bluuebunny/crossref_metadata_2025 huggingface dataset:
Copyright
Authors: Seville Catherine
Published: May 2023

The nineteenth century saw significant change in the context and focus of copyright law. During the eighteenth century, copyright laws had national effect, and were tailored to national interests. But during the nineteenth century, different political, industrial, and economic conditions led to demands for a wider outlook. British copyright law exemplifies the challenge of these changes. In 1837 the lawyer and author Thomas Talfourd introduced a copyright bill which expressed a bold vision of copyright reform including significant domestic consolidation and active international copyright arrangements. It took five years before any bill was passed, and its provisions were significantly modified in the process. The resulting 1842 Copyright Act did not achieve all the reforms that its visionary champion had hoped for, and it proved to have a number of defects which grew more obvious as the century wore on. Nevertheless it formed the basis of modern copyright law, and in relation to domestic law its groundwork is visible well into the twentieth century. International copyright took rather longer to develop, but it was of increasing importance. British writers wanted copyright protection not just in Britain itself, but in all places where there was a market for their books. The position in continental Europe, in the British colonies, and in America was therefore of great significance. There were many changes affecting copyright law during this period, which were often ardently contested. There was a great deal of significant legal activity, both in the form of legislation and also in case law. Given the extent of the market for British copyright works, this wider geographical legal context was of direct relevance to all Victorian writers and publishers—and to readers. One difficulty when reforming copyright law is the breadth and significance of the activities and themes that it touches. These include the nature of copyright (and of intellectual property more widely), literary and artistic culture in the broadest sense, popular education, the public interest, the publishing trade, international trade and competition, constitutional freedom and independence, and national character. It is challenging to take account of such issues, even in a domestic context. When other national positions are brought to bear on the outcome, the task of negotiating a copyright law that reconciles all interests can seem almost impossible. In addition, these matters will be subject to political and economic pressures, and touched by the general trends and changes which affect all societies. The debate regarding copyright’s proper aims and mechanisms was a fierce one in the Victorian era—as it had been since the first British copyright statute, the Statute of Anne 1710. It is a debate which is still very much continuing today.
The Weapon Focus Effect in Eyewitness Memory
Authors: Steblay Nancy K.
Published: May 2023

The identification of criminal perpetrators by eyewitnesses is a staple form of evidence in courts of law. In the 1970s psychological scientists began a systematic study of eyewitness identification using controlled experiments, and much has been learned through thousands of lab studies about factors that put the reliability of eyewitness evidence at risk. Laboratory science has soundly established that the rate of mistaken identification varies as a function of conditions during the witnessed event, the retention interval, and the method of conducting an identification procedure. A useful distinction has been made between two types of factors that influence eyewitness accuracy: system and estimator variables. System variables are those that are (or could be) controlled to improve the accuracy of eyewitness reports, particularly through science-informed police procedures such as non-leading interview protocols, fair lineup structure, and double-blind lineups. Estimator variables influence eyewitness memory and accuracy but are not under the control of the criminal justice system, such as conditions during the crime event (e.g., lighting, distance, obstacles to view), aspects of the criminal (e.g., number of perpetrators, facial disguise), and characteristics of the witness (e.g., visual acuity, stress). One estimator variable—referred to as the weapon focus effect—describes the phenomenon in which the presence of a weapon at the scene of a crime impairs the witness’s memory for the perpetrator and other details of the crime. The basic idea is that the weapon captures the visual attention of the witness and thereby distracts witness attention from other important features of the visual scene such as the face of the perpetrator. The eyewitness is simply less able to adequately encode and subsequently recall details peripheral to the weapon. The weapon focus effect has garnered attention in labs and courtrooms over the more than forty years of eyewitness research. The cumulative body of weapon focus research provides support for the claim that the presence of a weapon draws the attention of an eyewitness. In doing so, this weapon focus can diminish the ability of the eyewitness to later recognize and describe the culprit.
Jews and Animals
Authors: Berkowitz Beth
Published: May 2023

Jews and animals. The two would seem a fraught pair, just as the pairing of any human group with animals suggests an assault on the dignity of that group. The academic field of critical animal studies challenges the set of associations that makes such pairings fraught, however: human = rational and reflective, versus animal = irrational and instinctive. Critical animal studies historicizes the human/animal binary, reconstructing the process and politics by which the human has been separated from and made superior to the animal. As part of this, critical animal studies looks at how certain human identities—racial, ethnic, religious, gender—are “animalized,” that is to say, they are migrated over to the animal side. When critical animal studies meets Jewish studies, hereafter “Jewish animal studies,” scholars ask how Jews have either been animalized or have animalized others. Scholars ask also how Jews have resisted animalization of or by Jews along with the binary itself, as Jews ask what it means to be human or animal and test the boundary between the two. Like all humans, Jews throughout their history have lived with animals and used them for labor, transport, food, and companionship, among other functions, and so Jewish animal studies looks also at the role of actual animals within the Jewish experience. Animals have always fired the human imagination; Jewish animal studies looks at the roles played by animals within Jewish literary, visual, and material culture. Jewish animal studies looks for the animal also in Jewish reflection on God and in Jewish forms of devotion and piety, in which the animal is often contrasted with the human but sometimes is thought to join the human in collective inter-species worship of God. Finally, Jewish animal studies considers the real-life consequences of the human/animal binary for both animals and humans. Jewish ethics, philosophy, and law asks about Jewish obligation toward other species in light of biblical and rabbinic traditions and the experience of oppression that Jews and animals have in common. Those who engage in Jewish animal studies soon realize that “Jews and animals” is a false dichotomy. Jews are animals. Whether Jews themselves recognize this, and to what effect, is one of the many questions that Jewish animal studies addresses.
Revenge Tragedy
Authors: Dunne Derek
Published: May 2023

