bluuebunny/crossref_metadata_2025 huggingface dataset:
An evolutionary perspective on social inequality and health disparities
Authors: Wells Jonathan C K
Published: August 2023

There is growing concern with social disparities in health, whether relating to gender, ethnicity, caste, socio-economic position or other axes of inequality. Despite addressing inequality, evolutionary biologists have had surprisingly little to say on why human societies are prone to demonstrating exploitation. This article builds on a recent book, ‘The Metabolic Ghetto’, describing an overarching evolutionary framework for studying all forms of social inequality involving exploitation. The dynamic ‘producer-scrounger’ game, developed to model social foraging, assumes that some members of a social group produce food, and that others scrounge from them. An evolutionary stable strategy emerges when neither producers nor scroungers can increase their Darwinian fitness by changing strategy. This approach puts food systems central to all forms of human inequality, and provides a valuable lens through which to consider different forms of gender inequality, socio-economic inequality and racial/caste discrimination. Individuals that routinely adopt producer or scrounger tactics may develop divergent phenotypes. This approach can be linked with life history theory to understand how social dynamics drive health disparities. The framework differs from previous evolutionary perspectives on inequality, by focussing on the exploitation of foraging effort rather than inequality in ecological resources themselves. Health inequalities emerge where scroungers acquire different forms of power over producers, driving increasing exploitation. In racialized societies, symbolic categorization is used to systematically assign some individuals to low-rank producer roles, embedding exploitation in society. Efforts to reduce health inequalities must address the whole of society, altering producer–scrounger dynamics rather than simply targeting resources at exploited groups.
Spectral top-down recovery of latent tree models
Authors: Aizenbud Yariv , Jaffe Ariel , Wang Meng , Hu Amber , Amsel Noah , Nadler Boaz , Chang Joseph T , Kluger Yuval
Published: August 2023

Modeling the distribution of high-dimensional data by a latent tree graphical model is a prevalent approach in multiple scientific domains. A common task is to infer the underlying tree structure, given only observations of its terminal nodes. Many algorithms for tree recovery are computationally intensive, which limits their applicability to trees of moderate size. For large trees, a common approach, termed divide-and-conquer, is to recover the tree structure in two steps. First, separately recover the structure of multiple, possibly random subsets of the terminal nodes. Second, merge the resulting subtrees to form a full tree. Here, we develop spectral top-down recovery (STDR), a deterministic divide-and-conquer approach to infer large latent tree models. Unlike previous methods, STDR partitions the terminal nodes in a non random way, based on the Fiedler vector of a suitable Laplacian matrix related to the observed nodes. We prove that under certain conditions, this partitioning is consistent with the tree structure. This, in turn, leads to a significantly simpler merging procedure of the small subtrees. We prove that STDR is statistically consistent and bound the number of samples required to accurately recover the tree with high probability. Using simulated data from several common tree models in phylogenetics, we demonstrate that STDR has a significant advantage in terms of runtime, with improved or similar accuracy.
The Characteristic Polynomial of Sums of Random Permutations and Regular Digraphs
Authors: Coste Simon , Lambert Gaultier , Zhu Yizhe
Published: August 2023

Let $A_{n}$ be the sum of $d$ permutation matrices of size $n\times n$, each drawn uniformly at random and independently. We prove that the normalized characteristic polynomial $\frac {1}{\sqrt {d}}\det (I_{n} - z A_{n}/\sqrt {d})$ converges when $n\to \infty $ towards a random analytic function on the unit disk. As an application, we obtain an elementary proof of the spectral gap of random regular digraphs. Our results are valid both in the regime where $d$ is fixed and for $d$ slowly growing with $n$.
Longitudinal investigation of factors influencing mental health during centralized quarantine for COVID-19
Authors: Yu Haoran , Huang Wenyan , Yang Xin , Yang Hao , Ma Hui , Zhang Ning
Published: August 2023

Background

Centralized quarantine was applied in response to the coronavirus disease 2019 outbreak. The present study aimed to investigate changes in psychological status of isolated individuals before and after quarantine.

Methods

Between August 2020 and July 2021, 648 participants completed the following psychometric evaluations before and after centralized quarantine: 9-item Patient Health Questionnaire for depression, 7-item Generalized Anxiety Disorder for anxiety, the Chinese version of the Connor Davidson Resilience Scale for psychological resilience, the Chinese version of the Simplified Coping Style Questionnaire for coping style, Jiang's revised Chinese version of the Perceived Social Support Scale for social support and the Chinese version of the Impact of Events Scale for stress.

