bluuebunny/crossref_metadata_2025 huggingface dataset:
The visual nature of information warfare: the construction of partisan claims on truth and evidence in the context of wars in Ukraine and Israel/Palestine
Authors: Hameleers Michael
Published: November 2024

Despite the potential of visual disinformation to deceive people on pressing socio-political issues, we currently lack an understanding of how online visual disinformation (de)legitimizes partisan truth claims at times of war. As an important next step in disinformation theory and research, this article inductively mapped a wide variety of global visual disinformation narratives on armed conflicts disseminated via social media. The narratives were sampled through various international fact-checking databases, involving multiple social media platforms and countries. The analyses reveal that visual disinformation mainly consisted of existing footage that was decontextualized in a deceptive manner based on time, location, or fictionality. Moving beyond existing research exploring how decontextualized visuals offer proof for counter-factual narratives, our findings indicate that visuals contribute to the process of othering by constructing a “delusional rationality” that legitimizes mass violence and the destruction of the other. These findings have crucial ramifications for international policy and interventions at times of global armed conflicts that are covered widely across social media channels.
Frequentist inference for semi-mechanistic epidemic models with interventions
Authors: Bong Heejong , Ventura Valérie , Wasserman Larry
Published: November 2024

The effect of public health interventions on an epidemic are often estimated by adding the intervention to epidemic models. During the Covid-19 epidemic, numerous papers used such methods for making scenario predictions. The majority of these papers use Bayesian methods to estimate the parameters of the model. In this article, we show how to use frequentist methods for estimating these effects which avoids having to specify prior distributions. We also use model-free shrinkage methods to improve estimation when there are many different geographic regions. This allows us to borrow strength from different regions while still getting confidence intervals with correct coverage and without having to specify a hierarchical model. Throughout, we focus on a semi-mechanistic model which provides a simple, tractable alternative to compartmental methods.
Laparoscopic removal of a broken acupuncture needle in pancreatic head: a case report
Authors: Kim Kil Hwan , Jo Sungho , Song Sanghyun
Published: November 2024

Acupuncture, a well-established traditional medical practice in East Asia, is rarely associated with complications associated with broken needles. A 45-year-old woman had received acupuncture treatment 3 months before presentation to relieve back pain and complained of persistent epigastric pain. Radiological studies revealed chronic cholecystitis with stones and a broken acupuncture needle in the pancreatic head. Laparoscopic cholecystectomy and foreign body removal were performed, and the patient recovered quickly during a short hospital stay. We confirm that a needle found in the pancreas can usually be safely removed with minimally invasive surgery.
Successful treatment of grade III traumatic pancreatic injury with non-operative management: a case report
Authors: Matsushita Kazuki , Urakami Atsushi , Takaoka Munenori , Ishii Katsunori , Tanikawa Tomohiro , Kawamoto Hirofumi , Yamatsuji Tomoki
Published: November 2024

According to the American Association for the Surgery of Trauma, distal pancreatectomy or pancreatic duct drainage is recommended for grade III traumatic pancreatic injuries. We report a case of traumatic pancreatic injury involving the main pancreatic duct in which this method failed to drain fluid from the area distal to the injury site. A 19-year-old woman presented with a bruised upper left abdomen after a bicycle fall. Computed tomography revealed a linear area of poor contrast in the pancreatic body, leading to the diagnosis of grade III pancreatic injury. Endoscopic retrograde pancreatography revealed damage to the pancreatic duct, prompting endoscopic pancreatic stent placement. We added abdominal cavity drainage, peritoneal lavage, and endoscopic ultrasound-guided transgastric pseudocyst drainage. In the patient with pancreatic duct injury, drainage distal to the injury site was unattainable with a pancreatic duct stent; therefore, alternative drainage sites were utilized, thereby obviating the need for surgery.
Fulminant amoebic colitis: a challenging diagnosis for the surgeon
Authors: Barrón-Díaz David Rafael , Meza-Hernández Javier , Hernández-Montiel Erika , Solis-Coronado Orlando , Betancourt-Ferreyra Jessica Jazmín , Núñez-Venzor Alejandra , Trejo-Ávila Mario , Alvarez-Bautista Francisco E
Published: November 2024

Fulminant amoebic colitis is a rare complication of amoebiasis that carries a high mortality rate. Its diagnosis is challenging and requires a high index of suspicion, and its early recognition is a priority to provide timely medical and surgical treatment. We present the case of a male patient who came to the emergency department with unspecific clinical presentation of abdominal pain, systemic inflammatory response and imaging study showing intestinal perforation of the right colon. Fecal peritonitis and perforation at the level of the hepatic flexure were observed, so a right hemicolectomy with terminal ileostomy was performed. Despite adequate medical and surgical treatment, the patient presented progressive deterioration and died. Colon perforation due to Entamoeba histolytica was the final diagnosis.
Lung resection from wedge to pneumonectomy as surgical options for pulmonary mucormycosis
Authors: Pohlman Alexander , Nizamuddin Mohammad , Albarillo Fritzie S , Abdelsattar Zaid M
Published: November 2024

