bluuebunny/crossref_metadata_2025 huggingface dataset:
Medicaid Enrollment and Intergenerational Transfers of Wealth Among Older Adults
Authors: Spishak-Thomas Amanda
Published: June 2024

Background and Objectives

Medicaid look-back periods are meant to prevent Medicaid applicants from gifting assets to meet eligibility requirements. These policies have the potential to affect families across generations given their ability to restrict the transfer of assets between parent and child.

Research Design and Methods

Using 2008–2018 data from the Health and Retirement Study, this study analyzed the estate planning and familial wealth transfer behaviors of a cohort of older adults aged 65 and older who became Medicaid recipients during a 10-year period.

Results

There were 8,347 respondents aged 65 and older in 2008 and 11.96% of respondents who were not Medicaid recipients at baseline became recipients over the study period. A little more than one third (36.47%) of Medicaid recipients participated in estate planning and asset transfer prior to becoming a recipient, with significant differences among select demographic characteristics. Married recipients were more likely to transfer money compared to their widowed counterparts (51.69% compared to 36.44%; p < .001) and transferred larger amounts compared to those unmarried ($16,286.94 compared to 5,379.13). White, well-educated, married, men participated in higher rates of estate planning, likely a reflection of who has access to resources to make necessary arrangements early.

Discussion and Implications

This analysis concludes that more structurally advantaged groups are more likely to engage in estate planning prior to Medicaid enrollment. This analysis demonstrates that some individuals may circumvent Medicaid policies like look-back periods and estate recovery, while others cannot. Policymakers should consider policies that promote the financial health of low-income families.
SL n Contravariant Matrix-Valued Valuations on Polytopes
Authors: Zeng Chunna , Zhou Yuqi
Published: June 2024

Without any continuity assumptions, a complete classification of $\textrm{SL}(n)$ contravariant, matrix-valued valuations on convex polytopes is established. Furthermore, the constraint for matrix symmetry is removed. If $n\geq 4$, then such valuations are uniquely characterized by the generic Lutwak–Yang–Zhang matrix; in dimension three, a new function appears. The classification result in the 2-dimensional case is consistent with the established example of $\textrm{SL}(2)$-equivariant matrix-valued valuation.
Establishing Correlates of Maternal-Fetal Cytomegalovirus Transmission—One Step Closer Through Predictive Modeling
Authors: Marchant Arnaud , Adali Sancar , Alsdurf Hannah , Bol Vanesa , Capelle Xavier , De Schrevel Nathalie , Delroisse Jean-Marc , Devlieger Roland , Dieussaert Ilse , Donner Catherine , Janssens Michel , Loquet Philip , Panackal Anil A , Seidl Claudia , van den Berg Robert A , Paris Robert
Published: June 2024

Background

Determinants of maternal-fetal cytomegalovirus (CMV) transmission and factors influencing the severity of congenital CMV (cCMV) infection are not well understood.

Methods

We conducted a descriptive, multicenter study in pregnant women ≥18 years old with primary CMV infection and their newborns to explore maternal immune responses to CMV and determine potential immunologic/virologic correlates of cCMV following primary infection during pregnancy. We developed alternative approaches looking into univariate/multivariate factors associated with cCMV, including a participant clustering/stratification approach and an interpretable predictive model–based approach using trained decision trees for risk prediction (post hoc analyses).

Results

Pregnant women were grouped in 3 distinct clusters with similar baseline characteristics, particularly gestational age at diagnosis. We observed a trend for higher viral loads in urine and saliva samples from mothers of infants with cCMV versus without cCMV. When using a trained predictive-model approach that accounts for interaction effects between variables, anti-pentamer immunoglobulin G antibody concentration and viral load in saliva were identified as biomarkers jointly associated with the risk of maternal-fetal CMV transmission.

Conclusions

We identified biomarkers of CMV maternal-fetal transmission. After validation in larger studies, our findings will guide the management of primary infection during pregnancy and the development of vaccines against cCMV.

Clinical Trials Registration

NCT01251744.
Internal carbon recycling by heterotrophic prokaryotes compensates for mismatches between phytoplankton production and heterotrophic consumption
Authors: Eigemann Falk , Tait Karen , Temperton Ben , Hellweger Ferdi L
Published: June 2024

Molecular observational tools are useful for characterizing the composition and genetic endowment of microbial communities but cannot measure fluxes, which are critical for the understanding of ecosystems. To overcome these limitations, we used a mechanistic inference approach to estimate dissolved organic carbon (DOC) production and consumption by phytoplankton operational taxonomic units and heterotrophic prokaryotic amplicon sequence variants and inferred carbon fluxes between members of this microbial community from Western English Channel time-series data. Our analyses focused on phytoplankton spring and summer blooms, as well as bacteria summer blooms. In spring blooms, phytoplankton DOC production exceeds heterotrophic prokaryotic consumption, but in bacterial summer blooms heterotrophic prokaryotes consume three times more DOC than produced by the phytoplankton. This mismatch is compensated by heterotrophic prokaryotic DOC release by death, presumably from viral lysis. In both types of summer blooms, large amounts of the DOC liberated by heterotrophic prokaryotes are reused through internal recycling, with fluxes between different heterotrophic prokaryotes being at the same level as those between phytoplankton and heterotrophic prokaryotes. In context, internal recycling accounts for approximately 75% and 30% of the estimated net primary production (0.16 vs 0.22 and 0.08 vs 0.29 μmol l−1 d−1) in bacteria and phytoplankton summer blooms, respectively, and thus represents a major component of the Western English Channel carbon cycle. We have concluded that internal recycling compensates for mismatches between phytoplankton DOC production and heterotrophic prokaryotic consumption, and we encourage future analyses on aquatic carbon cycles to investigate fluxes between heterotrophic prokaryotes, specifically internal recycling.
The role of gaming for information, education and communication of AMR: full review of online education resources
Authors: Trehan Romita , Goujet Raphael , Sharma Tina , Vats Abhinav , Patel Nidhiben , Bhardwaj Anshu
Published: June 2024

