bluuebunny/crossref_metadata_2025 huggingface dataset:
Work flexibility and firm growth: evidence from LEED data on the Emilia-Romagna region
Authors: Arrighetti Alessandro , Cattani Luca , Landini Fabio , Lasagni Andrea
Published: March 2021

In the last decades, work flexibility emerged as a key requirement firms must meet to face volatile markets and highly differentiated product demand. This article compares two alternative approaches to strengthen work flexibility: internal flexibility, that is, practices that focus on the employees’ ability to perform a variety of highly qualified tasks in a context of stable employment relationships; and external flexibility, that is, practices that align employment and labor costs to demand fluctuations using a buffer of nonstandard employees involved in routine tasks. We empirically verify whether both practices are able to boost sales growth using a linked employer-employee panel of manufacturing firms from the Emilia-Romagna region (Italy). While internal flexibility positively affects firm growth, external flexibility is at best not significant, and in some empirical specifications, it appears to hamper firm growth. Such a negative effect, however, decreases when we limit the analysis to industries with high demand volatility and cost-based competition. The related managerial and policy implications are discussed.
The Continued Challenges in the Diagnosis of Acute Pelvic Inflammatory Disease: Focus on Clinically Mild Disease
Authors: Soper David E , Wiesenfeld Harold C
Published: March 2021

Many women with lower genital tract infections associated with sexually transmitted pathogens have evidence of upper genital tract inflammation despite the absence of symptoms and signs traditionally associated with pelvic inflammatory disease (PID). New biomarkers are needed to identify these women with clinically mild PID or subclinical PID (silent salpingitis) to facilitate initiation of early treatment and ameliorate the sequelae associated with upper genital tract infection and inflammation.
The Time is Now: A Call for Renewed Support of Infectious Diseases Physician-Scientist Trainees in the Era of Coronavirus Disease 2019
Authors: Queen Jessica , Karaba Sara , Albin John , Karaba Andrew , Howard-Anderson Jessica , Skinner Nicole , Herman Jonathan David , Paras Molly L , Melia Michael T
Published: March 2021

Infectious diseases fellows’ futures have been uniquely imperiled by the pandemic. In this article, we issue a call to action to sustain their careers as the future leaders of infectious diseases inquiry.
Foodways and Foodwashing: Israeli Cookbooks and the Politics of Culinary Zionism
Authors: Baron Ilan Zvi , Press-Barnathan Galia
Published: March 2021

The paper explores the political narratives produced in English-language Israeli cookbooks. We examine an understudied, yet central component of everyday international relations, everyday nationalism, and identity contestations as practiced through gastronomy, and highlight the dilemma between the different political uses of popular culture in the context of conflict resolution and resistance. Our argument identifies different narratives represented in what we term Culinary Zionism. One narrative is explicitly political, discusses Israeli cuisine as a foodway, and contributes to creating a space of, and a path for, coexistence and recognition of the Other. A second narrative is found in tourist-orientated cookbooks that offer a supposedly apolitical story of culinary tours in Israel. We problematize the political and normative implications of these narratives by exploring the potential role of these books to open space for dialogue and to increase the familiarity and interest of foreign audiences of Israel and the conflict. We contrast this possibility with their potential to what we term foodwashing, namely the process of using food to symbolically wash over violence and injustices (the violence of the Israeli–Palestinian conflict in this case).
Robust suicide risk assessment on social media via deep adversarial learning
Authors: Sawhney Ramit , Joshi Harshit , Gandhi Saumya , Jin Di , Shah Rajiv Ratn
Published: March 2021

Objective

The prevalence of social media for sharing personal thoughts makes it a viable platform for the assessment of suicide risk. However, deep learning models are not able to capture the diverse nature of linguistic choices and temporal patterns that can be exhibited by a suicidal user on social media and end up overfitting on specific cues that are not generally applicable. We propose Adversarial Suicide assessment Hierarchical Attention (ASHA), a hierarchical attention model that employs adversarial learning for improving the generalization ability of the model.

Material and Methods

We assess the suicide risk of a social media user across 5 levels of increasing severity of risk. ASHA leverages a transformer-based architecture to learn the semantic nature of social media posts and a temporal attention-based long short-term memory architecture for the sequential modeling of a user’s historical posts. We dynamically generate adversarial examples by adding perturbations to actual examples that can simulate the stochasticity in historical posts, thereby making the model robust.

Results

Through extensive experiments, we establish the face-value of ASHA and show that it significantly outperforms existing baselines, with the F1 score of 64%. This is a 2% and a 4% increase over the ContextBERT and ContextCNN baselines, respectively. Finally, we discuss the practical applicability and ethical aspects of our work pertaining to ASHA, as a human-in-the-loop framework.

Discussion and Conclusions

Adversarial samples can be helpful in capturing the diverse nature of suicidal ideation. Through ASHA, we hope to form a component in a larger human-in-the-loop infrastructure for suicide risk assessment on social media.
Incorporating real-world evidence into the development of patient blood glucose prediction algorithms for the ICU
Authors: Fitzgerald Oisin , Perez-Concha Oscar , Gallego Blanca , Saxena Manoj K , Rudd Lachlan , Metke-Jimenez Alejandro , Jorm Louisa
Published: March 2021

Objective

Glycemic control is an important component of critical care. We present a data-driven method for predicting intensive care unit (ICU) patient response to glycemic control protocols while accounting for patient heterogeneity and variations in care.