Revenge tragedy is one of the most recognizable subgenres of early modern English drama, containing as it does such well-known plays as The Spanish Tragedy, Hamlet, and The Revenger’s Tragedy. While the moniker of “revenge tragedy” is a retrospective coinage, it’s undeniable that authors of the period responded and reacted to each other’s writing, from the knowing title of Marston’s Antonio’s Revenge to the melancholic protagonist of Chettle’s The Tragedy of Hoffman sending up Shakespeare’s Danish prince. Revenge is a ubiquitous motive and theme in world literature, from Homer’s Iliad to Marvel’s Avengers blockbusters. Even so, the Elizabethan and Jacobean periods witnessed an unprecedented upsurge of interest in the motivations and methods of vigilants operating in a world without justice. As Titus Andronicus puts it “Terras Astraea reliquit” (4.3.4)—justice has fled the earth. At first literary criticism was most concerned with tracing how far this reflected the reality—and morality—of revenge in the early modern world, but gradually a more nuanced approach emerged that saw the genre as critiquing contemporary society on a number of fronts, from the social to the economic to the legal.
Knowledge Economy: Spatial Approaches
Authors: Moisio Sami
Published: May 2023

Knowledge economy can be defined in several ways. It is abstract yet concrete, a thing and a process, structured by practices and structuring societal practices, imagined and material, economic and political, theorized and experienced. As a scholarly abstraction, it has been debated under many rubrics, such as knowledge-based economy, intangible economy, knowledge capitalism, learning economy, cognitive capitalism, new economy, information economy, and creative economy. The knowledge economy is nonetheless customarily used to denote the socio-spatial organization of late capitalism since 1980s. In this context, knowledge and creativity are highlighted in the economic production process at the expense of physical resources and manual labor. The knowledge economy has been extensively studied from the perspective of social sciences. The emergence of thematic journals such as the Journal of the Knowledge Economy indicates at least a gradual institutionalization of the knowledge economy as an interdisciplinary field of study. The geographical literature on the knowledge economy includes two main and partly overlapping strands. Economic geographical literature conceptualizes the knowledge economy as both spatial innovation systems and as knowledge creation and transfer. A critical political economy approach, in turn, examines the knowledge economy as connected to urban transformation, the state, and geopolitics.
Clade-Level Interactions and Macroevolution
Authors: Quental Tiago B. , Pires Mathias M.
Published: May 2023

The notion that biotic interactions affect how populations grow or decline and, as a consequence, whether they persist or perish has been central to the development of ecology and evolutionary theory. Darwin framed evolution as the outcome of intraspecific competition and highlighted the roles of interspecific interactions in driving adaptations. Therefore, the role of biotic interactions is well accepted and frequently studied in ecology and evolutionary studies pertaining to one or very few species. A macroevolutionary perspective of how entire clades are affected by other clades, on the other hand, has not been as well documented, nor theoretically explored, as happened with lower-level studies at shallower time scales or fewer species. This article calls clade-level interaction any clade-level outcome, such as changes in speciation and extinction rates, phenotypic trends, or spatial distribution of the clade, that results from interactions among several species from distinct evolutionary lineages. It is important to note that clade-level interactions are large-scale epiphenomena resulting from the interactions among populations of different species at a local scale, but they require a deeper time perspective to be properly documented and studied. The macroevolutionary literature, particularly in paleontology, has been dominated by how abiotic factors might drive biodiversity patterns, but it has become clear that species interactions can play a significant role and, just like in ecology, drive not only the fate of populations but also perhaps of whole clades.
Moral Grounds for Economic and Social Rights
Authors: Nickel James W.
Published: May 2023

This chapter considers possible moral grounds for recognizing and realizing economic and social rights (ESRs) as human rights. It begins by suggesting that ESRs fall into three families: (1) welfare-oriented ESRs, which protect adequate income, education, health, and safe and healthful working conditions; (2) freedom-oriented ESRs, which prohibit slavery, ensure free choice of employment, and protect workers’ freedoms to organize and strike: and (3) fairness-oriented ESRs, which require nondiscrimination and equal opportunity in the workplace along with fair remuneration for one’s work. To accommodate the normative diversity found in these three families, the chapter suggests a pluralistic justificatory framework that appeals to three kinds of moral reasons: human welfare, freedom, and fairness. A final section considers the possibility of subsuming all three of these approaches to justification under the idea of human dignity or the associated idea of equal respect for persons.
Spatiotemporal and microstructural characterization of heterotopic ossification in healing rat Achilles tendons
Authors: Pierantoni Maria , Hammerman Malin , Silva Barreto Isabella , Larsson Daniel , Notermans Thomas , Bodey Andrew J. , Eliasson Pernilla , Isaksson Hanna
Published: May 2023

