bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the deciphering properties of Cyamopsis Tetragonoloba: its food application, feasibility, and future aspects
Authors: Rani Ritu , Kaushik Deepika , Babagil Gülçin Emel , Proestos Charalampos , Brennan Charles , Oz Fatih , Kumar Mukul
Published: January 2025

Cyamopsis tetragonoloba belongs to the Fabaceae family and is an erect, drought-resistant, coarse-textured, annual legume. This species serves as a valuable source of nutrition for both livestock and humans. The purpose of this review is to explore the nutritional profile of C. tetragonoloba, highlighting its richness in dietary fiber, proteins, and essential minerals, alongside its bioactive compounds, such as flavonoids and polysaccharides, which demonstrate antioxidant, anticancer, and antidiabetic properties and its applications. The potential of C. tetragonoloba in developing biodegradable packaging materials is also explored, highlighting its ability to enhance mechanical properties and food product storage stability, making it a viable alternative to petrochemical-based plastics. Additionally, this review addresses C. tetragonoloba cultivation’s environmental impact and sustainability, emphasizing the importance of efficient byproduct Valorization, pharma industry and its role in circular economy practices. Key challenges and future research directions include improving processing technologies, exploring novel applications for C. tetragonoloba -based materials, and enhancing C. tetragonoloba cultivation and utilization for environmental and economic sustainability.
Preliminary study on the correlation between enzyme activity assays and substrate preferences of microbial transglutaminase
Authors: Zheng Xinyue , Luo Wenjie , Wang Mingfeng , Chen Xing , Liu Jing , Wang Lei , Zhang Wei , Hu Weiyao , Dong Gaofeng , Pan Hongyang , Wang Zhaojun , Chen Qiuming
Published: January 2025

The transglutaminase (TGase) derived from microorganisms, known for its exceptional protein cross-linking properties, holds significant application potential across various fields. In order to meet market demands such as temperature preferences, catalytic capabilities, selectivity, and the exploration of novel TGases, challenges have arisen for the development of TGases. In this study, we conducted enzymatic activity assays on TGases from Shouchella clausii (strain KSM-K16) (Alkalihalobacillus clausii) and Couchioplanes caeruleus, randomly selected from the TrEMBL database in UniProt. We also simulated the reaction process of these assays and provided interpretations of the results. Subsequently, we examined their cross-linking abilities with protein substrates bovine serum albumin (BSA) and Soy protein isolate (SPI). By validating with commercial TGase, we identified the correlation between the two commonly used enzymatic activity assay methods for TGase and the substrate preference of TGase. This correlation will aid in the specific modification of TGase.
Local income inequality and product variety: empirical evidence
Authors: Pennerstorfer Dieter , Schindler Nora , Yontcheva Biliana
Published: January 2025

This article investigates the relationship between local income inequality and firms’ location and product choices. Using detailed information on income at a regionally disaggregated level and individual data on Austrian restaurants, we show that product variety crucially depends on the distribution (in addition to the level) of income. Local markets with higher income inequality are characterized by a larger number of firms, offering a wider range of products and less common product variants. These findings suggest that local demand is substantially influenced by the heterogeneity of consumers’ income endowments, resulting in large differences in product variety.
Insights into the fine-scale habitat use of Eurasian Water Shrew (Neomys fodiens) using radio tracking and LiDAR
Authors: van der Putten Towi A W , Verhees Joris J F , Koma Zsofia , van Hoof Paul H , Heijkers Dirk , de Boer Willem F , Esser Helen J , Hoogerwerf Gert , Lemmers Pim
Published: January 2025

The Eurasian Water Shrew (Neomys fodiens) is one of the largest shrew (Soricidae) species in Eurasia. In Western Europe, this semiaquatic species often occurs in riparian and marshland habitats that have a high degree of naturalness, but is being threatened by habitat degradation and other anthropogenic factors. The species mostly occurs in low abundance and is elusive. Therefore, understanding its habitat use is challenging, yet imperative for establishing species-specific conservation measures. Technological developments in radio tracking and high-resolution remote sensing such as Light Detection And Ranging (LiDAR) now enable the quantification of ecological niches and provide insight into habitat requirements for a species. Here, we combined radio tracking and LiDAR to quantify habitat use by Eurasian water shrews. Alongside a lowland brook in the Netherlands, 20 individuals were tracked between September and October 2022, resulting in 332 unique locations of Eurasian water shrews. For each of these locations, 11 LiDAR-derived variables were calculated and subsequently analyzed in a species distribution model (SDM). The SDM yielded a model with a high accuracy (predictive performance AUC = 0.93). The variable of highest importance was dense and relatively short vegetation <1 m, which had a positive effect on Eurasian Water Shrew occurrence. Open areas seem to be avoided. Vegetation of heights between 1 and 15 m were found to be less important for the occurrence. The probability of occurrence decreased with increasing distance to water, indicating that the species occurs in the proximity of water, although vegetation-related variables were more important. The obtained detailed knowledge of fine-scale habitat use can be used to improve habitat conservation, restoration, and management for the species. Combining radiotelemetry data with LiDAR data is a promising approach to identifying species–habitat relationships of elusive species such as the Eurasian Water Shrew.
Cats in farms: ranging behavior of the Fishing Cat (Prionailurus viverrinus) in a human-dominated landscape
Authors: Mishra Rama , Lamichhane Babu Ram , Leirs Herwig , Subedi Naresh , Adhikari Sabin , Acharya Hem Raj , de Iongh Hans H
Published: January 2025

