bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic Capability of Intra-Articular Injections for Femoroacetabular Impingement Syndrome: A Systematic Review
Authors: Fernandes Daniel Araujo , Martins Eduardo Campos , Melo Gilberto , Locks Renato , Adam Guilherme Pradi , Neves Fabrício Souza
Published: May 2024

Objective:

To review and critically appraise available literature concerning the diagnostic capability of intra-articular injections for femoroacetabular impingement (FAI) syndrome.

Design:

Systematic review.

Setting:

N/A.

Participants:

N/A.

Interventions:

N/A.

Main Outcome Measures:

Studies assessing pain relief following intra-articular injections for the diagnosis of FAI syndrome, compared with arthroscopy as diagnostic reference standard, were considered eligible. Searches were performed across 8 databases, and the risk of bias was evaluated through the Quality Assessment of Diagnostic Accuracy Studies tool.

Results:

From 489 articles identified, 4 were included for analysis. Intra-articular injections were composed of anesthetic agents (such as lidocaine, bupivacaine, and ropivacaine), combined or not with corticosteroids (triamcinolone and betamethasone). All studies were judged as “at risk of bias”, and a substantial heterogeneity was found considering assessment methods and pain relief thresholds for a positive response to intra-articular injections. Overall, 2 studies reported that intra-articular injections presented a high accuracy in determining the presence of FAI syndrome. However, the remaining 2 studies indicated that intra-articular injections might present restricted diagnostic capability to discriminate FAI syndrome from healthy individuals or those with other hip pathologies.

Conclusions:

Based on limited evidence, the diagnostic capability of intra-articular injections for FAI syndrome cannot be supported. It remains unclear which pain relief thresholds are related to a higher diagnostic capability. The combination of anesthetics with corticosteroids should also be further explored, including multiple pain assessments for evaluation of prolonged effects.
Lateral Epicondylalgia and Thoracic Kyphosis: A Study on Young Athletes
Authors: Šarčević Zoran , Stanković Milan , Tepavčević Andreja
Published: May 2024

Objective:

The etiology of lateral epicondylalgia (LE) remains unclear, although it has been linked to various factors. Recent theories suggest a potential connection between LE and impairments in the kinetic chain. In our study, we aimed to investigate the association between another factor influencing kinetic chain impairment, specifically an increased angle of thoracic kyphosis, and the presence of initial signs of LE in young athletes.

Design:

This study employed an observational, case–control design.

Setting:

The participants underwent examination during a routine preventive checkup conducted by a sports physician at Novi Sad Healthcare Center, Sports Medicine Center.

Participants:

One hundred young athletes aged 10 to 15 years were included in the study. Half of the participants reported pain in the lateral aspect of the elbow during maximal hand grip, while the remaining athletes served as controls and did not experience any pain.

Assessment of Independent Variables:

Thoracic kyphosis inclination angles were measured using a digital inclinometer.

Main Outcome Measures:

Pain was assessed using the pressure pain threshold at a specific point associated with lateral epicondylalgia, measured by a digital algometer.

Results:

Participants exhibiting initial signs of LE displayed significantly different angles of anteroposterior curvatures of the spine compared with the control group. Moreover, the angle of thoracic kyphosis was significantly associated with pain in the lateral aspect of the elbow.

Conclusions:

Our findings confirm an association between initial signs of lateral epicondylalgia and the grade of thoracic kyphosis in young athletes.
Popularizing Surgical Cures: Walter Dandy and the Vestibular Neurectomy for Menière's Disease at the Johns Hopkins Hospital
Authors: Perdomo Dianela , Ward Bryan K.
Published: May 2024

Objectives

To uncover the context that allowed for the vestibular neurectomy to grow in favor and practice at the Johns Hopkins Hospital in the early 20th century, and the reasons for its broad abandonment since.

Methods

The Walter E. Dandy (1905–1946) and Samuel J. Crowe collections (1905–1920) at the Alan Mason Chesney Medical Archives were reviewed, as well as the Samuel J. Crowe and Stacy Guild Temporal Bone Collection.

Results

Speculation on the etiology of Menière's disease (MD) has been countless, as have the medical and surgical interventions aimed at treating it. At the Johns Hopkins Hospital, Walter Dandy popularized the neurectomy for MD and performed 692 procedures from 1924 to 1946, believing it to be a curative therapy for vertigo. When he later modified the procedure from a total cranial nerve section to a partial vestibular neurectomy preserving auditory function, surgical candidacy expanded to include nearly any patient with vestibular symptoms. After his passing, trainees' attention shifted to traumatic injuries, likely influenced by WWII. This left the procedure scarcely used until third parties rekindled interest decades later.

Conclusions

Neurectomy as the preferential treatment for MD at the Johns Hopkins Hospital was not driven by pure scientific reasoning but was rather contingent on historical context and sponsorship by a prominent figure like Walter Dandy. Appreciation of MD's natural history has since curtailed the favorability of destructive procedures in preference for conservative management.
Impact of Cochlear Implantation on Quality of Life in Chinese Americans
Authors: Fan Caleb J. , Mavrommatis Maria A. , Wanna George B. , Cosetti Maura K.
Published: May 2024

Objectives

To investigate the quality of life (QOL) of adult Mandarin-speaking Chinese Americans after cochlear implantation (CI) using the cross-culturally adapted Chinese Cochlear Implant Quality of Life-10 (CIQOL-10) Global.

Study Design

Cross-sectional.

Setting

Tertiary care neurotology practice in New York City.

