bluuebunny/crossref_metadata_2025 huggingface dataset:
The Indian Police
Authors: Mangla Akshay
Published: February 2023

Prevention of collective violence between social groups is essential for internal security and a critical task for police agencies. Yet, the challenge of violence prevention is acute, especially in multiethnic polities with weak public institutions. In India, managing collective violence is made more challenging due to resource constraints and political interferences, which can lead to breakdowns of public order. How, under such conditions, do police agencies work to prevent collective violence? Drawing on fieldwork conducted in Madhya Pradesh, Mangla finds that local police agencies have developed organizational repertoires for socially embedded policing, involving intensive planning and coordination between senior-level and frontline officers, along with input from societal groups to prevent conflict. The chapter develops the argument through ethnographic observations of police activities around the twenty-fifth anniversary of the demolition of the Babri Masjid. It then locates socially embedded policing within the broader institutional capabilities and constraints of India’s state police forces. While a militaristic and stratified hierarchy enables police agencies to coordinate activities on a large scale, it limits information-sharing by frontline officers. A severe shortage of personnel, along with biases in police training, makes it difficult to institutionalize socially embedded policing practices. Consequently, police agencies are more likely to be overwhelmed or resort to heavy-handed physical tactics during public order situations. The chapter concludes with reflections for future research on policing and internal security.
India’s Intelligence in Internal Security
Authors: Datta Saikat
Published: February 2023

Intelligence has always been recognized as one of the key pillars of successful governance. The efficacy of intelligence in managing India’s internal security challenges remain debatable. Part of its inadequacies remains in India’s colonial past that birthed the Intelligence Bureau (IB). After India gained independence, the IB emerged as the preeminent organization for India’s internal security, far outgrowing its role for generating intelligence to carrying out a plethora of functions. Intelligence in the state police forces had a similar trajectory into evolving as organizations with multiple tasks aimed at political stability for the government and managing internal security challenges. But this dual tasking of intelligence as a tool of statecraft has not produced any spectacular success for internal security. The causes for the systemic failures and lack of success are discussed at length in this chapter.
m6A mRNA modification promotes chilling tolerance and modulates gene translation efficiency in Arabidopsis
Authors: Wang Shuai , Wang Haiyan , Xu Zhihui , Jiang Shasha , Shi Yucheng , Xie Hairong , Wang Shu , Hua Jian , Wu Yufeng
Published: February 2023

N 6-methyladenosine (m6A), the most prevalent mRNA modification in eukaryotes, is an emerging player of gene regulation at transcriptional and translational levels. Here, we explored the role of m6A modification in response to low temperature in Arabidopsis (Arabidopsis thaliana). Knocking down mRNA adenosine methylase A (MTA), a key component of the modification complex, by RNA interference (RNAi) led to drastically reduced growth at low temperature, indicating a critical role of m6A modification in the chilling response. Cold treatment reduced the overall m6A modification level of mRNAs especially at the 3′ untranslated region. Joint analysis of the m6A methylome, transcriptome and translatome of the wild type (WT) and the MTA RNAi line revealed that m6A-containing mRNAs generally had higher abundance and translation efficiency than non-m6A-containing mRNAs under normal and low temperatures. In addition, reduction of m6A modification by MTA RNAi only moderately altered the gene expression response to low temperature but led to dysregulation of translation efficiencies of one third of the genes of the genome in response to cold. We tested the function of the m6A-modified cold-responsive gene ACYL-COA:DIACYLGLYCEROL ACYLTRANSFERASE 1 (DGAT1) whose translation efficiency but not transcript level was reduced in the chilling-susceptible MTA RNAi plant. The dgat1 loss-of-function mutant exhibited reduced growth under cold stress. These results reveal a critical role of m6A modification in regulating growth under low temperature and suggest an involvement of translational control in chilling responses in Arabidopsis.
Safety and efficacy associated with long-term low-dose glucocorticoids in rheumatoid arthritis: a systematic review and meta-analysis
Authors: Palmowski Andriko , Nielsen Sabrina M , Boyadzhieva Zhivana , Schneider Abelina , Pankow Anne , Hartman Linda , Da Silva José A P , Kirwan John , Wassenberg Siegfried , Dejaco Christian , Christensen Robin , Boers Maarten , Buttgereit Frank
Published: February 2023

Objectives

The aim of this study was to assess the safety and efficacy of long-term low-dose glucocorticoids (GCs) in RA.

Methods

A protocolised systematic review and meta-analysis (PROSPERO No. CRD42021252528) of double-blind, placebo-controlled randomised trials (RCTs) comparing a low dose of GCs (≤ 7.5mg/day prednisone) to placebo over at least 2 years was performed. The primary outcome investigated was adverse events (AEs). We performed random-effects meta-analyses and used the Cochrane RoB tool and GRADE to assess risk of bias and quality of evidence (QoE).

Results

Six trials with 1078 participants were included. There was no evidence of an increased risk of AEs (incidence rate ratio 1.08; 95% CI 0.86, 1.34; P = 0.52); however, the QoE was low. The risks of death, serious AEs, withdrawals due to AEs, and AEs of special interest did not differ from placebo (very low to moderate QoE). Infections occurred more frequently with GCs (risk ratio 1.4; 1.19–1.65; moderate QoE). Concerning benefit, we found moderate to high quality evidence of improvement in disease activity (DAS28: −0.23; −0.43 to −0.03), function (HAQ −0.09; −0.18 to 0.00), and Larsen scores (–4.61; −7.52 to −1.69). In other efficacy outcomes, including Sharp van der Heijde scores, there was no evidence of benefits with GCs.

