Elements of surgery /

Includes bibliographical references and index.

Addresses and other papers,

The early history of practical anatomy.--The history of the Philadelphia school of anatomy and its relation to medical teaching.--Our recent debts to vivisection.--Recent progress in surgery.--The new era in medicine and its demands upon the profession and the college.--The real rewards of medicine.--Medicine as a career for educated men.--Vivisection and brain surgery.--Medical education.--The advantages of an academic training for a medical career.--Literary methods in medicine.--Address at the unveiling of the statue of the late Prof. Samuel D. Gross, M.D.--Semicentennial address in surgery before the American medical association.--The debt of the public to the medical profession.--The endowment of medical colleges.--The ideal physician.--Address at the Royal college of surgeons of England at the conferring of honorary degrees at the centenary celebration of the granting of its present charter.--The progress of surgery in the nineteenth century.--The mission of a medical college.--The duties and responsibilities of trustees of public medical institutions.--The qualities essential to success in medicine.--The cheerfulness of death.--The need for increased endowments for medical instruction.--Age and youth in medicine.--Surgical reminiscences of the civil war.

Novel peptide antagonists of adrenomedullin and calcitonin gene-related peptide receptors:identification, pharmacological characterization, and interactions with position 74 in receptor activity-modifying protein 1/3

Human adrenomedullin (AM) is a 52-amino acid peptide belonging to the calcitonin peptide family, which also includes calcitonin gene-related peptide (CGRP) and AM2. The two AM receptors, AM(1) and AM(2), are calcitonin receptor-like receptor (CL)/receptor activity-modifying protein (RAMP) (RAMP2 and RAMP3, respectively) heterodimers. CGRP receptors comprise CL/RAMP1. The only human AM receptor antagonist (AM(22-52)) is a truncated form of AM; it has low affinity and is only weakly selective for AM(1) over AM(2) receptors. To develop novel AM receptor antagonists, we explored the importance of different regions of AM in interactions with AM(1), AM(2), and CGRP receptors. AM(22-52) was the framework for generating further AM fragments (AM(26-52) and AM(30-52)), novel AM/alphaCGRP chimeras (C1-C5 and C9), and AM/AM(2) chimeras (C6-C8). cAMP assays were used to screen the antagonists at all receptors to determine their affinity and selectivity. Circular dichroism spectroscopy was used to investigate the secondary structures of AM and its related peptides. The data indicate that the structures of AM, AM2, and alphaCGRP differ from one another. Our chimeric approach enabled the identification of two nonselective high-affinity antagonists of AM(1), AM(2), and CGRP receptors (C2 and C6), one high-affinity antagonist of AM(2) receptors (C7), and a weak antagonist selective for the CGRP receptor (C5). By use of receptor mutagenesis, we also determined that the C-terminal nine amino acids of AM seem to be responsible for its interaction with Glu74 of RAMP3. We provide new information on the structure-activity relationship of AM, alphaCGRP, and AM2 and how AM interacts with CGRP and AM(2) receptors.

Polarization-independent high-resolution spectral interrogation of FBGs using a BFBG-CCD array for optical sensing applications

Optical fibre strain sensors using Fibre Bragg Gratings (FBGs) are poised to play a major role in structural health monitoring in a variety of application from aerospace to civil engineering. At the heart of technology is the optoelectronic instrumentation required to convert optical signals into measurands. Users are demanding compact, lightweight, rugged and low cost solutions. This paper describes development of a new device based on a blazed FBG and CCD array that can potentially meet the above demands. We have shown that this very low cost technique may be used to interrogate a WDM array of sensor gratings with highly accurate and highly repeatable results unaffected by the polarisation state of the radiation. In this paper, we present results showing that sensors may be interrogated with an RMS error of 1.7pm, drift below 0.12pm and dynamic range of up to 65nm.

Polarization-independent high-resolution spectral interrogation of FBGs using a BFBG-CCD array for optical sensing applications

Optical fibre strain sensors using Fibre Bragg Gratings (FBGs) are poised to play a major role in structural health monitoring in a variety of application from aerospace to civil engineering. At the heart of technology is the optoelectronic instrumentation required to convert optical signals into measurands. Users are demanding compact, lightweight, rugged and low cost solutions. This paper describes development of a new device based on a blazed FBG and CCD array that can potentially meet the above demands. We have shown that this very low cost technique may be used to interrogate a WDM array of sensor gratings with highly accurate and highly repeatable results unaffected by the polarisation state of the radiation. In this paper, we present results showing that sensors may be interrogated with an RMS error of 1.7pm, drift below 0.12pm and dynamic range of up to 65nm.

