bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between post-traumatic stress disorder and hypertension in Congolese exposed to violence: a case–control study
Authors: Bapolisi Achille , Maurage Pierre , Pappaccogli Marco , Georges Coralie M.G. , Petit Géraldine , Balola Mitterrand , Cikomola Cirhuza , Bisimwa Ghislain , Burnier Michel , Persu Alexandre , de Timary Philippe
Published: December 2021

Background:

Numerous risk factors have been involved in the pathogenesis of hypertension. The contribution of psychological factors, including post-traumatic stress disorder, remains largely underexplored, despite their potential role in hypertension.

Objectives:

We compared the prevalence of trauma, post-traumatic stress and other psychological disorders between hypertensive and normotensive patients from Bukavu (Democratic Republic of Congo), a 25-year war-exposed city.

Methods and measures:

In this case–control study, we assessed past traumatic events with the Stressful-Events-Scale, post-traumatic stress disorder through the post-traumatic diagnostic scale, depression and alcohol use disorder through the MINI-International-Neuropsychiatric-Interview, and emotion regulation through the Emotion-Regulation-Questionnaire in 106 hypertensive and 106 normotensive patients, enrolled at the Bukavu General Hospital.

Results:

Compared with normotensive controls (73% women, age: 43 ± 14 years, BP: 121 ± 10/75 ± 8 mmHg), hypertensive patients (57% women, age: 42 ± 13 years, BP: 141 ± 12/82 ± 7 mmHg, on a median of two antihypertensive drugs) were exposed to more man-made traumas (61 vs. 13%, P < 0.001), used more expressive suppression (P = 0.05) and less cognitive reappraisal (P = 0.02) as emotional regulation strategies. They developed more frequent post-traumatic stress disorder (36 vs. 7%, P < 0.001) and major depressive disorder (37 vs. 13%, P = 0.001), often in association with alcohol use disorder (23 vs. 4%, P < 0.001). In multivariate logistic regression, post-traumatic stress disorder [OR = 3.52 (1.23–6.54)], man-made trauma [OR = 2.24 (1.15–4.12)], family history of hypertension [OR = 2.24 (1.06–4.44)], fasting blood glucose [OR = 1.85 (1.07–3.08)], BMI [OR = 1.28 (1.12–2.92)], expressive suppression [OR = 1.23 (1.11–2.23)] and cognitive reappraisal [OR = 0.76 (0.63–0.98)] were independent predictors of hypertension.

Conclusion:

In Congolese populations exposed to war, man-made trauma exposure and post-traumatic stress disorder appear to be more tightly related to hypertension than classical hypertension risk factors.
Assessment of Left Ventricular Function and Mitral Regurgitation Severity Early After Percutaneous Device Closure of the Atrial Septal Defect
Authors: Sahebjam Mohammad , Toofaninejad Neda , Ajam Ali , Hosseini Kaveh , Jalali Arash , Zoroufian Arezou
Published: December 2021

Background:

Atrial septal defect (ASD) is one the most prevalent forms of congenital heart disease in adults. Closure of ASDs eliminates left-to-right shunt and reduces right heart volumes, but the effects of ASD closure, on the left ventricle (LV) and mitral valve competence are somewhat inconsistent. Therefore, we designed this study to evaluate the early effect of percutaneous closure of ASD on LV function and mitral regurgitation (MR) severity.

Methods:

In this prospective study, we enrolled 32 patients with ASD secundum who underwent percutaneous device closure in Tehran Heart Center. We used transthoracic and transesophageal echocardiography (TEE) before the procedure and TTE 24 hours after the procedure, then compared obtained LV parameters before and after the procedure.

Results:

LV end-diastolic diameter (LVEDD) increased significantly from 44.8 ± 2.4 to 45.8 ± 2.8 (P < 0.001). LV end-systolic diameter (LVESD) also increased but was statistically insignificant (P = 0.063) and LV ejection fraction (LVEF) remained nearly unchanged. Highest alteration was in right ventricular systolic pressure (12.4% decrease; P < 0.001) and mitral early Doppler/tissue Doppler velocity ratio (E/E′) (9.7% increase; P = 0.010). The change in MR severity was insignificant using Wilcoxon signed-rank test (P = 0.157).

Conclusions:

We concluded that systolic functions do not change immediately. However, LVEDD and E/E′ will increase immediately, resulting from the passage of all blood from the LA into the LV in the early diastole just after closure. We also observed the positive effect of device closure on reducing right ventricular systolic pressure, and at least it does not worsen MR early after the procedure.
TREATMENT DEFERRAL DURING COVID-19 LOCKDOWN
Authors: Montesel Andrea , Gigon Anthony , Giacuzzo Clarice , Mantel Irmela , Eandi Chiara M.
Published: December 2021

Purpose:

To investigate the visual and anatomical impact of intravitreal injection treatment deferral because of the COVID-19 lockdown on patients affected by neovascular age-related macular degeneration.

Methods:

We retrospectively reviewed 314 patients (394 eyes) who were scheduled to receive the impact of intravitreal injections during the Swiss lockdown. We compared patients who continued to receive scheduled impact of intravitreal treatment without clinical consultation (Group Continue ‟C”; n = 215) and patients for whom the impact of intravitreal treatment was completely deferred (Group Stop, ‟S”; n = 179). Functional and anatomical parameters were collected at four time points before and after the lockdown.

