Custom-made rotating hinge total knee replacement in a patient with congenital tibial deficiency avoids the need for amputation.

We report a unique case of a patient with type 2 congenital tibial deficiency and disabling knee osteoarthritis in whom a custom-made rotating hinge knee replacement was successfully performed, allowing continued mobilisation with a below-knee prosthesis, thereby avoiding the need for an above-knee amputation. Level of evidence Therapeutic study, Level IV.

Custom rotating-hinge total knee replacement in patients with spina bifida and severe neuromuscular dysfunction.

Spina bifida (SB) is a congenital disorder which may result in a number of musculoskeletal problems. Total knee replacement (TKR) in this patient group is technically demanding due to bone deformity, soft tissue contracture, muscle tone abnormality and ligament insufficiency. This is a retrospective review of three patients with SB and disabling knee arthritis who were managed with a custom rotating-hinge (RHK) total knee system. All patients reported an improvement in knee pain and stability at mean follow-up 47 months (43-53). Mean Oxford Knee score improved from 21 preoperatively to 32 at final follow-up. One patient required revision of tibial and patella components at 37 months for lateral patella instability and excessive wear. Custom RHK for patients with SB, severe neuromuscular dysfunction and bone deformity relieves pain, restores stability and improves early knee function; however there is a significant risk of extensor mechanism complications and functional outcome is worse than primary TKR in the general population.

Assessing microplastic exposure of large marine filter-feeders.

Large filter-feeding animals are potential sentinels for understanding the extent of microplastic pollution, as their mode of foraging and prey mean they are continuously sampling the environment. However, there is considerable uncertainty about the total and mode of exposure (environmental vs trophic). Here, we explore microplastic exposure and ingestion by baleen whales feeding year-round in coastal Auckland waters, New Zealand. Plastic and DNA were extracted concurrently from whale scat, with 32 ± 24 (mean ± SD, n = 21) microplastics per 6 g scat sample detected. Using a novel stochastic simulation modeling incorporating new and previously published DNA diet information, we extrapolate this to total microplastic exposure levels of 24,028 (95% CI: 2119, 69,270) microplastics per mouthful of prey, or 3,408,002 microplastics (95% CI: 295,810, 10,031,370) per day, substantially higher than previous estimates for large filter-feeding animals. Critically, we find that the total exposure is four orders of magnitude more than expected from microplastic measurements of local coastal surface waters. This suggests that trophic transfer, rather than environmental exposure, is the predominant mode of exposure of large filter feeders for microplastic pollution. Measuring plastic concentration from the environment alone significantly underestimates exposure levels, an important consideration for future risk assessment studies.

Mail and Telephone Outreach from Electronic Health Records for Research Participation on Cognitive Health and Aging.

OBJECTIVES: This report describes the efficacy and utility of recruiting older individuals by mail to participate in research on cognitive health and aging using Electronic Health Records (EHR). METHODS: Individuals age 65 or older identified by EHR in the Mount Sinai Health System as likely to have Mild Cognitive Impairment (MCI) were sent a general recruitment letter (N=12,951). A comparison group of individuals with comparable age and matched for gender also received the letter (N=3,001). RESULTS: Of the 15,952 individuals who received the mailing, 953 (6.0%) responded. 215 (1.3%) declined further contact. Overall rate of expression of interest was 4.6%. Of the 738 individuals who responded positively to further contact, 321 indicated preference for further contact by telephone. Follow-up of these individuals yielded 30 enrollments (0.2% of 15,952). No differences in response rate were noted between MCI and comparison groups, but the comparison group yielded higher enrollment. 6 individuals who were not the intended recipients of mailing but nevertheless contacted our study were also enrolled. CONCLUSIONS: Mailings to individuals identified through a trusted source, such as a medical center from which they have received clinical care, may be a viable means of reaching individuals within this age group as this effort yielded a low rejection rate. However, EHR information did not enhance study enrollment. Implications for improving recruitment are discussed.

Adult disclosure of a history of childhood sexual abuse: implications for behavioral psychotherapy.

