bluuebunny/crossref_metadata_2025 huggingface dataset:
Multicenter, prospective, phase II study of maintenance bevacizumab for children and adults with NF2-related schwannomatosis and progressive vestibular schwannoma
Authors: Plotkin Scott R , Allen Jeffrey , Dhall Girish , Campian Jian L , Clapp D Wade , Fisher Michael J , Jain Rakesh K , Tonsgard James , Ullrich Nicole J , Thomas Coretta , Edwards Lloyd J , Korf Bruce , Packer Roger , Karajannis Matthias A , Blakeley Jaishri O
Published: April 2023

Background

Prospective data on maintenance therapy with bevacizumab for persons with NF2-related schwannomatosis (NF2-SWN) is lacking. In this prospective multicenter phase II study, we evaluated the efficacy, safety, and tolerability of bevacizumab for maintenance therapy in children and adults with NF2-SWN and hearing loss due to vestibular schwannomas (VS).

Methods

Following induction therapy, participants received bevacizumab 5 mg/kg every 3 weeks for 18 months. Participants were monitored for changes in hearing, tumor size, and quality of life (QOL), and for adverse events. Hearing loss was defined as a statistically significant decline in word recognition score (WRS) or pure-tone average compared to the study baseline; tumor growth was defined as >20% increase in volume compared to baseline.

Results

Twenty participants with NF2-SWN (median age 23.5 years; range, 12.5–62.5 years) with hearing loss in the target ear (median WRS 70%, range 2%–94%) received maintenance bevacizumab. Freedom from hearing loss in the target ear was 95% after 48 weeks, 89% after 72 weeks, and 70% after 98 weeks. Freedom from tumor growth in the target VS was 94% after 48 weeks, 89% after 72 weeks, and 89% after 98 weeks. NF2-related QOL remained stable for 98 weeks whereas tinnitus-related distress decreased. Maintenance bevacizumab was well tolerated, with 3 participants (15%) discontinuing treatment due to adverse events.

Conclusions

Maintenance bevacizumab (5 mg/kg every 3 weeks) is associated with high rates of hearing and tumor stability during 18 months of follow-up. No new unexpected adverse events related to bevacizumab were identified in this population.
Efficacy and Dose-Response Relationship of Stereotactic Body Radiotherapy for Abdominal Lymph Node Metastases from Hepatocellular Carcinoma
Authors: Wang Yuting , Li Qiaoqiao , Zhang Li , Liu Shiliang , Zhu Jinhan , Yang Yadi , Liu Mengzhong , Zhang Yaojun , Xi Mian
Published: April 2023

Background

The objective of this study was to investigate the treatment efficacy of stereotactic body radiotherapy (SBRT) and evaluate the influence of radiation dose on local control and survival in patients with abdominal lymph node metastases (LNM) from hepatocellular carcinoma (HCC).

Patients and methods

Between 2010 and 2020, data of 148 patients with HCC with abdominal LNM, including 114 who underwent SBRT and 34 who received conventional fractionation radiation therapy (CFRT), were collected. A total radiation dose of 28-60 Gy was delivered in 3-30 fractions, with a median biologic effective dose (BED) of 60 Gy (range, 39-105 Gy). Freedom from local progression (FFLP) and overall survival (OS) rates were analyzed.

Results

With a median follow-up of 13.6 months (range, 0.4-96.0 months), the 2-year FFLP and OS rates of the entire cohort were 70.6% and 49.7%, respectively. Median OS of the SBRT group was longer than the CFRT group (29.7 vs. 9.9 months, P = .007). A dose-response relationship was observed between local control and BED in either the entire cohort or the SBRT subgroup. Patients who received SBRT with a BED ≥60 Gy had significantly higher 2-year FFLP and OS rates than those who received a BED <60 Gy (80.1% vs. 63.4%, P = .004; 68.3% vs. 33.0%, P < .001). On multivariate analysis, BED was an independent prognostic factor for both FFLP and OS.

Conclusions

SBRT achieved satisfactory local control and survival with feasible toxicities in patients with HCC with abdominal LNM. Moreover, the findings of this large series suggest a dose-response relationship between local control and BED.
Financial Disruptions and the Organization of Innovation: Evidence from the Great Depression
Authors: Babina Tania , Bernstein Asaf , Mezzanotti Filippo
Published: April 2023

We examine innovation following the Great Depression using data on a century’s worth of U.S. patents and a difference-in-differences design that exploits regional variation in the crisis severity. Harder-hit areas experienced large and persistent declines in independent patenting, mostly reflecting the disruption in access to finance during the crisis. This decline was larger for young and inexperienced inventors and lower-quality patents. In contrast, innovation by large firms increased, especially among young and inexperienced inventors. Overall, the Great Depression contributed to the decline in technological entrepreneurship and accelerated the shift of innovation into larger firms.
The Political Work of Migration Governance Binaries: Responses to Zimbabwean “Survival Migration” at the Zimbabwe–South Africa Border
Authors: Vanyoro Kudakwashe
Published: April 2023

