bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Acellular Dermal Matrix Type in Treatment of Capsular Contracture in Breast Augmentation: A Systematic Review and Meta-Analysis
Authors: Samuels Kaitlyn , Millet Emily , Wong Lesley
Published: August 2023

Background

Capsular contracture is a known complication of breast augmentation and is among the top reasons for revisional breast augmentation procedures. The use of acellular dermal matrix (ADM) has been shown to reduce the rate of capsular contracture in breast reconstruction and augmentation, theorizing that it acts as a protective barrier between the implant capsule and inflammatory process responsible for capsular contracture. The role of ADM in treatment of capsular contracture has been investigated in numerous studies, with a variety of ADMs.

Objectives

The aim of this study was to perform a systematic review of existing literature on the use of ADM for treatment of capsular contracture in aesthetic breast augmentation patients to investigate differences in efficacy of ADM types.

Methods

The PubMed, Embase, and CINAHL databases were systematically reviewed for articles pertaining to capsular contracture, acellular dermal matrices, and breast augmentation. Number of patients, type of ADM, Baker grade, follow-up time, complication rate, and capsular contracture rate were recorded from identified articles. Data was pooled from studies to calculate a capsular contracture rate for each ADM type, with a chi-squared test performed for analysis. Identified studies with a comparative group were included in a meta-analysis utilizing risk ratio (RR) to assess the efficacy of ADM.

Results

Nine articles including ADM for treatment of capsular contracture in breast augmentation met criteria for inclusion, with a total of 481 breasts. Strattice was the most commonly utilized ADM (n = 391), followed by AlloDerm (n = 57). There was a statistically significant difference in efficacy of ADM among the studied ADM types (P < .001). AlloDerm, FlexHD, and DermaMatrix had the lowest capsular contracture rates (0%). NeoForm and SurgiMend had the highest capsular contracture rates (each 25%, but with n = 4 and n = 8, respectively). Strattice had a capsular contracture rate of 1.53% in the pooled data, and meta-analysis showed that Strattice reduced the risk of capsular contracture (RR 0.14 [95% CI 0.06, 0.31]) compared with conventional treatment.

Conclusions

Acellular dermal matrices appear to be effective at treating capsular contracture after breast augmentation while maintaining a low complication rate. Overall capsular contracture rates are low with the use of ADM. There is a statistically significant difference in efficacy among ADM types. Meta-analysis shows that Strattice is effective at reducing the risk of capsular contracture in breast augmentation patients when compared to conventional treatment. Future research, especially in the form of randomized controlled trials, is needed to further investigate the efficacy of various ADMs in the treatment of capsular contracture.

Level of Evidence: 4
Diversity and evolution of telomeric motifs and telomere DNA organization in insects
Authors: Lukhtanov Vladimir A , Pazhenkova Elena A
Published: August 2023

The telomerase mechanism and telomeric motifs are vital for maintaining chromosome integrity. Their functions are conserved in eukaryotic organisms; therefore, it is not surprising that the structure of telomeric motifs is stable. For example, the TTAGG motif persists for hundreds of millions of years in most insects and other arthropods. Here we describe bursts of high diversity of telomeric motifs that have evolved independently in pentatomomorphic bugs (Hemiptera, Pentatomomorpha) and several lineages of parasitic and stinging wasps and bees (Hymenoptera, Apocrita). We show that in most insects, the telomeric DNA sequence is not just a collection of short repeats, but a very long array consisting of (TTAGG)n (or other motifs such as TTGGG, TCAGG, TCTGGG, TTAGGGATGG, TTAGGGGTGG, TTAGGGTGGT, TTAGGTCTGGG, TTAGGTTGGGG, TTAGGTTTGGG and TTGGGTCTGGG), regularly and specifically interrupted by the insertion of non-long terminal repeat (non-LTR) retrotransposons of the TRAS and SART families. Long (173–381 bp) repeats were found at chromosome ends in flies of the families Syrphidae and Tachinidae (Diptera). We hypothesize that the balance of telomerase-dependent machinery and telomerase-independent mechanisms (such as SART and TRAS transpositions) maintains telomeres in many insects. We also discuss how shifting this balance can lead to an increased variability of telomeric motifs and to their complete disappearance.
Activation of endothelial TRPM2 exacerbates blood–brain barrier degradation in ischemic stroke
Authors: Zong Pengyu , Feng Jianlin , Li Cindy X , Jellison Evan R , Yue Zhichao , Miller Barbara , Yue Lixia
Published: August 2023

Aims

Damage of the blood–brain barrier (BBB) is a hallmark of brain injury during the early stages of ischemic stroke. The subsequent endothelial hyperpermeability drives the initial pathological changes and aggravates neuronal death. Transient receptor potential melastatin 2 (TRPM2) is a Ca2+-permeable nonselective cation channel activated by oxidative stress. However, whether TRPM2 is involved in BBB degradation during ischemic stroke remains unknown. We aimed to investigate the role of TRPM2 in BBB degradation during ischemic stroke and the underlying molecular mechanisms.

