bluuebunny/crossref_metadata_2025 huggingface dataset:
Surviving Seemingly Endless Refugeeship—Social Representations and Strategies of Palestinian Refugees in Ein El Hilweh
Authors: Nilsson Marco , Badran Dany
Published: December 2020

Today, about 470,000 Palestinian refugees are registered with the United Nations Relief and Works Agency for Palestine Refugees in the Near East in Lebanon, with 45 per cent of them living in the 12 official Palestinian refugee camps. Previous research identified several socio-economic problems facing the Palestinian refugees in Lebanon. The refugee camps have generally been very poor and relatively dangerous places to live. Moreover, all the Palestinian camps suffer from overcrowding, unemployment, poor housing conditions, inadequate infrastructure, as well as a lack of access to justice. Although previous research has identified several difficulties with living in a Palestinian refugee camp, this study takes a fresh look at life in the largest camp in Lebanon—Ein El Hilweh. In addition to identifying such problems and difficulties, it also explores the various strategies adopted by Palestinian refugees to handle them. While acknowledging that not all problems can be resolved, these problem-solving strategies of refugees is a significant gap in the literature on refugees that warrants further investigation. The study is grounded in Serge Moscovici’s theory of social representations, analyzing Palestinian refugees’ shared experiences in facing difficult situations as well as their strategies for solving them.
Filamentous growth is a general feature of Candida auris clinical isolates
Authors: Fan Shuru , Yue Huizhen , Zheng Qiushi , Bing Jian , Tian Sufei , Chen Jingjing , Ennis Craig L , Nobile Clarissa J , Huang Guanghua , Du Han
Published: December 2020

A striking feature of pathogenic Candida species is morphological plasticity that facilitates environmental adaptation and host infection. Candida auris is an emerging multidrug-resistant fungal pathogen first described in Japan in 2009. In this study, we demonstrate that clinical isolates of C. auris have multiple colony and cellular morphologies including the yeast, filamentous, aggregated, and elongated forms. This phenotypic diversity has been observed in eight clinical isolates of C. auris representing four major genetic clades, suggesting that it could be a general characteristic. We further demonstrate that different cell types of C. auris exhibit distinct antifungal resistance and virulence properties in a Galleria mellonella infection model. Our findings imply that morphological diversity is an important biological feature of C. auris and could be a contributor to its emergence and rapid prevalence worldwide.

Lay Summary

Candida auris is an emerging multidrug-resistant fungal pathogen. Morphological analyses indicate that filamentation is a general feature of clinical isolates of C. auris. This ability is associated with antifungal resistance and virulence.
Exploring the origin and evolution of the Kepler 36 system
Authors: Rimlinger Thomas , Hamilton Douglas
Published: December 2020

We examine the origins of the Kepler 36 planetary system, which features two very different planets: Kepler 36b ($\rm \rho = 7.46$  $\rm g$  $\rm cm^{-3}$) and Kepler 36c ($\rm \rho = 0.89$  $\rm g$  $\rm cm^{-3}$). The planets lie extremely close to one another, separated by just 0.01 au, and they orbit just a tenth of an au from the host star. In our origin scenario, Kepler 36b starts with far less mass than Kepler 36c, a gaseous giant planet that forms outside the ice line and quickly migrates inwards, capturing its neighbour into its 2:1 mean-motion resonance while continuing to move inwards through a swarm of planetesimals and protoplanets. Subsequent collisions with these smaller bodies knock Kepler 36b out of resonance and raise its mass and density (via self-compression). We find that our scenario can yield planets whose period ratio matches that of Kepler 36b and c, although these successes are rare, occurring in just 1.2 per cent of cases. However, since systems like Kepler 36 are themselves rare, this is not necessarily a drawback.
The impact of modified gravity on the Sunyaev–Zeldovich effect
Authors: Mitchell Myles A , Arnold Christian , Hernández-Aguayo César , Li Baojiu
Published: December 2020

We study the effects of two popular modified gravity theories, which incorporate very different screening mechanisms, on the angular power spectra of the thermal (tSZ) and kinematic (kSZ) components of the Sunyaev–Zeldovich effect. Using the first cosmological simulations that simultaneously incorporate both screened modified gravity and a complete galaxy formation model, we find that the tSZ and kSZ power spectra are significantly enhanced by the strengthened gravitational forces in Hu-Sawicki f(R) gravity and the normal-branch Dvali–Gabadadze–Porrati model. Employing a combination of non-radiative and full-physics simulations, we find that the extra baryonic physics present in the latter acts to suppress the tSZ power on angular scales l ≳ 3000 and the kSZ power on all tested scales, and this is found to have a substantial effect on the model differences. Our results indicate that the tSZ and kSZ power can be used as powerful probes of gravity on large scales, using data from current and upcoming surveys, provided sufficient work is conducted to understand the sensitivity of the constraints to baryonic processes that are currently not fully understood.
Physical effects on compact high-velocity clouds in the circumgalactic medium
Authors: Sander Bastian , Hensler Gerhard
Published: December 2020

