bluuebunny/crossref_metadata_2025 huggingface dataset:
White Habitus Among Polish White Female Converts to Islam
Authors: Piela Anna , Krotofil Joanna
Published: July 2022

This article addresses the question of how the racial habitus of Polish White female converts (PWFCs) to Islam is performed in different social settings. We draw from in-depth interviews with 35 PWFCs living in Poland and the United Kingdom. While the notion of habitus has been used to analyze socialization into Islam, racial habitus has not been analyzed in relation to White converts to Islam. We argue that White habitus is an important concept that elucidates racial positioning among White converts in multiracial Muslim settings. Whiteness, often indexed in the data as “Europeanness,” is foundational for the PWFC identity. Furthermore, we extend the understanding of how Whiteness operates in Eastern Europe through the analysis of the White habitus among those who occupy non-normative places in racial and religious hierarchies. Thus, this article contributes to a growing body of scholarship on decentering Whiteness in Eastern Europe.
The dark septate endophyte Phialocephala sphaeroides suppresses conifer pathogen transcripts and promotes root growth of Norway spruce
Authors: Wang Kai , Wen Zilan , Asiegbu Fred O
Published: July 2022

Plant-associated microbes including dark septate endophytes (DSEs) of forest trees play diverse functional roles in host fitness including growth promotion and increased defence. However, little is known about the impact on the fungal transcriptome and metabolites during tripartite interaction involving plant host, endophyte and pathogen. To understand the transcriptional regulation of endophyte and pathogen during co-infection, Norway spruce (Picea abies) seedlings were infected with DSE Phialocephala sphaeroides, or conifer root-rot pathogen Heterobasidion parviporum, or both. Phialocephala sphaeroides showed low but stable transcripts abundance (a decrease of 40%) during interaction with Norway spruce and conifer pathogen. By contrast, H. parviporum transcripts were significantly reduced (92%) during co-infection. With RNA sequencing analysis, P. sphaeroides experienced a shift from cell growth to anti-stress and antagonistic responses, while it repressed the ability of H. parviporum to access carbohydrate nutrients by suppressing its carbohydrate/polysaccharide-degrading enzyme machinery. The pathogen on the other hand secreted cysteine peptidase to restrict free growth of P. sphaeroides. The expression of both DSE P. sphaeroides and pathogen H. parviporum genes encoding plant growth promotion products were equally detected in both dual and tripartite interaction systems. This was further supported by the presence of tryptophan-dependent indolic compound in liquid culture of P. sphaeroides. Norway spruce and Arabidopsis seedlings treated with P. sphaeroides culture filtrate exhibited auxin-like phenotypes, such as enhanced root hairs, and primary root elongation at low concentration but shortened primary root at high concentration. The results suggested that the presence of the endophyte had strong repressive or suppressive effect on H. parviporum transcripts encoding genes involved in nutrient acquisition.
Comparison of Clinical Profiles and Mortality Outcomes Between Influenza and COVID-19 Patients Invasively Ventilated in the ICU: A Retrospective Study From All Paris Public Hospitals From 2016 to 2021
Authors: Marois Clémence , Nedelec Thomas , Pelle Juliette , Rozes Antoine , Durrleman Stanley , Dufouil Carole , Demoule Alexandre
Published: July 2022

OBJECTIVES:

Studies comparing outcomes of ICU patients admitted for either COVID-19 or seasonal influenza are limited. Our objective was to describe baseline clinical profiles, care procedures, and mortality outcomes by infection status (influenza vs COVID-19) of patients who received invasive mechanical ventilation in the ICU.

DESIGN:

Retrospective observational study.

SETTING:

Data were extracted from the Assistance Publique—Hopitaux de Paris database from September 1, 2016, to April 20, 2021. It includes data from the 39 university hospitals.

PATIENTS:

A total of 752 influenza adult patients and 3,465 COVID-19 adult patients received invasive mechanical ventilation in one of the ICUs of the Paris area university hospitals, France.

INTERVENTION:

The characteristics and outcome by infection status were compared. Factors associated with mortality were assessed using Cox proportional hazard models after controlling for potential confounders, including infection status.

MEASUREMENTS AND MAIN RESULTS:

The median age at admission to the ICU was 67 (interquartile range [IQR], 57–77) and 63 yr (IQR, 54–71 yr) for influenza and COVID-19 patients, respectively. At ICU admission, COVID-19 patients were more frequently obese, more frequently had diabetes mellitus or high blood pressure, and were less likely to have chronic heart failure, chronic respiratory disease, chronic kidney failure, or active cancer than influenza patients. The overall survival at 90 days was 57% for COVID-19 patients and 66% for influenza patients (p < 0.001). In a multivariable Cox model, higher age, organ transplant, severe acute respiratory syndrome coronavirus 2 infection, and chronic kidney failure were associated with shorter survival, whereas obesity and high blood pressure were associated with longer survival after invasive ventilation.

CONCLUSIONS:

COVID-19 and influenza patients requiring mechanical ventilation in the ICU differed by many characteristics. COVID-19 patients showed lower survival independently of potential confounders.
Trends in Early and Late Mortality in Patients With Severe Acute Pancreatitis Admitted to ICUs: A Nationwide Cohort Study
Authors: Wolbrink Daniel R. J. , van de Poll Marcel C. G. , Termorshuizen Fabian , de Keizer Nicolette F. , van der Horst Iwan C. C. , Schnabel Ronny , Dejong Cees H. C. , van Santvoort Hjalmar C. , Besselink Marc G. , van Goor Harry , Bouwense Stefan A. W. , van Bussel Bas C. T. ,   for the Dutch Pancreatitis Study Group and the Dutch National Intensive Care Evaluation (NICE) Collaborators
Published: July 2022

OBJECTIVES:

To investigate national mortality trends over a 12-year period for patients with severe acute pancreatitis (SAP) admitted to Dutch ICUs. Additionally, an assessment of outcome in SAP was undertaken to differentiate between early (< 14 d of ICU admission) and late (> 14 d of ICU admission) mortality.