Conclusion

There is very low to moderate QoE for no harm with long-term low dose GCs in RA, except for an increased risk of infections in GC users. The benefit-risk ratio might be reasonable forusing low-dose long-term GCs considering the moderate to high quality evidence for disease-modifying properties.
Wheat Class III Peroxidase TaPOD70 Is a Potential Susceptibility Factor Negatively Regulating Wheat Resistance to Blumeria graminis f. sp. tritici
Authors: Li Ruobing , Zhang Xiaoxu , Zhao Bingjie , Song Panpan , Zhang Xiaomei , Wang Baotong , Li Qiang
Published: February 2023

Powdery mildew, caused by Blumeria graminis f. sp. tritici ( Bgt), is one of the most important diseases on wheat worldwide and can lead to a large reduction in wheat production. Class III peroxidases (PODs), a kind of secretory enzyme and members of a multigene family in higher plants, have been linked to various plant physiological functions and defensive responses. However, the role of PODs in wheat resistance to Bgt remains unclear. TaPOD70, a class III POD gene, was identified from the proteomics sequencing of the incompatible interaction between wheat ( Triticum aestivum) cultivar Xingmin 318 and Bgt isolate E09. After transient expression of the TaPOD70-GFP fusion protein in Nicotiana benthamiana leaves, TaPOD70 was located in the membrane region. Yeast secretion assay showed that TaPOD70 was a secretory protein. Furthermore, Bax-induced programmed cell death was inhibited by transient expression of TaPOD70 in N. benthamiana. The transcript expression level of TaPOD70 was significantly upregulated in the wheat– Bgt compatible interaction. More crucially, knocking down TaPOD70 using virus-induced gene silencing increased wheat resistance to Bgt compared with the control plants. In response to Bgt, histological analyses indicated that hyphal development of Bgt was significantly reduced, whereas H2O2 production was enhanced in TaPOD70-silenced leaves. These findings imply that TaPOD70 may act as a susceptibility factor, adversely regulating wheat resistance to Bgt.
Should Acellular Dermal Matrices Be Used for Implant-based Breast Reconstruction after Mastectomy? Clinical Recommendation Based on the GRADE Approach
Authors: Cinquini Michela , Rocco Nicola , Catanuto Giuseppe , Garreffa Emanuele , Ferrando Pietro Maria , Gonzalez-Lorenzo Marien , Maglia Anna , Montagna Giacomo , Villanucci Amedeo , Visintini Cividin Valentina , Nava Maurizio Bruno ,   GRADE MBN 2021 Collaborative Group
Published: February 2023

Background:

Acellular dermal matrices (ADMs) entered the market in the early 2000s and their use has increased thereafter. Several retrospective cohort studies and single surgeon series reported benefits with the use of ADMs. However, robust evidence supporting these advantages is lacking. There is the need to define the role for ADMs in implant-based breast reconstruction (IBBR) after mastectomy.

Methods:

A panel of world-renowned breast specialists was convened to evaluate evidence, express personal viewpoints, and establish recommendation for the use of ADMs for subpectoral one-/two-stage IBBR (compared with no ADM use) for adult women undergoing mastectomy for breast cancer treatment or risk reduction using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

Results:

Based on the voting outcome, the following recommendation emerged as a consensus statement: the panel members suggest subpectoral one- or two-stage IBBR either with ADMs or without ADMs for adult women undergoing mastectomy for breast cancer treatment or risk reduction (with very low certainty of evidence).

Conclusions:

The systematic review has revealed a very low certainty of evidence for most of the important outcomes in ADM-assisted IBBR and the absence of standard tools for evaluating clinical outcomes. Forty-five percent of panel members expressed a conditional recommendation either in favor of or against the use of ADMs in subpectoral one- or two-stages IBBR for adult women undergoing mastectomy for breast cancer treatment or risk reduction. Future subgroup analyses could help identify relevant clinical and pathological factors to select patients for whom one technique could be preferable to another.
The Disparity Challenge: How Governance Can Lead the Way on Diversity, Equity, and Inclusion
Authors: Hardy-Waller Antoinette
Published: February 2023

Hospitals, health systems, pharmaceutical companies, device makers, and payers have a responsibility to provide high-quality, innovative, cost-effective care and services to their patients and communities. The governing boards of these institutions provide the vision, strategy, and resources and choose the best leaders to achieve those outcomes. Healthcare boards can play a vital role in ensuring that resources are distributed where they are most needed. The need is great in communities of racial and ethnic diversity, which are almost always underserved—a preexisting condition that came into stark relief during the COVID-19 pandemic. Widespread inequities in access to care, housing, nutrition, and other components of good health were documented, and boards promised to pursue change, including becoming more diverse themselves. More than two years later, healthcare boards and senior executives remain mostly white and male. This continuing reality is especially unfortunate because diversity in governance and the C-suite has positive implications for financial, operational, and clinical success, including solving persistent inequities and disparities experienced in disadvantaged communities.
Patient Satisfaction, Visual Outcomes, and Regression Analysis in Post-LASIK Patients Implanted With Multifocal, EDOF, or Monofocal IOLs
Authors: Bucci Frank A.
Published: February 2023

Objective:

To compare and contrast functional visual outcomes and levels of patient satisfaction in post–laser in situ keratomileusis (LASIK) cataract patients with multifocal, extended depth of focus (EDOF), or monofocal intraocular lens (IOLs).

