Though longer follow-up is needed, these data suggest that even in populations living in isolated regions, diabetic amputations can be prevented by a coordinated system to identify high-risk feet and provide preventive treatment and education in the context of a comprehensive diabetes management program in an integrated health system.

Maintaining synaptic structure and function over time is vital for overall nervous system function and survival. The processes that underly synaptic development are well understood. However, the mechanisms responsible for sustaining synapses throughout the lifespan of an organism are poorly understood. Here, we demonstrate that a previously uncharacterized gene, CG31475, regulates synaptic maintenance in adult Drosophila NMJs. We named CG31475 mayday due to the progressive loss of flight ability and synapse architecture with age. Mayday is functionally homologous to the human protein Cab45, which sorts secretory cargo from the Trans Golgi Network (TGN). We find that Mayday is required to maintain trans-synaptic BMP signaling at adult NMJs in order to sustain proper synaptic structure and function. Finally, we show that mutations in mayday result in the loss of both presynaptic motor neurons as well as postsynaptic muscles, highlighting the importance of maintaining synaptic integrity for cell viability.

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SummaryProximate mechanisms involved in forming extracellular matrix (ECM) variations within and between bones are not yet clear. Deficiencies in the collective understanding of details required to illuminate the process that forms a highly ordered ECM are exposed when considering that there is still significant debate as to the importance of cellular control in the assembly of the ECM vs. the observation of collagen fibrillar “self-assembly” (i. e., occurring devoid of cells). We examined data and opinions with respect to possible mechanisms involved in the formation of distinctly different ECM patterns of secondary osteon morphotypes (SOMs). Important considerations include: (1) stretch within the osteoid during fibrillogenesis, (2) various mechanotransduction mechanisms, and (3) whether or not the formation of regional variations in osteonal ECMs requires osteo blast alignment and/or rotation and migration. We propose that primary cilia of osteoblasts and osteocytes have an important role in their perception of variant-related (vectorial) stimuli, which is deemed essential in the genesis of distinctive and mechanically relevant ECM patterns of SOMs.

IntroductionPediatric thyroidectomy is performed by a variety of surgical specialties. Thyroidectomy can result in a number of complications. Previous studies cite that the most common complications in children are pain and transient hypocalcemia. The purposes of this report are to assess the adverse events of thyroidectomies performed in the pediatric population and to assess the relationship between surgical specialties and postoperative thyroidectomy complications.MethodsWe conducted a cross-sectional analysis of cases from January 1, 2014 through November 1, 2015 using the National Surgical Quality Improvement Program database for patients undergoing excision of cyst or adenoma of the thyroid, unilateral thyroid lobectomy, or total thyroidectomy.ResultsOf the 344 patients who underwent thyroidectomy, 10 (2.9%) experienced at least one complication. The most common complications were readmission, surgical site infections, and wound disruption. There was a statistically significant association between complication incidence and surgical specialty (p=0.006). Pediatric otolaryngology had a statistically significantly higher number of complications than pediatric surgery (p<0.008).ConclusionOverall, the incidence of adverse events following pediatric thyroidectomy was low.