bluuebunny/crossref_metadata_2025 huggingface dataset:
State policies regulating short-term limited duration insurance plans and cancer stage at diagnosis
Authors: Barnes Justin M , Kirchhoff Anne C , Yabroff K Robin , Chino Fumiko
Published: August 2023

Short-term limited duration insurance plans, which proliferated following 2018 federal regulations, may not provide adequate protections for patients with suspected or newly diagnosed cancer and can destabilize insurance markets for comprehensive insurance plan enrollees. Individuals aged 18-64 years with newly diagnosed cancer from 11 states during 2016-2017 and 2019 were identified from the Surveillance, Epidemiology, and End Results program. Difference-in-differences analyses were used to compare changes in early-stage cancer diagnoses from 2016-2017 to 2019 in states that prohibited vs did not regulate short-term limited duration insurance plans. In adjusted difference-in-differences analyses, early-stage diagnoses increased 0.95 percentage points (95% confidence interval = 0.53 to 1.38, P < .001) in states that prohibited short-term limited duration insurance plans vs did not regulate short-term limited duration insurance plans. State policies resulting in unavailability of short-term limited duration insurance plans were associated with an increased percentage of early-stage diagnoses.
Psychosocial characteristics and quality of life among sexual and gender minority patients with cancer
Authors: Yang Min-Jeong , Pérez-Morales Jaileene , Quinn Gwendolyn P , Miller Jarred D , Simmons Vani N , Schabath Matthew B
Published: August 2023

Background

Underserved and minoritized patients with cancer often experience more psychosocial concerns and inferior quality of life (QOL) compared with majority populations. This study compared patient-reported psychosocial characteristics and QOL among self-identified sexual and gender minority patients with cancer vs cisgender-heterosexual patients with cancer treated at a National Cancer Institute–designated comprehensive cancer center in the United States.

Methods

Self-report data from 51 503 patients were obtained from an institutional standard-of-care electronic patient questionnaire that was completed prior to, or on the day of, the patient’s initial visit. The electronic patient questionnaire collects demographic information, including sexual orientation and gender identity, psychosocial variables, and QOL using the validated Short Form Health Survey–12. Sexual orientation and gender identity information was used to identify self-identified sexual and gender minority and cisgender-heterosexual persons (ie, non–self-identified sexual and gender minority). Using parametric analyses, psychosocial variables and QOL measures were compared for self-identified sexual and gender minority vs non–self-identified sexual and gender minority patients with cancer.

Results

Compared with non–self-identified sexual and gender minority patients (n = 50 116), self-identified sexual and gender minority patients (n = 1387, 2.7%) reported statistically significantly greater concerns regarding getting help during treatment (2.6% vs 4.3%, respectively; P = .001) and concerns with ability to seek care (16.7% vs 21.6%, respectively, P < .001). Self-identified sexual and gender minority patients reported statistically significantly elevated mental health concerns and daily emotional and pain interference (all P < .001), whereas there was no statistically significant difference in daily interference due to physical functioning.

Conclusion

These data reveal real-world disparities among self-identified sexual and gender minority patients with cancer, which can be used to develop psychosocial interventions tailored to address the unique psychosocial and QOL needs of this underserved and minoritized population and to ultimately improve cancer care.
Thermal performance of open microchannel heat sink with NACA airfoil shaped pin fins
Authors: Wu Kun-Da , Weng Huei Chu
Published: August 2023

The main purpose of this study is to numerically investigate the effect of pin-fin National Advisory Committee for Aeronautics (NACA) airfoil on the heat transfer performance of a single open microchannel heat sink with a fixed surface area and a constant wall heat flux. It was found that the helical flow within the microchannel and the converging–diverging flow near the two sides of the microchannel, caused by the periodically arranged NACA airfoil shaped pin fins with an attack angle, dominate the overall heat dissipation ability of the heat sink. The heat dissipation ability can be further improved by increasing the attack angle and Reynolds number. Of the airfoils considered, the symmetrical airfoil NACA0012 in no attack angle case presents the smallest pressure drop, but also the smallest thermal performance value, which can still achieve a Nusselt number improvement of 35.15% and a thermal performance factor (TPF) improvement of 1.38%, compared to the no-fin case. The NACA airfoil effect can be improved when asymmetric airfoils are considered. In terms of overall thermal performance, the NACA6412 would be the best choice. Its percentage increases in the Nusselt number and TPF can be further enhanced by up to 57.62% and 35.43%, respectively, compared to the no-attack-angle NACA0012 case.
Evaluating direct amplification from viral transport medium for SARS-CoV-2 detection, strain typing, and angiotensin-converting enzyme genotyping and expression assays
Authors: Schilter Kala F , Kapoor Shivani , Smith Brandon A , Saleem Ayofemi , Scott Samantha J , Batchelor Dana , Stoll Kathryn A , Nie Qian , Reddi Honey V
Published: August 2023

Objective

The aim of this study was to compare the performance of direct amplification of viral nucleic acid from transport medium to extracted nucleic acid for polymerase chain reaction (PCR), sequencing, and genotyping applications.

Methods

XpressAmp lysate and extracted total nucleic acid from viral transport medium containing nasopharyngeal specimens were evaluated across different molecular applications to determine performance characteristics.

Results

SARS-CoV-2 quantitative PCR and angiotensin-converting enzyme (ACE) genotyping assays worked well with XpressAmp lysate, almost equal with or better than extracted nucleic acid in some specimens. However, XpressAmp completely failed to perform in next-generation sequencing for strain typing. Both protocols failed to detect ACE2 expression in viral transport medium.

