bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contemporary Trends in Reconstruction for Patients With Sarcoma of the Breast
Authors: Kiefer Jurij , Paidisetty Praneet , Elmorsi Rami A. I. , Nguyen Christopher H. M. , Yu Jessie Z. , Hunt Kelly K. , Lillemoe Heather A. , Mericli Alexander F. , Olenczak J. Bryce 
Published: December 2024

ABSTRACTIntroductionBreast sarcomas are rare, heterogeneous malignancies often associated with prior radiation and require a multidisciplinary approach, including a comprehensive reconstruction plan. We analyzed reconstructive outcomes in a large cohort of patients with breast sarcomas and provide a contemporary treatment algorithm.MethodsWe retrospectively reviewed patients who underwent breast reconstruction after surgical treatment for breast sarcoma at our institution between January 2010 and December 2023. We analyzed patient and tumor characteristics, oncologic treatments, reconstructive approaches, and outcomes.ResultsEighty patients underwent 81 reconstructions. The median age at diagnosis was 53 years. The most common subtypes were primary angiosarcoma (35.8%) and radiation‐associated angiosarcoma (33.3%). The median follow‐up was 23 months. Oncologic management was multimodal: 63.0% received preoperative chemotherapy, 59.3% received post‐operative chemotherapy, 35.8% received both pre‐ and post‐operative chemotherapy, and 34.6% received pre‐ or post‐operative radiation therapy. Forty‐three (53.1%) patients underwent total mastectomy with or without chest wall resection requiring soft‐tissue reconstruction. Thirty‐eight (46.9%) patients underwent formal breast reconstruction. Autologous reconstructions included local tissue rearrangement (39.5%), pedicled flaps (18.5%), regional flaps (16.0%), and free flaps (13.6%). Most patients (82.7%) underwent immediate reconstruction.ConclusionBreast sarcomas are managed with multimodal therapy, and most patients undergo immediate reconstruction. Autologous reconstruction remains the first choice in radiated patients, however implant‐based reconstruction has increased with modern approaches. Complication rates are acceptable and similar across sarcoma subtypes. Breast reconstruction is an essential component of care for these patients and can be performed safely and with good results.
Great Lakes mallard population dynamics
Authors: Luukkonen Benjamin Z. , Winterstein Scott R. , Hayes Daniel B. , Fowler Drew N. , Soulliere Gregory J. , Coluccy John M. , Shipley Amy A. , Simpson John , Shirkey Brendan , Winiarski Jason M. , O'Neal Benjamin J. , Avers Barbara A. , Urquhart Gerald R. , Lavretsky Philip 
Published: December 2024

AbstractBreeding mallard (Anas platyrhynchos) populations in the Great Lakes region (Michigan, Minnesota, Wisconsin, USA) declined by >40% between 2000–2022 based on abundance data collected during spring aerial surveys. Mallards are an important waterfowl species in this region, where an estimated 60–80% of the mallard harvest is composed of locally banded birds. Extensive population monitoring datasets are available for mallards, presenting an opportunity to address complex questions such as estimating productivity at large spatial and temporal scales, identifying the effects of harvest on mallard demography, quantifying mechanisms for harvest compensation, and integrating multiple datasets to quantify the demographic drivers of population change. Our objective was to simultaneously examine factors affecting demographic parameters and their relative contribution to Great Lakes mallard population dynamics. We used 32 years of banding, band recovery, and aerial survey data collected for mallards from Michigan and Wisconsin to develop an integrated population model (IPM). We used age ratios at banding to estimate productivity, band recoveries from hunter‐harvested birds to estimate annual survival and cause‐specific mortality (i.e., harvest or non‐hunting), and modeled abundance using aerial survey and demographic parameter estimates from 1991–2022. The IPM results indicated the decline in Great Lakes mallard abundance was caused by increased non‐hunting mortality and a decline in productivity. Productivity varied spatially but temporally declined with the loss of Conservation Reserve Program area. Moreover, our productivity assessment provided evidence of density dependence in reproduction. Non‐hunting mortality was 3.5–6.7 times and 1.3–4.2 times greater than harvest mortality for adult and juvenile female mallards, respectively, indicating environmental factors during spring and summer, not harvest, most greatly influenced annual mortality for female mallards. Our IPM reduced uncertainty in the factors affecting Great Lakes mallard population dynamics and indicated management actions that address non‐hunting mortality and productivity would be most effective in increasing Great Lakes mallard abundance.
Hydrogen‐Sensitive Inks with 4D Printing of a Fiber‐Tip Hydrogen Microsensor
Authors: Liao Changrui , Huang Haoqiang , Zou Mengqiang , Wang Ying , Jiang Shangben , Zhu Dezhi , Huang Jiabin , Guan Jiajun , Wang Famei , Zhao Cong , Zheng Mengjie , Bao Weijia , Liu Dejun , Weng Xiaoyu , Liu Liwei , Qu Junle , Wang Yiping 
Published: December 2024

