bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex Differences in the Association of E-cigarette and Cigarette Use and Dual Use With Self-Reported Hypertension Incidence in US Adults
Authors: Shi Hangchuan , Leventhal Adam M , Wen Qiang , Ossip Deborah J , Li Dongmei
Published: July 2022

Background

While there is some evidence and conceptual plausibility that tobacco product use is associated with hypertension incidence and that this association varies by sex, extant longitudinal research had been conducted prior to the emergence of e-cigarette and dual e-cigarette and cigarette use.

Aims and Methods

Data were analyzed from the US Population Assessment of Tobacco and Health study for adults with no lifetime history of hypertension at wave 1 (2013–2014) who completed waves 2–4 follow-up surveys (2014–2018; n = 16 434). Sex-stratified weighted covariate-adjusted multivariable Cox regression models were used to examine the association between established current e-cigarette or cigarette exclusive or dual-use (as a time-varying and time-lagged regressor) and subsequent self-reported hypertension onset.

Results

Weighted cumulative hypertension incidence by wave 4 varied by waves 1–3 e-cigarette, cigarette, and dual use status in females (nonuse [incidence: 9.9%], exclusive e-cigarette use [11.8%], exclusive cigarette use [14.8%], dual-use [12.4%]; p = .003 for omnibus differences among all groups) but not males (nonuse [12.6%], exclusive e-cigarette use [9.7%], exclusive cigarette use [13.7%], dual-use [9.3%]; p = .231). Among females, exclusive cigarette (vs. no) use (hazard ratio: 1.69, 95%CI 1.21 to 2.34; p = .002), but not exclusive e-cigarette or dual-use, was significantly associated with subsequent hypertension. Dose–response models were suggestive that consistent exclusive e-cigarette or dual-use versus nonuse across multiple may be associated with hypertension among females, but results were nonsignificant.

Conclusions

The association of e-cigarette, cigarette, and dual use with hypertension may differ by sex, whereby exclusive cigarette use could be a prospective risk factor for subsequent self-reported hypertension in US adult females.

Implications

This nationally representative cohort study provides the very first evidence of whether there are prospective associations of established e-cigarette and cigarette use and dual use with future hypertension onset among US adult females and males. We found that exclusive cigarette smoking was associated with an increased risk of incident hypertension among females, but not males. We observed a trend of a dose–response relationship between e-cigarette use and risk of incident hypertension among female exclusive e-cigarette users or dual e-cigarette and cigarette users. Our study will contribute to understanding the chronic health risks of vaping to prevent the potential long-term e-cigarette use-related health burden.
Association Between Geriatric Assessment and Post-Chemotherapy Functional Status in Older Patients with Cancer
Authors: Rier Hánah N , Meinardi Marieke C , van Rosmalen Joost , Westerweel Peter E , de Jongh Eva , Kitzen Jos J E M , van den Bosch Joan , Trajkovic Marija , Levin Mark-David
Published: July 2022

Background

Maintaining functional status is among the most important patient-centered outcomes for older adults with cancer. This study investigated the association between comprehensive geriatric assessment (CGA) and progressive disease or decline of IADL-independence 1 year after chemotherapy, overall survival (OS), and premature termination of chemotherapy. CGA-based functional status and quality of life (QOL) 1 year after chemotherapy are also described.

Methods

This prospective cohort study involved patients aged ≥65 years treated with chemotherapy for any cancer type. CGA and the G8-screening tool were performed before and after the completion of chemotherapy. Analyses were adjusted for tumor type and treatment intent: (a) indolent hematological malignancies, (b) aggressive hematological malignancies, c) solid malignancies treated with curative intent, and (d) solid malignancies treated with palliative intent.

Results

All 291 included patients lived in The Netherlands; 193 (67.4%) lived fully independent prior to chemotherapy. The median age was 72 years; 164 (56.4%) were male. IADL independence, CGA-based functional status, and QOL were maintained in half of the patients 1 year after chemotherapy. An abnormal G8-score before chemotherapy was a higher risk for progressive disease or a decline of IADL-independence (OR 3.60, 95% CI, 1.98-6.54, P < .0001), prematurely terminated chemotherapy (OR 2.12, 95% CI, 1.24-3.65, P = .006), and shorter median OS (HR 1.71, 95% CI, 1.16-2.52, P = .007). The impact of an abnormal G8-score differed across tumor type (oncological or hematological) and treatment indication (adjuvant or palliative).

Conclusion

An abnormal G8 score before chemotherapy is associated with progressive disease and functional decline after chemotherapy and shorter median OS, especially in patients with solid malignancies.
Parasitic plant small RNA analyses unveil parasite-specific signatures of microRNA retention, loss, and gain
Authors: Zangishei Zahra , Annacondia Maria Luz , Gundlach Heidrun , Didriksen Alena , Bruckmüller Julien , Salari Hooman , Krause Kirsten , Martinez German
Published: July 2022