Conclusion

Direct amplification of viral nucleic acid from viral transport medium containing nasopharyngeal specimen works well for molecular assays with low thresholds of quality; however, it does have limitations with assays that require high quality nucleic acid for input. Use of the XpressAmp protocol significantly improves turnaround time and allows for easy ramp-up of PCR and genotyping assays.
Recovery of kidney function after acute kidney disease—a multi-cohort analysis
Authors: Sawhney Simon , Ball William , Bell Samira , Black Corri , Christiansen Christian F , Heide-Jørgensen Uffe , Jensen Simon K , Lambourg Emilie , Ronksley Paul E , Tan Zhi , Tonelli Marcello , James Matthew T
Published: August 2023

Background

There are no consensus definitions for evaluating kidney function recovery after acute kidney injury (AKI) and acute kidney disease (AKD), nor is it clear how recovery varies across populations and clinical subsets. We present a federated analysis of four population-based cohorts from Canada, Denmark and Scotland, 2011–18.

Methods

We identified incident AKD defined by serum creatinine changes within 48 h, 7 days and 90 days based on KDIGO AKI and AKD criteria. Separately, we applied changes up to 365 days to address widely used e-alert implementations that extend beyond the KDIGO AKI and AKD timeframes. Kidney recovery was based on resolution of AKD and a subsequent creatinine measurement below 1.2× baseline. We evaluated transitions between non-recovery, recovery and death up to 1 year; within age, sex and comorbidity subgroups; between subset AKD definitions; and across cohorts.

Results

There were 464 868 incident cases, median age 67–75 years. At 1 year, results were consistent across cohorts, with pooled mortalities for creatinine changes within 48 h, 7 days, 90 days and 365 days (and 95% confidence interval) of 40% (34%–45%), 40% (34%–46%), 37% (31%–42%) and 22% (16%–29%) respectively, and non-recovery of kidney function of 19% (15%–23%), 30% (24%–35%), 25% (21%–29%) and 37% (30%–43%), respectively. Recovery by 14 and 90 days was frequently not sustained at 1 year. Older males and those with heart failure or cancer were more likely to die than to experience sustained non-recovery, whereas the converse was true for younger females and those with diabetes.

Conclusion

Consistently across multiple cohorts, based on 1-year mortality and non-recovery, KDIGO AKD (up to 90 days) is at least prognostically similar to KDIGO AKI (7 days), and covers more people. Outcomes associated with AKD vary by age, sex and comorbidities such that older males are more likely to die, and younger females are less likely to recover.
A new type of cell related to organ movement for selfing in plants
Authors: Wang Yin-Zheng , Lin Yan-Xiang , Liu Qi , Liu Jing , Barrett Spencer C H
Published: August 2023

Many plants employ osmotic and hydrostatic pressure to generate movement for survival, but little is known about the cellular mechanisms involved. Here, we report a new cell type in angiosperms termed ‘contractile cells’ in the stigmas of the flowering plant Chirita pumila with a much-expanded rough endoplasmic reticulum (RER). Cryo-scanning electron microscopy and transmission electron microscopy analyses revealed that the RER is continuously distributed throughout the entirety of cells, confirmed by endoplasmic reticulum (ER)-specific fluorescent labeling, and is distinct from the common feature of plant ER. The RER is water-sensitive and extremely elongated with water absorption. We show that the contractile cells drive circadian stigma closing–bending movements in response to day-to-night moisture changes. RNA-seq analyses demonstrated that contractile cells have distinct molecular components. Furthermore, multiple microstructural changes in stigma movements convert an anti-selfing structure into a device promoting selfing—a unique cellular mechanism of reproductive adaptation for uncertain pollination environments.
Barriers and Enablers to Implementing a Smoke-free Home and Car During Pregnancy: A Qualitative Study Among Expectant Israeli Fathers
Authors: Guri-Scherman Anne-Laure Yehudit , Neumark Yehuda , Rodnay Maya , Bar-Zeev Yael
Published: August 2023

Introduction

Secondhand smoke exposure during pregnancy is a significant cause of negative health effects. This study aims to identify barriers and facilitators for implementing a smoke-free home and car among expectant Israeli fathers.

Aims and Methods

Twenty-four qualitative semistructured telephone interviews were audio-recorded, transcribed, and analyzed according to a reflexive and collaborative thematic approach. Inclusion criteria were being male, Hebrew speaker, age ≥18 years, smoking at least one cigarette a day, and living with their nonsmoking pregnant spouse. The Capability, Opportunity and Motivation for Behavior (COM-B) model was used as a theoretical model for analysis.

Results

Participants reported feeling a strong responsibility for their pregnant spouse’s comfort and health, stating that they are doing the best they can to reduce their spouse’s secondhand smoke exposure (Motivation). Participants had a low level of knowledge about specific secondhand smoke health consequences, effective strategies to reduce secondhand smoke exposure, with incorrect perceptions about what constitutes exposure (Capability). Couple relationships were not affected by the husband’s smoking habits, and participants expressed mutual consideration and understanding (Opportunity). Participants also expressed positive attitudes regarding smoke-free home and car implementation but emphasized that any changes have to be their own decision (Motivation).

Conclusions

The present study identified principal Capability, Opportunity and Motivation barriers and facilitators that influence Israeli expectant fathers’ decision to implement a smoke-free home and car. Those findings will inform the development of a digital behavioral intervention targeting expectant fathers to reduce prenatal secondhand smoke exposure.