Results

At the beginning of centralized quarantine, 83.2% (n=539) of participants had no depressive mood, 11% (n=71) had mild depressive mood and 5.8% (n=38) had moderate–severe depressive mood. At the end of quarantine, 80.8% (n=524) of participants had no depressive mood, 13% (n=84) had mild depressive mood and 6.2% (n=41) had moderate–severe depressive mood. At the beginning of the centralized quarantine, 86.7% (n=562) of participants had no anxiety, 9.6% (n=62) had mild anxiety and 3.7% (n=24) had moderate–severe anxiety. At the end of quarantine, 85.8% (n=556) of participants had no anxiety, 11.6% (n=75) had mild anxiety and 2.6% (n=17) had moderate–severe anxiety. After 2 weeks of centralized quarantine, anxiety (t=2.175, p<0.05), stress (t=7.453, p<0.01) and three stress subscale scores (p<0.01) decreased significantly; psychology resilience (t=−3.63, p<0.01), tenacity (t=−4.747, p<0.01), active coping style (t=−3.83, p<0.01) and support outside family (t=−3.07, p<0.05) all increased significantly. No significant change was observed in depression, strength, optimism, passive coping style or support inside family. Depression and anxiety scores associated significantly with resilience, stress, coping styles and social support scores. Anxiety (B=0.488, β=0.413, p<0.01), psychological resilience (B=−0.047, β=−0.203, p<0.01) and stress (B=1.475, β=0.167, p<0.1) scores before centralized quarantine were associated with depression after quarantine. Depression (B=0.323, β=0.422, p<0.01), psychological resilience (B=−0.022, β=−0.123, p<0.01) and stress (B=1.408, β=0.207, p<0.01) scores before quarantine also influenced anxiety levels after quarantine. A cross-lagged panel model indicated that depression, anxiety, resilience and stress scores at the first assessment were predictive of depression and anxiety levels at the second assessment.

Conclusions

Good mental health during centralized quarantine was associated with high scores of psychological resilience, impact of events, coping styles and social support and did not become worse in settings where adequate support was available.
Boundaries for genotype, phenotype, and pedigree truncation in genomic evaluations in pigs
Authors: Bussiman Fernando , Chen Ching-Yi , Holl Justin , Bermann Matias , Legarra Andres , Misztal Ignacy , Lourenco Daniela
Published: August 2023

Historical data collection for genetic evaluation purposes is a common practice in animal populations; however, the larger the dataset, the higher the computing power needed to perform the analyses. Also, fitting the same model to historical and recent data may be inappropriate. Data truncation can reduce the number of equations to solve, consequently decreasing computing costs; however, the large volume of genotypes is responsible for most of the increase in computations. This study aimed to assess the impact of removing genotypes along with phenotypes and pedigree on the computing performance, reliability, and inflation of genomic predicted breeding value (GEBV) from single-step genomic best linear unbiased predictor for selection candidates. Data from two pig lines, a terminal sire (L1) and a maternal line (L2), were analyzed in this study. Four analyses were implemented: growth and “weaning to finish” mortality on L1, pre-weaning and reproductive traits on L2. Four genotype removal scenarios were proposed: removing genotyped animals without phenotypes and progeny (noInfo), removing genotyped animals based on birth year (Age), the combination of noInfo and Age scenarios (noInfo + Age), and no genotype removal (AllGen). In all scenarios, phenotypes were removed, based on birth year, and three pedigree depths were tested: two and three generations traced back and using the entire pedigree. The full dataset contained 1,452,257 phenotypes for growth traits, 324,397 for weaning to finish mortality, 517,446 for pre-weaning traits, and 7,853,629 for reproductive traits in pure and crossbred pigs. Pedigree files for lines L1 and L2 comprised 3,601,369 and 11,240,865 animals, of which 168,734 and 170,121 were genotyped, respectively. In each truncation scenario, the linear regression method was used to assess the reliability and dispersion of GEBV for genotyped parents (born after 2019). The number of years of data that could be removed without harming reliability depended on the number of records, type of analyses (multitrait vs. single trait), the heritability of the trait, and data structure. All scenarios had similar reliabilities, except for noInfo, which performed better in the growth analysis. Based on the data used in this study, considering the last ten years of phenotypes, tracing three generations back in the pedigree, and removing genotyped animals not contributing own or progeny phenotypes, increases computing efficiency with no change in the ability to predict breeding values.
A high-throughput plate method for nucleic acid extraction from beet leafhopper (Hemiptera: Cicadellidae) and potato psyllid (Hemiptera: Triozidae) for pathogen detection
Authors: Gorman Christopher J , Crowder David W , Swisher Grimm Kylie D
Published: August 2023

Plant pathogens that are transmitted by insect vectors cause considerable damage to crops when pests or pathogens are not detected early in the season and populations are not controlled. Knowledge of pathogen prevalence in insect pest populations can aid growers in their insect pest management decisions but requires the timely dissemination of results. This process requires that specimen capture, identification, nucleic acid extraction, and molecular detection of a pathogen(s) occur alongside a platform for sharing results. The potato psyllid (Bactericera cockerelli, Sulc; Hemiptera: Triozidae) and beet leafhopper (Circulifer tenellus, Baker; Hemiptera: Cicadellidae) transmit pathogens to potato and other vegetable or seed crops each season in the northwestern United States. While the potato psyllid has been tested for pathogen occurrence for the past decade, testing of the beet leafhopper is a new endeavor and substantially increases the specimen number that must be tested by our laboratories each season. To aid in the rapid processing of individual insect specimens, we optimized and validated a new high-throughput 96-well plate nucleic acid extraction method for use in place of a standard 1.5-ml single-tube extraction method. Processing efficiency, in terms of total specimens processed over a 2-day period, improved 2.5-fold, and the cost associated with processing a single sample was nearly cut in half with this newly developed plate nucleic acid extraction method. Overall, this method has proven to be an excellent tool for the rapid testing of large numbers of small, individual insect vectors to enable timely dissemination of data on pathogen prevalence to growers.
Knowing and Believing Things: What DP-Complementation Can Tell us about the Meaning and Composition of (Factive) Attitudes
Authors: Djärv Kajsa
Published: August 2023

