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Microglia may only represent 10% of central nervous system (CNS) cells but they perform critical roles in development, homeostasis and neurological disease. Microglia are also environmentally regulated, quickly losing their transcriptomic and epigenetic signature after leaving the CNS. This facet of microglia biology is both fascinating and technically challenging influencing the study of the genetics and function of human microglia in a manner that recapitulates the CNS environment. In this review we provide a comprehensive overview of existing in vitro and in vivo methodology to study human microglia, such as immortalized cells lines, stem cell-derived microglia, cerebral organoids and xenotransplantation. Since there is currently no single method that completely recapitulates all hallmarks of human ex vivo adult homeostatic microglia, we also discuss the advantages and limitations of each existing model as a practical guide for researchers.

Objective: To determine if screw fixation across a cement mantle is safe and effective during plate fixation of well-fixed periprosthetic femur fractures. Design: Retrospective cohort study. Setting: Academic Level I Trauma Center. Patients: Twenty-eight patients with AO/OTA 32A[B1] or 32A[C] periprosthetic femur fractures treated with open reduction and internal plate and screw fixation after cemented or uncemented hip arthroplasty. Intervention: Screw placement into the cement mantle during internal fixation. Outcome Measurements: Primary outcome was revision arthroplasty for aseptic loosening. Secondary outcomes included radiographic evidence of aseptic loosening, infection, nonunion, implant failure, and overall reoperation rate. Results: There were 28 patients who met inclusion criteria. A total of 9 patients had screws placed in the cement mantle while the remaining 19 patients had screws placed around an uncemented stem. At a mean of 3.7-year follow-up, there were no cases of revision arthroplasty or aseptic loosening in either group. There were no significant differences in rates of infection, nonunion, implant failure, or reoperation rate between patients who had screw placement into a cement mantle vs around an uncemented stem. Conclusion: Drilling into the cement mantle during fixation of a periprosthetic femur fracture around a well-fixed cemented hip stem appears safe and effective. When possible, surgeons can consider bicortical screws around a cemented stem, given the biomechanical advantages over unicortical screw or cerclage fixation. Larger prospective trials confirming the safety of this technique are warranted prior to routine implementation. Level of Evidence: III. [ABSTRACT FROM AUTHOR]

Purpose: To assess the experimental visual performance and dysphotopsia characteristics of the new Tecnis Symfony OptiBlue extended-depth-of-focus with violet light-filtering (ZXR00V) intraocular lens (IOL) compared with the colorless Tecnis Symfony (ZXR00) IOL. Methods: Range of vision was assessed with simulated visual acuity defocus curves, predicted by white light through focus modulation transfer function (MTF) measurements. The clinical visual acuity defocus curve of the ZXR00 IOL was used to validate the predicted range of vision. Image quality was compared by measuring white light MTF at a spatial frequency of 15 cycles per degree (c/deg) for 3 mm and 5 mm pupil diameters with optical powers of 5 D, 20 D, and 34 D using the average corneal eye (ACE) model with the average spherical and chromatic aberration of the cataract population. Effects on dysphotopsias were predicted by measurement and computer simulation of light scatter (straylight parameter) and subsequent determination of retinal veiling luminance (RVL) in vitro. Contrast enhancement under challenging light conditions was calculated based on the effects in RVL. Results: The simulated visual acuity defocus curves and image quality outcomes were comparable between the ZXR00V and ZXR00 IOLs. The area under the straylight curve for the straylight parameter showed a 19% improvement in halo performance with ZXR00V versus ZXR00. A 12% to 17% reduction in RVL was achieved in favor of ZXR00V over ZXR00, which enhanced contrast vision by 9% to 13% under challenging light conditions Conclusion: The violet light-filtering technology and improved manufacturing of ZXR00V delivers a comparable range of vision and tolerance to refractive error to ZXR00 while mitigating dysphotopsias and enhancing contrast vision. [ABSTRACT FROM AUTHOR]

Background: The medial patellofemoral complex (MPFC) is a structure composed of the medial quadriceps tendon–femoral ligament (MQTFL) superiorly and the medial patellofemoral ligament (MPFL) inferiorly. The pediatric MPFL anatomy has been well described, but the precise anatomy of the MQTFL has only recently been described and studied in skeletally immature patients. Purpose: To describe the anatomic relationship between the MQTFL and its insertion on the quadriceps tendon and patella in pediatric specimens. Study Design: Descriptive laboratory study. Methods: A total of 22 pediatric cadaveric knee specimens were dissected to analyze attachment of the MQTFL to the quadriceps tendon and patella. Dissection was facilitated using lateral parapatellar arthrotomy followed by eversion of the extensor mechanism to evaluate MQTFL fibers from its undersurface. Results: The mean specimen age was 7.4 years. Specimens were divided based on age into a younger cohort (1-2 years), middle cohort (4-8 years), and older cohort (9-12 years). The quadriceps tendon attachment (QTA) of the MQTFL proximal to the patella extended a median of 5.0 mm in the younger cohort, 11.4 mm in the middle cohort, and 12.0 mm in the older cohort, with significant differences found between the younger and middle cohorts (P <.047) and the younger and older cohorts (P <.001). The QTA as a percentage of patellar articular height averaged 44.4% across all specimens. The vertical height of the patella measured a median of 14.0 mm, 22.3 mm, and 27.3 mm in the younger, middle, and older cohorts, respectively. Conclusion: This study expands on the recently described anatomy of the pediatric MPFC to quantify the anatomic relationship between the MQTFL attachment to the quadriceps tendon and patella in a more clinically relevant cohort of donor specimens. Clinical Relevance: As access to pediatric cadaveric tissue is extremely limited, a better understanding of MPFC and MQTFL anatomy will support surgeons in preoperative planning and intraoperative considerations for their approach to MQTFL and MPFL reconstruction. This may facilitate improved anatomic surgical stabilization of the patellofemoral joint in pediatric patients. [ABSTRACT FROM AUTHOR]