Methods and results

Specific deletion of Trpm2 in endothelial cells using Cdh5 Cre produces a potent protective effect against brain injury in mice subjected to middle cerebral artery occlusion (MCAO), which is characterized by reduced infarction size, mitigated plasma extravasation, suppressed immune cell invasion, and inhibited oxidative stress. In vitro experiments using cultured cerebral endothelial cells (CECs) demonstrated that either Trpm2 deletion or inhibition of TRPM2 activation attenuates oxidative stress, Ca2+ overload, and endothelial hyperpermeability induced by oxygen–glucose deprivation (OGD) and CD36 ligand thrombospondin-1 (TSP1). In transfected HEK293T cells, OGD and TSP1 activate TRPM2 in a CD36-dependent manner. Noticeably, in cultured CECs, deleting Trpm2 or inhibiting TRPM2 activation also suppresses the activation of CD36 and cellular dysfunction induced by OGD or TSP1.

Conclusions

In conclusion, our data reveal a novel molecular mechanism in which TRPM2 and CD36 promote the activation of each other, which exacerbates endothelial dysfunction during ischemic stroke. Our study suggests that TRPM2 in endothelial cells is a promising target for developing more effective and safer therapies for ischemic stroke.
Targeting endothelial vascular cell adhesion molecule-1 in atherosclerosis: drug discovery and development of vascular cell adhesion molecule-1–directed novel therapeutics
Authors: Pickett Jessica R , Wu Yuao , Zacchi Lucia F , Ta Hang T
Published: August 2023

Vascular cell adhesion molecule-1 (VCAM-1) has been well established as a critical contributor to atherosclerosis and consequently as an attractive therapeutic target for anti-atherosclerotic drug candidates. Many publications have demonstrated that disrupting the VCAM-1 function blocks monocyte infiltration into the sub-endothelial space, which effectively prevents macrophage maturation and foam cell transformation necessary for atherosclerotic lesion formation. Currently, most VCAM-1-inhibiting drug candidates in pre-clinical and clinical testing do not directly target VCAM-1 itself but rather down-regulate its expression by inhibiting upstream cytokines and transcriptional regulators. However, the pleiotropic nature of these regulators within innate immunity means that optimizing dosage to a level that suppresses pathological activity while preserving normal physiological function is extremely challenging and oftentimes infeasible. In recent years, highly specific pharmacological strategies that selectively inhibit VCAM-1 function have emerged, particularly peptide- and antibody-based novel therapeutics. Studies in such VCAM-1–directed therapies so far remain scarce and are limited by the constraints of current experimental atherosclerosis models in accurately representing the complex pathophysiology of the disease. This has prompted the need for a comprehensive review that recounts the evolution of VCAM-1–directed pharmaceuticals and addresses the current challenges in novel anti-atherosclerotic drug development.
Catheter ablation of atrial fibrillation in patients with and without hypertrophic cardiomyopathy: systematic review and meta-analysis
Authors: Ezzeddine Fatima M , Agboola Kolade M , Hassett Leslie C , Killu Ammar M , Del-Carpio Munoz Freddy , DeSimone Christopher V , Kowlgi Gurukripa N , Deshmukh Abhishek J , Siontis Konstantinos C
Published: August 2023

Background

Atrial fibrillation (AF) is common in hypertrophic cardiomyopathy (HCM). There is limited data regarding the outcomes of AF catheter ablation in HCM patients. In this study, we aimed to synthesize all available evidence on the effectiveness of ablation of AF in patients with HCM compared to those without HCM.

Methods and results

We systematically reviewed bibliographic databases to identify studies published through February 2023. We included cohort studies with available quantitative information on rates of recurrent atrial arrhythmias, anti-arrhythmic drug (AAD) therapy, and repeat ablation procedures after initial AF ablation in patients with vs without HCM. Estimates were combined using random-effects meta-analysis models and reported as risk ratios (RR) and 95% confidence intervals (CI). Eight studies were included in quantitative synthesis (262 HCM and 642 non-HCM patients). During median follow-up 13–54 months across studies, AF recurrence rates ranged from 13.3% to 92.9% in HCM and 7.6% to 58.8% in non-HCM patients. The pooled RR for recurrent atrial arrhythmia after the first AF ablation in HCM patients compared to non-HCM controls was 1.498 (95% CI = 1.305–1.720; P < 0.001). During follow-up, HCM patients more often required AAD therapy (RR = 2.844; 95% CI = 1.713–4.856; P < 0.001) and repeat AF ablation (RR = 1.544; 95% CI = 1.070–2.228; P = 0.02). The pooled RR for recurrent atrial arrhythmias after the last AF ablation was higher in patients with HCM than those without HCM (RR = 1.607; 95% CI = 1.235–2.090; P < 0.001).

