bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonsurgical Rhinoplasty in Patients of African Descent: A Retrospective Review
Authors: Harb Ayad , Abdul-Razzak Amane 
Published: June 2023

Background:
There is a paucity of research on nonsurgical rhinoplasty in the population of African descent. In this group, underlying anatomy and aesthetic ideals vary, necessitating differences in the consultation process and in treatment. The authors present a case series from a single clinician’s practice performing nonsurgical rhinoplasty on patients of African descent.

Methods:
A retrospective chart review was completed on eligible patients who underwent nonsurgical rhinoplasty treatment with hyaluronic acid filler injections performed by the first author (A.H.) from March of 2018 to February of 2021. Demographic variables, indications for treatment, patient-reported outcomes, and adverse events were reviewed. The authors also share the first author’s technique for nonsurgical rhinoplasty in this patient cohort.

Results:
A total of 487 patients of African descent or mixed race including African descent were included in this study. The most common indications for treatment were lack of bridge definition (63.9%), excessive alar width (61.6%), and a bulbous tip (61.6%). Median filler volume was 0.6 mL (range, 0.3 to 2.1 mL) at the initial treatment visit. There were no reported cases of infection, vascular occlusion, or necrosis.

Conclusions:
This study is the first to illustrate the effectiveness and safety profile of nonsurgical rhinoplasty in a population of African descent. Anatomical variations and the desire for racially congruent results must be acknowledged to ensure satisfactory outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Prevalence and incidence of stroke among people with HIV
Authors: Du Min , Wang Yaping , Qin Chenyuan , Mi Donghua , Liu Min , Liu Jue 
Published: June 2023

Objective:We aimed to obtain more precise estimates of stroke to address the wide variation of stroke burden among people with HIV (PWH) in different clinical settings.Design:Systematic review and meta-analysis.Methods:We systematically searched PubMed, EMBASE, and Web of Science for original articles reporting the prevalence and incidence of stroke among PWH up to November 23, 2022. Der Simonian-Laird random effects were used to obtain pooled estimates and 95% confidence intervals (CIs).Results:We included 17 observational studies covering 1 749 003 PWH on estimation of prevalence, and 17 cohort studies covering 249 606 PWH on estimation of incidence. The pooled prevalence of stroke was 1.30% (95% CI: 1.01%, 1.59%) for PWH aged at least 15 years, and 3.98% (95% CI: 2.45%, 5.51%) for PWH aged at least 50 years. The pooled incidence of stroke was 17.86 per 10 000 person-years (95% CI: 15.96, 19.76), meanwhile, the pooled incidence of ischemic stroke (31.50 per 10 000 person-years; 95% CI: 11.11, 51.89) was higher than hemorrhagic stroke (4.43 per 10 000 person-years; 95% CI: 1.95, 6.91) among PWH aged at least 15 years.Conclusion:The prevalence of stroke was nearly one per hundred among PWH aged ≥15 years, and reached four per hundred for those aged ≥50 years. The occurrence of stroke is common during HIV progression, particularly ischemic stroke. Therefore, more efforts should be made on implementing policies, strategies, and programs aimed at identifying the risk factors, improving treatment, and facilitating rehabilitation for stroke to reduce the disease burden among PWH.
A Case of Adenomyosis Showing Size Reduction in a Follicular Lymphoma Patient Receiving Chemotherapy With R-Bendamustine
Authors: Seo Minjung , Lee Yoo Jin , Choi Hyung Jin , Jo Jae Cheol , Park Seol Hoon 
Published: June 2023

Abstract
We describe a case of adenomyosis that reduced in size in a patient with lymphoma on receiving chemotherapy. A 48-year-old woman with worsening left flank pain was diagnosed with follicular lymphoma. [18F]FDG PET/CT revealed multiple hypermetabolic lymph nodes in the bilateral cervical, axillary, mediastinal, mesenteric, retroperitoneal, iliac, and inguinal regions. In addition, adenomyosis with mild hypermetabolism was demonstrated on [18F]FDG PET/CT. The size and metabolism of adenomyosis decreased after chemotherapy with R-bendamustine; in addition, along with decrease in estradiol levels, the patient experienced amenorrhea and hot flushes. The patient was diagnosed with chemotherapy-induced early menopause.
Prognosis-Guided Reconstruction of Scalp and Skull Defects in Neurosurgical Patients
Authors: Meyers Abigail , Krebs Jillian , Xia Thomas , Kshettry Varun R. , Angelov Lilyana , Nagel Sean , Rampazzo Antonio , Bassiri Gharb Bahar 
Published: June 2023

Background
This study aimed to formulate reconstructive recommendations for neurosurgical patients presenting with scalp and/or skull defects based on outcomes in a large series of patients.

