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Purpose: The purpose of the study was to assess and compare the masticatory performance in children receiving preformed metal crown by Hall technique and conventional technique. Methods: Children having teeth indicated for restorative/endodontic therapy and belonging to the age group of six to ten years were invited to participate in the study. Eighteen children received preformed metal crowns (PMCs) by Hall technique. Meanwhile, nineteen children received preformed metal crowns by the conventional technique. Their masticatory performance (MP) was assessed at T0 (pre-intervention), T1 (day 1 post-intervention), T2 (1 week), T3 (2 weeks), T4 (1 month) and T5 (3 months) using Hue-check Gum® (University of Bern, Switzerland). The chewing gum samples were scanned within 24 h of their collection and processed in the ViewGum Software©. The software calculated the hue value (VOH) which indicated the masticatory performance of the individual. A questionnaire was given to the parents at T4 and T5 to assess any discomfort or pain associated with PMCs placed in both groups. Results: The evaluation of masticatory performance using the two-color chewing method revealed reduction in MP on day 1 post-intervention (p< 0.001) for both groups. However, the MP values recorded at T5 were comparable to the baseline values at T0 (p= 0.009). No significant discomfort or pain was reported in both groups. Conclusion: The findings of the current clinical study indicate that placement of PMCs by both conventional and Hall technique in children deteriorates their MP which equilibrates within 1 month. Clinical trial registry of India number: CTRI/2021/02/031532 [Registered on: 25/02/2021]-Trial Registered Prospectively.

IMPORTANCE: There is increasing evidence that early diagnosis and treatment are key for outcomes in infants with spinal muscular atrophy (SMA), and newborn screening programs have been implemented to detect the disease before onset of symptoms. However, data from controlled studies that reliably confirm the benefits of newborn screening are lacking. OBJECTIVE: To compare data obtained on patients with SMA diagnosed through newborn screening and those diagnosed after clinical symptom onset. DESIGN, SETTING, AND PARTICIPANTS: This nonrandomized controlled trial used data from the SMARTCARE registry to evaluate all children born between January 2018 and September 2021 with genetically confirmed SMA and up to 3 SMN2 copies. The registry includes data from 70 participating centers in Germany, Austria, and Switzerland. Data analysis was performed in February 2023 so that all patients had a minimal follow-up of 18 months. EXPOSURE: Patients born in 2 federal states in Germany underwent screening in a newborn screening pilot project. All other patients were diagnosed after clinical symptom onset. All patients received standard care within the same health care system. MAIN OUTCOMES: The primary end point was the achievement of motor milestones. RESULTS: A total of 234 children (123 [52.6%] female) were identified who met inclusion criteria and were included in the analysis: 44 (18.8%) in the newborn screening cohort and 190 children (81.2%) in the clinical symptom onset cohort. The mean (SD) age at start of treatment with 1 of the approved disease-modifying drugs was 1.3 (2.2) months in the newborn screening cohort and 10.7 (9.1) months in the clinical symptom onset cohort. In the newborn screening cohort, 40 of 44 children (90.9%) gained the ability to sit independently vs 141 of 190 (74.2%) in the clinical symptom onset cohort. For independent ambulation, the ratio was 28 of 40 (63.6%) vs 28 of 190 (14.7%). CONCLUSIONS AND RELEVANCE: This nonrandomized controlled trial demonstrated effectiveness of newborn screening for infants with SMA in the real-world setting. Functional outcomes and thus the response to treatment were significantly better in the newborn screening cohort compared to the unscreened clinical symptom onset group. TRIAL REGISTRATION: German Clinical Trials Register: DRKS00012699

Background:Dalbavancin (DAL) may obviate concerns regarding misuse of IV access in persons who use drugs (PWUD) completing treatment for infections in an outpatient setting. However, hesitancy to adopt its use exists due to the cost-prohibitive nature of DAL and perceived issues with insurance reimbursement. Our study looks to determine the financial impact of DAL use in actual, measured cost, and health care utilization, data as well as the effect on treatment completion rates. Methods:This is a retrospective cohort comparing cost information and treatment completion rates of patients who received DAL to a random sample of patients with Staphylococcus aureusbacteremia prior to the institutional availability of DAL. Results:From June 2020 to January 2022, 29 PWUD received DAL. Dalbavancin use resulted in the completion of intended duration in 19 patients (66%) compared with 11 (55%) without DAL. The contribution margin with DAL use was $7180 compared with $6655 without; this was not statistically significant (P= 0.47). Conclusion:Dalbavancin use in PWUD may increase treatment completion, with no statistically significant difference in contribution margins.