Materials and Methods

Using electronic medical records (EMRs) of 18 961 ICU admissions from the MIMIC-III dataset, including 318 574 blood glucose measurements, we train and validate a gradient boosted tree machine learning (ML) algorithm to forecast patient blood glucose and a 95% prediction interval at 2-hour intervals. The model uses as inputs irregular multivariate time series data relating to recent in-patient medical history and glycemic control, including previous blood glucose, nutrition, and insulin dosing.

Results

Our forecasting model using routinely collected EMRs achieves performance comparable to previous models developed in planned research studies using continuous blood glucose monitoring. Model error, expressed as mean absolute percentage error is 16.5%–16.8%, with Clarke error grid analysis demonstrating that 97% of predictions would be clinically acceptable. The 95% prediction intervals achieve near intended coverage at 93%–94%.

Discussion

ML algorithms built on observational data sources, such as EMRs, present a promising approach for personalization and automation of glycemic control in critical care. Future research may benefit from applying a combination of methodologies and data sources to develop robust methodologies that account for the variations seen in ICU patients and difficultly in detecting the extremes of observed blood glucose values.

Conclusion

We demonstrate that EMRs can be used to train ML algorithms that may be suitable for incorporation into ICU decision support systems.
The Ambivalence of the Hindus: The Buddha as Avatāra of Viṣṇu in the Mahāpurāṇas and Beyond
Authors: Clough Bradley S
Published: March 2021

This article examines the formation of Vaiṣṇava theology’s conception of the Buddha as an avatāra or ‘divine incarnation’ of their Supreme Lord Viṣṇu, with a focus on the mahāpurāṇas. My aim is to move beyond the synthetic kinds of treatment that have typified most of the scholarly investigations of this phenomenon, by attending more closely to the dynamic historical development of the Buddhāvatāra idea than previous efforts appear to have done. Contrary to conclusions drawn by earlier studies, which assert that this concept followed decidedly unidirectional and unvarying patterns of development, the thesis that I will support maintains that great variety and ambivalence is evident in this idea’s creation and articulation in these vitally central Hindu scriptures.
Dosimetry of radon progeny deposited on skin in air and thermal water
Authors: Sakoda Akihiro , Ishimori Yuu , Kanzaki Norie , Tanaka Hiroshi , Kataoka Takahiro , Mitsunobu Fumihiro , Yamaoka Kiyonori
Published: March 2021

It is held that the skin dose from radon progeny is not negligibly small and that introducing cancer is a possible consequence under normal circumstances as there are a number of uncertainties in terms of related parameters such as activity concentrations in air and water, target cells in skin, skin covering materials, and deposition velocities. An interesting proposal has emerged in that skin exposure to natural radon-rich thermal water as part of balneotherapy can produce an immune response to induce beneficial health effects. The goal of this study was to obtain generic dose coefficients with a focus on the radon progeny deposited on the skin in air or water in relation to risk or treatment assessments. We thus first estimated the skin deposition velocities of radon progeny in air and thermal water based on data from the latest human studies. Skin dosimetry was then performed under different assumptions regarding alpha-emitting source position and target cell (i.e. basal cells or Langerhans cells). Furthermore, the impact of the radon progeny deposition on effective doses from all exposure pathways relating to ‘radon exposure’ was assessed using various possible scenarios. It was found that in both exposure media, effective doses from radon progeny inhalation are one to four orders of magnitude higher than those from the other pathways. In addition, absorbed doses on the skin can be the highest among all pathways when the radon activity concentrations in water are two or more orders of magnitude higher than those in air.
Moderating Uncertainty: The Reception of Refugee Children in the German Early Childhood Education and Care Sector
Authors: Scholz Antonia
Published: March 2021

Located at the crossroads of integration and early childhood education and care (ECEC) policies, this article draws on empirical research conducted from the perspective of ECEC centres to provide insights into the local reception of refugee children in Germany. In recent years, the ECEC sector in Germany has faced the challenge of organizing access to childcare for many newly arrived children and their families—a process that has been shaped by uncertainty for policymakers and service providers alike. The article analyses data from the first survey among ECEC centres throughout Germany on this topic. It sheds light on enrolment patterns of refugee children, admission procedures, support structures and local collaboration. The results reveal the uncertainties that ECEC centres faced after the 2015 ‘refugee crisis’, and their diverse approaches. To better understand the role of ECEC centres as crucial actors in local integration processes, a conceptualization as ‘street-level’ organizations is suggested.
Mycobacterium mucogenicum Infection in a Patient with an Open Fracture: A Case Report
Authors: Li Wanxiang , Li Min , Liu Mi , Ma Jie
Published: March 2021

