bluuebunny/crossref_metadata_2025 huggingface dataset:
Collective Layoffs and Offshoring: A Social Contract Account
Authors: Granulo Armin , Kranzbühler Anne-Madeleine , Fuchs Christoph , Puntoni Stefano
Published: January 2025

Collective layoffs can occur for many reasons, often related to a firm’s pursuit of greater efficiency and cost reduction, and they tend to trigger negative reactions among the public. Anecdotal evidence suggests that offshoring, one of the most controversial and politicized aspects of globalization, evokes particularly negative reactions. We propose a social contract account of consumer reactions to collective layoffs and demonstrate differential consumer responses to collective layoffs due to offshoring versus other reasons, such as automation. Layoffs due to offshoring are perceived as an especially egregious violation of the normative expectation that firms should support members of their society. Data from nine experimental studies (N = 5,568; seven reported in the main paper and two in the General Discussion), public consumer responses to layoffs in a large online community (N = 29,045), and layoff announcements in the European Union (N = 1,261) show that consumers react more negatively to collective layoffs due to offshoring compared to other reasons. Supporting our social contract account, the negative effect of offshoring is stronger when offshoring affects workers in the consumers’ home (vs. foreign) country, when the firm is domestic (vs. foreign), and when most customers are domestic (vs. foreign).
When and Why Consumers (Erroneously) Believe Income Impacts the Enjoyment of Consumption Experiences
Authors: Olson Jenny G , McFerran Brent , Morales Andrea C , Dahl Darren W
Published: January 2025

We examine how people (as observers) anticipate levels of happiness from psychological consumption experiences (e.g., learning a new language or visiting a park). All else being equal, we propose and demonstrate that people expect differences in happiness based on income. Specifically, we show that relative to observers themselves, individuals simultaneously expect low-income consumers to enjoy psychological consumption experiences less and high-income consumers to enjoy them more. This is because consumers hold a lay theory that human needs must be fulfilled in a sequential, linear manner, which leads to income-based inferences of need prioritization. Thus, observers simultaneously believe that low-income consumers do (and should) prioritize their low-level physical needs first, but high-income consumers (who have presumably already fulfilled their physical needs) can prioritize their high-level psychological needs. Critically, we demonstrate that these lay theory-driven inferences are faulty, showing that the priority level assigned to these needs and the actual happiness resulting from psychological consumption experiences do not follow the predicted pattern. Namely, income either has no relationship with actual happiness (visitors to theme parks, sporting events, and concerts), or the reverse relationship, such that lower-income consumers report greater happiness than higher-income consumers (secondary data from a major league professional sports team).
Trade mark dilemmas in the Metaverse: interplay between stakeholders
Authors: Yarmak Alona
Published: January 2025

The opposite interests of the stakeholders in the Metaverse produce more and more legal uncertainty. The relationship between stakeholders is defined by the author as the triangle of opposite interests, where each interest shapes the development of the Metaverse. If we have too much freedom of expression for developers but little attention is dedicated to IP clearance in which interested trade mark holders find themselves, the Metaverse collapses because of the uncontrolled circulation of fake digital goods. In this situation, developers put pressure on the whole IP system. The value of digital goods decreases which evokes negative reputational consequences for the Metaverse. In contrast, constraints from trade mark holders are also dangerous because the Metaverse will stagnate, and designers will lock in limited creative choices. In this uncertainty, we need to balance conflicting interests and revise lessons from trade mark and technology history. This problem requires an examination of the European Union and the United State case law and scholarly comments because court practice tends to limit the fair use of trade marks in favour of trade mark holders. In contrast, scholars signal potential issues with this approach as overly limiting freedom of artistic expression.
Time Is a Tool: Evaluation of a Prolonged Casualty Care Curriculum With a Focus on Temporal Fidelity
Authors: Hildreth Amy F , Cole Rebekah , Henderson Jonathan , Shen Cynthia
Published: January 2025

Introduction

In current and anticipated future conflicts, including large-scale combat operations, medical teams are tasked to provide prolonged casualty care (PCC) or extended patient care that occurs when delays in evacuation exceed the team’s capabilities. Although the principles of PCC are often taught to military medical providers using simulation, educators rarely dedicate the time to training required to simulate the prolonged nature of these encounters. Therefore, a lack of knowledge exists regarding which aspects of extended care may be lost in an accelerated training scenario.

Materials and Methods

To close this knowledge gap within military medical education and training, we modified an existing PCC curriculum at the USU, Operation Gunpowder, to focus on temporal fidelity, extending the length of the simulated encounter to 21 hours. We used a qualitative phenomenological design to explore the students’ experiences and perceptions by closely analyzing their assigned reflection papers.

Results

We identified four themes from the students’ reflection papers: (1) Recognized effects of fatigue, (2) navigated resource limitations, (3) realized the value of teamwork, and (4) noted the importance of communication and documentation. These themes revealed benefits of incorporating temporal fidelity into PCC training, including self-awareness of personal limits and possible strategies to mitigate fatigue when medical or operational mission requirements dictate sleep deprivation. Future studies are needed to determine other training scenarios that would benefit from adherence to temporal fidelity.

