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111.
Animals that move through complex habitats must frequently contend with obstacles in their path. Humans and other highly cognitive vertebrates avoid collisions by perceiving the relationship between the layout of their surroundings and the properties of their own body profile and action capacity. It is unknown whether insects, which have much smaller brains, possess such abilities. We used bumblebees, which vary widely in body size and regularly forage in dense vegetation, to investigate whether flying insects consider their own size when interacting with their surroundings. Bumblebees trained to fly in a tunnel were sporadically presented with an obstructing wall containing a gap that varied in width. Bees successfully flew through narrow gaps, even those that were much smaller than their wingspans, by first performing lateral scanning (side-to-side flights) to visually assess the aperture. Bees then reoriented their in-flight posture (i.e., yaw or heading angle) while passing through, minimizing their projected frontal width and mitigating collisions; in extreme cases, bees flew entirely sideways through the gap. Both the time that bees spent scanning during their approach and the extent to which they reoriented themselves to pass through the gap were determined not by the absolute size of the gap, but by the size of the gap relative to each bee’s own wingspan. Our findings suggest that, similar to humans and other vertebrates, flying bumblebees perceive the affordance of their surroundings relative their body size and form to navigate safely through complex environments.

Avoiding collisions with obstacles is a requirement for successful locomotion through most natural habitats, where the physical environment is often cluttered and complex. At the most elemental level, animals moving through their environments need to identify gaps between obstacles and assess their passability. In this context, whether a gap between obstacles “affords” passing is determined by the fit between the spatial layout of the environment and the properties of the organism’s form and action system, as described in classical theses on affordances (13). In humans and other highly cognitive vertebrates, the perception of affordances for performing visually guided actions such as grasping, passing through apertures, and climbing is actively shaped throughout ontogeny, as body size, configuration, and experience change (2, 47). However, the strategies used by animals with much smaller brains, such as insects, to contend with the challenges of navigating environmental clutter and spatial heterogeneity are unclear.We used bumblebees to investigate whether flying insects take into account their own size during interactions with their surroundings. Bumblebees and other volant insects that travel long distances (8) and frequently encounter regions of dense clutter can be expected to exhibit strategies to avoid collisions, because damage to sensitive structures such as the wings is irreparable and adversely impacts flight performance and lifespan (9, 10). For an animal attempting to navigate through tight spaces, perceiving the relationship between the layout of the environment and its own size can help inform the animal of its potential for collision-free passage. Bumblebee workers naturally display large variation in body size within a given colony (11, 12), and thus are particularly suitable models for testing the effects of insect body size on aerial navigation and for determining whether insects perceive the external environment in relation to their own spatial dimensions.To elicit repeatable flight behavior, we trained foraging bumblebees to fly within a 1.6 × 0.3 × 0.3 m (l × w × h) flight tunnel that separated the hive from a foraging arena (Materials and Methods, SI Appendix, Fig. S1, and Movie S1). After bees were habituated to the setup and began foraging normally, we placed an unexpected obstacle within the tunnel, consisting of a thin vertical wall (5-mm thickness) spanning the tunnel’s width and height. The obstructing wall contained a rectangular gap starting midway up and extending to the top of the wall (Materials and Methods, SI Appendix, Fig. S1, and Movie S1). The width of the gap was varied between 20 and 60 mm over different trials, with the presenting order of gap sizes chosen randomly. A high-speed camera placed above the tunnel was used to record bees’ instantaneous positions, heading/yaw orientations (Fig. 1A), and trajectories as they approached the obstructing wall and passed through the gap. To prevent bees from becoming familiar with the experimental paradigm, the obstructing wall was removed after each flight recording. In total, we recorded and analyzed over 400 flights of bees of varying body sizes flying through seven different gap sizes (SI Appendix, Table S1). For the population of bees recorded, wingspan was the longest dimension of the body and it varied linearly by a factor of 1.9 compared to their longitudinal body length while in flight (SI Appendix, Fig. S2A).Open in a separate windowFig. 