bluuebunny/crossref_metadata_2025 huggingface dataset:
Automated proximal coronary artery calcium identification using artificial intelligence: advancing cardiovascular risk assessment
Authors: Zhou Jianhang , Shanbhag Aakash D , Han Donghee , Marcinkiewicz Anna M , Buchwald Mikolaj , Miller Robert J H , Killekar Aditya , Manral Nipun , Grodecki Kajetan , Geers Jolien , Pieszko Konrad , Yi Jirong , Zhang Wenhao , Waechter Parker , Gransar Heidi , Dey Damini , Berman Daniel S , Slomka Piotr J
Published: January 2025

Aims

Identification of proximal coronary artery calcium (CAC) may improve prediction of major adverse cardiac events (MACE) beyond the CAC score, particularly in patients with low CAC burden. We investigated whether the proximal CAC can be detected on gated cardiac CT and whether it provides prognostic significance with artificial intelligence (AI).

Methods and results

A total of 2016 asymptomatic adults with baseline CAC CT scans from a single site were followed up for MACE for 14 years. An AI algorithm to classify CAC into proximal or not was created using expert annotations of total and proximal CAC and AI-derived cardiac structures. The algorithm was evaluated for prognostic significance on AI-derived CAC segmentation. In 303 subjects with expert annotations, the classification of proximal vs. non-proximal CAC reached an area under receiver operating curve of 0.93 [95% confidence interval (CI) 0.91–0.95]. For prognostic evaluation, in an additional 588 subjects with mild AI-derived CAC scores (CAC score 1–99), the AI proximal involvement was associated with worse MACE-free survival (P = 0.008) and higher risk of MACE when adjusting for CAC score alone [hazard ratio (HR) 2.28, 95% CI 1.16–4.48, P = 0.02] or CAC score and clinical risk factors (HR 2.12, 95% CI 1.03–4.36, P = 0.04).

Conclusion

The AI algorithm could identify proximal CAC on CAC CT. The proximal location had modest prognostic significance in subjects with mild CAC scores. The AI identification of proximal CAC can be integrated into automatic CAC scoring and improves the risk prediction of CAC CT.
An ensemble learning model for detection of pulmonary hypertension using electrocardiogram, chest X-ray, and brain natriuretic peptide
Authors: Kishikawa Risa , Kodera Satoshi , Setoguchi Naoto , Tanabe Kengo , Kushida Shunichi , Nanasato Mamoru , Maki Hisataka , Fujita Hideo , Kato Nahoko , Watanabe Hiroyuki , Takahashi Masao , Sawada Naoko , Ando Jiro , Sato Masataka , Sawano Shinnosuke , Shinohara Hiroki , Nakanishi Koki , Minatsuki Shun , Ishida Junichi , Fujiu Katsuhito , Akazawa Hiroshi , Morita Hiroyuki , Takeda Norihiko
Published: January 2025

Aims

Delayed diagnosis of pulmonary hypertension (PH) is a known cause of poor patient prognosis. We aimed to develop an artificial intelligence (AI) model, using ensemble learning method to detect PH using electrocardiography (ECG), chest X-ray (CXR), and brain natriuretic peptide (BNP), facilitating accurate detection and prompting further examinations.

Methods and results

We developed a convolutional neural network model using ECG data to predict PH, labelled by ECG from seven institutions. Logistic regression was used for the BNP prediction model. We referenced a CXR deep learning model using ResNet18. Outputs from each of the three models were integrated into a three-layer fully connected multimodal model. Ten cardiologists participated in an interpretation test, detecting PH from patients’ ECG, CXR, and BNP data both with and without the ensemble learning model. The area under the receiver operating characteristic curves of the ECG, CXR, BNP, and ensemble learning model were 0.818 [95% confidence interval (CI), 0.808–0.828], 0.823 (95% CI, 0.780–0.866), 0.724 (95% CI, 0.668–0.780), and 0.872 (95% CI, 0.829–0.915). Cardiologists’ average accuracy rates were 65.0 ± 4.7% for test without AI model and 74.0 ± 2.7% for test with AI model, a statistically significant improvement (P < 0.01).

Conclusion

Our ensemble learning model improved doctors’ accuracy in detecting PH from ECG, CXR, and BNP examinations. This suggests that earlier and more accurate PH diagnosis is possible, potentially improving patient prognosis.
How do hospitals exert market power? Evidence from health systems and commercial health plan prices
Authors: Li Suhui (Evelyn) , Jones David , Rich Eugene , Lansdale Aimee
Published: January 2025

Consolidation of independent hospitals and physician practices into integrated health systems has reshaped the delivery of health care. While the literature suggests that provider consolidation raises prices, few studies have examined the interplay of health systems and insurers in relation to prices. Using negotiated price data that commercial insurers recently released under the Transparency in Coverage Final Rule, we examined the association between hospital concentration under health systems and prices for outpatient procedures in local health care markets with different levels of insurer concentration. We found that hospital prices are higher in more concentrated hospital markets, while lower in more concentrated insurer markets. However, the negative relationship between insurer concentration and hospital prices is attenuated in highly concentrated hospital markets, suggesting that insurers' bargaining leverage is lessened at greater levels of hospital consolidation. Considering the continued consolidation among hospitals and vertical integration of physician practices into health systems, our findings suggest that commercial payers may encounter increased challenges in controlling health care spending for their beneficiaries as providers' bargaining power continues to grow.
Intersectional legal academy
Authors: Atrey Shreya
Published: January 2025

