Showing papers by "Rutgers University published in 2023"

Imagining Institutional Care, Practicing Domestic Care: Inscriptions around Aging in Southern Ghana

Abstract: Elder care has become a significant national conversation in Ghana due to urban and international migration, lower birth rates, family nuclearization, and longer life spans. In the rural towns of Ghana’s Eastern Region, new elder care practices and discourses are emerging. These age-inscriptions signal the agency of older persons, which is often neglected and overlooked. Discursively, older adults express curiosity about Western care facilities, a heterodox idea in relation to the orthodox position expressed by the Ghanaian government and NGOs which support kin care for older adults. Through this heterodox discourse, aged persons are able to critique the state and the church for not providing care and re-imagine a Western institution as fitting their locally constructed needs. On the other hand, pragmatically, aged persons and their children are adapting existing practices of adolescent fosterage to help provide elder care, a practice which is not discursively elaborated, and is therefore alterodox. Both age-inscriptions are less articulated than standardized discourses about the significance of adult children’s care, the orthodox position. This paper therefore illustrates how social change in norms occurs, through older people’s anxiety about their own aging, the use of their imagination, and their refashioning of existing care practices.

A JWST Near- and Mid-infrared Nebular Spectrum of the Type Ia Supernova 2021aefx

Abstract: We present JWST near- and mid-infrared spectroscopic observations of the nearby normal Type Ia supernova SN 2021aefx in the nebular phase at $+255$ days past maximum light. Our Near Infrared Spectrograph (NIRSpec) and Mid Infrared Instrument (MIRI) observations, combined with ground-based optical data from the South African Large Telescope (SALT), constitute the first complete optical $+$ NIR $+$ MIR nebular SN Ia spectrum covering 0.3$-$14 $\mu$m. This spectrum unveils the previously unobserved 2.5$-$5 $\mu$m region, revealing strong nebular iron and stable nickel emission, indicative of high-density burning that can constrain the progenitor mass. The data show a significant improvement in sensitivity and resolution compared to previous Spitzer MIR data. We identify numerous NIR and MIR nebular emission lines from iron-group elements and as well as lines from the intermediate-mass element argon. The argon lines extend to higher velocities than the iron-group elements, suggesting stratified ejecta that are a hallmark of delayed-detonation or double-detonation SN Ia models. We present fits to simple geometric line profiles to features beyond 1.2 $\mu$m and find that most lines are consistent with Gaussian or spherical emission distributions, while the [Ar III] 8.99 $\mu$m line has a distinctively flat-topped profile indicating a thick spherical shell of emission. Using our line profile fits, we investigate the emissivity structure of SN 2021aefx and measure kinematic properties. Continued observations of SN 2021aefx and other SNe Ia with JWST will be transformative to the study of SN Ia composition, ionization structure, density, and temperature, and will provide important constraints on SN Ia progenitor and explosion models.

An Event Study of the Ethereum Transition to Proof-of-Stake

Abstract: On 15 September 2022, the Ethereum network adopted a proof-of-stake (PoS) consensus mechanism. We study the impact on the network and competing platforms in a two month event window around the Beacon chain merge. We find that the transition to PoS has reduced energy consumption by 99.98%. Miners have not transformed into validators, and total block reward income (in USD) has fallen by 97%, though transaction fees (in ETH) for Ether have increased nearly 10%. The Herfindahl index for the top 10 is 1009; the network is 19% less concentrated after the merge. Ethereum supply growth has been deflationary since the merge. The time between consecutive blocks is now steady at 12 s and transactions per day are up 7.0%. On Polygon, Matic fees rose but token fees fell. Polygon also slows, processing 3.3% fewer transactions per day. Solana’s fees fall by $0.0003, and transactions per day are down 48%. Stablecoin transfer volumes fall on Ethereum and Polygon, but rise on Solana.