Mycobacterium mucogenicum is a nontuberculous mycobacterium that is ubiquitous in nature. However, M. mucogenicum infection in patients with orthopedic trauma is rarely reported in the literature. Herein, we describe a 48 year old male Han Chinese patient whose right leg was squeezed by agricultural machinery, resulting in open tibial fractures. Postoperative antimicrobial treatment was administered because the wound had been contaminated by soil. However, no long-term wound closure occurred, and a culture of the wound exudation tested positive for M. mucogenicum. We established the clinical treatment plan according to the characteristics and drug sensitivity test results of M. mucogenicum, and the patient was discharged uneventfully. Increasingly, more reports of infection caused by nontuberculous mycobacteria are being published; however, to our knowledge, this is the first report of an orthopedic infection caused by M. mucogenicum. Because the treatment process of M. mucogenicum infection is long and complex, isolation and identification of M. mucogenicum are of great significance to effective clinical treatment.
The Evolution of Sox Gene Repertoires and Regulation of Segmentation in Arachnids
Authors: Baudouin-Gonzalez Luis , Schoenauer Anna , Harper Amber , Blakeley Grace , Seiter Michael , Arif Saad , Sumner-Rooney Lauren , Russell Steven , Sharma Prashant P , McGregor Alistair P
Published: March 2021

The Sox family of transcription factors regulates many processes during metazoan development, including stem cell maintenance and nervous system specification. Characterizing the repertoires and roles of these genes can therefore provide important insights into animal evolution and development. We further characterized the Sox repertoires of several arachnid species with and without an ancestral whole-genome duplication and compared their expression between the spider Parasteatoda tepidariorum and the harvestman Phalangium opilio. We found that most Sox families have been retained as ohnologs after whole-genome duplication and evidence for potential subfunctionalization and/or neofunctionalization events. Our results also suggest that Sox21b-1 likely regulated segmentation ancestrally in arachnids, playing a similar role to the closely related SoxB gene, Dichaete, in insects. We previously showed that Sox21b-1 is required for the simultaneous formation of prosomal segments and sequential addition of opisthosomal segments in P. tepidariorum. We studied the expression and function of Sox21b-1 further in this spider and found that although this gene regulates the generation of both prosomal and opisthosomal segments, it plays different roles in the formation of these tagmata reflecting their contrasting modes of segmentation and deployment of gene regulatory networks with different architectures.
Ablation of Mto1 in zebrafish exhibited hypertrophic cardiomyopathy manifested by mitochondrion RNA maturation deficiency
Authors: Zhang Qinghai , He Xiao , Yao Shihao , Lin Tianxiang , Zhang Luwen , Chen Danni , Chen Chao , Yang Qingxian , Li Feng , Zhu Yi-Min , Guan Min-Xin
Published: March 2021

Deficient maturations of mitochondrial transcripts are linked to clinical abnormalities but their pathophysiology remains elusive. Previous investigations showed that pathogenic variants in MTO1 for the biosynthesis of τm5U of tRNAGlu, tRNAGln, tRNALys, tRNATrp and tRNALeu(UUR) were associated with hypertrophic cardiomyopathy (HCM). Using mto1 knock-out(KO) zebrafish generated by CRISPR/Cas9 system, we demonstrated the pleiotropic effects of Mto1 deficiency on mitochondrial RNA maturations. The perturbed structure and stability of tRNAs caused by mto1 deletion were evidenced by conformation changes and sensitivity to S1-mediated digestion of tRNAGln, tRNALys, tRNATrp and tRNALeu(UUR). Notably, mto1KO zebrafish exhibited the global decreases in the aminoacylation of mitochondrial tRNAs with the taurine modification. Strikingly, ablated mto1 mediated the expression of MTPAP and caused the altered polyadenylation of cox1, cox3, and nd1 mRNAs. Immunoprecipitation assay indicated the interaction of MTO1 with MTPAP related to mRNA polyadenylation. These alterations impaired mitochondrial translation and reduced activities of oxidative phosphorylation complexes. These mitochondria dysfunctions caused heart development defects and hypertrophy of cardiomyocytes and myocardial fiber disarray in ventricles. These cardiac defects in the mto1KO zebrafish recapitulated the clinical phenotypes in HCM patients carrying the MTO1 mutation(s). Our findings highlighted the critical role of MTO1 in mitochondrial transcript maturation and their pathological consequences in hypertrophic cardiomyopathy.
The Pif1 helicase is actively inhibited during meiotic recombination which restrains gene conversion tract length
Authors: Vernekar Dipti Vinayak , Reginato Giordano , Adam Céline , Ranjha Lepakshi , Dingli Florent , Marsolier Marie-Claude , Loew Damarys , Guérois Raphaël , Llorente Bertrand , Cejka Petr , Borde Valérie
Published: March 2021