We numerically investigate the evolution of compact high-velocity clouds (CHVCs) passing through a hot, tenuous gas representing the highly ionized circumgalactic medium (CGM) by applying the adaptive-mesh refinement code flash. The model clouds start from both hydrostatic and thermal equilibrium and are in pressure balance with the CGM. Here, we present 14 models, divided into two mass categories and two metallicities each and different velocities. We allow for self-gravity and thermal conduction or not. All models experience mass diffusion, radiative cooling, and external heating leading to dissociation and ionization. Our main findings are (1) self-gravity stabilizes clouds against Rayleigh–Taylor instability, which is disrupted within 10 sound-crossing times without; (2) clouds can develop Jeans-instable regions internally even though they are initially below Jeans mass; (3) all clouds lose mass by ram pressure and Kelvin–Helmholtz instability; (4) thermal conduction substantially lowers mass-loss rates, by this, extending the clouds’ lifetimes, particularly, more than doubling the lifetime of low-mass clouds; (5) thermal conduction leads to continuous, filamentary stripping, while the removed gas is heated up quickly and mixes efficiently with the ambient CGM; (6) without thermal conduction the removed gas consists of dense, cool, clumpy fragments; (7) thermal conduction might prevent CHVCs from forming stars; and (8) clouds decelerated by means of drag from the ambient CGM form head-tail shapes and collapse after they reach velocities characteristic for intermediate-velocity clouds. Conclusively, only sophisticated modelling of CHVCs as non-homogeneous and non-isothermal clouds with thermal conduction and self-gravity explains observed morphologies and naturally leads to the suppression of star formation.
New insights into the WR nebula M1-67 with SITELLE
Authors: Sévigny Marcel , St-Louis Nicole , Drissen Laurent , Martin Thomas
Published: December 2020

We present a detailed study of M1-67, a well-known nebula around the population I Wolf–Rayet star WR 124 (WNh 8), based on datacubes obtained with the imaging Fourier transform spectrometer SITELLE at the Canada–France–Hawaii Telescope. This allowed us to reconstruct detailed emission-line ratio maps that highlight clear orthogonal features from a chemical abundance point of view, a complete extinction map, as well as the electron density and temperature structures. In addition to this information, velocity maps were obtained shedding light on the bow shock structure due to the high velocity of WR124, qualified as a runaway star, which is about +190 km s−1 relative to the local interstellar medium. Interaction between the latter structure and spherical and non-spherical outburst could explain the global morphology of M1-67.
A low-frequency study of linear polarization in radio galaxies
Authors: Mahatma V H , Hardcastle M J , Harwood J , O’Sullivan S P , Heald G , Horellou C , Smith D J B
Published: December 2020

Radio galaxies are linearly polarized – an important property that allows us to infer the properties of the magnetic field of the source and its environment. However, at low frequencies, Faraday rotation substantially depolarizes the emission, meaning that comparatively few polarized radio galaxies are known at low frequencies. Using the LOFAR Two-metre Sky Survey at 150 MHz and at a resolution of 20 arcsec, we select 342 radio galaxies brighter than 50 mJy and larger than 100 arcsec in angular size, of which 67 are polarized (18 per cent detection fraction). These are predominantly Fanaroff–Riley type II sources. The detection fraction increases with total flux density, and exceeds 50 per cent for sources brighter than 1 Jy. We compare the sources in our sample detected by the LOw Frequency ARray (LOFAR) to those also detected in NRAO VLA Sky Survey at 1400 MHz, and find that our selection bias towards bright radio galaxies drives a tendency for sources depolarized between 1400 and 150 MHz to have flatter spectra over that frequency range than those that remain polarized at 150 MHz. By comparing observed rotation measures with an analytic model, we find that we are preferentially sensitive to sources in low-mass environments. We also infer that sources with one polarized hotspot are inclined by a small angle to the line of sight, while sources with hotspots in both lobes lie in the plane of the sky. We conclude that low-frequency polarization in radio galaxies is related to a combination of environment, flux density, and jet orientation.
Beyond halo mass: quenching galaxy mass assembly at the edge of filaments
Authors: Song Hyunmi , Laigle Clotilde , Hwang Ho Seong , Devriendt Julien , Dubois Yohan , Kraljic Katarina , Pichon Christophe , Slyz Adrianne , Smith Rory
Published: December 2020

We examine how the mass assembly of central galaxies depends on their location in the cosmic web. The Horizon-AGN simulation is analysed at z ∼ 2 using the DisPerSE code to extract multi-scale cosmic filaments. We find that the dependency of galaxy properties on large-scale environment is mostly inherited from the (large-scale) environmental dependency of their host halo mass. When adopting a residual analysis that removes the host halo mass effect, we detect a direct and non-negligible influence of cosmic filaments. Proximity to filaments enhances the build-up of stellar mass, a result in agreement with previous studies. However, our multi-scale analysis also reveals that, at the edge of filaments, star formation is suppressed. In addition, we find clues for compaction of the stellar distribution at close proximity to filaments. We suggest that gas transfer from the outside to the inside of the haloes (where galaxies reside) becomes less efficient closer to filaments, due to high angular momentum supply at the vorticity-rich edge of filaments. This quenching mechanism may partly explain the larger fraction of passive galaxies in filaments, as inferred from observations at lower redshifts.
Baryonic effects on the detectability of annihilation radiation from dark matter subhaloes around the Milky Way
Authors: Grand Robert J J , White Simon D M
Published: December 2020