Results:

In Group C, the visual acuity at baseline and after the lockdown did not differ significantly. In Group S, the visual acuity deteriorated significantly compared with baseline and then improved slightly after the resumption of treatment, but it did not recover to baseline values. The mean central subfield thickness remained stable in Group C, whereas it increased in Group S and then returned to prelockdown values after the resumption of treatment.

Conclusion:

An “injection-only” approach was effective in managing patients with neovascular age-related macular degeneration during the pandemic lockdown, whereas patients who deferred their scheduled treatment showed partially irreversible deterioration of visual function. We recommend treatment continuation in patients with neovascular age-related macular degeneration during a lockdown.
Assessment of Corneal Densitometry in Big-Bubble Dissection Versus Manual Dissection Deep Anterior Lamellar Keratoplasty
Authors: Hashish Aya M. , El-Awady Hatem E. , Sabry Dalia M. , Awad Eman A.
Published: December 2021

Purpose:

The aim of this study was to assess corneal densitometry and visual outcomes after big-bubble deep anterior lamellar keratoplasty (BB-DALK) and manual dissection deep anterior lamellar keratoplasty in patients with keratoconus.

Methods:

This retrospective comparative observational study included 40 keratoconic patients who underwent DALK surgery: 22 eyes had BB-DALK (group I) and 18 eyes had failed BB technique and DALK was completed by manual dissection (group II). Best -corrected visual acuity (BCVA), corneal topographic parameters, residual stromal tissue thickness, and endothelial cell count were recorded at 1, 3, 6, and 12 months postoperatively. Densitometric analysis of different corneal layers and zones was performed using Scheimpflug tomography at each visit; values were recorded and compared between the 2 groups.

Results:

At 1 and 6 months postoperatively, BCVA was better in group I than in group II, but with no statistically significant difference. At 12 months, the visual acuities became nearly similar in both groups (0.30 ± 0.13 vs. 0.30 ± 0.14 logarithm of the minimum angle of resolution, P = 0.888). Regarding corneal densitometric analysis, the recorded values for the posterior corneal layer were significantly higher in group II compared with group I at 3, 6, 9, and 12 months postoperatively in the 0- to 2-mm zone (P < 0.001) and the 2- to 6-mm zone (P = 0.029, 0.028, 0.001, and <0.001).

Conclusions:

Manual dissection DALK after failed BB technique may affect the interface stromal reflectivity up to 12 months postoperatively. However, this does not significantly affect the visual acuity in comparison with successful BB-DALK.
An exploratory study of ascitic fluid lactate as prognostic factor of mortality in cirrhotic patients with spontaneous bacterial peritonitis
Authors: Mani Iliana , Alexopoulos Theodoros , Hadziyannis Emilia , Tsiriga Athanasia , Vourli Georgia , Alexopoulou Alexandra
Published: December 2021

Background

The diagnostic value of ascitic fluid lactate (AF lactate) was previously evaluated in spontaneous bacterial peritonitis (SBP) but its prognostic value was not established.

Aim

To assess the prognostic value of AF lactate in SBP.

Methods

We prospectively studied 63 consecutive patients with SBP. Fifty patients with acute-on-chronic liver failure (ACLF) or acute decompensation (AD) (ACLF/AD group) without SBP and 30 with stable decompensated cirrhosis (DC) were included as controls. In SBP, mortality was recorded at 30, 90 and 180 days.

Results

Arterial and AF lactate were significantly higher in SBP compared to other groups. Analyzing the SBP group alone, AF lactate accurately differentiated survivors from nonsurvivors in all time points. The prognostic performance of AF lactate was improved over time, with the area under the receiver operating characteristic computed at 0.894, 0.927 and 0.934 at 30, 90 and 180 days, respectively. The cutoff level of 2 mmol/L was associated with 100, 100 and 94.7% sensitivity, 57.9, 73.3 and 80% specificity, 61, 80.5 and 87.8% positive predictive value and 100, 100 and 90.9% negative predictive value, respectively. Arterial lactate, neutrophil-to-lymphocyte ratio (NLR) and Model for End-Stage Liver Disease (MELD) score predicted outcomes less accurately than AF lactate. Patients with AF lactate >2 mmol/L had a worse prognosis compared to patients with ≤2 mmol/L (log-rank P < 0.001). No case with AF lactate ≤2 mmol/L died within 90 days postSBP diagnosis. In Cox multivariate analysis at all time points, only AF lactate and NLR were independent predictors of mortality.

Conclusion

An AF lactate level of 2 mmol/L has a high ability to differentiate survivors from nonsurvivors in the first 180 days postSBP. Its prognostic value outperformed arterial-lactate, NLR and MELD.
Radiomics and deep learning approach to the differential diagnosis of parotid gland tumors
Authors: Gündüz Emrah , Alçin Ömer Faruk , Kizilay Ahmet , Piazza Cesare
Published: December 2021

Purpose of review

Advances in computer technology and growing expectations from computer-aided systems have led to the evolution of artificial intelligence into subsets, such as deep learning and radiomics, and the use of these systems is revolutionizing modern radiological diagnosis. In this review, artificial intelligence applications developed with radiomics and deep learning methods in the differential diagnosis of parotid gland tumors (PGTs) will be overviewed.

Recent findings

The development of artificial intelligence models has opened new scenarios owing to the possibility of assessing features of medical images that usually are not evaluated by physicians. Radiomics and deep learning models come to the forefront in computer-aided diagnosis of medical images, even though their applications in the differential diagnosis of PGTs have been limited because of the scarcity of data sets related to these rare neoplasms. Nevertheless, recent studies have shown that artificial intelligence tools can classify common PGTs with reasonable accuracy.