Meiotic recombination ensures proper chromosome segregation to form viable gametes and results in gene conversions events between homologs. Conversion tracts are shorter in meiosis than in mitotically dividing cells. This results at least in part from the binding of a complex, containing the Mer3 helicase and the MutLβ heterodimer, to meiotic recombination intermediates. The molecular actors inhibited by this complex are elusive. The Pif1 DNA helicase is known to stimulate DNA polymerase delta (Pol δ) -mediated DNA synthesis from D-loops, allowing long synthesis required for break-induced replication. We show that Pif1 is also recruited genome wide to meiotic DNA double-strand break (DSB) sites. We further show that Pif1, through its interaction with PCNA, is required for the long gene conversions observed in the absence of MutLβ recruitment to recombination sites. In vivo, Mer3 interacts with the PCNA clamp loader RFC, and in vitro, Mer3-MutLβ ensemble inhibits Pif1-stimulated D-loop extension by Pol δ and RFC-PCNA. Mechanistically, our results suggest that Mer3-MutLβ may compete with Pif1 for binding to RFC-PCNA. Taken together, our data show that Pif1’s activity that promotes meiotic DNA repair synthesis is restrained by the Mer3-MutLβ ensemble which in turn prevents long gene conversion tracts and possibly associated mutagenesis.
The HIV-1 nucleocapsid chaperone protein forms locally compacted globules on long double-stranded DNA
Authors: Jiang Kai , Humbert Nicolas , K.K. Sriram , Rouzina Ioulia , Mely Yves , Westerlund Fredrik
Published: March 2021

The nucleocapsid (NC) protein plays key roles in Human Immunodeficiency Virus 1 (HIV-1) replication, notably by condensing and protecting the viral RNA genome and by chaperoning its reverse transcription into double-stranded DNA (dsDNA). Recent findings suggest that integration of viral dsDNA into the host genome, and hence productive infection, is linked to a small subpopulation of viral complexes where reverse transcription was completed within the intact capsid. Therefore, the synthesized dsDNA has to be tightly compacted, most likely by NC, to prevent breaking of the capsid in these complexes. To investigate NC’s ability to compact viral dsDNA, we here characterize the compaction of single dsDNA molecules under unsaturated NC binding conditions using nanofluidic channels. Compaction is shown to result from accumulation of NC at one or few compaction sites, which leads to small dsDNA condensates. NC preferentially initiates compaction at flexible regions along the dsDNA, such as AT-rich regions and DNA ends. Upon further NC binding, these condensates develop into a globular state containing the whole dsDNA molecule. These findings support NC’s role in viral dsDNA compaction within the mature HIV-1 capsid and suggest a possible scenario for the gradual dsDNA decondensation upon capsid uncoating and NC loss.
Letter to the editor regarding “Omega-3 fats in pregnancy: could a targeted approach lead to better metabolic health for children?”
Authors: Rice Harry B , Bannenberg Gerard
Published: March 2021

The purpose of our letter to the editor is to offer additional perspective regarding 4 statements that do not fully represent the totality of the available scientific evidence. The 4 statements are as follows: (1) “Multiple studies have shown that n-3 PUFA products frequently have less n-3 PUFA content than labelled”; (2) “Recently, krill oil supplementation was shown to induce insulin resistance, indicating that it is potentially harmful”; (3) “… fish oil products are frequently oxidized at the time of purchase”; and (4) “In rats, supplementation with oxidized fish oil during pregnancy induced persistent maternal insulin resistance and increased neonatal mortality rate.” We respectfully request the authors’ future publications consider the totality of the available scientific evidence.
Police Treatment of the Public in Police Stations: Evidence from Zaria, Nigeria
Authors: Arisukwu Ogadimma , Adebisi Tunde , Igbolekwu Chisaa , Asamu Festus
Published: March 2021

The police occupy a very important position in the entire criminal justice system in Nigeria. The nature of police relationship with the people and the manner in which the public were handled at the station and on the street daily within the community affects the way the people perceive them and the level of cooperation they get from the people in curbing crime in the society. The study took place in Zaria, Kaduna state, Northern Nigeria. A study population was the police in Zaria. Three police stations (Zaria City, Sabon Gari, and Samaru police stations) were purposively selected reflecting the socio-cultural and demographic backgrounds of Zaria residence and population. The Divisional Police officers and police officers in-charge of crime were interviewed. The police crime and incidence records were examined while the general conduct and social atmosphere of the police and police stations were observed. Using in-depth interview, observational method, and police records, it was discovered that the socio-economic status of suspects affected how they were treated by the police in the police stations studied. Also, the environment suspect lives affected how they were treated too by the police. It was recommended that the police make the rule of law their guide in the handling of suspects in the police stations irrespective of socio-demographic variable or area of habitation of the suspects. Police brutality and violations of citizen’s rights should be checked by senior police officers, while community-policing style should be implemented across communities in Nigeria.
Spotlight on community engagement: NICE resources in the context of COVID-19—NICE public health guidance update
Authors: Maiden Hannah , Jagroo James , Shearn Peter , Wasielewska Anna , Nolan Kay , Baillie Nick
Published: March 2021

This article focuses on how the National Institute for Health and Care Excellence (NICE) quality standard on ‘Community engagement: improving health and wellbeing’ (QS148) may be used to support local areas with pandemic recovery planning. This article sets the standard in the context of the coronavirus pandemic, explores some of its content and highlights additional NICE resources to support its use across the health and care system.
Research on Researchers. Coping during COVID-19. Results on a Nation-Wide Survey
Authors: Sachini Evi , Labrianidis Lois , Sioumalas-Christodoulou Konstantinos , Chrysomallidis Charalampos , Siganos Galatios , Belouli Agathi , Karampekios Nikolaos
Published: March 2021