We use six, high-resolution ΛCDM simulations of galaxy formation to study how emission from dark matter annihilation is affected by baryonic processes. These simulations produce isolated, disc-dominated galaxies with structure, stellar populations, and stellar and halo masses comparable to those of the Milky Way. They resolve dark matter structures with mass above ∼106  $\rm M_{\odot }$ and are each available in both full-physics and dark-matter-only versions. In the full-physics case, formation of the stellar galaxy enhances annihilation radiation from the dominant smooth component of the galactic halo by a factor of three, and its central concentration increases substantially. In contrast, subhalo fluxes are reduced by almost an order of magnitude, partly because of changes in internal structure, partly because of increased tidal effects; they drop relative to the flux from the smooth halo by 1.5 orders of magnitude. The expected flux from the brightest Milky Way subhalo is four orders of magnitude below that from the smooth halo, making it very unlikely that any subhalo will be detected before robust detection of the inner Galaxy. We use recent simulations of halo structure across the full ΛCDM mass range to extrapolate to the smallest (Earth-mass) subhaloes, concluding, in contrast to earlier work, that the total annihilation flux from Milky Way subhaloes will be less than that from the smooth halo, as viewed both from the Sun and by a distant observer. Fermi-LAT may marginally resolve annihilation radiation from the very brightest subhaloes, which, typically, will contain stars.
Effects of calcitriol and paricalcitol on renal fibrosis in CKD
Authors: Martínez-Arias Laura , Panizo Sara , Alonso-Montes Cristina , Martín-Vírgala Julia , Martín-Carro Beatriz , Fernández-Villabrille Sara , García Gil-Albert Carmen , Palomo-Antequera Carmen , Fernández-Martín José Luis , Ruiz-Torres María Piedad , Dusso Adriana S , Carrillo-López Natalia , Cannata-Andía Jorge B , Naves-Díaz Manuel
Published: December 2020

Background

In chronic kidney disease, the activation of the renin–angiotensin–aldosterone system (RAAS) and renal inflammation stimulates renal fibrosis and the progression to end-stage renal disease. The low levels of vitamin D receptor (VDR) and its activators (VDRAs) contribute to worsen secondary hyperparathyroidism and renal fibrosis.

Methods

The 7/8 nephrectomy model of experimental chronic renal failure (CRF) was used to examine the anti-fibrotic effects of treatment with two VDRAs, paricalcitol and calcitriol, at equivalent doses (3/1 dose ratio) during 4 weeks.

Results

CRF increased the activation of the RAAS, renal inflammation and interstitial fibrosis. Paricalcitol treatment reduced renal collagen I and renal interstitial fibrosis by decreasing the activation of the RAAS through renal changes in renin, angiotensin receptor 1 (ATR1) and ATR2 mRNAs levels and renal inflammation by decreasing renal inflammatory leucocytes (CD45), a desintegrin and metaloproteinase mRNA, transforming growth factor beta mRNA and protein, and maintaining E-cadherin mRNA levels. Calcitriol showed similar trends without significant changes in most of these biomarkers.

Conclusions

Paricalcitol effectively attenuated the renal interstitial fibrosis induced by CRF through a combination of inhibitory actions on the RAAS, inflammation and epithelial/mesenchymal transition.
There May Be Many Arithmetical Gödel Sentences†
Authors: Lajevardi Kaave , Salehi Saeed
Published: December 2020

We argue that, under the usual assumptions for sufficiently strong arithmetical theories that are subject to Gödel’s First Incompleteness Theorem, one cannot, without impropriety, talk about the Gödel sentence of the theory. The reason is that, without violating the requirements of Gödel’s theorem, there could be a true sentence and a false one each of which is provably equivalent to its own unprovability in the theory if the theory is unsound.
Relationships between Physical Health and Employment among People with Serious Mental Illness
Authors: O’Neill Elizabeth A
Published: December 2020

Individuals with serious mental illness (SMI) have high rates of chronic physical health conditions and unemployment. Research suggests that a person’s health is related to their employment. Although available research indicates that mental health is related to employment for adults with SMI, there is a need for further inquiry regarding physical health. This study used data from three waves of the Medical Expenditures Panel Survey to examine multivariate relationships between physical health conditions, health-related quality of life (HRQOL), and employment among a sample of individuals with SMI (N = 648). Findings suggested that people with SMI and physical health conditions had lower HRQOL, compared with those with SMI only, and that physical and mental HRQOL mediated relationships between physical health conditions and employment. It is important to note that physical HRQOL had a stronger relationship with employment than mental HRQOL. These findings have important implications for integrated health care practice and research and policies aimed at expanding or restricting access to health care.
A Comprehensive Approach to Detect Hybridization Sheds Light on the Evolution of Earth’s Largest Lizards
Authors: Pavón-Vázquez Carlos J , Brennan Ian G , Keogh J Scott
Published: December 2020

