bluuebunny/crossref_metadata_2025 huggingface dataset:
VISION-RELATED MALPRACTICE INVOLVING PRISONERS
Authors: Jeng Franklin , Bonnell Alyssa C. , O'Neil Erin C. , Mehran Nikki A. , Kolomeyer Natasha N. , Brucker Alexander J. , Kolomeyer Anton M.
Published: December 2021

Purpose:

To characterize vision-related malpractice litigation involving prisoners.

Methods:

Retrospective legal database review using the Westlaw database was performed to identify vision-related malpractice lawsuits involving prisoners in the United States from 1914 to 2020. Main outcomes and measurements were allegations of malpractice, verdicts, and settlements.

Results:

Sixty-four vision-related malpractice lawsuits involving prisoners were identified. Mean defendant age was 49 years (range, 28–74 years). Fifty-seven percent of the defendants were ophthalmologists and 43% were optometrists. The cases were most commonly from the South and Midwest (n = 19 [30%] for each). Allegations of malpractice included inadequate medical care or treatment refusal (n = 21 [33%]), failure to treat fully leading to continued suffering (n = 18 [28%]), and delay in treatment or referral (n = 17 [27%]). Retina-related diagnoses were most common (n = 18 [28%]). Forty-six (72%) cases were closed, 14 (22%) were open, and four (6.3%) were partially closed. Only two (3.1%) cases were decided in favor of the plaintiff. The most common reason for an unsuccessful suit was lack of deliberate indifference by the eye care professional (n = 21 [46%]).

Conclusion:

The most common reasons for vision-related malpractice brought forth by prisoners were inadequate or incomplete eye care and treatment refusal. Retina was the most commonly involved subspecialty. However, the success rate of these suits was extremely low.
Repeatability and Agreement of Horizontal Corneal Diameter Measurements Between Scanning-Slit Topography, Dual Rotating Scheimpflug Camera With Placido Disc Tomography, Placido Disc Topography, and Optical Coherence Tomography
Authors: Namkung Soobin , Boyle Alexander Buckenham , Li Ye , Gokul Akilesh , McGhee Charles , Ziaei Mohammed
Published: December 2021

Purpose:

The purpose of this study was to assess the repeatability and agreement of horizontal white-to-white (WTW) measurements using 4 different imaging modalities including a slit-scanning elevation topographer, dual rotating Scheimpflug camera and Placido Disc tomographer, Placido Disc topographer, and anterior segment optical coherence (OCT) tomographer.

Methods:

In this prospective study, 33 eyes of 33 healthy subjects were scanned 3 times using each of the Orbscan IIz, Sirius, Nidek OPD III, and DRI OCT Triton devices and WTW measurements were recorded. Repeatability was assessed using the intraclass correlation coefficient (ICC), and agreement was analyzed using Bland–Altman plots.

Results:

Mean WTW values obtained from the Orbscan IIz, Sirius, Nidek, and DRI OCT Triton devices were 11.76 ± 0.41, 12.10 ± 0.45, 12.14 ± 0.41, and 12.40 ± 0.48 mm, respectively. Overall, there was high repeatability, with the ICC >0.86 for all devices. The Sirius showed the highest repeatability (ICC = 0.993), and the Nidek the lowest (ICC = 0.870). All pairwise comparison showed significant differences in the mean WTW measurements (P < 0.01) except between Sirius and Nidek (P = 0.27). Mean differences showed that the DRI OCT Triton had the highest WTW values, followed by Nidek, Sirius, and finally by Orbscan, which provided the lowest measurements. All pairwise comparisons had wide limits of agreements (between 0.60 and 0.80 mm).

Conclusions:

In healthy subjects the 4 devices demonstrated high repeatability in WTW measurement. However, a poor agreement between the devices suggests that they should not be used interchangeably for WTW measurements in clinical practice.
911 Calls for Emergency Medical Services in Heart Failure
Authors: Jung Miyeon , Hays Laura M. , Pang Peter S. , Newhouse Robin P. , Arkins Thomas P. , O'Donnell Daniel , Cook Ryan , Gradus-Pizlo Irmina , McAdams Ellen , Pressler Susan J.
Published: December 2021

Background

Heart failure (HF) is a common condition leading to activation of emergency medical services (EMS).

Objective

The aim of this study was to describe reasons given by persons with HF, family members, or other caregivers for requesting EMS activation during 911 calls.

Methods

In this descriptive qualitative study, a content analysis was performed on transcribed audio files of 383 EMS requests involving 383 persons with HF in the community.

Results

One hundred forty-seven calls (38.4%) were placed by the family members, 75 (19.6%) were placed by the patients, 56 (14.6%) were placed by healthcare workers or personnel from living facilities, and the remaining calls (n = 105, 27.4%) were placed by others (eg, friends, neighbors, officers). Three broad categories of symptoms, signs, and events were identified as the reasons for an EMS request. Frequently reported symptoms were breathing problems (55.4%), chest pain (18.3%), and other pain (eg, head, extremities) (16.7%). Signs included decreased consciousness (15.4%), swelling (5.7%), and bleeding (5.0%). The reported events involved falls (8.1%), heart attack (6.3%), hypoxic episodes (6.0%), stroke (5.2%), and post–hospital-discharge complications (4.7%). In most calls (74.9%), multiple reasons were reported and a combination of symptoms, signs, and events were identified. Heart failure diagnosis was mentioned in fewer than 10% of the calls.

