bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimizing Postoperative Pain in Autologous Breast Reconstruction With the Omental Fat–Augmented Free Flap
Authors: Deptula Peter , Zak Yulia , Dua Monica , Wapnir Irene , Nguyen Dung 
Published: February 2022

Introduction
The omental fat–augmented free flap (O-FAFF) is a recently developed technique for autologous breast reconstruction. Our aim of the study is to evaluate the outcomes of our early case series. We assess the O-FAFF donor site morbidity in terms of postoperative pain, narcotic, and antiemetic use.

Methods
A retrospective analysis of patients undergoing O-FAFF from 2019 to 2021 was performed. Patients were evaluated for demographic data, operative time, hospital course, and complications. Mean pain scores (1–10 scale) and narcotic pain medication use in oral morphine equivalents and doses of antiemetic medications during their hospital course were analyzed. We compared outcomes of our O-FAFF group with those of a control group of patients who underwent breast reconstruction with traditional free abdominal tissue transfer.

Results
A total of 14 patients underwent O-FAFF breast reconstruction, representing 23 breasts. Patients had an average age of 48.5 years (±2.3 years) and body mass index of 22.6 kg/m2 (±1.09 kg/m2). Average follow-up was 232 days (±51 days). Average mastectomy weight was 245.6 g (±30.2 g) and average O-FAFF weight was 271 g (±31.7 g). Average pain scores on postoperative day 1 (POD1), POD2, and POD3 were 3.1 (±0.28), 2.8 (±0.21), and 2.1 (±0.35), respectively. The average narcotic use by patients in oral morphine equivalents on POD1, POD2, and POD3 are 24.3 (±5.5), 21.9 (±4.6), and 6.2 (±2.4), respectively. Total narcotic use during hospital stay was 79.4 mg (±11.1 mg). Average pain scores and narcotic use are significantly lower when compared with a previously published cohort of patients who underwent autologous breast reconstruction with free abdominal tissue transfer (P < 0.05). Average antiemetic use was lower in the O-FAFF group compared with the control group: 3.5 versus 4.8 doses (P = 0.6). Hospital length of stay was 3.0 days (±0.0 days). No complications were noted (0%). Patients were universally satisfied with their reconstructive outcome (100%).

Conclusions
The O-FAFF is proven to be a viable method of autologous breast reconstruction. Early series of patients undergoing O-FAFF reconstruction suggest a lower donor site morbidity as demonstrated by lower postoperative pain scores and lower consumptions of narcotic pain medications.
Implementation of Telehealth in a Pediatric Plastic Surgery Clinic: A Single Center's Response to COVID-19
Authors: Kim Erinn N. , Tyrell Richard , Moss Whitney D. , Siddiqi Faizi A. 
Published: February 2022

Background
With limitation of in-person clinical visits due to the COVID-19 pandemic, telehealth has emerged as an important platform to deliver healthcare. Satisfaction with telehealth has been examined previously in the adult plastic surgery population. However, studies examining its use and satisfaction in the pediatric plastic surgery population are limited. In this study, we explore patient/caregiver satisfaction with the rapid institution of telehealth in our pediatric plastic surgery clinic and factors affecting satisfaction scores.

Methods
From March 2020 to February 2021, families of pediatric patients seen via video telehealth in the pediatric plastic surgery clinic at our center were invited to participate in a posttelehealth session survey. Telehealth visits encompassed both preliminary consultations as well as follow-up visits. After appropriate consent was obtained, patients' families completed a posttelehealth survey conveying demographics and satisfaction with telehealth via a 5-point Likert scale.

Results
Seventy eight of 131 eligible families elected to participate. Visit types included the following: initial consultations (23.1%), preoperative visits (10.3%), postoperative visits (29.5%), and follow-up visits (37.1%). A total of 80.3% of the respondents were overall satisfied with their telehealth experience. A total of 85.3% of the respondents agreed that telehealth made it easier for them to see their doctor, and 96.7% of the respondents felt using telehealth saved them time in traveling to the clinic. A total of 89.5% of the respondents felt it important for the state of Utah to have a telehealth program available to pediatric patients.

