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Background Cognitive improvement after endovascular embolization of an intracranial dural arteriovenous fistula (dAVF) remains unexplored. We aim to investigate cognitive changes following endovascular embolization of dAVFs. Methods Neuropsychology in dural ArterIal Fistula (NAIF) was a prospective multicentric study including patients with an angiographic diagnosis of dAVF who underwent endovascular embolization over the course of 4 years. A complete neuropsychological evaluation comprising five cognitive domains (attention and executive functions, memory, language, praxis, gnosis) was performed at baseline and 3 months follow-up. Mean Z scores for cognitive tests were compared pre- and post-treatment using paired sample t-tests, where higher Z scores indicate better cognition. Effect sizes were computed as Cohen's d. Results A total of 32 patients (mean age 61.1±15.4 years, 10 (31.3%) females) were included. Patients exhibited improved performance in attention and executive functions: executive functions--attention (+0.282, P=0.009, d=0.29), executive functions--fluencies (+0.283, P=0.029, d=0.4), and executive functions--processing speed (+0.471, P=0.039, d=0.41). There was an increase in memory: verbal learning and verbal delayed recall scores (+0.513, P<0.001, d=0.55, and +0.385, P=0.001, d=0.41, respectively), while verbal recognition parameters (+0.839, P=0.086, d=0.37) and visual memory (delayed recall) (+0.430, P=0.060, d=0.35) displayed trends toward improved performance. Regarding language, there was significant overall improvement (+0.300, P=0.014, d=0.24), but neither praxis nor gnosis changed significantly. These cognitive outcomes were independent of the severity (measured as Cognard classification), and no patient experienced cognitive worsening. Conclusion This study suggests that endovascular embolization confers cognitive benefits on dAVF patients undergoing endovascular embolization and may be beneficial even for patients with a low risk of hemorrhage. [ABSTRACT FROM AUTHOR]

Malignant proliferating trichilemmal tumors (MPTTs), arising from the external root sheath of hair follicles, are exceptionally rare, with limited documentation of their genetic alterations. We present a case of a 64-year-old African American woman who initially presented with a gradually enlarging nodule on her posterior scalp. An initial biopsy at an outside hospital suggested metastatic adenocarcinoma or squamous cell carcinoma (SCC) of an uncertain origin. A subsequent wide local excision revealed a 2.0 cm tumor demonstrating characteristic trichilemmal keratinization, characterized by an abrupt transition from the nucleated epithelium to a laminated keratinized layer, confirming MPTT. Immunohistochemistry demonstrated diffuse p53 expression, patchy CD 34 expression, focal HER2 membranous expression, and patchy p16 staining (negative HPV ISH). A molecular analysis identified TP53 mutation and amplifications in the ERBB2 (HER2), BRD4, and TYMS. Additional gene mutations of uncertain significance included HSPH1, ATM, PDCD1 (PD-1), BARD1, MSH3, LRP1B, KMT2C (MLL3), GNA11, and RUNX1. Assessments for the homologous recombination deficiency, PD-L1 expression, gene rearrangement, altered splicing, and DNA mismatch repair gene expression were negative. The confirmation of ERBB2 (HER2) amplification in the MPTT through a molecular analysis suggests potential therapeutic avenues involving anti-HER2 monoclonal antibodies. The presence of the TP53 mutation, without the concurrent gene mutations typically observed in SCC, significantly aided in this differential diagnosis. [ABSTRACT FROM AUTHOR]

Objectives: Implementing enhanced recovery after surgery (ERAS) protocols and decreasing length of stay (LOS) have become a priority for major surgeries, including microvascular free tissue transfer (MVFTT) reconstruction of the head and neck. We describe an ERAS protocol with the goal to further reduce length of stay beyond national medians. Methods: Retrospective chart review between August 2016 and February 2023, including all patients who underwent MVFTT after oral cavity, skull base, salivary gland, and cutaneous ablative surgery. An ERAS protocol was implemented in March 2020. Results: A total of 383 patients were included. Approximately 59.8% underwent oral cavity MVFTT, 34.5% cutaneous and lateral skull base, and 5.8% maxillary and anterior skull base. A total of 209 (54.7%) patients had surgery prior to implementation of the ERAS protocol and 174 (45.3%) after. Median LOS decreased from 9 days (interquartile interval [IQR] 8–11) to 6 (IQR 5–7.5, p < 0.0001) following oral cavity MVFTT. For cutaneous and lateral skull base reconstruction, median LOS decreased from 6 days (IQR 5–8) to 3 (IQR 3–7, p < 0.0001). For anterior skull base and sinonasal MVFTT, median LOS decreased from 8 (IQR 7–9) to 5 days (IQR 4.5–7, p = 0.0005). Rate of discharge to skilled nursing or subacute rehabilitation facilities decreased (24% before ERAS, 9.2% after, p < 0.0001). Thirty‐day readmission rate was similar before and after implementation (10.5% vs. 10.3, p = 0.954). Discharge to facility was associated with readmission (OR 2.34, 95% CI 1.12–4.89, p = 0.024). Conclusion and Relevance: Implementation of the ERAS protocol was associated with decreased LOS. There was no increase in rate of readmission. Level of Evidence: NA Laryngoscope, 134:4527–4534, 2024 [ABSTRACT FROM AUTHOR]

We present trace , an almost time-reversible hybrid integrator for the planetary N -body problem. Like hybrid symplectic integrators, trace can resolve close encounters between particles while retaining many of the accuracy and speed advantages of a fixed time-step symplectic method such the Wisdom–Holman map. trace switches methods time-reversibly during close encounters following the prescription of Hernandez & Dehnen. In this paper we describe the derivation and implementation of trace and study its performance for a variety of astrophysical systems. In all our test cases, trace is at least as accurate and fast as the hybrid symplectic integrator mercurius. In many cases, trace 's performance is vastly superior to that of mercurius. In test cases with planet–planet close encounters, trace is as accurate as mecurius with a 12× speed-up. If close encounters with the central star are considered, trace achieves good error performance while mercurius fails to give qualitatively correct results. In ensemble tests of violent scattering systems, trace matches the high-accuracy IAS15 while providing a 15× speed-up. In large N systems simulating lunar accretion, trace qualitatively gives the same results as ias15 but at a 41× speed-up. We also discuss some cases such as von Zeipel–Lidov–Kozai cycles where hybrid integrators perform poorly and provide some guidance on which integrator to use for which system. trace is freely available within the rebound package. [ABSTRACT FROM AUTHOR]

Background Recent randomized trials have demonstrated the efficacy of mechanical thrombectomy in treating acute ischemic stroke, however, further research is required to optimize this technique. We aimed to evaluate the impact of guide catheter position and clot crossing on revascularization rates using A Direct Aspiration First Pass Technique (ADAPT). Methods Data were collected between January 2018 and August 2019 as part of the Spanish ADAPT Registry on ACE catheters (SARA), a multicenter observational study assessing real-world thrombectomy outcomes. Demographic, clinical, and angiographic data were collected. Subgroup analyses assessed the relationship between guide catheter/microguidewire position and modified Trombolysis in Cerebral Infarction (mTICI) scores. First pass effect (FPE) was defined as mTICI 3 after single pass of the device. Results From a total of 589 patients, 80.8% underwent frontline aspiration thrombectomy. The median score on the National Institutes of Health Stroke Scale (NIHSS) was 16.0. After adjusting for confounders, the likelihood of achieving FPE (adjusted Odds Ratio (aOR), 0.587; 95% confidence interval (CI), 0.38 to 0.92; p=0.0194) were higher among patients with more distal petrocavernous placement of guide catheter. The likelihood of achieving FPE (aOR, 0.592; 95% CI, 0.39 to 0.90; p=0.0138) and final angiogram complete reperfusion (aOR, 0.465; 95% CI, 0.30 to 0.73; p=0.0008) were higher among patients without microguidewire crossing the clot. No difference was noted for time from arterial puncture to reperfusion in any study group. At the 90-day follow-up, the mortality rate was 9.2% and 65.8% of patients across the entire study cohort were functionally independent (modified Rankin Scale (mRS) 0-2). Conclusions Petrocavernous guide catheter placement improved first-pass revascularization. Crossing the occlusion with a microguidewire lowered the likelihood of achieving FPE and complete reperfusion after final angiogram. [ABSTRACT FROM AUTHOR]