Implications

Secondhand smoke exposure during pregnancy is a significant cause of negative health effects. Interventions among expectant fathers that focus on creating a smoke-free home and car may be effective because pregnancy has been identified as a “window of opportunity” that generates a strong motivation and creates a sense of urgency to change smoking behavior, while being considered more achievable than smoking cessation. Interventions might be effective if they focus on strengthening the parental responsibility among expectant fathers and emphasize the benefits of a smoke-free home and car, while maintaining male autonomy and increasing skills to effectively implement a smoke-free home and car.
Efficacy of Minocycline for the Treatment ofMycoplasma genitalium
Authors: Clarke Emily J , Vodstrcil Lenka A , Plummer Erica L , Aguirre Ivette , Samra Ranjit S , Fairley Christopher K , Chow Eric P F , Bradshaw Catriona S
Published: August 2023

Background

High levels of macrolide resistance and increasing fluoroquinolone resistance are making Mycoplasma genitalium increasingly difficult to treat. Minocycline is an alternative treatment for patients with macrolide-resistant M genitalium infections that have failed moxifloxacin, or for those with fluoroquinolone contraindications or resistance. Published efficacy data for minocycline for M genitalium are limited.

Methods

We evaluated minocycline 100 mg twice daily for 14 days at Melbourne Sexual Health Centre (MSHC). Microbial cure was defined as a negative test of cure within 14–90 days after completing minocycline. The proportion cured and 95% confidence intervals (CIs) were calculated, and logistic regression was used to explore factors associated with treatment failure. We pooled data from the current study with a prior adjacent case series of patients with M genitalium who had received minocycline 100 mg twice daily for 14 days at MSHC.

Results

Minocycline cured 60 of 90 (67% [95% CI, 56%–76%]) infections. Adherence was high (96%) and side effects were mild and self-limiting. No demographic or clinical characteristics were associated with minocycline failure in regression analyses. In the pooled analyses of 123 patients, 83 (68% [95% CI, 58%–76%]) were cured following minocycline.

Conclusions

Minocycline cured 68% of macrolide-resistant M genitalium infections. These data provide tighter precision around the efficacy of minocycline for macrolide-resistant M genitalium and show that it is a well-tolerated regimen. With high levels of macrolide resistance, increasing fluoroquinolone resistance, and the high cost of moxifloxacin, access to nonquinolone options such as minocycline is increasingly important for the clinical management of M genitalium.
Gallbladder Empyema and Epidural Abscess Due to Salmonella Enteritidis After Treatment of Primary Infection: Case Report and Review of the Literature
Authors: Malik Ambreen , Sharma Mamta , Johnson Leonard B , Bhargava Ashish
Published: August 2023

Nontyphoidal Salmonella can cause gallbladder empyema and disseminated disease in patients with suppressed immune systems. We are reporting a unique case of concomitant gallbladder empyema and epidural abscess due to Salmonella enterica subsp enterica serovar Enteritidis in a patient who was appropriately treated for the primary Salmonella infection complicated by bacteremia. A high degree of suspicion is needed in high-risk patients as timely intervention can avoid life-threatening complications.
Synergies between interstellar dust and heliospheric science with an interstellar probe
Authors: Sterken Veerle J , Hunziker S , Dialynas K , Leitner J , Sommer M , Srama R , Baalmann L R , Li A , Herbst K , Galli A , Brandt P , Riebe M , Baggaley W J , Blanc M , Czechowski A , Effenberger F , Fields B , Frisch P , Horanyi M , Hsu H-W , Khawaja N , Krüger H , Kurth W S , Ligterink N F W , Linsky J L , Lisse C , Malaspina D , Miller J A , Opher M , Poppe A R , Postberg F , Provornikova E , Redfield S , Richardson J , Rowan-Robinson M , Scherer K , Shen M M , Slavin J D , Sternovsky Z , Stober G , Strub P , Szalay J , Trieloff M
Published: August 2023

We discuss the synergies between heliospheric and dust science, the open science questions, the technological endeavours, and programmatic aspects that are important to maintain or develop in the decade to come. In particular, we illustrate how we can use interstellar dust in the solar system as a tracer for the (dynamic) heliosphere properties, and emphasize the fairly unexplored, but potentially important science question of the role of cosmic dust in heliospheric and astrospheric physics. We show that an interstellar probe mission with a dedicated dust suite would bring unprecedented advances to interstellar dust research, and can also contribute – through measuring dust – to heliospheric science. This can, in particular, be done well if we work in synergy with other missions inside the solar system, thereby using multiple vantage points in space to measure the dust as it ‘rolls’ into the heliosphere. Such synergies between missions inside the solar system and far out are crucial for disentangling the spatially and temporally varying dust flow. Finally, we highlight the relevant instrumentation and its suitability for contributing to finding answers to the research questions.
Role of mitochondrial disruption and oxidative stress in plasticizer phthalate-induced cytotoxicity to human bone osteoblasts
Authors: Elmorsy Ekramy Mahmoud , Al-Ghafari Ayat , Al Doghaither Huda
Published: August 2023