Conclusions

Wars and disasters require medical providers trained in PCC. Future educational activities aimed at teaching PCC should continue to incorporate temporal fidelity to help teach these valuable lessons.
The FLAMINGO Project: An assessment of the systematic errors in the predictions of models for galaxy cluster counts used to infer cosmological parameters
Authors: Kugel Roi , Schaye Joop , Schaller Matthieu , Forouhar Moreno Victor J , McGibbon Robert J
Published: January 2025

Galaxy cluster counts have historically been important for the measurement of cosmological parameters and upcoming surveys will greatly reduce the statistical errors. To exploit the potential of current and future cluster surveys, theoretical uncertainties on the predicted abundance must be smaller than the statistical errors. Models used to predict cluster counts typically combine a model for the dark matter only (DMO) halo mass function (HMF) with an observable–mass relation that is assumed to be a power law with lognormal scatter. We use the FLAMINGO suite of cosmological hydrodynamical simulations to quantify the biases in the cluster counts and cosmological parameters resulting from the different ingredients of conventional models. For the observable–mass proxy, we focus on the Compton-Y parameter quantifying the thermal Sunyaev–Zel’dovich effect, which is expected to result in cluster samples that are relatively close to mass-selected samples. We construct three mock samples based on existing (Planck and SPT) and upcoming (Simons Observatory) surveys. We ignore measurement uncertainties and compare the biases in the counts and inferred cosmological parameters to each survey’s Poisson errors. We find that widely used models for the DMO HMF differ significantly from each other and from the DMO version of FLAMINGO, leading to significant biases for all three surveys. For upcoming surveys, dramatic improvements are needed for all additional model ingredients, i.e. the functional forms of the fits to the observable–mass scaling relation and the associated scatter, the priors on the scaling relation and the prior on baryonic effects associated with feedback processes on the HMF.
The language of glioblastoma: a tale of cytokines and sex hormones communication
Authors: Alemán Omar Rafael , Quintero Juan Carlos , Camacho-Arroyo Ignacio
Published: January 2025

Glioblastoma (GB) is the most aggressive and frequent tumor in the central nervous system and, in humans, represents the worst prognosis for cancer. GB develops a very complex microenvironment, recruiting and interacting with a variety of cells and soluble factors, including immune cells, cytokines, and sex hormones, that contribute to GB survival and progression. Recent evidence has shown a crosstalk between cytokine and sex hormone signaling in GB. This communication could provide GB resistance to treatments and malignancy. Then, how GB orchestrates this communication is a matter of interest. For instance, a critical interaction between tumor necrosis factor beta (TGF-β) and estrogen receptor signaling has been reported in regulating epithelial-mesenchymal transition, an essential step in GB progression. Furthermore, an inhibition of TGF-β signaling by androgen receptor has been reported to promote GB tumorigenesis in men. On the other hand, it has been described that cytokines regulate steroid hormone production in different organs, and this mechanism could be involved in GB development and progression. All these data suggest an intercommunication between the immune and endocrine systems in the tumor microenvironment. Thus, in this review, we focus on explaining the knowledge about this critical intercommunication system and its implication in GB progression.
(Un)Remembering Sexual Violence in South African History
Authors: Bridger Emily
Published: January 2025

South Africa is a country known for its high rates of gender-based and sexual violence. Historical research demonstrates that such issues are not new to the post-apartheid era but have deep roots stretching into the country’s colonial and apartheid periods. Yet when asked to reflect on historic sexual violence, oral history interviewees — Black women in their sixties, seventies and eighties — largely recalled the apartheid past as a period devoid of sexual violence, describing the problem to researchers as something that only started happening ‘now, in your days’. This article unpacks such statements and argues that much rape perpetrated during apartheid, particularly within communities, has been subject to a collective unremembering. It highlights four central explanations for this: how rape was historically silenced by families, communities and the police; the refusal to name rape as such in the past, with sexual violence more commonly characterized as ‘force’; how histories of intra-communal sexual violence have been sidelined within dominant historical or political narratives of apartheid; and how discourse of South Africa’s present rape ‘crisis’ fosters historical amnesia and promotes nostalgia for a past believed to be without rape.
Policy knowledge production in de-democratizing contexts
Authors: Krizsán Andrea , Jezierska Katarzyna , Sörbom Adrienne
Published: January 2025

In an era of post-truth, the legitimacy of policy knowledge is questioned, especially in de-democratizing contexts where governments purposefully engage in post-truth politics to support their regimes. In such contexts, technocratic evidence-based policymaking is undermined, and the role played by policy advice changes. Recognizing the significance of political contextual factors that might differ across de-democratizing contexts, we analyzed how changes in policymaking and public administration in de-democratization contexts impact policy advice, focusing on think tanks in two de-democratizing countries of the European Union: Hungary and Poland. We identify four aspects of policymaking that are particularly consequential for the role of think tanks and the knowledge they produce in policymaking processes: questioning and politicizing expertise, centralizing policymaking, politicizing public administration, and dismantling accountability mechanisms. We argue that changes in policymaking along these four aspects are conducive to a controlled policy advice system, favoring short-term policy advice aligned with government ideology, while marginalizing and excluding the actors and knowledge that do not align. Our research, along with other literature on knowledge regimes in consolidated autocracies, suggests that control in these European Union–based contexts is not complete, and the think tank field continues to be characterized by diversity, particularly contestation and polarization between those who are aligned with the regime and those who oppose it. We substantiate our claims using an original interview dataset on think tanks in Hungary and Poland.
From benign to malign: unintended consequences and the growth of Zombie policies
Authors: Peters B. Guy , Nagel Maximilian L
Published: January 2025