This Afterword to Gráinne de Búrca, Rosalind Dixon, and Marcela Prieto Rudolphy’s Foreword “Gender and the Legal Academy” picks up on and interrogates a point made by the authors—that a feminist legal academy is needed for gender equality in the academy. It shows that a truly feminist legal academy has to be intersectional, both normatively and practically. This has implications, as intersectionality necessarily excludes exclusive or limiting ideas of feminism. Whether a legal academy is able to embrace the full force of an intersectional legal academy depends on the context in which that academy is situated and the acceptance of intersectionality in that context.
Impact of kernel hardness, protein and total starch content on wheat starch digestibility
Authors: Du Mei , Deng Guangbin , Liu Rong , Lu Jing , Wang Mingxiu , Cheng Jiasheng , Luo Xuelian , Zhang Lei , Zhang Chihong , Li Yunfang , Wu Yu
Published: January 2025

Wheat starch digestibility is crucial for its nutritional value, yet the impact of kernel hardness, protein content, and total starch content on this process remains unclear. To investigate this, we analysed 272 wheat varieties that were collected worldwide for hardness index (HI), grain protein content (GP), total starch content (TS), rapidly digestible starch content (RDS), slowly digestible starch content (SDS), and resistant starch content (RS). Correlation and regression analysis revealed that increased kernel hardness is associated with higher RDS and lower SDS, while GP negatively correlates with RS, and TS positively influences RS. Path analysis shows that TS has a stronger impact on starch digestibility, whereas the effect of GP is weaker. The results suggest that wheat varieties with softer kernels, higher TS, and lower GP content exhibit slower starch digestion, offering insights for breeding strategies to improve nutritional quality.
Unmasking Long QT Syndrome in a Serviceman: Effects of Hypoglycemia and a Flight Duty Medical Examination
Authors: Olatunbosun Samuel T , Neely Joseph L , Ha Leslie T , Babu Vedesh K
Published: January 2025

We report the case of a 29-year-old male soldier with a time in service above 10 years, found to have asymptomatic long QT syndrome (LQTS), a condition associated with increased risk of potentially fatal ventricular arrhythmias, during a flight physical. A review of his past medical history revealed a transient QT prolongation during an episode of hypoglycemia due to endogenous hyperinsulinism caused by an insulinoma, as an infantryman 7 years earlier; the resolution of the QT prolongation was spontaneous. He was evaluated and considered fit for duty by cardiology. Before returning to duty, he underwent a Whipple procedure for the resection of the insulinoma; there was no sequela or recurrence. Seven years later, he was noted to have QT prolongation on a resting electrocardiogram during a routine evaluation to obtain clearance for advanced schooling to become a helicopter pilot. Consequently, he underwent additional workup including genetic testing and was found to be heterozygous for a well-known pathogenic variant KCNQ1: c.1031C > T (p.Ala344Val), LQT1 locus, and additionally for a rare variant in the SNTA1 gene, SNTA1: c.1003_1021dup (p.Ala341Glufs*103), LQT12 locus. The clinical implication, management, and the medical retention determination are presented. We conclude that the stringent requirement for an electrocardiogram as part of medical evaluation for fitness for flight duties in the U.S. Military setting facilitated the detection of an otherwise occult LQTS in this asymptomatic young serviceman. Retrospectively, the LQTS was transiently unmasked during an episode of hypoglycemia. Hypoglycemia deserves more recognition as a potential cause of QT prolongation.
Punctuated versus gradual shifts in the multivariate evolutionary process: a test with paired radiations of scincid lizards
Authors: Stepanova Natasha , Boyko James D , Lin Jada , Davis Rabosky Alison R , Rabosky Daniel L
Published: January 2025

As lineages become separated in time, they are expected to accumulate mutational (or developmental-genetic) differences that influence the macroevolutionary trajectories of those lineages even under similar environmental conditions. Here, we compare the dynamics of phenotypic evolution in radiations of scincid lizards from Australia and Madagascar that are separated by more than 100 million years of independent evolution and show rampant phenotypic parallelism. We collected linear measurements of the skull, limbs, and limb girdles from micro-CT scans of 94 Australian and 29 Malagasy species. Using multivariate comparative methods, we tested whether the underlying evolutionary covariance structure for this superficial parallelism was conserved and whether these patterns were consistent across distinct functional modules. Malagasy and most Australian skinks have similar covariance matrices for skull evolution. Results are ambiguous for limbs and limb girdles, as some trait subsets support different evolutionary processes and for other subsets, a shared covariance matrix could not be rejected. However, across most trait sets, the extremely speciose Australian genus Ctenotus exhibits a radically different covariance structure from all other lizards in these groups, including several closely related genera. The shift in Ctenotus demonstrates that the architecture of trait correlations can change at relatively shallow timescales and may explain the unique position of this clade in morphospace relative to other scincid lizards from both geographic regions. More generally, our results demonstrate that the multivariate evolutionary process can change dramatically in a relatively short period of time.
Efficacy of programs containing synthetic and biorational fungicides for control of brown rot in peach, 2024
Authors: Wesche Johanna , Schnabel Guido , Hopkins Jeffrey
Published: January 2025

