bluuebunny/crossref_metadata_2025 huggingface dataset:
Solving climate change requires changing our food systems
Authors: Feigin Svetlana V , Wiebers David O , Blumstein Daniel T , Knight Andrew , Eshel Gidon , Lueddeke George , Kopnina Helen , Feigin Valery L , Morand Serge , Lee Kelley , Brainin Michael , Shackelford Todd K , Alexander Shelley M , Marcum James , Merskin Debra , Skerratt Lee F , Van Kleef Gerben A , Whitfort Amanda , Freeman Carrie P , Winkler Andrea Sylvia
Published: January 2025

Humanity is facing an important existential threat—irreversible climate change caused by human activity. Until recently, most of the proposals to address climate change have downplayed or ignored the adverse impact of food systems, especially intensive animal agriculture. This is in spite of the fact that up to a third of global greenhouse gas production to date can be attributed to animal agriculture. Recent developments at COP28 have signaled that the tide is turning, however, and that food systems are becoming part of global discussions on climate change solutions. The pressing nature of irreversible climate change requires rethinking our food systems. To solve the climate change crisis, we propose transitioning to a predominantly plant-based diet, and phasing out intensive animal agriculture as diets shift, without increasing pastoral farming. We suggest that such transformations in global food systems can be accomplished largely through education and large-scale public information campaigns, removal of subsidies, taxation to account for externalized costs of animal agriculture, improved labelling of products, and various investment/divestment drivers. Better metrics and industry benchmarks involving food and agriculture-specific performance indicators that reflect food system sustainability will be important. Increased global awareness of these issues and a change in mindset (which will drive political will) also are needed. Our current trajectory is untenable, and we must begin to turn the ship now towards sustainable food systems and diets.
Comparing quantitative imaging biomarker alliance volumetric CT classifications with RECIST response categories
Authors: Zhao Binsheng , Obuchowski Nancy , Yang Hao , Chou Yen , Ma Hong , Guo Pingzhen , Tang Ying , Schwartz Lawrence , Sullivan Daniel
Published: January 2025

Purpose

To assess agreement between CT volumetry change classifications derived from Quantitative Imaging Biomarker Alliance Profile cut-points (ie, QIBA CTvol classifications) and the Response Evaluation Criteria in Solid Tumors (RECIST) categories.

Materials and Methods

Target lesions in lung, liver, and lymph nodes were randomly chosen from patients in 10 historical clinical trials for various cancers, ensuring a balanced representation of lesion types, diameter ranges described in the QIBA Profile, and variations in change magnitudes. Three radiologists independently segmented these lesions at baseline and follow-up scans using 2 software tools. Two types of predefined disagreements were assessed: Type I: substantive disagreement, where the disagreement between QIBA CTvol classifications and RECIST categories could not be attributed to the improved sensitivity of volumetry in detecting changes; and Type II: disagreement potentially arising from the improved sensitivity of volumetry in detecting changes. The proportion of lesions with disagreements between QIBA CTvol and RECIST, as well as the type of disagreements, was reported along with 95% CIs, both overall and within subgroups representing various factors.

Results

A total of 2390 measurements from 478 lesions (158 lungs, 170 livers, 150 lymph nodes) in 281 patients were included. QIBA CTvol agreed with RECIST in 66.6% of interpretations. Of the 33.4% of interpretations with discrepancies, substantive disagreement (Type I) occurred in only 1.5% (95% CI: [0.8%, 2.1%]). Factors such as scanner vendor (P = .584), segmentation tool (P = .331), and lesion type (P = .492) were not significant predictors of disagreement. Significantly more disagreements were observed for larger lesions (≥50 mm, as defined in the QIBA Profile).

Conclusion

We conclude that QIBA CTvol classifications agree with RECIST categories.
Addressing the unfettered authority of sport governing bodies through EU competition law: the effect of International Skating Union and European Super League
Authors: Bantekas Ilias , Mercado Jaén Pedro José
Published: January 2025

The unfettered authority of sports governing bodies (SGBs) has given rise to a distinct number of human rights claims, but it has also led to the distortion of the free movement of persons and competition law in the European Union. In the International Skating Union and European Super League Company, the Court of Justice of the European Union (CJEU) emphasized that while SBGs have a right to achieve legitimate sporting aims, such as integrity and sporting fairness, this cannot be done at the expense of competition rules. The CJEU highlighted that SGBs are not allowed to prevent their member associations from organizing and operating competitive leagues and events, nor can they inflict sanctions on them for attempting to do so. These judgments will revolutionize the transnational sports law landscape and reshape SGB institutional rules and their relationships with their members.
Compliance and enforcement in the AIA through AI
Authors: Micklitz Hans-W , Sartor Giovanni
Published: January 2025

The Artificial Intelligence Act (AIA) relies on public authorities to survey and monitor the compliance systems of private companies and establish appropriate discovery mechanisms to render ex-officio enforcement possible. The article analyses the intricacies of compliance and enforcement of the AIA and the interaction between private companies and public authorities, thus preventing the marketing of AI systems that are dangerous to both people and society. The striking complexity of the enforcement structure invites us to consider the use of AI in compliance and enforcement. Such areas to consider are: handling the communication between hundreds of competent national authorities; communication between the European Union (EU) and the private compliance bodies; generating and processing information on the design and use of AI systems, in facilitating regulatory action in the EU as a whole.
Appreciating Appreciation: Residents’ Experience Feeling Valued Differently as Learners, Physicians, and Employees
Authors: Bogerd Rosa , Silkens Milou E.W.M. , Henriques José P.S. , Lombarts Kiki M.J.M.H.
Published: January 2025