Conclusions
Video telehealth is a useful adjunct in the care of pediatric plastic surgery patients with high caregiver satisfaction.
Early Postoperative Sequelae After Open Sky Access in Nasal Osteotomy
Authors: Zaher Mahmoud M. , Elfeki Bassem , Ismail Khalid A. , Ismail Taha A. , Hegazy Safwat A. 
Published: February 2022

Introduction
Nasal osteotomy is a powerful cornerstone step in almost all rhinoplasty procedures and is a major cause of postoperative periorbital ecchymosis and edema after rhinoplasty. Different accesses for osteotomy have been described, the most popular of which is the external perforating and the internal continuous methods. These accesses are blind maneuvers and have some drawbacks such as possible visible scar formation in the percutaneous access or high rate of mucosal tear in the endonasal access. Open sky access osteotomy after wide subperiosteal dissection had been described to overcome those disadvantages. Early postoperative sequelae have not been assessed in the literature after using this access. In the present study, we aim to assess early postoperative sequelae after using this technique in comparison with percutaneous perforating osteotomy.

Materials and Methods
The study was conducted between November 2017 and January 2021. Forty patients were randomly assigned into 2 equal groups. Group A was subjected to lateral osteotomy by percutaneous perforating method, whereas group B underwent lateral osteotomy by the open sky access technique using a 2-mm curved osteotome. Early postoperative periorbital sequelae were assessed on the second and seventh postoperative days, using the grading system suggested by Kara et al (Plast Reconstr Surg. 1999;104:2213–2218). Mucosal tear was assessed on the second postoperative day using nasal endoscopy after removal of nasal packs.

Results
There was a statistically nonsignificant difference between the studied groups regarding ecchymosis and edema occurring on the second or seventh days. Meanwhile, mucosal tear was significantly less in the open sky access osteotomy group.

Conclusions
Open sky access osteotomy is a safe method for lateral nasal osteotomy with direct visualization of the surgical field. It does not require a skin incision that could lead to a scar formation. It produces less mucosal tear than percutaneous perforating osteotomy. No statistically significant difference is found between both techniques regarding postoperative periorbital ecchymosis and edema on the second and seventh postoperative days.
Quantity of Acellular Dermal Matrix in Immediate Breast Reconstruction and Outcomes
Authors: Driscoll Cassandra R. , Prabhu Shamit S. , Davidson Amelia L. , Katz Adam J. 
Published: February 2022

Purpose
This study aimed to determine the impact of the quantity of acellular dermal matrix (ADM), “ADM burden,” used in implant-based breast reconstruction on infection, drain duration, and seroma formation.

Methods
A single-institution, retrospective review from 2015 to 2020 was conducted for patients who underwent immediate, implant-based breast reconstruction after mastectomy. Three cohorts were generated based on the amount of ADM used: (1) total ADM, (2) sling ADM, and (3) no ADM.

Results
In total, there were 374 patients who satisfied the inclusion criteria yielding 641 breasts with 143, 432, and 66 breasts in the total ADM, sling ADM, and no-ADM groups, respectively. The no-ADM group had higher mastectomy weights (788.4 g) than the sling (654.2 g) and total ADM (503.4 g) groups (F = 10.8, P < 0.001). Total ADM had higher rates of explantation secondary to infection compared with no ADM (P < 0.001). Linear regression analysis for drain duration was significant for body mass index (P < 0.0001) but not for ADM quantity (P = 0.52). Logistic regression analysis demonstrated a higher risk of infection in the total ADM group (odds ratio [OR], 5.4; P < 0.0001). Diabetes mellitus was a risk factor for both infection (OR, 3.6; P = 0.05) and seroma formation (OR, 0.04; P = 0.04).

Conclusions
Higher ADM burden is associated with an increased risk of infections and device explantation secondary to those infections. Although ADM has created new avenues in breast reconstruction, these findings indicate a need to evolve the technique to minimize the ADM burden. By doing so, patients can minimize their risk of postoperative complications while reducing the financial impact on institutions.
Follow that cell: leukocyte migration in L-plastin mutant zebrafish
Authors: Linehan J.B. , Zepeda J.L. , Mitchell T.A. , LeClair E.E. 
Published: February 2022

