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This article, published in the Journal of Neurological Surgery, examines the diagnostic accuracy of beta-2 transferrin gel electrophoresis (B2Tf GE) in detecting cerebrospinal fluid (CSF) rhinorrhea. The study conducted a retrospective review of patients who presented with unilateral thin clear rhinorrhea (UTCR) and underwent B2Tf GE. The results showed that B2Tf GE had a sensitivity of 87.5%, specificity of 76.9%, positive predictive value of 77.8%, and negative predictive value of 87% in detecting CSF rhinorrhea. However, the study also highlighted the potential limitations of B2Tf GE and suggested considering other diagnostic tests in cases where B2Tf GE results deviate from clinical suspicion. [Extracted from the article]

Objectives: Unilateral clear thin rhinorrhea (UCTR) can be concerning for a nasal cerebrospinal fluid (CSF) leak. Beta‐2 transferrin electrophoresis has been the gold standard for initial non‐invasive confirmatory testing for CSF rhinorrhea, but there can be issues with fluid collection and testing errors. Ipratropium bromide nasal spray (IBNS) is highly effective at reducing rhinitis‐related rhinorrhea, and should presumably not resolve CSF rhinorrhea. This study assessed whether different clinical features and IBNS response helped predict presence or absence of CSF rhinorrhea. Methods: A prospective cohort study was conducted where all patients with UCTR had nasal fluid tested for beta‐2 transferrin, and were prescribed 0.06% IBNS. Patients were diagnosed with CSF rhinorrhea or other rhinologic conditions. Clinical variables like IBNS response (rhinorrhea reduction), positional worsening, salty taste, postoperative state, female gender, and body‐mass index were assessed for their ability to predict CSF rhinorrhea. Sensitivity, specificity, and predictive values and odds ratios were calculated for all clinical variables. Results: Twenty patients had CSF rhinorrhea, and 53 had non‐CSF etiologies. Amongst clinical variables assessed for predicting CSF absence or presence, significant associations were shown for IBNS response (OR = 844.66, p = 0.001), positional rhinorrhea worsening (OR = 8.22, p = 0.049), and body‐mass index ≥30 (OR = 2.92, p = 0.048). IBNS response demonstrated 96% sensitivity and 100% specificity, and 100% positive and 91% negative predictive values for predicting CSF rhinorrhea. Conclusions: In patients with UCTR, 0.06% IBNS response is an excellent screening tool for excluding CSF rhinorrhea, and should be considered in the diagnostic workup of CSF rhinorrhea. Level of Evidence: 2 Laryngoscope, 134:56–61, 2024 [ABSTRACT FROM AUTHOR]

Background We observed an increase in the frequency of false-positive (FP) human immunodeficiency virus (HIV) test results that correlated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) prevalence. We measured FP rates of laboratory-based fourth-generation HIV antigen/antibody test among those with polymerase chain reaction (PCR)-confirmed infection with SARS-CoV-2 compared with FP rate of those who tested SARS-CoV-2 PCR-negative. Methods All patients PCR tested for SARS-CoV-2 within 2 weeks of an HIV fourth-generation assay were selected. Positive HIV fourth-generation assays were reviewed and divided into groups of FP, true positive (TP), and presumptive negative (PN). Variables included age, race, ethnicity, gender, pregnancy, and Coronavirus Disease 2019 (COVID-19) immunization status. Associations with positive SARS-CoV-2 tests were assessed using linear logistic regression. Multivariate logistic regression was used to assess sets of variables. Results There were 31 910 medical records that met criteria. The frequency of SARS-CoV-2 positive tests was calculated in groups of HIV TP, FP, and PN. In total, 31 575 patients had PN HIV test result, 248 patients had TP, and 87 patients had FP. Those with HIV FP tests had the highest percentage of COVID-19–positive test results at 19.5%, which was significantly higher than HIV PN (11.3%; P =.016) and HIV TP (7.7%; P =.002). After adjustment for all covariates, only FP HIV was significantly associated with COVID-19 (odds ratio, 4.22; P =.001). Conclusions This study reveals that patients with positive SARS-CoV-2 PCR tests are significantly more likely to have an FP fourth-generation HIV test than those with negative SARS-CoV-2 PCR tests. [ABSTRACT FROM AUTHOR]

Compared with conventional coagulation tests and factor-specific assays, viscoelastic hemostatic assays (VHAs) can provide a more thorough evaluation of clot formation and lysis but have several limitations including clot deformation. In this proof-of-concept study, we test a noncontact technique, termed resonant acoustic rheometry (RAR), for measuring the kinetics of human plasma coagulation. Specifically, RAR utilizes a dual-mode ultrasound technique to induce and detect surface oscillation of blood samples without direct physical contact and measures the resonant frequency of the surface oscillation over time, which is reflective of the viscoelasticity of the sample. Analysis of RAR results of normal plasma allowed defining a set of parameters for quantifying coagulation. RAR detected a flat-line tracing of resonant frequency in hemophilia A plasma that was corrected with the addition of tissue factor. Our RAR results captured the kinetics of plasma coagulation and the newly defined RAR parameters correlated with increasing tissue factor concentration in both healthy and hemophilia A plasma. These findings demonstrate the feasibility of RAR as a novel approach for VHA, providing the foundation for future studies to compare RAR parameters to conventional coagulation tests, factor-specific assays, and VHA parameters. [ABSTRACT FROM AUTHOR]