Phthalates are frequently utilized in a wide range of products such as plasticizers with reported negative effects on bones. The current study evaluated the effect of butyl cyclohexyl phthalate on the human osteoblasts via different assays. MTT and lactate dehydrogenase assays were used to examine the in-vitro cytotoxic effect of butyl cyclohexyl phthalate on human bone osteoblasts in concentrations 0.1, 1, 10, and 100 μM for 12 to 72 h postexposures. Incubation of osteoblasts with butyl cyclohexyl phthalate significantly reduced cell viability based on its concentrations and durations of exposure. In parallel, osteoblast secretion of procollagen type 1, osteocalcin, as well as alkaline phosphatase was significantly decreased by butyl cyclohexyl phthalate in concentrations (1 or 2 μM). Butyl cyclohexyl phthalate decreased ATP synthesis and mitochondrial complexes I and III activities, with increased lactate production, all of which were detrimental to cellular bioenergetics. The cellular redox defense systems were significantly depleted by increased lipid peroxidation, elevated reactive oxygen species, decreased catalase and superoxide dismutase enzymes activities, and decreased intracellular reduced glutathione (GSH). Redox stress was also induced. Interestingly, preincubating osteoblasts with reduced GSH before exposing them to butyl cyclohexyl phthalate significantly lowered the cytotoxicity of the butyl cyclohexyl phthalate, suggesting that antioxidants may play a helpful protective effect.
Genome-wide identification of late embryogenesis abundant protein family and their key regulatory network in Pinus tabuliformis cold acclimation
Authors: Zhou Chengcheng , Niu Shihui , El-Kassaby Yousry A , Li Wei
Published: August 2023

Cold acclimation is a crucial biological process that enables conifers to overwinter safely. The late embryogenesis abundant (LEA) protein family plays a pivotal role in enhancing freezing tolerance during this process. Despite its importance, the identification, molecular functions and regulatory networks of the LEA protein family have not been extensively studied in conifers or gymnosperms. Pinus tabuliformis, a conifer with high ecological and economic values and with high-quality genome sequence, is an ideal candidate for such studies. Here, a total of 104 LEA genes were identified from P. tabuliformis, and we renamed them according to their subfamily group: PtLEA1–PtLEA92 (group LEA1–LEA6), PtSMP1–PtSMP6 (group seed maturation protein) and PtDHN1–PtDHN6 (group Dehydrin). While the sequence structure of P. tabuliformis  LEA genes are conserved, their physicochemical properties exhibit unique characteristics within different subfamily groupings. Notably, the abundance of low-temperature responsive elements in PtLEA genes was observed. Using annual rhythm and temperature gradient transcriptome data, PtLEA22 was identified as a key gene that responds to low-temperature induction while conforming to the annual cycle of cold acclimation. Overexpression of PtLEA22 enhanced Arabidopsis freezing tolerance. Furthermore, several transcription factors potentially co-expressed with PtLEA22 were validated using yeast one-hybrid and dual-luciferase assays, revealing that PtDREB1 could directly bind PtLEA22 promoter to positively regulate its expression. These findings reveal the genome-wide characterization of P. tabuliformis  LEA genes and their importance in the cold acclimation, while providing a theoretical basis for studying the molecular mechanisms of cold acclimation in conifers.
Prevalence and associated factors of stunting and thinness among adolescent Sudanese schoolchildren: a cross-sectional study
Authors: Bilal Jalal A , Osman Almarwa A , Al-Nafeesah Abdullah , AlEed Ashwaq , Adam Ishag
Published: August 2023

Background

Malnutrition among adolescents is a considerable health problem worldwide. There are scarce data on undernutrition among adolescents in Sudan.

Methods

A cross‑sectional study was conducted to investigate the prevalence and associated factors of stunting and thinness among adolescent schoolchildren in northern Sudan. The questionnaires were used to collect information on sociodemographics. Weights and heights were measured and the height-for-age and body mass index-for-age cut-offs recommended by the WHO were applied, followed by logistic regression analysis.

Results

Of 384 enrolled adolescents, 202 (52.6%) were females and 182 (47.4%) were males. The median (IQR) age of these adolescents was 15.1 (14.0‒16.3) y. Seventy-six (19.8%) and 52 (15.4%) adolescents had stunting and thinness, respectively, and 15 (3.9%) had both stunting and thinness. Multivariate analysis showed that increased age (adjusted OR [AOR]=1.30, 95% CI 1.08 to 1.57) and male gender (AOR=5.82, 95% CI 3.11 to 10.91) were associated with stunting. Male gender (AOR=2.08, 95% CI 1.14 to 3.82) and smoking/tobacco snuff (AOR=2.61, 95% CI 1.07 to 6.36) were associated with thinness.

Conclusions

The findings of the current study are that both stunting and thinness are important health problems, especially among boys, older participants and smokers.
The largest Palaeozoic whip scorpion and the smallest (Arachnida: Uropygi: Thelyphonida); a new species and a new ichnospecies from the Carboniferous of New England, USA
Authors: Knecht Richard J , Benner Jacob S , Dunlop Jason A , Renczkowski Mark D
Published: August 2023