Patients

Thirty adult Mandarin-speaking Chinese Americans (22.8–89.4 yr, mean 48.9 yr) with prelingual (12) or postlingual (18) deafness who underwent CI between 1995 and 2020. All patients were at least 1 year from CI activation.

Intervention

CI.

Main Outcomes Measures

Chinese CIQOL-10 Global score.

Results

There were no detectable differences in mean Chinese CIQOL-10 Global scores between the prelingual (mean 51.9, SD 11.0) and postlingual (mean 44.0, SD 16.4) cohorts (p = 0.1; 95% CI, −2.3 to 18.1; Hedges' g = 0.5). Comparison of the overall cohort (mean 47.1, SD 14.8) with previously published CIQOL-10 Global scores of English-speaking American CI users (mean 51.5, SD 10.4) demonstrated a significant difference (p = 0.02; 95% CI, 0.4–8.4; Hedges' g = 0.4). For the overall cohort, multivariable analysis demonstrated that combined household income (p = 0.007, β = 7.4; 95% CI, 0.7–14.0) was positively associated with Chinese CIQOL-10 Global scores.

Conclusions

This study is the first to evaluate QOL after CI in Mandarin-speaking Chinese American adults. The CIQOL-10 Global scores of Mandarin-speaking Chinese Americans CI users are significantly worse than those of English-speaking American CI users. Combined household income may be positively associated with QOL in the Mandarin-speaking Chinese American CI population. More resources are needed to assess outcomes and support rehabilitation in this population.
Sarcopenia is an independent risk factor for short-term mortality in patients undergoing transjugular intrahepatic portosystemic shunt
Authors: Stoffel Elina , Hwang Soo Young , Qian Xia , Geller Brian , Morelli Giuseppe , Zhang Wei
Published: May 2024

Background

Sarcopenia is common in patients with cirrhosis and is a risk factor for increased mortality. Transjugular intrahepatic portosystemic shunt (TIPS) placement has been utilized in cirrhosis patients with decompensation . We investigated the role of sarcopenia in predicting mortality in patients undergoing TIPS.

Methods

We conducted a single-center retrospective study of 232 patients with cirrhosis who underwent TIPS between January 2010 and December 2015. Sarcopenia was defined by the psoas muscle index (PMI) cutoff value, calculated based on dynamic time-dependent outcomes using X-tile software. Kaplan–Meier analysis demonstrated the difference in survival in the sarcopenia group versus the non-sarcopenia group. . Univariate and multivariate analyses were used to identify the relationship between sarcopenia and post-TIPS mortality during a follow-up period of 1 year.

Results

For TIPS indications, 111 (47.84%) patients had refractory ascites, 69 (29.74%) patients had variceal bleeding, 12 (5.17%) patients had ascites, and 40 (17.24%) for other indications. The mean PMI was 4.40 ± 1.55. Sarcopenia was defined as a PMI value of <4.36 in males, and <3.23 in females. Sarcopenia was present in 96 (41.38%) of patients. . Kaplan–Meier analysis showed thatsarcopenia is associated with worse survival (log-rank P < 0.01). Multivariate Cox regression analysis showed that sarcopenia is independently associated with worse survival during the 1-year follow-up period with an hazard ratio of 2.435 (95% CI 1.346–4.403) (P < 0.01), after adjusting for age, BMI, indications for TIPS, etiology for cirrhosis, and MELD score and stratified by sex.

Conclusion

Sarcopenia is an independent risk factor for 1-year mortality in patients undergoing TIPS and should be considered when patients are evaluated as a candidate for TIPS.
Mediating effect of diabetes on the relationship between nonalcoholic fatty liver disease and atherosclerotic cardiovascular disease: a prospective cohort study
Authors: Yuan Wei , Ran Ying , Wang Jierui , Pei Fei , Cui Liufu , Chen Shuohua , Wu Shouling , Zhou Lu
Published: May 2024

Objective

This study explored the mediating effect of diabetes on the relationship between nonalcoholic fatty liver disease (NAFLD) and atherosclerotic cardiovascular disease (ASCVD).

Methods

In this prospective community cohort study, 82 975 participants were enrolled, with the primary outcome being the incidence of new-onset ASCVD. Using the Cox proportional hazards model, the hazard ratio (HR) and 95% confidence interval (CI) for ASCVD occurrence were computed between NAFLD and non-NAFLD groups. The correlation between NAFLD and diabetes was assessed using a binary logistic regression model, and that between NAFLD, diabetes and ASCVD using a mediation model.

Results

During follow-up, 9471 ASCVD cases were observed. Compared with individuals without NAFLD, those with NAFLD showed an increased ASCVD risk (HR: 1.424; 95% CI: 1.363–1.488; P < 0.001). Stratifying NAFLD based on metabolic subphenotypes revealed a higher ASCVD risk in the NAFLD combined with diabetes subgroup than in the non-NAFLD subgroup (HR: 1.960; 95% CI: 1.817–2.115; P < 0.001). NAFLD was positively associated with baseline diabetes (odds ratio: 2.983; 95% CI: 2.813–3.163; P < 0.001). Furthermore, NAFLD severity was positively correlated with diabetes risk. Mediation analysis indicated that diabetes partially mediated the effect of NAFLD on ASCVD incidence, accounting for 20.33% of the total effect.