Conclusions

Compared to non-HCM patients, those with HCM had higher rates of recurrent atrial arrhythmias, AAD use, and need for repeat AF ablation after initial ablation of AF.
Timber yield of commercial tree species in the eastern Brazilian Amazon based on 33 years of inventory data
Authors: Reategui-Betancourt Jorge Luis , Mazzei de Freitas Lucas José , Santos Kenia Ribeiro Brito , Briceño Guido , Matricardi Eraldo Aparecido Trondoli , Ruschel Ademir Roberto , de Faria Ferreira Natália Cássia
Published: August 2023

Selective logging in neotropical forests has directly affected the dynamics of tree species, compromising species conservation and timber yield. Sustainable use of logged forests requires new tree recruitment and diameter growth in remaining trees to compensate for trees removed between cutting cycles. This long-term study investigated timber yields in four species groups with differing values (lower, intermediate, high, and mixed) in logged and unlogged forests in the plateau region of the Tapajós River in the eastern Brazilian Amazon. Analysis was based on two size classes: medium and large commercial-sized trees. In both forest types (logged and unlogged), we found relevant tree recruitment and changes in size classes for all value groups. Most of the recruited trees observed during the 33 years of monitoring remained in the medium size class, but they also occurred in the large size class in logged forests. Over the same period, a significant loss of timber yield was seen, resulting from high mortality among the remaining trees in both size classes due to natural processes and the aftereffects of logging. Timber yield was also seen to be influenced by species richness within the group of commercial species, and recruitment and tree diameter growth capacity to counterbalance losses from mortality of the remaining trees after logging had become restricted. Forest timber yield was mainly regulated by light-demanding species, and shade-tolerant species contributed little to timber yield during the first cut. Continuous monitoring of the remaining trees and measures to reduce tree mortality during cutting cycles can encourage growth and reduce losses in stocked trees. Additionally, the national rules for forest management in the Brazilian Amazon need to be improved to achieve long-term management sustainability.
WISDOM Project – XVII. Beam-by-beam properties of the molecular gas in early-type galaxies
Authors: Williams Thomas G , Bureau Martin , Davis Timothy A , Cappellari Michele , Choi Woorak , Elford Jacob S , Iguchi Satoru , Gensior Jindra , Liang Fu-Heng , Lu Anan , Ruffa Ilaria , Zhang Hengyue
Published: August 2023

We present a study of the molecular gas of seven early-type galaxies with high angular resolution data obtained as part of the mm-Wave Interferometric Survey of Dark Object Masses (WISDOM) project with the Atacama Large Millimeter/submillimeter Array. Using a fixed spatial-scale approach, we study the mass surface density (Σ) and velocity dispersion (σ) of the molecular gas on spatial scales ranging from 60 to 120 pc. Given the spatial resolution of our data (20–70 pc), we characterize these properties across many thousands of individual sightlines (≈50 000 at our highest physical resolution). The molecular gas along these sightlines has a large range (≈2 dex) of mass surface densities and velocity dispersions $\approx 40~{{\ \rm per\ cent}}$ higher than those of star-forming spiral galaxies. It has virial parameters αvir that depend weakly on the physical scale observed, likely due to beam smearing of the bulk galactic rotation, and is generally supervirial. Comparing the internal turbulent pressure (Pturb) to the pressure required for dynamic equilibrium (PDE), the ratio Pturb/PDE is significantly less than unity in all galaxies, indicating that the gas is not in dynamic equilibrium and is strongly compressed, in apparent contradiction to the virial parameters. This may be due to our neglect of shear and tidal forces, and/or the combination of three-dimensional and vertical diagnostics. Both αvir and Pturb anticorrelate with the global star-formation rate of our galaxies. We therefore conclude that the molecular gas in early-type galaxies is likely unbound, and that large-scale dynamics likely plays a critical role in its regulation. This contrasts to the giant molecular clouds in the discs of late-type galaxies, that are much closer to dynamical equilibrium.
High-energy interference-free K-lines synchrotron X-ray fluorescence microscopy of rare earth elements in hyperaccumulator plants
Authors: van der Ent Antony , Brueckner Dennis , Spiers Kathryn M , Falch Ken Vidar , Falkenberg Gerald , Layet Clément , Liu Wen-Shen , Zheng Hong-Xiang , Le Jean Marie , Blaudez Damien
Published: August 2023

Synchrotron-based micro-X-ray fluorescence analysis (µXRF) is a nondestructive and highly sensitive technique. However, element mapping of rare earth elements (REEs) under standard conditions requires care, since energy-dispersive detectors are not able to differentiate accurately between REEs L-shell X-ray emission lines overlapping with K-shell X-ray emission lines of common transition elements of high concentrations. We aim to test REE element mapping with high-energy interference-free excitation of the REE K-lines on hyperaccumulator plant tissues and compare with measurements with REE L-shell excitation at the microprobe experiment of beamline P06 (PETRA III, DESY). A combination of compound refractive lens optics (CRLs) was used to obtain a micrometer-sized focused incident beam with an energy of 44 keV and an extra-thick silicon drift detector optimized for high-energy X-ray detection to detect the K-lines of yttrium (Y), lanthanum (La), cerium (Ce), praseodymium (Pr), and neodymium (Nd) without any interferences due to line overlaps. High-energy excitation from La to Nd in the hyperaccumulator organs was successful but compared to L-line excitation less efficient and therefore slow (∼10-fold slower than similar maps at lower incident energy) due to lower flux and detection efficiency. However, REE K-lines do not suffer significantly from self-absorption, which makes XRF tomography of millimeter-sized frozen-hydrated plant samples possible. The K-line excitation of REEs at the P06 CRL setup has scope for application in samples that are particularly prone to REE interfering elements, such as soil samples with high concomitant Ti, Cr, Fe, Mn, and Ni concentrations.
Midbrain organoids—development and applications in Parkinson’s disease
Authors: Toh Hilary S Y , Choo Xin Yi , Sun Alfred Xuyang
Published: August 2023