DESIGN:

Data from the Dutch National Intensive Care Evaluation and health insurance companies’ databases were extracted. Outcomes included 14-day, ICU, hospital, and 1-year mortality. Mortality before and after 2010 was compared using mixed logistic regression and mixed Cox proportional-hazards models. Sensitivity analyses, excluding early mortality, were performed to assess trends in late mortality.

SETTING:

Not applicable.

PATIENTS:

Consecutive adult patients with SAP admitted to all 81 Dutch ICUs between 2007 and 2018.

INTERVENTIONS:

Not applicable.

MEASUREMENTS AND MAIN RESULTS:

Among 4,160 patients treated in 81 ICUs, 14-day mortality was 17%, ICU mortality 17%, hospital mortality 23%, and 1-year mortality 33%. After 2010 in-hospital mortality adjusted for age, sex, modified Marshall, and Acute Physiology and Chronic Health Evaluation III scores were lower (odds ratio [OR], 0.76; 95% CI, 0.61–0.94) than before 2010. There was no change in ICU and 1-year mortality. Sensitivity analyses excluding patients with early mortality demonstrated a decreased ICU mortality (OR, 0.45; 95% CI, 0.32–0.64), decreased in-hospital (OR, 0.48; 95% CI, 0.36–0.63), and decreased 1-year mortality (hazard ratio, 0.81; 95% CI, 0.68–0.96) after 2010 compared with 2007–2010.

CONCLUSIONS:

Over the 12-year period examined, mortality in patients with SAP admitted to Dutch ICUs did not change, although after 2010 late mortality decreased. Novel therapies should focus on preventing early mortality in SAP.
BREAST-Q and Donor Site Comparison in Bilateral Stacked Autologous Breast Reconstruction
Authors: Haddock Nicholas T. , Dickey Ryan M. , Perez Kevin , Garza Ricardo , Liu Yulun , Teotia Sumeet S.
Published: July 2022

Background:

Patients undergoing bilateral autologous breast reconstruction may benefit from increased flap volume using bilateral stacked deep inferior epigastric perforator (DIEP) and profunda artery perforator (PAP) flaps. Our aim was to characterize the donor site morbidity and patient-reported outcomes in four-flap breast reconstruction.

Methods:

Retrospective review was performed for all patients undergoing four-flap breast reconstruction by two surgeons between January 2010 and September 2021. Outcome measures including the BREAST-Q reconstructive module, the lower extremity functional scale (LEFS), inpatient surgical site pain scores by numeric pain rating scale (NPRS), and a postoperative subjective survey comparing donor sites were obtained. Four-flap BREAST-Q scores were compared with bilateral DIEP and bilateral PAP patients.

Results:

A total of 79 patients undergoing four-flap breast reconstruction were identified. Four-flap BREAST-Q scores (n = 56) were similar to bilateral DIEP and bilateral PAP reconstruction patients. Long-term survey outcomes from the LEFS demonstrated improved score trend after 6 months. Mean instances of donor site pain location recorded at the abdomen were significantly higher than the thigh during the postoperative admission. Subjective survey data revealed more long-term donor site pain at the PAP site, a patient preference for the DIEP donor site, and easier postoperative care for the DIEP donor site.

Conclusions:

This is the largest consecutive series of four-flap breast reconstruction outcomes reported to date. BREAST-Q scores in four-flap patients demonstrate overall patient satisfaction that is similar to both bilateral DIEP and bilateral PAP reconstruction patients. The DIEP donor site appears to be preferred by patients over the PAP donor site.
Targeted Nipple Areola Complex Reinnervation: Technical Considerations and Surgical Efficiency in Implant-based Breast Reconstruction
Authors: Gfrerer Lisa , Sager Jessica Erdmann , Ford Olivia Abbate , Carty Matthew J. , Verdial Francys C. , Gadd Michele A. , Specht Michelle C. , Winograd Jonathan M. , Valerio Ian L.
Published: July 2022

Background:

Despite promising pilot study results, adoption of neurotization of immediate implant-based reconstructions has not occurred.

Methods:

For surgeons interested in adopting breast reinnervation techniques, we present ways to overcome initial barriers by decreasing operative time and maximizing chances of sensory recovery.

Results:

We discuss the combined experience at two academic teaching hospitals, where neurotization of both immediate tissue expander cases and direct-to-implant reconstructions are performed through varying mastectomy incisions.

Conclusion:

Initial barriers can be overcome by shortening operative time and providing an individualized reinnervation approach that aims to increase the chance of meaningful sensation.
Physical Therapy Management of Functional Constipation in Adults: A 2021 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association's Academy of Pelvic Health Physical Therapy
Authors: LaCross Jennifer A. , Borello-France Diane , Marchetti Gregory F. , Turner Rose , George Susan
Published: July 2022

Background:

Functional constipation, diagnosed by physicians utilizing the Rome criteria, is a nonpathologic bowel condition resulting in difficulty with defecation. Adults with functional constipation experience infrequent defecation and may strain and/or use manual maneuvers to produce a bowel movement. Physical therapy should be offered as part of conservative intervention. The goals of this guideline were to describe the available evidence and create a reference document of evidence for physical therapists managing adults with functional constipation symptoms.

