The Combined Pedicled Anterolateral Thigh and Vastus Lateralis Flap as Filler for Complex Perineal Defects.

Extensive defects of the pelvis and genitoperineal region are a reconstructive challenge. We discuss a consecutive series of 25 reconstructions with the pedicled anterolateral thigh (ALT) flap including muscle part of the vastus lateralis (VL) in 23 patients from October 1999 to September 2012.Only surface defects larger than 100 cm and reconstructions by composite ALT + VL were included in this retrospective analysis. Of the 23 patients, 19 underwent oncologic resection, whereas 4 cases presented Fournier gangrene. Three patients did not reach 6 months of follow-up and were excluded from further data analysis. Among the remaining 20 patients (22 reconstructions), average follow-up period was 14 months (range, 10-18 months). Patient's average age was 60 years. Average size of the defect was 182 cm.Postoperative complications included 1 (4.5%) flap necrosis out of 22 raised flaps, 1 partial flap necrosis after venous congestion, and 2 cases where a complementary reconstructive procedure was performed due to remaining defect or partial flap failure. In 6 cases, peripheral wound dehiscence (27%) was treated by debridement followed by split-thickness skin graft or advancement local flaps. Defect size was significantly related to postoperative complications and increased hospital stay, especially in those patients who underwent preoperative radiotherapy. At the end of the follow-up period, a long-term and satisfactory coverage was obtained in all patients without functional deficits.This consecutive series of composite ALT + VL flap shows that, in case of extended defects, the flap provides an excellent and adjustable muscle mass, is reliable with minimal donor-site morbidity, and can even be designed as a sensate flap.

Radanohjaimen suunnittelu leveille päällystyskoneille

Radanohjaimia käytetään radan poikkisuuntaiseen paikoitukseen sekä oskillointiin ja ne ovat osa paperinvalmistuslinjojen radanhallintajärjestelmiä. Oikein suunnitellulla ja sijoitetulla radanohjaimella voidaan estää haitallisten ratasiirtymien esiintyminen, pienentää hylkymateriaalin määrää sekä parantaa rullauksen laatua. Ohjausperiaatteet sekä niihin liittyvä laitetekniikka on tunnettu jo vuosikymmenten ajan, joskin todelliset radanohjaustarpeet ja -laitteet ovat tähän asti rajoittuneet paino-, tekstiili- ja metalliteollisuudessa käytössä oleville kapeille radoille. Tämän työn tavoitteena oli selvittää 5… 12 metriä leveälle, modernissa päällystyskoneessa kulkevalle paperiradalle soveltuvat ohjausperiaatteet sekä muodostaa radan todennäköisimpiin vauriomuotoihin perustuvat suunnittelukriteerit kahdelle erityyppiselle ohjainkonstruktiolle. Yksitelainen, taivuttava radanohjain soveltuu kohteisiin, joissa ohjainta edeltää suhteellisen pitkä vapaa ratavienti. Kaksitelainen, taittava radanohjain on puolestaan sijoitettavissa huomattavasti lyhyempään ratavientiin. Radanohjauksen teoria pohjautuu pitävän telan ja radan väliseen kohtisuoran tulokulman periaatteeseen, jonka perusteella mikä tahansa yhdensuuntaisuuspoikkeama kahden telan välillä johtaa radan poikkisuuntaiseen siirtymään. Tämän periaatteen pohjalta voidaan dynaamista ohjaustilannetta approksimoida staattisin menetelmin sekä muodostaa kireysmuutoksiin ja aaltoiluun perustuvat geometrian mitoitusperiaatteet ohjaimen ympäristön ratavienneille. Nopean ohjauksen toteutus edellyttää radanohjaimen liikkeen olevan nivelen ympäri tapahtuvaa yhdistettyä translaatio- ja rotaatioliikettä. Ohjainkonstruktiot suunnitellaan siten, että teorian mukaiset optimaaliset liikeradat toteutuvat vaaditulla ohjausnopeudella. Suunnittelua ohjaavat tuotteille asetetut lujuus- ja värähtelykriteerit sekä aiheeseen liittyvät koneturvallisuusstandardit. Konstruointi suoritetaan järjestelmällisen tuotesuunnitteluprosessin vaiheiden ja menetelmien mukaisesti.