Human brain development is spatially and temporally complex. Insufficient access to human brain tissue and inadequacy of animal models has limited the study of brain development and neurodegenerative diseases. Recent advancements of brain organoid technology have created novel opportunities to model human-specific neurodevelopment and brain diseases. In this review, we discuss the use of brain organoids to model the midbrain and Parkinson’s disease. We critically evaluate the extent of recapitulation of PD pathology by organoids and discuss areas of future development that may lead to the model to become a next-generation, personalized therapeutic strategy for PD and beyond.
Empire
Authors: Bayly Martin J.
Published: August 2023

Empire has traditionally been a blind spot in International Relations (IR)’s substantive and theoretical coverage, but this is no longer the case. Historical IR has been at the forefront of a ‘re-turn’ to empire in the discipline, thickening our understanding of the imperial contexts that shape the systemic, intellectual, and normative structure of contemporary world politics. This chapter surveys the contributions of this literature before offering some reflections on work yet to be done. Recent work on empire and IR has demonstrated how global modernity, and by extension the modern international system, was built on the connections that empire forged. But an overemphasis on what empire is, what it does to the world, and how it should be distinguished from other polities, obscures the global entanglements that constituted imperial power. The chapter turns attention to more relational conceptions of empire, in particular those that illuminate the patterns of resistance that empire fostered.
Barbarism and Civilization
Authors: Zhang Yongjin
Published: August 2023

The opposition of civilization versus barbarism has long been considered one of the most potent discursive frames of international orders in world history. The ideas of barbarism and civilization carry long and complex historical memories of shifting antithesis, symbiotic existence, and dialectic relationship in intercultural encounters, exchanges, and conflicts. Through explorations of moments of their articulation and invention in a kaleidoscope of slices of Western and Chinese history, this chapter seeks to provide an analysis of the conceptual co-evolution of barbarism and civilization in contrasting cultures and intellectual traditions with a certain level of historical granularity, to unpack the fluid webs of contested intersubjective meanings of these two ideas in historical complexity, and to tease out the historicity of these two concepts. In so doing, this chapter sketches the intricate historical construction of the opposition of barbarism versus civilization as a discursive framework for international ordering and highlights the contentious nature of such a construction in shaping contemporary international practices.
The Diplomacy of Genocide
Authors: Moses A. Dirk
Published: August 2023

This chapter delineates a particular domain of international relations: the ‘diplomacy of genocide’. This domain comprises the intranational and international interactions between state and nonstate actors about genocide, in particular how to categorize and memorialize mass violence, and how to assess the merits of intervention to prevent or stop it. Despite the lofty rhetoric accompanying the United Nations Convention on the Punishment and Prevention of Genocide (1948), civilians were not comprehensively protected from mass violence. While the new diplomacy expanded humanitarian sensitivity in the stigmatization of genocide, it was accompanied by a contraction of the humanitarian imagination due to the immense symbolic aura of its archetype, the Holocaust, which set an impossibly high analogical bar. Moreover, the stimulation of intervention constituencies invoking the Holocaust analogy, and eventually the Responsibility to Protect norm, ran up against the UN Charter’s hardening of state sovereignty in the general prohibition on intervention in other states.
War and History in World Politics
Authors: Barkawi Tarak
Published: August 2023

This chapter begins by reflecting on war as a force which shapes knowledge about it, both in History and in International Relations (IR). It outlines distinctions between history, historicism, and historiography, pointing out that granular studies can lead to conceptual and paradigmatic change. It introduces the significance of amateur, public, and veterans’ history, looking at their role in reproducing war and at their critical potential. The chapter turns to the war and society tradition for new resources for thinking about war in IR, discussing the problems involved in putting war and society into the same analytic frame. It looks at how war experience shapes military history, and in turn at how military histories shape identities and ways of warfare in world politics. The chapter closes with the example of a white supremacist military imaginary, sustained in part through popular and military history, and shaping actual wars.
Interpolity Law
Authors: Benton Lauren
Published: August 2023

This chapter outlines an approach to the history of the global legal order that incorporates non-Western polities and encompasses the period before the rise of Western-dominated international law. The approach centres on the study of ‘interpolity law’, defined as a set of legal practices with broad recognition and participation across a diverse range of polities in the early modern and modern world. Drawing on recent research and emphasizing interpolity law in relation to European empires, the chapter probes three prominent categories of legal action and discourse: jurisdictional politics, protection arrangements, and the regulation of violence. It draws on recent research to outline a series of generalizations about these widely occurring modalities, then briefly considers their influence on the formation of interpolity zones and other pluri-political configurations.
Regulating Commerce
Authors: Helleiner Eric
Published: August 2023

Contemporary debates between free traders and neomercantilists have intellectual roots in older ones from the late eighteenth, nineteenth, and early twentieth centuries. International Political Economy (IPE) scholars usually focus on thinkers from Europe and America when discussing these older debates, but this intellectual history can be told from a more global perspective that includes thinkers from many other regions of the world. This wider approach helps to support recent initiatives to create a more ‘Global IPE’ that is less Western-centric. It also contributes to efforts in the fields of both history and IPE to deepen understandings of international ideational diffusion, including with attention to processes of resonance, appropriation, and the multidirectional flow of economic ideas. In addition, this global intellectual history provides a wider perspective from which to view current ideological debates about the regulation of international commerce.
The ‘Premodern’ World
Authors: Costa Lopez Julia
Published: August 2023