Few policymakers initiate policies that they know are malign, and are contrary to the public interest. Well-intentioned policies may, however, have unintended consequences that over time do make them, at least in part, malign. These policies may continue to produce some positive results for society, but they may also have significant negative consequences. Further, given that the malign nature of the policy tends to benefit powerful political and economic interests, once the malign aspects of the policy begin to manifest themselves, they tend to persist. This paper will use four mini-cases to understand better the transition from benign to malign policies. Two of the cases come from the United States and two come from Germany. Two cases will be in health policy, one in infrastructure, and one in crisis management policies. In all four cases policies that have over time began to demonstrate negative features continue to be implemented because of the benefits that they create for some interests in society–interests other than the original targets of the programs. In addition to the emerging literature on malign policies, this paper will have relevance for the large literature on unintended consequences (beginning with Merton in 1936), as well as the literature on Zombie ideas and failed policy ideas.
Against inferential moral knowledge: A defence of Hume’s Law
Authors: Backes Marvin
Published: January 2025

According to Hume’s Law, we cannot infer moral conclusions from wholly non-moral premises; or, more concisely, we cannot infer an ‘ought’ from an ‘is’. While Hume’s Law (at least in qualified form) has enjoyed widespread acceptance, recent years have seen an upsurge of interest in anti-Humean accounts of moral knowledge. According to these accounts, we can come to know moral conclusions via inferences from wholly non-moral premises. The main aim of this paper is to defend Hume’s Law against these recent threats and to argue, more generally, that there are good reasons to remain pessimistic about anti-Humean accounts of moral knowledge. In particular, the paper (1) raises doubts about the leading accounts of inferential moral knowledge currently found in the literature, (2) proposes a new account of inferential moral knowledge that promises to avoid the shortcomings of its predecessors, but (3) argues that the new account too is ultimately unsuccessful.
Long-term tofacitinib efficacy and safety in psoriatic arthritis with or without prior biologic DMARD exposure: a post hoc analysis
Authors: Gladman Dafna D , Dougados Maxime , Marzo-Ortega Helena , Cadatal Mary Jane , Agarwal Ekta , Kinch Cassandra D , Nash Peter
Published: January 2025

Objective

To assess long-term tofacitinib efficacy and safety in patients with PsA with or without prior biologic (b)DMARD exposure.

Methods

Data were pooled post hoc from three Phase (P)3 and one long-term extension (LTE) PsA studies and stratified by TNF inhibitor-inadequate responder (TNFi-IR) or bDMARD-naïve patient status at P3 study baseline. Data were reported as all tofacitinib (patients receiving ≥1 tofacitinib dose) or average tofacitinib 5 and 10 mg twice daily (patients receiving an average total daily dose <15 and ≥15 mg, respectively). Drug survival to Month 51, efficacy to Month 42 and safety were assessed descriptively.

Results

408 TNFi-IR patients (including 29 TNFi-experienced with unknown IR status) and 562 bDMARD-naïve patients were included. At baseline, TNFi-IR patients were more likely to be ≥ 65 years old, have cardiovascular/venous thromboembolism risk, and longer disease duration vs bDMARD-naïve patients. Drug survival was numerically shorter in TNFi-IR vs bDMARD-naïve patients. Tofacitinib efficacy was generally sustained to Month 42, regardless of prior bDMARD treatment. MDA/PASDAS ≤3.2/PASI75 response rates were numerically lower in TNFi-IR vs bDMARD-naïve patients to Month 42 but rates of achieving HAQ-DI ≤0.5 and enthesitis/dactylitis resolution were similar. In TNFi-IR vs bDMARD-naïve patients, treatment-emergent adverse event incidence rates were higher, and serious adverse event, serious infection and herpes zoster incidence rates were numerically higher (CI overlapped).

Conclusion

These findings support long-term tofacitinib efficacy and safety in TNFi-IR and bDMARD-naïve patients. However, the benefit-risk profile appeared more favourable in bDMARD-naïve patients, likely due to differences in baseline characteristics and risk factors between subgroups.

Trial registration

ClinicalTrials.gov: NCT01877668; NCT01882439; NCT03486457; NCT01976364
Double-edged Swords? Party Ideology, Activism, and Visibility in the Careers of Italian LGBT+ Politicians
Authors: Prearo Massimo , Trastulli Federico
Published: January 2025

This article analyzes the careers of lesbian, gay, bisexual, transgender (LGBT+) politicians in Italy, focusing on the dual role of party affiliation, visibility, and the relationship with LGBT+ organized activism. Qualitative analysis of twenty-two semi-structured interviews with out LGBT+ politicians shows that party affiliation, activism, and personal openness can both advance and hinder their careers, depending on contextual and individual circumstances. Across left- and right-wing parties alike, LGBT+ politicians can both be favored in the stage of candidate selection due to the opportunistic need of “ticking the LGBT+ box” and face discrimination from party élites and members. Further, while the support of organized activism can legitimize LGBT+ candidates, some interviewees found it uninfluential or, especially if trans, outright lacking. Finally, while local-level intensified visibility can serve as both a protective mechanism and a valuable condition for acceptance in smaller communities, body “hypervisibility” can expose some LGBT+ politicians to harmful political attacks.
Tracing the Labor Migration Treadmill: A Global Political Economy Analysis of Central Asians on the Move
Authors: Kangas Anni , Artist Anonymous
Published: January 2025