Methods
An institutional review board-approved retrospective review of patients who underwent scalp and/or calvarial reconstruction was conducted. Complications were divided into minor and major; early, intermediate, and late. Univariate logistic regression models were conducted to identify independent predictors of complications. Mann-Whitney U tests were used to compare survival time. Kaplan-Meier curves were developed to compare exposure of titanium and bone cranioplasties.

Results
One hundred seventy-one patients who underwent 418 procedures were included (median 1 [1–3] surgeries per patient). Average age was 55 ± 15 years; 53% of patients were male. Median follow-up was 25.5 months [13.9–55.6 months], and 57 patients (33%) were deceased. Complications occurred following 48% of procedures; most common were titanium hardware exposure (36%), nonhealing wounds (23%), and infection (9%). Titanium cranioplasties became exposed 0.47 months [0.3–4.0 months] postoperatively. Frontal defect location was an independent predictor of major complications (odds ratio, 1.59; 95% confidence interval, 1.06–2.39; P = 0.026). Mortality rate for malignant intracranial neoplasms was 68.4% (median survival, 4.3 months), 39.1% for malignancies of both scalp and skull (7.0 months), 37.5% for scalp cancers (16.0 months), and 16.7% for meningiomas (28.2 months).

Conclusions
Neurosurgical patients requiring scalp and/or skull reconstruction are a complex population undergoing multiple procedures with high complication rates. Given high exposure rate of titanium hardware shortly after reconstruction, titanium cranioplasty is recommended for patients with a prognosis less than 2 to 8 months.
Seroma After Breast Reconstruction With Tissue Expanders
Authors: Ozturk Cemile Nurdan , Ozturk Can , Magner William J. , Ali Adil , Diehl Jeremy , Sigurdson S. Lynn 
Published: June 2023

Background
Seroma is a relatively common complication after breast reconstruction with tissue expanders. The main risk in the presence of seroma is development of periprosthetic infection, which can lead to implant loss. Our goals were to identify risk factors for seroma, and to describe our protocol for managing fluid accumulation.

Patients and Methods
An IRB approved breast reconstruction database was reviewed to identify patients who underwent tissue expander reconstruction. Patient characteristics, details of surgery, outcomes and treatment were recorded.

Results
Two hundred nineteen tissue expander reconstructions were performed in 138 patients. Twenty-eight reconstructions developed seroma (12.8%), and 75 were identified to have prolonged drains (34.2%). Seroma was more common in patients with lymph node surgery (P = 0.043), delayed reconstruction (P = 0.049), and prepectoral reconstruction (P = 0.002). Seroma and/or prolonged drains were more commonly noted in patients with higher body mass index (P = 0.044) and larger breast size (P = 0.001). Aspiration was the most common intervention (85.7%), which was performed in the clinic utilizing the expander port site. There was no difference in infection or explantation rate between seroma and no-seroma patients (P = 0.546 and 0.167), whereas patients with any fluid concern (seroma and/or prolonged drains) were more prone to developing infection and undergoing explantation (P = 0.041 and P < 0.005).

