Blowout Fractures of the Floor of the Orbit

Blowout fractures of the orbit, a frequent complication of midfacial trauma, result from an increased intraorbital pressure which “blows out” the weakest area—the floor. Intraorbital fat and muscles herniated into the maxillary sinus, muscles incarcerated in the fracture, and the displaced orbital contents produce diplopia. After incarceration, elevation of the affected eye is impossible.Diagnosis is frequently difficult because initial intraorbital hemorrhage may limit mobility. Tomograms in the Waters'' projection may show the fracture but frequently reveal only a cloudy antrum. The muscle traction test described herein is most helpful.The surgical correction aims at bridging the defect with Teflon or stainless-steel mesh or endogenous bone graft placed beneath the periosteum. Entry is gained through the lower lid. If repaired early, there is no functional loss and the repair is cosmetically excellent.     

On the mechanism of chromatin loss induced by the B chromosome of maize

Knobbed regions of the regular maize complement frequently are eliminated at the second microspore division in spores which have two or more B chromosomes. Evidence is presented that no or little loss occurs in spores with one B and that the rate is not increased in spores with more than two B's.—The B chromosomes from an unrelated strain proved as effective in inducing loss as did the B's of the original high loss stock.—Chromatin loss induced by B's is restricted to knobbed A chromosomes and occurs only at the second microspore division. Knobbed chromosomes 3, 5, and 9 have been tested and all interact with B's to give loss. Chromosomes with large knobs are more frequently broken than are those with smaller knobs and knobless chromosomes show negligible loss.—Although knobs and B's are essential for chromatin elimination, modifying genes can markedly affect the rate of loss.——Two knobbed heterologous chromosomes undergo simultaneous loss more frequently than expected from independent events. The data indicate that joint loss occurs in competent cells and that preferential assortment of the two deficient chromosomes to specific poles is unlikely.—B chromosomes and deficient chromosomes assort independently at the second microspore anaphase.—Genetic data from crosses with marker genes in both arms of chromosome 3 show that breakage of the postulated dicentric bridge does not occur solely at the centric region since a variety of deficient chromosomes were recovered.—Nondisjunction of B chromosomes and elimination of knobbed chromatin take place during the second microspore mitosis. The argument is advanced that the two phenomena result from faulty replication of heterochromatic segments. The position of the nonreplicating segment in the two kinds of chromosomes determines whether nondisjunction or breakage takes place.—Finally, it is suggested that all of the reported effects of the B chromosome can be accounted for if the B is a parasitic entity having no genetic function other than controlling the replication of its proximal heterochromatic knob and increasing the ability of B-containing sperm cells to compete successfully for fertilization of the egg.     

Cell groups reveal structure of stimulus space

An important task of the brain is to represent the outside world. It is unclear how the brain may do this, however, as it can only rely on neural responses and has no independent access to external stimuli in order to “decode” what those responses mean. We investigate what can be learned about a space of stimuli using only the action potentials (spikes) of cells with stereotyped—but unknown—receptive fields. Using hippocampal place cells as a model system, we show that one can (1) extract global features of the environment and (2) construct an accurate representation of space, up to an overall scale factor, that can be used to track the animal's position. Unlike previous approaches to reconstructing position from place cell activity, this information is derived without knowing place fields or any other functions relating neural responses to position. We find that simply knowing which groups of cells fire together reveals a surprising amount of structure in the underlying stimulus space; this may enable the brain to construct its own internal representations.     

Prolonged and variable intervals between EEG complexes in subacute inclusion body encephalitis

Should effective therapy of SIBE ever depend upon early diagnosis, periodic EEG complexes must be sought carefully when the condition is suspected, bearing in mind that initially the duration of intervals between complexes may be more prolonged and more variable than commonly appreciated. Prolonged, uninterrupted recording at reduced speed, taken both while the patient is awake and asleep, may well facilitate recognition of periodic events as unusual as those observed in the 20-year-old young man described in this paper, who was examined during the early stage of the disease. When initial EEG complexes are separated, as in our patient, by variable and prolonged intervals — up to 86 seconds'' duration — their periodicity and diagnostic implication can be overlooked, particularly in a so-called routine electroencephalogram. Optimal dispaly of such unusual findings calls for suitable electroencephalographic techniques.     

