bluuebunny/crossref_metadata_2025 huggingface dataset:
The Ten-Year Revolution
Authors: D’Alessandra Federica
Published: May 2024

This article reviews the evolution of the role of civil society documentation efforts in international justice proceedings since 2013 circa. It is written from my personal perspective by virtue of my involvement in a series of initiatives aimed to strengthen civil society’s (as well as other international justice actors’) documentation efforts through the collection of standards and best practices, which the essay also discusses. In particular, it reviews the process and challenges of setting forth the first comprehensive guidance and set of best practices for civil society documentation with the Public International Law and Policy Group’s ‘Handbook on Civil Society Documentation of Serious Human Rights Violations’. It argues that civil society documentation efforts have undergone a revolution within the field: from the margins to the very heart of international judicial proceedings upholding accountability for international crimes. This revolution was, in part, rendered possible by a changing documentation landscape and the proliferation of documentation resources and capabilities now readily available to the civil society. After reviewing the current state of play with respect to documentary efforts and documentation best practices, which I situate within the context of a broader evolution of the international justice ‘ecosystem’, the article addresses some ongoing challenges in documentation and areas that would benefit of further strengthening in the future.
Exploring the frontiers of therapeutic breadth of antifungal peptides: A new avenue in antifungal drugs
Authors: Ul Haq Ihtisham , Maryam Sajida , Shyntum Divine Y , Khan Taj A , Li Fan
Published: May 2024

The growing prevalence of fungal infections alongside rising resistance to antifungal drugs poses a significant challenge to public health safety. At the close of the 2000s, major pharmaceutical firms began to scale back on antimicrobial research due to repeated setbacks and diminished economic gains, leaving only smaller companies and research labs to pursue new antifungal solutions. Among various natural sources explored for novel antifungal compounds, antifungal peptides (AFPs) emerge as particularly promising. Despite their potential, AFPs receive less focus than their antibacterial counterparts. These peptides have been sourced extensively from nature, including plants, animals, insects, and especially bacteria and fungi. Furthermore, with advancements in recombinant biotechnology and computational biology, AFPs can also be synthesized in lab settings, facilitating peptide production. AFPs are noted for their wide-ranging efficacy, in vitro and in vivo safety, and ability to combat biofilms. They are distinguished by their high specificity, minimal toxicity to cells, and reduced likelihood of resistance development. This review aims to comprehensively cover AFPs, including their sources—both natural and synthetic—their antifungal and biofilm-fighting capabilities in laboratory and real-world settings, their action mechanisms, and the current status of AFP research.

One-Sentence Summary

This comprehensive review of AFPs will be helpful for further research in antifungal research.
T cell responses in immune-mediated IgA nephropathy
Authors: Xie Shimin , Sun Mengying , Zhang Xiaohan , Kan Chao , Shi Guojuan , Peng Weixiang , Guo Junli , Wu Dantong , Yin Zhinan , Yang Quanli , Zhang Rui
Published: May 2024

Immunoglobulin A nephropathy is a complex autoimmune disease with various underlying causes and significant clinical heterogeneity. There are large individual differences in its development, and the etiology and pathogenesis are still poorly understood. While it is known that immunobiological factors play a significant role in the pathophysiology of immunoglobulin A nephropathy, the specific nature of these factors has yet to be fully elucidated. Numerous investigations have verified that CD4+ and CD8+ T lymphocytes are involved in the immunopathogenesis of immunoglobulin A nephropathy. Furthermore, certain data also point to γδT cells’ involvement in the pathophysiology of immunoglobulin A nephropathy. By thoroughly examining the mechanisms of action of these T cells in the context of immunoglobulin A nephropathy, this review sheds light on the immunopathogenesis of the disease and its associated factors. The review is intended to provide reference value for the future research in this field and promising treatment clues for clinical patients.
Seasonal shifts in the habitat selection patterns of male American Marten (Martes americana) at a fine spatial scale
Authors: Viau Julie-Pier , Sigouin Daniel , St-Laurent Martin-Hugues
Published: May 2024

Old-growth forests harbor a large amount of complex structural features that result in a wide array of wildlife habitats. However, intensive forest management is gradually converting old-growth forest into younger, even-aged stands, reducing structural complexity and threatening the persistence of old-growth-dependent species. Maintaining elements of complex stand structure is critical to the conservation of old-growth forest specialists that use different habitat components at different periods of their annual cycle, and it requires a comprehensive understanding of seasonal variation in the habitat needs of these species. However, difficulties in observing free-ranging animals have sometimes limited our ability to assess such variations in habitat requirements, especially for small, elusive species. To address this, we used GPS telemetry collars to describe fine-scale habitat selection patterns of 6 male American Martens (Martes americana) during 2 contrasting periods of the year (snow-free, from mid-April to mid-November; snow-covered, from mid-November to mid-April), an objective formerly hard to achieve using conventional VHF telemetry. We used resource selection functions conducted at the fourth order of selection to compare habitat characteristics found at the sites used by martens (GPS locations, n = 100) to those found on an equal number of available sites (random points, n = 100) within each individual seasonal home range. We conducted vegetation surveys on these 200 sites to describe habitat and built candidate models representing different concurrent hypotheses. Our results showed that proxies of prey availability, predator avoidance, and thermal constraints were the primary factors influencing marten habitat selection during both periods, although their respective importance differed between periods. Martens selected sites with a high density of large-diameter snags (≥30·ha−1), high conifer canopy closure (≥53%), and a dense lateral cover (≥81%) during the snow-free period, but selected sites with a high volume of coarse woody debris (≥64 m3·ha−1) and high conifer canopy closure (≥48%) during the snow-covered period. Our results highlight the importance of contrasting seasonal changes in habitat selection patterns of small carnivores and may help maintain structural attributes in the landscape that are suitable for male American Martens.
Project Hephaistos – II. Dyson sphere candidates from Gaia DR3, 2MASS, and WISE
Authors: Suazo Matías , Zackrisson Erik , Mahto Priyatam K , Lundell Fabian , Nettelblad Carl , Korn Andreas J , Wright Jason T , Majumdar Suman
Published: May 2024

