bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flattening the Curve and Cutting Corners—Pearls and Pitfalls Facial Gender Affirming Surgery
Authors: Gunther Sven , Carboy Jourdan , Jedrzejewski Breanna , Berli Jens 
Published: June 2023

Study Design This is an experiential article based on the past 6 years experience of providing facial gender confirmation surgery (fGAS) at an academic medical center. Objective While trainees are getting increasing exposure to aspects of facial gender affirming surgery (fGAS), the gap between trained providers and patients who can access care is currently still widening. A handful of fellowships across the country have emerged that include fGAS in their curriculum, but it will take another decade before the principles of affirming care and surgeries are systematically taught. Fortunately, the surgical principles and techniques required to perform fGAS are part of the skill set of any specialty surgeon trained in adult craniofacial trauma and esthetic facial surgery/rhinoplasty. It is the aim of this article to provide directly applicable knowledge with the goal to assist surgeons who consider offering fGAS in flattening the learning curve and hopefully contribute to increasing the quality of care provided for the transgender and gender diverse population. We hope to provide the reader with a very tangible article with the aims to 1) provide a simple systematic framework for an affirming consultation and preoperative assessment and 2) provide translatable surgical pearls and pitfalls for forehead feminization and gonial angle resection. The frontal sinus set back and gonial angle resection in our opinion are the most unique aspect to fGAS as rhinoplasty, genioplasty and other associated procedures (e.g., fat grafting) follow well established principles. We hope that the value of this article lies in the translatability of the presented principle to any practice setting without the need for VSP, special surgical instruments or technology beyond basic craniofacial tools. Methods This is an experiential article based on the senior authors 6 year experience offering fGAS in an academic setting. The article is structured to outline both pearls and pittfalls and is supplemented by photographs and a surgical video. Results A total of 19 pearls and pitfalls are outlined in the article. Conclusions Facial gender affirming surgery mostly follows established craniofacial and esthetic surgery principles. Forehead feminization and gonial angle feminization are the 2 components that diverge most from established surgical techniques and this article hopefully provides guidance to shorten the learning curve of surgeons.
Predialysis trajectories of estimated GFR and concurrent trends of Chronic Kidney Disease-relevant biomarkers
Authors: Tsao Hsiao-Mei , Lai Tai-Shuan , Chou Yu-Hsiang , Lin Shuei-Liong , Chen Yung-Ming 
Published: June 2023

Background: The glomerular filtration rate (GFR) decline varies in patients with advanced chronic kidney disease (CKD), and the concurrent changes in CKD-related biomarkers are unclear. Objectives: This study aimed to examine the changes in CKD-related biomarkers along with the kidney function decline in various GFR trajectory groups. Design: This study was a longitudinal cohort study originated from the pre-end-stage renal disease (pre-ESRD) care program in a single tertiary center between 2006 and 2019. Methods: We adopted a group-based trajectory model to categorize CKD patients into three trajectories according to estimated glomerular filtration rate (eGFR) changes. A repeated-measures linear mixed model was used to estimate the concurrent biomarker trends in a 2-year period before dialysis and to examine the differences among trajectory groups. A total of 15 biomarkers were analyzed, including urine protein, serum uric acid, albumin, lipid, electrolytes, and hematologic markers. Results: Using longitudinal data from 2 years before dialysis initiation, 1758 CKD patients were included. We identified three distinct eGFR trajectories: persistently low eGFR levels, progressive loss of eGFR, and accelerated loss of eGFR. Eight of the 15 biomarkers showed distinct patterns among the trajectory groups. Compared with the group with persistently low eGFR values, the other two groups were associated with a more rapid increase in the blood urea nitrogen (BUN) level and urine protein–creatinine ratio (UPCR), especially in the year before dialysis initiation, and a more rapid decline in hemoglobin and platelet counts. A rapid eGFR decline was associated with lower levels of albumin and potassium, and higher levels of mean corpuscular hemoglobin concentration (MCHC) and white blood cell (WBC). The albumin level in the group with an accelerated loss of eGFR was below the normal range. Conclusion: Using longitudinal data, we delineated the changes in CKD biomarkers with disease progression. The results provide information to clinicians and clues to elucidate the mechanism of CKD progression.
Exploring patient participation during video consultations: A qualitative study
Authors: Bavngaard Martin Vinther , Lüchau Elle Christine , Hvidt Elisabeth Assing , Grønning Anette 
Published: June 2023