Home range studies provide valuable insights into animal ecology and behavior, informing conservation efforts and management strategies. Although the Fishing Cat (Prionailurus viverrinus) is a globally threatened habitat specialist species, only a few studies have been conducted on their home range and social organization, especially in response to human influence. In this study, we tracked 11 fishing cats with satellite GPS collars to investigate their home range size and habitat use in and around Koshi Tappu Wildlife Reserve, Nepal. The minimum convex polygon (MCP) and autocorrelation-informed kernel density estimation (AKDE) were used to estimate home range sizes of the fishing cats. Altogether 2,303 locations were obtained from 11 collared cats. The average home ranges of fishing cats (n = 8) with 95% MCP and 95% AKDE were 29.12 ± SD 16.89 km2 and 39.88 ± 26.16 km2, respectively. Home range (95% AKDE) of adult females (21.72 ± SD 16.39 km2, n = 4) was significantly smaller compared to males (58.03 ± SD 21.19 km2, n = 4). Sex-specific social organization with a single male overlapping with multiple nonoverlapping adult females was consistent with home range behaviors of other carnivores. The highest number of locations of collared fishing cats were in tall grasslands, whereas they highly preferred wetlands. A large part (over one-third) of fishing cat home ranges covers human-dominated areas such as fishponds, agriculture, and settlements encompassing various threats to fishing cats including persecution, road kills, and dog attacks. To ensure long-term survival of these cats amid habitat alteration and human–wildlife conflict, we recommend Fishing Cat conservation activities focusing on raising awareness, especially in human-dominated landscapes.
Repairing the mitral valve without touching the mitral valve—a novel technique
Authors: Sitaranjan Daniel , Kumar Ujjawal , Al-Zubaidi Fadi , Smith Harry , Kumar Sambhavi S , Large Stephen
Published: January 2025

A 44-year-old gentleman presented with severe ischemic cardiomyopathy and mitral regurgitation post-inferior myocardial infarction. Echocardiography and magnetic resonance imaging revealed a dilated left ventricle with a large left ventricular aneurysm (9.3 × 9.5 cm) and associated thrombus. Severe mitral regurgitation due to leaflet tethering and a left ventricular ejection fraction (LVEF) of 25% were also seen. The patient underwent successful aneurysmectomy with patch repair and papillary muscle approximation. Following initial weaning from cardiopulmonary bypass, 6 days of postoperative temporary veno-arterial extracorporeal membrane oxygenation support were required. The patient was subsequently discharged on postoperative day sixteen with improved cardiac function (LVEF of 45%) and trace residual mitral regurgitation, highlighting the efficacy of geometric restoration in addressing such mitral regurgitation, avoiding conventional intervention on the mitral valve itself.
AGN energetics and lifetimes from remnant radio galaxies
Authors: Quici Benjamin , Turner Ross J , Seymour Nicholas , Hurley-Walker Natasha
Published: January 2025

The energy coupling efficiency of active galactic nucleus (AGN) outbursts is known to vary significantly with factors including the jet kinetic power, duration of the outburst, and properties of the host galaxy group or cluster. As such, constraints on their jet power and lifetime functions are crucial to quantify the role of kinetic-mode AGN feedback on the evolution of galaxies since $z \sim 1$. In this work, we address this issue by measuring the energetics of a sample of 79 low-redshift (0.02 $\lt z \lt $ 0.2) remnant radio galaxies compiled from large-sky radio surveys – remnants uniquely probe the full duration of an AGN outburst. The jet kinetic power and outburst duration of each remnant are determined using the raise dynamical model based on the surface brightness distribution observed in multifrequency radio images. We compare the energetics constrained for this sample to those predicted for mock radio source populations – with various intrinsic functions for jet power and lifetime distributions – to correct for sample selection biases imposed on our sample. The intrinsic jet power and lifetime functions that yield a selection-biased mock population most similar to our observed sample are determined using Bayesian inference. Our analysis places robust constraints on assumed power-law indices for the intrinsic jet power and lifetime functions: $p(Q)\propto Q^{-1.49\pm 0.07}$ and $p(t_{\mathrm{on}})\propto t_{\mathrm{on}}^{-0.97\pm 0.12}$, respectively. We discuss the implications of these findings for feedback-regulated accretion and the self-regulating nature of jet activity. The methodology proposed in this work can be extended to active radio galaxies in future studies.
Rapid Mid-Infrared Spectral-Timing with JWST: I. GRS 1915+105 during a MIR–bright and X-ray–obscured state
Authors: Gandhi P , Borowski E S , Byrom J , Hynes R I , Maccarone T J , Shaw A W , Adegoke O K , Altamirano D , Baglio M C , Bhargava Y , Britt C T , Buckley D A H , Buisson D J K , Casella P , Segura N Castro , Charles P A , Corral-Santana J M , Dhillon V S , Fender R , Gúrpide A , Heinke C O , Igl A B , Knigge C , Markoff S , Mastroserio G , McCollough M L , Middleton M , Miller J M , Miller-Jones J C A , Motta S E , Paice J A , Pawar D D , Plotkin R M , Pradhan P , Ressler M E , Russell D M , Russell T D , Santos-Sanz P , Shahbaz T , Sivakoff G R , Steeghs D , Tetarenko A J , Tomsick J A , Vincentelli F M , George M , Gurwell M , Rao R
Published: January 2025