Conclusion

NAFLD is an independent predictor of increased ASCVD risk, which may be slightly mediated by diabetes in patients with NAFLD. Evaluating NAFLD and diabetes may be crucial in the early screening and prevention of ASCVD.
Clinicopathological and Molecular Features of Penile Melanoma With a Proposed Staging System
Authors: Cornejo Kristine M. , Goyal Amrita , Valencia Guerrero Aida , Astudillo Michael , Dias-Santagata Dora , Johnson Matthew M. , Feldman Adam S. , Hoang Mai P.
Published: May 2024

Penile melanomas (PM) are an exceedingly rare subtype of mucosal melanoma (MM), and we reviewed the clinicopathologic features and molecular profile in 8 PMs. The patient ages ranged from 46 to 78 (mean: 62.8) years with involvement on the glans (n=5; 62.5%), penile urethra (n=2; 25%), and foreskin (n=1, 12.5%). Tumor depth ranged from 1.6 to 10.0 (mean: 5.25) mm. Most of the patients underwent partial penectomy (n=6; 75%) and sentinel lymph node (LN) biopsy N=7; 87.5%). Seven patients had metastatic disease at diagnosis, 6 involving LNs and 1 the adrenal gland, and 4 died of disease with a mean follow-up period of 40.5 (2 to 95) months. Five of 7 (71%) cases identified 15 molecular alterations within KIT, CDKN2A, NF1, PTEN, and APC (n=2 each), and NRAS, MAP3K1, CDH1, MSH6, and TERT (n=1 each). Two cases were not found to harbor genetic aberrations, and 1 case failed testing. In addition, we reviewed the English literature and included 93 cases with a reported depth of invasion and follow-up. A total of 101 PMs were analyzed for prognostic parameters, and the overall survival was significantly worse in patients with LN metastasis (P=0.0008), distant metastasis (P=0.0016), and greater depth of invasion (P=0.0222) based upon T-stage. While T4 conferred substantially worse survival, the delineation of the survival curves between T2 and T3 was less clear, and combining T2+T3 disease had a strong prognostic impact (P=0.0024). Prognostic parameters used in the staging of cutaneous melanomas may also be used in PMs. An alternative staging system expanding the inclusion criteria for T2 might provide a more accurate prognostic stratification.
Frailty recommendations and guidelines. An evaluation of implementability and critical appraisal of clinical applicability by the ISPRM Frailty Focus Group
Authors: Antoniadou Eleftheria , Giusti Emanuele Maria , Capodaglio Paolo , HAN Dersheng , Gimigliano Francesca , Guzman Juan Manuel , OhPARK Mooyeon , Frontera Walter
Published: May 2024

Objective:

Aging is associated with an increased burden of multimorbidity and disease-related functional loss and disability, widely impacting patients and health care systems. Frailty is a major factor in age-related disability and is an important target for rehabilitation interventions, considering that is a reversible condition.

Methods:

A working group of members of the International Society of Physical Medicine and Rehabilitation, responding to the World Health Organization (WHO) 2030 call for action to strengthen rehabilitation, was established to assess the quality and implementability of the existing guidelines for the rehabilitation of frailty. Guidelines were retrieved using a systematic search on Pubmed, Scopus, and Web of Science and from the reference lists of screened articles. The included guidelines were evaluated using the AGREE II to assess their quality and using the AGREE-REX to assess their clinical credibility and implementability. Guidelines with a score >4 in the AGREE II item evaluating the overall quality of the guideline were considered for endorsement. Finally, 9 external reviewers evaluated the applicability of each recommendation from the endorsed guidelines, providing comments about the barriers and facilitators for their implementation in their country.

Results:

Ten guidelines were retrieved and evaluated by the working group, of which 4 guidelines, that is, the WHO Guidelines on Integrated Care for Older People, the FOCUS guidelines, the Asia-Pacific Clinical Practice Guidelines for the Management of Frailty, and the ICFSR International Clinical Practice Guidelines for Identification and Management of Frailty, were considered for endorsement. All these guidelines were rated as of adequate quality and implementability.

Conclusion:

The WHO Guidelines on Integrated Care for Older People (24), the ICFSR International Clinical Practice Guidelines for Identification and Management of Frailty (15), the FOCUS guidelines (25), and the Asia-Pacific Clinical Practice Guidelines (14) for the Management of Frailty have the best quality and applicability of the existing guidelines on the management of frailty, we suggest that should be employed to define the standards of care for patients with frailty. There are barriers to their implementation, as stated by our experts, to take into account, and some of them are country or region-specific. Screening for frailty, exercise, nutrition, pharmacological management, social and psychological support, management of incontinence, and overall comprehensive clinical management are the best tools to face frailty.
Comparison of standard goal attainment scaling (GAS) and the GAS-light method for evaluation of goal attainment during neurorehabilitation of the upper limb
Authors: Pike Shannon , Cusick Anne , Turner-Stokes Lynne , Giummarra Melita J. , Chen Zhibin , Buckley David , Li Teng Han Michael , Lannin Natasha A.
Published: May 2024

Background:

Goal attainment scaling (GAS) is now widely used as a person-centered measure of outcome from rehabilitation and has demonstrated validity in diverse populations with sensitivity to change. However, as originally described, it is time-consuming for use in busy clinical settings. The “GAS-light” is a simplified version designed for application in routine clinical practice. Although increasingly taken up by clinicians, published evidence of the validity of GAS-light method is currently lacking.

Objective:

To evaluate the validity and sensitivity of the GAS-light rating method as a measure of goal attainment in clinical neurorehabilitation practice. To examine its agreement with the standard GAS rating (as originally described by the developers) as the gold standard and to assess its clinical utility and acceptability.