Palaeozoic fossils of whip scorpions (Arachnida: Uropygi: Thelyphonida) are extremely rare, with only seven species of this age previously described. A new species of fossil whip scorpion, as well as the first ichnospecies assignable to this group, are described here from the Carboniferous Narragansett Basin of Massachusetts, USA. A body fossil from the Rhode Island Formation (Moscovian) is referred to as Parilisthelyphonus bryantae gen. nov., sp. nov.. At more than 34 mm long it represents both the largest known Palaeozoic whip scorpion and the first fossil arachnid found in the Rhode Island Formation in ~130 years of scrutiny. The whip scorpion trace fossil, comprising a full-body impression and associated tracks, is described from the subjacent Wamsutta Formation (Late Bashkirian) of Massachusetts, USA as Inmontibusichnus charleshenryturneriigen. nov., isp. nov.. With an estimated body length of less than 10 mm, the producer would be the smallest known Palaeozoic thelyphonid. These discoveries within the Narragansett Basin represent only the second site in the western hemisphere, in what was western Laurasia, to yield Palaeozoic whip scorpions. The Narragansett Basin is of significant Pangaean biogeographical importance among whip scorpion sites, being located between the westernmost Mazon Creek Lagerstätte of Illinois and the eastern assemblage of localities in Europe, and serves as an important new fossil calibration point for phylogenetic studies of this arachnid group.
Electrical Impedance Tomography Identifies Evolution of Regional Perfusion in a Porcine Model of Acute Respiratory Distress Syndrome
Authors: Martin Kevin T. , Xin Yi , Gaulton Timothy G. , Victor Marcus , Santiago Roberta R. , Kim Taehwan , Morais Caio C. A. , Kazimi Aubrey A. , Connell Marc , Gerard Sarah E. , Herrmann Jacob , Mueller Ariel L. , Lenart Austin , Shen Jiacheng , Khan Sherbano S. , Petrov Mihail , Reutlinger Kristan , Rozenberg Karina , Amato Marcelo , Berra Lorenzo , Cereda Maurizio
Published: August 2023

Background

Bedside electrical impedance tomography could be useful to visualize evolving pulmonary perfusion distributions when acute respiratory distress syndrome worsens or in response to ventilatory and positional therapies. In experimental acute respiratory distress syndrome, this study evaluated the agreement of electrical impedance tomography and dynamic contrast–enhanced computed tomography perfusion distributions at two injury time points and in response to increased positive end-expiratory pressure (PEEP) and prone position.

Methods

Eleven mechanically ventilated (VT 8 ml · kg−1) Yorkshire pigs (five male, six female) received bronchial hydrochloric acid (3.5 ml · kg−1) to invoke lung injury. Electrical impedance tomography and computed tomography perfusion images were obtained at 2 h (early injury) and 24 h (late injury) after injury in supine position with PEEP 5 and 10 cm H2O. In eight animals, electrical impedance tomography and computed tomography perfusion imaging were also conducted in the prone position. Electrical impedance tomography perfusion (QEIT) and computed tomography perfusion (QCT) values (as percentages of image total) were compared in eight vertical regions across injury stages, levels of PEEP, and body positions using mixed-effects linear regression. The primary outcome was agreement between QEIT and QCT, defined using limits of agreement and Pearson correlation coefficient.

Results

Pao
2/Fio
2 decreased over the course of the experiment (healthy to early injury, −253 [95% CI, −317 to −189]; early to late injury, −88 [95% CI, −151 to −24]). The limits of agreement between QEIT and QCT were −4.66% and 4.73% for the middle 50% quantile of average regional perfusion, and the correlation coefficient was 0.88 (95% CI, 0.86 to 0.90]; P < 0.001). Electrical impedance tomography and computed tomography showed similar perfusion redistributions over injury stages and in response to increased PEEP. QEIT redistributions after positional therapy underestimated QCT in ventral regions and overestimated QCT in dorsal regions.

Conclusions

Electrical impedance tomography closely approximated computed tomography perfusion measures in experimental acute respiratory distress syndrome, in the supine position, over injury progression and with increased PEEP. Further validation is needed to determine the accuracy of electrical impedance tomography in measuring perfusion redistributions after positional changes.

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Contribution of cardiovascular disease to the burden of non-communicable diseases in Africa: an analysis of data from Global Burden of Disease database, 1990–2019
Authors: Maimaitiming Mailikezhati , Kakunze Adelard , Feng Yikai , Wang Minmin , Li Na , Shi Junyi , Huang Kepei , Jin Yinzi , Zheng Zhi-Jie
Published: August 2023

Background and purpose:

Disease burden of non-communicable diseases (NCDs) has been increasing in low- and middle-income countries, especially in African countries. Cardiovascular disease (CVD) is a common NCDs and the leading cause of death in Africa. Yet, evidence on the contribution of CVD to the total NCDs burden is scarce. This study aimed to investigate the contribution of CVD to the total disease burden caused by NCDs in Africa between 1990 and 2019.

Methods:

Data on NCDs, including CVD, were extracted from the Global Burden of Disease (GBD) database. Disease burden was measured by disability-adjusted life years (DALYs) and deaths.

Results:

From 1990 to 2019, the share of CVD in the total NCDs burden increased and remained as the first contributor. In 2019, NCDs caused 204 million DALYs and over 2.18 million deaths in the Africa Union, among which 49.1% of the total DALYs and 66.0% of deaths were caused by the traditional five NCDs, including CVD that accounted for the largest burden of NCDs (20.5% of DALYs and 35.2% of deaths). The proportion of CVD to the total NCDs burden was most considerable, reaching up to 32.4% and 52.4% in Northern Africa for DALYs and deaths, respectively. CVD were important contributors to NCDs burden in Africa, including ischemic heart disease (1334 DALYs per 100,000 and 27.79 deaths per 100,000) and intracerebral hemorrhage (632 DALYs per 100,000 and 13.53 deaths per 100,000) that were the top two causes of NCDs in 2019.