We introduce a family of cluster algebras of infinite rank associated with root systems of type A$A$, D$D$, E$E$. We show that suitable completions of these cluster algebras are isomorphic to the Grothendieck rings of the categories OZ$\mathcal {O}_\mathbb {Z}$ of the corresponding shifted quantum affine algebras. The cluster variables of a class of distinguished initial seeds are certain formal power series defined by E. Frenkel and the second author, which satisfy a system of functional relations called QQ$QQ$‐system. We conjecture that all cluster monomials are classes of simple objects of OZ$\mathcal {O}_\mathbb {Z}$. In the final section, we show that these cluster algebras contain infinitely many cluster subalgebras isomorphic to the coordinate ring of the open double Bruhat cell of the corresponding simple simply connected algebraic group. This explains the similarity between QQ$QQ$‐system relations and certain generalized minor identities discovered by Fomin and Zelevinsky. [ABSTRACT FROM AUTHOR]

Generalized Baxter’s TQ-relations and the QQ-system are systems of algebraic relations in the category O of representations of the Borel subalgebra of the quantum affine algebra U q (g ^) , which we established in our earlier works (Frenkel and Hernandez in Duke Math J 164, 2407–2460, 2015; Commun Math Phys 362, 361–414, 2018). In the present paper, we conjecture a family of analogous relations labeled by elements of the Weyl group W of g , so that the original relations correspond to the identity element. These relations are closely connected to the W-symmetry of q-characters established in our earlier paper. We prove these relations for all w ∈ W if g has rank two, and we prove the extended TQ-relations if w is a simple reflection. We also generalize our results and conjectures to the shifted quantum affine algebras. [ABSTRACT FROM AUTHOR]

Background: Proton therapy is a form of radiotherapy commonly used to treat various cancers. Due to its high conformality, minor variations in patient anatomy can lead to significant alterations in dose distribution, making adaptation crucial. While cone‐beam computed tomography (CBCT) is a well‐established technique for adaptive radiation therapy (ART), it cannot be directly used for adaptive proton therapy (APT) treatments because the stopping power ratio (SPR) cannot be estimated from CBCT images. Purpose: To address this limitation, Deep Learning methods have been suggested for converting pseudo‐CT (pCT) images from CBCT images. In spite of convolutional neural networks (CNNs) have shown consistent improvement in pCT literature, there is still a need for further enhancements to make them suitable for clinical applications. Methods: The authors introduce the 3D vision transformer (ViT) block, studying its performance at various stages of the proposed architectures. Additionally, they conduct a retrospective analysis of a dataset that includes 259 image pairs from 59 patients who underwent treatment for head and neck cancer. The dataset is partitioned into 80% for training, 10% for validation, and 10% for testing purposes. Results: The SPR maps obtained from the pCT using the proposed method present an absolute relative error of less than 5% from those computed from the planning CT, thus improving the results of CBCT. Conclusions: We introduce an enhanced ViT3D architecture for pCT image generation from CBCT images, reducing SPR error within clinical margins for APT workflows. The new method minimizes bias compared to CT‐based SPR estimation and dose calculation, signaling a promising direction for future research in this field. However, further research is needed to assess the robustness and generalizability across different medical imaging applications. [ABSTRACT FROM AUTHOR]

Introduction: It has been suggested that nicotinic acetylcholine receptors (nAchRs) expressed in the ventral tegmental area (VTA) and the nucleus accumbens (nAcc) modulate the effects of drug abuse. This research assessed the effects of intra-accumbal administration of the nAchR antagonist (mecamylamine) and agonist (cytisine) on the operant oral self-administration of ethanol (EtOH) in rats. Methods: Male Wistar rats were water-deprived for 24 h and then trained to lever-press for EtOH reinforcement on a fixed-ratio 1 (FR1) schedule for three sessions. After that, the number of responses in the FR schedule increased to 3 until the response rate remained stable at 80%. After this training, the rats received an intra-accumbal injection of the nAchR antagonist, mecamylamine (0.0, 1.25, 2.5, and 5.0 µg), then nAchR agonist, cytisine (0.0, 0.8, 1.6, and 3.2 µg) or the combination of mecamylamine (0.0, 1.25, 2.5, and 5.0 µg) and cytisine (3.2 µg) before being provided access to EtOH on a FR3 schedule. Results: The data showed that intra-accumbal administration of mecamylamine reduced operant oral self-administration of EtOH, whereas cytisine increased operant oral self-administration of EtOH. This effect was reversed by mecamylamine. Conclusion: These findings suggest that nAchRs in the nAcc may modulate the operant oral self-administration of EtOH in rats. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate the factors most associated with early and late complications following microvascular free tissue transfer (MVFTT) after mandibulectomy. Methods: A retrospective review of patients undergoing MVFTT after segmental mandibulectomy from September 2016 to February 2021 was performed across a single academic institution. Surgical variables were collected, including the location of the resultant mandibular defect (anterior vs posterior) and flap type (osseous or non-osseous). The primary outcome variables included postoperative complications (early, <90 days; and late, >90 days) and the patients' functional status (return to oral intake). Descriptive statistics, chi-square test, Fischer's exact test, and 2-sample t tests were used to analyze differences among variables. Results: We analyzed a cohort of 114 consecutive patients with mandibular defects, comprising 57 anterior and 57 posterior defects. Bony free flaps with hardware were used to reconstruct 98% of anterior defects compared to 58% of posterior defects (P <.001). All soft tissue only flaps did not utilize any hardware during the reconstruction. Anterior defects demonstrated more late complications requiring additional surgery (30% vs 9%, P =.04). A secondary analysis of posterior mandibular reconstructions compared soft tissue only flaps and bony free flaps with hardware and showed equivalent rates of early (12% vs 13%, P >.99) and late (9% vs 8%, P >.99) complications requiring additional surgery while demonstrating a similar return to full oral competence (55% vs 46%, P =.52) and recovery of a 100% oral diet (67% vs 54%, P =.53). Conclusion: Osseous free tissue transfer for segmental mandibular defects remains the gold standard in reconstruction. In our patient cohort, anterior mandibular defects are associated with greater late (>90 day) complications requiring additional surgery. Comparable outcomes may be achieved with soft tissue only versus osseous free flap reconstruction of posterior mandibular defects. [ABSTRACT FROM AUTHOR]

Background: CKD patients on hemodialysis (HD) with Staphylococcus aureus (SA) bacteremia present high morbidity, mortality and increased risk of MRSA. Vancomycin is the antibiotic of choice in these cases, it has a narrow therapeutic margin and inadequate dosage generates a risk of toxicity, therefore, the recommendation is to dosage it through serum levels. Methods: This is a retrospective cohort study in 3 hospitals of third level of complexity in the city of Medellin in which there were differences in the measurement and implementation of vancomycin25 dosage based on trough levels (VL) in patients with chronic kidney disease on hemodialysis (CKD- HD) with uncomplicated bacteremia based infection by methilcillin-resistant Staphyloccocus aureus (MRSA). The primary outcome was the composite of hospital mortality, clinical response (fever, hemodynamic instability and altered consciousness), complications associated with bacteremia, or bacteriological response failure (positive cultures at first week follow-up) at 7 days. The composite variables were analyzed individually as secondary outcomes. Results: The main unadjusted outcome (OR 1.3, CI 0.6 - 2.7) and adjusted for age, Charlson index, loading dose, initial dose, dosing frequency and MIC to vancomycin (OR 1.2, CI 0.5 - 2.7). Regarding adjusted secondary outcomes: clinical response (OR 1.4 CI 0.3 - 5.8), death (OR 1.3 CI 0.3 - 4.6) and complications (OR 0.9, CI 0.37 - 2.2). Conclusions: We conclude that the measurement of trough levels in patients with HD-CKD does not modify the composite outcome. The main limitation is the sample size and type of study, randomized control trials may be required to confirm the results presented. [ABSTRACT FROM AUTHOR]