In the Hintikkan tradition, attitude verbs are viewed as relations between individuals and propositions. Previous work on know and believe with Content DPs like the rumour has tended to treat know CP vs. know DP as polysemy. In this paper, I show that polysemy runs into conceptual and empirical problems, and propose instead a new decompositional approach to know-verbs, which avoids polysemy; linking both know DP and know CP to the same lexical root, which describes, broadly speaking, acquaintance. This analysis thus provides an explicit and compositional morpho-semantic link between know DP and know CP that accounts for the interpretation of DPs as objects of acquaintance, and further captures the idea that knowledge, and factivity more broadly, is tied to acquaintance with a situation, the res ( Kratzer 2002, a.o.). Based on detailed examination of the morpho-syntax and interpretation of DP and CP complements of believe, I further show that DPs can either combine with believe in the same fashion as CPs, as a direct object (saturating a propositional argument slot, as in Uegaki 2016), or as an indirect object, via a type of attitudinal applicative (proposed here). The former option is defined for Content DPs and the latter for agentive DPs, so-called Source DPs. Together, these proposals account for the observation that the interpretation of believe DP sentences varies depending on the type of DP (believe the rumour vs. believe the referee), whereas for know-verbs, both types of DPs are interpreted as objects of acquaintance. At the core of the current proposal is the idea that verbs like know and believe differ fundamentally at the level of argument structure and internal morpho-semantic composition, and thus combine with DPs via different routes; contrary to uniform approaches to know and believe. Whereas believe-verbs describe relations to intensional content, and require external licensing mechanisms to combine with DPs, know-verbs describe complex relations, fundamentally anchored in the attitude holder’s acquaintance with (abstract or concrete) individuals in the world, and thus make reference to individuals as part of their argument structure. The current proposal also builds on and adds to previous insights about connections between factivity, DP-complementation, and question-embedding.
Enhanced Scanning Electron Microscopy Using Auto-Optimized Image Restoration With Constrained Least Squares Filter for Nanoscience
Authors: Hwang Junhyeok , Park In-Yong , Jung Min Kyo , Jung Haewon , Ogawa Takashi
Published: August 2023

The growing demands of nanoscience require the continuous improvement of visualization methods. The imaging performance of scanning electron microscopy (SEM) is fundamentally limited by the point spread function of the electron beam and degrades because of noise. This paper proposes an auto-optimization algorithm based on deconvolution for the restoration of SEM images. This algorithm uses a constrained least squares filter and does not dependent on the user's experience or the availability of nondegraded images. The proposed algorithm improved the quality of the SEM images of 10-nm Au nanoparticles, and achieved balance among the sharpness, contrast-to-noise ratio (CNR), and image artifacts. For the SEM image of 100-nm pitched line patterns, the analysis of the spatial frequencies allowed the 2.5-fold improvement of the intensity of 4-nm information, and the noise floor decreased approximately 32 times. Along with the results obtained by the application of the proposed algorithm to images of tungsten disulfide (WS2) flakes, carbon nanotubes (CNTs), and HeLa cells, the evaluation results confirm that the proposed algorithm can enhance the SEM imaging of nanoscale features that lie close to the microscope's resolution limit.
Microscopic Visualization of Crystal Twinning in Accessory Zircon
Authors: Sturm Robert
Published: August 2023

In general, crystal twinning in accessory zircon represents a rare, but in almost all granites and gneisses, encounterable phenomenon. Since only the crystal face {101} occurs as a twin plane, formation of crystal twins turns out to be relatively simple. Besides geniculate twins, which develop by rotation of the crystal structure about the line [101], parallel twins that are arranged parallel to the crystallographic main axis of zircon can also be observed by light and electron microscopy. While geniculate twins usually show a frequency within the region of a permille, the number of parallel twins can rise to several percent depending on the investigated rock. In the present contribution, a brief insight into the microscopic world of zircon twinning is provided.
Neuromeningeal Cryptococcosis and Tuberculosis Coinfection in Bamako: A One-Year Case Series
Authors: Ouedraogo Dramane , Cissoko Yacouba , Soumare Mariam , Alle Akakpo Amavi Essénam , Loua Ouo-Ouo , Konate Issa , Niare Doumbo Safiatou , Dao Sounkalo
Published: August 2023

Cryptococcosis and tuberculosis are life-threatening opportunistic infections that occur in apparently immunocompetent or severely immunocompromised individuals worldwide. As both infections are strongly linked to HIV infection, they may share certain clinical manifestations, and the interaction of their treatments should be considered. However, despite their similarity, concurrent tuberculosis and cryptococcal infections have rarely been reported in West Africa. Herein, we present 3 cases of neuromeningeal cryptococcosis and lung tuberculosis coinfection collected prospectively over a year at the Department of Infectious Diseases of the Point G Teaching Hospital in Bamako. Two patients had HIV disease, and the third patient had no underlying immunosuppressive illnesses. Thus, active screening for tuberculosis and cryptococcosis, particularly in individuals with HIV, can reduce misdiagnosis and ensure appropriate coinfection management. Moreover, this may reduce mortality due to AIDS-related opportunistic infections in resource-limited settings.
When it comes to sedentary behaviour modification, should people be told what to do? A randomized comparison trial among home-based office workers living in Ontario, Canada
Authors: Hiemstra Madison , Dillon-Rossiter Kirsten , Bartmann Nina , Prapavessis Harry , Rollo Scott , Mitchell Marc
Published: August 2023