Conclusions

Overall, symptoms and signs of HF exacerbation were common reasons to activate 911 calls. Falls were frequently reported. Under the duress of the emergent situations surrounding the 911 call, callers rarely mentioned the existence of HF. Interventions are needed to guide patients with HF and their family members to promote the management of HF to reduce EMS activation as well as to activate EMS quickly for acute changes in HF conditions.
The Heterogeneity of Physical and Anxiety Symptoms and Quality of Life Among Patients With Heart Failure
Authors: Ye Yi , Mei Jiaojiao , Zhang Jie , Zhao Qiuge , Fan Xiuzhen
Published: December 2021

Background

Patients with heart failure (HF) experience a severe burden of symptoms and reduced quality of life (QoL). However, little is known about the heterogeneity of these symptoms and the association with QoL.

Objectives

The aims of this study were to conduct a latent class analysis on co-occurring physical and anxiety symptoms and to determine whether the underlying subgroups differ regarding the QoL among patients with HF.

Methods

The authors of this cross-sectional study recruited 329 patients with HF from 2 hospitals. Patients' symptoms and QoL were self-reported, and data were analyzed using latent class analysis, χ2 test, analysis of variance, and hierarchical linear regression analysis.

Results

Three latent classes (all low, all high, and high physical-partial anxiety) were identified based on the occurrence of patients' physical and anxiety symptoms. Patients with a lower body mass index, a worse New York Heart Association class, and a longer disease duration were more likely to belong to the all-high class. Hierarchical linear regression analysis showed that distinct subgroups (all low vs all high: β = −0.299, P < .001; all low vs high physical-partial anxiety: β = −0.228, P < .001) were significantly associated with the physical summary component score for QoL. Likewise, distinct subgroups (all low vs all high: β = −0.509, P < .001; all low vs high physical-partial anxiety: β = −0.128, P = .012) were significantly associated with the mental summary component score for QoL.

Conclusions

Patients with HF showed heterogeneity in physical and anxiety symptoms; the subgroup with severe symptoms exhibited a poor QoL. The associations between symptom subgroups and QoL require targeted symptom-based interventions.
Facemask Use During High Intensity Interval Exercise in Temperate and Hot Environments
Authors: Wells Andrew , Fennel Zachary , Ducharme Jeremy , Masoud Abdulaziz , Houck Jonathan , Bellovary Bryanne , Deyhle Michael , Hsiao Yu Yu , Amorim Fabiano , Mermier Christine
Published: December 2021

Objective:

The purpose of this study was to investigate the effects of surgical mask use during high intensity interval exercise (HIIE) on physiological and perceptual responses in hot and temperate environments.

Methods:

In a randomized fashion, 10 healthy participants completed two HIIE sessions in a 36°C hot (HUE-HOT) and two HIIE sessions in a 23°C temperate environment (HIIE-TEMP) while wearing (MASK) and not wearing a surgical mask (CON).

Results:

No differences in physiological variables were found between MASK and CON during HIIE. An increase in perceived dyspnea and average RPE was found comparing MASK and CON. Interaction effects showed the greatest changes in perceived dyspnea and average RPE occurred in the HIIE-HOT/MASK condition.

Conclusion:

Wearing a surgical mask during HIIE increases the perception of dyspnea and exertion with the greatest effect occurring in hot environments.
Association Between Workplace Social Capital and Neck Pain
Authors: Tezuka Masato , Saeki Kenta , Nakatsuka Kiyomasa , Uchida Kazuaki , Horibe Kana , Goto Ryo , Encho Haruhi , Tamura Kazuya , Mukaijo Mao , Yamada Naoki , Ono Rei
Published: December 2021

Objective:

We examined the association between workplace social capital (WSC) and presence of neck pain (NP) among workers.

Methods:

This cross-sectional study included 595 workers. Presence of NP was assessed using Numerical Rating scale. WSC (overall, bonding, bridging, and linking) was divided into three categories (low, middle, and high) based on tertile distributions. We used logistic regression analysis to investigate the association between WSC and presence of NP.

Results:

Low overall, bonding, and linking social capital were significantly associated with presence of NP in comparison with each high social capital (overall: adjusted odds ratio [aOR] = 1.76, 95% confidence interval [CI] = 1.14 to 2.73; bonding: aOR = 1.78, 95% CI = 1.19 to 2.67, linking: aOR = 2.18, 95% CI = 1.32 to 3.63).

Conclusion:

Lower WSC had an association with higher prevalence of NP among workers.
Guided growth: indications and techniques for correction of knock knees and bowlegs
Authors: Tuca María , Franz Pia , Guerra Daniela , Sepúlveda Matías
Published: December 2021

Purpose of review

Lower extremities axis alterations are a frequent cause for consultation in the medical practice of the care of paediatric patients. When it corresponds to pathological situations, guided growth surgery has been positioned as a possibility of well tolerated, reproducible and predictable resolution. For this reason, its use has increased significantly in recent years. In this review, its current indications, preoperative study, results and complications described in the updated literature will be discussed.