Background

The first objective of the Global Action Plan on antimicrobial resistance (AMR) is to improve awareness and understanding of AMR through effective communication, education and training. Towards this several efforts have been made to create AMR awareness resources. The aim of these resources is to inform the public about responsible antibiotic use and drive positive behavioural change. Digital media and specifically games can serve as unique innovative platforms in public communication programmes.

Objectives

This study focuses on compiling and evaluating game-based AMR resources. Recognizing the engaging and creative potential of games as learning tools, the primary objective of this study was to identify games that can be used, individually or in combination depending on their unique focus and gameplay experience, for AMR awareness. Furthermore, games are evaluated on five objective criteria and recommendations are made towards further development of gaming resources towards AMR awareness.

Methods

Meticulous curation was performed to mine information, education and communication resources, with a primary focus on games for AMR awareness and evaluating them based on game design and gameplay, AMR content and learning, engagement and replay appeal, learning outcomes, and level of difficulty and challenges.

Results

In this study, we selected 12 AMR games. Our evaluations, spanning various gamification elements and interactive parameters, informed recommendations for future AMR resource development, including multilevel game design, varied graphics, simple-to-understand rules, sustained challenge and a sense of reward, among others.

Conclusions

This study generated the first-ever comprehensive catalogue of AMR games that may assist public communication programmes for AMR awareness. Evaluation of these games led to actionable design recommendations for future resources towards effective communication of AMR complexity, enhanced learning and awareness.
Identities without Products: When the Preference for Self-Linked Products Weakens
Authors: Weiss Liad , Tanner Robin J
Published: June 2024

Extant literature and common marketing practices converge around the idea that stronger self-links to a brand and its products lead to increased brand loyalty. In this article, we challenge this conventional notion by revealing situations where the preference for self-linked brands diminishes, despite the self-links remaining unchanged. We introduce a key distinction between two types of consumer identities based on whether identity expression relies on specific products: product-dependent (e.g., chef) and product-independent (e.g., foodie). Our theory posits that self-links to products exert less influence on preference when a product-independent identity is prominent. Across five studies examining consumer leisure identities, we find that priming a product-independent (vs. product-dependent) identity reduces preference for self-linked products/brands. Interestingly, it can also enhance preference for negatively self-linked (dissociative) products/brands among materialistic consumers. In a sixth experiment and a real-world Facebook study, we illustrate that the extent to which consumers’ identity is chronically product-independent can be assessed either directly or indirectly from social media interests, allowing for more effective targeting of brand-switching appeals. Adding to the literature on the symbolic role of products in identity expression, our research uniquely investigates the functional role of products in identity expression and its profound impact on product/brand preference.
Estimates of net primary productivity and actual evapotranspiration over the Tibetan Plateau from the Community Land Model version 4.5 with four atmospheric forcing datasets
Authors: Lin Shan , Huang Kewei , Sun Xiangyang , Song Chunlin , Sun Juying , Sun Shouqin , Wang Genxu , Hu Zhaoyong
Published: June 2024

The accuracy of the simulation of carbon and water processes largely relies on the selection of atmospheric forcing datasets when driving land surface models (LSM). Particularly in high-altitude regions, choosing appropriate atmospheric forcing datasets can effectively reduce uncertainties in the LSM simulations. Therefore, this study conducted four offline LSM simulations over the Tibetan Plateau (TP) using the Community Land Model version 4.5 (CLM4.5) driven by four state-of-the-art atmospheric forcing datasets. The performances of CRUNCEP (CLM4.5 model default) and three other reanalysis-based atmospheric forcing datasets (i.e. ITPCAS, GSWP3 and WFDEI) in simulating the net primary productivity (NPP) and actual evapotranspiration (ET) were evaluated based on in situ and gridded reference datasets. Compared with in situ observations, simulated results exhibited determination coefficients (R2) ranging from 0.58 to 0.84 and 0.59 to 0.87 for observed NPP and ET, respectively, among which GSWP3 and ITPCAS showed superior performance. At the plateau level, CRUNCEP-based simulations displayed the largest bias compared with the reference NPP and ET. GSWP3-based simulations demonstrated the best performance when comprehensively considering both the magnitudes and change trends of TP-averaged NPP and ET. The simulated ET increase over the TP during 1982–2010 based on ITPCAS was significantly greater than in the other three simulations and reference ET, suggesting that ITPCAS may not be appropriate for studying long-term ET changes over the TP. These results suggest that GSWP3 is recommended for driving CLM4.5 in conducting long-term carbon and water processes simulations over the TP. This study contributes to enhancing the accuracy of LSM in water–carbon simulations over alpine regions.
Provisional SPS Measures
Authors: Gruszczynski Lukasz
Published: June 2024

