bluuebunny/crossref_metadata_2025 huggingface dataset:
Subpectoral Implant Repositioning With Partial Capsule Preservation: Treating the Long-Term Complications of Subglandular Breast Augmentation
Authors: Hauch Adam T , Francis Cameron S , Artz Jourdain D , Chasan Paul E
Published: March 2021

Background

Patients with long-term complications associated with subglandular breast augmentation are being seen in increasing numbers in the Southern California community. Late deformities include a characteristic “slide-down” deformity as well as capsular contracture, implant wrinkling, and nipple-areola complex enlargement. Repositioning the implant to a subpectoral pocket is a recognized revisionary technique to treat this problem; however, technical details of how this is accomplished are lacking in the literature.

Objectives

To review our technique for treating long-term complications associated with subglandular implants using subpectoral repositioning with partial capsule preservation and mastopexy, without the need for an acellular dermal matrix (ADM) or mesh.

Methods

A retrospective review of all patients undergoing subpectoral repositioning over the course of 6 years was performed. Patient data and long-term outcomes were assessed. A technique is presented utilizing a partial capsulectomy that preserves a portion of the capsule as an ADM/mesh equivalent, ensuring adequate implant coverage and preventing window shading of the pectoralis major muscle.

Results

Twenty-four patients with subglandular implants and slide-down deformity as well as other associated complications including capsular contracture, implant wrinkling, and enlarged areolas underwent revision surgery with a subpectoral site change. Often, patients presented many years after their initial augmentation (mean 18 years, range 4-38 years). The average patient follow-up was 3.1 years (range 1.0-6.8 years). Two patients required minor revisions with local anesthetic, while another 2 revisions required general anesthesia.

Conclusions

Long-term deformities associated with subglandular breast augmentation can reliably be corrected by subpectoral repositioning, mastopexy, and utilization of residual breast capsule in the place of an ADM or mesh.

Level of Evidence: 4
Autologous Fat Injection for Augmentation Rhinoplasty: A Systematic Review
Authors: Keyhan Seied Omid , Ramezanzade Shaqayeq , Bohluli Behnam , Fallahi Hamid Reza , Mirzahoseini Sanaz , Nahai Foad
Published: March 2021

Background

Autologous fat has become more frequently used for nasal volume augmentation and nasal correction. Nasal lipofilling refers to the use of injectable autologous fat grafts for nonsurgical aesthetic corrections.

Objectives

This systematic review aims to assess the satisfaction, complication, and retention rates of fat injection in nasal shape corrections.

Methods

The authors searched PubMed/Medline and Google Scholar up to and including October 2020 with no time and language restrictions for pertinent materials. Two authors conducted a duplicate searching process independently to determine proper materials based on the inclusion and exclusion criteria. One author retrieved the following data from the finally included studies based on a predefined checklist worksheet.

Results

The included studies report data from a total of 564 patients undergoing nasal fat injection in 12 studies. The mean score in our included materials was 6.08 with a range of 4 to 7 scores. In most of our included materials, no complication was reported for the peri/postsurgical period. Although some papers reported manageable complications such as an insufficient volume or decreased volume by resorption, tip excess and supratip fillness, and mild displacement, more than half of our included materials reported on patient satisfaction with aesthetic results of fat injection. The satisfaction rates were mostly high and ranged from 63% to 100%.

Conclusions

Autologous fat injection is an effective and minimally invasive treatment for nasal aesthetic and contour correction with a high satisfaction rate and low complication rate. Clinical expertise is essential to have a safe injection and to minimize the potential complications.

Level of Evidence: 4
Influence of SARS-CoV-2 during pregnancy: a placental view
Authors: da Costa Marcos Aurélio Santos , de Albuquerque Britto Diana Babini Lapa , da Silva Maria Eduarda , de Carvalho Jennyfer Martins , de Oliveira Maria Luísa Figueira , da Silva Gomes José Anderson , Mendes Tenorio Fernanda das Chagas Angelo , Leite Sônia Pereira
Published: March 2021

Since the beginning of the current coronavirus outbreak (COVID-19), there has been great concern over a disease that has spread rapidly in several countries worldwide, with the result of several deaths, including deaths of pregnant women. Therefore, the aim of this study was to conduct a literature review on placental changes in infected pregnant women and/or asymptomatic carriers of COVID-19 during pregnancy, aiming at the possible vertical transmission. A systematic collection was carried out on the effects of that COVID-19 can cause directly and/or indirectly to pregnancy and the placenta in the following databases: Pubmed, Science Direct, Scielo, Lilacs, and Web of Science. For search, the following descriptors were used: placenta, pregnant woman, COVID-19, maternal–fetal. The results indicate transplacental transmission in some cases reviewed in many reports from this study. The presence of the virus was seen in the amniotic fluid, umbilical cord, and peripheral blood. Finally, pathological studies suggest that there are morphological changes related to infection in the placentas. We can conclude that, based on the researched material, there is little evidence of transplacental vertical viral transmission and its respective morphological changes related to viral infection in the placenta.
The policing of cuckooing in ‘County Lines’ drug dealing: An ethnographic study of an amplification spiral
Authors: Spicer Jack
Published: March 2021

