bluuebunny/crossref_metadata_2025 huggingface dataset:
A Survey of Practice Patterns for Clinical Nodal Staging Prior to Neoadjuvant Chemotherapy in Breast Cancer
Authors: Lee Han-Byoel , Lee Kyung-Hun , Song Seok Hyun , Kim Kyubo , Kim Hong Kyu , Moon Hyeong-Gon , Han Wonshik , Lee Dae-Won , Im Seock-Ah , Jang Bum-Sup , Kim Yong Bae , Yu Jonghan , Kim Jee Hyun , Park Yeon Hee , Shin Kyung Hwan , Chang Ji Hyun
Published: June 2023

Background

The importance of clinical staging in breast cancer has increased owing to the wide use of neoadjuvant systemic therapy (NST). This study aimed to investigate the current practice patterns regarding clinical nodal staging in breast cancer in real-world settings.

Materials and Methods

A web-based survey was administered to board-certified oncologists in Korea, including breast surgical, medical, and radiation oncologists, from January to April 2022. The survey included 19 general questions and 4 case-based questions.

Results

In total, 122 oncologists (45 radiation, 44 surgical, and 33 medical oncologists) completed the survey. Among them, 108 (88%) responded that clinical staging before NST was primarily performed by breast surgeons. All the respondents referred to imaging studies during nodal staging. Overall, 64 (52.5%) responders determined the stage strictly based on the radiology reports, whereas 58 (47.5%) made their own decision while noting radiology reports. Of those who made their own decisions, 88% referred to the number or size of the suspicious node. Of the 75 respondents involved in prescribing regimens for neoadjuvant chemotherapy, 58 (77.3%) responded that the reimbursement regulations in the selection of NST regimens affected nodal staging in clinical practice. In the case-based questions, high variability was observed among the clinicians in the same cases.

Conclusions

Diverse assessments by specialists owing to the lack of a clear, harmonized staging system for the clinical nodal staging of breast cancer can lead to diverse practice patterns. Thus, practical, harmonized, and objective methods for clinical nodal staging and for the outcomes of post-NST response are warranted for appropriate treatment decisions and accurate outcome evaluation.
La pharmacothérapie en fonction des gènes
Authors: Rassekh S Rod , Rieder Michael , ‘t Jong Geert
Published: June 2023

Depuis vingt ans, le savoir médical sur le rôle des facteurs génétiques de variabilité a énormément évolué, tant à l’égard des maladies humaines que de la réponse aux médicaments. Ce savoir se traduit de plus en plus par des directives qui influent sur la posologie, la surveillance de l’efficacité et de l’innocuité et la détermination de la pertinence d’agents particuliers pour traiter les patients. Santé Canada et la Food and Drug Administration des États-Unis recommandent d’utiliser l’information génétique pour orienter la posologie de plus de 20 médicaments. Il n’existe actuellement pas de directives pédiatriques complètes pour aider les professionnels de la santé à utiliser la génétique afin d’établir la posologie, l’innocuité et l’efficacité des médicaments chez les enfants, et ces directives s’imposent d’urgence. Le présent document de principes aide le clinicien à comprendre le rôle de la pharmacogénétique et à utiliser l’information qu’il en tire pour prescrire des médicaments en pédiatrie.
Histone Deacetylases Regulate MORE AXILLARY BRANCHED 2-Dependent Germination of Arabidopsis thaliana
Authors: Temmerman Arne , De Keyser Annick , Boyer François-Didier , Struk Sylwia , Goormachtig Sofie
Published: June 2023

Under specific conditions, the germination of Arabidopsis thaliana is dependent on the activation of the KARRIKIN INSENSITIVE 2 (KAI2) signaling pathway by the KAI2-dependent perception of karrikin or the artificial strigolactone analogue, rac-GR24. To regulate the induction of germination, the KAI2 signaling pathway relies on MORE AXILLARY BRANCHED 2- (MAX2-)dependent ubiquitination and proteasomal degradation of the repressor protein SUPPRESSOR OF MAX2 1 (SMAX1). It is not yet known how the degradation of SMAX1 proteins eventually results in the regulation of seed germination, but it has been hypothesized that SMAX1-LIKE generally functions as transcriptional repressors through the recruitment of co-repressors TOPLESS (TPL) and TPL-related, which in turn interact with histone deacetylases. In this article, we show the involvement of histone deacetylases HDA6, HDA9, HDA19 and HDT1 in MAX2-dependent germination of Arabidopsis, and more specifically, that HDA6 is required for the induction of DWARF14-LIKE2 expression in response to rac-GR24 treatment.
Asymmetric variation in DNA methylation during domestication and de-domestication of rice
Authors: Cao Shuai , Chen Kai , Lu Kening , Chen Shiting , Zhang Xiyu , Shen Congcong , Zhu Shuangbin , Niu Yanan , Fan Longjiang , Chen Z Jeffrey , Xu Jianlong , Song Qingxin
Published: June 2023