Objective Video consultations enable a digital point of contact between the general practitioner and patient. With their medium-specific characteristics, video consultations may create novel conditions for the enactment of patient participation during consultations. Although numerous studies have explored patients’ experiences of video consultations, research explicitly investigating patient participation within this new consultation setting remains sparse. This qualitative study explores how patients participate during interactions with their general practitioner by drawing on the affordances of video consultations. Methods The data corpus comprises eight recorded video consultations (59 minutes and 19 seconds in total) between patients and their general practitioner, all subjected to reflexive thematic analysis yielding three themes illustrating concrete participatory use cases. Results We find that video consultations provide an accessible format for patients otherwise unable to attend a physical consultation due to physical and mental barriers. Moreover, patients participate by drawing on resources situated in their spatial setting to settle health-related questions of doubt arising during the consultation. Lastly, we posit that patients enact participation by visually communicating their impromptu engagement in decision-making and reporting to their general practitioner by making use of the qualities of their smartphone during their consultation. Conclusions Our findings illustrate how video consultations provide a communicative context in which patients may enact distinct forms of participation by drawing on its technologically contingent affordances during interactions with their general practitioner. More research is needed to explore the participatory opportunities of video consultations in telemedical healthcare services for different patient groups.
Sonographic Reference Values for Median Nerve Cross-sectional Area: A Meta-analysis of Data From Healthy Individuals
Authors: Roll Shawn C. , Takata Sandy C. , Yao Buwen , Kysh Lynn , Mack Wendy J. 
Published: June 2023

Objective: Establish median nerve cross-sectional area (CSA) reference values and identify patient-level factors impacting diagnostic thresholds. Materials and Methods: Studies were identified through a robust search of multiple databases, and quality assessment was conducted using a modified version of the National Institute of Health Study Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A meta-analysis was performed to identify normative values stratified by anatomic location. A meta-regression was conducted to examine heterogeneity effects of age, sex, and laterality. Results: The meta-analysis included 73 studies; 41 (56.2%) were high quality. The median nerve CSA [95% confidence interval, CI] was 6.46 mm2 [6.09–6.84], 8.68 mm2 [8.22–9.13], and 8.60 mm2 [8.23–8.97] at the proximal forearm, the carpal tunnel inlet, and the proximal carpal tunnel, respectively. Age was positively associated with CSA at the level of proximal carpal tunnel (β = 0.03 mm2, P = .047). Men (9.42 mm2 [8.06–10.78]) had statistically larger proximal tunnel CSA ( P = .03) as compared with women (7.71 mm2 [7.01–8.42]). No difference was noted in laterality. Conclusion: A reference value for median nerve CSA in the carpal tunnel is 8.60 mm2. Adjustments may be required in pediatrics or older adults. The diagnostic threshold of 10.0 mm2 for male patients should be cautiously applied as the upper limit of normative averages surpasses this threshold.
The pre-conception maternal exposure to Sofosbuvir affects the mitochondrial biogenesis in prenatal fetal tissues: Experimental study on rats
Authors: Mahmoud Shimaa A. , Abdel-Aziz Maryam M. , Khafaga Rana H. M. , Hafez Hala A. , Kamel Maher A. , Shaker Sara A. 
Published: June 2023

Abstract
Background
Hepatitis C virus (HCV) infection is a global public health problem and Egypt has the highest HCV prevalence worldwide. Hence, global efforts target to eliminate HCV by 2030. Sofosbuvir is a nucleotide analogue inhibitor of HCV polymerase essential for viral replication. Animal studies prove that Sofosbuvir metabolites cross the placenta and are excreted in the milk of nursing animals. We aimed to investigate the possible effects of preconception maternal exposure to Sofosbuvir on mitochondrial biogenesis in prenatal fetal liver, skeletal muscle, and placental tissues.

