bluuebunny/crossref_metadata_2025 huggingface dataset:
Mistletoe-induced carbon, water and nutrient imbalances are imprinted on tree rings
Authors: González de Andrés Ester , Gazol Antonio , Querejeta José Ignacio , Colangelo Michele , Camarero J Julio
Published: August 2024

Mistletoes are xylem-tapping hemiparasites that rely on their hosts for water and nutrient uptake. Thus, they impair tree performance in the face of environmental stress via altering the carbon and water relations and nutritional status of trees. To improve our understanding of physiological responses to mistletoe and ongoing climate change, we investigated radial growth, stable carbon and oxygen isotopic signals, and elemental composition of tree rings in silver fir (Abies alba Mill.) and Scots pine (Pinus sylvestris L.) forests infested with Viscum album L. We compared temporal series (1990–2020) of basal area increment (BAI), intrinsic water-use efficiency (iWUE), oxygen isotope composition (δ18O), nutrient concentrations and stoichiometric ratios between non-infested (NI) and severely infested (SI) fir and pine trees from populations located close to the xeric distribution limit of the species in north-eastern Spain. The SI trees showed historically higher growth, but the BAI trend was negative for more than three decades before 2020 and their growth rates became significantly lower than those of NI trees by the mid-2010s. Mistletoe infestation was related to an enhanced sensitivity of radial growth to vapour pressure deficit (atmospheric drought). The SI trees showed less pronounced iWUE increases (fir) and lower iWUE values (pine) than NI trees. The lower tree-ring δ18O values of SI trees may be the result of several superimposed effects operating simultaneously, including leaf-level evaporative enrichment, source water isotopic signals, and anatomical and phenological differences. We observed a deterioration of potassium (K) nutrition in tree-ring wood of both species in SI trees, along with accumulation of manganese (Mn). We suggest that such nutritional patterns are driven by the indirect effect of mistletoe-induced drought stress, particularly in pine. The combined analyses of different physiological indicators imprinted on tree rings provided evidence of the progressive onset of carbon, water and nutrient imbalances in mistletoe-infested conifers inhabiting seasonally dry regions.
Biogeography and phylogeny of the scavenging amphipod genus Valettietta (Amphipoda: Alicelloidea), with descriptions of two new species from the abyssal Pacific Ocean
Authors: Stewart Eva C D , Bribiesca-Contreras Guadalupe , Weston Johanna N J , Glover Adrian G , Horton Tammy
Published: August 2024

Valettietta Lincoln & Thurston, 1983 (Amphipoda: Alicelloidea) is an infrequently sampled genus of scavenging amphipod, with a known bathymetric range from 17–5467 m encompassing a variety of habitats from anchialine caves to abyssal plains. Molecular systematics studies have uncovered cryptic speciation in specimens collected from the abyssal Pacific, highlighting uncertainty in the description of Valettietta anacantha (Birstein & Vinogradov, 1963). Here, we apply an integrative taxonomic approach and describe two new species, Valettietta trottarum sp. nov. and Valettietta synchlys sp. nov., collected at abyssal depths in the Clarion-Clipperton Zone, Pacific Ocean. Both species can be distinguished by characters of the gnathopods, uropod 3, and the inner plate of the maxilliped. Further, molecular phylogenetic analyses of two mitochondrial (16S rDNA and COI) and two nuclear (Histone 3 and 28S rRNA) regions found both new species to form well-supported clades and allowed us to re-identify previously published records based on genetic species delimitation. The biogeography of Valettietta is discussed in light of these re-evaluated records, and a new taxonomic key to the genus is provided. These new taxa highlight the strength of applying an integrated taxonomic approach to uncover biodiversity, which is critical in regions being explored for potential industrial purposes.
Microbiome and metabolome analyses indicate variations in the gut microbiota that disrupt regulation of appetite
Authors: Qi Renli , Zhang Bin , Qiu Xiaoyu , Liu Xin , Bao Shili , Wang Jing , Wang Qi , Yang Yong , Yang Haili , Liu Zuohua
Published: August 2024

The mechanism connecting gut microbiota to appetite regulation is not yet fully understood. This study identifies specific microbial community and metabolites that may influence appetite regulation. In the initial phase of the study, mice were administered a broad‐spectrum antibiotic cocktail (ABX) for 10 days. The treatment significantly reduced gut microbes and disrupted the metabolism of arginine and tryptophan. Consequently, ABX‐treated mice demonstrated a notable reduction in feed consumption. The hypothalamic expression levels of CART and POMC, two key anorexigenic factors, were significantly increased, while orexigenic factors, such as NPY and AGRP, were decreased. Notably, the levels of appetite‐suppressing hormone cholecystokinin in the blood were significantly elevated. In the second phase, control mice were maintained, while the ABX‐treated mice received saline, probiotics, and short‐chain fatty acids (SCFAs) for an additional 10 days to restore their gut microbiota. The microbiota reconstructed by probiotic and SCFA treatments were quite similar, while microbiota of the naturally recovering mice demonstrated greater resemblance to that of the control mice. Notably, the abundance of Akkermansia and Bacteroides genera significantly increased in the reconstructed microbiota. Moreover, microbiota reconstruction corrected the disrupted arginine and tryptophan metabolism and the abnormal peripheral hormone levels caused by ABX treatment. Among the groups, SCFA‐treated mice had the highest feed intake and NPY expression. Our findings indicate that gut microbes, especially Akkermansia, regulate arginine and tryptophan metabolism, thereby influencing appetite through the microbe‐gut‐brain axis.
Medical management of endometriosis
Authors: Alonso Anais , Gunther Kate , Maheux-Lacroix Sarah , Abbott Jason
Published: August 2024

Purpose of review

While laparoscopic surgery plays a key role in the management of endometriosis, symptoms commonly recur, and repeat surgery comes with increased risk. Medical management, including hormonal and nonhormonal treatment, is vital in managing painful symptoms. This review summarizes recent evidence regarding various medical management options available to treat pelvic pain associated with endometriosis.