Conclusions:

CVD has been the biggest contributor to NCDs burden in the Africa Union over the thirty years. Given the increase in the share of NCDs burden attributable to CVD, it demands a close attention to implementing cost-effective policies and interventions for CVD to achieve an improvement in population health and reduction of health loss from NCDs.
The Role of Eye Banking in Implementation of the Integrated People-Centered Eye Care (IPEC) Model
Authors: Schwarz Kaitlin , Bashshur Ramona
Published: August 2023

Vision loss and blindness are global public health concerns. Measures must be taken to address the magnitude and causes. The integrated people-centered model of eye care (IPEC) has been advanced by the World Health Organization and the International Agency to Prevent Blindness to address these challenges and facilitate the delivery of eye care. The US eye banking community occupies a distinct sector within the spectrum of vision services and global public health efforts. Alignment with the IPEC model and these global priorities is a logical development for the cornea and eye banking sector, and addressing gaps in the evidence base for corneal disease will serve to strengthen these efforts.
Prevalence of International Medical Graduates in Integrated Plastic Surgery Programs
Authors: Porras Fimbres Denisse Cristina , Zeng Steven , Phillips Brett Thomas
Published: August 2023

Background:

International medical graduates (IMGs) are physicians who did not attend medical school in the USA or Canada. IMGs comprise nearly one-quarter of the physician workforce and play a vital role in health care. Here, we aimed to identify the prevalence of IMGs in integrated programs and evaluate factors that influence their success in the residency match.

Methods:

The annual match reports from 2010 to 2020 were retrieved and summarized. Electronic surveys for program directors and program coordinators were distributed to US integrated plastic surgery programs. Each program’s website was appraised for information regarding the eligibility of IMGs. Websites were also used to identify the number of IMG residents.

Results:

The number of applicants who matched into integrated programs ranged from 69 to 180 per year, of which US applicants comprised 61–165. US IMGs filled one to three positions per year, whereas non-US IMGs filled two to seven. Although 48% of programs have matched non-citizen IMGs and 79% have not encountered difficulties during the visa process, 67% of coordinators reported that the onboarding process is more challenging for IMGs. There are no IMGs in 52% of programs, and most institutions offer information on their website regarding visa sponsorship.

Conclusion:

IMGs make up less than 10% of filled positions per cycle. Although most programs accept IMGs, a small number matriculate. This may be explained by the competitiveness of integrated programs and the volume of IMG applications. Further research is needed to identify contributing factors of low IMG representation in plastic surgery programs.
Analysis on the Difference between the Practical Brassiere Size and Real Breast Volume
Authors: Lee Seok Joon , Han Woo Yeon , Eom Jin Sup , Kim Eun Key , Han Hyun Ho
Published: August 2023

Background:

Brassiere cup size is defined as the difference in chest circumference between the inframammary fold and the fullest part of the breast. However, a large number of women are not aware of the correct definition and are prone to wearing incorrectly-sized brassieres. In this report, the authors compared the cup size of worn brassieres and the actual measurement.

Methods:

This study was a retrospective review of patients who had undergone breast reconstruction operation between May 2020 and June 2021. All patients who visited the plastic surgery clinic for breast reconstruction were inquired about their cup size, and their breast circumferences were measured. The patient demographic information, ptosis grade, mastectomy specimen weight, measured breast circumference, and known cup size were analyzed.

Results:

Overall, 163 women were included. Notably, 92 of 163 patients (56.4%) were wearing a correctly-sized brassiere. Patients were more likely to wear a correctly-sized brassiere as the cup size became smaller. Moreover, patients with A-cup breasts tended to wear larger brassieres, whereas patients with B and C-cup breasts tended to wear smaller brassieres than their actual breast cup size.

Conclusions:

Approximately one in two women do not know their correct brassiere cup size. Women tend to wear a brassiere of the wrong size as their cup size becomes larger. Therefore, it is important for surgeons to be aware of their patient’s brassiere wearing habit and their perception when a surgery, such as augmentation or reconstruction, is planned.
Recognition and Respect: Contextualizing the History and Contributions of Black American Plastic Surgeons
Authors: Glahn Joshua Zev , Hooper Rachel C. , Butler Paris D.
Published: August 2023

Recently, there has been heightened interest in the history of Black American plastic surgeons and their contributions to the field of plastic and reconstructive surgery (PRS). Despite the increased awareness and attention toward the lack of racial and ethnic diversity of the PRS workforce, the history of how PRS became one of the most ethnically segregated surgical specialties remains unexplored. Here, we outline the various political and cultural factors that contributed to the exclusion of Black practitioners from American PRS professional societies. This work contextualizes the rise of American PRS within the Jim Crow era and highlights the cultural significance of reconstructive procedures performed in the treatment of disfigured soldiers. Through this lens, we identify circumstances where Black surgeons were systematically denied opportunities to participate in the emerging specialty. Despite these barriers, we demonstrate how Black physicians established informal networks for professional advancement and shed light on several previously unrecognized contributions to PRS from Black surgeons. In addition, we explore how the inclusion of Black voices in PRS sparked a paradigm shift in the treatment of non-White patients that expanded the cosmetic marketplace in ways that remain significant today. Finally, we situate the ongoing disparities in Black representation in PRS within a broader historical narrative and illustrate how the stories we tell about our past continue to shape the future of our field.
Estimation of Mastectomy Volume Using Preoperative Mastectomy Simulation Images Acquired by the Vectra H2 System
Authors: Kim Jiwoo , Matsumine Hajime , Niimi Yosuke , Osada Atsuyoshi , Sakurai Hiroyuki
Published: August 2023

Background:

Preoperative prediction of breast volume is very important in planning breast reconstruction. In this study, we assessed the usefulness of a novel method for preoperative estimation of mastectomy volume by comparing the weight of actual mastectomy specimens with the values predicted by the developed method using the Vectra H2.