Methods:

A systematic search of the literature was performed for articles published between 1990 and 2019 related to physical therapy interventions for adult functional constipation. A summary of details including benefits, risks, harms, and costs related to each intervention category is provided.

Results:

Strong evidence suggests that physical therapists should offer biofeedback interventions to their patients with functional constipation, including either electromyographic, rectal balloon catheter, or anorectal manometry biofeedback. Moderate evidence supports the use of manual therapy, whereas weak evidence was found to support the use of electrical stimulation to manage adult functional constipation. Finally, although we were not able to grade the evidence for the use of patient education and therapeutic exercise in the physical therapy management of functional constipation, we did provide a summary of these interventions in the literature.

Discussion/Conclusions:

Our findings suggest that physical therapists can confidently include biofeedback interventions into the plan of care for adults with functional constipation, as they are supported by strong evidence. Manual therapy also provided a degree of evidence suitable to recommend its use.
Clinical Performance, Safety, and Patient-Reported Outcomes of an Active Osseointegrated Steady-State Implant System
Authors: Briggs Robert , Birman Catherine S. , Baulderstone Nicholas , Lewis Aaran T. , Ng Iris H.Y. , Östblom Anna , Rousset Alex , Tari Sylvia , Tong Michael C.F. , Cowan Robert
Published: July 2022

Objective

To investigate the clinical performance, safety, and patient-reported outcomes of an active osseointegrated steady-state implant system that uses piezoelectric technology.

Study Design

A prospective, multicenter, open-label, single-arm, within-subject clinical investigation.

Setting

Three tertiary referral clinical centers located in Melbourne, Sydney, and Hong Kong.

Patients

Twenty-nine adult subjects, 24 with mixed hearing loss or conductive hearing loss and 5 with single-sided sensorineural deafness.

Intervention

Implantation with the Cochlear Osia 2 System.

Main Outcome Measures

Audiological threshold evaluation and speech recognition in quiet and in noise. Patient satisfaction and safety.

Results

At 6-month follow-up after surgery, a mean improvement in pure-tone average of 26.0 dB hearing level and a mean improvement of 8.8 dB signal-to-noise ratio in speech reception threshold in noise was achieved with the investigational device as compared with the unaided situation. Usability of the investigational device was rated 71.4/100 mm for sound processor retention and 81.4/100 mm for overall comfort using a visual analog scale.

Conclusion

These outcomes confirm the clinical safety, performance, and benefit of an innovative active transcutaneous bone conduction implant using a piezoelectric transducer design in subjects with conductive hearing loss, mixed hearing loss, or single-sided sensorineural deafness.
Petrous Apicitis: A Systematic Review and Case Presentation
Authors: Talmor Guy , Vakil Mayand , Tseng Chris , Svider Peter , Ying Mary , Eloy Jean Anderson
Published: July 2022

Introduction

Petrous apicitis (PA) is a rare but dangerous complication of acute otitis media. The objective of this study is to present a case of PA and systematically review the existing literature on PA to characterize clinical presentation, diagnosis, management, and outcomes in the antibiotic era.

Methods

A comprehensive search from 1983 to June 1, 2020, of PubMed, MEDLINE, Cochrane Library, and EmBase databases was conducted. Studies with clinical data regarding patients with PA were included. Non-English literature or studies with insufficient individual patient data were excluded. Sixty-seven studies were included with a total of 134 patients.

Results

A total of 67 articles were found to meet criteria for inclusion. The mean age of presentation was 33 years. Recent acute otitis media was reported in 78 patients (58.2%). Only 3 patients (2.2%) were immunocompromised, and 8 patients (6.0%) had a history of diabetes. Gradenigo’s triad of abducens palsy, otorrhea, and retro-orbital or facial pain was reported in 28 patients (20.9%); however, these presenting symptoms were common individually (51.5%, 48.5%, and 64.2%, respectively). Hearing loss (35.8%), facial weakness (17.9%), and vertigo (7.5%) were also reported.

The most frequently cultured pathogen was Pseudomonas (34.2%), followed by Streptococcus and Staphylococcus. All 134 patients underwent imaging, with computed tomography being the most frequently used modality (56.0%). Nearly all patients received antibiotic therapy (95.6%), with 91 (67.9%) undergoing surgery ranging from myringotomy (26.9%) to petrosectomy (25.4%). Five patients (5.7%) died because of complications related to PA. Mean follow-up was 11.0 months.

Conclusions

Petrous apicitis has a variable presentation with potential for severe morbidity. Mortality rates are low, and presentation with Gradenigo’s triad is uncommon. Appropriate medical management with surgical drainage can avoid long-term sequelae.
Machine Learning for Computed Tomography Radiomics
Authors: Bian Yun , Liu Yan Fang , Li Jing , Liu Fang , Fang Xu , Lu Jianping , Shao Chengwei
Published: July 2022

Objectives

The aims of the study were to develop and validate a machine learning classifier for preoperative prediction of tumor-infiltrating lymphocytes (TILs) in patients with pancreatic ductal adenocarcinoma (PDAC).

Methods

In this retrospective study of 183 PDAC patients who underwent multidetector computed tomography and surgical resection, CD4+, CD8+, and CD20+ expression was evaluated using immunohistochemistry, and TIL scores were calculated using the Cox regression model. The patients were divided into TIL-low and TIL-high groups. An extreme gradient boosting (XGBoost) classifier was developed using a training set consisting of 136 consecutive patients, and the model was validated in 47 consecutive patients. The discriminative ability, calibration, and clinical utility of the XGBoost classifier were evaluated.