All studies aimed at the differential diagnosis of benign vs. malignant PGTs or the identification of the commonest PGT subtypes were identified, and five studies were found that focused on deep learning-based differential diagnosis of PGTs. Data sets were created in three of these studies with MRI and in two with computed tomography (CT). Additional seven studies were related to radiomics. Of these, four were on MRI-based radiomics, two on CT-based radiomics, and one compared MRI and CT-based radiomics in the same patients.
Noninvasive methods to reduce cardiac complications postheart transplant
Authors: Zhou Leon , Wolfson Aaron , Vaidya Ajay S.
Published: December 2021

Purpose of review

Long-term success of heart transplantation is limited by allograft rejection and cardiac allograft vasculopathy (CAV). Classic management has relied on frequent invasive testing to screen for early features of rejection and CAV to allow for early treatment. In this review, we discuss new developments in the screening and prevention of allograft rejection and CAV.

Recent findings

Newer noninvasive screening techniques show excellent sensitivity and specificity for the detection of clinically significant rejection. New biomarkers and treatment targets continue to be identified and await further studies regarding their utility in preventing allograft vasculopathy.

Noninvasive imaging and biomarker testing continue to show promise as alternatives to invasive testing for allograft rejection. Continued validation of their effectiveness may lead to new surveillance protocols with reduced frequency of invasive testing. Furthermore, these noninvasive methods will allow for more personalized strategies to reduce the complications of long-term immunosuppression whereas continuing the decline in the overall rate of allograft rejection.
The Professional Nurse
Authors: Lal M. Maureen
Published: December 2021

As one of the world's oldest occupations, nursing has seen, inspired, and innovated a host of changes. The evolution has been especially evident for the last 39 years. Since the 1980s, a growing focus on autonomy, research, and evidence-based practice has transformed nursing from a job to a profession. Concepts such as shared governance, interprofessional collaboration, and frontline engagement have transformed nurses from doctors' assistants to empowered and independent clinicians directly impacting patient outcomes and the healthcare environment. As the 30th anniversary of the American Nurses Credentialing Center comes to an end and the original Magnet® research celebrates a 39th birthday, we take a closer look at how the Magnet framework reflects these changes and how Magnet-designated organizations continue to advance nursing practice with innovation, knowledge, and leadership.
Forever Changed: RNs Speak of their COVID-19 Experiences through a System-Wide Nursing Web Site
Authors: Rosenfeld Peri , DeMarco Kathleen , Rodenhausen Nancy
Published: December 2021

A COVID19RNStories website allowed RNs in this integrated health system to “tell their stories” during the recent pandemic. From April to August 2020, approximately 100 items were posted with 4 themes emerging. COVID19RNStories had no preconceived hypotheses or specific questions to answer: RNs shared whatever they felt was relevant to their experiences. This approach provided real-time information on issues and concerns of RNs during the 1st wave of COVID-19. This article discusses the identified themes with recommendations for nursing leaders to support staff during the pandemic and future unexpected emergency situations.
Nurse Faculty Shortage
Authors: Jarosinski Judith M. , Seldomridge Lisa , Reid Tina P. , Willey Jeffrey
Published: December 2021

Background:

The nurse faculty shortage has impacted current and future nursing workforce needs and health outcomes. What has not been expansively reported is the perspective of nursing program administrators as they grapple with the nurse faculty shortage and its effect in their schools.

Purpose:

The purpose was to explore nursing program administrators' perspectives of the nurse faculty shortage.

Method:

Administrators from 8 community colleges and 8 universities representing undergraduate and graduate nursing programs in the mid-Atlantic region participated in semistructured interviews pre-coronavirus disease (SARS COVID-19). Researchers used a 7-stage Heideggerian hermeneutic analysis.

Findings:

Twenty-four interviews elicited 4 themes: onboarding and integration; “elephant in the room”; making do: getting by; and changing expectations.

Conclusions:

Administrators faced increasing faculty workloads, academic/practice pay disparities, and staffing challenges—a stark contrast to their goal of teaching excellence, quality student outcomes, and faculty satisfaction. An unexpected finding was a deterioration in workplace climate and its untoward effects on meeting workforce needs.
Validation of a New Software Application for Tear Breakup Measurement
Authors: Pena-Verdeal Hugo , Ramos Lucía , Garcia-Queiruga Jacobo , García-Resúa Carlos , Giráldez María J. , Yebra-Pimentel Eva
Published: December 2021

SIGNIFICANCE

Tear film instability has been recognized as one key mechanism on dry eye disease. There is a need for new instruments, methods, or protocols to improve the repeatability and reproducibility of the tear film stability to facilitate its clinical evaluation use as a rapid and reliable primary diagnostic test.

PURPOSE

The present pilot study aimed to validate a method to automatically measure the tear film breakup time (BUT).

METHODS

A total of 264 videos of BUT were randomly selected among the clinical history of subjects attending the optometry clinic. Videos were stored in a backup server through a secure file transfer protocol and analyzed by three different examiners: two masked observers (subjective evaluation) and a third investigator using the automatic software application (objective evaluation). Subjective evaluation was conducted only once on an online software designed for this protocol where videos were presented in random masked order. Automatic evaluation based on color and texture analysis was performed by (1) automatic localization of sequences of interest in the video, (2) extraction of the region of interest within each frame, and (3) automatic BUT measurement from evolution curves in the region of interest as time elapsed from the beginning of the sequence of interest until the curve exceeds a threshold.