AbstractOptical fiber hydrogen (H2) sensors have garnered attention for avoiding explosion hazards in flammable gas environments. Conventional optical fiber sensors rely on electron beam sputtering and chemical coating for functionalization, but these methods may not achieve precise functionalization of intricate structures. Based on 4D printing principles, an H2‐sensitive ink containing methacrylate groups modified palladium (Pd) nanoparticles (NPs) is reported, with a printing resolution of 200 nm. Then, a fiber‐tip clamped‐beam H2 sensor is fabricated with the femtosecond (Fs) laser‐induced two‐photon polymerization (TPP) technique. The sensor exhibits compact dimensions and fast responses, only 2.64 s for a 4.0 vol.% H2 concentration. A high sensitivity of roughly 165 pm %−1 is achieved as the H2 concentration increases from 0% to 5.5 vol.%. This study demonstrates that H2‐sensitive microstructures can be flexibly achieved by TPP of H2‐sensitive inks, offering a solution for achieving on‐chip direct laser writing of integrated H2 microsensors.
Authenticity and Conflicting Identity Goals: How Consumers Protect Their “Authentic Self” While Consuming Inauthentic Marketplace Offerings
Authors: Min Hyun Jeong 
Published: December 2024

ABSTRACTThis study examined how consumers achieve their desired authenticity when tension arises between their individual and collective identity goals. Insa‐dong, a popular tourist attraction in Seoul, was chosen as a conducive research setting to examine conflicting identity goals given that the place has been criticized as inauthentic by many consumers while often touted as a must‐visit tourist attraction for experiencing traditional Korean culture. The primary data were collected through in‐depth interviews and focus groups with 24 native Korean individuals with prior experience in Insa‐dong. Additionally, promotional materials, relevant mass media content, and TripAdvisor reviews were included as supplemental data. The analysis revealed the tension between different goals based on multiplicity in the self and two main strategies to maintain one's desired identity while performing socially expected roles. Based on these findings, the present study demonstrated that the quest for authenticity is a social endeavor enmeshed with various social roles with their accompanying expectations and obligations. Additionally, the current study expands the understanding of authenticity in consumer experience by identifying middle‐ground strategies between downright resistance and conjuring the perception of authenticity.
Reducing Nitrogen Waste: Factors Influencing Neem‐Coated Urea Adoption in Bhutan
Authors: Begho Toritseju , Dorji Tashi , Dendup Sonam 
Published: December 2024

ABSTRACTIn Bhutan, farmers face constraints due to limited arable land, prompting a need to increase agricultural production per unit of inputs, but in the most sustainable way given the nation’s most stringent environmental conservation laws. This study investigates the factors influencing the adoption of an enhanced‐efficiency fertiliser, that is, neem‐coated urea (NCU). Analysing data from 235 farmers using a double hurdle regression model, the paper identified several positive drivers of NCU adoption, including multiple plots, larger farm size, organic fertiliser use, recent agricultural training, and seeking advice on fertiliser decisions. Conversely, factors such as irrigation, crop demonstration attendance, machinery subsidies, rigid fertiliser usage adherence, perceived difficulty in handling fertilisers, and attitudes towards soil and crop management hinder adoption. Older farmers exhibit higher adoption rates, potentially due to accumulated knowledge, while male farmers surpass their female counterparts in adoption rates, reflecting existing gender disparities in NCU adoption. These findings offer insights for policymakers, extension services, and agricultural stakeholders to tailor interventions for promoting NCU adoption, thereby mitigating nitrogen waste and pollution in crop production.
Patient‐specific mapping of fundus photographs to three‐dimensional ocular imaging
Authors: Haasjes Corné , Vu T. H. Khanh , Beenakker Jan‐Willem M. 
Published: December 2024