POST-TRAUMATIC SUPERIOR LARYNGEAL NEURALGIA

Several years after tonsillectomy—or more quickly after foreign-body trauma—the superior laryngeal nerve may be so bound by fibrosis that any regional inflammation or further local trauma, aggravated by normal laryngeal movements, can give rise to localized neuritis at the thyrohyoid membrane and cause a characteristic pain.In every one of 21 patients observed in the past five years, a point of tenderness was readily found by digital palpation over the lateral portion of the thyrohyoid membrane or over the superior cornu of the thyroid cartilage. Frequently the pain extended into the throat and became worse as anything was swallowed past this point.Medical therapy alone or with external injection followed by five minutes of local massage relieved the pain in most cases. It seems possible that, in a more recalcitrant case, relief could be obtained by incising the thyrohyoid membrane so as to relax the superior laryngeal nerve.     

Genes Confer Similar Robustness to Environmental,Stochastic, and Genetic Perturbations in Yeast

Gene inactivation often has little or no apparent consequence for the phenotype of an organism. This property—enetic (or mutational) robustness—is pervasive, and has important implications for disease and evolution, but is not well understood. Dating back to at least Waddington, it has been suggested that mutational robustness may be related to the requirement to withstand environmental or stochastic perturbations. Here I show that global quantitative data from yeast are largely consistent with this idea. Considering the effects of mutations in all nonessential genes shows that genes that confer robustness to environmental or stochastic change also buffer the effects of genetic change, and with similar efficacy. This means that selection during evolution for environmental or stochastic robustness (also referred to as canalization) may frequently have the side effect of increasing genetic robustness. A dynamic environment may therefore promote the evolution of phenotypic complexity. It also means that “hub” genes in genetic interaction (synthetic lethal) networks are generally genes that confer environmental resilience and phenotypic stability.     

Approach to Assessment of Risk Factors in Mild Hypertension

Criteria are urgently needed for the early detection of subjects with only mildly raised blood pressure who may be at high risk of developing the complications of hypertension. As a step towards the establishment of such criteria we have examined the association of certain possible “risk” factors—namely, x-ray evidence of cardiac enlargement, high serum cholesterol levels, effort pain, E.C.G. abnormalities, and high systolic blood pressure—with fatal or morbid endpoints in a five-year follow-up study of subjects whose diastolic pressure had been found initially to be between 95 and 114 mm Hg. The index group consisted of 22 patients in whom these end-points occurred. They comprised death from cardiovascular disease, clinical or E.C.G. deterioration, and either an increase in diastolic pressure of at least 10 mm Hg or a diastolic pressure of 115 mm Hg or both. The control group consisted of 22 subjects chosen at random from other respondents with the same range of diastolic pressures and the same age and sex distribution.“Any two or more” of the possible risk factors examined were found to occur significantly more often in the index group than in the controls, suggesting a possible approach to the early detection of high-risk subjects. The value of longterm studies along these lines and the urgent need for them are emphasized.     