Hundreds of plant species have been domesticated to feed human civilization, while some crops have undergone de-domestication into agricultural weeds, threatening global food security. To understand the genetic and epigenetic basis of crop domestication and de-domestication, we generated DNA methylomes from 95 accessions of wild rice (Oryza rufipogon L.), cultivated rice (Oryza sativa L.) and weedy rice (O. sativa f. spontanea). We detected a significant decrease in DNA methylation over the course of rice domestication but observed an unexpected increase in DNA methylation through de-domestication. Notably, DNA methylation changes occurred in distinct genomic regions for these 2 opposite stages. Variation in DNA methylation altered the expression of nearby and distal genes through affecting chromatin accessibility, histone modifications, transcription factor binding, and the formation of chromatin loops, which may contribute to morphological changes during domestication and de-domestication of rice. These insights into population epigenomics underlying rice domestication and de-domestication provide resources and tools for epigenetic breeding and sustainable agriculture.
The African cancer burden: what is the potential role of modern oncology innovation in reducing the continent’s rapidly rising mortality?
Authors: Awuah Wireko Andrew , Ng Jyi Cheng , Mehta Aashna , Nansubuga Esther Patience , Abdul-Rahman Toufik , Kundu Mrinmoy , Ou Yong Brian M , Kalmanovich Jacob , Hussain Aysha , Jessica Otumara Urowoli , Kamanousa Karl , Akilimali Aymar , Sikora Kateryna , Isik Arda
Published: June 2023

With increasing prevalence and an expected rise in disease burden, cancer is a cause of concern for African healthcare. The cancer burden in Africa is expected to rise to 2.1 million new cases per year and 1.4 million deaths annually by the year 2040. Even though efforts are being made to improve the standard of oncology service delivery in Africa, the current state of cancer care is not yet on par with the rise in the cancer burden. Cutting-edge technologies and innovations are being developed across the globe to augment the battle against cancer; however, many of them are beyond the reach of African countries. Modern oncology innovations targeted to ward Africa would be promising to address the high cancer mortality rates. The innovations should be cost-effective and widely accessible to tackle the rapidly rising mortality rate on the African continent. Though it may seem promising, a multidisciplinary approach is required to overcome the challenges associated with the development and implementation of modern oncology innovations in Africa.
Biallelic variants in RBM42 cause a multisystem disorder with neurological, facial, cardiac, and musculoskeletal involvement
Authors: Chen Yiyao , Yang Bingxin , Zhang Xiaoyu Merlin , Chen Songchang , Wang Minhui , Hu Liya , Pan Nina , Li Shuyuan , Shi Weihui , Yang Zhenhua , Wang Li , Tan Yajing , Wang Jian , Wang Yanlin , Xing Qinghe , Ma Zhonghua , Li Jinsong , Huang He-Feng , Zhang Jinglan , Xu Chenming
Published: June 2023

Here, we report a previously unrecognized syndromic neurodevelopmental disorder associated with biallelic loss-of-function variants in the RBM42 gene. The patient is a 2-year-old female with severe central nervous system (CNS) abnormalities, hypotonia, hearing loss, congenital heart defects, and dysmorphic facial features. Familial whole-exome sequencing (WES) reveals that the patient has two compound heterozygous variants, c.304C>T (p.R102*) and c.1312G>A (p.A438T), in the RBM42 gene which encodes an integral component of splicing complex in the RNA-binding motif protein family. The p.A438T variant is in the RRM domain which impairs RBM42 protein stability in vivo. Additionally, p.A438T disrupts the interaction of RBM42 with hnRNP K, which is the causative gene for Au-Kline syndrome with overlapping disease characteristics seen in the index patient. The human R102* or A438T mutant protein failed to fully rescue the growth defects of RBM42 ortholog knockout ΔFgRbp1 in Fusarium while it was rescued by the wild-type (WT) human RBM42. A mouse model carrying Rbm42 compound heterozygous variants, c.280C>T (p.Q94*) and c.1306_1308delinsACA (p.A436T), demonstrated gross fetal developmental defects and most of the double mutant animals died by E13.5. RNA-seq data confirmed that Rbm42 was involved in neurological and myocardial functions with an essential role in alternative splicing (AS). Overall, we present clinical, genetic, and functional data to demonstrate that defects in RBM42 constitute the underlying etiology of a new neurodevelopmental disease which links the dysregulation of global AS to abnormal embryonic development.
Yeast biopanning against site-specific phosphorylations in tau
Authors: Arbaciauskaite Monika , Pirhanov Azady , Ammermann Erik , Lei Yu , Cho Yong Ku
Published: June 2023

The detection of site-specific phosphorylation in the microtubule-associated protein tau is emerging as a means to diagnose and monitor the progression of Alzheimer’s Disease and other neurodegenerative diseases. However, there is a lack of phospho-specific monoclonal antibodies and limited validation of their binding specificity. Here, we report a novel approach using yeast biopanning against synthetic peptides containing site-specific phosphorylations. Using yeast cells displaying a previously validated phospho-tau (p-tau) single-chain variable region fragment (scFv), we show selective yeast cell binding based on single amino acid phosphorylation on the antigen. We identify conditions that allow phospho-specific biopanning using scFvs with a wide range of affinities (KD = 0.2 to 60 nM). Finally, we demonstrate the capability of screening large libraries by performing biopanning in 6-well plates. These results show that biopanning can effectively select yeast cells based on phospho-site specific antibody binding, opening doors for the facile identification of high-quality monoclonal antibodies.
Why States Preempt City Ordinances: The Case of Workers’ Rights Laws
Authors: Goodman Christopher B , Hatch Megan E
Published: June 2023