Methods design:

A direct, head-to-head comparison of the 2 GAS rating methods in a cohort of adults undergoing upper limb motor rehabilitation programs across a range of rehabilitation settings, including hospital, community outpatient, and spasticity clinic services. Study population: 60 patients (n=54 poststroke) set a total of 136 goals (range 1–4 per patient). In this comparative study, patients acted as their own controls.

Measures:

The 2 rating methods were applied independently and in parallel from a single goal-setting discussion. Goal attainment was measured on the original 5-point GAS using a predetermined follow-up guide and the GAS-light with its 6-point verbal rating scale. The evaluation included concurrent validity (intraclass correlation coefficients and agreement between the 2 ratings) and sensitivity to change using the standardized response mean (SRM). Thirteen clinicians and 52 participants completed surveys of clinical utility and patient acceptance, respectively.

Results:

Individual absolute agreement of 2-way mixed-effects intraclass correlation between the tools indicated good agreement (ICC(A,1)=0.88, 95% CI: 0.80, 0.93), and small systematic bias (–1.72 (95% CI: −3.04, −0.41). Both tools measured similar levels of change over time (GAS SRM=1.79; GAS-light SRM=1.62). Clinicians perceived GAS-light had stronger clinical utility, being quicker and easier to administer, score, and understand. Patients perceived GAS-light as acceptable, comfortable, worthwhile, and helpful.

Conclusions:

GAS-light is reliable and sensitive to change, with better clinical utility than the standard GAS. Either tool may be used to assess goal attainment in clinical upper limb neurorehabilitation.
Changes in HIV Internalized and Experienced Stigmas and Social Support After an Urban Gardens and Peer Nutritional Counseling Intervention Among People With HIV and Food Insecurity in the Dominican Republic
Authors: Derose Kathryn P. , Palar Kartika , Then-Paulino Amarilis , Han Bing , Armenta Gabriela , Celeste-Villalvir Alane , Sheira Lila A. , Jimenez-Paulino Gipsy , Acevedo Ramón , Donastorg Yeycy , Farías Hugo , Wagner Glenn J.
Published: May 2024

Background:

Food insecurity and HIV-related stigma negatively affect HIV outcomes. Few studies have examined how food security interventions affect HIV-related stigma and social support.

Setting:

Two HIV clinics in the Dominican Republic.

Methods:

A pilot cluster randomized controlled trial of an urban gardens and peer nutritional counseling intervention was conducted to examine outcomes of HIV-related stigmas and social support. Adult patients (≥18 years of age) with moderate or severe household food insecurity and evidence of suboptimal ART adherence and/or a detectable viral load were enrolled; standard measures of internalized and experienced stigmas and social support were collected at baseline and at 6 and 12 months. Intervention clinic participants received training and materials from agronomists for a home garden, 3–4 sessions of nutritional counseling from the clinic's peer counselor, and a garden produce cooking workshop facilitated by professional nutritionists.

Results:

Of 109 study participants (46 intervention and 63 control), 103 (94%) completed 12-month follow-up. Difference-in-differences multivariate longitudinal linear regressions adjusting for sociodemographic factors found that intervention participants had reduced internalized stigma by 3.04 points (scale 0–32) at 12 months (P = 0.002); reduced probability of experiencing HIV-related stigma or discrimination in the past 6 months (20 percentage points at 6 months, P = 0.05 and 25 percentage points at 12 months, P = 0.02); and modestly improved social support at 12 months (1.85 points on 30-pt scale, P = 0.093).

Conclusion:

A fully powered, larger trial is needed to establish the efficacy of the intervention and assess pathways by which the intervention may improve HIV stigma and social support.
Progress in Eliminating Perinatal HIV Transmission in the Metropolitan DC Area Between 2018-2022
Authors: Unternaher Justin , Koay Wei Li A. , Mareuil Joanna , Williams Tierra , Rakhmanina Natella
Published: May 2024

Background:

The number of perinatal HIV cases have continued to decline since the United States achieved the goal of perinatal HIV elimination in 2019. We aimed to evaluate dynamics in perinatal HIV transmission in the metropolitan District of Columbia (DC) area during 2018–2022.

Setting:

Children's National Hospital's (CNH) is a major referral site for the metropolitan DC area, including suburban Maryland and Virginia, and evaluates >95% of HIV-exposed infants (HEI) in the region.

Methods:

A retrospective cohort study of mother–infant pairs with perinatal HIV exposure seen at CNH during 2018–2022. We describe the demographics, intrapartum/postpartum management, and outcomes among mothers and HEI.

Results:

We analyzed 503 HEI; most (78.9%) were at low risk for perinatal HIV. Most mothers were African or African American (87.1%) and had HIV RNA <50 copies/mL around delivery (78.1%). The proportion of HEI at high risk for perinatal HIV decreased from 28.2% to 15.5% in 2018 and 2020, respectively, but increased to 24.8% in 2022. Most HEI received postnatal antiretroviral drugs for at least 4 weeks (95.3%). Seventy-nine infants (15.7%) were born to mothers diagnosed with HIV during pregnancy. Two infants (0.4%) were diagnosed with perinatally acquired HIV.