Pulmonary mucormycosis (PM) is a rare and life-threatening condition, most prevalent in immunocompromised patients. Early signs and symptoms are often nonspecific. A high index of suspicion in at risk patients should prompt early infectious work-up, including bronchoscopy, followed by aggressive antifungal therapy and early surgical resection when indicated. We demonstrate these core tenants of diagnosis and management of PM via two patient presentations, the first involving a kidney transplant recipient who presented with a mild cough, found to have a lung lesion with rapid growth over a few weeks; the second involving a patient with acute lymphoblastic leukemia who presented with hemoptysis and imaging revealing a 5 cm perihilar mass obliterating the left pulmonary artery. Both patients were managed with aggressive surgical therapy.
To the logical foundations of random number generator construction
Authors: Enikeev Ruslan
Published: November 2024

This study explores fundamental aspects of probability theory within the framework of constructing random sequences or random number generators. We propose an interpretation of probability spaces and operations on formal events through the theory of formal languages, utilizing string manipulation techniques. As part of the research, we present a direct implementation of the discussed concepts in the form of a program that generates random numbers of the required type by processing signals from a sound card. Additionally, the problem of primality testing, which is particularly relevant to practical cryptographic applications, is addressed. We critically examine common misconceptions regarding the properties of Carmichael numbers and the application of Fermat’s Little Theorem. Furthermore, we propose an efficient primality testing algorithm.
New tools for studying planarity in galaxy satellite systems: Milky Way satellite planes are consistent with ΛCDM
Authors: Uzeirbegovic E , Martin G , Kaviraj S , Jackson R A , Kraljic K , Dubois Y , Pichon C , Devriendt J , Peirani S , Silk J , Yi S K
Published: November 2024

We introduce a new concept – termed ‘planarity’ – which aims to quantify planar structure in galaxy satellite systems without recourse to the number or thickness of planes. We use positions and velocities from the Gaia EDR3 to measure planarity in Milky Way (MW) satellites and the extent to which planes within the MW system are kinematically supported. We show that the position vectors of the MW satellites exhibit strong planarity but the velocity vectors do not, and that kinematic coherence cannot, therefore, be confirmed from current observational data. We then apply our methodology to NewHorizon, a high-resolution cosmological simulation, to compare satellite planarity in MW-like galaxies in a Lambda cold dark matter ($\rm {\Lambda CDM}$)-based model to that in the MW satellite data. We demonstrate that kinematically supported planes are common in the simulation and that the observed planarity of MW satellites is not in tension with the standard $\rm {\Lambda CDM}$ paradigm.
Conservation ecology of land snails: a synthesis for Estonia
Authors: Remm Liina , Vaikre Maarja , Linnamägi Merike , Lõhmus Asko
Published: November 2024

We provide a synthesis of how the regional fauna of land snails, a flagship group among invertebrates, is distributed across ecosystems and how that translates to conservation priorities in Estonia. The data were compiled from 24 assemblage studies (mostly sample quadrats or substrate volume sampling; totalling >80,000 individuals) and from species records of infrequent species in the country since the 1970s. These data were quantitatively analysed for snail diversity and species frequencies by ecosystem types, and for the conservation status and indicator value of species. The known Estonian extant fauna contains 80 native and 12 presumably non-native species, of which 11 native species were assessed as threatened (2 not found in the 21st century). Hydrologically functional fens, old eutrophic forests, wooded meadows and calcareous areas appeared hotspots for threatened species and for overall snail diversity and abundance. As conservation measures, strict protection of natural forests and fens is fundamental, whereas the consequences of ecological restoration of alvars and fens require further study. Invasion of non-native species has greatly accelerated in the last 15 years, but it still mostly affects human settlements and their surroundings. We conclude that the Estonian land snail fauna is in a vulnerable state that largely depends on the integrity of hotspot ecosystems. There is a critical lack of knowledge on the value of small habitat patches and ecological restoration, and ecological responses to the snail invasions.
Medicine for a Changing Planet: Online Clinical Cases in Planetary Health and Infectious Diseases
Authors: Judson Seth D , Ripp Kelsey , Benzekri Noelle A , LaBeaud A Desiree , Veidis Erika , Xie Michael , Tin Alice , Barry Michele , Rabinowitz Peter
Published: November 2024

Planetary health and One Health have become key concepts in public health, scientific, and veterinary training, yet these concepts remain incompletely integrated into clinical medical education. Recognizing this gap, we created a free online curriculum called “Medicine for a Changing Planet,” geared towards training the next generation of health professionals in clinical skills to detect and manage the impacts of global and local environmental change on their patients. Using a case conference-style format familiar to medical trainees, we created 11 clinical case studies teaching both planetary health concepts and clinical competencies, leveraging Bloom’s Taxonomy. Here we describe the creation of these clinical cases, highlighting those centered on emerging infectious diseases that teach clinical skills related to the human-animal interface, globalization, and climate change. The online cases have been visited by over 4,000 unique users from 99 countries, piloted with residency and medical school programs, and made available for CME credit.
Prevention of cardiac tamponade by left intercostal Pericardiotomy for massive recurrent pericardial effusion: a case report
Authors: Nakajima Tomohiro , Mukawa Kei , Kouzu Hidemichi , Kamada Ayaka , Kawaharada Nobuyoshi
Published: November 2024

This case involved an 89-year-old woman with a history of left nephrectomy for left renal cell carcinoma at the age of 87 years. She had been gradually accumulating pericardial effusion for the past 4 years. She presented with signs of tachycardia and hypotension suggestive of cardiac tamponade due to pericardial effusion, and pericardiocentesis was performed below the xiphoid process in the cardiology department. Serous fluid was aspirated, and malignancy was ruled out by various tests. The patient subsequently developed recurrent pericardial effusion and was admitted to the hospital. Cardiovascular surgery was performed for pericardial drainage. A left intercostal incision was made for pericardiotomy and drainage of the pericardial effusion, allowing it to accumulate in the left pleural cavity in case of future accumulation. Pathological examination of the pericardium revealed no specific findings, and no cancer cells were present in the pericardial fluid. Prednisolone therapy was initiated for idiopathic pericarditis.
Hepatic epithelioid Hemangioendothelioma presenting synchronously with hepatocellular carcinoma-a case report
Authors: Pan Anna , Xu Shuang , Hong Liang , Zhu Wenwei , Zhou Yu , Wang Xiaoyang
Published: November 2024

Backgrounds: Primary hepatic epithelioid hemangioendothelioma (HEHE) is a rare neoplasm of vascular origin with varying biologic behavior, making it challenging to diagnose.