Achilles tendon rupture is a common debilitating medical condition. The healing process is slow and can be affected by heterotopic ossification (HO), which occurs when pathologic bone‐like tissue is deposited instead of the soft collagenous tendon tissue. Little is known about the temporal and spatial progression of HO during Achilles tendon healing. In this study we characterize HO deposition, microstructure, and location at different stages of healing in a rat model. We use phase contrast‐enhanced synchrotron microtomography, a state‐of‐the‐art technique that allows 3D imaging at high‐resolution of soft biological tissues without invasive or time‐consuming sample preparation. The results increase our understanding of HO deposition, from the early inflammatory phase of tendon healing, by showing that the deposition is initiated as early as one week after injury in the distal stump and mostly growing on preinjury HO deposits. Later, more deposits form first in the stumps and then all over the tendon callus, merging into large, calcified structures, which occupy up to 10% of the tendon volume. The HOs were characterized by a looser connective trabecular‐like structure and a proteoglycan‐rich matrix containing chondrocyte‐like cells with lacunae. The study shows the potential of 3D imaging at high‐resolution by phase‐contrast tomography to better understand ossification in healing tendons.
Integrative transcriptomics and cell systems analyses reveal protective pathways controlled by Igfbp‐3 in anthracycline‐induced cardiotoxicity
Authors: Chen Junjie , Chapski Douglas J. , Jong Jeremy , Awada Jerome , Wang Yijie , Slamon Dennis J. , Vondriska Thomas M. , Packard René R. Sevag
Published: May 2023

Anthracyclines such as doxorubicin (Dox) are effective chemotherapeutic agents; however, their use is hampered by subsequent cardiotoxicity risk. Our understanding of cardiomyocyte protective pathways activated following anthracycline‐induced cardiotoxicity (AIC) remains incomplete. Insulin‐like growth factor binding protein (IGFBP) 3 (Igfbp‐3), the most abundant IGFBP family member in the circulation, is associated with effects on the metabolism, proliferation, and survival of various cells. Whereas Igfbp‐3 is induced by Dox in the heart, its role in AIC is ill‐defined. We investigated molecular mechanisms as well as systems‐level transcriptomic consequences of manipulating Igfbp‐3 in AIC using neonatal rat ventricular myocytes and human‐induced pluripotent stem cell‐derived cardiomyocytes. Our findings reveal that Dox induces the nuclear enrichment of Igfbp‐3 in cardiomyocytes. Furthermore, Igfbp‐3 reduces DNA damage, impedes topoisomerase IIβ expression (Top2β) which forms Top2β‐Dox‐DNA cleavage complex leading to DNA double‐strand breaks (DSB), alleviates detyrosinated microtubule accumulation—a hallmark of increased cardiomyocyte stiffness and heart failure—and favorably affects contractility following Dox treatment. These results indicate that Igfbp‐3 is induced by cardiomyocytes in an effort to mitigate AIC.
Simultaneous evaluation of treatment efficacy and toxicity for bispecific T‐cell engager therapeutics in a humanized mouse model
Authors: Yang Jiwon , Jiao Jing , Draheim Kyle M. , Yang Guoxiang , Yang Hongyuan , Yao Li‐Chin , Shultz Leonard D. , Greiner Dale L. , Rajagopal Deepa , Vessillier Sandrine , Maier Curtis C. , Mohanan Sunish , Cai Danying , Cheng Mingshan , Brehm Michael A. , Keck James G.
Published: May 2023

Immuno‐oncology (IO)‐based therapies such as checkpoint inhibitors, bi‐specific antibodies, and CAR‐T‐cell therapies have shown significant success in the treatment of several cancer indications. However, these therapies can result in the development of severe adverse events, including cytokine release syndrome (CRS). Currently, there is a paucity of in vivo models that can evaluate dose‐response relationships for both tumor control and CRS‐related safety issues. We tested an in vivo PBMC humanized mouse model to assess both treatment efficacy against specific tumors and the concurrent cytokine release profiles for individual human donors after treatment with a CD19xCD3 bispecific T‐cell engager (BiTE). Using this model, we evaluated tumor burden, T‐cell activation, and cytokine release in response to bispecific T‐cell‐engaging antibody in humanized mice generated with different PBMC donors. The results show that PBMC engrafted NOD‐scid Il2rgnullmice lacking expression of mouse MHC class I and II (NSG‐MHC‐DKO mice) and implanted with a tumor xenograft predict both efficacy for tumor control by CD19xCD3 BiTE and stimulated cytokine release. Moreover, our findings indicate that this PBMC‐engrafted model captures variability among donors for tumor control and cytokine release following treatment. Tumor control and cytokine release were reproducible for the same PBMC donor in separate experiments. The PBMC humanized mouse model described here is a sensitive and reproducible platform that identifies specific patient/cancer/therapy combinations for treatment efficacy and development of complications.
Circulating exosomal miR‐155‐5p contributes to severe acute pancreatitis‐associated intestinal barrier injury by targeting SOCS1 to activate NLRP3 inflammasome‐mediated pyroptosis
Authors: Shao Yang , Li Yiming , Jiang Yingjian , Li Hongbo , Wang Jiang , Zhang Dianliang
Published: May 2023