Striving for Excellence Sometimes Hinders High Achievers: Performance-Approach Goals Deplete Arithmetical Performance in Students with High Working Memory Capacity

We tested whether the goal to attain normative superiority over other students, referred to as performance-approach goals, is particularly distractive for high-Working Memory Capacity (WMC) students—that is, those who are used to being high achievers. Indeed, WMC is positively related to high-order cognitive performance and academic success, a record of success that confers benefits on high-WMC as compared to low-WMC students. We tested whether such benefits may turn out to be a burden under performance-approach goal pursuit. Indeed, for high achievers, aiming to rise above others may represent an opportunity to reaffirm their positive status—a stake susceptible to trigger disruptive outcome concerns that interfere with task processing. Results revealed that with performance-approach goals—as compared to goals with no emphasis on social comparison—the higher the students’ WMC, the lower their performance at a complex arithmetic task (Experiment 1). Crucially, this pattern appeared to be driven by uncertainty regarding the chances to outclass others (Experiment 2). Moreover, an accessibility measure suggested the mediational role played by status-related concerns in the observed disruption of performance. We discuss why high-stake situations can paradoxically lead high-achievers to sub-optimally perform when high-order cognitive performance is at play.     

Plasticity is a locally adapted trait with consequences for ecological dynamics in novel environments

Phenotypic plasticity is predicted to evolve in more variable environments, conferring an advantage on individual lifetime fitness. It is less clear what the potential consequences of that plasticity will have on ecological population dynamics. Here, we use an invertebrate model system to examine the effects of environmental variation (resource availability) on the evolution of phenotypic plasticity in two life history traits—age and size at maturation—in long‐running, experimental density‐dependent environments. Specifically, we then explore the feedback from evolution of life history plasticity to subsequent ecological dynamics in novel conditions. Plasticity in both traits initially declined in all microcosm environments, but then evolved increased plasticity for age‐at‐maturation, significantly so in more environmentally variable environments. We also demonstrate how plasticity affects ecological dynamics by creating founder populations of different plastic phenotypes into new microcosms that had either familiar or novel environments. Populations originating from periodically variable environments that had evolved greatest plasticity had lowest variability in population size when introduced to novel environments than those from constant or random environments. This suggests that while plasticity may be costly it can confer benefits by reducing the likelihood that offspring will experience low survival through competitive bottlenecks in variable environments. In this study, we demonstrate how plasticity evolves in response to environmental variation and can alter population dynamics—demonstrating an eco‐evolutionary feedback loop in a complex animal moderated by plasticity in growth.     

Pathogenesis of Cardiac Oedema

When the heart ceases to meet the requirements of the body for oxygen, the sympathetic-adrenal system is activated. This occurs in people with a healthy heart when the demands for oxygen are excessive—for example, in heavy muscular work—and in subjects with a failing heart when the demands are normal or small. Eventually, when the heart is unable to meet even the ordinary requirements of everyday life, the sympathetic activity becomes more or less continuous. It may lessen during rest at night, but with a further failing of the heart its output may become inadequate even in complete rest.The sympathetically-medicated renal vasoconstriction, with reduction of the glomerular sodium load, redistribution of the blood flow in the renal cortex to the juxtamedullary glomeruli, and the mobilization of the renin-angiotensin-aldosterone system, is responsible for the salt and water retention which will ultimately become clinically manifest as oedema—especially when it is no longer counteracted by the tidal output of water and sodium at night. A by-product of this continuing dehydration reaction is a cumulative potassium loss which may lead to disastrous consequences if untreated.     

Genetic conflict,kin and the origins of novel genetic systems

Genetic conflict may have played an important role in the evolution of novel genetic systems. The ancestral system of eumendelian genetics is highly symmetrical. Those derived from it (e.g. thelytokous parthenogenesis, haplodiploidy and parent-specific allele expression) are more asymmetrical in the genetic role played by maternal versus paternal alleles. These asymmetries may have arisen from maternal–paternal genetic conflict, or cytonuclear conflict, or from an interaction between them. Asymmetric genetic systems are much more common in terrestrial and freshwater taxa than in marine taxa. We suggest three reasons for this, based on the relative inhospitability of terrestrial environments to three types of organism: (i) pathogens—departure from the marine realm meant escape from many pathogens and parasites, reducing the need for sexual reproduction; (ii) symbionts—symbionts are no more important in the terrestrial realm than the marine realm but are more likely to be obligately intracellular and vertically transmitted, making them more likely to disrupt their host''s genetic systems; (iii) Gametes and embryos—because neither gametes nor embryos can be shed into air as easily as into seawater, the mother''s body is a more important environment for both types of organisms in the terrestrial realm than in the marine realm. This environment of asymmetric kinship (with neighbours more closely related by maternal alleles than by paternal alleles) may have helped to drive asymmetries in expression and transmission.     