Case presentation: We present a case of synchronous hepatocellular carcinoma (HCC) and HEHE in a 43-year-old Chinese male patient. Multiple hypoechoic liver lesions were depicted, but no specific imaging findings were detected on enhanced computed tomography (CT) or contrast-enhanced magnetic resonance imaging (MRI). The patient then underwent [18F]-FDG PET/CT, [11C]-acetate PET/CT, and [68Ga]Ga-FAPI-04 PET/CT. The HEHE lesions demonstrated no uptake on both 18F-FDG and 11C-acetate PET/CT imaging, but presented a clear visualization in [68Ga]Ga-FAPI-04 PET/CT. The largest lesion located in segment VII was finally diagnosed as HCC, while the other smaller ones were diagnosed as HEHE, which was confirmed by immunohistochemical staining for CD31. To the best of our knowledge, only 2 cases have been reported in the worldwide literature, and the first case undertook both 11C-acetate and [68Ga]Ga-FAPI-04 PET/CT instead of 18F-FDG PET/CT.

Conclusion: In this report, we show that HCC and HEHE may occur synchronously, and HEHE should be considered when liver lesions are detected. [68Ga]Ga-FAPI-04 PET/CT has great potential in the detection, staging and therapy selection of HEHE.
Beyond the expected: left ventricular myocardial hydatid cyst a case report
Authors: Lanjeri Safae , Imrani Kaoutar , Mesbah Oumaima , Mouatassim Billah Nabil , Nassar Ittimade
Published: November 2024

Hydatid disease is an infection caused by the larval form of Echinococcus. It is a zoonosis primarily affecting the lungs and liver. While pulmonary involvement is most common, the cysts can develop in various extrapulmonary sites within the thorax, such as the pleural cavity, fissures, mediastinum, heart, vascular structures, chest wall, and diaphragm. However, intracardiac localization of hydatid cyst is very rare and it is found in less than 2% of cases. Cardiac involvement can be caused by systemic or pulmonary circulation, or by direct spread from adjacent structures. Imaging techniques, particularly MRI, play a crucial role not only in diagnosing hydatid cysts, but also in assessing their extension and identifying complications. We report a case of a 13-year-old girl, with a left ventricular myocardial hydatid cyst.
An evaluation of the impact of a national Minimum Unit Price on alcohol policy on alcohol behaviours
Authors: Mohan Gretta
Published: November 2024

Background

In 2018, Scotland pioneered national legislation which set a Minimum Unit Price (MUP) of 50 pence (∼US$0.64, €0.59) per unit of UK alcohol sold (8 g/10 ml). To inform policy development, we examine the policy effect using the Alcohol Use Disorders Identification Test (AUDIT-C), employing longitudinal data for over 17 200 individuals.

Methods

The effect of MUP on AUDIT-C scores is inferred by employing difference-in-difference regression. Pre- and post-intervention alcohol behaviours of individuals from Scotland are compared to a matched ‘control’ from England. Drinking at hazardous and harmful levels could be identified, as well as the frequency of alcohol consumption, number of drinks and heavy episodic drinking. Estimates adjust for demographic, socioeconomic and health characteristics. Potential inequalities by gender, age and household income are examined.

Results

MUP led to an estimated 5.3% reduction in the number of drinks consumed on drinking occasions, though a statistically significant effect on overall reported AUDIT-C scores or drinking at hazardous levels was not detected, with few differential effects for subgroups.

Conclusions

Differences in the findings of this research compared to other studies may be explained by differences in population coverage collected in the survey data, compared to more comprehensive, population-wide administrative data, as well as sample attrition.
Neural divergence between individuals with and without minor depression during dynamic emotion processing: a movie-fMRI Study
Authors: Zhang Manqi , Deng Mengjie , Li Xiaowen , Zhang Rui , Liao Jiejie , Peng Jun , Feng Huiyan , Tang Shixiong , Chen Yujie , Mo Lei
Published: November 2024

Research on the neuropathological mechanisms underlying minor depression (MD), particularly in individuals with a history of recurrent minor depressive episodes, is very limited. This study focuses on the abnormality in processing real-life emotional stimuli among individuals with MD. Thirty-two individuals with MD and 31 normal controls (NC) were recruited and underwent comprehensive clinical interview, cognitive assessment, and magnetic resonance imaging (MRI) scans. During functional MRI scanning, subjects watched positive, negative, and neutral emotional movie clips. We used the inter-subject correlation and inter-subject functional connectivity analysis to investigate the neural differentiation between MD and NC during film viewing. The relationships between neural differentiation, symptom severity, and psychological resilience were analysed. We found that neural differentiations between individuals with MD and NC in the post cingulate cortex (PCC) and precuneus (PCUN) were consistent across three emotional conditions. Notably, the similarity of neural responses in the PCC and PCUN with NC but not MD was negatively correlated with depressive symptoms. Furthermore, this neural similarity mediated the relationship between psychological resilience and depression severity. Our findings support that the PCC and PCUN, two core areas of the default mode network, play a critical role in MD’s emotion processing deficit.
Laryngeal Carcinoma Radiologic Staging and What the Surgeon Wants to Know
Authors: Tork MAJ Craig A. , Avey Gregory D.
Published: November 2024