Methods:

Three cohorts of post-LASIK eyes with multifocal, EDOF, or monofocal IOLs were evaluated. Objective preoperative and postoperative clinical metrics, including higher-order aberration, contrast sensitivity, and visual acuities, plus subjective responses to a questionnaire about satisfaction, spectacle use, and ability to perform tasks were compared. Variables were regressed against “overall patient satisfaction” to identify predictors of satisfaction.

Results:

Ninety-seven percent of patients were “very satisfied” or “satisfied.” “Very satisfied” was significantly greater in multifocal (86.8%, 33 of 38) and EDOF (72.7%, 8 of 11) vs. monofocal (33.3%, 6 of 18) IOLs. However, EDOF IOLs outperformed monofocal IOLs for intermediate (P=0.04). Contrast sensitivity was significantly worse at distance for multifocal vs. both EDOF (P=0.05) and monofocal (P=0.005) IOLs. Regression revealed that greater patient satisfaction in multifocal was explained by near visual function variables, including UNVA (P=0.001) and UIVA (P=0.04), reading acuity (P=0.014), reading speed (P=0.05), spectacle use at near (P=0.0014), and ability to read moderate print (P=0.002).

Conclusions:

Multifocals achieved high satisfaction levels in post-LASIK patients despite higher-order aberrations and lower contrast sensitivity scores; regression revealed that uncorrected near visual function variables explained high levels of satisfaction; dysphotopsias did not contribute significantly to scores for satisfaction; multifocal IOLs are a viable choice for cataract patients who have previously undergone LASIK.
Collapsing glomerulopathy: unraveling varied pathogeneses
Authors: Smith Kelly D. , Akilesh Shreeram
Published: February 2023

Purpose of review

Collapsing glomerulopathy presents clinically with nephrotic syndrome and rapid progressive loss of kidney function. Animal models and patient studies have uncovered numerous clinical and genetic conditions associated with collapsing glomerulopathy, as well as putative mechanisms, which will be reviewed here.

Recent findings

Collapsing glomerulopathy is classified pathologically as a variant of focal and segmental glomerulosclerosis (FSGS). As such, most research efforts have focused on the causative role of podocyte injury in driving the disease. However, studies have also shown that injury to the glomerular endothelium or interruption of the podocyte–glomerular endothelial cell signaling axis can also cause collapsing glomerulopathy. Furthermore, emerging technologies are now enabling exploration of diverse molecular pathways that can precipitate collapsing glomerulopathy using biopsies from patients with the disease.

Since its original description in the 1980s, collapsing glomerulopathy has been the subject of intense study, and these efforts have uncovered numerous insights into potential disease mechanisms. Newer technologies will enable profiling of the intra-patient and inter-patient variability in collapsing glomerulopathy mechanisms directly in patient biopsies, which will improve the diagnosis and classification of collapsing glomerulopathy.
Aggressive High-grade Uterine Sarcoma Harboring MEIS1-NCOA2 Fusion and Amplification of Multiple 12q13-15 Genes: A Case Report With Morphologic, Immunohistochemical, and Molecular Analysis
Authors: Niu Shuang , Rivera-Colon Glorimar , Lucas Elena
Published: February 2023

MEIS1-NCOA1/2 fusions are recently described gene rearrangements found in rare sarcomas, mainly involving the genitourinary and gynecologic tracts, with 3 cases reported in the uterine corpus. Although local recurrence was very common, no death has been reported, and some investigators consider these sarcomas low grade. Amplification of genes located at the 12q13-15 locus, especially MDM2, is the hallmark genetic abnormality in well-differentiated and dedifferentiated liposarcoma of the soft tissue. Some uterine tumors have also been reported to harbor MDM2 amplification, including a proportion of Müllerian adenosarcomas, BCOR fusion-positive high-grade endometrial stromal sarcoma, BCORL1-altered high-grade endometrial stromal sarcoma, rare JAZF1 fusion-positive low-grade endometrial stromal sarcoma, rare undifferentiated uterine sarcoma, and a single case of MEIS1-NCOA2 fusion sarcoma. Here, we report a case of high-grade MEIS1-NCOA2 fusion uterine sarcoma which also harbored amplification of multiple 12q13-15 genes, including MDM2, CDK4, MDM4, and FRS2, that exhibited aggressive clinical course leading to patient’s death within 2 yr of the initial diagnosis. To the best of our knowledge, this is the first documented case of fatal MEIS1-NCOA2 fusion uterine sarcoma, and the second case of MEIS1-NCOA2 fusion uterine sarcoma that also harbors MDM2 amplification.
An Unusual Endometrial Stromal Neoplasm With JAZF1-BCORL1 Rearrangement
Authors: Moghaddam Parnian A. , Young Robert H. , Ismiil Nadia D. , Bennett Jennifer A. , Oliva Esther
Published: February 2023