We present mid-infrared (MIR) spectral-timing measurements of the prototypical Galactic microquasar GRS 1915+105. The source was observed with the Mid-Infrared Instrument (MIRI) onboard JWST in June 2023 at a MIR luminosity LMIR ≈ 1036 erg s−1 exceeding past IR levels by about a factor of 10. In contrast, the X-ray flux is much fainter than the historical average, in the source’s now–persistent ‘obscured’ state. The MIRI low-resolution spectrum shows a plethora of emission lines, the strongest of which are consistent with recombination in the hydrogen Pfund (Pf) series and higher. Low amplitude (∼ 1%) but highly significant peak-to-peak photometric variability is found on timescales of ∼ 1,000 s. The brightest Pf (6–5) emission line lags the continuum. Though difficult to constrain accurately, this lag is commensurate with light-travel timescales across the outer accretion disc or with expected recombination timescales inferred from emission line diagnostics. Using the emission line as a bolometric indicator suggests a moderate (∼ 5–30 % Eddington) intrinsic accretion rate. Multiwavelength monitoring shows that JWST caught the source close in-time to unprecedentedly bright MIR and radio long-term flaring. Assuming a thermal bremsstrahlung origin for the MIRI continuum suggests an unsustainably high mass-loss rate during this time unless the wind remains bound, though other possible origins cannot be ruled out. PAH features previously detected with Spitzer are now less clear in the MIRI data, arguing for possible destruction of dust in the interim. These results provide a preview of new parameter space for exploring MIR spectral-timing in XRBs and other variable cosmic sources on rapid timescales.
Incidence of Acute Kidney Injury in Relapsed and Refractory Multiple Myeloma treated with Teclistamab versus CAR T-cells
Authors: Charkviani Mariam , Brochero Maria Jose Vargas , Mohan Arjunmohan , Vaughan Lisa E , Sandahl Tyler B , De Menezes Silva Corrae Andre , Lin Yi , Leung Nelson , Herrmann Sandra M
Published: January 2025

Background and Hypothesis

Teclistamab, a novel bispecific monoclonal antibody targeting CD3 and B-cell maturation antigen (BCMA), and chimeric antigen receptor T-cell (CAR-T) therapy are promising options for treating relapsed/refractory multiple myeloma (MM). However, the rates of acute kidney injury (AKI) associated with teclistamab remain inadequately characterized. This study aims to compare the incidence, severity, and outcomes of AKI between patients receiving teclistamab and CAR-T therapy.

Methods

This was a retrospective study involving 64 patients with relapsed/refractory MM treated with either teclistamab or CAR-T therapy. All patients had previously received at least four lines of chemotherapy before being treated with either teclistamab or CAR-T. The primary outcome was the incidence of AKI, and secondary outcomes included AKI severity, kidney recovery rates, and mortality. Kaplan-Meier estimates for AKI-free survival were calculated, and hazard ratios (HRs) for AKI risk were determined using Cox proportional hazards models.

Results

Sixty-four patients met inclusion criteria for this study (30 received CAR-T and 34 received teclistamab therapy). Among these patients, 14 AKI events occurred in total (22%), with 10 events (29%) in the teclistamab group and 4 events (13%) in the CAR-T group. AKI-free survival estimates at 180 days after treatment initiation were 68% (95% confidence interval [CI]: 53%-87%) for teclistamab patients and 90% (95% CI: 79%-100%) for CAR-T patients. While patients receiving teclistamab were found to have an increased risk of an AKI event compared to those receiving CAR-T therapy, the results were not statistically significant (HR [95% CI]: 3.38 [0.93–12.31], P = 0.065).

Conclusions

This study suggests that patients treated with teclistamab may experience a higher incidence of AKI compared to those receiving CAR-T therapy. However, further research is required to determine whether this increased risk is attributable to disease progression or teclistamab itself. These results highlight the need for close kidney function monitoring in patients receiving teclistamab.
Prevalence of Nicotine Pouch Use Among Youth and Adults in Great Britain—Analysis of Cross-Sectional, Nationally Representative Surveys
Authors: Brose Leonie , Bunce Laura , Cheeseman Hazel
Published: January 2025

Background

The public health impact of new nicotine products will depend on their use by different population groups. We assessed the prevalence of nicotine pouch use among youth and adults in Great Britain (GB).

Aims and Methods

Cross-sectional annual Action on Smoking and Health Smokefree GB Adult Surveys 2020-2024 (n: 12 247 to 13 266, 18+) and Action on Smoking and Health Smokefree GB Youth Survey 2024 (n = 2872 11-18-year-olds). Weighted proportions and 95% confidence intervals for pouch ever and current use among adults over time, and in 2024 among youth and adults overall, by socio-demographics, mental health, tobacco smoking, vaping, past-12-month gambling, cannabis, and alcohol use; for youth also family members’ smoking and vaping. Multivariable logistic regression assessed the association with ever pouch use.

Results

The prevalence of adult ever and current use doubled from 2020 to 2024, reaching 5.4% (95% confidence interval = 5.0 to 5.8) and 1.0% (0.8-1.1). Among youth, 3.3% (2.7-4.0) reported ever use, including 1.2% (0.8-1.6) reporting current use. Ever use was associated with the use of other addictive products. Among adults, ever use was also more common among younger groups (18-24, 25-34, 35-44 vs. 55+), males, and those in rented accommodation or receiving mental health treatment. Among youth, ever use was also more common among those in London than elsewhere in England.

Conclusions

Pouch use in GB is rare with about 1 in 100 youth and adults reporting current use. However, use appears to be increasing and is higher in some groups, including younger adults, males and people with experience of vaping, smoking, and use of other addictive products.