This paper presents findings of a nation-wide study examining the impact of COVID-19 on researchers. Findings indicate that more than half of researchers experienced personal or family mental strain due to COVID-19 pandemic effects. COVID-19 pandemic is being treated as an opportunity by six out of ten researchers in terms of more time for study and planning future research activities (78 per cent). The majority of researchers (73 per cent) believe that Science and Technology will emerge enhanced from the pandemic in the public sphere. Relating our findings with research outcomes of existed surveys, it appears that COVID-19 had a significant impact on researchers’ and workers’ psychosocial life. Researchers’ and scientists’ standpoint suggest that Science and Technology will be upgraded in the public dialogue. Finally, researchers viewed the pandemic as an opportunity for more time for study and planning of future research activities while working time, with respect to other countries, decreased the most.
Chronic exercise training activates histone turnover in mouse skeletal muscle fibers
Authors: Ohsawa Ikumi , Kawano Fuminori
Published: March 2021

Epigenetic regulation of skeletal muscle adaptation to exercise is a recent topic for which there is limited information. This study investigated whether exercise training activates histone turnover in the skeletal muscle fibers of mice. Experiments using a tetracycline‐inducible H2B‐GFP expression model demonstrated that 4 weeks of running training, but not 2 weeks of training, significantly promoted the incorporation of H2B‐GFP into nucleosomes and the dissociation of histone H3.3 at both transcriptionally upregulated and nonresponsive loci. Muscle‐specific PGC‐1α‐b‐overexpressing mice crossed with H2B‐GFP mice showed a slight increase in H2B‐GFP incorporation at transcriptionally active loci, but not in the dissociation of H3.3 from nucleosomes. Gene expression responses to a single bout of running were significantly enhanced in 4‐week trained mice when compared with those in 2‐week trained mice. The most drastic increase in the gene response was found in the expression of Hspa1a and Hspa1b, in which the magnitude of upregulation in response to running was significantly enhanced from 8‐fold in 2 week trained mice to 97‐ and 121‐fold in 4 week trained mice, respectively. It was also found that the HSP70 level increased during the training period. In a myonuclear immunohistochemical analysis of chromatin remodelers, we further found that the level of SPT16, an H2A‐H2B‐specific chaperone, was upregulated after running training. These results revealed that 4 weeks of running training activated histone turnover in skeletal muscle fibers. They also suggested that histone turnover led to loosening of the nucleosomes and enhanced gene responses to exercise.
Rotating a Segmental Maxilla to Close a Serious Vertically Displaced Alveolar Cleft
Authors: Liu Weilong , Li Yuanyuan , Tsauo Chialing , Shi Bing , Li Chenghao
Published: March 2021

In recent years, alveolar bone grafting has emerged as the first treatment choice for space closure in the secondary dentition. Despite this, a high possibility of failure still exists for patients with a vertical discrepancy of cleft segments. This is attributed to the absence of valid contact between the grafted bone and the surfaces of bone segments in the cleft region. In cases of minor discrepancies, the vertical distance can be reduced orthodontically, allowing for subsequent alveolar bone grafting.
1
However, in severe cases, isolated orthodontic treatment is not viable due to a high risk of periodontal problems and increased tooth mobility. Under the circumstances, surgical intervention is essential. Herein, we report a case in which the alveolar segment is aligned using a novel application of segmental maxillary osteotomy to rotate the segment with a subperiosteal tunnel. Rigid fixation of the segment in the desired position is then performed with concurrent bone grafting. Therefore, performing segmental maxillary osteotomy before bone grafting could be an alternative to correcting the vertical discrepancy encountered in cleft patients.
Increasing Perfusion Pressure Does Not Distend Perforators or Anastomoses but Reveals Arteriovenous Shuntings
Authors: Gascoigne Adam C. , Taylor G. Ian , Corlett Russell J. , Briggs Chris , Ashton Mark W.
Published: March 2021

Background:

It has been proposed that hyperperfusion of perforators and distension of anastomotic vessels may be a mechanism by which large perforator flaps are perfused. This study investigates whether increasing perfusion pressure of radiographic contrast in cadaveric studies altered the radiographic appearance of vessels, particularly by distending their anastomotic connections.

Methods:

From 10 fresh cadavers, bilateral upper limbs above the elbow were removed. Three cadavers were excluded. Seven pairs of limbs were injected with lead oxide solutions via the brachial artery while distally monitoring intravascular pressure in the radial artery using a pressure transducer. One limb was injected slowly (0.5 mL/s) and the other rapidly (1.5 mL/s) to produce low and high perfusion pressures, respectively. Skin and subcutaneous tissue were then removed and radiographed.

Results:

The filling of perforators and their larger caliber branches appeared unchanged between low- and high-pressure injections, with no significant increase in true anastomoses (P = 0.32) and no association between maximum perfusion pressure and number (P = 0.94) or caliber (P = 0.10). However, high-pressure injections revealed arteriovenous shunting with filling of the tributaries of the major veins.

