bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ptotic versus Nonptotic Breasts in Nipple-sparing Mastectomy and Immediate Prepectoral Breast Reconstruction
Authors: Ostapenko Edvin , Nixdorf Larissa , Devyatko Yelena , Exner Ruth , Math Pia , Wimmer Kerstin , Haeusler Theresa , Fitzal Florian 
Published: May 2023

Background:
In recent years, nipple-sparing mastectomy followed by implant-based breast reconstruction has gained popularity due to improved cosmetic and psychological benefits. However, patients with ptotic breasts remain the main challenge for surgeons, owing to the potential risk of postoperative complications.

Methods:
A retrospective chart review was performed for patients who underwent nipple-sparing mastectomy and prepectoral implant-based breast reconstruction between March 2017 and November 2021. Patient demographics, incidence of complications, and quality of life assessed using the BREAST-Q questionnaire were compared between the two different incisions [inverted-T for ptotic versus inframammary fold (IMF) for nonptotic breasts].

Results:
A total of 98 patients were examined: 62 in the IMF cohort and 36 in the inverted-T cohort. The results demonstrated equivalence in the safety metrics between the two groups, including hematoma (p=0.367), seroma (p=0.552), infection (P = 1.00), skin necrosis (P = 1.00), local recurrence (P = 1.00), implant loss (P = 0.139), capsular contracture (P = 1.00), and nipple-areolar complex necrosis (P = 0.139). The BREAST-Q scores were equally high in both groups.

Conclusion:
Our results suggest that inverted-T incision for ptotic breasts is a safe modality with similar complication rates and high aesthetic results compared with IMF incision for nonptotic breasts. A higher rate of nipple-areolar complex necrosis in the inverted-T group, although not significant, should be considered during careful preoperative planning and patient selection.
Telemonitoring Wound Recovery with Smartphone: An Italian Experience during Pandemic Period
Authors: Gesuete Francesco Paolo , Molle Marcello , Gubitosi Adelmo , Izzo Sara , Todde Salvatore , Nicoletti Giovanni Francesco , Ferraro Giuseppe Andrea 
Published: May 2023

Summary:
An important problem of plastic surgeons is monitoring wound healing, loss of substance, and postsurgical scar in different pathologies of the skin. Face to face monitoring is expensive and cannot be performed in periods of social crisis such as the recent COVID-19 pandemic. The use of telemedicine techniques is rising in this field of healthcare, promising the same results as the standard follow-up with more flexibility and savings. The purpose of this case study was to evaluate the effectiveness of remote monitoring and treatment through remote follow-up using digital applications. We followed up 25 patients with postoperative or diabetic ulcers for a period of 6 months (ranging from 2 to 6 months). We have performed clinical assessments using the Scar Cosmesis Assessment and Rating scale, and we have measured patient satisfaction using questionnaires. We chose to use the application for smartphone, describing the types of ulcers, number and average consultations, and the type of recovery, whether partial or complete. Monitoring wound recovery was very easy, and the patients found the experience very satisfactory. The total number of consultations was 255 with a significant reduction in outpatient visits during the pandemic period. Telemedicine is a useful tool in wound management and can be used to provide an optimal health care service with no inferior results to standard care.
Meningococcal Purpura Fulminans After Rectal Sexual Intercourse in Men Having Sex With Men
Authors: Bush Larry M. , Patel Janak B. , Byrd Lauren , Wilson Danielle D. 
Published: May 2023

Abstract
Over the past few decades, the incidence of meningococcal disease in the United States has been steadily declining and has reached historic lows. Much of this decrease in numbers of cases is attributed to the effectiveness and acceptance of immunization with conjugate meningococcal vaccines. Although the Advisory Committee on Immunization Practices has expanded its recommendation for vaccination to include all persons older than 2 years with HIV infection, uninfected men who have sex with men (MSM) without other underling conditions have never been singled out for vaccination. However, outbreaks of invasive meningococcal infection in MSM have been reported in recent years, including the largest and most recent one in Florida. The increased rate of urogenital and anorectal colonization with Neisseria meningitidis in MSM and risk of sexual transmission suggests that MSM, regardless of HIV status, should also be vaccinated against meningococcal disease.
Level of Overestimation Among Dutch Recreational Skiers: Unskilled Tourists in the Mountains
Authors: Luppino Floriana , van Diepen Merel , den Hollander-Gijsman Margien , Bartlema Kornelis , Dekker Friedo 
Published: May 2023

Objective:
To examine the level of overestimation (LO), associated factors, and identify the group of severe overestimators, among recreational skiers.