This chapter focuses on provisional sanitary and phytosanitary (SPS) measures. In this context, it analyzes in details four constituting conditions of Article 5.7: (i) a measure must be imposed in respect of a situation where ‘relevant scientific information is insufficient’; (ii) such a measure needs to be adopted ‘on the basis of available pertinent information’; (iii) the Member in question must ‘seek to obtain the additional information necessary for a more objective assessment of risk’; and (iv) the Member in question must ‘review the . . . measure accordingly within a reasonable period of time’. The chapter also looks at the dispute settlement dimensions of Article 5.7, examining the problem of burden of proof and applicable standard of review. Last but not least, the chapter analyzes the status of the precautionary principle in the context of the SPS Agreement.
Control, Inspection, and Approval Procedures
Authors: Gruszczynski Lukasz
Published: June 2024

This chapter expounds on the notion of control, inspection, and approval procedures found in the Agreement on the Application of Sanitary and Phytosanitary Measures (the SPS Agreement). It mentions that proceduralism is a key element of many modern theories of regulations, citing its influence on the relationship of private and public actors. Procedures are increasingly deployed as instruments to induce reflexivity in governance and the ongoing, contextual, elaboration of norms. Against this background, the chapter elaborates on the procedures indicated in Article 8 and Annex C of the SPS Agreement as developed by the WTO dispute settlement bodies.
Co-evolution of dust grains and protoplanetary disks. II. Structure and evolution of protoplanetary disks: An analytical approach
Authors: Tsukamoto Yusuke
Published: June 2024

In our previous study (Tsukamoto et al. 2023b, PASJ, 75, 835), we investigated the formation and early evolution of protoplanetary disks with 3D non-ideal magnetohydrodynamics simulations considering dust growth, and found that the modified equations of the conventional steady accretion disk model that consider magnetic braking, dust growth, and ambipolar diffusion reproduce the disk structure (such as density and vertical magnetic field) obtained from simulations very well. In this paper, as a sequel to our previous study, we analytically investigate the structure and evolution of protoplanetary disks corresponding to Class 0/I young stellar objects using the modified steady accretion disk model combining an analytical model of envelope accretion. We estimate that the disk radius is several astronomical units at the disk formation epoch and increases to several hundred astronomical units at the end of the accretion phase. The disk mass is estimated to be $0.01 \lesssim M_{\rm disk} \lesssim 0.1 \, M_\odot$ for a disk with a radius of several tens of astronomical units and a mass accretion rate of $\dot{M}_{\rm disk} \sim 10^{-6} \, M_\odot \,\, {\rm yr^{-1}}$. These estimates seems to be consistent with recent observations. We also found that, with typical disk ionization rates (ζ ≳ 10−19 s−1) and a moderate mass accretion rate ($\dot{M}_{\rm disk}\gtrsim 10^{-8} \, M_\odot \,\, {\rm yr^{-1}}$), magnetorotational instability is suppressed in the disk because of low plasma β and efficient ambipolar diffusion. We argue that the radial profile of specific angular momentum (or rotational velocity) at the disk outer edge should be continuously connected to that of the envelope if the disk evolves by magnetic braking, and should be discontinuous if the disk evolves by an internal angular momentum transport process such as gravitational instability or magnetorotational instability. Future detailed observations of the specific angular momentum profile around the disk outer edge are important for understanding the angular momentum transport mechanism of protoplanetary disks.
Nudging down residential burglaries: A randomized control trial
Authors: Crowe Andrew , Cooper John , Roach Jason
Published: June 2024

Although the use of ‘nudges’ to influence decision-making and behaviour continues to be widely adopted by social policymakers, such as encouraging increases in organ donations, it is yet to get a similar foothold in the thinking and practice of reducing crime and policing. This paper seeks to assess the utility of the Nudge approach for achieving a reduction in residential burglary in Durham, England, by testing its efficacy using a Randomised Control Trial.
Danielle Allen's Design for Democracy: A Review Essay
Authors: Johnston David
Published: June 2024

In Justice by Means of Democracy, author Danielle Allen argues that justice in the fullest sense requires a robust set of democratic institutions and practices. Focused on the United States, the author challenges the idea that justice can be achieved by first maximizing economic output and then redistributing funds and benefits to enhance the welfare of poor and less-well-off people. In the book, Allen suggests a wide range of policy proposals and institutional reforms intended to lead toward participatory constitutional democracy; social practices that enable people to make connections across divides of race, class, and the like; a more inclusive approach to immigration and integration of immigrants into American society; and an economy that empowers ordinary people and strengthens democracy. However, the author's arguments for these proposals suffer from lack of intellectual clarity about principles, institutions, and democratic practices. The argument is also weakened by its avoidance of the hard issues that arise when scholars and others turn from lofty principles to attempts to implement them. Consequently, the book falls far short of achieving its bold ambitions.
Factors affecting 12-month unplanned readmissions for chronic obstructive pulmonary disease patients: the effect of mental disorders in an Australian cohort
Authors: Wijekulasuriya Shalini , Sa Zhisheng , Badgery-Parker Tim , Long Janet C , Braithwaite Jeffrey , Chapman David G , Levesque Jean-Frédéric , Watson Diane E , Westbrook Johanna I , Mitchell Rebecca
Published: June 2024

Background

Many individuals with chronic obstructive pulmonary disease (COPD) experience frequent hospitalization and readmissions, which is burdensome on the health system. This study aims to investigate factors associated with unplanned readmissions and mortality following a COPD-related hospitalization over a 12-month period in Australia, focusing on mental disorders and accounting for the acute phase of the COVID-19 pandemic.

