Versatility of the perforator radial artery flap in the reconstruction of the upper limbs and comparison of the outcomes with the "classic" radial flap, a retrospective study

Introduction

Radial forearm flap, first described in the early eighties in China, is a well-known and handy flap to cover soft tissue defects of the distal upper limb. It has, though, some inconveniences, such as the sacrifice of the radial artery and non-neglectable esthetic sequelae in the donor site. In the following years, a similar flap based on the perforators of the radial artery has been described as achieving similar results, allowing to spare a main vessel. The authors reviewed retrospectively the patients that underwent surgery with one of those two flaps in their center to compare outcomes.

Materials and methods

Patients operated between January 2016 and January 2022 have been reviewed. Ten had a classic radial artery flap, and ten had a radial artery perforator flap. Twelve weeks after surgery, Vancouver Scar Scale was used to assess the results at the donor site and over the flap. Reintervention and failure rate within one year and patient satisfaction -using a visual analog scale ranging from 0 to ten-at 12 months were also assessed.

Results

All classic radial artery flap group patients had "successful" surgery, and none needed secondary surgery. On the other side, three patients required a second surgery in the perforator flap group, and nine out of ten ended up with "successful" flaps. Mean Vancouver Scar Scale results regarding the flap are comparable, whereas those at the donor site are significantly better in the patients with the perforator flap. Patients' satisfaction results are similar in both groups.

Conclusion

The radial artery perforator flap is an important flap to be held in mind by all surgeons approaching reconstruction of the elbow, the forearm, and the hand, and should be preferred, when possible, to the classic radial forearm flap.

The multifunction of HSP70 in cancer: Guardian or traitor to the survival of tumor cells and the next potential therapeutic target

Heat shock protein 70 (HSP70) is a highly conserved protein composed of nucleotide-binding domains (NBD) and C-terminal substrate binding domain (SBD) that can function as a "molecular chaperone". HSP70 was discovered to directly or indirectly play a regulatory role in both internal and external apoptosis pathways. Studies have shown that HSP70 can not only promote tumor progression, enhance tumor cell resistance and inhibit anticancer effects but also induce an anticancer response by activating immune cells. In addition, chemotherapy, radiotherapy and immunotherapy for cancer may be affected by HSP70, which has shown promising potential as an anticancer drug. In this review, we summarized the molecular structure and mechanism of HSP70 and discussed the dual effects of HSP70 on tumor cells and the possibility and potential methods of using HSP70 as a target to treat cancer.

A modular system of flexible receive-only coil arrays for 3 T Magnetic Resonance Imaging

Flexible form-fitting radiofrequency coils provide high signal-to-noise ratio (SNR) for magnetic resonance imaging (MRI), and in array configuration large anatomical areas of interest can be covered. We propose a modular system - "ModFlex"- of flexible lightweight 4-channel coaxial coil arrays for 3 T MRI. We investigated the performance difference between commercial reference coils and 8- and 16-channel ModFlex receive-only array systems. In vivo, six anatomical targets in four regions of interest - the neck, the ankle, the spine and the hip - were imaged with the novel coil array system. The versatility of ModFlex and the robustness of the coil characteristics for different use cases is demonstrated. We measured an SNR gain for 4 out of 6 and similar SNR for 2 out of 6 anatomical target regions as compared to commercial reference coils. Parallel imaging capabilities are comparable to standard coils in hip and neck imaging, but ModFlex outperforms standard coils in ankle and spine imaging. High SNR combined with high acceleration possibilities enables faster imaging workflows and/or high-resolution MR acquisitions. The coil's versatility is beneficial for use cases with varying subject sizes and could improve patient comfort.