Responding to cases of ‘cuckooing’, where drug dealers take over other people’s homes, has become a significant policing activity in the United Kingdom. Drawing on ethnographic data and the deviancy amplification spiral model, this article theorizes how police responses to cuckooing emerged, developed and became established. Five stages of the spiral are outlined: identifying cuckooing as a problem; demonstrating a response; spreading the problem; making it other people’s problem too; the establishment of a policing priority. The article advances amplification theory by considering it from within the setting of the police and the contemporary drug supply context of County Lines. It concludes by stressing the importance of critically considering the dynamic relationship between the police and their drug market targets.
Hospital-diagnosed infections before age 20 and risk of a subsequent multiple sclerosis diagnosis
Authors: Xu Yin , Smith Kelsi A , Hiyoshi Ayako , Piehl Fredrik , Olsson Tomas , Montgomery Scott
Published: March 2021

The involvement of specific viral and bacterial infections as risk factors for multiple sclerosis has been studied extensively. However, whether this extends to infections in a broader sense is less clear and little is known about whether risk of a multiple sclerosis diagnosis is associated with other types and sites of infections such as the CNS. This study aims to assess if hospital-diagnosed infections by type and site before age 20 years are associated with risk of a subsequent multiple sclerosis diagnosis and whether this association is explained entirely by infectious mononucleosis, pneumonia, and CNS infections. Individuals born in Sweden between 1970 and 1994 were identified using the Swedish Total Population Register (n = 2 422 969). Multiple sclerosis diagnoses from age 20 years and hospital-diagnosed infections before age 20 years were identified using the Swedish National Patient Register. Risk of a multiple sclerosis diagnosis associated with various infections in adolescence (11–19 years) and earlier childhood (birth–10 years) was estimated using Cox regression, with adjustment for sex, parental socio-economic position, and infection type. None of the infections by age 10 years were associated with risk of a multiple sclerosis diagnosis. Any infection in adolescence increased the risk of a multiple sclerosis diagnosis (hazard ratio 1.33, 95% confidence interval 1.21–1.46) and remained statistically significant after exclusion of infectious mononucleosis, pneumonia, and CNS infection (hazard ratio 1.17, 95% confidence interval 1.06–1.30). CNS infection in adolescence (excluding encephalomyelitis to avoid including acute disseminated encephalitis) increased the risk of a multiple sclerosis diagnosis (hazard ratio 1.85, 95% confidence interval 1.11–3.07). The increased risk of a multiple sclerosis diagnosis associated with viral infection in adolescence was largely explained by infectious mononucleosis. Bacterial infections in adolescence increased risk of a multiple sclerosis diagnosis, but the magnitude of risk reduced after excluding infectious mononucleosis, pneumonia and CNS infection (hazard ratio 1.31, 95% confidence interval 1.13–1.51). Respiratory infection in adolescence also increased risk of a multiple sclerosis diagnosis (hazard ratio 1.51, 95% confidence interval 1.30–1.75), but was not statistically significant after excluding infectious mononucleosis and pneumonia. These findings suggest that a variety of serious infections in adolescence, including novel evidence for CNS infections, are risk factors for a subsequent multiple sclerosis diagnosis, further demonstrating adolescence is a critical period of susceptibility to environmental exposures that raise the risk of a multiple sclerosis diagnosis. Importantly, this increased risk cannot be entirely explained by infectious mononucleosis, pneumonia, or CNS infections.
The (Im)Possibility on Constructing Verifiable Random Functions
Authors: Cao Shujiao , Xue Rui
Published: March 2021

In this paper, we further explore the properties of the verifiable random functions in both a black-box and a non-black-box manner. The results are mainly following two parts:

$\bullet $  Black-Box Barrier: It is set up for an impossibility result of black-box reduction from verifiable random functions to injective one-way functions and indistinguishability obfuscators, where the verifiable random functions are suggested to be domain-invariant (i.e. the support of the distribution of keys and the domain of the evaluation space are independent of the underlying building blocks). Our result illustrates how the non-domain-invariant constructions circumvent the black-box barriers for constructing verifiable random functions and sheds light on why it is so difficult to give a domain-invariant instantiation.

$\bullet $  Non-Black-Box Construction: On the other hand, the verifiable unpredictable functions are constructed from a given primitive by a non-black-box technique called the hitting-set generator. To show it's a somewhat useful technique for constructing the verifiable unpredictable functions, we further derive a limitation of the black-box barrier by proving the barrier still holds between the given primitive and verifiable unpredictable functions.

Our results not only analyse the properties of verifiable random functions theoretically, but also reveal the limitation of indistinguishability obfuscators in a black-box manner, and show the advantages by adopting non-black-box techniques.
Dynamic left ventricular outflow tract gradient resulting from Takotsubo cardiomyopathy ameliorated by intra-aortic balloon pump counterpulsation: a case report
Authors: O’Brien Jim , Mahony Stephen , Byrne Roger J , Byrne Robert A
Published: March 2021

Background

Takotsubo cardiomyopathy is a variant of acute coronary syndrome with characteristic acute left ventricular apical ballooning. Uncommonly, there can be associated left ventricular outflow tract (LVOT) obstruction causing cardiogenic shock refractory to inotropic support. The use of afterload-reducing mechanical support such as intra-aortic balloon pump (IABP) counterpulsation is not routinely employed in instances of this kind.