Recent findings

The success of the technique remains high in the current literature, expanding the technique to other segments and disorders, and describing new ways of performing tension band with sutures. In addition, there is an increase in its incidence and a decrease in the associated hospitalized days, which can associate with techniques of lower morbidity.

As guided growth surgery allows for successful correction of axis alterations, to achieve this, it is important to know the main indications, preoperative analysis and theoretical bases on which this technique is based, to carry it out in an adequate and timely manner, seeking an adequate resolution of the child's problem.
Coccidioides immitis
Authors: Amoth Haley , Kemp Walter L.
Published: December 2021

Coccidioides immitis is a dimorphic fungus, growing as a fungus in the soil and as a yeast in the human body, that is geographically limited in the United States, being most commonly associated with the San Joaquin Valley and found in California and Arizona. In most individuals, infection with C. immitis causes an asymptomatic, self-limited pulmonary infection; however, in a small percentage of individuals, the infection is disseminated and can involve any organ. We present the case of a 50-year-old man who was found unresponsive in his home in the northern portion of the United States. Autopsy revealed a 2163-g spleen. The initial differential diagnosis for the splenomegaly was an infection or a neoplastic process, such as leukemia. Because of the geographic location where the body was found, C. immitis was not initially considered; however, microscopic examination confirmed the presence of C. immitis spherules, which were found in the spleen and other organs. Granulomatous inflammation, often associated with spherules, was also present in a kidney, the pancreas, the thyroid gland, a parathyroid gland, and the heart. Additional investigation after the autopsy revealed that the decedent had spent time in the past in California, which would have allowed for exposure to C. immitis. The decedent had a rare form of a disease process not normally associated with the geographic location in which he was found, which highlights the need for continued diligence in death investigation so as to not allow a first impression to impair the correct final determination.
Flow-Through Arterialized Posterior Interosseous Nerve Grafts for Digital Neurovascular Bundle Defects: Anatomical Study
Authors: Claro Gilles , Zelenski Nicole A. , Balaguer Thierry , Chaput Benoit , Isola Nicolas , Baqué Patrick , Bronsard Nicolas , Camuzard Olivier
Published: December 2021

Background:

Digital neurovascular bundle defects are often encountered during crush or avulsion injuries and require complex reconstruction. Use of an arterialized nerve graft (neurovascular graft) serving both as an interpositional arterial conduit and as a nerve graft could be a reconstructive option in these cases. In this anatomical study, the authors aimed to describe a neurovascular graft of the posterior interosseous nerve and a branch of the anterior interosseous artery for neurovascular bundle reconstruction of the fingers.

Methods:

Eighteen forearms were injected with red latex in order to collect the anatomical characteristics of the posterior interosseous nerve and the artery running near it.

Results:

In all cases, the posterior interosseous nerve was followed by a branch of the anterior interosseous artery: the distal dorsal branch of the anterior interosseous nerve. The origin of this artery was proximal to the radiocarpal joint, at an average of 56.5 ± 11.1 mm. The proximal and distal diameters of the branch of the anterior interosseous artery were 1.6 ± 0.2 and 1.1 ± 0.2 mm, respectively. The proximal and distal diameters of the posterior interosseous nerve were 1.2 ± 0.3 mm and 1.1 ± 0.3 mm, respectively.

Conclusions:

These results show that a potential free neurovascular graft using the posterior interosseous nerve as nerve graft and the anterior interosseous artery as an arterial bypass to reconstruct both the nerve and arterial tree of the finger could be a useful approach. The authors speculate that this graft could be used to reconstruct the neurovascular bundle of amputated or devascularized digits.
Should Antiplatelet Therapy Be Withheld Perioperatively? The First Study Examining Outcomes in Patients Receiving Dual Antiplatelet Therapy in the Lower Extremity Free Flap Population
Authors: Mishu Mark D. , Zolper Elizabeth G. , Dekker Paige K. , Fleury Christopher M. , Bekeny Jenna C. , Fan Kenneth L. , Attinger Christopher E. , Evans Karen K.
Published: December 2021

Background:

Antiplatelet agents are typically withheld perioperatively because of bleeding concerns. Dual antiplatelet therapy, such as aspirin and clopidogrel, has significant morbidity and mortality benefits in patients with ischemic heart disease or peripheral vascular disease. This study aims to evaluate the impact of perioperative dual antiplatelet therapy in the lower extremity free tissue transfer population.

Methods:

Lower extremity free tissue transfers performed by the senior author (K.K.E.) from 2011 to 2019 were retrospectively reviewed. Demographics, comorbidities, perioperative dual antiplatelet therapy, and free tissue transfer characteristics were recorded. Outcomes of interest included flap success, hematoma formation, blood transfusion requirements, and cardiac event occurrence.

Results:

One hundred ninety-five free tissue transfers were included. Median age at the time of free tissue transfer was 56.5 years. Median Charlson Comorbidity Index was 3. Thirty-four patients were on clopidogrel, which was either withheld (n = 20) or continued (n = 14) on the day of free tissue transfer. Incidence of blood transfusion was significantly higher in both the withheld and continued versus nonclopidogrel groups. Flap success was statistically equivalent between groups (withheld, 90.0 percent; continued, 92.9 percent; nonclopidogrel, 95.0 percent; p = 0.346). Cardiac events occurred most often in the continued group (21.4 percent) compared to the withheld (5.0 percent) and nonclopidogrel (0.6 percent) groups. On multivariate analysis, holding clopidogrel remained significant for increased odds of postoperative transfusion. The clopidogrel group was no longer significant for intraoperative transfusion.