The search for extraterrestrial intelligence is currently being pursued using multiple techniques and in different wavelength bands. Dyson spheres, megastructures that could be constructed by advanced civilizations to harness the radiation energy of their host stars, represent a potential technosignature, that in principle may be hiding in public data already collected as part of large astronomical surveys. In this study, we present a comprehensive search for partial Dyson spheres by analysing optical and infrared observations from Gaia, 2MASS, and WISE. We develop a pipeline that employs multiple filters to identify potential candidates and reject interlopers in a sample of five million objects, which incorporates a convolutional neural network to help identify confusion in WISE data. Finally, the pipeline identifies seven candidates deserving of further analysis. All of these objects are M-dwarfs, for which astrophysical phenomena cannot easily account for the observed infrared excess emission.
Observational constraints on the stellar recycled gas in active galactic nuclei feeding
Authors: Riffel Rogério , Dahmer-Hahn Luis G , Vazdekis Alexandre , Davies Richard , Rosario David , Almeida Cristina Ramos , Audibert Anelise , Martín-Navarro Ignacio , Martins Lucimara Pires , Rodríguez-Ardila Alberto , Riffel Rogemar A , Storchi-Bergmann Thaisa , Bertoldo-Coelho Michele , Trevisan Marina , Hicks Erin , Müller Allan Schnorr- , Marinho Lais Nery , Veilleux Sylvain
Published: May 2024

Near-infrared long-slit spectroscopy has been used to study the stellar population (SP) of the low luminosity active galactic nuclei (AGNs) and matched analogues (LLAMA) sample. To perform the SP fits we have employed the X-shooter simple stellar population models together with the starlight code. Our main conclusions are: The star formation history of the AGNs is very complex, presenting many episodes of star formation during their lifetimes. In general, AGN hosts have higher fractions of intermediate-age SP (light-weighted mean ages,  L ≲ 4.5 Gyr) when compared with their analogues ( L ≲ 8.0 Gyr). AGNs are more affected by reddening and require significant fractions of featureless continuum and hot dust components. The ratio between the AGN radiated energy and the gravitational potential energy of the molecular gas (ERad/EPG) for the AGN is compared with the  L and a possible anticorrelation is observed. This suggests that the AGN is affecting the star formation in these galaxies, in the sense that more energetic AGN [log(ERad/EPG) ≳ 3] tend to host nuclear younger SP ( L ≲4 Gyr). We found that the recent (t <2 Gyr) returned (recycled) stellar mass is higher in AGN than in the controls. We also provide evidence that the mass-loss of stars would be enough to feed the AGN, thus providing observational constraints for models that predict that AGN feeding is partially due to the recycled gas from dying stars.
Consequences of a low-mass high-pressure star formation mode in early galaxies
Authors: Fabian A C , Sanders J S , Ferland G J , McNamara B R , Pinto C , Walker S A
Published: May 2024

High resolution X-ray spectra reveal hidden cooling flows depositing cold gas at the centres of massive nearby early-type galaxies with little sign of normal star formation. Optical observations are revealing that a bottom-heavy initial mass function is common within the inner kpc of similar galaxies. We revive the possibility that a low-mass star formation mode is operating due to the high thermal pressure in the cooling flow, thus explaining the accumulation of low-mass stars. We further explore whether such a mode operated in early high-redshift galaxies and has sporadically continued to the present day. The idea links observed distant galaxies with black holes which are ultramassive for their stellar mass, nearby red nuggets and massive early-type galaxies. Nearby elliptical galaxies may be red but they are not dead.
Optical spectroscopic and photometric classification of the X-ray transient EP240309a (EP J115415.8−501810) as an intermediate polar
Authors: Potter Stephen B , Buckley David A H , Scaringi S , Monageng I M , Egbo Okwudili D , Charles Philip A , Erasmus N , van Gend Carel , Loubser Egan , Titus Keegan , Rosie Kathryn , Gajjar Hitesh , Worters H L , Chandra Sunil , Julie R P M , Hlakola Moloko
Published: May 2024

We report on optical follow-up observations of an X-ray source initially detected by the Einstein Probe mission. Our investigations categorize the source as an intermediate polar, a class of magnetic cataclysmic variables, exhibiting an orbital period of 3.7614(4) h and a white dwarf spin period of 3.97 min. The orbital period was identified through TESS observations, while our high-speed photometric data, obtained using the 1.9m and Lesedi 1.0m telescopes at the South African Astronomical Observatory, revealed both the spin and beat periods. Additionally, we present orbitally phase-resolved spectroscopic observations using the 1.9m telescope, specifically centred on the H β emission line, which reveal two emission components that exhibit Doppler variations throughout the orbital cycle.
Liver Steatosis is Prevalent in Lean People With HIV and Associated With Exposure to Antiretroviral Treatment—A Cross-sectional Study
Authors: van Eekeren Louise E , Vadaq Nadira , Vos Wilhelm A J W , Blaauw Marc J T , Groenendijk Albert L , van Lunzen Jan , Stalenhoef Janneke E , Berrevoets Marvin A H , Verbon Annelies , Weijers Gert , Netea Mihai G , van der Ven André J A M , de Mast Quirijn , Joosten Leo A B , Tjwa Eric T T L
Published: May 2024

