bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Permanent Nipple-Areolar Complex Sensitivity Loss Following Reduction Mammaplasty
Authors: Francalancia Stephanie , Lou Mary , McIntire Damon , Sobti Nikhil , Barrow Brooke , Marquez-Garcia Josué , Kwan Daniel , Sullivan Rachel , Liu Paul , Breuing Karl 
Published: October 2024

Abstract

Background
Predictors for permanent nipple-areolar complex (NAC) insensitivity after reduction mammaplasty are sparsely defined.

Objectives
We analyzed factors associated with NAC insensitivity over long-term follow-up.

Methods
A retrospective analysis of reduction mammaplasties on 1598 breasts performed by 4 surgeons from March 2015 to February 2023 was conducted. Data on patient demographics, intraoperative factors, and postoperative complications were collected from patient records. Analysis was conducted by breast, separated into breasts with NAC insensitivity (permanent and transient) and those without. Wilcoxon rank sum test for continuous variables and Fisher's exact test or Pearson's chi-square test for categorical variables evaluated differences between the groups. Univariate and multivariate logistic regression analyzed the association of pedicle choice with NAC insensitivity onset and permanence.

Results
Of 1598 breasts, 9.8% had loss of NAC sensation, of which 49.0% had permanent loss. A total of 51.0% regained sensitivity, taking an average of 116 days (median 64, range 6-798) to regain sensation. NAC-insensitive breasts had longer sternal notch to NAC (P &lt; .001) and NAC to IMF (P &lt; .001) measurements, greater weight removed (P &lt; .001), and fat necrosis co-complication (P = .022). Greater weight removed (P = .044) and longer sternal notch to NAC measurements (P = .011) were associated with permanent insensitivity. The superomedial pedicle was associated with an increased rate of transient NAC insensitivity, whereas the inferior pedicle had a decreased rate. There was no significant association between pedicle choices and permanent insensitivity.

Conclusions
Transient loss of NAC sensitivity is associated with pedicle choice, and breasts with permanent insensitivity were more likely to have longer breast measurements and a greater amount of tissue removed.

Level of Evidence: 4 (Therapeutic)
Deep contrastive learning for predicting cancer prognosis using gene expression values
Authors: Sun Anchen , Franzmann Elizabeth J , Chen Zhibin , Cai Xiaodong 
Published: October 2024

Abstract
Recent advancements in image classification have demonstrated that contrastive learning (CL) can aid in further learning tasks by acquiring good feature representation from a limited number of data samples. In this paper, we applied CL to tumor transcriptomes and clinical data to learn feature representations in a low-dimensional space. We then utilized these learned features to train a classifier to categorize tumors into a high- or low-risk group of recurrence. Using data from The Cancer Genome Atlas (TCGA), we demonstrated that CL can significantly improve classification accuracy. Specifically, our CL-based classifiers achieved an area under the receiver operating characteristic curve (AUC) greater than 0.8 for 14 types of cancer, and an AUC greater than 0.9 for 3 types of cancer. We also developed CL-based Cox (CLCox) models for predicting cancer prognosis. Our CLCox models trained with the TCGA data outperformed existing methods significantly in predicting the prognosis of 19 types of cancer under consideration. The performance of CLCox models and CL-based classifiers trained with TCGA lung and prostate cancer data were validated using the data from two independent cohorts. We also show that the CLCox model trained with the whole transcriptome significantly outperforms the Cox model trained with the 16 genes of Oncotype DX that is in clinical use for breast cancer patients. The trained models and the Python codes are publicly accessible and provide a valuable resource that will potentially find clinical applications for many types of cancer.
Rural areas as winners of COVID-19, digitalization and remote working? Empirical evidence from recent internal migration in Germany
Authors: Knuepling Louis , Sternberg Rolf , Otto Anne 
Published: October 2024

Abstract
The COVID-19 pandemic has caused economic crises and increased inter-regional economic disparities. However, the catalyst effect that the pandemic has had on digitalization may change the traditional pattern of internal migration, in favour of rural areas. Using time-sensitive register data we explain changes in net migration rates of German districts from an economic geography perspective. We show that, since the beginning of the pandemic, rural regions benefited more from migration. In particular, younger and highly skilled individuals increasingly move to rural areas. This confirms that rural regions can benefit from increasing remote work, but these effects differ across region types and individual skill levels.
Comparison of open and hybrid endovascular repair for aortic arch: a multi-centre study of 1052 adult patients
Authors: Sakamoto Kazuhisa , Shimamoto Takeshi , Esaki Jiro , Komiya Tatsuhiko , Ohno Nobuhisa , Nakayama Shogo , Paku Masaki , Hidaka Yu , Morita Satoshi , Marui Akira , Minatoya Kenji ,   Advance-Kyoto Investigators, Ikeda Tadashi , Yamazaki Kazuhiro , Masumoto Hidetoshi , Ide Yujiro , Kawatou Masahide , Kumagai Motoyuki , Sakai Jiro 
Published: October 2024