RESULTS

Substantial correlation was observed among the examiners (intraclass correlation coefficient, 0.752). There was a statistical difference between observer 1 and 2 evaluations (t test, P < .001), whereas data provided by the software showed no significant differences from those of the observers (t test, P ≥ .26). Similar results to the whole data set analysis were obtained when the sample was reassessed only considering mean BUT values ≤15 seconds.

CONCLUSIONS

The present pilot study showed acceptable clinical results for the software application designed to objectively measure the BUT.
A Critical Assessment of Current Grading Schemes for Diffuse Pleural Mesothelioma With a Proposal for a Novel Mesothelioma Weighted Grading Scheme (MWGS)
Authors: Fuchs Talia L. , Chou Angela , Aksoy Yagiz , Mahjoub Mahiar , Sheen Amy , Sioson Loretta , Ahadi Mahsa , Gill Anthony J.
Published: December 2021

Although there is early support for schemes based on nuclear grade, necrosis and mitotic rate, there is currently no widely implemented grading system for diffuse pleural mesothelioma (DPM). We investigated current systems and propose a novel Mesothelioma Weighted Grading Scheme (MWGS). The MWGS assigns weighted scores from 0 to 10 based on age (≤74, >74 yrs: 0,1); histologic type (epithelioid, biphasic, sarcomatoid: 0,1,2); necrosis (absent, present: 0,2); mitotic count per 2 mm2 (≤1, 2 to 4, ≥5: 0,1,2); nuclear atypia (mild, moderate, severe: 0,1,2); and BRCA1-associated protein 1 (BAP1) expression (lost, retained: 0,1). A score of 0 to 3 is low grade, 4 to 6 intermediate grade, and 7 to 10 high grade. In 369 consecutive DPMs, median survival was 17.1, 10.1, and 4.1 months for low, intermediate, and high grades (P<0.0001). A progressive increase in score correlated with worsening overall survival (P<0.0001). Interobserver concordance was substantial (κ=0.588), with assessment of nuclear grade being the most subjective parameter (κ=0.195). We compared the MWGS to the 2-tiered system discussed in the World Health Organization (WHO) fifth edition. The WHO system predicted median survival in epithelioid (median 18.0 vs. 11.3 mo, P=0.003) and biphasic (16.2 vs. 4.2 mo, P=0.002), but not sarcomatoid DPM (5.4 vs. 4.7 mo, P=0.407). Interestingly, the WHO grading system was prognostic in cases with BAP1 loss (median survival 18.7 vs. 10.4 mo, P<0.0001), but not retained BAP1 expression (8.9 vs. 6.2 mo, P=0.061). In conclusion, the WHO scheme has merit in epithelioid/biphasic and BAP1-deficient DPM, however, the MWGS can be used for risk stratification of all DPMs, regardless of histologic subtype and BAP1 status.
Inflammation-mediated vitamin K and vitamin D effects on vascular calcifications in people with HIV on active antiretroviral therapy
Authors: Janus Scott E. , Durieux Jared C. , Hajjari Jamal , Carneiro Herman , McComsey Grace A.
Published: December 2021

Background:

People with HIV (PWH) experience increased systemic inflammation and monocyte activation, leading to increased risk of cardiovascular events (death, stroke, and myocardial infarction) and higher coronary artery calcium scores (CACs). Vitamins D and K2 have significant anti-inflammatory effects; in addition, vitamin K2 is involved in preventing vascular calcifications in the general population. The roles of vitamins D and K in increased coronary calcifications in successfully treated PWH is less understood.

Methods:

We prospectively recruited 237 PWH on antiretroviral treatment (ART) and 67 healthy controls. CACs were derived from noncontrast chest computed tomography (CT) and levels of 25-hydroxyvitamin D (vitamin D) and inactive vitamin K-dependent dephosphorylated-uncarboxylated matrix Gla protein (dp-uc MGP, marker of vitamin K deficiency) were measured in plasma during a fasting state. The relationship between inflammation markers, dp-uc MGP, and vitamin D on CACs were estimated using zero-inflated negative binomial regression. Adjusted models included 25(OH)D, MGP, sex, race, age, and markers of inflammation or monocyte activation.

Results:

Overall, controls had lower median age (45.8 vs. 48.8; P = 0.03), a larger proportion of female individuals (55.2 vs. 23.6%; P < 0.0001), and nonwhite (33.8 vs. 70%; P < 0.0001). Among PWH, less than 1% had detectable viral load and the median CD4+ cell count was 682 (IQR: 473.00–899.00). 62.17% of the participants had zero CACs and 51.32% were vitamin D-deficient (<20 ng/ml). There was no difference in detectable CACs (P = 0.19) or dp-uc MGP (P = 0.42) between PWH and controls. In adjusted models, PWH with nonzero CACs have three times greater expected CAC burden compared with controls. Every 1% increase in MGP (worse K status) decreases the probability of having CACs equal to zero by 21.33% (P = 0.01). Evidence suggests that the effects of 25(OH)D and MGP are inflammation-mediated, specifically through sVCAM, TNF-αRI, and TNF-αRII.