This article’s purpose is to analyse the political work of binaries used in both domestic and global migration governance responses with a particular focus on Zimbabwean “survival migration” at the Zimbabwe–South Africa border. This article finds that there is peculiar complementarity between South Africa’s domestic migration governance framework and global migration governance frameworks aimed at a migration management approach. This article argues that this nice fit normalises the ostensibly clear distinction between migrants and refugees to deny protection to deserving asylum-seekers, which is productive in serving the political interests of the South African government. Without access to the appropriate papers and encountering a border refugee reception office that has developed de facto gatekeeping measures to prevent them from seeking asylum, as well as a United Nations High Commissioner for Refugees field office that perceives them as economic migrants, many Zimbabweans living in South Africa occupy a liminal area of categorisation and protection. Hence, the possibilities of the global migration governance providing legitimacy to exclusionary practices at the national level in South Africa are immense. This points to the need for serious engagement with “survival migration” as a category of mobility in analysis, policy, law as well as practice.
Association between circadian sleep regulation and cortical gyrification in young and older adults
Authors: Deantoni Michele , Reyt Mathilde , Berthomier Christian , Muto Vincenzo , Hammad Gregory , De Haan Stella , Dourte Marine , Taillard Jacques , Lambot Eric , Cajochen Christian , Reichert Carolin F , Maire Micheline , Baillet Marion , Schmidt Christina
Published: April 2023

The circadian system orchestrates sleep timing and structure and is altered with increasing age. Sleep propensity, and particularly REM sleep is under strong circadian control and has been suggested to play an important role in brain plasticity. In this exploratory study, we assessed whether surface-based brain morphometry indices are associated with circadian sleep regulation and whether this link changes with age. Twenty-nine healthy older (55–82 years; 16 men) and 28 young participants (20–32 years; 13 men) underwent both structural magnetic resonance imaging and a 40-h multiple nap protocol to extract sleep parameters over day and night time. Cortical thickness and gyrification indices were estimated from T1-weighted images acquired during a classical waking day. We observed that REM sleep was significantly modulated over the 24-h cycle in both age groups, with older adults exhibiting an overall reduction in REM sleep modulation compared to young individuals. Interestingly, when taking into account the observed overall age-related reduction in REM sleep throughout the circadian cycle, higher day–night differences in REM sleep were associated with increased cortical gyrification in the right inferior frontal and paracentral regions in older adults. Our results suggest that a more distinctive allocation of REM sleep over the 24-h cycle is associated with regional cortical gyrification in aging, and thereby point towards a protective role of circadian REM sleep regulation for age-related changes in brain organization.
Di(2-ethylhexyl) phthalate mediates oxidative stress and activates p38MAPK/NF-kB to exacerbate diabetes-induced kidney injury in vitro and in vivo models
Authors: Ding Wen-Jie , Huang Shou-Lin , Huang Song , Xu Wei-Ping , Wei Wei
Published: April 2023

Plasticizer di(2-ethylhexyl) phthalate (DEHP) is employed to make polyethylene polymers. Some studies in epidemiology and toxicology have shown that DEHP exposure over an extended period may be hazardous to the body, including nephrotoxicity, and aggravate kidney damage in the context of underlying disease. However, studies on the toxicity of DEHP in diabetes-induced kidney injury have been rarely reported. Using a high-fat diet (HFD) and streptozotocin (STZ, 35 mg/kg)-induced kidney injury in mice exposed to various daily DEHP dosages, we explored the impacts of DEHP on diabetes-induced kidney injury. We discovered that DEHP exposure significantly promoted the renal inflammatory response and oxidative stress in mice, with increased P-p38 and P-p65 protein levels and exacerbated the loss of podocin. The same findings were observed in vitro after stimulation of podocytes with high glucose (30 mmol/L) and exposure to DEHP. Our results suggest that DEHP exacerbates diabetes-induced kidney injury by mediating oxidative stress and activating p38MAPK/NF-κB.
Clinical Interpretation of Word-Recognition Scores for Listeners with Sensorineural Hearing Loss: Confidence Intervals, Limits, and Levels
Authors: Margolis Robert H. , Wilson Richard H. , Saly George L.
Published: April 2023

Objectives:

Confidence levels were established to determine if a word-recognition score is within the expected range for a hearing loss group (based on 3-frequency pure-tone average) or significantly below or above the expected range.

Design:

Two large clinical databases were mined to produce data-sets composed of word-recognition scores obtained with Q/MASS NU-6 materials and VA NU-6 materials for patients with average hearing losses ranging from 0 to 70 dB HL. Percentiles representing scores that are below (2.5%, 5%, and 10%) and above (90%, 95%, and 97.5%) the expected range (defined as the 80% confidence interval) were established. To estimate the distribution of scores and percentiles for the Auditec NU-6 materials (for which a large database is not available) Q/MASS scores were transformed to Auditec scores based on published psychometric functions.

Results:

The resulting confidence levels and expected ranges of word-recognition scores should be useful for interpreting the relationship between a score and the distribution of scores for the patient’s hearing loss severity. Confidence levels are described as low, moderate, and high corresponding to the statistical level of assurance that a score is lower or higher than the expected score.

