Reassessing the multiple values of lowland British floodplains.

Ecosystem services provided by lowland British floodplains respectively under semi-natural conditions and converted for intensive maize production were assessed. Floodplains across lowland Britain have been extensively disconnected from river channels, depleting habitat for wildlife and other beneficial ecosystem services. Conservation measures are often regarded as costly constraints on economic and development freedoms whilst, conversely, conversion for intensive agricultural production is rewarded by markets despite many often-overlooked externalities.

Multilocular Thymic Cyst in a Patient with Untreated HIV/AIDS: Case Report and Review of the Literature.

Background: Multilocular thymic cysts (MTCs) in adults with human immunodeficiency virus (HIV) are rarely reported.

Case Presentation: We describe a case of symptomatic MTC in a male with untreated HIV. A presumptive diagnosis was established based on radiographic imaging and biopsy.

Successful beating-heart repair of pulmonary artery dissection using a composite valve-tube graft.

Pulmonary artery dissection is rare but highly lethal. Recent reports suggest that surgical repair of pulmonary artery dissection may yield good outcomes in selected patients, although postoperative right ventricular failure and death have been described. Currently, only one patient over age 60 years old has been reported to survive open surgical repair of pulmonary artery dissection.

Recyclable, Strong, and Highly Malleable Thermosets Based on Boroxine Networks.

Traditional thermoset materials have favorable material properties but are unable to reprocess and are difficult to recycle. Small molecule boroxines have been shown to undergo a reversible exchange reaction. Herein we employ boroxine as dynamic cross-links to construct a novel type of thermoset material that is strong, highly malleable, and recyclable.

Frequency and Associated Clinical Features of Functional Tricuspid Regurgitation in Patients With Chronic Atrial Fibrillation.

Significant functional tricuspid regurgitation (TR) can develop in some but not all patients with chronic atrial fibrillation (AF). This study sought to identify factors likely to be involved in determining the severity of TR in patients with chronic AF. In this retrospective cohort study of adult patients referred for transthoracic echocardiography for evaluation of AF between 2004 and 2015, we identified 170 patients with chronic AF in the absence of structural or known coronary heart disease.

Changes in the incidence, patterns and outcomes of graft failure following hematopoietic stem cell transplantation for Hurler syndrome.

Hematopoietic stem cell transplantation (HSCT) is the standard of care in children with Hurler syndrome (HS) as it is the only therapy that can arrest disease progression. We examined the incidence, patterns and outcomes of graft failure in all HS children undergoing first HSCT at the Royal Manchester Children's Hospital or the University of Minnesota Children's Hospital from 1983 to 2016. Implementation of busulfan pharmacokinetic monitoring started in 2004 in both institutions.

Recovery of a Missile Embolus From the Right Ventricle.

Missile embolism is a clinical entity in which a projectile object enters a blood vessel and is carried to a distant part of the body. We present a case of the discovery of an iliac vein to right ventricle missile embolus in a young man, with successful extraction through a right atriotomy. We provide a historical overview of the literature concerning missile embolism, and we argue that whereas acute embolized projectiles should be removed in almost all cases, it may be reasonable to simply observe an asymptomatic chronic missile embolus.

Creation and Global Deployment of a Mobile, Application-Based Cognitive Simulator for Cardiac Surgical Procedures.

Several modern learning frameworks (eg, cognitive apprenticeship, anchored instruction, and situated cognition) posit the utility of nontraditional methods for effective experiential learning. Thus, development of novel educational tools emphasizing the cognitive framework of operative sequences may be of benefit to surgical trainees. We propose the development and global deployment of an effective, mobile cognitive cardiac surgical simulator.

Synthesis, electrochemical properties, and crystal packing of perfluororubrene.

A synthesis of perfluorinated rubrene is reported. Electrochemical analysis revealed the significantly increased electron affinity of perfluororubrene compared with non-modified rubrene. Crystallographic investigation revealed two polymorphs and a solvate, each displaying twisted backbone conformations of perfluororubrene.

Inheriting the Learner's View: A Google Glass-Based Wearable Computing Platform for Improving Surgical Trainee Performance.

Background: It is speculated that, in operative environments, real-time visualization of the trainee's viewpoint by the instructor may improve performance and teaching efficacy. We hypothesized that introduction of a wearable surgical visualization system allowing the instructor to visualize otherwise "blind" areas in the operative field could improve trainee performance in a simulated operative setting.