1.Bumblebees can safely fly through gaps that are smaller than their wingspan. (A and B) Illustrations indicating the wingspan of bees (Ws), the size of the gap (Gs), and the positive and negative yaw (heading) angles for bees flying in the tunnel, respectively. (C) Schematic illustration of the flight of a bee flying through a gap that is much wider than its wingspan. (D) The instantaneous yaw angle of bee shown in C. (E) Schematic illustrationof the flightofabeeflying through a gap that is smaller than its wingspan. (F) The instantaneous yaw angle of bee shown in E. Flights, in both cases (C and E), consisted of approach, lateral peering, and—for the smaller gap size (E)—body reorientation (an increase in yaw angle) while passing through the gap. The differences in reorientation behavior can be noted at x = 0 (location of the gap), whereas in F the bee displays a large increase in yaw angle that reorients its body to pass through the small gap, and body reorientation in D is minimal. For the flight shown in C and D, Ws = 27.5 mm and Gs = 50 mm, while for the flight shown in E and F, Ws = 27 mm and Gs = 25 mm.  相似文献   
112.
Congenital factor VII deficiency is an autosomal recessive serious disorder of blood coagulation with wide genotypic and phenotypic variations. The clinical presentation can vary from asymptomatic patients to patients with major bleedings in severe deficiency (factor VII <1%). Investigations show prolonged PT and low factor VII. Treatment modalities include FFP and repeated recombinant factor VII infusions. We hereby report the first successful LRLT for factor VII deficiency in an infant, the first‐ever youngest baby reported worldwide. A six‐month‐old male child presented with easy bruisability, ecchymotic patches, hematuria, and convulsions. CT of the head showed subdural hemorrhage, which was treated conservatively. He had markedly increased PT (120 s) with normal platelets, and aPTT with factor VII level <1%. Despite the treatment by rFVIIa administration weekly, which was very expensive, he still had repeated life‐threatening bleeding episodes. LRLT was performed with mother as the donor, whose factor VII level was 57%. A factor VII infusion plan for pre‐, intra‐ and postoperative periods was formulated and TEG followed. Postoperatively, his factor VII started increasing from third day and was 38% on 24th day with PT <14 s. He had uneventful intraoperative and postoperative courses. LT is a safe and definite cure for factor VII deficiency.  相似文献   
113.
Objective—To evaluate outcome in patients managed outside an intensive care unit after open heart surgery.Background—The high cost of cardiac surgery is mainly due to the needs of traditional postoperative care. The requirements for intensive care and treatment has decreased with improvements in techniques of cardiac surgery and anaesthesia. In this setting the need to continue to depend on intensive care units for the recovery of cardiac surgical patients is questionable on clinical and economic grounds.Design—Postoperative outcome in 245 patients over a four month period was studied prospectively.Patients—Mean age of the patients was 63·2 years. They underwent a wide variety of operative procedures. Ninety percent of them recovered in a dedicated three bed cardiac surgical recovery area where the management protocol led to rapid extubation and step down in dependency care.Results—Median time for ventilatory support was 90 minutes after transfer to the area. Only five patients were subsequently admitted to the general intensive care unit for prolonged respiratory and cardiac support. Ten patients were electively admitted to the general intensive care unit. Two deaths occurred in hospital in this group (0·8%). Four patients were ventilated for 24 hours in the recovery area itself and made an uncomplicated recovery.Conclusion—This study confirms that over 90% of patients undergoing cardiac surgery would recover safely and be treated effectively in a more economical area than intensive care.  相似文献   
114.
The current study aims at the development of an electrochemical sensor based on a silver nanoparticle–reduced graphene oxide–polyaniline (AgNPs–rGO–PANI) nanocomposite for the sensitive and selective detection of hydrogen peroxide (H2O2). The nanocomposite was fabricated by simple in situ synthesis of PANI at the surface of rGO sheet which was followed by stirring with AEC biosynthesized AgNPs to form a nanocomposite. The AgNPs, GO, rGO, PANI, rGO–PANI, and AgNPs–rGO–PANI nanocomposite and their interaction were studied by UV-vis, FTIR, XRD, SEM, EDX and XPS analysis. AgNPs–rGO–PANI nanocomposite was loaded (0.5 mg cm−2) on a glassy carbon electrode (GCE) where the active surface area was maintained at 0.2 cm2 for investigation of the electrochemical properties. It was found that AgNPs–rGO–PANI–GCE had high sensitivity towards the reduction of H2O2 than AgNPs–rGO which occurred at −0.4 V vs. SCE due to the presence of PANI (AgNPs have direct electronic interaction with N atom of the PANI backbone) which enhanced the rate of transfer of electron during the electrochemical reduction of H2O2. The calibration plots of H2O2 electrochemical detection was established in the range of 0.01 μM to 1000 μM (R2 = 0.99) with a detection limit of 50 nM, the response time of about 5 s at a signal-to-noise ratio (S/N = 3). The sensitivity was calculated as 14.7 μA mM−1 cm−2 which indicated a significant potential as a non-enzymatic H2O2 sensor.