Implications

While currently low, close monitoring of pouch use is indicated. It is currently concentrated among those with experience of nicotine use. However, given the higher levels of use among young adults and teenagers, consideration of regulation may be required to minimize uptake among groups that would otherwise not have used nicotine-containing products.
Distinct Virulence Mechanisms of Burkholderia gladioli in Onion Foliar and Bulb Scale Tissues
Authors: Paudel Sujan , Franco Yaritza , Zhao Mei , Dutta Bhabesh , Kvitko Brian H.
Published: January 2025

Slippery skin of onion caused by Burkholderia gladioli pv. alliicola (Bga) is a common bacterial disease reported from onion growing regions around the world. Despite the increasing attention in recent years, our understanding of the virulence mechanisms of this pathogen remains limited. In this study, we characterized the predicted genetic determinants of virulence in Bga strain 20GA0385 using reverse genetics approach. Using the closely related rice pathogen, B. glumae as a reference, comparative genomics analysis was performed to identify Bga candidate virulence factors and regulators. Marked and unmarked deletion mutants were generated using allelic exchange and the mutants were functionally validated using in vitro and in vivo assays. The role of mutants in pathogenic phenotypes was analyzed using onion foliar/seedling necrosis assays, the Red Scale Necrosis (RSN) assay and in planta bacterial population counts. The phytotoxin toxoflavin was a major contributor to foliar necrosis and bacterial populations whereas the type II and type III secretion system (T2SS/T3SS) were dispensable for foliar symptoms. In onion scale tissue, the T2SS single mutant gspC and its double and triple mutant derivatives all contributed to scale lesion area. Neither the lipocyclopeptide icosalide, toxoflavin, nor T3SS were required for scale symptoms. Our results suggest the quorum sensing tofIMR system in Bga regulates, toxoflavin, T2SS, and T3SS, contributing to onion symptom production. We show different virulence factors contribute to onion tissue-specific virulence patterns in Bga and that decreases in scale symptoms often do not result in decreased Bga populations in onion tissue.
Bariatric Surgery Is Associated With Reduced Incidence of Mild Cognitive Impairment and Alzheimer Disease and Related Dementias: A Retrospective Cohort Study
Authors: Chen You , Feng Yubo , Zhang Xinmeng , Gifford Katherine A. , Elmanzalawi Yasser , Samuels Jason , Albaugh Vance L. , English Wayne J. , Flynn Charles R. , Yu Danxia , Zhang Rui , Ikramuddin Sayeed
Published: January 2025

Objective:

To evaluate the association of bariatric surgery with reduced incidence and delayed development of mild cognitive impairment (MCI) and Alzheimer disease and related dementias (ADRD) in patients with obesity.

Background:

This retrospective longitudinal study utilized Electronic Health Records from Vanderbilt University Medical Center, covering 5303 patients who underwent bariatric surgery and 10,606 propensity score-matched obese patients who did not, from 2000 to 2023. Patients with prior MCI, ADRD, schizophrenia, alcoholism, gastric cancer, gastric ulcers, inflammatory bowel disease, coagulopathy, stroke, Parkinson disease, or brain cancer were excluded from both groups.

Methods:

Differences in time to MCI/ADRD between surgical and control groups were analyzed using linear regression, and adjusted for confounders: demographics, medical history, and socioeconomic status. Survival probability differences for MCI and ADRD between the 2 groups over time were assessed using Kaplan-Meier curves and log-rank tests. Incidence differences of MCI and ADRD between the groups were evaluated using Fine-Gray subdistribution hazard models, accounting for the competing risk of death and confounders.

Results:

Bariatric surgery was associated with a significantly reduced incidence of ADRD, evidenced by a subdistribution hazard ratio (SHR) of 0.37 (95% confidence interval [CI]: 0.15–0.89; P = 0.03). Similarly, the incidence of MCI was significantly lower in the surgical group, with an SHR of 0.57 (95% CI: 0.39–0.85; P = 0.01). Additionally, patients who underwent bariatric surgery experienced a delay of 2.01 years before developing MCI compared with the control group (95% CI: 0.70–3.50; P = 0.004).

Conclusions:

These findings suggest that bariatric surgery may serve as an effective strategy to delay the onset of MCI and reduce the risk of both MCI and ADRD in patients with obesity.
Windows in the ICU and Postoperative Delirium: A Retrospective Cohort Study
Authors: Anderson Diana C. , Warner Paige E. , Smith Matthew R. , Albanese Marissa L. , Mueller Ariel L. , Messervy John , Renne B. Christian , Smith Samuel J.
Published: January 2025

Objectives:

The ICU built environment—including the presence of windows—has long been thought to play a role in delirium. This study investigated the association between the presence or absence of windows in patient rooms and ICU delirium.

Design:

Retrospective single institution cohort study. Delirium was assessed with the Confusion Assessment Method for the ICU.

Setting and Patients:

ICU patients between January 1, 2020, and September 1, 2023, were categorized into windowed or nonwindowed groups based on their ICU room design. The primary outcome was the presence or absence of delirium at any time during the patient’s ICU stay. Secondary outcomes included the presence of delirium during the first 7 days of the ICU stay, hospital length of stay, ICU length of stay, in-hospital mortality, pain scores, and Richmond Agitation-Sedation Scale scores.

Interventions:

None.

Measurements and Main Results:

A total of 3527 patient encounters were included in the final analysis, of which 1292 distinct patient encounters were admitted to a room without windows (37%). Delirium was observed in 21% of patients (460/2235) in windowed rooms and 16% of patients (206/1292) in nonwindowed rooms. In adjusted analyses, patients in windowed rooms were associated with an increase in the odds of the presence of delirium (odds ratio, 1.29; 95% CI, 1.07–1.56; p = 0.008). Patients in windowed rooms were found to have longer hospital (adjusted hazard ratio [aHR], 0.94; 95% CI, 0.87–1.00) and ICU length of stay (aHR, 0.93; 95% CI, 0.87–1.00) compared with patients in the nonwindowed rooms, although this was not statistically significant in adjusted analyses (p = 0.06 and 0.05, respectively). No statistically significant difference was observed in other secondary outcomes.