Background

Steatotic liver disease is suggested to have a higher prevalence and severity in people with HIV (PHIV), including in those with a normal body mass index (BMI). In this study, we used data from the 2000HIV cohort to (1) assess the prevalence of liver steatosis and fibrosis in lean versus overweight/obese PHIV and (2) assess associations in these subgroups between steatosis and fibrosis with traditional risk factors and HIV-specific characteristics.

Methods

The 2000HIV study cohort comprises 1895 virally suppressed PHIV that were included between 2019 and 2021 in 4 HIV treatment centers in the Netherlands. The majority (58.5%) underwent vibration-controlled transient elastography for the assessment of liver steatosis and fibrosis. The prevalence of steatosis (controlled attenuation parameter ≥263 dB/m) and fibrosis (liver stiffness measurement ≥7.0 kPa) was estimated. Multiple factors including HIV characteristics and antiretroviral drugs were tested in a logistic regression model for association with steatosis and fibrosis. Analyses were performed separately for lean (Asian descent: BMI < 23 kg/m2, other descent: BMI < 25 kg/m2) and overweight/obese (other BMI) participants.

Results

Of 1050 PHIV including 505 lean and 545 overweight/obese PHIV, liver steatosis was observed in 37.7% of the overall study population, 19.7% of lean, and 54% of overweight/obese PHIV, whereas fibrosis was observed in 9.0% of the overall study population, 5.9% of lean, and 12.0% of overweight/obese PHIV.

All associations with fibrosis and most associations with steatosis concerned metabolic factors such as type 2 diabetes mellitus (overall population: adjusted odds ratio [aOR] for steatosis: 2.3 [1.21-4.4], P = .011; aOR for fibrosis: 3.7 [1.82-7.53], P < .001). Furthermore, in lean PLHIV, liver steatosis was associated with CD4 and CD8 counts at enrollment, dual therapy, and history of treatment with raltegravir (aOR: 3.6 [1.53-8.47], P = .003), stavudine (aOR: 3.73 [1.69-8.2], P = .001), and indinavir (aOR: 3.86 [1.59-9.37], P = .003). These associations were not observed in overweight/obese PHIV.

Conclusions

Liver steatosis was highly prevalent, affecting approximately one-fifth of lean PHIV and half of overweight/obese PHIV. Fibrosis was observed in a minority. Both steatosis and fibrosis were associated with traditional metabolic risk factors. In addition, (prior) exposure to specific antiretroviral drugs was associated liver steatosis in lean, but not in overweight/obese PHIV. Implementing increased screening protocols could enhance the identification of steatotic liver disease in lean PHIV.
The Incidence of Skin and Soft Tissue Infections in the United States and Associated Healthcare Utilization Between 2010 and 2020
Authors: Vella Venanzio , Derreumaux Dominique , Aris Emmanuel , Pellegrini Michele , Contorni Mario , Scherbakov Michael , Bagnoli Fabio
Published: May 2024

Background

The number of patients with skin and soft tissue infections (SSTIs) in the United States appeared to be increasing well into the 21st century. However, no recent data have confirmed this trend.

Methods

This retrospective, observational cohort study used claims data over 11 years (2010–2020) from Optum's de-identified Clinformatics Data Mart Database. SSTI episodes, complications, and comorbidities were identified using International Classification of Diseases codes. Annual SSTI incidence rates, proportions of recurrent SSTI, SSTI-associated deaths, and total costs were estimated.

Results

During the study period, 5.4 million patients experienced 9.1 million SSTI episodes, with an incidence of 77.5 (95% confidence interval, 77.4–77.5) per 1000 person-years of observation (PYO). Annual incidence did not change significantly over time. Overall incidence (per 1000 PYO) of SSTI episodes in patients without comorbidities was 32.1 (highest incidence was for previous SSTI [113.5]) versus much higher rates if comorbidities were present. Incidence rates (per 1000 PYO) of chronic ulcers increased over time from 11.3 to 18.2 (P < .0001) and complicated disease from 3.5 to 6.3 (P < .0001). Deaths occurring within 30 days post–SSTI hospitalization rose from 2.6% to 4.6% in 2020. Recurrences occurred in 26.3% of index cases. The mean cost of an SSTI episode was US$3334 (median US$190) and was highest for surgical site infections and chronic ulcers.