The bioaccessibility of tannins as antioxidants in meat is essential to maximise their effectiveness in protecting the product. This property determines the amount of tannins available to interact with meat components, inhibiting lipid and protein oxidation and, consequently, prolonging shelf life and preserving the sensory quality of the product. The objective of this study was to evaluate the bioaccessibility of condensed tannins (CT) from Acacia mearnsii extract (AME) and their effect on the physico-chemical characteristics of fattened lamb meat. Thirty-six Dorset × Hampshire lambs (3 months old and 20.8 ± 3.3 kg live weight) were used. The lambs were distributed equally (n = 9) into four treatments: T1, T2, T3 and T4, which included a basal diet plus 0%, 0.25%, 0.5% and 0.75% of CT from AME, respectively. At the end of the fattening period, bioaccessibility was evaluated, the animals were slaughtered and a sample of the longissimus dorsi (LD) muscle was collected to assess colour, lipid oxidation, cooking weight loss and shear force on days 1, 4, 7 and 14 of shelf-life, in samples preserved at −20 °C. In addition, the long chain fatty acid profile was analysed. A completely randomised design was used, and the means were compared with Tukey's test (P < 0.05). The mean lightness (L*), yellowness (b*) and hue (H*) values were higher for T3 and T4. The addition of CT did not affect (P > 0.05) redness (a*), cooking weight loss (CWL) or shear force (SF). T4 decreased (P < 0.05) stearic acid and increased cis-9 trans-12 conjugated linoleic acid (CLA). Bioaccessibility was higher in the supplemented groups (T1 < T2, T3 and T4). In conclusion, supplementing CT from AME in the diet of lambs did not reduce lipid oxidation, but T3 or T4 improved some aspects of meat colour and CLA deposition. [ABSTRACT FROM AUTHOR]

We present new 'almost' time-reversible integrators for solution of planetary systems consisting of 'planets' and a dominant mass ('star'). The algorithms can be considered adaptive generalizations of the Wisdom–Holman method, in which all pairs of planets can be assigned time-steps. These time-steps, along with the global time-step, can be adapted time-reversibly, often at no appreciable additional compute cost, without sacrificing any of the long-term error benefits of the Wisdom–Holman method. The method can also be considered a simpler and more flexible version of the symba symplectic code. We perform tests on several challenging problems with close encounters and find the reversible algorithms are up to 2.6 times faster than a code based on symba. The codes presented here are available on Github. We also find adapting a global time-step reversibly and discretely must be done in block-synchronized manner or similar. [ABSTRACT FROM AUTHOR]

In the field of knee imaging, the incorporation of MR-based pseudo-CT synthesis holds the potential to mitigate the need for separate CT scans, simplifying workflows, enhancing patient comfort, and reducing radiation exposure. In this work, we present a novel DL framework, grounded in the development of the Cycle-Consistent Generative Adversarial Network (CycleGAN) method, tailored specifically for the synthesis of pseudo-CT images in knee imaging to surmount the limitations of current methods. Upon visually examining the outcomes, it is evident that the synthesized pseudo-CTs show an excellent quality and high robustness. Despite the limited dataset employed, the method is able to capture the particularities of the bone contours in the resulting image. The experimental Mean Absolute Error (MAE), Peak Signal-to-Noise Ratio (PSNR), Structural Similarity Index Measure (SSIM), Zero-Normalized Cross Correlation (ZNCC), Mutual Information (MI), Relative Change (RC), and absolute Relative Change (|RC|) report values of 30.4638 ± 7.4770, 28.1168 ± 1.5245, 0.9230 ± 0.0217, 0.9807 ± 0.0071, 0.8548 ± 0.1019, 0.0055 ± 0.0265, and 0.0302 ± 0.0218 (median ± median absolute deviation), respectively. The voxel-by-voxel correlation plot shows an excellent correlation between pseudo-CT and ground-truth CT Hounsfield units (m = 0.9785; adjusted R 2 = 0.9988; ρ = 0.9849; p < 0.001). The Bland–Altman plot shows that the average of the differences is low (( H U C T − H U p s e u d o − C T = 0.7199 ± 35.2490; 95% confidence interval [−68.3681, 69.8079]). This study represents the first reported effort in the field of MR-based knee pseudo-CT synthesis, shedding light to significantly advance the field of knee imaging. [ABSTRACT FROM AUTHOR]

Background Robotic-assisted neurointervention was recently introduced, with implications that it could be used to treat neurovascular diseases. Objective To evaluate the effectiveness and safety of the robotic-assisted platform CorPath GRX for treating cerebral aneurysms. Methods This prospective, international, multicenter study enrolled patients with brain aneurysms that required endovascular coiling and/or stent-assisted coiling. The primary effectiveness endpoint was defined as successful completion of the robotic-assisted endovascular procedure without any unplanned conversion to manual treatment with guidewire or microcatheter navigation, embolization coil(s) or intracranial stent(s) deployment, or an inability to navigate vessel anatomy. The primary safety endpoint included intraprocedural and periprocedural events. Results The study enrolled 117 patients (74.4% female) with mean age of 56.6 years from 10 international sites,. Headache was the most common presenting symptom in 40/117 (34.2%) subjects. Internal carotid artery was the most common location (34/122, 27.9%), and the mean aneurysm height and neck width were 5.7±2.6 mm and 3.5±1.4 mm, respectively. The overall procedure time was 117.3±47.3 min with 59.4±32.6 min robotic procedure time. Primary effectiveness was achieved in 110/117 (94%) subjects with seven subjects requiring conversion to manual for procedure completion. Only four primary safety events were recorded with two intraprocedural aneurysm ruptures and two strokes. A Raymond-Roy Classification Scale score of 1 was achieved in 71/110 (64.5%) subjects, and all subjects were discharged with a modified Rankin Scale score of ≤2. Conclusions This first-of-its-kind robotic-assisted neurovascular trial demonstrates the effectiveness and safety of the CorPath GRX System for endovascular embolization of cerebral aneurysm procedures. [ABSTRACT FROM AUTHOR]

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Objectives: The objective of this study was to compare the rate of post‐operative radiation therapy (PORT) initiation within 6 weeks for head and neck squamous cell carcinoma patients treated at a safety net, academic institutio between 2019 and 2021 versus those treated in 2022 after implementation of a new clinical pathway. Methods: A retrospective case–control study was performed at a single tertiary care, safety‐net, academic institution. Patient demographics, tumor characteristics, dates of surgery, and other treatment dates were collected from the electronic medical record. The time from surgery to PORT was calculated. Patients who started radiation treatment within 42 days of surgery were regarded as having started PORT on time. The demographics, tumor characteristics, and rate of timely PORT for the two cohorts of patients were compared. Results: From 2018 to 2021, our rate of PORT initiation within 6 weeks of surgery was 12% (n = 57). In 2022, our rate of timely PORT was 88% (n = 16), p < 0.5. Patient demographics and characteristics were similar with the exception of marital status and use of free‐flap reconstruction. The 2022 cohort was more likely to be single (p < 0.5), and all patients underwent free‐flap reconstruction in 2022 (p < 0.05). Conclusion: Early referrals, frequent communication, and use of a secure registry were the key to the success found by our group despite the socioeconomic challenges of our underserved, safety‐net hospital patient population. The changes made at our institution should serve as a template for other institutions seeking to improve the quality of care for their HNSCC patients. [ABSTRACT FROM AUTHOR]