Endometrial stromal tumors represent the second most common category of uterine mesenchymal tumors. Several different histologic variants and underlying genetic alterations have been recognized, one such being a group associated with BCORL1 rearrangements. They are usually high-grade endometrial stromal sarcomas, often associated with prominent myxoid background and aggressive behavior. Here, we report an unusual endometrial stromal neoplasm with JAZF1-BCORL1 rearrangement and briefly review the literature. The neoplasm formed a well-circumscribed uterine mass in a 50-yr-old woman and had an unusual morphologic appearance that did not warrant a high-grade categorization. It was characterized by a predominant population of epithelioid cells with clear to focally eosinophilic cytoplasm growing in interanastomosing cords and trabeculae set in a hyalinized stroma as well as nested and fascicular growths imparting focal resemblance to a uterine tumor resembling ovarian sex-cord tumor, PEComa, and a smooth muscle neoplasm. A minor storiform growth of spindle cells reminiscent of the fibroblastic variant of low-grade endometrial stromal sarcoma was also noted but conventional areas of low-grade endometrial stromal neoplasm were not identified. This case expands the spectrum of morphologic features seen in endometrial stromal tumors, especially when associated with a BCORL1 fusion and highlights the utility of immunohistochemical and molecular techniques in the diagnosis of these tumors, not all of which are high grade.
Mesonephric Adenomyofibroma: A Biphasic Vaginal Mass of Mesonephric Type With Molecular Analysis: A Case Report of a Rare Entity
Authors: Shahi Maryam , Palsgrove Doreen N. , Ronnett Brigitte M. , Lin Jeffrey , Murdock Tricia A.
Published: February 2023

Mesonephric neoplasms of the lower female genital tract are rare. To date, there are scarce reports of benign biphasic vaginal mesonephric lesions, and none have included immunohistochemical and/or molecular analysis. A biphasic neoplasm of mesonephric-type was incidentally identified in the vaginal submucosal tissue of a 55-yr-old woman who underwent a right salpingo-oophorectomy for an ovarian cyst. The well-circumscribed, 5 mm nodule exhibited white-tan, firm homogenous cut surfaces. Microscopic examination showed a lobular arrangement of glands with columnar to the cuboidal epithelium and intraluminal eosinophilic secretions, embedded within a myofibromatous stroma. Cytologic atypia and mitotic activity were absent. Immunohistochemical staining for PAX8 and GATA3 demonstrated diffuse expression in the glandular epithelium, CD10 exhibited a patchy luminal expression pattern, while TTF1, ER, PR, p16, and NKX3.1 were negative. Desmin highlighted a subset of the stromal cells, but myogenin was negative. Whole exome sequencing demonstrated variants of unknown significance in multiple genes including PIK3R1 and NFIA. The morphologic and immunohistochemical profiles are consistent with a benign mesonephric neoplasm. This is the first report describing the immunohistochemical and whole exome sequencing results for a benign biphasic vaginal mesonephric neoplasm. To the best of our knowledge, benign mesonephric adenomyofibroma has not been previously reported in this anatomic location.
Clinical Features of SARS-CoV-2 Infection During Pregnancy and Associated Placental Pathologies
Authors: Ryan Emily E. , Brar Nivaz , Allard Grace , Wang Aihui , Winn Virginia D. , Folkins Ann , Yang Eric J. , Tan Serena , Hazard Florette K. , Howitt Brooke E.
Published: February 2023

We reviewed the clinicopathologic findings of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-exposed placentas at our institution. We identified patients diagnosed with SARS-CoV-2 during pregnancy (March–October 2020). Clinical data included gestational age at diagnosis and delivery and maternal symptoms. Hematoxylin and eosin slides were reviewed for maternal vascular malperfusion, fetal vascular malperfusion, chronic villitis, amniotic fluid infection, intervillous thrombi, fibrin deposition, and infarction. Immunohistochemistry (IHC) for coronavirus spike protein and RNA in situ hybridization (ISH) for SARS-CoV-2 was performed on a subset of blocks. A review of placentas from age-matched patients received March–October 2019 was conducted as a comparison cohort. A total of 151 patients were identified. Placentas in the 2 groups were similar in weight for gestational age and had similar rates of maternal vascular malperfusion, fetal vascular malperfusion, amniotic fluid infection, intervillous thrombi, fibrin deposition, and infarction. Chronic villitis was the only significantly different pathologic finding between cases and controls (29% of cases showed chronic villitis vs. 8% of controls, P<0.001). Overall, 146/151 (96.7%) cases were negative for IHC and 129/133 (97%) cases were negative for RNA ISH. There were 4 cases that stained positively for IHC/ISH, 2 of which showed massive perivillous fibrin deposition, inflammation, and decidual arteriopathy. coronavirus disease 2019 (COVID-19)-positive patients were more likely to self-identify as Hispanic and more likely to have public health insurance. Our data suggests SARS-CoV-2 exposed placentas that stain positively for SARS-CoV-2 show abnormal fibrin deposition, inflammatory changes, and decidual arteriopathy. The group of patients with clinical COVID-19 are more likely to show chronic villitis. IHC and ISH evidence of viral infection is rare.
Single-Case Experimental Design in Rehabilitation: Basic Concepts, Advantages, and Challenges
Authors: Yang Lujia , Armijo-Olivo Susan , Gross Douglas P.
Published: February 2023