Brown rot, caused in the southeastern United States by the fungal pathogen Monilinia fructicola, is one of the most devastating diseases of peach in humid peach production regions of the United States. On mature or ripening fruit, brown rot typically develops as a rapidly spreading, firm, brown decay. This report evaluates the efficacy of spray programs with synthetic and biorational fungicides for the management of brown rot. The trial was conducted in 2024 in Seneca, SC on 10-year-old Prunus persica var. nucipersica ‘Juneprincess’ nectarines. Results from these trials will help advise U.S. peach producers in developing management programs for this disease.
Efficacy of biorational fungicide programs for control of brown rot in peach, 2024
Authors: Schnabel Guido , Gura William P. , Hopkins Jeffrey
Published: January 2025

Brown rot, caused by the fungal pathogen Monilinia fructicola, is one of the most devastating diseases of peach in humid peach production regions of the southeastern United States. On mature or ripening fruit, brown rot typically develops as a rapidly spreading, firm, brown decay. This report evaluates the efficacy of spray programs with biorational fungicides for the management of green fruit rot and brown rot. The trial was conducted in 2024 in Seneca, SC on 10-year-old Prunus persica ‘Juneprince’ peaches. Results from these trials will help advise U.S. peach producers in developing management programs for this disease.
Evaluation of fungicide products to control Botrytis fruit rot and Anthracnose fruit rot in annual strawberry in South Carolina, 2023-24
Authors: Wesche Johanna , Schnabel Guido , Hopkins Jeffrey
Published: January 2025

Botrytis fruit rot and Anthracnose fruit rot, caused in the southeastern United States by the fungal pathogens Botrytis cinerea and Colletotrichum nymphaea, respectively, are some of the most devastating diseases of strawberry in humid strawberry production regions of the United States. On mature or ripening fruit, Botrytis fruit rot typically develops as a rapidly spreading, soft, light to medium brown decay often covered with gray masses of mycelium, conidiophores and conidia. Anthracnose fruit rot develops into firm, round lesions, which often turn dark brown to black but may remain tan. This report evaluates the efficacy of spray programs with synthetic and biological fungicides for the management of Botrytis fruit rot and Anthracnose fruit rot. The trial was conducted in spring of 2024 in Seneca, SC on Fragaria x ananassa ‘Albion’ plants that were planted as plugs the previous fall in plastic mulch. Results from these trials will help advise U.S. strawberry producers in developing management programs for these diseases.
Public Xylazine Awareness and Support for Policies and Initiatives to Address the Xylazine Threat among US Adults
Authors: Golan Olivia K. , Liu Weiwei , Taylor Bruce
Published: January 2025

Objectives

Xylazine, a nonopioid veterinary tranquilizer, is increasingly being added to the illicit opioid supply. When used by humans, xylazine can cause severe skin ulcers and extreme sedation. This study aimed to examine awareness of xylazine and support for policies/initiatives to address the xylazine threat among US adults.

Methods

An AmeriSpeak survey with US nationally representative adults aged 18 and older was administered in March 2024. Survey questions assessed awareness of xylazine and potential xylazine use, drug/opioid use history, and support for 10 policies/initiatives to address the xylazine threat (including a range of drug checking initiatives, wound care initiatives, punitive policies, harm reduction policies, and xylazine education campaigns). We conducted weighted descriptive and regression analysis of survey data from a nationally representative sample of 1215 US adults.

Results

Most respondents were not aware of xylazine (88%, n = 1063). Approximately 10% (n = 117) were aware of xylazine but had not used it, and around 2% (n = 23) were aware of xylazine and possibly had used it. On average, participants supported only 1.52 (SD = 2.41) of 10 listed policies/initiatives to address the xylazine threat. The number of policies/initiatives supported varied by xylazine awareness, gender, marital status, and drug use history.

Conclusions

Among the US public, xylazine awareness and support for policies/initiatives to address the xylazine threat are low. Public xylazine educational campaigns may be warranted to help the public understand the severity of the xylazine threat, garner support for associated policies/initiatives, and reduce xylazine-related harms.
Explaining deuterium-depleted water as a cancer therapy: a narrative review
Authors: Kyriakopoulos Anthony M. , Seneff Stephanie
Published: January 2025

Deuterium is a natural heavy isotope of hydrogen, containing a neutron and a proton. This gives it distinct biophysical and biochemical properties, compared with hydrogen. Deuterium alters enzymatic activity in significant ways. Human metabolic processes minimize the amount of deuterium in mitochondrial water, because it causes a dysfunction in mitochondrial ATPase pumps, leading to excessive reactive oxygen species (ROS) and loss of ATP production. Mitochondrial dysfunction is a characteristic feature of cancer and many other diseases. Lactate plays an important role in cancer progression, and a central role holds also for vacuolar ATPases (V-ATPases). In the presence of excess deuterium, cancer cells show a remarkably altered metabolic policy, enabling invasion and proliferation. Cancer cells protect their mitochondria from excessive ROS by minimizing the use of ATPase to synthesize ATP. Instead, they rely on glycolysis to supply ATP and support the massive synthesis of lactate, which is excreted into the microenvironment. They also use V-ATPases in an unusual way at the plasma membrane to pump deuterium-depleted protons out of the cell, enriching cytoplasmic deuterium. These complex processes suggest that cancer cells are able to sense deuterium levels in the medium and commit apoptosis when deuterium levels are low or proliferate when they are high. Tumorigenesis involves a metabolic switch that supports increased cellular deuterium levels, decreasing the deuterium burden overall in the organism. Strong clinical evidence supports deuterium-depleted water (DDW) as an anticancer treatment. More investigations on cancer autophagic behavior are needed to guide DDW clinical use.
Phenol Dilution With Saline Solution Versus Alcohol in Partial Matricectomy for Onychocryptosis
Authors: Espiñeira Sicre Joaquín , García Sirvent Lucía , Ruiz Sánchez Juan , Álvarez Chinchilla Pedro , García Fernández Laura , Miralles Botella Julia
Published: January 2025

BACKGROUND

Onychocryptosis significantly impacts quality of life. Chemical partial matricectomy with phenol is a common surgical treatment. The use of alcohol as a solvent during this procedure has been controversial. In vitro studies suggest that physiologic saline solution (PSS) may be a more effective solvent for phenol.