Methods

A retrospective cohort study using linked hospitalization and mortality records identified individuals aged ≥40 years who had at least one hospital admission with a principal diagnosis of COPD between 2014 and 2020 in New South Wales, Australia. A semi-competing risk analysis was conducted to examine factors associated with unplanned readmission and mortality.

Results

Adults with a mental disorder diagnosis, specifically anxiety, had a higher risk of 12-month unplanned readmission. Individuals with anxiety and dementia also had a higher risk of mortality pre- and post-unplanned readmission. Individuals who were admitted during the acute phase of the COVID-19 pandemic period had lower risk of unplanned readmission, but higher risk of mortality without unplanned readmission.

Conclusion

Interventions aimed at reducing admissions should consider adults living with mental disorders such as anxiety or dementia to improve healthcare delivery and health outcomes for individuals living with COPD.
Ovomemolins: Egg‐derived peptides that improved cognitive decline after oral administration in mice
Authors: Nakajima Takanobu , Shobako Maiko , Kaneko Kentaro , Kurabayashi Atsushi , Sato Masaru , Ohinata Kousaku
Published: June 2024

Eggs not only contain all the molecules necessary to nurture new life but are also rich in nutrients such as high‐quality protein. For example, epidemiologic studies have shown that egg intake is positively correlated with cognitive function. Thus, we specifically examined the effect of ovalbumin, a major protein present in egg whites, on cognitive function. First, we found that an orally administered enzymatic digest of ovalbumin improves cognitive function in mice fed a high‐fat diet. Then, we narrowed down candidate peptides based on the prediction of peptide production according to enzyme‐substrate specificity and comprehensive peptide analysis of the digest. We found that three peptides, namely ILPEY, LYRGGLEP, and ILELP, improve cognitive function after oral administration. We also showed that ILPEY, LYRGGLEP, and ILELP were present in the digest and named them ovomemolins A (OMA), B, and C, respectively. Notably, ovomemolins are the first peptides derived from egg whites that have been shown to improve cognitive function. The cognitive improvement induced by OMA, the most abundant of the peptides in the digest, was inhibited by methyllycaconitine, an antagonist of α7nAChR, which is known to be related to memory. These results suggest that OMA improves cognitive function through the acetylcholine system. After OMA administration, brain‐derived neurotrophic factor (BDNF) mRNA expression and the number of 5‐bromo‐2′‐deoxyuridine‐positive cells suggested that OMA increases hippocampal BDNF expression and neurogenesis.
Dynamic Magnetic Resonance Imaging Protocol: An Effective and Useful Tool to Assess Discoid Lateral Meniscus Instability in Children
Authors: Cance Nicolas , Rouchaud Aymeric , Chousta Aygulph , Josse Antoine , James Dan Michael , Chotel Franck
Published: June 2024

Objectives:

One of the most common symptoms in cases of discoid lateral meniscus (DLM) in children is a “snapping” knee. The clock in extension, followed by a pop in flexion, perceived by the clinician, reflects the meniscal displacement caused by the peripheral meniscocapsular detachment. Standard magnetic resonance imaging (MRI) results in a 40% false-negative rate for detecting this instability. The hypothesis was that a dynamic MRI protocol could reduce the false negative rate and improve the efficiency of the MRI in detecting the direction of instability.

Methods:

Eight DLM knees (8 patients) with snapping knees (grade 2 of Lyon’s classification) were included in this monocentric prospective preliminary study in a referral center of pediatric orthopaedic surgery. Every patient underwent a dynamic MRI protocol with both T2-Fat-Sat sagittal and coronal slices, performed “after the clock” and again “after the pop” in a knee with standard 20 degrees of flexion during acquisition. All the MRI data were correlated with an arthroscopic description of the peripheral tear of the DLM according to Ahn’s classification to assess for diagnostic accuracy.

Results:

The standard MRI protocol resulted in a false-negative rate of 50% for detecting the direction of instability. The dynamic MRI protocol allowed the identification of, and classification of the meniscal instability, meniscal shift, and meniscocapsular tear in 8 of 8 patients (0% false-negative rate), perfectly correlated with arthroscopic findings.

Conclusion:

This preliminary series, although short, allowed us to understand all the types of movements and lesions associated with the child’s discoid meniscus. The detailed case analysis showed a strong benefit of such a protocol for planning the surgical suture procedure. The functionality and reliability of the dynamic MRI protocol is a good and method relatively simple method which does not require specific equipment, minimizing any additional cost compared with standard MRI.