AbstractActin assemblies are important in motile cells such as leukocytes which form dynamic plasma membrane extensions or podia. L-plastin (LCP1) is a leukocyte-specific calcium-dependent actin-bundling protein that, in mammals, is known to affect immune cell migration. Previously, we generated CRISPR/Cas9 engineered zebrafish lacking L-plastin (lcp1-/-) and reported that they had reduced survival to adulthood, suggesting that lack of L-plastin might negatively affect the immune system. To test this hypothesis, we examined the distribution and migration of neutrophils and macrophages in the transparent tail of early zebrafish larvae using cell-specific markers and an established wound-migration assay. Knockout larvae were similar to their heterozygous siblings in having equal body sizes and comparable numbers of neutrophils in caudal hematopoietic tissue at two days post-fertilization, indicating no gross defect in neutrophil production or developmental migration. When stimulated by a tail wound, all genotypes of neutrophils were equally migratory in a two-hour window. However for macrophages we observed both migration defects and morphological differences. L-plastin knockout macrophages still homed to wounds but were slower, less directional and had a star-like morphology with many leading and trailing projections. In contrast, wild type macrophages were faster, more directional, and had a more streamlined, slug-like morphology. Overall, these findings show that in larval zebrafish L-plastin knockout primarily affects the macrophage response with possible consequences for organismal immunity. Consistent with our observations, we propose a model in which cytoplasmic L-plastin negatively regulates macrophage integrin adhesion by holding these transmembrane heterodimers in a ‘clasped’, inactive form and is a necessary part of establishing macrophage polarity during chemokine-induced motility.
Leukemia-intrinsic determinants of CAR-T response revealed by iterativein vivogenome-wide CRISPR screening
Authors: Ramos Azucena , Koch Catherine E. , Liu Yunpeng , Hellinger Riley D. , Kyung Taeyoon , Abbott Keene L. , Fröse Julia , Goulet Daniel , Gordon Khloe S. , Larson Rebecca C , Doench John G. , Regev Aviv , Vander Heiden Matthew G. , Maus Marcela V. , Birnbaum Michael E. , Hemann Michael T. 
Published: February 2022

AbstractCAR-T therapy is a promising new treatment modality for B-cell malignancies. However, the majority of patients inevitably go on to experience disease relapse through largely unknown means. To investigate leukemia-intrinsic CAR-T resistance mechanisms, we performed genome-wide CRISPR-Cas9 loss-of-function screens in an immunocompetent murine model of B-cell acute lymphoblastic leukemia (B-ALL) utilizing a novel, modular guide RNA library. We identified IFNγ/JAK/STAT signaling and components of antigen processing and presentation pathway as key mediators of resistance to CAR-T therapyin vivo, but notin vitro. Transcriptional characterization of this model demonstrated an upregulation of these pathways in CAR-T treated relapsed tumors, and examination of data from CAR-T treated patients with B-ALL revealed an association between poor outcomes and increased expression of JAK/STAT/MHC-I in leukemia cells. Overall, our data identify an unexpected mechanism of resistance to CAR-T therapy in which tumor cell interaction with CAR-T cellsin vivoinduces expression of an adaptive T-cell resistance program in tumor cells.
Factors that affected the qualification of standardized residency training of internal medicine: a prospective longitudinal study
Authors: Sun Yunjuan , Xu Jialiang , Hu Limei , Qi Jiajun 
Published: February 2022

ABSTRACTIntroductionSince the standardized residency training (SRT) was launched in 2014, there were very few data on evaluation of the factors that could influence the residents’ competency in China.MethodsAll residents who started their SRT programme from September 2015 to September 2018 were enrolled in this study. During the following years, they finished the programme and took examinations. The demographic information and exam scores of each subject were collected and analyzed.ResultsWe found that the qualification rates of SRT programme differed significantly annually. Age, gender, the highest medical education degree, residents from different places, training duration and years of medical school study were also different significantly year by year. According to the scores of examinations, residents were divided into two groups: the qualified group and the non-qualified group. Age, the highest medical education degree, residents from different places, training duration, years of medical school study and prior medical work experience differed significantly between the two groups. Multivariate Logistic regression analysis showed the residents from different places and the training duration were factors that affected the qualification rate of SRT programme independently (P = 0.000 and 0.005, respectively).DiscussionThe “homogeneity” of SRT had been achieved regardless of the individual discrepancy, while the resident from different places and the training duration were obstacles we need to overcome further. Therefore, we should further advance the process of the transition from “Unit Persons” to “Society Persons”. And extending training duration will facilitate their qualification and be benefit to improve their competency.
A two-gene strategy increases the iron and zinc concentration of wheat flour and improves mineral bioaccesibility for human nutrition
Authors: Harrington Sophie A , Connorton James M , Nyangoma Natasha I M , McNelly Rose , Morgan Yvie M L , Aslam Mohamad F , Sharp Paul A , Johnson Alexander A T , Uauy Cristobal , Balk Janneke 
Published: February 2022