Engagements with the premodern world in International Relations have so far focused on specific periods and spaces. Rather than examining each locale separately, this chapter unpacks the ways in which specific assumptions about the emergence of modernity and its fundamental features have coloured our narratives of the premodern. Specifically, I reconstruct four existing ways of tackling the premodern world that respectively emphasize its religiosity, localism, complexity, and similarity to the present, and interrogate what types of questions these different premoderns allow us to pose, but also what types of inquiry they preclude. Against these, I consider what insights it could yield to have an alternative conceptualization of premodern world, one which places plurality, diversity, and global interconnectedness centerstage. Approaching the premodern in this way, however, raises serious questions about concepts and methods and ultimately calls into question the use of the ‘premodern’ itself.
The ‘Americas’ in the History of International Relations
Authors: Gobat Michel
Published: August 2023

Since the Americas joined the international order as an independent locale in the nineteenth century, the concept has been defined by three paradoxes. First, the Americas constitute a regional system that has facilitated both the hegemonic aspirations of its most powerful member (the United States) and anti-hegemonic challenges by the rest. Second, they are home to the world’s oldest international system, yet they are also the world region most identified with modernity. A tension between tradition and modernity thus distinguishes pan-Americanism. Finally, the identification of the Americas with modernity has spurred state and non-state actors to globalize pan-American principles. These three paradoxes guide the following overview of how the Americas evolved as a regional system from the Age of Revolution to the present. Such an approach seeks to overcome the Manichean view marking much of the scholarship on inter-American relations while making the Americas more integral to international history.
The Fall of Constantinople
Authors: Harris Jonathan
Published: August 2023

The diplomatic manoeuvrings prompted by the fall of Constantinople to the Ottoman Turks in 1453 are often placed in the context of the long narrative of the expansion of Islam and the preaching of Christian crusades in response. However, they also serve as an instructive example of early modern international relations in a complicated and diverse environment. This chapter will consider three salient factors that influenced and often dictated the western European response to the disaster. First the sharp tension that existed between religious allegiance and economic and political interests. Secondly, the remarkable ability of the Roman Church to promote international dialogue and publicity in a world that was in other respects fragmented and localized. Finally, the role of local issues and national agendas in moulding and sometimes derailing any concerted Christian response.
The Peace of Westphalia
Authors: Phillips Andrew
Published: August 2023

This chapter revisits debates on the significance of the Peace of Westphalia as a benchmark date marking the advent of the modern system of sovereign states. Following a précis of the context and content of the treaties that comprised the Peace of Westphalia, I survey International Relations (IR) debates between traditionalist defenders of Westphalia’s epochal significance, versus their revisionist critics. I conclude that revisionists are correct in questioning Westphalia as definitively signifying either the sovereign state’s triumph, the birth of the modern state system, or the secularization of European international society. Drawing insights from global history, I nevertheless offer a qualified defence of Westphalia’s historical importance in the evolution of the modern international system. Specifically, I argue that Westphalia instantiated a distinctive diversity regime that tied legitimate political authority to the recognition of authorized forms of confessional religious difference. This regime entrenched a protean sovereign state system that consolidated in subsequent centuries. Contemporaneous crises of political authority elsewhere across Eurasia aided the consolidation of regional empires, and accompanying diversity regimes favouring imperial unipolarity. The resulting conjunction of European multipolarity and Asian unipolarity laid the basis for early modern globalization, making the advent of the world’s first genuinely global international system possible.
The Congress of Vienna
Authors: Mitzen Jennifer , Rogg Jeff
Published: August 2023

Late-twentieth century International Relations (IR) (re)discovered the Congress of Vienna as scholars debated the Concert of Europe as a possible case of great power ‘long peace’ and the Vienna Settlement as potential pre-cursor to contemporary liberal global governance. The congress itself played a limited role—indeed, the terms ‘Congress of Vienna’, ‘Concert of Europe’, and ‘Vienna Settlement’ have not been well differentiated. This chapter summarizes the debates, then shows that they rest on implicit assumptions, some IR-specific, others more general, all of which fall under the heading of ‘modern’. These assumptions have disciplined the cumulation of knowledge, making the importance of the event derivative of other concerns. Then, with the theme of granularity in mind, the chapter returns to the event. Drawing on a wave of recent scholarship, it contextualizes the congress, looking more closely ‘around’ and ‘at’ the congress itself. What emerges is a holistic phenomenon, a global event, and a sense of the many potentialities in both the event itself and the interdisciplinary conversation.
The Revolutions of 1848
Authors: Green Daniel M.
Published: August 2023

The Revolutions of 1848 were an explosion of liberal-nationalist political rebellions, largely confined to Europe, that at the time had little lasting impact on international relations. Though marked by transnational demonstration and spread effects, the revolutions in most places were determined by domestic factors and largely ended in failure and suppression. While 1848 is not one of International Relation’s (IR) resonant dates, if we shift from events to macro-structural changes in predominant unit-type and political formations, 1848 becomes highly significant, indeed a founding moment, shaping the fundamentals of the ‘modern’ international system, with implications for understanding the wave of populist ethnonationalism today. The topic connects IR to the historical-sociological literatures on macro-scale socio-economic shifts, watersheds in state formation, and the development of nationalism and the nation-state, but also with postcolonial thought and the coloniality narrative of history. That the initial locale of events is Europe makes this a Eurocentric topic, yet shifting out to the macro-structural, yields insights into globe-wide experiences today.
Gender, History, and International Relations
Authors: Sjoberg Laura
Published: August 2023