Conclusions

The epidemiology of SSTI in the United States is changing and the disease burden is increasing despite stabilization in overall incidence. These data can inform identification of priority populations who could benefit from targeted interventions.
‘Hard AI Crime’: The Deterrence Turn
Authors: Nerantzi Elina , Sartor Giovanni
Published: May 2024

Machines powered by artificial intelligence (AI) are increasingly taking over tasks previously performed by humans alone. In accomplishing such tasks, they may intentionally commit ‘AI crimes’, ie engage in behaviour which would be considered a crime if it were accomplished by humans. For instance, an advanced AI trading agent may—despite its designer’s best efforts—autonomously manipulate markets while lacking the properties for being held criminally responsible. In such cases (hard AI crimes) a criminal responsibility gap emerges since no agent (human or artificial) can be legitimately punished for this outcome. We aim to shift the ‘hard AI crime’ discussion from blame to deterrence and design an ‘AI deterrence paradigm’, separate from criminal law and inspired by the economic theory of crime. The homo economicus has come to life as a machina economica, which, even if cannot be meaningfully blamed, can nevertheless be effectively deterred since it internalises criminal sanctions as costs.
Hidden citations obscure true impact in science
Authors: Meng Xiangyi , Varol Onur , Barabási Albert-László
Published: May 2024

References, the mechanism scientists rely on to signal previous knowledge, lately have turned into widely used and misused measures of scientific impact. Yet, when a discovery becomes common knowledge, citations suffer from obliteration by incorporation. This leads to the concept of hidden citation, representing a clear textual credit to a discovery without a reference to the publication embodying it. Here, we rely on unsupervised interpretable machine learning applied to the full text of each paper to systematically identify hidden citations. We find that for influential discoveries hidden citations outnumber citation counts, emerging regardless of publishing venue and discipline. We show that the prevalence of hidden citations is not driven by citation counts, but rather by the degree of the discourse on the topic within the text of the manuscripts, indicating that the more discussed is a discovery, the less visible it is to standard bibliometric analysis. Hidden citations indicate that bibliometric measures offer a limited perspective on quantifying the true impact of a discovery, raising the need to extract knowledge from the full text of the scientific corpus.
Healthcare professionals perspectives on tuberculosis barriers in Portuguese prisons—a qualitative study
Authors: Aguiar Ana , Abreu Mariana , Duarte Raquel
Published: May 2024

Background

Tuberculosis (TB) remains a significant public health concern, particularly within prison settings, where the confluence of adverse health factors and high-risk behaviors contribute to a heightened risk of transmission. This study delves into the perspectives of medical doctors, regarding the implementation of the 2014 TB protocol in Portugal.

Methods

The study has a qualitative, descriptive design. Individual semi-structured interviews with medical doctors from TB outpatient centers in Porto and Lisbon were used for data collection. For the analysis thematic analysis method was used.

Results

The study population comprised 21 medical doctors with the majority being female (61.9%) and 57.1% specializing in pulmonology. The results indicate varied perceptions of the protocol’s usefulness, with positive impacts on coordination reported by some participants. Improved communication and evolving collaboration between TB outpatient centers and prisons were highlighted, although challenges in contact tracing and resource constraints were acknowledged. The study also sheds light on the role of nurses in patient education.

Conclusion

Despite overall positive perceptions, challenges such as sustaining therapy post-symptomatic improvement and delays in diagnostic methods were identified. The findings underscore the importance of continuous collaboration between prisons and TB control programs to address challenges, improve disease control and prevent TB transmission.
Banks’ Market Power, Access to Finance, and Leverage
Authors: Bustamante M Cecilia , D’Acunto Francesco
Published: May 2024

How does lending-market competitiveness shape new firms’ financing? Using a unique U.S. representative panel of new firms, we document that in more concentrated local lending markets: (a) new firms are less likely to access credit; (b) new firms have lower leverage; and (c) the best-performing firms are more severely affected by reduced debt financing. We develop a contingent-claims model with monopolistically competitive banks that rationalizes these facts and shows how credit-market conditions determine loan fees and concentration. Our findings highlight banks’ market power as a channel through which the financial sector influences firms’ development and, hence, economic growth. (JEL D82, G21, G32, G34, L26)
Dolimandro’s ‘Turkish Knife’: Geopolitics and Narrative Style in Mary Wroth’s Urania
Authors: Grayson Spencer
Published: May 2024

This essay examines Lady Mary Wroth’s engagement with early seventeenth-century Anglo-Ottoman relations in The Countess of Montgomery’s Urania. The Urania follows a group of rulers who create an international Christian coalition in what was historically part of the Ottoman Empire. Besides Bernadette Andrea, no other critic has seriously considered the Urania’s allusions to Ottoman peoples, places, and objects. I propose that Wroth’s prose, filled with interpretive cruxes resulting from syntactical and pronominal ambiguities, resonates with England’s ambiguously identificatory relationship with the Ottoman Empire to create a geopolitically inflected narrative style. Following critical work on early modern race as a measure of ‘proximity’, I identify English desires both to identify with and differentiate themselves from the Ottoman Empire within literary and diplomatic discourses. I demonstrate how members of the Sidney-Herbert circle negotiated overlaps in English and Ottoman political, legal, religious, and racial identity markers. I then argue that these overlaps synergize with Wroth’s use of what I term syntactical and pronominal ‘severalty’ of character voices, particularly those of her narrator and characters identified with Ottoman regions. I conclude by demonstrating how Wroth experiments with her narrative style to imagine a Christian empire that surpasses Ottoman authority. In identifying a dialectic between contemporary Anglo-Ottoman relations and Wroth’s narrative style, this essay expands critical approaches to the politics of the Urania beyond more global narratological analysis.
Random-Effects Substitution Models for Phylogenetics via Scalable Gradient Approximations
Authors: Magee Andrew F , Holbrook Andrew J , Pekar Jonathan E , Caviedes-Solis Itzue W , Matsen IV Fredrick A , Baele Guy , Wertheim Joel O , Ji Xiang , Lemey Philippe , Suchard Marc A
Published: May 2024