Laryngeal cancer accounts for approximately 25% of head and neck cancers and is an extremely morbid malignancy, severely affecting quality of life by impeding the ability to communicate, swallow, and breathe. Patients can present with a myriad of symptoms including hoarseness, pain, dysphagia, and even otalgia. Initial clinical evaluation often includes laryngoscopy, assessing for mucosal lesions and vocal fold mobility. Imaging has a secondary role in laryngeal cancer confined to the mucosal surface, as clinical evaluation is more sensitive for the detection and evaluation of small mucosal lesions. However, T1 and T2 lesions may still be encountered as part of an initial evaluation or incidental presentation. While laryngoscopy can determine the superficial extent and size of a lesion, CT and MRI are central in determining deep tissue extent, invasion into adjacent tissues, and evidence of nodal metastases. Treatment options include surgical resection, chemotherapy, and/or chemoradiation therapy. Surgical options can be as limited as transoral laser microsurgery or as extensive as total laryngopharyngectomy. In this setting, the radiologist plays a vital role, as imaging interpretation will help determine the treatment regimen. Imaging findings largely dictate the T stage based on compartment/subsite location, additional subsite or adjacent tissue invasion, visible involvement of the vocal cord(s), and invasion beyond the larynx. Imaging is also key to the assessment for nodal or metastatic disease. Accurate staging is key, as overstaging could lead to unnecessary total laryngectomy, whereas understaging could contribute to treatment failure.
Cervical Degenerative Myelopathy is an Unexpected Risk Factor for Hip Fractures
Authors: Plais Nicolas , Garzón-Alfaro Adoración , Carrasco Jiménez Carlos José , Almagro Gil Maria Isabel , Jiménez-Herrero Enrique , Gómez Sánchez Rafael Carlos , Martín Roldán José Luis , Lafage Virginie , Schwab Frank
Published: November 2024

Study Design:

Cross-sectional study.

Objective:

To assess the potential role of degenerative myelopathy as a risk factor for major fragility fractures in older patients.

Background:

Degenerative cervical myelopathy (DCM) stands as the foremost spinal disorder affecting adults, significantly impacting patients’ quality of life. However, it is often underdiagnosed, with its prevalence traditionally considered low (0.06%–0.112%). Despite the rising prevalence of hip fractures with an aging population and the identification of numerous risk factors, DCM is not typically regarded as a primary risk factor for such fractures. In 2015, an American study revealed an unexpectedly high rate of 18% of undiagnosed DCM in patients with hip fractures within a small cohort. We sought to replicate this study in a larger cohort of a European population.

Materials and Methods:

Our cross-sectional study targeted patients older than 65 years with hip fractures and aimed to identify cases of DCM at the time of fracture. Exclusions were made for patients with preexisting DCM diagnoses, neurological disorders, prior cervical surgeries, and instances of high-energy trauma. Comprehensive demographic, clinical, and radiologic data were collected, followed by descriptive and statistical analysis.

Results:

In our study, 147 patients (mean age: 82.9 y) were included. Through a combination of clinical assessment and physical examination, 23 patients (15.6%) were identified as indicative of myelopathy. Confirmation through magnetic resonance imaging led to an estimated overall prevalence of DCM at 10.5%. Logistic regression analysis revealed that the presence of hypertonic reflexes, cervical pain, or cervicobrachialgia were specific and valuable indicators for diagnosing myelopathy.

Conclusion:

This study marks the first investigation of its kind in a European population, highlighting the notably high prevalence of undiagnosed DCM among older patients who have experienced hip fractures. This underscores DCM as a potential risk factor for hip fractures in the elderly, despite its underdiagnosis and undertreatment.

Level of Evidence:

Level III.
Lowering low-density lipoprotein cholesterol targets to below 1.0 mmol/L in acute coronary syndrome patients: a potential new standard
Authors: Chen Zhenyue , Lu Guoping
Published: November 2024

Despite significant advancements in the diagnosis and treatment of ischemic heart disease primarily, atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide. Low-density lipoprotein cholesterol (LDL-C) plays a causal role in the development and progression of atherosclerosis. Randomized controlled trials have demonstrated that achieving lower LDL-C levels in patients with acute coronary syndrome (ACS) can stabilize or even reverse coronary plaque. This article examines existing evidence to explore whether further reducing LDL-C levels in all ACS patients (not just those with recurrent events) to below 1.0 mmol/L, lower than current guideline recommendations, could effectively reduce the incidence of adverse cardiovascular events.
Maternal and Neonatal Infectious Outcomes Compared According to Rupture of Membrane Duration and Antibiotic Administration: A Retrospective Study
Authors: Abu Shqara Raneen , Glikman Daniel , Lowenstein Lior , Frank Wolf Maya
Published: November 2024

Background:

Prolonged rupture of membranes (ROM) is associated with peripartum infections; the optimal timing to initiate prophylactic antibiotic treatment is inconclusive. We compared maternal and neonatal infectious morbidity and bacterial distribution in chorioamniotic-membrane cultures according to a ROM-to-delivery interval of 12–18 versus ≥18 hours.