AbstractDietary deficiencies of iron and zinc cause human malnutrition globally, which can be mitigated by biofortified staple crops. Conventional breeding approaches to increase grain mineral concentrations in wheat (Triticum aestivum L.) have had only limited success so far due to relatively low genetic variation. Here we demonstrate that a transgenic approach combining endosperm-specific expression of the wheat vacuolar iron transporter gene TaVIT2-D with constitutive expression of the rice nicotianamine synthase gene OsNAS2 has the potential to dramatically improve mineral micronutrient intake from wheat products. In two distinct bread wheat cultivars, we show that the VIT-NAS construct led to a two-fold increase in zinc to ∼50 µg g-1 in wholemeal flour and a two-fold increase in both zinc and iron in hand-milled white flour. In highly pure, roller-milled white flour, the concentration of iron was enhanced three-fold to ∼25 µg g-1. A greater than three-fold increase in the level of the natural plant metal chelator nicotianamine in the grain of VIT-NAS lines was associated with improved iron and zinc bioaccessibility in white flour. The growth of VIT-NAS plants in the greenhouse was indistinguishable from untransformed controls. We conclude that the effects of each gene cassette are additive in altering the total concentration and distribution of iron and zinc in wheat grains. This demonstrates the potential of a transgenic approach to enhance the nutritional quality of wheat well beyond what is possible by breeding approaches in order to alleviate dietary mineral deficiencies.
nPoRe:n-Polymer Realigner for improved pileup variant calling
Authors: Dunn Tim , Blaauw David , Das Reetuparna , Narayanasamy Satish 
Published: February 2022

ABSTRACTDespite recent improvements in nanopore basecalling accuracy, germline variant calling of small insertions and deletions (INDELs) remains poor. Although precision and recall for single nucleotide polymorphisms (SNPs) now regularly exceeds 99.5%, INDEL recall at relatively high coverages (85×) remains below 80% for standard R9.4.1 flow cells [22, 23, 31]. Current nanopore variant callers work in two stages: an efficient pileup-based method identifies candidates of interest, and then a more expensive full-alignment model provides the final variant calls. Most false negative INDELs are lost during the first (pileup-based) step, particularly in low-complexity repeated regions. We show that read phasing and realignment can recover a significant portion of INDELs lost during this stage. In particular, we extend Needleman-Wunsch affine gap alignment by introducing new gap penalties for more accurately aligning repeatedn-polymer sequences such as homopolymers (n= 1) and tandem repeats (2 ≤n≤ 6). On our dataset with 60.6× coverage, haplotype phasing improves INDEL recall in all evaluated high confidence regions from 63.76% to 70.66% and then nPoRe realignment improves it further to 73.04%, with no loss of precision.
IKK2/NFkB signaling controls lung resident CD8 T cell memory during influenza infection
Authors: Pritzl Curtis J. , Luera Dezzarae , Knudson Karin M. , Quaney Michael J. , Daniels Mark A. , Teixeiro Emma 
Published: February 2022

AbstractCD8 tissue resident memory (TRM) cells are especially suited to control pathogen spread at mucosal sites. However, their maintenance in lung is limited. Here, we found that enhancing NFkB signaling in T cells once memory to influenza is established increased pro-survival Bcl-2 and CD122 levels boosting lung CD8 TRM maintenance. By contrast, enhancing NFkB signals during the contraction phase of the response led to a defect in TRM differentiation without impairing recirculating memory subsets. Specifically, inducible activation of NFkB via constitutive active IKK2 or tumor necrosis factor (TNF) interfered with tumor growth factor beta (TGFβ) signaling resulting in defects of lung CD8 TRM imprinting molecules CD69, CD103, Runx3 and Eomes. Conversely, inhibiting NFkB signals not only recovered but improved the transcriptional signature and generation of lung CD8 TRM. Thus, NFkB signaling is a critical regulator of tissue resident memory, whose levels can be tuned at specific times during infection to boost lung CD8 TRM.
Kinesin-1 promotes centrosome clustering and nuclear migration in theDrosophilaoocyte
Authors: Loh Maëlys , Bernard Fred , Guichet Antoine 
Published: February 2022