Hurdles to developing and scaling remote patients' health management tools and systems: a scoping review

BACKGROUND

Despite all the excitement and hype generated regarding the expected transformative impact of digital technology on the healthcare industry, traditional healthcare systems around the world have largely remained unchanged and resultant improvements in developed countries are slower than anticipated. One area which was expected to significantly improve the quality of and access to primary healthcare services in particular is remote patient monitoring and management. Based on a combination of rapid advances in body sensors and information and communication technologies (ICT), it was hoped that remote patient management tools and systems (RPMTSs) would significantly reduce the care burden on traditional healthcare systems as well as health-related costs. However, the uptake or adoption of above systems has been extremely slow and their roll out has not yet properly taken off especially in developing countries where they ought to have made the greatest positive impact.

AIM

The aim of the study was to assess whether or not recent, relevant literature would support the development of in-community, design, deployment and implementation framework based on three factors thought to be important drivers and levers of RPMTS's adoption and scalability.

METHODS

A rapid, scoping review conducted on relevant articles obtained from PubMed, MEDLINE, PMC and Cochrane databases and grey literature on Google and published between 2012 and May 2020, by combining a number of relevant search terms and phrases.

RESULTS

Most RPMTSs are targeted at and focused on a single disease, do not extensively involve patients and clinicians in their early planning and design phases, are not designed to best serve a specific catchment area and are mainly directed at post-hospital, disease management settings. This may be leading to a situation where patients, potential patients and clinicians simply do not make use of these tools, leading to low adoption and scalability thereof.

CONCLUSION

The development of a user-centred, context-dependent, customizable design and deployment framework could potentially increase the adoption and scalability of RPMTSs, if such framework addressed a combination of diseases, prevalent in a given specific catchment area, especially in developing countries with limited financial resources.

The p factor, crime, and criminal justice: A criminological study of Caspi et al.'s general psychopathology general theory

The general psychopathology general theory or p Factor is an influential theoretical development in the social and behavioral sciences, but has yet to gain traction in criminology and criminal justice. Drawing on data from a sample of 1722 federal pretrial defendants, we created a 22-item composite indicator or additive index of the p Factor containing externalizing, internalizing, substance use, paraphilic, and forensic indicators. Negative binomial regression models found that age, sex, and diverse forms of trauma exposure are associated with higher p Factor scores. Higher p scores strongly predicted total, violent, sexual, property, weapon, and drug arrest charges net the effects of demographic features and adverse childhood experiences. There is broad heterogeneity in psychopathology within this sample with nearly 29% of clients exhibiting zero psychopathology, nearly 61% showing average psychopathology or less, and nearly 40% evincing average to exceedingly high psychopathology. As a general theory, the p Factor has considerable potential to inform the assorted morbidities that often accompany criminal activity, including self-harm, reduced global functioning, substance use, and social dysfunction and thus is a parsimonious conceptual framework to understand the overlapping and systemic personal problems that typify chronic and serious criminal offenders.

"Mucus-on-Chip": A new tool to study the dynamic penetration of nanoparticulate drug carriers into mucus

The mucus covering of epithelial tissues presents one significant biological barrier to the uptake and absorption of particulate carriers. Improved understanding of the mechanisms mediating the transport of nanoparticles across such mucus layers would accelerate their development as optimised mucosal drug delivery formulations (e.g. via oral and rectal routes). Herein, an in vitro mucus model ("Mucus-on-Chip") was developed to enable the interaction and transport of functionalised nanoparticles and reconstituted mucus to be quantitatively investigated in real-time. We verified that the diffusion of nanoparticles into mucus is highly dependent on their biointerfacial properties. Muco-inert modification (PEGylation) significantly enhanced the mucopenetration of 50 nm and 200 nm nanoparticles, whereas limited mucopenetration was observed for pectin coated mucoadhesive nanoparticles. Furthermore, this model can be easily adapted to mimic specific physiological mucus environments. Mucus pre-treated with a mucolytic agent displayed reduced barrier function and therefore significantly accelerated mucopenetration of nanoparticles, which was independent of their size and biointerfacial properties. This new "Mucus-on-Chip" methodology provides detailed insight into the dynamics of nanoparticle-mucus interaction, which can be applied to refine the design of particulate formulations for more efficient mucosal drug delivery.