Methods:

This retrospective cohort study was conducted in a single tertiary university-affiliated hospital from January 2020 to January 2023. Labor was induced in term singleton pregnant women with ROM ≥12 hours who did not deliver spontaneously within 12–24 hours. Prophylactic ampicillin was administered based on risk factors. Outcomes were compared between ROM 12–18 hours (n = 683) and >18 hours (n = 1039); the latter uniformly received intrapartum antibiotics. The primary maternal outcome was clinical chorioamnionitis. The secondary outcomes included intrapartum fever, cesarean delivery, puerperal endometritis and hospitalization length. Neonatal outcomes included early-onset sepsis, 5-minute Apgar score <7, length of stay, respiratory distress and ventilation support.

Results:

The clinical chorioamnionitis rate was comparable between the ROM 12- to 18- and the ≥18-hour groups. However, intrapartum fever occurred more frequently in the former (15.5% vs. 11.6%, P = 0.024), and postoperative infections were significantly higher (11.7% vs. 4.5%, P = 0.020). Cesarean deliveries were more common in ROM ≥18 versus 12–18 hours (21.3% vs. 16.3%, P = 0.028). Neonatal outcomes were similar between the groups. The bacterial distributions among chorioamniotic-membrane cultures were similar, the most common isolated pathogens were Enterobacteriaceae.

Conclusions:

Although the risk of chorioamnionitis was similar, the incidence of intrapartum fever and postoperative infections were higher in ROM 12–18 versus ≥18 hours. Initiating antibiotic prophylactic treatment at 12 hours post-prelabor ROM may be beneficial.
High Prevalence of Sexually Transmitted Infections and Poor Sensitivity and Specificity of Screening Algorithms for Chlamydia and Gonorrhea Among Female Sex Workers in Zimbabwe: Analysis of Respondent-Driven Sampling Surveys in 3 Communities
Authors: Chabata Sungai T. , Fearon Elizabeth , Musemburi Sithembile , Machingura Fortunate , Machiha Anna , Hargreaves James R. , Ndowa Francis J. , Mugurungi Owen , Cowan Frances M. , Steen Richard
Published: November 2024

Background

Effective strategies to reduce sexually transmitted infection burden and transmission among female sex workers (FSWs) and their networks are needed. We report sexually transmitted infection prevalence among FSWs in Zimbabwe and investigate the performance of screening algorithms.

Methods

Respondent-driven sampling (RDS) surveys, including blood sampling for syphilis serology, were conducted among FSWs in 3 communities in Zimbabwe in 2017. In addition, a random sample of one-third of participants were offered genital examination and sexually transmitted infection (STI) testing. Data on symptoms and clinical signs were analyzed to determine the proportion of asymptomatic and clinically inapparent STIs by HIV status, and the sensitivity, specificity, and predictive values of syndromic, clinical, and hybrid screening algorithms for chlamydia and gonorrhea. Analyses were RDS-II weighted.

Results

Overall, 2507 women were included in the RDS surveys, and 661 of 836 (79.1%) of those randomly offered genital examination and STI testing accepted. The prevalence of STI by site ranged from 15.7% to 20.0% for syphilis (rapid plasma reagin + Treponema pallidum hemagglutination assay), 6.8% to 14.3% for gonorrhea, 8.4% to 10.1% for chlamydia, 26.6% to 35.5% for trichomonas, and 37.0% to 47.6% for any high-risk human papilloma virus. A high proportion of infections were both asymptomatic and clinically undetectable (gonorrhea: 41.2%, chlamydia: 51.7%, trichomonas: 62.8%). Screening algorithms performed poorly whether based on symptoms only (sensitivity: 53.3% gonorrhea, 43.3% chlamydia) or either symptoms or clinical signs (sensitivity: 58.7% gonorrhea, 48.3% chlamydia).

Conclusions

Sexually transmitted infection burden is high among FSWs in Zimbabwe. The low sensitivity and specificity of screening algorithms used to guide syndromic management mean that more effective approaches are required to strengthen STI control. As access to HIV-specific prevention methods like preexposure prophylaxis increases, support for consistent condom use needs to be strengthened.
Increasing STI and HIV preventive behaviors and addressing community-prioritized social determinants of health among young GBQMSM and transgender women of color: Piloting a bilingual multilevel intervention
Authors: Rhodes Scott D. , Mann-Jackson Lilli , Alonzo Jorge , Song Eunyoung Y. , Garcia Manuel , Robles Arvizu José A. , Bell Jonathan , Trent Scott , Aguilar-Palma Sandy , Aviles Lucero Refugio , Smart Benjamin D.
Published: November 2024

Background

Sexually transmitted infections (STIs) and HIV disproportionately affect young people; gay, bisexual, queer, and other men who have sex with men (GBQMSM); transgender women; and persons of color. Our community-based participatory research partnership developed and implemented Impact Triad, a bilingual multilevel intervention harnessing peer navigation and mHealth to increase STI/HIV preventive behaviors and address four community-prioritized social determinants of health -- education, employment, social support, and discrimination -- among young African American/Black and Latine GBQMSM and transgender women.

Methods

Fifteen community-based peer navigators were trained to work within their social networks for 12 months. Each navigator engaged five social network members who completed baseline and immediate post-intervention assessments (retention rate = 97.3%). Regression modeling was used to assess changes in outcomes between baseline and follow-up.