This article presents a behavioral conceptualization of the difficulties associated with adult disclosure in psychotherapy of a history of childhood sexual abuse. Using a contemporary behavioral perspective and a functional analysis of various clinical presentations, we examine the factors that may contribute to nondisclosure of a history of abuse. Traumagenic dynamics are used to frame a discussion of childhood factors that may further influence disclosure of abuse. The construct of stigma is linked to aspects of experiential avoidance, which is considered to be a core mediator of the difficulties associated with a history of abuse. Acceptance and commitment therapy and functional analytic psychotherapy, 2 "third-wave" behavioral treatments, are presented generally with specific discussions of these therapies as they relate to the issue of disclosure. Important therapist factors as well as implications for future investigations are presented.

Multi-locus DNA metabarcoding of zooplankton communities and scat reveal trophic interactions of a generalist predator.

To understand the ecosystem dynamics that underpin the year-round presence of a large generalist consumer, the Bryde's whale (Balaenoptera edeni brydei), we use a DNA metabarcoding approach and systematic zooplankton surveys to investigate seasonal and regional changes in zooplankton communities and if whale diet reflects such changes. Twenty-four zooplankton community samples were collected from three regions throughout the Hauraki Gulf, New Zealand, over two temperature regimes (warm and cool seasons), as well as 20 samples of opportunistically collected Bryde's whale scat. Multi-locus DNA barcode libraries were constructed from 18S and COI gene fragments, representing a trade-off between identification and resolution of metazoan taxa. Zooplankton community OTU occurrence and relative read abundance showed regional and seasonal differences based on permutational analyses of variance in both DNA barcodes, with significant changes in biodiversity indices linked to season in COI only. In contrast, we did not find evidence that Bryde's whale diet shows seasonal or regional trends, but instead indicated clear prey preferences for krill-like crustaceans, copepods, salps and ray-finned fishes independent of prey availability. The year-round presence of Bryde's whales in the Hauraki Gulf is likely associated with the patterns of distribution and abundance of these key prey items.

The relationship between spinopelvic measurements and patient-reported outcome scores in patients with multiple myeloma of the spine.

AIMS: Patients with multiple myeloma (MM) develop deposits in the spine which may lead to vertebral compression fractures (VCFs). Our aim was to establish which spinopelvic parameters are associated with the greatest disability in patients with spinal myeloma and VCFs. PATIENTS AND METHODS: We performed a retrospective cross-sectional review of 148 consecutive patients (87 male, 61 female) with spinal myeloma and analysed correlations between spinopelvic parameters and patient-reported outcome scores. The mean age of the patients was 65.5 years (37 to 91) and the mean number of vertebrae involved was 3.7 (1 to 15). RESULTS: The thoracolumbar region was most commonly affected (109 patients, 73.6%), and was the site of most posterior vertebral wall defects (47 patients, 31.8%). Poorer Oswestry Disability Index scores correlated with an increased sagittal vertical axis (p = 0.006), an increased number of VCFs (p = 0.035) and sternal involvement (p = 0.012). Poorer EuroQol visual analogue scale scores correlated with posterior vertebral wall defects in the thoracolumbar region (p = 0.012). The sagittal vertical axis increased with the number of fractures and kyphosis in the thoracolumbar (p = 0.009) and lumbar (p < 0.001) regions. CONCLUSIONS: In MM, patients with VCFs have poorer clinical scores at presentation in the presence of sagittal imbalance. Outcome is particularly affected by multiple fractures in the thoracolumbar and lumbar regions and by failure to prevent kyphosis. Patients with MM should be screened for spinal lesions early. Cite this article: Bone Joint J 2016;98-B:1234-9.

A consensus map for loblolly pine (Pinus taeda L.). I. Construction and integration of individual linkage maps from two outbred three-generation pedigrees.

A consensus map for loblolly pine (Pinus taeda L.) was constructed from the integration of linkage data from two unrelated three-generation outbred pedigrees. The progeny segregation data from restriction fragment length polymorphism, random amplified polymorphic DNA, and isozyme genetic markers from each pedigree were recoded to reflect the two independent populations of parental meioses, and genetic maps were constructed to represent each parent. The rate of meiotic recombination was significantly greater for males than females, as was the average estimate of genome length for males (1983.7 cM [Kosambi mapping function (K)]) and females [1339.5 cM(K)]. The integration of individual maps allows for the synthesis of genetic information from independent sources onto a single consensus map and facilitates the consolidation of linkage groups to represent the chromosomes n = 12 of loblolly pine. The resulting consensus map consists of 357 unique molecular markers and covers approximately 1300 cM(K).