Im Jahr 2023 wurden in Studien, die sich mit US-amerikanischen Kohorten befassten, für Typ-1-Diabetes ein medianes Manifestationsalter von 24 Jahren sowie eine Adipositasprävalenz, die vergleichbar der von nichtdiabetischen Individuen war, belegt. Dies unterstreicht, dass die Stigmata junge, schlanke Typ-1-Diabetes-Patient*innen sowie alte und adipöse Typ-2-Diabetes-Patient*innen weiterhin falsch sind und bleiben. Darüber hinaus wurde in zahlreicher Arbeiten der Einsatz immunmodulatorischer Pharmaka zum Erhalt der Betazellfunktion untersucht. Diesbezüglich liegen nunmehr Ergebnisse vor, die verschiedene Substanzen in fortgeschrittener Entwicklung zeigen und teilweise kurz vor der Zulassung stehend. Selbstverständlich bleiben Insuline zentraler Bestandteil der Behandlung, der Fokus der ausgewählten Arbeiten lag hierbei auf neuartigen, wöchentlich zu applizierenden Langzeitinsulinen. Die Geschwindigkeit des technologischen Fortschritts im Bereich der automatisierten Insulindosierungssysteme (AID) ist weiterhin beeindruckend. Hier konnten erneut zahlreiche Arbeiten bestätigen, dass AID zur Steigerung der Lebensqualität und signifikanter Verbesserung der Glukosezielbereiche beitragen, insbesondere auch bei vulnerablen Patient*innengruppen.

Abstract: The microstructures of five internally oxidized Ag–Sn–In materials were investigated using ion polishing, field emission scanning electron microscopy and electron backscatter diffraction. The ion polished sections showed a subtle material contrast in the oxide particles that could be attributed to different oxide phases generated during internal oxidation. The phases could be identified as tetragonal SnO2 that surrounds the cubic In2O3 core of the combined oxide particles. It is shown that In2O3 exhibits an orientation relationship to the Ag matrix and for SnO2 and Ag another orientation relationship is likely. Interrupted internal oxidation experiments were applied to identify the growth mechanism of the oxide particles. A consistent view on the role of In during the internal oxidation of Ag–Sn–In alloys as heterogeneous nucleation agent of SnO2 is presented.

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The article discusses the spread of misinformation on social media, particularly on the platform X, during the Israel-Hamas conflict in October 2023. It highlights that verified X Premium accounts played a significant role in sharing false narratives related to the war, and it provides examples of these false claims.

Mittels Post-hoc-Analysen lieferten epidemiologische Rechenmodelle einen Ausblick auf die deutlich steigenden Patient*innenzahlen bis zum Jahr 2040 und die damit verbundenen Herausforderungen in der ambulanten und stationären Versorgung des Typ-1-Diabetes (T1D). Aktuell leben laut der geschätzten Prävalenz weltweit mehr Menschen > 60 Jahre mit T1D als Menschen < 20 Jahre. Weiterhin wurden in einer neuen Studie die Sicherheit von Insulin degludec in der Schwangerschaft bei Patientinnen mit T1D nachgewiesen und somit eine Entscheidungshilfe und Optionserweiterung für die Wahl der Insuline unter Therapie mit täglich mehreren Insulininjektionen (MDI [„multiple daily injection“]) in der Schwangerschaft geliefert. Bei Systemen mit kontinuierlichem („continuous“) Glukosemonitoring (CGM) und mit automatisierter Insulinabgabe (AID [„automated insulin delivery“]) konnte in mehreren Studien gezeigt werden, dass CGM-Systeme die Zeit im Zielbereich (TIR [„time in range“]) sowie den HbA1c(glykiertes Hämoglobin) der Betroffenen verbessern. Die AID-Systeme erwiesen sich in Bezug auf Lebensqualität, Sicherheit und Erreichen stabiler Zielkorridore der MDI-Therapie deutlich überlegen. Auch sog. nicht zugelassene Open-Source-AID-Systeme weisen ähnlich positive Effekte wie die kommerziell entwickelten AID-Systeme auf und bieten im Vergleich dazu erweiterte Personalisierungsmöglichkeiten. Schließlich wurden in einer Machbarkeitsstudie („proof of concept trial“) günstige glykämische Daten unter einer SGLT-2-Hemmer-Behandlung (SGLT-2: Natrium-Glukose-Kotransporter 2 [„sodium glucose linked transporter 2]“) als Add-on zu einer AID-Therapie nachgewiesen.