Abstract

OBJECTIVES
We aimed to evaluate early and late outcomes by comparing open total arch repair and endovascular arch repair using proximal landing zone analysis in a multicentre cohort.

METHODS
From 2008 to 2019, patients treated surgically for aortic arch disease at 6 centres were included, excluding cases with type A aortic dissection, additional aortic root replacement and extensive aortic aneurysm. In all patients and populations with proximal landing zones 0/1 (N = 144) and 2 (N = 187), early and late outcomes were compared using propensity score matching.

RESULTS
A total of 1052 patients, including 331 (31%) and 721 (69%) patients undergoing endovascular arch repair and open total arch repair, respectively, were enrolled. After propensity score match (endovascular arch repair, 295; open total arch repair, 566), no significant difference was observed in in-hospital mortality rate (endovascular arch repair, 6.8%; open total arch repair, 6.2%; P = 0.716). Open total arch repair was associated with a lower risk of all-cause death [log-rank test; P = 0.010, hazard ratio (HR) 1.41 (95% confidence interval 1.17–1.71)]. The incidence of aorta-related death was higher in endovascular arch repair [Gray’s test; P = 0.030, HR; 1.44 (95% confidence interval 1.20–1.73)]. When compared to endovascular arch repair with proximal landing zone 0/1, open total arch repair was associated with lower risks of all-cause death [log-rank test; P &lt; 0.001, HR 2.04 (95% confidence interval 1.43–2.90)] and aorta-related death [Gray’s test; P = 0.002, HR 1.67 (95% confidence interval; 1.25–2.24)]. There was no difference in the risk of all-cause death [log-rank test; P = 0.961, HR 0.99 (95% confidence interval 0.67–1.46)] and aorta-related death [Gray’s test; P = 0.55, HR 1.31 (95% confidence interval 1.03–1.67)] between endovascular arch repair with proximal landing zone 2 and open total arch repair.

CONCLUSIONS
Open total arch repair was considered the 1st choice based on early and late results; however, endovascular arch repair may be a useful option if the proximal landing zone is limited to zone 2.
Coronary artery bypass grafting vs. percutaneous coronary intervention in severe ischaemic cardiomyopathy: long-term survival
Authors: Bloom Jason E , Vogrin Sara , Reid Christopher M , Ajani Andrew E , Clark David J , Freeman Melanie , Hiew Chin , Brennan Angela , Dinh Diem , Williams-Spence Jenni , Dawson Luke P , Noaman Samer , Chew Derek P , Oqueli Ernesto , Cox Nicholas , McGiffin David , Marasco Silvana , Skillington Peter , Royse Alistair , Stub Dion , Kaye David M , Chan William 
Published: October 2024

Abstract

Background and Aims
The optimal revascularization strategy in patients with ischaemic cardiomyopathy remains unclear with no contemporary randomized trial data to guide clinical practice. This study aims to assess long-term survival in patients with severe ischaemic cardiomyopathy revascularized by either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI).

Methods
Using the Australian and New Zealand Society of Cardiac and Thoracic Surgeons and Melbourne Interventional Group registries (from January 2005 to 2018), patients with severe ischaemic cardiomyopathy [left ventricular ejection fraction (LVEF) &lt;35%] undergoing PCI or isolated CABG were included in the analysis. Those with ST-elevation myocardial infarction and cardiogenic shock were excluded. The primary outcome was long-term National Death Index–linked mortality up to 10 years following revascularization. Risk adjustment was performed to estimate the average treatment effect using propensity score analysis with inverse probability of treatment weighting (IPTW).