Conclusions:

This study demonstrated that increased perfusion pressure of the cutaneous arteries (1) did not change the caliber of vessels; (2) did not convert choke to true anastomoses; and (3) revealed arteriovenous shunting between major vessels with retrograde filling of venous tributaries as pressure increased. This suggests that it is not possible to distend anastomotic connections between vascular territories by increasing perfusion alone.
Site V Surgery for Temporal Migraine Headaches
Authors: Baldelli Ilaria , Mangialardi Maria Lucia , Raposio Edoardo
Published: March 2021

Background:

Auriculotemporal nerve is demonstrated to contribute to migraine pain in temporal area. In particular, its relationship with the superficial temporal artery in the soft tissues superficial to the temporal parietal fascia has attracted researchers’ attention for many decades. The objective of this review was to explore whether site V nerve surgical decompression is effective for pain relief in temporal area.

Methods:

A literature search, according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, was conducted to evaluate the surgical treatment of auriculotemporal migraine. Inclusion was based on studies written in English, published between 2000 and February 2020, containing a diagnosis of migraine in compliance with the classification of the International Headache Society. The treatment must consist of surgical procedures involving the auriculotemporal nerve and/or arteries in site V, with outcome data available for at least 3 months.

Results:

Three hundred twenty-four records were identified after duplicates were removed, 31 full-text articles were assessed for eligibility, and 2 records were selected for inclusion. A total of 77 patients were included in the review. A direct approach at the anatomical site identified with careful physical examination and confirmed with a handheld Doppler probe is generally performed under local anesthesia. Blunt dissection to the superficial temporal fascia to expose the auriculotemporal nerve and the superficial temporal artery is followed by artery cauterization/ligament and eventual nerve transection/avulsion. Site V surgery results in a success rate from 79% to 97%.

Conclusions:

Despite the recent advances in extracranial trigger site surgery and a success rate (>50% improvement) from 79% to 97%, site V decompression is still poorly described. Elaborate randomized trials are needed with accurate reporting of patient selection, surgical procedure, adverse events, recurrencies or appearance of new trigger points, quality of life outcome, and longer follow-up times.
Robot-assisted Intercostal Nerve Harvesting: A Technical Note about the First Case in Japan
Authors: Naito Kiyohito , Imashimizu Kota , Nagura Nana , Goto Kenji , Obata Hiroyuki , Kaneko Ayaka , Sugiyama Yoichi , Kaneko Kazuo
Published: March 2021

Recently, surgical robotic systems have been used to perform microsurgery. Surgical robots have certain properties that make them well suited to microsurgery; for example, they possess 3-dimensional vision, which can be magnified up to 25 times; their movements are up to 5 times more precise than those of surgeons; they possess 7 degrees of wrist articulation; they do not suffer from physiologic tremors; and they can achieve ergonomic surgical positions. The purpose of this study was to report the feasibility of robot-assisted intercostal nerve harvesting in a clinical case. A healthy 57-year-old man suffered a left plexus injury. On diagnosis of clavicular brachial plexus injury, the intercostal nerve transfer to the muscular cutaneous nerve to restore elbow flexion was performed with Da Vinci Xi robot. The harvesting of intercostal nerves using the conventional open approach involves significant surgical exposure, which can lead to perioperative complications. Robot-assisted intercostal nerve harvesting might reduce postoperative pain, shorten patients’ hospital stays, lower complication rates, and produce better quality-of-life outcomes. There are many issues to be solved when performing robotic surgery on peripheral nerves in Japan. However, robot-assisted intercostal nerve harvesting was a feasible surgical procedure, and patient satisfaction was high.
Analysis of Allergan’s Biocell Implant Recall in a Major University Breast Center
Authors: Danino Michel A. , Dao Lan , Retchkiman Meir , Matetsa Edwige , Iezzoni Jessica , Bou-Merhi Joseph S.
Published: March 2021

Background:

In May 2019, Health Canada released a national recall of all macrotextured breast implants that later became international in July 2019 regarding increasing accounts of suspected breast implant–associated anaplastic large cell lymphoma. In Canada, this recall targeted Allergan’s Biocell implants. This report presents the postmortem of this comprehensive single-center recall, which had to be undertaken in a limited time.

Methods:

Four months after the beginning of the recall, the authors analyzed the transcript of meetings to characterize the team assembled during the recall. Then, to reconstruct the systemic work plan as well as the crucial steps and actors of the recall process, a chronologic table of the 5 meetings held during the recall, agendas and transcripts of every meeting, electronic correspondences, and other documents created during the recall were consulted.

Results:

Between 1996 and 2018, 1260 women were affected by the recall, meaning that they received Allergan’s macrotextured implants. Ninety-two patients underwent explantation of the device or will undergo implant explantation. To this day, no patient was diagnosed with breast implant–associated anaplastic large cell lymphoma.