Objective: To compare functional outcomes of total laryngectomy (TL) with microvascular free tissue transfer (MVFTT) reconstruction in the treatment of dysfunctional larynx (DL) versus salvage therapy for locally recurrent disease in patients with a history of laryngeal squamous cell carcinoma (SCC). Methods: Retrospective review from a tertiary medical center between August 2015 and August 2022. Results: Sixty‐nine patients underwent TL with MVFTT following primary laryngeal radiation or chemoradiation; 15 (22%) patients underwent functional laryngectomy (FL) and 54 (78%) underwent a salvage laryngectomy (SL). There were no total flap failures. Four (6%) patients developed a pharyngocutaneous fistula; one (7%) FL patient and 3 (6%) in the SL cohort. There was no significant difference in average hospital length of stay (LOS) between the cohorts (8.6 ± 3.0 days vs. 12.8 ± 10.1 days, p = 0.12). All patients (100%) in the FL cohort achieved a total oral diet compared to 41 (76%) in the SL cohort (p = 0.03). Two (13%) and 10 (19%) patients developed pharyngoesophageal stenosis in the FL and SL cohorts, respectively (p = 1.0). Nine (60%) and 23 (43%) patients in the FL and SL cohorts underwent tracheoesophageal puncture (TEP) placement, with 89% and 91% achieving fluency, respectively (p = 0.23). Conclusion: Although the role of TL for the definitive treatment of laryngeal SCC has decreased over the past 30 years, organ‐preservation protocols can impact speech, swallowing, and airway protection with life‐threatening consequences. The use of elective FL with MVFTT for the treatment of DL results in similar or better functional outcomes compared to SL for recurrent disease. Level of Evidence: 3 Laryngoscope, 134:222–227, 2024 [ABSTRACT FROM AUTHOR]

We study the category Osh of representations over a shifted Yangian. This category has a tensor product structure and contains distinguished modules, the positive prefundamental modules and the negative prefundamental modules. Motivated by the representation theory of the Borel subalgebra of a quantum affine algebra and by the relevance of quantum integrable systems in this context, we prove that tensor products of prefundamental modules with irreducible modules are either cyclic or cocyclic. This implies the existence and uniqueness of morphisms, the R-matrices, for such tensor products. We prove the R-matrices are polynomial in the spectral parameter, and we establish functional relations for the R-matrices. As applications, we prove the Jordan-Holder property in the category Osh. We also obtain a proof, uniform for any finite type, that any irreducible module factorizes through a truncated shifted Yangian. [ABSTRACT FROM AUTHOR]

WNK (With no Lysine [K]) kinases have critical roles in the maintenance of ion homeostasis and the regulation of cell volume. Their overactivation leads to pseudohypoaldosteronism type II (Gordon syndrome) characterized by hyperkalemia and high blood pressure. More recently, WNK family members have been shown to be required for the development of the nervous system in mice, zebrafish, and flies, and the cardiovascular system of mice and fish. Furthermore, human WNK2 and Drosophila Wnk modulate canonical Wnt signaling. In addition to a well-conserved kinase domain, animal WNKs have a large, poorly conserved C-terminal domain whose function has been largely mysterious. In most but not all cases, WNKs bind and activate downstream kinases OSR1/SPAK, which in turn regulate the activity of various ion transporters and channels. Here, we show that Drosophila Wnk regulates Wnt signaling and cell size during the development of the wing in a manner dependent on Fray, the fly homolog of OSR1/SPAK. We show that the only canonical RF(X)V/I motif of Wnk, thought to be essential for WNK interactions with OSR1/SPAK, is required to interact with Fray in vitro. However, this motif is unexpectedly dispensable for Fray-dependent Wnk functions in vivo during fly development and fluid secretion in the Malpigian (renal) tubules. In contrast, a structure function analysis of Wnk revealed that the less-conserved C-terminus of Wnk, that recently has been shown to promote phase transitions in cell culture, is required for viability in vivo. Our data thus provide novel insights into unexpected in vivo roles of specific WNK domains. Author summary: Members of the conserved WNK kinase family are large proteins that have essential developmental roles, as well as crucial functions in the regulation of ion transporters in kidneys via the intermediary kinases OSR1 and SPAK. Using Drosophila as model system, we show that the fly homolog of the intermediary kinases, Fray, acts downstream of Wnk during the development of the fly wing to regulate cell size. Surprisingly though, our work reveals that Wnk does not need the canonical motif that binds to Fray for function in vivo. In contrast, we find an essential function for the less-well conserved C-terminus of Wnk that recently was shown to form membraneless organelles. Our findings thus reveal unanticipated roles of WNK domains. [ABSTRACT FROM AUTHOR]

Background Flow diverters have emerged in recent years as a safe and effective treatment for intracranial aneurysms, with expanding indications. The Derivo embolization device (DED) is a second-generation flow diverter with a surface finish that may reduce thrombogenicity. We report our multicenter experience evaluating its safety and efficacy. Methods We retrospectively analyzed all patients treated with the DED in eight centers in Spain between 2016 and 2020. Demographics, clinical data, procedural complications, morbidity and aneurysm occlusion rates were collected. Results A total of 209 patients with 250 aneurysms were treated (77.5% women). The majority of aneurysms were located in the internal carotid artery (86.8%) and most (69.2%) were small (<10 mm) with a median maximum diameter of 5.85 mm and median neck size of 4 mm. DED deployment was successful in all cases, despite two malfunctioning devices (1%). Major complications occurred in nine patients (4.3%), while mild neurologic clinical events were registered in 23 (11%); four patients died (1.9%). A total of 194 aneurysms had an angiographic follow-up at 6 months and showed complete aneurysm occlusion in 75% of cases. Twelve-month follow-up was available for 112 of the treated aneurysms, with a total occlusion rate of 83%. Conclusion The DED is a second-generation surface-modified flow diverter that presents an option for treatment of intracranial aneurysms with comparable safety and efficacy to other available flow diverter devices. Nonetheless, risks are not negligible, and must be balanced against the natural history risk of cerebral aneurysms, considering the tendency to widen indications for treatment of smaller and less complex lesions in day-to-day use. [ABSTRACT FROM AUTHOR]

Existing devices for measuring material appearance in spatially-varying samples are limited to a single scale, either micro or mesoscopic. This is a practical limitation when the material has a complex multi-scale structure. In this paper, we present a system and methods to digitize materials at two scales, designed to include high-resolution data in spatially-varying representations at larger scales. We design and build a hemispherical light dome able to digitize flat material samples up to 11x11cm. We estimate geometric properties, anisotropic reflectance and transmittance at the microscopic level using polarized directional lighting with a single orthogonal camera. Then, we propagate this structured information to the mesoscale, using a neural network trained with the data acquired by the device and image-to-image translation methods. To maximize the compatibility of our digitization, we leverage standard BSDF models commonly adopted in the industry. Through extensive experiments, we demonstrate the precision of our device and the quality of our digitization process using a set of challenging real-world material samples and validation scenes. Further, we demonstrate the optical resolution and potential of our device for acquiring more complex material representations by capturing microscopic attributes which affect the global appearance: we characterize the properties of textile materials such as the yarn twist or the shape of individual fly-out fibers. We also release the SEDDIDOME dataset of materials, including raw data captured by the machine and optimized parameteres. [ABSTRACT FROM AUTHOR]

