Anterior vertebral tethering for adolescent idiopathic scoliosis: our initial ten year clinical experience.

Background: Anterior vertebral tethering (AVT) is a minimally invasive alternative to fusion surgery for adolescent idiopathic scoliosis (AIS) that offers the potential for definitive scoliosis treatment with the possibility of preservation of the growth, motion, function and overall health of the spine. This study represents our first ten years using AVT to treat AIS.

Methods: In this retrospective review we analyzed our first 74 AIS patients treated with AVT 2010-2020.

Chronic Pseudoaneurysm and Anterior Dislocation After Total Hip Arthroplasty Complicated by Arterial Injury: A Case Report.

Case: A 64-year-old man presented 18 months after total hip arthroplasty complicated by vascular injury with a history of leg pain, inability to mobilize, and progressive chronic leg edema. It is presumed that there was persistent subtle bleeding over time with pseudoaneurysm formation and prosthetic hip dislocation secondary to the mass effect.

Conclusion: Physicians should consider pseudoaneurysm as a possible diagnosis when confronted with a large intra-articular mass in the hip after a relatively short follow-up period, particularly in the context of a prior vascular injury at the time of the index procedure.

Surgical Management of Delayed Brachial Plexopathy After Clavicle Nonunion.

Brachial plexopathy after conservative therapy or surgical treatment of clavicular fractures is an uncommon, yet serious complication that is associated with compression of the brachial plexus or the subclavian artery and vein because they traverse through the thoracic outlet. Surgical decompression of the brachial plexus is the recommended treatment if this condition is to occur. Although there are multiple reports of these cases in the literature, at present, there are no clear guidelines for their management.

Exogenous trehalose improves growth under limiting nitrogen through upregulation of nitrogen metabolism.

Background: The trehalose (Tre) pathway has strong effects on growth and development in plants through regulation of carbon metabolism. Altering either Tre or trehalose 6-phosphate (T6P) can improve growth and productivity of plants as observed under different water availability. As yet, there are no reports of the effects of modification of Tre orT6P on plant performance under limiting nutrition.

Transient Coma Due To Epidural Anesthesia: The Role of Loss of Sensory Input.

Background: Epidural anesthesia is the most commonly used method of pain relief during labor in the USA. It is not classically associated with alterations in level of alertness. Coma during the procedure is rare, with a reported incidence of 0.

Systems responses to progressive water stress in durum wheat.

Durum wheat is susceptible to terminal drought which can greatly decrease grain yield. Breeding to improve crop yield is hampered by inadequate knowledge of how the physiological and metabolic changes caused by drought are related to gene expression. To gain better insight into mechanisms defining resistance to water stress we studied the physiological and transcriptome responses of three durum breeding lines varying for yield stability under drought.

Source/sink interactions underpin crop yield: the case for trehalose 6-phosphate/SnRK1 in improvement of wheat.

Considerable interest has been evoked by the analysis of the regulatory pathway in carbohydrate metabolism and cell growth involving the non-reducing disaccharide trehalose (TRE). TRE is at small concentrations in mesophytes such as Arabidopsis thaliana and Triticum aestivum, excluding a role in osmoregulation once suggested for it. Studies of TRE metabolism, and genetic modification of it, have shown a very wide and more important role of the pathway in regulation of many processes in development, growth, and photosynthesis.

Using goal analysis to drive improvements in performance and outcomes.

Economic pressures for public health and human services systems to control budgets are increasing the need for demonstrating value of support services provided to persons with intellectual disabilities. In this article, we build from earlier work that presented a method for assessing goal attainment to expand the study of goal characteristics as a means to gain an improved understanding of individual outcomes and service performance. The study results suggest a positive relationship between targeting intentional skill teaching in person-centered planning and service delivery and increasing the ability of individuals to live more independently in communities with decreased levels of paid staff support.

Genetic engineering to improve plant performance under drought: physiological evaluation of achievements, limitations, and possibilities.

Fully drought-resistant crop plants would be beneficial, but selection breeding has not produced them. Genetic modification of species by introduction of very many genes is claimed, predominantly, to have given drought resistance. This review analyses the physiological responses of genetically modified (GM) plants to water deficits, the mechanisms, and the consequences.

Hyperaromatic stabilization of arenium ions: a remarkable cis stereoselectivity of nucleophilic trapping of β-hydroxyarenium ions by water.

Cis- and trans-1,2-dihydrodiol isomers of benzene undergo acid-catalyzed dehydration to form phenol. In principle the isomeric substrates react through a common β-hydroxybenzenium (cyclohexadienyl) carbocation. Notwithstanding, the isomers show a large difference in reactivity, k(cis)/k(trans) = 4500.

Hyperaromatic stabilization of arenium ions: cyclohexa- and cycloheptadienyl cations-experimental and calculated stabilities and ring currents.

Measurements of pK(R) show that the cycloheptadienyl cation is less stable than the cyclohexadienyl (benzenium) cation by 18 kcal mol(-1). This difference is ascribed here to "hyperaromaticity" of the latter. For the cycloheptadienyl cation a value of K(R) = [ROH][H(+)]/[R(+)] is assigned by combining a rate constant for reaction of the cation with water based on the azide clock with a rate constant for the acid-catalyzed formation of the cation accompanying equilibration of cycloheptadienol with its trifluoroethyl ether in TFE-water mixtures.

Hyperaromatic stabilization of arenium ions.