Methods
The study was conducted on 20 female albino rats divided into a control group receiving a placebo and an exposed group receiving 4 mg/kg orally/day for 3 months of Sofosbuvir. At the end of the treatment period, pregnancy was induced in both groups by mating with healthy male rats overnight. At gestational day 17, all pregnant female rats were sacrificed. Each fetus was dissected to obtain the fetal liver, skeletal muscle, and placental tissues.

Results
The results of our study indicated that the exposure of young female rats to Sofosbuvir affects pregnancy outcomes. Fetal liver and muscle showed lower mitochondrial DNA-copy number (mtDNA-CN) by about 24% and 29% respectively, peroxisome proliferator-activated receptor-gamma coactivator-1 alpha and its downstream targets; nuclear respiratory factor-1 and mitochondrial transcription factor A. While the placental tissues showed different patterns, particularly elevated in mtDNA-CN by about 43%.

Conclusions
The study provides preliminary evidence of the detrimental effects of Sofosbuvir on the pregnancy outcomes of the exposed females and may impair the placental and fetal organs’ development. These effects may be mediated through modulating mitochondrial homeostasis and functions.
Mitochondrial reprogramming in peripheral blood mononuclear cells of patients with glycogen storage disease type Ia
Authors: Rossi Alessandro , Assunto Antonia , Rosano Carmen , Tucci Sara , Ruoppolo Margherita , Caterino Marianna , Pirozzi Francesca , Strisciuglio Pietro , Parenti Giancarlo , Melis Daniela 
Published: June 2023

Abstract
Background
Glycogen storage disease type Ia (GSDIa) is an inborn metabolic disorder caused by the deficiency of glucose-6-phospatase-α (G6Pase-α) leading to mitochondrial dysfunction. It remains unclear whether mitochondrial dysfunction is present in patients’ peripheral blood mononuclear cells (PBMC) and whether dietary treatment can play a role. The aim of this study was to investigate mitochondrial function in PBMC of GSDIa patients.

Methods
Ten GSDIa patients and 10 age-, sex- and fasting-time matched controls were enrolled. Expression of genes involved in mitochondrial function and activity of key fatty acid oxidation (FAO) and Krebs cycle proteins were assessed in PBMC. Targeted metabolomics and assessment of metabolic control markers were also performed.

Results
Adult GSDIa patients showed increased CPT1A, SDHB, TFAM, mTOR expression (p < 0.05) and increased VLCAD, CPT2 and citrate synthase activity in PBMC (p < 0.05). VLCAD activity directly correlated with WC (p < 0.01), BMI (p < 0.05), serum malonycarnitine levels (p < 0.05). CPT2 activity directly correlated with BMI (p < 0.05).

Conclusion
Mitochondrial reprogramming is detectable in PBMC of GSDIa patients. This feature may develop as an adaptation to the liver enzyme defect and may be triggered by dietary (over)treatment in the frame of G6Pase-α deficiency. PBMC can represent an adequate mean to assess (diet-induced) metabolic disturbances in GSDIa.
Preferences for policy measures to regulate urban vehicle access for climate change mitigation
Authors: Ogunkunbi Gabriel Ayobami , Meszaros Ferenc 
Published: June 2023

AbstractIn cognisance of the urgent need to decarbonise the transport sector to limit its impact on climate change and to internalise other negative transport externalities, regulating vehicle access in urban areas is essential. However, urban areas often struggle to implement these regulations due to concerns relating to social acceptability, heterogeneity of citizen preferences, lack of information on preferred measure attributes, and other factors that can boost the acceptance of urban vehicle access regulations. This study explores the acceptability and willingness to support Urban Vehicle Access Regulations (UVAR) in Budapest, Hungary to reduce transportation emissions and promote sustainable urban mobility. Using a structured questionnaire, which includes a choice-based conjoint exercise, the study finds that 42% of respondents were willing to support a car-free policy measure. Results were analysed to elicit preferences for specific UVAR measure attributes, identify population subgroups, and assess factors influencing willingness to support UVAR implementation. Access fee and proportion of revenue earmarked for transport development were the most important attributes to respondents. The study also identified three distinct subgroups of respondents with differing preferences, which could be characterised based on access to passenger cars, age, and employment status. The findings suggest that for effective UVAR, access fees for non-compliant vehicles should be excluded from measure designs, and the attribute preference approach highlights the importance of considering the heterogeneity of residents’ preferences in UVAR measure planning.
Seasonal fluctuations and diversity of Ingoldian mycobiota in two water bodies receiving different effluents at Assiut Governorate (Upper Egypt)
Authors: Khallil Abdel-Raouf M. , Ali Essam H. , Ibrahim Sabreen S. , Hassan Elhagag Ahmed 
Published: June 2023