Conclusion:

Vitamin K deficiency is a modifiable preventive factor against coronary calcification in PWH. Further research should determine whether vitamin K supplementation would reduce systemic inflammation, vascular calcification, and risk of cardiovascular events in PWH.
Effects of Sex, Existing Antibodies, and HIV-1–Related and Other Baseline Factors on Antibody Responses to Quadrivalent HPV Vaccine in Persons With HIV
Authors: Kang Minhee , Umbleja Triin , Ellsworth Grant , Aberg Judith , Wilkin Timothy
Published: December 2021

Background:

We compared antibody (Ab) responses to a quadrivalent (types 6, 11, 16, and 18) human papillomavirus (HPV) vaccine between men and women with HIV-1.

Methods:

A retrospective analysis of participant-level data from published clinical trials of HPV vaccine administered at study entry and at weeks 8 and 24 was conducted separately for baseline Ab undetectable and baseline Ab detectable using Ab titers and titer changes from baseline, respectively, at week 28 and year 1.5. Generalized estimating equations accounted for multiple HPV types and were adjusted for multiple baseline factors, including existing HPV antibodies before vaccination from natural exposure.

Results:

We evaluated 575 participants with CD4+ count >200 cells/mm3, 323 men and 252 women: median ages 46 and 38 years, respectively. Week 28 and year 1.5 Ab titers were similar between men and women regardless of the baseline Ab detection in multivariate models. HIV-1 RNA ≥400 copies/mm3 was associated with a lower week 28 Ab response; in baseline Ab detectable, the baseline HPV Ab titer level, HPV DNA detection, and lower CD4+/CD8+ ratio were also associated with a lower response. CD4+/CD8+ ratio was a stronger predictor in the year 1.5 Ab analysis than in the week 28 analysis. Ab responses among baseline Ab detectable were only somewhat higher than those among baseline Ab undetectable (eg, type 16 week 28 median 3.46 vs 3.20 log10 mMU/mL) despite the existing baseline titer (median 1.74).

Conclusions:

We did not find any sex differences of serologic response to HPV vaccine. Ab titer gain was lower in those with preexisting antibodies due to previous natural infection.
Rehabilitation of Atrophic Maxilla With Immediate Loading of Extrasinus Zygomatic Implant
Authors: de Carvalho Laura Firmo , de Carvalho Liliane Pacheco , Sotto-Maior Bruno Salles , Dias André Luiz , Bezerra Fabio José Barbosa , Bergamo Edmara T.P. , de Carvalho Alexandre Marcelo
Published: December 2021

The aim of this case series was to evaluate the long-term success rate of immediate occlusal loading of extrasinus zygomatic dental implants after a 3-year follow-up. The sample consisted of 31 patients (mean age of 64 years) with atrophic maxillae rehabilitated with 1 to 4 extrasinus zygomatic implants, placed unilaterally or bilaterally. All the patients received complete implant-supported dental prostheses with immediate loading by associating zygomatic implants with conventional implants. None of the procedures were associated with bone grafts. During the 3-year period of follow-up in the present study, all the patients attended clinical sessions and underwent radiographic exams every 6 months. In total 55 zygomatic and 69 conventional implants were placed, where 1 zygomatic and 2 conventional implants were lost, representing success rates of 98.18% and 97.20%, respectively. None of the studied patients had signs of sinusitis or changes in the maxillary sinuses. All the patients showed occlusal contact on natural antagonist teeth or implant-supported dental prostheses. Therefore, it was concluded that the use of exteriorized zygomatic implants with immediate loading represented a feasible option with high success rates for the treatment of atrophic maxilla.
Application of Computer-Aided Design and Individualized Templates for Bilateral Zygomaticomaxillary Complex Fractures
Authors: Zhou Tianren , Li Jianping , Chen Songling , Ren Jing , Geng Ningbo
Published: December 2021

Purpose:

Reduction of the bilateral zygomaticomaxillary complex (ZMC) fracture with individualized templates based on computer- aided surgical simulation system. To evaluate the practicality and accuracy of this approach in the treatment of bilateral ZMC fracture.

Methods:

Sixteen patients with bilateral ZMC fractures were collected to create a study model. The authors reconstruct the ZMC on one side via the three-dimensional (3D) model, and then mirrored to the opposite side. Multiple individualized templates were made based on the 3D model, and used as intraoperative guidance to reduce fractures. After surgery, the facial symmetry and the position of zygoma were observed. The mouth opening, pupil level, and sensation of infraorbital nerve were evaluated. Some mark points on zygoma were measured and the postoperative horizontal asymmetry rate (H) was calculated. Besides, orbital height and width were measured.

Results:

For all patients, the position of bilateral ZMC was basically restored. The patients with restriction of mouth opening all recovered to normal. The H values were less than 3.0% at all mark points. There was almost no difference in bilateral orbital width and height. Meanwhile, there was no significant difference between the preoperative measurements of the ideal virtual 3D model and the postoperative measurements of patients.

Conclusions:

The study proves that application of computer-aided design and individualized templates can accurately guide the reduction operation of ZMC fracture, restore the ideal shape of ZMC, and obtain good facial symmetry.
Effects of Positioning Errors Onto the Ratio and Angle Measurements in Photographs of Patients With Unilateral Cleft Lip and Palate
Authors: Titiz Serap
Published: December 2021

Background:

Nasolabial esthetics is 1 of the most important issues in the evaluation of treatment outcomes in patients with unilateral cleft lip and palate (CLP). Frontal and basal view photographs are commonly used to evaluate nasolabial esthetics in patients with unilateral CLP. High-quality photography plays an important role in evaluating the treatment outcomes and poor quality photographs can result in errors, whereas evaluating the treatment results. Facial proportions and angles are important in the esthetic perception of the face. Hence, this study aimed to determine the effects of positioning errors on the ratio and angle measurements in photographs of patients with unilateral CLP.