Case summary

In our case report, we describe a 66-year-old female with acute Takotsubo cardiomyopathy and associated LVOT obstruction which failed to respond to high-dose dobutamine and whose clinical trajectory was worsened by fast atrial fibrillation with rapid ventricular response. Within 24 h of admission, the patient had an IABP placed which rapidly improved her haemodynamics. Two days later, IABP was removed and within 6 days of admission, apical ballooning and LVOT obstruction had fully recovered.

Conclusion

We recommend early use of mechanical support with IABP counterpulsation to expedite recovery in patients with acute Takotsubo cardiomyopathy with associated LVOT obstruction.
Transition of May Measurement Month to an online hypertension awareness campaign in Korea during the COVID-19 pandemic
Authors: Shin Jinho , Lee Hae Young , Park Sungha , Sohn Il Suk , Kim Sun Ho , Pyun Wook Bum , Kim Kee-Sik , Cho Myeong-Chan
Published: March 2021

Aims 

May Measurement Month (MMM) is a global campaign to enhance hypertension awareness by intensive blood pressure measuring campaign during a month period of May. May Measurement Month 2020 was not officially executed globally, especially in light of COVID-19 pandemic. But in Korea, the MMM committee decided to carry on with self-initiated project to succeed MMM started in 2019 in Korea. And we adopted new online strategies for those with age of 18 or older under the MMM

Methods and results 

Korea 2020 theme in Korean of ‘Look for the Young Hypertension’. A promotional video, a subtitled translated global promotional video, and four educational contents were uploaded on Youtube®. Seven online posters or card news were uploaded on main blog. And 71 articles by 60 websites from 10 medical media company were published. The MMM keyword exposure in Naver® portal Search Advertisements was 2500 searches per day. There were 3519 visits to the MMM blog, and 114 people participated in snapshot challenges. Four social network service channels were activated, and there was an increase in Facebook and Instagram followers of 6.5- and 5.8-fold, respectively. GoodDoc® application programming interface messages were sent 97876 times (2589 responses). For a user created contents contest, 28 competitors, mostly young, participated.

Conclusion 

Even during the COVID-19 pandemic, the MMM campaign was able to survive using a ‘new normal’ online format. The shift to on-line activity during the pandemic will contribute to a breakthrough MMM campaign in the future that can be combined with off-line protocols even after the pandemic.
Whole-genome resequencing reveals genetic characteristics of different duck breeds from the Guangxi region in China
Authors: Wang Ran , Sun Junli , Han Hu , Huang Yingfei , Chen Tao , Yang Manman , Wei Qiang , Wan Huofu , Liao Yuying
Published: March 2021

Distinctive indigenous duck (Anas platyrhynchos) populations of Guangxi, China, evolved due to the geographical, cultural, and environmental variability of this region. To investigate the genetic diversity and population structure of the indigenous ducks of Guangxi, 78 individuals from eight populations were collected and sequenced by whole-genome resequencing with an average depth of ∼9.40×. The eight indigenous duck populations included four breeds and four resource populations. Moreover, the genome data of 47 individuals from two typical meat-type breeds and two native egg-type breeds were obtained from a public database. Calculation of heterozygosity, nucleotide diversity (π), Tajima’s D, and FST indicated that the Guangxi populations were characterized by higher genetic diversity and lower differentiation than meat-type breeds. The highest diversity was observed in the Xilin-Ma ducks. Principal component, structure, and phylogenetic tree analyses revealed the relationship between the indigenous duck populations of Guangxi. A mild degree of differentiation was observed among the Guangxi populations, although three populations were closer to the meat or egg breeds. Indigenous populations are famous for their special flavor, small body size, and slow growth rates. Selective sweep analysis revealed the candidate genes and pathways associated with these growth traits. Our findings provide a valuable source of information regarding genetic diversity, population conservation, and genome-associated breeding of ducks.
Patterns of Body Shape Diversity and Evolution in Intertidal and Subtidal Lineages of Combtooth Blennies (Blenniidae)
Authors: Egan Joshua P , Buser Thaddaeus J , Burns Michael D , Simons Andrew M , Hundt Peter J
Published: March 2021

Marine intertidal zones can be harsher and more dynamic than bordering subtidal zones, with extreme and temporally variable turbulence, water velocity, salinity, temperature, and dissolved oxygen levels. Contrasting environmental conditions and ecological opportunities in subtidal versus intertidal habitats may generate differing patterns of morphological diversity. In this study we used phylogenetic comparative methods, measurements of body length, and two-dimensional landmarks to characterize body shape and size diversity in combtooth blennies (Ovalentaria: Blenniidae) and test for differences in morphological diversity between intertidal, subtidal, and supralittoral zones. We found that subtidal combtooth blennies have significantly higher body shape disparity and occupy a region of morphospace three times larger than intertidal lineages. The intertidal morphospace was almost entirely contained within the subtidal morphospace, showing that intertidal combtooth blennies did not evolve unique body shapes. We found no significant differences in body size disparity between tidal zones, no correlations between body shape and tidal zone or body size and tidal zone, and no body shape convergence associated with tidal zone. Our findings suggest that a subset of combtooth blenny body shapes are suitable for life in both subtidal and intertidal habitats. Many species in regions of morphospace unique to subtidal combtooth blennies exhibit distinct microhabitat use, which suggests subtidal environments promoted morphological diversification via evolutionary microhabitat transitions. In contrast, limited intertidal body shape diversity may be due to strong selective pressures that constrained body shape evolution and environmental filtering that prevented colonization of intertidal zones by certain subtidal body shapes.
“Hanging Out” while Studying “Up”: Doing Ethnographic Fieldwork in International Relations
Authors: Nair Deepak
Published: March 2021