Conclusions:

The current study provides insightful information regarding associations between a component of the ICU built environment, specifically the presence or absence of windows, and the frequency of delirium.
Investigation of Teicoplanin Trough Concentrations and Safety Following High-Dose Loading in a Pediatric Population
Authors: Okuzono Sayaka , Yamada Takaaki , Motomura Yoshitomo , Kanemasa Hikaru , Ishimura Masataka , Koga Yuhki , Torisu Hiroyuki , Kanno Shunsuke , Ieiri Ichiro , Ohga Shouichi
Published: January 2025

Background:

Therapeutic drug monitoring–informed teicoplanin dosage adjustments are recommended for safe and effective use. The authors' group previously reported that only half of children reached the recommended blood concentration range at the standard teicoplanin loading dose. It has been suggested that higher loading doses are necessary; however, the usefulness and safety of high-dose loading in pediatric patients in clinical practice are unknown.

Methods:

This retrospective cohort study was conducted between January 2018 and June 2021 using electronic medical records. The analysis included 2- to 16-year-old patients treated with teicoplanin who met the eligibility criteria. We assessed the trough concentration of teicoplanin and its safety after high-dose loading in pediatric patients.

Results:

Overall, 86 patients received a high-dose loading regimen (15 mg/kg every 12 hours for 3 doses, followed by 10 mg/kg once daily). Notably, 55 of the 86 patients (64%) achieved the target trough concentration (>15 mg/L) at significantly higher rates without increasing the incidence of organ damage compared with the standard loading regimen. Multivariate analysis revealed significant differences in age and renal function as factors that inhibited the attainment of the target trough concentration. Simulation analysis using a nomogram stratified by age and renal function revealed that the predicted teicoplanin trough levels were within the target trough values in 73% of patients.

Conclusions:

High-dose teicoplanin loading safely increases trough blood concentrations in the pediatric population. For further optimization, the dose selection should be stratified according to age and renal function.
Mondor’s disease of the penis: a common presentation of an uncommon disease
Authors: Lodhia Jay , Mremi Alex , Maro Nyamhanga Nsaho , Shirima Denis , Mbwambo Orgeness , Ngowi Bartholomeo Nicholaus
Published: January 2025

Background:

Penile Mondor’s disease (PMD) is a rare clinical condition with an estimated incidence of 1.39%, though the true incidence may be higher as it is often self-limiting. Many patients may not seek medical attention due to stigma, potentially leading to untreated psychological distress and sexual dysfunction.

Case presentation:

We report the case of a young man who presented with a cord-like swelling on his penile shaft, persisting for three months. The swelling was accompanied by mild pain during erection and was initially managed with oral paracetamol. Due to ongoing symptoms and increasing anxiety, the patient sought medical attention. Surgical excision of the swelling was performed, and histopathological analysis confirmed thrombosis of the dorsal penile vein, consistent with a diagnosis of Mondor’s disease (MD) of the penis. The patient had an uneventful recovery, with no recurrence observed at the 2-month follow-up.

Clinical discussion:

The pathogenesis of MD of the penis remains unclear, though trauma to the penile shaft, such as external compression, is considered a primary risk factor. While management is generally conservative, surgery may be warranted in persistent or severe cases.

Conclusion:

Clinicians should consider MD in the differential diagnosis of penile swelling, as it may be a sign of an underlying vascular condition. Early recognition and appropriate management can help alleviate symptoms and reduce psychological distress.
Surgical Dressing Cosmesis in the Immediate Postoperative Setting: A Crowdsourcing-based Study
Authors: Clark Alexa , Su Shannon , Wang Jennifer , Shauly Orr , Losken Albert , Brooks Kendall , Cuzzone Daniel
Published: January 2025

Background:

Postoperative dressings expedite wound healing and decrease the rate of infection. Options for wound dressings vary based on cost, time to apply, method of wound healing, and availability at the hospital; however, a significant difference in postoperative complications between each type has not been found. As such, this study evaluates patient cosmetic preferences for various wound dressings as it relates to early postoperative satisfaction.

Methods:

A cross-sectional study was conducted using an online crowdsourcing service that connects research studies to participants. The survey asked users to rate images of various wound dressings. Steri-Strips, Dermabond PRINEO (Johnson & Johnson, Ethicon, Inc.), gauze, surgical tape, and metal staples were the materials assessed. The ratings, based on cleanliness, compactness, and aesthetics, culminated in an average cosmetic score for each dressing.

Results:

Controlled for demographics, Steri-Strips and staples were the highest rated dressing types by participants and may correlate with increased patient satisfaction in the immediate postoperative period. Gauze was highly rated for aesthetics and cleanliness but averaged lower scores due to dressing bulk. Dermabond and surgical tape had the lowest and second lowest cosmetic score, respectively.