The migration corridor between Central Asia and Russia is one of the busiest in the world. In this article, we intend to answer the following question: which political economy dynamics animate labor migration from Central Asia to Russia? To do so, we provide a sketch of the labor migration treadmill by detailing its structural and “cruelly optimistic” affective logics. We identify four structural themes in the treadmill: (1) dispossession, (2) politics of belonging and racialization, (3) gender and patriarchal dynamics, and (4) externalization of social reproduction. A scrutiny of these themes shows that the treadmill of Central Asian labor migration is grounded in a specific but globally resonant political economic condition of “post-Soviet precarity.” This article is based on solicited journals written by migrant workers and analyzed jointly by an artist and an academic. Consequently, the interplay of drawings and textual narration is integral to the article’s logic of inquiry.
Using transcriptomic signatures to elucidate individual and mixture effects of inorganic arsenic and manganese in human placental trophoblast HTR-8/SVneo cells
Authors: Freedman Anastasia N , Hartwell Hadley , Fry Rebecca
Published: January 2025

Prenatal exposure to the toxic metal inorganic arsenic (iAs) is associated with adverse pregnancy and fetal growth outcomes. These adverse outcomes are tied to physiological disruptions in the placenta. Although iAs co-occurs in the environment with other metals such as manganese (Mn), there is a gap in the knowledge of the effects of metal mixtures on the placenta. To address this, we exposed human placental trophoblast cells to iAs, Mn, and an iAs–Mn mixture at 3 concentrations and evaluated transcriptome-wide gene expression and placental migration. We hypothesized that co-exposure to iAs–Mn in a mixture would result in a synergistic/enhanced transcriptomic effect compared to either metal alone. We also anticipated that genes involved in inflammatory or immune-related pathways would be differentially expressed in relation to the mixture compared to single-metals. The results highlight that iAs exposure alone had a stronger genomic response than Mn exposure, with 2-fold the number of differentially expressed genes (DEGs). When analyzing DEGs present across all concentrations of study, the iAs–Mn mixture resulted in the greatest number of DEGs. The results highlight that iAs exposure alone influences the expression of toll-like receptor-initiated response pathways including Triggering Receptor Expressed on Myeloid Cells-1. Exposure to Mn alone influenced the expression of Nicotinamide adenine dinucleotide biosynthesis pathways. In contrast, exposure to the iAs–Mn mixtures resulted in altered expression of inflammatory and immune response-related pathways, including the Nuclear factor erythroid 2-related factor 2 (NRF2)-mediated oxidative stress response pathway. Migration was unaffected by iAs, Mn, or the iAs–Mn mixture. These findings provide novel toxicogenomic insights into iAs- and Mn-induced placental transcriptomic dysregulations at environmentally relevant concentrations, with implications that in utero exposure to metal mixtures can influence inflammatory and immune pathways within the placenta.
Diagnostic sensitivity of formalin-fixed faecal microscopy for the detection of soil-transmitted helminths
Authors: Larkins Andrew , Keokhamphavanh Boualay , Knight Breanna , Taggart Kelly , Keatley Sarah , Insisiengmay Bounnaloth , Ash Amanda
Published: January 2025

Background

Faecal microscopy is the mainstay of soil-transmitted helminth diagnosis and commonly completed on formalin-fixed samples when resources are insufficient to analyse fresh samples. This study assessed the diagnostic sensitivity of microscopic techniques using formalin-fixed samples.

Methods

Formalin-fixed faecal samples from 574 individuals were tested by the formalin-ethyl acetate concentration technique (FECT), Malachite smear, McMaster and McMaster2 methods. Agreement between tests was assessed by Kappa. Bayesian latent class models and a composite reference standard estimated the diagnostic sensitivity of each test.

Results

Moderate-to-good agreement between tests was observed for A. lumbricoides. Agreement was poorer for hookworm and Trichuris trichiura. The FECT (72.70%, credible interval [CrI]: 68.92–76.56%) and McMaster2 method (67.93%, 95% CrIs: 62.41–73.31%) had the highest sensitivities for A. lumbricoides. For hookworm, the McMaster2 method (70.56%, 95% CrIs: 64.10–76.96%) was more sensitive than all other tests. For T. trichiura, the McMaster (90.10%, 95% CrIs: 83.29–94.67%) and McMaster2 (89.3%, 95% CrIs: 82.28–94.52%) methods were the most sensitive.

Conclusions

The McMaster2 method is a viable alternative to FECT and provides important information on the intensity of infection. The effect of formalin-fixation on test performance may not be as great as previously assumed. This study reports formalin-fixed sensitivities similar to previous estimates using fresh samples.
Ghrelin alleviates liver fibrosis by triggering HSCs ferroptosis via regulating injured hepatocyte‐derived exosomal LncMALAT1/GPX4 pathway
Authors: Luo Xin , Chen Kan , Zhang Jie , Yao Zhilu , Guo Chuanyong , Qu Ying , Lu Lungen , Mao Yuqing
Published: January 2025