Despite being popular with the public and preventing racial and economic inequality, states often preempt their local governments’ ability to adopt workers’ rights laws. We test several competing theories of preemption (ideology, political institutions, interest group involvement, demographics, and policy diffusion) using a time-series, cross-sectional approach. Using data on state legislative activity from 1993 to 2018, we find that increasing legislative conservatism, and more unified political control of the state government, regardless of party, are associated with a higher risk of preempting local workers’ rights laws, all else equal. Our focus on legislative ideology, a more precise measure than party control at the subnational level, as the nexus of preemption activity helps clarify prior contradictory results in the literature. For those looking to prevent or overturn workers’ rights preemptions, the most direct approach appears to be to change the ideology of state legislatures.
Protection of SARS-CoV-2 trial vaccines in human is a function of the viral genomes
Authors: Alhaji Saganuwan Saganuwan
Published: June 2023

Objectives

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has devastated mankind with complaints that many vaccines developed against the disease could not offer protection and guarantee safety, hence many vaccinated individuals either came down with the infection and died or transmitted the infection. Therefore permanent immunization may become difficult due to interplay between the viral and human genomes.

Methods

In view of this, literatures were searched on the trial vaccines against SARS-CoV-2. Concentration log10 (copies/ml) of the virus, log10 viral copies, populations of human vaccinated, protection indices of the vaccines, population of Tcells, lethal concentration 1 of the virus, doses of the trial vaccines and vaccine regimens of the SARS-CoV-2 obtained from membrane ribonucleic acid, replication-defective viral vector, inactivated pathogen vaccine, protein subunit vaccine, virus-like particle and deoxyribonucleic acid vaccine (DNAV) were used with an intent to assessing the pathogenicity and virulence of the vaccines.

Key findings

Findings have shown that virion of 3.3 × 108–9 could kill humans over a period of ≥20 days, and 109–11 virions have killed 3 in every 100 humans. However, viral load of detection (3.22 × 103), positivity threshold (3.3 × 103) and index patient value (6.6 × 106) respectively have been established. The protection index is between 11% and 99%.

Conclusions

The viral load of coronavirus found in the affected patients was relatively high and could be fatal. However, DNAV-based vaccine (2 mg) administered twice 4 weeks apart provided the best protection index that lasted for 40–60 days.
Borders and Boundaries in Daily Urban Mobility Practices of Refugees in Cape Town, South Africa
Authors: Chekero Tamuka
Published: June 2023

This ethnographic study investigates the ways in which the label of refugee creates and reinforces particular kinds of boundaries and borders in mobility and survival efforts. Specifically, it looks at refugees’ movement in Bellville, Cape Town, to see how state and local borders affect intra-city refugee movement and how refugees deal with these obstacles in order to find localised protection and long-term survival strategies. This article builds on Nyamnjoh’s work on “nimble-footedness” and “conviviality” to show how refugees use nimbleness to form convivial social networks, which they convert into social capital. Despite their accommodation in the National Constitution, this article shows how refugees in Bellville are continually excluded and marginalised due to state and local level boundaries and borders. This article examines police blockages and state-based COVID-19 lockdowns and curfews and their effects on refugees and their movement. The findings show that, while having significant impact on their daily lives, refugees still find ways to negotiate through, around or avoid these barriers, as they navigate the city in search of livelihoods, services, and forms of protection. By utilising nimble-footedness and conviviality, this article depicts refugees as rational individuals who rely on numerous interconnections, inseparable entanglements, and creative interdependencies to survive.
Science diplomacy from a nation-state’s perspective: a general framing and its application to Global South countries
Authors: Ruffini Pierre-Bruno , Krasnyak Olga
Published: June 2023

Based on International Relations (IRs) grounding theories, this article outlines a realist-constructivist perspective in science diplomacy when assessing a nation-state’s foreign policy decision-making and behaviour. The proposed theoretical framing helps us evaluate existing practices of science diplomacy within the larger context of IRs and allows us to better understand the increasing role of science diplomacy and its potency in the foreign policy of emerging and developing countries. The proposed exploratory research methodology outlines the contours of a science diplomacy reading grid breaking it down into the categories of objectives, strategic drivers, and tools. The data collection and semi-structured interviews with high-ranking practitioners and experts allowed us to assess the meaning of science diplomacy as understood and implemented by Global South countries and to distinguish science diplomacy practices as oriented towards the satisfaction of domestic needs and international positioning.
Scientific collaborations between Latin America and Europe: an approach from science diplomacy towards international engagement
Authors: Echeverría-King Luisa F , Fossati Aura , Raja Nussaïbah B , Bonilla Kleinsy , Urbani Bernardo , Whiffen Radenka Krsmanović , Vizinová Tereza
Published: June 2023

International collaborations show asymmetries and imbalances that influence how countries take part in international relations. In this context, science diplomacy (SD) could offer possibilities towards building partnerships and meaningful engagement between Europe and Latin America. The purpose of this article is to analyse how scientific collaborations between Latin American and European researchers are carried out, observing trends, behaviours, and perceptions. Qualitative methodologies and the analysis of empirical data collected through a survey allow the extraction of relevant experiences from real cases of international joint projects. Findings indicate that addressing the asymmetries in the collaboration between partnering researchers from Europe and Latin America is essential, and SD approaches may facilitate such endeavour. SD may not represent a panacea; however, it seems to facilitate the internationalisation of research in terms of mobility, international scientific collaborations, and knowledge exchange with under-represented actors in traditional international scientific schemes, such as indigenous communities.
Does providing feedback and guidance on sleep perceptions using sleep wearables improve insomnia? Findings from “Novel Insomnia Treatment Experiment”: a randomized controlled trial
Authors: Spina Marie-Antoinette , Andrillon Thomas , Quin Nina , Wiley Joshua F , Rajaratnam Shantha M W , Bei Bei
Published: June 2023