Conclusion
We recommend that prolonged drain placement longer than 3 weeks should be avoided, and patients should be screened for fluid accumulation after drain removal. Serial aspiration via expander port site and continuation of expansion provide a safe and effective method to manage seromas to avoid infection and expander loss.
Retinal and Choriocapillaris Vascular Changes in Early Alzheimer Disease Patients Using Optical Coherence Tomography Angiography
Authors: Di Pippo Mariachiara , Cipollini Virginia , Giubilei Franco , Scuderi Gianluca , Abdolrahimzadeh Solmaz 
Published: June 2023

Background:
Alzheimer disease (AD) is a neurodegenerative disorder characterized by ß-amyloid accumulation in the brain. A simple and reliable biomarker for AD that is not invasive is urgently needed, particularly in the preclinical and early stages of the disease. The retina shares with the brain, the same embryologic origins and it is affected by similar vascular changes. The aim of this study was to analyze the characteristics of the retinal and choriocapillaris vascular structure through optical coherence tomography-angiography (OCTA) evaluation in patients with early AD.

Methods:
Eighteen patients with early AD (study group) and 18 healthy age-matched subjects (control group) were enrolled in the study. All patients underwent full neurologic and ophthalmologic examination, and OCTA scans.

Results:
We found a significant reduction in flow area of choriocapillaris in the study group compared with the control group (P-value: 0.006), suggesting an impairment of choriocapillaris circulation in patients with early AD.

Conclusions:
OCTA provides accumulative evidence on the microvasculature changes of the retina and choriocapillaris in patients with AD. Further studies and improved OCTA software are necessary to better evaluate the role of vascular changes shown with OCTA as potential biomarkers in early disease.
There Is No Such Thing as Too Soon: Long-Term Outcomes of Early Cholecystectomy for Frail Geriatric Patients with Acute Biliary Pancreatitis
Authors: Nelson Adam C , Bhogadi Sai Krishna , Hosseinpour Hamidreza , Stewart Collin , Anand Tanya , Spencer Audrey L , Colosimo Christina , Magnotti Louis J , Joseph Bellal 
Published: June 2023

BACKGROUND:
Early cholecystectomy (CCY) for acute biliary pancreatitis (ABP) is recommended but there is a paucity of data assessing this approach in frail geriatric patients. This study compares outcomes of frail geriatric ABP patients undergoing index admission CCY vs nonoperative management (NOM) with endoscopic retrograde cholangiopancreatography (ERCP).

STUDY DESIGN:
Retrospective analysis of the Nationwide Readmissions Database (2017). All frail geriatric (65 years or older) patients with ABP were included. Patients were grouped by treatment at index admission: CCY vs NOM with endoscopic retrograde cholangiopancreatography. Propensity score matching was performed in a 1:2 ratio. Primary outcomes were 6-month readmissions, mortality, and length of stay. Secondary outcomes were 6-month failure of NOM defined as readmission for recurrent ABP, unplanned pancreas-related procedures, or unplanned CCY. Subanalysis was performed to compare outcomes of unplanned CCY vs early CCY.

RESULTS:
A total of 29,130 frail geriatric patients with ABP were identified and 7,941 were matched (CCY 5,294; NOM 2,647). Patients in the CCY group had lower 6-month rates of readmission for pancreas-related complications, unplanned readmissions for pancreas-related procedures, overall readmissions, and mortality, as well as fewer hospitalized days (p < 0.05). NOM failed in 12% of patients and 7% of NOM patients were readmitted within 6 months to undergo CCY, of which 56% were unplanned. Patients who underwent unplanned CCY had higher complication rates and hospital costs, longer hospital lengths of stay, and increased mortality compared with early CCY (p < 0.05).

CONCLUSIONS:
For frail geriatric patients with ABP, early CCY was associated with lower 6-month rates of complications, readmissions, mortality, and fewer hospitalized days. NOM was unsuccessful in nearly 1 of 7 within 6 months; of these, one-third required unplanned CCY. Early CCY should be prioritized for frail geriatric ABP patients when feasible.
A statistical method for image-mediated association studies discovers genes and pathways associated with four brain disorders
Authors: He Jingni , Antonyan Lilit , Zhu Harold , Li Qing , Enoma David , Zhang William , Liu Andy , Cao Bo , MacDonald M. Ethan , Arnold Paul D. , Long Quan 
Published: June 2023