Conclusions:

The confidence levels and expected ranges may be helpful for interpreting word-recognition scores obtained with three widely used sets of NU-6 test materials.
Antegrade Flexible Nailing for Pediatric Metaphyseal-diaphyseal Junction Distal Radius Fracture, is it Safe?
Authors: Lam Aaron , Gordon Adam M. , Thabet Ahmed M. , Abdelgawad Amr A.
Published: April 2023

Fractures involving the distal radius metaphyseal-diaphyseal junction (MDJ) present a unique challenge for pediatric orthopedic surgeons. These fractures are too proximal for percutaneous K-wire fixation and too distal for retrograde flexible nailing. The purpose of this study was to: (1) determine the safety of a described antegrade approach from the posterior interosseous nerve (PIN); (2) assess the efficacy of antegrade nailing in cases of distal MDJ fractures; and (3) describe a standardized lateral approach to the proximal radius. A cadaveric study was performed using 10 adult forearms. Anterograde flexinail was introduced at the proximal radius based on the described “safe zone”. Distal MDJ fractures were created using osteotomes. We evaluated the distance between the entry point to the PIN in addition to the quality of the reduction for the fracture. The average distance between the entry point and piercing instrument to the PIN was 5.4 cm (range: 4.7 to 6.0 cm). When grouped based on sex, the average distance was significantly further for males (5.8 cm, range: 5.2 to 6.0 cm) versus females (4.9 cm, range: 4.7 to 5.2 cm), P=0.004. Fracture reduction was not maintained after the introduction of the antegrade flexible nail across the fracture site. For all specimens, >25% displacement was seen on the anterior-posterior imaging. Our modified lateral approach to the starting point in the proximal radius is safe as long as the entry point for antegrade flexible nailing stays proximal to the radial tuberosity during the lateral approach to the proximal radius while the elbow is flexed and the forearm pronated.
Management of acute diverticulitis with pericolic free gas (ADIFAS): an international multicenter observational study
Authors: Tejedor Patricia , Pastor Carlos , Pellino Gianluca , Di Saverio Salomone , Gorter-Stam Marguerite , Sylla Patricia , Francis Nader ,   on behalf of the Collaborative Study Group
Published: April 2023

Background:

There are no specific recommendations regarding the optimal management of this group of patients. The World Society of Emergency Surgery suggested a nonoperative strategy with antibiotic therapy, but this was a weak recommendation. This study aims to identify the optimal management of patients with acute diverticulitis (AD) presenting with pericolic free air with or without pericolic fluid.

Methods:

A multicenter, prospective, international study of patients diagnosed with AD and pericolic-free air with or without pericolic free fluid at a computed tomography (CT) scan between May 2020 and June 2021 was included. Patients were excluded if they had intra-abdominal distant free air, an abscess, generalized peritonitis, or less than a 1-year follow-up. The primary outcome was the rate of failure of nonoperative management within the index admission. Secondary outcomes included the rate of failure of nonoperative management within the first year and risk factors for failure.

Results:

A total of 810 patients were recruited across 69 European and South American centers; 744 patients (92%) were treated nonoperatively, and 66 (8%) underwent immediate surgery. Baseline characteristics were similar between groups. Hinchey II–IV on diagnostic imaging was the only independent risk factor for surgical intervention during index admission (odds ratios: 12.5, 95% CI: 2.4–64, P=0.003). Among patients treated nonoperatively, at index admission, 697 (94%) patients were discharged without any complications, 35 (4.7%) required emergency surgery, and 12 (1.6%) percutaneous drainage. Free pericolic fluid on CT scan was associated with a higher risk of failure of nonoperative management (odds ratios: 4.9, 95% CI: 1.2–19.9, P=0.023), with 88% of success compared to 96% without free fluid (P<0.001). The rate of treatment failure with nonoperative management during the first year of follow-up was 16.5%.

Conclusion:

Patients with AD presenting with pericolic free gas can be successfully managed nonoperatively in the vast majority of cases. Patients with both free pericolic gas and free pericolic fluid on a CT scan are at a higher risk of failing nonoperative management and require closer observation.
Skin problems among the wheelchair users: a prospective cross-sectional study
Authors: Alkhalifah Azzam , Aljohani Moath , Almasaud Weam , Alsalamah Rola , Alhomili Amjad , Almasaud Abdulrahman , Tobeigei Faisal H.
Published: April 2023

Background:

Skin is the largest and the outermost body organ. It is directly affected by the external environment. The biomechanical differences in wheelchair users compared to healthy people make them prone to different risk factors of skin problems. Nevertheless, these patients are under-represented in the dermatologic literature.

Objective:

The primary objective was to determine the frequency of different skin problems among wheelchair users. The secondary objective is to determine the different precautions they are taking to prevent these problems.

Methods:

The prospective study followed a cross-sectional design, conducted during the period of the coronavirus disease 2019 curfew between May and June 2020. The survey’s link was distributed among adult wheelchair users in Saudi Arabia. The questionnaire was administered using google forms. All statistical analyses were performed using SPSS version 22.

Results:

The results show that the vast majority of wheelchair users (85%) experienced skin problems. Pressure ulcer (PU) is the most frequently reported skin condition (54%), followed by traumatic wounds, fungal infections, and hand skin dryness and thickening. The commonest preventive measure was using cushions to avoid PUs.

Conclusion:

Most of wheelchair users reported having a history of skin complaints, of which PU was the most common followed by traumatic wounds and fungal infections. Thus, spreading awareness of the risk factors and preventive methods would help them avoid its development and prevent its negative impact on quality of life. Assessing the different kinds of wheelchairs and cushions to avoid PUs would be an interesting area for future studies.
Intermediate risk of choledocholithiasis: are we on the right path?
Authors: Girón Felipe , Rodríguez Lina M. , Conde Danny , Rey Chaves Carlos E. , Vanegas Marco , Venegas David , Gutiérrez Fernando , Nassar Ricardo , Hernández Juan D. , Jiménez Daniel , Núñez-Rocha Ricardo E. , Niño Laura , Rojas Susana
Published: April 2023

Introduction:

The risk of choledocholithiasis should be assessed in every patient undergoing cholecystectomy to define the next step. The American Society for Gastrointestinal Endoscopy proposed a stratified predictor scale of choledocholithiasis. Therefore, we aimed to describe our experience managing patients with an intermediate risk of choledocholithiasis according to the American Society for Gastrointestinal Endoscopy guidelines and the actual presence of bile duct stones in magnetic resonance cholangiopancreatography.