This article advances a methodological argument on how to do ethnographic fieldwork amid social elites and inaccessible bureaucracies in international politics. Instead of participant observation or semi-structured interviews, the article proposes “hanging out” as an alternative strategy to generate immersion and ethnographic insight. While the ethnographer studying “down” is arguably always “hanging out” (the village as the exemplary mise-en-scene of this genre), this technique takes a more defined form when studying “up” elites. Specifically, hanging out when studying “up” is a strategy where the fieldworker commits to a period of continuous residence amid members of a community; engages in ludic, informal, and often sociable interactions outside or at the sidelines of their professional habitats; and participates in a range of activities where building rapport is as important as the primary goals of the research. I illustrate this methodological strategy and its payoffs by reflecting upon a year of fieldwork among the diplomats and bureaucrats of the Association of Southeast Asian Nations—an informal, quiet, and often sub rosa diplomatic project run by a band of mostly authoritarian states in Southeast Asia. This article contributes to debates on the viability of ethnographic fieldwork in international relations (IR); advances a methodological corrective to fieldwork prescriptions in new micropolitical studies of practice, interactions, and emotions in IR; and offers a practical illustration of what studying “up” looks like in diplomacy and international politics.
Of rodents and ruminants: a comparison of small noncoding RNA requirements in mouse and bovine reproduction
Authors: Chukrallah Lauren G , Badrinath Aditi , Seltzer Kelly , Snyder Elizabeth M
Published: March 2021

Ruminants are major producers of meat and milk, thus managing their reproductive potential is a key element in cost-effective, safe, and efficient food production. Of particular concern, defects in male germ cells and female germ cells may lead to significantly reduced live births relative to fertilization. However, the underlying molecular drivers of these defects are unclear. Small noncoding RNAs, such as piRNAs and miRNAs, are known to be important regulators of germ-cell physiology in mouse (the best-studied mammalian model organism) and emerging evidence suggests that this is also the case in a range of ruminant species, in particular bovine. Similarities exist between mouse and bovids, especially in the case of meiotic and postmeiotic male germ cells. However, fundamental differences in small RNA abundance and metabolism between these species have been observed in the female germ cell, differences that likely have profound impacts on their physiology. Further, parentally derived small noncoding RNAs are known to influence early embryos and significant species-specific differences in germ-cell born small noncoding RNAs have been observed. These findings demonstrate the mouse to be an imperfect model for understanding germ-cell small noncoding RNA biology in ruminants and highlight the need to increase research efforts in this underappreciated aspect of animal reproduction.
Defining Benchmarks in Pediatric Burn Care: Inception of the Pediatric Injury Quality Improvement Collaborative
Authors: Patterson Kelli N , Fabia Renata , Giles Sheila , Verlee Sarah N , Marx Daniel , Aguayo Pablo , Ziegfeld Susan , Parrish Carisa , Stewart F Dylan , Fritzeen Jennifer , Burd Randall S , Vitale Lisa , Cloutier Dawn , Shanti Christina , Klein Justin , Thakkar Rajan K
Published: March 2021

Pediatric burn care is highly variable nationwide. Standardized quality and performance benchmarks are needed for guiding performance improvement within pediatric burn centers. A network of pediatric burn centers was established to develop and evaluate pediatric-specific best practices. A multi-disciplinary team including pediatric surgeons, nurses, advanced practice providers, pediatric intensivists, rehabilitation staff, and child psychologists from five pediatric burn centers established a collaborative to share and compare performance improvement data, evaluate outcomes, and exchange best care practices. In December 2016, the Pediatric Injury Quality Improvement Collaborative (PIQIC) was established. PIQIC members chose quality improvement indicators, drafted and approved a memorandum of understanding (MOU), data use agreement (DUA) and charter, formalized the multidisciplinary membership, and established a steering committee. Since inception, PIQIC has conducted monthly teleconferences and biannual in-person or virtual group meetings. A centralized data repository has been established where data is collated and analyzed for benchmarking in a blinded fashion. PIQIC has shown the feasibility of multi-institutional data collection, implementation of performance improvement metrics, publication of research, and enhancement of aggregate and institution-specific pediatric burn care.
Lack of Replication or Generalization? Cultural Values Explain a Question Wording Effect
Authors: Silber Henning , Tvinnereim Endre , Stark Tobias H , Blom Annelies G , Krosnick Jon A , Bosnjak Michael , Clement Sanne Lund , Cornilleau Anne , Cousteaux Anne-Sophie , John Melvin , Jonsdottir Gudbjorg Andrea , Lawson Karen , Lynn Peter , Martinsson Johan , Shamshiri-Petersen Ditte , Tu Su-Hao
Published: March 2021