The article discusses In March of 2020, as the world's states began fully responding to a global pandemic that had been unfolding for months, still evidenced in the year stamped on the virus's name, COVID-19, Philippine President Rodrigo Duterte imposed a military-style lockdown on the country's largest and most populous island, Luzon, including Metro Manila and its environs.

As a representative of Task Force Detainees of the Philippines (TFDP), Sr. Mariani Dimaranan traveled worldwide, working to highlight human rights injustice in the Philippines and to gather support for the efforts of her organization. TFDP's efforts to highlight political detention took place in the milieu of 1970s international human rights discourse. While the importance of Western Europe and the United States on this discourse is often highlighted, less attention is given to the work of grassroots activists in places such as the Philippines. This article highlights the navigation between local and international political issues within Philippinebased grassroots opposition to the Marcos dictatorship. In so doing, I add to the literature on international human rights as well as religious social movements in opposition to martial law. [ABSTRACT FROM AUTHOR]

Background: Administration of exogenous progesterone for luteal phase support has become a standard of practice. Intramuscular (IM) injections of progesterone in oil (PIO) and vaginal administration of progesterone are the primary routes of administration. This report describes the administration preferences expressed by women with infertility that were given progesterone vaginal insert (PVI) or progesterone in oil injections (PIO) for luteal phase support during fresh IVF cycles. Methods: A questionnaire to assess the tolerability, convenience, and ease of administration of PVI and PIO given for luteal phase support was completed by infertile women diagnosed with PCOS and planning to undergo IVF. The women participated in an open-label study of highly purified human menopausal gonadotropins (HP-hMG) compared with recombinant FSH (rFSH) given for stimulation of ovulation. Results: Most women commented on the convenience and ease of administration of PVI, while a majority of women who administered IM PIO described experiencing pain. In addition, their partners often indicated that they had experienced at least some anxiety regarding the administration of PIO. The most distinguishing difference between PVI and PIO in this study was the overall patient preference for PVI. Despite the need to administer PVI either twice a day or three times a day, 82.6% of the patients in the PVI group found it "very" or "somewhat convenient" compared with 44.9% of women in the PIO group. Conclusions: The results of this comprehensive, prospective patient survey, along with findings from other similar reports, suggest that PVI provides an easy-to-use and convenient method for providing the necessary luteal phase support for IVF cycles without the pain and inconvenience of daily IM PIO. Moreover, ongoing pregnancy rates with the well-tolerated PVI were as good as the pregnancy rates with PIO. [ABSTRACT FROM AUTHOR]

The article focuses on the impact of the increasing shortage of general surgeons in the U.S. Various studies have demonstrated that while the population continues to grow at an alarming rate, the overall number of general surgeons has remained relatively static. The current and future physician shortages are related to medical school enrollment patterns. By becoming a mentor to medical students and residents, the general surgeon can strongly influence future career choices.

Antibiotic resistance remains a global public health concern with significant patient morbidity and tremendous associated health care costs. Drivers of antibiotic resistance are multifaceted and differ between developing and developed countries. Under evolutionary pressure, microbes acquire antibiotic tolerance through a variety of mechanisms at the cellular level. Patients after orthopaedic trauma are vulnerable to drug-resistant pathogens, particularly after open fractures. Traumatologists practicing appropriate antibiotic prophylaxis and treatment regimens mitigate infection and propagation of antibiotic resistance., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association.)

Objective: To determine the pregnancy rates of microtubal reanastomosis (MTR) and any associated clinical variables, to determine pregnancy rates and live birth rates of MTR as compared to in vitro fertilization (IVF) and to study the rates of ectopic pregnancy and spontaneous abortion (SAB) after MTR., Study Design: Retrospective chart review., Results: At our institution, the pregnancy rate in the first 12 months following MTR was 44.3%. The study also showed that 2 clinical variables of the MTR procedure that had higher pregnancy rates were when Hulka clips (Hulka-Clemens, Richard Wolf, Rosemont, Illinois) or Filshie clips (Coopersurgical, Lake Forest, California) were used as the mechanism of tubal occlusion and if bilateral MTR was performed instead of unilateral. There was not a significant difference in the pregnancy rates of MTR (44.3%) vs. IVF (38%). However, there was a statistically significant difference in the live birth rate of MTR (19%) vs. IVF (31%) (p=0.007). The rates of ectopic pregnancy and SAB after MTR were 10% and 15.7%, respectively., Conclusion: This study showed a significantly higher live birth rate when patients underwent IVF as compared to MTR in the first 12 months following an MTR procedure.