Methods:

In the clinical and computer environment, a mechanism was set up to take photos at standard and at different angles. A real-size unilateral CLP silicone doll was constructed for the photographs to be taken in the clinical setting. A test-retest was performed to determine the reliability of the measured values.

Results:

The correlation coefficients for the first measurement and remeasurement values were statistically significant; positive and strong correlations were obtained.

Conclusions:

Based on the data obtained from our study, the angle and ratio measurements obtained from the two-dimensional photographs provided reliable results.
Reduction Malarplasty Using Customized Surgical Stent Based on 3D Virtual Surgery, CAD/CAM, and 3D Printing Technology: Case Series
Authors: Ha Sung-Ho , Jung Sungyoung , Choi Jin-Young
Published: December 2021

The zygomatic bone is a structure that protrudes symmetrically on both sides of the midface and plays an important role in the overall aesthetic appearance of the face. Unlike Caucasians, the mesocephalic facial shape is predominant in Asians, and therefore, many people have a relatively laterally developed zygomatic bone. In Asians, when the zygomatic bone is excessively developed, it gives a strong and stubborn image, and aesthetically, many people want to reduce the zygomatic bone because they prefer an oval and slim face.

To reduce the excessive zygomatic bone, a reduction malar- plasty through an intraoral and preauricular approach has been performed. Although reducing the zygomatic bone is not a big problem in most cases of symmetric reduction malarplasty, it is not easy to produce surgical results as intended by the surgeon in asymmetric malar patients or patients requiring a three-dimensional (3D) change of zygoma. In addition, because of the mobility of the zygoma segment, it may be difficult to drill holes and fix plate after osteotomy. Moreover, these factors can increase the possibility of malunion or nonunion.

In this study, cutting guides made with the aid of 3D virtual surgery, 3D printing, and customized titanium plates manufactured with the computer-aided design/computer-aided manufacturing technology are used for 8 patients to maximize the recovery of 3D symmetry and minimize complications through accurate fixation after surgery. During the surgical procedures, screw hole drilling and osteotomy were performed using a cutting guide, and then, the malar segment was fixed by matching the premade customized plates with the predrilled holes. As a result of checking the accuracy of the surgery by superimposing the postoperative 3D cone beam computed tomography image and virtual surgery data based on the skull base, the 2 images almost overlapped and no significant differences were observed, so it was confirmed that the operation was performed exactly as planned.

When using the 3D technology, it is possible to perform a more accurate surgery in patients with asymmetry due to congenital anomalies or trauma as well as simple asymmetry, so it can be concluded that using the 3D technology can overcome the limitations and disadvantages of the conventional method as in the cases in this study. The accurate prediction of soft tissue is still insufficient, and further research is needed to overcome this limitation
An MD-2-related lipid-recognition protein is required for insect reproduction and integument development
Authors: Wang Wei , Ma Ya , Yang Rui-Rui , Cheng Xu , Huang Hai-Jian , Zhang Chuan-Xi , Bao Yan-Yuan
Published: December 2021

The myeloid differentiation factor 2 (MD-2)-related lipid-recognition protein is involved in immune responses through recognizing bacteria lipopolysaccharide in mammals, arthropods and plants. However, the physiological roles of MD-2 in other biological processes are largely unknown. Here, we identified three homologue MD-2 genes (
NlML1
,
NlML2
and
NlML3
) by searching the genome and transcriptome databases of the brown planthopper
Nilaparvata lugens
, a hemipteran insect species. Temporospatial analysis showed that the
NlML1
gene was highly expressed in the fat body but much less so in the other tissues, while the
NlML2
and
NlML3
genes were highly expressed in the testis or digestive tract. RNA interference-mediated depletion of the
NlML1
gene significantly downregulated the transcription of numerous integument protein genes. The
NlML1
knockdown led to moulting failure and mortality at the nymph–adult transition phase, impaired egg laying and hatching, and reduced 20-hydroxyecdysone (20E) production in the nymphs. 20E could rescue the deficient moulting phenotypes derived from ds
NlML1
RNAi. These novel findings indicate that
NlML1
is required for nymphal moulting and female reproductive success as it plays an important role in regulating 20E synthesis, lipid and chitin metabolisms in
N. lugens
, thus contributing to our understanding of developmental and reproductive mechanisms in insects.
Female in-nest attendance predicts the number of ectoparasites in Darwin's finch species
Authors: Kleindorfer Sonia , Common Lauren K. , O'Connor Jody A. , Garcia-Loor Jefferson , Katsis Andrew C. , Dudaniec Rachael Y. , Colombelli-Négrel Diane , Adreani Nico M.
Published: December 2021

Selection should act on parental care and favour parental investment decisions that optimize the number of offspring produced. Such predictions have been robustly tested in predation risk contexts, but less is known about alternative functions of parental care under conditions of parasitism. The avian vampire fly (
Philornis downsi
) is a myasis-causing ectoparasite accidentally introduced to the Galápagos Islands, and one of the major mortality causes in Darwin's finch nests. With an 11-year dataset spanning 21 years, we examine the relationship between parental care behaviours and number of fly larvae and pupae in Darwin's finch nests. We do so across three host species (
Camarhynchus parvulus
,
C. pauper
,
Geospiza fuliginosa
) and one hybrid
Camarhynchus
group. Nests with longer female brooding duration (minutes per hour spent sitting on hatchlings to provide warmth) had fewer parasites, and this effect depended on male food delivery to chicks. Neither male age nor number of nest provisioning visits were directly associated with number of parasites. While the causal mechanisms remain unknown, we provide the first empirical study showing that female brooding duration is negatively related to the number of ectoparasites in nests. We predict selection for coordinated host male and female behaviour to reduce gaps in nest attendance, especially under conditions of novel and introduced ectoparasites.
Tolerant pattern recognition: evidence from phonotactic responses in the cricketGryllus bimaculatus(de Geer)
Authors: Bent Adam M. , Hedwig Berthold
Published: December 2021