In the context of the current “replication crisis” across the sciences, failures to reproduce a finding are often viewed as discrediting it. This paper shows how such a conclusion can be incorrect. In 1981, Schuman and Presser showed that including the word “freedom” in a survey question significantly increased approval of allowing a speech against religion in the USA. New experiments in probability sample surveys (n = 23,370) in the USA and 10 other countries showed that the wording effect replicated in the USA and appeared in four other countries (Canada, Germany, Taiwan, and the Netherlands) but not in the remaining countries. The effect appeared only in countries in which the value of freedom is especially salient and endorsed. Thus, public support for a proposition was enhanced by portraying it as embodying a salient principle of a nation’s culture. Instead of questioning initial findings, inconsistent results across countries signal limits on generalizability and identify an important moderator.
The effect of aspherical stellar wind of giant stars on the symbiotic channel of Type Ia supernovae
Authors: Wu Chengyuan , Liu Dongdong , Wang Xiaofeng , Wang Bo
Published: March 2021

The progenitor systems accounting for explosions of Type Ia supernovae (SNe Ia) is still under debate. Symbiotic channel is one of the possible progenitor scenarios, in which the WDs in these systems increase in mass through wind accretion from their red giant companions. The mass-loss processes of the giants in the symbiotic systems could produce the amount of circumstellar medium (CSM), and detections of interaction signals between SN ejecta and CSM can be used as an ideal way to distinguish different progenitor models. However, the density distribution and geometric structure of the CSM around the symbiotic systems remain highly uncertain. By assuming that the tidal torque from binary interaction can increase the mass-loss rate of the red giant and cause the stellar wind concentrate towards the equatorial plane, we provide a simplified method to estimate the density and the degree of deviation from spherical symmetry for the CSM. Based on the calculations of the binary evolutions of symbiotic systems using stellar evolution code mesa, we obtained the parameter space for producing SNe Ia. We found that SNe Ia could originate from symbiotic systems with massive carbon-oxygen white dwarfs (CO WDs), while the half-opening angle of the stellar wind from red giant towards the WD varies with the binary evolution, resulting in the formation of surrounding CSM with different geometric structures. The corresponding properties of ejecta–CSM interactions may be examined by spectropolarimetry observations in the future, from which one may find an additional relationship between circumstellar environment of SNe Ia and their progenitor systems.
A little FABLE: exploring AGN feedback in dwarf galaxies with cosmological simulations
Authors: Koudmani Sophie , Henden Nicholas A , Sijacki Debora
Published: March 2021

Contrary to the standard lore, there is mounting observational evidence that feedback from active galactic nuclei (AGN) may also play a role at the low-mass end of the galaxy population. We investigate this using the cosmological simulation suite fable, with a particular focus on the dwarf regime (Mstellar < 109.5 M⊙). We find that overmassive black holes (BHs), with respect to the mean scaling relations with their host galaxies, drive hotter and faster outflows and lead to significantly reduced gas mass fractions. They are also more likely to display a kinematically misaligned ionized gas component in our mock MaNGA velocity maps, although we caution that cosmic inflows and mergers contribute to misalignments as well. While in the local Universe the majority of AGN in dwarfs are much dimmer than the stellar component, for z ≥ 2 there is a significant population that outshines their hosts. These high-redshift overmassive BHs contribute to the quenching of dwarfs, whereas at late cosmic times supernova (SN) feedback is more efficient. While our results are overall in good agreement with X-ray observations of AGN in dwarfs, the lack of high-luminosity X-ray AGN in fable at low redshifts highlights an interesting possibility that SN feedback could be too strong in fable’s dwarfs, curtailing AGN growth and feedback. We predict that future observations may uncover many more AGN in dwarfs with lower luminosities and at higher redshifts.
Di-phosphorylated BAF shows altered structural dynamics and binding to DNA, but interacts with its nuclear envelope partners
Authors: Marcelot Agathe , Petitalot Ambre , Ropars Virginie , Le Du Marie-Hélène , Samson Camille , Dubois Stevens , Hoffmann Guillaume , Miron Simona , Cuniasse Philippe , Marquez Jose Antonio , Thai Robert , Theillet François-Xavier , Zinn-Justin Sophie
Published: March 2021

Barrier-to-autointegration factor (BAF), encoded by the BANF1 gene, is an abundant and ubiquitously expressed metazoan protein that has multiple functions during the cell cycle. Through its ability to cross-bridge two double-stranded DNA (dsDNA), it favours chromosome compaction, participates in post-mitotic nuclear envelope reassembly and is essential for the repair of large nuclear ruptures. BAF forms a ternary complex with the nuclear envelope proteins lamin A/C and emerin, and its interaction with lamin A/C is defective in patients with recessive accelerated aging syndromes. Phosphorylation of BAF by the vaccinia-related kinase 1 (VRK1) is a key regulator of BAF localization and function. Here, we demonstrate that VRK1 successively phosphorylates BAF on Ser4 and Thr3. The crystal structures of BAF before and after phosphorylation are extremely similar. However, in solution, the extensive flexibility of the N-terminal helix α1 and loop α1α2 in BAF is strongly reduced in di-phosphorylated BAF, due to interactions between the phosphorylated residues and the positively charged C-terminal helix α6. These regions are involved in DNA and lamin A/C binding. Consistently, phosphorylation causes a 5000-fold loss of affinity for dsDNA. However, it does not impair binding to lamin A/C Igfold domain and emerin nucleoplasmic region, which leaves open the question of the regulation of these interactions.
Temozolomide chronotherapy in patients with glioblastoma: a retrospective single-institute study
Authors: Damato Anna R , Luo Jingqin , Katumba Ruth G N , Talcott Grayson R , Rubin Joshua B , Herzog Erik D , Campian Jian L
Published: March 2021

Background

Chronotherapy is an innovative approach to improving survival through timed delivery of anti-cancer treatments according to patient daily rhythms. Temozolomide (TMZ) is a standard-of-care chemotherapeutic agent for glioblastoma (GBM). Whether timing of TMZ administration affects GBM patient outcome has not previously been studied. We sought to evaluate maintenance TMZ chronotherapy on GBM patient survival.