Purpose

Cultures of wellness, defined as shared norms, values, attitudes, and behaviors that promote personal and professional growth and well-being, are robust determinants of professional fulfillment and professional performance. A major and largely overlooked aspect of a culture of wellness in medicine is residents’ perceived appreciation or experience of feeling valued. Considering the pressing workforce and retention challenges that residency programs face, this study addressed the following research questions: How does appreciation at work manifest in the eyes of residents and how do residents perceive appreciation in relation to their professional fulfillment and performance?

Method

Guided by an interpretative phenomenological approach, this qualitative study purposively sampled 12 residents from different specialties, training years, regions in the Netherlands, and genders. Residents’ individual experiences with appreciation at work were explored in semistructured interviews conducted between October 2022 and March 2023. Thematic analysis was used for data analysis.

Results

Residents perceived appreciation as “being seen and heard” and further described how appreciation at work manifested using 3 narratives. As learners, residents felt appreciated when their competencies were acknowledged and supervisors created room for individual growth. As physicians or colleagues, residents felt appreciated when they experienced meaningful patient contact, high levels of collegiality, and self-appreciation through successes at work. As employees, residents felt appreciated when their (extra) efforts were noticed, they were properly facilitated in their work and training, and their well-being was prioritized. Residents said that receiving appreciation boosted their mental health, self-confidence, professional commitment, and professional fulfillment, thereby benefiting their performance and the quality of patient care they deliver.

Conclusions

Appreciation at work is important for residents and manifests itself within the narratives of learner, physician or colleague, and employee. Which narrative is foregrounded depends on context, but regardless feeling “seen and heard” at work is crucial for residents’ fulfillment and performance.
Analysis of Mood and Anxiety Disorder Content in Common U.S. Obstetrics and Gynecology Residency Educational Resources
Authors: Lennon Clare , Toscano Marika
Published: January 2025

Purpose

This study investigates mental health–related content to delineate potentially deficient topics for improvement in future obstetrics and gynecology (OBGYN) resident educational curriculum initiatives.

Method

In this quantitative content analysis, educational resources commonly used by OBGYN residents were selected based on a 2020 multi-institutional survey of OBGYN residents and informal group discussion with 32 OBGYN residents from a New York academic institution in April 2020. After independent screening, the authors iteratively developed, tested, and implemented a coding scheme for relevant keywords. The primary outcome was total depression and anxiety content in the educational resource materials. Information about other mental health conditions was additionally collected, and content ratings were assigned. Descriptive statistics were used and interrater reliability calculated. Data were accessed and archived on July 30, 2020, for all future analyses.

Results

From 7 materials reviewed, 36 items were analyzed. The cumulative percentage of resources with mental health–related content was 1.1%. Professional society publications contained the most content at 5.0% (95% CI, 1.4%-12.3%), and a podcast series contained the least at 0.6% (95% CI, 0.02%-3.3%). Depressive (30 [83.3%]), anxiety (12 [33.3%]), and bipolar (9 [25.0%]) disorders were the most common content, whereas posttraumatic stress disorder (5 [13.9%]), postpartum psychosis (4 [11.1%]), obsessive compulsive disorder (3 [8.3%]), and schizophrenia (2 [5.6%]) were the least. The content ratings for schizophrenia, postpartum psychosis, posttraumatic stress disorder, obsessive compulsive disorder, pathophysiology of mental health conditions, lactation safety, and fetal and maternal adverse effects of psychiatric medications and psychiatric disease were low. No educational resource reviewed in this study contained all recommended Council on Resident Education in Obstetrics and Gynecology residency curriculum topics related to mental health.

Conclusions

Mental health disorders are underrepresented in commonly used OBGYN educational resources, reinforcing the need for more comprehensive inclusion of these topics in OBGYN curriculum initiatives.
Current Opinion in Acute Aortic Dissection
Authors: Nappi Francesco
Published: January 2025

In recent years, there have been significant improvements in the management of acute aortic dissection, including screening, diagnosis, and surgical options. However, acute aortic dissection represents a serious cardiovascular disease associated with a high risk of early mortality and significant morbidity in those who emerge from the emergency phase. Considerable progress has been made in the last decade in improving our understanding of the pathophysiology of this disorder. The current classifications of acute aortic dissection have faced challenges. There is a growing scientific consensus in favor of a classification that integrates existing features based on both morphological and functional criteria. The location and size of the initial tear in the innermost layer of the aorta determine the main cause of the aortic dissection. This tear causes the middle layer of the aortic wall to rupture and affects the size of the effected area. It is crucial to determine the necessary course of action for the patient, which may involve emergency surgery, endovascular intervention, or the most appropriate conservative care. The management and monitoring of acute aortic dissection is a constantly evolving field of research. This review provides an overview of preventing, recognizing, and treating life-threatening acute aortic dissections.
Iloprost: Old and New Indications
Authors: Banerji Brinda , Parikh Manish A. , Minkin Ruth , Frishman William H. , Peterson Stephen J.
Published: January 2025