Phylogenetic and discrete-trait evolutionary inference depend heavily on an appropriate characterization of the underlying character substitution process. In this paper, we present random-effects substitution models that extend common continuous-time Markov chain models into a richer class of processes capable of capturing a wider variety of substitution dynamics. As these random-effects substitution models often require many more parameters than their usual counterparts, inference can be both statistically and computationally challenging. Thus, we also propose an efficient approach to compute an approximation to the gradient of the data likelihood with respect to all unknown substitution model parameters. We demonstrate that this approximate gradient enables scaling of sampling-based inference, namely Bayesian inference via Hamiltonian Monte Carlo, under random-effects substitution models across large trees and state-spaces. Applied to a dataset of 583 SARS-CoV-2 sequences, an HKY model with random-effects shows strong signals of nonreversibility in the substitution process, and posterior predictive model checks clearly show that it is a more adequate model than a reversible model. When analyzing the pattern of phylogeographic spread of 1441 influenza A virus (H3N2) sequences between 14 regions, a random-effects phylogeographic substitution model infers that air travel volume adequately predicts almost all dispersal rates. A random-effects state-dependent substitution model reveals no evidence for an effect of arboreality on the swimming mode in the tree frog subfamily Hylinae. Simulations reveal that random-effects substitution models can accommodate both negligible and radical departures from the underlying base substitution model. We show that our gradient-based inference approach is over an order of magnitude more time efficient than conventional approaches.
Application of Within-Methods Triangulation to Analyze Hospital System Health
Authors: Brittain Angela C. , Carrington Jane M.
Published: May 2024

Qualitative descriptive research can be used when researchers are seeking to find the “how,” “what,” or “when” of phenomena. The most common qualitative descriptive analysis methods are content and thematic analyses. Data triangulation through content analysis and natural language processing was first described in 2018 for the analysis of nurse-to-nurse communication in an acute care setting. The purpose of this article is to discuss a within-methods data triangulation of interviews done with nurses and nursing leaders in Magnet- and non–Magnet-designated hospitals through integration and application of content analysis, code quantification via the Goodwin statistic, and natural language processing.
A Cadaveric Study: Does Ankle Positioning Affect the Quality of Anatomic Syndesmosis Reduction?
Authors: Aneja Arun , Nazal Mark R. , Griffin Jarod T. , Foster Jeffrey A. , Muhammad Maaz , Sierra-Arce Carlos R. , Southall Wyatt G. S. , Wagner Robert Kaspar , Ly Thuan V. , Srinath Arjun
Published: May 2024

OBJECTIVE:

The objective of this study was to compare the quality of syndesmotic reduction with the ankle in maximal dorsiflexion versus neutral plantarflexion (normal resting position).

METHODS:

Baseline computed tomography (CT) imaging of 10 cadaveric ankle specimens from 5 donors was obtained with the ankles placed in normal resting position. Two fellowship-trained orthopaedic surgeons disrupted the syndesmosis of each ankle specimen. All ankles were then placed in neutral plantarflexion and were subsequently reduced with thumb pressure under direct visualization through an anterolateral approach and stabilized with one 0.062-inch K-wire placed from lateral to medial in a quadricortical fashion across the syndesmosis. Postreduction CT scans were then obtained with the ankle in normal resting position. This process was repeated with the ankles placed in maximal dorsiflexion during reduction and stabilization. Postreduction CT scans were then obtained with the ankles placed in normal resting position. All postreduction CT scans were compared with baseline CT imaging using mixed-effects linear regression with significance set at P < 0.05.

RESULTS:

Syndesmotic reduction and stabilization in maximal dorsiflexion led to increased external rotation of the fibula compared with baseline scans [13.0 ± 5.4 degrees (mean ± SD) vs. 7.5 ± 2.4 degrees, P = 0.002]. There was a tendency toward lateral translation of the fibula with the ankle reduced in maximal dorsiflexion (3.3 ± 1.0 vs. 2.7 ± 0.7 mm, P = 0.096). No other statistically significant differences between measurements of reduction with the ankle placed in neutral plantarflexion or maximal dorsiflexion compared with baseline were present (P > 0.05).

CONCLUSIONS:

Reducing the syndesmosis with the ankle in maximal dorsiflexion may lead to malreduction with external rotation of the fibula. There was no statistically significant difference in reduction quality with the ankle placed in neutral plantarflexion compared with baseline. Future studies should assess the clinical implications of ankle positioning during syndesmotic fixation.
Effects of sacubitril/valsartan versus olmesartan on left atrial structure in hypertensive patients without HFrEF: a randomized controlled trial
Authors: Meng Peina , Guo Yajie , Dong Jing , Wu Zhiming , Wu Xiangqi , Huang Tianyi , You Wei , Ji Meili , Jia Haibo , Ye Fei
Published: May 2024

Background and purpose:

Treatment with sacubitril plus valsartan attenuates cardiac remodeling in patients with heart failure with reduced ejection fraction (HFrEF). Evidence for potential effects of sacubitril/valsartan on left atrial remodeling in hypertensive patients without HFrEF, however, is limited. Therefore, we aimed to compare the effects of sacubitril/valsartan and olmesartan on the left atrial structure in Chinese hypertensive patients.