Hybridization between species occurs more frequently in vertebrates than traditionally thought, but distinguishing ancient hybridization from other phenomena that generate similar evolutionary patterns remains challenging. Here, we used a comprehensive workflow to discover evidence of ancient hybridization between the Komodo dragon (Varanus komodoensis) from Indonesia and a common ancestor of an Australian group of monitor lizards known colloquially as sand monitors. Our data comprise $>$300 nuclear loci, mitochondrial genomes, phenotypic data, fossil and contemporary records, and past/present climatic data. We show that the four sand monitor species share more nuclear alleles with $V$. komodoensis than expected given a bifurcating phylogeny, likely as a result of hybridization between the latter species and a common ancestor of sand monitors. Sand monitors display phenotypes that are intermediate between their closest relatives and $V$. komodoensis. Biogeographic analyses suggest that $V$. komodoensis and ancestral sand monitors co-occurred in northern Australia. In agreement with the fossil record, this provides further evidence that the Komodo dragon once inhabited the Australian continent. Our study shows how different sources of evidence can be used to thoroughly characterize evolutionary histories that deviate from a treelike pattern, that hybridization can have long-lasting effects on phenotypes, and that detecting hybridization can improve our understanding of evolutionary and biogeographic patterns.[Biogeography; introgression; Komodo dragon; phylogenetic networks; phylogenomics; reticulation; Varanus.]
Region-Wide Comprehensive Implementation of Roguing Infected Trees, Tree Replacement, and Insecticide Applications Successfully Controls Citrus Huanglongbing
Authors: Yuan Xiaoyong , Chen Cixiang , Bassanezi Renato Beozzo , Wu Feng , Feng Zheng , Shi Damin , Li Jinyun , Du Yimin , Zhong Ling , Zhong Balian , Lu Zhanjun , Song Xiang , Hu Yan , Ouyang Zhigang , Liu Xinjun , Xie Jinzhao , Rao Xi , Wang Xi , Wu Dapeng Oliver , Guan Zhengfei , Wang Nian
Published: December 2020

Huanglongbing (HLB) is a devastating citrus disease worldwide. A three-pronged approach to controlling HLB has been suggested, namely, removal of HLB-symptomatic trees, psyllid control, and replacement with HLB-free trees. However, such a strategy did not lead to successful HLB control in many citrus-producing regions, such as Florida. We hypothesize that this is because of the small-scale or incomprehensive implementation of the program; conversely, a comprehensive implementation of such a strategy at the regional level can successfully control HLB. To test our hypothesis, we investigated the effects of region-wide comprehensive implementation of this scheme to control HLB in Gannan region, China, with a total planted citrus acreage of over 110,000 ha from 2013 to 2019. With the region-wide implementation of comprehensive HLB management, the overall HLB incidence in Gannan decreased from 19.71% in 2014 to 3.86% in 2019. A partial implementation of such a program (without a comprehensive inoculum removal) at the regional level in Brazil resulted in HLB incidence increasing from 1.89% in 2010 to 19.02% in 2019. Using dynamic regression model analyses with data from both Brazil and China, we constructed a model to predict HLB incidence when all three components were applied at 100%. It was predicated that in a region-wide comprehensive implementation of such a program, HLB incidence would be controlled to a level of less than 1%. We conducted economic feasibility analyses and showed that average net profits were positive for groves that implemented the comprehensive strategy, but groves that did not implement it had negative net profits over a 10-year period. Overall, the key for the three-pronged program to successfully control HLB is the large scale (region-wide) and comprehensiveness in implementation. This study provides valuable information to control HLB and other economically important endemic diseases worldwide.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Mobility Measures in Older Cancer Survivors: An Examination of Reliability, Validity, and Minimal Detectable Change
Authors: Blackwood Jennifer , Rybicki Kateri , Huang Min
Published: December 2020

Background:

Cancer and its treatment contribute to multiple sequelae affecting physical function, including difficulty in balance and walking. Although clinical tests should be used to assess fall risks in older cancer survivors, the literature describing the validity, reliability, measurement error, and minimal detectable change (MDC) of mobility measures is lacking.

Objective:

The purpose of this study was to describe the reliability, validity, standard error of the measurement (SEM), and minimal detectable change at 95% confidence (MDC95) of mobility measures in older cancer survivors.

Methods:

Fifty cancer survivors (breast, prostate, lung, or colorectal) aged 65+ years participated. Measures of gait speed (GS) (usual, fast, and dual-task) and mobility (Timed Up and Go [TUG], TUG-cognitive, and TUG-manual) were performed once and then repeated 2 weeks later. Test-retest reliability was assessed using intraclass correlation coefficient (ICC2,1). MDC95 and SEM were calculated. Construct validity was examined using Pearson's correlation coefficient with 6-item Activities-specific Balance Confidence scale and Short Physical Performance Battery performance.

Results:

Test-retest reliability was excellent for all mobility measures, with ICC values ranging from 0.89 to 0.94 for GS and 0.95 to 0.98 for TUG measures. Construct validity was present for TUG (r = −0.53 to −0.73) and GS (r = 0.29 to 0.5) measures. Low SEM values demonstrated excellent reproducibility. To be considered real change, usual GS should be 0.14 m/s or more and TUG 2.49 seconds or more.

Conclusions:

Measures of GS and TUG have excellent reliability and construct validity and should be considered for use in older cancer survivors. Further study is indicated to establish the psychometric values of mobility measures by cancer type.
Real-world clinical outcomes of anticancer treatments and prognostic factors in patients with advanced melanoma in China
Authors: Cui Chuanliang , Yan Xieqiao , Li Ben , Si Lu , Zhihong Chi , Sheng Xinan , Lian Bin , Wang Xuan , Mao Lili , Tang Bixia , Zhou Li , Bai Xue , Li Siming , Guo Jun
Published: December 2020

Purpose:

China has much lower 5-year survival rates among melanoma patients than Western countries. This retrospective study describes real-world clinical outcomes and prognostic factors in locally advanced/metastatic melanoma in China.