This chapter looks at the gendered and sexed disciplinary sociological and epistemological blind spots that make International Relations (IR) incomplete, skewed, and problematic approaches to (disciplinary and) global history possible. It shows that women have always been in IR and its histories, but until recently, obscured. It then argues that ‘solving’ the ‘problem’ is not as simple as ‘correcting’ the obscuring of women. Instead, the project of de-masculinizing histories is a transformative, rather than piecemeal, process, which requires rethinking the substances of the discipline, its politics, and its histories as well as historical and historicizing processes and methods. Such rethinking reveals that histories of the state and the histories of gender have always been intertwined and inseparable, even as many IR scholars separate out the concepts completely. The conclusion of this chapter looks that the various interruptions and revisions that gender analysis might make in thinking about and doing international histories.
Tax progressivity and taxing the rich in developing countries: lessons from Latin America
Authors: Bergolo Marcelo , Londoño-Vélez Juliana , Tortarolo Darío
Published: August 2023

This article discusses the challenges and potential policy choices for levying progressive taxes and taxing the rich in Latin America, a region known for its high-income inequality, limited tax-collection capacity, and low share of taxes collected from personal income and wealth. Factors such as high exemption thresholds, low top marginal tax rates, and limited administrative capacity undermine the redistributive ability and revenue collection of the tax systems in the region. Moreover, the income composition for the top percentiles largely comes from capital, and the effective tax rates they face are often low due to the preferential treatment of capital income and wealth. After discussing the evidence of how the rich in Latin America respond to progressive taxes on income and wealth and changes in enforcement policy, we provide some insights on potential policy choices to tax them effectively. These may include broadening the income tax base by lowering the number of exempt and non-taxable income items and the statutory exemption thresholds, reevaluating preferential tax rates on capital income, monitoring foreign income, addressing the abuse of tax treatment by business earners, and enhancing tax administration capacity. Additionally, wealth taxes may complement the tax system with updates to property registers and scrutiny of foreign assets.
Genetic architecture of source–sink-regulated senescence in maize
Authors: Kumar Rohit , Brar Manwinder S , Kunduru Bharath , Ackerman Arlyn J , Yang Yuan , Luo Feng , Saski Christopher A , Bridges William C , de Leon Natalia , McMahan Christopher , Kaeppler Shawn M , Sekhon Rajandeep S
Published: August 2023

Source and sink interactions play a critical but mechanistically poorly understood role in the regulation of senescence. To disentangle the genetic and molecular mechanisms underlying source–sink-regulated senescence (SSRS), we performed a phenotypic, transcriptomic, and systems genetics analysis of senescence induced by the lack of a strong sink in maize (Zea mays). Comparative analysis of genotypes with contrasting SSRS phenotypes revealed that feedback inhibition of photosynthesis, a surge in reactive oxygen species, and the resulting endoplasmic reticulum (ER) stress were the earliest outcomes of weakened sink demand. Multienvironmental evaluation of a biparental population and a diversity panel identified 12 quantitative trait loci and 24 candidate genes, respectively, underlying SSRS. Combining the natural diversity and coexpression networks analyses identified 7 high-confidence candidate genes involved in proteolysis, photosynthesis, stress response, and protein folding. The role of a cathepsin B like protease 4 (ccp4), a candidate gene supported by systems genetic analysis, was validated by analysis of natural alleles in maize and heterologous analyses in Arabidopsis (Arabidopsis thaliana). Analysis of natural alleles suggested that a 700-bp polymorphic promoter region harboring multiple ABA-responsive elements is responsible for differential transcriptional regulation of ccp4 by ABA and the resulting variation in SSRS phenotype. We propose a model for SSRS wherein feedback inhibition of photosynthesis, ABA signaling, and oxidative stress converge to induce ER stress manifested as programed cell death and senescence. These findings provide a deeper understanding of signals emerging from loss of sink strength and offer opportunities to modify these signals to alter senescence program and enhance crop productivity.
Can Baseline Disability Predict Outcomes in Adult Spinal Deformity Surgery?
Authors: Passias Peter G. , Joujon-Roche Rachel , Mir Jamshaid M. , Tretiakov Peter , Dave Pooja , Williamson Tyler K. , Imbo Bailey , Krol Oscar , Schoenfeld Andrew J.
Published: August 2023

Study Design.

Retrospective Cohort Study.

Objective.

To assess if there is a threshold of baseline disability beyond which the patient-reported outcomes after surgical correction of adult spinal deformity (ASD) are adversely impacted.

Background.

Patient-reported outcomes vary after correction of adult spinal deformity, even when patients are optimally realigned. There is a paucity of literature examining the impact of baseline disability on patient-reported outcomes in ASD.

Methods.