Recent findings

Efficacy of dienogest vs. combined oral contraceptive on pain associated with endometriosis: randomized clinical trial.

Once daily oral relugolix combination therapy vs. placebo in patients with endometriosis-associated pain: two replicate phase 3, randomised, double-blind, studies (SPIRIT 1 and 2).

A randomized, double-blind, placebo-controlled pilot study of the comparative effects of dienogest and the combined oral contraceptive pill in women with endometriosis.

Two-year efficacy and safety of relugolix combination therapy in women with endometriosis-associated pain: SPIRIT open-label extension study.

All symptomatic women with suspected endometriosis who are not desiring immediate fertility can be offered suppressive treatment to control symptoms and slow the progression of disease. First-line treatments include the combined oral contraceptive pill and progestogens. Second-line treatments include gonadotropin-releasing hormone agonists and antagonists but current guidelines recommend that these should be reserved for people whose symptoms fail to be controlled by first-line agents. The use of complementary and alternative medicines is also increasing in both volume and number of agents used.
The Utility of Preoperative Phenylephrine Testing in Müller Muscle Conjunctival Resection Surgery for Involutional Ptosis
Authors: Saffari Persiana S. , Dallalzadeh Liane O. , Kikkawa Don O. , Korn Bobby S. , Ramesh Sathyadeepak , Shinder Roman , Rootman Daniel B.
Published: August 2024

Purpose:

Phenylephrine testing prior to Müller muscle conjunctival resection has traditionally been used to predict postoperative outcomes. The purpose of this study is to determine if preoperative phenylephrine testing impacts postoperative changes in eyelid position.

Methods:

In this multicenter cross-sectional cohort study, 270 eyelids of participants with involutional ptosis and levator function >12 mm who underwent Müller muscle conjunctival resection were divided into 2 comparison groups. Participants who had preoperative phenylephrine testing served as the control group and those who did not were the study group. The primary outcome measure was postoperative marginal reflex distance from the upper eyelid margin (marginal reflex distance 1 [MRD1]) at the latest follow-up visit. Secondary outcomes included change in MRD1, reoperation rate, and predictive capacity of preoperative phenylephrine testing.

Results:

Of the 270 eyelids that underwent Müller muscle conjunctival resection, 116 eyelids served as controls and 154 were in the study group. Mean age of participants was 62.6 years. Levator function, resection length, preoperative MRD1, change in MRD1, and latest postoperative MRD1 measures when compared in the control and study groups demonstrated no significance (p > 0.05) via 2-tailed t-test. Postoperative MRD1 was correctly predicted within 1 mm for 60.2% of eyelids that underwent preoperative phenylephrine testing.

Conclusions:

Preoperative phenylephrine testing does not significantly predict postoperative eyelid elevation following Müller muscle conjunctival resection. Surgeons may thereby reassess the utility of preoperative phenylephrine testing given the lack of influence on surgical outcomes.
Long-term Outcome of Conjunctival Transposition Flaps for Contracted Sockets
Authors: Vahdani Kaveh , Rose Geoffrey E.
Published: August 2024

Purpose:

To assess the efficacy, and reintervention rate, of a conjunctival transposition technique in the treatment of contracted fornices in anophthalmic sockets.

Methods:

Retrospective case-note review of patients with contracted anophthalmic sockets who received a novel conjunctival mucosal transposition flap for augmentation of socket lining. Contracted anophthalmic sockets were categorized as grade 1 (minimal contraction), grade 2 (inferior and/or superior fornix), grade 3 (advanced scarring of the entire upper and lower fornices), and grade 4 (severe palpebral phimosis, recurrent cases, and irradiated sockets).

Results:

Of 32 patients (56% male), 53% had mild-to-moderate contracted anophthalmic sockets (grades 1 or 2). The transposition flap was combined with secondary ball implantation (3 cases), ball exchange (1 case), primary orbital floor (1 case), or revisional floor (3 cases) implantation. By an average follow up of 9.2 years, 16% (5 cases with grade 3 or 4) required additional relining, with another patient declining further surgery; this yielding an overall anatomic success of 81% (100% in grades 1 and 2; 60% in grades 3 and 4). At the last follow up, 91% of patients had adequate socket lining and 94% reported a comfortable socket with stable prostheses.