When the amplitude modulation of species-specific acoustic signals is distorted in the transmission channel, signals become difficult to recognize by the receiver. Tolerant auditory pattern recognition systems, which after having perceived the correct species-specific signal transiently broaden their acceptance of signals, would be advantageous for animals as an adaptation to the constraints of the environment. Using a well-studied cricket species,Gryllus bimaculatus, we analysed tolerance in auditory steering responses to ‘Odd’ chirps, mimicking a signal distorted by the transmission channel, and control ‘Silent’ chirps by employing a fine-scale open-loop trackball system.Oddchirps on their own did not elicit a phonotactic response. However, when inserted into a calling song pattern with attractiveNormalchirps, the females' phonotactic response toward these patterns was significantly larger than to patterns withSilentchirps. Moreover, females actively steered towardOddchirps when these were presented within a sequence of attractive chirps. Our results suggest that crickets employ a tolerant pattern recognition system that, once activated, transiently allows responses to distorted sound patterns, as long as sufficient natural chirps are present. As pattern recognition modulates how crickets process non-attractive acoustic signals, the finding is also relevant for the interpretation of two-choice behavioural experiments.
Detection of acne by deep learning object detection
Authors: Sangha Amandip , Rizvi Mohammad
Published: December 2021

Importance

State-of-the art performance is achieved with a deep learning object detection model for acne detection. There is little current research on object detection in dermatology and acne in particular. As such, this work is early in this field and achieves state of the art performance.

Objective

Train an object detection model on a publicly available data set of acne photos.

Design, Setting, and Participants

A deep learning model is trained with cross validation on a data set of facial acne photos.

Main Outcomes and Measures

Object detection models for detecting acne for single-class (acne) and multi-class (four severity levels). We train and evaluate the models using standard metrics such as mean average precision (mAP). Then we manually evaluate the model predictions on the test set, and calculate accuracy in terms of precision, recall, F1, true and false positive and negative detections.

Results

We achieve state-of-the art mean average precision mAP@0.5 value of 37.97 for the single class acne detection task, and 26.50 for the 4-class acne detection task. Moreover, our manual evaluation shows that the single class detection model performs well on the validation set, achieving true positive 93.59 %, precision 96.45 % and recall 94.73 %.

Conclusions and Relevance

We are able to train a high-accuracy acne detection model using only a small publicly available data set of facial acne. Transfer learning on the pre-trained deep learning model yields good accuracy and high degree of transferability to patient submitted photographs. We also note that the training of standard architecture object detection models has given significantly better accuracy than more intricate and bespoke neural network architectures in the existing research literature.

Key Points

Question

Can deep learning-based acne detection models trained on a small data set of publicly available photos of patients with acne achieve high prediction accuracy?

Findings

We find that it is possible to train a reasonably good object detection model on a small, annotated data set of acne photos using standard deep learning architectures.

Meaning

Deep learning-based object detection models for acne detection can be a useful decision support tools for dermatologists treating acne patients in a digital clinical practice. It can prove a particularly useful tool for monitoring the time evolution of the acne disease state over prolonged time during follow-ups, as the model predictions give a quantifiable and comparable output for photographs over time. This is particularly helpful in teledermatological consultations, as a prediction model can be integrated in the patient-doctor remote communication.
Contribution of endogenous and exogenous antibodies to clearance of SARS-CoV-2 during convalescent plasma therapy
Authors: Marconato Maddalena , Abela Irene A. , Hauser Anthony , Schwarzmüller Magdalena , Katzensteiner Rheliana , Braun Dominique L. , Epp Selina , Audigé Annette , Weber Jacqueline , Rusert Peter , Schindler Emèry , Pasin Chloé , West Emily , Böni Jürg , Kufner Verena , Huber Michael , Zaheri Maryam , Schmutz Stefan , Frey Beat M. , Kouyos Roger D. , Günthard Huldrych F. , Manz Markus G. , Trkola Alexandra
Published: December 2021

Neutralizing antibodies are considered a key correlate of protection by current SARS-CoV-2 vaccines. The ability of antibody-based therapies, including convalescent plasma, to affect established disease remains to be elucidated. Only few monoclonal therapies and only when used at a very early stage of infection have shown efficacy. Here, we conducted a proof-of-principle study of convalescent plasma therapy in a phase I trial in 30 COVID-19 patients including immunocompromised individuals hospitalized early after onset of symptoms. A comprehensive longitudinal monitoring of the virologic, serologic, and disease status of recipients in conjunction with detailed post-hoc seroprofiling of transfused convalescent plasma, allowed deciphering of parameters on which plasma therapy efficacy depends. Plasma therapy was safe and had a significant effect on viral clearance depending on neutralizing and spike SARS-CoV-2 antibody levels in the supplied convalescent plasma. Endogenous immunity had strong effects on virus control. Lack of endogenous neutralizing activity at baseline was associated with a higher risk of systemic viremia. The onset of endogenous neutralization had a noticeable effect on viral clearance but, importantly, even after adjusting for their endogenous neutralization status recipients benefitted from therapy with high neutralizing antibody containing plasma.