Patología Dual y rasgos de personalidad:situación actual y líneas futuras de trabajo

Dual diagnosis (DD) is the co-occurrence, in the same person, of a mental disorder (MD) and a substance use disorder (SUD). Nowadays, the study of the personality with DD is realized mainly from a categorical view, focusing on the detection of personality disorders and not on the traits associated to DD and the possible differential profile compared to those patients with only MD or SUD. Studies analyzing personality traits of patients with DD and their possible differential profile are very limited. However, existing data indicates that DD patients show higher levels of Sensation Seeking, Impulsivity, Harm Avoidance and Neuroticism; and lower levels of Persistence, Self-Direction, Self-Transcendence and Cooperation. Therefore, DD is associated to personality characteristics that suggest more disruptive behaviors, fewer resources for recovering and keeping abstinent and worse prognosis compared to those with only one disorder. Progress in the characterization of personality traits in DD, taking into consideration the methodological aspects to be improved could allow better adaptation of the integrated treatment of these patients in the future.

Are we modular lying cues detectors ? The answer is "yes sometimes"

We quickly form first impressions about newly encountered people guiding our subsequent behaviour (approach, avoidance). Such instant judgments might be innate and automatic, being performed unconsciously and independently to other cognitive processes. Lying detection might be subject to such a modular process. Unfortunately, numerous studies highlighted problems with lying detection paradigms such as high error rates and learning effects. Additionally, humans should be motivated doing both detecting others' lies and dis- guising own lies. Disguising own lies might even be more challenging than detecting other people's lies. Thus, when trying to disguise cheating behaviour, liars might display a mixture of disguising (fake) trust cues and uncontrolled lying cues making the interpretation of the expression difficult (perceivers are guessing). In two consecutive online studies, we tested whether seeing an increasing amount (range 0-4) of lying cues (LC) and non-lying cues (NLC) on a standard face results in enhanced guessing behaviour (studies 1 and 2) and that enhanced guessing is accompanied by slower responding (study 2). Results showed that pronounced guessing and slowest responding occurred for faces with an intermediate number and not with the highest number of LC and NLC. In particular, LC were more impor- tant than NLC to uncertain lying decisions. Thus, only a few LC may interfere with automatic processing of lying detection (irrespective of NLC), probably because too little lying cue information is yet available.

Incendiaires et pyromanes [Arson and pyromania, update 2015].

While the fire constitutes a threat and provokes avoidance by the entire animal world, its control as lighting and maintenance is inseparable from the history of humankind. For 1% of the population that use is turned to harm, repeatedly and without objective reason, responding to the historical definition of pyromania. The profile of arsonists does not appear to be different from that of the general criminal population: alcohol abuse, nicotine, marijuana and antisocial personality do not make fire setters a special case. However positive fire experience lived in childhood, emotional avoidance and expertise in fire settings' control seems to be specific, as recidivism risk below that of the general criminal population.

High-Speed Rail: lessons for policy makers from experiences abroad

In April 2009, the US government unveiled its blueprint for a national network of high-speed passenger rail (HSR) lines aimed at reducing traffic congestion, cutting national dependence on foreign oil and improving rural and urban environments. In implementing such a program, it is essential to identify the factors that might influence decision making and the eventual success of the HSR project, as well as foreseeing the obstacles that will have to be overcome.

Differences between genders in coping: different strategies or different stressors?

These study analysed gender specificity in coping behaviours by taking into account the types of problem faced by Spanish adolescents attending school. It was focused on the ten problems most frequently reported by participants (828 adolescents, 355 boys, and 473 girls; Mage = 14.07, SD = 1.34), which were classified using a multi-axial classification system. Coping was examined as a two separate measures of approach and avoidance coping, and as a combined measure indicating the predominant use of coping, and total coping effort. A MANCOVA and subsequent univariate tests were conducted to analyse the specificity of coping according to problem and gender, controlled by age. The results showed that the percentage of types of problems reported by adolescents differed according to gender. The influence of gender on coping was scarcely relevant when the type of problem was controlled for. There were no gender differences when the predominant type of coping was considered, but when a total coping effort measure was analysed girls showed more coping efforts than boys to face interpersonal relationship problems and personal illness. Keywords: adolescence, coping, gender differences, stressors.