Results

The prediction model showed good discrimination in the training (area under the curve, 0.93; 95% confidence interval, 0.89–0.97) and validation (area under the curve, 0.79; 95% confidence interval, 0.65–0.92) sets with good calibration. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for the training set were 0.93, 0.85, 0.90, 0.89, and 0.91, respectively, while those for the validation set were 0.63, 0.91, 0.77, 0.88, and 0.70, respectively.

Conclusions

The XGBoost-based model could predict PDAC TILs and may facilitate clinical decision making for immune therapy.
Digital Image Analysis and Quantitative Bead Standards in Root Cause Analysis of Immunohistochemical Staining Variability: A Real-world Example
Authors: Rojansky Rebecca , Sompuram Seshi R. , Gomulia Ellen , Natkunam Yasodha , Troxell Megan L. , Fernandez-Pol Sebastian
Published: July 2022

Assessment of automated immunohistochemical staining platform performance is largely limited to the visual evaluation of individual slides by trained personnel. Quantitative assessment of stain intensity is not typically performed. Here we describe our experience with 2 quantitative strategies that were instrumental in root cause investigations performed to identify the sources of suboptimal staining quality (decreased stain intensity and increased variability). In addition, these tools were utilized as adjuncts in validation of a new immunohistochemical staining instrument. The novel methods utilized in the investigation include quantitative assessment of whole slide images (WSI) and commercially available quantitative calibrators. Over the course of ~13 months, these methods helped to identify and verify correction of 2 sources of suboptimal staining. One root cause of suboptimal staining was insufficient/variable power delivery from our building’s electrical circuit. This led us to use uninterruptible power managers for all automated immunostainer instruments, which restored expected stain intensity and consistency. Later, we encountered one instrument that, despite passing all vendor quality control checks and not showing error alerts was suspected of yielding suboptimal stain quality. WSI analysis and quantitative calibrators provided a clear evidence that proved critical in confirming the pathologists’ visual impressions. This led to the replacement of the instrument, which was then validated using a combination of standard validation metrics supplemented by WSI analysis and quantitative calibrators. These root cause analyses document 2 variables that are critical in producing optimal immunohistochemical stain results and also provide real-world examples of how the application of quantitative tools to measure automated immunohistochemical stain output can provide a greater objectivity when assessing immunohistochemical stain quality.
Approach to FNA of Myxoid Soft Tissue Tumors
Authors: Satturwar Swati , Wakely Paul E. , Pantanowitz Liron
Published: July 2022

Myxoid tumors of the soft tissue encompass a group of heterogenous tumors that are characterized by the presence of abundant extracellular myxoid or chondromyxoid matrix material. Fine needle aspiration (FNA) is variably used for diagnosing primary, recurrent, and metastatic myxoid soft tissue tumors. The spectrum of myxoid soft tissue tumors encountered in practice ranges from benign lesions such as simple ganglion cysts to high-grade malignant sarcomas such as myxofibrosarcoma. These myxoid tumors have clinical, cytologic, and histologic overlap. Therefore, making an accurate diagnosis by FNA alone is challenging. Despite this challenge, using a systematic cytomorphologic approach and ancillary studies, an accurate diagnosis is feasible in the majority of cases. This article provides a systematic approach to diagnosing myxoid soft tissue tumors by FNA along with a review of the literature.
Approach to Fine Needle Aspiration of Adrenal Gland Lesions
Authors: Cantley Richard L.
Published: July 2022

Adrenal gland lesions are present in 1% to 5% of patients and are most commonly identified incidentally on abdominal imaging. Fine needle aspiration (FNA) cytology plays an important role in the initial workup of adrenal gland nodules, especially in patients with a known history of malignancy. The most common reason for adrenal gland FNA is to differentiate benign adrenal lesions, such as adrenal cortical adenoma, from metastatic malignancy. However, there is a significant cytomorphologic overlap between primary and metastatic adrenal neoplasms. This review focuses on the current state of adrenal gland FNA cytology, with an emphasis on distinguishing adrenocortical adenoma from carcinoma and adrenal cortical neoplasms from metastatic malignancies. The role of immunohistochemistry in specifically diagnosing adrenal neoplasms is discussed. Proposed diagnostic classification systems for adrenal gland FNA cytology are also described.
Minimally Invasive Approach to Skin Tightening of the Face and Body: A Systematic Review of Monopolar and Bipolar Radiofrequency Devices
Authors: Rohrich Rod J. , Schultz Kelly P. , Chamata Edward S. , Bellamy Justin L. , Alleyne Brendan
Published: July 2022

Background:

Radiofrequency (RF) treatment is a relatively new and increasingly popular option for patients desiring skin tightening and an improvement in facial or body contour without undergoing an excisional surgical procedure. A systematic review of the literature was performed to investigate the safety and efficacy of monopolar and bipolar radiofrequency devices for facial and body rejuvenation.

Methods:

A computerized search of the MEDLINE database was performed for clinical studies investigating the use of monopolar and bipolar radiofrequency devices in facial and body rejuvenation. Data on the type of device, treated areas, number of patients, number of treatments, follow-up, complications, and outcomes was collected.