Objective: Cisplatin forms the backbone of systemic chemotherapy treatment for oropharyngeal squamous cell carcinoma (OPSCC). The ideal cisplatin dosing regimen remains yet to be fully defined for achieving optimal efficacy and toxicity profiles in patients with comorbidity. Methods: We retrospectively reviewed oncologic and toxicity data for patients with OPSCC treated at the Michael E. DeBakey Veterans Affairs Medical Center between 2000 and 2020 who initiated curative intent, definitive chemo‐radiation with one of three single agent regimens: high dose (HD) cisplatin, low dose (LD) cisplatin or cetuximab. Results: Patients with HPV‐associated tumors and nonsmokers demonstrated improved overall and disease‐free survival along with locoregional and distant metastatic control regardless of chemotherapy regimen. Regardless of regimen selection, patients which received a cumulative cisplatin dose ≥200 mg/m2 had a lower rate of distant metastasis. The HD regimen resulted in a greater fraction (75% vs. 50%) of patients receiving a cumulative cisplatin dose ≥200 mg/m2 and a comparable measured toxicity burden compared to the LD regimen. Conclusions: Both HD and LD cisplatin regimens can be safely delivered to a Veteran OPSCC patient population which should allow for straightforward application of conclusions drawn from completed and active clinical trials testing cisplatin regimens. Level of Evidence: 4. Both high dose and low dose cisplatin regimens can be safely delivered to a Veteran OPSCC patient population which should allow for straightforward application of conclusions drawn from completed and active clinical trials testing cisplatin regimens. [ABSTRACT FROM AUTHOR]

Fatalities from landslides are rising worldwide, especially in cities in mountainous regions, which often expand into the steep slopes surrounding them. For residents, often those living in poor neighborhoods and informal settlements, integrated landslide early warning systems (LEWS) can be a viable solution, if they are affordable and easily replicable. We developed a LEWS in Medellín, Colombia, which can be applied in such semi-urban situations. All the components of the LEWS, from hazard and risk assessment, to the monitoring system and the reaction capacity, were developed with and supported by all local stakeholders, including local authorities, agencies, NGO's, and especially the local community, in order to build trust. It was well integrated into the social structure of the neighborhood, while still delivering precise and dense deformation and trigger measurements. A prototype was built and installed in a neighborhood in Medellín in 2022, comprising a dense network of line and point measurements and gateways. The first data from the measurement system are now available and allow us to define initial thresholds, while more data are being collected to allow for automatic early warning in the future. All the newly developed knowledge, from sensor hardware and software to installation manuals, has been compiled on a wiki-page, to facilitate replication by people in other parts of the world. According to our experience of the installation, we give recommendations for the implementation of LEWSs in similar areas, which can hopefully stimulate a lively exchange between researchers and other stakeholders who want to use, modify, and replicate our system. [ABSTRACT FROM AUTHOR]

We present a simple algorithm to switch between N -body time integrators in a reversible way. We apply it to planetary systems undergoing arbitrarily close encounters and highly eccentric orbits, but the potential applications are broader. Upgrading an ordinary non-reversible switching integrator to a reversible one is straightforward and introduces no appreciable computational burden in our tests. Our method checks whether the integrator during the time-step violates a time-symmetric selection condition and redoes the step if necessary. In our experiments, a few per cent of steps would have violated the condition without our corrections. By eliminating them, the algorithm avoids long-term error accumulation, of several orders of magnitude in some cases. [ABSTRACT FROM AUTHOR]

We aim to identify a profile of intracranial thrombus resistant to recanalization by mechanical thrombectomy (MT) in acute stroke treatment. The first extracted clot of each MT was analyzed by flow cytometry obtaining the composition of the main leukocyte populations: granulocytes, monocytes, and lymphocytes. Demographics, reperfusion treatment, and grade of recanalization were registered. MT failure (MTF) was defined as final thrombolysis in cerebral infarction score IIa or lower and/or need of permanent intracranial stenting as a rescue therapy. To explore the relationship between stiffness of intracranial clots and cellular composition, unconfined compression tests were performed in other cohorts of cases. Thrombi obtained in 225 patients were analyzed. MTF were observed in 30 cases (13%). MTF was associated with atherosclerosis etiology (33.3% vs. 15.9%; p = 0.021) and higher number of passes (3 vs. 2; p < 0.001). Clot analysis of MTF showed higher percentage of granulocytes [82.46 vs. 68.90% p < 0.001] and lower percentage of monocytes [9.18% vs.17.34%, p < 0.001] in comparison to successful MT cases. The proportion of clot granulocytes (aOR 1.07; 95% CI 1.01–1.14) remained an independent marker of MTF. Among thirty-eight clots mechanically tested, there was a positive correlation between granulocyte proportion and thrombi stiffness (Pearson's r = 0.35, p = 0.032), with a median clot stiffness of 30.2 (IQR, 18.9–42.7) kPa. Granulocytes-rich thrombi are harder to capture by mechanical thrombectomy due to increased stiffness, so a proportion of intracranial granulocytes might be useful to guide personalized endovascular procedures in acute stroke treatment. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of ocular injury associated with maxillofacial trauma remains poorly defined, with reported rates ranging from 0.8% to 92%. Our study aims to more accurately characterize ocular injuries associated with midface fractures. Methods: We performed a retrospective review of 1677 patients from 2015 to 2020 with midface fractures at a Level I trauma center. Isolated nasal bone and frontal process of the maxilla fractures were excluded. Demographic information, mechanism of injury, need for surgery, and ophthalmologic findings were documented. Statistical analysis was conducted using SPSS. Results: 773 patients between the ages of 15 and 92 were identified. Trauma most commonly resulted from assault (63.8%). The association between the mechanism of injury and ocular injury was statistically significant (p = 0.003), with 78.6% of gunshot wounds and 44.3% of assault patients having an ocular injury. The Ophthalmology service evaluated 62.6% of cases preoperatively. Minor ocular injury occurred in 36% of patients, including 46.1% of isolated orbital floor, and 28.2% of zygomaticomaxillary complex fractures. Major ocular injury occurred in 10.5% of patients. Conclusions: Over 10% of patients with midface fractures were found to have major ocular injuries. Ophthalmologic exams should be performed for all patients with midface fractures to guide clinical decision making and prevent further intraoperative ocular insults. Level of Evidence: Level 4. This study represents a retrospective cohort study analyzing ocular injuries detected in patients presenting to a Level I trauma center with maxillofacial fractures between 2015 and 2020 Laryngoscope, 133:1624–1629, 2023 [ABSTRACT FROM AUTHOR]

We develop the representation theory of shifted quantum affine algebras |$\mathcal {U}_\mu (\hat {\mathfrak {g}})$| and of their truncations, which appeared in the study of quantized K-theoretic Coulomb branches of 3d |$N = 4$| SUSY quiver gauge theories. Our approach is based on novel techniques, which are new in the cases of shifted Yangians or ordinary quantum affine algebras as well: realization in terms of asymptotical subalgebras of the quantum affine algebra |$\mathcal {U}_q(\hat {\mathfrak {g}})$|⁠ , induction and restriction functors to the category |$\mathcal {O}$| of representations of the Borel subalgebra |$\mathcal {U}_q(\hat {\mathfrak {b}})$| of |$\mathcal {U}_q(\hat {\mathfrak {g}})$|⁠ , relations between truncations and Baxter polynomiality in quantum integrable models, and parametrization of simple modules via Langlands dual interpolation. We first introduce the category |$\mathcal {O}_\mu $| of representations of |$\mathcal {U}_\mu (\hat {\mathfrak {g}})$| and we classify its simple objects. Then we establish the existence of fusion products and we get a ring structure on the sum of the Grothendieck groups |$K_0(\mathcal {O}_\mu)$|⁠. We classify simple finite-dimensional representations of |$\mathcal {U}_\mu (\hat {\mathfrak {g}})$| and we obtain a cluster algebra structure on the Grothendieck ring of finite-dimensional representations. We prove a truncation has only a finite number of simple representations and we introduce a related partial ordering on simple modules. Eventually, we state a conjecture on the parametrization of simple modules of a non-simply-laced truncation in terms of the Langlands dual Lie algebra. We have several evidences, including a general result for simple finite-dimensional representations. [ABSTRACT FROM AUTHOR]