ABSTRACTBrain imaging and genomics are critical tools enabling characterization of the genetic basis of brain disorders. However, imaging large cohorts is expensive, and may be unavailable for legacy datasets used for genome-wide association studies (GWAS). Using an integrated feature selection/aggregation model, we developed Image-Mediated Association Study (IMAS), which utilizes borrowed imaging/genomics data to conduct association mapping in legacy GWAS cohorts. By leveraging the UK Biobank image-derived phenotypes (IDPs), IMAS discovered genetic bases underlying four neuropsychiatric disorders and verified them by analyzing annotations, pathways, and expression Quantitative Trait Loci (eQTLs). A cerebellar-mediated mechanism was identified to be common to the four disorders. Simulations show that, if the goal is identifying genetic risk, IMAS is more powerful than a hypothetical protocol in which the imaging results were available in the GWAS dataset. This implies the feasibility of reanalyzing legacy GWAS datasets without conducting additional imaging, yielding cost-savings for integrated analysis of genetics and imaging.
Caudate Volume is Prospectively Associated with Irritability in Toddlerhood
Authors: Dufford Alexander J. , MacNeill Leigha , Nielsen Ashley , Smyser Christopher , Luby Joan L. , Rogers Cynthia E. , Norton Elizabeth , Wakschlag Lauren 
Published: June 2023

AbstractIrritability refers to the dispositional tendency toward angry emotion with both mood and behavioral elements. The dimensional spectrum of irritability is an RDoC-informed transdiagnostic marker of psychopathology risk, specifically the common and modifiable internalizing and externalizing disorders. Despite substantial interest in this robust developmentally based transdiagnostic indicator of psychopathology risk, its early brain markers are understudied. Here, we present data (n=31) from an imaging sub-study of the When to Worry study, in which we examined prospective associations between volume in three subcortical regions implicated in irritability (the caudate, putamen, and amygdala) around the infants’ first birthday (Baseline) and the dimensional spectrum of observed irritability using the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS) around toddlers’ second birthday (Follow-up). Both left (q<.04, FDR corrected) and right caudate volumes (q<.04, FDR corrected) at Baseline were negatively associated with a measure of irritability measured at Follow-up. We did not find support for associations between putamen and amygdala volumes at Baseline and observed irritability at Follow-up. These findings identify early prospective neuroanatomical correlates of toddler irritability and provide preliminary support for the caudate being an important brain region for understanding the developmental sequalae of irritability.
Visual Motion Detection Thresholds Can Be Reliably Measured During Walking and Standing
Authors: DiBianca Stephen , Jeka John , Reimann Hendrik 
Published: June 2023

AbstractIn upright standing and walking, the motion of the body relative to the environment is estimated from a combination of visual, vestibular and somatosensory cues. Associations between vestibular or somatosensory impairments and balance problems are well established, but less is known about how the ability of the visual system to detect motion affects balance control. Here we asked whether motion detection thresholds can be reliably measured during walking and standing. Typically, motion threshold values have been obtained while sitting, with the head fixated to eliminate self-motion. In this study we 1) tested whether a visual motion detection threshold can be reliably measured during standing and walking in the presence of natural self-motion; and 2) investigated whether visual motion detection thresholds differ during standing and walking.MethodsTwenty-nine subjects stood on and walked along a self-paced, instrumented treadmill inside a virtual environment displayed on a large dome. Participants performed a 2-alternative forced choice experiment in which they discriminated between a counterclockwise (“left”) and clockwise (“right”) rotation of a visual scene projected on a large dome. A 6-down 1-up adaptive staircase algorithm was implemented to change the amplitude of the rotation. A psychometric fit to the participants’ binary responses provided an estimate for the detection thresholdResultsWe found strong correlations between the repeated measurements in both the walking (R = 0.84, p < 0.001) and the standing condition (R = 0.73, p < 0.001) as well as good agreement between the repeated measures with Bland-Altman plots. Average thresholds during walking (mean = 1.04 degrees, SD = 0.43 degrees) were significantly higher than during standing (mean = 0.73 degrees, SD = 0.47 degrees).ConclusionVisual motion detection thresholds can be reliably measured during both walking and standing, and thresholds are higher during walking.
Neuronal alterations in AKT isotype expression in schizophrenia
Authors: Devine Emily A. , Joyce Alex W. , Imami Ali S. , Hammoud Abdul-rizaq , Golchin Hasti , Eby Hunter , Shedroff Elizabeth A. , Asah Sophie M. , Walss-Bass Consuelo , O’Donovan Sinead , McCullumsmith Robert E. 
Published: June 2023