Parasitism is a successful life strategy that has evolved independently in several families of vascular plants. The genera Cuscuta and Orobanche represent examples of the two profoundly different groups of parasites: one parasitizing host shoots and the other infecting host roots. In this study, we sequenced and described the overall repertoire of small RNAs from Cuscuta campestris and Orobanche aegyptiaca. We showed that C. campestris contains a number of novel microRNAs (miRNAs) in addition to a conspicuous retention of miRNAs that are typically lacking in other Solanales, while several typically conserved miRNAs seem to have become obsolete in the parasite. One new miRNA appears to be derived from a horizontal gene transfer event. The exploratory analysis of the miRNA population (exploratory due to the absence of a full genomic sequence for reference) from the root parasitic O. aegyptiaca also revealed a loss of a number of miRNAs compared to photosynthetic species from the same order. In summary, our study shows partly similar evolutionary signatures in the RNA silencing machinery in both parasites. Our data bear proof for the dynamism of this regulatory mechanism in parasitic plants.
Assessment of Neutron HP(10) Using Workplace Correction Factors Obtained Through Monte Carlo Simulation for Alnor Albedo Dosemeter
Authors: Ferreira Max S , Silva Everton R , Mauricio Claudia L P
Published: July 2022

Albedo dosemeters for neutron individual monitoring are used worldwide and their response to the same dose can vary by more than one order of magnitude, depending on the neutron workplace spectrum. Two-component albedo dosemeters use two pairs of TLDs, one pair to measure incident neutrons (i) and another to measure albedo neutrons (a), used to corrections to the neutron HP(10). A Workplace Correction Factor (WCF) as a function of the i/a ratio can be plotted from experimental or simulated measurements. This paper uses a Monte Carlo MCNPX simulation of the Alnor albedo dosemeter response to plot WCF × i/a curves for several neutron fields. Experimental results were used to validate the simulation. The use of the proposed curves to calculate WCF can reduce the inaccuracies of the neutron dose assessment for different neutron fields of several facilities. However, it is necessary to be careful with the uncertainties of the i/a values.
Direct TLR2 Signaling Through mTOR and TBK1 Induces C/EBPβ and IRF7-Dependent Macrophage Differentiation in Hematopoietic Stem and Progenitor Cells
Authors: Bono Cristina , Guerrero Paula , Erades Ana , Jordán-Pla Antonio , Yáñez Alberto , Gil María Luisa
Published: July 2022

During an infection, hematopoiesis is altered to increase the output of mature myeloid cells to fight off the pathogen. Despite convincing evidence that hematopoietic stem and progenitor cells (HSPCs) can sense pathogens directly, more mechanistic studies are needed to reveal whether pattern recognition receptor (PRR) signaling initiates myeloid development directly, or indirectly through the production of cytokines by HSPCs that can act in an autocrine/paracrine manner, or by a combination of both direct and indirect mechanisms. In this study, we have used an in vitro model of murine HSPCs to study myeloid differentiation in response to the TLR2 ligand Pam3CSK4 and showed that, besides indirect mechanisms, TLR2 stimulation of HSPCs promotes myelopoiesis directly by initiating a MyD88-dependent signaling. This direct differentiation program involves a combined activation of the transcription factors PU.1, C/EBPβ, and IRF7 driven by TBK1 and PI3K/mTOR. Notably, downstream of MyD88, the activated TBK1 kinase can activate mTOR directly and IRF7 induction is mediated by both TBK1 and mTOR. TLR2 signaling also induces NF-κB dependent IL-6 production that may further induce indirect myeloid differentiation. Our results have identified the direct signaling pathways and the transcription factors involved in macrophage development from HSPCs in response to TLR2 engagement, a critical process to trigger a rapid immune response during infection.
Fossils Do Not Substantially Improve, and May Even Harm, Estimates of Diversification Rate Heterogeneity
Authors: Beaulieu Jeremy M , O’Meara Brian C
Published: July 2022

The fossilized birth–death (FBD) model is a naturally appealing way of directly incorporating fossil information when estimating diversification rates. However, an important yet often overlooked property of the original FBD derivation is that it distinguishes between two types of sampled lineages. Here, we first discuss and demonstrate the impact of severely undersampling, and even not including fossils that represent samples of lineages that also had sampled descendants. We then explore the benefits of including fossils, generally, by implementing and then testing two types of FBD models, including one that converts a fossil set into stratigraphic ranges, in more complex likelihood-based models that assume multiple rate classes across the tree. Under various simulation scenarios, including a scenario that exists far outside the set of models we evaluated, including fossils rarely outperform analyses that exclude them altogether. At best, the inclusion of fossils improves precision but does not influence bias. Similarly, we found that converting the fossil set to stratigraphic ranges, which is one way to remedy the effects of undercounting the number of k-type fossils, results in turnover rates and extinction fraction estimates that are generally underestimated. Although fossils remain essential for understanding diversification through time, in the specific case of understanding diversification given an existing, largely modern tree, they are not especially beneficial. [Fossilized birth–death; fossils; MiSSE; state speciation extinction; stratigraphic ranges; turnover rate.]
12Postcolonial Theory
Authors: Rask Knudsen Eva , Rahbek Ulla
Published: July 2022

This chapter covers selected research in postcolonial theory published in 2021. It begins with a discussion of how postcolonial theory can be said to take a local turn with reference to a volume that treats the phenomenon of BrexLit, before focusing on two texts that take postcolonial theory into the arena of the social sciences. The chapter then reviews a book that parses how postcolonial theory is embroiled in matters ideological before ending with a discussion of a text that provides an alternative history of gender and sexualities. The varied work discussed in this chapter demonstrates how postcolonial theory remains a productive resource in attempts to revitalize already established fields of study and, by extension, that postcolonial theory continues to hold critical and explanatory traction. The essay is divided into five sub-sections: 1. Introduction; 2. BrexLit; 3. The Social Sciences; 4. Ideology; 5. Sexualities.
Incorporating Music-Listening Interventions into Clinical Nursing Practice
Authors: Kiernan Jason Micheal
Published: July 2022