Conclusions:

Despite increases in volume of blood products transfused, free tissue transfer can be performed safely with perioperative dual antiplatelet therapy. Withholding dual antiplatelet therapy on the day of free tissue transfer was not associated with decreased intraoperative transfusion; thus, dual antiplatelet therapy can safely be continued throughout the operative course to minimize cardiovascular risk.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Anatomy of the Breast Fascial System: A Systematic Review of the Literature
Authors: Duncan Anna M. , Al Youha Sarah , Joukhadar Nadim , Konder Ricarda , Stecco Carla , Wheelock Margaret E.
Published: December 2021

Background:

Understanding the anatomy of the fascial and ligamentous structures of the breast is important in both aesthetic and reconstructive breast surgery. Several structures have been identified that play a significant role in the aesthetic qualities and support of the breast warranting consideration in the context of breast reconstruction.

Methods:

The authors performed a systematic review of anatomical, clinical, histologic, and radiologic studies that have described, characterized, and named these structures. The authors have summarized and critically appraised prior research to clarify and define the key fascial structures of the breast, their anatomical function, and their clinical significance in aesthetic and reconstructive breast surgery.

Results:

Through their review, six distinct breast fascial structures were encountered consistently in the literature. The authors have organized them into intraglandular and extraglandular structures and have reviewed their significance in the context of reconstructive breast surgery.

Conclusions:

The primary fascial structures of the breast are important anatomical landmarks with numerous clinical applications. Cooper ligaments divide the breast parenchyma. The superficial and deep layers of the superficial fascia encase the breast in a “pocket,” condensing into one thickened layer of fascia along the peripheral breast footprint. The inframammary fold supports and defines the inferior pole. The horizontal septum is a reliable neurovascular landmark. The vertical septum is a newly discovered fascial structure. There are certainly clinical implications that have yet to be described because of the relatively limited and disputed information on the fascia of the female breast and, ultimately, more research is warranted.
Exercise after Breast Augmentation: A Randomized Controlled Trial
Authors: Basile Filipe V. , Oliveira Thais S.
Published: December 2021

Background:

There are limited scientific data regarding the impact of exercise after breast augmentation surgery. Recommendations range from a few weeks to a few months of physical activity avoidance. To decide whether early exercise after breast augmentation is safe, a prospective randomized trial was designed to measure complications, scar quality, and patient-reported outcomes in this setting.

Methods:

The present study was a randomized controlled trial to investigate the effects of early exercise (1 week after surgery) on postoperative complications, scar quality, and patient-reported outcome (BREAST-Q). All women undergoing primary breast augmentation surgery in the authors’ institution were randomized to either standard restrictions or exercise. The three primary outcomes measured were the presence of a complication and reoperation, scar quality, and patient-reported outcome.

Results:

A total of 225 participants were included in the final analysis. No differences were found among the groups for age (p = 0.66), implant size (p = 0.56), or implant pocket (p = 0.29); complication rates did not change between the control (7.5 percent) and exercise groups (6.9 percent). When assessed 12 months after surgery, the scar quality was comparable between the groups (29.9 control and 29.6 exercise, p = 0.204). Intervention groups (exercise) performed better on the BREAST-Q Augmentation Module: Satisfaction with Outcome score (66.3 control and 83.4 exercise, p < 0.01).

Conclusions:

Early exercise following primary breast augmentation does not increase complication or reoperation rates or cause a reduction in scar quality after 1 year. In addition, a patient-reported outcome showed improvement in the exercise groups.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, II.
TULUA Male High-Definition Abdominoplasty
Authors: Babaitis Ricardo , Villegas Francisco J. , Hoyos Alfredo E. , Perez Mauricio , Mogollon Ivan R.
Published: December 2021

Background:

Abdominoplasty is a surgical technique for body contouring that has been shown to improve the patient’s quality of life. It has become more common among male patients, so clear differences between procedures for men and women have to be stated. The authors present their experience with high-definition lipoabdominoplasty with transverse plication in men.

Methods:

Records of male patients undergoing transverse plication full abdominoplasty in addition to high-definition liposculpture were analyzed. A total of 24 consecutive cases were found between January of 2017 and June of 2019. Patient ages ranged from 24 to 60 years. Patients aged 18 years or younger were excluded. Body mass index ranged from 25 to 33 kg/m2. Photographic records were taken before and during follow-up at 2 days and 1, 3, 6, and 12 months after surgery.

Results:

Male TULUA (transverse plication, no undermining, full liposuction, neoumbilicoplasty, and low transverse abdominal scar) with high-definition lipoabdominoplasty was successfully achieved in 24 cases. No major complications were reported. Six minor complications were reported (25 percent). Rectus abdominis diastases are less common in men compared to women, as pregnancy is the most determining factor in its development. Fat distribution is also a key difference when performing lipoabdominoplasty for the male or the female patient. The authors recommend a transverse plication of the abdominal wall, instead of a vertical one, as flap viability is preserved and enhanced muscular definition can be accomplished.

