bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterisation of 3D-printable thermoplastics to be used as tissue-equivalent materials in photon and proton beam radiotherapy end-to-end quality assurance devices
Authors: Bento Mariana , Cook Hannah , Anaya Virginia Marin , Bär Esther , Nisbet Andrew , Lourenço Ana , Hussein Mohammad , Veiga Catarina
Published: August 2024

Objective. To investigate the potential of 3D-printable thermoplastics as tissue-equivalent materials to be used in multimodal radiotherapy end-to-end quality assurance (QA) devices. Approach. Six thermoplastics were investigated: Polylactic Acid (PLA), Acrylonitrile Butadiene Styrene (ABS), Polyethylene Terephthalate Glycol (PETG), Polymethyl Methacrylate (PMMA), High Impact Polystyrene (HIPS) and StoneFil. Measurements of mass density (

ρ

), Relative Electron Density (RED), in a nominal 6 MV photon beam, and Relative Stopping Power (RSP), in a 210 MeV proton pencil-beam, were performed. Average Hounsfield Units (HU) were derived from CTs acquired with two independent scanners. The calibration curves of both scanners were used to predict average

ρ
,

RED and RSP values and compared against the experimental data. Finally, measured data of

ρ
,

RED and RSP was compared against theoretical values estimated for the thermoplastic materials and biological tissues. Main results. Overall, good

ρ

and RSP CT predictions were made; only PMMA and PETG showed differences >5%. The differences between experimental and CT predicted RED values were also <5% for PLA, ABS, PETG and PMMA; for HIPS and StoneFil higher differences were found (6.94% and 9.42/15.34%, respectively). Small HU variations were obtained in the CTs for all materials indicating good uniform density distribution in the samples production. ABS, PLA, PETG and PMMA showed potential equivalency for a variety of soft tissues (adipose tissue, skeletal muscle, brain and lung tissues, differences within 0.19%–8.35% for all properties). StoneFil was the closest substitute to bone, but differences were >10%. Theoretical calculations of all properties agreed with experimental values within 5% difference for most thermoplastics. Significance. Several 3D-printed thermoplastics were promising tissue-equivalent materials to be used in devices for end-to-end multimodal radiotherapy QA and may not require corrections in treatment planning systems’ dose calculations. Theoretical calculations showed promise in identifying thermoplastics matching target biological tissues before experiments are performed.
Equivalence of cost concentration and gradient vanishing for quantum circuits: an elementary proof in the Riemannian formulation
Authors: Miao Qiang , Barthel Thomas
Published: August 2024

The optimization of quantum circuits can be hampered by a decay of average gradient amplitudes with increasing system size. When the decay is exponential, this is called the barren plateau problem. Considering explicit circuit parametrizations (in terms of rotation angles), it has been shown in Arrasmith et al (2022 Quantum Sci. Technol.
7 045015) that barren plateaus are equivalent to an exponential decay of the variance of cost-function differences. We show that the issue is particularly simple in the (parametrization-free) Riemannian formulation of such optimization problems and obtain a tighter bound for the cost-function variance. An elementary derivation shows that the single-gate variance of the cost function is strictly equal to half the variance of the Riemannian single-gate gradient, where we sample variable gates according to the uniform Haar measure. The total variances of the cost function and its gradient are then both bounded from above by the sum of single-gate variances and, conversely, bound single-gate variances from above. So, decays of gradients and cost-function variations go hand in hand, and barren plateau problems cannot be resolved by avoiding gradient-based in favor of gradient-free optimization methods.
Separable effects for adherence
Authors: Wanis Kerollos Nashat , Stensrud Mats Julius , Sarvet Aaron Leor
Published: August 2024

Comparing different medications is complicated when adherence to these medications differs. We can overcome the adherence issue by assessing effectiveness under sustained use, as in usual causal “per-protocol” estimands. However, when sustained use is challenging to satisfy in practice, the usefulness of these estimands can be limited. Here we propose a different class of estimands: separable effects for adherence. These estimands compare modified medications, holding fixed a component responsible for nonadherence. Under assumptions about treatment components’ mechanisms of effect, a separable effects estimand can quantify the effectiveness of medication initiation strategies on an outcome of interest under the adherence mechanism of one of the medications. These assumptions are amenable to interrogation by subject-matter experts and can be evaluated using causal graphs. We describe an algorithm for constructing causal graphs for separable effects, illustrate how these graphs can be used to reason about assumptions required for identification, and provide semi-parametric weighted estimators.

This article is part of a Special Collection on Pharmacoepidemiology.
Deimplementation of ineffective and harmful medical practices: a data-driven commentary
Authors: Pineles Beth L , Bonafide Christopher P , Ashcraft Laura Ellen
Published: August 2024

Deimplementation is the discontinuation or abandonment of medical practices that are ineffective or of unclear effectiveness, ranging from simply unhelpful to harmful. With epidemiology expanding to include more translational sciences, epidemiologists can contribute to deimplementation by defining evidence, establishing causality, and advising on study design. An estimated 10%-30% of health care practices have minimal to no benefit to patients and should be targeted for deimplementation. The steps in deimplementation are (1) identify low-value clinical practices, (2) facilitate the deimplementation process, (3) evaluate deimplementation outcomes, and (4) sustain deimplementation, each of which is a complex project. Deimplementation science involves researchers, health care and clinical stakeholders, and patient and community partners affected by the medical practice. Increasing collaboration between epidemiologists and implementation scientists is important to optimizing health care delivery.
Secondary metabolites from marine fungus Penicillium chrysogenum VH17 and their antimicrobial and cytotoxic potential
Authors: Anh Nguyen Mai , Minh Le Thi Hong , Linh Nguyen Thuy , Dao Phi Thi , Quynh Do Thi , Huong Doan Thi Mai , Van Cuong Pham , Huyen Vu Thi Thu , Dat Ton That Huu
Published: August 2024