A call to expand the study and use of this effective adjunct therapy.
Medicare Advantage Plans: Popular but Controversial
Authors: Seegert Liz
Published: July 2022

Are they gaming the system or providing value for enrollees?
A Tai Chi for Arthritis and Fall Prevention Program for Older Adults During COVID-19
Authors: Lee Kathleen , Galet Colette , Lilienthal Michele , Skeete Dionne
Published: July 2022

To minimize COVID-19 transmission, the University of Iowa suspended all in-person fall injury prevention programs in March 2020. However, falls continued to be the leading cause of injury-related mortality in Iowa; therefore, the university converted its in-person Tai Chi for Arthritis and Fall Prevention (TCAFP) program to a virtual program. Here, the authors describe the virtual TCAFP program and participants' overall experience. Among 83 older adults who participated in the first three virtual programs, 61 (73.5%) completed the programs. Of the 31 (37.3%) participants who filled out the postprogram satisfaction surveys, 30 (96.8%) found the Zoom platform easy to use and said the program met their expectations, 28 (90.3%) were happy with the quality of the instruction, and 29 (93.5%) said they learned the tai chi forms taught during the program and used an online video to practice between classes. Judging by the largely positive participant feedback, the authors considered the implementation of a virtual TCAFP program a success. The potential for the use of such a program beyond the pandemic to improve injury prevention efforts in rural environments warrants further exploration.
Global Health and Nursing Advocacy
Authors: Shimek Aric , Branden Pennie Sessler , Clary-Muronda Valerie , Hawkins Janice , Mousa Dania Itani
Published: July 2022

Editor's note: The Sigma Theta Tau International Honor Society of Nursing is a global organization focused on leadership and scholarship, with more than 135,000 members from more than 100 countries. This second article in a series highlights the work of Sigma's representatives at the United Nations and their perspectives on advocating for global health and nursing leadership.
A Conversation with Teresa Gray
Authors: Fauteux Nicole
Published: July 2022

This nurse is on an international mission to fill gaps in medical care.
To Care When There Isn't Enough
Authors: Stoltzfus Alison
Published: July 2022

At a refugee camp, reaching out a hand, one life at a time.
Increasing Attendance in Addiction Treatment With Limited Resources: A Narrative Review
Authors: Rubenis Adam James , Nation Jennifer A. , Katz Elizabeth C. , Arunogiri Shalini
Published: July 2022

Treatment nonattendance frequently compromises client outcomes in psychosocial addiction treatment services. However, there is limited literature on strategies that increase attendance and retention without a significant resource burden on clinician or organization. This review of 13 studies describes strategies that do not financially reward clients for attendance or require more than 1 day of training/supervision to implement. These strategies are as follows: role induction; pretreatment written or verbal contact; short message service and telephone reminders; and contracting, prompting, and reinforcement. There is some evidence that role induction strategies can increase attendance in early treatment, with stronger evidence for a more intensive approach. Short message service and telephone reminders show a consistent positive impact on early attendance, although the relationship may weaken over time and for individuals with more complex needs (ie, high impulsivity). The strategy: contracting, prompting, and reinforcement shows promising findings, particularly in the first 3 months of treatment. There is considerable variability in study designs, interventions, and sample sizes—future research should more precisely identify relationships between outcomes and the “active ingredients” in each strategy. However, preliminary evidence suggests that some low clinician/organization-burden strategies increase treatment attendance and retention. The mechanisms underpinning these strategies may overlap with therapeutic engagement theories (eg, outcome expectations, common-factors model). Although these interventions have small to moderate effect sizes, their relative simplicity and low cost increase the likelihood of being implemented at a broad scale, amplifying their benefits.
Roe v Wade and the Threat to Fertility Care
Authors: Feinberg Eve C. , Kawwass Jennifer F. , Cedars Marcelle I.
Published: July 2022

On June 24, 2022, the U.S. Supreme Court ruling in Dobbs v Jackson Women's Health overturned Roe v Wade, and authority to regulate abortion was returned to individual states. It is critically important for all physicians to understand the implications that this ruling may have on reproductive autonomy with regard to abortion care and in vitro fertilization (IVF). Although the intended consequence of abortion bans is to prohibit legal abortion, one unintended consequence may be undue restriction of in vitro fertilization. We summarize the potential of abortion bans, particularly those with personhood clauses, to affect IVF practice. We detail the implications of these bans on embryo cryopreservation, preimplantation genetic testing, single embryo transfer, and access to infertility treatments. In the United States in 2019, nearly 84,000 children were born as a result of IVF (2.2% of all births), and nearly 250,000 IVF cycles were performed. These bans will have a profound effect beyond abortion, and these implications are not widely understood in the medical community.
Perioperative Practices in Dermatologic Surgery
Authors: Erickson Stephen P. , Schneider Samantha L. , Cohen Joel L. , Alam Murad , Council Martha Laurin
Published: July 2022

BACKGROUND

Mohs micrographic surgery is generally safe and well tolerated. Various perioperative practices are employed with the aim of reducing adverse events; however, implementation is variable, and limited efficacy data are available.