Conclusions:

Although cost, availability, and time to apply are common factors surgeons evaluate when picking a dressing, cosmetic preference is another consideration. Allowing the patient to participate in dressing selection may give them more perceived autonomy and increase immediate postoperative satisfaction. Limitations of this study include limited lighting/positioning standardization of dressing photographs. This analysis does not consider opinions on later wound healing or scarring using the chosen material.
Postoperative Outcomes in Prepectoral Versus Retropectoral Immediate Implant-based Breast Reconstruction Across Body Mass Index Categories
Authors: Zinner Gauthier , Martineau Jérôme , Lam Giang Thanh , Correia Daniel , Kalbermatten Daniel F. , Oranges Carlo M.
Published: January 2025

Background:

Prepectoral (PP) immediate implant-based breast reconstruction (IBBR) is gaining popularity over the retropectoral (RP) breast reconstruction technique. This study aims to compare complication rates across different body mass index (BMI) groups in patients undergoing PP or RP IBBR.

Methods:

A monocentric retrospective analysis was conducted on patients who underwent mastectomy and IBBR from January 2018 to December 2023. Preoperative characteristics, BMI, type of mastectomy procedure, PP or RR implant placement, and postoperative outcomes were collected and analyzed.

Results:

A total of 217 patients were included, representing 276 IBBRs. The overall complication rate on a per breast basis was 26.4%. The overall complication rate did not differ across BMI groups (P = 0.314) and between PP and RP IBBR (P = 0.8083). In the PP group, anemia rate increased with low BMI (odds ratio [OR] 0.0215, P = 0.033) and skin complications were more frequent with higher BMI (OR 0.0428, P = 0.0389). In the RP group, higher BMI was correlated with a higher seroma rate in the RP IBBR group (OR 1.2045, P = 0.0334) and a longer hospital length of stay (coefficient 0.248, adjusted R² 0.082, SD 0.098, P = 0.014).

Conclusions:

PP IBBR was associated with a significantly higher rate of anemia in patients with low BMI, and a significantly higher rate of skin complications in high BMI. RP IBBR was associated with higher seroma rate and longer hospital length of stay in patients with higher BMI.
Instagram Versus Reality: Who Are Actually Plastic Surgeons?
Authors: Singh Nikhi P. , Holohan Mary M. , Harmon Cameron , Fallah Kasra N. , Gross Jeffrey , Patel Aadarsh , Boyd Carter J. , Greives Matthew R. , de la Torre Jorge , Gordillo Gayle , King Timothy W.
Published: January 2025

Background:

Instagram has become one of the most powerful marketing tools available to plastic surgeons because patients have increasingly turned to online resources to find physicians. Within, we review the online presence of self-ascribed plastic surgeons in the United States to identify potential misinformation and dishonest advertising.

Methods:

The Inflact database was queried for the search terms: “plastic surgeon/surgery,” “plastic and reconstructive surgeon/surgery,” “aesthetic surgeon/surgery,” and “cosmetic surgeon/surgery.” US physician account information, history of medical training, American Board of Plastic Surgery (ABPS) certification status, and posts were reviewed.

Results:

In total, 1399 physicians practicing within the United States were identified. Most attended medical school in the United States (93%), a minority received integrated plastic surgery training in the United States (14%), and the majority attended general surgery residency in the United States (57%) followed by independent plastic surgery residency in the United States (50%). Altogether, 1141 individuals were explicitly listed as “plastic surgeons” on Instagram, nearly a quarter of these (325 individuals, 28%) were not certified by the ABPS, and nearly a fifth (251 individuals, 22%) received no training in plastic surgery.

Conclusions:

Nearly one-third of “plastic surgeons” on Instagram are not certified through the ABPS. This is detrimental to the reputation of plastic surgery and has the potential to create broader consequences and may lead to patients mistakenly receiving care from unqualified physicians. It is paramount that plastic surgeons create a united front against such endeavors through advocacy efforts within the American Society of Plastic Surgeons.
Reshaping Our Understanding of Sensation and Pain Following Breast Reduction Surgery
Authors: Remy Katya , Cetrulo Curtis L. , Hyland Colby J. , Baker Riley , Reaman Anna , Vyas Krishna , Gfrerer Lisa , Austen William G. , Carruthers Katherine H.
Published: January 2025

Background:

This study evaluated the sensory and breast pain outcomes in inferior versus superomedial pedicle breast reduction.

Methods:

Twenty patients undergoing the inferior pedicle technique were matched to 20 patients undergoing the superomedial pedicle technique based on age, BMI, and resection weight. Patients were evaluated preoperatively and postoperatively at 1, 3, 6, and 12 months. Monofilament testing was performed on the nipple-areola complex (NAC) and surrounding breast. Patient-reported outcomes included nipple and breast sensation (5-point Likert scale), pain intensity (0–10), and the Patient-reported Outcome Measurement Information System Neuropathic Pain Quality scale.

Results:

At the NAC, mean monofilament values and patient-reported sensation were significantly better in the inferior versus the superomedial pedicle group at 1 and 3 months postoperatively (P < 0.05) and comparable at 6 and 12 months (P > 0.05). At 12 months, 72.5% of patients reported complete (5 of 5) nipple sensation (77.5% inferior versus 67.5% superomedial, P > 0.05). At the breast, the mean monofilament values and patient-reported sensation were similar between pedicle groups throughout follow-up. At 12 months, 82.5% of the patients reported complete (5 of 5) breast sensation (85.0% inferior versus 80% superomedial, P > 0.05). Rates of postoperative breast pain were similar between groups throughout follow-up (P > 0.05). At 12 months, 25% of patients reported breast pain, with neuropathic qualities in 85% of cases.