Materials and methods:

Adults patients with unresectable stage III or IV melanoma treated between January 1, 2014 and December 31, 2015, at the Beijing Cancer Hospital were eligible (data cutoff: December 31, 2017). The Kaplan-Meier method and Log-Rank test were used to estimate the median value of time-to-event outcomes. A Cox proportional hazards model was simulated to evaluate associations of patients’ characteristics with survival.

Results:

Overall, there were 221 and 116 Chinese locally advanced and/or metastatic melanoma patients were enrolled in the first line (1L) and the second line (2L) treatments, respectively. The real-world objective response rate was <10% (1L: 6.3%; 2L: 3.4%); median progression-free survival was under 4 months (1L: 3.5; 2L: 2.3); median overall survival (OS) was <1 year (1L: 10.5; 2L: 7.5) with a low 12-month OS rate (43.5% for 1L, 30.5% for 2L). Based on univariate analyses, those with Eastern Cooperative Oncology Group (ECOG) Performance Status ≥2 (vs. ECOG=0) in 1L, and 2L treatment (vs. 1L treatment) or ECOG ≥2 (vs. ECOG=1) among 1L/2L were associated with statistically significantly worse outcomes.

Conclusion:

The current clinical outcomes in advanced melanoma patients in China are poor. High ECOG performance score independently increase risk of death both from 1L and 2L treatments, suggesting a high unmet medical need for immunotherapy in advanced melanoma.
Advances in vascularized flaps for skull base reconstruction
Authors: Oostra Amanda , Koutsarnakis Christos , Georgalas Christos
Published: December 2020

Purpose of review

Advances in anterior skull base surgery have resulted in the increasing diversification of reconstructive techniques. New vascularized flaps have been suggested in the last years, some quite similar, whereas new uses and applications have been suggested for some vascularized flaps, which have already established their value over the last decades. In this article, we describe the developments in skull base reconstruction with vascularized flaps and analyse the international experience in the use of vascularized flaps published with a focus on the last 18 months.

Recent findings

Over the past 18 months, a number of novel or modified vascularized intranasal flaps have been described, focusing on reconstruction of larger defects, the medial orbital wall, the anterior skull base (septal flip-flap) and dissection of the nasoseptal flap from the SPA foramen. Extranasal vascularized flaps, which have been around for a long time, still have their rightful place in skull base reconstruction and have recently been adjusted for endoscopic use.

We present an overview of the latest developments in vascularized flaps (intranasal and extranasal), their new implications, their modifications and complications or predictions of viability.
Prospective Randomized Trial Comparing Opioids versus Nonsteroidal Antiinflammatory Drugs for Postoperative Analgesia in Outpatient Rhinoplasty
Authors: Frants Anna , Garber David , Lafer Marissa P. , Gordon Steven A. , Markey Jeffrey D. , Zhang Yan , Wang Binhuan , Lee Judy W.
Published: December 2020

Background:

The misuse and abuse of opioids, including overprescription, has led to the current opioid epidemic and national crisis. There is a national effort to eliminate the unnecessary prescription of opioids for analgesia.

Methods:

Seventy patients were randomized to receive postoperative analgesia with either 5 mg hydrocodone with 325 mg acetaminophen (opioid control group) or 400 mg of ibuprofen [nonsteroidal antiinflammatory drug (NSAID) experimental group]. Pain levels were assessed on postoperative days 1, 2, and 7. Outcome measures included numeric pain rating scores and assessments of frequency and amount of analgesic used.

Results:

There was no significant difference in gender (p = 0.81) or age (p = 0.61) between groups. On postoperative day 0, the NSAID group (mean ± SD, 2.54 ± 1.57) was found to be noninferior to the opioid group (mean ± SD, 3.14 ± 1.75; p = 0.003). On postoperative day 1, the NSAID group showed a lower mean pain score (mean ± SD, 1.84 ± 1.29) than the opioid group (mean ± SD, 2.46 ± 1.90; p = 0.01). However, on postoperative day 7, the difference in pain scores between the NSAID (mean ± SD, 3.29 ± 2.14) and opioid (mean ± SD, 3.14 ± 2.12; p = 0.17) groups lost statistical significance. There was no significant difference in mean day of medication cessation between the NSAID (mean ± SD, 4.73 ± 1.57) and opioid (mean ± SD, 4.28 ± 2.23; p = 0.26) groups. Seventy-six percent of patients who were prescribed opioids took fewer than eight tablets. Five patients escalated from NSAIDs to opioids. There were no adverse effects related to NSAID use.

Conclusions:

NSAIDs are an acceptable and safe alternative to opioids for postoperative analgesia in rhinoplasty and potentially lead to better overall pain control in some patients. Significantly reducing or eliminating opioid prescriptions may be considered in light of the current opioid epidemic.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, II.
Latest Advancements in Autologous Breast Reconstruction
Authors: Chang Edward I.
Published: December 2020

Learning Objectives:

After studying this article, the participant should be able to: 1. Understand the available donor sites for autologous breast reconstruction. 2. Describe the advantages and limitations of each donor site. 3. Provide a rational, algorithmic preoperative evaluation and approach for patients seeking autologous breast reconstruction. 4. Develop an effective postoperative monitoring system to minimize complications and maximize salvage of microvascular thromboses.