Patients with baseline (BL) and two-year data were included. Disability was ranked according to BL Oswestry Disability Index (ODI) into quintiles: Q1 (lowest ODI score) to Q5 (highest ODI score). Adjusted logistic regression analyses evaluated the likelihood of reaching ≥1 MCID in Scoliosis Research Society Outcomes Questionnaire (SRS-22) Pain, SRS-22 Activity, and Short Form-36 physical component summary at two years across disability groups Q1–Q4 with respect to Q5. Sensitivity tests were performed, excluding patients with any “0” Schwab modifiers at BL.

Results.

Compared with patients in Q5, the odds of reaching MCID in SRS-22 Pain at 2Y were significantly higher for those in Q1 (OR: 3.771), Q2 (OR: 3.006), and Q3 (OR: 2.897), all P<0.021. Similarly, compared with patients in Q5, the odds of reaching MCID in SRS-22 Activity at two years were significantly higher for those in Q2 (OR: 3.454) and Q3 (OR: 2.801), both P<0.02. Lastly, compared with patients in Q5, odds of reaching MCID in Short Form-36 physical component summary at two years were significantly higher for patients in Q1 (OR: 5.350), Q2 (OR: 4.795), and Q3 (OR: 6.229), all P<0.004.

Conclusions.

This study found that patients presenting with moderate disability at BL (ODI<40) consistently surpassed health-related quality of life outcomes as compared with those presenting with greater levels of disability. We propose that a baseline ODI of 40 represents a disability threshold within which operative inte rvention maximizes patient-reported outcomes. Furthermore, delaying the intervention until patients progress to severe disability may limit the benefits of surgical correction in ASD patients.

Level of Evidence.

3
Insights From Henri Nouwen for Intellectual Disability Nursing
Authors: Hartnett Liz
Published: August 2023

Henri Nouwen's writings provide opportunity for nurses, students, and educators to reflect on nursing in the context of Christian faith. This article offers insight from Nouwen's work and its relevance to intellectual disability nursing practice and education. Five themes are developed from Nouwen's insights: 1) the descending way, 2) insignificance and marginalization, 3) learning to support the person, 4) building relationship, and 5) trusting God will catch you.
Ureteral Injury
Authors: Zhao Yue , Tan Winson Jianhong
Published: August 2023

CASE SUMMARY:

A 70-year-old man underwent laparoscopic low anterior resection for a rectal adenocarcinoma after neoadjuvant chemoradiotherapy. Postoperatively, the patient had high drain volume output, with 800 mL of clear serous fluid being drained on the second postoperative day. Drain creatinine returned as 300 mmol/L, with a corresponding serum creatinine of 100 mmol/L. CT scan of the abdomen and pelvis confirmed a left ureteric injury with an associated urinoma. After urology consultation, the patient underwent a left ureteric reimplantation emergently.
Development and validation of a prognostic score to identify the optimal candidate for preemptive TIPS in patients with cirrhosis and acute variceal bleeding
Authors: Lv Yong , Bai Wei , Zhu Xuan , Xue Hui , Zhao Jianbo , Zhuge Yuzheng , Sun Junhui , Zhang Chunqing , Ding Pengxu , Jiang Zaibo , Zhu Xiaoli , Ren Weixin , Li Yingchun , Zhang Kewei , Zhang Wenguang , Li Kai , Wang Zhengyu , Luo Bohan , Li Xiaomei , Yang Zhiping , Guo Wengang , Xia Dongdong , Xie Huahong , Pan Yanglin , Yin Zhanxin , Fan Daiming , Han Guohong
Published: August 2023

Background and Aim:

Baveno VII workshop recommends the use of preemptive TIPS (p-TIPS) in patients with cirrhosis and acute variceal bleeding (AVB) at high- risk of treatment failure. However, the criteria defining “high-risk” have low clinical accessibility or include subjective variables. We aimed to develop and externally validate a model for better identification of p-TIPS candidates.

Approach and Results:

The derivation cohort included 1554 patients with cirrhosis and AVB who were treated with endoscopy plus drug (n = 1264) or p-TIPS (n = 290) from 12 hospitals in China between 2010 and 2017. We first used competing risk regression to develop a score for predicting 6-week and 1-year mortality in patients treated with endoscopy plus drugs, which included age, albumin, bilirubin, international normalized ratio, white blood cell, creatinine, and sodium. The score was internally validated with the bootstrap method, which showed good discrimination (6 wk/1 y concordance-index: 0.766/0.740) and calibration, and outperformed other currently available models. In the second stage, the developed score was combined with treatment and their interaction term to predicate the treatment effect of p-TIPS (mortality risk difference between treatment groups) in the whole derivation cohort. The estimated treatment effect of p-TIPS varied substantially among patients. The prediction model had good discriminative ability (6 wk/1 y c-for-benefit: 0.696/0.665) and was well calibrated. These results were confirmed in the validation dataset of 445 patients with cirrhosis with AVB from 6 hospitals in China between 2017 and 2019 (6-wk/1-y c-for-benefit: 0.675/0.672).