Conclusions:

Having results similar to free grafting but without remote donor-site morbidity, this novel transposition flap satisfactorily addresses mild-to-moderate fornix contracture, and most patients achieve stable and comfortable prosthetic wear. Some patients with severe contracted anophthalmic sockets required further autologous grafting: this generally arose because the transposition flap included tissue from above the socket’s horizontal raphé (with later contracture of the upper fornix).
Peripheral nerve injury results in a biased loss of sensory neuron subpopulations
Authors: Cooper Andrew H. , Barry Allison M. , Chrysostomidou Paschalina , Lolignier Romane , Wang Jinyi , Redondo Canales Magdalena , Titterton Heather F. , Bennett David L. , Weir Greg A.
Published: August 2024

There is a rich literature describing the loss of dorsal root ganglion (DRG) neurons following peripheral axotomy, but the vulnerability of discrete subpopulations has not yet been characterised. Furthermore, the extent or even presence of neuron loss following injury has recently been challenged. In this study, we have used a range of transgenic recombinase driver mouse lines to genetically label molecularly defined subpopulations of DRG neurons and track their survival following traumatic nerve injury. We find that spared nerve injury leads to a marked loss of cells containing DRG volume and a concomitant loss of small-diameter DRG neurons. Neuron loss occurs unequally across subpopulations and is particularly prevalent in nonpeptidergic nociceptors, marked by expression of Mrgprd. We show that this subpopulation is almost entirely lost following spared nerve injury and severely depleted (by roughly 50%) following sciatic nerve crush. Finally, we used an in vitro model of DRG neuron survival to demonstrate that nonpeptidergic nociceptor loss is likely dependent on the absence of neurotrophic support. Together, these results profile the extent to which DRG neuron subpopulations can survive axotomy, with implications for our understanding of nerve injury–induced plasticity and pain.
Long-term outcomes in critically ill patients with acute respiratory failure
Authors: Ippolito Mariachiara , Galvano Alberto Nicolò , Cortegiani Andrea
Published: August 2024

Purpose of review

This review aims to explore the latest evidence on long-term outcomes in patients admitted to the ICU because of acute respiratory failure (ARF).

Recent findings

As the survival rate of critically ill patients with acute respiratory failure improves, long-term mortality and disability still influence the quality of life of survivors and their caregivers. Patients admitted to the ICU because of ARF are at risk of developing the postintensive care syndrome, which presents with physical, cognitive and mental symptoms, all of which may impair their quality of life. Caregivers seem to be affected as well, which may lead to intergenerational trauma. The need for more care, including prone positioning, invasive support (e.g. mechanical ventilation, ECMO) and deep sedation are probably adjunctive risk factors for poor long-term outcomes.

There is not much data on the long-term outcomes of patients who have survived ARF. More follow-up studies should be conducted, especially in centers providing higher levels of costly care (e.g. ECMO). Randomized controlled trials on interventions for ARF should include patient-centered long-term outcomes in addition to mortality rates. The high mortality rates associated with ARF mandate collaboration among multiple centers to achieve an adequate sample size for studying the long-term outcomes of survivors.
Evaluating 64Cu-DOTA-rituximab as a PET agent in patients with B-cell lymphoma: a head-to-head comparison with 18F-fluorodeoxyglucose PET/computed tomography
Authors: Lee Inki , Byun Byung Hyun , Kim Byung Il , Choi Chang Woon , Kang Hye Jin , Kang Chi Soo , Woo Sang-Keun , Lee Kyo Chul , Kang Joo Hyun , Lim Ilhan
Published: August 2024

Background

This study aimed to evaluate the biodistribution of 64Cu-DOTA-rituximab and its diagnostic feasibility for lymphoma using CD20-targeted 64Cu-DOTA-rituximab PET/computed tomography (PET/CT).

Methods

A prospective study involving six patients diagnosed with lymphoma was conducted between January 2022 and January 2023. These patients underwent 18F-fluorodeoxyglucose (18F-FDG) and 64Cu-DOTA-rituximab PET/CT scans. 64Cu-DOTA-rituximab PET/CT images were acquired at 1, 24, and 48 h after administering 64Cu-DOTA-rituximab to assess the biodistribution and dosimetry over time. The observed lymph nodes were categorized into specific regions, including cervical and supraclavicular, axillary and infraclavicular, mediastinal, hilar, abdominal paraaortic and retroperitoneal, iliac, mesenteric, and inguinal regions, to compare the diagnostic ability of 18F-FDG and 64Cu-DOTA-rituximab PET/CT in detecting lymphoma lesions. Furthermore, the tumor-to-background ratio was calculated and compared with the maximum standardized uptake (SUVmax) of the tumors and the mean standardized uptake (SUVmean) of normal organs. Internal radiation dosimetry was determined using the OLINDA/EXM software.

Results

64Cu-DOTA-rituximab uptake in lymph nodes associated with lymphoma progressively increased from 1 to 48 h after injection. In contrast, 64Cu-DOTA-rituximab uptake in normal organs, such as blood, lung, kidney, bladder, muscle, bone, and brain, decreased over time, whereas it increased in the liver and spleen. When it comes to the comparison between 64Cu-DOTA-rituximab and 18F-FDG, the SUVmax of tumors was higher on 64Cu-DOTA-rituximab PET/CT (18.1 ± 8.3) than on 18F-FDG PET/CT (5.2 ± 1.5). Additionally, the tumor-to-background ratio, measured using the SUVmean of normal muscles, was higher on 64Cu-DOTA-rituximab PET/CT (55.7 ± 31.0) than on 18F-FDG PET/CT (8.6 ± 2.8). No adverse events related to 64Cu-DOTA-rituximab injection were reported.

Conclusion

The results of this study demonstrate the feasibility of using 64Cu-DOTA-rituximab PET/CT to evaluate the CD20 expression. The increased 64Cu-DOTA-rituximab uptake in lymph nodes associated with tumors, higher SUVmax, and tumor-to-muscle ratios observed with 64Cu-DOTA-rituximab PET/CT compared with 18F-FDG PET/CT, highlight the diagnostic potential of this imaging modality.
Brief Report:Availability of and Interest in Gender-Affirming Care, PrEP, and HIV Prevention Services in a Global Sample of Transmasculine Persons
Authors: Paine Emily Allen , Appenroth Max , Scheim Ayden , Goldrich Madison , Giguere Rebecca , Sandfort Theodorus
Published: August 2024

Background:

We assessed access to pre-exposure prophylaxis (PrEP) and interest in integration of PrEP with gender-affirmative care in a global sample of transmasculine persons.