In summary, our data demonstrate a clear impact of exogenous antibody therapy on the rapid clearance of viremia in the early stages of infection and provide directions for improved efficacy evaluation of current and future SARS-CoV-2 therapies beyond antibody-based interventions. Incorporating an assessment of the endogenous immune response and its dynamic interplay with viral production is critical for determining therapeutic effects.

One Sentence Summary

This study demonstrates the impact of exogenous antibody therapy by convalescent plasma containing high neutralizing titers on the rapid clearance of viremia in the early stages of SARS-CoV-2 infection.
COVID-19 booster vaccine attitudes and behaviors among university students and staff: the USC Trojan Pandemic Research Initiative
Authors: Lee Ryan C. , Hu Howard , Kawaguchi Eric S. , Kim Andre. E , Soto Daniel W. , Shanker Kush , Klausner Jeffrey D. , Van Orman Sarah , Unger Jennifer B.
Published: December 2021

Introduction

Although COVID-19 vaccines significantly reduce morbidity and mortality, recent evidence suggests that immunity wanes after 6-9 months, and that a third vaccine dose could further reduce COVID-19 transmission and severe illness. However, previous studies have not assessed attitudes about getting booster doses. This study examined COVID-19 booster vaccine attitudes and behaviors among university students and staff in the fall of 2021.

Methods

Participants responded to an email invitation and completed electronic surveys. Results. In our sample, 96.2% of respondents indicated willingness to get a COVID-19 booster shot at least once per year. In both bivariate and multivariate analyses higher trust in science was associated with having higher odds of booster willingness. Those who identify as Black, on average, reported trusting science less than other racial/ethnic groups.

Conclusions

Our findings demonstrate high willingness to receive a COVID-19 booster shot and highlight the importance of educational and motivational messages that focus on trust in science to increase willingness to get the COVID-19 booster. More research is needed to better understand the impact of cultural beliefs on booster willingness and vaccine hesitancy. This understanding will help determine what messages and populations to target to increase booster willingness in the future.
Phenome-Wide Association Study of Actigraphy in the UK Biobank
Authors: Brooks Thomas G. , Lahens Nicholas F. , Grant Gregory R. , Sheline Yvette I. , FitzGerald Garret A. , Skarke Carsten
Published: December 2021

Wrist-worn accelerometer actigraphy devices present the opportunity for large-scale data collection from people during their daily lives. Using data from approximately 100,000 participants in the UK Biobank, actigraphy-derived measures of physical activity, sleep, and diurnal rhythms were associated in exploration and validation cohorts with a full phenome-wide set of diagnoses, biomarkers and metadata. Rhythmicity was captured by two independent models based on accelerometer and skin temperature harnessing behavioral (diurnal) and molecular (circadian) components. We found that robust rhythms significantly with biomarkers, survival, and phenotypes including diabetes, hypertension, mood disorders, and chronic airway obstruction; these associations were comparable to those with physical activity and sleep. Surprisingly, associations were mostly consistent between the sexes, while modulation by age was significant. More importantly, rhythms were found to be powerful predictors of future diseases: a two standard deviation difference in wrist temperature rhythms corresponded to increases in rate of diagnosis of 61% in diabetes, 38% in chronic airway obstruction, 27% in anxiety disorders, and 22% in hypertension. Our PheWAS of actigraphy data in the UK Biobank establishes that rhythmicity is fundamental to modeling disease trajectories, as are physical activity and sleep. Integration of long-term remote biosensing into patient care could thus afford an individualized approach to risk management.
Disruption in structural-functional network repertoire and time-resolved subcortical-frontoparietal connectivity in disorders of consciousness
Authors: Panda Rajanikant , Thibaut Aurore , Lopez-Gonzalez Ane , Escrichs Anira , Bahri Mohamed Ali , Hillebrand Arjan , Deco Gustavo , Laureys Steven , Gosseries Olivia , Annen Jitka , Tewarie Prejaas
Published: December 2021

Understanding recovery of consciousness and elucidating its underlying mechanism is believed to be crucial in the field of basic neuroscience and medicine. Ideas such as the global neuronal workspace and the mesocircuit theory hypothesize that failure of recovery in conscious states coincide with loss of connectivity between subcortical and frontoparietal areas, a loss of the repertoire of functional networks states and metastable brain activation. We adopted a time-resolved functional connectivity framework to explore these ideas and assessed the repertoire of functional network states as a potential marker of consciousness and its potential ability to tell apart patients in the unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS). In addition, prediction of these functional network states by underlying hidden spatial patterns in the anatomical network, i.e. so-called eigenmodes, were supplemented as potential markers. By analysing time-resolved functional connectivity from fMRI data, we demonstrated a reduction of metastability and functional network repertoire in UWS compared to MCS patients. This was expressed in terms of diminished dwell times and loss of nonstationarity in the default mode network and fronto-parietal subcortical network in UWS compared to MCS patients. We further demonstrated that these findings co-occurred with a loss of dynamic interplay between structural eigenmodes and emerging time-resolved functional connectivity in UWS. These results are, amongst others, in support of the global neuronal workspace theory and the mesocircuit hypothesis, underpinning the role of time-resolved thalamo-cortical connections and metastability in the recovery of consciousness.