Conclusions:

Combining transverse plication with high-definition lipoabdominoplasty (transverse plication, no undermining, full liposuction, neoumbilicoplasty, and low transverse abdominal scar plus high-definition lipoabdominoplasty) is a safe and reproducible technique for the male patient. It offers higher aesthetic results in line with modern beauty ideals.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Anal cancer incidence in men with HIV who have sex with men: are black men at higher risk?
Authors: McNeil Candice J. , Lee Jennifer S. , Cole Stephen R. , Patel Shivani A. , Martin Jeffrey , Mathews William C. , Moore Richard D. , Mayer Kenneth H. , Eron Joseph J. , Saag Michael S. , Kitahata Mari M. , Achenbach Chad J.
Published: December 2021

Objective:

To assess differences in anal cancer incidence between racial/ethnic groups among a clinical cohort of men with HIV who have sex with men.

Design:

Clinical cohort study

Methods:

We studied men who have sex with men (MSM) in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) who initiated antiretroviral therapy (ART) under HIV care in CNICS. We compared anal cancer incidence between Black and non-Black men and calculated hazard ratios controlling for demographic characteristics (age, CNICS site, year of ART initiation), HIV disease indicators (nadir CD4+, peak HIV RNA), and co-infection/behavioral factors including hepatitis B virus (HBV), hepatitis C virus (HCV), tobacco smoking and alcohol abuse.

Results:

We studied 7473 MSM with HIV who contributed 41 810 person-years of follow-up after initiating ART between 1996 and 2014 in CNICS. Forty-one individuals had an incident diagnosis of anal cancer under observation. Crude rates of anal cancer were 204 versus 61 per 100 000 person-years among Black versus non-Black MSM. The weighted hazard ratio for anal cancer in Black MSM (adjusting for demographics, HIV disease factors, and co-infection/behavioral factors) was 2.37 (95% confidence interval: 1.17, 4.82) compared to non-Black MSM.

Conclusions:

In this large multicenter cohort, Black MSM were at significantly increased risk for anal cancer compared to non-Black MSM. Further detailed studies evaluating factors impacting anal cancer incidence and outcomes in Black men with HIV are necessary. Inclusion of more diverse study cohorts may elucidate modifiable factors associated with increased anal cancer risk experienced by Black MSM.
Incidence of lung and human papilloma virus-associated malignancies in HIV-infected patients
Authors: Chaussade Hélène , Le Marec Fabien , Coureau Gaëlle , Leleux Olivier , Neau Didier , Lazaro Estibaliz , Amadeo Brice , Duffau Pierre , Ferrand Hélène , Courtault Carine , Foucan Anne-Sophie , Wittkop Linda , Bonnet Fabrice
Published: December 2021

Objective:

Cancers represent one of the leading cause of mortality/morbidity in patients with HIV (PWH) in industrialized countries. The objective of our study was to compare incidence of lung and human papilloma virus (HPV)-related cancers among PWH with general population over the 2010–2017 period.

Design:

Prospective and multicenter cohort study.

Methods:

The study included patients with lung and HPV-related cancers from the ANRS CO3 Aquitaine cohort (PWH) and the general population-based cancer registry in Gironde area. We calculated incidence rates for 100 000 person-years and incidence rate ratios (IRR).

Results:

Among the 3572 PWH, 70 cancers were diagnosed in 68 patients including 35 lung and 35 HPV-related cancers (18 oropharyngeal, 11 anal, 6 cervix). Incidence rates of lung and HPV-related-cancers were 311.1 in PWH and 209.8 in general population for 100 000 person-years, respectively. IRR were significantly increased in PWH for lung 1.8 [1.4–2.2] and HPV-related cancer 1.3 [1.0–1.6] and particularly high for patients between 40 and 49 years old [IRR 4.4 (2.3–8.4) for lung cancer and 3.7 (2.1–6.5) for HPV-related cancer].

Conclusion:

We emphasized the persistent high risk of lung and HPV-related cancer despite advent of antiretroviral therapies, particularly in the age strata of 40–49 years. Screening procedures should take into account this finding.
Deep Learning Algorithm for Fully Automated Detection of Small (≤4 cm) Renal Cell Carcinoma in Contrast-Enhanced Computed Tomography Using a Multicenter Database
Authors: Toda Naoki , Hashimoto Masahiro , Arita Yuki , Haque Hasnine , Akita Hirotaka , Akashi Toshiaki , Gobara Hideo , Nishie Akihiro , Yakami Masahiro , Nakamoto Atsushi , Watadani Takeyuki , Oya Mototsugu , Jinzaki Masahiro
Published: December 2021

Objectives

Renal cell carcinoma (RCC) is often found incidentally in asymptomatic individuals undergoing abdominal computed tomography (CT) examinations. The purpose of our study is to develop a deep learning-based algorithm for fully automated detection of small (≤4 cm) RCCs in contrast-enhanced CT images using a multicenter database and to evaluate its performance.