Epithelial tissues adapt their form and function following mechanical perturbations, or mechano-adapt, and these changes often result in reactive forces that oppose the direction of the applied change. Tissues subjected to ectopic tensions, for example, employ behaviors that lower tension, such as increasing proliferation or actomyosin turnover. This oppositional behavior suggests that the tissue has a mechanical homeostasis. Whether attributed to maintenance of cellular area, cell density, or cell and tissue tensions, epithelial mechanical homeostasis has been implicated in coordinating embryonic morphogenesis, wound healing, and maintenance of adult tissues. Despite advances toward understanding the feedback between mechanical state and tissue response in epithelia, more work remains to be done to examine how tissues regulate mechanical homeostasis using epithelial sheets with defined micropatterned shapes. Here, we used cellular microbiaxial stretching (CμBS) to investigate mechano-adaptation in micropatterned tissues of different shape consisting of Madin–Darby canine kidney cells. Using the CμBS platform, tissues were subjected to a 30% stretch that was held for 24 h. We found that, following stretch, tissue stresses immediately increased then slowly evolved over time, approaching their pre-stretch values by 24 h. Organization of the actin cytoskeletal was found to play a role in this process: anisotropic ally structured tissues exhibited anisotropic stress patterns, and the cytoskeletal became more aligned following stretch and reorganized over time. Interestingly, in unstretched tissues, stresses also decreased, which was found to be driven by proliferation-induced cellular confinement and change in tissue thickness. We modeled these behaviors with a continuum-based model of epithelial growth that accounted for stress-induced actin remodeling and proliferation, and found this model to strongly capture experimental behavior. Ultimately, this combined experimental-modeling approach suggests that epithelial mechano-adaptation depends on cellular architecture and proliferation, which can be modeled with a field-averaged approach applicable to more specific contexts in which change is driven by epithelial mechanical homeostasis. Insight box Epithelial tissues adapt their form and function following mechanical perturbation, and it is thought that this 'mechano-adaptation' plays an important role in driving processes like embryonic morphogenesis, wound healing, and adult tissue maintenance. Here, we use cellular microbiaxial stretching to probe this process in vitro in small epithelial tissues whose geometries were both controlled and varied. By using a highly precise stretching device and a continuum mechanics modeling framework, we revealed that tissue mechanical state changes following stretch and over time, and that this behavior can be explained by stress-dependent changes in actin fibers and proliferation. Integration of these approaches enabled a systematic approach to empirically and precisely measure these phenomena. [ABSTRACT FROM AUTHOR]

An urgent need exists to develop a more sophisticated screening system in order to improve diagnostic accuracy of clinically significant cancer and also to reduce the drawbacks of prostate-specific antigen (PSA) screening including overdetection and overtreatment. The most promising next-generation PSA test, which can improve the management of prostate cancer, may be proenzyme PSA (proPSA) or precursor PSA (pPSA). proPSA has pro-leader peptide sequences of seven or less amino acids and previous studies demonstrated that [−2]proPSA, which contains only a 2-amino-acid propeptide leader, could be more useful not only to distinguish between men with and without cancer, but also between tumors with aggressive features with performance exceeding other classical PSA-related indices including ratio of free PSA to total PSA (%f-PSA) and PSA density. Recently, it was demonstrated that baseline [−2]proPSA-related indices were independent factors to predict pathological reclassification at one year or several years after entering active surveillance. Furthermore, a retrospective study suggested that [−2]proPSA might be a useful predictive marker for future developing clinically manifested prostate cancer as well as aggressive tumors. ProPSA-related indices may have the potential for developing a more ideal risk classification for men at risk for prostate cancer, with a screening system maintaining the sensitivity of detecting clinically significant prostate cancer while saving cost, individualized treatment strategies, and follow-up procedures of active surveillance or active treatments. At a minimum, proPSA will be one of the most important new markers on the prostate cancer management in the near future. [ABSTRACT FROM AUTHOR]

This article profiles the violence that occurs in the films that compose the most popular (top-grossing) genres of 1994: comedy, drama, and action. The critical features used to describe film violence are intentionality, frequency, seriousness, consequences, explicitness, and severity (damage to the body of the recipient). Scales for seriousness, explicitness, and severity were systematically applied to the films using frame-by-frame analysis. Although the initiators of violence in American films employ lethal violence in nearly half the violent events, depiction of any consequences to the recipient' s body occurs in 1 out of 10 cases. Throughout, the effects of violence on the victim's body are mystified by a form of narrative that occults and minimizes consequences arising from clearly depicted intentional assaults. So far as violence is concerned, the Hollywood body is an impossible one, merely a dramaturgical figure. [ABSTRACT FROM AUTHOR]

The article focuses on the report of Friedrich Sorge, corresponding secretary of the North American Central Committee of the International Workingmen's Association, about a civil disturbance which had occurred in New York City in July, 1871. According to the report the riot had been fomented and invited by the inflammatory articles of the mercenary, black-mailing unscrupulous press of this city and precipitated by the blunders and crimes of the city and state authorities. The accuracy of this report is supported by the coverage of the disturbance which appeared in both the leading newspapers, The New York Times and the New York Tribune, with the sole exception of the casualty figures. The crowd's actions had been provocative and violent, but such a response still seemed indiscriminate and out of order. But the press, softening the tragic overtones of the incident, found that though the troops acted hastily and ill-advisedly, they were not to be condemned for they checked the belligerent tendency of the mob.