Design:
Cross-sectional observational study.

Setting:
An intermediate difficulty slope in an artificial snow indoor ski hall, and one in the mountains (Flachau, Austria).

Participants:
Dutch recreational skiers.

Independent Variables:
Participants were asked to rate themselves (SRSS, self-reported skill score). While skiing downhill they were objectively evaluated by 2 expert assessors (OSS, observed skill score). Potential associated factors and predictors for severe overestimation were assessed by a questionnaire.

Main outcome measures:
The LO, calculated by subtracting the OSS from the SRSS, was categorized into “no,” “mild,” and “severe.” Potential differences between these groups were analyzed, and regression analyses were performed to identify the factors associated with severe overestimation. To construct a profile of severe overestimators, the dataset was stratified based on 3 variables.

Results:
Overestimation was largely present (79.8%), and was severe in 32%. The LO decreased toward the more skilled skiers. Severe overestimators were mainly male, skied the least hours per day, were more avoidant, and showed the highest proportions of beginners and slightly advanced skiers. The profile of “severe overestimator” is characterized by physically unprepared males, avoidant for certain weather circumstances.

Conclusions:
Overestimation among recreational Dutch skiers is largely present, particularly among physically unprepared males, avoidant of certain snow and weather conditions. These features may function as a proxy to identify “severe overestimators” in comparable populations. Preventive strategies should focus to increase awareness particularly among these subjects.
MHC Class I Masking to Prevent AMR in a Porcine Kidney Transplantation Model in Alloimmunized Recipients
Authors: Kervella Delphine , Branchereau Julien , Prudhomme Thomas , Nerrière-Daguin Véronique , Renaudin Karine , Minault David , Hervouet Jérémy , Martinet Bernard , Bruneau Sarah , Le Bas-Bernardet Stéphanie , Blancho Gilles 
Published: May 2023

Background:
Presensitized patients awaiting a kidney transplant have a lower graft survival and a longer waiting time because of the limited number of potential donors and the higher risk of antibody-mediated rejection (AMR), particularly in the early posttransplant period, because of preformed donor-specific antibodies binding major histocompatibility complex (MHC) molecules expressed by the graft endothelium followed by the activation of the complement. Advances in kidney preservation techniques allow the development of ex vivo treatment of transplants. We hypothesized that masking MHC ex vivo before transplantation could help to prevent early AMR in presensitized recipients. We evaluated a strategy of MHC I masking by an antibody during ex vivo organ perfusion in a porcine model of kidney transplantation in alloimmunized recipients.

Methods:
Through the in vitro calcein-release assay and flow cytometry, we evaluated the protective effect of a monoclonal anti–swine leukocyte antigen class I antibody (clone JM1E3) against alloreactive IgG complement-dependent cytotoxicity toward donor endothelial cells. Kidneys perfused ex vivo with JM1E3 during hypothermic machine perfusion were transplanted to alloimmunized recipients.

Results:
In vitro incubation of endothelial cells with JM1E3 decreased alloreactive IgG cytotoxicity (mean complement-dependent cytotoxicity index [% of control condition] with 1 µg/mL 74.13% ± 35.26 [calcein assay] and 66.88% ± 33.46 [cytometry]), with high interindividual variability. After transplantation, acute AMR occurred in all recipients on day 1, with signs of complement activation (C5b-9 staining) as soon as 1 h after transplantation, despite effective JM1E3 binding on graft endothelium.