Breast reconstruction remains at the heart of the field of plastic and reconstructive surgery, and it is continuously evolving. Tremendous advances in breast implant technology and supplemental products, particularly acellular dermal matrices, have revolutionized breast reconstruction in the modern era. However, microvascular free flap breast reconstruction has also witnessed profound advancements with exceptionally high success rates, with the ability to provide the most durable and natural breast reconstruction. Although the pendulum oscillates between prosthesis-based reconstruction and autologous tissue, the present synopsis will focus on autologous free flap breast reconstruction from an historical perspective, recent advancements in microsurgery, and the future of autologous breast reconstruction.
Modified Buccal Myomucosal Flap Closure of Large Anterior Palatal Oronasal Fistulas
Authors: Kalmar Christopher L. , Siu Armando , Alvarez Edwar , Swanson Jordan W.
Published: December 2020

Large oronasal palatal fistulas can be challenging to reconstruct. The authors present a modified buccal myomucosal flap repair technique and review intermediate-term outcomes. In this technique, large anterior palatal fistulas are closed in two layers. First, apposing nasal turnover flaps of vomer mucosa medially and nasal wall mucosa laterally are approximated. Second, a posteriorly based buccal flap incorporating full-thickness buccinator muscle and overlying mucosa is transposed with interposition of the flap in the retromolar trigone and lateral palate to preserve dental occlusion. Consecutive patient cases performed in low-resource settings were reviewed and outcomes reported. Among eight subjects aged 3 to 22 years, with average defect size of 2.5 cm2 (range, 0.8 to 3.5 cm2), the flap was viable in all cases and required revision or pedicle division in only two patients (25 percent); all patients showed symptom improvement. The modified buccal myomucosal flap shows promising intermediate-term results as a single-stage reconstruction suitable to a wide patient age range, low airway/anesthetic risk, reliable functional outcomes, and low comorbidity.
Experimental parasite community perturbation reveals associations between Sin Nombre virus and gastrointestinal nematodes in a rodent reservoir host
Authors: Sweeny Amy R. , Thomason Courtney A. , Carbajal Edwin A. , Hansen Christina B. , Graham Andrea L. , Pedersen Amy B.
Published: December 2020

Individuals are often co-infected with several parasite species, yet measuring within-host interactions remains difficult in the wild. Consequently, the impacts of such interactions on host fitness and epidemiology are often unknown. We used anthelmintic drugs to experimentally reduce nematode infection and measured the effects on both nematodes and the important zoonosis Sin Nombre virus (SNV) in its primary reservoir (Peromyscusspp.). Treatment significantly reduced nematode infection, but increased SNV seroprevalence. Furthermore, mice that were co-infected with both nematodes and SNV were in better condition and survived up to four times longer than uninfected or singly infected mice. These results highlight the importance of investigating multiple parasites for understanding interindividual variation and epidemiological dynamics in reservoir populations with zoonotic transmission potential.
Multiple cleaner species provide simultaneous services to coral reef fish clients
Authors: Rose Amelia , Titus Benjamin M. , Romain Joseph , Vondriska Clayton , Exton Dan A.
Published: December 2020

Cleaning symbioses on tropical coral reefs are typically documented between two species: a single client fish and one or more conspecific cleaners. However, multiple cleaner species living sympatrically in the Caribbean have been anecdotally reported to simultaneously clean the same client. Nothing is known about the patterns and processes driving these interactions, which may differ from those involving a single cleaner species. Here, we used remote underwater videography on three reefs in Honduras to record simultaneous cleaning interactions involving Pederson's cleaner shrimp (
Ancylomenes pedersoni
) and cleaner gobies (
Elacatinus
spp.). A pilot study on adjacent shrimp and goby stations found interactions were always initiated by shrimp. A larger, multi-year dataset shows cleaner gobies joined 28% of all interactions initiated at
A. pedersoni
cleaning stations with cleaner gobies residing nearby. Client body size significantly predicted simultaneous cleaning interactions, with 45% of interactions simultaneous for clients greater than 20 cm total body length compared with only 8% for clients less than 20 cm. We also found that simultaneous cleaning interactions lasted over twice as long as shrimp-only interactions. We propose these novel multi-species interactions to be an ideal model system to explore broader questions about coexistence, niche overlap and functional redundancy among sympatric cleaner species.
Senescent cells and macrophages: key players for regeneration?
Authors: Elder Sonia S. , Emmerson Elaine
Published: December 2020