Severe acute pancreatitis (SAP) represents a common and serious disease that can cause intestinal barrier dysfunction. However, the pathogenesis of this barrier dysfunction remains unclear. Exosomes are a new intercellular communication method involved in multiple diseases. Consequently, the present study sought to determine the function of circulating exosomes in barrier dysfunction associated with SAP. A rat model of SAP was established by injecting biliopancreatic duct with 5% sodium taurocholate. Circulating exosomes were purified from SAP (SAP‐Exo) and sham operation rats (SO‐Exo) using a commercial kit. In vitro, SO‐Exo and SAP‐Exo were cocultured with rat intestinal epithelial (IEC‐6) cells. In vivo, naive rats were treated with SO‐Exo and SAP‐Exo. We found SAP‐Exo‐induced pyroptotic cell death and barrier dysfunction in vitro. In addition, miR‐155‐5p exhibited a remarkable increase in SAP‐Exo than SO‐Exo, and miR‐155‐5p inhibitor partially abolished the negative effect of SAP‐Exo on IEC‐6 cells. Furthermore, miRNA functional experiments revealed that miR‐155‐5p could induce pyroptosis and barrier loss in IEC‐6 cells. Overexpression of suppressor of cytokine signaling 1 (SOCS1), a miR‐155‐5p target, could partially reverse IEC‐6 cells from the harmful impact of miR‐155‐5p. In vivo, SAP‐Exo significantly triggered pyroptosis in intestinal epithelial cells and caused intestinal injury. In addition, blocking exosome release with GW4869 attenuated intestinal injury in SAP rats. In summary, our study demonstrated that miR‐155‐5p is highly enriched in circulating exosomes from SAP rat plasma and can be transported to intestinal epithelial cells, where it targets SOCS1 to activate NOD‐like receptor protein 3 (NLRP3) inflammasome‐mediated pyroptosis leading to intestinal barrier damage.
DMD Gene and Dystrophinopathy Phenotypes Associated With Mutations: A Systematic Review for Clinicians
Authors: Andrews Jennifer G. , Galindo Maureen Kelly , Thomas Shiny , Mathews Katherine D. , Whitehead Nedra
Published: May 2023

The diagnosis of Duchenne and Becker muscular dystrophy (DBMD) is made by genetic testing in approximately 95% of cases. Although specific mutations can be associated with skeletal muscle phenotype, pulmonary and cardiac comorbidities (leading causes of death in Duchenne) have not been associated with Duchenne muscular dystrophy mutation type or location and vary within families. Therefore, identifying predictors for phenotype severity beyond frameshift prediction is important clinically. We performed a systematic review assessing research related to genotype–phenotype correlations in DBMD. While there are severity differences across the spectrum and within mild and severe forms of DBMD, few protective or exacerbating mutations within the dystrophin gene were reported. Except for intellectual disability, clinical test results reporting genotypic information are insufficient for clinical prediction of severity and comorbidities and the predictive validity is too low to be useful when advising families. Including expanded information coupled with proposed severity predictions in clinical genetic reports for DBMD is critical for improving anticipatory guidance.
Prognostic Analysis of Lymphovascular Invasion in Stages I–III Colorectal Cancer
Authors: Lin Zhuoqun , Zheng Yitao , Yang Jun , Jin Wei , Wang Junqi , Wang Weichen , Li Shaotang
Published: May 2023

Introduction:

Lymphovascular invasion (LVI) is a micropathological tumor factor believed to increase the risk of tumor metastasis and spread. Propensity score matching (PSM) is a statistical method that can control confounding factors. Current research rarely considers the confounding relationship between LVI and other factors that may influence prognosis. This study aimed to investigate the relationship between LVI and prognosis in patients with stage I–III colorectal cancer (CRC) by using propensity score matching (PSM).

Methods:

This was a retrospective study involving 610 patients. PSM was used to adjust for baseline differences between the groups. The survival rates were calculated. A nomogram was constructed based on the Cox proportional hazards model before matching. The C-index, receiver operating characteristic curve (ROC), and calibration curve were used to evaluate the nomogram.

Results:

A total of 150 patients tested positive for LVI, accounting for 24.6% of the total, and 120 couples of patients were identified after PSM. The survival curve and Cox proportional hazards model after matching confirmed the adverse effects of LVI on tumor prognosis. The Cox proportional hazards model before matching showed that age, carcinoembryonic antigen level, T stage, N stage, histologic grade and LVI were independent prognostic factors. The C-index of the nomogram established based on the Cox proportional hazards model was 0.787 (95% CI=0.728–0.845). The areas under the curve were 0.796 in the 3-year ROC.