Methods:

This single-center randomized controlled trial was conducted at Nanjing First Hospital from June 2021 to February 2022. Adult patients (18–80 years of age) with essential hypertension but no HFrEF were randomized at a 1:1 ratio to receive sacubitril/valsartan or olmesartan. Initial dosage was 100 mg/day for sacubitril/valsartan and 20 mg/day for olmesartan. In patients who did not reach the target blood pressure (<140/90 mmHg) within a week, dosage was increased to 200 to 400 mg/day for sacubitril/valsartan and 40 mg/day for olmesartan. In patients who failed to reach the target blood pressure at 4 weeks, other antihypertensive drugs were used at physician’s discretion. The patients should reach the target blood pressure at 8 weeks. The primary endpoint was the change of left atrial volume index (LAVI) from baseline to 24 weeks. Secondary endpoints included the changes of left atrial diameter (LAD), left atrial emptying fraction (LAEF), left ventricular ejection fraction (LVEF), and left ventricular end-diastolic diameter (LVEDD) from baseline to 24 weeks. Results are shown as median and interquartile range (IQR).

Results:

A total of 153 patients were enrolled. The final analysis included 145 patients who completed the 24-week assessment: 71 and 74 in the sacubitril/valsartan and olmesartan groups, respectively. Demographic and key baseline characteristics (e.g., blood pressure) were comparable between the 2 groups. Target blood pressure was achieved in all 145 patients at 8 weeks. In comparison to the olmesartan group, the sacubitril/valsartan group had significantly greater change in LAVI (−4.19 [−2.87, −5.43] vs. −0.61 [−0.53, −1.13] mL/m2, P < 0.001), LAEF (1.00% [2.00%, 0%] vs. 0% [1.00%, −1.00%], P = 0.014), LVEDD (−2.00 [0, −3.00]mm vs. −1.00 [0, −1.00]mm, P < 0.001), and LVEF (1.00% [3.00%, 1.00%] vs. 0% [1.00%, 0%], P < 0.001), but not LAD, LAVI, LAEF, LVEDD, and LVEF at 24 weeks relative to the baseline.

Conclusions:

In comparison to olmesartan, sacubitril/valsartan resulted in more robust improvements in left atrial and ventricular structure and function in hypertensive patients without HFrEF.
Evaluation of Facial Aging in Different Age and Gender Groups With Computed Tomography–Based Calvarium and Face Measurements
Authors: Nur Kuzan Beyza , Yusuf Kuzan Taha
Published: May 2024

BACKGROUND

The human face is a complex area formed by the combination of many different components and varies among individuals according to gender, age, and ethnicity.

OBJECTIVE

The aim of this study was to evaluate age-related changes in the facial and calvarial bones in a large sample of both genders.

METHODS

The retrospective study included nontraumatic brain computed tomography scans of 280 Turkish adults. Participants were divided into 7-decade groups with the age ranging from 20 to 89 years. Measurements of the face and calvaria were recorded, and calvarial volume was calculated. The relationship of these parameters with age and gender was examined.

RESULTS

Statistically significant differences were observed in all the facial and calvarial measurements, except the transverse diameter of the head, with increasing age in both genders. Regardless of age, no significant differences were found in facial and calvarial measurements between genders. In addition, there was a significant decrease in the calvarial volume in both genders after the seventh decade of life.

CONCLUSION

The structure of the face and calvarium continues to change and differentiate throughout life. Taking these changes into account during surgical and facial rejuvenation procedures can help predict outcomes and avoid the use of incorrect techniques.
Ultrasonographic Study of the Submandibular Gland for Botulinum Neurotoxin Injection
Authors: Yi Kyu-Ho , Kim Soo-Bin , Hu Hyewon , An Hyo-Sang , Hidajat Inneke Jane , Lim Ting Song , Kim Hee-Jin
Published: May 2024

BACKGROUND

Hypertrophied submandibular glands provide a bulky contour to the lower face. Botulinum neurotoxin injection methods are commonly used for facial contouring; however, no studies have suggested injection points because of the lack of delicate anatomical information on the submandibular gland.

OBJECTIVE

The aim of this study was to determine the optimal injection site for botulinum neurotoxin injections in the submandibular gland.

MATERIALS AND METHODS

Anatomical considerations when injecting botulinum neurotoxin into the submandibular gland were determined using ultrasonography. The thickness of the submandibular gland, its depth from the skin surface, and the location of the vascular bundle were observed bilaterally in 42 participants. Two cadavers were dissected to measure the location of the submandibular gland corresponding to the ultrasonographic observation.

RESULTS

The thickest part of the submandibular gland measured 11.12 ± 2.46 in width with a depth of 4.63 ± 0.76. At the point where it crosses the line of the lateral canthus, it measured 5.53 ± 1.83 in width and 8.73 ± 1.64 in depth.

CONCLUSION

The authors suggest optimal injection sites based on external anatomical landmarks. These guidelines aim to maximize the effects of botulinum neurotoxin therapy by minimizing its deleterious effects, which can be useful in clinical settings.
Adult Day Services for People With Intellectual and Developmental Disabilities
Authors: Westmore Megan R. , Anderson Keith A.
Published: May 2024

Background:

Adult day services (ADS) are therapeutic, social, and health-related activities that keep people in their homes, rather than institutional settings. While there is a growing body of literature on ADS for older adults, there is far less information available about ADS for younger adults with intellectual and/or developmental disabilities (IDDs).