Results:

The systematic review was performed in September 2020. A total of 207 articles examined the use of radiofrequency technology for cosmetic purposes, and 23 articles remained after all inclusion and exclusion criteria were considered. Nine articles evaluated monopolar devices and five articles evaluated bipolar devices for treatment of the face. Three articles evaluated monopolar devices and six articles evaluated bipolar devices for treatment of various body areas.

Conclusion:

There is clinical evidence that monopolar and bipolar radiofrequency devices produce measurable improvement in skin laxity of the face and body with an acceptable complication profile. Although the vast majority of reported complications are minor and transient in nature, major complication rates are higher with the use of monopolar devices than with the use of bipolar devices.
Impact of Panniculectomy and/or Abdominoplasty on Quality of Life: A Retrospective Cohort Analysis of Patient Reported Outcomes”
Authors: Rios-Diaz Arturo J. , Morris Martin P. , Elfanagely Omar , Cunning Jessica R. , Davis Harrison , Shakir Sameer , Broach Robyn B. , Fischer John P.
Published: July 2022

Background:

The incidence of obesity and massive weight loss continue to increase across the United States. Subsequently, body contouring procedures are increasing, as excess skin after weight loss affects patient-reported quality of life (QoL). We aimed to (1) identify factors associated low preoperative QoL, (2) quantify the QoL benefit of abdominal BCP (aBCP), and (3) evaluate benefits across grades of obesity.

Methods:

Patients seeking aBCP between 2018-2019 with a completed pre-operative BODY-Q™ questionnaire were identified. Patient characteristics and surgical outcomes were extracted. Chi-squared tests were used to determine characteristics associated with low preoperative QoL by comparing lowest versus highest tertiles for each of 10 BODY-Q domains. Wilcoxon signed-rank tests were used to compare preoperative to postoperative change in patients’ QoL. Chi-squared tests were used to determine QoL differences by obesity class: Class 1-2 (BMI = 30-39.9 kg/m2) versus Class 3 (BMI ≥ 40 kg/m2).

Results:

183 patients completed preoperative QoL questionnaires. Preoperative factors associated with low QoL included age >40 years old, African American race, public insurance, hypertension, and ASA class (all p<0.05). Of patients who completed a preoperative BODY-Q and underwent surgery, 46 patients (63%) completed both surveys. QoL improved postoperatively across all domains (p<0.01). The presence of an SSO did not impact postoperative QoL in any domain (p>0.05). Obesity classification did not affect change in QoL pre to postoperatively (p>0.05).

Conclusions:

QoL is significantly lower at baseline in older, African-American, publicly insured, and multimorbid patients, but improves dramatically after aBCP regardless of incidence of complication or degree of obesity.
Maximizing Safety and Optimizing Outcomes of Labiaplasty: A Systematic Review and Meta-Analysis
Authors: Escandón Joseph M. , Duarte Bateman Daniela , Bustos Valeria P. , Escandón Lauren , Mantilla-Rivas Esperanza , Mascaro-Pankova Andres , Ciudad Pedro , Langstein Howard N. , Manrique Oscar J.
Published: July 2022

Background:

The considerable increase in labiaplasty, demands plastic surgeons to be acquainted with the surgical techniques, their respective complications and satisfaction rates. This is a systematic review of the available evidence on labia minoraplasty looking at surgical techniques, clinical outcomes and patient satisfaction.

Methods:

A comprehensive search across PubMed, Web of Science, SCOPUS and Cochrane CENTRAL was executed through October 2020. A random-effect model meta-analysis was performed to assess the satisfaction and complications rates.

Results:

Forty-six studies including 3804 patients fulfilled the inclusion criteria. The pooled satisfaction rate following labia minoraplasty was 99% (95%CI: 97%–99%). Substantial heterogeneity was present across studies (I
2 = 63.09%, p < 0.001). The highest pooled incidence of dehiscence was reported for laser-assisted labiaplasty (5%, 95%CI: 2%–8%) and wedge resection (3%, 95%CI: 1%–5%). The highest pooled incidence of hematoma formation (8%, 95%CI: <1%–23%) and postoperative bleeding (2%, 95%CI: <1%–15%) was reported for W-shape resection. The highest pooled incidence of transient pain or discomfort was reported for deepithelialization (2%, 95%CI: <1%–23%) and W-shape resection (2%, 95%CI: <1%–15%). Three flap necrosis were reported, two occurred using wedge resection labia minoraplasty and one was not specified. The most common causes for revision surgery (n=169) were dehiscence and aesthetic concerns.

Conclusion:

Overall, labia minoraplasty is a very safe procedure. However, serious complications requiring surgical management have been reported. In this sense, an experienced surgeon, proper knowledge of female genital anatomy, and a thorough technique selection in accordance with the patient characteristics is mandatory.
Dorsal Augmentation Using a Glued Diced Cartilage Graft Fashioned with a Newly Developed Mold in Asian Rhinoplasty
Authors: Yoo Shin Hyuk , Kim Don-Han , Jang Yong Ju
Published: July 2022

Backgrounds:

In dorsal augmentation, costal cartilage can be used in number of different ways: monoblock form, fascia wrapped or glued diced cartilage grafting (GDCG). In order to make the use of GDCG more convenient, the authors developed a mold. This report describes our experience with the GDCG using a novel mold for dorsal augmentation.

Methods:

The study involved 80 patients who underwent dorsal augmentation with the molded GDCG. Facial photographs, medical records were reviewed to assess the patients’ satisfaction and postoperative complications. For the 23 patients who had three-dimensional (3D) scanned images, dorsal widths, dorsal heights at the radix and rhinion levels were measured to investigate the changes of the implants over time. The resorption of the graft was assessed comparing the 3-month postoperative photograph with the latest photograph, taken at the last follow-up (at least one year after the surgery). The serial changes of dorsum were assessed with 3D scanned images.