Methods: A total of 11 surgery residents (4 in general surgery training and 7 in an integrated 6-year cardiothoracic surgery program) participated in the study.

A Rare Case of Plastic Bronchitis in an Adult Patient After Cardiopulmonary Bypass.

Plastic bronchitis is a rare life-threatening complication observed after cardiopulmonary bypass (CPB). We describe a case of a 54-year-old man in whom a fulminant case of plastic bronchitis developed after coronary artery bypass grafting (CABG) and mitral valve repair. A brief review of the literature is also presented.

Effect of size (mis)matching in clinical double-lung transplantation.

Current United Network for Organ Sharing policy requires listing lung transplant recipients with an acceptable donor weight range, but lung size is a function of height, age, sex, and race. Frequently, lung transplant recipients are underweight, which results in a large discrepancy between donor and recipient weights. We reviewed our experience with size discrepancy between donors (D) and recipients (R) of 49 double-lung transplant (DLTX) procedures since July 1990.

Improved results of lung transplantation for patients with cystic fibrosis.

Patients with cystic fibrosis pose particular challenges for lung transplant surgeons. Earlier reports from North American centers suggested that patients with cystic fibrosis were at greater risk for heart-lung or isolated lung transplantation than other patients with end-stage pulmonary disease. During a 3 1/2 year period, 44 patients with end-stage lung disease resulting from cystic fibrosis underwent double lung transplantation at this institution.

A new bone anchor for re-attachment of soft tissue and management of fractures and dislocations.

The attachment of soft tissue to bone is a problem in orthopedic surgery. Over the last one hundred years several methods have been used. The earliest method involved drilling a hole in the bone, pulling the tendon through the hole and sewing the tendon onto itself.

Homoharringtonine-induced hyperglycemia.

Homoharringtonine (HHT) has been reported to induce hyperglycemia. This report describes a study conducted to characterize the effect of HHT on insulin production and action. Our data indicate that HHT-induced hyperglycemia results from the development of insulin resistance.

Osteoarthritic knee pain: a behavioral analysis.

This study used behavioral assessment techniques to analyze pain in osteoarthritis (OA) patients. Eighty-seven OA patients having chronic knee pain served as subjects. Pain behavior was evaluated using a standard observation method and functional impairment was assessed using the Arthritis Impact Measurement Scales.

Varicella arthritis.

Varicella arthritis is an acute self-limited arthritis, occurring in close temporal association with clinical varicella, which is usually monarthric, involving the knee of a prepubertal girl. We have reported a case of varicella arthritis and summarized the clinical and laboratory findings of our case and the cases reported in the English literature. It is important to differentiate this condition from septic arthritis.

Experimental evidence for a vagally mediated and cholecystokinin-independent enteropancreatic reflex.

Truncal vagotomy results in diminished pancreatic protein secretion in response to intraduodenal fat. This diminished secretion may be due, at least in part, to interruption of the vagal reflexes between the intestine and the pancreas that work independently of cholecystokinin (CCK). In five dogs with chronic pancreatic fistulas, plasma CCK concentrations and pancreatic protein secretion in response to an intestinal stimulant (intraduodenal oleate) and to two exogenous peptides (bombesin and CCK-33) were compared before and after bilateral truncal vagotomy.

Cytoprotective effect of pentagastrin and epidermal growth factor on stress ulcer formation. Possible role of somatostatin.

This study was designed to test the effects of pentagastrin and epidermal growth factor (EGF) on stress-induced ulceration and on the antral content of gastrin and somatostatin (SLI) in rats. Four groups of 14 to 15 rats had been prepared for 7 days by one of the following methods: saline injection (control); injection of pentagastrin (250 micrograms/kg, 3 times/day); injection of EGF (10 micrograms/kg, 3 times/day); or injection of EGF plus pentagastrin. At the end of the treatment period, half of each group of rats were sacrificed (nonstress group).

Physiologic role of cholecystokinin in the intestinal phase of pancreatic polypeptide release.

Release of pancreatic polypeptide (PP) after a meal is biphasic, with an early transient peak believed to be under cholinergic control, and a secondary, prolonged intestinal phase thought to be mediated by hormones. Endogenous release of PP was stimulated by intraduodenal oleate (6.8 mmol/hr) or by intravenous administration of pure cholecystokinin-33 (CCK-33, 0.