Single case experimental design (SCED) is a family of experimental methods that can be used to examine the efficacy of interventions by testing a small number of patients or cases. This article provides an overview of SCED research for use in rehabilitation as another option along with traditional group-based research when studying rare cases and rehabilitation interventions of unknown efficacy. Basic concepts related to SCED and the characteristics of common subtypes (N-of-1 randomized controlled trial, withdrawal design, multiple baseline design, multiple treatment design, changing criterion/intensity design, and alternating treatment design) are introduced. The advantages and disadvantages of each subtype are discussed along with challenges in data analysis and interpretation. Criteria and caveats for interpreting SCED results and their use in evidence-based practice decisions are discussed. Recommendations are provided for appraising SCED articles as well as using SCED principles to improve real-world clinical evaluation.
Incision and Capsular Contracture Risk
Authors: Swanson Eric
Published: February 2023

Background

Breast implants can be introduced through a variety of incisions, most commonly an inframammary incision, but also a periareolar incision or an axillary incision. Usually, the implant is inserted through the same incision used in performing an augmentation/mastopexy. Some authors use a separate inframammary incision. Capsular contracture is the most common complication of breast augmentation. One theory holds that it is caused by an infected biofilm, prompting surgeons to minimize implant handling, known as the “no touch” technique. This review was undertaken to investigate the relationship, if any, between the access incision and the risk of capsular contracture.

Methods

An electronic literature search was conducted to identify publications comparing capsular contracture rates by the access incision.

Results

Ten studies were evaluated. Most were retrospective series. Three were prospective core studies. Some studies reported an increased risk of capsular contracture for a periareolar incision; a similar number did not. One study supported a separate inframammary incision at the time of vertical augmentation/mastopexy.

Discussion

Bacterial studies in the last decade show that the resident bacteria on the skin surface and within breast tissue are similar. Sophisticated microbiological evaluation of breast capsules reveals that the microbiome relates to the patient, as opposed to a specific bacterial profile for capsular contracture. A review of the statistics used in determining an advantage for a separate incision at the time of vertical augmentation/mastopexy reveals that there is no statistically significant risk reduction when using an additional inframammary incision, which adds an unnecessary scar.

Conclusions

The access incision at the time of breast augmentation or augmentation/mastopexy is unlikely to affect the capsular contracture risk. There is no need to make a separate incision to insert the implant at the time of augmentation/mastopexy, or to isolate the implant from contact with breast parenchyma. Little evidence supports the “no touch” technique. The etiology of capsular contracture remains unknown.
Do Racial and Ethnic Disparities Exist in Management of Pediatric Mandible Fractures? A 30-Year Outcome Analysis
Authors: Lopez Christopher D. , Girard Alisa O. , Yusuf Cynthia T. , Yesantharao Lekha V. , Redett Richard J. , Manson Paul N. , Lopez Joseph , Yang Robin
Published: February 2023

Background

Mandibular fractures are the most common of pediatric facial fractures. The effect of race on management/outcomes in these injuries has not been previously studied. Given the significant association between race and healthcare outcomes in many other pediatric conditions, an in-depth study of race as related to mandibular fractures in the pediatric patient population is warranted.

Methods

This was a 30-year retrospective, longitudinal study of pediatric patients who presented to a single institution with mandibular fractures. Patient data were compared between patients of different races and ethnicities. Demographic variables, injury characteristics, and treatment variables were analyzed to find predictors of surgical treatment and posttreatment complications.

Results

One hundred ninety-six patients met inclusion criteria, of whom 49.5% were White, 43.9% were Black, 0.0% were Asian, and 6.6% were classified as “other.” Black and “other” patients were more likely than their White counterparts to be injured as pedestrians (P= 0.0005). Black patients were also more likely than White patients or “other” patients to be injured by assault than by sports-related injuries or animal-related accidents (P= 0.0004 andP= 0.0018, respectively). Race or ethnicity were not found to be a predictor of receiving surgical treatment (ORIF) or of posttreatment complications. The posttreatment rates for all the complications observed were comparable among all race and ethnic groups. Higher mandible injury severity score (odds ratio [OR], 1.25), condyle fracture (OR, 2.58), and symphysis fracture (OR, 3.20) were positively correlated with receiving ORIF as treatment. Mandible body fracture (OR, 0.36), parasymphyseal fracture (OR, 0.34), bilateral mandible fracture (OR, 0.48), and multiple mandibular fractures (OR, 0.34) were negatively correlated with receiving ORIF as treatment. Only high mandible injury severity score (OR, 1.10) was identified as an independent predictor of posttreatment complications. Lastly, Maryland's transition to an all-payer model in 2014 also had no impact on treatment modality; treatment of fractures among race and ethnicity were not significantly different pre- and post-2014.

Conclusions

There is no difference in how patients are treated (surgically vs nonsurgically) and no difference in outcomes for patients based on race at our institution. This could be due to institutional ideology, services provided by a tertiary care center, or simply the more diverse patient population at baseline.
Evaluation of Perioperative Versus Extended Courses of Antibiotic Prophylaxis After Immediate Implant-Based Breast Reconstruction
Authors: Zhang Casey , Moroni Elizabeth A. , Bustos Samyd S. , De La Cruz Carolyn , Gimbel Michael L. , Nguyen Vu T.
Published: February 2023

Background

Immediate implant-based breast reconstruction (IIBR) is the most commonly used method in breast reconstruction in the United States. However, postoperative surgical site infections (SSIs) can cause devastating reconstructive failure. This study evaluates the use of perioperative versus extended courses of antibiotic prophylaxis after IIBR for the prevention of SSI.