Short‐term high‐fat diet feeding of mice suppresses catecholamine‐stimulated Ca ²⁺ signalling in hepatocytes and intact liver

Abstract: Excess consumption of carbohydrates, fat and calories leads to non-alcoholic fatty liver disease (NAFLD) and hepatic insulin resistance; these are major factors in the pathogenesis of type II diabetes. Hormones and catecholamines acting through G-protein coupled receptors (GPCRs) linked to phospholipase C (PLC) and increases in cytosolic Ca2+ ([Ca2+]c) regulate many metabolic functions of the liver. In the intact liver, catabolic hormones such as glucagon, catecholamines and vasopressin integrate and synergize to regulate the frequency and extent to which [Ca2+]c waves propagate across hepatic lobules to control metabolism. Dysregulation of hepatic Ca2+ homeostasis has been implicated in the development of metabolic disease, but changes in hepatic GPCR-dependent Ca2+ signalling have been largely unexplored in this context. We show that short-term, 1-week, high-fat diet (HFD) feeding of mice attenuates noradrenaline-stimulated Ca2+ signalling, reducing the number of cells responding and suppressing the frequency of [Ca2+]c oscillations in both isolated hepatocytes and intact liver. The 1-week HFD feeding paradigm did not change basal Ca2+ homeostasis; endoplasmic reticulum Ca2+ load, store-operated Ca2+ entry and plasma membrane Ca2+ pump activity were unchanged compared to low-fat diet (LFD)-fed controls. However, noradrenaline-induced inositol 1,4,5-trisphosphate production was significantly reduced after HFD feeding, demonstrating an effect of HFD on receptor-stimulated PLC activity. Thus, we have identified a lesion in the PLC signalling pathway induced by short-term HFD feeding, which interferes with hormonal Ca2+ signalling in isolated hepatocytes and the intact liver. These early events may drive adaptive changes in signalling, which lead to pathological consequences in fatty liver disease. Key points Non-alcoholic fatty liver disease (NAFLD) is a growing epidemic. In healthy liver, the counteracting effects of catabolic and anabolic hormones regulate metabolism and energy storage as fat. Hormones and catecholamines promote catabolic metabolism via increases in cytosolic Ca2+ ([Ca2+]c). We show that 1 week high-fat diet (HFD) feeding of mice attenuated the Ca2+ signals induced by physiological concentrations of noradrenaline. Specifically, HFD suppressed the normal pattern of periodic [Ca2+]c oscillations in isolated hepatocytes and disrupted the propagation of intralobular [Ca2+]c waves in the intact perfused liver. Short-term HFD inhibited noradrenaline-induced inositol 1,4,5-trisphosphate generation, but did not change basal endoplasmic reticulum Ca2+ load or plasma membrane Ca2+ fluxes. We propose that impaired Ca2+ signalling plays a key role in the earliest phases of the etiology of NAFLD, and is responsible for many of the ensuing metabolic and related dysfunctional outcomes at the cellular and whole tissue level.

Genomics of turions from the Greater Duckweed reveal its pathways for dormancy and re‐emergence strategy

Abstract: Over 15 families of aquatic plants are known to use a strategy of developmental switching upon environmental stress to produce dormant propagules called turions. However, few molecular details for turion biology have been elucidated due to the difficulties in isolating high-quality nucleic acids from this tissue. We successfully developed a new protocol to isolate high-quality transcripts and carried out RNA-seq analysis of mature turions from the Greater Duckweed Spirodela polyrhiza. Comparison of turion transcriptomes to that of fronds, the actively growing leaf-like tissue, were carried out. Bioinformatic analysis of high confidence, differentially expressed transcripts between frond and mature turion tissues revealed major pathways related to stress tolerance, starch and lipid metabolism, and dormancy that are mobilized to reprogram frond meristems for turion differentiation. We identified the key genes that are likely to drive starch and lipid accumulation during turion formation, as well as those in pathways for starch and lipid utilization upon turion germination. Comparison of genome-wide cytosine methylation levels also revealed evidence for epigenetic changes in the formation of turion tissues. Similarities between turions and seeds provide evidence that key regulators for seed maturation and germination were retooled for their function in turion biology.

