Drink-driving is very common at night-time in Bhutan. Routine roadside random breath-testing, and media campaigns emphasising the risk of apprehension and consequent serious financial and social penalties, should be considered to deter drink-driving.
  Mandibulotomy helps access posterior oral cavity tumors. If osteotomy designs affect postoperative and postradiotherapy complications, needs to be tested clinically.
 
  Two hundred and eighteen patients who underwent midline mandibulotomy for primary tongue cancer wide excision and flap reconstruction at Chang Gung Memorial Hospital during 2014-2019.
 
  There were 114 straight, 54 notched, and 50 stair-stepped osteotomy cases. Stair-stepped osteotomy had less advanced tumor stages (P = .009) and notched osteotomy more common single-plate fixations (P = .012). The former showed higher mandibular heights (P = .000) and more intact midline teeth (P = .011) than notched and straight ones. Straight osteotomy cases showed lower early infection rates (P = .039).  https://www.selleckchem.com/products/opicapone.html  Single-plate fixation was related to more flap dehiscence (P = .001) and oro-cutaneous fistulas (P = .035).
 
  Complex osteotomy does not offer long-term benefits in midline mandibulotomies for primary tongue cancers and has higher early infections. Single-plate fixation increases postoperative complications.
 Complex osteotomy does not offer long-term benefits in midline mandibulotomies for primary tongue cancers and has higher early infections. Single-plate fixation increases postoperative complications.This study was conducted to provide comprehensive information on the anatomical and histological features of the upper (UL) and lower (LL) lips of Rahmani sheep by gross examination, morphometric analysis in addition to Light and scanning electron microscope (SEM). Samples from normal healthy adult male sheep heads were collected directly after slaughtering. UL and LL were dissected, and specimens were collected for both light and SEM. The UL was longer approximately by one-fold and thicker by one-fold at the median and the oral angle areas, and by one- and half-folds at the paramedian area than the LL. The free border of both lips was characterized rostrally by the presence of labial projections. By SEM the edges of the inner aspect of the lips and of the philtrum were distinguished by labial projections. These projections which surrounding the philtrum subdivided into polygonal areas with numerous keratinized scales especially at the apical parts which increased dorsally toward the nostril. Most of the openings of the upper labial salivary glands were volcanic crater-shaped while that of the lower labial salivary glands were various shapes; round folded margin, rosette and whirlpool shaped. Histologically, the shape of the projection or papillae differs at the median and paramedian areas of the UL than the LL. However, there was no differences near the oral angle area. In conclusion, the shape, size and amount of keratinization of the papillae may offer efficiency to the lips during feeding process.Esophageal squamous cell carcinoma (ESCC) is one of the most common malignant tumors of the digestive tract in humans. Several studies have indicated that PAK4 is associated with the risk of ESCC and may be a potential druggable kinase for ESCC treatment. However, the underlying mechanism remains largely unknown. The aim of our study is to identify the functional role of PAK4 in ESCC. To determine the expression of PAK4 in ESCC, Western blot analysis and immunohistochemistry were performed, and the results showed that PAK4 is significantly upregulated in ESCC tissues and cell lines compared with normal controls and normal esophageal epithelial cell line. To further investigate the role of PAK4 in ESCC, cell viability assays, anchorage-independent cell growth assays, wound healing assays, cellular invasion assays, in vivo xenograft mouse models, and metastasis assays were conducted, and the results showed that PAK4 can significantly facilitate ESCC proliferation and metastasis in vitro and in vivo. To determine the potential target of PAK4 in ESCC progression, a pull-down assay was performed, and the results showed that LASP1 may be a potential target of PAK4. An immunoprecipitation assay and confocal microscopy analysis confirmed that PAK4 can bind to and colocalize with LASP1 in vitro and in cells. Notably, rescue experiments further illustrated the mechanistic network of PAK4/LASP1. Our research reveals the oncogenic roles of PAK4 in ESCC and preliminarily elucidates the mechanistic network of PAK4/LASP1 in ESCC.
  B-lines are a lung ultrasound (LUS) artifact that often indicate pathology. Little is known about the optimal ultrasound machine settings to assess B-lines. We compared settings typically used to evaluate B-lines at our institution with adjusted settings based on recent studies.
 
  In order to determine typical settings for B-line assessment, we retrospectively reviewed LUS images obtained at our institution. We then prospectively performed LUS with both typical and adjusted settings, using curvilinear and phased array probes, in 20 patients presenting to the emergency department with shortness of breath. The prospectively obtained clips were rated for quality and quantity of B-lines by 14 clinicians with experience in LUS, with 1 assigned for typical settings "much greater," 2 for typical settings "slightly greater," 3 for both settings "similar," 4 for adjusted settings "slightly greater," and 5 for adjusted settings "much greater."
 
  Mean ratings and 95% confidence intervals significantly exceeded the null value of 3 for both B line quality (curvilinear probe 4.68, 4.50-4.85; phased array probe 4.02, 3.70-4.35) and B line quantity (curvilinear probe 4.16, 3.84-4.49; phased array probe 3.68, 3.41-3.96).
 
  B-line quality and quantity were rated higher using adjusted settings based on recently published evidence than when using settings that are typically employed in our institution. Our findings suggest that B-line assessment should be performed with focal zone at the level of the pleura, harmonics off, and gain increased in the far field.
 B-line quality and quantity were rated higher using adjusted settings based on recently published evidence than when using settings that are typically employed in our institution. Our findings suggest that B-line assessment should be performed with focal zone at the level of the pleura, harmonics off, and gain increased in the far field.