Results:

Total 66 patients (82.5%) were satisfied with their surgical outcomes. Complications were encountered in 19 patients (23.8%), and 8 (10%) revision surgeries were performed. Only one patient undergone revision surgery due to resorption of the GDCG. Analysis using a three-dimensional scanning device showed a significant increment of the dorsal height (P<0.05) without dorsal widening when comparing preoperative with 1-year postoperative follow-up data. There were no significant reductions in dorsal height between postoperative 3-months and postoperative 1-year.

Conclusions:

The use of a novel mold for shaping glued diced cartilage appears to be a useful technique for dorsal augmentation in rhinoplasty.
Intersectional stigmas are associated with lower viral suppression rates and antiretroviral therapy adherence among women living with HIV
Authors: Norcini Pala Andrea , Kempf Mirjam-Colette , Konkle-Parker Deborah , Wilson Tracey E. , Tien Phyllis C. , Wingood Gina , Neilands Torsten B. , Johnson Mallory O. , Weiser Sheri D. , Logie Carmen H. , Turan Janet M. , Turan Bulent
Published: July 2022

Objectives:

To explore the associations between intersectional poverty, HIV, sex, and racial stigma, adherence to antiretroviral therapy (ART), and viral suppression among women with HIV (WHIV).

Design:

We examined intersectional stigmas, self-report ART adherence, and viral suppression using cross-sectional data.

Methods:

Participants were WHIV (N = 459) in the Women's Adherence and Visit Engagement, a Women's Interagency HIV Study substudy. We used Multidimensional Latent Class Item Response Theory and Bayesian models to analyze intersectional stigmas and viral load adjusting for sociodemographic and clinical covariates.

Results:

We identified five intersectional stigma-based latent classes. The likelihood of viral suppression was approximately 90% lower among WHIV who experienced higher levels of poverty, sex, and racial stigma or higher levels of all intersectional stigmas compared with WHIV who reported lower experiences of intersectional stigmas. ART adherence accounted for but did not fully mediate some of the associations between latent intersectional stigma classes and viral load.

Conclusion:

The negative impact of intersectional stigmas on viral suppression is likely mediated, but not fully explained, by reduced ART adherence. We discuss the research and clinical implications of our findings.
CROSS Versus FLOT Regimens in Esophageal and Esophagogastric Junction Adenocarcinoma
Authors: Donlon Noel E. , Moran Brendan , Kamilli Anitha , Davern Maria , Sheppard Andrew , King Sinead , Donohoe Claire L. , Lowery Maeve , Cunningham Moya , Ravi Narayanasamy , Mueller Carmen , Cools-Lartigue Jonathan , Ferri Lorenzo , Reynolds John V.
Published: July 2022

Background:

The FLOT protocol and the CROSS trimodality regimen represent current standards in the management of locally advanced esophageal adenocarcinoma. In the absence of published Randomised Controlled Trial data, this propensity-matched comparison evaluated tolerance, toxicity, impact on sarcopenia and pulmonary physiology, operative complications, and oncologic metrics.

Methods:

Two hundred and twenty-two patients, 111 in each arm, were included from 2 high-volume centers. Computed tomography-measured sarcopenia, and pulmonary function (forced expiratory volume in first second/forced vital capacity/diffusion capacity for carbon monoxide) were compared pretherapy and posttherapy. Operative complications were defined as per the Esophageal Complications Consensus Group (ECCG) criteria, and severity per Clavien-Dindo. Tumor regression grade and R status were measured, and survival estimated per Kaplan-Meier.

Results:

A total of 83% were male, cT3/cN+ was 92%/68% for FLOT, and 86%/60% for CROSS. The full prescribed regimen was tolerated in 40% of FLOT patients versus 92% for CROSS. Sarcopenia increased from 16% to 33% for FLOT, and 14% to 30% in CROSS (P<0.01 between arms). Median decrease in diffusion capacity for carbon monoxide was −8.25% (−34 to 25) for FLOT, compared with −13.8%(−38 to 29), for CROSS (P=0.01 between arms). Major pathologic response was 27% versus 44% for FLOT and CROSS, respectively (P=0.03). In-hospital mortality, respectively, was 1% versus 2% (P=0.9), and Clavien Dindo >III 22% versus 27% (P=0.59), however, respiratory failure was increased by CROSS, at 13% versus 3% (P<0.001). Three-year survival was similar at 63% (FLOT) and 60% (CROSS) (P=0.42).

Conclusions:

Both CROSS and FLOT resulted in equivalent survival. Operative outcomes were similar, however, the CROSS regimen increased postoperative respiratory failure and atrial fibrillation. Less than half of patients received the prescribed FLOT regimen, although toxicity rates were acceptable. These data support clinical equipoise, caution, however, may be advised with CROSS in patients with greatest respiratory risk.
Effect of the Use of Reinforced Stapling on the Occurrence of Pancreatic Fistula After Distal Pancreatectomy
Authors: Merdrignac Aude , Garnier Jonathan , Dokmak Safi , Regenet Nicolas , Lesurtel Mickaël , Mabrut Jean Yves , Sa Cunha Antonio , Fuks David , Bergeat Damien , Robin Fabien , Le Pabic Estelle , Boudjema Karim , Turrini Olivier , Laviolle Bruno , Sulpice Laurent
Published: July 2022

Objective:

The aim of the study was to evaluate the impact of the use of a reinforced stapler (RS) during distal pancreatectomy (DP) on postoperative outcomes.

