Nipple Sparing Mastectomy Techniques: A Literature Review and an Inframammary Technique

Nipple sparing mastectomy (NSM) has quickly become an accepted technique for patients with selected cancers and for risk reducing surgery. Much of its surgical acceptance over the last decade has been based on the low risk of nipple areolar complex (NAC) occurrence in breast cancer patients. Improved patient satisfaction due to improved cosmetic outcomes with reconstruction have also driven its popularity. We reviewed current English journals to determine the NSM techniques which achieve the lowest complications, best outcomes, and best patient satisfaction. We researched studies showing reductions in complications with improved surgical techniques and patient selection which have been implicated in improved results. In the studies reviewed, incision placement, away from the nipple, resulted in the lowest rates of ischemic nipple complications and the best cosmetic outcomes. The effect of other factors such as surgeon experience and thickness of skin flap development were more difficult to prove. Leaving a 2-3 mm rim of tissue around the nipple bundle was shown to help preserve the nipple vascularity. Lower complication rates with improved outcomes and patient satisfaction were reported in the literature in patients with B or smaller cup sizes, non-smokers, and patients with lower body mass index (BMI). Incision placement, away from the nipple, with preservation of a 2-3 mm rim of tissue around the nipple bundle along with careful patient selection were the most significant variables reviewed which helped to lower complications rates of NSM. Coordinated surgical planning with the breast and plastic surgeons to determine the best surgical approach for each individual patient is necessary to obtain the best results. Although short-term oncologic follow-up seems to be acceptable, longer follow-up will still be needed to define the best breast cancer surgical candidates for the nipple sparing approach

Genome assembly and characterization of a complex zfBED-NLR gene-containing disease resistance locus in Carolina Gold Select rice with Nanopore sequencing

Long-read sequencing facilitates assembly of complex genomic regions. In plants, loci containing nucleotide-binding, leucine-rich repeat (NLR) disease resistance genes are an important example of such regions. NLR genes constitute one of the largest gene families in plants and are often clustered, evolving via duplication, contraction, and transposition. We recently mapped the Xo1 locus for resistance to bacterial blight and bacterial leaf streak, found in the American heirloom rice variety Carolina Gold Select, to a region that in the Nipponbare reference genome is NLR gene-rich. Here, toward identification of the Xo1 gene, we combined Nanopore and Illumina reads and generated a high-quality Carolina Gold Select genome assembly. We identified 529 complete or partial NLR genes and discovered, relative to Nipponbare, an expansion of NLR genes at the Xo1 locus. One of these has high sequence similarity to the cloned, functionally similar Xa1 gene. Both harbor an integrated zfBED domain, and the repeats within each protein are nearly perfect. Across diverse Oryzeae, we identified two sub-clades of NLR genes with these features, varying in the presence of the zfBED domain and the number of repeats. The Carolina Gold Select genome assembly also uncovered at the Xo1 locus a rice blast resistance gene and a gene encoding a polyphenol oxidase (PPO). PPO activity has been used as a marker for blast resistance at the locus in some varieties; however, the Carolina Gold Select sequence revealed a loss-of-function mutation in the PPO gene that breaks this association. Our results demonstrate that whole genome sequencing combining Nanopore and Illumina reads effectively resolves NLR gene loci. Our identification of an Xo1 candidate is an important step toward mechanistic characterization, including the role(s) of the zfBED domain. Finally, the Carolina Gold Select genome assembly will facilitate identification of other useful traits in this historically important variety. Author summary Plants lack adaptive immunity, and instead contain repeat-rich, disease resistance genes that evolve rapidly through duplication, recombination, and transposition. The number, variation, and often clustered arrangement of these genes make them challenging to sequence and catalog. The US heirloom rice variety Carolina Gold Select has resistance to two important bacterial diseases. Toward identifying the responsible gene(s), we combined long- and short-read sequencing technologies to assemble the whole genome and identify the resistance gene repertoire. We previously narrowed the location of the gene(s) to a region on chromosome four. The region in Carolina Gold Select is larger than in the rice reference genome (Nipponbare) and contains twice as many resistance genes. One shares unusual features with a known bacterial disease resistance gene, suggesting that it confers the resistance. Across diverse varieties and related species, we identified two widely-distributed groups of such genes. The results are an important step toward mechanistic characterization and deployment of the bacterial disease resistance. The genome assembly also identified a resistance gene for a fungal disease and predicted a marker phenotype used in breeding for resistance. Thus, the Carolina Gold Select genome assembly can be expected to aid in the identification and deployment of other valuable traits

DIYA: a bacterial annotation pipeline for any genomics lab

Summary:DIYA (Do-It-Yourself Annotator) is a modular and configurable open source pipeline software, written in Perl, used for the rapid annotation of bacterial genome sequences. The software is currently used to take DNA contigs as input, either in the form of complete genomes or the result of shotgun sequencing, and produce an annotated sequence in Genbank file format as output

Breast animation deformity

Breast animation deformity (BAD) has been reported to occur after submuscular implant placement following breast augmentation and immediate breast reconstruction. Despite its apparent impact on patients’ quality of life, BAD has only recently become a topic of general concern. Its incidence and etiology have yet to be established. The aim of this systematic review was to identify papers that clearly defined and classified BAD and described how the degree of animation was assessed. We performed a search in PubMed and Embase. Studies meeting the inclusion criteria that described BAD after implant-based breast augmentation or immediate breast reconstruction were included. After screening 866 publications, four studies were included: three describing BAD after breast augmentation and one describing BAD after immediate breast reconstruction. The median percentage of patients with some degree of BAD was 58%. The highest percentages were found in patients operated on using the Regnault technique or the dual-plane technique (73%–78%). The lowest percentages were found following the dual-plane muscle-splitting technique (30%) and the triple-plane technique (33%). We found no studies meeting the inclusion criteria that analyzed BAD after prepectoral implant placement. This review of the current literature suggests that the degree of BAD is proportional to the degree of muscle involvement. Evidence is scarce, and the phenomenon seems to be underreported. Future comparative studies are warranted