Fibroblast growth factor 5 (FGF5) and its missense mutant FGF5-H174 underlying trichomegaly: a molecular dynamics simulation investigation

Abstract: The missense mutation Y174H of FGF5 (FGF5-H174) had been associated with trichomegaly, characterized by abnormally long and pigmented eyelashes. The amino acid tyrosine (Tyr/Y) at position 174 is conserved across many species, proposedly holding important characteristics for the functions of FGF5. Microsecond molecular dynamics simulations along with protein-protein docking and residue interacting network analysis were employed to investigate the structural dynamics and binding mode of both wild-type (FGF5-WT) and its mutated counterpart (FGF5-H174). It was found that the mutation decreased number of hydrogen bonds within the protein, sheet secondary structure, interaction of residue 174 with other residues, and number of salt-bridges. On the other hand, the mutation increased solvent accessible surface area, number of hydrogen bonds between the protein and solvent, coil secondary structure, protein C-alpha backbone root mean square deviation, protein residue root mean square fluctuations, as well as occupied conformational space. In addition, protein-protein docking integrated with molecular dynamics simulations and molecular mechanics - Poisson-Boltzmann surface area (MM/PBSA) binding energy calculation demonstrated that the mutated variant possessed stronger binding affinity towards fibroblast growth factor receptor 1 (FGFR1). However, residue interaction network analysis demonstrated that the binding mode of the FGFR1-FGF5-H174 complex was drastically different from that of the FGFR1-FGF5-WT complex. In conclusion, the missense mutation conferred more instability within itself and stronger binding affinity towards FGFR1 with distinctively altered binding mode or residue connectivity. These findings might help explain the decreased pharmacological activity of FGF5-H174 towards FGFR1, underlying trichomegaly.Communicated by Ramaswamy H. Sarma.

Bank default risk propagation along supply chains: Evidence from the U.K.

Abstract: How does banks' default risk affect the probability of default of non-financial businesses? The literature has focused on the banks' direct corporate customers. It fails to consider the role of supply chain relationships as a powerful channel for default risk contagion. Our paper fills this gap by analyzing the direct as well as the indirect impact of banks' default risk on firms' default risk in the U.K. Relying on Input-Output tables, we devise methods that enable us to examine this question in the absence of data on firm-to-firm linkages. To capture all potential propagation channels, we account for horizontal and vertical linkages, both between the firm and upstream industries (suppliers) and between the firm and downstream industries (customers). We further examine how trade credit and contract specificity amplify or dampen the propagation of default risk. Our results show that increases in banks’ default risk from the banking crisis of 2007–2008 propagated strongly to U.K. non-financial firms via supply chains.

The Framework for Assessing Changes To Sea-level (FACTS) v1.0-rc: A platform for characterizing parametric and structural uncertainty in future global, relative, and extreme sea-level change

Abstract: Abstract. Future sea-level rise projections are characterized by both quantifiable uncertainty and unquantifiable, structural uncertainty. Thorough scientific assessment of sea-level rise projections requires analysis of both dimensions of uncertainty. Probabilistic sea-level rise projections evaluate the quantifiable dimension of uncertainty; comparison of alternative probabilistic methods provide an indication of structural uncertainty. Here we describe the Framework for Assessing Changes To Sea-level (FACTS), a modular platform for characterizing alternative probability distributions of global mean, regional, and extreme sea-level rise. We demonstrate its application by generating seven alternative probability distributions under multiple alternative emissions scenarios for both future global mean sea level and future relative and extreme sea level at New York City. These distributions, closely aligned with those presented in the Intergovernmental Panel on Climate Change Sixth Assessment Report, emphasize the role of the Antarctic and Greenland ice sheet as drivers of structural uncertainty in sea-level rise projections.