Conclusions:

Our center’s experience highlights the utmost importance of building a national breast implants registry. We recommend breast centers to develop preestablished crisis centers and train staff to better prepare for future device recalls and minimize waste of time. Finally, we believe that implants should be identified based on the characteristics rather than their brand name.
Two-stage Reconstruction of the Scalp with Facial AV Loop
Authors: Clegg Devin J. , Winstead Michael L. , Herbig Kathleen S.
Published: March 2021

We present the case of a 65-year-old woman with extensive osteoradionecrosis of the scalp and calvaria after external beam radiation therapy for follicular lymphoma. Due to the compromise of her adjacent vasculature including the superficial temporal vessels, she underwent two-stage reconstruction with the creation of an AVL (arteriovenous loop) graft utilizing her great saphenous vein. This was anastomosed to her right facial artery and vein, which was then matured. She underwent resection of the necrotic portions of calvaria and soft tissue of approximately 180 cm2, and a vascularized free latissimus dorsi muscle flap was harvested and anastomosed to her new conduit. This free muscle flap was then covered with a split-thickness skin graft harvested from her thigh. She achieved satisfactory functional and cosmetic results with minimal morbidity and without complication despite her age, multiple co-morbidities, and extensive and complex disease process.
Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence
Authors: Bustos Valeria P. , Bustos Samyd S. , Mascaro Andres , Del Corral Gabriel , Forte Antonio J. , Ciudad Pedro , Kim Esther A. , Langstein Howard N. , Manrique Oscar J.
Published: March 2021

Background:

There is an unknown percentage of transgender and gender non-confirming individuals who undergo gender-affirmation surgeries (GAS) that experiences regret. Regret could lead to physical and mental morbidity and questions the appropriateness of these procedures in selected patients. The aim of this study was to evaluate the prevalence of regret in transgender individuals who underwent GAS and evaluate associated factors.

Methods:

A systematic review of several databases was conducted. Random-effects meta-analysis, meta-regression, and subgroup and sensitivity analyses were performed.

Results:

A total of 27 studies, pooling 7928 transgender patients who underwent any type of GAS, were included. The pooled prevalence of regret after GAS was 1% (95% CI <1%–2%). Overall, 33% underwent transmasculine procedures and 67% transfemenine procedures. The prevalence of regret among patients undergoing transmasculine and transfemenine surgeries was <1% (IC <1%–<1%) and 1% (CI <1%–2%), respectively. A total of 77 patients regretted having had GAS. Twenty-eight had minor and 34 had major regret based on Pfäfflin’s regret classification. The majority had clear regret based on Kuiper and Cohen-Kettenis classification.

Conclusions:

Based on this review, there is an extremely low prevalence of regret in transgender patients after GAS. We believe this study corroborates the improvements made in regard to selection criteria for GAS. However, there is high subjectivity in the assessment of regret and lack of standardized questionnaires, which highlight the importance of developing validated questionnaires in this population.
Commentary on 2 Cases of Neuropsychiatric Symptoms Occurring in Association With COVID-19
Authors: Garakani Amir
Published: March 2021

Two cases are presented involving neuropsychiatric symptoms occurring in the context of coronavirus disease 2019 (COVID-19) infections. The first case involved a middle-age man with no known psychiatric history who presented with acute psychotic symptoms (delusions, hallucinations, disorganization) after recovery from a recent respiratory illness. This patient tested positive for COVID-19 on admission. The patient’s symptoms were not consistent with delirium and testing did not suggest a neurological etiology. The patient’s psychosis eventually resolved 6 weeks after its abrupt onset with treatment with antipsychotic medication. The second case involved a 44-year-old man with a history of depression and psychotic symptoms who presented after a serious suicide attempt and tested positive for COVID-19 on admission. The patient had subsequent negative tests while on the inpatient psychiatric unit before again testing positive later in his admission. The patient’s positive COVID-19 tests appeared to coincide with exacerbations in his mood symptoms, which led to the suicide attempt and psychotic episode that initially caused his admission. This patient was successfully treated with clozapine. In both of these cases, the question arose as to whether there was a link between the COVID-19 infections and the neuropsychiatric symptoms. Growing evidence suggests that severe neuropsychiatric sequelae can develop after COVID-19 infection.
The Psychiatric Inpatient Multidisciplinary Team Meeting: A Model for Current Practice
Authors: RUSS MARK J.
Published: March 2021

The multidisciplinary treatment team meeting (MTTM) has been the central forum for treatment planning and clinical decision-making on many psychiatric inpatient units for decades. While the principles underlying MTTMs were described in the distant past, a detailed model for how these meetings are structured and how they function has not been well presented. In an era of very brief hospital lengths of stay, collaborative, thoughtful, comprehensive, and efficient team meetings have become increasingly important. The goal of this article is to describe a highly structured, successful MTTM model that borrows heavily from an invaluable knowledge base and tradition and is well suited for the modern era.
The sounds of prehistoric speech
Authors: Everett Caleb
Published: March 2021

Evidence is reviewed for widespread phonological and phonetic tendencies in contemporary languages. The evidence is based largely on the frequency of sound types in word lists and in phoneme inventories across the world's languages. The data reviewed point to likely tendencies in the languages of the Upper Palaeolithic. These tendencies include the reliance on specific nasal and voiceless stop consonants, the relative dispreference for posterior voiced consonants and the use of peripheral vowels. More tenuous hypotheses related to prehistoric languages are also reviewed. These include the propositions that such languages lacked labiodental consonants and relied more heavily on vowels, when contrasted to many contemporary languages. Such hypotheses suggest speech has adapted to subtle pressures that may in some cases vary across populations.