The effects of adding choice architecture to a theory-based (Health Action Process Approach; HAPA) sedentary intervention remain unknown. To investigate whether choice architecture enhances a theory-based sedentary behaviour reduction intervention in home-based office workers. A 4-week HAPA-based intervention was conducted in London, Canada. Choice architecture was tested as an enhancement via a two (group: ‘Choice of Intervention’ vs. ‘No Choice Intervention’) by two (time: Baseline vs. Week 4) factorial repeated measure randomized comparison design. Sedentary behaviour reduction strategies focussed on obtaining a sedentary break frequency (BF) of every 30–45 min with break durations (BD) of 2–3 min. BF, BD, sitting, standing, and moving time were objectively measured (activPAL4™) at both time points. Participants (n = 148) were 44.9 ± 11.4 years old and 72.3% female. BF and total sitting time showed a time effect (P < .001), where both groups improved over the 4 weeks; there were no significant differences between groups across time. BD, standing, and moving time had a significant group by time effect where the ‘No Choice’ group showed significant increases in BD (P < .001), standing (P = .006), and moving time (P < .001) over the 4 weeks. Augmenting a theory-based intervention with choice architecture resulted in change in some sedentary behaviours in at home office workers. Specifically, while BF increased for all participants, the ‘No Choice’ group exhibited greater changes for BD, standing, and moving time compared with the ‘Choice’ group. Overall, these changes exceeded the intervention BF and BD goals.
A Review of Community Health Worker Interventions for Latinx/o/a Individuals With Unhealthy Alcohol Use
Authors: Carson Mariam , Fernandez Alicia , Martin Marlene
Published: August 2023

Unhealthy alcohol use (UAU) affects nearly 1 in 4 Latinx/o/a individuals in the United States (US). Compared with White individuals, Latinx/o/a individuals with UAU face increased morbidity, decreased access to addiction treatment, and higher rates of incarceration. Community health workers (CHWs), also known as promotores, provide culturally and linguistically informed services while augmenting social and health care interventions. Although there is extensive literature evaluating the role of CHW interventions for chronic conditions including hypertension and diabetes, less is known about CHW interventions for UAU in the US. To better understand how CHWs can address UAU in the Latinx/o/a community in the US, we performed a scoping review of the literature for CHW interventions for UAU in the Latinx/o/a population. We reviewed publications up to March 8, 2022, which described CHW interventions for UAU in Latinx/o/a individuals in the US and identified 6 publications that met inclusion criteria after full-text review. These publications included 3 randomized controlled trials, 2 follow-up feasibility and acceptability assessments within the randomized controlled trial intervention group, and a pre-post noncontrolled feasibility study. All interventions were brief, with low-intensity touchpoints between CHWs and patients. None included medications for alcohol use disorder. We found few publications related to CHW-delivered interventions for UAU within the Latinx/o/a population. Given the acceptance and success of CHW-delivered interventions other conditions, as well as the increasing use of CHWs in the US, we need to invest in research that examines the efficacy of the CHWs in UAU.
Association of Labor Neuraxial Analgesia with Maternal Blood Transfusion
Authors: Guglielminotti Jean , Landau Ruth , Daw Jamie , Friedman Alexander M. , Li Guohua
Published: August 2023

Background

Labor neuraxial analgesia may reduce the odds of postpartum hemorrhage, the leading indication for maternal blood transfusion during childbirth. This study tested the hypothesis that labor neuraxial analgesia is associated with reduced odds of maternal blood transfusion overall.

Methods

U.S. birth certificate data in the Natality File of the National Vital Statistics System for all 50 states from 2015 to 2018 for vaginal and intrapartum cesarean deliveries were analyzed. The exposure was labor neuraxial analgesia. The primary outcome was maternal blood transfusion, recorded on the birth certificate, which has low sensitivity for this outcome. Adjusted odds ratios and 95% CIs of blood transfusion associated with neuraxial analgesia were estimated using propensity score matching. The adjusted odds ratios were estimated overall and according to delivery mode, and treatment effect was compared between vaginal and intrapartum cesarean deliveries using an interaction term. Sensitivity analyses were performed using inverse propensity score weighting and quantitative bias analysis for outcome misclassification.

Results

Of the 12,503,042 deliveries analyzed, 9,479,291 (75.82%) were with neuraxial analgesia, and 42,485 (0.34%) involved maternal blood transfusion. After propensity score matching, the incidence of blood transfusion was 0.30% in women without neuraxial analgesia (7,907 of 2,589,493) and 0.20% in women with neuraxial analgesia (5,225 of 2,589,493), yielding an adjusted odds ratio of 0.87 (95% CI, 0.82 to 0.91) overall. For intrapartum cesarean deliveries, the adjusted odds ratio was 0.55 (95% CI, 0.48 to 0.64), and for vaginal deliveries it was 0.93 (95% CI,. 0.88 to 0.98; P value for the interaction term < 0.001). The results were consistent in the sensitivity analyses, although the quantitative bias analysis demonstrated wide variation in potential effect size point estimates.

Conclusions

Labor neuraxial analgesia may be associated with reduced odds of maternal blood transfusion in intrapartum cesarean deliveries and, to a lesser extent, vaginal deliveries. The specific effect size varies widely by delivery mode and is unclear given the poor sensitivity of the data set for the maternal transfusion primary outcome.