OBJECTIVE

To evaluate the in vivo efficacy of PSS as a phenol solvent, in terms of postoperative outcomes, compared to alcohol.

METHODS

A retrospective unicentric cohort study was conducted on patients who underwent partial chemical matricectomy with phenol for onychocryptosis. Sociodemographic and clinical variables were collected and compared between the alcohol and PSS groups. Clinical staging followed Martinez Nova and colleagues' classification. Patients were followed up over a 12-month period to assess postoperative complications.

RESULTS

The study population demonstrated typical characteristics of onychocryptosis, with a median age of 20 years. No statistically significant differences were found between the groups in terms of pain, infections, or bleeding postoperatively. There were also no differences in terms of recurrence, days of analgesic use, or need for antibiotic therapy (p > .05).

CONCLUSION

The results suggest that PSS is as effective and safe as alcohol as a solvent for phenol in chemical partial matricectomy.
Gestational exposure to PM2.5, NO2, and sex steroid hormones: Identifying critical windows of exposure in the Rochester UPSIDE Cohort
Authors: Kahwaji Mariah , Duttweiler Luke , Thurston Sally W. , Harrington Donald , Miller Richard K. , Murphy Susan K. , Wang Christina , Brunner Jessica , Ge Yihui , Lin Yan , Hopke Philip K. , O’Connor Thomas G. , Zhang Junfeng J. , Rich David Q. , Barrett Emily S.
Published: January 2025

Background:

Sex steroid hormones are critical for maintaining pregnancy and optimal fetal development. Air pollutants are potential endocrine disruptors that may disturb sex steroidogenesis during pregnancy, potentially leading to adverse health outcomes.

Methods:

In the Environmental influences on Child Health Outcomes Understanding Pregnancy Signals and Infant Development pregnancy cohort (Rochester, NY), sex steroid concentrations were collected at study visits in early-, mid-, and late-pregnancy in 299 participants. Since these visits varied by the gestational age at blood draw, values were imputed at 14, 22, and 30 weeks gestation. Daily NO2 and PM2.5 concentrations were estimated using random forest models, with daily concentrations from each 1-km2 grid containing the subject’s residence. Associations between gestational week mean NO2 and PM2.5 concentrations and sex steroid concentrations were examined utilizing distributed lag nonlinear models.

Results:

Each interquartile range (IQR = 9 ppb) increase in NO2 during weeks 0–5 was associated with higher early-pregnancy total testosterone levels (cumulative β = 0.45 ln[ng/dl]; 95% CI = 0.07, 0.83), while each IQR increase in NO2 during weeks 12–14 was associated with lower early-pregnancy total testosterone levels (cumulative β = −0.27 ln[ng/dl]; 95% CI = −0.53, −0.01). Similar NO2 increases during gestational weeks 0–14 were associated with higher late-pregnancy estradiol concentrations (cumulative β = 0.29 ln[pg/ml]; 95% CI = 0.10, 0.49), while each IQR increase in NO2 concentrations during gestational weeks 22–30 was associated with lower late-pregnancy estradiol concentrations (cumulative β = −0.18 ln[pg/ml]; 95% CI = −0.34, −0.02). No associations with PM2.5 were observed, except for an IQR increase in PM2.5 concentrations (IQR = 4 µg/m3) during gestational weeks 5–11 which was associated with lower late-pregnancy estriol levels (cumulative β = −0.16 ln[ng/ml]; 95% CI = −0.31, −0.00).

Conclusions:

Residential NO2 exposure was associated with altered sex steroid hormone concentrations during pregnancy with some indication of potential compensatory mechanisms.
Is Topical Tranexamic Acid Effective in Reducing Hematoma and Seroma in Breast Surgery? A Systematic Review and Meta-analysis
Authors: Hashemi Ammar S.A. , Hussein Sara M. , Alshehab Zainab H. , Al Qurashi Abdullah A. , Kreutz-Rodrigues Lucas , Sharaf Basel A.
Published: January 2025

Background:

Postoperative fluid-related complications, such as hematoma and seroma formation, are common concerns in breast surgery, adversely affecting surgical outcomes and patient recovery. Topical tranexamic acid (TXA) has emerged as a promising intervention to minimize bleeding while reducing systemic adverse effects linked to intravenous administration. However, evidence on the efficacy of topical TXA in breast surgery remains sparse.

Methods:

This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English-language databases were searched through April 2024 to identify randomized controlled trials and cohort studies assessing the effects of topical TXA on postoperative outcomes in breast surgery, including hematoma, seroma, infection rates, and drain output/duration.