Materials and Methods

For the algorithmic detection of RCC, we retrospectively selected contrast-enhanced CT images of patients with histologically confirmed single RCC with a tumor diameter of 4 cm or less between January 2005 and May 2020 from 7 centers in the Japan Medical Image Database. A total of 453 patients from 6 centers were selected as dataset A, and 132 patients from 1 center were selected as dataset B. Dataset A was used for training and internal validation. Dataset B was used only for external validation. Nephrogenic phase images of multiphase CT or single-phase postcontrast CT images were used. Our algorithm consisted of 2-step segmentation models, kidney segmentation and tumor segmentation. For internal validation with dataset A, 10-fold cross-validation was applied. For external validation, the models trained with dataset A were tested on dataset B. The detection performance of the models was evaluated using accuracy, sensitivity, specificity, and the area under the curve (AUC).

Results

The mean ± SD diameters of RCCs in dataset A and dataset B were 2.67 ± 0.77 cm and 2.64 ± 0.78 cm, respectively. Our algorithm yielded an accuracy, sensitivity, and specificity of 88.3%, 84.3%, and 92.3%, respectively, with dataset A and 87.5%, 84.8%, and 90.2%, respectively, with dataset B. The AUC of the algorithm with dataset A and dataset B was 0.930 and 0.933, respectively.

Conclusions

The proposed deep learning–based algorithm achieved high accuracy, sensitivity, specificity, and AUC for the detection of small RCCs with both internal and external validations, suggesting that this algorithm could contribute to the early detection of small RCCs.
Chiral mode transfer of symmetry-broken states in anti-parity-time-symmetric mechanical system
Authors: Geng Linlin , Zhang Weixuan , Zhang Xiangdong , Zhou Xiaoming
Published: December 2021

Non-Hermitian systems with parity-time (PT) symmetry reveal rich physics beyond the Hermitian regime. As the counterpart of conventional PT symmetry, anti-parity-time (APT) symmetry may lead to new insights and applications. Complementary to PT-symmetric systems, non-reciprocal and chiral mode switching for symmetry-broken modes have been reported in optics with an exceptional point dynamically encircled in the parameter space of an APT-symmetric system. However, it has remained an open question whether and how the APT-symmetry-induced chiral mode transfer could be realized in mechanical systems. This paper investigates the implementation of APT symmetry in a three-element mass–spring system. The dynamic encircling of an APT-symmetric exceptional point has been implemented using dynamic-modulation mechanisms with time-driven stiffness. It is found that the dynamic encircling of an exceptional point in an APT-symmetric system with the starting point near the symmetry-broken phase leads to chiral mode switching. These findings may provide new opportunities for unprecedented wave manipulation in mechanical systems.
Reduced older male presence linked to increased rates of aggression to non-conspecific targets in male elephants
Authors: Allen Connie R. B. , Croft Darren P. , Brent Lauren J. N.
Published: December 2021

Males in many large mammal species spend a considerable portion of their lives in all-male groups segregated from females. In long-lived species, these all-male groups may contain individuals of vastly different ages, providing the possibility that behaviours such as aggression vary with the age demographic of the social environment, as well as an individual's own age. Here, we explore social factors affecting aggression and fear behaviours in non-musth male African elephants (Loxodonta africana) aggregating in an all-male area. Adolescent males had greater probabilities of directing aggressive and fearful behaviours to non-elephant targets when alone compared to when with other males. All males, regardless of age, were less aggressive towards non-elephant targets (e.g. vehicles and non-elephant animals) when larger numbers of males from the oldest age cohort were present. The presence of older males did not influence the probability that other males were aggressive to conspecifics or expressed fearful behaviours towards non-elephant targets. Older bulls may police aggression directed towards non-elephant targets or may lower elephants’ perception of their current threat level. Our results suggest male elephants may pose an enhanced threat to humans and livestock when adolescents are socially isolated, and when fewer older bulls are nearby.
A preference to learn from successful rather than common behaviours in human social dilemmas
Authors: Burton-Chellew Maxwell N. , D'Amico Victoire
Published: December 2021

Human cooperation is often claimed to be special and requiring explanations based on gene–culture coevolution favouring a desire to copy common social behaviours. If this is true, then individuals should be motivated to both observe and copy common social behaviours. Previous economic experiments, using the public goods game, have suggested individuals' desire to sacrifice for the common good and to copy common social behaviours. However, previous experiments have often not shown examples of success. Here we test, on 489 participants, whether individuals are more motivated to learn about, and more likely to copy, either common or successful behaviours. Using the same social dilemma and standard instructions, we find that individuals were primarily motivated to learn from successful rather than common behaviours. Consequently, social learning disfavoured costly cooperation, even when individuals could observe a stable, pro-social level of cooperation. Our results call into question explanations for human cooperation based on cultural evolution and/or a desire to conform with common social behaviours. Instead, our results indicate that participants were motivated by personal gain, but initially confused, despite receiving standard instructions. When individuals could learn from success, they learned to cooperate less, suggesting that human cooperation is maybe not so special after all.
Out from under the wing: reconceptualizing the insect wing gene regulatory network as a versatile, general module for body-wall lobes in arthropods
Authors: Fisher Cera R. , Kratovil Justin D. , Angelini David R. , Jockusch Elizabeth L.
Published: December 2021