ABSTRACTIntroductionAcute poisoning is a significant global health burden, and the causative agent is often unclear. The primary aim of this pilot study was to develop a deep learning algorithm that predicts the most probable agent a poisoned patient was exposed to from a pre-specified list of drugs.Research design & methodsData were queried from the National Poison Data System (NPDS) from 2014 through 2018 for eight single-agent poisonings (acetaminophen, diphenhydramine, aspirin, calcium channel blockers, sulfonylureas, benzodiazepines, bupropion, and lithium). Two Deep Neural Networks (PyTorch and Keras) designed for multi-class classification tasks were applied.ResultsThere were 201,031 single-agent poisonings included in the analysis. For distinguishing among selected poisonings, PyTorch model had specificity of 97%, accuracy of 83%, precision of 83%, recall of 83%, and a F1-score of 82%. Keras had specificity of 98%, accuracy of 83%, precision of 84%, recall of 83%, and a F1-score of 83%. The best performance was achieved in the diagnosis of single-agent poisoning in diagnosing poisoning by lithium, sulfonylureas, diphenhydramine, calcium channel blockers, then acetaminophen, in PyTorch (F1-score = 99%, 94%, 85%, 83%, and 82%, respectively) and Keras (F1-score = 99%, 94%, 86%, 82%, and 82%, respectively).ConclusionDeep neural networks can potentially help in distinguishing the causative agent of acute poisoning. This study used a small list of drugs, with polysubstance ingestions excluded.Reproducible source code and results can be obtained at https://github.com/ashiskb/npds-workspace.git.

Cells respond to perturbations such as inflammation by sensing changes in metabolite levels. Especially prominent is arginine, which has known connections to the inflammatory response. Aminoacyl-tRNA synthetases, enzymes that catalyse the first step of protein synthesis, can also mediate cell signalling. Here we show that depletion of arginine during inflammation decreased levels of nuclear-localized arginyl-tRNA synthetase (ArgRS). Surprisingly, we found that nuclear ArgRS interacts and co-localizes with serine/arginine repetitive matrix protein 2 (SRRM2), a spliceosomal and nuclear speckle protein, and that decreased levels of nuclear ArgRS correlated with changes in condensate-like nuclear trafficking of SRRM2 and splice-site usage in certain genes. These splice-site usage changes cumulated in the synthesis of different protein isoforms that altered cellular metabolism and peptide presentation to immune cells. Our findings uncover a mechanism whereby an aminoacyl-tRNA synthetase cognate to a key amino acid that is metabolically controlled during inflammation modulates the splicing machinery.

Lightning discharges between charged clouds and the Earth’s surface are responsible for considerable damages and casualties. It is therefore important to develop better protection methods in addition to the traditional Franklin rod. Here we present the first demonstration that laser-induced filaments—formed in the sky by short and intense laser pulses—can guide lightning discharges over considerable distances. We believe that this experimental breakthrough will lead to progress in lightning protection and lightning physics. An experimental campaign was conducted on the Säntis mountain in north-eastern Switzerland during the summer of 2021 with a high-repetition-rate terawatt laser. The guiding of an upward negative lightning leader over a distance of 50 m was recorded by two separate high-speed cameras. The guiding of negative lightning leaders by laser filaments was corroborated in three other instances by very-high-frequency interferometric measurements, and the number of X-ray bursts detected during guided lightning events greatly increased. Although this research field has been very active for more than 20 years, this is the first field-result that experimentally demonstrates lightning guided by lasers. This work paves the way for new atmospheric applications of ultrashort lasers and represents an important step forward in the development of a laser based lightning protection for airports, launchpads or large infrastructures.