Conclusions:

We report high rates of antiretroviral drugs use among mother–infant pairs and a low rate of perinatal HIV transmission in metropolitan DC. Despite a 1.8-fold decrease in the number of high-risk perinatal HIV exposures since 2018, this rate rebounded in 2022. There remain opportunities to optimize maternal care and reduce the number of high-risk HEI.
Brief Report: Interest in Long-acting Injectable PrEP Among Transgender Women in Eastern and Southern United States
Authors: Cooney Erin E. , Reisner Sari L. , Poteat Tonia C. , Althoff Keri N. , Radix Asa , Stevenson Meg , Wawrzyniak Andrew J. , Cannon Christopher , Schneider Jason S. , Mayer Kenneth H. , Beyrer Chris , Brown Carolyn A. , Vannappagari Vani , de Ruiter Annemiek , Ragone Leigh , Wirtz Andrea L.
Published: May 2024

Background:

Among communities with elevated HIV burden, increased uptake of PrEP, including long-acting injectable (LAI) PrEP, could lower HIV incidence. Lack of data on LAI PrEP interest among transgender women in the United States has limited scientific understanding of the potential impact of LAI PrEP on new infections within transgender communities. Our objective was to determine the percent of transgender women interested in LAI PrEP and identify correlates of interest.

Methods:

Transgender women enrolled in the LITE Cohort who completed 12-month surveys between March 2019 and September 2021 were asked about interest in using LAI PrEP. Prevalence ratios (PR) estimated with modified Poisson regression models were assessed for predictors of interest in LAI PrEP.

Results:

Among 867 participants, 15% were current users of oral PrEP and 11% were former oral PrEP users. In total, 47% reported interest in LAI PrEP. Interest in LAI PrEP was more common among participants who were Black (PR: 1.28; 95% CI: 1.05 to 1.55), college-educated (PR: 1.28; 95% CI: 1.04 to 1.57), food insecure (PR: 1.19; 95% CI: 1.00 to 1.41), and had PrEP indications (PR: 1.44; 95% CI: 1.21 to 1.71). LAI PrEP interest was also more common among adherent users of oral PrEP and those who had discontinued oral PrEP, compared with PrEP-naïve participants.

Conclusions:

Interest in LAI PrEP among transgender women varied by demographic and clinical characteristics. Increased interest in LAI PrEP among Black transgender women, those with PrEP indications, and those who had previously discontinued oral PrEP underscores the need to increase LAI PrEP access for transgender women who are interested.
Detecting Amyloid Goiter With 99mTc-PYP SPECT/CT in the Setting of Ankylosing Spondylitis
Authors: Denizmen Dilara , Salmaslioglu Artur , Bakkaloglu Dogu Vuralli , Simsek Duygu Has , Sanli Yasemin
Published: May 2024

We present a case with systemic amyloidosis secondary to ankylosing spondylitis (AA amyloidosis), whose 99mTc PYP scintigraphy revealed amyloid deposition in the thyroid gland (amyloid goiter). Amyloidosis is characterized by extracellular accumulation of amyloid fibril proteins leading to organ malfunction. Even though AA amyloidosis can be observed in patients with systemic inflammatory diseases, it is a very rare complication in ankylosing spondylitis. SPECT/CT images showed diffuse tracer uptake in enlarged thyroid gland containing fat density areas.
New Approaches for Robot-Assisted Neck Surgery: Clavicular and Submental Approaches Using the da Vinci SP System
Authors: Virós Porcuna David , Suen Ka Hei , Stein Hubert , Pollán Guisasola Carlos
Published: May 2024

Background:

Minimally invasive robot-assisted thyroid surgery or neck dissection can improve cosmetic results and reduce surgical trauma. Several approaches have been described but each has both advantages and limitations. We aimed to determine the feasibility of performing robot-assisted neck surgery using the da Vinci SP system.

Methods:

The clavicular approach using the da Vinci SP system was done in 1 cadaveric model. Lateral neck dissection was carried out with parapharyngeal space dissection, lateral thyroid gland exposure, and anatomical references. The submental approach was performed in the same cadaveric model. Total thyroidectomy plus lateral neck dissection was performed.

Results:

The required 2.5-cm skin incision, minimal flap development to insert the SP Access Port plus docking was done in 5 minutes for each procedure. The neck dissection by clavicular access took 77 minutes, the parapharyngeal dissection 60 minutes, and hemi-thyroidectomy 30 minutes. The neck dissection by submental access took 60 minutes and the total thyroidectomy took 45 minutes.

Conclusion:

We have demonstrated the feasibility of single-incision clavicular and submental approaches in neck surgery using the da Vinci SP system. The amount of skin flap dissection was minimal, the system docking was rapid, and no additional ports or retractors were required. Further studies on patients are warranted.
B-Cell Lymphoma Arising From a Nasal Implant: A Brief Clinical Study
Authors: Chung Do Hyun , Kim Ji-Eun , Hong Seung-No
Published: May 2024

Continuous exposure to foreign substances initiates a sustained inflammatory reaction in the body, and subsequent chronic inflammation is recognized as one of the causes of lymphoma. Most lymphomas caused by foreign bodies are composed of 2 major phenotypes. Diffuse large B-cell lymphoma arising from metallic prosthesis, also called metallic implant-associated lymphoma and T-cell phenotype anaplastic large cell lymphoma, commonly associated with breast implants. Augmentation rhinoplasty is often performed to improve the esthetics of the nasal dorsum and various synthetic materials have been used as implants. The occurrence of lymphoma originating from a nasal implant is scarcely documented, and even more uncommon is its manifestation as epstein-barr virus (EBV)-negative extranodal marginal zone lymphoma. Here, the authors describe a rare case of B-cell lymphoma of the nose and nasolacrimal duct in a 49-year-old woman who underwent rhinoplasty with a silicone implant 20 years ago.
Endoscopic Optic Nerve Decompression in a Hamamy Syndrome Patient With Bilateral Optic Canal Stenosis
Authors: Özer Serdar , Külekci Çağri
Published: May 2024