Results

Among 74 enrolled social network members, the average age was 27.8; 61% identified as African American/Black, 31% as Latine, and 8% as multiracial/multiethnic. The majority self-identified as cisgender men and 8% as transgender women; 78% identified as gay. About half reported monthly income below $1,000.

Compared to baseline, at follow-up, social network members increased: STI screening (P = .001), HIV testing (P = .001), condom use (P = .03), and PrEP use (P = .02). Knowledge of PrEP (P < .0001) and of community-based educational (P = .047), job-training (P = .002), and job-finding resources (P = .02) also increased. Social support increased (P < .0001) and perceived discrimination decreased (P < .01).

Conclusions

Pilot findings suggest that Impact Triad is promising in increasing STI/HIV protective behaviors and addressing social determinants of health among young GBQMSM and transgender women of color; further testing is warranted.
Comparison of Patient-Specific Plates and Pre-Bent Plates for Preserving Condylar Position in Mandible Reconstruction
Authors: Le Phuc H. , Kim Hyounmin , Son Moo H. , Cha In-Ho , Kim Hyung J. , Nam Woong , Kim Dongwook
Published: November 2024

Objectives:

To compare the efficacy of patient-specific 3-dimensional (3D)-printed plates (PSP) and pre-bent universal reconstruction plates (PBP) in preserving the 3D position of the mandibular condyle and total operation time during mandibular reconstruction with a fibula-free flap.

Materials and Methods:

This retrospective study included 18 patients who underwent mandibular reconstruction using fibular free flaps. Both groups utilized virtual surgical planning (VSP) and 3D-printed surgical guides. Nine patients received PSP, and 9 received PBP. Postoperative and computed tomography (CT) scans were analyzed to assess 3D deviations of the mandibular condyles and operation times.

Results:

PSP demonstrated superior accuracy in medial-lateral condylar displacement (2.5 ± 1.42 versus 4.92 ± 2.42 mm, P = 0.02) and better angular accuracy in the coronal (1.46 ± 1.16 deg versus 5.45 ± 2.75 deg, P = 0.001) and transverse planes (3.55 ± 2.82 deg versus 8.99 ± 5.56 deg, P = 0.023). There was no significant difference in total operation time between PSP and PBP groups (487.7 ± 90.1 versus 547.3 ± 110.1 min, P = 0.226), despite all PSP patients having additional immediate implant placement and prosthesis delivery.

Conclusions:

PSP offers better condylar accuracy and allows immediate implant placement without increasing surgical time compared with PBP.
A Mortise and Tenon Framework Composed of Costal Cartilage and Expanded Polytetrafluoroethylene in Rhinoplasty for Asians: Application Ⅱ of Dai Exogenous Extension Stent Concept
Authors: Yu Bao-Fu , Wei Jiao , Dai Chuan-Chang
Published: November 2024

Background:

The septum is often underdeveloped in East Asian populations, and traditional endogenous extension stents may not adequately fulfill the requirements for rhinoplasty. Herein, we present an innovative exogenous extension framework featuring a mortise and tenon structure specifically designed for East Asians.

Methods:

This framework comprises a mushroom-shaped rib cartilage component and a lancet-shaped expanded polytetrafluoroethylene (ePTFE) element, which are interconnected through a mortise and tenon design. The costal cartilage serves as a strut to support the nasal column and elevate the nasal tip. The ePTFE is utilized to augment the nasal dorsum and root, enhancing overall shape while being securely attached to the rib cartilage via the mortise and tenon structure. This configuration establishes a stable exogenous extension framework that also facilitates nose elongation. The safety and efficacy have been validated through over 10 years of clinical practice.

Results:

Over the past decade, we have performed this procedure in more than 500 cases without any complications, such as necrosis of the nasal column, ischemia of the nasal tip, or adverse graft appearances. Notable improvements in nasal morphology were observed across all patients. In addition, no postoperative restrictions on nasal ventilation were reported by any patient. Overall, patient satisfaction regarding surgical outcomes was exceptionally high.

Conclusions:

This framework represents an advanced implementation of exogenous extension stent concept, which is particularly effective for East Asians since it does not require a well-developed nasal septum to provide support. In addition, it does not increase the risk of restricted nasal ventilation.

Level of Evidence:

Level IV.
U-Shaped Osseous Release for Le Fort 1 Osteotomy: Potential Application to Superior Repositioning
Authors: Shiokawa Hiroyuki , Mochizuki Keita , Hama Shion , Miyahara Yuka , Sakamoto Mizuki , Kaneko Naoki , Ogata Kenichi , Hayashida Jun-Nosuke , Kawano Shintaro , Takahashi Ichiro , Moriyama Masafumi
Published: November 2024

This study was performed to investigate the utility of U-shaped osseous release (USOR) for Le Fort 1 osteotomy as a novel surgical technique for superior repositioning. Thirty-six patients with jaw deformities were divided into 2 groups based on whether or not USOR was adopted (18 in the non-adoption group and 18 in the adoption group). Maxillary surgical time, blood loss, and discrepancy from the planned amount of movement (anterior-posterior and superior-inferior directions) were compared between the 2 groups. Correlations between these items and the planned amount of superior-inferior movement were also examined. There were no significant differences in mean age, preset displacement, surgical time, blood loss, body mass index, or preset displacement error. However, a significant positive correlation was observed between the planned and actual amount of vertical movement only in the adoption group (P=0.0018). In addition, there was a tendency for the error (downward) to increase as the amount of upward movement increased in the non-adoption group, but not the adoption group. These findings suggest that USOR may be a useful technique because it can safely and conveniently remove bony interference and can enable guidance to a more precise position, especially in cases with substantial superior movement.
Revealing reassortment in influenza A viruses with TreeSort
Authors: Markin Alexey , Macken Catherine A. , Baker Amy L. , Anderson Tavis K.
Published: November 2024