Specificity of Exercise in Exercise-induced Asthma

Ventilatory function after three types of exercise—running, cycling, and swimming—was studied in 10 control subjects and 40 asthmatic patients. All performed eight minutes of submaximal aerobic exercise during each of the programmes, which were conducted in a randomly selected order. Biotelemetric monitoring of heart rates was used to equate the intensity of the exertion undertaken during the three systems of exercise. No control subject showed any significant variation in ventilatory capacity after exercise, and the responses after the three forms of exercise did not differ.In asthmatics exercise-induced asthma was observed after 72·5% of running tests, 65% of cycling tests, and 35% of swimming tests. In addition, those patients who developed exercise-induced asthma after swimming were noted to have significantly smaller falls in FEV₁ levels than were recorded after running and cycling. These results were statistically significant (P <0·01).The unexplained aetiology of increased airways resistance after exercise in asthmatics is discussed. This study indicates that swimming should be recommended in preference to running or cycling as an exercise programme for adults and children with asthma.     

The Cost of Male Aggression and Polygyny in California Sea Lions (Zalophus californianus)

In polygynous mating systems, males often increase their fecundity via aggressive defense of mates and/or resources necessary for successful mating. Here we show that both male and female reproductive behavior during the breeding season (June–August) affect female fecundity, a vital rate that is an important determinant of population growth rate and viability. By using 4 years of data on behavior and demography of California sea lions (Zalophus californianus), we found that male behavior and spatial dynamics—aggression and territory size—are significantly related to female fecundity. Higher rates of male aggression and larger territory sizes were associated with lower estimates of female fecundity within the same year. Female aggression was significantly and positively related to fecundity both within the same year as the behavior was measured and in the following year. These results indicate that while male aggression and defense of territories may increase male fecundity, such interactions may cause a reduction in the overall population growth rate by lowering female fecundity. Females may attempt to offset male-related reductions in female fecundity by increasing their own aggression—perhaps to defend pups from incidental injury or mortality. Thus in polygynous mating systems, male aggression may increase male fitness at the cost of female fitness and overall population viability.     

Using Latent Selection Difference to Model Persistence in a Declining Population

Population persistence is a direct measure of the viability of a population. Monitoring the distribution of declining populations or subpopulations over time can yield estimates of persistence, which we show can be modeled as a latent selection difference (LSD) contrasting attributes of sites where populations have persisted versus those that have not. Predicted persistence can be modeled with predictor covariates to identify factors correlated with species persistence. We demonstrate how to model persistence based on changes in occupancy that can include adjustments for detection probability. Using a known historical distribution of the western grebe (Aechmophorus occidentalis), we adapted methods originally developed for occupancy modeling to evaluate how environmental covariates including emergent vegetation and human developments have affected western grebe persistence in Alberta. The relative probability of persistence was correlated with the extent of shoreline bulrush (Scirpus lacustris), which is important vegetation for nesting cover. We also documented that western grebe populations were less likely to persist on lakes in the boreal forest, primarily located on the northern boundary of the species'' range. Factors influencing occupancy were different than those determining persistence by western grebes; persistence and occupancy were not correlated. Persistence was more likely on lakes with recreational development, reflecting reliance by grebes on the larger, fish-bearing waterbodies that also are attractive for lakeshore development. Unfortunately, the correlation with recreational development on Alberta''s lakes puts grebes at risk for loss of brood-rearing habitats—primary threats to altricial birds—if steps are not taken to prevent disturbance to bulrush stands. Identifying factors related to the persistence of a species—especially one in decline—is a fundamental step in conservation management.     