Methods

This retrospective study reviewed patients with newly diagnosed GBM from January 1, 2010 to December 31, 2018 at Washington University School of Medicine who had surgery, chemoradiation, and were prescribed TMZ to be taken in the morning or evening. The Kaplan–Meier method and Cox regression model were used for overall survival (OS) analyses. The propensity score method accounted for potential observational study biases. The restricted mean survival time (RMST) method was performed where the proportional hazard assumption was violated.

Results

We analyzed 166 eligible GBM patients with a median follow-up of 5.07 years. Patients taking morning TMZ exhibited longer OS compared to evening (median OS, 95% confidence interval [CI] = 1.43, 1.12–1.92 vs 1.13, 0.84–1.58 years) with a significant year 1 RMST difference (−0.09, 95% CI: −0.16 to −0.018). Among MGMT-methylated patients, median OS was 6 months longer for AM patients with significant RMST differences at years 1 (−0.13, 95% CI = −0.24 to −0.019) to 2.5 (−0.43, 95% CI = −0.84 to −0.028). Superiority of morning TMZ at years 1, 2, and 5 (all P < .05) among all patients was supported by RMST difference regression after adjusting for confounders.

Conclusions

Our study presents preliminary evidence for the benefit of TMZ chronotherapy to GBM patient survival. This impact is more pronounced in MGMT-methylated patients.
To Test, Perchance to Diagnose: Practical Strategies for Severe Acute Respiratory Syndrome Coronavirus 2 Testing
Authors: Humphries Romney M , Azar Marwan M , Caliendo Angela M , Chou Andrew , Colgrove Robert C , Fabre Valeria , Ginocchio Christine C , Hanson Kimberly E , Hayden Mary K , Pillai Dylan R , Pollock Nira R , Lee Francesca M
Published: March 2021

Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in symptomatic and asymptomatic patients is an important component of the multifaceted approach of managing the coronavirus disease 2019 pandemic. Determining how to best define testing strategies for different populations and incorporating these into broader infection prevention programs can be complex. Many circumstances are not addressed by federal, local, or professional guidelines. This commentary describes various scenarios in which testing of symptomatic or asymptomatic individuals for SARS-CoV-2 virus (antigen or ribonucleic acid) can be of potential benefit. Consideration to pretest probability, risks of testing (impact of false-positive or false-negative results), testing strategy, as well as action based on test results are explored. Testing, regardless of setting, must be incorporated into overarching infection control plans, which include use of personal protective equipment (eg, masks), physically distancing, and isolation when exposure is suspected.
Evaluation of 2 Lateral Flow Rapid Tests in the Diagnosis of Chagas Disease in the Washington Metropolitan Area
Authors: Castro-Sesquen Yagahira E , Saldaña Antonella , Patino Nava Dhayanna , Paulette Evans Diana , Bayangos Tabitha , DeToy Kelly , Trevino Alexia , Marcus Rachel , Bern Caryn , Gilman Robert H , Talaat Kawsar R ,   Chagas Working Group in Peru and the United States, Avila Carol , Camacho Fabiola , Herrera Sdenka , Jimenez Andres , Lozano Veronika , Malaga Edith , Merida Mariel , Morales Carolina , Solis Rodrigo , Sotomayor Fiorella , Tung Alisha , Spector Anna , Verastegui Manuela , Yang Younghee , Zapata Fatima
Published: March 2021

We compared the accuracy of the Stat-Pak and Chagas Detect Plus with a latent class analysis. Sensitivity values of 89.7% and 91.9% and specificities of 97.1% and 80.3%, respectively, were seen in the serodiagnosis of Chagas disease in Hispanic immigrants, revealing the limitations of these tests in diverse populations.
A Case of Severe Acute Respiratory Syndrome Coronavirus 2 Treatment With Remdesivir in a Hepatitis C-Coinfected Patient Resulting in Temporary Viral Control and Posttreatment Flare
Authors: da Cunha Maria Ribeiro , Rodrigues Inês Coelho , Trigueiros Frederico , Freitas Luís Carlos , Braz Sandra , Cota Medeiros Fábio
Published: March 2021

We report a case of a man with chronic hepatitis C infection treated with remdesivir for COVID-19, resulting in lowered HCV viral load, followed by a rebound after its discontinuation. Concomitant treatment with tocilizumab possibly caused loss of anti-HBs.
Phrenic Nerve Stimulator Placement via the Cervical Approach: Technique and Anatomic Considerations
Authors: Padmanaban Varun , Payne Russell , Corbani Karen , Corl Sheena , Rizk Elias B
Published: March 2021

BACKGROUND

Diaphragmatic pacing via phrenic nerve stimulation can help improve breathing and facilitate mechanical ventilation weaning in patients with respiratory failure secondary to brainstem injury, high cervical spinal cord injury, or congenital central hypoventilation. Devices can be placed utilizing several techniques; however, nuances regarding placement are not well published.

OBJECTIVE

To describe our experience with phrenic nerve stimulator placement via the cervical approach with a focus on surgical anatomy, variations, and technique.