Methods:

All patients underwent skin-sparing mastectomy and immediate autologous breast reconstruction. Preoperatively, the patient’s breast was scanned using the Vectra H2 and a postmastectomy simulation image was constructed on a personal computer. The estimated mastectomy volume was calculated by comparing the preoperative and postmastectomy three-dimensional simulation images. Correlation coefficients with the estimated mastectomy volume were calculated for the actual mastectomy weight and the transplanted flap weight.

Results:

Forty-five breasts of 42 patients were prospectively analyzed. The correlations with the estimated mastectomy volume were r = 0.95 (P < 0.0001) for actual mastectomy weight and r = 0.84 (P < 0.0001) for transplanted free-flap weight. The mastectomy weight estimation formula obtained by linear regression analysis using the estimated mastectomy volume was 0.98 × estimated mastectomy volume + 5.4 (coefficient of determination R2 = 0.90, P < 0.0001). The root-mean-square error for the mastectomy weight estimation formula was 38 g.

Conclusions:

We used the Vectra H2 system to predict mastectomy volume. The predictions provided by this method were highly accurate. Three-dimensional imaging is a noncontact, noninvasive measurement method that is both accurate and simple to perform. Use of this effective tool for volume prediction is expected to increase in the future.
Nerve Transfers Using a Dedicated Microsurgical Robotic System
Authors: Schäfer Benedikt , Bahm Jörg , Beier Justus P.
Published: August 2023

Microsurgical demands in peripheral nerve surgery are increasing. Because of the development of multiple simultaneous selective nerve transfers, the transposition of very small nerves and even single fascicles has evolved. Coaptation of these increasingly smaller structures require high skills in microsurgical techniques. In addition, the surgical situs often has very limited access and is difficult to reach with conventional microsurgical options. Robot technology, the Symani Surgical System (Medical Microinstruments, S.p.A, Calci, Pisa, Italy), was used for epineural coaptation of three donor nerves (intercostal nerves 4–6) to the long thoracic nerve and the thoracodorsal nerve as recipient nerves in a patient with brachial plexus palsy. The coaptations could be carried out successfully with the microsurgical robot technology. In combination with a high-magnification (up to 26×) 3D-exoscope, the epineural sutures could be placed very precisely and accurately. Using this new microsurgical robotic system, successful coaptation of very small nerve structures is possible. This opens possibilities for the microsurgeon to carry out even finer, more targeted and more complex nerve transfers, including procedures in anatomical regions that are difficult to reach.
Knee-saving Amputation by Use of a Bipedicled Four-zone Deep Inferior Epigastric Artery Perforator Flap
Authors: Saritas Sinem , Jul Kiil Birgitte , Sværdborg Mille
Published: August 2023

Degloving traumatic lower extremity injuries can lead to an above-knee amputation with decreased functional capacity compared with below-knee amputation. The unique properties of the deep inferior epigastric artery perforator flap providing a substantial amount of skin and subcutaneous tissue combined with reliability and low donor-site morbidity makes the flap ideal for coverage of below-knee amputation stumps when soft tissue is required. A bipedicled four-zone deep inferior epigastric artery perforator flap with a skin area of 13 × 33 cm was used as coverage of a degloved lower leg amputation stump, in a 27-year-old woman with a left-sided Gustillo type 3B comminute diaphyseal tibial fractur and major degloving injury. Hereby, above-knee amputation was avoided. Ten months postoperatively the patient had achieved full prosthetic function.
Enhanced Dosimetric Accuracy Using Quality Factor Compensation Method for In Vivo Electron Paramagnetic Resonance Tooth Dosimetry
Authors: Choi Kwon , Koo Chang Uk , Oh Jeonghun , Kim Jiwon , Park Jong In , Kim Sung Hwan , Lee Jong Hoon , Kang Dae Gyu , Ye Sung-Joon
Published: August 2023

We aim to develop a dose assessment method compensating for quality factors (Q factor) observed during in vivo EPR tooth dosimetry. A pseudo-in-vivo phantom made of tissue-equivalent material was equipped with one each of four extracted human central incisors. A range of Q factors was measured at tooth-depths of −2, 0, and 2 mm in the pseudo-in-vivo phantom. In addition, in vivo Q factors were measured from nine human volunteers. For the dose-response data, the above four sample teeth were irradiated at 0, 1, 2, 5, and 10 Gy, and the radiation-induced signals were measured at the same tooth-depths using an in vivo EPR tooth dosimetry system. To validate the method, the signals of two post-radiotherapy patients and three unirradiated volunteers were measured using the same system. The interquartile range of the Q factors measured in the pseudo-in-vivo phantom covered that observed from the human volunteers, which implied that the phantom represented the Q factor distribution of in vivo conditions. The dosimetric sensitivities and background signals were decreased as increasing the tooth-depth in the phantom due to the decrease in Q factors. By compensating for Q factors, the diverged dose-response data due to various Q factors were converged to improve the dosimetric accuracy in terms of the standard error of inverse prediction (SEIP). The Q factors of patient 1 and patient 2 were 98 and 64, respectively, while the three volunteers were 100, 92, and 99. The assessed doses of patient 1 and patient 2 were 2.73 and 12.53 Gy, respectively, while expecting 4.43 and 13.29 Gy, respectively. The assessed doses of the unirradiated volunteers were 0.53, 0.50, and − 0.22 Gy. We demonstrated that the suggested Q factor compensation could mitigate the uncertainty induced by the variation of Q factors.
Long-Term Outcomes After Corneal Cross-linking for Progressive Keratoconus and Corneal Ectasia: A 10-Year Follow-Up of the Pivotal Study
Authors: Greenstein Steven A. , Yu Austin S. , Gelles John D. , Huang Steven , Hersh Peter S.
Published: August 2023

Objectives:

To report on the topographic and visual outcomes 10 years after corneal cross-linking in patients with progressive keratoconus and corneal ectasia after refractive surgery.