A spatial-temporal analysis of section 404 wetland permitting in Texas and Florida: Thirteen years of impact along the coast

Over the past 200 years, an estimated 53% (about 47 million ha) of the original wetlands in the conterminous United States have been lost, mainly as a result of various human activities. Despite the importance of wetlands (particularly along the coast), and a longstanding federal policy framework meant to protect their integrity, the cumulative impact on these natural systems over large areas is poorly understood. We address this lack of research by mapping and conducting descriptive spatial analyses of federal wetland alteration permits (pursuant to section 404 of the Clean Water Act) across 85 watersheds in Florida and coastal Texas from 1991 to 2003. Results show that more than half of the permits issued in both states (60%) fell under the Nationwide permitting category. Permits issued in Texas were typically located outside of urban areas (78%) and outside 100-year floodplains (61%). More than half of permits issued in Florida were within urban areas (57%) and outside of 100-year floodplains (51%). The most affected wetlands types were estuarine in Texas (47%) and palustrine in Florida (55%). We expect that an additional outcome of this work will be an increased awareness of the cumulative depletion of wetlands and loss of ecological services in these urbanized areas, perhaps leading to increased conservation efforts.

Biodiversity context of selected samples from the Tara Oceans Expedition (2009-2013)

The present data set provides contextual data for samples from the Tara Oceans Expedition (2009-2013) that were selected for publication in a special issue of the SCIENCE journal (see related references below). Contextual data include various diversity indexes calculated for the sampling location using satellite and model climatologies (Darwin project, Physat) and results from the sequencing of Tara Oceans samples.

A monovalent chimpanzee adenovirus Ebola vaccine boosted with MVA

BACKGROUND The West African outbreak of Ebola virus disease that peaked in 2014 has caused more than 11,000 deaths. The development of an effective Ebola vaccine is a priority for control of a future outbreak. METHODS In this phase 1 study, we administered a single dose of the chimpanzee adenovirus 3 (ChAd3) vaccine encoding the surface glycoprotein of Zaire ebolavirus (ZEBOV) to 60 healthy adult volunteers in Oxford, United Kingdom. The vaccine was administered in three dose levels — 1×1010 viral particles, 2.5×1010 viral particles, and 5×1010 viral particles — with 20 participants in each group. We then assessed the effect of adding a booster dose of a modified vaccinia Ankara (MVA) strain, encoding the same Ebola virus glyco- protein, in 30 of the 60 participants and evaluated a reduced prime–boost interval in another 16 participants. We also compared antibody responses to inactivated whole Ebola virus virions and neutralizing antibody activity with those observed in phase 1 studies of a recombinant vesicular stomatitis virus–based vaccine expressing a ZEBOV glycoprotein (rVSV-ZEBOV) to determine relative potency and assess durability. RESULTS No safety concerns were identified at any of the dose levels studied. Four weeks after immunization with the ChAd3 vaccine, ZEBOV-specific antibody responses were similar to those induced by rVSV-ZEBOV vaccination, with a geometric mean titer of 752 and 921, respectively. ZEBOV neutralization activity was also similar with the two vaccines (geo- metric mean titer, 14.9 and 22.2, respectively). Boosting with the MVA vector increased virus-specific antibodies by a factor of 12 (geometric mean titer, 9007) and increased glycoprotein-specific CD8+ T cells by a factor of 5. Significant increases in neutralizing antibodies were seen after boosting in all 30 participants (geometric mean titer, 139; P<0.001). Virus-specific antibody responses in participants primed with ChAd3 remained positive 6 months after vaccination (geometric mean titer, 758) but were significantly higher in those who had received the MVA booster (geometric mean titer, 1750; P<0.001). CONCLUSIONS The ChAd3 vaccine boosted with MVA elicited B-cell and T-cell immune responses to ZEBOV that were superior to those induced by the ChAd3 vaccine alone. (Funded by the Wellcome Trust and others; ClinicalTrials.gov number, NCT02240875.)