Methods:

A retrospective observational study with a prospective database was conducted. The analysis included sociodemographic data, laboratory values, and imaging. Bivariate, multivariate, and receiver operating characteristic analysis were performed.

Results:

Three hundred twenty-seven patients had an intermediate risk for choledocholithiasis. Half the patients were at least 65 years old. 24.77% were diagnosed with choledocholithiasis. Bile duct dilation was documented in only 3.06% of cases. Diagnosis of choledocholithiasis is associated with an age odds ratio (OR): 1.87 (P 0.02), alkaline phosphatase OR: 2.44 (P 0.02), and bile duct dilation greater than 6 mm OR: 14.65 (P 0.00).

Conclusions:

High variability in the accuracy of imaging techniques results in a large number of patients classified as intermediate risk without choledocholithiasis in cholangioresonance. Therefore, enhancing the criteria to define intermediate risk for patients in order to optimize resources is of paramount importance.
Management of a floating shoulder accompanied by a scapular surgical neck fracture: a case report and review of the literature
Authors: Sharifpour Sadula , Mirghaderi Peyman , Ghaseminejad Raeini Amirhossein , Mirghaderi Reza , Moharrami Alireza , Kalantar Seyed Hadi
Published: April 2023

Introduction and Importance:

In this article, we want to present a floating shoulder case accompanied by a scapular surgical neck fracture and review the literature about its diagnosis and management.

Case Presentation:

Our patient was a 40-year-old man who suffered a severe left shoulder injury as a result of a car-to-pedestrian accident. Computed tomography scan revealed a scapular surgical neck and body fracture, a spinal pillar fracture, and a dislocation of the acromioclavicular (AC) joint. The medial-lateral displacement and glenopolar angle were 21.65 mm and 19.8°, respectively. There was a 37° angular displacement and a greater than 100% translational displacement.

Initially, the AC joint dislocation was approached via a superior incision on the clavicle and reduced with a single hook plate. A Judet approach was then used to expose the scapula fractures. The scapular surgical neck was fixed with a reconstruction plate. The spinal pillar was stabilized with two reconstruction plates following reduction.

Following a year of follow-up, the patient’s shoulder range of motion was acceptable, and an American Shoulder and Elbow Surgeons score of 88 was achieved.

Discussion and Conclusion:

Floating shoulder management is still controversial. Floating shoulders are often treated surgically due to their consequent instability and potential risk of nonunion and malunion. As shown in this article, the indications for operating on isolated scapula fractures may also apply to floating shoulders. A well-planned approach to fractures is also imperative, and the AC joint should always be a priority.
Coexistence of a huge Brenner’s tumour and mucinous cystadenoma in a 62-year-old female: a case report from Syria
Authors: Zahlout Jaafar , Shmayyes Nour A. , Zahlout Batoul , Kassab Yahya , Alshehabi Zuheir
Published: April 2023

Introduction and importance:

The coexistence of a benign Brenner tumour and a mucinous cystadenoma is rare, and their relationship and origin are still enigmatic and challenging.

Case presentation:

In this manuscript, the authors report a case of a 62-year-old nulliparous Syrian woman who presented with severe abdominal distension, which was followed by laparotomy and the excision of a 25×20 cm-cyst; its pathological examination confirmed a benign Brenner’s tumour and mucinous cystadenoma.

Clinical discussion:

Ovarian Brenner and mucinous are usually benign and can rarely grow asymptomatically to very big sizes. Herein, the authors aim to emphasize the importance of excluding malignancy by pathology examination.

Conclusion:

Walthard cell nests undergo metaplasia to give rise to different kinds of Brenner and mucinous neoplasm formations according to their genetic alterations. This paper adds to the available literature, which is still poor, by providing evidence of the first case of this rare combination from Syria with a review of different theories of origin and differential diagnoses. More studies directed towards exploring this combination’s genetic origin are needed to boost our understanding of ovarian tumours in general.
Afterhours patient phone calls: a quality improvement study
Authors: Tideman Grace , Hadley Morgan , Campbell Tanner , Templeton Kimberly
Published: April 2023

Objective:

The objective was to determine the most common topic of patient phone calls received by on-call orthopedic residents at a single academic institution in order to identify areas of improvement for patient outcome and resident workload and wellbeing.

Design:

Patient phone calls over 82 shifts were documented from May 2020 to January 2021 by on-call orthopedic residents. The length, nature, and associated attending physician of each call were recorded, as well as whether the call resulted in an emergency department visit. The nature of each phone call was categorized into one of 12 categories.

Setting:

An urban, tertiary care academic institution in the Midwest, USA.

Participants:

All orthopedic residents on-call during this period logged the phone calls that they received and related relevant data.