Iloprost is a synthetic long-acting prostacyclin-analog drug used to treat various vascular diseases. The Federal Drug Administration approved the drug in 2004 for pulmonary arterial hypertension, and it has since been shown to be helpful in other vascular conditions such as scleroderma and Raynaud phenomenon. The Federal Drug Administration has now approved the use of iloprost for severe frostbite. This review summarizes the pharmacologic properties of iloprost, its clinical applications, and potential therapeutic benefits in vascular conditions.
When should the tricuspid valve be repaired during mitral valve repair?
Authors: An Kevin R. , Nwajei Ekene , Chu Michael W.A.
Published: January 2025

Purpose of review

Management of tricuspid regurgitation and annular dilation during mitral valve repair remains controversial. We review the latest evidence on indications to repair the tricuspid valve during mitral valve repair and discuss surgical strategies and complications.

Recent findings

Concomitant tricuspid valve repair of moderate tricuspid regurgitation is effective in reducing tricuspid regurgitation progression at 2 years, but has not shown benefit to late survival, quality of life, or functional benefit, and is associated with increased permanent pacemaker implantation (PPM) rates, which is associated with reduced late survival. Progression of less than moderate tricuspid regurgitation with annular dilation alone is uncommon, obviating the need for concomitant repair.

Repairing concomitant moderate tricuspid regurgitation at the time of mitral repair reduces tricuspid regurgitation progression at 2 years, at the cost of a higher PPM implantation rate. However, repairing less than moderate tricuspid regurgitation for annular dilation alone has not been shown to reduce tricuspid regurgitation progression, bringing current guideline recommendations surrounding repair for annular dilation into question. Longer-term follow-up data, at 5 years, will shed further light on this topic.
OCT Angiography characteristics of Bilateral Mactel type 1: revealing the Aneurysmo occlusive variety.
Authors: Pradhan Amrita , Sen Ahana , Chowdhury Ruchira , Sharma Survee , Majumdar Bristi , Chattree Surabhi , Das Debmalya , Nigam Eesh , Saurabh Kumar , Roy Rupak
Published: January 2025

Purpose:

To report OCTA (Optical coherence tomography angiography) characteristics of bilateral MacTel type 1 with capillary obliteration.

Method:

Colour fundus photo (CFP), OCT angiography (OCTA), Fundus fluorescein angiography (FFA), Fundus autofluorescence (FAF)

Result:

We describe three cases of bilateral MacTel Type 1 with a special emphasis on OCTA characteristics.

Conclusion:

OCTA is a non-invasive method to detect capillary telangiectasia and abnormal vascular tortuosity in the superficial capillary plexus and deep capillary plexus. OCT angiography demonstrates that bilateral mactel type 1 may have both aneurysmal and occlusive components.
Comorbid psoriasis and morphea treated successfully with apremilast
Authors: Spatholt Danielle , Shaw Kristian , Cvengros Gabrielle
Published: January 2025

Psoriasis and morphea are clinically and histologically distinct entities but few case reports exist regarding coexistence within the same patient. Management of these 2 immune-mediated disorders at the same time has not been well established. The relationship between psoriasis and morphea is unclear. Here, we highlight the successful use of apremilast on-label for psoriasis and off-label for morphea.
Developing a New Paradigm for Healthcare Delivery: Lessons Learned from Same-Day Access
Authors: Chen Allen M.
Published: January 2025

Goal:

Excessively lengthy wait times for appointments with clinicians are a major source of frustration for patients, and difficulties with access represent a public health problem facing populations across all societies. As delays in care have been associated with inferior outcomes, same-day appointments have been proposed as a patient-centric means of improving healthcare delivery. However, this paradigm represents a radical shift from conventional scheduling tactics, and skepticism has long existed regarding its feasibility and real-world applicability to clinical practice. Given the limited data available about same-day access and the lack of guidance on this strategy, the need to evaluate experiences and engage in introspective reflection (i.e., examine thoughts, emotions, judgments, and perceptions) for quality improvement are paramount. Thus, the purpose of this study was to review a single-institutional practice with same-day access, focusing on lessons learned over a two-year period.

Methods:

From March 2021 to March 2023, a total of 4,301 consecutive patients with newly diagnosed cancer were offered same-day appointments as part of a prospective pilot initiative conducted in the outpatient setting at a tertiary-based academic medical center. Systematic analysis demonstrated the positive impact of this initiative on access-related benchmarks. A retrospective review was conducted to identify core themes pertaining to the feasibility of the initiative with respect to its design and implementation. An interpretive synthesis was then presented in descriptive fashion.

Principal Findings:

Of the 3,414 patients scheduled, 477 (14%) opted for same-day appointments. While same-day appointments significantly reduced the time to consultation and treatment for patients with newly diagnosed cancer, the initiative presented new challenges—both expected and unexpected—that could have hindered its development, acceptance, and adoption. These challenges related to scheduling capacity, logistical coordination, workflow efficiency, resource allocation, and cultural change. A consistent, proactive management approach, coupled with an unwavering commitment to communication, was required to overcome these operational barriers.