Implementation of deep learning artificial intelligence in vision-threatening disease screenings for an underserved community during COVID-19

Abstract: Introduction Age-related macular degeneration, diabetic retinopathy, and glaucoma are vision-threatening diseases that are leading causes of vision loss. Many studies have validated deep learning artificial intelligence for image-based diagnosis of vision-threatening diseases. Our study prospectively investigated deep learning artificial intelligence applications in student-run non-mydriatic screenings for an underserved, primarily Hispanic community during COVID-19. Methods Five supervised student-run community screenings were held in West New York, New Jersey. Participants underwent non-mydriatic 45-degree retinal imaging by medical students. Images were uploaded to a cloud-based deep learning artificial intelligence for vision-threatening disease referral. An on-site tele-ophthalmology grader and remote clinical ophthalmologist graded images, with adjudication by a senior ophthalmologist to establish the gold standard diagnosis, which was used to assess the performance of deep learning artificial intelligence. Results A total of 385 eyes from 195 screening participants were included (mean age 52.43 ± 14.5 years, 40.0% female). A total of 48 participants were referred for at least one vision-threatening disease. Deep learning artificial intelligence marked 150/385 (38.9%) eyes as ungradable, compared to 10/385 (2.6%) ungradable as per the human gold standard ( p < 0.001). Deep learning artificial intelligence had 63.2% sensitivity, 94.5% specificity, 32.0% positive predictive value, and 98.4% negative predictive value in vision-threatening disease referrals. Deep learning artificial intelligence successfully referred all 4 eyes with multiple vision-threatening diseases. Deep learning artificial intelligence graded images (35.6 ± 13.3 s) faster than the tele-ophthalmology grader (129 ± 41.0) and clinical ophthalmologist (68 ± 21.9, p < 0.001). Discussion Deep learning artificial intelligence can increase the efficiency and accessibility of vision-threatening disease screenings, particularly in underserved communities. Deep learning artificial intelligence should be adaptable to different environments. Consideration should be given to how deep learning artificial intelligence can best be utilized in a real-world application, whether in computer-aided or autonomous diagnosis.

The Global Anglophone: An Institutional Argument

Abstract: Most accounts of the rise of Global Anglophone as a disciplinary category and academic field have characterized it as an expansion, revision, or “repackaging” of the Postcolonial within literary studies. In this introductory essay, I make the case that the increased prominence of Global Anglophone in hiring in the US academy derives from broader shifts in the institutional landscape of English departments over the past twenty years. After situating Global Anglophone within a contemporary turn toward organizing literary fields around transnational, ethnic, and subnational categories rather than nation-states, I offer a model for approaching Global Anglophone as an umbrella term for all teaching and scholarship conducted in English departments. Using James Baldwin’s The Fire Next Time (1963) as a test case, I propose a newly revamped Global Anglophone curriculum that would better reflect the kinds of research that literary scholars are producing in the twenty-first century.

The ubiquitin ligase TRIM21 regulates mutant p53 accumulation and gain-of-function in cancer

Abstract: The tumor suppressor TP53 is the most frequently mutated gene in human cancers. Mutant p53 (mutp53) proteins often accumulate to very high levels in human cancers to promote cancer progression through the gain-of-function (GOF) mechanism. Currently, the mechanism underlying mutp53 accumulation and GOF is incompletely understood. Here, we identified TRIM21 as a critical E3 ubiquitin ligase of mutp53 by screening for specific mutp53-interacting proteins. TRIM21 directly interacted with mutp53 but not WT p53, resulting in ubiquitination and degradation of mutp53 to suppress mutp53 GOF in tumorigenesis. TRIM21 deficiency in cancer cells promoted mutp53 accumulation and GOF in tumorigenesis. Compared with p53R172H knockin mice, which displayed mutp53 accumulation specifically in tumors but not normal tissues, TRIM21 deletion in p53R172H knockin mice resulted in mutp53 accumulation in normal tissues, an earlier tumor onset, and a shortened life span of mice. Furthermore, TRIM21 was frequently downregulated in some human cancers, including colorectal and breast cancers, and low TRIM21 expression was associated with poor prognosis in patients with cancers carrying mutp53. Our results revealed a critical mechanism underlying mutp53 accumulation in cancers and also uncovered an important tumor-suppressive function of TRIM21 and its mechanism in cancers carrying mutp53.