Multifunctional CNTs-PAA/MIL101(Fe)@Pt Composite Membrane for High-throughput Oily Wastewater Remediation

A surge of effort has been devoted to establishing super-wetting membranes with versatility for oily waste water purification. However, persistent challenge remains the lower separation flux. Moreover, the majorities of catalysts are only adsorbed on the surface and easily fall off after multiple cyclic separations. In this work, an effective strategy has been taken to construct a composite membrane consisting of polyacrylic acid functionalized carbon nanotubes (CNTs-PAA) and MIL101(Fe)@platinum nanoparticles (MIL101(Fe)@Pt NPs). The obtained CNTs-PAA/MIL101(Fe)@Pt composite membrane can achieve degradation of dye molecules and at the same time effective separation of oil-in-water emulsions. The separation throughput of this composite membrane can reach up to 11000 L m^-2 h^-1 bar^-1, which has exceeded most of the previous reported multifunctional separation membranes. Furthermore, this composite membrane has presented stable mechanical property and excellent anti-corrosion ability. This work gives comprehensive consideration to excellent separation performance, versatility and stability, which could have potential applications in practical oily wastewater treatment.

A self-designed versatile and portable sensing device based on smart phone for colorimetric detection

A UV-vis spectrometer, as a sort of important analytical instrument, has been widely used to analyze various substances. However, expensive equipment and skilled operators are required, which limits its broad applications for out-of-lab and daily measurements. In this work, a self-designed sensing device based on smart phone was developed as a sensitive, cost-effective, facile, and portable testing tool. The sensing device fabricated by 3D printing was used to lodge a sample solution and produce a light signal, and the optical sensor on a smart phone worked as a transducer. The light source in the device generated wide-wavelength radiation, which passed through an inner filter and only light of a designated wavelength reached the testing solution. The intensity of transmitted light was then measured by an optical sensor internally installed in most smart phones, where the signals were processed as well. The feasibility of our device was verified by detecting four kinds of common heavy metal ions in actual water samples, and the testing results showed good agreement with those obtained from the UV-vis spectrometer. This work is expected to shed some light on the construction of smart phone-based sensors, featuring decent portability, simple operation, low cost, high sensitivity, and good accuracy.

Reliability and versatility of the Wise pattern, medial pedicle for breast reduction in South Africa

Background

Breast hypertrophy is a condition of abnormal enlargement of the breast which may continue until each breast weighs more than 1.5 kg (macromastia) or even more than 2 kg (gigantomastia). Supporting such heavy weights leads to cervical and upper thoracic back pain, costochondritis, and fungal infections in the mammary folds, making reduction mammoplasty essential. However, there is a lack of consensus among plastic surgeons as to the best technique. This study reports the results of reduction mammoplasties in South African women using the Wise pattern, minimally undermined with a medial pedicle.

Methods

A retrospective record review of the reduction mammoplasties was conducted over a 1-year period. Patient records were assessed for early complications related to vascular reliability.

Results

One hundred and fourteen Wise pattern minimally undermined, medial pedicle techniques were performed on 57 consecutive patients in the 1-year period at the NetCare Rand Clinic in Berea, Johannesburg, South Africa (EN). The patients' sternal notch to nipple distances ranged from 28 to 52 cm. The volume of breast reduction ranged from 345 g to 3300 g per breast. The overall complication rate was 9.7%, consisting of fat necrosis (3.5%), infection (1.7%), dehiscence (3.5%), and nipple epidermolysis (0.9%).

Conclusion

The minimally undermined Wise pattern medial pedicle breast reduction technique proved to be a reliable technique for breast reduction in the South African population. Safety in pedicle breast reduction with sternal notch to nipple distances of up to 50 cm, as well as reliability and versatility in a wide range of breast sizes, was demonstrated.