OBJECTIVE

This study sought to assess perioperative practice patterns among dermatologic surgeons with regards to antibiotic prophylaxis (AP), anticoagulation, activity restrictions, and antiseptic choice.

METHODS AND MATERIALS

Two surveys were distributed by the American College of Mohs Surgery (ACMS) and the American Society for Mohs Surgery (ASMS) to their membership via email.

RESULTS

One hundres seventy-seven surgeons participated, with membership from ACMS (61%), ASMS (35%), or both organizations (4%) represented. Systemic AP is prescribed preoperatively by 96% (162/168) and postoperatively by 91% (161/177) of surgeons for variable clinical indications. Therapeutic antiplatelet and anticoagulant medications are rarely held (3%–5%, 4–7/149), whereas preventative aspirin (30%, 45/149), NSAIDs (25%, 36/145), and supplements known to have an anticoagulant effect (54%, 80/149) are more commonly held. Antiseptic choice and recommended activity restrictions vary.

CONCLUSION

Perioperative practices of dermatologic surgeons are variable and, where applicable, may deviate from guidelines. These findings underscore the need for standardization and updated guidelines for perioperative practices in dermatologic surgery.
Impact of personality on the decision process and on satisfaction rates in pseudophakic presbyopic correction
Authors: Ntonti Panagiota , Bakirtzis Minas , Delibasis Konstantinos , Seimenis Ioannis , Tsinopoulos Ioannis , Labiris Georgios
Published: July 2022

Purpose:

To explore the impact of personality on the decision process and satisfaction rates in pseudophakic presbyopic correction.

Setting:

Department of Ophthalmology, University Hospital of Alexandroupolis, Greece.

Design:

Prospective, comparative study.

Methods:

A consistent consultation was conducted in patients with cataract that explained the benefits and the drawbacks of bilateral trifocal correction, which was offered at no extra cost. In all participants, personality was evaluated by The Traits Personality Questionnaire 5. Data modeling with decision trees and multiple regression analysis identified the contributions of personality traits to the decision process and postoperative satisfaction.

Results:

Of 120 participants (60 men and 60 women), 81 (67.5%, 24 men, 57 women) selected premium correction. In men, low neuroticism and high extraversion were the primary personality contributors for selecting premium surgery. In women, all personality traits contributed to the selection process. Women were more demanding in the expected postoperative distant acuity than men (0.1 vs 0.2 logMAR) to present high satisfaction. For both men and women, openness to experience, conscientiousness, and extraversion are primary contributors for optimal satisfaction rates.

Conclusions:

Men and women demonstrate differences in the selection process for premium pseudophakic surgery and differences in the expected postoperative visual acuity. It seems that the personality of the patient plays a significant role in the perceived outcome after premium surgery.
COMPARISON OF POST CATARACT SURGERY ANTI-INFLAMMATORY REGIMENS ON THE INCIDENCE OF CYSTOID MACULAR EDEMA, IRITIS, PAIN, AND PHOTOPHOBIA
Authors: Visco Denise M.
Published: July 2022

Purpose:

To compare post-cataract surgery anti-inflammatory regimens of intracanalicular dexamethasone insert and topical bromfenac on the incidence of cystoid macular edema (CME), iritis, pain, and photophobia.

Setting:

Eyes of York Cataract & Laser Center, York, PA, USA.

Design:

Retrospective chart review.

Methods:

Case records of 647 consecutive patients (1001 eyes) who underwent cataract surgery and received dexamethasone intracanalicular insert 0.4 mg (group 1; 482 eyes) or topical non-steroidal anti-inflammatory drug (NSAID) (bromfenac 0.075% BID) for four weeks postoperatively (group 2; 519 eyes) were included. Both groups received intracameral moxifloxacin and phenylephrine/ketorolac. Patients with prior CME, vitreomacular traction, combined cataract/glaucoma surgery, and medication protocols different from those examined in this study were excluded.

Results:

Compared with the dexamethasone insert group, the topical NSAIDs group had significantly lower incidence of CME (0.4% (2/519) vs 3.9% (19/482), P<.001) and photophobia (1.9% (10/519) vs 4.8% (23/482), P=0.012). The incidence of breakthrough iritis (3.5% (18/519) vs 5.6% (27/482), P=0.104) and pain also trended lower (4.0% (21/519) vs 5.4% (26/482), P=0.314) in the topical NSAID group.