Practical Applications:

Same-day appointments in the ambulatory setting has the potential to improve health outcomes and care quality, while fundamentally changing the way healthcare is delivered for the betterment of patients. However, thoughtful preparation and team-based planning are imperative to establish a methodical approach that will optimize the likelihood of success. Given the potentially disruptive nature of this paradigm, the need for steady leadership, accompanied by the consistent promotion of standardized guidelines, is critical to ensure engagement among all stakeholders. Lastly, the importance of promoting positive cultural change and creating an environment of shared purpose, trust, and transparency cannot be overemphasized.
Corporate Motivation and Performance to Participate in the Government-Led Health Productivity and Management Initiatives in Japan
Authors: Sakai Kosuke , Nakazawa Shoko , Furuya Yuko , Fukai Kota , Tatemichi Masayuki
Published: January 2025

Objective

In this study, we aimed to structure motivation for workplace health promotion (WHP) and explore the relationship between motivation and WHP performance.

Methods

We qualitatively categorized the WHP motivations written on the Health Productivity and Management (HPM) survey sheet in Japan. We then quantitatively analyzed the relationship between the categories and their HPM rankings using multiple logistic regression.

Results

Responses from 2003 companies were analyzed. The WHP motivations were summarized into 12 categories. Higher-ranked companies more frequently mentioned corporate impressions, workplace environments, employee productivity, employee autonomy, and system management and less often mentioned recruitment and retention.

Conclusions

For more effective WHPs, companies need to support their current workforce, set specific goals, and allocate resources in the appropriate direction, such as increasing work engagement.
Parenteral lipid emulsions: the state of the art
Authors: Da Prat Valentina , Caccialanza Riccardo , Cotogni Paolo
Published: January 2025

Purpose of review

Several types of injectable lipid emulsions (ILEs) have become available for parenteral nutrition. The purpose of this review is to highlight the most recent and interesting articles in the field of ILEs.

Recent findings

Recent literature has compared ILEs in various clinical scenarios (e.g. abdominal surgery, chronic intestinal failure, critical illness, and preterm birth). Favorable clinical effects of ILEs containing fish oil have been observed in studies on surgical patients with Crohn's disease, critically ill patients, and patients with intestinal failure-associated liver dysfunction, whereas other trials have shown no clear benefit. Ongoing research is focused on finding novel strategies to reduce liver toxicity of ILEs, including the use of ‘artificial intelligence’ tools and liver organoids. Promising new applications for ILEs are emerging, including the prevention of neonatal hypoxic brain injury.

Although ILEs with the goal of reducing the levels of pro-inflammatory omega-6 fatty acids appear to confer some advantage in some settings (e.g. surgery), conclusive data on the superiority of one ILE over another are lacking. In particular, research is needed to compare different types of mixed-oil ILEs with each other and with pure fish oil ILEs.
Short-chain fatty acids in clinical practice: where are we?
Authors: Martindale Robert G. , Mundi Manpreet S. , Hurt Ryan T. , McClave Stephen A.
Published: January 2025

Purpose of review

Once considered to have only local influences on the gut mucosa, short-chain fatty acids (SCFAs) now appear to have a much wider anti-inflammatory, immune-modulating, systemic effect. This article reviews recent evidence to suggest a much wider clinical application of this valued dietary substrate.

Recent findings

SCFAs act systemically through stimulation of G protein receptors (GPRs) and inhibition of histone deacetylases (HDACs). SCFAs cause appetite suppression, reduce systemic inflammation, improve insulin sensitivity, increase energy expenditure, promote mitochondrial function, stimulate satiety, reduce blood pressure, and improve cognitive function from various neurologic maladies.

Dietary strategies should be implemented to provide this beneficial substrate across a wide spectrum of disease conditions. Use of prebiotic fiber or liquid supplements containing high SCFA-producing organisms should be considered as therapeutic targets for multiple metabolic, immunologic, and neurodegenerative diseases.
The impact of n-3 polyunsaturated fatty acids in patients with cancer: emerging themes
Authors: van der Meij Barbara , Parsons Sarah , Mazurak Vera
Published: January 2025

Purpose of review

This review summarizes recent literature falling broadly under the topic of n-3 polyunsaturated fatty acids (PUFAs) in the oncology setting, highlighting emerging themes and emphasizing novel explorations.

Recent findings

Meta-analyses continue to confirm safety and efficacy of n-3 PUFA supplementation on reducing inflammation and improving survival in people with cancer. Common themes in recent studies emphasize improving tumor-directed efficacy and reducing toxicities of common cancer therapies. New areas of interest include the impact of n-3 PUFA when combined with immunotherapies and applications in pediatric acute lymphoid leukemia. Novel assessments include specialized pro-resolving lipid mediators, the intestinal microbiome and psychological well being. A variety of clinically relevant outcomes including nutritional status, toxicities and survival are being explored in ongoing clinical studies.