Anchored reference loci in loblolly pine (Pinus taeda L.) for integrating pine genomics.

Anchored reference loci provide a framework for comparative mapping. They are landmarks to denote conserved chromosomal segments, allowing the synthesis of genetic maps from multiple sources. We evaluated 90 expressed sequence tag polymorphisms (ESTPs) from loblolly pine (Pinus taeda L.) for this function. Primer sets were assayed for amplification and polymorphism in six pedigrees, representing two subgenera of Pinus and a distant member of the Pinaceae, Douglas-fir (Pseudotsuga menziesii [Mirb.] Franco). On average, 89% of primer sets amplified in four species of subgenus Pinus, 49% in one species of subgenus Strobus, and 22% in Douglas-fir. Polymorphisms were detected for 37-61% of the ESTPs within each pedigree. Comparative mapping in loblolly and slash pine (P. elliottii Englm.) revealed that ESTPs mapped to the same location. Disrupted synteny or significant disruptions in colinearity were not detected. Thirty-five ESTPs met criteria established for anchor loci. The majority of those that did not meet these criteria were excluded when map location was known in only a single species. Anchor loci provide a unifying tool for the community, facilitating the creation of a "generic" pine map and serving as a foundation for studies on genome organization and evolution.

Effects of temperature on fecundity in vitro, egg hatching and reproductive development of Benedenia seriolae and Zeuxapta seriolae (Monogenea) parasitic on yellowtail kingfish Seriola lalandi.

Globally, aquaculture industries involved with commercial culture of kingfish (Seriola spp.) experience outbreaks of monogenean parasites, which can cause heavy stock losses. In Australia and New Zealand, aquaculturists of kingfish Seriola lalandi incur financial losses caused by two monogenean species: Benedenia seriolae and Zeuxapta seriolae which parasitise the skin and gills, respectively. This study provides information on some basic temperature-dependent life-cycle parameters of these problematic monogeneans on S. lalandi. Hatching times and age at maturity were inversely related to water temperature within the range experienced by wild kingfish in New Zealand (13-21 degrees C). Mature B. seriolae in vitro laid on average 37 eggs/day that hatched over approximately 4 days; peak hatching occurred 9, 11 and 22 days post-deposition at temperatures of 21, 17.5 and 13+/-1.0 degrees C, respectively. Z. seriolae in vitro laid on average 246 eggs/day that hatched over 2 days; peak hatching occurred 7, 9 and 15 days post-deposition at these respective temperatures. B. seriolae matured within 20, 25 and 48 days p.i. at 21, 18 and 13 degrees C. Z. seriolae matured within 25, 37 and >52 days p.i. at the same temperatures. This research describes stages in the reproductive development of B. seriolae and Z. seriolae and discusses the inclusion of basic parasitic life-cycle parameters into management strategies designed to maximise treatment efficacy and limit monogenean epizootics in sea-cage kingfish culture.

Genetic causes of maturity onset diabetes of the young may be less prevalent in American pregnant women recently diagnosed with diabetes mellitus than in previously studied European populations.

CONTEXT: There are many causes of impaired glucose tolerance in pregnant women. It is unclear whether genetic etiologies are a source of impaired glucose tolerance in pregnant women. OBJECTIVE: To prospectively determine the prevalence of maturity onset diabetes of the young (MODY) due to glucokinase (GCK) mutations in an American population of women with recent onset diabetes mellitus and gestational diabetes. We hypothesized that based on America's higher prevalence of gestational diabetes mellitus (GDM) and Type 2 diabetes, there may be an increased prevalence of GK mutations in our population than in previously reported studies from European studies. DESIGN: Over a three-year period, 72 pregnant women with recently diagnosed diabetes mellitus were prospectively assessed for presence of the most common pathogenic GCK mutations. SETTING: This study was performed in a gestational diabetes clinic in Urban America and a high-risk pregnancy clinic that served the military and their families on an American military base in Germany. PATIENTS: Seventy-two women; 65 with diagnosis of diabetes mellitus in this pregnancy (GDM/overt diabetes) and 7 with diagnosis in the last nine years prior to pregnancy were recruited during pregnancy and blood samples were obtained. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Each study participant's blood sample was analyzed with restriction fragment length polymorphism to assess for mutations in the GCK gene. RESULTS: There were 38 female and 34 male neonates born at 38 weeks gestation ± 1.2 weeks. Mean birth weight was 3351 g ± 450 g. There were no patients with GCK mutations found in our population 0/72. This prevalence is not greater than that seen in previous a similar study in European women with gestational diabetes, but in fact significantly less (p = 0.03). CONCLUSION: American women with recently diagnosed diabetes mellitus likely have no higher prevalence of MODY than in previously studied European women with diabetes mellitus and may have a lower prevalence.