Conclusions:

We developed and validated a clinical prediction model that can help to identify individuals who will benefit from p-TIPS, which may guide clinical decision-making.
Understanding Yin-Yang Philosophic Concept Behind Tai Chi Practice
Authors: Liu Hao (Howe) , Nichols Charles , Zhang Hong
Published: August 2023

Yin-yang theorizes that everything in the world is interoppositionally unified with 2 dynamic opposites (yin and yang), interrooted, interchangeable, and interconvertible. Tai chi (TC) movements and postures are essentially yin-yang concept-based. However, there is still a lack of understanding of yin-yang concepts and applications among people practicing TC. So, in this concept review, we aimed to provide basic understanding of the yin-yang concept and characteristics behind TC practice. Terms derived from the yin-yang concept in TC practice may include blood/qi (energy), stability/mobility, closing/opening moves, expiration/inspiration, solid/empty stance, and defensive/offensive hand movements and postures. These yin-yang attributes are interrestricted and dependent on maintaining a dynamic mind-body harmony. With the yin-yang application, TC can be considered a self-controlled balance perturbation exercise to challenge the stability-mobility (yin-yang) to a new level of harmony. As a health promotion holistic intervention, TC can facilitate the flow in blood/qi pathways or meridians to improve medical conditions. As an integrative mind-body exercise, TC can activate different body parts and brain regions to participate in and coordinate the combined physical and mental activities.
Complementary and Alternative Medicine Methods Used by Older Adults During the COVID-19 Pandemic
Authors: Çürük Gülsüm Nihal , Karadağ Songül , Özgül Ecem
Published: August 2023

This study sought to determine complementary and alternative medicine (CAM) methods used by older adults during the COVID-19 pandemic. The sample for this descriptive study comprised 415 adults older than 65 years who completed an online questionnaire between August and October 2020. The study used descriptive statistical methods and a χ2 test for the statistical analysis of data. In the study, 55.4% of participants had used one or more CAM methods during the pandemic. The most frequently used methods were vitamin and mineral supplements (48.5%) and herbal products (37.2%). The study determined that 43.1% of participants did not inform their health care professionals of the method they had used. It is possible that the use of CAM methods by older adults during the pandemic and the decrease in the frequency of seeking care at health care institutions could complicate the management of health problems related to the use of CAMs.
CAR-T in the Treatment of Acute Myeloid Leukemia: Barriers and How to Overcome Them
Authors: Vanhooren Jolien , Dobbelaere Rani , Derpoorter Charlotte , Deneweth Larissa , Van Camp Laurens , Uyttebroeck Anne , De Moerloose Barbara , Lammens Tim
Published: August 2023

Conventional therapies for acute myeloid leukemia (AML) are characterized by high rates of relapse, severe toxicities, and poor overall survival rates. Thus, the development of new therapeutic strategies is crucial for improving the survival and quality of life of AML patients. CD19-directed chimeric antigen receptor (CAR) T-cell immunotherapy has been extremely successful in the treatment of B-cell acute lymphoid leukemia and several mature B-cell lymphomas. However, the use of CAR T-cell therapy for AML is currently prevented due to the lack of a myeloid equivalent to CD19, as currently known cell surface targets on leukemic blasts are also expressed on healthy hematopoietic stem and progenitor cells as well as their progeny. In addition, the immunosuppressive tumor microenvironment has a dampening effect on the antitumor activity of CAR-T cells. Here, we review the therapeutic challenges limiting the use of CAR T-cell therapy for AML and discuss promising novel strategies to overcome them.
Safety and Efficacy of Baloxavir Marboxil in Influenza-infected Children 5–11 Years of Age: A Post Hoc Analysis of a Phase 3 Study
Authors: Baker Jeffery B. , Block Stanley L. , Cagas Steven E. , Macutkiewicz Laura Burleigh , Collins Colleen , Sadeghi Mitra , Sarkar Sriparna , Williams Sarah
Published: August 2023

Background:

miniSTONE-2 (NCT03629184) was a global, phase 3, randomized, controlled study that investigated the safety and efficacy of single-dose baloxavir marboxil in otherwise healthy children 1–<12 years of age and showed a positive risk-benefit profile. This post hoc analysis evaluated the safety and efficacy of baloxavir versus oseltamivir in children 5–11 years old with influenza.

Methods:

Children received single-dose baloxavir or twice-daily oseltamivir for 5 days. Safety was the primary objective. Efficacy and virological outcomes included time to alleviation of symptoms, duration of fever and time to cessation of viral shedding by titer. Data were summarized descriptively.

Results:

Ninety-four children 5–11 years old were included (61 baloxavir and 33 oseltamivir). Baseline characteristics were similar between the groups. The incidence of adverse events was balanced and low in both treatment groups, with the most common being vomiting (baloxavir 5% vs. oseltamivir 18%), diarrhea (5% vs. 0%) and otitis media (0% vs. 5%). No serious adverse events or deaths occurred. Median (95% CI) time to alleviation of symptoms with baloxavir was 138.4 hours (116.7–163.4) versus 126.1 hours (95.9–165.7) for oseltamivir; duration of fever was comparable between groups [41.2 hours (23.5–51.4) vs. 51.3 hours (30.7–56.8), respectively]. Median time to cessation of viral shedding was shorter in the baloxavir group versus oseltamivir (1 vs. ≈3 days).

Conclusions:

Safety, efficacy and virological results in children 5–11 years were similar to those from the overall study population 1–<12 years of age. Single-dose baloxavir provides an additional treatment option for pediatric patients 5–11 years old with influenza.