Methods:

Transmasculine persons (N = 590) aged 18 years and above from 57 countries completed a brief online survey from April to July 2022 about sexual behavior, knowledge, and interest in PrEP, current access to PrEP and gender-affirmative care, and preferred context for accessing PrEP. Descriptive analyses were stratified by country income group.

Results:

Most participants (54.4%) lived near a health center offering care to trans people. Overall, 1.9% of respondents reported ever receiving a positive HIV test result. Among those who had not (n = 579), more than a third reported engaging in receptive sex in the past year (35.2%) or anticipated doing so in the next year (41.5%), 86.9% had never received information about HIV prevention specific to transmasculine people, and 76.3% had heard of PrEP. Among those who had heard of PrEP (n = 440), only 18.9% had discussed or been offered it by a provider, and only 3.6% were currently taking it—yet 67.9% who had heard of it but were not using it would “definitely” (28.5%) or “maybe” (39.4%) be interested in taking it were it available for free. Out of these participants, the majority (60.5%) preferred the idea of accessing PrEP from the same clinic where they received gender-affirming care.

Conclusions:

Interventions are needed to improve PrEP access for transmasculine people globally. Clinics already providing gender-affirming care to trans people are acceptable clinical contexts to integrate such interventions.
Feasibility of Epicardial Adipose Tissue Quantification Using Non–electrocardiogram-Gated Chest Computed Tomography Images
Authors: Mikami Tomio , Yokomachi Kazushi , Mizuno Kenji , Kobayashi Masayuki
Published: August 2024

Objective

Epicardial adipose tissue (EAT) is an important imaging indicator of cardiovascular risk. EAT volume is usually measured using electrocardiogram (ECG) gating. However, there are concerns regarding the influence of motion artifacts when measuring EAT volume on non‐ECG-gated plain chest computed tomography (CT) images. Few studies have evaluated the EAT volume using non-ECG gating. This study aimed to validate the accuracy of EAT quantification using non‐ECG-gated chest CT imaging.

Methods

We included 100 patients (64 males, 36 females) who underwent simultaneous coronary artery calcification score imaging (ECG gated) and plain chest CT imaging (non‐ECG gated). Images taken using non-ECG gating were reconstructed using the same field of view and slice thickness as those obtained with ECG gating. The EAT capacity of each image was measured and compared. An AZE Virtual Place (Canon) was used for the measurements. The Mann-Whitney U test and intraclass correlation coefficient were used for statistical analyses. P values <0.05 were considered statistically significant. Concordance was evaluated using Bland-Altman analysis.

Results

The mean EAT volume measured by ECG-gated imaging was 156.5 ± 66.9 mL and 155.4 ± 67.9 mL by non‐ECG-gated imaging, with no significant difference between the two groups (P = 0.86). Furthermore, the EAT volumes measured using ECG-gated and non‐ECG-gated imaging showed a strong correlation (r = 0.95, P < 0.05). Bland-Altman analysis revealed that the mean error of the EAT volume (non‐ECG-gated imaging ‐ ECG-gated imaging) was −1.02 ± 2.95 mL (95% confidence interval, −6.49 to 4.76).

Conclusions

The EAT volume obtained using non‐ECG-gated imaging was equivalent to that obtained using ECG-gated imaging.
Impact of the Novel MRI Contrast Agent Gadopiclenol on Radiotherapy Decision Making in Patients With Brain Metastases
Authors: Sarria Gustavo R. , Fleckenstein Jens , Eckl Miriam , Stieler Florian , Ruder Arne , Bendszus Martin , Schmeel Leonard C. , Koch David , Feisst Andreas , Essig Marco , Wenz Frederik , Giordano Frank A.
Published: August 2024

Purpose

The aim of this study was to assess the effect of gadopiclenol versus gadobenate dimeglumine contrast-enhanced magnetic resonance imaging (MRI) on decision-making between whole-brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS) for treatment of brain metastases (BMs).

Methods

Patients with BMs underwent 2 separate MRI examinations in a double-blind crossover phase IIb comparative study between the MRI contrast agents gadopiclenol and gadobenate dimeglumine, both administered at 0.1 mmol/kg. The imaging data of a single site using identical MRI scanners and protocols were included in this post hoc analysis. Patients with 1 or more BMs in any of both MRIs were subjected to target volume delineation for treatment planning. Two radiation oncologists contoured all visible lesions and decided upon SRS or WBRT, according to the number of metastases. For each patient, SRS or WBRT treatment plans were calculated for both MRIs, considering the gross target volume (GTV) as the contrast-enhancing aspects of the tumor. Mean GTVs and volume of healthy brain exposed to 12 Gy (V12), as well as Dice similarity coefficient scores, were obtained. The Spearman rank (ρ) correlation was additionally calculated for assessing linear differences. Three different expert radiation oncologists blindly rated the contrast enhancement for contouring purposes.