Disease progression in patients with spinal muscular atrophy (SMA) has changed dramatically within the past years due to the approval of three different disease-modifying treatments. Nusinersen was the first drug to be approved for the treatment of SMA patients. Clinical trials provided data from infants with SMA type 1 and children with SMA type 2, but there is still insufficient evidence and only scarcely reported long-term experience for nusinersen treatment in ambulant patients. Here, we report data from the SMArtCARE registry of ambulant patients under nusinersen treatment with a follow-up period of up to 38 months. SMArtCARE is a disease-specific registry in Germany, Austria and Switzerland. Data are collected as real-world data during routine patient visits. Our analysis included all patients under treatment with nusinersen able to walk independently before start of treatment with focus on changes in motor function. Data from 231 ambulant patients were included in the analysis. During the observation period, 31 pediatric walkers (27.2%) and 31 adult walkers (26.5%) experienced a clinically meaningful improvement of≥30 m in the 6-Minute-Walk-Test. In contrast, only five adult walkers (7.7%) showed a decline in walking distance≥30 m, and two pediatric walkers (1.8%) lost the ability to walk unassisted under treatment with nusinersen. HFMSE and RULM scores improved in pediatric and remained stable in adult patients. Our data demonstrate a positive effect of nusinersen treatment in most ambulant pediatric and adult SMA patients. We not only observed a stabilization of disease progression or lack of deterioration, but clinically meaningful improvements in walking distance.

Seismic ambient noise has a strongly nonstationary time-frequency statistics that demand better interstation correlation methods to improve the balance of highly variable ambient-noise sources, reduce the influence of high-energy poorly-distributed signals, and accelerate the convergence to a robust signal or a broadband empirical Green’s function (EGF). The wavelet cross-correlation method is convenient to analyze the statistics of the cross-correlation of two signals in terms of lag time and scale/frequency. Here, we introduce wavelet phase cross-correlation (WPCC) functions better adapted to the statistics of seismic ambient noise by combining the ideas of: using only the instantaneous phase information of the phase cross-correlation (PCC) method to assess amplitude unbiasedness, and analyzing cross-correlations scale by scale of the wavelet cross-correlation to balance strong and weak frequency components. These features allow WPCC to extract clean broadband signals useful for seismic imaging and monitoring studies. Further, we analyze and discuss benefits and limitations of WPCC compared to PCC in two examples using low-frequency seismic ambient noise (hum), but results are easily extrapolated to higher frequencies. In hum autocorrelations, WPCC can correct for the baseline and extract cleaner signals, and in hum cross-correlations, can extract richer and more frequency-balanced EGFs allowing for a significant increase of Rayleigh phase- and group-velocity measurements and an improvement of their accuracy. Finally, we offset the increase in computational cost of WPCC compared to PCC by using the graphics processing unit (GPU), and show that WPCC is an efficient approach that permits processing large data volumes as commonly encountered in seismic interferometry studies.

•Unrelieved pain is a significant problem in oncology patients.•Perturbations in neuroinflammatory pathways contribute to chronic pain.•Complex neuroimmune interactions are involved in the maintenance of chronic pain.

Metabolic syndrome is a cluster of disease states that increases an individual’s risk of developing diabetes or cardiovascular disease. When treating metabolic syndrome, lifestyle and diet are primary areas for interventions. A dietician-led grocery nutrition system scoring patients’ purchases may correlate to better control of metabolic health.