AbstractIn the current study, fifty-eight Ingoldain fungal species assignable to forty-one genera were recovered from two water bodies receiving the treated sewage and the effluents of oils and soaps factory at Assiut Governorate (Upper Egypt), of which Anguillospora, Amniculicola, Flagellospora, and Mycocentrospora were the most prevalent genera. The most widespread identified species were Anguillospora furtive, Amniculicola longissima and Flagellospora fusarioides. Forty-three species were identified for the first time in Egypt. The most Ingoldain taxa were estimated for El-Zinnar canal, with the highest recorded taxa in winter. Whereas, the highest dominance of Ingoldian fungi was estimated for the El-Ibrahimia canal. The highest Simpson and Shannon diversity indexes were estimated for El-Zinnar canal samples recording 0.9683 and 3.741, respectively. The poorest water sites with Ingoldian fungi were those exposed directly to either treated sewage or industrial effluents, with which relatively higher values of water conductivity, cations and anions. Water temperature was the main abiotic factor driving the seasonal occurrence of Ingoldian fungi. It is interesting to isolate some Ingoldian fungal species from the stressful water sites receiving the effluents which provide valuable insights regarding their adaptation, predictive and putative role as bioindicators and their potentiality in pollutants degradation, organic decomposition, and transformation of xenobiotic compounds.
Acceptance of diagnosis and management satisfaction of patients with “suspected Lyme borreliosis” after 12 months in a multidisciplinary reference center: a prospective cohort study
Authors: Raffetin Alice , Chahour Amal , Schemoul Julien , Paoletti Giulia , He Zhuoruo , Baux Elisabeth , Patrat-Delon Solène , Nguala Steve , Caraux-Paz Pauline , Puppo Costanza , Arias Pauline , Madec Yoann , Gallien Sébastien , Rivière Julie 
Published: June 2023

Abstract
Introduction
Because patients with a “suspicion of Lyme borreliosis (LB)” may experience medical wandering and difficult care paths, often due to misinformation, multidisciplinary care centers were started all over Europe a few years ago. The aim of our study was to prospectively identify the factors associated with the acceptance of diagnosis and management satisfaction of patients, and to assess the concordance of the medical health assessment between physicians and patients 12 months after their management at our multidisciplinary center.

Methods
We included all adults who were admitted to the Tick-Borne Diseases Reference Center of Paris and the Northern Region (TBD-RC) (2017–2020). A telephone satisfaction survey was conducted 12 months after their first consultation. It consisted of 5 domains and 13 items rated between 0 (lowest) and 10 (highest grade): (1)Reception; (2)Care and quality of management; (3)Information/explanations given to the patients; (4)Current medical condition and acceptance of the final diagnosis; (5)Overall appreciation. Factors associated with diagnosis acceptance and management satisfaction at 12 months were identified using logistic regression models. The concordance of the health status as assessed by doctors and patients was calculated using a Cohen’s kappa test.

Results
Of the 569 patients who consulted, 349 (61.3%) answered the questionnaire. Overall appreciation had a median rating of 9 [8;10] and 280/349 (80.2%) accepted their diagnoses. Patients who were “very satisfied” with their care paths at TBD-RC (OR = 4.64;CI95%[1.52–14.16]) had higher odds of diagnosis acceptance. Well-delivered information was strongly associated with better satisfaction with the management (OR = 23.39;CI95%[3.52–155.54]). The concordance between patients and physicians to assess their health status 12 months after their management at TBD-RC was almost perfect in the groups of those with confirmed and possible LB (κ = 0.99), and moderate in the group with other diagnoses (κ = 0.43).