Over the last decade, our understanding of the physiological role of senescent cells has drastically evolved, from merely indicators of cellular stress and ageing to having a central role in regeneration and repair. Increasingly, studies have identified senescent cells and the senescence-associated secretory phenotype (SASP) as being critical in the regenerative process following injury; however, the timing and context at which the senescence programme is activated can lead to distinct outcomes. For example, a transient induction of senescent cells followed by rapid clearance at the early stages following injury promotes repair, while the long-term accumulation of senescent cells impairs tissue function and can lead to organ failure. A key role of the SASP is the recruitment of immune cells to the site of injury and the subsequent elimination of senescent cells. Among these cell types are macrophages, which have well-documented regulatory roles in all stages of regeneration and repair. However, while the role of senescent cells and macrophages in this process is starting to be explored, the specific interactions between these cell types and how these are important in the different stages of injury/reparative response still require further investigation. In this review, we consider the current literature regarding the interaction of these cell types, how their cooperation is important for regeneration and repair, and what questions remain to be answered to advance the field.
The role of disorder in RNA binding affinity and specificity
Authors: Ottoz Diana S. M. , Berchowitz Luke E.
Published: December 2020

Most RNA-binding modules are small and bind few nucleotides. RNA-binding proteins typically attain the physiological specificity and affinity for their RNA targets by combining several RNA-binding modules. Here, we review how disordered linkers connecting RNA-binding modules govern the specificity and affinity of RNA–protein interactions by regulating the effective concentration of these modules and their relative orientation. RNA-binding proteins also often contain extended intrinsically disordered regions that mediate protein–protein and RNA–protein interactions with multiple partners. We discuss how these regions can connect proteins and RNA resulting in heterogeneous higher-order assemblies such as membrane-less compartments and amyloid-like structures that have the characteristics of multi-modular entities. The assembled state generates additional RNA-binding specificity and affinity properties that contribute to further the function of RNA-binding proteins within the cellular environment.
The Association Between Alpha-1 Adrenergic Receptor Antagonists and In-Hospital Mortality from COVID-19
Authors: Rose Liam , Graham Laura , Koenecke Allison , Powell Michael , Xiong Ruoxuan , Shen Zhu , Kinzler Kenneth W. , Bettegowda Chetan , Vogelstein Bert , Athey Susan , Vogelstein Joshua T. , Konig Maximilian F. , Wagner Todd H.
Published: December 2020

Effective therapies for coronavirus disease 2019 (COVID-19) are urgently needed, and preclinical data suggest alpha-1 adrenergic receptor antagonists (α1-AR antagonists) may be effective in reducing mortality related to hyperinflammation independent of etiology. Using a retrospective cohort design with patients in the Department of Veterans Affairs healthcare system, we use doubly robust regression and matching to estimate the association between baseline use of α1-AR antagonists and likelihood of death due to COVID-19 during hospitalization. Having an active prescription for any α1-AR antagonist (tamsulosin, silodosin, prazosin, terazosin, doxazosin, or alfuzosin) at the time of admission had a significant negative association with in-hospital mortality (relative risk reduction 18%; odds ratio 0.73; 95% CI 0.63 to 0.85; p ≤ 0.001) and death within 28 days of admission (relative risk reduction 17%; odds ratio 0.74; 95% CI 0.65 to 0.84; p ≤ 0.001). In a subset of patients on doxazosin specifically, an inhibitor of all three alpha-1 adrenergic receptors, we observed a relative risk reduction for death of 74% (odds ratio 0.23; 95% CI 0.03 to 0.94; p = 0.028) compared to matched controls not on any α1-AR antagonist at the time of admission. These findings suggest that use of α1-AR antagonists may reduce mortality in COVID-19, supporting the need for randomized, placebo-controlled clinical trials in patients with early symptomatic infection.
The Ensembl COVID-19 resource: Ongoing integration of public SARS-CoV-2 data
Authors: De Silva Nishadi H. , Bhai Jyothish , Chakiachvili Marc , Contreras-Moreira Bruno , Cummins Carla , Frankish Adam , Gall Astrid , Genez Thiago , Howe Kevin L. , Hunt Sarah E. , Martin Fergal J. , Moore Benjamin , Ogeh Denye , Parker Anne , Parton Andrew , Ruffier Magali , Sakthivel Manoj Pandian , Sheppard Dan , Tate John , Thormann Anja , Thybert David , Trevanion Stephen J. , Winterbottom Andrea , Zerbino Daniel R. , Finn Robert D. , Flicek Paul , Yates Andrew D.
Published: December 2020

The COVID-19 pandemic has seen unprecedented use of SARS-CoV-2 genome sequencing for epidemiological tracking and identification of emerging variants. Understanding the potential impact of these variants on the infectivity of the virus and the efficacy of emerging therapeutics and vaccines has become a cornerstone of the fight against the disease. To support the maximal use of genomic information for SARS-CoV-2 research, we launched the Ensembl COVID-19 browser, incorporating a new Ensembl gene set, multiple variant sets (including novel variation calls), and annotation from several relevant resources integrated into the reference SARS-CoV-2 assembly. This work included key adaptations of existing Ensembl genome annotation methods to model ribosomal slippage, stringent filters to elucidate the highest confidence variants and utilisation of our comparative genomics pipelines on viruses for the first time. Since May 2020, the content has been regularly updated and tools such as the Ensembl Variant Effect Predictor have been integrated. The Ensembl COVID-19 browser is freely available at https://covid-19.ensembl.org.
A sustained type I IFN-neutrophil-IL-18 axis drives pathology during mucosal viral infection
Authors: Lebratti Tania J. , Lim Ying Shiang , Cofie Adjoa , Andey Prabhakar S. , Jiang Xiaoping , Scott Jason M. , Fabbrizi Maria Rita , Ozanturk Ayse N. , Pham Christine T.N. , Clemens Regina A. , Artyomov Maxim , Dinauer Mary C. , Shin Haina
Published: December 2020