Hamamy Syndrome is an autosomal recessive syndrome with craniofacial, neurological, and osteological implications. Patients most commonly present with repeated long fractures however, other affected systems with their respective clinical presentations warrant a thorough reporting and understanding of this genetic disorder. Herein, the authors, present a 21-year-old male patient diagnosed with Hamamy Syndrome with bilateral stenosis of the optic canals and associated bilateral vision loss. This case report documents the patient’s initial presentation 6 years ago, which included a history of right vision loss for 2 months, followed by a 6-year follow-up period during which the patient underwent 3 optic nerve decompression surgeries. There is currently a limited number of reports in the English literature on Hamamy Syndrome, with the primary focus being on genetic, dental, orthopedic, and neuropsychiatric aspects, but the neural foraminal narrowing with associated neuropathy has never been reported.
Quantifying Patient Risk Threshold in Managing Pancreatic Intraductal Papillary Mucinous Neoplasms
Authors: Kaslow Sarah R. , Sharma Acacia R. , Hewitt D. Brock , Bridges John F.P. , Javed Ammar A. , Wolfgang Christopher L. , Braithwaite Scott , Sacks Greg D.
Published: May 2024

Objective:

We aimed to better understand patients’ treatment preferences and quantify the level of cancer risk at which treatment preferences change (risk threshold) to inform better counseling of patients with intraductal papillary mucinous neoplasms (IPMNs).

Summary Background Data:

The complexity of IPMN management provides an opportunity to align treatment with individual preference.

Methods:

We surveyed a sample of healthy volunteers simulating a common scenario: undergoing an imaging study that incidentally identifies an IPMN. In the scenario, the estimated risk of cancer in the IPMN was 5%. Patients were asked their treatment preference (surgery or surveillance), to quantify the level of cancer risk in the IPMN at which their treatment preference would change (i.e. risk threshold), and their level of cancer anxiety as measured on a 5-point Likert scale. We examined associations between participant characteristics, treatment preferences, and risk threshold using multivariable linear regression.

Results:

The median risk threshold among the 520 participants was 25% (IQR 2.3-50%). The risk threshold had a bimodal distribution: 40% of participants had a risk threshold between 0-10% and 47% had a risk threshold above 30%. When informed that the risk of cancer was 5%, 62% of participants (n=323) preferred surveillance, and the remaining 38% (n=197) preferred surgery. After adjusting for potential confounders, participants who expressed “worry” or “extreme worry” about the malignancy risk of IPMN had significantly lower risk thresholds than participants who were “not at all worried” (Coefficient -12, 95%CI -21 to -2, P=0.015 and Coefficient -18, 95%CI -29 to -8, P<0.001, respectively).

Conclusions:

Participants varied in treatment preference and risk threshold of incidentally identified IPMNs. Given the uncertainty in estimating the true malignant potential of IPMNs, a better understanding of a patient’s risk threshold, as influenced by patient concern about malignancy, will help inform the shared decision-making process.
What Is the Optimal Strategy for Pouch Salvage at Time of Redo Ileal-Pouch Anal Anastomosis? Pouch Repair with Reanastomosis vs Pouch Excision with Neopouch
Authors: Uchino Tairin , Maspero Marianna , Alipouriani Ali , Hernandez Dominguez Oscar , Holubar Stefan D , Gorgun Emre , Steele Scott R , Hull Tracy L
Published: May 2024

BACKGROUND:

The long-term risk of pouch failure after restorative proctocolectomy with ileal-pouch anal anastomosis (IPAA) range from 5% to 15%. Salvage surgery for failing IPAA may be achieved by disconnecting the IPAA and either repairing and reusing the existing pouch (REP) or constructing a neopouch (NEO). We aimed to evaluate whether there are differences in long-term functional pouch survival and functional outcomes between the REP group and the NEO group. We hypothesized that patients undergoing REP have higher long-term pouch survival rates compared with patients who require NEO pouch construction.

STUDY DESIGN:

Our prospectively maintained Pouch Registry was queried for patients who underwent a pouch salvage surgery with either pouch REP or NEO from 1988 to 2020. Patients who underwent pouch repair without disconnection from the anus were excluded. The primary endpoint was long-term pouch survival after redo pouch surgery. Secondary outcomes were patient-reported quality of life and pouch function.

RESULTS:

Of 653 patients undergoing redo IPAA, 462 met inclusion criteria of transabdominal redo surgery with pouch reconnection: 243 (52.6%) had REP and 219 (47.4%) had NEO. Median age was 39 years and 59% were women. Median time between index and redo IPAA was 34 months for REP vs 54 months for NEO (p = 0.002). The 5-year pouch survival after redo IPAA was similar between REP (79.5%) and NEO (76.8%) groups (p = 0.4). Fewer patients in the REP group reported nighttime pad use (51.4% vs 68.2%, p = 0.04).