Conclusion:

Topical NSAIDs were found to be more effective in controlling CME, pain, iritis, and photophobia after cataract surgery compared with the intracanalicular dexamethasone insert in the presence of intracameral phenylephrine/ketorolac.
Examining Stigma and Disclosure Among Women With HIV in the Southern United States: Qualitative Study Guided by the Adaptive Leadership Framework for Chronic Illness
Authors: McMillian-Bohler Jacquelyn M. , Holt Lauren , Adimora Adaora A. , Bailey Donald “Chip” E. , Johnson Ragan , Koch Amie , McGee Kara , Ramirez Catalina , Randolph Schenita D. , Ritchwood Tiarney D. , Relf Michael V.
Published: July 2022

Stigma is a fundamental cause of health inequities. Guided by the Adaptive Leadership Framework for Chronic Illness (ALFCI), this descriptive qualitative study explored the challenges of stigma and disclosure experienced by women with HIV (WWH) in the Southern United States. A convenience sample of 22 WWH aged 36 to 62 years were interviewed for this study. Analysis of participant interviews revealed that WWH face a multitude of stigma-related technical and adaptive challenges, which are consistent with the ALFCI. Once identified, technical challenges, such as recognizing the need for support, lack of trust, and fear of rejection, can be overcome by technical work, including providing assistance with HIV disclosure and building a trusted network. By identifying specific adaptive and technical challenges faced by WWH and engaging in technical and adaptive work, the WWH and the provider can reduce the fear of disclosure and the effect of stigma.
Trends in Mortality and Health Care Burden of Cirrhotic Decompensation in Hospitalized Patients
Authors: Afridi Faiz , Mittal Anmol , Pyrsopoulos Nikolaos
Published: July 2022

Introduction:

Mortality caused by cirrhosis is now the 14th most common cause of death worldwide and 12th most common in the United States. We studied trends in inpatient mortality and hospitalization charges associated with cirrhotic decompensation from esophageal variceal bleeding, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, and hepatorenal syndrome from 2007 to 2017.

Materials and Methods:

Using the National Inpatient Sample databases, we first isolated patients 18 years or older with the diagnosis of cirrhosis using International Classification of Diseases, Ninth Revision (ICD-9) or International Classification of Diseases, Tenth Revision (ICD-10) codes. We then identified patients with the admission diagnosis of esophageal variceal bleeding, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, and hepatorenal syndrome. Time-series regression was used to determine whether a trend occurred over the study period. We also evaluated for patient-related demographic changes over the study period.

Results:

A total of 259,897 cirrhotic patients with the studied decompensations were captured. During the study period, time-series regression confirmed downtrends in mortality rates and length of stay for all types of decompensations. Conversely, we found increases in hospitalization charges for all types of decompensations. Patient age increased over the study period. Patients were also more likely to be White and pay with.

Conclusion:

From 2007 to 2017, inpatient mortality rates and lengths of stay decreased for cirrhotic decompensations for all causes of decompensation. Total charges, conversely, increased for all causes.
“The effect of breast reconstruction on kinematics and performance during upper limb-focused functional tasks”
Authors: Lang Angelica E. , Card Annika , Barden John , Kim Soo Y.
Published: July 2022

Background:

Breast reconstruction after curative breast cancer surgery is becoming increasingly common. There is evidence to suggest that these surgeries have negative effects on shoulder function, but to date there are no investigations of shoulder biomechanics during functional tasks in this group. The purpose of this study was to define and compare upper limb motion of breast cancer survivors (mastectomy-only or mastectomy + reconstruction) to a non-cancer control group during a range of work-related functional tasks.

Methods:

Ninety-five women participated: 25 controls, 25 mastectomy-only breast cancer survivors and 45 mastectomy + reconstruction (implant, latissimus dorsi flap, or DIEP) breast cancer survivors. Motion of the torso, humeri and scapulae were tracked during arm-focused functional tasks, involving reaching, dexterity, and lifting overhead, and joint angles were calculated. Mean, maximum, and minimum angles were calculated and compared between groups using one-way ANOVAs (p<.05).

Results:

The reconstruction group had significantly different kinematics than the other two groups. Throughout task performance, post-reconstruction survivors had increased scapular posterior tilt and increased humeral external rotation. These findings are consistent with reconstruction surgical procedures and may highlight muscle pattern alterations that interfere with co-contraction, stability, and functional task performance.

Conclusions:

Findings suggest that breast reconstruction surgery influences functional task performance. Scapular and humeral kinematics may indicate movement pattern differences that are important to address in rehabilitation.
The Superficial Vein Only (SVO)-DIEP Flap
Authors: Nigro Lauren , Shankaran Vidya , Miller Payton , Chang Bernard
Published: July 2022

Background:

The deep inferior epigastric artery perforator (DIEP) flap, often considered the gold standard in autologous breast reconstruction, is reliant on robust arterial inflow and venous outflow. Venous outflow issues remain a critical part in determining the success of the DIEP flap. Previously, the superficial inferior epigastric vein (SIEV) has been used to augment venous outflow, or as a salvage option when flow through the deep inferior epigastric vein is compromised or insufficient. We describe a variant of the DIEP flap, the superficial vein only (SVO)-DIEP, utilizing the deep inferior epigastric artery (DIEA) and the SIEV as a viable alternative when indicated.

Methods:

We conducted a retrospective review of all patients undergoing autologous breast reconstruction by the senior author from July 2015 - March 2020 to identify DIEP flaps whose only source of venous outflow was the SIEV, excluding those performed as a salvage maneuver.

Results:

We identified 30 patients (35 flaps) and describe their characteristics, flap characteristics, complications, and details of the flap harvest. Notably, we experienced complications in 26.7% of flaps, of which 62.5% were minor, and no flap loss. This was comparable to the complication rate observed in the standard DIEP flap population.