Highly active antiretroviral treatment in HIV infection: benefits for neuropsychological function.

OBJECTIVES: To determine whether highly active antiretroviral therapy (HAART) is associated with reduced HIV-associated neuropsychological impairment. DESIGN: Cross-sectional analysis in a natural history study of adaptation to HIV/AIDS. METHOD: A sample of 130 homo-/bisexual men with HIV/AIDS (mean age, 41 years; 42% non-white) were evaluated with a neuropsychological battery assessing attention, concentration, psychomotor speed, learning, memory and executive function. Subjects taking HAART were compared with those not taking HAART on demographics, CD4 cell count, viral load, scores on individual neuropsychological tests and proportion with neuropsychological impairment. RESULTS: Sixty-nine (53%) subjects were taking HAART, and 48 (37%) were neuropsychologically impaired. Subjects taking HAART had lower mean CD4 cell counts than those not taking HAART (254 versus 342 x 10(6)/l; P < 0.05), although they were more likely to have undetectable viral load (42 versus 20%; P < 0.01) and were less likely to be neuropsychologically impaired (22 versus 54%; P < 0.0001). Subjects taking HAART performed significantly better on tests of attention, concentration, learning, memory, and psychomotor speed. After excluding subjects with potential non-HIV confounders of neuropsychological function, those without neuropsychological impairment had significantly lower mean viral load levels and were more likely to have undetectable viral load than those with impairment. CONCLUSION: These preliminary findings suggest that HAART benefits neuropsychological function through the reduction of viral load.

Expression of acquired immunity to Heligmosomoides polygyrus in mice concurrently infected with Trypanosoma congolense.

The effects of concurrent Heligmosomoides polygyrus and Trypanosoma congolense infection on the expression of acquired resistance to homologous nematode challenge were studied in female outbred TO mice. Mice were infected with 500 infective larvae (L3) of H. polygyrus and the infection was terminated by anthelminthic treatment on Day 12, when the worms were adults. Eight days later sub-groups of these pre-exposed mice, and of similar mice which had not experienced the previous infection with H. polygyrus, were either simultaneously infected with 500 L3 of H. polygyrus and 10(4) bloodstream forms of T. congolense, or with only one of these parasites, or were not infected. The experiment was monitored by routine parasitological and immunological techniques, including quantitative assessment of worm burden, trypanosome parasitaemia, growth of nematodes and measurement of the parameters reflecting pathological and antibody responses for 30 days after immunization. Concurrent H. polygyrus and T. congolense infection resulted in abrogation of the partial immunity against challenge infection with H. polygyrus in the pre-exposed mice, and in depressed humoral antibody responses following infection. Mortality was greatly reduced in pre-exposed mice infected with T. congolense alone compared to naive mice. The growth of male H. polygyrus worms was not affected by either the immune or infection status of their host. Although the increased size of the female worms from pre-exposed and then concurrently infected mice compared to similar mice infected only with H. polygyrus was significant, the egg production per worm was not affected.

Identification of QTLs influencing wood property traits in loblolly pine ( Pinus taeda L.). II. Chemical wood properties.

Chemical wood property traits were analyzed for the presence of quantitative trait loci (QTLs) in a three-generation outbred pedigree of loblolly pine ( Pinus taeda L.). These traits were assayed using pyrolysis molecular beam mass spectrometry and include mass spectrum peak intensities associated with carbohydrates, alpha-cellulose and hemicellulose sugars, and lignin. Models for projection to latent structures (PLS) were used to also estimate the chemical composition of cell walls (i.e., alpha-cellulose, galactan and lignin) from mass spectrum data using multivariate regression. Both earlywood and latewood fractions from the fifth annual ring were analyzed for each trait. An interval mapping approach designed for an outbred pedigree was used to estimate the number of QTLs, the magnitude of QTL effects, and their genomic position. Eight unique QTLs influencing cell wall chemistry were detected from multiple peak intensities and/or PLS estimates using the one- and two-QTL models. Significant differences in chemical contents were observed among the populations from North Carolina vs Oklahoma, and results from QTLxenvironment analyses suggest that QTLs interact with environmental location. QTLs should be verified in larger experiments and in different genetic and environmental backgrounds. QTL mapping will help towards eventually identifying genes having a major effect on chemical wood properties.