Results

Thirteen adult patients were included. Gadopiclenol depicted additional BM as compared with gadobenate dimeglumine in 7 patients (54%). Of a total of 63 identified metastatic lesions in both MRI sets, 3 subgroups could be defined: A, 48 (24 pairs) detected equal GTVs visible in both modalities; B, 13 GTVs only visible in the gadopiclenol set (mean ± SD, 0.16 ± 0.37 cm3); and C, 2 GTVs only visible in the gadobenate dimeglumine set (mean ± SD, 0.01 ± 0.01). Treatment indication was changed for 2 (15%) patients, 1 from no treatment to SRS and for 1 from SRS to WBRT. The mean GTVs and brain V12 were comparable between both agents (P = 0.694, P = 0.974). The mean Dice similarity coefficient was 0.70 ± 0.14 (ρ = 0.82). According to the readers, target volume definition was improved in 63.9% of cases (23 of 36 evaluations) with gadopiclenol and 22.2% with gadobenate dimeglumine (8 of 36), whereas equivalence was obtained in 13.9% (5 of 36).

Conclusions

Gadopiclenol-enhanced MRI improved BM detection and characterization, with a direct impact on radiotherapy treatment decision between WBRT and SRS. Additionally, a more exact target delineation and planning could be performed with gadopiclenol. A prospective evaluation in a larger cohort of patients is required to confirm these findings.
Optimal Spectral Performance on Pediatric Photon-Counting CT
Authors: Zhou Wei , Ataei Afrouz , Huo Donglai , Ren Liqiang , Browne Lorna P. , Zhou Xin , Weinman Jason P.
Published: August 2024

Purpose

The comprehensive evaluation of kV selection on photon-counting computed tomography (PCCT) has yet to be performed. The aim of the study is to evaluate and determine the optimal kV options for variable pediatric body sizes on the PCCT unit.

Materials and Methods

In this study, 4 phantoms of variable sizes were utilized to represent abdomens of newborn, 5-year-old, 10-year-old, and adult-sized pediatric patients. One solid water and 4 solid iodine inserts with known concentrations (2, 5, 10, and 15 mg I/mL) were inserted into phantoms. Each phantom setting was scanned on a PCCT system (Siemens Alpha) with 4 kV options (70 and 90 kV under Quantum Mode, 120 and 140 kV under QuantumPlus Mode) and clinical dual-source (3.0 pitch) protocol. For each phantom setting, radiation dose (CTDIvol) was determined by clinical dose settings and matched for all kV acquisitions. Sixty percent clinical dose images were also acquired. Reconstruction was matched across all acquisitions using Qr40 kernel and QIR level 3. Virtual monoenergetic images (VMIs) between 40 and 80 keV with 10 keV interval were generated on the scanner. Low-energy and high-energy images were reconstructed from each scan and subsequently used to generate an iodine map (IM) using an image-based 2-material decomposition method. Image noise of VMIs from each kV acquisition was calculated and compared between kV options. Absolute percent error (APE) of iodine CT number accuracy in VMIs was calculated and compared. Root mean square error (RMSE) and bias of iodine quantification from IMs were compared across kV options.

Results

At the newborn size and 50 keV VMI, noise is lower at low kV acquisitions (70 kV: 10.5 HU, 90 kV: 10.4 HU), compared with high kV acquisitions (120 kV: 13.8 HU, 140 kV: 13.9 HU). At the newborn size and 70 keV VMI, the image noise from different kV options is comparable (9.4 HU for 70 kV, 8.9 HU for 90 kV, 9.7 HU for 120 kV, 10.2 HU for 140 kV). For APE of VMI, high kV (120 or 140 kV) performed overall better than low kV (70 or 90 kV). At the 5-year-old size, APE of 90 kV (median: 3.6%) is significantly higher (P < 0.001, Kruskal-Wallis rank sum test with Bonferroni correction) than 140 kV (median: 1.6%). At adult size, APE of 70 kV (median: 18.0%) is significantly higher (P < 0.0001, Kruskal-Wallis rank sum test with Bonferroni correction) than 120 kV (median: 1.4%) or 140 kV (median: 0.8%). The high kV also demonstrated lower RMSE and bias than the low kV across all controlled conditions. At 10-year-old size, RMSE and bias of 120 kV are 1.4 and 0.2 mg I/mL, whereas those from 70 kV are 1.9 and 0.8 mg I/mL.

Conclusions

The high kV options (120 or 140 kV) on the PCCT unit demonstrated overall better performance than the low kV options (70 or 90 kV), in terms of image quality of VMIs and IMs. Our results recommend the use of high kV for general body imaging on the PCCT.
Complications of Fat Grafting and Repositioning for Correction of Lower Eyelid Pouch With Tear Trough Deformity or Lid-Cheek Junction
Authors: Xu Zenghui , Zheng Fan , Zhao Xian , Wang Songmei , Wang Ruiheng , He Jia , Gan Fengshan
Published: August 2024

Background

Fat grafting and repositioning may serve as a convenient, economical, and effective surgical method for correcting lower eyelid pouch with a tear trough deformity or lid-cheek junction. However, comprehensive systematic reviews and meta-analyses investigating the complications associated with this technique are lacking.

Objective

This study aimed to summarize and gather data on complications related to fat grafting and repositioning for the correction of tear trough deformity or lid-cheek junction in lower eyelid blepharoplasty.

Methods

A thorough search was performed across multiple databases including PubMed, Cochrane, Embase, ProQuest, Ovid, Scopus, and Web of Science. Specific inclusion and exclusion criteria were applied to screen the articles. The occurrence of complications was analyzed using a random-effects model.