Results:

Orthopedic surgery residents took an average of 8.6 patient phone calls (average 53.3 total minutes) per shift. The most common reasons for the phone calls were pain, prescription, and pharmacy concerns, which together represented over half of the calls. Twenty-one (4.1%) phone calls resulted in an emergency department visit.

Conclusion:

Concerns about pain and prescriptions were among the most common reasons for patient phone calls. This information points to opportunities for interventions that could help guide how postoperative pain is discussed with patients, including providing patients with reasonable expectations for pain control, function, and tools for better self-efficacy. This approach could not only enhance patient care but also decrease resident on-call workload and improve resident wellbeing.
Learning to Fly in the Time of COVID-19
Authors: Sabatini Roxanne , Horan Kathleen , McKnight Ashley , Thomas Jolly Varughese , Stroh Lauren , Silverstein Wendy
Published: April 2023

This qualitative study, designed by nursing professional development specialists, explored novice nurses' experiences working during the first COVID-19 surge of 2020. Semistructured focus group interviews were conducted in June–December 2020 with 23 novice nurses who cared for patients with COVID-19 in March–April 2020. Sixteen themes were identified under three broad categories (viz., stimuli, coping, and adaptation). These themes and participant exemplars are shared along with recommendations on how best to support novice nurses working through the ongoing pandemic.
Histopathologic and Immunohistochemical Assessment of Acute Respiratory Distress Syndrome (ARDS): Challenges and Complexities of Postmortem Diagnosis
Authors: de Araújo Leonardo José Tadeu , de Oliveira Louzado Ligia Cândido , Cirqueira Cinthya Santos , Réssio Rodrigo Albergaria , Sansone Marcelo , Guerra Juliana Mariotti
Published: April 2023

Acute respiratory distress syndrome (ARDS) is a life-threatening condition due to acute lung injury (ALI), characterized by rapid-onset respiratory failure, leading to the clinical manifestations of poor lung compliance, severe hypoxemia, and dyspnea. ARDS/ALI has many causes, most commonly related to infections (sepsis, pneumonia), traumas, and multiple transfusions. The objective of this study is to assess the performance of postmortem anatomopathological examination in identifying etiological agents associated with ARDS or ALI in deceased patients from the State of São Paulo from 2017 to 2018. A retrospective cross-sectional study was performed based on the final outcome obtained by histopathology, histochemical, and immunohistochemical examination for ARDS/ALI differential diagnosis at the Pathology Center of the Adolfo Lutz Institute in São Paulo, Brazil. Of the 154 patients clinically diagnosed with ARDS or ALI, 57% tested positive for infectious agents, and the most frequent outcome was influenza A/H1N1 virus infection. In 43% of cases, no etiologic agent was identified. The opportunity to establish a diagnosis, identify particular infections, confirm a microbiological diagnosis, and uncover unanticipated etiologies is provided by postmortem pathologic analysis of ARDS. A molecular assessment could improve the diagnosis accuracy and lead to research into host responses and public health measures.
An Elegant Method for Removing Breast Implants - a Novel Surgical Device
Authors: Gronovich Yoav , Maisel-Lotan Adi
Published: April 2023

The use of breast implants is constantly on the rise due to the increase in aesthetic and reconstructive breast surgery. Implant rupture is a potential complication, the rate of which has increased over time. Consequently, implant removal or replacement is a common procedure, inevitable for all breast implants at some point during the patient's lifetime. Currently, surgical removal of ruptured implants is messy, cumbersome, time consuming and, in all, unpleasant. We have developed a custom-made device that effectively removes a silicone implant, whether ruptured or intact. In order to determine its efficiency, we conducted a prospective clinical trial of 25 women (45 breasts) undergoing removal or replacement of breast implants with our device between January 2019 and January 2022. Device safety and efficiency were assessed, and the need for the device was evaluated through a survey among 25 board certified plastic surgeons. In our trial, the mean implant age was 12.8 years and mean volume, 370gr. Mean time to extract the implant with the device was 10.7 seconds. Twenty-two implants (49%) were ruptured. There were no minor or major complications during the procedure or follow-up. Mean follow-up period was six months. Surgeons’ intentions to use this device in their own practices for removal of intact and ruptured implants was very high. In conclusion, our novel device may prove indispensable for explantation of both intact and ruptured silicone implants.
Hybrid breast augmentation, double benefit or double risk? A comparative study of 932 cases
Authors: Li Zhengyao , Zhang Ziying , Zhang Zixuan , Guan Xiaoyu , Xin Minqiang
Published: April 2023

Background

We propose a hybrid breast augmentation (HBA) method combining implants and fat grafting and explore the outcome and safety through a retrospective, single-center, propensity score-matched (PSM) comparative study.

Method

Outcome, satisfaction, and complications were compared between the HBA group (302 cases) and the implant-based breast augmentation (IBA) group (353 cases), the HBA group and the autologous fat grafting (AFG) group (277 cases).

Result

The mean follow-up period was 31.7 months. After PSM, 270 cases were matched between the HBA and IBA groups, and 156 cases were matched between the HBA and AFG groups. Compared to the IBA group: HBA achieved higher scores of implant visibility/palpability and upper pole contour with the specialists’ evaluations (before and after PSM, P<0.05). Regarding patient satisfaction, the scores of softness (before and after PSM), smoothness of the upper pole (before PSM), and overall satisfaction (after PSM) of the HBA group were better (P<0.05). Implant-related complications occurred at a similar rate. Compared to the AFG group: HBA achieved higher scores of shape (before and after PSM) and symmetry (after PSM) with evaluations of specialists (P<0.05). The scores of shape, symmetry and overall satisfaction in the HBA group were better (before and after PSM, P<0.05). The HBA group showed a lower incidence of palpable cysts, fat necrosis, oil cysts, and fat calcification (before PSM, P<0.05).