Conclusions:

LVI is an adverse prognostic factor in patients with stage I-III colorectal cancer.
Chagas Disease Cardiomyopathy
Authors: Jimenez Ariana , Winokur Elizabeth J.
Published: May 2023

Abstract Chagas disease is a prominent neglected tropical disease endemic to many countries in Latin America. Cardiomyopathy is the most serious manifestation due to the severity and complications of heart failure. As a result of expanded immigration and globalization, there is an increased number of patients with Chagas cardiomyopathy who are being admitted to hospitals in the United States. It is imperative as a critical care nurse to be educated on the nature of Chagas cardiomyopathy as it differs from the more commonly seen ischemic and nonischemic forms. This article provides an overview of the clinical course, management, and treatment options of Chagas cardiomyopathy.
Loss of toll-like receptor 5 potentiates spontaneous hepatocarcinogenesis in farnesoid X receptor–deficient mice
Authors: Golonka Rachel M. , Yeoh Beng San , Saha Piu , Gohara Amira , Tummala Ramakumar , Stepkowski Stanislaw , Tiwari Amit K. , Joe Bina , Gonzalez Frank J. , Gewirtz Andrew T. , Vijay-Kumar Matam
Published: May 2023

Background:

HCC is the most common primary liver cancer and a leading cause of cancer-related mortality. Gut microbiota is a large collection of microbes, predominately bacteria, that harbor the gastrointestinal tract. Changes in gut microbiota that deviate from the native composition, that is, “dysbiosis,” is proposed as a probable diagnostic biomarker and a risk factor for HCC. However, whether gut microbiota dysbiosis is a cause or a consequence of HCC is unknown.

Methods:

To better understand the role of gut microbiota in HCC, mice deficient of toll-like receptor 5 (TLR5, a receptor for bacterial flagellin) as a model of spontaneous gut microbiota dysbiosis were crossed with farnesoid X receptor knockout mice (FxrKO), a genetic model for spontaneous HCC. Male FxrKO/Tlr5KO double knockout (DKO), FxrKO, Tlr5KO, and wild-type (WT) mice were aged to the 16-month HCC time point.

Results:

Compared with FxrKO mice, DKO mice had more severe hepatooncogenesis at the gross, histological, and transcript levels and this was associated with pronounced cholestatic liver injury. The bile acid dysmetabolism in FxrKO mice became more aberrant in the absence of TLR5 due in part to suppression of bile acid secretion and enhanced cholestasis. Out of the 14 enriched taxon signatures seen in the DKO gut microbiota, 50% were dominated by the Proteobacteria phylum with expansion of the gut pathobiont γ-Proteobacteria that is implicated in HCC.

Conclusions:

Collectively, introducing gut microbiota dysbiosis by TLR5 deletion exacerbated hepatocarcinogenesis in the FxrKO mouse model.
Functional diversity and team innovation
Authors: van Zijl Alissa Lysanne , Vermeeren Brenda , Koster Ferry , Steijn Bram
Published: May 2023

Background

Bringing together professionals with different knowledge and skills comes with the opportunity to spur the innovativeness of primary care teams. Nevertheless, empirical evidence shows that it is not self-evident that these innovations are also realized. The social categorization theory suggests that a better understanding of whether these potential team innovations are realized can be obtained by looking at the social cohesion of such teams.

Purpose

The aim of this study was to study the relationship between functional diversity and team innovation in primary care teams by examining the mediating role of social cohesion.

Methodology

Survey responses and administrative data of 887 primary care professionals and 75 supervisors in 100 primary care teams were analyzed. Structural equation modeling was used to examine a curvilinear mediated relationship among functional diversity and team innovation through social cohesion.

Results

The findings show a positive relationship between social cohesion and team innovation as expected. Contrary to the expectations, the relationship between functional diversity and social cohesion is insignificant, and the results show an inverted U-shaped relationship between functional diversity and team innovation instead.

Conclusions

This study reveals an unexpected inverted U-shaped relationship between functional diversity and team innovation. This relationship is not mediated by social cohesion; however, social cohesion is still a significant predictor of team innovation.

Practice Implications

Policymakers should be aware of the relevance as well as the complexity of creating social cohesion in functionally diverse primary care teams. As long as it remains unknown how social cohesion is stimulated in functionally diverse teams, it seems best for the team innovation to prevent bringing together too many, but also too few, different functions.
Genetic risk shared across 24 chronic pain conditions: identification and characterization with genomic structural equation modeling
Authors: Zorina-Lichtenwalter Katerina , Bango Carmen I. , Van Oudenhove Lukas , Čeko Marta , Lindquist Martin A. , Grotzinger Andrew D. , Keller Matthew C. , Friedman Naomi P. , Wager Tor D.
Published: May 2023

Chronic pain conditions frequently co-occur, suggesting common risks and paths to prevention and treatment. Previous studies have reported genetic correlations among specific groups of pain conditions and reported genetic risk for within-individual multisite pain counts (≤7). Here, we identified genetic risk for multiple distinct pain disorders across individuals using 24 chronic pain conditions and genomic structural equation modeling (Genomic SEM). First, we ran individual genome-wide association studies (GWASs) on all 24 conditions in the UK Biobank (N ≤ 436,000) and estimated their pairwise genetic correlations. Then we used these correlations to model their genetic factor structure in Genomic SEM, using both hypothesis- and data-driven exploratory approaches. A complementary network analysis enabled us to visualize these genetic relationships in an unstructured manner. Genomic SEM analysis revealed a general factor explaining most of the shared genetic variance across all pain conditions and a second, more specific factor explaining genetic covariance across musculoskeletal pain conditions. Network analysis revealed a large cluster of conditions and identified arthropathic, back, and neck pain as potential hubs for cross-condition chronic pain. Additionally, we ran GWASs on both factors extracted in Genomic SEM and annotated them functionally. Annotation identified pathways associated with organogenesis, metabolism, transcription, and DNA repair, with overrepresentation of strongly associated genes exclusively in brain tissues. Cross-reference with previous GWASs showed genetic overlap with cognition, mood, and brain structure. These results identify common genetic risks and suggest neurobiological and psychosocial mechanisms that should be targeted to prevent and treat cross-condition chronic pain.
The State of Health, Burnout, Healthy Behaviors, Workplace Wellness Support, and Concerns of Medication Errors in Pharmacists During the COVID-19 Pandemic
Authors: Melnyk Bernadette Mazurek , Hsieh Andreanna Pavan , Tan Alai , McAuley James W. , Matheus Maritza , Larson Bayli , Dopp Anna Legreid
Published: May 2023