A Gene Wiki for Community Annotation of Gene Function

This manuscript describes the creation of comprehensive gene wiki, seeded with data from public domain sources, which will enable and encourage community annotation of gene function

Science that "knows" and science that "asks"

Clinician-researchers and experimental scientists do not speak the same language; they have different professional environments and different end-points in their research. This creates considerable problems of comprehension and communication, which constitute a major drawback in multidisciplinary work such as translational medicine. A stereotypic representation of both these worlds is presented as a starting point to encourage debate on this issue

When The News Was Sung: Ballads as News Media in Early Modern Europe

News songs differ in crucial ways to the other news media of the early modern period like newsletters, newspapers, or diplomatic correspondence – they differ even from the prose broadsheets and pamphlets that they so closely resemble. As historians of news we need to ask different kinds of questions of these multi-media artifacts. For example, how does the presentation in a performative genre affect the dissemination and reception of information about events? What part do orality and aurality play in how the news was sold and received? Here the activities and social status of street singers play an important role. We must consider the production, format and distribution of these songs in order to understand their impact. We also need to pay attention to the conjunction between text and melody, and the ways in which this affected the presentation of a news event. On a broader scale, what kind of information can ballads provide about specific news events that other documents cannot or will not provide? Can they offer us a new medium by which to interpret historical events? And lastly, how should historians deal with these profoundly emotive texts? The combination of sensationalist language and affecting music meant that songs had the potential to provoke a more powerful response than any other contemporary news source, and this emotional potency can at times be challenging for a modern historian to decipher and explain. This article will attempt to answer some of these questions and suggest some of the skills we as historians need to develop in order to appreciate the full meaning of songs as the most popular of news media in early modern Europe

The screen test 1915–1930:how stars were born

This article examines the emergence of the screen test as a cultural phenomenon during the silent era in the US and Europe and its role in the development of the star system. The lore that grew up around the screen test almost from its inception held out the possibility for members of the public to cross a threshold into the rarefied world of celebrity. The screen test itself is situated in the liminal space not only between audience and actor, but also between fiction and non-fiction, Europe and Hollywood, the silent era and the talkies, and the public and private spheres. In order to trace the ways in which the screen test as such was narrativized and conceptualized in its foundational stages, this article will analyse accounts from Hollywood and European fan magazines of the silent era, including articles, short fiction, and early cinema apocrypha. The article culminates in a discussion of the film Prix de Beauté / Beauty Prize (Augusto Genina, 1930), which starred Louise Brooks, herself a transnational film icon whose film career spanned the divide between Hollywood and Europe. The film’s final scene, in which a beauty queen is shot dead by her jealous husband as she watches a screen test of herself, has been invoked by a number of film scholars as an allegory of the work performed by cinema, which preserves and disseminates the image of the star far beyond the actor’s physical presence. Speaking to historical conditions of star-making while also capturing its resonance in cultural mythology, the conclusion of Prix de Beauté allows us to consider the origins and functions of screen test discourse itself

Assessing the carcinogenic potential of low-dose exposures to chemical mixtures in the environment: the challenge ahead.

Lifestyle factors are responsible for a considerable portion of cancer incidence worldwide, but credible estimates from the World Health Organization and the International Agency for Research on Cancer (IARC) suggest that the fraction of cancers attributable to toxic environmental exposures is between 7% and 19%. To explore the hypothesis that low-dose exposures to mixtures of chemicals in the environment may be combining to contribute to environmental carcinogenesis, we reviewed 11 hallmark phenotypes of cancer, multiple priority target sites for disruption in each area and prototypical chemical disruptors for all targets, this included dose-response characterizations, evidence of low-dose effects and cross-hallmark effects for all targets and chemicals. In total, 85 examples of chemicals were reviewed for actions on key pathways/mechanisms related to carcinogenesis. Only 15% (13/85) were found to have evidence of a dose-response threshold, whereas 59% (50/85) exerted low-dose effects. No dose-response information was found for the remaining 26% (22/85). Our analysis suggests that the cumulative effects of individual (non-carcinogenic) chemicals acting on different pathways, and a variety of related systems, organs, tissues and cells could plausibly conspire to produce carcinogenic synergies. Additional basic research on carcinogenesis and research focused on low-dose effects of chemical mixtures needs to be rigorously pursued before the merits of this hypothesis can be further advanced. However, the structure of the World Health Organization International Programme on Chemical Safety 'Mode of Action' framework should be revisited as it has inherent weaknesses that are not fully aligned with our current understanding of cancer biology

3D-Beacons: decreasing the gap between protein sequences and structures through a federated network of protein structure data resources

While scientists can often infer the biological function of proteins from their 3-dimensional quaternary structures, the gap between the number of known protein sequences and their experimentally determined structures keeps increasing. A potential solution to this problem is presented by ever more sophisticated computational protein modeling approaches. While often powerful on their own, most methods have strengths and weaknesses. Therefore, it benefits researchers to examine models from various model providers and perform comparative analysis to identify what models can best address their specific use cases. To make data from a large array of model providers more easily accessible to the broader scientific community, we established 3D-Beacons, a collaborative initiative to create a federated network with unified data access mechanisms. The 3D-Beacons Network allows researchers to collate coordinate files and metadata for experimentally determined and theoretical protein models from state-of-the-art and specialist model providers and also from the Protein Data Bank