Evidence confirms the safety of n-3 PUFA for patients with cancers, as well as benefits in some, but not all areas of exploration. Larger, well designed trials with biological assessment of compliance compared to the prescribed n-3 PUFA dose would strengthen the evidence needed to integrate n-3 PUFA recommendations into clinical practice for patients with cancer.
Good and bad indications for adjuvant radiotherapy after transoral laser microsurgery for laryngeal cancer
Authors: Sampieri Claudio , Ruiz-Sevilla Laura , Vilaseca Isabel
Published: January 2025

Purpose of review

To summarize current evidence regarding the indication of adjuvant treatment after transoral laser microsurgery (TOLMS).

Recent findings

Apart from well known risk factors, margins represent the key point in the decision-making. If margins are affected, additional treatment is mandatory. One exception could be the presence of one superficial margin in early tumors that can be strictly followed up by fiberendoscopy. As a general rule, the best option is margin-revision surgery by repeating TOLMS or switching to open partial surgery. (Chemo)radiotherapy can be also considered, being total laryngectomy the last alternative. In locally advanced tumors with uncertain margins (e.g. posterior paraglottic space invasion, vertical anterior commissure reaching the cartilage during primary resection), adjuvant treatment may improve local control with laser but with little impact on disease-specific or overall survival. In this scenario, QoL may be in part reduced after radiotherapy, although recent studies suggest that functional outcomes are favorable. Therefore, decision should be discussed individually with the patient, especially if a total laryngectomy is the only alternative after a possible relapse.

Considerable work needs to be done to identify those cases that may benefit from adjuvant treatment after TOLMS, including a detailed description of functional outcomes.
Exploring Rehabilitation Protocols for Primary Anterior Cruciate Ligament Repair: Insights from a Scoping Review
Authors: Chang Alan , Chan Cheng-Yen , Lin Meng-Tin , Wu Chueh-Hung , Özçakar Levent
Published: January 2025

Objectives

The primary repair of the anterior cruciate ligament (ACL) has re-emerged as a treatment for acute ruptures. While numerous studies have investigated rehabilitation after ACL reconstruction, few have focused on primary repair. We aimed to describe the rehabilitation protocols for primary ACL repair, and to identify knowledge gaps and differences between primary ACL repair and reconstruction.

Design

A scoping review design was selected due to the descriptive and exploratory nature, aiming to identify and map available research evidence from various databases relevant to the research question. Evaluation of study quality and risk of bias is not required in scoping reviews.

Results

A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science identified a total of 66 studies involving over 3,100 participants. No randomized controlled trials directly comparing postoperative rehabilitation protocol were identified. Eight items of the rehabilitation protocols were analyzed, based on existing clinical practice guidelines for ACL reconstruction. This review highlights the inadequacy and heterogeneity of the available data.

Conclusions

This review revealed a lack of consistent evidence and call for the development of standardized, technique-specific rehabilitation guidelines after primary ACL repair. Clinical trials and transparent reporting are needed to establish validated protocols.
Impact of body-height increase on gastrocnemius muscle stiffness in children with cerebral palsy: A one-year prospective cohort study
Authors: Nakamura Shinya , Kimoto Minoru , Wakasa Masahiko , Saito Akira , Sakamoto Hitoshi , Misawa Akiko , Kawanobe Uki , Okada Kyoji
Published: January 2025

Objective

To investigate whether the impacts of height increase on gastrocnemius muscle (GM) stiffness are greater in children with spastic cerebral palsy (CP) than in those with typical development (TD).

Design

This one-year cohort study enrolled children (CP, 23; TD, 23) who underwent two measurements conducted at entry and after one year. Lateral and medial GM-strain ratios representing muscle stiffness were obtained using elastography.

Results

All regression equations (dependent variable, rate of change [RoC] of height; independent variable, RoC of the GM-strain ratios) were significant and all R
2s in children with CP (all p < 0.001; lateral GM’s R
2 = 0.81; medial GM’s R
2 = 0.74) were greater than those in children with TD (p < 0.001 and R
2 = 0.49; medial GM’s R
2 = 0.49). The coefficients of equations in children with CP were significantly larger than those in TD (p < 0.05).

Conclusion

The greater R
2 values in CP than TD could explain how the variation in height predicts the variations in GM stiffness more accurately in CP than in TD. GM stiffness worsens more in children with CP than that in TD.
Late re-engagement into HIV care among adults in the Swiss HIV Cohort Study
Authors: Haas Andreas D , Kusejko Katharina , Cavassini Matthias , Günthard Huldrych , Stöckle Marcel , Calmy Alexandra , Bernasconi Enos , Schmid Patrick , Egger Matthias , Wandeler Gilles ,   the Swiss HIV Cohort Study
Published: January 2025

Introduction:

Little is known about the clinical status of persons with HIV (PWH) who re-engage in care after an interruption. We evaluated the immunological and clinical characteristics of individuals re-engaging in care within the Swiss HIV Cohort Study.

Methods:

Participants who re-engaged in care after an interruption >14 months with a viral load ≥100 copies/mL were classified as having interrupted ART. We defined late re-engagement as re-engaging with a CD4 cell count of <350 cells/µL or a new CDC stage C disease. Linear and logistic regression models with restricted cubic splines were used to estimate the mean CD4 cell count at re-engagement and the probability of late re-engagement as a function of care interruption duration.