Conclusion:

We believe the SVO-DIEP flap is an excellent option for the appropriate patient. It is an added tool to make abdominal-based breast reconstruction more reliable and successful. The use of the SIEV in an SVO flap should be considered as part of any routine DIEP flap reconstruction.
“Breast Resection Weight Prediction and Insurance Reimbursement in Reduction Mammoplasty: Which Scale is Reliable?”
Authors: Yan Maria , Bustos Samyd S. , Kuruoglu Doga , Manrique Oscar J. , Tran Nho V. , Sharaf Basel A. , Harless Christin A. , Martinez-Jorge Jorys , Forte Antonio J. , Nguyen Minh-Doan T.
Published: July 2022

Background:

Many insurance companies in the United States rely on the Schnur Sliding Scale to predict resection weights to determine medical necessity for breast reduction surgery. Accurate methods to predict resection weights are needed to avoid insurance denials. Our aim is to compare the accuracy of formulas such as Schnur, Appel, Descamps and Galveston in predicting resection weights, and to assess if it influences insurance coverage decision.

Methods:

A retrospective review of bilateral reduction mammoplasty procedures from June 2017-June 2019 was performed at Mayo Clinic, Rochester. Oncoplastic reduction surgeries were excluded. The accuracy of each formula-based estimate was evaluated with linear regression analysis.

Results:

154 patients (308 breasts) were reviewed. The Schnur had low correlation with actual resection weight (r2=0.381, b1=1.153, p<0.001). Appel was the most accurate (r2=0.642, b1=1.01, p<0.001), followed by Descamps (r2=0.572, b1=0.934, p<0.001) and Galveston (r2=0.672, b1=0.654, p<0.001) scales. Appel, Descamps and Galveston were more accurate for resection weights≥500g, BMI>30kg/m² and patients<50 years of age. For resection weights ≥500g, the median difference between the estimated and actual resection weight for Schnur, Appel, Descamps and Galveston were -211.4g ±272.3, -17.5g ±272.3, -9.6g ±229.5 and -99.2g ±238.5, respectively. None of the scales were accurate for resection weights <500g. Insurance reimbursement was denied in 15.56% patients, of these, 23% had resection weights<500g. The Schnur overestimated the resection weights in 28.9% of patients.

Conclusion:

The Schnur scale is a poor predictor of breast resection weight. Appel is the most accurate estimator, especially in the young and obese population with larger resections.
Drug discovery and potential gene and pathway associated with polycystic ovary syndrome through text mining and biomedical databases
Authors: Wang Yan , Zhao Bin , Yuan Xiao-Jing
Published: July 2022

Objectives:

Polycystic ovary syndrome (PCOS) is a common endocrine disease in women of childbearing age. Although it is a leading cause of menstrual disorders, infertility, obesity, and other diseases, its molecular mechanism remains unclear. This study aimed to analyze the target genes, pathways, and potential drugs for PCOS through text mining.

Methods:

First, three different keywords (“polycystic ovary syndrome”, “obesity/adiposis”, and “anovulation”) were uploaded to GenCLiP3 to obtain three different gene sets. We then chose the common genes among these gene sets. Second, we performed gene ontology and signal pathway enrichment analyses of these common genes, followed by protein–protein interaction (PPI) network analysis. Third, the most significant gene module clustered in the protein–protein network was selected to identify potential drugs for PCOS via gene–drug analysis.

Results:

A total of 4291 genes related to three different keywords were obtained through text mining, 72 common genes were filtered among the three gene sets, and 69 genes participated in PPI network construction, of which 23 genes were clustered in the gene modules. Finally, six of the 23 genes were targeted by 30 existing drugs.

Conclusions:

The discovery of the six genes (CYP19A1, ESR1, IGF1R, PGR, PTGS2, and VEGFA) and 30 targeted drugs, which are associated with ovarian steroidogenesis (P <0.001), may be used in potential therapeutic strategies for PCOS.
Association of Patient Factors and Follow-Up in an International Volunteer Cleft Lip and Palate Repair Clinic in El Salvador
Authors: Van Swol Joshua M. , Wolf Bethany J. , Annan Nur B. , Hamdan Usama S. , Patel Krishna G.
Published: July 2022

Background:

In countries which lack robust health care systems, congenital conditions such as cleft lip and/or palate deformities are often untreated in certain individuals. Many volunteer organizations have stepped in to fill this gap but certain factors, such as continuity of care, are yet to be studied for these clinics.

Methods:

This is a retrospective cohort study of 167 pediatric patients with cleft lip and/or palate residing in El Salvador treated by a nongovernmental organizations between 2011 and 2020. This data was used in univariate and multivariable models to associate particular patient factors to their likelihood of following up to their annual clinic visits.

Results:

Each 1-year increase in duration of follow-up was associated with a 27% decrease in the odds of attending a visit. In addition, 33.7% of cleft lip and 49.7% of cleft palate/cleft lip and palate patients returned at least once. Males had 36% higher odds of attending a return visit compared with females but this difference was not statistically significant. Time spent travelling to the clinic had no effect on follow-up rates.

Conclusion:

Nongovernmental organizations utilizing a diagonal care model should consider using more strategies to maximize continuity of care by increasing communication with patients and emphasizing the need of following up during clinic visits. Continued and increased collaboration with the local team is also of great importance.
Nonpharmacological approaches for improving gut resilience to chemotherapy
Authors: Bullard Brooke M. , McDonald Sierra J. , Cardaci Thomas D. , VanderVeen Brandon N. , Murphy E. Angela
Published: July 2022

Purpose of review

Mucositis of the gastrointestinal tract is a debilitating side effect of chemotherapy that negatively influences treatment tolerance and patient life quality. This review will evaluate the recent literature on nonpharmacological strategies that have the potential to improve chemotherapy-induced mucositis (CIM).