Reassortment among influenza A viruses (IAV) facilitates genomic evolution and has been associated with interspecies transmission and pandemics. We introduce a novel tool called TreeSort that accurately identifies recent and ancestral reassortment events on datasets with thousands of IAV whole genomes. The algorithm has immediate relevance to modern large-scale surveillance studies that generate thousands of whole genomes. TreeSort uses the phylogeny of a selected IAV segment as a reference and finds the branches on the phylogeny where reassortment has occurred with high probability by incorporating information from other gene segments. The tool reports the particular gene segments that were involved in reassortment and how different they are from prior gene pairings. Using TreeSort, we studied reassortment patterns of different IAV subtypes isolated in avian, swine, and human hosts. Avian IAV demonstrated more reassortment than human and swine IAV, with the avian H7 subtype displaying the most frequent reassortment. Reassortment in the swine and human H3 subtypes was more frequent than in the swine and human H1 subtypes, respectively. The highly pathogenic avian influenza H5N1 clade 2.3.4.4b had elevated reassortment rates in the 2020-2023 period; however, the surface protein-encoding genes (HA, NA, and MP) co-evolved together with almost no reassortment among these genes. We observed similar co-evolutionary patterns with very low rates of reassortment among the surface proteins for the human H1 and H3 lineages, suggesting that strong co-evolution and preferential pairings among surface proteins are a consequence of high viral fitness. Our algorithm enables real-time tracking of IAV reassortment within and across different hosts, can be applied to determine how specific genes evolve in response to reassortment events, and can identify novel viruses for pandemic risk assessment. TreeSort is available athttps://github.com/flu-crew/TreeSort.
Contributions to the force of infection of SARS-CoV-2 in Dutch long-term care facilities
Authors: de Wit Mariken M. , van Zelst Marino , Boere Tjarda M. , van Gaalen Rolina D. , de Jong Mart C. M. , van Hoek Albert Jan , ten Bosch Quirine
Published: November 2024

Background

Residents of long-term care facilities (LTCFs) have been disproportionately affected during the COVID-19 pandemic. To inform decision-making around interventions, we quantified the SARS-CoV-2 infection risk for residents and the relative contribution of different infection sources. We estimated the force of infection (FOI) experienced by Dutch LTCF residents over time and quantified the contribution of residents, LTCF healthcare workers (HCWs), and the general population.

Methods & findings

Case data were obtained by Municipal Health Services as part of the Dutch national surveillance program. During the study period (1 October 2020 to 10 November 2021), testing policies included symptom-based testing, exposure-based testing, and facility-wide serial testing. We used a data augmentation approach to include uncertainty in the timing of infection, while taking account of different testing policies. We constructed a Bayesian generalized linear model to estimate group-specific transmission rate parameters and contributions to the FOI experienced by residents.

During the study period 36,877 cases were registered among residents and 19,676 among HCWs. The total daily FOI towards residents was highest in December 2020 (1.7*10−3, 95% CI: 1.5*10−3– 1.9*10−3) and lowest in June 2021 (1.1*10−595%CI: 7.6*10−6– 1.7*10−5). Resident-directed type-reproduction numbers and FOI declined as COVID-19 vaccination rollout started in residents, HCWs, and the older general population (February-May 2021). Most resident infections in spring and summer 2021 were attributable to infections in the general population. The relative contribution of the general population to the FOI decreased in summer 2021 when vaccination was available population-wide. In October-November 2021, type-reproduction numbers and FOI increased again. We observed an increase in residents’ susceptibility to infection in this period, which was only partially explained by the emergence of the Delta variant. Sensitivity analyses showed that the temporal trends in relative contributions to the FOI were not impacted by assumptions about immunity build-up among residents, nor by underreporting of infections.

Conclusions

COVID-19 vaccination appears to have been effective in reducing SARS-CoV-2 transmission towards residents, although other factors such as seasonality or non-pharmaceutical interventions may also have contributed to this. This effect seemed to have decreased by autumn 2021, which could be due to waning of immunity or changes in control practices. Our estimates of temporal trends in relative contributions to the FOI in LTCF residents can help target intervention efforts.
Pushing the Boundaries for Centrally Located Breast Tumors in Oncoplastic Breast Surgery: A Single Centre Audit
Authors: Koppiker C.B , Noor Aijaz Ul , Joshi Sneha , Mishra Rupa , Sivadasan Priya , Sheikh Shama , Vartak Anushree , Athavle Namrata , Sharma Purva , Pai Mugdha , Deshmukh Chetan , Dhar Upendra , Busheri Laleh , Munshi Manasi
Published: November 2024

Background

Breast Conservative Surgery (BCS) was considered a contraindication for centrally located breast tumor (CLBT), with mastectomy being the preferred treatment. However, advances in oncoplastic techniques now offer promising alternatives by facilitating wider surgical margins and enhancing cosmetic outcomes. This study aims to evaluate surgical, oncological, aesthetic outcome and quality of life (QoL) of oncoplastic breast surgery (OBS) for CLBT.