Back Pain Prevalence and Its Associated Factors in Brazilian Athletes from Public High Schools: A Cross-Sectional Study

Most studies on the prevalence of back pain have evaluated it in developed countries (Human Development Index—HDI > 0.808), and their conclusions may not hold for developing countries. The aim of this study was to identify the prevalence of back pain in representative Brazilian athletes from public high schools. This cross-sectional study was performed during the state phase of the 2015 Jogos dos Institutos Federais (JIF), or Federal Institutes Games, in Brazil (HDI = 0.744), and it enrolled 251 athletes, 173 males and 78 females (14–20 years old). The dependent variable was back pain, and the independent variables were demographic, socioeconomic, psychosocial, hereditary, exercise-level, anthropometric, strength, behavioral, and postural factors. The prevalence ratio (PR) was calculated using multivariable analysis according to the Poisson regression model (α = 0.05). The prevalence of back pain in the three months prior to the study was 43.7% (n = 104), and 26% of the athletes reported feeling back pain only once. Multivariable analysis showed that back pain was associated with demographic (sex), psychosocial (loneliness and loss of sleep in the previous year), hereditary (ethnicity, parental back pain), strength (lumbar and hand forces), anthropometric (body mass index), behavioral (sleeping time per night, reading and studying in bed, smoking habits in the previous month), and postural (sitting posture while writing, while on a bench, and while using a computer) variables. Participants who recorded higher levels of lumbar and manual forces reported a lower prevalence of back pain (PR < 0.79), whereas feeling lonely in the previous year, obesity, and ethnicity exhibited the highest prevalence ratio (PR > 1.30). In conclusion, there is no association between exercise levels and back pain but there is an association between back pain and non-exercise related variables.     

Lightning Injury: Two Case Histories and a Review of Management

Two cases of fatal lightning injury are described. Fixed dilated pupils should not be taken as an indicator of death after a lightning strike. Persons who fail to breath spontaneously within one minute of lightning shock should receive external cardiac massage and mouth-to-mouth resuscitation. Paralysis may persist as result of cerebral oedema or prolonged hypoxia—it is therefore suggested that adequate ventilation and metabolic balance should be maintained until recovery or death.     

Surgical aspects of international drug smuggling

The internal concealment of cocaine and other drugs in packets by “body packers”—those who swallow packets of drugs or hide them in their vagina or rectum—to avoid detection by customs officials has been increasing in both the United States and Europe. The types of package and how they are concealed are changing as the traffickers become more sophisticated in their methods. The latest parcels are less likely to burst, but obstruction of the bowel may occur.Awareness of the problem is important for staff of emergency medical services near international ports of arrival.     

Cell Lineages and the Logic of Proliferative Control

It is widely accepted that the growth and regeneration of tissues and organs is tightly controlled. Although experimental studies are beginning to reveal molecular mechanisms underlying such control, there is still very little known about the control strategies themselves. Here, we consider how secreted negative feedback factors (“chalones”) may be used to control the output of multistage cell lineages, as exemplified by the actions of GDF11 and activin in a self-renewing neural tissue, the mammalian olfactory epithelium (OE). We begin by specifying performance objectives—what, precisely, is being controlled, and to what degree—and go on to calculate how well different types of feedback configurations, feedback sensitivities, and tissue architectures achieve control. Ultimately, we show that many features of the OE—the number of feedback loops, the cellular processes targeted by feedback, even the location of progenitor cells within the tissue—fit with expectations for the best possible control. In so doing, we also show that certain distinctions that are commonly drawn among cells and molecules—such as whether a cell is a stem cell or transit-amplifying cell, or whether a molecule is a growth inhibitor or stimulator—may be the consequences of control, and not a reflection of intrinsic differences in cellular or molecular character.