One new compound, methyl 3-((1-((2-carbamoylphenyl)amino)-1-oxopropan-2-yl)amino)-3-oxopropanoate (1), along with 9 known secondary metabolites (2-10) were isolated and elucidated chemical structures from the methanol extract of the marine-derived fungus Penicillium chrysogenum VH17. Subsequent bioassays showed the antimicrobial and cytotoxic potential of the isolated compounds. All compounds 1-10 displayed antimicrobial effects against at least one tested reference microorganism with MIC values ranging from 32 to 256 µg mL−1. Furthermore, compound 4 exhibited significant cytotoxicity against all tested cell lines, HepG2, A549, and MCF7 with IC50 values of 29.43 ± 1.37, 33.02 ± 1.53, and 36.72 ± 1.88 µM, respectively, whereas compound 3 exhibited weak cytotoxicity against MCF7 and HepG2 cell lines with IC50 values of 87.17 ± 6.31 and 97.32 ± 5.66 µM, respectively.
Quality-of-life assessment and the impact of early diagnosis and treatment in lichen planopilaris: a systematic review
Authors: Kelati Awatef , Jafferany Mohammad
Published: August 2024

Lichen planopilaris (LPP) and its variants, mainly frontal fibrosing alopecia (FFA), affect the hair follicles, causing cicatricial alopecia. The condition has a significant negative impact on self-confidence and quality of life (QoL). This systematic review investigates the psychoemotional impact of LPP and its variants using the PRISMA guidelines. The review revealed that LPP and FFA cause significant psychological distress and impaired QoL. Higher LPP disease activity and severity were associated with higher depression and anxiety scores, lower quality-of-life scores, and higher scores of role limitations (physical and emotional). Additionally, facial lesions in patients with FFA, especially with eyebrow involvement, can be very distressing, leading to impaired self-esteem and reduced QoL. This negative impact of active and severe LPP and FFA on patients’ QoL and self-esteem causes psychiatric conditions including anxiety and depression. Therefore, an early diagnosis must be encouraged in these patients.
A novel sand cat swarm optimization algorithm-based SVM for diagnosis imaging genomics in Alzheimer’s disease
Authors: Wang Luyun , Sheng Jinhua , Zhang Qiao , Yang Ze , Xin Yu , Song Yan , Zhang Qian , Wang Binbing
Published: August 2024

In recent years, brain imaging genomics has advanced significantly in revealing underlying pathological mechanisms of Alzheimer’s disease (AD) and providing early diagnosis. In this paper, we present a framework for diagnosing AD that integrates magnetic resonance imaging (fMRI) genetic preprocessing, feature selection, and a support vector machine (SVM) model. In particular, a novel sand cat swarm optimization (SCSO) algorithm, named SS-SCSO, which integrates the spiral search strategy and alert mechanism from the sparrow search algorithm, is proposed to optimize the SVM parameters. The optimization efficacy of the SS-SCSO algorithm is evaluated using CEC2017 benchmark functions, with results compared with other metaheuristic algorithms (MAs). The proposed SS-SCSO-SVM framework has been effectively employed to classify different stages of cognitive impairment in Alzheimer’s Disease using imaging genetic datasets from the Alzheimer’s Disease Neuroimaging Initiative. It has demonstrated excellent classification accuracies for four typical cases, including AD, early mild cognitive impairment, late mild cognitive impairment, and healthy control. Furthermore, experiment results indicate that the SS-SCSO-SVM algorithm has a stronger exploration capability for diagnosing AD compared to other well-established MAs and machine learning techniques.
From breaking to faking the code: Alan Turing’s Imitation Game latest upgrade for discerning Artificial Intelligence (AI)-generated deepfakes
Authors: Angelides Marios C.
Published: August 2024

Alan Turing developed a simple test for verifying whether machine or man. He did this with a vision that was decades ahead of the time but with the technology that was available to him at the time. Back in the time, the notion of AI was a future prospect, and not a real threat in any way to humanity. Roll the clock forward to today and AI is not a prospect but a stark reality and the threat to humanity, according to the sceptics, all but real. But how serious has the threat become? This paper investigates.
Esophagectomy in patients with esophageal squamous cell carcinoma and distant nodal metastasis
Authors: Liu Chia , Tsai Ping-Chung , Chien Ling-I , Huang Chien-Sheng , Hsieh Chih-Cheng , Hsu Han-Shui , Hsu Po-Kuei
Published: August 2024