Results
A total of 2042 patients were included, of whom 1451 patients were treated by CABG and 591 by PCI. Inverse probability of treatment weighting–adjusted demographics, procedural indication, coronary artery disease extent, and LVEF were well balanced between the two patient groups. After risk adjustment, patients treated by CABG compared with those treated by PCI experienced reduced long-term mortality [adjusted hazard ratio 0.59, 95% confidence interval (CI) 0.45–0.79, P = .001] over a median follow-up period of 4.0 (inter-quartile range 2.2–6.8) years. There was no difference between the groups in terms of in-hospital mortality [adjusted odds ratio (aOR) 1.42, 95% CI 0.41–4.96, P = .58], but there was an increased risk of peri-procedural stroke (aOR 19.6, 95% CI 4.21–91.6, P &lt; .001) and increased length of hospital stay (exponentiated coefficient 3.58, 95% CI 3.00–4.28, P &lt; .001) in patients treated with CABG.

Conclusions
In this multi-centre IPTW analysis, patients with severe ischaemic cardiomyopathy undergoing revascularization by CABG rather than PCI showed improved long-term survival. However, future randomized controlled trials are needed to confirm the effect of any such benefits.
Low ambient temperature and incident myocardial infarction with or without obstructive coronary arteries: a Chinese nationwide study
Authors: Huang Jia , He Qinglin , Jiang Yixuan , Wong Jennifer Ming Jen , Li Jianxuan , Liu Jiangdong , Wang Ruochen , Chen Renjie , Dai Yuxiang , Ge Junbo 
Published: October 2024

Abstract

Background and Aims
Although non-optimum ambient temperature is a major non-traditional risk factor for acute myocardial infarction, there is no prior knowledge on whether non-optimum ambient temperature could differentially affect myocardial infarction with obstructive coronary artery disease (MI-CAD) and myocardial infarction with non-obstructive coronary arteries (MINOCA).

Methods
Using the Chinese Cardiovascular Association database-Chest Pain Center Registry, a nationwide, time-stratified, case-crossover investigation was conducted from 2015 to 2021. Meteorological data were obtained from an established satellite-based model, and daily exposures were assigned according to the onset of myocardial infarction in each patient. A conditional logistic regression model combined with distributed lag non-linear models (10 days) was used to estimate the exposure–response relationships.

Results
A total of 83 784 MINOCA patients and 918 730 MI-CAD patients were included. The risk of MINOCA and MI-CAD associated with low temperature occurred at lag 2 day and lasted to 1 week. Extremely low temperature was associated with a substantially greater odds ratio (OR) of MINOCA [OR 1.58, 95% confidence interval (CI) 1.31–1.90] than MI-CAD (unmatched: OR 1.32, 95% CI 1.23–1.43; equally matched by age and sex: OR 1.25, 95% CI 1.04–1.50), compared with the corresponding reference temperatures (30°C, 35°C, and 30°C). Stronger associations were observed for patients who were aged ≥65 years, female, or resided in the south. There was no significant difference for the impacts of high temperature on MINOCA and MI-CAD.

Conclusions
This nationwide study highlights the particular susceptibility of MINOCA patients to ambient low temperature compared with that of MI-CAD patients.
High Mortality Rates Among Individuals Misdiagnosed With Tuberculosis: A Matched Retrospective Cohort Study of Individuals Diagnosed With Tuberculosis in Brazil
Authors: Thompson Ryan R , Kim Sun , Pelissari Daniele Maria , Harada Luiza Ohana , de Barros Silva José Nildo , Oliveira Patricia Bartholomay , Castro Marcia C , Cohen Ted , Menzies Nicolas A 
Published: October 2024

AbstractWe conducted a matched retrospective cohort study comparing mortality among individuals receiving a false-positive tuberculosis (TB) diagnosis (n = 3701) to individuals correctly diagnosed with TB (n = 8595) in Brazil from 2007 to 2016. Over an average 5.4-year follow-up period, we estimated a mortality rate ratio of 1.95 (95% confidence interval, 1.80–2.11) for individuals incorrectly diagnosed with TB compared to controls. The leading causes of death among the misdiagnosed were malignant neoplasms (40.9%) and respiratory system disorders (15.9%), conditions with symptoms similar to TB. Our findings highlight the need for improved follow-up care after identification of false-positive cases to increase survival for this high-risk population.
Bactericidal versus bacteriostatic antibacterials: clinical significance, differences and synergistic potential in clinical practice
Authors: Ishak Angela , Mazonakis Nikolaos , Spernovasilis Nikolaos , Akinosoglou Karolina , Tsioutis Constantinos 
Published: October 2024