Level of Evidence:

Level IV.
Development and Validation of Eyes Care Bundle for Mechanically Ventilated Patients
Authors: Ali Sahar Ahmed , Mohammed Tark Ahmed , Mohammed Mona Aly , Mahgoub Asmaa Aly
Published: June 2024

Lack of proper eye care (EC) for mechanically ventilated patients can lead to serious ocular complications. Objective of this study is to develop and validate eyes care bundle for mechanically ventilated patients. A Delphi design study was conducted between March and May 2021. The Content Validity Index (CVI) was used to calculate the degree of agreement among the experts to analyze the bundle. Content validity was determined by 5 experts using a 4-point Likert scale. They evaluated the items in terms of the following: 1 = “irrelevant,” 2 = “somewhat relevant if the phrasing is profoundly adjusted,” 3 = “relevant with some adjustment,” and 4 = “very relevant.” The CVI was applied, and the accepted value was ≥0.50. The validation of EC bundle was conducted through 3 rounds after developed it based on the evaluated research evidence. The items were reviewed for content and face validity. The bundle was validated with 5 items with a total CVI of 0.96, a face validity of 1, and a Scale-Level Content Validity Index/Universal Agreement calculation method value of 0.8. This bundle can help critical care nurses, doctors, academics, and students assess and provide standard EC for mechanically ventilated patients.
Individual and additive-effect relationships of menopausal symptoms and subjective cognitive decline among nurses during menopausal transition: a cross-sectional study
Authors: He Xudong , Hou Fangyan , Shen Xiaona , Zhao Di , Zhao Xiangyu , Qi Meiling , Li Ping
Published: June 2024

Objective

This study aimed to examine the individual and additive-effect relationships between menopausal symptoms and subjective cognitive decline among nurses during menopausal transition.

Methods

Between February and September 2019, a convenience sampling strategy was used, involving 1,335 Chinese nurses undergoing menopausal transition. A general information survey that included the Subjective Cognitive Decline Scale and the Menopause Rating Scale was completed. Based on a cut-off point of the subjective cognitive decline score of 7.5, the overall sample was divided into mild and severe groups. Propensity score matching was performed to balance covariates of mild and severe subjective cognitive decline. The individual and cumulative effects of menopausal symptoms and subjective cognitive decline were analyzed using binary logistic regression and the Cochran-Armitage trend test, respectively.

Results

After propensity score matching, none of the parameters showed significant differences between the groups. Logistic regression analysis revealed that four menopausal symptoms were closely associated with severe subjective cognitive decline. The Cochran-Armitage trend test indicated odds ratios linking the presence of these symptoms with increased severe subjective cognitive impairment. In addition, nurses simultaneously experiencing two or more core menopausal symptoms were over six times more likely to have severe subjective cognitive decline than nurses experiencing none or one core menopausal symptom during menopausal transition.

Conclusions

Individual and additive numbers of menopausal symptoms significantly influenced subjective cognitive decline in nurses during their menopausal transition. These findings suggest that interventions aimed at enhancing the cognitive performance of nurses experiencing menopause should consider menopausal symptoms.
The Dual-plane Technique for Correcting Sunken Upper Eyelid Deformity with Hyaluronic Acid Filler Injections
Authors: Bagci Bulent
Published: June 2024

The dual-plane technique is an effective and safe method that aims to correct sunken upper eyelid deformity by increasing the volume of retro-orbicularis oculi fat, and especially supraorbital fat, through hyaluronic acid filler injection. Filling in the superficial plane allows for a more precise correction of sunken upper eyelid deformity with a smaller amount of filler. Contrary to common knowledge in the literature, this technique—filling the superficial plane with a filler, such as subcutaneous fat—does not lead to irregular filler accumulation and surface irregularity on the skin. Additionally, the risk of complications is much lower compared with techniques that recommend filling the deep plane using a sharp needle.
Mixed Reality in the Operating Room: An Initial Use in Frontal Sinus Setback in Gender-affirming Facial Surgery
Authors: Kass Nicolás M. , Cheng Lucille G. , Irgebay Zhazira , Moroni Elizabeth , Dvoracek Lucas , Canton Stephen P. , Sharma Nikhil , Steuer Fritz , Andrews Edward G. , Goldstein Jesse A.
Published: June 2024

Demand for gender-affirming facial surgery is growing rapidly. Frontal sinus setback, one of the key procedures used in gender-affirming facial surgery, has a particularly high impact on gender perception. Mixed reality (MR) allows a user to view and virtually overlay three-dimensional imaging on the patient and interact with it in real time. We used the Medivis’s SurgicalAR system in conjunction with the Microsoft HoloLens Lucille2 (Microsoft). Computed tomography imaging was uploaded to SurgicalAR, and a three-dimensional (3D) hologram was projected onto the display of the HoloLens. The hologram was registered and matched to the patient, allowing the surgeon to view bony anatomy and underlying structures in real time on the patient. The surgeon was able to outline the patient’s frontal sinuses using the hologram as guidance. A 3D printed cutting guide was used for comparison. Negligible difference between the mixed reality-based outline and 3D-printed outline was seen. The process of loading the hologram and marking the frontal sinus outline lasted less than 10 minutes. The workflow and usage described here demonstrate significant promise for the use of mixed reality as imaging and surgical guidance technology in gender-affirming facial surgery.
Isolated Medial Platysmaplasty and Harmonization of the Lower Third of Face with Local Fat Autograft: A Case Report
Authors: Borisenko Anastasiya S. , Sharobaro Valentin I. , Burkhonova Nigora S. , Avdeev Alexey E. , Ermolaev Alexander A. , Ahmed Alsheikh Yousif M.
Published: June 2024