Method:

Researchers conducted a scoping review of 6 databases (892 total articles).

Results:

After applying inclusion and exclusion criteria, 74 full articles were reviewed, with 10 articles meeting study requirements. The research team found the literature is limited to simple descriptive reports or interventions that use ADS as a platform.

Conclusions:

Simply put, we know very little about the services provided to younger adults with IDD in ADS. Implications for future research are discussed, including the need to catalog the services offered in ADS for younger adults with IDD and to evaluate their impact on participant well-being.
Computed tomography on the 5th postoperative day helps distinguish grade C from grade B pancreatic fistula after pancreaticoduodenectomy for periampullary cancer
Authors: Vo Truong Quoc , Minh Tri Phan , Tran Long Cong Duy , Doan My Tien
Published: May 2024

Background

Grade C pancreatic fistula (PF) is the most dangerous complication after pancreaticoduodenectomy (PD) and had not been identified on the early postoperative day yet. In this study, we aimed to introduce a new approach to distinguish grade C from grade B PF by using features on the 5th postoperative day’s computed tomography (CT).

Materials and Methods

A bicentric prospective cohort study was conducted from August 2021 to October 2023 at the University Medical Center (UMC) and Cho Ray Hospital, Vietnam. Patients who diagnosed pancreatic fistula and underwent a CT scan on the 5th postoperative day were followed up within 90 days after PD. The characteristics of CT scan images were analyzed to differentiate both grades of PF.

Results

During 26 months, 77 patients with periampullary cancer underwent PD and met the criteria of the study (46 males, mean age: 57.1 ± 13.7). Of these, 52 patients had biochemical PF and 25 had CRPF (18 grade B PFs and 7 grade C PFs). Specifications on the 5th postoperative day’s CT scan that can discriminate grade C from grade B included fluid diffusing throughout abdomen, retroperitoneal abscess, hematoma beneath the liver, size of the fluid collection next to the pancreas (P = 0.031), and size of pancreatojejunostomy anastomosis dehiscence (P = 0.045).

Conclusions

Features on CT scan could be used to identify grade C pancreatic fistula from the 5th postoperative day. This result can help surgeons to make a plan for a careful follow-up and early reoperation for those patients.
Efficacy of the minimal-invasive vacuum-assisted biopsy under direct visualization with ultrasound for impalpable breast lesions in Taiwanese female: A retrospective case-control study
Authors: Chen Sherry Ying-Hsuan , Moi Sin-Hua , Pan Mei-Ren , Chiang Chih-Po , Luo Chi-Wen , Lin Huei-Shan , Kao Chieh-Ni , Wu Cheng-Che , Li Chung-Liang , Shiau Jun-Ping , Yang Ping-Fu , Kan Jung-Yu , Chuang Chieh-Han , Shih Shen-Liang , Chen Fang-Ming , Hou Ming-Feng
Published: May 2024

Background

Although surgical excisional biopsy provides robust diagnostic results, the ultrasound-assisted vacuum-assisted biopsy (VABB) offers an alternative for Asian candidates with dense breasts and lesions which cannot be approached by stereotactic biopsy. The study aims to investigate the efficacy of the ultrasound-assisted VABB for impalpable mammographic-detected lesions.

Materials and Methods

A retrospective case-control study is conducted in a group of Taiwanese female patients who have impalpable breast lesions such as microcalcifications at screening mammography that are limited to BI-RADS category 4. Specifically, the lesions are categorized into three groups: 4a, 4b, and 4c and the histology from B2 through B5. The cases underwent ultrasound-assisted VABB and the controls had lumpectomies. The diagnostic accuracy, rate of discordance, excited tumor size, and the proportion of cancer cases is evaluated and compared using Fisher’s exact test, Cohen’s kappa test, chi-Square test, and the use of IBM SPSS statistical programs.

Results

The histology of the majorities of the collected specimen is B2 benign fibrocystic changes (60–70%). In cases of patients who are diagnosed with breast cancer, most are ductal carcinoma in situ and early-stage diseases. The cancer risks for lesions categorized under BI-RADS 4a, 4b, and 4c, respectively, are consistent with clinical practice. Meanwhile, the diagnostic accuracy of VABB is similar to lumpectomy, as the histologic discordance rate did not differ significantly.

Conclusions

Ultrasound-assisted VABB does offer an option for patients who are not candidates for stereotactic biopsy, as it has shown to have noninferior diagnostic values and cosmetic benefits when compared to surgical excision. The use of sonography monitors the biopsy process and guides the needle insertion, which is thus capable of obtaining samples from multiple directions, without risking the pectoralis muscles underneath. However, VABB may be intended for biopsies in lower-risk findings such as BI-RADS category 4a because doubts persist as complete excisional rates are operator-dependent.
Evaluating the effects of hormone therapy termination on skeletal muscle and physical independence in postmenopausal women
Authors: Wullems Jorgen Antonin , Degens Hans , Morse Christopher Ian , Onambélé-Pearson Gladys Leopoldine
Published: May 2024

Objective

In women, the age-related decline in skeletal muscle structure and function is accelerated after menopause, which implicates the role of decreased circulating estrogen levels. Indeed, boosting estrogen, by means of postmenopausal hormone therapy (HT), generally proves beneficial to skeletal muscle. The evidence regarding whether these benefits persist even after cessation of HT is limited, nor is it clear how physical behavior (PB) impacts on benefits. Hence, this exploratory study focused on the interplay between HT administration/cessation, PB and in vivo skeletal muscle structure and function.