AbstractBackgroundOcular proton beam therapy (OPT) planning would benefit from an accurate incorporation of fundus photographs, as various intra‐ocular structures, such as the fovea, are not visible on conventional modalities such as Magnetic Resonance Imaging (MRI). However, the use of fundus photographs in OPT is limited, as the eye's optics induce a nonuniform patient‐specific deformation to the images.PurposeTo develop a method to accurately map fundus photographs to three‐dimensional images.MethodsPersonalized optical raytracing simulations were performed for 27 subjects, using subject‐specific eye models based on corneal topography, biometry, and MRI. Light rays were traced through the eye for angles of 0°–85° with respect to the optical axis, in steps of 5°. These simulations provided a reference mapping between camera angles and retinal locations and were used to develop a mapping method without raytracing. The accuracy of this and earlier proposed methods was evaluated. Finally, the most accurate method was implemented in RayOcular, an image‐based OPT planning system, and the fundus photography‐based tumor contour was compared with MRI.ResultsWhen a patient‐specific second nodal point is taken as a reference to describe the retinal location, the camera, and retinal angles show a strong linear relation with a small variation between subjects. At a camera angle of 60°, for example, a corresponding retinal angle of 59.9° ± 0.4° (mean ± SD) was found. When this linear relation is used to predict the corresponding retinal location (without raytracing) of a camera angle of 40°, the mean (Euclidian distance) error in the retinal location was 0.02 mm (SD = 0.06 mm), which was significantly (p < 0.001) lower than earlier proposed methods including EYEPLAN 4.16 mm (SD = 0.25 mm), the Lamberth projection −0.12 mm (SD = 0.46 mm) or polar projection 0.26 mm (SD = 0.57 mm). When implemented in the fundus view of RayOcular, the median distance between contours based on MRI and fundus photography was 0.2 mm (IQR = 0.1–0.3 mm).ConclusionsThe second nodal point provides a patient‐specific reference for an accurate mapping of fundus photographs to three‐dimensional images with sub‐millimeter errors.
Stage‐specific transcriptome profiling highlights key modules associated with structurally conserved secreted proteins in Puccinia polysora infection of maize
Authors: Guo Yuanwen , Liu Yuyan , Mei Jie , Jiao Zeyu , Yang Yan , Liu Wende 
Published: December 2024

AbstractSouthern corn rust (SCR), caused by the biotrophic fungal pathogen Puccinia polysora, is a globally significant disease that poses a severe threat to maize production, particularly in tropical and subtropical regions. Despite its economic importance, many aspects of the molecular interactions between P. polysora and maize remain poorly understood. In this study, we performed stage‐specific transcriptome profiling to explore gene expression dynamics during key phases of P. polysora infection: conidia formation, spore germination, penetration, and colonization. We identified and characterized co‐regulated modules of effector proteins that are critical for successful host infection. Utilizing AlphaFold3, we identified structurally conserved proteins co‐expressed throughout the infection process. Notably, Cluster 7, a structurally conserved protein group, exhibited uniquely peak expression during the penetration stage, suggesting a pivotal role in overcoming host defenses. This research offers new insights into the molecular processes involved in P. polysora infection and provides a valuable resource for developing novel strategies to mitigate the global impact of SCR.
Factors Influencing Shoulder Joint Function in Patients With Type 2 Diabetes Mellitus Following Arthroscopic Rotator Cuff Repair: A Mixed‐Methods Study
Authors: Zhang Ming , Zhang Huaixia , Zheng Jun 
Published: December 2024

ABSTRACTTo identify the influencing factors of shoulder joint function after Arthroscopic Rotator Cuff Repair (ARCR) in patients with Type 2 Diabetes Mellitus (T2DM). A sequential explanatory mixed‐methods design was conducted. Participants were recruited from the Northern Jiangsu People's Hospital from January 2023 to May 2023. Quantitative data were collected using the Constant‐Murley Shoulder Joint Function Score, the General Self‐Efficacy Scale, and the Perceived Social Support Scale. A total of 134 patients were recruited (120 participants for questionnaire survey, 14 participants for interview). Spearman's correlations were performed to initially identify the influencing factors of shoulder joint function. Qualitative data were collected through face‐to‐face interviews with 14 patients. To understand patients' experiences during the process of shoulder joint recovery, interpretative phenomenological analysis was employed. The triangulation was conducted using convergence coding matrix. Three themes and seven sub‐themes were identified, including capability (postoperative pain management, self‐management of T2DM), opportunity (medical supports, perceived social and family supports, demands of economic supports), and motivation (sense of benefits, psychological motivation). The recovery of shoulder joint function in patients with T2DM following ARCR is influenced by factors related to capability, opportunity, and motivation. Healthcare providers should enhance the timing and content of educational interventions and provide intensive psychological support to facilitate successful behavior change and optimize shoulder joint recovery in this patient population. The findings of this study can inform the development of an optimized care model for patients with T2DM following ARCR, empowering them to take control of their condition. Considering the long‐term challenges of rehabilitation, which present physical and psychological difficulties for patients, it is essential to design interventions strategies that address physiological decline and pain management.
DNA methylation in cord blood partially mediates the effects of prepregnancy BMI on early childhood offspring BMI
Authors: Maguolo Alice , Jönsson Josefine , Perfilyev Alexander , Maziarz Marlena , Vaag Allan , Malchau Carlsen Emma , Nørgaard Kirsten , Franks Paul W. , Renault Kristina M. , Ling Charlotte 
Published: December 2024