Abstract
Antibacterial activity can be classified as either bactericidal or bacteriostatic, using methods such as the MBC/MIC ratio and time–kill curves. However, such categorization has proven challenging in clinical practice, as these definitions only apply under specific laboratory conditions, which may differ from clinical settings. Several factors, such as the specific bacteria or infectious medium, can affect the action of antibiotics, with many antibacterials exerting both activities. These definitions have also led to the belief that bactericidal antibacterials are superior to bacteriostatic, especially in more severe cases, such as endocarditis, neutropenia and bacteraemia. Additionally, current dogma dictates against the combination of bactericidal and bacteriostatic antibacterials in clinical practice, due to potential antagonism. This review aimed to assess the differences in antibacterial activity of bactericidal and bacteriostatic antibacterials based on in vitro and in vivo studies and examine their antagonistic or synergistic effects. Our findings show that specific bacteriostatic agents, such as linezolid and tigecycline, are clinically non-inferior to bactericidals in multiple infections, including pneumonia, intra-abdominal infections, and skin and soft tissue infections. Studies also support using several bacteriostatic agents as salvage therapies in severe infections, such as neutropenic fever and endocarditis. Additionally, not all combinations of bacteriostatic and bactericidal agents appear to be antagonistic, with many combinations, such as linezolid and rifampicin, already being used. The findings should be interpreted with caution, as most evidence is from observational studies and there is a need for randomized controlled trials to assess their effectiveness and combinations, especially within the context of rising antimicrobial resistance.
Efficacy of meropenem against ceftazidime–avibactam-resistant Klebsiella pneumoniae producing KPC-31, KPC-33, KPC-90, KPC-106 and KPC-114
Authors: Pariona Jesus G M , Vásquez-Ponce Felipe , Pariona Eva M M , Sousa-Carmo Rubens R , Martins-Gonçalves Thais , Becerra Johana , de Lima Aline V , Queiroga Gustavo , Sampaio Jorge L M , Lincopan Nilton 
Published: October 2024

Abstract

Background
Klebsiella pneumoniae producing KPC variants conferring resistance to ceftazidime–avibactam often remain susceptible to meropenem, suggesting a potential therapeutic use of this antibiotic.

Objectives
In this study, the efficacy of clinically relevant concentrations of meropenem was evaluated against high-risk clones of ceftazidime–avibactam-resistant K. pneumoniae strains producing KPC variants, in a tandem in vitro time-kill/in vivo Galleria mellonella survival model.

Methods
In vitro/in vivo efficacy of meropenem against ceftazidime–avibactam-resistant K. pneumoniae of CG16, CG25 and CG258, producing KPC-31, KPC-33, KPC-90, KPC-106 and KPC-114 variants, was evaluated using EUCAST dosing recommendation adjusted to the G. mellonella model. For in vivo assays, untreated, meropenem (40 mg/kg × 1)-treated and ceftazidime–avibactam (40 mg/kg ceftazidime–10 mg/kg avibactam × 1)-treated groups were established, with 60 larvae per group. Kaplan–Meier curves, log-rank tests, univariate Cox regression and hazard ratios (HR) were used to assess treatment effects (P &lt; 0.05).

Results
For all KPC-variant producers, time-kill assays showed &gt;3 log-kills reduction (−6.91 ± 1.28 SD) after 6 h interaction when exposed to 8–32 mg/L meropenem MIC values (i.e.  ≥  × 4 MIC). In the assessment of in vivo efficacy of meropenem, at the 4-day follow-up, mortality rates were 96.7% (untreated), 83.3% (ceftazidime–avibactam-treated) and 13.3% (meropenem-treated) (P &lt; 0.05). Univariate Cox regression analysis showed significantly lower risk in the meropenem group compared to untreated group [HR 0.02 (95% CI: 0.01–0.05)].

Conclusions
These pre-clinical results might support use of meropenem as a potential alternative for treatment of infections due to KPC-variant producers displaying in vitro susceptibility to meropenem.
It all made sense: ASL-first approach in classroom practice
Authors: Noschese Emily Jo 
Published: October 2024