Methods

This is a single-institution retrospective study of patients who underwent IIBR between June 2018 and April 2020. Detailed demographic and clinical information was collected. Patients were divided into subgroups based on antibiotic prophylaxis regimen: group 1 consisted of patients who received 24 hours of perioperative antibiotics and group 2 consisted of patients who received ≥7 days of antibiotics. Statistical analyses were conducted using SPSSv26.0 with P ≤ 0.05 considered statistically significant.

Results

A total of 169 patients (285 breasts) who underwent IIBR were included. The mean age was 52.4 ± 10.2 years, and the mean body mass index (BMI) was 26.8 ± 5.7 kg/m2. Twenty-five percent of patients (25.6%) underwent nipple-sparing mastectomy, 69.1% skin-sparing mastectomy, and 5.3% total mastectomy. The implant was placed in the prepectoral, subpectoral, and dual planes in 16.7%, 19.2%, and 64.1% cases, respectively. Acellular dermal matrix was used in 78.7% of cases. A total of 42.0% of patients received 24-hour prophylaxis (group 1), and 58.0% of patients received extended prophylaxis (group 2). Twenty-five infections (14.8%) were identified, of which 9 (5.3%) resulted in reconstructive failure. In bivariate analyses, no significant difference was found between groups in rates of infection (P = 0.273), reconstructive failure (P = 0.653), and seroma (P = 0.125). There was a difference in hematoma rates between groups (P = 0.046). Interestingly, in patients who received only perioperative antibiotics, infection rates were significantly higher in those with BMI ≥ 25 (25.6% vs 7.1%, P = 0.050). There was no difference in overweight patients who received extended antibiotics (16.4% vs 7.0%, P = 0.160).

Conclusions

Our data demonstrate no statistical difference in infection rates between perioperative and extended antibiotics. This suggests that the efficacies of current prophylaxis regimens are largely similar, with choice of regimen based on surgeon preference and patient-specific considerations. Infection rates in patients who received perioperative prophylaxis and were overweight were significantly higher, suggesting that BMI should be taken into consideration when choosing a prophylaxis regimen.
Whole-body variational modularity in the zebrafish: an inside-out story of a model species
Authors: Vanhaesebroucke Olivia , Larouche Olivier , Cloutier Richard
Published: February 2023

Actinopterygians are the most diversified clade of extant vertebrates. Their impressive morphological disparity bears witness to tremendous ecological diversity. Modularity, the organization of biological systems into quasi-independent anatomical/morphological units, is thought to increase evolvability of organisms and facilitate morphological diversification. Our study aims to quantify patterns of variational modularity in a model actinopterygian, the zebrafish (Danio rerio), using three-dimensional geometric morphometrics on osteological structures isolated from micro-CT scans. A total of 72 landmarks were digitized along cranial and postcranial ossified regions of 30 adult zebrafishes. Two methods were used to test modularity hypotheses, the covariance ratio and the distance matrix approach. We find strong support for two modules, one comprised paired fins and the other comprised median fins, that are best explained by functional properties of subcarangiform swimming. While the skull is tightly integrated with the rest of the body, its intrinsic integration is relatively weak supporting previous findings that the fish skull is a modular structure. Our results provide additional support for the recognition of similar hypotheses of modularity identified based on external morphology in various teleosts, and at least two variational modules are proposed. Thus, our results hint at the possibility that internal and external modularity patterns may be congruent.
Atomic force microscopy-based indentation of cells: modelling the effect of a pericellular coat
Authors: Argatov Ivan , Jin Xiaoqing , Mishuris Gennady
Published: February 2023

A simple analytical model is built up to account for the interface deformation effect in a spherical atomic force microscopy (AFM)-based quasi-static indentation of a living cell covered with a pericellular brush. The compression behaviour of the pericellular coat is described using the Alexander–de Gennes model that allows for nonlinear deformation. An approximate second-order relation between contact force and indenter displacement is obtained in implicit form, using the Hertzian solution as a first-order approximation. A method of fitting the indentation brush/cell model to experimental data is suggested based on the non-dimensionalized version of the displacement–force relation in the parametric form and illustrated with a specific example of AFM raw data taken from the literature.
Moments of moments of the characteristic polynomials of random orthogonal and symplectic matrices
Authors: Claeys Tom , Forkel Johannes , Keating Jonathan P.
Published: February 2023

By using asymptotics of Toeplitz+Hankel determinants, we establish formulae for the asymptotics of the moments of the moments of the characteristic polynomials of random orthogonal and symplectic matrices, as the matrix size tends to infinity. Our results are analogous to those that Fahs obtained for random unitary matrices in (Fahs B. 2021
Communications in Mathematical Physics
383
, 685–730. (doi:
10.1007/s00220-021-03943-0
)). A key feature of the formulae we derive is that the phase transitions in the moments of moments are seen to depend on the symmetry group in question in a significant way.
Compliance with the provisions related to higher educational institutes of anti-tobacco/smoking law by institutes of national importance in India.
Authors: Singh Raja
Published: February 2023