Study Objectives

Insomnia is a disorder diagnosed based on self-reported sleep complaints. Differences between self-reported and sensor-based sleep parameters (sleep–wake state discrepancy) are common but not well-understood in individuals with insomnia. This two-arm, parallel-group, single-blind, superiority randomized-controlled trial examined whether monitoring sleep using wearable devices and providing support for interpretation of sensor-based sleep data improved insomnia symptoms or impacted sleep–wake state discrepancy.

Methods

A total of 113 (age M = 47.53; SD = 14.37, 64.9% female) individuals with significant insomnia symptoms (Insomnia Severity Index(ISI) ≥10) from the community were randomized 1:1 (permuted block randomization) to receive 5 weeks (1) Intervention (n = 57): feedback about sensor-based sleep (Fitbit and EEG headband) with guidance for data interpretation and ongoing monitoring, and (2) Control (n = 56): sleep education and hygiene. Both groups received one individual session and two check-in calls. The ISI (primary outcome), sleep disturbance (SDis), sleep-related impairment (SRI), depression, and anxiety were assessed at baseline and post-intervention.

Results

In total, 103 (91.2%) participants completed the study. Intention-to-treat multiple regression with multiple imputations showed that after controlling for baseline values, compared to the Control group (n = 51), the Intervention group (n = 52) had lower ISI (p = .011, d = 0.51) and SDis (p = .036, d = 0.42) post-intervention, but differences in SRI, depression, anxiety, and sleep–wake state discrepancy parameters (total sleep time, sleep onset latency, and wake after sleep onset) were not meaningful (P-values >.40).

Conclusions

Providing feedback and guidance about sensor-based sleep parameters reduced insomnia severity and sleep disturbance but did not alter sleep–wake state discrepancy in individuals with insomnia more than sleep hygiene and education. The role of sleep wearable devices among individuals with insomnia requires further research.

Clinical Trial Registration

The Novel Insomnia Treatment Experiment (NITE): the effectiveness of incorporating appropriate guidance for sleep wearables in users with insomnia. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378452, Australia New Zealand Clinical Trials Registry: ACTRN12619001636145.
Fisetin Attenuates Cellular Senescence Accumulation During Culture Expansion of Human Adipose-Derived Stem Cells
Authors: Mullen Michael , Nelson Anna Laura , Goff Alexander , Billings Jake , Kloser Heidi , Huard Charles , Mitchell John , Hambright William Sealy , Ravuri Sudheer , Huard Johnny
Published: June 2023

Mesenchymal stem cells (MSCs) have long been viewed as a promising therapeutic for musculoskeletal repair. However, regulatory concerns including tumorgenicity, inconsistencies in preparation techniques, donor-to-donor variability, and the accumulation of senescence during culture expansion have hindered the clinical application of MSCs. Senescence is a driving mechanism for MSC dysfunction with advancing age. Often characterized by increased reactive oxygen species, senescence-associated heterochromatin foci, inflammatory cytokine secretion, and reduced proliferative capacity, senescence directly inhibits MSCs efficacy as a therapeutic for musculoskeletal regeneration. Furthermore, autologous delivery of senescent MSCs can further induce disease and aging progression through the secretion of the senescence-associated secretory phenotype (SASP) and mitigate the regenerative potential of MSCs. To alleviate these issues, the use of senolytic agents to selectively clear senescent cell populations has become popular. However, their benefits to attenuating senescence accumulation in human MSCs during the culture expansion process have not yet been elucidated. To address this, we analyzed markers of senescence during the expansion of human primary adipose-derived stem cells (ADSCs), a population of fat-resident MSCs commonly used in regenerative medicine applications. Next, we used the senolytic agent fisetin to determine if we can reduce these markers of senescence within our culture-expanded ADSC populations. Our results indicate that ADSCs acquire common markers of cellular senescence including increased reactive oxygen species, senescence-associated β-galactosidase, and senescence-associated heterochromatin foci. Furthermore, we found that the senolytic agent fisetin works in a dose-dependent manner and selectively attenuates these markers of senescence while maintaining the differentiation potential of the expanded ADSCs.
Duncan Tanner Essay Prize Winner 2022
Authors: Smith Holly
Published: June 2023

Ronan Point was a residential tower block that partially collapsed in Newham in 1968, provoking a nationwide scandal. The Ronan Point disaster is frequently cited as a symbolic ‘turning point’ in the urban history of Britain, but it has been surprisingly underexplored on an archival level. It has been identified as a moment at which high-rise architecture was overwhelmingly discredited: a defining event within narratives of ‘urban crisis’ and ‘decline’ in late twentieth-century Britain. This article proposes that the Ronan Point scandal should be understood as a moment of democratic crisis, rather than one unique to the ‘inner city’. The disaster foregrounded a profound democratic deficit within the political culture of post-war reconstruction. However, this article revises standard narratives of the Ronan Point disaster exclusively as a moment of crisis to consider it dually as a moment of possibility for the British welfare state, and for social democracy. The scandal constituted a key moment at which anti-deferential discourses were harnessed by grassroots actors to challenge the legitimacy of technocratic expertise and to lobby for a more participatory reimagination of the post-war settlement. The article goes on, nevertheless, to explore how such discourses of empowerment would also be mobilized to justify a movement away from public housing and towards owner-occupation.
Slope of the power spectral density flattens at low frequencies (<150 Hz) with healthy aging but also steepens at higher frequency (>200 Hz) in human electroencephalogram
Authors: Aggarwal Srishty , Ray Supratim
Published: June 2023