Benzene-cis- and trans-1,2-dihydrodiols undergo acid-catalyzed dehydration at remarkably different rates: k(cis)/k(trans) = 4500. This is explained by formation of a β-hydroxycarbocation intermediate in different initial conformations, one of which is stabilized by hyperconjugation amplified by an aromatic no-bond resonance structure (HOC(6)H(6)(+) ↔ HOC(6)H(5) H(+)). MP2 calculations and an unfavorable effect of benzoannelation on benzenium ion stability, implied by pK(R) measurements of -2.

American Pediatric Surgical Association New Technology Committee review on video-assisted thoracoscopic surgery for childhood cancer.

Background/purpose: Although the use of minimally invasive surgical (MIS) techniques for children with cancer is being practiced by some, its role remains unclearly defined. The purpose of this review was to describe the current literature on MIS for thoracic and mediastinal lesions in children.

Methods: We performed a literature search for English studies that evaluated MIS techniques for biopsy or resection in children with suspected or established cancer.

Test of time: a case study in the functioning of social systems as a defence against anxiety: rereading 50 years on.

In this paper I revisit Isabel Menzies's classic 'nursing paper' (I.E.P.

Best practice updates for pediatric/adolescent weight loss surgery.

The objective of this study is to update evidence-based best practice guidelines for pediatric/adolescent weight loss surgery (WLS). We performed a systematic search of English-language literature on WLS and pediatric, adolescent, gastric bypass, laparoscopic gastric banding, and extreme obesity published between April 2004 and May 2007 in PubMed, MEDLINE, and the Cochrane Library. Keywords were used to narrow the search for a selective review of abstracts, retrieval of full articles, and grading of evidence according to systems used in established evidence-based models.

Musings about the effects of environment on photosynthesis.

Understanding of how plants respond to their environment, particularly to extreme conditions to which their metabolisms are not adapted, is advancing on many fronts. An enormous matrix of plant and environmental factors exists from which mechanisms and assessments of quantitative responses must be developed if further progress in understanding how to improve plant (and particularly crop) production is to be achieved. This Special Issue contains assessments of different areas of plant sciences, ranging from genome to field, but with a focus on photosynthesis.

Causes of decreased photosynthetic rate and metabolic capacity in water-deficient leaf cells: a critical evaluation of mechanisms and integration of processes.

Background: Water deficit (WD) decreases photosynthetic rate (A) via decreased stomatal conductance to CO(2) (g(s)) and photosynthetic metabolic potential (A(pot)). The relative importance of g(s) and A(pot), and how they are affected by WD, are reviewed with respect to light intensity and to experimental approaches.

Scope And Conclusions: With progressive WD, A decreases as g(s) falls.

Assessing goal attainment for quality improvement.

Organizations that support persons with intellectual disabilities will likely experience increasing pressure to provide evidence of the benefits of services to participants in programs. In this article we propose a model for assessing goal attainment modified from scales used with other populations that both develops from the person-centered planning process and informs on program and organizational efficacy. Implications for assessing goal attainment and considerations for applying information to improve individual, program and organization quality are presented.

Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon.

Background: Multiple studies have individually documented cardiac dysfunction and biochemical evidence of cardiac injury after endurance sports; however, convincing associations between the two are lacking. We aimed to determine the associations between the observed transient cardiac dysfunction and biochemical evidence of cardiac injury in amateur participants in endurance sports and to elicit the risk factors for the observed injury and dysfunction.

Methods And Results: We screened 60 nonelite participants, before and after the 2004 and 2005 Boston Marathons, with echocardiography and serum biomarkers.

Sudden onset of paraplegia from acute aortic occlusion: a review of 2 cases and their unique presentation.

Acute aortic occlusion is an uncommon entity requiring prompt recognition and intervention to limit morbidity and mortality. We describe 2 patients with acute aortic occlusion who presented uniquely with sudden onset of paraplegia. In addition, we highlight their circuitous diagnostic course and the adverse impact of diagnostic delay in their management and outcome.

Persistent and reversible cardiac dysfunction among amateur marathon runners.

Aims: Transient systolic and diastolic abnormalities in ventricular function have previously been documented during endurance sports. However, these described alterations may be limited by the techniques applied. We sought, using less load-dependent methods, to characterize both the extent and the chronology of the cardiac changes associated with endurance events.

Nonstomatal limitations are responsible for drought-induced photosynthetic inhibition in four C grasses.

•   Here, the contribution of stomatal and nonstomatal factors to photosynthetic inhibition under water stress in four tropical C grasses was investigated (Panicum coloratum, Bothriochloa bladhii, Cenchrus ciliaris and Astrebla lappacea). •   Plants were grown in well watered soil, and then the effects of soil drying were measured on leaf gas exchange, chlorophyll a fluorescence and water relations. •   During the drying cycle, leaf water potential (Ψ ) and relative water content (RWC) decreased from c.

Limitation to photosynthesis in water-stressed leaves: stomata vs. metabolism and the role of ATP.

Decreasing relative water content (RWC) of leaves progressively decreases stomatal conductance (gs), slowing CO2 assimilation (A) which eventually stops, after which CO2 is evolved. In some studies, photosynthetic potential (Apot), measured under saturating CO2, is unaffected by a small loss of RWC but becomes progressively more inhibited, and less stimulated by elevated CO2, below a threshold RWC (Type 1 response). In other studies, Apot and the stimulation of A by elevated CO2 decreases progressively as RWC falls (Type 2 response).