India formulated an anti-tobacco and anti-smoking law in 2003 in response to its resolutions in the United Nations bodies. This law has been detailed subsequently to make it focussed on educational institutions, which are supposed to perform on-ground action. The first is to put up signboards prohibiting the sale of cigarettes and tobacco products within 100 yards, the second is prohibiting smoking within the campus, and the third is implementing the law and collecting fines from the offenders. The focus of this paper is on Indias premier educational institutions called the Institutions of National Importance by the Indian legislature. These are Indias public institutions which have a focus of the government in making them high quality. The paper checked for the compliance of the Indian anti-smoking and anti-tobacco laws in 79 of these institutions. The Right to Information Act, 2005, Indias transparency law, was used to file applications for information, and certified information from the institutions was collected and reported. The results show an overall weak compliance with the law. Indias health regulators and educational watchdogs must implement anti-smoking and anti-tobacco laws strictly in Indian educational institutions.
Homeostatic inflammation in the placenta is protective against adult cardiovascular and depressive outcomes
Authors: Fitzgerald Eamon , Shen Mo Jun , Juen Yong Hannah Ee , Wang Zihan , Pokhvisneva Irina , Patel Sachin , O’Toole Nicholas , Chan Shiao-Yng , Chong Yap Seng , Chen Helen , Gluckman Peter D , Chan Jerry , Ming Lee Patrick Kia , Meaney Michael J
Published: February 2023

Pathological placental inflammation increases the risk for several adult disorders, but these mediators are also expressed under homeostatic conditions, where their contribution to adult health outcomes is unknown. Here we define an expression signature of homeostatic inflammation in the term placenta and use expression quantitative trait loci (eQTLs) to create a polygenic score (PGS) predictive of its expression. Using this PGS in the UK Biobank we carried out a phenome-wide association study, followed by mendelian randomization and identified protective, sex-dependent effects of the placental module on cardiovascular and depressive outcomes. Genes differentially regulated by intra-amniotic infection and preterm birth were also over-represented within the module. Our data support a model where disruption of placental homeostatic inflammation, following preterm birth or intra-amniotic infection, contributes to the increased risk of depression and cardiovascular disease observed in these individuals. Finally, we identify aspirin as a putative modulator of this homeostatic inflammatory signature.
A Mummers Farce - Retractions of Medical Papers conducted in Egyptian Institutions
Authors: Menshawey Rahma , Menshawey Esraa , Mahamud Bilal A.
Published: February 2023

Rationale and Objective

Egypt currently holds a record for the most retractions in the continent of Africa according to the Retraction Watch database, and the 2ndhighest of countries in the Middle East. The purpose of this study was to perform a specific analysis on retracted medical publications from Egyptian affiliations to outline or delineate specific problems and solutions.

Materials and Methods

The Retraction Watch Database, Google Scholar, SCOPUS, PubMed, and journals sponsored by the Egyptian Knowledge Bank were searched for all Egypt affiliated retracted medical publications up to the date of August 31st2022. We observed for the reason(s) for retraction, number of citations, the length of time between publication and retraction and more.

Results

68 retractions were identified that could be linked directly to a known Egyptian institution listed in the study methodology. Most retractions originated from the speciality of Obstetrics and Gynecology (n=22), followed by Anesthesia (n=7). The top 3 reasons for retraction included unreliable results, FFP level misconduct, and duplicate publication. The number of retractions significantly increased over the years, especially in 2022. When taking into account the number of medical publications per institution, the institute with the highest rate of retractions was Mansoura University, while the lowest rate was Cairo University.

Conclusion

The number of retracted medical Egyptian publications continues to increase over time, as more issues are uncovered in research coming from this region. Medical papers from this area have been the focus of investigations that have suggested that many results are statistically unlikely to have occurred. Authors must employ a higher ethical standard in their work, while institutions must be openly collaborative with investigations and enact penalties where needed to deter future misconduct. Future studies on retracted articles should employ a methodology that considers the institutions where the studies were conducted in order to obtain a better understanding of specific problems in certain countries or regions.
Redefining Left Bundle Branch Block from High-density Electroanatomical Mapping
Authors: Zou Jun-Hua , Hua Bao-Tong , Shao Xiao-Xia , Wang Chao , Li Hao , Lu Ya-Nan , Tian Xin , Li Zhi-Xuan , Pu Li-Jin , Wang Jing
Published: February 2023

Background

The current ECG criteria for diagnosing left bundle branch block (LBBB) still cannot fully differentiate between true and false blocks. The absence or presence of an LBBB is key in improving the response rate of clinical cardiac resynchronization therapy (CRT).

Methods

We hypothesized that the notch width of the QRS complex in the lateral leads (I, avL, V5, V6) on the LBBB-like ECG could further confirm the diagnosis of true complete left bundle branch block (t-LBBB). We performed high-density, three-dimensional electroanatomical mapping in the cardiac chambers of 37 patients scheduled to undergo CRT and whose preoperative electrocardiograms met the ACC/AHA/HRS guidelines for the diagnosis of complete LBBB. If the left bundle branch potential could be mapped from the bottom of the heart to the apex on the left ventricular septum, it was defined as a false complete left bundle branch block (f-LBBB). Otherwise, it was categorized as a t-LBBB. We compared the clinical characteristics, the real-time correspondence between the spread of ventricular electrical excitation and the QRS wave, the QRS notch width of the lateral leads (I, avL, V5, V6), and the notch width/left ventricular end-diastolic diameter (Nw/LVd) ratio between the two groups. Through ROC correlation analysis of Nw/LVd and t-LBBB, the sensitivity, specificity, and cut-off value of Nw/LVd diagnostic authenticity were obtained.