The role of surgery in oligometastatic esophageal squamous cell carcinoma (ESCC) remains controversial. This study evaluated the oncological outcomes after esophagectomy in patients with ESCC with distant lymph node (LN) metastasis. Patients with ESCC and nodal metastasis treated with chemoradiotherapy or chemotherapy followed by esophagectomy between 2010 and 2020 were included. Overall survival (OS) and recurrence-free survival (RFS) were compared between patients with distant LN metastasis (dLN+) and exclusively regional LN metastasis (dLN–). The cohort comprised 69 dLN+ and 111 dLN– patients. Survival was significantly better in the dLN– group than in the dLN+ group (5-year OS, 51.9% vs. 25.5%, P < 0.001; RFS, 47.2% vs. 18.1%, P < 0.001). Stratified by the yp stage, 49 (44.1%) dLN– and 30 (43.5%) dLN+ patients achieved a pathological complete response (pCR). In the dLN– and dLN+ groups, the OS rates were significantly higher in the pCR group than in the non-pCR group (dLN–: 76.7% vs. 32.4%, P < 0.001; dLN+: 39.6% vs. 14.2%; P = 0.002). The dLN–/pCR group had the best OS, significantly outperforming the dLN−/non-pCR and dLN+/pCR groups. OS did not differ between the dLN−/non-pCR and dLN+/pCR groups. The dLN+/non-pCR group had the worst OS. The RFS analysis paralleled the OS findings. Patients with dLN+ disease had worse outcomes than their dLN– counterparts, irrespective of the pCR status. The survival rates were poor but comparable between the dLN+/pCR and dLN−/non-pCR groups. Adjuvant therapy may be required for dLN+ patients following systemic treatment and surgery, even after achieving pCR.
Most frequent value analysis of distance measurements to M87
Authors: Zhang Jiang , Li Lingdou , Su Han , Chen Yandong , Shi Weibin
Published: August 2024

We reanalyse the recent compilation of distance measurements to M87 by collecting the data from published literature. Different from the traditional statistical methods, based on the principle of minimum information loss, we use a robust most frequent value (MFV) procedure to estimate the distance to M87, irrespective of the Gaussian or non-Gaussian distributions. The MFV-based robust estimate for the M87 distance modulus is given by $31.09^{+0.04}_{-0.03}$ (statistical) $^{+0.05}_{-0.07}$ (systematic) mag corresponding to a 68.27 per cent confidence interval, whereas the result of combining the two uncertainties in quadrature is $31.09^{+0.06}_{-0.08}$ mag. We also construct the error distributions of M87 distance moduli values according to the weighted mean, median, and MFV, which is non-Gaussian. This demonstrates that the MFV method offers a more accurate and robust estimate of the distance to M87 compared to methods that depend on the unfulfilled assumption of Gaussianity.
Using Ly α transits to constrain models of atmospheric escape
Authors: Schreyer Ethan , Owen James E , Loyd R O Parke , Murray-Clay Ruth
Published: August 2024

Ly $\alpha$ transits provide an opportunity to test models of atmospheric escape directly. However, translating observations into constraints on the properties of the escaping atmosphere is challenging. The major reason for this is that the observable parts of the outflow often comes from material outside the planet’s Hill sphere, where the interaction between the planetary outflow and circumstellar environment is important. As a result, 3D models are required to match observations. Whilst 3D hydrodynamic simulations are able to match observational features qualitatively, they are too computationally expensive to perform a statistical retrieval of properties of the outflow. Here, we develop a model that determines the trajectory, ionization state, and 3D geometry of the outflow as a function of its properties and system parameters. We then couple this model to a ray tracing routine in order to produce synthetic transits. We demonstrate the validity of this approach, reproducing the trajectory of the outflows seen in 3D simulations. We illustrate the use of this model by performing a retrieval on the transit spectrum of GJ 436 b. The bound on planetary outflow velocity and mass-loss rates are consistent with a photoevaporative wind.
The C-terminal 4CXXC-type zinc finger domain of CDCA7 recognizes hemimethylated DNA and modulates activities of chromatin remodeling enzyme HELLS
Authors: Shinkai Akeo , Hashimoto Hideharu , Shimura Chikako , Fujimoto Hiroaki , Fukuda Kei , Horikoshi Naoki , Okano Masaki , Niwa Hitoshi , Debler Erik W , Kurumizaka Hitoshi , Shinkai Yoichi
Published: August 2024

The chromatin-remodeling enzyme helicase lymphoid-specific (HELLS) interacts with cell division cycle-associated 7 (CDCA7) on nucleosomes and is involved in the regulation of DNA methylation in higher organisms. Mutations in these genes cause immunodeficiency, centromeric instability, and facial anomalies (ICF) syndrome, which also results in DNA hypomethylation of satellite repeat regions. We investigated the functional domains of human CDCA7 in HELLS using several mutant CDCA7 proteins. The central region is critical for binding to HELLS, activation of ATPase, and nucleosome sliding activities of HELLS-CDCA7. The N-terminal region tends to inhibit ATPase activity. The C-terminal 4CXXC-type zinc finger domain contributes to CpG and hemimethylated CpG DNA preference for DNA-dependent HELLS-CDCA7 ATPase activity. Furthermore, CDCA7 showed a binding preference to DNA containing hemimethylated CpG, and replication-dependent pericentromeric heterochromatin foci formation of CDCA7 with HELLS was observed in mouse embryonic stem cells; however, all these phenotypes were lost in the case of an ICF syndrome mutant of CDCA7 mutated in the zinc finger domain. Thus, CDCA7 most likely plays a role in the recruitment of HELLS, activates its chromatin remodeling function, and efficiently induces DNA methylation, especially at hemimethylated replication sites.
Tracking live-cell single-molecule dynamics enables measurements of heterochromatin-associated protein–protein interactions
Authors: Chen Ziyuan , Seman Melissa , Fyodorova Yekaterina , Farhat Ali , Ames Amanda , Levashkevich Alexander , Biswas Saikat , Huang Fengting , Freddolino Lydia , Biteen Julie S , Ragunathan Kaushik
Published: August 2024