Results:

Six studies, encompassing 823 patients and 1477 breasts, were included. Subgroup meta-analysis demonstrated a statistically significant reduction in hematoma rates in patients who underwent mastectomy (risk ratio [RR] = 0.14; 95% confidence interval [CI], 0.03–0.78; P = 0.02), but not in patients who underwent breast reduction (RR = 0.76; 95% CI, 0.08–7.08; P = 0.24). No significant differences were found in overall hematoma rates (RR = 0.32; 95% CI, 0.08–1.195; P = 0.09), seroma formation (RR = 1.22; 95% CI, 0.99–1.51; P = 0.07), or infection rates (RR = 0.85; 95% CI, 0.46–1.56; P = 0.59).

Conclusions:

Topical TXA significantly reduced hematoma rates in patients who underwent mastectomy but showed no significant effect on other outcomes. Larger studies with standardized methodologies are required to fully establish the role of topical TXA in optimizing breast surgery outcomes.
Chimeric Osteocutaneous Free Flap Solution to Variation in Vascular Anatomy
Authors: Deering Augustine J. , Harrah Payden A. , Won Brian Wong , Austin John Michael , Khan Mustafa T. , Ferrell Jay K. , Fries C. Anton
Published: January 2025

When squamous cell carcinoma necessitates mandibular resection, the resultant defect can be complex. An osteocutaneous fibula free flap is an effective reconstruction option, typically supplied by the peroneal artery for both the fibula and skin flap. In this case report, an anatomical variation was found: the skin paddle was supplied by soleus musculocutaneous perforators of the posterior tibial artery, whereas the fibula was supplied by the peroneal artery. The posterior tibial artery perforator vessels from the skin paddle were anastomosed to the distal end of the peroneal vessels. The peroneal vessels were anastomosed to the left superior thyroid artery and a branch of the internal jugular vein, with confirmation of adequate blood flow via implantable Doppler signal. Septocutaneous perforators from the peroneal artery are absent in 5%–10% of the population; thus, an approach to anomalous vasculature in the setting of fibula free flap harvest that decreases morbidity and multiple operations is valuable.
Risks of Autologous Abdominal Free Flap Breast Reconstruction in Patients With Elevated Body Mass Index
Authors: Teitler Nathaniel A. , Doherty Courtney J. , Adams Madalyn R. , Podber Anna A. , Granger Peter M. , Samson Kaeli K. , Figy Sean C. , Wong Shannon L. , Hon Heidi H.
Published: January 2025

Background:

Obesity is widely recognized as a significant risk factor for postoperative complications of breast reconstruction. Despite extensive research, there remains a lack of consensus regarding the specific complications and outcomes experienced by patients with obesity who undergo deep inferior epigastric perforator (DIEP) flap reconstruction. To provide a clearer understanding of the challenges faced by patients with obesity, we present a single-center outcome analysis of individuals who underwent DIEP flap reconstruction.

Methods:

A cohort of 194 patients who underwent at least 1 DIEP flap was retrospectively analyzed at the University of Nebraska Medical Center utilizing electronic medical records. Patients who underwent DIEP flap breast reconstruction were organized into 5 categories using World Health Organization weight status by body mass index (BMI) obtained from the day of surgery. Surgical complications within 120 days and postsurgical complication-related procedural interventions were also evaluated and compared. Comparisons of variables of interest between weight groups were assessed using Mantel–Haenszel chi-square tests or Spearman correlations.

Results:

Increases in patient weight category were associated with increased length of operation (P = 0.003), increased rates of breast fat necrosis (P = 0.04), breast wound dehiscence (P = 0.01), abdominal wound dehiscence (P = 0.02), numbers of abdominal complications (P = 0.001), and rates of requiring an intervention (P = 0.03).

Conclusions:

The findings imply that higher BMI values may lead to a higher likelihood of postoperative complications and the need for intervention. It is crucial for patients with obesity to be aware of the elevated risk associated with rising BMI values.
“Nip and Tuck”: Training the Next Generation of Aesthetic Plastic Surgeons
Authors: Cheung Lok Ka , Skepastianos Vasilios , Kostopoulos Epameinodas , Skepastianos Georgios
Published: January 2025

The demand for aesthetic surgery continues to increase, and it is therefore essential to ensure that the next generation of plastic surgeons are adequately trained. We propose a safe method in aesthetic training in abdominoplasty and facelift, utilizing free deep inferior epigastric perforator (DIEP) flap and parotidectomy for training aesthetic procedures. The trainees’ focus differed between the 2 procedures. In the DIEP cases, the trainees’ focus was the preoperative marking of the abdomen; elevation of the abdominoplasty flap; rectus plication; and quilting of the abdominoplasty flap to the rectus sheath and umbiloplasty. In the parotidectomy cases, the focus was skin flap elevation using the classic face lift incision; superficial musculoaponeurotic system flap elevation; superficial musculoaponeurotic system; and skin redraping. A questionnaire was given to all involved trainees for evaluation after the training exercises in aesthetic surgery, this included how they felt about performing aesthetic procedures afterwards, their level of knowledge, and their confidence in performing abdominoplasty and rhytidectomy. The results of the trainee questionnaires were positive; competence and level of confidence were high. There were minor complications including wound healing problems but no revisions. This training procedure can be safely applied during plastic surgery training under safe conditions.
Dimples as Desired Outcomes: Rethinking Their Role in Thread Lifting Procedures
Authors: Yi Kyu-Ho , Chua Deborah
Published: January 2025