The power spectral density (PSD) of the brain signals is characterized by two distinct features: oscillations, which are represented as distinct “bumps,” and broadband aperiodic activity, that reduces in power with increasing frequency and is characterized by the slope of the power falloff. Recent studies have shown a change in the slope of the aperiodic activity with healthy aging and mental disorders. However, these studies analyzed slopes over a limited frequency range (<100 Hz). To test whether the PSD slope is affected over a wider frequency range with aging and mental disorder, we analyzed the slope till 800 Hz in electroencephalogram data recorded from elderly subjects (>49 years) who were healthy (n = 217) or had mild cognitive impairment (MCI; n = 11) or Alzheimer’s Disease (AD; n = 5). Although the slope reduced up to ~ 150 Hz with healthy aging (as shown previously), surprisingly, at higher frequencies (>200 Hz), it increased with age. These results were observed in all electrodes, for both eyes open and eyes closed conditions, and for different reference schemes. However, slopes were not significantly different in MCI/AD subjects compared with healthy controls. Overall, our results constrain the biophysical mechanisms that are reflected in the PSD slopes in healthy and pathological aging.
Inhibition of DNA and RNA methylation disturbs root development of moso bamboo
Authors: Liufu Yuxiang , Xi Feihu , Wu Lin , Zhang Zeyu , Wang Huihui , Wang Huiyuan , Zhang Jun , Wang Baijie , Kou Wenjing , Gao Jian , Zhao Liangzhen , Zhang Hangxiao , Gu Lianfeng
Published: June 2023

DNA methylation (5mC) and N6-methyladenosine (m6A) are two important epigenetics regulators, which have a profound impact on plant growth development. Phyllostachys edulis (P. edulis) is one of the fastest spreading plants due to its well-developed root system. However, the association between 5mC and m6A has seldom been reported in P. edulis. In particular, the connection between m6A and several post-transcriptional regulators remains uncharacterized in P. edulis. Here, our morphological and electron microscope observations showed the phenotype of increased lateral root under RNA methylation inhibitor (DZnepA) and DNA methylation inhibitor (5-azaC) treatment. RNA epitranscriptome based on Nanopore direct RNA sequencing revealed that DZnepA treatment exhibits significantly decreased m6A level in the 3′-untranslated region (3′-UTR), which was accompanied by increased gene expression, full-length ratio, higher proximal poly(A) site usage and shorter poly(A) tail length. DNA methylation levels of CG and CHG were reduced in both coding sequencing and transposable element upon 5-azaC treatment. Cell wall synthesis was impaired under methylation inhibition. In particular, differentially expressed genes showed a high percentage of overlap between DZnepA and 5-azaC treatment, which suggested a potential correlation between two methylations. This study provides preliminary information for a better understanding of the link between m6A and 5mC in root development of moso bamboo.
The hidden diversity of ancient bornaviral sequences from X and P genes in vertebrate genomes
Authors: Garcia Bea Clarise B , Mukai Yahiro , Tomonaga Keizo , Horie Masayuki
Published: June 2023

Endogenous bornavirus–like elements (EBLs) are heritable sequences derived from bornaviruses in vertebrate genomes that originate from transcripts of ancient bornaviruses. EBLs have been detected using sequence similarity searches such as tBLASTn, whose technical limitations may hinder the detection of EBLs derived from small and/or rapidly evolving viral X and P genes. Indeed, no EBLs derived from the X and P genes of orthobornaviruses have been detected to date in vertebrate genomes. Here, we aimed to develop a novel strategy to detect such ‘hidden’ EBLs. To this aim, we focused on the 1.9-kb read-through transcript of orthobornaviruses, which encodes a well-conserved N gene and small and rapidly evolving X and P genes. We show a series of evidence supporting the existence of EBLs derived from orthobornaviral X and P genes (EBLX/Ps) in mammalian genomes. Furthermore, we found that an EBLX/P is expressed as a fusion transcript with the cellular gene, ZNF451, which potentially encodes the ZNF451/EBLP fusion protein in miniopterid bat cells. This study contributes to a deeper understanding of ancient bornaviruses and co-evolution between bornaviruses and their hosts. Furthermore, our data suggest that endogenous viral elements are more abundant than those previously appreciated using BLAST searches alone, and further studies are required to understand ancient viruses more accurately.
Changes in Private Pensions and Income Inequality in Retirement: A Decomposition Analysis by Income Source in Nine European Countries (1986–2018)
Authors: Doctrinal Laure
Published: June 2023