The Canary and Madeira Islands are two distinct hotspots in the Central‐East Atlantic that are close to each other. Their volcanism is generally attributed to underlying mantle plumes, but the detailed structure of these plumes is still not well understood. The thermal and compositional structure of the plume introduces complexities in the phase transitions of the mantle, which impact the depth and magnitude of seismic discontinuities. We use 1,268 high‐quality receiver functions from stations located at the two hotspots to detect P‐to‐s converted phases through a common‐conversion point stacking approach and conduct a detailed analysis of mantle seismic discontinuities. The results show that both hotspots are characterized by a thin mantle transition zone (MTZ), with sharp 410 and 660 discontinuities at depths of 428–421 km and 647–664 km, beneath the Canaries and Madeira respectively. The results indicate that the Canary plume crosses the MTZ, whereas the Madeira plume mainly influences the upper portion of the MTZ. Furthermore, we find reliable detections of a sharp X discontinuity beneath the Canaries at 287 km. Its presence suggests the accumulation of silica‐rich recycled eclogite at these depths. We also use the amplitudes of P410s and PXsto derive velocity jumps at corresponding discontinuities. Based on these measurements, we estimate that the basalt proportion is 60%–80%, with accumulation being more significant in the Canaries than in Madeira. The MTZ thickness, the presence of the X discontinuity, and the high basalt proportion provide compelling evidence for a deep‐rooted thermochemical plume beneath the study area. We examine the Canary and Madeira Islands, two separate groups of islands in the Atlantic Ocean, close to each other. While it is generally accepted that volcanic activity in these regions is driven by underlying mantle plumes, the precise characteristics of these plumes remain relatively unknown. Tomography studies have revealed distinct structures of the plumes, with the Canary plume extending vertically throughout the upper mantle, while the Madeira plume is visible up to a depth of 300 km, beyond which the resolution of the images deteriorates. We use receiver functions, derived from the analysis of seismic waveforms, particularly the conversion of compressional waves to shear waves at seismic discontinuities within the Earth. Receiver functions offer a higher resolution compared to tomographic images, primarily due to their ability to directly measure seismic wave conversions at specific depths, reflecting where mantle minerals change their crystal structure. This analysis provides insights into the variations in temperature and mineral chemistry in the mantle, as both factors influence the depths of crystal rearrangements. Our research provides evidence supporting the existence of a deep‐seated thermochemical plume beneath the study area. However, beneath Madeira, the plume may be less vigorous or presently disconnected from its deep source. We investigate the upper mantle discontinuities below Canary and Madeira using P receiver functionsDeeper 410 in both, shallower 660 in Canaries, normal in Madeira: suggests Canary plume crosses MTZ, Madeira plume only affects upper MTZDetection of X discontinuity suggests a deep‐rooted thermochemical plume We investigate the upper mantle discontinuities below Canary and Madeira using P receiver functions Deeper 410 in both, shallower 660 in Canaries, normal in Madeira: suggests Canary plume crosses MTZ, Madeira plume only affects upper MTZ Detection of X discontinuity suggests a deep‐rooted thermochemical plume

Pallister-Hall syndrome, typically caused by germline or de novovariants within the GLI3gene, has key features of hypothalamic hamartoma and polydactyly. Recently, a few similar cases have been described with bi-allelic SMOvariants. We describe two siblings born to non-consanguineous unaffected parents presenting with hypothalamic hamartoma, post-axial polydactyly, microcephaly amongst other developmental anomalies. Previous clinical diagnostic exome analysis had excluded a pathogenic variant in GLI3. We performed exome sequencing re-analysis and identified bi-allelic SMOvariants including a missense and synonymous variant in both affected siblings. We functionally characterised this synonymous variant showing it induces exon 8 skipping within the SMOtranscript. Our results confirm bi-allelic SMOvariants as an uncommon cause of Pallister-Hall syndrome and describe a novel exon-skipping mechanism, expanding the molecular architecture of this new clinico-molecular disorder.

Purpose: The aim of this study was to investigate the effect of oral factors on adherence to the Mediterranean diet in an older population Methods: 130 persons over 60 years visiting Open Care Community Centers for Older People participated in this study. Oral interviews recorded demographic and sociomedical information, subjective oral complaints, and dental habits. Adherence to Mediterranean diet was assessed using the MDI_BNC4H index (range: 0–14). An oral examination was performed, and evaluation of the masticatory performance was carried out using a two-color chewing gum that was digitally analysed. Results: The mean age of the study participants was 73.9 ± 8.5 years. The score of adherence to the Mediterranean diet ranged from 3 to 9 (5.6 ± 1.4). 58 participants used removable prostheses, while 20 used a pair of complete dentures. Univariate analyses revealed that the parameters that negatively significantly, or marginally significantly, affected the level of adherence to the Mediterranean diet were lower masticatory performance (p= 0.050), larger number of drugs per day (p= 0.056), higher BMI (p= 0.043) and smoking (p= 0.053). The multivariable analysis revealed that lower adherence to the Mediterranean diet was significantly associated with higher BMI (p= 0.047) and lower masticatory performance (p= 0.050). Conclusions: Increased masticatory performance was an independent predictor of better adherence to the Mediterranean diet in an older population.