Facial thread lifts, known for being minimally invasive with quick results, can sometimes lead to dimpling. A case report of a 35-year-old Asian man who developed a pleasing unilateral dimple after a thread lift highlights the potential for intentional dimple creation through this method. With surgical dimple creation in demand, as dimples symbolize good luck in Chinese culture and beauty in Arabic traditions, thread lifts may offer a less invasive alternative for those seeking dimples without surgery. The patient in the case report was satisfied and chose not to reduce the dimple, though further studies are needed to ensure safety and improve patient satisfaction.
Adverse effect of Henle fiber layer hemorrhage due to retinal arterial macroaneurysm rupture on retinal sensitivity
Authors: Akatsuka Riku , Kimura Shuhei , Doi Shinichiro , Hosokawa Mio Morizane , Shiode Yusuke , Matoba Ryo , Morita Tetsuro , Morizane Yuki
Published: January 2025

Purpose:

To investigate the effect of Henle fiber layer hemorrhage (HFLh) on retinal sensitivity (RS) before and after displacement of the submacular hemorrhage (SMH) caused by retinal arterial macroaneurysm (RAM) rupture.

Methods:

This retrospective study included 31 eyes undergoing vitrectomy for SMH. Eyes were grouped based on the presence or absence of HFLh (HFLh [+/-] group). RS was assessed in the fovea and in the area of the HFLh present preoperatively.

Results:

The HFLh (+) and HFLh (-) groups had 21 and 10 eyes, respectively. Both groups showed improved postoperative foveal RS (both P < 0.05), which was significantly higher in the HFLh (-) group (P = 0.02). In the HFLh (+) group, RS was significantly lower in the affected eye when compared to the fellow eye (P < 0.01), whereas in the HFLh (-) group, no significant difference was noted between both eyes (P = 0.58). Despite the significant improvement in the postoperative RS in areas with preoperative HFLh (P < 0.001), it remained lower than the RS of the fellow eye (P < 0.05).

Conclusion:

SMH displacement improved RS regardless of HFLh presence, although the degree of improvement was limited in the presence of HFLh.
What is the phenotype of heterozygous lipoprotein lipase deficiency?
Authors: Hegele Robert A.
Published: January 2025

Purpose of review

Genetic testing of patients with severe hypertriglyceridemia often identifies a single heterozygous pathogenic variant in the LPL gene. The complex and variable phenotype associated with this genotype is the topic of this review.

Recent findings

Previous research showed that heterozygosity for lipoprotein lipase deficiency is associated with reduced but variable post heparin lipolytic activity alongside inconsistent plasma lipid phenotypes ranging from normal to mild-to-moderate to severe hypertriglyceridemia. Recent research confirms and extends these observations, showing that a heterozygous individual can express a highly variable phenotype over time, depending on the presence of secondary factors. About 10% (range 8–20%) of patients with severe hypertriglyceridemia or multifactorial chylomicronemia syndrome are heterozygous for a rare pathogenic LPL variant, and a clinically relevant minority of these has recalcitrant or sustained hypertriglyceridemia.

Heterozygosity for lipoprotein lipase deficiency predisposes to hypertriglyceridemia, which is sometimes severe depending on secondary factors, but is typically quite responsive to routine interventions such as diet, lifestyle and existing lipid-lowering therapies. However, many heterozygotes for pathogenic variants in LPL have completely normal plasma lipids.
Evaluation of the Reliability of ChatGPT to Provide Guidance on Recombinant Zoster Vaccination for Patients With Rheumatic and Musculoskeletal Diseases
Authors: Sood Akhil , Moyer Amanda , Jahangiri Pegah , Mar Diane , Nitichaikulvatana Prachaya , Ramreddy Nitya , Stolyar Liya , Lin Janice
Published: January 2025

Introduction

Large language models (LLMs) such as ChatGPT can potentially transform the delivery of health information. This study aims to evaluate the accuracy and completeness of ChatGPT in responding to questions on recombinant zoster vaccination (RZV) in patients with rheumatic and musculoskeletal diseases.

Methods

A cross-sectional study was conducted using 20 prompts based on information from the Centers for Disease Control and Prevention (CDC), the Advisory Committee on Immunization Practices (ACIP), and the American College of Rheumatology (ACR). These prompts were inputted into ChatGPT 3.5. Five rheumatologists independently scored the ChatGPT responses for accuracy (Likert 1 to 5) and completeness (Likert 1 to 3) compared with validated information sources (CDC, ACIP, and ACR).

Results

The overall mean accuracy of ChatGPT responses on a 5-point scale was 4.04, with 80% of responses scoring ≥4. The mean completeness score of ChatGPT response on a 3-point scale was 2.3, with 95% of responses scoring ≥2. Among the 5 raters, ChatGPT unanimously scored with high accuracy and completeness to various patient and physician questions surrounding RZV. There was one instance where it scored with low accuracy and completeness. Although not significantly different, ChatGPT demonstrated the highest accuracy and completeness in answering questions related to ACIP guidelines compared with other information sources.

Conclusions

ChatGPT exhibits promising ability to address specific queries regarding RZV for rheumatic and musculoskeletal disease patients. However, it is essential to approach ChatGPT with caution due to risk of misinformation. This study emphasizes the importance of rigorously validating LLMs as a health information source.
Women at the receiving end: Exploring Couples’ experiences of infertility challenges in Nigeria
Authors: Esan Deborah Tolulope , Nnamani Kelechukwu Queendaline , Olajide Adetunmise Oluseyi , Akingbade Oluwadamilare , Oluwade David Bamidele , Olawade David Bamidele , Ramos Carlos Guillermo
Published: January 2025

Background

Infertility remains a significant global health issue with profound emotional and social consequences, particularly in patriarchal societies. This study explores the lived experiences of infertile couples in Nigeria, focusing on societal perceptions, gendered blame, and the role of spirituality.