One of the most common complaints of patients seeking plastic surgery is the presence of age-related changes in the lower third of the face. These often include vertical platysmal bands, a double chin, Venus rings, the absence of the cervico-mental angle, hypertonicity of the muscles in the mental area, and insufficient projection of the chin. The development and implementation of less-traumatic methods of correction of the lower third of the face and harmonization of the projection of the cervico-mental region remain relevant. This article discusses a comprehensive and individualized approach with minimally invasive techniques for correcting age-related changes in the lower third of the face and harmonizing the definition of the jawline. Isolated platysmaplasty with autologous local fat grafting to the chin is effective, safe, minimally invasive, and has a short rehabilitation period, with stable long-term aesthetic outcomes.
Prediction of footplate position after implantable collamer lens implantation based on iris and ciliary body morphologies
Authors: Wu Hao , Wang Yi-ou , Chen Jiong-pu , Luo Dong-qiang , Chen Jiao , Zhong Ding-juan , Wang Hua
Published: June 2024

Purpose:

To investigate the factors affecting footplate position and its influence on vault characteristics after implantable collamer lens (ICL) implantation.

Setting:

Hunan Provincial People's Hospital, Changsha, China.

Design:

Retrospective case series.

Methods:

This study included 124 patients (124 eyes). Ultrasound biomicroscopy (UBM) was performed to assess the iris and ciliary body morphologies and observe the footplate position. Using multiple linear regression, the relationship between various ocular and ICL parameters and the vault as well as the factors affecting the footplate distance (FD) were analyzed. Based on the FD, 3 groups were formed: group 1 (<500 μm), group 2 (500 to 1000 μm), and group 3 (>1000 μm). The distribution of the vault range postoperatively was observed for the 3 groups.

Results:

Ciliary sulcus angle and FD significantly affected the vault (adjusted R
2 = 0.190, F = 6.763, P < .001), with FD being the most important factor influencing the vault (β = −0.383, P < .001). Postoperative UBM revealed that the footplate was located at different positions in the posterior chamber, with the majority (52%) being located on the ciliary body. The mean size of the 4 footplate orientations was 0.88 ± 0.24 mm. Multiple linear regression analysis revealed that ciliary body thickness (CBT), iris curvature (IC), and ICL iris contact length (IRCL) significantly influenced the FD (adjusted R
2 = 0.373, F = 11.432, P < .001). The vault range differed significantly among the 3 groups (X2 = 32.33, P < .001).

Conclusions:

Different postoperative ICL footplate positions significantly affect the vault. CBT, IC, and IRCL can alter the position of the footplate from the expected position. This study provides reference for ICL size selection and vault prediction.
Trends in Sexually Transmitted Infections Associated With the Doxycycline Postexposure Prophylaxis Guidelines in San Francisco
Authors: Liu Andy , Hao Jiayuan , Pickering Trevor A. , Klausner Jeffrey D.
Published: June 2024

The San Francisco Department of Public Health was the first to issue guidance on the use of doxycycline for postexposure prophylaxis against sexually transmitted infections in at-risk populations. We investigated the association between the issuance of these guidelines and rates of male rectal chlamydia, male rectal gonorrhea, and adult male syphilis.
The Expression of PRAME as an Aid for Diagnosis and Evaluation of Histologic Margins of Intraepidermal Cutaneous Melanoma in Xeroderma Pigmentosum Patients
Authors: Ferreira Leonardo Ávila , Kim Esther Hae Ji , Stelini Rafael Fantelli , Velho Paulo Eduardo Neves Ferreira , de Moraes Aparecida Machado , Buffo Thais , Cintra Maria Letícia
Published: June 2024

Xeroderma Pigmentosum (XP) is a genetic disorder characterized by photosensitivity, dyschromia, and high risk of skin cancer. From a clinical and histologic view, it can be difficult to diagnose cutaneous melanoma (CM) in XP patients and to define its resection margins. We aimed to study the role of PRAME (PReferentially Expressed Antigen in MElanoma) in differentiating intraepidermal CM from superficial atypical melanocytic proliferation of uncertain significance (SAMPUS) and evaluating the histological margins of CMs. We included XP patients. melanocitic and nonmelanocytic lesions with adjacent skin, and, as control groups, sun-damaged skin from non-XP individuals. Melanocytic lesions with a consensus diagnosis were grouped into CM, SAMPUS, or benign. The selected samples were PRAME-immunoshistochemically stained, and the ratio between immuno-positive cells/mm was recorded, according to Olds and colleagues for intraepidermal lesions. Lezcano and colleagues' method was used for intradermal lesions. Clinical data from XP patients were reviewed. All 9 patients were alive and well at the study closure, even those who developed melanoma metastases. Positive/diffuse PRAME expression was found in 29% (7/24) of intraepidermal CMs and 20% (1/5) SAMPUS samples. All 103 XP control samples and 24 adjacent lesions skin of non-XP patients were PRAME negative. This was a single-center and retrospective study, using a relatively small sample, limiting our conclusions. In XP patients’ lesions, PRAME expression could help in the setting of challenging melanocytic tumors and surgical margins evaluation. It is also possible that the method can avoid overdiagnosis and, consequently, more aggressive treatment recommendation in unequivocal CM cases.
Efficacy of Empirical 131I Radioiodine Therapy in Well-Differentiated Thyroid Carcinoma Patients With Thyroglobulin-Elevated Negative Iodine Scintigraphy Syndrome
Authors: Kim Keunyoung , Hong Chae Moon , Ha Mihyang , Choi Miyoung , Bang Ji-In , Park Sohyun , Seo Youngduk , Chong Ari , Oh So Won , Lee Sang-Woo
Published: June 2024

Objectives

This study aimed to perform a systematic review and meta-analysis on the efficacy of empirical high-dose radioiodine therapy in treating differentiated thyroid cancer patients with thyroglobulin (Tg)-elevated negative iodine scintigraphy (TENIS) syndrome.