Conclusions:

The inferior pedicle may allow for earlier restoration of quantitative and patient-reported NAC sensation, but long-term sensation is comparable between techniques. A quarter of patients reported persistent breast pain regardless of the pedicle type.
Treatment Considerations for Pyoderma Gangrenosum After Reduction Mammoplasty in an Unsuspecting Patient Demographic
Authors: Pluta Natalia A. , Kemp Tamara L. , Rivard Shayna C
Published: January 2025

Pyoderma gangrenosum (PG) is a rare, often idiopathic, noninfectious inflammatory neutrophilic dermatitis that causes painful ulcerative cutaneous papillomatous lesions. PG often mimics surgical infection, wound dehiscence, and postoperative cellulitis, leading to high rates of misdiagnosis and mistreatment. Here, a healthy 17-year-old adolescent girl with congenital breast asymmetry, macromastia, and a history of only mild intermittent autoimmune conditions developed an open wound along her inferior left breast incision 2 weeks after reduction mammoplasty. With continued enlargement and development of new ulcerative lesions despite appropriate local wound care, clinical suspicion for PG was raised. Standard treatment with oral prednisolone and topical tacrolimus led to incomplete resolution, and subsequent regression on attempts to taper the corticosteroid. Transition to oral cyclosporine with continued daily topical tacrolimus ultimately led to complete healing. This case underscores the need for a high clinical suspicion for PG in nonhealing ulcerative lesions after breast surgery, in addition to the importance of timely initiation of immunomodulatory agents and modification of the regimen if incomplete resolution is encountered.
Structural and load-dependent arterial stiffness across the adult life span
Authors: Xing Changyang , Xu Lei , Li Fan , Xie Xiujing , Guan Xiangping , Zhan Xiaojun , Chen Wu , Yang Hengli , Wang Xiangzhu , Wang Yingli , Li Jinsong , Zhou Qi , Mu Yuming , Zhou Qing , Ding Yunchuan , Zheng Yu , Wu Yu , Sun Xiaofeng , Li Hua , Zhang Chaoxue , Zhao Cheng , Qiu Shaodong , Yan Guozhen , Yang Hong , Mao Yinjuan , Zhan Weiwei , Ma Chunyan , Gu Ying , Xie Mingxing , Jiang Tianan , Yuan Lijun ,   the Study Investigators†
Published: January 2025

Background:

The arterial stiffening is attributed to the intrinsic structural stiffening and/or load-dependent stiffening by increased blood pressure (BP). The respective lifetime alterations and major determinants of the two components with normal aging are not clear.

Methods:

A total of 3053 healthy adults (1922 women) aged 18–79 years were enrolled. The carotid intima–media thickness, diameter, and local BPs were automatically determined by the radio frequency ultrasound system. The Peterson and Young elastic moduli were then calculated to represent total arterial stiffness. Structural stiffness was recalculated at a reference BP of 120/80 mmHg with established models. Load-dependent stiffness was the difference between total and structural stiffness.

Results:

Both structural and load-dependent stiffness increased with aging, with much larger changes in the structural components. The age-related increasing rates were higher in women for the structural stiffness than men (P < 0.05), but similar for the load-dependent stiffness. The clinical characteristics and arterial stiffness were widely correlated, but most correlations were quite weak (r < 0.3) other than BPs. Multiple regression analyses adjusted for sex, age and other clinical correlates showed that structural stiffness increased with pulse pressure (PP) and load-dependent stiffness increased with mean arterial pressure (MAP), respectively.

Conclusion:

The age-related arterial stiffening is mainly caused by the intrinsic structural stiffening, which demonstrated significant age–sex interaction. BPs were the major clinical determinants of arterial stiffness, with PP and MAP associated with different arterial stiffness components. The differentiation of the structural and load-dependent arterial stiffness should be highlighted for the optimal vascular health management.
Supplemental Operational Guidance for Minimizing Potential Inhalation Doses to Workers and Volunteers at Community Reception Centers and Public Shelters
Authors: Mauro John , Porrovecchio Joseph , Amann William , Marschke Stephen , Brightwell Michael S. , Davison Ron , DeMore Duane , Mangel Amy , Anspaugh Lynn , Salame-Alfie Adela , Ansari Armin
Published: January 2025

In the event of a nuclear explosion in an urban environment, contaminated persons may be directed to Community Reception Centers (CRC) and/or public shelters. This paper is a companion document to a previous paper that addresses the inhalation hazard to workers at a CRC from resuspension of fallout from the evacuees. To limit the inhalation hazard evacuees must be screened to prevent severely contaminated persons from entering a CRC. The suggested screening level is 10,000 dpm cm−2 and rapid methods of screening arriving evacuees are presented. Practical advice is provided on methods that can be used to limit contamination within a CRC. These methods include alterations to heating and cooling systems and the implementation of monitoring strategies to guard against unexpected increases in airborne activity levels.
Implementation of Stochastic Gradient Descent in an Automated Glow Peak Identification Software for Multiple Thermoluminescent Dosimeter Types
Authors: Noey Jordan D. , Stewart Colin J. , Yu Wenjin , Kearfott Kimberlee J.
Published: January 2025

A glow-curve analysis code was previously developed in C++ to analyze thermoluminescent dosimeter glow curves using automated peak detection while a first-order kinetics model. A newer version of this code was implemented to improve the automated peak detection and curve fitting models. The Stochastic Gradient Descent Algorithm was introduced to replace the prior approach of taking first and second-order derivatives for peak detection. Additionally, early stopping mechanisms were invoked to improve the previously used Levenberg-Marquardt Algorithm employed for curve fitting. The two software versions were compared through glow curve analysis of different thermoluminescent dosimeter materials and calculation of the corresponding figures of merit. Overall improvements were shown, namely an increase in the number of peaks detected and a reduction of the mean figure of merit by approximately 46%.
Correlation of Anterior Segment Optical Coherence Tomography and Slit-Lamp Imaging in Infectious Keratitis
Authors: Elzawahry Farida , Rossi Costanza , Said Dalia , Dua Harminder S.
Published: January 2025

Purpose:

Anterior segment optical coherence tomography (AS-OCT) is increasingly being used to complement slit-lamp biomicroscopy in the evaluation of corneal infections. Our purpose was to analyze, compare, and correlate the clinical signs elicited by these 2 methods in patients with infectious keratitis (IK).