CONCLUSIONS:

Pouch survival and functional outcomes after salvage surgery for failing ileoanal pouch was similar regardless of pouch salvage procedure. When performing redo pouch surgery, surgeons should not hesitate to construct a new pouch if indicated.
Epileptic seizure detection using CHB-MIT dataset: The overlooked perspectives
Authors: Ali Emran , Angelova Maia , Karmakar Chandan
Published: May 2024

Epilepsy is a life-threatening neurological condition. Manual detection of epileptic seizures (ES) is laborious and burdensome. Machine learning techniques applied to electroencephalography (EEG) signals are widely used for automatic seizure detection. Some key factors are worth considering for the real-world applicability of such systems: (i) continuous EEG data typically has a higher class imbalance; (ii) higher variability across subjects is present in physiological signals such as EEG; and (iii) seizure event detection is more practical than random segment detection. Most prior studies failed to address these crucial factors altogether for seizure detection. In this study, we intend to investigate a generalized cross-subject seizure event detection system using the continuous EEG signals from the CHB-MIT dataset that considers all these overlooked aspects. A 5-second non-overlapping window is used to extract 92 features from 22 EEG channels; however, the most significant 32 features from each channel are used in experimentation. Seizure classification is done using a Random Forest (RF) classifier for segment detection, followed by a post-processing method used for event detection. Adopting all the above-mentioned essential aspects, the proposed event detection system achieved 72.63% and 75.34% sensitivity for subject-wise 5-fold and leave-one-out analyses, respectively. This study presents the real-world scenario for ES event detectors and furthers the understanding of such detection systems.
Video-tracked
Anopheles arabiensis
entry and exit behaviour at washed and damaged pyrethroid-treated bednets
Authors: Parker J. E. A. , Kakilla C. , Nelwin K. , Kroner C. , Logan R. , Ismail H. M. , Towers C. , Manjurano A. , Towers D. , McCall P. J.
Published: May 2024

Insecticide-treated nets (ITNs) are the most effective method for malaria prevention in Africa. Using near-infrared video tracking in a laboratory environment, we recorded and assessed bednet entry and exit by a northern Tanzanian population of
Anopheles arabiensis
at a human-occupied untreated net and a PermaNet® 2.0 ITN. Both had 12 holes, each 10 cm in diameter, punctured at specific locations, and the ITN was washed 20 times to further simulate the wear and tear of ageing. Washing reduced the insecticide content of ITNs by 61%, which then showed similar rates to the untreated nets for net entry (39% entered untreated net and 41% entered ITN;
p
= 0.84) and exit (37% and 43%, respectively;
p =
0.67). Regardless of treatment, approximately 40% of mosquitoes entered nets within 20 s of first appearing in the field of view and reached the volunteer’s skin within 5 s of entering the net. Mortality rates post-exposure were significantly higher (
p =
0.048) at ITNs (26.6%; 95% CI 13.4%–39.7%) than at untreated controls (6.4%; 95% CI 1.8%–14.6%). The washed and aged ITN provided little additional personal protection for the sleeper over an untreated net. Simple adjustments to materials and design that could extend the effective lifespan of ITNs are discussed.
Deep learning based on small sample dataset: prediction of dielectric properties of SrTiO
3
-type perovskite with doping modification
Authors: Luo Quan , Hao Hua , Liu Hanxing
Published: May 2024

The perovskite crystal structure represents a semiconductor material poised for widespread application, underpinned by attributes encompassing heightened efficiency, cost-effectiveness and remarkable flexibility. Notably, strontium titanate (SrTiO
3
)-type perovskite, a prototypical ferroelectric dielectric material, has emerged as a pre-eminent matrix material for enhancing the energy storage capacity of perovskite. Typically, the strategy involves augmenting its dielectric constant through doping to enhance energy storage density. However, SrTiO
3
doping data are plagued by significant dispersion, and the small sample size poses a formidable research hurdle, hindering the investigation of dielectric property and energy storage density enhancements. This study endeavours to address this challenge, our foundation lies in the compilation of 200 experimental records related to SrTiO
3
-type perovskite doping, constituting a small dataset. Subsequently, an interactive framework harnesses deep neural network models and a one-dimensional convolutional neural network model to predict and scrutinize the dataset. Distinctively, the mole percentage of doping elements exclusively serves as input features, yielding significantly enhanced accuracy in dielectric performance prediction. Lastly, rigorous comparisons with traditional machine learning models, specifically gradient boosting regression, validate the superiority and reliability of deep learning models. This research advances a novel, effective methodology and offers a valuable reference for designing and optimizing perovskite energy storage materials.
New interactive machine learning tool for marine image analysis
Authors: Clark H. Poppy , Smith Abraham George , McKay Fletcher Daniel , Larsson Ann I. , Jaspars Marcel , De Clippele Laurence H.
Published: May 2024

Advancing imaging technologies are drastically increasing the rate of marine video and image data collection. Often these datasets are not analysed to their full potential as extracting information for multiple species is incredibly time-consuming. This study demonstrates the capability of the open-source interactive machine learning tool,
RootPainter
, to analyse large marine image datasets quickly and accurately. The ability of
RootPainter
to extract the presence and surface area of the cold-water coral reef associate sponge species,
Mycale lingua
, was tested in two datasets: 18 346 time-lapse images and 1420 remotely operated vehicle video frames. New corrective annotation metrics integrated with
RootPainter
allow objective assessment of when to stop model training and reduce the need for manual model validation. Three highly accurate
M. lingua
models were created using
RootPainter
, with an average dice score of 0.94 ± 0.06. Transfer learning aided the production of two of the models, increasing analysis efficiency from 6 to 16 times faster than manual annotation for time-lapse images. Surface area measurements were extracted from both datasets allowing future investigation of sponge behaviours and distributions. Moving forward, interactive machine learning tools and model sharing could dramatically increase image analysis speeds, collaborative research and our understanding of spatiotemporal patterns in biodiversity.
Ecological lifestyle and gill slit height across sharks
Authors: VanderWright Wade J. , Bigman Jennifer S. , Iliou Anthony S. , Dulvy Nicholas K.
Published: May 2024