Results

A total of 33 studies involving 4671 patients met the criteria for systematic evaluation and were included in this meta-analysis. The overall complication rates were 0.112 (95% confidence interval [CI]: 0.060–0.177) for total complications, 0.062 (95% CI: 0.003–0.172) for unsatisfactory correction or contour irregularity, 0.062 (95% CI: 0.009–0.151) for hematoma, swelling (not specified as bulbar conjunctiva), ecchymosis, or oozing of blood, and 0.024 (95% CI: 0.013–0.038) for reoperation.

Conclusions

Fat grafting and repositioning for correcting a lower eyelid pouch with tear trough deformity or lid-cheek junction was associated with high rates of complications. Therefore, it is crucial to closely monitor the rates of unsatisfactory correction or contour irregularity, hematoma, swelling (not specified as bulbar conjunctiva), ecchymosis, or oozing of blood, and reoperation. In addition, effective communication with patients should be prioritized.
Review of Gender Affirming Mastectomy Surgery
Authors: Cordero Justin J. , Alaniz Leonardo , Kalavacherla Sandhya , Kadakia Nikita , Machol Jacques A. , Carré Antoine L. , Klausmeyer Melissa A. , Chu Michael W.
Published: August 2024

Background

Gender-affirming mastectomy can improve mental health and gender expression. However, there is no consensus on routine drain usage in gender-affirming surgeries. The purpose of this study is to compare gender-affirming mastectomies with and without drains and review complications.

Methods

An institutional review board–approved, retrospective review was performed to identify patients between 2017–2021 who had double-incision mastectomy, with or without nipple graft, and separated into drain and no-drain cohorts. Patient demographics, outcomes, and postoperative complications were analyzed, including unplanned return to the operating room, seromas, hematomas, postoperative infection, and postoperative antibiotic use. Univariate and multivariate analysis was performed.

Results

There were 359 patients that had a gender-affirming mastectomy surgery between 2017 and 2021. The mean age was 26.1 years old, and mean body mass index was 27.4. There were 144 patients (40.1%) who had a drain, and 215 patients (59.9%) without a drain. For postoperative complications of all patients, there were 12 (3.3%) unplanned returns to the operating room, 18 seromas (5.0%), 26 hematomas (7.2%), 50 (13.9%) postoperative antibiotic use, and 4 postoperative infections (1.1%). There were no significant differences found between drain use for all postoperative complications, but no-drain use was significantly associated with less prescribed postoperative antibiotics compared to drain use (3.7% and 29.0%, respectively; P < 0.001).

Conclusions

Gender-affirming mastectomy surgeries are safe and effective treatment options. No-drain placement was not associated with increased postoperative complications. Surgeons may consider not prescribing routine postoperative antibiotics if using drains, and avoiding drains for gender-affirming mastectomies may be considered in selected individuals based on clinical judgment.
The Lateral Antebrachial Neurocutaneous Flap: Case Series
Authors: Zeina Ahmed Mahmoud , Zahra Tarek , Mahgoub Mohamed Ali , el Halim Mostafa Abd
Published: August 2024

Background

The neurocutaneous flap was developed based on the understanding that every superficial cutaneous nerve includes vessels, also known as vasa nervorum or paraneural vessels, which run around and inside the nerves and deliver blood to the skin above. A cutaneous perforator connected to paraneural vessels that vascularize the skin and nerves is referred to as a neurocutaneous perforator. The lateral antebrachial cutaneous nerve (LACN), the most dependable blood supply from the primary underlying veins of the neurocutaneous flap, is the subject of this study.

Methods

We reviewed the results of 30 flap coverage procedures in 10 children. The applied flap was based distally along the radial aspect of the hand and wrist. The pivot point of the flap was located dorsally. This study considered patients with posttraumatic tissue loss, vital structure exposure, or hand contractures with an LACN flap. There was a case-by-case assessment.

Results

Thirteen male patients were included; their ages ranged from 6 to 65 years. Demographic data, preoperative cause of trauma, and postoperative complications were collected. Statistically significant improvements were observed after flap healing.

Conclusions

The LACN flap is a more versatile flap with less morbidity than other alternative flaps for coverage of soft tissue defect restoration around the hand, wrist, and distal forearm.
Entering a Post–COVID-19 Landscape
Authors: Di Chiaro Bianca , Kujalowicz Christopher , Siemers Parinaz J. , Yang Maelee , Hodkiewicz Victoria , Cho Subin , King Timothy W.
Published: August 2024

Introduction

The Plastic Surgery Integrated track remains one of the most competitive fields in the National Residency Match Program. Match trends during the COVID-19 pandemic featured a distinct rise in regional and home program matches among plastic surgery applicants. The purpose of this study is to evaluate whether these trends have continued into the most recent residency match cycle in 2024.

Methods

Residency match data from 2019 to 2024 was gathered through the Accreditation Council for Graduate Medical Education, Electronic Residency Application Service, integrated plastic surgery program websites, and plastic surgery residency program social media accounts. Current trends were compared with match cycles before and during the pandemic.

Results

After COVID, the number of students matching at their home institution decreased to rates consistent with prepandemic norms. In the 2024 cycle, 46.9% of applicants matched at integrated plastic surgery programs within the geographical region of their medical school, which is similar to pre-COVID rates. Further, the emergence of a female-predominant plastic surgery match cohort during the pandemic has continued. In 2024, 125 (58.7%) of 213 matched applicants into integrated plastic surgery programs were female, which represents a continuation of female-majority resident cohorts since 2021. Our data showed that a sizable component of matched applicants completed visiting student electives at their matched institution. Finally, a large number of matched applicants completed a research fellowship, and a historically stable number completed research fellowships at their matched institution.