Recent findings

Alternatives to pharmacological approaches have shown great promise in preventing CIM. Natural products, including curcumin, ginseng, quercetin, and patchouli all show potential in mitigating CIM. In addition, dietary patterns, such as the elemental diet, high fiber diet, and diets high in amino acids have documented benefits in preventing CIM. Perhaps the greatest advancement coming to this arena in recent years is in the field of probiotics. Indeed, research on single species as well as probiotic mixtures show potential in reducing CIM insofar as probiotics are now being suggested for treatment of CIM by governing bodies. Although behavioral interventions including psychological interventions and exercise interventions have shown promise in reducing cancer therapy-related side effects, more work in this domain is warranted and particularly in the context of CIM.

Alternatives to pharmacological approaches show great potential for use in prevention and treatment of CIM and should be further developed for use in the clinic.
COVID-19 could cause long term peripheral nerve demyelination and axonal loss: A One Year Prospective Cohort Study
Authors: Yang Qian , Zhang Meng , Lai Yanhui , Liu Xuzhao , Liu Fengshuang , Zang Hongmin , Song Jinzhong , Li Na , Cui Shuhua , Shao Wei , Ma Jiang , Wang Zhibo , Cui Ling , Sun Feng , Zhao Yubin
Published: July 2022

Background

There is a lack of studies on large-sample, medium-, or long-term follow-up data of peripheral neuropathy (PNP) in the COVID-19 survivors. This study evaluated the characteristics and related risk factors of PNP in the medium- and long-term rehabilitation, which provided real-world study data for the complete recovery of COVID-19 patients.

Methods

This study was a prospective cohort study of the COVID-19 survivors. We collected data on baseline characteristics, symptoms at onset and after discharge during the 6-month and 12-month follow-up. Peripheral nerves were measured by electromyography and inducible potentiometer. We used multivariable logistic regression to analyze the influencing factors of PNP. Additionally, we compared the difference between the two measurements among the population who completed both measurements.

Results

313 patients were included in the study and all of them underwent nerve conduction study. 67 patients completed two measurements at 6-month and 12-month follow-up. Commonly reported symptoms contained memory loss (86%), hair loss (28%), anxiety (24%), and sleep difficulties (24%). 232 patients (74%) were found with PNP, including 51 (16%) with mononeuropathy and 181 (58%) with generalized PNP. Patients with measurement at 12-month follow-up had a higher prevalence of generalized PNP (p=0.006). For pathological types, 64 (20%) patients had only axonal loss, 67 (21%) had only demyelination, and 101 (32%) had a mixed type. There was no significant difference in the prevalence of accompanying symptoms after discharge between the two groups with or without PNP. After adjustment, age was positively associated with PNP (OR=1.22 per 10-year increase of age, 95% CI, 1.05-1.41). Compared with less than the median amount of IgG at discharge, higher amount of IgG was associated with decreased risk of F-wave abnormality (OR=0.32, 95%CI, 0.11-0.82), but no significant difference in other types of PNP.

Conclusions and Relevance

SARS-CoV-2 could cause PNP in hospital survivors with COVID-19, which persisted and was associated with age, education, and IgG antibody at discharge, but had no significant correlation with symptoms after discharge.
MiniVess: A dataset of rodent cerebrovasculature from in vivo multiphoton fluorescence microscopy imaging
Authors: Poon Charissa , Teikari Petteri , Rachmadi Muhammad Febrian , Skibbe Henrik , Hynynen Kullervo
Published: July 2022

We present MiniVess, the first annotated dataset of rodent cerebrovasculature, acquired using two-photon fluorescence microscopy. MiniVess consists of 70 3D image volumes with segmented ground truths. Segmentations were created using traditional image processing operations, a U-Net, and manual proofreading. Code for image preprocessing steps and the U-Net are provided. Supervised machine learning methods have been widely used for automated image processing of biomedical images. While much emphasis has been placed on the development of new network architectures and loss functions, there has been an increased emphasis on the need for publicly available annotated, or segmented, datasets. Annotated datasets are necessary during model training and validation. In particular, datasets that are collected from different labs are necessary to test the generalizability of models. We hope this dataset will be helpful in testing the reliability of machine learning tools for analyzing biomedical images.
Single-cell level temporal profiling of tumour-reactive T cells under immune checkpoint blockade
Authors: Hassan Jehanne , Appleton Elizabeth , Kalfaoglu Bahire , Pedersen Malin , Almeida-Santos José , Kanemaru Hisashi , Irie Nobuko , Foo Shane , Reda Omnia , Tan Benjy J.Y. , Okazaki Il-mi , Okazaki Taku , Satou Yorifumi , Harrington Kevin , Melcher Alan , Ono Masahiro
Published: July 2022

