Armstrong Jonasson (jartank6)

Bone loss of the distal tibia represents a major challenge for the treating surgeons and the reconstruction technique. This is particularly true for septic bone loss. Several techniques are available, ranging from callus distraction of Ilizarov frames and monorail techniques as well as transport with plates and nails; however, implants for internal segmental transport for bone defects have so far not been available. This case report describes worldwide the first reconstruction of a distal tibial defect by reconstruction of the major arterial flow path with flap coverage and all inside segmental transport using a motorized segmental transport nail without additional osteosynthesis or add-on module.Arginine, homoarginine (hArg), asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) affect nitric oxide metabolism and altered concentrations are associated with cardiovascular morbidity and mortality. We analyzed these metabolites using liquid chromatography-tandem mass spectrometry in patients with atrial fibrillation (AF) (n = 241) with a focus on heart rhythm at blood withdrawal, AF progression phenotypes, and successful sinus rhythm (SR) restoration (n = 22). AF progression phenotypes were defined as paroxysmal AF with/without low voltage areas (LVA) and persistent AF with/without LVA. selleck compound While arginine, ADMA, and hArg were within reference limits for healthy controls, SDMA was higher in the AF cohort (0.57 ± 0.12 vs. 0.53 μmol/L (97.5th percentile in reference cohort)). SR restoration in AF patients resulted in normalization of SDMA concentrations (0.465 ± 0.082 vs. 0.570 ± 0.134 μmol/L at baseline, p less then 0.001). Patients with AF at the time of blood sampling had significantly lower hArg (1.65 ± 0.51 vs. 1.85 ± 0.60 μmol/L, p = 0.006) and higher ADMA concentrations (0.526 ± 0.08 vs. 0.477 ± 0.08 μmol/L, p less then 0.001) compared with AF patients in SR. hArg concentrations were lower in patients with advanced AF progression phenotypes (persistent AF with LVA (p = 0.046)) independent of heart rhythm at blood sampling. Summarizing, arginine metabolism imbalance is associated with AF in general and AF progression and may contribute to associated risk. KEY MESSAGES • Heart rhythm at blood withdrawal affects ADMA and hArg level in AF patients. • SDMA is higher in AF patients. • SDMA levels normalize after sinus rhythm restoration. • hArg levels decrease in advanced AF progression phenotypes.In the original publication of the article, Fig. 3 is incorrect.Growing evidence suggests that global climate change promotes the dominance of mixotrophic algae especially in oligotrophic aquatic ecosystems. While theory predicts that mixotrophy increases trophic transfer efficiency in aquatic food webs, deleterious effects of some mixotrophs on consumers have also been reported. Here, using a widespread mixotrophic algal genus Dinobryon, we aimed to quantify how colonial taxa contribute to secondary production in lakes. We, therefore, studied the dietary effects of Dinobryon divergens on Cladocera (Daphnia longispina) and Copepoda (Eudiaptomus gracilis), representing two main taxonomic and functional groups of zooplankton. In feeding experiments, we showed that Dinobryon was largely grazing resistant and even inhibited the uptake of the high-quality reference food in Daphnia. Eudiaptomus could to some extent compensate with selective feeding, but a negative long-term food quality effect was also evident. Besides, Eudiaptomus was more sensitive to the pure diet of Dinobryon than Daphnia. Low lipid content and high CP elemental ratio further supported the low nutritional value of the mixotroph. In a stable isotope approach analysing a natural plankton community, we found further evidence that carbon of Dinobryon was not conveyed efficiently to zooplankton. Our results show that the increasing dominance of colonial mixotrophs can result in reduced dietary energy transfer to consumers at higher trophic le