AbstractObjectiveWe investigated whether prepregnancy BMI (prePregBMI) in women with obesity was associated with differential DNA methylation (DNAm) in cord blood (CB) and whether DNAm may mediate the association of prePregBMI and early childhood BMI z score (BMIz).MethodsFrom the Treatment of Obese Pregnant Women (TOP) study, 232 mother–child pairs were included. We conducted an epigenome‐wide association study on prePregBMI and CB DNAm (450k array), followed by causal mediation analyses to test whether DNAm may mediate effects of prePregBMI on BMIz at age 36 months (BMIz36).ResultsDNAm at 5345 CpG sites annotated to 2842 genes, which were overrepresented in biological processes linked to carbohydrate metabolism and plasma lipoprotein particle clearance, was associated with prePregBMI (false discovery rate < 10%). Causal mediation analyses of 168 methylation sites associated with BMIz36 (p < 0.05) and overlapping with the 5345 prePregBMI‐associated sites identified two sites on SYT7 and DEAF1, partially mediating the effect of prePregBMI on BMIz36 (p ≤ 0.01). After cross‐validation, a methylation risk score including these two sites could predict the highest quartile of BMIz36 and fat mass (in grams) with area under the curve = 0.72 (95% CI: 0.58–0.85) and area under the curve = 0.71 (95% CI: 0.58–0.85), respectively.ConclusionsCB DNAm at birth may partially mediate effects of prePregBMI on early childhood BMIz36, supporting its plausible role in influencing individual future obesity risk.
American Academy of Otolaryngology–Head and Neck Surgery (AAO‐HNS) Report on Artificial Intelligence
Authors: Ayoub Noel F. , Rameau Anaïs , Brenner Michael J. , Bur Andrés M. , Ator Gregory A. , Briggs Selena E. , Takashima Masayoshi , Stankovic Konstantina M. ,   AAO‐HNS Artificial Intelligence Task Force
Published: December 2024

AbstractThis report synthesizes the American Academy of Otolaryngology–Head and Neck Surgery (AAO‐HNS) Task Force's guidance on the integration of artificial intelligence (AI) in otolaryngology–head and neck surgery (OHNS). A comprehensive literature review was conducted, focusing on the applications, benefits, and challenges of AI in OHNS, alongside ethical, legal, and social implications. The Task Force, formulated by otolaryngologist experts in AI, used an iterative approach, adapted from the Delphi method, to prioritize topics for inclusion and to reach a consensus on guiding principles. The Task Force's findings highlight AI's transformative potential for OHNS, offering potential advancements in precision medicine, clinical decision support, operational efficiency, research, and education. However, challenges such as data quality, health equity, privacy concerns, transparency, regulatory gaps, and ethical dilemmas necessitate careful navigation. Incorporating AI into otolaryngology practice in a safe, equitable, and patient‐centered manner requires clinician judgment, transparent AI systems, and adherence to ethical and legal standards. The Task Force principles underscore the importance of otolaryngologists' involvement in AI's ethical development, implementation, and regulation to harness benefits while mitigating risks. The proposed principles inform the integration of AI in otolaryngology, aiming to enhance patient outcomes, clinician well‐being, and efficiency of health care delivery.
Hepatotoxicity Score: A New Method to Adjust for Use of Potentially Hepatotoxic Medications by Chronic Liver Disease Status
Authors: Lo Re Vincent , Newcomb Craig W. , Carbonari Dean M. , Mezochow Alyssa K. , Hennessy Sean , Rentsch Christopher T. , Park Lesley S. , Tate Janet P. , Bräu Norbert , Bhattacharya Debika , Lim Joseph K. , Mezzacappa Catherine , Njei Basile , Roy Jason A. , Taddei Tamar H. , Justice Amy C. , Torgersen Jessie 
Published: December 2024