Methods

Fifty healthy women (≥60 y) were included; 19 had an HT administration history (≥9 mo, with now ~8-y hiatus in treatment) and 31 no such history. On seven continuous days, PB data were collected using triaxial accelerometry and analyzed using compositional data analysis. Gastrocnemius medialis muscle volume, architecture, and function were determined using ultrasonography, electromyography, dual x-ray absorptiometry, and dynamometry. Current serum estradiol levels were measured using ELISA.

Results

Only fascicle length and duration of HT administration were positively associated. With respect to PB levels, we found a pattern suggesting greater vitality (higher physical activity and lower sedentarism) in previous HT users, compared with nonusers, despite the two groups currently no longer exhibiting significantly different levels of circulating estradiol.

Conclusions

After an 8-year hiatus in treatment, HT provides limited advantages in gastrocnemius medialis muscle properties. Interestingly, it perhaps enhances vitality despite prolonged cessation, which in the longer term would facilitate greater physical independence, especially considering the association of sedentary behavior with greater frailty.
“Micro–Viscous Fluid Control”: A Simple Homemade New Tool to Access Subretinal Space in a Controlled Way
Authors: Boral Subhendu Kumar , Dan Shouvick , Mitra Santanu
Published: May 2024

Purpose:

To develop a simple tool to remove retained submacular perfluorocarbon liquid bubbles (R-PFCL) and to inject recombinant tissue plasminogen activator safely in subretinal space in submacular hematomas.

Method:

A retrospective, interventional study was performed where a simple homemade micro–viscous fluid control was developed to gain access to subretinal space in a controlled way. The rubber cap of the plunger of a 1-mL syringe was cut; this cut rubber cap of the plunger was fitted inside an empty 1-mL tuberculin syringe, and its end was fitted with the tubings of viscous fluid control of the vitrectomy machine. Now, viscous fluid control mode was activated by attaching a 38-G/41-G subretinal needle for extracting submacular PFCL bubbles (R-PFCL group, n = 12) and to deliver recombinant tissue plasminogen activator injection in significant submacular hematomas cases (submacular hematomas group, n = 32). Best-corrected visual acuity (BCVA), fundus photographs, and optical coherence tomography were analyzed. Follow-up was done for at least 6 months.

Results:

Vision improved from preoperative mean BCVA logarithm of the minimum angle of resolution 0.99 (20/195) ± 0.27 to postoperative mean BCVA logarithm of the minimum angle of resolution 0.75 (20/112) ± 0.21 (P-value < 0.05) in R-PFCL group and from preoperative mean BCVA logarithm of the minimum angle of resolution 1.99 (20/1954) ± 0.75 to postoperative mean BCVA logarithm of the minimum angle of resolution 0.75 (20/112) ± 0.37 (P-value < 0.001) in submacular hematomas group.

Conclusion:

Our homemade micro–viscous fluid control is a safe tool to extract retained submacular PFCL bubbles and to deliver a precise dose of subretinal drugs like recombinant tissue plasminogen activator for a subretinal hematoma in a controlled way.
VITREORETINAL OUTCOMES FOLLOWING SECONDARY INTRAOCULAR LENS IMPLANTATION WITH PARS PLANA VITRECTOMY
Authors: Kaufmann Gabriel T. , Gupta Omesh , Yu Julia , Nguyen Michael , Lee Crystal Y. , Achuck Kathryn , Hsu Jason , Ho Allen , Regillo Carl , Garg Sunir , Klufas Michael A. , Mehta Sonia , Xu David , Cohen Michael , Yonekawa Yoshihiro , Kuriyan Ajay , Starr Matthew R.
Published: May 2024

Background:

Retrospective cohort study of 561 adult patients undergoing secondary intraocular lens (IOL) implantation by vitreoretinal surgeons at a single institution from April 2015 to December 2020.

Methods:

Patient historical factors, intraoperative/postoperative complications, and outcomes of IOL type (anterior chamber IOL versus scleral sutured IOL versus scleral fixated IOL versus. sulcus) were assessed. Primary outcomes were rates of postoperative retinal tears and rhegmatogenous retinal detachment. Secondary outcomes were rates of intraoperative endolaser, intraoperative retinal tear, and further IOL surgery.

Results:

The incidence of intraoperative retinal tears was 7.3% and not significantly different between techniques. Rates of intraoperative endolaser use were 17.5% among all techniques and not significantly different between techniques. Rates of postoperative retinal tear were low (0%–2.7%). Rates of postoperative rhegmatogenous retinal detachment were not significantly different between techniques (anterior chamber IOL 9/198 [4.5%], SFIOL 1/54 [1.9%], scleral sutured IOL 14/274 [5.1%], sulcus 2/35 [5.7%], total 26/561 [4.6%], P = 0.79). Rates of repeat IOL surgery trended higher in sulcus lenses (anterior chamber IOL 5/198 [2.5%], SFIOL 4/54 [7.4%], scleral sutured IOL 16/274 [5.8%], sulcus 5/35 [14.3%], total 30/561 [5.3%], P = 0.12).

Conclusion:

Intraoperative endolaser use and intraoperative retinal tear are not uncommon in secondary IOL surgery and underscore the importance of careful vitreoretinal management among these patients.