Objectives

The aims of the study were to describe the well-being and lifestyle behaviors of health-system pharmacists during the COVID-19 pandemic and to determine the relationships among well-being, perceptions of workplace wellness support, and self-reported concern of having made a medication error.

Methods

Pharmacist (N = 10,445) were randomly sampled for a health and well-being survey. Multiple logistic regression assessed associations with wellness support and concerns of medication error.

Results

The response rate was 6.4% (N = 665). Pharmacists whose workplaces very much supported wellness were 3× more likely to have no depression, anxiety, and stress; 10× more likely to have no burnout; and 15× more likely to have a higher professional quality of life. Those with burnout had double the concern of having made a medication error in the last 3 months.

Conclusions

Healthcare leadership must fix system issues that cause burnout and actualize wellness cultures to improve pharmacist well-being.
The future of commercial genetic testing
Authors: Solomon Benjamin D.
Published: May 2023

Purpose of review

There are thousands of different clinical genetic tests currently available. Genetic testing and its applications continue to change rapidly for multiple reasons. These reasons include technological advances, accruing evidence about the impact and effects of testing, and many complex financial and regulatory factors.

Recent findings

This article considers a number of key issues and axes related to the current and future state of clinical genetic testing, including targeted versus broad testing, simple/Mendelian versus polygenic and multifactorial testing models, genetic testing for individuals with high suspicion of genetic conditions versus ascertainment through population screening, the rise of artificial intelligence in multiple aspects of the genetic testing process, and how developments such as rapid genetic testing and the growing availability of new therapies for genetic conditions may affect the field.

Genetic testing is expanding and evolving, including into new clinical applications. Developments in the field of genetics will likely result in genetic testing becoming increasingly in the purview of a very broad range of clinicians, including general paediatricians as well as paediatric subspecialists.
Immunosuppression in HIV-positive kidney transplant recipients
Authors: Sorohan Bogdan Marian , Ismail Gener , Leca Nicolae
Published: May 2023

Purpose of study

The purpose of this review is to provide the current state of immunosuppression therapy in kidney transplant recipients (KTR) with HIV and to discuss practical dilemmas to better understand and manage these patients.

Recent findings

Certain studies find higher rates of rejection, which raises the need to critically assess the approach to immunosuppression management in HIV-positive KTR. Induction immunosuppression is guided by transplant center-level preference rather than by the individual patient characteristics. Earlier recommendations expressed concerns about the use of induction immunosuppression, especially utilizing lymphocyte-depleting agents; however, updated guidelines based on newer data recommend that induction can be used in HIV-positive KTR, and the choice of agent be made according to immunological risk. Likewise, most studies point out success with using first-line maintenance immunosuppression including tacrolimus, mycophenolate, and steroids. In selected patients, belatacept appears to be a promising alternative to calcineurin inhibitors with some well established advantages. Early discontinuation of steroids in this population carries a high risk of rejection and should be avoided.

Immunosuppression management in HIV-positive KTR is complex and challenging, mainly because of the difficulty of maintaining a proper balance between rejection and infection. Interpretation and understanding of the current data towards a personalized approach of immunosuppression could improve management in HIV-positive KTR.
The Future of Nursing 2020-2030
Authors: Bernhardt Jean M. , Breakey Suellen , Sipe Margie , Nicholas Patrice K.
Published: May 2023

Climate change represents a looming health challenge and a critical area for nursing leadership at all levels of organizations and settings. With a lens on The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity, addressing climate change–related health consequences should be a major focus and spotlight for nurses and nurse leaders with a lens on individuals, communities, populations, and from a national and global perspective.
The Effect of Pectoral Nerve Blocks on Opioid use and Postoperative Pain in Masculinizing Mastectomy: A Randomized Controlled Trial
Authors: Wallace Adam B. , Song Siyou , Yeh Peter , Kim Esther A.
Published: May 2023

BACKGROUND:

Bilateral masculinizing mastectomy is the most common gender affirmation operation performed. Currently, there is lack of data regarding intraoperative and postoperative pain control for this population. It is our aim to study the effects of the Pecs I and II regional nerve blocks in patients undergoing masculinizing mastectomy.

METHODS:

A randomized, double-blind, placebo-controlled trial was performed. Patients undergoing bilateral gender affirmation mastectomy were randomized to receive either a Pecs block with Ropivacaine or placebo injection. The patient, surgeon, and anesthesia team were blinded to the allocation. Intraoperative and postoperative opioid requirements were collected and recorded as morphine milligram equivalents (MME). Participants recorded postoperative pain scores at specific time points on the day of surgery through postoperative day seven.