Metabolic morphology—the morphological features related to metabolic rate—offers broad comparative insights into the physiological performance and ecological function of species. However, some metabolic morphological traits, such as gill surface area, require costly and lethal sampling. Measurements of gill slit height from anatomically accurate drawings, such as those in field guides, offer the opportunity to understand physiological and ecological function without the need for lethal sampling. Here, we examine the relationship between gill slit height and each of the three traits that comprise ecological lifestyle: activity, maximum body size, and depth across nearly all sharks (
n
= 455). We find that gill slit heights are positively related to activity (measured by the aspect ratio of the caudal fin) and maximum size but negatively related to depth. Overall, gill slit height is best explained by the suite of ecological lifestyle traits rather than any single trait. These results suggest that more active, larger and shallower species (and endothermic species) have higher metabolic throughput as indexed by gill slit height (oxygen uptake) and ecological lifestyle (oxygen expenditure). We show that meaningful ecophysiological relationships can be revealed through measurable metabolic morphological traits from anatomically accurate drawings, which offers the opportunity to estimate class-wide traits for analyses of life history theory and the relationship between biodiversity and ecological function.
Spatial roost networks and resource selection of female wild turkeys
Authors: Bakner Nicholas W. , Ulrey Erin E. , Wightman Patrick H. , Gulotta Nick A. , Collier Bret A. , Chamberlain Michael J.
Published: May 2024

Wildlife demography is influenced by behavioural decisions, with sleep being a crucial avian behaviour. Avian species use roost sites to minimize thermoregulation costs, predation risk and enhance foraging efficiency. Sleep locations are often reused, forming networks within the home range. Our study, focusing on female eastern wild turkeys (
Meleagris gallopavo silvestris
) during the reproductive season, used social network analysis to quantify both roost site selection and network structure. We identified roost networks which were composed of a small percentage of hub roost sites connecting satellite roosts. Hub roosts were characterized by greater values of betweenness (
β
= 0.62, s.e. = 0.02), closeness (
β
= 0.59, s.e. = 0.03) and eigenvalue centrality (
β
= 1.15, s.e. = 0.05), indicating their importance as connectors and proximity to the network’s functional centre. The probability of a roost being a hub increased significantly with greater eigenvalue centrality. Female wild turkeys consistently chose roost sites at lower elevations and with greater topographical ruggedness. Hub roost probability was higher near secondary roads and further from water. Our research highlights well-organized roost site networks around hub roosts, emphasizing the importance of further investigations into how these networks influence conspecific interactions, reproduction and resource utilization in wild turkeys.
Characterization of viable but nonculturable state of
Campylobacter concisus
Authors: Wahid Syeda Umme Habiba , Campbell Bronwyn E. , Moore Robert J. , Istivan Taghrid
Published: May 2024

Campylobacter concisus
is an opportunistic bacterial pathogen linked with a range of human diseases. The objective of this study was to investigate the viable but nonculturable (VBNC) state of the bacterium. To induce the VBNC state,
C. concisus
cells were maintained in sterilized phosphate-buffered saline at 4°C for three weeks. The VBNC cells were monitored using quantitative analysis by propidium monoazide (PMAxx) coupled with quantitative real-time PCR (PMAxx-qPCR), targeting the
DNA gyrase
subunit B gene. The results demonstrated that
C. concisus
ATCC 51562 entered the VBNC state in 15 days, while ATCC 51561 entered the VBNC state in 9 days. The viable cell counts, assessed by PMAxx-qPCR, consistently remained close to the initial level of 10
7
CFU ml
−1
, indicating a substantial portion of the cell population had entered the VBNC state. Notably, morphological analysis revealed that the VBNC cells became coccoid and significantly smaller. The cells could be resuscitated through a temperature increase in the presence of a highly nutritious growth medium. In conclusion, under environmental stress, most
C. concisus
cells converted to the VBNC state. The VBNC state of
C. concisus
may be important for its environmental survival and spread, and the presence of VBNC forms should be considered in environmental and clinical monitoring.
Quasi-static responses of marine mussel plaques detached from deformable wet substrates under directional tensions
Authors: Pang Yong , Sun Wei , Liu Tao
Published: May 2024

Quantifying the response of marine mussel plaque attachment to wet surfaces remains a significant challenge to a mechanistic understanding of plaque adhesion. Here, we develop a novel, customized microscope system, combined with two-dimensional
in situ
digital image correlation (DIC), to quantify the in-plane deformation of a deformable substrate that interacts with a mussel plaque under directional tension. By examining the strain field within the substrate, we acquired an understanding of the mechanism by which in-plane traction forces are transmitted from the mussel plaque to the underlying substrate. Finite-element (FE) models were developed to assist in the interpretation of the experimental measurement. Our study revealed a synergistic effect of pulling angle and substrate stiffness on plaque detachment, with mussel plaques anchoring to a ‘stiff’ substrate at small pulling angles, i.e. natural anchoring angles, having mechanical advantages with higher load-bearing capacity and less plaque deformation. We identify two distinct failure modes, i.e. shear-traction-governed failure (STGF) and normal-traction-governed failure (NTGF). It was found that increasing the stiffness of the substrate or reducing the pulling angle results in a change of the failure mode from NTGF to STGF. Our findings offer new insights into the mechanistic understanding of mussel plaque–substrate interaction, providing a plaque-inspired strategy to develop high-performance and artificial wet adhesion.