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A Split-Face Study to Evaluate Efficacy of Autologous Injectable Platelet-Rich Fibrin With Microneedling Against Microneedling With Normal Saline (Placebo Control) in Atrophic Acne Scars
Authors: Krishnegowda Ranjitha , Pradhan Shekhar N. , Belgaumkar Vasudha A.
Published: August 2023

BACKGROUND

Acne scars cause significant psychosocial stress. Despite a wide armamentarium, there is a constant search for an effective modality. Autologous injectable platelet-rich fibrin (i-PRF) is a promising novel option in the management of atrophic scars.

OBJECTIVE

To compare efficacy of autologous i-PRF with microneedling against microneedling alone in atrophic acne scars.

MATERIALS AND METHODS

A split-face prospective interventional study was conducted on 40 patients with atrophic acne scars. Autologous i-PRF and normal saline were injected into each scar on right (study) and left (control) sides, respectively, followed by microneedling on both sides. Four sessions were performed at monthly intervals with follow-up at 2 months. For assessment, Goodman and Baron (GB) scale, physician subjective score, and patient satisfaction scores were used.

RESULTS

Mean baseline GB grade on each side was 3.45. At 24 weeks, mean GB grade was significantly reduced on the study side (1.47, SD 0.56) than control side (3.33, SD 0.53). Mean patient satisfaction score was significantly higher on the right side (5.95) compared with the left side (5.35). Rolling scars responded the best followed by boxcar and ice-pick scars.

CONCLUSION

Autologous i-PRF and microneedling act synergistically to improve acne scars.
Experimental Study of Warburg Effect in Keloid Nodules: Implication for Downregulation of miR-133b
Authors: Lee Yuumi , Ito Yuko , Taniguchi Kohei , Nuri Takashi , Lee SangWoong , Ueda Koichi
Published: August 2023

Background:

A keloid is composed of several nodules, which are divided into two zones: the central zone (CZ; a hypoxic region) and the marginal zone (MZ; a normoxic region). Keloid nodules play a key role in energy metabolic activity for continuous growth by increasing in number and total area. In this study, we aimed to investigate the roles of the zones in the execution of the Warburg effect and identify which microRNAs regulate this phenomenon in keloid tissue.

Methods:

Eleven keloids from patients were used. Using immunohistochemical analysis, 179 nodules were randomly chosen from these keloids to identify glycolytic enzymes, autophagic markers, pyruvate kinase M (PKM) 1/2, and polypyrimidine tract binding protein 1 (PTBP1). Western blot and qRT-PCR tests were also performed for PKM, PTBP1, and microRNAs (miR-133b and miR-200b, c).

Results:

Immunohistochemical analysis showed that the expression of the autophagic (LC3, p62) and glycolytic (GLUT1, HK2) were significantly higher in the CZ than in the MZ. PKM2 expression was significantly higher than PKM1 expression in keloid nodules. Furthermore, PKM2 expression was higher in the CZ than in the MZ. However, PKM1 and PTBP1 expression levels were higher in the MZ than in the CZ. The qRT-PCR analysis showed that miR-133b-3p was moderately downregulated in the keloids compared with its expression in the normal skin tissue.

Conclusions:

The Warburg effect occurred individually in nodules. The MZ presented PKM2-positive fibroblasts produced by activated PTBP1. In the CZ, PKM2-positive fibroblasts produced lactate. MiR-133b-3p was predicted to control the Warburg effect in keloids.
Combined Dynamic Osteotomies for Craniosynostosis
Authors: Cardim Vera Lúcia N. , Peres Geórgia M.C. , Silva Alessandra dos S.
Published: August 2023

Background:

In primary craniosynostosis, the premature fusion of one or more sutures prevents the perpendicular expansion of brain tissue (primary defect). Providing space for the brain to expand, the compensatory growth of unaffected sutures causes progressive skull deformation (secondary defect). Understanding the need to treat the osteogenic matrix responsible for the cranial vault’s shape was essential to develop a novel surgical concept known as dynamic osteotomy. It uses springs to activate stenotic sutures and trigger dura-mater distension while flexibilizing compensatory osseous defects via helicoid osteotomy (nautilus technique), allowing for efficient bone expansion and remodeling in craniosynostosis.

Method:

This case series describes patients with craniosynostosis treated with dynamic osteotomy utilizing structural transformation inductors such as springs and helicoid osteotomy (nautilus technique), operated on between July 2004 and January 2020 at a single center in Brazil.

Result:

Dynamic osteotomy longitudinally achieved stable osseous remodeling during growth period while maintaining good vitality and continuity of the osteotomized cranial vault.