Results:

Of 14,864 participants with a median follow-up of 10.2 years (IQR 4.7-17.2 years), 2,768 (18.6%) interrupted care, of whom 1,489 (53.8%) re-engaged. Among those re-engaging, 62.3% had interrupted ART. For participants who interrupted ART, the mean CD4 count declined from 374 cells/µL (95% CI 358-391 cells/µL) before the interruption to 250 cells/µL (95% CI 221-281 cells/µL) among those re-engaging after 14 months, and to 185 cells/µL (95% CI 160-212 cells/µL) among those re-engaging after 60 months. The estimated risk of late re-engagement in care was 68.6% (95% CI 62.3-74.4%) for participants who interrupted ART for 14 months and 75.2% (95% CI 68.9-80.6%) for those who interrupted ART for 60 months.

Conclusion:

Although HIV care interruptions are not very common in Switzerland, the majority of PWH re-engaging after interrupting ART return with late-stage HIV.
Resolution of Neuropsychiatric Adverse Events After Switching to a Doravirine-Based Regimen in the Open-Label Extensions of the DRIVE-AHEAD and DRIVE-FORWARD Trials
Authors: Moyle Graeme , Meng Fanxia , Wan Hong , Sklar Peter , Plank Rebeca M. , Lahoulou Rima
Published: January 2025

Background:

Neuropsychiatric adverse events (NPAEs) are associated with several antiretrovirals. Doravirine (DOR), a non-nucleoside reverse transcriptase inhibitor indicated for HIV-1 treatment, does not interact significantly with known neurotransmitter receptors in vitro. First-line therapy with DOR-based regimens resulted in significantly fewer NPAEs than efavirenz/emtricitabine/tenofovir disoproxil fumarate (EFV/FTC/TDF) and similar rates to those of ritonavir-boosted darunavir (DRV/r) with 2 nucleos(t)ide reverse transcriptase inhibitors (NRTIs) through Week 96 of the phase 3 DRIVE-AHEAD and DRIVE-FORWARD studies, respectively.

Methods:

In DRIVE-AHEAD (NCT02403674) and DRIVE-FORWARD (NCT02275780), treatment-naive adults randomly received DOR/lamivudine/TDF or EFV/FTC/TDF and DOR + 2 NRTIs or DRV/r + 2 NRTIs, respectively, for a 96-week double-blind phase; afterward, participants could continue or switch to a DOR-based regimen for a 96-week open-label extension.

Results:

Overall, 269 and 233 participants in DRIVE-AHEAD and DRIVE-FORWARD, respectively, switched to a DOR-based regimen. At Week 96, 26 and 15 participants randomized to EFV/FTC/TDF and DRV/r + 2 NRTIs, respectively, had ongoing NPAEs, resolving by Week 192 in 73% (19/26) and 40% (6/15) of participants switching to a DOR-based regimen. New-onset NPAEs were reported by 9% (25/269) and 8% (18/233) of participants; by Week 192, new-onset NPAEs were resolved and/or resolving in 60% (15/25) and 61% (11/18) of participants.

Conclusions:

In both trial extensions, NPAEs persisted in 3–4% of participants 96 weeks after switching to a DOR-based regimen, possibly representing the background rate for these events. This suggests DOR-based therapy may be a good option for adults with baseline neuropsychiatric symptoms or those experiencing NPAEs with other antiretrovirals.
Intraoperative Skull Fracture During Halo Application in Subcranial Le Fort III: Strategies for Managing a Rare Complication
Authors: Moreno Stephen D. , Raffaelli Samuel D. , Liu Robert H. , Steinberg Barry
Published: January 2025

External rigid distraction is an established method for achieving subcranial Le Fort III advancement in severe syndromic craniosynostosis. Craniofacial surgeons commonly use halo-type devices for these corrections, as they allow for multiple vectors of pull and facilitate larger midfacial advancements. Although most complications related to their use involve pin displacement or infection, rare complications such as skull fractures have been reported. At 3 months of age, a patient with Apert Syndrome underwent endoscopic-assisted craniectomies for bilateral coronal craniosynostosis. After a year of helmet therapy, he developed pansynostosis and required fronto-orbital advancement. Later at the age of 6, a Le Fort III distraction using a RED II rigid external distractor was performed to address his midfacial hypoplasia, exorbitism, and severe obstructive sleep apnea. While placing the RED II distractor, a shift in the device was noted upon pin fixation, raising suspicion for a unilateral depressed skull fracture. Although computed tomography imaging revealed pin displacement, there was no clinical indication for immediate repair. Given the surgical and psychological burden this could have on the patient, the decision was made to leave the RED II device in place and proceed with the distraction. After distraction and an 8-week latency period for complete consolidation of the facial bony architecture, the RED II device was removed, and the skull fracture was repaired. In patients with multi-operated skulls and residual cranial defects, halo-type devices may present an increased risk of skull fractures. This report discusses alternatives in the literature and presents an example of a rare complication successfully managed with delayed repair.
A Patient With Intracranial Multiple Meningiomas Combined With Neurofibromatosis type I
Authors: Guo Penghang , Xie Dong , Zhang Tingfu , Nan Yaqiang , Zhao Guohui , Zhang Jianan , Zhou Jie
Published: January 2025