Body plan evolution often occurs through the differentiation of serially homologous body parts, particularly in the evolution of arthropod body plans. Recently, homeotic transformations resulting from experimental manipulation of gene expression, along with comparative data on the expression and function of genes in the wing regulatory network, have provided a new perspective on an old question in insect evolution: how did the insect wing evolve? We investigated the metamorphic roles of a suite of 10 wing- and body-wall-related genes in a hemimetabolous insect,Oncopeltus fasciatus. Our results indicate that genes involved in wing development inO. fasciatusplay similar roles in the development of adult body-wall flattened cuticular evaginations. We found extensive functional similarity between the development of wings and other bilayered evaginations of the body wall. Overall, our results support the existence of a versatile development module for building bilayered cuticular epithelial structures that pre-dates the evolutionary origin of wings. We explore the consequences of reconceptualizing the canonical wing-patterning network as a bilayered body-wall patterning network, including consequences for long-standing debates about wing homology, the origin of wings and the origin of novel bilayered body-wall structures. We conclude by presenting three testable predictions that result from this reconceptualization.
Novel spikey ionocytes are regulated by cortisol in the skin of an amphibious fish
Authors: Ridgway Megan R. , Tunnah Louise , Bernier Nicholas J. , Wilson Jonathan M. , Wright Patricia A.
Published: December 2021

Cortisol is a major osmoregulatory hormone in fishes. Cortisol acts upon the gills, the primary site of ionoregulation, through modifications to specialized ion-transporting cells called ionocytes. We tested the hypothesis that cortisol also acts as a major regulator of skin ionocyte remodelling in the amphibious mangrove rivulus (Kryptolebias marmoratus) when gill function ceases during the water-to-land transition. When out of water,K. marmoratusdemonstrated a robust cortisol response, which was linked with the remodelling of skin ionocytes to increase cell cross-sectional area and Na+-K+-ATPase (NKA) content, but not when cortisol synthesis was chemically inhibited by metyrapone. Additionally, we discovered a novel morphology of skin-specific ionocyte that are spikey with multiple cell processes. Spikey ionocytes increased in density, cell cross-sectional area and NKA content during air exposure, but not in metyrapone-treated fish. Our findings demonstrate that skin ionocyte remodelling during the water-to-land transition in amphibious fish is regulated by cortisol, the same hormone that regulates gill ionocyte remodelling in salinity-challenged teleosts, suggesting conserved hormonal function across diverse environmental disturbances and organs in fishes.
Does healthy lifestyle attenuate the detrimental effects of urinary polycyclic aromatic hydrocarbons on phenotypic aging? An analysis from NHANES 2001–2010
Authors: Yang Zhenqing , Pu Fan , Cao Xingqi , Li Xueqin , Sun Sudan , Zhang Jingyun , Chen Chen , Han Liyuan , Yang Yongli , Wang Wei , Zhang Yawei , Liu Zuyun
Published: December 2021

Objectives

It remains unknown whether healthy lifestyle attenuates the detrimental effects of urinary monohydroxy polycyclic aromatic hydrocarbons (OH-PAHs) on aging. This study aims: 1) to examine the associations of OH-PAHs and lifestyle with Phenotypic Age Acceleration (PhenoAge.Accel), a novel aging measure, respectively; and 2) to evaluate the potential interaction effects of OH-PAHs and lifestyle on PhenoAge.Accel.

Methods

Cross-sectional data of 2579 participants (aged 20-84 years, n=1292 females) from the National Health and Nutrition Examination Survey for years 2001-2010 were analyzed. A lifestyle index was constructed based on five components (drinking, smoking, body mass index, physical activity, and diet), ranging from 0 to 5. We calculated PhenoAge.Accel using algorithms developed previously. General linear regression models were used to examine the associations.

Results

We observed strong associations of OH-PAHs and lifestyle with PhenoAge.Accel. For instance, one unit increase in ∑NAP (sum of 1- and 2-hydroxynaphthalene) was associated with 0.37 year (95% confidence interval [CI]: 0.26, 0.48) increase in PhenoAge.Accel. We did not observe statistically significant interaction effects between OH-PAHs and lifestyle on PhenoAge.Accel. After stratified by sex, we observed strong associations as well as statistically significant interactions of OH-PAHs and lifestyle with PhenoAge.Accel among females.

Conclusions

Both OH-PAHs and lifestyle were independently associated with phenotypic aging and there were statistically significant interactions between OH-PAHs and lifestyle on phenotypic aging among females. The findings highlight the importance of adherence to a healthy lifestyle to attenuate the detrimental effects of exposures to PAHs on phenotypic aging among females.
Modelling the impact of urban and hospital wastewaters eco-exposomes on the antibiotic-resistance dynamics
Authors: Henriot Paul , Buelow Elena , Petit Fabienne , Ploy Marie-Cécile , Dagot Christophe , Opatowski Lulla
Published: December 2021

Antibiotic-resistance emergence and selection have become major public health issues globally. The presence of antibiotic resistant bacteria (ARB) in natural and anthroposophical environments threatens to compromise the sustainability of care in human and animal populations. This study was undertaken to develop a simple model formalizing the selective impact of antibiotics and pollutants on the dynamics of bacterial resistance in water and use the model to analyze longitudinal spatiotemporal data collected in hospital and urban wastewaters. Longitudinal-sampling data were collected between 2012 and 2015 in four different locations in Haute-Savoie, France: hospital and urban wastewaters, before and after water-treatment plants. Concentration in three different types of compounds: 1) heavy metals 2) antibiotics and 3) surfactants; and abundance of 88 individual genes and mobile genetic elements, mostly conferring resistance to antibiotics, were simultaneously collected. A simple hypothesis-driven model describing the weekly ARB dynamics was proposed to fit available data by assuming normalized gene abundance to be proportional to ARB populations in water. Compounds impacts on the dynamics of 17 genes found in multiple sites were estimated. We found that while mercury and vancomycin had relevant effects on ARB dynamics, respectively positively affecting the dynamics of 10 and 12 identified genes, surfactants antagonistically affected genes dynamics (identified for three genes). This simple model enables analyzing the relationship between resistance-gene persistence in aquatic environments and specific compounds inherent to human activities. Applying our model to longitudinal data, we identified compounds that act as co-selectors for antibiotic resistance.