Conclusion

Our group reports stabilization in plastic surgery match trends in the wake of the COVID-19 pandemic, along with the continuation of growth in the number of female plastic surgery residents. Although home institution retention rates returned to the baseline proportionality exhibited prior to COVID-19, medical school geographical region may continue to play an important role in the integrated plastic surgery residency match.
PROGRESS OF RESUSCITATIVE ENDOVASCULAR BALLOON OCCLUSION OF THE AORTA IN PREHOSPITAL EMERGENCY TREATMENT FOR PELVIC FRACTURE
Authors: Gao Xing , Sun Huiqun , He Jialin , Kong Jingbo , Fan Haojun , Lv Qi , Hou Shike
Published: August 2024

Pelvic fractures are severe traumatic injuries often accompanied by potentially fatal massive bleeding. Rapid control of hemorrhages in prehospital emergency settings is critical for improving outcomes in traumatic bleeding. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a promising technique for controlling active bleeding from pelvic fractures. By inserting a balloon catheter into the aorta, REBOA helps maintain blood flow to vital organs such as the brain and heart. This paper provides a comprehensive overview of the initial management of noncompressive trunk hemorrhage caused by pelvic fractures, introduces the technical principles and developments of REBOA, and explores its extensive application in prehospital emergency care. It delves into the operational details and outlines strategies for effectively managing potential complications. We aim to offer a theoretical framework for the future utilization of REBOA in managing uncontrollable hemorrhage associated with pelvic fractures in prehospital emergencies.
Active inference goes to school: the importance of active learning in the age of large language models
Authors: Di Paolo Laura Desirèe , White Ben , Guénin-Carlut Avel , Constant Axel , Clark Andy
Published: August 2024

Human learning essentially involves embodied interactions with the material world. But our worlds now include increasing numbers of powerful and (apparently) disembodied generative artificial intelligence (AI). In what follows we ask how best to understand these new (somewhat ‘alien’, because of their disembodied nature) resources and how to incorporate them in our educational practices. We focus on methodologies that encourage exploration and embodied interactions with ‘prepared’ material environments, such as the carefully organized settings of Montessori education. Using the active inference framework, we approach our questions by thinking about human learning as epistemic foraging and prediction error minimization. We end by arguing that generative AI should figure naturally as new elements in prepared learning environments by facilitating sequences of precise prediction error enabling trajectories of self-correction. In these ways, we anticipate new synergies between (apparently) di
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embodied and (essentially) embodied forms of intelligence.

This article is part of the theme issue ‘Minds in movement: embodied cognition in the age of artificial intelligence’.
How bipedalism shapes humans’ actions with hand tools
Authors: Fragaszy Dorothy M. , Kelty-Stephen Damian G. , Mangalam Madhur
Published: August 2024

The task for an embodied cognitive understanding of humans’ actions with tools is to elucidate how the human body, as a whole, supports the perception of affordances and dexterous action with objects in relation to other objects. Here, we focus on the relationship between humans’ actions with handheld tools and bipedal posture. Posture plays a pivotal role in shaping animals’ perception and action dynamics. While humans stand and locomote bipedally, other primates predominantly employ quadrupedal postures and locomotion, relying on both hands and feet to support the body. Drawing upon evidence from evolutionary biology, developmental psychology and performance studies, we elucidate the influence of bipedalism on our actions with objects and on our proficiency in using tools. We use the metaphor of cascades to capture the dynamic, nonlinear transformations in morphology and behaviour associated with posture and the use of tools across evolutionary and developmental timescales. Recent work illustrates the promise of multifractal cascade analysis to reveal nonlinear, cross-scale interactions across the entire body in real-time, supporting the perception of affordances for actions with tools. Cascade analysis enriches our comprehension of real-time performance and facilitates exploration of the relationships among whole-body coordination, individual development, and evolutionary processes.

This article is part of the theme issue ‘Minds in movement: embodied cognition in the age of artificial intelligence’.
Growth rate-driven modelling reveals how phenotypic adaptation drives drug resistance in BRAFV600E-mutant melanoma
Authors: Hamis Sara , Browning Alexander P , Jenner Adrianne L , Villa Chiara , Maini Philip , Cassidy Tyler
Published: August 2024

Phenotypic adaptation, the ability of cells to change phenotype in response to external pressures, has been identified as a driver of drug resistance in cancer. To quantify phenotypic adaptation in BRAFV600E-mutant melanoma, we develop a theoretical model that emerges from data analysis of WM239A-BRAFV600E cell growth rates in response to drug challenge with the BRAF-inhibitor encorafenib. Our model constitutes a cell population model in which each cell is individually described by one of multiple discrete and plastic phenotype states that are directly linked to drug-dependent net growth rates and, by extension, drug resistance. Data-matched simulations reveal that phenotypic adaptation in the cells is directed towards states of high net growth rates, which enables evasion of drug-effects. The model subsequently provides an explanation for when and why intermittent treatments outperform continuous treatments in vitro, and demonstrates the benefits of not only targeting, but also leveraging, phenotypic adaptation in treatment protocols.
The heat sensitivity of sperm in the lizardAnolis sagrei
Authors: Wang Wayne Wen-Yeu , Page Natalie R. , Strickler Anthony M. , Kusaka Alicia K. , Gunderson Alex R.
Published: August 2024