Private pensions have expanded in recent decades in many European countries, albeit to different extent. As private pensions historically have been more unequally distributed than public pensions, it is reasonable to expect that pension privatization has increased the dispersion of incomes among the retired. However, few studies have empirically tested this claim. The purpose of this study is to assess how the expansion of private pensions affects developments of income inequality among the retired. Using microdata from the Luxembourg Income Study, decomposition analyses of income inequality by income source are conducted around 1986 and 2018 in nine European countries. To account for cross-country variations in the public–private pension mix, the study distinguishes between mature multi-pillar systems, emergent multi-pillar systems, and dominant public systems. The results highlight an interesting paradox. Higher shares of private pensions in retirement incomes have a substantial inequality-increasing effect; yet, overall income inequality among the retired has not necessarily increased, for 2 reasons. First, more equally distributed public pensions in emergent multi-pillar systems and declining shares of capital income in mature multi-pillar systems either fully or partially compensated for increased inequality due to larger shares of private pensions. Second, private pensions became more equally distributed among the retired in most countries.
Opioid Utilization After Scoliosis Surgery is Greater in Marfan Syndrome Than Adolescent Idiopathic Scoliosis
Authors: Benes Gregory A. , Hunsberger Joann B. , Dietz Harry C. , Sponseller Paul D.
Published: June 2023

Study Design:

Retrospective matched case cohort.

Objective:

Compare postoperative opioid utilization and prescribing behaviors between patients with Marfan syndrome (MFS) and adolescent idiopathic scoliosis (AIS) after posterior spinal fusion (PSF).

Summary of Background Data:

Opioids are an essential component of pain management after PSF. However, due to the potential for opioid use disorder and dependence, current analgesic strategies aim to minimize their use, especially in younger patients. Limited information exists on opioid utilization after PSF for syndromic scoliosis.

Patients and Methods:

Twenty adolescents undergoing PSF with MFS were matched with patients with AIS (ratio, 1:2) by age, sex, degree of spinal deformity, and the number of vertebral levels fused. Inpatient and outpatient pharmaceutical data were reviewed for the quantity and duration of opioid and adjunct medications. Prescriptions were converted to morphine milligram equivalents (MMEs) using CDC’s standard conversion factor.

Results:

Compared with patients with AIS, patients with MFS had significantly greater total inpatient MME use (4.9 vs. 2.1 mg/kg, P ≤ 0.001) and longer duration of intravenous patient-controlled anesthesia (3.4 vs. 2.5 d, P = 0.001). Within the first 2 postop days, MFS patients had more patient-controlled anesthesia boluses (91 vs. 52 boluses, P = 0.01) despite similar pain scores and greater use of adjunct medications. After accounting for prior opioid use, MFS was the only significant predictor of requesting an opioid prescription after discharge (odds ratio: 4.1, 95% CI: 1.1–14.9, P = 0.03). Patients with MFS were also more likely to be discharged with a more potent prescription (1.0 vs. 0.72 MME per day/kg, P ≤ 0.001) and to receive a longer-duration prescription (13 vs. 8 d, P = 0.005) with a greater MME/kg (11.6 vs. 5.6 mg/kg, P ≤ 0.001) as outpatients.

Conclusion:

Despite a similar intervention, patients with MFS and AIS seem to differ in their postoperative opioid usage after PSF, presenting an opportunity for further research to assist clinicians in better anticipating the analgesic needs of individual patients, particularly in light of the ongoing opioid epidemic.
Biomechanical Computational Study of Pedicle Screw Position and Density in Adolescent Idiopathic Scoliosis Instrumentation
Authors: Wang Xiaoyu , Larson A. Noelle , Polly David W. , Aubin Carl-Eric
Published: June 2023

Study Design:

Computer simulation of adolescent idiopathic scoliosis instrumentation.

Objective:

To test the hypothesis that different screw densities would result in different apical vertebral rotation (AVR) corrections and bone-screw forces in adolescent idiopathic scoliosis instrumentation.

Summary of Background Data:

The “Minimize Implants Maximize Outcomes” Clinical Trial revealed that the use of more versus fewer screws resulted in similar coronal plane correction for Lenke 1A curves. However, the biomechanical impact of screw density on transverse plane correction is still unclear. Further investigation is needed to determine if and how transverse plane correction is correlated with screw density.

Patients and Methods:

We simulated apical vertebral derotation after segmental translation using patient-specific computer models of 30 patients from the “Minimize Implants Maximize Outcomes” Trial. For each case, 10 alternative screw patterns were tested with overall densities ranging between 1.2 and 2 screws per level fused, and local density at the 3 apical levels ranging between 0.7 and 2 (total: 600 simulations). Main thoracic (MT) Cobb angle, thoracic kyphosis (TK), AVR, and bone-screw forces were computed and compared.

Results:

The presenting MT (62 ± 11°; range: 45° to 86°), TK (27 ± 20°; −5° to 81°), and AVR (14±7°; −2° to 25°) were corrected through segmental translation to 22 ± 7° (10° to 41°), 26 ± 5° (18° to 45°), and 14 ± 7° (−4° to 26°). After apical vertebral derotation, they became 16 ± 8° (1° to 41°), 24 ± 4° (13° to 40°), and 4 ± 5° (−12° to 18°). There was no significant difference in MT among screw patterns; higher screw density had lower bone-screw forces (P < 0.05). The apical vertebral derotation maneuver reduced AVR by an average of 70%, positively correlated with apical screw density (r = 0.825, P < 0.05). There was no significant difference in TK.