Conclusion

By comparing the three techniques objectively, HBA presented better indices of aesthetic outcomes, satisfaction and acceptable complications rates when compared to IBA and AFG.
Novel Clinical Anatomic Consideration of the Superficial and Deep Layers of the Deep Temporal Fascia
Authors: Lee Hyung-Jin , Kim Hyoung Moon , Ahn Hyo-Sang , Lee Ji-Hyun , Kim Hee-Jin
Published: April 2023

Background:

The deep temporal fascia provides anchoring during thread lifting, which is a minimally invasive facelifting procedure. However, anatomic studies involving the deep temporal fascia as well as effective and safe thread lifting procedures are scarce. We clarified the anatomy of the superficial layer of the deep temporal fascia and its surrounding structure using ultrasonography, histologic sections, and cadaveric dissection to propose an effective thread lifting procedure guideline.

Methods:

We included 20 healthy young South Korean participants. Real-time, two-dimensional, B-mode ultrasonography was performed. Longitudinal scanning was performed along three vertical lines: the line passing through the jugale, the anterior margin of the condylar process of the mandible, and the midpoint between the jugale and anterior margin of the condylar process. Histologic samples from three fresh adult cadavers were harvested from 2.5 cm above and below the zygomatic arch. Eighteen fresh adult hemifaces of South Korean cadavers (six males, three females; age, 67.3 ± 7.2 years) were used to confirm the morphology of the deep temporal fascia.

Results:

The superficial layer of the deep temporal fascia crossed the zygomatic arch and was connected to the origin of the zygomaticus major muscle at the line passing through the jugale. The superficial layer continued inferiorly to the parotidomasseteric fascia at the line passing through the midpoint and condylar process of the mandible.

Conclusions:

This study yielded the novel anatomy of the superficial layer of the deep temporal fascia, and this anatomic structure may be used for an ideal thread lifting procedure.
Internal Fixation of Redistributed Orbital Fat in Transconjunctival Lower Eyelid Blepharoplasty
Authors: Gu Jieyu , Duan Ran , Wei Boxuan , Xie Feng , Liu Caiyue , Gao Bowen
Published: April 2023

Fat redistribution combined with release of the tear trough ligament in transconjunctival lower blepharoplasty is widely performed to correct lower eyelid bags and tear trough deformities, but the method of suturing the released fat in such a narrow, dissected space remains a challenge during the procedure. The purpose of this study was to introduce a new surgical technique of internal fixation that advances and sutures the pedicled orbital fat firmly to the midcheek through premaxillary and prezygomatic spaces. Twenty-two patients (range, 22 to 39 years) diagnosed with predominant orbital fat prolapse and tear trough deformity without noticeable lower eyelid skin laxity were treated with this method, all of whom presented impressive correction of the eyelid bags and tear trough deformities and were aesthetically pleased during an average follow-up of 11.8 months (range, 10 to 14 months). No patients complained about postoperative hematoma, ectropion or midface numbness. The maneuver of internal fixation of redistributed orbital fat provides a novel and safe approach to correct eyelid bags and tear trough deformities without additional percutaneous sutures in transconjunctival lower eyelid blepharoplasty.
Mapping the Design Space of Technology-Based Solutions for Better Chronic Pain Care: Introducing the Pain Tech Landscape
Authors: Janevic Mary R. , Murnane Elizabeth , Fillingim Roger B. , Kerns Robert D. , Reid M. Cary
Published: April 2023

Objectives

Technology has substantial potential to transform and extend care for persons with chronic pain, a burdensome and costly condition. To catalyze the development of impactful applications of technology in this space, we developed the Pain Tech Landscape (PTL) model, which integrates pain care needs with characteristics of technological solutions.

Methods

Our interdisciplinary group representing experts in pain and human factors research developed PTL through iterative discussions. To demonstrate one potential use of the model, we apply data generated from a narrative review of selected pain and technology journals (2000–2020) in the form of heat map overlays, to reveal where pain tech research attention has focused to date.

Results

The PTL comprises three two-dimensional planes, with pain care needs on each x axis (measurement to management) and technology applications on the y axes according to a) user agency (user- to system-driven), b) usage time frame (temporary to lifelong), and c) collaboration (single-user to collaborative). Heat maps show that existing applications reside primarily in the “user-driven/management” quadrant (e.g., self-care apps). Examples of less developed areas include artificial intelligence and Internet of Things (i.e., Internet-linked household objects), and collaborative/social tools for pain management.