AbstractAccurate positioning of the nucleus is essential. Microtubules and their associated motors are important players in this process. Although nuclear migration inDrosophilaoocytes is controlled by microtubule, a role for microtubule-associated molecular motors in nuclear positioning has yet to be reported. We characterize novel landmarks that allow a precise description of the pre-migratory stages. Using these newly defined stages, we report that, prior to migration, the nucleus moves from the oocyte anterior side toward the center and concomitantly the centrosomes cluster at the posterior of the nucleus. In absence of Kinesin-1, centrosome clustering is impaired and the nucleus fails to position and migrate properly. The maintenance of a high level of Polo-kinase at centrosomes prevents centrosome clustering and impairs nuclear positioning. In absence of Kinesin-1, SPD2 an essential component of the pericentriolar material is increased at the centrosomes, suggesting that Kinesin-1 associated defects result from a failure to reduce centrosome activity. Consistently, depleting centrosomes rescues the nuclear migration defects induced by Kinesin-1 inactivation. Our results suggest that Kinesin-1 controls nuclear migration in the oocyte by modulating centrosome activity.Summary statementIn this study, we identified a crucial role of Kinesin-1 in centrosome clustering required for nuclear positioning and migration in theDrosophilaoocyte.
Excited-state dynamics of the all-trans protonated retinal Schiff base in CRABPII-based rhodopsin mimics
Authors: Li Gaoshang , Hu Yongnan , Pei Sizhu , Meng Jiajia , Wang Jiayu , Wang Ju , Yue Shuai , Wang Zhuan , Wang Shufeng , Liu Xinfeng , Weng Yuxiang , Peng Xubiao , Zhao Qing 
Published: February 2022

AbstractThe rhodopsin mimic is a chemically synthetized complex with the retinyl Schiff base (RSB) formed between protein and the retinal chromophore, which can mimic the natural rhodopsin-like protein. The artificial rhodopsin mimic is more stable and designable than the natural protein and hence has wider uses in photon detection devices. The mimic structure RSB, like the case in the actual rhodopsin-like protein, undergoes isomerization and protonation throughout the photoreaction process. As a result, understanding the dynamics of the RSB in the photoreaction process is critical. In this study, the transient absorption spectra (TAS) of three mutants of the cellular retinoic acid-binding protein II (CRABPII)-based rhodopsin mimic at PH = 3 were recorded, from which the related excited-state dynamics of the all-trans protonated RSB (AT-PRSB) were investigated. The transient fluorescence spectra (TFS) measurements are used to validate some of the dynamic features. We find that the excited-state dynamics of AT-PRSB in three mutants share a similar pattern that differs significantly from the dynamics of 15-cis PRSB (15C-PRSB) of the rhodopsin mimic in neutral solution. By comparing the dynamics across the three mutants, we discovered that the aromatic residues near the β-ionone ring structure of the retinal may help stabilize the AT-PRSB and hence slow down its isomerization rate. Furthermore, from the three mutants, we find one protein with near-infrared fluorescence emission up to 688 nm, leading to further possible applications in sensing or bioimaging.
A natural broad-spectrum inhibitor of enveloped virus entry, effective against SARS-CoV-2 and Influenza A Virus in preclinical animal models
Authors: Narayan Rohan , Sharma Mansi , Yadav Rajesh , Biji Abhijith , Khatun Oyahida , Rajmani Raju , Sharma Pallavi Raj , Jeyasankar Sharumathi , Rani Priya , Rao C. Durga , Satchidanandanam Vijaya , Das Saumitra , Agarwal Rachit , Tripathi Shashank 
Published: February 2022

SummaryThe COVID-19 pandemic has highlighted the need for novel antivirals for pandemic management and preparedness. Targeting host processes that are co-opted by viruses is an attractive strategy for developing antivirals with a high resistance barrier. Picolinic acid (PA) is a byproduct of tryptophan metabolism, endogenously produced in humans and other mammals. Here we report broad-spectrum antiviral effects of PA against enveloped viruses, including Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), Influenza A virus (IAV), Flaviviruses, Herpes Simplex Virus, and Human Parainfluenza Virus. We further demonstrate using animal models that PA is effective against SARS-CoV-2 and IAV, especially as an oral prophylactic. The mode of action studies revealed that PA inhibits viral entry of enveloped viruses, primarily by interfering with viral-cellular membrane fusion, inhibiting virus-mediated syncytia formation, and dysregulating cellular endocytosis. Overall, our data establish PA as a broad-spectrum antiviral agent, with promising preclinical efficacy against pandemic viruses SARS-CoV-2 and IAV.