Conclusion:

Screw density had no significant effect on 3-dimensional correction through the primary segmental translation maneuver. Transverse plane correction through subsequent apical vertebral derotation was positively correlated with screw density at the apical levels (r = 0.825, P < 0.05). Bone-screw forces were negatively correlated with overall screw density (P < 0.05).
Multiple Electrolytes Solution Versus Saline as Bolus Fluid for Resuscitation in Pediatric Septic Shock: A Multicenter Randomized Clinical Trial*
Authors: Sankar Jhuma , Muralidharan Jayashree , Lalitha A. V. , Rameshkumar Ramachandran , Pathak Mona , Das Rashmi Ranjan , Nadkarni Vinay M. , Ismail Javed , Subramanian Mahadevan , Nallasamy Karthi , Dev Nishanth , Kumar U. Vijay , Kumar Kiran , Sharma Taniya , Jaravta Kanika , Thakur Neha , Aggarwal Praveen , Jat Kana Ram , Kabra S. K. , Lodha Rakesh
Published: June 2023

OBJECTIVE:

To determine if initial fluid resuscitation with balanced crystalloid (e.g., multiple electrolytes solution [MES]) or 0.9% saline adversely affects kidney function in children with septic shock.

DESIGN:

Parallel-group, blinded multicenter trial.

SETTING:

PICUs of four tertiary care centers in India from 2017 to 2020.

PATIENTS:

Children up to 15 years of age with septic shock.

METHODS:

Children were randomized to receive fluid boluses of either MES (PlasmaLyte A) or 0.9% saline at the time of identification of shock. All children were managed as per standard protocols and monitored until discharge/death. The primary outcome was new and/or progressive acute kidney injury (AKI), at any time within the first 7 days of fluid resuscitation. Key secondary outcomes included hyperchloremia, any adverse event (AE), at 24, 48, and 72 hours, and all-cause ICU mortality.

INTERVENTIONS:

MES solution (n = 351) versus 0.9% saline (n = 357) for bolus fluid resuscitation during the first 7 days.

MEASUREMENTS AND MAIN RESULTS:

The median age was 5 years (interquartile range, 1.3–9); 302 (43%) were girls. The relative risk (RR) for meeting the criteria for new and/or progressive AKI was 0.62 (95% CI, 0.49–0.80; p < 0.001), favoring the MES (21%) versus the saline (33%) group. The proportions of children with hyperchloremia were lower in the MES versus the saline group at 24, 48, and 72 hours. There was no difference in the ICU mortality (33% in the MES vs 34% in the saline group). There was no difference with regard to infusion-related AEs such as fever, thrombophlebitis, or fluid overload between the groups.

CONCLUSIONS:

Among children presenting with septic shock, fluid resuscitation with MES (balanced crystalloid) as compared with 0.9% saline resulted in a significantly lower incidence of new and/or progressive AKI during the first 7 days of hospitalization.
Treatment and Prevention of Umbilical Sagging with Laser-assisted Liposuction: The New Happy Protocol
Authors: Faustino Leandro D. , Cruciol Felipe S. , Motoki Thamy H. C. , Figueiredo Igor A.T. S. , Garcia Arthur F. E. , Nahas Fábio X. , Ferreira Lydia M.
Published: June 2023

Sagging of the periumbilical skin, also known as the “sad umbilicus,” is one of the most common postoperative complications in liposuction. It is characterized by an increase in the width and decrease in the height of the umbilicus. Technological advances in power-assisted liposuction resulting in skin tightening have been central to improvements in the treatment of sagging skin. Laser-assisted liposuction is a procedure in which a laser fiber induces lipolysis and skin tightening. Laser treatment delivered using a 980-nm diode laser may result in up to 30% skin surface area contraction. The aim of this study was to describe a new technique called the “happy protocol” for the treatment and prevention of the sad umbilicus. The periumbilical region is treated using a 980-nm diode laser set to an output power of 20 W, with a total delivered energy of 5000 J. The developed technique may be applied to correct shape distortions or to create a natural-looking and aesthetically pleasant umbilicus during liposuction. A decrease in the width of the umbilicus followed by an increase in height are observed in the first postoperative days. Patients who were followed up for 7 months postoperatively showed positive aesthetic results. The final outcome was an oval-shaped umbilicus, with increased height and reduced sagging in the periumbilical region.
Brassiere Cup Size Agreement between Patients and Plastic Surgeons: Do Surgeons and Patients Speak the Same Size Language?
Authors: Sandberg Lars Johan , Tønseth Kim , Kloster-Jensen Kristine , Reece Gregory , Selber Jesse Creed
Published: June 2023

Background:

Patients undergoing plastic surgery of the breasts often communicate their size expectations as a brassiere cup size. However, multiple factors may cause a miscommunication between the surgeon and patient when brassiere cup size is used as a measure of results. The aim of this study was to determine the degree of agreement between disclosed and estimated brassiere cup size and also interrater agreement.

Methods:

Three-dimensional (3D) scans of 32 subjects were evaluated by 10 plastic surgeons estimating cup size using the American brassiere system. The surgeons were blinded to all parameters, including the 3D surface software-derived volume measures of the Vectra scan. The 3D scans of the anterior torsos were viewed. The plastic surgeons’ estimations were compared with the cup sizes stated by the subjects (disclosed cup size), using simple and weighted Kappa statistics.

Results:

Agreement between the estimated and disclosed brassiere sizes was only slight (0.1479 ± 0.0605) using a simple Kappa analysis. Even when a Fleiss-Cohen–weighted comparison was used, only moderate agreement (0.6231 ± 0.0589) was found. The interrater agreement intraclass correlation coefficient was 0.705. Rater accuracy varied. The percentage of time spent in cosmetic practice and gender were not significantly correlated with accuracy.