Conclusions

Collaborative development between the pain and tech fields in early developmental stages using the PTL as a common language could yield impactful solutions for chronic pain management. The PTL could also be used to track developments in the field over time. We encourage periodic reassessment and refinement of the PTL model, which can also be adapted to other chronic conditions.
The Accuracy and Stability of Intentional Change of Frontal-Ramal Inclination in Orthognathic Surgery for Facial Asymmetry Patients
Authors: Ha Sung-Ho , Meny Arwa Habib , Jeong Chun-Gi , Yeo Je-Hyeok , Baek Seung-Hak , Choi Jin-Young
Published: April 2023

Facial asymmetry can be defined as differences in the left and right sides of the face, and most of the patients with facial asymmetry have different left and right frontal-ramal inclinations (FRIs). Restoring the symmetry of both FRIs is important in the surgery of facial asymmetry patients, but it is very difficult to achieve perfect symmetry through conventional orthognathic surgery. However, by using 3-dimensional (3D) virtual planning and CAD/CAM technolo gies, intentional change of FRIs can be possible so the symmetry can be improved. The purpose of this study is to evaluate the surgical accuracy and long-term stability of intentional change of FRIs by 3D virtual surgery, CAD/CAM-assisted orthognathic surgery for patients with facial asymmetry. The study included 20 patients who had undergone orthognathic surgery for skeletal class III malocclusion from January 2019 to December 2021. To evaluate the accuracy of surgery, 3D facial cone beam computed tomography (CBCT) taken immediately after surgery (T1) and virtual surgery data (Tv) were measured and the difference values were calculated. The evaluation of the long-term stability of intentional change of FRI was performed by measuring T1 and T2 (3D facial cone beam computed tomography images taken 6 mo after surgery) and the difference values were calculated. The difference values of FRIs in the left and right proximal segments of each patient were calculated. And then, for comparison depending on the direction of rotation, increased FRI groups (n=20, medial rotation) and decreased FRI groups (n=20, lateral rotation) were analyzed separately. As a result, all difference values at both (ΔT1−Tv) and (ΔT2−T1) were <1 degree. As a result of analyzing the entire FRI by dividing it into decreasing and increasing groups, the mean value of (ΔT1−Tv) was 0.225 degrees for the decreasing group and 0.275 degrees for the increasing group. It means that the proximal segment moved less than the movement implemented by the virtual surgery through actual surgery but it shows a very small error, which means that the overall operation almost accurately implements the virtual surgical planning. Compared with (ΔT1−Tv), the mean value of (ΔT2−T1) showed a much smaller error value, and no specific tendency was observed. This indicates that the stability after surgery is very good. Based on this study, using 3D virtual surgery planning and CAD/CAM technologies for treating patients with facial asymmetry was very useful, and surgery could be performed accurately and predictably. In particular, left-right symmetry was almost perfectly achieved through virtual simulation and could be implemented through actual surgery. Therefore, it can be said that the use of these 3D technologies is recommended for the surgical approach of facial asymmetry.
Digoxin is a potent inhibitor of Bunyamwera virus infection in cell culture
Authors: Pacheco Beatriz , Fernández-Oliva Alberto , García-Serradilla Moisés , Risco Cristina
Published: April 2023

Drug repurposing is a valuable source of new antivirals because many compounds used to treat a variety of pathologies can also inhibit viral infections. In this work, we have tested the antiviral capacity of four repurposed drugs to treat Bunyamwera virus (BUNV) infection in cell cultures. BUNV is the prototype of the Bunyavirales order, a large group of RNA viruses that includes important pathogens for humans, animals and plants. Mock- and BUNV-infected Vero and HEK293T cells were treated with non-toxic concentrations of digoxin, cyclosporin A, sunitinib and chloroquine. The four drugs inhibited BUNV infection with varying potency in Vero cells, and all except sunitinib also in HEK293T cells, with digoxin rendering the lowest half maximal inhibitory concentration (IC50). Since digoxin rendered the best results, we selected this drug for a more detailed study. Digoxin is an inhibitor of the Na+/K+ ATPase, a plasma membrane enzyme responsible for the energy-dependent exchange of cytoplasmic Na+ for extracellular K+ in mammalian cells and involved in many signalling pathways. Digoxin was shown to act at an early time point after viral entry reducing the expression of the viral proteins Gc and N. Effects on the cell cycle caused by BUNV and digoxin were also analysed. In Vero cells, digoxin favoured the transition from G1 phase of the cell cycle to S phase, an effect that might contribute to the anti-BUNV effect of digoxin in this cell type. Transmission electron microscopy showed that digoxin impedes the assembly of the characteristic spherules that harbour the BUNV replication complexes and the morphogenesis of new viral particles. Both BUNV and digoxin induce similar changes in the morphology of mitochondria that become more electron-dense and have swollen cristae. The alterations of this essential organelle might be one of the factors responsible for digoxin-induced inhibition of viral infection. Digoxin did not inhibit BUNV infection in BHK-21 cells that have a digoxin-resistant Na+/K+ ATPase, which suggests that the effects of the blockade of this enzyme is a key factor of the antiviral activity of digoxin in BUNV-infected Vero cells.
Unzipped assemblies of polyploid root-knot nematode genomes reveal new kinds of unilateral composite telomeric repeats
Authors: Zotta Mota Ana-Paula , Koutsovoulos Georgios D , Perfus-Barbeoch Laetitia , Despot-Slade Evelin , Labadie Karine , Aury Jean-Marc , Robbe-Sermesant Karine , Bailly-Bechet Marc , Belser Caroline , Péré Arthur , Rancurel Corinne , Kozlowski Djampa K , Hassanaly-Goulamhoussen Rahim , Da Rocha Martine , Noël Benjamin , Mestrovic-Radan Nevenka , Wincker Patrick , Danchin Etienne GJ
Published: April 2023