Defensive Metabolites from Antarctic Invertebrates: Does Energetic Content Interfere with Feeding Repellence?

Many bioactive products from benthic invertebrates mediating ecological interactions have proved to reduce predation, but their mechanisms of action, and their molecular identities, are usually unknown. It was suggested, yet scarcely investigated, that nutritional quality interferes with defensive metabolites. This means that antifeedants would be less effective when combined with energetically rich prey, and that higher amounts of defensive compounds would be needed for predator avoidance. We evaluated the effects of five types of repellents obtained from Antarctic invertebrates, in combination with diets of different energetic values. The compounds came from soft corals, ascidians and hexactinellid sponges; they included wax esters, alkaloids, a meroterpenoid, a steroid, and the recently described organic acid, glassponsine. Feeding repellency was tested through preference assays by preparing diets (alginate pearls) combining different energetic content and inorganic material. Experimental diets contained various concentrations of each repellent product, and were offered along with control compound-free pearls, to the Antarctic omnivore amphipod Cheirimedon femoratus. Meridianin alkaloids were the most active repellents, and wax esters were the least active when combined with foods of distinct energetic content. Our data show that levels of repellency vary for each compound, and that they perform differently when mixed with distinct assay foods. The natural products that interacted the most with energetic content were those occurring in nature at higher concentrations. The bioactivity of the remaining metabolites tested was found to depend on a threshold concentration, enough to elicit feeding repellence, independently from nutritional quality.

Shadow on the Plant: A Strategy to Exit.

The light spectrum perceived by plants is affected by crowding, which results in the shade avoidance syndrome (SAS). Findings presented by Pedmale et al. bring cryptochromes to the forefront of SAS and elucidate a fascinating molecular crosstalk between photoreceptor systems operating in different wavebands.

Multimodal stimulus coding by a gustatory sensory neuron in Drosophila larvae.

Accurate perception of taste information is crucial for animal survival. In adult Drosophila, gustatory receptor neurons (GRNs) perceive chemical stimuli of one specific gustatory modality associated with a stereotyped behavioural response, such as aversion or attraction. We show that GRNs of Drosophila larvae employ a surprisingly different mode of gustatory information coding. Using a novel method for calcium imaging in the larval gustatory system, we identify a multimodal GRN that responds to chemicals of different taste modalities with opposing valence, such as sweet sucrose and bitter denatonium, reliant on different sensory receptors. This multimodal neuron is essential for bitter compound avoidance, and its artificial activation is sufficient to mediate aversion. However, the neuron is also essential for the integration of taste blends. Our findings support a model for taste coding in larvae, in which distinct receptor proteins mediate different responses within the same, multimodal GRN.

Photomorphogenesis and Photoreceptors

Plants use light as their main source of energy and to gather information about their surroundings. The light environment is monitored through an extensive set of photoreceptors and largely dictates plant development through induction of processes such as germination and flowering, entrainment of the circadian clock and photomorphogenic responses. Plants display remarkable phenotypic plasticity upon perception of changes in the light, ranging from seedling de-etiolation to shade avoidance and phototropic responses in competition for light. Here, we describe photomorphogenic responses and their underlying mechanisms such as they occur in a leaf canopy. This shade avoidance review will largely focus on the model plant species Arabidopsis thaliana as the underlying mechanisms controlling shade avoidance are particularly well elucidated in this species.

Cavernous sinus syndrome due to rhino-orbital-cerebral mucormycosis

The present report describes the case of a 43-year-old diabetic patient with facial pain, protruding eyes, nasal congestion and decreased right vision (involvement of the ipsilateral cranial nerves III, IV and V). Computed tomography showed diffuse sinusitis at right, cribriform plate erosion and presence of a hypodense collection in the frontal lobe with peripheral enhancement. Magnetic resonance imaging confirmed the presence of a cerebral abscess. Samples were collected from the lesion, confirming hyphae compatible with mucormycosis.