Methods

We searched PubMed, EMBASE, and the Cochrane Library to identify relevant studies published until April 2022. This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and registered in an international prospective register of systematic reviews (PROSPERO). Meta-analyses of proportions and odds ratios were performed to assess the beneficial effect of empirical high-dose radioiodine therapy in patients with TENIS syndrome. Subgroup analysis was also performed according to the presence of micrometastasis or macrometastasis.

Results

We identified 14 studies including 690 patients who received empirical high-dose radioiodine therapy for TENIS syndrome. Those who had micrometastasis exhibited additional lesions not previously observed on diagnostic whole-body scan (prop = 0.64, 95% confidence interval [CI], 0.51–0.77) and had reduced serum Tg levels (prop = 0.69; 95% CI, 0.52–0.84) after empirical radioiodine treatment. No such findings were observed among patients with macrometastasis. Moreover, we found that the empirical radioiodine treatment group had lower serum Tg levels than did controls (odds ratio = 0.27; 95% CI, 0.09–0.87), which suggests a lower risk of disease progression.

Conclusions

Our findings indicate that empirical high-dose radioiodine therapy promoted beneficial effects and could be recommended for patients with TENIS syndrome, especially those with micrometastasis.
Post-RFA Pulmonary Vein Stenosis Mimicking Lymphangitic Carcinomatosis in a Patient With History of Liposarcoma
Authors: Kwon Soo Jin , Yoo Ie Ryung , Jung Jung Im
Published: June 2024

A 58-year-old man with resected liposarcoma exhibited persistent irregular interlobular septal thickening of lung on CT concerning lymphangitic metastasis. FDG PET/CT was positive in these foci. There was a narrowing of the pulmonary veins, which had not been seen on the imaging conducted prior to radiofrequency ablation therapy for atrial fibrillation. Lung perfusion scanning demonstrated more extensive hypoperfusion. This case highlights the diagnostic pitfalls of interstitial thickening of the lung in cancer patients. Meticulous history review and nuclear imaging helped distinguish the postablation pulmonary venous stenosis from metastatic spread to the lung interstitium.
18F-FDG Uptake in Pancreatic AL Amyloidosis Associated With Multiple Myeloma
Authors: Kaida Hayato , Chikugo Takaaki , Tanaka Hirokazu , Ishii Kazunari
Published: June 2024

A 60-year-old woman underwent whole-body contrast-enhanced CT because multiple myeloma was suspected. The contrast-enhanced CT showed pancreatic enlargement without main pancreatic duct dilatation and increased peripancreatic fat tissue. 18F-FDG PET/CT demonstrated diffuse uptake in the enlargement of the pancreas, left and right ventricles, and vertebral column. Biopsy and bone marrow aspiration cytology revealed amyloid light-chain amyloidosis associated with multiple myeloma. Chemotherapy was performed; 18F-FDG uptake in the pancreas then disappeared, and the pancreatic enlargement decreased. When diffuse 18F-FDG uptake in pancreatic enlargement is observed in multiple myeloma patients, amyloid light-chain amyloidosis should be considered.
False-Positive Bone Pitfall Lesion and Collateral Circulation
Authors: Moreau Aurélie , Pretet Valentin , Kryza David
Published: June 2024

We report the case of a patient followed up for squamous cell carcinoma of the buccal floor with lymph node involvement. The initial staging PET/CT revealed bone foci that were not definitively pathological in the context of a regional collateral circulation secondary to a defibrillator. A new monitoring examination, conducted due to the rapid local progression, revealed a dissociated evolution of the bone uptake adjacent to the collateral circulation, some confirming false-positives, but one indicating a real metastasis. This case illustrates that bone uptakes without morphological lesions adjacent to a collateral circulation are not easily interpretable.
A Rare Case of Renal Malakoplakia Incidentally Detected on 18F-FDG PET/CT in a Patient With Concomitant Breast Cancer and Lymphoma
Authors: Wakankar Ritwik , Bal Jaspriya , Sharma Kanchan , Dougall Pankaj
Published: June 2024

Malakoplakia is a rare inflammatory disease that most frequently affects the urinary tract. We present the case of a patient who had been receiving treatment for breast cancer, who later on went on to develop diffuse large B-cell lymphoma for which she was started on RCHOP therapy. It was during her treatment that she underwent a whole-body 18F-FDG PET/CT for response evaluation and was incidentally diagnosed to have bilateral renal malakoplakia, which resolved after a prolonged course of antibiotic therapy.
Early nimodipine treatment in reversible cerebral vasoconstriction syndrome: a serial transcranial Doppler study
Authors: Cho Soohyun , Lee Mi Ji
Published: June 2024

Background

Although nimodipine is commonly used to treat reversible cerebral vasoconstriction syndrome (RCVS), its disease-modifying effects are not yet understood. We aimed to investigate the effect of nimodipine and treatment initiation timing on the prevention of worsened vasoconstriction.