Telomeres play central roles in senescence, aging and chromosome integrity. Using ONT long read sequencing we have assembled the genomes ofMeloidogyne incognita,M. javanicaandM. arenaria, the three most devastating plant-parasitic nematodes at unparalleled contiguity. The telomeric repeat (TTAGGC)n, evolutionarily conserved in nematodes, was not found in these genomes. Furthermore, no evidence for a telomerase enzyme or for orthologs ofC. eleganstelomere-associated proteins could be found. Instead, we identified species-specific composite repeats mostly present at one end of contigs. These repeats were G-rich, oriented and transcribed, similarly to known telomeric repeats. Using FISH we confirmed these repeats were present at one single end ofM. incognitachromosomes. The discovery of a new kind of telomeric repeat in these species highlights the evolutionary diversity of chromosome protection systems despite their central roles and opens new perspectives towards the development of more specific control methods against these pests.
Integrating Biotic Interactions In Niche Analyses Unravels Patterns Of Community Composition in Clownfishes
Authors: Jiménez Alberto García , Guisan Antoine , Broennimann Olivier , Gaboriau Théo , Salamin Nicolas
Published: April 2023

Biotic interactions shape the ecology of species and communities, yet their integration into ecological niche modeling methods remains challenging. Despite being a central topic of research for the past decade, the impact of biotic interactions on species distributions and community composition is often overlooked. Mutualistic systems offer ideal case studies for examining the effects of biotic I nteractions on species niches and community dynamics. This study presents a novel approach to incorporating mutualistic interactions into niche modeling, using the clownfish-sea anemone system. By adapting existing niche quantification frameworks, we developed a method to estimate the partial effects of known interactions and refine ecological niche estimates. This approach allows for a more comprehensive understanding of how mutualistic relationships influence species distributions and community assembly patterns. We also used mutualistic information to investigate the resource-use overlap, identitying patterns of competition within clownfish communities. Our results reveal significant deviations in niche estimates when biotic interactions are considered, particularly for specialist species. Host partitioning among clownfish species reduces resource-use overlap, facilitating coexistence in species-rich habitats and highlighting mutualism’s role in promoting and maintaining diversity. We uncover complex dynamics in resource-use overlap among clownfish species, influenced by factors such as species richness, ecological niche overlap, and host specialization. Specialist-generalist interactions strike an optimal balance, supporting high species richness while minimizing competition. These insights enhance our understanding of clownfish biodiversity patterns, demonstrating how diverse mutualistic strategies contribute to diversity build-up and mitigate competitive exclusion in saturated communities. The analytical framework presented has broad applications beyond the clownfish-sea anemone system, potentially extending to a broader range of interactions. It enables a more comprehensive understanding of biodiversity maintenance in complex ecosystems and constitutes a valuable tool for conservation planning and ecosystem management.
Distribution of the invasiveAnisandrus maiche(Coleoptera: Scolytinae) in Switzerland, first record in Europe of its ambrosia fungusAmbrosiella cleistominuta, and its new association withXylosandrus crassiusculus
Authors: Ribeiro-Correia José Pedro , Prospero Simone , Beenken Ludwig , Biedermann Peter H. W. , Blaser Simon , Chittaro Yannick , Frey David , Hölling Doris , Kaya Sezer Olivia , Knížek Miloš , Mittelstrass Jana , Branco Manuela , Ruffner Beat , Sanchez Andreas , Brockerhoff Eckehard G.
Published: April 2023

In 2022, two independent insect surveys in canton Ticino (southern Switzerland) revealed the widespread occurrence of the invasive ambrosia beetleAnisandrus maichefrom southern to central-upper Ticino. This species is native to east Asia and has previously been found as a non-native invasive species in the United States, Canada, western Russia, Ukraine and, in 2021, in northern Italy. Here, we present the results of several trapping studies using different trap types (bottle traps, funnel traps and Polytrap intercept traps) and attractants and a map of the distribution of the species. In total, 685 specimens ofA. maiche, all female, were trapped, and the identity of selected individuals was confirmed by morphological and molecular identification based on three mitochondrial and nuclear markers (COI, 28S and CAD). Traps checked from early April to early September 2022 in intervals of two to four weeks showed that flights ofA. maicheoccurred mainly from June to mid-August. Isolation of fungal associates ofA. maichefrom beetles trapped alive revealed the presence of four fungal species, including the ambrosia fungusAmbrosiella cleistominuta, the known mutualists ofA. maiche. The identity ofA. cleistominutawas confirmed by comparing DNA sequences of its nuclear, internal transcribed spacer (ITS) gene with reference sequences in NCBI and BOLDSYSTEMS. This represents the first record ofA. cleistominutain Europe.Ambrosiella cleistominutawas also found in association with another non-native invasive ambrosia beetle,Xylosandrus crassiusculus, at a botanic garden in central Ticino. As ambrosia beetles usually show a high degree of fidelity with only one mutualistic fungus (in the case ofX. crassiusculusnormallyAmbrosiella roeperi), this association is highly unusual and probably the result of lateral transfer among these non-native invasive species. Of the other fungal associates isolated fromA. maichein Ticino,Fusarium lateritiumis of note as there is a possibility thatA. maichecould act as a vector of this plant pathogen. We highlight several research needs that should be addressed to gain insight into the potential impact of these non-native species and to overcome problems with heteroplasmy in COI sequences in studies of invasion and population genetics of ambrosia beetles.