Ghrelin is a gastric peptide that modulates various biological functions, including potential anti‐inflammatory and antifibrotic properties. Increasingly evidence have demonstrated that exosomes derived from injured hepatocytes (IHC‐Exo) can accelerate the activation of hepatic stellate cells (HSCs) and liver fibrosis. Ferroptosis, a type of novel programmed cell death, regulates diverse pathological processes, including liver fibrosis. However, it remains unclear whether ghrelin exerts its antifibrotic effect through mechanisms involving exosomes and ferroptosis. To explore the mechanism, IHC‐Exo were isolated from supernatant of injured mouse primary hepatocytes (HCs) treated with palmitic acid (PA). Mouse primary HSCs and a bile duct ligation (BDL)‐induced liver fibrosis murine model were then treated with IHC‐Exo or exosomes derived from ghrelin‐pretreated injured hepatocytes (GHR‐IHC‐Exo). The expression of α‐SMA, Collagen I and long noncoding (lnc) RNA MALAT1 in HSCs were then detected. The ferroptosis of HSCs was evaluated by assessing the level of CCK8, MDA, GSH, and GPX4 expression. Mouse serum and liver biopsy samples were used to determine whether ferroptosis is involved in the progression of liver fibrosis. Nanoparticle tracking analysis and electron microscopy characterized the features of IHC‐Exo. As the results suggested, compared with IHC‐Exo, GHR‐IHC‐Exo treatment significantly promoted ferroptosis of HSCs, inhibited their activation, and consequently alleviated liver fibrosis progression in BDL mice. The inhibitory effect of GHR‐IHC‐Exo on activation of HSCs was partially reversed by treatment with the ferroptosis inhibitor Ferrostatin‐1. The expression of lncMALAT1 was significantly down‐regulated in GHR‐IHC‐Exo as compared to IHC‐Exo. Serum exosome levels of MALAT1 were significantly higher in patients with severe liver fibrosis compared to those with mild liver fibrosis. Additionally, the expression of ferroptosis suppressor protein GPX4 was elevated as liver fibrosis progression, indicating decreased ferroptosis of HSCs in patients with severe liver fibrosis. In conclusion, Ghrelin reduced the pro‐fibrotic effect of IHC‐Exo in liver fibrosis by regulating lncMALAT1/GPX4 pathway mediated HSCs ferroptosis. Triggering HSCs ferroptosis via GHR‐IHC‐Exo may become a novel strategy to alleviate the progression of liver fibrosis.
A Threshold Technique Study to Understand Patient Preference for Smooth Versus Textured Breast Implants
Authors: Wood Dallas , Williams Peyton N. , Thompson Jessica E. , Peinado Susana , Tilley Avery A. , Gebben David , Major Jacqueline M. , Weinberg Jessica P. , Yoon Sung W. , Tarver Michelle E.
Published: January 2025

Background:

Breast implant surfaces are categorized as smooth or textured. Compared with smooth implants, textured surface implants have a higher risk of breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) but may have a lower risk of capsular contracture (CC). This study aimed to quantify whether survey respondents would be willing to accept a higher risk of BIA-ALCL in exchange for the potential reported benefits of textured breast implants.

Methods:

We fielded a threshold technique survey to 405 respondents from 4 cohorts: (1) patients with breast cancer who were considering but did not receive reconstruction with implants, (2) patients with breast cancer who had received reconstruction with implants, (3) persons considering breast augmentation with implants, and (4) patients who had received breast augmentation with implants.

Results:

The average maximum increase in the risk of BIA-ALCL that the survey respondents were willing to accept in exchange for textured implants—with both a teardrop-shaped option and a 10% reduction in the risk of CC—were as follows: 0.83% for patients who were considering breast reconstruction, 0.61% for patients who had received breast reconstruction, 0.85% for persons considering breast augmentation, and 0.60% for patients who had received breast augmentation.

Conclusions:

We found respondents generally were willing to accept the higher risk of BIA-ALCL associated with textured implants to gain the potential benefit of reduced risk of CC and the option of the teardrop-shaped implant. Patient perspectives and preferences are integral, and continued assessment of patient perspectives can help inform regulatory and care paradigms.
Utility of Free Fibula Flap With an Extended Banana-shaped Skin Paddle for Oro-mandibular Reconstructions
Authors: Hamahata Atsumori , Konoeda Hisato , Shirakura Satoshi , Yagihara Kazuhiro , Sakurai Hiroyuki
Published: January 2025

The free fibula flap is a common technique for mandibular bone defects. However, its limited skin paddle is disadvantageous in cases with significant soft-tissue defects. A free fibula dual-skin paddle flap is used for medium-sized soft-tissue defects. Just as the anterolateral thigh flap can be extended through linking vessels, so the peroneal skin flap can be extended to the adjacent proximal area through linking vessels. This has led to the development of the free fibula banana-shaped flap. From 2021 to 2023, 8 patients, with an average age of 68.1 years, underwent head and neck reconstructive surgery using the free fibula banana-shaped flap at the Saitama Cancer Center in Japan. Their primary disease, defect sites, flaps, bone size, and postoperative complications were analyzed retrospectively. The blood flow of the flap was examined using intraoperative indocyanine green imaging. All 8 patients had successful operations with only 1 partial necrosis of the flap tip. Four patients had buccal mucosa cancers, 3 had osteoradionecrosis of the jaw, and 1 had lower gingival cancer. The flap size averaged 25.0 ± 3.0 cm (long axis) and 4.1 ± 0.4 cm (short axis), with a transplanted bone length of 8.4 ± 1.9 cm. The number of perforators was 1–3 in the distal to the central area. All flaps’ microcirculation was confirmed with intraoperative indocyanine green imaging; the average time was 3 minutes 59 seconds. Postoperative complications included 1 surgical site infection and 1 minor salivary leak. The free fibula banana-shaped flap is a good option for head and neck reconstructive surgery in medium-sized soft-tissue defects with mandibular bone defects.
Evaluating the Safety and Satisfaction of HYAcorp MLF2 for Noninvasive Buttock Augmentation: A Multicenter Study
Authors: Crabai Piero , Campos-Martínez Luis , Marchetti Francesco , Fantozzi Fabio , Marques Ruben , Fontenete Silvia
Published: January 2025