Methods

We prospectively recruited patients with recent-onset (within 3 weeks of the first thunderclap headache), angiogram-proven RCVS. All participants underwent transcranial Doppler (TCD) examination to evaluate the mean flow velocities (MFVs) of the bilateral middle cerebral arteries at baseline and were serially followed-up after 10, 20, 30, and 90 days. Oral nimodipine treatment was initiated after the baseline TCD study, and patients were split into early and late treatment groups based on the time from onset to initial nimodipine administration. To estimate the worsening of vasoconstriction, we calculated the area of total time spent with MFVs above the baseline value (“MFV area”). We tested the correlation between the number of days from onset to treatment initiation and MFV area and performed linear regression analysis to examine the independent association between earlier treatment and MFV area.

Results

A total of 32 patients with RCVS (mean age: 51.5 ± 10.3 years; 91% female) completed this study. Baseline TCD assessment was performed at a mean of 7.1 ± 4.2 days after thunderclap headache onset. We observed that earlier treatment with nimodipine correlated with reduced MFV area (r = 0.37,p= 0.038). Furthermore, this association remained significant after adjusting for other clinical variables (regression coefficient 0.673, adjustedp= 0.023) in the multivariable linear regression.

Conclusions

Early oral nimodipine treatment prevents worsening of vasoconstriction, suggesting that nimodipine may have a disease-modifying effect in RCVS treatment.
Quantum-classical hybrid approach for codon optimization and its practical applications
Authors: Chung You Kyoung , Lee Dongkeun , Lee Junho , Kim Jaehee , Park Daniel K , Huh Joonsuk
Published: June 2024

Codon optimization is crucial for gene expression in heterologous hosts with varying genetic codes and codon usage, potentially resulting in enhanced protein expression and stability. Traditionally, the codon optimization problem has been solved using classical numerical techniques; however, with recent advancements, quantum algorithms deployed on quantum computers have been adopted for this purpose. This study proposes a codon sequence search protocol tailored to host preferences. Specifically, codon optimization is formulated as a constrained quadratic binary problem and solved using a quantum-classical hybrid approach, integrating quantum annealing with the Lagrange multiplier method. The proposed methodology is then applied to two real-world scenarios: optimizing the codon sequence of the severe respiratory syndrome coronavirus 2 spike protein in human hosts and insulin inEscherichia coli (E. coli)hosts. Finally, evaluations of several biological metrics demonstrate the effectiveness of our protocol, offering insights into the codon usage patterns governing translational efficiency and adaptation to the genetic code preferences of the host organisms.
PROPOSED SURVEY FOR PATIENTS PRIOR TO MAMMOGRAPHY AS A TOOL TO IMPROVE RADIOLOGICAL REPORTING
Authors: Villaseca Fernando Muñoz , Toro Valeria Pardo , Zulueta Elisabeth Cañipa , Herrera Marco Jiménez , Miranda Jeannette Soto
Published: June 2024

Background

Breast cancer is one of the leading causes of death among women worldwide. Therefore, early detection through quality mammography, along with information collected from the mammographic survey, is crucial.

The objective of this research is to propose a mammographic survey for patients prior to mammography to gather important information for radiologists specializing in mammography when preparing reports.

Methodology

This research was conducted using a semi-structured survey with both closed and open-ended questions, which was completed by 31 radiologists specializing in mammography.

Results

Relevant patient history and risk factors were collected, which are most useful for radiological reporting concerning patient history and potential risk factors.

Conclusion

Based on the responses collected from radiologists, we propose a final mammographic survey as a tool to aid radiologists in correlating clinical images with patient history. This survey emphasizes family history, gynecological-obstetric history, surgical history, among other factors.
Harnessing generative AI to annotate the severity of all phenotypic abnormalities within the Human Phenotype Ontology
Authors: Murphy Kitty B , Schilder Brian M , Skene Nathan G
Published: June 2024

0.1

There are thousands of human phenotypes which are linked to genetic variation. These range from the benign (white eyelashes) to the deadly (respiratory failure). The Human Phenotype Ontology has categorised all human phenotypic variation into a unified framework that defines the relationships between them (e.g. missing arms and missing legs are both abnormalities of the limb). This has made it possible to perform phenome-wide analyses, e.g. to prioritise which make the best candidates for gene therapies. However, there is currently limited metadata describing the clinical characteristics / severity of these phenotypes. With >17500 phenotypic abnormalities across >8600 rare diseases, manual curation of such phenotypic annotations by experts would be exceedingly labour-intensive and time-consuming. Leveraging advances in artificial intelligence, we employed the OpenAI GPT-4 large language model (LLM) to systematically annotate the severity of all phenotypic abnormalities in the HPO. Phenotypic severity was defined using a set of clinical characteristics and their frequency of occurrence. First, we benchmarked the generative LLM clinical characteristic annotations against ground-truth labels within the HPO (e.g. phenotypes in the ‘Cancer’ HPO branch were annotated as causing cancer by GPT-4). True positive recall rates across different clinical characteristics ranged from 89-100% (mean=96%), clearly demonstrating the ability of GPT-4 to automate the curation process with a high degree of fidelity. Using a novel approach, we developed a severity scoring system that incorporates both the nature of the clinical characteristic and the frequency of its occurrence. These clinical characteristic severity metrics will enable efforts to systematically prioritise which human phenotypes are most detrimental to human health, and best targets for therapeutic intervention.