Visualizing and measuring molecular-scale interactions in living cells represents a major challenge, but recent advances in single-molecule super-resolution microscopy are bringing us closer to achieving this goal. Single-molecule super-resolution microscopy enables high-resolution and sensitive imaging of the positions and movement of molecules in living cells. HP1 proteins are important regulators of gene expression because they selectively bind and recognize H3K9 methylated (H3K9me) histones to form heterochromatin-associated protein complexes that silence gene expression, but several important mechanistic details of this process remain unexplored. Here, we extended live-cell single-molecule tracking studies in fission yeast to determine how HP1 proteins interact with their binding partners in the nucleus. We measured how genetic perturbations that affect H3K9me alter the diffusive properties of HP1 proteins and their binding partners, and we inferred their most likely interaction sites. Our results demonstrate that H3K9 methylation spatially restricts HP1 proteins and their interactors, thereby promoting ternary complex formation on chromatin while simultaneously suppressing off-chromatin binding. As opposed to being an inert platform to direct HP1 binding, our studies propose a novel function for H3K9me in promoting ternary complex formation by enhancing the specificity and stimulating the assembly of HP1–protein complexes in living cells.
Segmentation of pre- and posttreatment diffuse glioma tissue subregions including resection cavities
Authors: Baig Saif , Vidic Igor , Mastorakos George M , Smith Robert X , White Nathan , Bash Suzie , Dale Anders M , McDonald Carrie R , Beaumont Thomas , Seibert Tyler M , Hattangadi-Gluth Jona , Kesari Santosh , Farid Nikdokht , Rudie Jeffrey D
Published: August 2024

Background

Evaluating longitudinal changes in gliomas is a time-intensive process with significant interrater variability. Automated segmentation could reduce interrater variability and increase workflow efficiency for assessment of treatment response. We sought to evaluate whether neural networks would be comparable to expert assessment of pre- and posttreatment diffuse gliomas tissue subregions including resection cavities.

Methods

A retrospective cohort of 647 MRIs of patients with diffuse gliomas (average 55.1 years; 29%/36%/34% female/male/unknown; 396 pretreatment and 251 posttreatment, median 237 days post-surgery) from 7 publicly available repositories in The Cancer Imaging Archive were split into training (536) and test/generalization (111) samples. T1, T1-post-contrast, T2, and FLAIR images were used as inputs into a 3D nnU-Net to predict 3 tumor subregions and resection cavities. We evaluated the performance of networks trained on pretreatment training cases (Pre-Rx network), posttreatment training cases (Post-Rx network), and both pre- and posttreatment cases (Combined networks).

Results

Segmentation performance was as good as or better than interrater reliability with median dice scores for main tumor subregions ranging from 0.82 to 0.94 and strong correlations between manually segmented and predicted total lesion volumes (0.94 < R2 values < 0.98). The Combined network performed similarly to the Pre-Rx network on pretreatment cases and the Post-Rx network on posttreatment cases with fewer false positive resection cavities (7% vs 59%).

Conclusions

Neural networks that accurately segment pre- and posttreatment diffuse gliomas have the potential to improve response assessment in clinical trials and reduce provider burden and errors in measurement.
The Role of the Gut, Urine, and Vaginal Microbiomes in the Pathogenesis of Urinary Tract Infection in Women and Consideration of Microbiome Therapeutics
Authors: Naji Amal , Siskin Drew , Woodworth Michael H , Lee John R , Kraft Colleen S , Mehta Nirja
Published: August 2024

The gut, urine, and vaginal microbiomes play significant roles in the pathogenesis of recurrent urinary tract infections (rUTIs). Analysis of these microbiota has shown distinct associations with urinary tract infections. Encouraging data indicate that rUTIs may be responsive to microbiome treatments such as fecal microbiota transplantation, expanding potential treatments beyond antibiotics, hydration, and behavioral interventions. If successful, these nonantibiotic therapies have the potential to increase time between rUTI episodes and reduce the prevalence of multidrug-resistant organisms. In this review, we discuss the role of the 3 microbiomes in the pathogenesis of rUTI and utilization of live biotherapeutic products as therapy for rUTI.
A Draft Genome Resource for a Cacao Thread Blight Disease–Causing Strain of Paramarasmius palmivorus
Authors: Baruah Indrani K. , Amoako-Attah Ishmael , Bukari Yahaya , Meinhardt Lyndel W. , Bailey Bryan A. , Cohen Stephen P.
Published: August 2024

