Template-directed self-assembly by way of molecular recognition at the micellar-solvent interface: modulation of the critical micelle concentration.

By incorporating the concepts of structural preorganisation and complementarity in concert with non-covalent donor-acceptor [ππ] and hydrophobic interactions, a duo of π-electron deficient bipyridinium-based linear and gemini amphiphiles capable of responding to molecular templation have been designed and synthesised. When combined with π-electron rich di(ethylene glycol)-disubstituted 1,5-dihydroxynaphthalene, a dramatic decrease in the critical aggregation concentration by ≈66% was observed with concomitant increases in the hydrodynamic diameter, ζ-potential, and Langmuir surface pressures of the micellar solutions-thus enhancing the detergents' efficiency and effectiveness at lowering the surface tension of water. By employing a phase separation model that takes into account the degree of counterion binding to the micellar aggregate superstructure, the effects of donor-acceptor templation on the Gibb's free energy of micellisation (ΔG) for the amphiphiles was quantified. It was found that donor-acceptor templation was capable of lowering ΔG by up to 1.75 kcal mol(-1) at which point it was observed, while under the influence of molecular templation, that linear single hydrophobic tailed detergent molecules exhibit properties characteristic of double-tailed phospholipid-like gemini surfactants.

Bacterial Pyomyositis in the Neck Due to Bacteroides Fragilis.

Bacterial pyomyositis is characterized by the formation of abscesses in skeletal muscle groups, frequently in the lower extremities. It is most prevalent in tropical climates and associated with Staphylococcus aureus. The presentation of pyomyositis in the neck is rare. We present a unique case of pyomyositis caused by a gut bacterium, Bacteroides fragilis. Additionally, the case highlights the difficulty in identifying the cause of spread of the bacteria from the gut to the affected musculature. A 77-year-old diabetic Caucasian male presented with progressive bilateral neck swelling and limited range of motion of the neck. CT imaging confirmed a peripherally enhancing sternocleidomastoid abscess, right pectoralis major muscle abscess, and a hypodense fluid collection found in the anterior mediastinum and retrosternal space. The patient underwent exploration with incision and drainage of the abscess. Blood and tissue culture-confirmed Bacteroides fragilis. Subsequent abdominal CT imaging revealed a perforated ascending colon, which, is thought to be responsible for the source of the bacterium. Bacterial pyomyositis is a rare condition and if not treated early can lead to sepsis and death. We present a rare case of bacteria from a gastrointestinal (GI) source that has not been reported in the literature. This highlights the importance of a thorough evaluation of a source of infection in patients with pyomyositis, especially in the setting of atypical microbes.

Optical Coherence Tomography in the Management of Skull Base Fibrous Dysplasia with Optic Nerve Involvement.

BACKGROUND: Fibrous dysplasia (FD) of the skull base can manifest with optic nerve compression. As most patients initially do not experience vision loss, controversy exists whether to proceed with prophylactic surgical decompression or elect for conservative observation. Optical coherence tomography (OCT), a physiologic imaging modality widely used to assess the condition of the retinal nerve fiber layer (RNFL), has been useful in monitoring compressive tumors on the optic nerve. This study evaluated potential use of OCT in management of patients with fibrous dysplasia and optic nerve involvement. METHODS: Six patients with suspected optic nerve compression who underwent OCT imaging as part of a neuro-ophthalmic examination were reviewed over a 2-year period. Patient records were evaluated for visual examination measures, most notably the presence of optic neuropathy, and radiographic measures on computed tomography. Measures were compared by age-adjusted RNFL thickness (above or below fifth percentile) on OCT imaging. RESULTS: Two patients were found to have mild optic neuropathy in 1 eye each. Three of 12 eyes fell below the age-adjusted fifth percentile of RNFL thickness. Presence of optic neuropathy was associated with abnormal age-adjusted RNFL thickness but not with optic nerve compression (P = 0.45). CONCLUSIONS: Abnormal RNFL thickness as measured by OCT better predicted the presence of optic neuropathy than computed tomography alone. OCT may be a valuable imaging modality to monitor patients with fibrous dysplasia for development of optic neuropathy during periods of conservative watchful waiting.

Academic Productivity of US Neurosurgery Residents as Measured by H-Index: Program Ranking with Correlation to Faculty Productivity.

Engagement in research and academic productivity are crucial components in the training of a neurosurgeon. This process typically begins in residency training. In this study, we analyzed individual resident productivity as it correlated to publications across all Accreditation Council for Graduate Medical Education (ACGME)-accredited neurosurgery training programs in an attempt to identify how programs have developed and fostered a research culture and environment. We obtained a list of current neurosurgery residents in ACGME-accredited programs from the American Association of Neurological Surgeons database. An expanded PubMed and Scopus search was conducted for each resident through the present time. We tabulated all articles attributed to each resident. We then categorized the publications based on each neurosurgical subspecialty while in residency. A spreadsheet-based statistical analysis was performed. This formulated the average number of resident articles, h-indices, and most common subspecialty categories by training program. We analyzed 1352 current neurosurgery residents in 105 programs. There were a total of 10 645 publications, of which 3985 were resident first-author publications during the period of study. The most common subspecialties among all resident publications were vascular (24.9%), spine (16.9%), oncology (16.1%), pediatric (5.6%), functional (4.9%), and trauma (3.8%). The average resident published 2.9 first-author papers with average of 38.0 first-author publications by total residents at each program (range 0-241). The average h-index per resident is 2.47 ± 3.25. When comparing previously published faculty h-index program rankings against our resident h-index rankings, there is a strong correlation between the 2 datasets with a clear delineation between Top-20 productivity and that of other programs (average h-index 4.2 vs 1.7, respectively, P < .001). Increasing program size leads to a clear increase in academic productivity on both the resident and faculty level (average h-index 1.6, 1.9, 3.9 for 1, 2, and 3 resident per year programs, respectively, P < .001). Resident first-author publications correlated with recently described academic departmental productivity. Subspecialty resident publications are highest in cerebrovascular surgery. Resident research and publication is a key metric for assessing the productivity of academic neurosurgery programs and is consistent with one of the core foci of neurosurgical training.