METHODS

Placement of phrenic nerve stimulator via a cervical approach is described in detail.

RESULTS

Successful placement of phrenic nerve stimulator without complication.

CONCLUSION

The cervical approach for the placement of a phrenic nerve stimulator is a safe and effective option for patients. Detailed knowledge of anatomy and anatomic variations is required. Potential advantages and disadvantages are discussed.
The current state of general paediatric fellowships in Canada
Authors: Al Maawali Ali , Puran Allan , Schwartz Sarah , Johnstone Julie , Bismilla Zia
Published: March 2021

Introduction

The field of Paediatric Medicine has grown tremendously over the last two decades. Several niche areas of practice have emerged, and opportunities for focused training in these areas have grown in parallel. The landscape of ‘General Paediatric Fellowship’ (GPF) Programs in Canada is not well described; this knowledge is needed to promote standardization and high-quality training across Canada. This study explores the structure and components of existing GPFs in Canada and identifies the interest and barriers to providing such programs.

Methods

A questionnaire was created to explore the landscape of GPF Programs in Canada. Invitations to participate were sent to leaders of General Paediatric Divisions across Canada, with a request to forward the survey to the most appropriate individual to respond within their local context.

Results

A total of 19 responses (95%) representing 17 different Canadian universities were obtained. Eight universities offered a total of 13 GPF Programs in 2019, with one additional university planning to start a program in the coming year. Existing programs were variable in size, structure and curriculum. Most programs identified as Academic Paediatric Programs, with an overlap in content and structure between Academic Paediatrics and Paediatric Hospital Medicine programs. The majority of respondents felt there was a need for GPF Programs in Canada but cited funding as the most common perceived barrier.

Conclusion

A growing number of GPF Programs exist in Canada. Current fellowship programs are variable in structure and content. Collaboration between programs is required to advance GPF training in Canada.
Failure of chronic hydroxychloroquine in preventing severe complications of COVID-19 in patients with rheumatic diseases
Authors: Pham Khanh , Torres Heidi , Satlin Michael J , Goyal Parag , Gulick Roy M
Published: March 2021

Objective

To compare baseline characteristics, clinical presentations and outcomes of patients with rheumatic conditions requiring hospitalization for coronavirus disease 2019 (COVID-19) who received chronic HCQ with those who did not receive chronic HCQ.

Methods

We identified all patients with a rheumatologic disease who were admitted with COVID-19 to two hospitals in New York City between 3 March 3 and 30 April 2020. Patients who received chronic HCQ prior to admission were matched 1:2 (±10 years of age) with patients who did not receive chronic HCQ. We compared demographics, comorbidities, HCQ dosages, concurrent medications, presentations and outcomes between the groups.

Results

There were 14 patients receiving HCQ and 28 matched control subjects. The median age of cases was 63 years [interquartile range (IQR) 43–73) and 60 years (IQR 41–75) for controls. Control subjects had a higher prevalence of pulmonary diseases (42.8%), diabetes (35.7%) and obesity (35.7%) than their case counterparts (28.6%, 14.3% and 7.1%, respectively). A higher proportion of cases than control subjects (50% vs 25%) reported the use of prednisone for their rheumatic conditions prior to admission. Despite these differences in baseline characteristics, univariate logistic regression revealed no statistically significant differences in the need for mechanical ventilation [OR 1.5 (95% CI 0.34, 6.38)] or in-hospital mortality [OR 0.77 (95% CI 0.13, 4.56)].

Conclusion

HCQ therapy in individuals with rheumatic conditions was not associated with less severe presentations of COVID-19 among hospitalized patients compared with individuals with rheumatic conditions not receiving HCQ.
The influence of the SARS-CoV-2 lockdown on patients with inflammatory rheumatic diseases on their adherence to immunomodulatory medication: a cross sectional study over 3 months in Germany
Authors: Hasseli R , Müller-Ladner U , Keil F , Broll M , Dormann A , Fräbel C , Hermann W , Heinmüller C -J , Hoyer B F , Löffler F , Özden F , Pfeiffer U , Saech J , Schneidereit T , Schlesinger A , Schwarting A , Specker C , Stapfer G , Steinmüller M , Storck-Müller K , Strunk J , Thiele A , Triantafyllias K , Vagedes D , Wassenberg S , Wilden E , Zeglam S , Schmeiser T
Published: March 2021

Objectives

To evaluate the influence of the SARS-CoV-2 pandemic on the adherence of patients with inflammatory rheumatic diseases (IRD) to their immunomodulatory medication during the three-month lockdown in Germany.

Methods

From 16th March until 15th June 2020, IRD patients from private practices and rheumatology departments were asked to answer a questionnaire addressing their behaviour with respect to their immunomodulating therapy. Eight private practices and nine rheumatology departments that included rheumatology primary care centres and university hospitals participated. A total of 4252 questionnaires were collected and evaluated.

Results

The majority of patients (54%) were diagnosed with RA, followed by psoriatic arthritis (14%), ankylosing spondylitis (10%), connective tissue diseases (12%) and vasculitides (6%). Most of the patients (84%) reported to continue their immunomodulatory therapy. Termination of therapy was reported by only 3% of the patients. The results were independent from the type of IRD, the respective immunomodulatory therapy and by whom the patients were treated (private practices vs rheumatology departments). Younger patients (<60 years) reported just as often as older patients to discontinue their therapy.