The coexistence of intracranial multiple meningiomas and neurofibromatosis type 1 is a rare occurrence in the field of neurosurgery, presenting complex treatment challenges, unfavorable prognoses, and significant burdens on both families and society. Currently, the primary objective is to perform surgical total resection as far as possible, while considering postoperative adjuvant radiotherapy for cases where complete tumor resection is challenging. In this case, the patient has previously undergone multiple brain tumor resections and received radiation therapy. Currently, the tumor is exerting pressure on the brain stem, leading to a diminished quality of life. Considering the patient’s personal preferences, overall physical condition, and economic circumstances, it was determined that surgical decompression would no longer be pursued. Instead, symptomatic treatment will be administered to alleviate pain and provide compassionate care.
Quality of Sexual Life Before and After Pelvic Organ Prolapse Surgery
Authors: Wihersaari Olga A.E. , Karjalainen Päivi , Tolppanen Anna-Maija , Mattsson Nina , Nieminen Kari , Jalkanen Jyrki
Published: January 2025

Importance

Although surgery for pelvic organ prolapse (POP) is generally associated with an improvement in sexual function, knowledge on specific changes is limited.

Objectives

The aim of this study was to describe and compare changes in sexual activity and function during a 5-year follow-up period after POP surgery.

Study Design

This was a nationwide cohort study of 3,515 women operated on for POP in 2015 in Finland. Sexual activity and function were assessed preoperatively and 6 months, 2 years, and 5 years after native tissue and mesh-augmented surgery using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire Short Form (PISQ-12).

Results

The PISQ-12 score improved significantly at 6-month follow-up, regardless of surgical approach. Negative emotional reactions (relative risk [RR], 0.21; 95% confidence interval [CI], 0.13–0.36), orgasm intensity (RR, 4.23; 95% CI, 2.94–6.07), and avoidance of sexual intercourse due to fear of incontinence (RR, 0.25; 95% CI, 0.15–0.43) or bulging (RR, 0.11; 95% CI, 0.07–0.17) improved remarkably at 6 months and remained up to 5 years after surgery. Satisfaction (RR, 1.10; 95% CI, 1.04–1.18), coital pain (RR, 0.71; 95% CI, 0.51–0.99), and coital incontinence (RR, 0.48; 95% CI, 0.15–0.43) improved only at 6-month follow-up. Among women with deteriorated sexual function, the decline was associated with loss of excitement and satisfaction, increased coital pain, and partner’s erectile problems. Partner-related factors and lack of sexual desire were main reasons for sexual inactivity both preoperatively and postoperatively.

Conclusions

Considering patient’s sexual wellbeing and informing them of the expected changes in individual sexual function items are important aspects of preoperative counseling. This may reduce false hopes regarding the effect of surgery on sexual function and improve postoperative patient satisfaction.
Interaction with refuse piles is associated with co-occurrence of core gut microbiota in workers of the ant Aphaenogaster picea
Authors: Pagalilauan Alison , Pavloudi Christina , Ospina Santiago Meneses , Smith Adam , Saw Jimmy
Published: January 2025

Comparing the diversity of gut microbiota between and within social insect colonies can illustrate interactions between bacterial community composition and host behavior. In many eusocial insect species, different workers exhibit different task behaviors. Evidence of compositional differences between core microbiota in different worker types could suggest a microbial association with division of labor among workers. Here we present the core microbiota of Aphaenogaster picea ant workers with different task behaviors. The genus Aphaenogaster is abundant worldwide, yet the associated microbiota of this group is unstudied. Bacterial communities from A. picea gut samples in this study consist of 19 phyla, dominated by Proteobacteria, Cyanobacteria, and Firmicutes. Analysis of 16S rRNA gene sequences reveals distinct similarity clustering of A. picea gut bacterial communities in workers that have more interactions with the refuse piles. Though gut bacterial communities of nurse and foraging ants are similar in overall composition and structure, the worker groups differ in relative abundances of dominant taxa. Gut bacterial communities from ants that have more interactions with refuse piles are dominated by ASVs associated with Entomoplasmataceae. Interaction with fecal matter via refuse piles seems to have the greatest impact on microbial taxa distribution, and this effect appears to be independent of worker type. This is the first report surveying the gut microbiome community composition of Aphaenogaster ants.
Self-other mentalizing and attachment insecurity in the dimensional model of personality disorders: From research to clinical practice
Authors: Jańczak Monika Olga , Górska Dominika , Jurek Paweł , Taubner Svenja
Published: January 2025

Background

Research on different aspects of mentalizing is essential for understanding the mechanisms underlying personality disorders (PD) and informing psychotherapy approaches, where mentalizing functions as a key mechanism of change. This study aimed to explore whether self- and other-mentalizing, in interaction with attachment insecurity, differentially explain Criteria A (level of personality functioning) and B (maladaptive traits) of the Alternative Model for Personality Disorders in the DSM-5.

Method

Our sample consisted of 109 participants (54% female, 41% male, 5% nonbinary). We used The Structured Clinical Interview for DSM-5 Personality Disorders, A Movie for the Assessment of Social Cognition, the Reflective Functioning Questionnaire, the Experiences in Close Relationships – Revised, The Self and Interpersonal Functioning Scale, and The Personality Inventory for DSM-5.