The Patient Protection and Affordable Care Act (ACA) of 2010 substantially expanded the availability of health insurance coverage, particularly for adults with disabilities. One notable change was the option for states to offer Medicaid coverage to adults with household incomes that were below 138% of the federal poverty line; most but not all states expanded Medicaid to this population. This article investigates whether states that expanded Medicaid coverage through the ACA in 2014—the first year that expansion was possible under the ACA, and the year that most states opted to expand—experienced differential changes in the employment rate of adults with disabilities relative to states that did not expand Medicaid. Using nationally representative data from the American Community Survey, we do not find evidence that the postexpansion employment trend in Medicaid expansion states was significantly different from that trend in states that did not expand Medicaid.

Supplemental Digital Content is available in the text.

Background: Myotonic dystrophy type 2 (DM2) is caused by a CCTG repeat expansion in intron 1 of the CCHC-Type Zinc Finger Nucleic Acid Binding Protein (CNBP) gene. Previous studies indicated that this repeat expansion originates from separate founders.Objective: This study was set out to determine whether or not patients with DM2 originating from European and non-European countries carry the previously described European founder haplotypes.Methods: Haplotype analysis was performed in 59 DM2 patients from 29 unrelated families. Twenty-three families were from European descent and 6 families originated from non-European countries (India, Suriname and Morocco). Seven short tandem repeats (CL3N122, CL3N99, CL3N59, CL3N117, CL3N119, CL3N19 and CL3N23) and 4 single nucleotide polymorphisms (SNP) (rs1871922, rs1384313, rs4303883 and CGAP_886192) in and around the CNBPgene were used to construct patients’ haplotypes. These haplotypes were compared to the known DM2 haplotypes to determine the ancestral origin of the CNBPrepeat expansion.Results: Of 41 patients, the haplotype could be assigned to the previously described Caucasian haplotypes. Three patients from Morocco and Portugal had a haplotype identical to the earlier reported Moroccan haplotype. Twelve patients from India and Suriname, however, carried a haplotype that seems distinct from the previously reported haplotypes. Three individuals could not be assigned to a specific haplotype.Conclusion: The ancestral origin of DM2 in India might be distinct from the Caucasian families and the solely described Japanese patient. However, we were unable to establish this firmly due to the limited genetic variation in the region surrounding the CNBPgene.

AbstractObjective:Evaluation of a mandatory immunization program to increase and sustain high immunization coverage for healthcare personnel (HCP).Design:Descriptive study with before-and-after analysis.Setting:Tertiary-care academic medical center.Participants:Medical center HCP.Methods:A comprehensive mandatory immunization initiative was implemented in 2 phases, starting in July 2014. Key facets of the initiative included a formalized exemption review process, incorporation into institutional quality goals, data feedback, and accountability to support compliance.Results:Both immunization and overall compliance rates with targeted immunizations increased significantly in the years after the implementation period. The influenza immunization rate increased from 80% the year prior to the initiative to >97% for the 3 subsequent influenza seasons (P< .0001). Mumps, measles and varicella vaccination compliance increased from 94% in January 2014 to >99% by January 2017, rubella vaccination compliance increased from 93% to 99.5%, and hepatitis B vaccination compliance from 95% to 99% (P< .0001 for all comparisons). An associated positive effect on TB testing compliance, which was not included in the mandatory program, was also noted; it increased from 76% to 92% over the same period (P< .0001).Conclusions:Thoughtful, step-wise implementation of a mandatory immunization program linked to professional accountability can be successful in increasing immunization rates as well as overall compliance with policy requirements to cover all recommended HCP immunizations.

Graphical Abstract

A young, morbidly obese woman with recent SARS-CoV-2 infection requiring hospitalization presented with visual and neurologic complications secondary to bilateral cerebral venous sinus thromboses. With elevated intracranial pressure and severe papilledema, she rapidly progressed to complete bilateral vision loss despite anticoagulation, therapeutic lumbar punctures with lumbar drain, bilateral optic nerve sheath fenestrations, and endovascular thrombectomy. It is possible that obese patients with a SARS-CoV-2 infection may be at greater risk of hypercoagulable cerebrovascular complications. It is impossible to know if an even more rapid response would have led to a different outcome, but we report this case in the hope that publishing this and similar cases may result in improved treatment protocols to preserve vision.Cerebral venous sinus thromboses related to recent or active SARS-CoV-2 infection has vision-threatening implications. Prompt diagnosis and early intervention may mitigate morbidity to preserve vision in these hypercoagulable patients.