Background:

The increasing demand for noninvasive gluteal augmentation using hyaluronic acid (HA) gel highlights the need for research into its safety and effectiveness. This study aimed to assess the safety and satisfaction levels of patients and physicians regarding HA body filler for buttock enhancement. It also explores variations in outcomes across different injection sites and among different practitioners.

Methods:

This retrospective, observational, descriptive multicenter study analyzed the outcomes of using a body HA filler (HYAcorp MLF2) for buttock augmentation across 4 Italian centers, with a 6-month follow-up period. Patients’ and physicians’ satisfaction levels were measured immediately postprocedure, and adverse events were monitored throughout the study period.

Results:

Thirty-five subjects received injections, with an average volume of 85.1 ± 42.2 mL per subject injected. Throughout follow-up, 94% of patients and 100% of physicians rated the improvement as “very good” or “good.” Adverse events were generally mild-to-moderate, typically resolving within 2–7 days. The most frequently recorded adverse effects were swelling, pain, and redness. No significant differences were observed among injectors (P > 0.05).

Conclusions:

HYAcorp MLF2 is safe and effective for buttock augmentation, demonstrated by high satisfaction rates and manageable, mild-to-moderate adverse events, with no significant variation based on practitioner experience or clinic site.
Reconstruction of Back Defect from Giant Congenital Melanocytic Nevus Using Dermal Substitute Matrix
Authors: Makkawi Kareem W. , Beaineh Paul T. , Emsieh Saif E. , Chrabieh Edwin E. , Ibrahim Amir E.
Published: January 2025

Giant congenital melanocytic nevi are large pigmented premalignant lesions present at birth that have an associated risk of malignant transformation. Full-thickness excision of these lesions would be required to eliminate this risk. However, giant nevi can leave behind large defects that can be challenging to reconstruct. We present the case of a pediatric patient with a lesion occupying the entirety of the back, or around 18% total body surface area, and in whom Integra and meshed skin grafts were successfully used. This represents the largest defect size in the literature resulting from a giant nevus that has been treated by this method. Full take of the skin grafts was observed 26 days from the excision of the lesion with satisfactory functional outcomes.
Herpetic Endotheliitis Induced Interface Fluid Syndrome 16 years After Laser in Situ Keratomileusis
Authors: Bough Matthew , Hwang Bryce , Santos Matthew , Syed Zeba A.
Published: January 2025

Purpose:

To report a case of herpes simplex virus (HSV) endotheliitis inducing acute interface fluid syndrome in a patient with a remote history of laser in situ keratomileusis (LASIK).

Methods:

Case report and literature review.

Results:

A 51-year-old man with a history of LASIK 16 years prior presented with unilateral HSV endotheliitis and was found to have acute interface fluid syndrome secondary to endothelial decompensation. The patient was treated with oral valacyclovir 1 g 3 times daily, prednisolone acetate 1% drops 4 times daily, timolol maleate 0.5% drops twice daily, topical 5% sodium chloride hypertonic ophthalmic solution drops 4 times daily, and 5% sodium chloride hypertonic ophthalmic ointment nightly. At 1-month follow-up, the patient had full resolution of the interface fluid and returned to baseline visual acuity.

Conclusions:

This case underscores the importance of considering viral etiologies, such as HSV endotheliitis, in interface fluid syndrome beyond a decade after LASIK.
The Handmann line and its visual consequences after LASIK
Authors: Chua Nicolette Eunice T. , Tan Reginald Robert G.
Published: January 2025

Introduction:

The purpose of this study was to describe the symptomatology, etiology, and management of a new type of dysphotopsia after laser-assisted in situ keratomileusis (LASIK).

Patient and Clinical Findings:

This report presents the case of a 32-year-old man who complained of new-onset bilateral vertical light streaks 9 years after LASIK. This was described as long, thick, vertical rays emanating from pinpoint light sources; more prominent in scotopic conditions; leaning toward the side of head tilt; and disappearing with eyelid fissure widening. There was no resolution with contact lenses or miotics. Corrected distance visual acuity was 6/6 with seemingly unremarkable corneas.

Diagnosis, Intervention, and Outcomes:

This photic phenomenon is related to eyelid position because of its distinct behavior. The upper eyelid imprints an arch line on the cornea, historically named “Handmann line,” which simulates a Maddox rod effect. Corneal epithelial mapping showed a sharp demarcation from the thinner superior epithelium covered by the upper eyelid vs the uncovered epithelium inferiorly. Scleral lenses were prescribed as barrier, which through time lessened the light streaks. Repeat epithelial mapping revealed a decreased epithelial thickness gradient on both eyes.