The stellate ganglion block (SGB) procedure has been used successfully for over twelve years to treat thousands of patients suffering from posttraumatic stress disorder (PTSD). Level 1b evidence supports this use of SGB, but no studies to date have reported specifically on anxiety symptom improvements following SGB. We collected Generalized Anxiety Disorder questionnaire (GAD-7) scores pre-procedure and at 1-week and 1-month post-procedure from 285 patients. The mean baseline GAD-7 score of 15.9 (indicating severe anxiety) declined significantly following SGB treatment. Changes in GAD-7 scores ≥ 4 were considered clinically meaningful. From baseline to 1 week, the GAD-7 scores dropped by 9.0 points (95% CI = 8.3–9.7, p < 0.001, d = 1.8), with 211 (79.6%) patients demonstrating clinically meaningful improvement. Furthermore, from baseline to 1 month, the GAD-7 scores dropped by 8.3 points (95% CI = 7.6–9.0, p < 0.001, d = 1.7), with 200 (75.5%) patients demonstrating clinically meaningful improvement. The stellate ganglion block treatment resulted in a decrease of GAD-7 scores of over twice the minimal clinically important difference in treating anxiety for at least 1 month following SGB. Given the results from this retrospective observational study, larger prospective studies should be conducted to determine the effects of SGB treatment as a novel therapeutic treatment for generalized anxiety disorder and other anxiety disorders. [ABSTRACT FROM AUTHOR]

Due to climate change and growing urbanization, fatalities from landslides are rising worldwide, and thus solutions for people at risk are needed. This is especially the case for the Andean cities which are often expanding into the steep slopes surrounding them. In Medellín, Colombia, a combination of landslide-prone dunite rock and steep slopes in the east of the city creates a high-hazard scenario for about 87,000 residents, most of whom live in informal settlements. We developed a landslide early warning system (LEWS) which can be applied in such semi-urban situations. The LEWS consists mainly of a measurement system of horizontal and vertical sensor lines across the slope and autonomous point-sensors in between these lines. All parts of the LEWS, from hazard assessment to the monitoring system and the reaction capacity, are supported by extensive activities together with the local community to gain trust and create synergies. This also includes local authorities, agencies and NGO's. To test such a system, a prototype has been installed in a neighborhood in Medellín in 2020 - 2022. The experiences of this installation resulted in a framework for LEWS's of this kind which we have compiled on a wiki-page to facilitate replication by people in other parts of the world. Hopefully, this can stimulate a lively exchange between researchers and other stakeholders who want to use, modify and replicate our system. [ABSTRACT FROM AUTHOR]

The United States (US) and Switzerland are affluent countries with different responses to surges in opioid use disorder (OUD) cases over the last thirty years. The Swiss "PROVE" trail implemented heroin-assisted treatment (HAT) for OUD alongside other medications for opioid use disorder (MOUD). In contrast, heroin remains highly controlled, HAT is inaccessible, and MOUD programs are generally more restrictive in the US than in Switzerland. We conducted a survey to compare practitioners' attitudes toward HAT across sites in both countries. Surveys were distributed electronically for voluntary, uncompensated completion (N = 120) at two mental health delivery sites, Psychiatrische Dienste Graubünden (PDGR) in Graubünden, Switzerland and Montefiore Medical Center (MMC) in the Bronx, NY. The survey instrument included 10 demographic and 19 "beliefs" questions measuring agreement level with a statement on a 5-point scale. Analysis included 79 PDGR respondents (mean age = 43.2, 59.5% women) and 41 MMC respondents (mean age = 44.7, 63.4% women), and did not show differences in confidence to treat OUD, addictions, and psychiatric disorders. For belief in HAT, Swiss respondents had a significantly more favorable view (b = 0.62) than those in New York (p = 0.00027). This study shows a difference in attitudes toward HAT among demographically similar staff treating OUD patients across sites. The cohorts demonstrate an overall positive attitude toward HAT but a more robust positive attitude was evident in Switzerland. Previously unreported attitude comparisons across sites with dissimilar OUD treatment availability may explain differences in practices and success in reducing harm from this disorder. [ABSTRACT FROM AUTHOR]

Background: Collagenase clostridium histolyticum‐aaes (CCH‐aaes) is approved in the United States for moderate‐to‐severe cellulite in the buttocks of adult women. Aim: Interim analysis to evaluate efficacy/safety of CCH‐aaes in the treatment of thigh cellulite. Methods: Data were analyzed from a phase 3, open‐label study (REAL). Women with mild‐to‐moderate cellulite on both thighs (Clinician Reported Photonumeric Cellulite Severity Scale score, 2 or 3) received ≤0.84 mg (volume, 18 ml) of CCH‐aaes subcutaneously, in up to 12 dimples per posterolateral thigh, in up to 3 treatment sessions (Days 1, 22, and 43). Follow‐up was on Day 90 (interim cutoff). A subset of women participated in the concurrent study (PIXELS), which included high‐definition photography and 3D‐image scanning of treatment areas. Results: Twenty‐two women (44 thighs) were included in the interim analysis (mean age, 42.3 years; thighs with mild cellulite, 68.2%). Investigators reported high percentages of responders (score of "improved" or better on Investigator Global Aesthetic Improvement Scale) at Day 90 for either thigh (86.4%; primary endpoint) or both thighs (72.7%). Patient‐reported bother due to cellulite was reduced at Day 90; mean change was 15.3 points (85.5% reduction) in BODY‐Q Appraisal of Cellulite Scale total score (possible range, 11–44). In PIXELS analysis, Day 90 3D‐image scans showed improvement from baseline in skin roughness in some of the treated thigh areas. The most commonly reported adverse events were injection‐site bruising and pain (95.5% and 50.0% of patients, respectively). Conclusions: CCH‐aaes treatment of mild‐to‐moderate thigh cellulite was effective and generally well tolerated, with markedly reduced cellulite‐related bother. [ABSTRACT FROM AUTHOR]

The incidence of sarcopenia, a geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality, increases with age and is associated with adverse health and quality of life outcomes. A 12-week strength training intervention program (STIP) was designed to improve measures of muscle mass, muscle strength, physical performance, and quality of life in elderly patients with sarcopenia. Data were collected on these measures at 4-week intervals over 12 weeks. Results showed that the STIP was an effective intervention for reducing the characteristics associated with sarcopenia. Significant gains were made in muscle mass, grip strength, balance, gait speed, chair stand, and quality of life over the 12-week period. Reduction in the incidence of sarcopenia among long-term care residents in skilled nursing facilities may contribute to reduced adverse effects of the disease process, such as falls, morbidity, and mortality, and may help residents achieve an overall higher quality of life. [ABSTRACT FROM AUTHOR]