The current study aims at the development of an electrochemical sensor based on a silver nanoparticle–reduced graphene oxide–polyaniline (AgNPs–rGO–PANI) nanocomposite for the sensitive and selective detection of hydrogen peroxide (H2O2).  相似文献   
115.
After orthotopic heart transplantation (OHT), the allograft undergoes characteristic alterations in myocardial structure, including hypertrophy, increased ventricular stiffness, ischemia, and inflammation, all of which may decrease overall graft survival. Methods to quantify these phenotypes may clarify the pathophysiology of progressive graft dysfunction post-OHT. We performed cardiac magnetic resonance (CMR) with T1 mapping in 26 OHT recipients (mean age 47?±?7 years, 30?% female, median follow-up post-OHT 6 months) and 30 age-matched healthy volunteers (mean age 50.5?±?15 years; LVEF 63.5?±?7?%). OHT recipients had a normal left ventricular ejection fraction (LVEF 65.3?±?11?%) with higher LV mass relative to age-matched healthy volunteers (114?±?27 vs. 85.8?±?18 g; p?<?0.001). There was no late gadolinium enhancement in either group. Both myocardial extracellular volume fraction (ECV) and intracellular lifetime of water (τic), a measure of cardiomyocyte hypertrophy, were higher in patients post-OHT (ECV: 0.39?±?0.06 vs. 0.28?±?0.03, p?<?0.0001; τic: 0.12?±?0.08 vs. 0.08?±?0.03, p?<?0.001). ECV was associated with LV mass (r?=?0.74, p?<?0.001). In follow-up, OHT recipients with normal biopsies by pathology (ISHLT grade 0R) in the first year post-OHT exhibited a lower ECV relative to patients with any rejection ≥2R (0.35?±?0.02 for 0R vs. 0.45?±?0, p?<?0.001). Higher ECV but not LVEF was significantly associated with a reduced rejection-free survival. After OHT, markers of tissue remodeling by CMR (ECV and τic) are elevated and associated with myocardial hypertrophy. Interstitial myocardial remodeling (by ECV) is associated with cellular rejection. Further research on the impact of graft preservation and early immunosuppression on tissue-level remodeling of the allograft is necessary to delineate the clinical implications of these findings.  相似文献   
116.

Objective

To determine adverse event rates for adult cranial neuro-oncologic surgeries performed at a high-volume quaternary academic center and assess the impact of resident participation on perioperative complication rates.

Patients and Methods

All adult patients undergoing neurosurgical intervention for an intracranial neoplastic lesion between January 1, 2009, and December 31, 2013, were included. Cases were categorized as biopsy, extra-axial/skull base, intra-axial, or transsphenoidal. Complications were categorized as neurologic, medical, wound, mortality, or none and compared for patients managed by a chief resident vs a consultant neurosurgeon.

Results

A total of 6277 neurosurgical procedures for intracranial neoplasms were performed. After excluding radiosurgical procedures and pediatric patients, 4151 adult patients who underwent 4423 procedures were available for analysis. Complications were infrequent, with overall rates of 9.8% (435 of 4423 procedures), 1.7% (73 of 4423), and 1.4% (63 of 4423) for neurologic, medical, and wound complications, respectively. The rate of perioperative mortality was 0.3% (14 of 4423 procedures). Case performance and management by a chief resident did not negatively impact outcome.

Conclusion

In our large-volume brain tumor practice, rates of complications were low, and management of cases by chief residents in a semiautonomous manner did not negatively impact surgical outcomes.  相似文献   
117.
118.
119.

Purpose

Hepatitis C, a chronic disease with deadly consequences, is no longer predominantly a disease of older people.

Methods

A limited search was conducted of the relevant literature on 2 topics: (1) the impact of hepatitis C on infants exposed by vertical transmission; and (2) the impact of hepatitis C infection on infected children and adolescents. The findings were supplemented by the first-hand experience of the authors.

Findings

Young people, including women of childbearing age, infants, children, and adolescents, are being especially affected by hepatitis C infection secondary to the intravenous drug use and opioid epidemic. Unfortunately, estimates of disease in young populations are all misleading because universal screening has not been implemented.

Implications

Lack of implementation of policies for screening and therapy on most affected populations will be responsible for perpetuation of this infection. In the era of highly effective therapy and a regimen that is approved by the US Food and Drug Administration for children, this outcome is unacceptable.  相似文献   
120.
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