Abstract
This qualitative study delves into the innovative Bilingual Grammar Curriculum. The curriculum aims to enhance bilingualism and linguistic skills among deaf students by integrating American Sign Language instruction and written language grammatical structures. The researcher conducted in-depth interviews with 12 experienced educators of the deaf who have implemented the curriculum in their teaching practices. Employing a thematic analysis approach, the researcher sought to uncover the educators’ perceptions, experiences, and insights regarding the curriculum’s effectiveness and its impact on bilingual language acquisition for deaf learners. Findings revealed a diverse range or perspectives, highlighting both the advantages and challenges of the curriculum’s implementation. Themes emerged encompassing the curriculum’s alignment with linguistic theories, its adaptability to diverse learning needs, the role of educator training, and the incorporation of cultural nuances within bilingual instruction. The study contributes valuable insights to the field of deaf education, shedding light on the intricate dynamics of bilingual grammar pedagogy and providing recommendations for curriculum refinement and educator professional development. Ultimately, this research underscores the significance of innovative approaches in enhancing the linguistic abilities and educational experiences of deaf and hard-of-hearing students within a bilingual framework.
Spectroscopic analysis of the strongly lensed SN Encore: constraints on cosmic evolution of Type Ia supernovae
Authors: Dhawan S , Pierel J D R , Gu M , Newman A B , Larison C , Siebert M , Petrushevska T , Poidevin F , Jha S W , Chen W , Ellis Richard S , Frye B , Hjorth J , Koekemoer Anton M , Pérez-Fournon I , Rest A , Treu T , Windhorst R A , Zenati Y 
Published: October 2024

ABSTRACT
Strong gravitational lensing magnifies the light from a background source, allowing us to study these sources in detail. Here, we study the spectra of a $z = 1.95$ lensed Type Ia supernova (SN Ia) SN Encore for its brightest image A, taken 39 d apart. We infer the spectral age with template matching using the supernova identification (snid ) software and find the spectra to be at $29.0 \pm 5.0$ and $37.4 \pm 2.8$ rest-frame days post-maximum, respectively, consistent with separation in the observer frame after accounting for time dilation. Since SNe Ia measure dark energy properties by providing relative distances between low- and high-z SNe, it is important to test for the evolution of spectroscopic properties. Comparing the spectra to composite low-z SN Ia spectra, we find strong evidence of the similarity between the local sample and SN Encore. The line velocities of common SN Ia spectral lines, Si ii 6355 $\mathring{\rm A}$ and Ca ii near-infrared triplet, are consistent with the distribution for the low-z sample as well as other lensed SNe Ia, e.g. iPTF16geu ($z = 0.409$) and SN H0pe ($z = 1.78$). The consistency between the low-z sample and lensed SNe at high-z suggests no obvious cosmic evolution demonstrating their use as high-z distance indicators, though this needs to be confirmed/refuted via a larger sample. We also find that the spectra of SN Encore match the predictions for explosion models very well. With future large samples of lensed SNe Ia, e.g. with the Vera C. Rubin Observatory, spectra at such late phases will be important to distinguish between different explosion scenarios.
A new multiple-arc model of the resonant Kuiper belt objects – Plutinos
Authors: Chen Yue , Li Jian 
Published: October 2024

ABSTRACT
To incorporate the gravitational influence of Kuiper belt objects (KBOs) in planetary ephemerides, uniform-ring models are commonly employed. In this paper, for representing the KBO population residing in Neptune’s 2:3 mean motion resonance (MMR), known as the Plutinos, we introduce a three-arc model by considering their resonant characteristics. Each ‘arc’ refers to a segment of the uniform ring and comprises an appropriate number of point masses. Then the total perturbation of Plutinos is numerically measured by the change in the Sun–Neptune distance ($\Delta d_{\mathrm {SN}}$). We conduct a comprehensive investigation to take into account various azimuthal and radial distributions associated with the resonant amplitudes (A) and eccentricities (e) of Plutinos, respectively. The results show that over a 100-yr period: (1) at the smallest $e=0.05$, the Sun–Neptune distance change $\Delta d_{\mathrm {SN}}$ caused by Plutinos decreases significantly as A reduces. It can deviate from the value of $\Delta d_{\mathrm {SN}}$ obtained in the ring model by approximately 100 km; (2) as e increases in the medium range of 0.1–0.2, the difference in $\Delta d_{\mathrm {SN}}$ between the arc and ring models becomes increasingly significant; (3) at the largest $e\gtrsim 0.25$, $\Delta d_{\mathrm {SN}}$ can approach zero regardless of A, and the arc and ring models exhibit a substantial difference in $\Delta d_{\mathrm {SN}}$, reaching up to 170 km. Then the applicability of our three-arc model is further verified by comparing it to the perturbations induced by observed Plutinos on the positions of both Neptune and Saturn. Moreover, the concept of the multiple-arc model, designed for Plutinos, can be easily extended to other MMRs densely populated by small bodies.