The Impact of Racial Disparities on Outcome in Patients With Stage IIIC Endometrial Carcinoma

Abstract: Objective: To report the impact of race on clinical outcomes in patients with stage IIIC endometrial carcinoma. Materials and Methods: A retrospective multi-institutional study included 90 black and 568 non-black patients with stage IIIC endometrial carcinoma who received adjuvant chemotherapy and radiation treatments. Overall survival (OS) and recurrence-free survival (RFS) were calculated by the Kaplan-Meier method. Propensity score matching (PSM) was conducted. Statistical analyses were conducted using SPSS version 27. Results: The Median follow-up was 45.3 months. black patients were significantly older, had more nonendometrioid histology, grade 3 tumors, and were more likely to have >1 positive paraaortic lymph nodes compared with non-black patients (all P <0.0001). The 5-year estimated OS and RFS rates were 45% and 47% compared with 77% and 68% for black patients versus non-black patients, respectively (P <0.001). After PSM, the 2 groups were well-balanced for all prognostic covariates. The estimated hazard ratios of black versus non-black patients were 1.613 (P value=0.045) for OS and 1.487 (P value=0.116) for RFS. After PSM, black patients were more likely to receive the “Sandwich” approach and concurrent chemoradiotherapy compared with non-black (P=0.013) patients. Conclusions: Black patients have higher rates of nonendometrioid histology, grade 3 tumors, and number of involved paraaortic lymph nodes, worse OS, and RFS, and were more likely to receive the “Sandwich” approach compared with non-black patients. After PSM, black patients had worse OS with a nonsignificant trend in RFS. Access to care, equitable inclusion on randomized trials, and identification of genomic differences are warranted to help mitigate disparities.

Transborder Literacies of (In)Visibility

Abstract: Drawing from an ethnography with mixed-status families residing in Mexico, we examine what we term transborder literacies of (in)visibility, or diasporic people's innovative interactions around texts that prepare them to move across incompatible mononational institutions divided by borders. Through close attention to the literacy practices families engaged in as they applied for their children's U.S. passports from Mexico, we demonstrate how these literacies were not just about expanding authentic ways of reading and writing to include both U.S. and Mexican ways, but instead required unique transborder literacies across mutually unintelligible, racializing mononational systems so that children could (re)access their rights on both sides of the border. We argue that recognizing families’ complex transborder literacy practices of (in)visibility could offer a novel anti-oppressive lens to transform how educators make sense of the complexity of immigrant families’ literacies, movements, and educational supports across borders and national schooling systems.

Critical commentary on labetalol and nifedipine use in postpartum hypertension management

Abstract: aAmerican Preventive Screening & Education Association (APSEA) bDepartment of Medicine, Rowan University School of Osteopathic Medicine, Stratford cDepartment of Biology, Rutgers, the State University of New Jersey, New Brunswick, New Jersey, USA Correspondence to David F. Lo, MBS, Department of Medicine, Rowan School of Osteopathic Medicine, 1 Medical Center Dr, Stratford, NJ 08084, USA. Tel: +1 973 996 8669; fax: +1 973 996 8668; e-mail: [email protected]

Addressing the “Hidden Curriculum” in Political Science Publishing

Abstract: Across the academy, there is growing concern over diversity within academic institutions. According to recent research published in three top political science journals, members of historically marginalized groups remain underrepresented and marginalized in submissions, publications, and even reviewer pools (Ayoub 2022; Bell et al. 2020; Reinhardt, Windsor, and King 2022). Expectations that scholars, especially early career researchers (ECRs), “publish or perish” thus exacerbate intersectional inequalities within the discipline (Briscoe-Palmer and Mattocks 2021; McKenzie 2017; Steinþórsdóttir et al. 2018). Further, the overwhelming pressure to publish at all costs can commodify knowledge production and foster a toxic, competitive environment based on peer rivalry rather than collaboration for the sake of advancing knowledge (Horta and Li 2023, 269–70, 271–72).

Contracting During COVID-19: Why Academic Integrity Issues Spread with the Pandemic?