RESULTS:

50 patients were enrolled between July, 2020 and February, 2022. 27 were randomized to the intervention group, and 23 to the control group with 43 patients undergoing analysis. There was no significant difference in intraoperative morphine milligram equivalents (MME) between the Pecs block group and control (9.8 vs. 11.1, p=0.29). Additionally, there was no difference in postoperative MME between the groups (37.5 vs. 40.0, p=0.72). Postoperative pain scores were also similar between the groups at each specified time point.

CONCLUSIONS:

There was no significant reduction in opioid consumption or postoperative pain scores in patients undergoing bilateral gender affirmation mastectomy who received a regional anesthetic when compared to placebo. Additionally, a postoperative opioid sparing approach may be appropriate for patients undergoing bilateral masculinizing mastectomy.
Impact of Initial Filling Medium on Outcomes of Subpectoral Two-Stage Implant-Based Breast Reconstruction: Air Versus Saline
Authors: Bae Juyoung , Lee Kyeong-Tae , Jeon Byung Joon , Mun Goo-Hyun , Bang Sa Ik , Pyon Jai Kyong
Published: May 2023

BACKGROUND:

In two-stage expander-based breast reconstruction, the use of air as the initial filling medium has been suggested to confer clinical advantages over conventional saline, but this has not been demonstrated in a large series. The present study aimed to evaluate the association between material type (air versus saline) for initial expander filling and postoperative outcomes.

METHODS:

This retrospective study included patients who underwent immediate subpectoral tissue expander-based breast reconstruction between January 2018 and March 2021. The subjects were categorized into two groups according to the material used for initial filling; saline-inflated expanders, which were used during the first 22 months consecutively; and air-inflated expanders, which were used during the latter 17 months consecutively. Complications including mastectomy flap necrosis, and postoperative expansion profiles were compared. Multivariable analyses were performed to identify independent predictors of postoperative complications.

RESULTS:

A total of 443 breasts (400 patients), including 161 air-filled and 282 saline-filled, were analyzed. The two groups had similar baseline characteristics. The air-filled group showed a significantly lower rate of mastectomy flap necrosis; this difference remained significant after the adjustment for other variables in the multivariable analysis. The rates of other complications did not differ between the two groups. The air-filled group had fewer office visits and a shorter period to complete expansion.

CONCLUSIONS:

The use of air for initial expander filling could provide safe and reliable outcomes with reduced patient discomfort during postoperative expansion; thus, air-filled expanders might be an effective alternative to saline-filled expanders.
Combined subbrow blepharoplasty and brow fat pad transfer for the simultaneous correction of dermatochalasis and sunken upper eyelids
Authors: Qu Linghan , Liang Zhen , Wang Jianzhang , Zhang Juan , Yu Zhou , Song Baoqiang
Published: May 2023

Background:

Women commonly have upper eyelid dermatochalasis and upper eyelid depression due to advancing age. Blepharoplasty is a suitable method for dermatochalasis but not sunken eyelid. This study proposed a novel technique for eyelid rejuvenation by simultaneously correcting dermatochalasis and sunken upper eyelids in middle-aged women.

Methods:

Forty patients underwent subbrow blepharoplasty combined with brow fat pad transfer. The ellipse-shape skin and subcutaneous tissue underneath the eyebrow were measured, demarcated, and excised. The orbicularis oculi muscle beneath the subcutaneous tissue was exposed and dissected in the upper-third area. The brow fat pad was turned downward using the lower edge as the pedicle and was fixed in the layer of retro-orbicularis oculi fat (ROOF) to fill the depressed area in the upper eyelid. The lower muscle flap was fixed to the supraorbital rim periosteum and upper musculocutaneous flaps, thereby forming a cross flap for interlocking fixation. The surgical outcomes were evaluated using Antera 3D camera and the Global Aesthetic Improvement Scale (GAIS).

Results:

The depth and volume of upper eyelid depression significantly decreased 3 months after the surgery and stabilized within 6 months. The GAIS scores significantly improved after the surgery, and the postoperative outcomes were acceptable.

Coclusion

The Novel technique is simple and effective for simultaneously correcting dermatochalasis and sunken upper eyelids in middle-aged women. The surgical outcomes are predictable and acceptable to most patients.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV
Ultrasound to Improve the Anatomic Approach to the Temple and a Retrospective Study on the Efficacy of Large-Volume Autologous Fat Grafting
Authors: Ge Haojie , Lin Biaobin , Fang Bairong
Published: May 2023

Background:

Autologous fat grafting (AFG) has been used widely in temporal-hollowing augmentation, but its efficacy and safety are unclear. The authors examined the use of Doppler ultrasound (DUS) in large-volume lipofilling after performing an anatomic study of the temporal region.

Methods:

To clarify safe and stable levels of AFG of the temporal fat compartments, 5 cadaveric heads (10 sides) were dissected after dye was injected into targeted fat pads with DUS guidance. In addition, the authors retrospectively analyzed 100 patients with temporal fat transplantation, including groups with conventional AFG (n = 50) and DUS-guided large-volume AFG (n = 50).