Methods

A qualitative exploratory design was adopted, with data collected from purposively sampled infertile couples attending the Federal Teaching Hospital, Ido-Ekiti, Nigeria. Semi-structured interviews were conducted, and thematic analysis was used to identify recurring patterns and themes.

Results

Thematic analysis identified two main themes and seven sub-themes. The first theme, Couples’Perception of Infertility, included five sub-themes: definition of infertility, perceived causes, perceived types, infertility as a feminine issue, and the role of spirituality. The second theme, Challenges of Couples Experiencing Infertility, comprised two sub-themes: women at the receiving end and poor societal support.

Conclusion

The findings shows the interplay of medical, cultural, and spiritual dimensions in shaping infertility perceptions. The study highlights the disproportionate burden on women and inadequate societal support, calling for public health interventions to address stigma and promote gender-inclusive reproductive health education.
The impact of Indigenous American-like ancestry on risk of acute lymphoblastic leukemia in Hispanic/Latino children
Authors: Langie Jalen , Chan Tsz Fung , Yang Wenjian , Kang Alice Y. , Morimoto Libby , Stram Daniel O. , Mancuso Nicholas , Ma Xiaomei , Metayer Catherine , Lupo Philip J. , Rabin Karen R. , Scheurer Michael E. , Wiemels Joseph L. , Yang Jun J. , de Smith Adam J. , Chiang Charleston W.K.
Published: January 2025

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer, with Hispanic/Latino children having a higher incidence of ALL than other racial/ethnic groups. Genetic variants, particularly ones found enriched in Indigenous American (IA)-like ancestry and inherited by Hispanics/Latinos, may contribute to this disparity. In this study, we characterized the impact of IA-like ancestry on overall ALL risk and the frequency and effect size of known risk alleles in a large cohort of self-reported Hispanic/Latino individuals. We also performed genome-wide admixture mapping analysis to identify potentially novel ALL risk loci. We found that global IA ancestry was positively associated with ALL risk, but the association was not significant after adjusting for socio-economic indicators. In a series of local ancestry analyses, we uncovered that at known ALL risk loci, increasing copies of the IA-like haplotype were positively and significantly associated with ALL case-control status. Further, the IA-like haplotype had ∼1.33 times the odds of harboring the risk allele compared to non-IA-like haplotypes. We found no evidence of interaction between genotype and ancestry (local or global) in relation to ALL risk. Admixture mapping identified association signals on chromosomes 2 (2q21.2), 7 (7p12.2), 10 (10q21.2), and 15 (15q22.31); however, only the variants at 7p12.2 and 10q21.2 replicated in additional cohorts. Taken together, our results suggest that increased risk of ALL in Hispanic/Latino children may be conferred by higher frequency of risk alleles within IA-like ancestry, which can be leveraged as targets of new precision health strategies and therapeutics.
Unveiling the influence of salt concentration on the different stages of the catalytic cycle of a halophilic enzyme
Authors: Vallejos-Baccelliere Gabriel , Kaufman Sergio B.
Published: January 2025

Enzymes from halophilic organisms have adapted to function in salt concentrations near saturation, making them an interesting model for studying the effect of salt on enzyme catalysis. The main insights into the effect of ionic strength on enzyme catalysis come primarily from enzymes with positively charged surfaces interacting with negatively charged substrates (e.g., ribonucleases), whose activity decreases at high salt concentrations. In this study, we investigated the effect of salt on the kinetics of Glucose-6-phosphate dehydrogenase (G6PDH) from the halophilic archaeonHaloferax volcanii(HvG6PDH), which has optimal activity conditions at concentrations exceeding 2 M KCl. The enzyme catalyzes the NAD+-dependent oxidation of G6P, a negatively charged substrate, and glucose, a non-charged substrate. Using steady-state kinetics, we determined that the enzyme follows an ordered-sequential kinetic mechanism, with NAD+ being the first substrate to bind and NADH being the last released product. Through steady-state kinetic experiments, we found that the main effect of salt is on the KMfor G6P, which decreased approximately 50-fold. For glucose dehydrogenase (glcDH) activity, the main effects were a 10-fold increase in kcatand a roughly 10-fold increase in kcat/KMfor glucose. To analyze the effect of salt on the different stages of the catalytic cycle, we performed pre-steady-state experiments for both activities. We found that KCl did not affect the catalytic step in G6PDH activity, but it did increase the rate of catalysis in glcDH. Using a minimal model that accounts for substrate binding, chemical transformation, and product release, we determined that the main effect on G6PDH activity was an increase in the rate of G6P association. In contrast, for glcDH activity, the main effect was an increase in the rates of catalysis and product release. The results show that charge screening plays an essential role in the effect of salt on catalysis. Furthermore, it suggests differences in ion penetration to the active site between the two activities.
SARS-CoV-2 nsp1 mediates broad inhibition of translation in mammals
Authors: Gen Risako , Addetia Amin , Asarnow Daniel , Park Young-Jun , Quispe Joel , Chan Matthew C , Brown Jack T , Lee Jimin , Campbell Melody G , Lapointe Christopher P , Veesler David
Published: January 2025