Differentiation of Taenia saginata and Taenia solium by enzyme electrophoresis.

Forty-four Taenia saginata and seven T. solium specimens were collected in Nigeria. Extracts of these worms and of their metacestodes were compared by enzyme electrophoresis. The mobility of glucose phosphate isomerase was consistently faster with T. saginata than with T. solium. Extracts of the strobilate and cysticercus forms of the same species gave identical results. It was thus possible to distinguish clearly between material of either species.

A comparison of the enzyme linked immunosorbent assay and the indirect haemagglutination technique applied to sera from cattle experimentally infected with Taenia saginata (Goeze, 1782).

The serological response of 6 calves to experimental oral infection with between 60,000 and 100,000 Taenia saginata eggs at 3-12 months of age was monitored by the enzyme-linked immunosorbent assay (ELISA) and the tanned cell indirect haemagglutination technique (IDH). A serum antibody response was detected by both techniques by 2-3 weeks post infection, rising to a plateau about 4-6 weeks post infection. The serum antibody levels began to decline by about 30 weeks post infection. Two uninfected control cattle gave negative reactions. In addition, the serological response of 5 calves which had received a dose of 10,000 T. saginata eggs at 2-3 days of age and then weekly serial doses of 500 eggs for 12 months thereafter, was compared with a similar group of 5 calves, which had received the single infection of 10,000 eggs at 2-3 days of age only. Calves in both groups developed an antibody response detectable by the ELISA technique whereas those in a group of 5 control calves did not show such a response. When studied individually however there was marked variation in the serum antibody levels of these young cattle, as although some calves gave a relatively strong serological response, others hardly varied from the controls.

13C-NMR studies on 1-N-[(S)-4-amino-2-hydroxybutyl]kanamycin A (butikacin) and related aminoglycosides.

The 13C-NMR spectra of 1-N-[(S)-4-amino-2-hydroxybutyl]kanamycin A (butikacin) (Fig. 1, 1b) and some of its related compounds have been recorded and are tabulated, assigned and discussed. The chemical shifts of many of the carbon nuclei are shown to be reasonably invariant amongst this series of compounds. A procedure is described for the determination of the (R,S)-epimer ratio of kanamycin A derivatives which have N-substituted groups containing a chiral centre.

Psychosocial characteristics of pregnant and nonpregnant HIV-seropositive women.

Thirty-three HIV-positive women, 12 of whom were pregnant, participated in semistructured interviews to define areas of psychosocial need. Eighty-eight percent of the subjects reported current unemployment. A history of substance abuse was reported by 82 percent, suicide attempts by 52 percent, and sexual problems by 43 percent. Approximately 30 percent reported elevated levels of depressive symptoms on standardized symptom inventories. The pregnant women appeared psychologically healthier than the nonpregnant group. HIV-positive women face multiple psychosocial stressors and may experience significant psychological distress.

Resistance to benzimidazole anthelmintics by trichostrongyles in sheep and goats in north-west Cameroon.

Following the routine use of tiabendazole at monthly intervals for several years, the trichostrongyle parasites of sheep and goats on a government research station in North-West Cameroon had become resistant to benzimidazole anthelmintics.

The specificity of somatic and metabolic Taenia taeniaeformis preparations in murine metacestode infections.

Excretory-secretory and somatic preparations of Taenia taeniaeformis contained shared immunologically-active components although immunoelectrophoresis indicated that the major antigen present in the excretory-secretory preparation was only a minor component of the somatic preparation. Both antigens gave similar immunoelectrophoretic reactions with sera from mice infected with either T. taeniaeformis or Taenia crassiceps, but there was evidence from the results using the ELISA technique that the excretory-secretory components showed more species specificity than those of somatic origin.