Conclusions:

Light streaks are a newly described visual phenomenon after LASIK brought about by the Handmann line. Management strategies should be aimed at minimizing pressure of the upper eyelid on the cornea.
Unveiling disparities in cancer care: a comparative study of service availability in low- and middle-income countries (LMICs) versus high-income countries (HICs)
Authors: Wang Ashley Wei-Ting , Bergerot Cristiane Decat , Bahcivan Ozan , Csaba Dégi L. , Kim Youngmee
Published: January 2025

Background:

Accessible supportive care is crucial for reducing unmet needs in cancer care and for improving cancer outcomes. However, significant disparities in supportive care resources exist between low- and middle-income countries (LMICs) and high-income countries (HICs). Health care priority is often set by health care professionals' (HCPs') evaluation about the adequacy of services and programs to meet their patients' needs. Thus, this study aimed to compare the perspectives of HCPs from LMICs versus HICs on the availability of supportive care services for patients with cancer and survivors (Aim 1). In addition, the study examined differences in service provision across four major age groups (Aim 2) and identified the types of services offered (Aim 3).

Methods:

Secondary analysis was conducted using the International Psycho-Oncology Society (IPOS) Survivorship Online Survey, targeting HCPs involved in clinical services and research with patients with cancer and survivors worldwide. The data from 177 (81 from LMICs and 96 from HICs) participants were subjected to subsequent analysis. Chi-squared tests were used to compare the availability of services for each of the 13 types of unmet needs overall and across four age groups and the types of services provided between LMICs and HICs.

Results:

HCPs from LMICs reported fewer services addressing patients' unmet needs related to sexuality/intimacy and financial concerns across all age groups and fewer services for various unmet needs (including symptom management, emotional distress, spiritual concerns, medical care, insomnia and fatigue, and personal care) of adolescents, young adults, and older adult patients, compared with HCPs from HICs. No significant differences were found between LMICs and HICs regarding service provision for middle-aged patients. Psychological counseling or psychotherapy was the most frequently provided service in both LMICs and HICs. However, HCPs from LMICs reported significantly fewer self-help materials and pharmacological services available but more support groups available for financial concerns and personal care.

Conclusions:

The study revealed significant disparities in the provision of supportive care services for patients with cancer between LMICs and HICs, highlighting the urgent need for targeted interventions and policy changes in LMICs. Future research should include broader geographical representation and focus on developing effective strategies to address critical unmet needs, particularly in sexuality/intimacy and financial concerns, to improve the quality of cancer care in LMICs.
Is Charles Bonnet Syndrome a Harbinger of Neurocognitive Disorder With Lewy Bodies? A Clinical Conundrum
Authors: Kumari Shalini , Nath Santanu , Narasimha Venkata Lakshmi
Published: January 2025

Charles Bonnet syndrome (CBS) is a clinical condition in which patients with visual impairment experience visual hallucinations (VH) in the presence of clear consciousness. It typically occurs in elderly people and confuses clinicians with multiple differential diagnoses due to VH, which can be present in a variety of clinical conditions ranging from psychosis to neurocognitive disorders (eg, neurocognitive disorder with Lewy bodies). In the latter, the concomitant presence of cognitive decline and parkinsonism aids the diagnosis. Here we report the case of an elderly man with retinitis pigmentosa (and thus significant visual loss), who presented with VH, thus warranting a diagnosis of CBS, but who later also manifested a rapid onset cognitive decline and parkinsonism, which necessitated a new diagnosis of major neurocognitive disorder with Lewy bodies. This case prompted us to consider whether CBS is a harbinger of neurocognitive disorder with Lewy bodies or whether there is a clinical overlap between these 2 clinical constructs. This case report attempts to unravel this clinical conundrum.
Insomnia in Patients With Substance Use Disorders: Assessment and Management
Authors: Hanacek Cris , Lane Julian , Tang Yi-lang
Published: January 2025

Insomnia, characterized by difficulty initiating or maintaining sleep, or poor sleep quality, is highly prevalent among individuals with substance use disorders (SUDs). The relationship between the 2 conditions is often bidirectional. We reviewed the impact of various substances (alcohol, stimulants, opioids, and cannabis) on sleep architecture and their potential to contribute to insomnia. The role of insomnia as a risk factor for different SUDs is also explored. Assessment strategies for co-occurring insomnia and SUDs are discussed, emphasizing the importance of reassessment throughout various phases of substance use treatment. Evidence-based nonpharmacologic and pharmacologic interventions for managing insomnia in SUD patients are presented, highlighting the importance of tailoring treatment approaches to individual needs and substance-specific considerations. Assessment and management of comorbid insomnia and SUDs is crucial but can be difficult; however, studies have shown some benefits using nonpharmacologic and pharmacologic approaches.
Association of Lambert-Eaton Myasthenic Syndrome and First Episode Psychosis: A Case Report
Authors: Siopa Carlos , Cordeiro Catarina , Moura Bernardo Melo
Published: January 2025

Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune neuromuscular junction disorder characterized by proximal weakness, autonomic dysfunction, and areflexia associated with antibodies against voltage-gated calcium channels (VGCCs). Psychotic symptoms can occur in many autoimmune neurological disorders but they have rarely been observed in myasthenic syndromes. We report the case of a 21-year-old woman with primary autoimmune LEMS due to anti-VGCC antibodies subtype P/Q, who developed psychotic symptoms 3 years after the onset of motor symptoms. These symptoms decreased after every cycle of monthly intravenous immunoglobulin therapy. Different causes of reversible psychosis were excluded, such as autoimmune encephalitis. Due to a worsening of the patient’s muscle strength, and the psychotic episodes, the patient received several treatments including an admission to a neurology unit. To our knowledge, this is the first described case of psychotic symptoms associated with LEMS. We speculate that VGCC antibodies could have a role in the development of mental symptoms, although additional hypotheses are also discussed.
Effect of fertility desire-based service on HIV seroconversion among serodiscordant partners: A 12-year retrospective cohort study
Authors: Yu Bin , Jike Chunnong , Lan Xiaomei , Wang Ju , Yu Gang , Yang Shujuan
Published: January 2025

Background:

Fertility desire-based service guided by behavioral theory is a potential strategy to mitigate the HIV transmission risk, while related evidence remains scarce. We examined the long-term effect of theory-guided fertility desire-based services on HIV seroconversion between seropositive/seronegative partners in areas with high HIV prevalence and a cultural emphasis on fertility in China.

Methods:

We established a retrospective cohort by recruiting 8,653 seropositive partners with seronegative partners between January 1, 2009, and December 31, 2020, in Liangshan, China. The differences in HIV seroconversion between partners who received fertility desire-based services guided by the extended Information-Motivation-Behavioral Skills (IMB) model and those who did not were estimated, based on multivariable and inverse probability weighting (IPW) adjusted multivariable Cox regression models. Subgroup analysis was conducted based on participants’ demographic and HIV-related characteristics.

Results:

Among the 8,653 HIV-seropositive partners, 7,958 (92.0%) and their seronegative partners received fertility desire-based services. At the end of the 12-year follow up, 18 seronegative partners who did not receive fertility desire-based services experienced HIV seroconversion (incidence density: 7.4/1,000 person-years), while 98 seronegative partners receiving such services exhibited HIV seroconversion (3.4/1,000 person-years). Fertility desire-based services significantly reduced the risk of HIV seroconversion according to multivariable (HR=0.32, 95%CI: 0.19-0.53) and IPW-adjusted multivariable Cox regression models (HR=0.48, 95%CI: 0.27-0.84). The effect of fertility desire-based services was more pronounced in males and those above 40 years old.

Conclusions:

Fertility desire-based services based on the extended IMB model may help reduce the HIV transmission risk between seropositive/seronegative partners in areas with high HIV prevalence.
Differentiation of Atherosclerotic Carotid Plaque Components With Dual-Energy Computed Tomography
Authors: Aizaz Mueez , Bierens Juul , Gijbels Marion J.J. , Schreuder Tobien H.C.M.L. , van Orshoven Narender P. , Daemen Jan-Willem H.C. , Mess Werner H. , Flohr Thomas , van Oostenbrugge Robert J. , Postma Alida A. , Kooi M. Eline
Published: January 2025

Objectives

Carotid plaque vulnerability is a strong predictor of recurrent ipsilateral stroke, but differentiation of plaque components using conventional computed tomography (CT) is suboptimal. The aim of our study was to evaluate the ability of dual-energy CT (DECT) to characterize atherosclerotic carotid plaque components based on the effective atomic number and effective electron density using magnetic resonance imaging (MRI) and, where possible, histology as the reference standard.

Materials and Methods

Patients with recent cerebral ischemia and a ≥2-mm carotid plaque underwent computed tomography angiography and MRI. A subgroup underwent carotid endarterectomy. Trained observers delineated plaque components on histology or MRI, independent of computed tomography angiography. DECT was coregistered with MRI and/or histology. Intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), fibrous tissue, and calcifications were delineated on DECT, and ρeff and Zeff values were determined in the derivation cohort (n = 55). Spatial separation of these components was evaluated in a ρeff-Zeff-cluster plot. Ranges that optimally differentiate plaque features were determined. For validation, plaque components were quantified in the validation cohort (n = 29) using these ρeff-Zeff ranges and literature-based Hounsfield unit (HU) ranges and correlated to MRI volumes.

Results

Eighty-four participants (68 ± 8 years; 55 male) were evaluated. In the derivation cohort, plaque components were well separated on the cluster plot, resulting in the following ranges: IPH:ρeff < 1.15, Zeff < 7.5, LRNC:ρeff < 1.15, Zeff:7.5–8.75, fibrous tissue:ρeff < 1.15, Zeff > 8.75, and calcifications: ρeff > 1.15, Zeff > 0. In the validation cohort, significant correlations were found between ρeff-Zeff-based and MRI plaque volumes for fibrous tissue (r = 0.69, P < 0.001), LRNC (r = 0.94, P < 0.001), IPH (r = 0.35, P = 0.03), and calcifications (r = 0.70, P < 0.001). Lower correlations were found between HU-based and MRI plaque volumes for fibrous tissue (r = 0.40, P = 0.02), LRNC (r = 0.86, P < 0.001), and calcifications (r = 0.47, P = 0.005), with no correlation for IPH (r = 0.02, P = 0.45).

Conclusions

We determined ρeff-Zeff ranges for plaque assessment. ρeff-Zeff-based volumes showed strong-to-very strong correlations with MRI for LRNC, fibrous tissue, and calcifications and a weak correlation for IPH. ρeff-Zeff-based volumes demonstrated superior agreement with MRI for all plaque components compared with HU-based volumes, highlighting the potential of DECT for the identification of patients with vulnerable plaques.