ABSTRACTBackgroundStudies evaluating the hepatic safety of medications have been limited by the inability to control for confounding from receipt of other hepatotoxic drugs.ObjectiveThe objective of this study was to develop an index (Hepatotoxicity Score) to adjust for concomitant hepatotoxic medication exposure within pharmacoepidemiology studies.MethodsWe identified 193 medications with ≥ 4 reports of hepatotoxicity and created cohorts of outpatient initiators in the Veterans Health Administration (2000–2021). Exposure occurred from initiation through 30 days after discontinuation or up to 1 year. We measured age‐/sex‐adjusted rates of hospitalization for severe acute liver injury (ALI) by chronic liver disease (CLD), identified drugs with high rates, and used these rates as weights in the score. To demonstrate real‐world use, we calculated the score for proton pump inhibitor (PPI) initiators. We summed the weights of the drugs dispensed within 90 days prior to PPI initiation. Hazard ratios (HRs) of severe ALI (95% confidence intervals) were measured with and without adjustment for Hepatotoxicity Score.ResultsAmong 89 512 PPI initiators with CLD, HRs of severe ALI were higher for lansoprazole (HR = 2.17 [95% CI, 1.24–3.82]), but not pantoprazole (HR = 0.83 [95% CI, 0.61–1.13]), versus omeprazole. Adjustment for Hepatotoxicity Score attenuated HRs of lansoprazole (HR = 1.99 [95% CI, 1.13–3.50]). Among 2 462 414 PPI initiators without CLD, HRs were not significantly higher for lansoprazole (HR = 1.66 [95% CI, 0.99–2.77]) but were significantly lower for pantoprazole (HR = 0.59 [95% CI, 0.37–0.95]), versus omeprazole. Adjustment for Hepatotoxicity Score attenuated HRs of lansoprazole (HR = 1.52 [95% CI, 0.91–2.54]).ConclusionsThe Hepatotoxicity Score provides a tool to adjust for confounding due to concomitant hepatotoxic drug exposure within hepatic safety studies.
Antibiotic Utilization Among People With Multiple Sclerosis in the Netherlands, 2018–2020
Authors: Leung Melissa W. Y. , Bazelier Marloes T. , Uitdehaag Bernard M. J. , De Jong Hilda J. I. , Klungel Olaf H. , van de Garde Ewoudt M. W. 
Published: December 2024

ABSTRACTPurposeThe purpose of this study was to describe the intensity and patterns of antibiotic drug use among people with multiple sclerosis (pwMS) in the Netherlands.MethodsPeople with prevalent MS between 1 January 2018 and 31 December 2020 were identified using ambulatory hospital records from the PHARMO Database Network that contains routinely collected healthcare data from the Netherlands. Out‐patient pharmacy dispensing data were used to assess type of antibiotic, dosage, and amounts dispensed. Antibiotic intensity in defined daily doses (DDD)/1000 patient‐days (PD) was calculated together with frequency of dispensing of the same (prolongation) or different (switch) antibiotic up to 3 days after the end of the last antibiotic prescription; and stratified by sex, age, polypharmacy (use of > 4 out‐patient prescription drugs for > 29 days), type of disease‐modifying treatment, and Sars‐CoV‐2‐related lockdown.ResultsA total of 1960 (37.8%) out of 5179 pwMS were dispensed ≥ 1 antibiotic. Of the 8762 dispensing events, 27.6%% were part of a prolongation, and 16.3% of a switch. Overall antibiotic use among pwMS was 18.8 DDD/1000 PD (95% confidence interval [95% CI]: 18.7–19.0) compared to 7.77–8.90 DDD/1000 PD in the general out‐patient population, as reported by the Dutch Working Party on Antibiotic Policy. Antibiotic use was higher among women, increased with age, and was higher in people with polypharmacy and lower during lockdown. Nitrofurantoin was the most commonly dispensed antibiotic (41.7%).ConclusionsThe intensity of antibiotic use is considerably higher among pwMS than the general population. This reflects the burden of infection in this susceptible population.