A perspective on the biotechnological applications of the versatile tyrosinase

Tyrosinase (E.C. 1.14.18. 1) is a type of Cu-containing oxidoreductase which has bifunctional activity for various phenolic substrates: ortho-hydroxylation of monophenols to diphenols (a cresolase activity) and oxidation of diphenols to quinones (a catecholase activity). Based on the broad substrate spectrum, tyrosinase has been used in bioremediation of phenolic pollutants, constructing biosensors for identifying phenolic compounds, and L-DOPA synthesis. Furthermore, not only tyrosinase has been used to produce useful polyphenol derivatives, but also it is recently revealed that the promiscuous activity of tyrosinase is closely related with delignification in the biorefinery. Accordingly, tyrosinase might be a potential biocatalyst for industrial applications (e.g., electroenzymatic L-DOPA production, but its long-term stability and reusability should be further explored. In this review, we emphasize the versatility of tyrosinase, which includes conventional applications, and suggest new perspectives as an industrial biocatalyst (e.g., electroenzymatic L-DOPA production). Especially, this review focuses on and comprehensively discusses recent innovative studies.

Construction of a biodegradable, versatile nanocarrier for optional combination cancer therapy

A novel biodegradable versatile nanocarrier (FA-CM) was fabricated based on the self-assembly of delaminated CoAl-layered double hydroxides (LDHs) and manganese dioxide (MnO₂) for optional combination cancer therapy. Biodegradation, versatility, targeting, bioimaging, in vitro cytotoxicity and in vivo antitumor efficacy were evaluated. The results showed that FA-CM could not only be effectively degraded into Co²⁺, Al³⁺ and Mn²⁺ to overcome the long-term toxic side effects, but also successfully load any positive-charged, negative-charged, hydrophilic, and hydrophobic drug, meeting the critical requirement of versatile nanocarrier. Meanwhile, the presence of FA led to the higher uptake efficiency, cytotoxicity, and excellent fluorescence imaging of FA-CM toward cancerous cells. In particular, FA-CM exhibited glutathione and pH dual-response drug release, avoiding any premature leakage and side effects. The applicability of the FA-CM was determined by co-loading hydrophilic (doxorubicin (DOX)) and hydrophobic drug (paclitaxel (PTX)) for synergistic combination chemotherapy. In vitro cytotoxicity evaluation and a xenograft tumor model of hepatoma showed that this combination exhibited more efficient anticancer effects compared with either free drug alone or the corresponding cocktail solutions. Especially, the ratios of DOX and PTX loaded on FA-CM could be tuned as needed. A powerful approach is provided for the design and preparation of a biodegradable versatile nanocarrier with targeted ability and excellent biocompatibility, which can be potentially applied in clinical practice and medical imaging. STATEMENT OF SIGNIFICANCE: Drug delivery nanocarriers that can transport an effective dosage of drug molecules to targeted cells and tissues have been extensively designed to overcome the adverse side effects and low effectiveness of conventional chemotherapy. However, lack of biodegradability and versatility existing in majority of nanocarriers limit their further clinical applications. Thus, constructing a novel biodegradable versatile nanocarrier that can carry various types of drugs, is in urgent need and more suitable for commercial production and clinical use. In this study, we developed a novel biodegradable versatile nanocarrier (FA-CM) based on the self-assembly of delaminated CoAl-layered double hydroxides (LDHs) and manganese dioxide (MnO₂) for optional combination cancer therapy. This work provides a new strategy for constructing versatile biodegradable platform for targeted drug delivery, which would have broad applications in cancer theranostics.

Latent Classes of Sexual Positioning Practices and Sexual Risk Among Men Who Have Sex with Men in Paris, France

HIV/STI risk varies by sexual positioning practices; however, limited data have characterized the behavioral profiles of men who have sex with men (MSM) in France. This study used latent class analysis (LCA) to explore sexual risk profiles among MSM in Paris, France. LCA was used to classify sexual positioning and serosorting profiles among MSM in Paris (n = 496). Age, HIV status, relationship status, substance use, group sex, and PrEP history were used in a multinomial regression model predicting class membership. Three latent classes were identified: majority top/serosorters, versatile/low partners, and majority bottom/some serosorters. Majority top/serosorters had the highest probability of condomless serosorting; majority bottom/some serosorters had the highest mean number of partners (~ 12 partners) for condomless receptive anal intercourse. HIV-positive MSM were more likely to be classified as majority bottom/some serosorters than versatile/low partners (AOR 7.61; 95% CI 2.28, 25.3). Findings support the need for tailored and targeted interventions for highest-risk individuals.