Neutrophil responses against pathogens must be balanced between protection and immunopathology. Factors that determine these outcomes are not well-understood. In a mouse model of genital herpes simplex virus-2 (HSV-2) infection, which results in severe genital inflammation, antibody-mediated neutrophil depletion reduced disease. Comparative single cell RNA-sequencing analysis of vaginal cells against a model of genital HSV-1 infection, which results in mild inflammation, demonstrated sustained expression of interferon-stimulated genes (ISGs) only after HSV-2 infection primarily within the neutrophil population. Both therapeutic blockade of IFNα/βreceptor 1 (IFNAR1) and genetic deletion of IFNAR1 in neutrophils concomitantly decreased HSV-2 genital disease severity and vaginal IL-18 levels. Therapeutic neutralization of IL-18 also diminished genital inflammation, indicating an important role for this cytokine in promoting neutrophil-dependent immunopathology. Our study reveals that sustained type I IFN signaling is a driver of pathogenic neutrophil responses, and identifies IL-18 as a novel component of disease during genital HSV-2 infection.
The assisting role of Polη in transcription facilitates formation of damage-induced cohesion
Authors: Wu Pei-Shang , Cameron Donald P. , Grosser Jan , Baranello Laura , Ström Lena
Published: December 2020

The structural maintenance of chromosome (SMC) complex cohesin mediates sister chromatid cohesion established during replication, and damage-induced cohesion formed in response to DSBs post-replication. The translesion synthesis polymerase Polη is required for damage-induced cohesion through a hitherto unknown mechanism. Since Polη is functionally associated with transcription, and transcription triggersde novocohesion inSchizosaccharomyces pombe, we hypothesized that transcription facilitates damage-induced cohesion inSaccharomyces cerevisiae. Here, we show dysregulated transcriptional profiles in Polη-depleted cells (rad30Δ), where genes involved in chromatin assembly and positive transcription regulation were downregulated. In addition, chromatin association of RNA polymerase II was reduced at promoters and coding regions inrad30Δcompared to WT cells, while occupancy of the H2A.Z variant (Htz1) at promoters was increased inrad30Δcells. Perturbing histone exchange at promoters inactivated damage-induced cohesion, similarly to deletion of theRAD30gene. Conversely, altering regulation of transcription elongation suppressed the deficient damage-induced cohesion inrad30Δcells. These results indicate that Polη has an assisting role during the transcriptional process, which consecutively facilitates formation of damage-induced cohesion. This further suggests a potential linkage between regulation of transcription and formation of damage-induced cohesion after replication.

Author Summary

The cohesin complex dynamically associates with chromosomes and holds sister chromatids together through cohesion established during replication. This ensures faithful chromosome segregation at anaphase. In budding yeast, DNA double strand breaks trigger sister chromatid cohesion even after replication. This so-called damage-induced cohesion is formed both close to the breaks, and genome-wide on undamaged chromosomes. The translesion synthesis polymerase eta (Polη) is specifically required for genome wide damage-induced cohesion. Although Polη is well characterized for its function in bypassing ultraviolet-induced DNA lesions, its mechanistic role in damage-induced cohesion is unclear. Here, we show that transcriptional regulation is perturbed in the absence of Polη. We propose that Polη could aid in chromatin association of RNA polymerase II through phosphorylation of the Polη-S14 residue, a non-canonical role of Polη which further facilitates formation of damage-induced cohesion genome wide. In addition, we observe the need of replication-independent nucleosome assembly/histone exchange for formation of damage-induced cohesion. This together provides new insight into formation of damage-induced cohesion after replication, which will be interesting to further explore.
Prevalence of influenza vaccination among adults with high-risk conditions, United States, 2019
Authors: Gopalan Saji Saraswathy , Mishra Devi Kalyan , Das Ashis Kumar
Published: December 2020

Background

Influenza could be associated with illnesses, severe complications, hospitalizations, and deaths among adults with high-risk medical conditions. Influenza vaccination reduces the risks and complications associated with influenza infection in high-risk conditions. We assessed the prevalence and predictors of influenza vaccination in a national sample of adults with high-risk medical conditions.

Methods

Using the nationally representative National Health Interview Survey of 2019, we estimated the prevalence of influenza vaccination among adults with high-risk conditions. We tested the associations between receipt of vaccination and sociodemographic predictors with adjusted multivariable logistic regression.

Results

Out of 15,258 adults with high-risk conditions, 56% reported receiving an influenza vaccine over the previous 12 months. Multivariable regressions show that respondents from older age groups, females, other race/ethnic group, married, higher annual family income, having a health insurance and those with more than two high-risk conditions are more likely to receive the influenza vaccine. However, adults from non-Hispanic Black race/ethnicity and living in the Southern census region are less likely to receive the vaccination. Education levels and living in a metro show no associations with vaccination status.

Conclusion

State authorities, primary physicians, specialists, and pharmacists have important roles in sensitizing and reminding individuals with high-risk conditions to receive timely vaccination. Similarly, affordability needs to be enhanced for influenza vaccination including better insurance coverage and reduced co-payment.