Thread blight disease (TBD) is an emerging foliar disease on cacao ( Theobroma cacao), the source of chocolate. Multiple species of pathogenic fungi in the Marasmiinae suborder of Agaricales are responsible for causing TBD in cacao. A recent phylogenetic study showed that Marasmius palmivorus, the second most frequently isolated TBD-causing fungus in Ghana, was phylogenetically distinct from the Marasmiaceae genera Marasmius and Moniliophthora, leading to the naming of a new genus, Paramarasmius. The genus currently contains two species, the type species P. palmivorus and P. mesosporus. This report describes our release of a draft nuclear genome assembly and annotation of P. palmivorus strain GH-12 derived from long- and short-read sequencing. This high-quality draft is the first released genome for P. palmivorus and provides insight into the pathogenicity and evolution of an emerging pathogen.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Barbed Sutures Compared With Conventional Sutures During Laparoscopic Myomectomy
Authors: Kathopoulis Nikolaos , Prodromidou Anastasia , Douligeris Athanasios , Diakosavvas Michail , Zacharakis Dimitrios , Kypriotis Konstantinos , Chatzipapas Ioannis , Grigoriadis Themos , Protopapas Athanasios
Published: August 2024

OBJECTIVE:

To accumulate the currently available literature on the safety and efficacy of the use of knotless barbed sutures for the reconstruction of the uterine wall during laparoscopic myomectomy based on comparison with traditional suture studies.

DATA SOURCES:

We searched PubMed/Medline, Scopus, ClinicalTrials.gov, and Google Scholar up to February 29, 2024.

METHODS OF STUDY SELECTION:

Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines and PICO criteria, we included all English-language, full-text articles that evaluated the perioperative outcomes of patients who had laparoscopic myomectomy and repair of the uterine wall defect with either barbed or traditional (extracorporeal or intracorporeal sutures).

TABULATION, INTEGRATION, AND RESULTS:

The application of barbed sutures resulted in significantly reduced operative time (2,111 patients, mean difference −12.04 minutes, 95% CI, −16.94 to −7.14, P<.001). This was also reflected when suturing time was separately analyzed (437 patients, mean difference −6.04 minutes, 95% CI, −7.43 to −4.65, P<.001) The mean difference in hemoglobin levels before and after surgery was significantly lower in the barbed suture group (1,277 patients, mean difference −0.40 g/dL, 95% CI, −0.72 to −0.09, P<.01) This was also observed in case of estimated blood loss, which was found to be lower in the barbed suture group (1,823 patients, mean difference −47.22 mL, 95% CI, −78.54 to −15.90, P=.003). Finally, the barbed suture group presented lower transfusion rates (1,217 patients, odds ratio 0.43, 95% CI, 0.19–1.00, P=.05). Concerning visual analog scale (VAS) score as evaluated by the surgeons for surgical difficulty, the control group proved to be more technically challenging compared with the barbed sutures group (184 patients, mean difference −1.66 95% CI, −2.37 to −0.94, P<.001). The VAS score for pain at 24 hours postoperatively, postoperative complication rates, and length of hospital stay were similar for both groups. Regarding reproductive outcomes, there was no difference in pregnancy, live birth, and birth complication rates.

CONCLUSION:

The use of barbed sutures during laparoscopic myomectomy presents many clinical benefits for the patient and the surgeon in terms of shorter operative and suturing time, less estimated blood loss, and ease of use. This pioneer technology may contribute to the expansion of laparoscopy on more complex myomectomies.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, CRD42023477304.
Prenatal Care Clinician Preferences Among Patients With Spanish-Preferred Language
Authors: Butler Haylie M. , Bazan Maria , Rivera Luis , Salinas Kevin E. , Hacker Michele R. , DeLevie-Orey Sophia , Siegel Molly R. , Larson Elysia , Molina Rose L.
Published: August 2024

OBJECTIVE:

To measure what patients with Spanish language preference and limited English proficiency value most when selecting a prenatal care clinician.

METHODS:

A discrete choice experiment was administered at two large academic medical centers in Boston, Massachusetts. Participants were identified by electronic medical record, had preferred Spanish language and self-identified limited English proficiency, and either were pregnant with a completed fetal anatomy scan or had given birth within the past 12 months at the time of the study. The discrete choice experiment consisted of eight attributes to consider when selecting a prenatal care clinician: clinician Spanish proficiency, type of interpreter used, interpersonal dynamics (ie, making patients feel seen, heard, and cared for), cultural concordance, continuity of care, shared decision making, distance from home, and wait times for appointments. Descriptive statistics of demographic variables were calculated. Hierarchical Bayesian models were used to analyze discrete choice experiment data.

RESULTS:

The attributes that were most important to 166 participants when choosing their prenatal care clinician were interpersonal dynamics within the patient–clinician dyad and clinician Spanish language proficiency (average importance 21.4/100 and 20.8/100, respectively). Of lowest importance were wait time to receive an appointment and continuity of care (average importance 5.1 and 6.1, respectively). Although participants highly preferred that their clinician be “fluent or near fluent in Spanish,” the second most preferred option was having a clinician with only basic Spanish proficiency rather than a more advanced level of Spanish proficiency with some misunderstandings.

CONCLUSION:

Our study demonstrates the importance of positive clinician–patient interpersonal dynamics and language-concordant care for patients with Spanish language preference in prenatal care. Promoting equitable patient-centered care for patients with limited English proficiency requires responding to preferences regarding clinician language proficiency and demonstrating attentiveness, empathy, and concern for prenatal care experiences.
Covert Consciousness in the ICU
Authors: Edlow Brian L. , Menon David K.
Published: August 2024

OBJECTIVES:

For critically ill patients with acute severe brain injuries, consciousness may reemerge before behavioral responsiveness. The phenomenon of covert consciousness (i.e., cognitive motor dissociation) may be detected by advanced neurotechnologies such as task-based functional MRI (fMRI) and electroencephalography (EEG) in patients who appear unresponsive on the bedside behavioral examination. In this narrative review, we summarize the state-of-the-science in ICU detection of covert consciousness. Further, we consider the prognostic and therapeutic implications of diagnosing covert consciousness in the ICU, as well as its potential to inform discussions about continuation of life-sustaining therapy for patients with severe brain injuries.

