditions, where opportunities of heat abatement are limited. We undertook an experimental design to assess the effect of heat abatement that water sprinkling might have on Iberian red deer calf growth and behaviour from birth to weaning (135 days). One group of ten mother-calf pairs lived on plots with water sprinkling (treatment) available during summer's hottest time of the day, while the control group (nine mother-calf pairs) occupied plots with no available water sprinkling. Treatment and control groups were fed ad libitum and swapped between plots every seven days to minimise any plot effect. Body weight was monitored weekly and individual behaviour was recorded once or twice a week at mid-day. We observed that calves had showers under the sprinklers and wallowed in mud puddles. The results clearly indicated that calves of the treatment group showed a significant increase in body weight at weaning in comparison with the control group, with no differences between sexes (treatment: male = 56.5 kg, female = 50.3 kg; control: male = 50.3 kg, female = 46.5 kg). Mother weight and mother age effects were negligible on calf body weight at weaning. The heavier the mother the faster was the rate of growth of its offspring, irrespective of calf sex. The model indicated that although males grew significantly slower than female calves in the control group, males grew faster than females when exposed to the treatment. Calves of the treatment group spent less time drinking, less time in the shade, similar time eating and more time in motion than calves of the control group. There were no behavioural differences between calf sexes of treatment and control groups. The results indicate the importance of providing animals with opportunities of heat abatement in hot environments to improve animal growth and welfare in farmed Iberian red deer.

Nursing care in therapeutic hypothermia in neonates with hypoxic-ischaemic encephalopathy. Review of the literature. / Cuidados enfermeros a neonatos con encefalopatía hipóxico-isquémica en hipotermia terapéutica. Revisión bibliográfica.

INTRODUCTION: Hypoxic-ischaemic encephalopathy is one of the main causes of neurological damage in the new-born. Therapeutic hypothermia is the current treatment to reduce mortality and disability in new-borns with this condition. OBJECTIVE: To identify nursing care in new-borns with severe to moderate hypoxic-ischaemic encephalopathy, treated with active therapeutic hypothermia. MATERIALS AND METHODS: A review of the scientific literature was carried out in different databases (PubMed, Lilacs, IBECS, Cinhal, OvidSP, Cuiden, Embase and Cochrane Plus) over the last five years. The documentary assessment was carried out by peers and the quality was evaluated using the CEBM and GRADE scales. RESULTS: Of the 22 articles selected and reviewed, it is evident that therapeutic hypothermia is effective in reducing the mobility and mortality of neo-nates with hypoxic-ischaemic encephalopathy. Nursing care during hypothermia treatment focuses on four basic pillars: general care for stabilisation of the new-born, preparation of the material, administration of medical treatment in all its phases and emotional support of the family. CONCLUSIONS: Therapeutic hypothermia is effective in reducing the sequelae and mortality of neonates with hypoxic-ischaemic encephalopathy. Nursing care is essential throughout the treatment, in the early detection of complications in the infant and psychological support for parents. It is essential for nurses to receive training in this care.

Nursing care in therapeutic hypothermia in neonates with hypoxic-ischaemic encephalopathy. Review of the literature.

INTRODUCTION: Hypoxic-ischaemic encephalopathy is one of the main causes of neurological damage in the new-born. Therapeutic hypothermia is the current treatment to reduce mortality and disability in new-borns with this condition. OBJECTIVE: To identify nursing care in new-borns with severe to moderate EHI, treated with active therapeutic hypothermia. MATERIALS AND METHODS: A review of the scientific literature was carried out in different databases (PubMed, Lilacs, IBECS, Cinhal, OvidSP, Cuiden, Embase and Cochrane Plus) over the last five years. The documentary assessment was carried out by peers and the quality was evaluated using the CEBM and GRADE scales. RESULTS: Of the 22 articles selected and reviewed, it is evident that therapeutic hypothermia is effective in reducing the mobility and mortality of neo-nates with hypoxic-ischaemic encephalopathy. Nursing care during hypothermia treatment focuses on four basic pillars: general care for stabilisation of the new-born, preparation of the material, administration of medical treatment in all its phases and emotional support of the family. CONCLUSIONS: Therapeutic hypothermia is effective in reducing the sequelae and mortality of neonates with hypoxic-ischaemic encephalopathy. Nursing care is essential throughout the treatment, in the early detection of complications in the infant and psychological support for parents. It is essential for nurses to receive training in this care.

Biometrics, testosterone, cortisol and antler growth cycle in Iberian red deer stags (Cervus elaphus hispanicus).