Background:

DP remains associated with significant postoperative morbidity owing to pancreatic fistula (PF). To date, there is no consensus on the management of the pancreatic stump. The use of an RS potentially represents a simple way to decrease the rate of PF.

Methods:

The REPLAY study (NCT03030170) is a prospective, multicenter, randomized study. Patients who underwent DP were randomized (1:1 ratio) in 2 groups for the use of a standard stapler (SS) or an RS to close remnant pancreatic parenchyma. The primary endpoint was the rate of overall PF. Secondary endpoints included severity of PF, length of hospital stay, overall morbidity, and rate of readmission for a PF within 90 days. Participants were blinded to the procedure actually carried out.

Results:

A total of 199 were analyzed (SS, n=99; RS, n=100). One patient who did not undergo surgery was excluded. Baseline characteristics were comparable in both groups. The rate of overall PF was higher in RS group (SS: 67.7%, RS: 83%, P=0.0121), but the rate of clinically relevant PF was similar (SS: 11.1%, RS: 14%, P=0.5387). Mean length of total hospital stay, readmission for PF, postoperative morbidity, and mortality at 90 days were similar.

Conclusion:

The results of this randomized clinical trial did not favor the use of RS during DP to reduce the rate of PF.
Great ape communication as contextual social inference: a computational modelling perspective
Authors: Bohn Manuel , Liebal Katja , Oña Linda , Tessler Michael Henry
Published: July 2022

Human communication has been described as a contextual social inference process. Research into great ape communication has been inspired by this view to look for the evolutionary roots of the social, cognitive and interactional processes involved in human communication. This approach has been highly productive, yet it is partly compromised by the widespread focus on how great apes use and understand individual signals. This paper introduces a computational model that formalizes great ape communication as a multi-faceted social inference process that integrates (a) information contained in the signals that make up an utterance, (b) the relationship between communicative partners and (c) the social context. This model makes accurate qualitative and quantitative predictions about real-world communicative interactions between semi-wild-living chimpanzees. When enriched with a pragmatic reasoning process, the model explains repeatedly reported differences between humans and great apes in the interpretation of ambiguous signals (e.g. pointing or iconic gestures). This approach has direct implications for observational and experimental studies of great ape communication and provides a new tool for theorizing about the evolution of uniquely human communication.

This article is part of the theme issue ‘Revisiting the human ‘interaction engine’: comparative approaches to social action coordination’.
Social tolerance and interactional opportunities as drivers of gestural redoings in orang-utans
Authors: Fröhlich Marlen , van Schaik Carel P.
Published: July 2022

Communicative repair is a fundamental and universal element of interactive language use. It has been suggested that the persistence and elaboration after communicative breakdown in nonhuman primates constitute two evolutionary building blocks of this capacity, but the conditions favouring it are poorly understood. Because zoo-housed individuals of some species are more social and more terrestrial than in the wild, they should be more likely to show gestural redoings (i.e. both repetition and elaboration) after communicative failure in the coordination of their joint activities. Using a large comparative sample of wild and zoo-housed orang-utans of two different species, we could confirm this prediction for elaboration, the more flexible form of redoings. Specifically, results showed that gestural redoings in general were best predicted by the specific social action context (i.e. social play) and interaction dyad (i.e. beyond mother–offspring), although they were least frequent in captive Bornean orang-utans. For gestural elaboration, we found the expected differences between captive and wild research settings in Borneans, but not in Sumatrans (the more socially tolerant species). Moreover, we found that the effectiveness of elaboration in eliciting responses was higher in Sumatrans, especially the captive ones, whereas effectiveness of mere repetition was influenced by neither species nor setting. We conclude that the socio-ecological environment plays a central role in the emergence of communicative repair strategies in great apes.

This article is part of the theme issue ‘Revisiting the human ‘interaction engine’: comparative approaches to social action coordination’.
The interaction engine: cuteness selection and the evolution of the interactional base for language
Authors: Levinson Stephen C.
Published: July 2022

The deep structural diversity of languages suggests that our language capacities are not based on any single template but rather on an underlying ability and motivation for infants to acquire a culturally transmitted system. The hypothesis is that this ability has an interactional base that has discernable precursors in other primates. In this paper, I explore a specific evolutionary route for the most puzzling aspect of this interactional base in humans, namely the development of an empathetic intentional stance. The route involves a generalization of mother–infant interaction patterns to all adults via a process (cuteness selection) analogous to, but distinct from, RA Fisher's runaway sexual selection. This provides a cornerstone for the carrying capacity for language.

This article is part of the theme issue ‘Revisiting the human ‘interaction engine’: comparative approaches to social action coordination’.
When and how do non-human great apes communicate to support cooperation?
Authors: Melis Alicia P. , Rossano F.
Published: July 2022

Several scholars have long suggested that human language and remarkable communicative abilities originate from the need and motivation to cooperate and coordinate actions with others. Yet, little work has focused on when and how great apes communicate during joint action tasks, partly because of the widely held assumption that animal communication is mostly manipulative, but also because non-human great apes' default motivation seems to be competitive rather than cooperative. Here, we review experimental cooperative tasks and show how situational challenges and the degree of asymmetry in terms of knowledge relevant for the joint action task affect the likelihood of communication. We highlight how physical proximity and strength of social bond between the participants affect the occurrence and type of communication. Lastly, we highlight how, from a production point of view, communicators appear capable of calibrating their signalling and controlling their delivery, showing clear evidence of first-order intentionality. On the other hand, recipients appear to struggle in terms of making use of referential information received. We discuss different hypotheses accounting for this asymmetry and provide suggestions concerning how future work could help us unveil to what degree the need for cooperation has shaped our closest living relatives' communicative behaviour.