Conclusions:

Agreement between cup size disclosed by subjects and estimates by plastic surgeons was low. A miscommunication between the surgeon and patient may occur when using brassiere sizes to communicate wishes and estimates in procedures that involve changes in breast volume.
Tear Trough Filler Using the Three-point Tangent Technique: Lessons from 1452 Tear Trough Applications
Authors: Wilde Caroline L. , Gupta Ankur , Lee Sieun , Ezra Daniel G.
Published: June 2023

Background:

This study describes a novel three-point tangent technique for tear trough filler and the results from the largest series to date.

Methods:

A retrospective case review was performed for all patients treated between 2016 and 2020. Patient demographics, filler details and complications were recorded. The injection technique involves using a blunt cannula to deliver filler along three linear tangents bespoke to each patient.

Results:

A total of 1452 applications of filler to the orbits of 583 patients were recorded. The median patient age was 41 years (range 19–77), and 84% were women. The mean volume of applied filler at the first appointment was 0.34 mL to each orbit (range 0.1–-1.5); 82% reported no complication, 10% reported swelling with a median duration of 4 weeks (range 1–52), 4.3% experienced bruising, 4.6% reported contour irregularities, and 3.3% experienced a Tyndall effect. Retrobulbar hemorrhage occurred in one patient (0.17%), which was managed immediately with no lasting visual compromise. Volume of filler injected was significantly associated with a risk of edema (P < 0.00001) and contour irregularities (P = 0.012). In total, 50% of cases of edema resolved spontaneously after 4 weeks. Filler was dissolved in 1.9% of orbits. Patients with a history of dissolving were significantly more likely to require dissolving after subsequent reinjection (P = 0.043).

Conclusions:

The three-point tangent technique is a safe and effective method. Increasing volume of filler administered is associated with complications of edema and contour irregularities. Edema is the most common complication and resolves spontaneously in half of patients by 4 weeks.
Local Dose Coefficients for Radionuclide Contamination in Wounds
Authors: Galipeau Natasha , Sugarman Stephen L. , Waller Edward
Published: June 2023

When a radiation accident has occurred that leads to radioactive material being imparted to a wound, this is treated as an internal contamination scenario. It is common for the material to transport throughout the body based upon biokinetics of the material in the body. While standard internal dosimetry approaches can be used to estimate committed effective dose from the insult, some material may get fixed for longer periods of time at the wound location, even after medical procedures such as decontamination and debridement have been applied. In this case, the radioactive material becomes a local dose contributor. This research was to generate local dose coefficients for radionuclide-contaminated wounds to supplement committed effective dose coefficients. These dose coefficients can be used to calculate activity limits at the wound site that could lead to a clinically significant dose. This is useful for emergency response to assist in decisions on medical treatment, including decorporation therapy. Wound models were created for injections, lacerations, abrasions, and burns, and the MCNP radiation transport code was used to simulate the dose to tissue considering 38 radionuclides. Biokinetic models accounted for biological removal of the radionuclides from the wound site. It was found that radionuclides that are not retained well at the wound site are likely of little concern locally, but for highly retained radionuclides, estimated local doses may require further investigation by medical and health physics personnel.
Evaluation of Low-dose Radiation-induced DNA Damage and Repair in 3D Printed Human Cellular Constructs
Authors: Chai Wenxuan , Kong Yunfan , Escalona Maria B. , Hu Chunshan , Balajee Adayabalam S. , Huang Yong
Published: June 2023

DNA double-strand breaks (DSBs) induced by ionizing radiation (IR) are considered to be the most critical lesion that when unrepaired or misrepaired leads to genomic instability or cell death depending on the radiation exposure dose. The potential health risks associated with exposures of low-dose radiation are of concern since they are being increasingly used in diverse medical and non-medical applications. Here, we have used a novel human tissue-like 3-dimensional bioprint to evaluate low-dose radiation-induced DNA damage response. For the generation of 3-dimensional tissue-like constructs, human hTERT immortalized foreskin fibroblast BJ1 cells were extrusion printed and further enzymatically gelled in a gellan microgel-based support bath. Low-dose radiation-induced DSBs and repair were analyzed in the tissue-like bioprints by indirect immunofluorescence using a well-known DSB surrogate marker, 53BP1, at different post-irradiation times (0.5 h, 6 h, and 24 h) after treatment with various doses of γ rays (50 mGy, 100 mGy, and 200 mGy). The 53BP1 foci showed a dose dependent induction in the tissue bioprints after 30 min of radiation exposure and subsequently declined at 6 h and 24 h in a dose-dependent manner. The residual 53BP1 foci number observed at 24 h post-irradiation time for the γ-ray doses of 50 mGy, 100 mGy, and 200 mGy was not statistically different from mock treated bioprints illustrative of an efficient DNA repair response at these low-dose exposures. Similar results were obtained for yet another DSB surrogate marker, γ-H2AX (phosphorylated form of histone H2A variant) in the human tissue-like constructs. Although we have primarily used foreskin fibroblasts, our bioprinting approach—mimicking a human tissue-like microenvironment—can be extended to different organ-specific cell types for evaluating the radio-response at low-dose and dose-rates of IR.