Diffantom: Whole-Brain Diffusion MRI Phantoms Derived from Real Datasets of the Human Connectome Project.

Food allergies are believed to be on the rise and currently management relies on the avoidance of the food. Hen's egg allergy is after cow's milk allergy the most common food allergy; eggs are used in many food products and thus difficult to avoid. A technological process using a combination of enzymatic hydrolysis and heat treatment was designed to produce modified hen's egg with reduced allergenic potential. Biochemical (SDS-PAGE, Size exclusion chromatography and LC-MS/MS) and immunological (ELISA, immunoblot, RBL-assays, animal model) analysis showed a clear decrease in intact proteins as well as a strong decrease of allergenicity. In a clinical study, 22 of the 24 patients with a confirmed egg allergy who underwent a double blind food challenge with the hydrolysed egg remained completely free of symptoms. Hydrolysed egg products may be beneficial as low allergenic foods for egg allergic patients to extent their diet. This article is protected by copyright. All rights reserved.

The Ionotropic receptors IR21a and IR25a mediate cool sensing in Drosophila.

Animals rely on highly sensitive thermoreceptors to seek out optimal temperatures, but the molecular mechanisms of thermosensing are not well understood. The Dorsal Organ Cool Cells (DOCCs) of the Drosophila larva are a set of exceptionally thermosensitive neurons critical for larval cool avoidance. Here, we show that DOCC cool-sensing is mediated by Ionotropic Receptors (IRs), a family of sensory receptors widely studied in invertebrate chemical sensing. We find that two IRs, IR21a and IR25a, are required to mediate DOCC responses to cooling and are required for cool avoidance behavior. Furthermore, we find that ectopic expression of IR21a can confer cool-responsiveness in an Ir25a-dependent manner, suggesting an instructive role for IR21a in thermosensing. Together, these data show that IR family receptors can function together to mediate thermosensation of exquisite sensitivity.

Markkinamekanismit sähkön tukkumarkkinoilla

Diplomityön tavoitteena on tehdä katsaus sähkömarkkinoiden integroitumiseen Euroopassa. Lisäksi keskeinen tavoite on löytää integraatiokehitystä ohjaavia tekijöitä, ja vertailla eri alueiden yhdistymiskehitystä. Markkinaintegraation taustalla on Euroopan Unionin tavoitteet luoda yhtenäiset sähkön sisämarkkinat. Aluksi kuitenkin luodaan alueelliset sähkömarkkinat, jotka yhdistetään yhteen myöhemmin. Työssä tarkastellaan Pohjoismaiden sähkömarkkinoita ja pörssitoimintaa. Tämän lisäksi paneudutaan Saksan, Ranskan, Hollannin ja Belgian sähkömarkkinoihin, sähköpörsseihin ja markkinaintegraatioprosesseihin. Näillä alueilla yhdistymisprosessit ovat edenneet kaikkein pisimmälle, joten ne ovat mielenkiintoisia tarkastelukohteita. Kutakin aluetta käsitellään sen omista lähtökohdista käsin ja lisäksi tehdään vertailu eri markkina-alueiden kehityksestä. Toinen näkökulma on tarkastella EU:n muiden alueiden (Iso-Britannia, Iberia, Italia ja Kreikka) sähkömarkkinoita ja integraatioprosesseja. Osassa näitä alueita on ollut ongelmia markkinoiden avaamisessa ja yhdistymiskehityksessä, joten näistä saadaan hyviä vertailukohtia. Merkittävä osa työtä on myös perehtyä erilaisiin hinnoittelumekanismeihin pörsseissä, ja siirtoverkon ruuhkaisuuden käsittelyyn liittyviin malleihin. Tässä yhteydessä esitellään myös yhdysvaltalaisia sähkömarkkinoita, ja siirtoverkon kapasiteetinjakomenetelmiä Euroopassa.