This article is part of the theme issue ‘Revisiting the human ‘interaction engine’: comparative approaches to social action coordination’.
Unbiased Classification of the Human Brain Proteome Resolves Distinct Clinical and Pathophysiological Subtypes of Cognitive Impairment
Authors: Higginbotham Lenora , Carter E. Kathleen , Dammer Eric B. , Haque Rafi U. , Johnson Erik C.B. , Duong Duc M. , Yin Luming , De Jager Philip L. , Bennett David A. , Lah James J. , Levey Allan I. , Seyfried Nicholas T.
Published: July 2022

The hallmark amyloid-β and tau deposition of Alzheimer’s disease (AD) represents only a fraction of its diverse pathophysiology. Molecular subtyping using large-scale -omic strategies can help resolve this biological heterogeneity. Using quantitative mass spectrometry, we measured ~8,000 proteins across >600 dorsolateral prefrontal cortex tissues from Religious Orders Study and Rush Memory and Aging Project participants with clinical diagnoses of no cognitive impairment, mild cognitive impairment (MCI), and AD dementia. Unbiased classification of MCI and AD cases based on individual proteomic profiles resolved three classes with expression differences across numerous cell types and biological ontologies. Two classes displayed molecular signatures atypical of those previously observed in AD neurodegeneration, such as elevated synaptic and decreased inflammatory markers. In one class, these atypical proteomic features were associated with clinical and pathological hallmarks of cognitive resilience. These results promise to better define disease heterogeneity within AD and meaningfully impact its diagnostic and therapeutic precision.
Multi-omics integrated analysis reveals a specific phenotype of CD8+ T cell may contribute to immunothromosis via Th17 response in severe and critical COVID-19
Authors: Li Wen-Xing , An San-Qi , Dai Shao-Xing , Zhou Zhao-Ming , Zeng Xin , Deng Guan-Hua , Huang Ying-Ying , Shen Ling-Yu , Xu An-Qi , Lin Yao , Jiang Jun-Jun , Zhou Mei-Juan , Wei Wu , Liang Hao , Guan Dao-Gang , Zhou Cheng
Published: July 2022

T lymphocyte reduction and immunosenescence frequently occur in severe and critical coronavirus disease 2019 (COVID-19) patients, which may cause immunothrombosis and numerous sequelae. This study integrated analyzed multi-omics data from healthy donors, pneumonia, COVID-19 patients (mild & moderate, severe, and critical), and convalescences, including clinical, laboratory test, PBMC bulk RNA-seq, PBMC scRNA-seq and TCR-seq, BAL scRNA-seq, and lung proteome. We revealed that there are certain associations among T lymphocyte reduction, CD8+ T cell senescence, Th17 immune activation, and immunothrombosis. A specific phenotype (S. P.) CD8+ T cells were identified in severe and critical COVID-19 patients in both PBMC and BAL scRNA-seq, which showed highly TCR homology with terminal effector CD8+ T cells and senescent CD8+ T cells. Pseudotime analysis showed that the S. P. CD8+ T cells were located in the transition trajectory from mild to severe disease. Which may be activated by terminal effector CD8+ T cells or senescent CD8+ T cells, thereby promoting Th17 cell differentiation. This phenomenon was absent in healthy donors, mild and moderate COVID-19 patients, or convalescences. Our findings are an important reference for avoiding the conversion of patients with mild to severe diseases and provide insight into the future prevention and control of COVID-19 and its variants.
Cell cycle and temporal transcription factors regulate proliferation and neuronal diversity of dedifferentiation-derived neural stem cells
Authors: Veen Kellie , Froldi Francesca , Dong Qian , Alvarez-Ochoa Edel , Nguyen Phuong-Khanh , Harvey Kieran F , McMullen John P D , Marshall Owen , Jusuf Patricia R , Cheng Louise Y
Published: July 2022

Dedifferentiation is the reversion of differentiated cells to a stem cell like fate, whereby, the gene expression program of mature cells is altered and genes associated with multipotency are expressed. Appropriate terminal differentiation of NSCs is essential for restricting the overall number of neurons produced; in addition, faithful production of neuronal subtypes that populate the brain is important for NSC function. Both characteristics of NSCs are specified through temporal patterning of the NSCs driven by the successive expression of temporal transcription factors (tTFs). In this study, we found that ectopic NSCs induced via bHLH transcription factor Deadpan (Dpn) expression fail to undergo timely expression of temporal transcription factors (tTFs), where they express mid-tTF, Sloppy-paired 1 (Slp-1) and fail to express late-tTF Tailless (Tll); consequently generating an excess of Twin of eyeless (Toy) positive neurons at the expense of Reversed polarity (Repo) positive glial cells. In addition to disrupted production of neuronal/glial progeny, Dpn overexpression also resulted in stalled progression through the cell cycle, and a failure to undergo timely terminal differentiation. Mechanistically, DamID studies demonstrated that Dpn directly binds to both Dichaete (D), a Sox-box transcription factor known to repress Slp-1, as well as a number of cell cycle genes. Promoting cell cycle progression or overexpression of D were able to re-trigger the progression of the temporal series in dedifferentiated NBs, restoring both neuronal diversity and timely NB terminal differentiation.