This article is part of the theme issue ‘Reconstructing prehistoric languages’.
T-cell receptor sequencing identifies prior SARS-CoV-2 infection and correlates with neutralizing antibody titers and disease severity
Authors: Elyanow Rebecca , Snyder Thomas M. , Dalai Sudeb C. , Gittelman Rachel M. , Boonyaratanakornkit Jim , Wald Anna , Selke Stacy , Wener Mark H. , Morishima Chihiro , Greninger Alex L. , Holbrook Michael R. , Kaplan Ian M. , Zahid H. Jabran , Carlson Jonathan M. , Baldo Lance , Manley Thomas , Robins Harlan S. , Koelle David M.
Published: March 2021

Measuring the adaptive immune response to SARS-CoV-2 can enable the assessment of past infection as well as protective immunity and the risk of reinfection. While neutralizing antibody (nAb) titers are one measure of protection, such assays are challenging to perform at a large scale and the longevity of the SARS-CoV-2 nAb response is not fully understood. Here, we apply a T-cell receptor (TCR) sequencing assay that can be performed on a small volume standard blood sample to assess the adaptive T-cell response to SARS-CoV-2 infection. Samples were collected from a cohort of 302 individuals recovered from COVID-19 up to 6 months after infection. Previously published findings in this cohort showed that two commercially available SARS-CoV-2 serologic assays correlate well with nAb testing. We demonstrate that the magnitude of the SARS-CoV-2-specific T-cell response strongly correlates with nAb titer, as well as clinical indicators of disease severity including hospitalization, fever, or difficulty breathing. While the depth and breadth of the T-cell response declines during convalescence, the T-cell signal remains well above background with high sensitivity up to at least 6 months following initial infection. Compared to serology tests detecting binding antibodies to SARS-CoV-2 spike and nucleoprotein, the overall sensitivity of the TCR-based assay across the entire cohort and all timepoints was approximately 5% greater for identifying prior SARS-CoV-2 infection. Notably, the improved performance of T-cell testing compared to serology was most apparent in recovered individuals who were not hospitalized and were sampled beyond 150 days of their initial illness, suggesting that antibody testing may have reduced sensitivity in individuals who experienced less severe COVID-19 illness and at later timepoints. Finally, T-cell testing was able to identify SARS-CoV-2 infection in 68% (55/81) of convalescent samples having nAb titers below the lower limit of detection, as well as 37% (13/35) of samples testing negative by all three antibody assays. These results demonstrate the utility of a TCR-based assay as a scalable, reliable measure of past SARS-CoV-2 infection across a spectrum of disease severity. Additionally, the TCR repertoire may be useful as a surrogate for protective immunity with additive clinical value beyond serologic or nAb testing methods.
Distinct transcriptomic signature of mRNA and microRNA in ulcerative colitis and irritable bowel syndrome
Authors: Luo Hanqing , Dai Jiacheng , Liu Chunyu , Lee Yue , Lv Hong , Qian Jiaming
Published: March 2021

Background

Ulcerative colitis (UC) and irritable bowel syndrome (IBS) are both chronic bowel diseases involving stress. To identify genes differentially expressed in UC and IBS, and to determine whether psychological stress can influence those gene expressions, we conducted this pilot study.

Methods

Patients of UC, irritable bowel syndrome (IBS) and normal controls (NC) (n=5 in each group) were recruited. Perceived stress scale (PSS) was adopted to assess psychological stress level. Sigmoid mucosa samples were collected during colonoscopy. Differentially expressed genes (DEGs) of both mRNA and microRNA (DEG-mRNA and DEG-miRNA) were identified by RNA-Seq and microarray, respectively. Weighted gene co-expression network analysis (WGCNA), gene ontology, and microRNA target analysis were performed to identify regulatory relationships and pathways involved. Pearson correlation was performed to identify the relationship between DEGs and PSS score.

Results

In total, 1,770 and 938 DEG-mRNAs, 107 and 3 DEG-miRNAs were identified in UC and IBS (nominal P<0.05), respectively. The transcriptome changes in UC and IBS were highly correlated but transcriptome severity was larger in UC. There were 268 overlapped DEG-mRNAs and 3 overlapped DEG-miRNAs between UC and IBS. Median PSS score was 27.5 (24.7, 40.0) in UC, 27.0 (17.5, 32.5) in IBS and 22.0 (12.0, 28.5) in NC. Five of the UC’s DEG-mRNAs were significantly correlated to PSS scores, including SLC4A7, PLCB1, SPATA33, DECR2, RP11-792A8.4. There were no DEGs correlate with PSS scores in IBS. One module enriched for immunological pathways was upregulated in UC. Metabolic pathways were enriched in IBS. Within the UC-related co-expression module, we identified 18 DEG-mRNAs that were also targets of DEG-miRNA.

Conclusions

Integration of microRNA and mRNA expression profiles identified changes of gene expression in both UC and IBS. Although the two diseases have significant overlapped transcriptomic changes, they have distinct signature. Immunological pathways are involved prominently in UC while metabolic pathways in IBS. Psychological stress is uniquely associated with the transcriptome changes of UC.