Background In patients with stroke, current guidelines recommend non-invasive vascular imaging to identify intracranial vessel occlusions (VO) that may benefit from endovascular treatment (EVT). However, VO can be missed in CT angiography (CTA) readings. We aim to evaluate the impact of consistently including CT perfusion (CTP) in admission stroke imaging protocols. Methods From April to October 2020 all patients admitted with a suspected acute ischemic stroke underwent urgent non-contrast CT, CTA and CTP and were treated accordingly. Hypoperfusion areas defined by time-to-maximum of the tissue residue function (Tmax) >6 s, congruent with the clinical symptoms and a vascular territory, were considered VO (CTP-VO). In addition, two experienced neuroradiologists blinded to CTP but not to clinical symptoms retrospectively evaluated non-contrast CT and CTA to identify intracranial VO (CTA-VO). Results Of the 338 patients included in the analysis, 157 (46.5%) presented with CTP-VO (median Tmax >6s: 73 (29-127) mL). CTA-VO was identified in 83 (24.5%) of the cases. Overall CTA-VO sensitivity for the detection of CTP-VO was 50.3% and specificity was 97.8%. Higher hypoperfusion volume was associated with increased CTA-VO detection (OR 1.03; 95% CI 1.02 to 1.04). EVT was performed in 103 patients (30.5%; Tmax >6s: 102 (63-160) mL), representing 65.6% of all CTP-VO. Overall CTA-VO sensitivity for the detection of EVT-VO was 69.9% and specificity was 95.3%. Among patients who received EVT, the rate of false negative CTA-VO was 30.1% (Tmax >6s: 69 (46-99.5) mL). Conclusion Systematically including CTP in acute stroke admission imaging protocols may increase the diagnosis of VO and rate of EVT. [ABSTRACT FROM AUTHOR]

The aim of the study was to find markers of high-risk cardioembolic etiology (HRCE) in patients with cryptogenic strokes (CS) through the analysis of intracranial clot by flow cytometry (FC). A prospective single-center study was designed including patients with large vessel occlusion strokes. The percentage of granulocytes, monocytes, lymphocytes, and monocyte-to-lymphocyte ratio (MLr) were analyzed in clots extracted after endovascular treatment (EVT) and in peripheral blood. Large arterial atherosclerosis (LAA) strokes and high-risk cardioembolic (HRCE) strokes were matched by demographics and acute reperfusion treatment data to obtain FC predictors for HRCE. Multilevel decision tree with boosting random forest classifiers was performed with each feature importance for HRCE diagnosis among CS. We tested the validity of the best FC predictor in a cohort of CS that underwent extensive diagnostic workup. Among 211 patients, 178 cases underwent per-protocol workup. The percentage of monocytes (OR 1.06, 95% CI 1.01–1.11) and MLr (OR 1.83, 95% CI 1.12–2.98) independently predicted HRCE diagnosis when LAA clots (n = 28) were matched with HRCE clots (n = 28). Among CS (n = 82), MLr was the feature with the highest weighted importance in the multilevel decision tree as a predictor for HRCE. MLr cutoff point of 1.59 yield sensitivity of 91.23%, specificity of 44%, positive predictive value of 78.79%, and negative predictive value of 68.75 for HRCE diagnosis among CS. MLr ≥ 1.6 in clot analysis predicted HRCE diagnosis (OR, 6.63, 95% CI 1.85–23.71) in a multivariate model adjusted for age. Clot analysis by FC revealed high levels of monocyte-to-lymphocyte ratio as an independent marker of cardioembolic etiology in cryptogenic strokes. [ABSTRACT FROM AUTHOR]

The endolysosomal system not only is an integral part of the cellular catabolic machinery that processes and recycles nutrients for synthesis of biomaterials, but also acts as signaling hub to sense and coordinate the energy state of cells with growth and differentiation. Lysosomal dysfunction adversely influences vesicular transport-dependent macromolecular degradation and thus causes serious problems for human health. In mammalian cells, loss of the lysosome associated membrane proteins LAMP1 and LAMP2 strongly affects autophagy and cholesterol trafficking. Here we show that the previously uncharacterized Drosophila Lamp1 is a bona fide ortholog of vertebrate LAMP1 and LAMP2. Surprisingly and in contrast to lamp1 lamp2 double-mutant mice, Drosophila Lamp1 is not required for viability or autophagy, suggesting that fly and vertebrate LAMP proteins acquired distinct functions, or that autophagy defects in lamp1 lamp2 mutants may have indirect causes. However, Lamp1 deficiency results in an increase in the number of acidic organelles in flies. Furthermore, we find that Lamp1 mutant larvae have defects in lipid metabolism as they show elevated levels of sterols and diacylglycerols (DAGs). Because DAGs are the main lipid species used for transport through the hemolymph (blood) in insects, our results indicate broader functions of Lamp1 in lipid transport. Our findings make Drosophila an ideal model to study the role of LAMP proteins in lipid assimilation without the confounding effects of their storage and without interfering with autophagic processes. Abbreviations: aa: amino acid; AL: autolysosome; AP: autophagosome; APGL: autophagolysosome; AV: autophagic vacuole (i.e. AP and APGL/AL); AVi: early/initial autophagic vacuoles; AVd: late/degradative autophagic vacuoles; Atg: autophagy-related; CMA: chaperone-mediated autophagy; Cnx99A: Calnexin 99A; DAG: diacylglycerol; eMI: endosomal microautophagy; ESCRT: endosomal sorting complexes required for transport; FB: fat body; HDL: high-density lipoprotein; Hrs: Hepatocyte growth factor regulated tyrosine kinase substrate; LAMP: lysosomal associated membrane protein; LD: lipid droplet; LDL: low-density lipoprotein; Lpp: lipophorin; LTP: Lipid transfer particle; LTR: LysoTracker Red; MA: macroautophagy; MCC: Manders colocalization coefficient; MEF: mouse embryonic fibroblast MTORC: mechanistic target of rapamycin kinase complex; PV: parasitophorous vacuole; SNARE: soluble N-ethylmaleimide sensitive factor attachment protein receptor; Snap: Synaptosomal-associated protein; st: starved; TAG: triacylglycerol; TEM: transmission electron microscopy; TFEB/Mitf: transcription factor EB; TM: transmembrane domain; tub: tubulin; UTR: untranslated region. [ABSTRACT FROM AUTHOR]

Background: We performed a study to assess sex-differences in incidence (2016–2020), clinical characteristics, use of therapeutic procedures, and in-hospital outcomes in patients with infective endocarditis (IE) according to T2DM status. Methods: Ours was a retrospective cohort study using data from the Spanish National Hospital Discharge Database. We estimated the incidence of hospitalizations for IE in men and women aged ≥ 40 years with and without T2DM. Propensity score matching (PSM) and multivariable logistic regression were used to compare subgroups according to sex and the presence of T2DM. Results: From 2016 to 2020, IE was coded in 9,958 patients (66.79% men). T2DM was diagnosed in 2,668 (26.79%). The incidence of IE increased significantly from 15.29 cases per 100,000 persons with T2DM in 2016 to 17.69 in 2020 (p < 0.001). However, this increment was significant only among men with T2DM (19.47 cases per 100,000 in 2016 vs. 22.84 in 2020; p = 0.003). The age-adjusted incidence of IE was significantly higher in people with T2DM (both sexes) than in those without T2DM (IRR, 2.86; 95% CI, 2.74–2.99). The incidence of IE was higher in men with T2DM than in women with T2DM (adjusted IRR, 1.85; 95% CI, 1.54–3.31). After PSM, in-hospital mortality (IHM) was higher among T2DM women than matched T2DM men (22.65% vs. 18.0%; p = 0.018). The presence of T2DM was not associated with IHM in men or women. Conclusions: T2DM is associated with a higher incidence of hospitalization for IE. Findings for T2DM patients who had experienced IE differed by sex, with higher incidence rates and lower IHM in men than in women. T2DM was not associated to IHM in IE in men or in women. [ABSTRACT FROM AUTHOR]