Conclusion
Patients seemed to approve of this multidisciplinary care organization for suspected LB. It helped them to accept their final diagnoses and enabled a high level of satisfaction with the information given by the doctors, confirming the importance of shared medical decisions, which may help to reduce health misinformation. This type of structure may be useful for any disease with a complex and controversial diagnosis.
Steroid responsive idiopathic calcitriol induced hypercalcemia: a case report and review of the literature
Authors: Fadel Omar El , Kenkare Anshel , Zhang Jingjing 
Published: June 2023

Abstract
Background
Idiopathic Calcitriol Induced Hypercalcemia is a rare cause of a common condition of hypercalcemia. Hypercalcemia is most commonly the result of hyperparathyroidism and together with hypercalcemia of malignancy accounts for over 95% of cases. Idiopathic Calcitriol Induced Hypercalcemia can mimic hypercalcemia secondary to granulomatous diseases like sarcoidosis, but with apparent absences of both imaging and physical exam findings consistent with the disease. We report here a 51-year-old man who presented with recurrent nephrolithiasis, hypercalcemia, and acute kidney injury.

Case presentation
A 51-year-old man presented with severe back pain and mild hematuria. He had a history of recurrent nephrolithiasis over the course of a 15-year period. On presentation his calcium was elevated at 13.4 mg/dL, creatinine was 3.1 mg/dL (from baseline of 1.2), and his PTH was reduced at 5 pg/mL. CT abdomen and pelvis showed acute nephrolithiasis which was managed medically. Work up for the hypercalcemia included an SPEP which was normal, Vit D,1,25 (OH)2 was elevated at 80.4 pg/mL, CT chest showed no evidence of sarcoidosis. Management with 10 mg prednisone showed marked improvement in the hypercalcemia and he no longer had any symptoms of hypercalcemia.

Conclusion
Idiopathic Calcitriol Induced Hypercalcemia is a rare cause of hypercalcemia. All reported cases benefit from more intensive long-term immunosuppression. This report helps consolidate the diagnosis of Idiopathic Calcitriol Induced Hypercalcemia and encourages researchers to better investigate its underlying pathogenesis.
Prevalence and predictors of chronic kidney disease of undetermined causes (CKDu) in Western Kenya’s “sugar belt”: a cross-sectional study
Authors: H. Hathaway Michelle , L. Patil Crystal , Odhiambo Aloyce , Onyango Dickens , Dorevitch Samuel 
Published: June 2023

Abstract
Background
Epidemics of chronic kidney disease of undetermined causes (CKDu) among young male agricultural workers have been observed in many tropical regions. Western Kenya has similar climatic and occupational characteristics as many of those areas. The study objectives were to characterize prevalence and predictors of CKDu, such as, HIV, a known cause of CKD, in a sugarcane growing region of Kenya; and to estimate prevalence of CKDu across occupational categories and evaluate if physically demanding work or sugarcane work are associated with reduced eGFR.

Methods
The Disadvantaged Populations eGFR Epidemiology Study (DEGREE) protocol was followed in a cross-sectional study conducted in Kisumu County, Western Kenya. Multivariate logistic regression was performed to identify predictors of reduced eGFR.

Results
Among 782 adults the prevalence of eGFR < 90 was 9.85%. Among the 612 participants without diabetes, hypertension, and heavy proteinuria the prevalence of eGFR < 90 was 8.99% (95%CI 6.8%, 11.5%) and 0.33% (95%CI 0.04%, 1.2%) had eGFR < 60. Among the 508 participants without known risk factors for reduced eGFR (including HIV), the prevalence of eGFR < 90 was 5.12% (95%CI 3.4%, 7.4%); none had eGFR < 60. Significant risk factors for reduced eGFR were sublocation, age, body mass index, and HIV. No association was found between reduced eGFR and work in the sugarcane industry, as a cane cutter, or in physically demanding occupations.

Conclusion
CKDu is not a common public health problem in this population, and possibly this region. We recommend that future studies should consider HIV to be a known cause of reduced eGFR. Factors other than equatorial climate and work in agriculture may be important determinants of CKDu epidemics.