Results

Twenty-five patients were recruited to the t-LBBB group, and 12 to the f-LBBB group. In the t-LBBB group, the first peak of the QRS notch corresponded to the depolarization of the right ventricle and septum, the trough corresponded to the depolarization of the left ventricle across the left ventricle, and the second peak corresponded to the depolarization of the left ventricular free wall. In the f-LBBB group, the first peak corresponded to the depolarization of the right ventricle and most of the left ventricle, the second peak corresponded to the depolarization of the latest, locally-activated myocardium of the left ventricle, and the trough was caused by the off-peak delayed activation of the left ventricle. The QRS notch width (45.2 ± 12.3 ms vs. 52.5 ± 9.2 ms,P<0.05) and the Nw/LVd (0.65 ± 0.19 ms/mm vs. 0.81 ± 0.17 ms/mm,P<0.05) were compared between the two groups. Through ROC correlation analysis, the sensitivity (88%), specificity (58%), and cut-off value (0.56) for Nw/LVd diagnosis of t-LBBB was obtained.

Conculuion

Using the current diagnostic criteria of LBBB, increasing the Nw/LVd value can diagnose LBBB more effectively.
Single shot dendritic cell targeting SARS-CoV-2 vaccine candidate induces broad and durable systemic and mucosal immune responses
Authors: Zhi Cheang Nicholas You , Tan Peck Szee , Purushotorma Kiren , Yap Wee Chee , Leong Chua Benson Yen , Tan Kai Sen , Tullett Kirsteen McInnes , Yeoh Aileen Ying-Yan , Hui Tan Caris Qi , Qian Xinlei , Wen Tay Douglas Jie , Caminschi Irina , Tan Yee Joo , Macary Paul Anthony , Tan Chee Wah , Lahoud Mireille Hanna , Alonso Sylvie
Published: February 2023

Current COVID-19 vaccines face certain limitations, which include waning immunity, immune escape by SARS-CoV-2 variants, limited CD8+cellular response, and poor induction of mucosal immunity. Here, we engineered a Clec9A-RBD antibody construct that delivers the Receptor Binding Domain (RBD) from SARS-CoV-2 spike protein to conventional type 1 dendritic cells (cDC1). We showed that single dose immunization with Clec9A-RBD induced high RBD-specific antibody titers with a strong T-helper 1 (TH1) isotype profile and exceptional durability, whereby antibody titers were sustained for at least 21 months post-vaccination. Uniquely, affinity maturation of the antibody response was observed over time, as evidenced by enhanced neutralization potency and breadth across the sarbecovirus family. Consistently and remarkably, RBD-specific T-follicular helper cells and germinal center B cells were still detected at 12 months post-immunization. Increased antibody-dependent cell-mediated cytotoxicity (ADCC) activity of the immune sera was also measured over time with comparable efficacy against ancestral SARS-CoV-2 and variants, including Omicron. Furthermore, Clec9A-RBD immunization induced a durable poly-functional TH1-biased cellular response that was strongly cross-reactive against SARS-CoV-2 variants, including Omicron, and with robust CD8+T cell signature. Lastly, Clec9A-RBD single dose systemic immunization primed effectively RBD-specific cellular and humoral mucosal immunity in lung. Taken together, Clec9A-RBD immunization has the potential to trigger robust and sustained, systemic and mucosal immune responses against rapidly evolving SARS-CoV2 variants.
Learning-induced reorganization of neuronal subnetworks in the primary sensory cortex
Authors: Yang Yexin , Shen Hao , Kwon Sung Eun
Published: February 2023

Perceptual learning alters the representation of sensory input in primary sensory cortex. Alterations in neuronal tuning, correlation structure and population activity across many subcortical and cortical areas have been observed in previous studies. However, relationships between these different neural correlates - and to what extent they are relevant to specific perceptual tasks - are still unclear. In this study, we recorded activity of the layer 2/3 neuronal populations in the whisker primary somatosensory cortex (wS1) using in vivo two-photon calcium imaging as mice were trained to perform a self-initiated, whisker vibration frequency discrimination task. Individual wS1 neurons displayed learning-induced broadening of frequency sensitivity within task-related categories only during task performance, reflecting both learning-and context-dependent enhancement of category selectivity. Learning increased both signal and noise correlations within pairs of neurons that prefer the same stimulus category (‘within-pool’), whereas learning decreased neuronal correlations between neuron pairs that prefer different categories (‘across-pool’). Increased noise correlations in trained animals resulted in less accurate decoding of stimulus categories from population activity but did not affect decoding of the animal’s decision to respond to stimuli. Importantly, within-pool noise correlations were elevated on trials in which animals generated the learned behavioral response. We demonstrate that learning drives formation of task-relevant ‘like-to-like’ layer 2/3 subnetworks in the primary sensory cortex that may facilitate execution of learned behavioral responses.

Significance Statement

We found that cortical plasticity during perceptual learning alters both neuronal tuning and the structure of pairwise correlations such that they become increasingly aligned to task-related categories, indicating the formation of ‘like-to-like’ subnetworks in layer 2/3 of sensory cortex. Category-specific increases in signal and noise correlations were induced by learning and only observed during active task performance, which points to top-down feedback as a driver of task-related subnetworks.