Highlights

We analyzed longitudinal wastewater resistance genes and environmental data

We developed a simple hypothesis-driven model to assess resistance selection

Mercury and vancomycin were key drivers of antibiotic resistance in wastewater
Functional connectivity and information pathways in the human entorhinal-hippocampal circuitry
Authors: Grande Xenia , Sauvage Magdalena , Becke Andreas , Düzel Emrah , Berron David
Published: December 2021

Abstract

Cortical processing streams for item and contextual information come together in the entorhinal-hippocampal circuitry. Various evidence suggest that information-specific pathways organize the cortical – entorhinal interaction and the circuitry’s inner communication along the transversal axis. Here, we leveraged ultra-high field functional imaging and advance Maass, Berron et al. (2015) who report two functional routes segregating the entorhinal cortex (EC) and subiculum. Our data show specific scene processing in the functionally connected posterior-medial EC and distal subiculum. The regions of another route, that connects the anterior-lateral EC and a newly identified retrosplenial-based anterior-medial EC subregion with the CA1/subiculum border, process object and scene information similarly. Our results support topographical information flow in human entorhinal-hippocampal subregions with organized convergence of cortical processing streams and a unique route for contextual information. They characterize the functional organization of the circuitry and underpin its central role in memory function and pathological decline.
Integration of public DNA methylation and expression networks via eQTMs improves prediction of functional gene–gene associations
Authors: Li Shuang , Qi Cancan , Deelen Patrick , Boulogne Floranne , de Klein Niek ,   BIOS Consortium, Koppelman Gerard H. , van der Velde K. Joeri , Franke Lude , Swertz Morris A. , Westra Harm-Jan
Published: December 2021

Gene co-expression networks can be used to infer functional relationships between genes, but they do not work well for all genes. We investigated whether DNA methylation can provide complementary information for such genes. We first carried out an eQTM meta-analysis of 3,574 gene expression and methylation samples from blood, brain and nasal epithelial brushed cells to identify links between methylated CpG sites and genes. This revealed 6,067 significant eQTM genes, and we observed that histone modification information is predictive of both eQTM direction and presence, enabling us to link many CpG sites to genes. We then generated a co-methylation network – MethylationNetwork – using 27,720 publicly available methylation profiles and integrated it with a public RNA-seq co-expression dataset of 31,499 samples. Here, we observed that MethylationNetwork can identify experimentally validated interacting pairs of genes that could not be identified in the RNA-seq datasets. We then developed a novel integration pipeline based on CCA and used the integrated methylation and gene networks to predict gene pairs reported in the STRING database. The integrated network showed significantly improved prediction performance compared to using a DNA co-methylation or a gene co-expression network alone. This is the first study to integrate data from two -omics layers from unmatched public samples across different tissues and diseases, and our results highlight the issues and potential of integrating public datasets from multiple molecular phenotypes. The eQTMs we identified can be used as an annotation resource for epigenome-wide association, and we believe that our integration pipeline can be used as a framework for future -omics integration analyses of public datasets.

We provide supporting materials and results, including the harmonized DNA methylation data from multiple tissues and diseases in https://data.harmjanwestra.nl/comethylation/, the discovered and predicted eQTMs, the corresponding CCA components and the trained prediction models in a Zenodo repository (https://zenodo.org/record/4666994). We provide notebooks to facilitate use of the proposed pipeline in a GitHub repository (https://github.com/molgenis/methylationnetwork).
Planning the potential future during multi-item visual working memory
Authors: Nasrawi Rose , van Ede Freek
Published: December 2021

Working memory allows us to retain visual information to guide upcoming future behavior. In line with this future-oriented purpose of working memory, recent studies have shown that action planning occurs during encoding and retention of a single visual item, for which the upcoming action is certain. We asked whether and how this extends to multi-item visual working memory, when visual representations serve the potential future. Human participants performed a visual working memory task with a memory-load manipulation (one/two/four items), and a delayed orientation-reproduction report (of one item). We measured EEG to track 15-25 Hz beta activity in electrodes contralateral to the required response hand – a canonical marker of action planning. We show an attenuation of beta activity, not only in load one (with one certain future action), but also in load two (with two potential future actions), compared to load four (with low prospective-action certainty). Moreover, in load two, potential action planning occurs regardless whether both visual items afford similar or dissimilar manual responses; and it predicts the speed of ensuing memory-guided behavior. This shows that potential action planning occurs during multi-item visual working memory, and brings the perspective that working memory helps us prepare for the potential future.