DATA SOURCES:

We reviewed salient medical literature regarding covert consciousness.

STUDY SELECTION:

We included clinical studies investigating the diagnostic performance characteristics and prognostic utility of advanced neurotechnologies such as task-based fMRI and EEG. We focus on clinical guidelines, professional society scientific statements, and neuroethical analyses pertaining to the implementation of advanced neurotechnologies in the ICU to detect covert consciousness.

DATA EXTRACTION AND DATA SYNTHESIS:

We extracted study results, guideline recommendations, and society scientific statement recommendations regarding the diagnostic, prognostic, and therapeutic relevance of covert consciousness to the clinical care of ICU patients with severe brain injuries.

CONCLUSIONS:

Emerging evidence indicates that covert consciousness is present in approximately 15–20% of ICU patients who appear unresponsive on behavioral examination. Covert consciousness may be detected in patients with traumatic and nontraumatic brain injuries, including patients whose behavioral examination suggests a comatose state. The presence of covert consciousness in the ICU may predict the pace and extent of long-term functional recovery. Professional society guidelines now recommend assessment of covert consciousness using task-based fMRI and EEG. However, the clinical criteria for patient selection for such investigations are uncertain and global access to advanced neurotechnologies is limited.
A Novel Approach to Incision Marking in Abdominoplasty Using 3D Printing Technology: A Description of Technique
Authors: Mortada Hatan , Alnaim Muna F. , Alhazmi Bushra , Alfawzan Mohammed , Alshomer Feras
Published: August 2024

Abdominoplasty is one of the most common plastic surgery procedures used to improve the appearance and contour of the abdominal region. Despite advances in surgical techniques, achieving optimal aesthetic results with minimal scarring remains a challenge. In this study, we describe a feasible approach to incision marking in abdominoplasty using a three-dimensional-printed incision marking tool. This technique with open source nature has the potential to revolutionize the field of plastic surgery and enhance patient satisfaction. Further studies are needed to confirm our findings and explore the potential applications of three-dimensional printing technology in other aesthetic procedures.
CD8+ T-cell deficiency protects mice from abdominal aortic aneurysm formation in response to calcium chloride2
Authors: Lin Zhuo , Zhao Mantong , Zhang Xian , Piao Jinshun , Zheng Xintong , Shu Shangzhi , Zhao Longguo , Zhang Meiping , Shi Guo-Ping , Lei Yanna , Cui Rihua , Yue Xueling , Cheng Xian Wu
Published: August 2024

Objective:

Abdominal aortic aneurysm (AAA) is an aneurysm-like dilated and highly fatal cardiovascular disease. CD8+ T cells have been shown to be critical for vascular pathological processes, but the contribution of these lymphocytes to vascular diseases remains elusive.

Methods and results:

Eight-week-old male wildtype (CD8+/+) and Cd8a knockout (CD8−/−) mice were used in a calcium chloride2 (CaCl2)-induced experimental AAA model. At 6 weeks after surgery, CD8+ T-cell deletion prevented the formation of AAA, accompanied by reductions of the levels of inflammatory (interferon-γ [IFN-γ], interleukin-1β, monocyte chemoattractant protein-1, intracellular adhesion molecule-1, vascular cell adhesion molecule-1, NOD-like receptor protein 3, caspase-1), oxidative stress [NADPH oxidase and gp91phox], and proteolysis (cathepsin S, cathepsin K, matrix metalloproteinase-2 [MMP-2] and MMP-9) proteins and/or genes in plasma and/or AAA tissues. Immunoreactivities of MMP-2 and MMP-9 were observed in macrophages. An injection of IFN-γ and adoptive transfer of CD8+ T cells of IFN-γ+/+ mice diminished CD8−/−-mediated vasculoprotective actions in the AAA mice. In vitro, IFN-γ enhanced MMP-2 and MMP-9 gelatinolytic activities in macrophage and/or vascular smooth muscle cells.

Conclusion:

The vasculoprotective effects of CD8+ T-cell deletion in a mouse CaCl2-induced AAA model were likely attributable to, at least in part, the attenuation of IFN-γ-dependent inflammation action, oxidative stress production, and proteolysis, suggesting a novel therapeutic target for AAA formation by regulating CD8+ T-cell-derived IFN-γ secretion.
Extreme monovision with EDOF intraocular lenses
Authors: Lentz P. Connor , Stockard Alyssa , Wagner Isabella V. , Ten Hulzen Richard D.
Published: August 2024

Introduction:

The successful outcome of maintaining natural extreme monovision in a patient through the implantation of extended depth-of-focus (EDOF) intraocular lenses (IOLs) in both eyes is reported.

Patient and Clinical Findings:

A 75-year-old woman with a history of extreme monovision (−3.50 diopters [D] spheroequivalent left eye) presented to the clinic for cataract evaluation. At presentation, bilateral blurry vision (both distance and near) was observed with or without spectacles. The patient noted that previous attempts at restoring binocularity with spectacles correction had been unsuccessful, and she maintained a strong desire to maintain her natural extreme monovision.