SARS-CoV-2 nonstructural protein 1 (nsp1) promotes innate immune evasion by inhibiting host translation in human cells. However, the role of nsp1 in other host species remains elusive, especially in bats which are natural reservoirs of sarbecoviruses and possess a markedly different innate immune system than humans. Here, we reveal that SARS-CoV-2 nsp1 potently inhibits translation in bat cells from Rhinolophus lepidus, belonging to the same genus as known sarbecovirus reservoirs hosts. We determined a cryo-electron microscopy structure of SARS-CoV-2 nsp1 bound to the Rhinolophus lepidus 40S ribosome and show that it blocks the mRNA entry channel via targeting a highly conserved site among mammals. Accordingly, we found that nsp1 blocked protein translation in mammalian cell lines from several species, underscoring its broadly inhibitory activity and conserved role in numerous SARS-CoV-2 hosts. Our findings illuminate the arms race between coronaviruses and mammalian host immunity (including bats), providing a foundation for understanding the determinants of viral maintenance in bat hosts and spillovers.
Predicting ADC Map Quality from T2-Weighted MRI: A Deep Learning Approach for Early Quality Assessment to Assist Point-of-Care
Authors: Brender Jeffrey R. , Ota Mitsuki , Nguyen Nathan , Ford Joshua W. , Kishimoto Shun , Harmon Stephanie A. , Wood Bradford J. , Pinto Peter A. , Krishna Murali Cherukuri , Choyke Peter L. , Turkbey Baris
Published: January 2025

Purpose

Poor quality prostate MRI images, especially ADC maps, can lead to missed lesions and unnecessary repeat scans. To address this issue, we aimed to develop an automated method to predict ADC map quality from T2 images acquired earlier in the scanning process.

Materials and Methods

A paired multi-site image corpus of T2-weighted images and ADC maps was constructed from 486 patients imaged in-house and at 62 external clinics. A senior radiologist assigned 1-3 quality ratings to each image set, later converted to a binary “non-diagnostic” or “diagnostic” scale. A deep learning model and a rectal cross-sectional area measurement approach were developed to predict ADC image quality from T2 images. Model performance was evaluated retrospectively by accuracy, sensitivity, negative and positive predictive value, and AUC.

Results

No single acquisition parameter in the metadata was statistically associated with image quality for either T2 or ADC maps. Quality scores of the same modality showed low correlation across sites (r∼0.2). In the challenging task of predicting ADC quality from prior T2 images, our model achieved performance comparable to current single-site models directly using ADC maps, with 83% sensitivity and 90% negative predictive value. The model showed stronger performance on in-house data (94±2% accuracy) despite being trained exclusively on multicenter external data. Rectal cross-sectional area on T2 images provided an interpretable quality metric (AUC 0.65).

Conclusion

The probability of low quality, uninterpretable ADC maps can be inferred early in the imaging process by neural network approach, allowing corrective action to be employed.
Antibiotic Prophylaxis in Dental Implant Procedures: Evidence from a Systematic Review
Authors: Hayat Qazi Jawad , Niaz Radaina , Haq Naeem Ul , Khan Ziad
Published: January 2025

Background

The use of antibiotic prophylaxis in dental implant surgery is controversial, with conflicting guidelines and variations in clinical practice. This systematic review aimed to evaluate the effectiveness of antibiotic prophylaxis in preventing implant failure and post-operative infection in healthy patients.

Methods

A systematic search of the PubMed database was conducted to identify relevant randomized controlled trials (RCTs). Four RCTs met the inclusion criteria and were included in the review. Data on implant failure, post-operative infection, and study characteristics were extracted.

Results

The four included RCTs, published between 2008 and 2022, encompassed 966 participants. The findings regarding the effect of antibiotic prophylaxis on implant failure were mixed. Two studies reported lower failure rates in the antibiotic group, one found similar rates, and one reported a higher failure rate in the antibiotic group. The findings regarding post-operative infections were also inconclusive, with generally low infection rates reported across both groups.

Conclusion

The evidence regarding the benefit of antibiotic prophylaxis in preventing implant failure and post-operative infection in healthy patients is mixed and inconclusive. Further well-designed and adequately powered RCTs are needed to clarify the role of antibiotic prophylaxis in this setting. In the meantime, clinicians should carefully consider the individual patient’s risk factors, the potential benefits and harms of antibiotic prophylaxis, and the available evidence when making decisions about antibiotic use in dental implant surgery.
Multibend achromat lattice with four dispersion bumps for sextupole cancellation
Authors: Tan Jiajie , Wei Bingfeng , Yang Penghui , Bai Zhenghe , Wang Lin , He Jianhua
Published: January 2025

Hybrid multibend achromat (MBA) lattice with a pair of dispersion bumps separated by −I transformation is used in some diffraction-limited storage ring (DLSR) designs, which can obtain relatively large dynamic apertures. However, the −I transformation also largely restricts the horizontal tune of the lattice cell. In this paper, an MBA lattice with four dispersion bumps is proposed, which has relatively good flexibility in adjusting the number of bends in the lattice cell and the lattice cell tunes, while also achieving the effective sextupole cancellation within the lattice arc section. The new lattice can have a larger horizontal cell tune than the hybrid MBA lattice with the same number of bends, which is beneficial for reducing the emittance. In the new lattice, −I transformation is not necessary for the sextupole cancellation between paired bumps, and a general relation of sextupole cancellation is used. Following this lattice concept, a 7BA lattice is preliminarily designed for a 1.5 GeV DLSR. This lattice concept can also be extended to the case of MBA lattice with more bumps.

Published by the American Physical Society
2025