LowDimensional Halide Perovskites and Their Advanced Optoelectronic Applications

Metal halide perovskites are crystalline materials originally developed out of scientific curiosity. They have shown great potential as active materials in optoelectronic applications. In the last 6 years, their certified photovoltaic efficiencies have reached 22.1%. Compared to bulk halide perovskites, low-dimensional ones exhibited novel physical properties. The photoluminescence quantum yields of perovskite quantum dots are close to 100%. The external quantum efficiencies and current efficiencies of perovskite quantum dot light-emitting diodes have reached 8% and 43 cd A-1, respectively, and their nanowire lasers show ultralow-threshold room-temperature lasing with emission tunability and ease of synthesis. Perovskite nanowire photodetectors reached a responsivity of 10 A W-1 and a specific normalized detectivity of the order of 1012 Jones. Different from most reported reviews focusing on photovoltaic applications, we summarize the rapid progress in the study of low-dimensional perovskite materials, as well as their promising applications in optoelectronic devices. In particular, we review the wide tunability of fabrication methods and the state-of-the-art research outputs of low-dimensional perovskite optoelectronic devices. Finally, the anticipated challenges and potential for this exciting research are proposed.

Evolutionary analysis of the global landscape of protein domain types and domain architectures associated with family 14 carbohydrate-binding modules

Domain promiscuity is a powerful evolutionary force that promotes functional innovation in proteins, thus increasing proteome and organismal complexity. Carbohydrate-binding modules, in particular, are known to partake in complex modular architectures that play crucial roles in numerous biochemical and molecular processes. However, the extent, functional, and evolutionary significance of promiscuity is shrouded in mystery for most CBM families. Here, we analyzed the global promiscuity of family 14 carbohydrate-binding modules (CBM14s) and show that fusion, fission, and reorganization events with numerous other domain types interplayed incessantly in a lineage-dependent manner to likely facilitate species adaptation and functional innovation in the family.

EXPERIENCE WITH miniplate osteosynthesis in THE MANAGEMENT OF mandibular fractures IN NORTHWEST NIGERIA

BACKGROUND

Fractures of the mandible are the commonest facial fractures and various treatment modalities exist like wire osteosynthesis and the use of miniplates and screw with most of the industrially developed world leaning towards the use of miniplates in the treatment of these fractures. The use has however been limited in developing countries (including Nigeria) mostly due to the cost of the plates and screws.

AIM AND OBJECTIVES

To identify the versatility of miniplates in the treatment of mandibular fractures at a tertiary care centre in a developing country.

METHODS

All Subjects aged 16 years and above in whom mandibular fractures were diagnosed were recruited over a two year period. Patients were treated under general anesthesia using either the miniplates and screws or wire osteosynthesis while some patients had both miniplates and maxillo-maxillary fixation.

RESULTS

A total of 94 patients were recruited for the study of which 89.4% were males while the age group 16 to 25 years constituted the majority. Though 29.8% of the study population was involved in business, only 9.6 % were professional motorcyclists. Motorcycle-related road traffic crashes constituted the commonest aetiologic agent with 41.5%, while combination fractures were the commonest fracture types seen in 54.3% of the study participants. Of the 94 patients, 77.7% had treatment of mandibular fractures by open reduction and immobilization with mini plates, while 7.4% had mini plates with Maxillo-maxillary fixation and 14.9% had wire osteosynthesis only. The site of fracture was significantly associated with the treatment modality (p= 0.02).

CONCLUSION

This study showed that the choice of fixation appliances in mandibular fractures was influenced by the number of fractures and the multiplicity of fracture sites. Miniplates offered functionally stable fixation with minimum complications.