Material and Methods

In this study, 136 patients with CLBT were treated with various oncoplastic techniques including Level I (Grisotti Flap), Level II (Therapeutic Mammoplasty), and Level III (Perforator Flap) techniques. Surgical approach selection was guided by breast-size and degree of ptosis. Oncological and cosmetic outcomes were evaluated by surgeons post-operatively.

Results

The mean age of the patient was 52.7 years (range: 22-79). The Level I oncoplasty technique was utilised in 7 patients (11.7%); Level II (Therapeutic Mammoplasty) oncoplasty in 57 patients (41.9%) and Level 3 (Perforator Flaps) in 52 patients (38.2%). 13.9% of post-operative complications were observed. Cosmetic score revealed good to excellent outcomes regarding the patients’ satisfaction toward the surgical procedure. The study observed low rate of local recurrence (4.4%), distant recurrence (5.8%) and metastasis (5.8%). Mortality was 3.6% while all survival (OS) and disease-free survival (DFS) were high at 93.82% and 90.6%, respectively demonstrate the effectiveness of the surgical and adjuvant therapy employed.

Discussion

OBS offer viable and effective approach for managing CLBT. These procedures not only achieve satisfactory aesthetic results, but also ensure oncological safety, making them a promising alternate to mastectomy for CLBT.
Early Prediction of Hypertensive Disorders of Pregnancy Using Machine Learning and Medical Records from the First and Second Trimesters
Authors: Mousavi Seyedeh Somayyeh , Tierney Kim , Robichaux Chad , Boulet Sheree Lynn , Franklin Cheryl , Chandrasekaran Suchitra , Sameni Reza , Clifford Gari D. , Katebi Nasim
Published: November 2024

Hypertensive disorders of pregnancy (HDPs) remain a major challenge in maternal health. Early prediction of HDPs is crucial for timely intervention. Most existing predictive machine learning (ML) models rely on costly methods like blood, urine, genetic tests, and ultrasound, often extracting features from data gathered throughout pregnancy, delaying intervention.

This study developed an ML model to identify HDP risk before clinical onset using affordable methods. Features were extracted from blood pressure (BP) measurements, body mass index values (BMI) recorded during the first and second trimesters, and maternal demographic information.

We employed a random forest classification model for its robustness and ability to handle complex datasets. Our dataset, gathered from large academic medical centers in Atlanta, Georgia, United States (2010-2022), comprised 1,190 patients with 1,216 records collected during the first and second trimesters. Despite the limited number of features, the model’s performance demonstrated a strong ability to accurately predict HDPs. The model achieved an F1- score, accuracy, positive predictive value, and area under the receiver-operating characteristic curve of 0.76, 0.72, 0.75, and 0.78, respectively.

In conclusion, the model was shown to be effective in capturing the relevant patterns in the feature set necessary for predicting HDPs. Moreover, it can be implemented using simple devices, such as BP monitors and weight scales, providing a practical solution for early HDPs prediction in low-resource settings with proper testing and validation. By improving the early detection of HDPs, this approach can potentially help with the management of adverse pregnancy outcomes.
NetworkCommons: bridging data, knowledge and methods to build and evaluate context-specific biological networks
Authors: Paton Victor , Türei Denes , Ivanova Olga , Müller-Dott Sophia , Rodriguez-Mier Pablo , Venafra Veronica , Perfetto Livia , Garrido-Rodriguez Martin , Saez-Rodriguez Julio
Published: November 2024

We present NetworkCommons, a platform for integrating prior knowledge, omics data, and network inference methods, facilitating their usage and evaluation. NetworkCommons aims to be an infrastructure for the network biology community that supports the development of better methods and benchmarks, by enhancing interoperability and integration.

Availability and Implementation

NetworkCommons is implemented in Python and offers programmatic access to multiple omics datasets, network inference methods, and benchmarking setups. It is a free software, available athttps://github.com/saezlab/networkcommons.

Contact

saezlab@ebi.ac.uk,martin.garrido@embl.de

Supplementary Data

Contribution guidelines, additional figures, and descriptions for data, knowledge, methods, evaluation strategies and their implementation are available in the Supplementary Data and in the NetworkCommons documentation athttps://networkcommons.readthedocs.io/.
UPR deficiency in budding yeast reveals a trade-off between ER folding capacity and maintenance of euploidy
Authors: Bartolutti Constantine , Kim Allison J , Brar Gloria A
Published: November 2024

The Unfolded Protein Response (UPR) was discovered in budding yeast as a mechanism that allows cells to adapt to ER stress. While the Ire1 branch of this pathway is highly conserved, it is not thought to be important for cellular homeostasis in the absence of stress. Surprisingly, we found that removal of UPR activity led to pervasive aneuploidy in budding yeast cells, suggesting selective pressure resulting from UPR-deficiency. Aneuploid UPR-deficient cells grew better than euploid cells, but exhibited heightened general proteostatic stress, a hallmark of aneuploidy in wild-type cells. Modulation of key genes involved in ER proteostasis that were encoded on aneuploid chromosomes, could phenocopy the effects of aneuploidy, indicating that the reason cells require UPR activity to maintain euploidy is to counteract protein folding stress in the ER. In support of this model, aneuploidy in UPR-deficient cells can be prevented by expression of a UPR-independent general ER chaperone. Overall, our results indicate an unexpected role for the UPR in basal cell growth that is sufficiently important for cells to accept the costly trade-off of aneuploidy in the absence of UPR activity.