Conclusion:

Dynamic osteotomy utilizing springs and nautilus technique, alone or in combination, is a successful treatment of craniosynostosis regardless of patient’s age.
Fasciocutaneous Free Tissue Transfer in Limb Salvage: Prior Flap as a Split-thickness Skin Graft Donor Site
Authors: Kaiser Dominik , Levin Lawrence Scott
Published: August 2023

Free flap surgery for limb salvage has become the surgical standard for reconstruction of bone and soft tissue with success rates and flap survivals of 94%–95%. The soft tissue defect dictates the technique of coverage. In many cases, multiple techniques of soft tissue coverage are necessary, ranging from myocutaneous and fasciocutaneous free flaps to split-thickness skin grafts (STSGs). It has been shown that fasciocutaneous free flaps are not inferior to muscle flaps in treatment of lower leg limb salvage. Although a complete flap loss is rare, it is not uncommon to have partial flap necrosis, wound dehiscence, or secondary soft tissue defects, necessitating further minor reconstruction, which we call “touch up” skin grafts. In many of these secondary procedures, split thickness skin grafts are sufficient. We have been using the skin portion of the fasciocutaneous free flap as a donor site for harvesting STSGs for quite some time without disadvantages. We believe that minimizing additional donor site morbidity is of great importance. The free tissue transfer is insensate and readily available at the site of injury, making prepping and draping simple as well as cosmetically acceptable, as the transferred free tissue, unfortunately, is rarely a perfect fit. The associated pain, discomfort, and scar of an additional donor site can be avoided. In our case series, we did not experience any flap loss, infections, or complications. Thus, harvesting an STSG from a fasciocutaneous free flap seems to be a feasible option to be considered in limb salvage.
Multicentric Study on the Relation between Perceived Department Radiation Shielding Policies and Staff Radiation Shielding Conscientiousness
Authors: Kellens Pieter-Jan , Soenens Gilles , Van Herzeele Isabelle , McWilliams Richard , Chan Tze Yuan , Fisher Robert , Bacher Klaus , Vlerick Peter
Published: August 2023

Personal protective equipment (PPE), including personal garments as well as in-room devices, is crucial to minimize ionizing radiation exposure during fluoroscopy-guided procedures. However, recent studies have highlighted a lack of knowledge and awareness between and within departments about the use and risks of ionizing radiation and radiation safety. Employees differ in their conscientiousness regarding PPE and perceive the program regarding PPE differently. It has been shown that being conscientious about safety precedes safety behavior and can be triggered through increased perception of the present safety policy. This study explores the relation between employees’ perception of the PPE program and their PPE conscientiousness. Employees from interventional cardiology (IC), interventional radiology (IR), and vascular surgery (VS) were invited to complete anonymously a self-administered online survey assessing the perceived PPE program, their own PPE conscientiousness, and demographics. Associations between PPE program and PPE conscientiousness were investigated using forward stepwise regression on a significance level of 5%. Study variables were standardized. Sixty-one out of the 72 (84.7%) participants answered the survey fully. The PPE program was positively associated with PPE conscientiousness [

=0.32 (CI: 0.02 to 0.51)]. This association was found to be department-dependent (p-value < 0.001). Significant mean differences in PPE conscientiousness were found between IC and IR and between IC and VS, respectively [

=1.25 (CI: 0.69 to 1.82)] and [

=0.63 (CI: 0.06 to 1.20)]. This study is the first to investigate the relation between the perceived PPE program and employees’ PPE conscientiousness. The positive association between PPE program and PPE conscientiousness suggests that employees’ perception of the prevailing PPE program in their department might influence their PPE conscientiousness. Therefore, policy makers are recommended to not only improve their PPE program but also enhance employees’ perception of the reigning PPE program in order to foster their radiation shielding behavior.
Teaching Provider Wellness and Physician Assistant Student Well-Being
Authors: Banning Adrian , Coplan Bettie , LeVasseur Michael T.
Published: August 2023

Purpose

The purpose of this novel study was to determine whether any association exists between student well-being and physician assistant (PA) program approaches to teaching provider health and well-being (provider wellness).

Methods

Data were sourced from 3 PA Education Association surveys. Data from the 2019 Matriculating Student and End of Program Surveys (EOPS) were analyzed to compare student-reported well-being across 6 measures. Next, data from the 2019 Didactic Curriculum Survey were assessed and matched to the 2019 EOPS data. Finally, generalized estimating equation models were used to assess the independent effects of course structure, mode of instruction, and contact hours on well-being scores among end-of-program students (within one month of graduation).

Results

While levels of well-being were generally favorable, except for “level of social activity” (P = .20), across measures, graduating student levels of well-being (P < .05) were statistically significantly lower than matriculating student levels of well-being. No associations were found between levels of student well-being and whether programs reported teaching or not teaching provider wellness. Some aspects of instruction (eg, contact hours) were inconsistently associated with various well-being measures.

Conclusion

In this study, no consistent associations between approaches to teaching provider wellness and various measures of student well-being were identified. Further research is needed to determine what approaches to promoting wellness are effective.
Obesity-hyperlipidemia, Hypertension, and Left Atrial Enlargement During Stroke in Young Adults
Authors: Zhang Shouye , Zuo Peng
Published: August 2023

Background:

This study investigated the association between left atrial enlargement and stroke severity in young adults. We also studied the differences between the normal and left atrial enlargement groups in clinical data.

Methods:

A total of 135 young stroke patients admitted to the Department of Neurology of the Taizhou People’s Hospital were recruited from January 2018 to December 2021. The patients were divided into normal and enlarged groups by left atrial size. The relationship between the left atrial diameter and the National Institutes of Health Stroke Scale score was analyzed apart from the differences in clinical variables.