AbstractSchizophrenia is characterized by substantial alterations in brain function, and previous studies suggest insulin signaling pathways, particularly involving AKT, are implicated in the pathophysiology of the disorder. This study demonstrates elevated mRNA expression of AKT1-3 in neurons from schizophrenia subjects, contrary to unchanged or diminished total AKT protein expression reported in previous postmortem studies, suggesting a potential decoupling of transcript and protein levels. Sex-specific differential AKT activity was observed, indicating divergent roles in males and females with schizophrenia. Alongside AKT, upregulation of PDK1, a critical component of the insulin signaling pathway, and several protein phosphatases known to regulate AKT were detected. Moreover, enhanced expression of the transcription factor FOXO1, a regulator of glucose metabolism, hints at possible compensatory mechanisms related to insulin signaling dysregulation. Findings were largely independent of antipsychotic medication use, suggesting inherent alterations in schizophrenia. These results highlight the significance of AKT and related signaling pathways in schizophrenia, proposing that these changes might represent a compensatory response to a primary defect of insulin signaling. This research underscores the need for a detailed understanding of these signaling pathways for the development of effective therapeutic strategies.
Dynamic noise estimation: A generalized method for modeling noise fluctuations in decision-making
Authors: Li Jing-Jing , Shi Chengchun , Li Lexin , Collins Anne G. E. 
Published: June 2023

AbstractComputational cognitive modeling is an important tool for understanding the processes supporting human and animal decision-making. Choice data in decision-making tasks are inherently noisy, and separating noise from signal can improve the quality of computational modeling. Common approaches to model decision noise often assume constant levels of noise or exploration throughout learning (e.g., theϵ-softmax policy). However, this assumption is not guaranteed to hold – for example, a subject might disengage and lapse into an inattentive phase for a series of trials in the middle of otherwise low-noise performance. Here, we introduce a new, computationally inexpensive method to dynamically infer the levels of noise in choice behavior, under a model assumption that agents can transition between two discrete latent states (e.g., fully engaged and random). Using simulations, we show that modeling noise levels dynamically instead of statically can substantially improve model fit and parameter estimation, especially in the presence of long periods of noisy behavior, such as prolonged attentional lapses. We further demonstrate the empirical benefits of dynamic noise estimation at the individual and group levels by validating it on four published datasets featuring diverse populations, tasks, and models. Based on the theoretical and empirical evaluation of the method reported in the current work, we expect that dynamic noise estimation will improve modeling in many decision-making paradigms over the static noise estimation method currently used in the modeling literature, while keeping additional model complexity and assumptions minimal.
Rats synchronize predictively to metronomes
Authors: Rajendran Vani G. , Tsdaka Yehonadav , Keung Tung Yee , Schnupp Jan W. H. , Nelken Israel 
Published: June 2023

AbstractHumans easily and naturally synchronize their motor activity to music, a behavior unparalleled by other species. As a consequence of the mystery surrounding its evolutionary and biological origins, there is rapidly growing interest in exploring the capacity of nonhuman species to synchronize motor activity with auditory rhythms. The hallmark observation in human studies is that synchronization is predictive. Given the highly variable behaviors observed in other animals, it is particularly difficult to distinguish a predictive synchronization behavior from one that perhaps resembles it, but relies on simpler strategies. Here, we introduce a novel modeling approach that quantitatively compares candidate strategies for explaining observed behaviors. Eight rats synchronized to metronomes across a range of tempi (0.5-2 Hz), and immediate water reward was delivered whenever they initiated a lick burst within a short time window around beats. We observed a roughly constant baseline lick probability throughout, with a ∼30% modulation of the lick rate around beats. We fitted to the results six candidate models, ranging from an ‘insensitive’ model assuming that rats lick at random, to predictive models where rats suppress licking between beats for a tempo-dependent duration of time. The predictive model consistently outperformed other models, including a reactive model, demonstrating that rats synchronize predictively to auditory metronomes.