Abstract: The COVID-19 pandemic, which started compromising education in March 2020, precipitated the most extreme educational disruption in over a century. For over 2 years, all levels of education shuttered in-person educational delivery and instituted online education. Many faculty members were teaching online for the first time and thus were distracted by the stress of switching instructional modalities. Students found themselves in a panic-filled transition in which they had little guidance for how to engage with online education as their faculty struggled. One of the residual impacts of this abrupt shift was the explosion in contract cheating, in which students pay a third party to complete homework assignments, take exams, and compose papers. The contract cheating issue is a global problem, with institutions reporting double- and triple-digit spikes in online cheating as the pandemic ensued. Additionally, some of the literature confirms that contract cheating does not meet cheaters’ objectives, given the substandard and tardy work that is often produced. Therefore, this chapter will not only examine the proliferation of contract cheating during the pandemic but other critical elements that result in unfortunate residuals. Plagiarism, academic misconduct, and online cheating, including colleges and universities revoking degrees, led to legal actions. Further, while affluent students and their parents may seek out and purchase ghost students’ services, students with less money find themselves unwittingly competing in inequitable conditions.

Foehn Winds at Pine Island Glacier and their role in Ice Changes

Abstract: Abstract. Pine Island Glacier (PIG) has recently experienced increased ice loss mostly attributed to basal melt and ocean-ice dynamics. However, atmospheric forcing also plays a role in the ice mass budget, as besides lower-latitude warm air intrusions, the steeply sloping terrain that surrounds the glacier promotes frequent Foehn winds. An investigation of 41-years of reanalysis data reveals that Foehn occurs more frequently from June to October, with Foehn episodes typically lasting about 5 to 9 h. An analysis of the surface mass balance indicated that their largest impact is on the surface sublimation, which is increased by about 1.4 mm water equivalent (w.e.) day−1 with respect to no-Foehn events. Blowing snow makes roughly the same contribution as snowfall, around 0.34–0.36 mm w.e. day−1, but with the opposite sign. The melting rate is three orders of magnitude smaller than the surface sublimation rate. The negative phase of the Antarctic Oscillation and the positive phase of the Southern Annular Mode promote the occurrence of Foehn at PIG. A particularly strong event took place on 09–11 November 2011, when 10-m winds speeds in excess of 20 m s−1 led to downward sensible heat fluxes higher than 75 W m−2 as they descended the mountainous terrain. Surface sublimation and blowing snow sublimation dominated the surface mass balance, with magnitudes of up to 0.13 mm w.e. hr−1. Satellite data indicated an hourly surface melting area exceeding 100 km2. Our results stress the importance of the atmospheric forcing on the ice mass balance at PIG.

Metal‐Organic Frameworks for C6 Alkane Separation

Abstract: The separation of alkane isomers is an important yet challenging process in the petrochemical industry. Being a crucial step to produce premium gasoline components as well as optimum ethylene feed, the current industrial separation by distillation is extremely energy intensive. Adsorptive separation based on zeolite is limited by insufficient adsorption capacity. Metal-organic frameworks (MOFs) hold enormous promise as alternative adsorbents due to their diverse structural tunability and exceptional porosity. Precise control of their pore geometry/dimensions has led to superior performance. In this minireview, we highlight the recent progresses in developing MOFs for the separation of C6 alkane isomers. Representative MOFs are reviewed based on their separation mechanisms. Emphasis is put on the material design rationale for achieving optimal separation capability. Finally, we briefly discuss the existing challenges, possible solutions, and future directions of this important field.