Methods:

Slit-lamp photomicrographs (diffuse and slit beam) and AS-OCT scans were obtained from 20 consecutive patients (21 eyes) with IK. AS-OCT horizontal line scans representing the top, middle, and bottom of the lesions were analyzed and compared with findings seen on slit-lamp photographs. Epithelial defects, thickness, irregularity; presence of infiltrate and its depth; corneal edema or melting; vascularization; Descemet membrane detachment; and presence of keratic precipitates were analyzed with both imaging techniques. AS-OCT features included hyperreflectivity, hyporeflectivity, shadowing, and tissue morphology. Statistical analysis was performed using GraphPad Prism 8.2.1.

Results:

AS-OCT was significantly more likely to detect corneal thickening (P < 0.001), epithelial hyperplasia (P = 0.027), infiltrate depth (P < 0.001), presence of inflammatory plaque (P = 0.0002), DM-endothelial complex undulations (P < 0.001), keratic precipitates (P = 0.0006), and Descemet membrane detachment (0.000), than slit-lamp imaging.

Conclusions:

AS-OCT can be a helpful adjunctive test in the evaluation of patients with IK. AS-OCT complements slit-lamp biomicroscopy and photography in the diagnosis and monitoring of IK and may serve an important role in telemedicine compared with slit-lamp photography alone.
Efficacy and Safety of Secondary Surgical Treatment for Refractory Recurrent Corneal Erosion
Authors: Ahn Hyunmin , Kim Young Jun , Seo Kyoung Yul , Chung Jae Lim
Published: January 2025

Purpose:

To investigate the efficacy and safety of secondary surgical intervention of combined phototherapeutic keratectomy (PTK) with alcohol delamination and peripheral anterior stromal puncture (ASP) for refractory recurrent corneal erosion (RCE).

Methods:

This retrospective comparative study defined refractory RCE as cases persisting for more than 6 months after primary surgical intervention. A total of 115 eyes from 115 patients with refractory RCE, treated either with (n = 92) or without (n = 23) the secondary surgical treatment combining PTK and ASP between January 2021 and January 2023, were included. The Kaplan–Meier survival analysis method was used to determine the intervention's efficacy.

Results:

The mean age was 34.4 ± 10.8 years, with a predominance of male patients (60%). Over a follow-up period exceeding 1 year, the recurrence rate was markedly lower at 27.2% in the group undergoing secondary surgical treatment compared with 69.6% in those receiving conservative treatment. Kaplan–Meier survival analysis revealed significantly reduced recurrence rates in the surgical group versus the conservative treatment group (log-rank test, P = 0.007). Notably, 96% of recurrences in the surgical cohort occurred within the first 6 months postintervention, with no recurrences observed after 9 months. At the final follow-up, 12% necessitated further surgical procedures 6 months after the secondary intervention. The study reported no significant surgical complications.

Conclusions:

The secondary surgical approach combining PTK with alcohol delamination and ASP presents a viable and safe treatment alternative for patients with refractory RCE, demonstrating a significant reduction in recurrence rates.
Comorbidities Associated With Different Degrees of Severity in Children and Young People Hospitalized With Acute COVID-19
Authors: Gastesi Irati , Domínguez-Rodríguez Sara , Le Prevost Marthe , Ramírez Andrea , Giaquinto Carlo , Mesa María Lucía , Ballesteros Alvaro , Jackson Charlotte , Vásquez-Hoyos Pablo , Alvarez Moreno Carlos , Grasa Carlos , Epalza Cristina , Soriano-Arandes Antoni , Moraleda Cinta , Tagarro Alfredo
Published: January 2025

In this prospective cohort study with 2326 hospitalized children and young people with coronavirus disease 2019 in Spain and Colombia, 36.4% had comorbidities. Asthma, recurrent wheezing, chronic neurological, cardiac and pulmonary diseases significantly increased the risk of severe outcomes such as death, mechanical ventilation and intensive care unit admission. The incremental risk with additional comorbidities underscores the importance of targeted vaccination strategies for vulnerable children and young people populations.
Potential beneficial impacts of tadalafil on cardiovascular diseases
Authors: Lan Tien-Yun , Chiang Chih-Hung , Chen Jaw-Wen , Chang Ting-Ting
Published: January 2025

Tadalafil is a selective phosphodiesterase type 5 (PDE5) inhibitor commonly used for the treatment of erectile dysfunction and benign prostatic hyperplasia. Its mechanism of action involves the inhibition of PDE5, leading to increased levels of nitric oxide and cyclic guanosine monophosphate in the corpus cavernosum, which facilitates smooth muscle relaxation. This article reviews studies using tadalafil in the treatment of cardiovascular diseases and emphasizes its potential advantages in conditions such as pulmonary arterial hypertension, atherosclerosis, coronary artery disease, myocardial infarction, heart failure, stroke, diabetic ulcers, and cardiomyopathy. Although tadalafil shows potential efficacy in treating cardiovascular disease, further experimental studies are needed to clarify its pharmacological effects on cardiovascular protection beyond PDE5 inhibition.