Results:

No relationship was observed between the left atrial diameter and the National Institutes of Health Stroke Scale score (r=−0.045 P=0.603). The univariate analysis of both groups revealed that hypertension (P=0.004), hyperlipidemia (P=0.001), body mass index (P=0.000), obesity (P=0.015), and not stroke etiologic subtypes were associated with left atrial enlargement. In binary logistic regression analysis models, hyperlipidemia 3.384 (95% CI, 1.536 to 7.452), hypertension 2.661 (95% CI, 1.066 to 6.639), and obesity 2.858 (95% CI, 1.158 to 7.052) were significantly associated with the young stroke of left atrial enlargement.

Conclusions:

In young adults, obesity-hyperlipidemia and hypertension were significantly associated with left atrial enlargement in stroke.
Early Rehabilitation and Nursing Intervention (ERNI) Accelerates the Recovery of Patients With Ischemic Stroke
Authors: Huang Jianghua , Zuo Juan , Tang Xuan , Zou Jieqiong , Zeng Yahua , Chen Shuangqin , He Gufen
Published: August 2023

Background:

Ischemic stroke, a severe disease with high disability and mortality, causes an overburden in society and demands more effective treatments. Early rehabilitation and nursing intervention (ERNI) helps the postoperative recovery of patients with hypertensive intracerebral hemorrhage. However, the effect of ERNI on the recovery of people after ischemic stroke remains unclear.

Methods:

Patients were treated with the ERNI program; subsequently, Mini-Mental State Examination, National Institute of Health stroke scale, Fugl-Meyer Assessment Scale, Daily living activity assessment, and Quality of life test were performed after the treatment of ERNI to evaluate the influence of ERNI on the cognitive function, motor function, and life quality of patients after ischemic stroke.

Results:

We observed that following the treatment of ERNI, cognitive, neurological, and motor functions, daily life qualities, and life quality in the ERNI-treated group were significantly better than that in the control group.

Conclusion:

ERNI promoted the recovery of neurological function and improved the life qualities of patients after ischemic stroke.
Case Report: Multimode Imaging of Chronic Syphilitic Chorioretinitis
Authors: Jiang Zhijian , Ji Huiying , Zhang Nan , Huang Liang , Dong Jianhong
Published: August 2023

Significance

The clinical manifestations of ocular syphilis may mimic those of other diseases, which may result in a missed diagnosis and delayed treatment.

Purpose

We describe multimodal imaging findings and treatment outcomes of a patient with chronic syphilitic chorioretinitis.

Case Report

A 40-year-old male patient complained of progressive decreased visual acuity of his left eye for over one year. The best-corrected visual acuity (BCVA) was 20/20 in the right eye and 3/50 in the left eye. Relative afferent pupillary defect and 1+ vitreous cells were detected in the left eye. The authors performed fundus examination, fluorescence angiography, ultra-widefield fundus autofluorescence, structure optical coherence tomography, widefield montage optical coherence tomography angiography and visual field. Laboratory tests including a toluidine red unheated serum test (TRUST; 1:32) and the Treponema pallidum antibody (9.01S/CO) were positive. The diagnosis of chronic syphilitic chorioretinitis was diagnosed in both eyes. The patient was admitted for administration of intravenous penicillin G for 14 days, followed by intramuscular benzathine penicillin G weekly for three doses. Six months after treatment, the TRUST ratio had decreased to 1:2 (positive). BCVA was 20/20 in the right eye and 6/20 in the left eye. The re-examination results showed the ocular structure and capillaris flow partially recovered.

Conclusions

Chronic syphilitic chorioretinitis profoundly affects the structure of the retina and choroid; however, eyes may partially recover after effective treatment. Ultra-widefield imaging technology has several advantages, such as broader imaging field and more details provided, in determining syphilis induced ocular disorders.
Localized Heat Treatment for Meibomian Gland Dysfunction: A Single-Center Retrospective Analysis of Efficacy over Time
Authors: Chester Thomas , Ferguson Tanner , Chester Emma
Published: August 2023

SIGNIFICANCE

Meibomian gland dysfunction (MGD) can produce a myriad of symptoms. The effective treatment of MGD can reduce the burden of this condition. Although several studies have indicated that TearCare (Sight Sciences, Menlo Park, CA) is an effective treatment for MGD, no studies currently provide information regarding the duration of efficacy.

PURPOSE

The purpose of this analysis was to determine the duration of efficacy of symptom relief and improvement of signs (as measured by gland function) for a treatment consisting of controlled heating of the meibomian glands using SmartLids (Sight Sciences) combined with manual expression of the liquefied meibum by a physician.

METHODS

This study involved retrospective analysis of data gathered from a single-center ophthalmology/optometry practice. Symptoms were assessed using the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, and the signs were assessed using the meibomian gland expression (MGE) scores before and at several time points (8 weeks, 6 months, 12 months, and 18 months). Further analysis evaluating the efficacy in subgroups based on age, race, and sex was performed.

RESULTS

There were 78 patients included in this study. The mean baseline SPEED score decreased from 14 to 7.9 at 8 weeks. The mean SPEED scores at 6 and 12 months were maintained at 7.7 and 7.9, respectively, and at 18 months went to 8.9. At baseline, the mean MGE was 4.9 in the right eye and 4.8 in the left eye. In both eyes, the mean MGE increased to 9.0 in both eyes at 8 weeks. At 6 months, the mean MGE score was maintained at 8.6 in the right and 8.2 in the left and remained consistent at 12 months with 7.8 in the right and 7.8 in the left. At 18 months, the MGE score went to 6.8 in the right eye and 7.0 in the left eye.

