No advantage was noted for ETE or ETS arterial anastomoses based on reconstructive outcomes. The choice of anastomotic technique in lower extremity free tissue transfer should be based on patient factors and the clinical circumstances encountered.
Characterizing how genomic sequence interacts with trans-acting regulatory factors to implement a program of gene expression in eukaryotic organisms is critical to understanding genome function. One means by which patterns of gene expression are achieved is through the differential packaging of DNA into distinct types of chromatin. While chromatin state exerts a major influence on gene expression, the extent to which cis-acting DNA sequences contribute to the specification of chromatin state remains incompletely understood. To address this, we have used a fission yeast sequence element (L5), known to be sufficient to nucleate heterochromatin, to establish de novo heterochromatin domains in the Schizosaccharomyces pombe genome. The resulting heterochromatin domains were queried for the presence of H3K9 di-methylation and Swi6p, both hallmarks of heterochromatin, and for levels of gene expression. We describe a major effect of genomic sequences in determining the size and extent of such de novo heterochromatin domains. Heterochromatin spreading is antagonized by the presence of genes, in a manner that can occur independent of strength of transcription. Increasing the dosage of Swi6p results in increased heterochromatin proximal to the L5 element, but does not result in an expansion of the heterochromatin domain, suggesting that in this context genomic effects are dominant over trans effects. Finally, we show that the ratio of Swi6p to H3K9 di-methylation is sequence-dependent and correlates with the extent of gene repression. Taken together, these data demonstrate that the sequence content of a genomic region plays a significant role in shaping its response to encroaching heterochromatin and suggest a role of DNA sequence in specifying chromatin state.
In 1989, the U.S. House of Representatives introduced the Omnibus Budget Reconciliation Act that was passed in the same year. The law established the "relative value unit," meant to quantify medical services. The relative value unit consists of three parts: the work relative value, the practice expense relative value, and the malpractice relative value. The work relative value unit is "based on the relative resources incorporating physician time and intensity required in furnishing the service." 1 The practice expense relative value unit takes into account "the nonphysician clinical and nonclinical labor of the practice, as well as expenses for building space, equipment, and office supplies." The malpractice relative value unit considers "the cost of malpractice insurance premiums." Of all three, the work relative value unit constitutes the largest component of the total relative value unit. For every service, the relative value units are calculated and then multiplied by a dollar conversion factor (approximately $35). This value became the metric for Medicare payments to physicians. 2 The concept of using a relative value scale of medical services to determine cost of care is not new. In 1978, a major study introduced this idea for surgery, where cost was determined with a formula that used the variables of time, complexity, investment in professional training, and overhead expenses. 3 Time was determined by adding the
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.