Patients with underlying neurologic disease, male sex, Denali filters, and implantation times greater than 6 months have significantly higher risk of developing filter-related inferior vena cava thrombosis.

This article is a qualitative case study of the relationships being formed between Jews and Rwandan Tutsis and the ways in which six individuals, four Tutsis and two Jews involved in advocating for the human rights and welfare of Rwandan genocide survivors articulate their understanding of the bonds between the two communities, their shared experiences, and how their history of having survived persecution and genocide brings them together. Through their testimonies, it examines similarities and differences between the Jewish and Tutsi experiences of vulnerability and persecution, ways in which Tutsis and Jews work in partnership to advance human rights and, in particular, the rights of Rwandan genocide survivors, and how their narratives of identity have evolved in interaction with one another and continue to develop. It discusses the particular projects and advocacy efforts in which both groups have engaged to advance the human rights of Rwandan genocide survivors and how through these efforts Jews and Rwandan Tutsis give expression to a shared understanding of and commitment to human rights.

Although high-throughput RNA sequencing (RNA-seq) has greatly advanced small non-coding RNA (sncRNA) discovery, the currently widely used complementary DNA library construction protocol generates biased sequencing results. This is partially due to RNA modifications that interfere with adapter ligation and reverse transcription processes, which prevent the detection of sncRNAs bearing these modifications. Here, we present PANDORA-seq (panoramic RNA display by overcoming RNA modification aborted sequencing), employing a combinatorial enzymatic treatment to remove key RNA modifications that block adapter ligation and reverse transcription. PANDORA-seq identified abundant modified sncRNAs—mostly transfer RNA-derived small RNAs (tsRNAs) and ribosomal RNA-derived small RNAs (rsRNAs)—that were previously undetected, exhibiting tissue-specific expression across mouse brain, liver, spleen and sperm, as well as cell-specific expression across embryonic stem cells (ESCs) and HeLa cells. Using PANDORA-seq, we revealed unprecedented landscapes of microRNA, tsRNA and rsRNA dynamics during the generation of induced pluripotent stem cells. Importantly, tsRNAs and rsRNAs that are downregulated during somatic cell reprogramming impact cellular translation in ESCs, suggesting a role in lineage differentiation.

Purpose: Renal damage secondary to fluoride ions and compound A (CpdA) after sevoflurane anesthesia remains unclear. For safety reasons, some countries still recommend minimum fresh-gas flows (FGFs) with sevoflurane. We review the evidence regarding the intraoperative use of sevoflurane for anesthesia maintenance and postoperative renal function compared with other anesthetic agents used for anesthetic maintenance. Secondarily, we examine the effects of peak plasma fluoride and CpdA levels and the effect of FGF and duration of anesthesia on these parameters. Source: The databases of MEDLINE (OVID and Pubmed), EMBASE, the Cochrane Library, Health Technology Assessment Database, CINAHL, and Web of Science were searched from inception until 23 April 2020 to identify randomized-controlled trials (RCTs) in humans utilizing sevoflurane or an alternative anesthetic for anesthesia maintenance with subsequent measurements of renal function. Two different paired reviewers independently selected the studies and extracted data. The quality of the evidence was appraised using GRADE recommendations. Principal findings: Of 3,766 publications screened, 41 RCTs in human patients were identified. There was no difference between creatinine at 24 hr (21 studies; n= 1,529), or creatinine clearance (CCR) at 24 hr (12 studies; n= 728) in the sevoflurane vsalternative anesthetic groups. Peak fluoride and fluoride measured at 24 hr were higher with sevoflurane compared with other inhaled anesthetics. Subgroup analyses for sevoflurane usage in various contexts showed no significant difference between sevoflurane and alternative anesthetics for creatinine or CCR at 24 hr at varying FGF, duration of exposure, baseline renal function, or absorbent use. Conclusions: We did not find any association between the use of sevoflurane and postoperative renal impairment compared with other agents used for anesthesia maintenance. The scientific basis for recommending higher FGF with the use of sevoflurane needs to be revisited.