Clinical Impact of Staphylococcus aureus Skin and Soft Tissue Infections

Abstract: The pathogenic bacterium Staphylococcus aureus is the most common pathogen isolated in skin-and-soft-tissue infections (SSTIs) in the United States. Most S. aureus SSTIs are caused by the epidemic clone USA300 in the USA. These infections can be serious; in 2019, SSTIs with S. aureus were associated with an all-cause, age-standardized mortality rate of 0.5 globally. Clinical presentations of S. aureus SSTIs vary from superficial infections with local symptoms to monomicrobial necrotizing fasciitis, which can cause systemic manifestations and may lead to serious complications or death. In order to cause skin infections, S. aureus employs a host of virulence factors including cytolytic proteins, superantigenic factors, cell wall-anchored proteins, and molecules used for immune evasion. The immune response to S. aureus SSTIs involves initial responders such as keratinocytes and neutrophils, which are supported by dendritic cells and T-lymphocytes later during infection. Treatment for S. aureus SSTIs is usually oral therapy, with parenteral therapy reserved for severe presentations; it ranges from cephalosporins and penicillin agents such as oxacillin, which is generally used for methicillin-sensitive S. aureus (MSSA), to vancomycin for methicillin-resistant S. aureus (MRSA). Treatment challenges include adverse effects, risk for Clostridioides difficile infection, and potential for antibiotic resistance.

The Poetics of the Wise Fool in the Music and Letters of Ignatius Sancho

Abstract: ABSTRACT While the correspondence of the Black British writer, musician, butler, and shopkeeper Ignatius Sancho has long been recognized as pioneering in its use of the sentimental literary style to articulate anti-racist and anti-slavery positions, his music has largely evaded serious interpretative consideration. This essay considers one way in which Sancho apparently used music to convey his moral messages. His song ‘Sweetest Bard’ and his instrumental dance piece ‘Mungo’s Delight’ suggest that he adopted and reappropriated the persona of the ‘wise fool’, a figure well known to eighteenth-century readers from characters such as Shakespeare’s Falstaff, Sterne’s Yorick, and Cervantes’s Sancho Panza. Understanding these two pieces of music through the lens of the wise fool helps to elucidate Sancho’s use of music as a means of calling attention to the prejudices of white British society.

Anesthetic Implications of Previously Undiagnosed Temporomandibular Joint Ankylosis: A Case Report

Abstract: Temporomandibular joint (TMJ) ankylosis is characterized by bony fusion that limits TMJ mobility. We present the case of an elderly woman who was brought to the operating room for dental rehabilitation under general anesthesia. The patient had an undiagnosed TMJ ankylosis, which was discovered only after induction of anesthesia due to her nonverbal status and advanced dementia. The surgical team canceled the case due to limited access to the surgical field. We discuss the factors that suggest TMJ ankylosis and propose the perioperative management when TMJ ankylosis is suspected but unconfirmed.

Evaluation of levetiracetam for early post-traumatic seizure prophylaxis: A level II trauma center experience

Abstract: Traumatic brain injury (TBI) can induce early or late post-traumatic seizures (PTS). While PTS incidence is low, prophylaxis is used despite a lack of consensus on agent or duration. Levetiracetam (LEV) for early PTS prophylaxis is preferred due to its safety and efficacy. The purpose of this study was to evaluate LEV for early PTS prophylaxis. A single-center, retrospective chart review of TBI patients ≥18 years who received LEV for early PTS prophylaxis between August 2018–July 2019. The primary outcome was LEV duration. Secondary outcomes were incidence of seizure, intensive care unit (ICU) and hospital length of stay (LOS). Of the 137 included, mean age was 59 ± 20 years and 69.3% were male. The mean admission GCS was 13 ± 4 and 77.4% had mild TBI. Median LEV duration was 7 (IQR 4–10) days and 13.9% met recommended 7-day duration. Those prescribed LEV >7 days had more than twice the median LEV duration than those prescribed ≤7 days [10.25 (8.5–15.5) vs 4 (1.5–4.5) days, p < 0.0001]. Electroencephalography-confirmed PTS occurred in 2.2%, with an early PTS incidence of 0.73%. Median ICU and hospital LOS were 2 (IQR 1–7) and 7 (IQR 3–16) days, respectively. The incidence of PTS was low as most patients in our study had mild or moderate TBI. Early PTS prophylaxis with LEV for 7 days is appropriate, although the majority of patients did not meet the recommended duration. Efforts to standardize and implement PTS prophylaxis protocols are needed.