Conclusion

The data show that most of the patients continued their therapy in spite of the pandemic. A significant change in behaviour with regard to their immunomodulatory therapy was not observed during the three months of observation. The results support the idea that the immediate release of recommendations of the German Society of Rheumatology were well received, supporting the well-established physician–patient relationship in times of a crisis.
Religious Moral Communities or Secular Tolerance? Individual-, National-, and Regional-Level Explanations for Restrictive Refugee Policy Preferences in Europe
Authors: Vaughan Kenneth R
Published: March 2021

Religious communities can encourage generosity toward strangers. In these communities, such norms are high among religious individuals and nonadherents. It remains unclear how these norms inform policy. Recent refugee crises provide critical tests of how charitable values translate into political preferences. As Europe experiences turmoil over the acceptance and integration of Muslim refugees, I ask how religion affects preferences regarding refugee admissions. I find that marginalized religious groups among new immigrants offer the highest levels of support for admitting refugees. Catholics are more restrictive than religious nones regarding policy preferences, while there are mixed results comparing nones to other Christian denominations. However, for Catholics and most other Christians, generous policy preferences increase with higher rates of religious service attendance. Respondents offer more generous policy preferences in regions with higher rates of Protestant and Catholic affiliation and in nations with higher Protestant affiliation. Restrictive preferences increase with regional and national percent unaffiliated.
A field trial comparing four oral nonsteroidal anti-inflammatory drugs on controlling cautery dehorning pain and stress in calves
Authors: Stock Matthew L , Kleinhenz Michael D , Mazloom Reza , Jaberi-Douraki Majid , Barth Laura A , Van Engen Nicholas K , Voris Erica A , Wang Chong , Coetzee Johann F
Published: March 2021

The purpose of this study was to compare the analgesic effect of four nonsteroidal anti-inflammatory drugs (NSAIDs) administered as a single, standardized, oral dose in dairy calves at the time of cautery dehorning. The NSAIDs investigated have pharmacokinetic properties in cattle that produce persistent plasma concentrations that may provide prolonged analgesia with the added practicality of a simple administration regimen. One hundred and eighty-five Holstein calves aged approximately 50 d old were either sham dehorned (n = 31) or cautery dehorned following oral administration of carprofen (n = 31), firocoxib (n = 31), flunixin meglumine (n = 30), meloxicam (n = 31) or placebo (n = 31) in a randomized, controlled trial. A standard dose of 2.0 mg/kg was administered to all calves receiving an oral NSAID. All calves received local anesthesia prior to actual or sham dehorning. Cortisol concentrations, heart rate, mechanical nociception thresholds, ocular and dehorning area temperatures, and average daily gains were evaluated. A linear mixed-effects model with repeated measures was used for statistical analysis. Administration of oral meloxicam, flunixin meglumine, and firocoxib at 2.0 mg/kg resulted in decreased cortisol concentrations compared to placebo-treated controls for the first 24 h postdehorning (AUEC0–24) (P = 0.03). Moreover, firocoxib, flunixin meglumine, and meloxicam attenuated the maximum cortisol concentrations compared to placebo-treated calves (P = 0.04, P= 0.02). In calves treated with flunixin meglumine, cortisol concentrations was reduced at 4 h (P = 0.04) and 8 h (P = 0.02). In addition, analgesic administration was associated with changes in ocular and dehorning area temperature differences (P = 0.09). Carprofen and meloxicam reduced heart rates during the entire study period (P = 0.003). Although a treatment effect (P < 0.0001) was observed in the determination of mechanical nociception threshold among all treatment groups, meloxicam expressed marginally significant effects (P = 0.09) among NSAID treated groups dehorned. A single dose of oral meloxicam, flunixin meglumine, or firocoxib administered at 2.0 mg/kg reduced the acute stress response associated with cautery dehorning. However, carprofen administration was associated with increased cortisol concentrations and dehorning area temperatures for the initial 24 h. Given the changes in pain and stress outcome variables assessed in this study, NSAIDs should be administered at the time of dehorning.
High-Frequency Visual Stimulation Primes Gamma Oscillations for Visually Evoked Phase Reset and Enhances Spatial Acuity
Authors: Lantz Crystal L , Quinlan Elizabeth M
Published: March 2021

The temporal frequency of sensory stimulation is a decisive factor in the plasticity of perceptual detection thresholds. However, surprisingly little is known about how distinct temporal parameters of sensory input differentially recruit activity of neuronal circuits in sensory cortices. Here we demonstrate that brief repetitive visual stimulation induces long-term plasticity of visual responses revealed 24 h after stimulation and that the location and generalization of visual response plasticity is determined by the temporal frequency of the visual stimulation. Brief repetitive low-frequency stimulation (2 Hz) is sufficient to induce a visual response potentiation that is expressed exclusively in visual cortex layer 4 and in response to a familiar stimulus. In contrast, brief, repetitive high-frequency stimulation (HFS, 20 Hz) is sufficient to induce a visual response potentiation that is expressed in all cortical layers and transfers to novel stimuli. HFS induces a long-term suppression of the activity of fast-spiking interneurons and primes ongoing gamma oscillatory rhythms for phase reset by subsequent visual stimulation. This novel form of generalized visual response enhancement induced by HFS is paralleled by an increase in visual acuity, measured as improved performance in a visual detection task.