Methods:

Cross-sectional cohort study of an original, prospective, randomized, clinical trial. Patients treated in a single center cornea and refractive surgery practice as part of the U.S. pivotal trials, which led to the Food and Drug Administration approval of corneal cross-linking, were recruited for a 10-year follow-up examination. LogMar lines (LL) of uncorrected visual acuity (UCVA) and best spectacle–-corrected visual acuity (BSCVA), maximum keratometry, and thinnest pachymetry were evaluated. In addition, the Belin ABCD progression display was used to determine progression (95% confidence interval) of the anterior curvature, posterior curvature, and corneal thickness of each individual eye included.

Results:

Nineteen eyes of 13 patients treated with standard cross-linking returned for a 10-year follow-up examination. Mean maximum keratometry changed from 58.2±12.0 diopters (D) to 58.3±10.1 D, thinnest pachymetry changed from 440.6±51.6 µm to 442.3±54.4 μm, UCVA changed from 0.79±0.42 LL to 0.86±0.46 LL, and BSCVA changed from 0.38±0.26 LL to 0.33±0.34 LL, 10 years after cross-linking. Individually, 68.5% of the entire cohort, 81.8% of keratoconus eyes, and 50% of eyes with corneal ectasia remained topographically stable 10 years after standard cross-linking.

Conclusions:

In the entire cohort, visual acuity and topography remained stable 10 years after cross-linking. Over the long-term, eyes with keratoconus seem to be more stable than those with corneal ectasia.
Big Data Analysis of Glaucoma Prevalence in Israel
Authors: Landau Prat Daphna , Zloto Ofira , Kapelushnik Noa , Leshno Ari , Klang Eyal , Sina Sigal , Segev Shlomo , Soudry Shahar , Ben Simon Guy J.
Published: August 2023

Précis:

The prevalence of glaucoma in the adult population included in this study was 2.3%. Normal values of routine eye examinations are provided including age and sex variations.

Purpose:

The purpose of this study was to analyze the prevalence of glaucoma in a very large database.

Methods:

Retrospective analysis of medical records of patients examined at the Medical Survey Institute of a tertiary care university referral center between 2001 and 2020. A natural language process (NLP) algorithm identified patients with a diagnosis of glaucoma. The main outcome measures included the prevalence and age distribution of glaucoma. The secondary outcome measures included the prevalence and distribution of visual acuity (VA), intraocular pressure (IOP), and cup-to-disc ratio (CDR).

Results:

Data were derived from 184,589 visits of 36,762 patients (mean age: 52 y, 68% males). The NLP model was highly sensitive in identifying glaucoma, achieving an accuracy of 94.98% (area under the curve=93.85%), and 633 of 27,517 patients (2.3%) were diagnosed as having glaucoma with increasing prevalence in older age. The mean VA was 20/21, IOP 14.4±2.84 mm Hg, and CDR 0.28±0.16, higher in males. The VA decreased with age, while the IOP and CDR increased with age.

Conclusions:

The prevalence of glaucoma in the adult population included in this study was 2.3%. Normal values of routine eye examinations are provided including age and sex variations. We proved the validity and accuracy of the NLP model in identifying glaucoma.
Leukocyte 8-hydroxy-2′-deoxyguanosine as an oxidative stress marker to predict cardiovascular events and death in chronic hemodialysis patients
Authors: Tang Ching-Fang , Wu Mei-Yi , Wei Yau-Huei , Ho Yang , Kuo Ko-Lin
Published: August 2023

Background:

Hemodialysis patients have a markedly increased risk of cardiovascular (CV) morbidity and mortality. Oxidative stress plays a pathogenic role in the progression of atherosclerosis and CV disease among chronic hemodialysis patients. The 8-hydroxy-2′-deoxyguanosine (8-OHdG) content in leukocyte deoxyribonucleic acid (DNA) has been shown as a sensitive and well-known biomarker of oxidant-induced DNA damage in chronic hemodialysis patients.

Methods:

We conducted a retrospective cohort study to investigate the association of leukocyte 8-OHdG and CV events and deaths in patients of chronic hemodialysis. In this study, 217 chronic hemodialysis patients were recruited from 2016 to 2021. The 8-OHdG content of leukocyte DNA was measured by a high-performance liquid chromatography electrochemical detection method. Study outcomes were CV events as well as CV and all-cause deaths. The patients were followed until May 2021.

Results:

The median follow-up period was 34.8 months. At the end of May 2021, 57 first CV events and 89 all-CV events occurred. Among the first and all CV events, 17 (29.8%) and 32 (36.0%) were fatal, respectively. Multivariate Cox regression analysis showed per 1/105 dG increment in leukocyte 8-OHdG values increased risk of CV events (adjusted hazard ratio [aHR], 1.19; 95% CI, 1.10-1.41; p < 0.001), CV death (aHR, 1.27; 95% CI, 1.03-1.72; p = 0.034), and all-cause death (aHR, 1.11; 95% CI, 1.01-1.30; p = 0.038).

Conclusion:

This is the first study to demonstrate that oxidative stress assessed by 8-OHdG levels of leukocyte DNA predicted CV events as well as CV and all-cause deaths among chronic hemodialysis patients.