In this article, we aimed to describe the changes related to mating season in red deer, especially those related to antler growth, body condition score, testosterone and cortisol. Antler growth was studied in 17 Iberian red deer males, including body weight, antler length, biometric measures and testosterone and cortisol determination during 15 months. Body weight, body condition score, thoracic perimeter (TP), neck perimeter (NL) and testicular diameter (TD) showed the highest values immediately before mating season (autumn), decreased during it and remained constant at winter. Antler growth lasted 158 days and produced antlers with a final length of 80.8 +/- 2.0 cm. Testosterone and cortisol showed seasonal changes with maximum values at September and May, respectively. Final antler size was related positively to cranial longitude, TP, NL, TD and body weight at casting time. No relationship between weight loss during precedent mating season and current antler size was found, but spring recovery weight was positively related to final antler size. Final length was related to the descent in testosterone values during previous mating season and to body weight before it. Spring recovery weight was related to relative weight loss during previous mating season. These results suggest that there is no relationship between the reproductive effort performed during one season and the next year size of the antler. In contrast, antler size was positively related to spring recovery weight, in the sense that those deer that recover a higher percentage of body weight at the early stages of antler growth develop higher antlers.

Heat stress reduces growth rate of red deer calf: Climate warming implications.

Climate models agree in predicting scenarios of global warming. In endothermic species heat stress takes place when they are upper their thermal neutral zone. Any physiological or behavioural mechanism to mitigate heat stress is at the cost of diverting energy from other physiological functions, with negative repercussions for individual fitness. Tolerance to heat stress differs between species, age classes and sexes, those with the highest metabolic rates being the most sensitive to stressing thermal environments. This is especially important during the first months of life, when most growth takes place. Red deer (Cervus elaphus) is supposedly well adapted to a wide range of thermal environments, based on its worldwide distribution range, but little is known about the direct effect that heat stress may have on calf growth. We assessed the effect that heat stress, measured by heat stress indices and physical environment variables (air temperature, relative air humidity, wind speed and solar radiation), have on calf and mother body weights from calf´s birth to weaning. We used 9265 longitudinal weekly body weight records of calf and mother across 19 years in captive Iberian red deer. We hypothesised that (i) heat stress in hot environments has a negative effect on calf growth, especially in males, as they are more energetically demanding to produce than females; and that (ii) the body weight of the mother through lactation should be negatively affected by heat stress. Our results supported hypothesis (i) but not so clearly hypothesis (ii). By weaning (day 143) calves growing under low heat stress environment grew up to 1.2 kg heavier than those growing in high heat stress environment, and males were more affected by heat stress than females. The results have implications in animal welfare, geographical clines in body size and adaptation to climate change.

What do rates of deposition of dental cementum tell us? Functional and evolutionary hypotheses in red deer.

Cementum is a bone connective tissue that provides a flexible attachment for the tooth to the alveolar bone in many mammalian species. It does not undergo continuous remodelling, unlike non-dental bone, which combined with its growth pattern of seasonal layering makes this tissue uniquely suitable as a proxy for tracking changes in body repair investment throughout an animal´s life. We tested functional and sexual selection hypotheses on the rate of cementum deposition related to the highly polygynous mating strategy of red deer. We used a sample of 156 first lower molars from wild Scottish red deer of known age between 1 and 17 years old, approximately balanced by sex and age class. Cementum deposition on the inter-radicular pad increased with age at a constant average rate of 0.26 mm per year, with no significant differences between sexes. Cementum deposition was independent of (i) tooth wear, other than that associated with age, and (ii) enamel and dentine micro-hardness. The results partially supported the hypothesis that the main function of cementum is the repositioning of the tooth to maintain opposing teeth in occlusion. However, teeth that had more wear or males´ teeth that had faster rates of tooth wear than those of females did not present the expected higher rates of cementum deposition.

Splenic volume as a biomarker of hepatic damage after chemotherapy in patients with resected colorectal liver metastases (CRLM).

BACKGROUND: Chemotherapy-associated liver injury (CALI) is a matter of concern for hepatobiliary surgeons as it can entail postoperative liver failure after an extensive hepatectomy. Recent studies have taken special interest in liver function parameters which can correlate with CALI to decrease this adverse event. Therefore, the current study investigates the usefulness of splenic volume as a biomarker of CALI through a portal hypertension mechanism, in patients with colorectal liver metastases (CRLM). STUDY DESIGN: We carried out a study in patients with CRLM operated on between 2009 and 2014 in our center. All samples of healthy liver were graded for non-alcoholic fatty liver disease (NAFLD) and sinusoidal obstructive syndrome. Computarized tomography scans for spleen volumetry were analyzed for each patient at CRLM diagnosis, after neoadjuvant chemotherapy, 1 and 6 months after resection. RESULTS: A group of 65 consecutive patients with CRLM of large bowel adenocarcinoma submitted to liver resection were included. Patients receiving neoadjuvant chemotherapy had a greater spleen volume increase than those who did not receive treatment (p = 0.053), finding a statistically significant spleen growth in patients with NAFLD (p = 0.036). There was no correlation between spleen enlargement and postoperative complications or average stay. However, survival was decreased in patients with spleen growth and CALI. CONCLUSIONS: Patients who receive neoadjuvant chemotherapy for liver metastasis surgery have a greater splenic volume increase, which correlates with NAFLD and a lower survival.