The heat sensitivity of reproduction is a critical determinant of population persistence under climate change. However, the heat sensitivity of gametes is poorly known relative to adults. We developed a method to measure the heat tolerance of lizard sperm cells, and used the method to test several aspects of sperm cell thermal biology in the brown anole lizard (Anolis sagrei). We estimated the repeatability of sperm traits by measuring heat tolerance and baseline motility of ejaculated sperm from the same individuals multiple times over 21 days. To investigate co-adaptation of sperm and adult thermal traits, we tested for a correlation between sperm heat tolerance and the heat tolerance of adults that produced them. Furthermore, we tested for effects of episodic heat stress experienced by males on sperm performance. Sperm heat tolerance and motility were both repeatable, consistent with evolutionary potential, though there was clear evidence for environmental effects on these traits as well. Contrary to the expectation of thermal co-adaptation, we found no correlation between sperm and adult heat tolerance. A single, episodic extreme heat event experienced by adult males immediately impaired sperm motility, consistent with detrimental effects of adult heat stress on stored sperm. Our study adds to the mounting evidence that sperm are heat-sensitive and represent a vulnerability to global warming, but also suggest evolutionary potential for thermal adaptation at the gamete level.

Summary statement

This study investigates gamete heat sensitivity in lizards, revealing heat tolerance and repeatability in sperm thermal traits. These findings are essential for understanding reproductive responses to climate change.
Seeing the Future: Anticipatory Eye Gaze as a Marker of Memory
Authors: Yamin D. , Schmidig J.F. , Sharon O. , Nadu Y. , Nir J. , Ranganath C. , Nir Y
Published: August 2024

Human memory is typically studied by direct questioning, and the recollection of events is investigated through verbal reports. Thus, current research confounds memory per-se with its report. Critically, the ability to investigate memory retrieval in populations with deficient verbal ability is limited. Here, using the MEGA (Memory Episode Gaze Anticipation) paradigm, we show that monitoring anticipatory gaze using eye tracking can quantify memory retrieval without verbal report. Upon repeated viewing of movie clips, eye gaze patterns anticipating salient events can quantify their memory traces seconds before these events appear on the screen. A series of experiments with a total of 126 participants using either tailor-made animations or naturalistic movies consistently reveal that accumulated gaze proximity to the event can index memory. Machine learning-based classification can identify whether a given viewing is associated with memory for the event based on single-trial data of gaze features. Detailed comparison to verbal reports establishes that anticipatory gaze marks recollection of associative memory about the event, whereas pupil dilation captures familiarity. Finally, anticipatory gaze reveals beneficial effects of sleep on memory retrieval without verbal report, illustrating its broad applicability across cognitive research and clinical domains.
Prelimbic corticopontine neurons gate extinction learning
Authors: Lee Hyoung-Ro , Choi Sung Hoon , Kim Yujin , Ko Seyeon , Kang Hyeji , Lee Inah , Park Alan Jung , Lee Suk-Ho
Published: August 2024

The prelimbic cortex is essential for association of temporally separated events, and impedes extinction of learned association. The network mechanism underlying reversal learning, however, remains elusive. Here, we found that mitochondria-dependent post-tetanic potentiation at synapses onto prelimbic corticopontine neurons impedes extinction learning without affecting initial associative learning. Rats underwent trace fear conditioning followed by extinction sessions. Pharmacological inhibition of post-tetanic potentiation using tetaraphenylphosphnium (TPP), a mitochondrial Ca2+ release blocker, accelerated extinction of trace fear memory, leaving trace fear memory formation intact. Optogenetic inhibition of corticopontine, but not commissural, neurons phenocopied these effects. Electrophysiological recordings and Ca2+ imaging revealed that TPP treatment reduced the persistent activity of corticopontine neurons encoding tone presentation. Mechanistically, associative learning triggers the bursting activity of prelimbic pyramidal neurons that induces post-tetanic potentiation of corticopontine neurons, an effect blocked by TPP treatment. Thus, we identified a prelimbic cell type- and local circuit-specific mechanism that selectively gates extinction learning.
High accuracy methylation identification tools on single molecular level for PacBio HiFi data
Authors: Chen Ying , Wu Bo , Ding Yuying , Niu Longjian , Bai Xin , Lin Zhuobin , Xiao Chuan-Le
Published: August 2024

PacBio Circular Consensus Sequencing (CCS) allows us to obtain highly accurate bases and simultaneously determine the methylation states of individual molecules. However, existing CCS-based methods for 5mC detection have low accuracy (<90% on most datasets) at the single-molecule level and can produce inaccurate methylation patterns. These methods rely on the information from 21 bp contexts surrounding the target CpGs and have over 29% low-confidence (<75% accuracy) calls at CpGs with less distinguishable signals. We hypothesize that incorporating CpG methylation correlation information at the single-molecule level could improve the methylation calls on low-confidence CpGs. Here, we present a novel deep graph convolutional network (hifimeth) that uses 400 bp context in CCS-based 5mC calling and show that its improved performance is mainly due to the inclusion of more neighboring CpGs in contexts. Hifimeth achieves an average single-molecule accuracy of 94.7% and an average F1 score of 94.2%, 5.5% and 5.9% higher than the previous state-of-the-art method, respectively. Hifimeth-based methylation frequency quantification by read counting outperforms previous methods on all human and zebrafish datasets tested. The results also show that the high-accuracy calls of hifimeth can reveal complex single-molecule methylation patterns, either related to haplotypes or repeat regions, with up to single-motif resolution.