We propose a novel quantum integrable model for every non-simply laced simple Lie algebra g , which we call the folded integrable model. Its spectra correspond to solutions of the Bethe Ansatz equations obtained by folding the Bethe Ansatz equations of the standard integrable model associated with the quantum affine algebra U q ( g ′ ^) of the simply laced Lie algebra g ′ corresponding to g . Our construction is motivated by the analysis of the second classical limit of the deformed -algebra of g , which we interpret as a “folding” of the Grothendieck ring of finite-dimensional representations of U q ( g ′ ^) . We conjecture, and verify in a number of cases, that the spaces of states of the folded integrable model can be identified with finite-dimensional representations of U q (L g ^) , where L g ^ is the (twisted) affine Kac–Moody algebra Langlands dual to g ^ . We discuss the analogous structures in the Gaudin model which appears in the limit q → 1 . Finally, we describe a conjectural construction of the simple g -crystals in terms of the folded q-characters. [ABSTRACT FROM AUTHOR]

Introduction  Standardized reconstruction protocols for large open anterior skull base defects with dural resection are not well described. Here we report the outcomes and technique of a multilayered reconstructive algorithm utilizing local tissue, dural graft matrix, and microvascular free tissue transfer (MVFTT) for reconstruction of these deformities. Design  This study is a retrospective review. Results  Eleven patients (82% males) met inclusion criteria, with five (45%) having concurrent orbital exenteration and eight (73%) requiring maxillectomy. All patients required dural resection with or without intracranial tumor resection, with the average dural defect being 36.0 ± 25.9 cm 2. Dural graft matrices and pericranial flaps were used for primary reconstruction of the dural defects, which were then reinforced with free fascia or muscle overlay by means of MVFTT. Eight (73%) patients underwent anterolateral thigh MVFTT, with the radial forearm, fibula, and vastus lateralis comprising the remainder. Average total surgical time of tumor resection and reconstruction was 14.9 ± 3.8 hours, with median length of hospitalization being 10 days (IQR: 9.5, 14). Continuous cerebrospinal fluid drainage through a lumber drain was utilized in 10 (91%) patients perioperatively, with an average length of indwelling drain of 5 days. Postoperative complications occurred in two (18%) patients who developed asymptomatic pneumocephalus that resolved with high-flow oxygen therapy. Conclusion  A standardized multilayered closure technique of dural graft matrix, pericranial flap, and MVFTT overlay in the reconstruction of large open anterior craniofacial dural defects can assist the reconstructive team in approaching these complex deformities and may help prevent postoperative complications. [ABSTRACT FROM AUTHOR]

Background: Patients on chronic pharmacologic immunosuppressive therapy are at increased risk of wound infection and complications after surgery. There is a paucity of data examining perioperative complications after microvascular free tissue transfer (MVFTT) reconstruction of the head and neck in this patient population. Methods: Retrospective cohort study performed at two tertiary referral centers between August 2016 and May 2020. Results: Nine hundred and seventy‐nine patients underwent MVFTT during the study period; of these 47 (5%) patients were taking chronic immunosuppressive medications. The most common indications for immunosuppression were solid organ transplant and autoimmune disease. Fourteen (30%) patients had surgical complications within 30 days of surgery: 8 (17%) wound dehiscences, 6 (12%) hematomas, and 2 (4%) surgical site infections. There was one total and one partial flap failure with a 30‐day reoperation rate of 4%. Conclusions: MVFTT of the head and neck appears to be safe in patients on chronic pharmacologic immunosuppression. [ABSTRACT FROM AUTHOR]

Let ( 𝔤 , 𝗀) {\mathfrak{g},\mathsf{g})} be a pair of complex finite-dimensional simple Lie algebras whose Dynkin diagrams are related by (un)folding, with 𝗀 {\mathsf{g}} being of simply-laced type. We construct a collection of ring isomorphisms between the quantum Grothendieck rings of monoidal categories 𝒞 𝔤 {\mathscr{C}_{\mathfrak{g}}} and 𝒞 𝗀 {\mathscr{C}_{\mathsf{g}}} of finite-dimensional representations over the quantum loop algebras of 𝔤 {\mathfrak{g}} and 𝗀 {\mathsf{g}} , respectively. As a consequence, we solve long-standing problems: the positivity of the analogs of Kazhdan–Lusztig polynomials and the positivity of the structure constants of the quantum Grothendieck rings for any non-simply-laced 𝔤 {\mathfrak{g}}. In addition, comparing our isomorphisms with the categorical relations arising from the generalized quantum affine Schur–Weyl dualities, we prove the analog of Kazhdan–Lusztig conjecture (formulated in [D. Hernandez, Algebraic approach to q , t q,t -characters, Adv. Math. 187 2004, 1, 1–52]) for simple modules in remarkable monoidal subcategories of 𝒞 𝔤 {\mathscr{C}_{\mathfrak{g}}} for any non-simply-laced 𝔤 {\mathfrak{g}} , and for any simple finite-dimensional modules in 𝒞 𝔤 {\mathscr{C}_{\mathfrak{g}}} for 𝔤 {\mathfrak{g}} of type B n {\mathrm{B}_{n}}. In the course of the proof we obtain and combine several new ingredients. In particular, we establish a quantum analog of T-systems, and also we generalize the isomorphisms of [D. Hernandez and B. Leclerc, Quantum Grothendieck rings and derived Hall algebras, J. reine angew. Math. 701 2015, 77–126, D. Hernandez and H. Oya, Quantum Grothendieck ring isomorphisms, cluster algebras and Kazhdan–Lusztig algorithm, Adv. Math. 347 2019, 192–272] to all 𝔤 {\mathfrak{g}} in a unified way, that is, isomorphisms between subalgebras of the quantum group of 𝗀 {\mathsf{g}} and subalgebras of the quantum Grothendieck ring of 𝒞 𝔤 {\mathscr{C}_{\mathfrak{g}}}. [ABSTRACT FROM AUTHOR]

Motivated by Maulik-Okounkov stable maps associated to quiver varieties, we define and construct algebraic stable maps on tensor products of representations in the category \mathcal {O} of the Borel subalgebra of an arbitrary untwisted quantum affine algebra. Our representation-theoretical construction is based on the study of the action of Cartan-Drinfeld subalgebras. We prove the algebraic stable maps are invertible and depend rationally on the spectral parameter. As an application, we obtain new R-matrices in the category \mathcal {O} and we establish that a large family of simple modules, including the prefundamental representations associated to Q-operators, generically commute as representations of the Cartan-Drinfeld subalgebra. We also establish categorified QQ^*-systems in terms of the R-matrices we construct. [ABSTRACT FROM AUTHOR]

Urethral stricture is a rare condition in women, representing a diagnostic challenge for the urologist. Its main etiology is traumatic or due to labor. Definitive treatment can be by means of dilations or urethroplasty using both local flaps and free grafts. In this study, we report the case of a patient with voiding symptoms during a period of 9 years after childbirth, despite an attempt of urethral dilation and chronic self-catheterization. The patient was finally diagnosed of a long distal urethral stricture, and she underwent urethroplasty with an anterior vaginal wall flap with satisfactory results. We take the opportunity to briefly review the diagnostic pathway in women with obstructive symptoms and the main female urethroplasty techniques. [ABSTRACT FROM AUTHOR]

Numerical integrations of the Solar system have been carried out for decades. Their results have been used, for example to determine whether the Solar system is chaotic, whether Mercury's orbit is stable, or to help discern Earth's climate history. We argue that all of the past studies we consider in this work are affected by numerical chaos to different degrees, affecting the possible orbits and instability probability of Mercury, sometimes significantly. We show how to eliminate the effects of numerical chaos by resolving Mercury's pericentre passage. We also show that several higher order symplectic maps do not exhibit significant differences in resolving pericentre passage of Mercury (at fixed time-step), making their advantages suspect for calculating long-term orbits. Resolving pericentre passage affects a wide array of orbital numerical studies, like exoplanet studies, studies of the galactic centre, and other N -body problems. [ABSTRACT FROM AUTHOR]