CONCLUSIONS

A single TearCare treatment effectively reduced both the symptoms and signs of MGD and maintained its effects for 12 months.
Utility for Uncorrected Refractive Errors in Adolescent Schoolchildren in Kakamega County, Kenya
Authors: Okenwa-Vincent Emmanuel E. , Naidoo Jyoti , Clarke-Farr Peter C.
Published: August 2023

Significance

Uncorrected refractive errors (UREs) present an enormous lifetime burden in children. Despite this, there is a dearth of knowledge on URE-related preference-based quality-of-life (QoL) in East Africa. This study demonstrates the positive impact of interventions on UREs; hence, it provides an empirical justification for advocacy to improve the QoL of children with URE.

Purpose

This study investigated the preference-based QoL (utility) for URE in school-going adolescents of Kakamega County, in Kenya.

Methods

An observational cross-sectional study with multi-stage sampling was conducted on randomly selected secondary school adolescents. School-going adolescents in Forms 1–4 were clinically examined for the presence of URE and classified according to their URE types. Prescreened students who met the selection criteria were classified into two groups: URE and normal sight. Participants in the normal-sight group were randomly selected from among screened students without URE. Selected participants were administered a previously validated adolescent-specific utility weighting instrument – Assessment of Quality of Life Six Dimensions (AQOL6D).

Results

A total of 330 participants aged 17.32 ± 1.60 years (URE:17.50 ± 1.58; normal-sight:17.15 ± 1.61) were included in the study. The mean utility score, as elicited by the AQOL6D scoring algorithm, was better in the normal-sight group (URE:0.496 ± 0.22; normal sight:0.567 ± 0.25) at baseline, whereas the converse was true at follow-up (URE:0.655 ± 0.20; normal sight:0.603 ± 0.25). In all cases, the differences were significant (P < .05); however, there was no significantly better (P > .05) utility elicited by any URE subtype at any given time point. Nonetheless, the URE group showed significantly better utility (P < .05) after spectacle correction.

Conclusions

UREs are associated with reduced utility in school-going adolescents, regardless of URE subtype. Spectacle correction resulted in a significantly improved utility for those with URE. Thus, this study recommends early public health strategies and spectacle interventions in schools for adolescents with URE.
Refractive Error Changes Due to COVID-19 Pandemic Confinement in Children from Puerto Rico: A Retrospective Study
Authors: Rodriguez Neisha M. , Acevedo Ariette , Torres Vionette Pereira , Romero Angel F.
Published: August 2023

SIGNIFICANCE

The progression of myopia increased in children after the pandemic confinement. A myopic shift in the refractive error of the Hispanic population was found regardless of the refractive status of the school-aged children studied.

PURPOSE

This study aimed to evaluate the refractive error in Puerto Rican children before and after the COVID-19 pandemic. We were interested in whether there was a significant change in refractive error attributed to online learning during the pandemic lockdown.

METHODS

A retrospective record review of children aged 7 to 18 years who underwent a comprehensive visual evaluation between 2018 and 2021 at the Inter American Eye Institute in Puerto Rico was performed. The spherical equivalent pre- and post-lockdown was compared. The study excluded the best-corrected visual acuities worse than 20/40, any corneal or retinal disease, and amblyopia.

RESULTS

In total, 801 records were included in this study. The mean age was 12.7 ± 3.2 years, with 50.3% male and 49.7% female children. The mean spherical equivalent for the right and left eyes was similar (r = 0.93, P ≤ .001). A significant difference in the mean spherical equivalent was found pre- and post- lockdown (0.22 ± 0.59 D, t
800 = 10.44, P ≤ .001). A myopic shift post-lockdown was significant for all ages except those in the 7- (0.13 ± 0.79 D, t
28 = 0.84, P = .40) and 8-year-old range (0.12 ± 0.65 D, t
40 = 1.22, P = .23), respectively. No significant change was found between sexes before (0.16 ± 0.12 D; t
799 = 1.38, P = .16) and after (0.15 ± 0.13 D; t
799 = 1.19, P = .23) confinement.

CONCLUSIONS

The current study revealed a significant myopic shift in Hispanic school-aged children as a result of the pandemic confinement.
Are all underimmunized measles clusters equally critical?
Authors: Afroj Moon Sifat , Marathe Achla , Vullikanti Anil
Published: August 2023

This research develops a novel system science approach to examine the potential risk of outbreaks caused by geographical clustering of underimmunized individuals for an infectious disease like measles. We use an activity-based population network model and school immunization records to identify underimmunized clusters of zip codes in the Commonwealth of Virginia. Although Virginia has high vaccine coverage for measles at the state level, finer-scale investigation at the zip code level finds three statistically significant underimmunized clusters. This research examines why some underimmunized geographical clusters are more critical in causing outbreaks and how their criticality changes with a possible drop in overall vaccination coverage. Results show that different clusters can cause vastly different outbreaks in a region, depending on their size, location, immunization rate and network characteristics. Among the three underimmunized clusters, we find one to be critical and the other two to be benign in terms of an outbreak risk. However, when the vaccine coverage among children drops by just 5% (or 0.8% overall in the population), one of the benign clusters becomes highly critical. This work also examines the demographic and network properties of these clusters to identify factors that are responsible for affecting the criticality of the clusters. Although this work focuses on measles, the methodology is generic and can be applied to study other infectious diseases.