The blockade of the immune checkpoints PD-1 and CTLA-4 enhances T cell response. However, it is largely unknown how antigen-reactive T cells regulate their checkpoint expression in vivo and whether and how the checkpoint blockade can change activation dynamics of tumour-reactive T cells. To address this, here we used Nr4a3-Timer-of-cell-kinetics-and-activity (Tocky), which allows analysis of temporal changes of activated T cells following TCR signalling in vivo. By analysing melanoma-bearing Nr4a3 Tocky mice, we elucidate hidden dynamics of tumour-reactive T cells in the steady-state. Checkpoint blockade depleted highly activated effector Treg, while promoting unique effector T cell populations, and thus differentially modulating activation of tumour-reactive T cell populations. Furthermore, multidimensional analysis and seamless analysis of Tocky and scRNA-seq revealed a full spectrum of T cell dynamics in response to tumour burden and treatment with checkpoint blockade. Lastly, we propose a rational design of combinatorial therapy to further enhance T cell activities.
Prior-guided Individualized Thalamic Parcellation based on Local Diffusion Characteristics using Deep Learning
Authors: Gao Chaohong , Wu Xia , Wang Yaping , Li Gang , Chu Congying , Madsen Kristoffer Hougaard , Fan Lingzhong
Published: July 2022

As a gateway for projections entering and exiting the cerebral cortex, the human thalamus processes information from sensory to cognition relevant to various neuropsychiatric disorders. It is composed of dozens of nuclei, which have been difficult to identify with clinical MR sequences. However, delineating thalamic nuclei accurately at an individual level is essential for precise neuromodulation treatment. Here, we not only identified the fine-grained thalamic nuclei using local diffusion properties in vivo but also employed a deep learning strategy to achieve highly reproducible individual-level parcellation. Using High-quality diffusion MRI (dMRI), we first constructed a fine-grained group thalamus atlas based on thalamic local diffusion features. Then, the high-probability core area of the group thalamus atlas was wrapped into the native space as prior guidance for individualized thalamus construction. Finally, we trained the semi-supervised multiple classification models to accurately construct the individualized thalamus atlas with single-subject local diffusion characteristics. Compared to group atlas registration and single-subject clustering strategies, our individualized thalamus atlas combines population commonality and individual specificity and is superior in depicting the individual thalamic nuclei boundaries. Besides, our atlas provides a more conspicuous capacity to capture the individual specificity of thalamic nuclei. Through the evaluation by 3.0T\7.0T and test-retest dMRI datasets, the proposed high-probability group prior guided individualized thalamus construction pipeline is robust and repeatable in different magnetic field strengths and scanning batches. In addition, the individual parcellation of the thalamic nuclei has a good correspondence with the histological atlas and captured both higher group consistency and inter-subjects variations, which could be a valuable solution for precision clinical treatment.
Cross Atlas Remapping via Optimal Transport (CAROT): Creating connectomes for any atlas when raw data is not available
Authors: Dadashkarimi Javid , Karbasi Amin , Liang Qinghao , Rosenblatt Matthew , Noble Stephanie , Foster Maya , Rodriguez Raimundo , Adkinson Brendan , Ye Jean , Sun Huili , Camp Chris , Farruggia Michael , Tejavibulya Link , Dai Wei , Jiang Rongtao , Pollatou Angeliki , Scheinost Dustin
Published: July 2022

Open-source, publicly available neuroimaging datasets—whether from large-scale data collection efforts or pooled from multiple smaller studies—offer unprecedented sample sizes and promote generalization efforts. Releasing data can democratize science, increase the replicability of findings, and lead to discoveries. Due to patient privacy and data storage concerns, researchers typically release preprocessed data with the voxelwise time series parcellated into a map of predefined regions, known as an atlas. However, releasing preprocessed data also limits the choices available to the end-user. This is especially true for connectomics, as connectomes created from different atlases are not directly comparable. Since there exist several atlases with no gold standards, it is unrealistic to have processed, open-source data available from all atlases. Together, these limitations directly inhibit the potential benefits of open-source neuroimaging data. To address these limitations, we introduce Cross Atlas Remapping via Optimal Transport (CAROT) to find a mapping between two atlases. This approach allows data processed from one atlas to be directly transformed into a connectome based on another atlas without the need for raw data access. To validate CAROT, we compare reconstructed connectomes against their original counterparts (i.e., connectomes generated directly from an atlas), demonstrate the utility of transformed connectomes in downstream analyses, and show how a connectome-based predictive model can generalize to publicly available data that was processed with different atlases. Overall, CAROT can reconstruct connectomes from an extensive set of atlases—without ever needing the raw data—allowing already processed connectomes to be easily reused in a wide range of analyses while eliminating redundant processing efforts. We share this tool as both source code and as a stand-alone web application (http://carotproject.com/).
Towards Self-Describing and FAIR Bulk Formats for Biomedical Data
Authors: Lukowski Michael , Prokhorenkov Andrew , Grossman Robert L.
Published: July 2022

We introduce a self-describing serialized format for bulk biomedical data called the Portable Format for Biomedical (PFB) data. The Portable Format for Biomedical data is based upon Avro and encapsulates a data model, a data dictionary, the data itself, and pointers to third party controlled vocabularies. In general, each data element in the data dictionary is associated with a third party controlled vocabulary to make it easier for applications to harmonize two or more PFB files. We describe experimental studies showing the performance improvements when importing and exporting bulk biomedical data in the PFB format versus using JSON and SQL formats.