Diagnosis, Intervention, and Outcomes:

The patient underwent EDOF IOL implantation (both eyes) with full monovision refractive targets of plano (right eye) and −1.50 D (left eye). Postoperatively, the patient expressed dissatisfaction about her limited near vision (left eye). 7 months later, she underwent an EDOF IOL exchange (left eye) with a new refractive target of −3.25 D. The patient perceived her extreme monovision correction to be a success.

Conclusions:

This case highlights that although EDOF IOLs are not specifically designed for monovision correction, they may still provide satisfactory results for certain patients.
Newborn congenital cytomegalovirus screening and hearing outcomes: a systematic review of current literature
Authors: Pollick Sarah A. , Mansour Yusra , Pesch Megan H.
Published: August 2024

Purpose of review

The purpose of this review is to summarize the very recent literature surrounding hearing outcomes of children with congenital cytomegalovirus (cCMV) detected through systematic screening programs.

Recent findings

There are several different approaches to cCMV screening including forms of targeted vs. universal screening of newborns as well as maternally-derived prenatal testing. However, many studies fail to document hearing-related outcomes both in the newborn period and further into childhood when late-onset sensorineural hearing loss (SNHL) can occur. This systematic review included studies of neonates screened for cCMV reporting hearing outcomes for at least one point in time. Hearing targeted screening appeared the most widely reported for detection of unilateral and bilateral SNHL in those with cCMV. A few studies examined these clinical findings in relation to antiviral treatment.

Congenital CMV is an important and common cause of childhood hearing loss. Newborn screening programs may expand opportunities for early diagnosis and treatment of the infection and its sequelae.
Salivary pepsin testing for laryngopharyngeal reflux: will it change our management?
Authors: Li Jinrang , Allen Jacqueline
Published: August 2024

Purpose of review

This review focus on the clinical value of salivary and laryngopharyngeal tissue pepsin measurement in the diagnosis and treatment of laryngopharyngeal reflux (LPR).

Recent findings

A growing body of research suggests that salivary pepsin detection provides a noninvasive method for the identifying LPR occurrence. Pepsin detection testing is still variable, and an optimal method that balances utility with accuracy has not been agreed. Timing and number of test samples recommended also remains controversial, however literature indicates that increasing the number of tests over a day increases pepsin detection rate. It remains unclear whether detection of pepsin alone can be used to confirm LPR diagnosis. Pepsin positivity is correlated with improved response to proton pump inhibitor (PPI) therapy, and therefore may play a role in guiding therapeutic choices. Detection of pepsin in laryngeal tissue has the same clinical value as detection in saliva and requires further investigation to determine utility.

As a noninvasive method for the diagnosis of LPR, the detection of salivary pepsin in the oropharynx shows potential clinical value, however the exact method of detection and diagnostic values are unclear. Salivary or tissue-based pepsin detection may be helpful in predicting therapeutic effects of PPI and providing personalized treatment options. The detection threshold of salivary pepsin may be different in different countries and regions. Timing and number of samples needed for detection is still controversial.
Update on the pathophysiology, diagnosis and management of Ménière's disease
Authors: Lopez-Escamez Jose A. , Perez-Carpena Patricia
Published: August 2024

Purpose of review

The aim of this work is to summarize the main advances on the pathophysiology, diagnosis, and treatment of Meniere's disease (MD).

Recent findings

Different immune responses to biotic stimuli may trigger MD, with subgroups identified based on cytokine and genetic profile, suggesting potential benefits from immune therapy, including antiallergic medication. Genetic and epigenetic research, along with imaging studies, reveal the complexity of MD, involving inflammation, immunity, and metabolic processes. Advanced imaging techniques define specific temporal bone features and endolymphatic hydrops, while machine learning models enhance diagnostic accuracy through clinical and laboratory data analysis. Differentiating MD from vestibular migraine remains challenging due to overlapping symptoms, but combining vestibular tests, audiological assessments, and biomarkers like cytokines and chemokines shows promise. Pharmacological treatments such as betahistine or corticosteroids show varying effectiveness and require further research according to immune subgroups. Surgical options like endolymphatic sac decompression, semicircular canal occlusion and labyrinthectomy are restricted to intractable cases.

Research into MD aims to improve diagnosis and treatment through genetic, immunological, and advanced imaging studies. Current treatments include pharmacological, intratympanic, and surgical interventions, but current research supports a personalized approach based on clinical and molecular re-definition of patient subgroups.
Artificial urinary sphincter: recent developments and the way forward
Authors: Reus Christine , Tran Stephanie , Mozer Pierre , Lenfant Louis , Beaugerie Aurélien , Chartier-Kastler Emmanuel
Published: August 2024

Purpose of review

The AMS 800 has dominated the treatment of postprostatectomy urinary incontinence (PPUI) due to intrinsic sphincter deficiency (ISD) for five decades. A narrative review from June 2022 to June 2024 was conducted using ‘artificial urinary sphincter’ (AUS) MeSH terms in Embase. We extracted information on innovative AUS, randomized controlled trials (RCTs) or prospective studies, and systematic reviews. We evaluated the latest guidelines and consensus and analyzed current trends to discuss options for advancing AUS practices.