Results

Regression analyses show that self-mentalizing deficits uniquely predict both Criterion A domains (self and interpersonal functioning) and all five maladaptive traits, while other-mentalizing is relevant only to interpersonal functioning. Explained variance (adjusted R²) ranges from 55% to 18%. Additionally, mentalization moderates the relationship between insecure attachment and personality pathology (Interpersonal functioning, Negative Affectivity and Detachment), mainly with greater mentalization deficits linked to more severe personality dysfunction under heightened attachment insecurity.

Conclusion

Our findings authorize mentalizing as a crucial factor in PD, supporting the potential value of mentalization-focused interventions in addressing both the severity and the “flavor” of PD. Notably, our findings suggest a hierarchy within self- and other-mentalizing, indicating that self-mentalizing plays a more foundational role in PD. Through a comprehensive, multi-method assessment of mentalization, this study offers a refined understanding of its role in psychopathology, providing valuable insights that could guide the development of more targeted therapeutic interventions.
Pathogenetic mechanisms of muscle-specific ribosomes in dilated cardiomyopathy
Authors: Murphy Michael R. , Ganapathi Mythily , Lee Teresa M. , Fisher Joshua M. , Patel Megha V. , Jayakar Parul , Buchanan Amanda , Rippert Alyssa L , Ahrens-Nicklas Rebecca C. , Nair Divya , Soni Rajesh K. , Yin Yue , Yang Feiyue , Reilly Muredach P. , Chung Wendy K. , Wu Xuebing
Published: January 2025

The heart employs a specialized ribosome in its muscle cells to translate genetic information into proteins, a fundamental adaptation with an elusive physiological role1–3. Its significance is underscored by the discovery of neonatal patients suffering from often fatal heart failure caused by severe dilated cardiomyopathy when both copies of the geneRPL3Lare mutated4–9. RPL3L is a muscle-specific paralog1–3of the ubiquitous ribosomal protein L3 (RPL3), which makes the closest contact of any protein to the ribosome’s RNA-based catalytic center10.RPL3L-linked heart failure represents the only known human disease associated with tissue-specific ribosomes, yet the underlying pathogenetic mechanisms remain poorly understood. Intriguingly, disease is linked to a large number of mostly missense variants inRPL3L, andRPL3L-knockout resulted in no severe heart defect in either human or mice3, 11–13, challenging the prevailing view that autosomal recessive diseases are caused by loss-of-function mutations. Here, we report three new cases ofRPL3L-linked severe neonatal heart failure and present a unifying pathogenetic mechanism by which a large number of variants in the muscle-specific ribosome led to disease. Specifically, affected families often carry one of two recurrent toxic gain-of-function variants alongside a family-specific putative loss-of-function variant. While the non-recurrent variants often trigger partial compensation ofRPL3similar toRpl3l-knockout mice, both recurrent variants exhibit increased affinity for the RPL3/RPL3L chaperone GRWD114–16and 60S biogenesis factors, sequester 28S rRNA in the nucleus, disrupt ribosome biogenesis, and trigger severe cellular toxicity that extends beyond the loss of ribosomes. These findings provide critical insights for genetic screening and therapeutic development of neonatal heart failure. Our results suggest that gain-of-toxicity mechanisms may be more prevalent in autosomal recessive diseases, and a combination of gain-of-toxicity and loss-of-function mechanisms could underlie many diseases involving genes with paralogs.
An endogenous retroviral element co-opts an upstream regulatory sequence to achieve somatic expression and mobility
Authors: Rubanova Natalia , Singh Darshika , Barolle Louis , Chalvet Fabienne , Netter Sophie , Poidevin Mickaël , Servant Nicolas , Bardin Allison J. , Siudeja Katarzyna
Published: January 2025

Retrotransposons, multi-copy sequences that propagateviacopy-and-paste mechanisms involving an RNA intermediate, occupy large portions of all eukaryotic genomes. A great majority of their manifold copies remain silenced in somatic cells, nevertheless, some are transcribed, often in a tissue specific manner, and a small fraction retains its ability to mobilize. Retrotransposon expression or mobility are increasingly recognized to contribute to normal development and tissue homeostasis, as well as to aging and disease. While it is well characterized that retrotransposon sequences may providecisregulatory elements for neighboring genes, how their own expression and mobility are achieved in different somatic contexts is not well understood. Here, using long-read DNA sequencing, we characterize somatic retrotransposition in theDrosophilaintestine. We show that retroelement mobility does not change significantly upon aging and is limited to very few active sub-families of retrotransposons. Importantly, we identify a polymorphic donor locus of an endogenous LTR retroviral elementrover, active in the intestinal tissue. We reveal that gut activity of theroverdonor copy depends on its genomic environment. Without affecting local gene expression, the copy co-opts its upstream enhancer sequence, rich in transcription factor binding sites, for somatic expression. Further we show thatescargot,a snail-type transcription factor critical for gut progenitor cell function, can drive transcriptional activity of the activerovercopy. These data provide new insights into how locus-specific features allow active retrotransposons to produce functional transcripts and mobilize in a somatic lineage.