Impacto de los Niveles de Tacrolimus en el Rechazo al Injerto y la Tasa de Filtración Glomerular en Pacientes con Trasplante Hepático realizado en la FCI-IC entre 2009 y 2014

Introducción: El tacrolimus es el medicamento de elección para evitar el rechazo al injerto hepático. Su dosis se ajusta a partir de los niveles séricos que se toman periódicamente para asegurar rango terapéutico. Además, niveles elevados se asocian con disfunción renal postrasplante. Sin embargo, no hay consenso frente a los niveles adecuados para pacientes con trasplante hepático. Objetivo: Determinar la relación entre los niveles de tacrolimus y la presencia de rechazo agudo al injerto hepático en pacientes con trasplante hepático realizado en la Fundación Cardioinfantil – Instituto de Cardiología (FCI-IC). Determinar la relación entre los niveles de tacrolimus y la TFG en pacientes con trasplante hepático realizado en la FCI-IC. Métodos: Estudio observacional tipo cohorte histórica en pacientes adultos con trasplante hepático realizado en la FCI-IC entre 2009-2014. Resultados: No se encontró una asociación estadísticamente significativa entre los niveles de tacrolimus y la presencia de rechazo agudo, en sus diferentes definiciones (OR=1,02, p=0,14 y OR=1,01, p=0,29) incluso al ajustar por otras covariables (OR=1,03, p=0,10 y OR=1,02, p=0,25). No fue posible corroborar el diagnóstico con biopsia porque no todos la tenían. Si bien la relación entre los niveles de tacrolimus y la TFG fue estadísticamente significativa (p≤0,001), tiene bajo impacto clínico, pues la TFG disminuyó menos de un punto por cada incremento en 1 ng/ml en los niveles de tacrolimus. Conclusiones: Se necesitan más estudios para establecer la relación entre la exposición a tacrolimus y estos desenlaces para definir si es seguro disminuir su dosis con el fin de reducir los eventos adversos.

Arrêt du conseil d'Etat qui ordonne que les acquéreurs des nouveaux offices de secrétaires du roi créés par édit de décembre 1708, et autres, seront tenus d'obtenir des provisions et de se faire recevoir auxdits offices pour jouir des privilèges et exemptions y attribués

[Acte. 1711-01-20. Versailles]

Arrêt du Conseil d'Etat qui subroge François Fontaine au lieu et place de François Cheron pour faire le recouvrement de la finance qui doit provenir de la vente des offices de conseillers secrétaires de Sa Majesté, créés par édit du mois de décembre 1708

[Acte. 1712-03-15. Versailles]

Arrêt du conseil d'Etat du roi qui ordonne que les offices de gardes des Sceaux, gardes scel et secrétaires des chancelleries près les cours supérieures et sièges présidiaux du royaume créés par édit du mois de juin 1715 et ceux de receveurs et payeurs des gages des officiers des dites chancelleries créés par édits des mois de novembre 1707 et décembre 1708 qui n'ont pas été levés, demeureront supprimés

[Acte. 1720-02-09. Paris]

Traduction de la lettre prétendue du juif Samuel Marrachitan à son maître Rabbi Isaac, sur la vérité du christianisme ; traduite de l'hébreu en latin par Alfonse d'Espagne et du latin en allemand par Vrinhert, curé de Strasbourg.

Traduction de la lettre prétendue du juif Samuel Marrachitan à son maître Rabbi Isaac sur la vérité du christianisme. Incipit : "Hie hebt sich an ein Epystel oder ein sandunge..." — Fol. 19 v° : Constitution de Frédéric Barberousse sur la puissance impériale, 1180, texte latin et traduction allemande, la dernière ajoutée postérieurement. Explicit (fol. 21) : "In der stat zu Regenspurg, in dem fronhof."

« Extrait d'un journal de voyage, fait en 1707, 1708 et 1709, aux costes de Guinée, en Affrique et à Buenos-Aires, dans l'Amérique méridionale, par le vaisseau du Roy la Sphère ; avec la carte de la rivière de La Plata ».

Cet extrait a été fait, d'après une note du fol. 1, en 1710, « par le sr Deslandes. »