Recent findings

Of 465 papers identified, 320 were excluded (irrelevant, duplicates, non-AUS devices, non-English, veterinary), and 145 were reviewed, with 24 selected: seven on novel AUS in development, 7 with higher-level evidence (1 RCT, 1 prospective, 4 systematic reviews, 1 nonsystematic review), and 9 retrospective relevant studies [pressure regulating balloon (PRB), revision strategies, radiotherapy history, manual dexterity/cognition, transscrotal vs. transperineal approach]. The final paper summarized current guidelines from Asia & Pacific on AUS.

In the past 2 years, six novel AUS have emerged, two female RCTs are ongoing, the SATURN study published its 1-year outcomes, and four systematic reviews on female AUS were conducted. These findings enhance evidence levels and position novel AUS to challenge the Gold Standard.
The Role of the Cervical Spine in Dizziness
Authors: Treleaven Julia
Published: August 2024

The neck can be implicated in dizziness via several, separate, discreet mechanisms. Proprioceptive cervicogenic dizziness (CGD) is the most common and reflects the cervical spine’s important role, along with visual and vestibular input, for sensorimotor control. Impaired cervical proprioception can lead to symptoms such as dizziness, unsteadiness, visual disturbances, and altered sensorimotor control, and treatment directed toward cervical musculoskeletal and sensorimotor control is efficacious to improve this in individuals with cervical musculoskeletal disorders.

Despite this, CGD is difficult to diagnose. Many people present with both neck pain and dizziness, and often the onset of both follows head and neck trauma, but neither necessarily implicate the neck as the cause of dizziness. Further, people often present with mixed forms of dizziness. Thus, rather than diagnosing CGD, it might be more important to consider the potential for the neck to have no (nil, co-morbid cervical condition) or some (minor, major, or compensatory) role in dizziness.

Determining the precise role of the cervical spine role in dizziness requires a skilled interview and examination for cervical musculoskeletal and related sensorimotor impairments and relevant testing of other potential causes. A combination and cluster of test outcomes in addition to comparing responses to specific tests when the cervical afferents are stimulated and not stimulated will be important.

Considering the role of the neck in dizziness will allow a balanced approach in assessment and management to allow timely, effective intervention to be provided to the large number of individuals presenting with neck pain and dizziness (Supplemental Digital Content, available at: http://links.lww.com/JNPT/A484).
Current Controversy in Prenatal Diagnosis: The Use of cfDNA to Screen for Monogenic Conditions in Low Risk Populations Is Ready for Clinical Use
Authors: Vora Neeta L. , Langlois Sylvie , Chitty Lyn S.
Published: August 2024

(Abstracted from Prenat Diagn 2024;44:389–397)

Pathogenic variants occurring in a single gene are referred to as monogenic conditions, whether the mutations are inherited or de novo. Pregnancies at risk for inheriting monogenic conditions are generally screened using cfDNA noninvasive tests or through DNA analysis from samples obtained through chorionic villi sampling or amniocentesis.
Effects of a communication skills training program to improve capacity to engage in advance care planning in caregivers of patients with malignant gliomas
Authors: Applebaum Allison J. , Loschiavo Morgan J. , Kastrinos Amanda , Schofield Elizabeth , Behrens Mia , Gebert Rebecca , Carver Alan , Parker Patricia A. , Han Paul K.J. , Diamond Eli L.
Published: August 2024

Background:

Family and friend caregivers play a critical role in advance care planning (ACP) discussions, which are difficult but necessary to carry out patients' goals of care. This role is particularly important among caregivers of patients with malignant gliomas (MGs), who are often tasked with quickly taking responsibility for healthcare communication. We developed and evaluated the feasibility, acceptability, and preliminary effects of a virtual communication skills training program to equip caregivers of patients with recurrent MGs with skills to navigate ACP conversations with patients and healthcare providers.

Methods:

Our 2-hour communication skills training combined a series of didactic exercises with roleplay scenarios and follow-up coaching through a booster call conducted 2 weeks after training completion. Caregivers were randomized to receive either the communication skills training or enhanced usual care (EUC), which included screening and the provision of targeted referrals. Assessments were completed at baseline (T1) and at 2 (T2) and 5 (T3) months of follow-up.

Results:

A total of 34 caregivers enrolled and were randomized, of whom 19 completed the T2 and 18 completed the T3 assessment. 10 of the 13 caregivers who completed the training participated in interviews at T2 about their experiences and perceived benefits of participation. At T3, results indicated a strong effect size for reduced anxiety and distress and increased preparedness for death in caregivers who received the intervention relative to EUC. Participants reported that the training helped them feel confident initiating ACP conversations, validated in their fears about death, and helped them feel supported and less alone.

Conclusion:

Despite the challenges of recruiting a highly distressed group of caregivers, there were notable benefits of our communication skills training. Additional larger trials are needed to rigorously evaluate the efficacy of the training program and those that include caregivers of patients with other sites and stages of cancer to determine the generalizability of findings.
IPOS at 40: how can we build on our success?
Authors: Jacobsen Paul B.
Published: August 2024

This invited commentary presents the author's reflections on the state of International Psycho-Oncology Society on the occasion of anniversary. The comments are presented in the form of an informal Strengths, Weaknesses, Opportunities, Threats analysis that characterizes the society's principal strengths and weaknesses, the opportunities it possesses, and the threats it faces. These comments are offered with the intent of stimulating greater discussion about how International Psycho-Oncology Society can best serve its members, achieve its goals going forward, and continue to be a vibrant and thriving society.