Results:

The anatomic study revealed the approach of 5 injection planes and 2 fat compartments in the temporal region: the superficial and deep temporal fat pads. In the AFG study, all patients were female, and there were no statistically significant differences between the groups in age, body mass index, tobacco or steroid use, or previous filling history. Between the conventional AFG group and the DUS-guided large-volume AFG group, the average volume of temporal lipofilling per side was 10.55 ± 2.25 versus 22.32 ± 5.19 mL/side (P < 0.001), surgeon Likert scale score was 2.86 ± 0.97 versus 4.24 ± 0.66 (P < 0.001), and rate of satisfaction was 74% versus 92% (P < 0.05) (statistically significant differences).

Conclusions:

The anatomic approach to the main temporal fat compartment is feasible. DUS-guided large-volume AFG is an effective and safe way to improve temporal hollowing augmentation.
Oncoplastic techniques and tricks to have in your toolbox
Authors: Huang Anne , Wong Daniel E. , Hanson Summer E
Published: May 2023

Oncoplastic breast reconstruction seeks to address partial mastectomy defects in the setting of breast conserving surgery to achieve superior aesthetic outcomes with comparable oncologic safety compared to traditional breast conservation surgery. As such, oncoplastic breast conserving surgery has grown in popularity in recent years. There are several techniques that have been used to displace the volume with the remaining breast tissue or replace it with local soft tissue options, with decision-making guided by patient and tumor characteristics, additional treatment requirements, patient preference and available tissue resources. The purpose of this review is to provide an overview of considerations in oncoplastic breast reconstruction with a focus on techniques and tips to achieve optimal outcomes.
Accumulation of 18F-FDG at Anomalous Systemic Arterial Supply to Normal Lung on 18F-FDG PET/CT
Authors: Usmani Sharjeel , Jain Anjali , Al Riyami Khulood , Munir Javeria , Abubakar Sofiullah
Published: May 2023

Anomalous systemic arterial supply to normal lung is an anatomical variant in which a portion of the lung is supplied by a systemic vessel without a distinct pulmonary sequestration. We report a case of mild to moderate accumulation of 18F-FDG in the medial basal segment of left lung; corresponding CT images localize this uptake in the tortuous artery arising from the descending aorta with similar uptake to that of descending aorta. Findings are suggestive of anomalous systemic arterial supply to normal segments of the lung. Hybrid PET/CT allows precise anatomical localization and helps in differentiate benign mimics of disease, which can alter patient management.
Pierre Robin Sequence and Respiratory Distress: Long-Term Evolution in Patients Submitted to the Conservative Treatment
Authors: Freitas Renato da Silva , do Prado Daniel , Guarezi Nasser Isis J. , Peressutti Carolina , Ogawa Vanessa S.
Published: May 2023

Background:

Pierre Robin Sequence (PRS) is characterized by micrognathia, glossoptosis, cleft palate, and airway distress. The aims of initial treatment are the improvement of airway and feeding. There are many therapeutic options, including conservative techniques (prone positioning and nasopharyngeal tube) and invasive procedures (mandibular distraction and tracheostomy). In our center, initially conservative treatment is the rule and many patients have been treated with nasopharyngeal tube.

Objective:

The aim was to analyze of the clinical evolution of respiratory distress in infants with PRS submitted to nonsurgical treatment.

Methods:

A retrospective and observational descriptive evaluation was carried out with 56 patients with the PRS at Centro de Atendimento Integral ao Fissurado Labiopalatal (CAIF). 21 patients were selected to a transversal phase.

Results:

The treatment has started in an average age of 1.5 months (±2.09) and 17 (94.4%) had respiratory distress at birth. Polysomnographic exams showed an average apnea/hypopnea index of 0.93, an average number of central apnea/hour of 0.3, an average number of obstructive apnea of 0.6 and an average oxygen saturation of 92%. There was the predominance of esthetic profile in class II with 16 (88.9%) patients in this group, and orthodontic profile in class II with 15 (83.3%) patients.

Conclusion:

The conservative treatment has presented remarkable results in the treatment of respiratory distress in bearers of PRS with a decrease of obstructive sleep events considering the growth of patient and the development of mandibular growth as well.
Clinical Application of a Resembling Rectangular Flap on Lateral Lip in Unilateral Cheiloplasty: A Modified Millard’s Technique
Authors: Wang Xiaorong , Liao Lishu , Li Yijun , Tang Shengyu , Li Wanshan
Published: May 2023

Purpose:

This clinical study aimed to design and utilize a modified rotation-advancement technique (MRAT) with a resembling rectangular flap on the lateral lip for primary unilateral cheiloplasty and evaluated its postoperative outcomes.

Materials and Methods:

A retrospective study was conducted on patients with a unilateral cleft lip who had undergone initial cheiloplasty with MRAT. The postoperative outcomes were assessed for nasolabial symmetry by photogrammetry. Repeated measures of ANOVA and two independent samples t tests were applied for statistical analysis.

Results:

Twenty patients with unilateral cleft lip met the inclusion criteria. Postoperatively, the patients had well-shaped nasal sill and centered nasal columella. In addition to, the bilateral symmetrical ratios noticeably improved (P<0.001). Simultaneously, the postoperative outcomes were independent of the cleft type and height differences of the two peaks (P>0.05).

Conclusions:

Unilateral cheiloplasty using the present MRAT can better preserve the nasolabial structure and symmetry. The postoperative scar is concealed and simulates a normal philtral ridge.