The juxta-oral organ of Chievitz (organum yuxtaorale) updated: Embryology, anatomy, function and pathology.

BACKGROUND: The Chievitz's organ or juxta-oral organ is a mysterious bilateral structure, phylogenetically preserved, which develops from the mouth epithelium as an invagination that loses connection to it in the prenatal period. It is located laterally to the walls of the oral cavity in an imprecise anatomical location and receives abundant innervation from the buccal nerve. Structurally it consists of non-keratinizing squamous-like neuroepithelial cells surrounded by two layers of connective tissue with nerve fibers and different morphotypes of sensory corpuscles. Its function is completely unknown although based on its rich innervation it is assumed that works as a mechanoreceptor. METHODS: We have performed immunohistochemistry for axonal and Schwann cells, and the putative mechanoproteins ASIC2, TRPV4 and Piezo2 in sections of fetal juxta-oral organ. RESULTS: Intraparenchymatous nerve fibers and sensory corpuscles were observed as well as immunoreactivity for Piezo2 in both nerve fibers and epithelial parenchymatous cells. CONCLUSIONS: We add indirect evidence that the juxtaoral organ is a mechanoreceptor because in addition to its dense innervation, the epithelial cells and sensory nerve fibers display immunoreactivity for the mechanogated ion channel Piezo2. Based on current knowledge, the functional and clinical importance of the juxta-oral organ should be further investigated.

Effect of milk minerals on calf gains and sex differences in mineral composition of milk from Iberian red deer (Cervus elaphus hispanicus).

Milk mineral content has received little attention in studies focusing on milk nutrient effects on offspring growth. This study examines calf growth in Iberian deer and compares the influence of milk minerals, other nutrients, and lactation variables relevant for growth to discern the relative weight of each factor. In addition, because Iberian deer hinds are the first mammal found to produce different milk for sons and daughters, the present study examines whether there are also sex differences in milk mineral composition. Concentrations and yields of Ca, P, Mg, Na, K, Fe, and Zn in milk of 46 red deer hinds were monitored through 18 weeks of lactation. Calf growth was influenced by Ca and P percent, and total Fe production. Milk for males had a lower content in Ca and P, a greater content of K, and Mg, whereas no sex effects were found in Na, Fe, or Zn percentages. Higher percentages in Ca and P for daughters might constitute a compensatory response, as daily production was not biased towards females in Ca or P, whereas in the latter and all the other minerals daily production was greater for heavier calves, which are usually males. In conclusion, milk mineral content and production influence calf growth even after controlling for other important lactation variables and nutrients, and they show effects and interactions more complicated than expected.

Morgagni-Larrey parasternal diaphragmatic hernia in the adult.

With a prevalence of 0.3-0.5/1000 births, congenital diaphragmatic hernia (CDH) remains a serious, poorly understood abnormality with a high mortality rate that cannot always be effectively managed. Its reported frequency in Spain is 0.69%00 with a yearly decreasing trend of 0.10%00 during the period 1980-2006. Up to 5% of cases are incidentally identified in adults undergoing studies for other reasons.We report the case of a 74-year-old woman with vomiting for three months due to parasternal diaphragmatic hernia of Morgagni-Larrey (retrochondrosternal, retrocostoxyphoid, retrosternal, subcostal, substernal or subcostosternal hernia), which allowed us to report an update on this condition in the adult, and on thoracoabdominal diaphragm morphogenesis. It is in the embryology of the diaphragm where an explanation may be found for some morphological changes and clinical manifestations, even though a number of uncertainties remain. We also analyze the extent of controversy persisting on some aspects of surgical treatment (access routes, mesh use, hernial sac reduction). Overall, minimally invasive techniques predominate. We consider laparoscopy the approach of choice for adult patients with parasternal hernia eligible for surgery.

Antlers - Evolution, development, structure, composition, and biomechanics of an outstanding type of bone.

Antlers are bony appendages of deer that undergo periodic regeneration from the top of permanent outgrowths (the pedicles) of the frontal bones. Of the "less familiar" bone types whose study was advocated by John Currey to gain a better understanding of structure-function relationships of mineralized tissues and organs, antlers were of special interest to him. The present review summarizes our current knowledge about the evolution, development, structure, mineralization, and biomechanics of antlers and how their formation is affected by environmental factors like nutrition. Furthermore, the potential role of antlers as a model in bone biology and several fields of biomedicine as well as their use as a monitoring tool in environmental studies are discussed.