Conclusions:
Despite a partial protective effect of swine leukocyte antigen I masking with JM1E3 in vitro, ex vivo perfusion of the kidney with JM1E3 before transplantation was not sufficient alone at preventing or delaying AMR in highly sensitized recipients.
Identification of Nocardioides marmotae sp. nov. and Nocardioides faecalis sp. nov., two new members of the genus Nocardioides
Authors: Zhang Gui , Liu Yue , Cheng Yanpeng , Yang Jing , Jin Dong , Lu Shan , Pu Ji , Li Weiguang , Ge Yajun , Ma Caiyun , Luo Wenbo , Xu Jianguo 
Published: May 2023

A polyphasic taxonomic characterization of two novel strain pairs (designated zg-579T/zg-578 and zg-536T/zg-ZUI104) isolated from the faeces of Marmota himalayana was conducted based on phylogenetic analysis of the nearly full-length 16S rRNA gene and genome, digital DNA–DNA hybridization, ortho-average nucleotide identity (Ortho-ANI), and phenotypic and chemotaxonomic traits. Comparative analysis of the nearly full-length 16S rRNA gene sequences showed that strain zg-579T was most closely related to

Nocardioides dokdonensis

FR1436T (97.57 %) and

Nocardioides deserti

SC8A-24T (97.36 %), whereas strain zg-536T had the highest similarity to

Nocardioides caeni

MN8T (98.33 %),

Nocardioides convexus

W2-2-3T (98.26 %) and

Nocardioides daeguensis

2C1-5T (98.19 %). Low levels of DNA–DNA relatedness and Ortho-ANI values (19.8–31.0 %/78.6–88.2 %, zg-579T; 19.9–31.3 %/78.8–86.2 %, zg-536T) between the two new type strains and previously known species within the genus

Nocardioides

support the hypothesis that the four newly characterized strains could be considered to represent two novel species within this genus. The dominant cellular fatty acids found in strain pair zg-536T/zg-ZUI104 were iso-C16 : 0 and C18 : 1
ω9c, whereas C17 : 1
ω8c was major component in zg-579T/zg-578. Galactose and ribose were the main cell-wall sugars in these two new strain pairs. Diphosphatidylglycerol (DPG), phosphatidylcholine, phosphatidylglycerol (PG) and phosphatidylinositol (PI) were the major polar lipids in zg-579T, whereas DPG, PG and PI predominated in zg-536T. Both strain pairs had MK8(H4) as the major respiratory quinone and ll-diaminopimelic acid as the major cell-wall peptidoglycan. The optimal growth conditions for the two novel strain pairs were 30 °C, pH 7.0 and 0.5 % NaCl (w/v). Based on these polyphasic characterizations, two novel species within the genus

Nocardioides

are proposed, i.e. Nocardioides marmotae sp. nov. and Nocardioides faecalis sp. nov., with zg-579T (=CGMCC 4.7663T=JCM 33892T) and zg-536T (=CGMCC 4.7662T=JCM 33891T) as the type strains.
Clustering by Multiple Long-Term Conditions and Social Care Needs: A cohort study amongst 10,025 older adults in England
Authors: Khan Nusrat , Chalitsios Christos V. , Nartey Yvonne , Simpson Glenn , Zaccardi Francesco , Santer Miriam , Roderick Paul , Stuart Beth , Farmer Andrew , Dambha-Miller Hajira 
Published: May 2023

AbstractBackgroundPeople with Multiple Long-Term Conditions (MLTC) face health and social care challenges. This study aimed to classify people by MLTC and social care need (SCN) into distinct clusters and quantify the association between derived clusters and care outcomes.MethodsA cohort study was conducted using the English Longitudinal Study of Ageing (ELSA), including people with up to ten MLTC. Self-reported SCN was assessed through 13 measures of difficulty with activities of daily living, ten measures of mobility difficulties, and whether health status was limiting earning capability. Latent class analysis was performed to identify clusters. Multivariable logistic regression quantified associations between derived SCN/MLTC clusters, all-cause mortality, and nursing home admission.ResultsThe cohort included 9171 people at baseline with a mean age of 66·3 years; 44·5% were males. Nearly 70·8% had two or more MLTC, the most frequent being hypertension, arthritis, and cardiovascular disease. We identified five distinct clusters classified as high SCN/MLTC through to low SCN/MLTC clusters. The high SCN/MLTC included mainly women aged 70 to 79 years who were white and educated to the upper secondary level. This cluster was significantly associated with higher nursing home admission (OR = 8·97; 95% CI: 4·36 to 18·45). We found no association between clusters and all-cause mortality.ConclusionsThis results in five clusters with distinct characteristics that permit the identification of high-risk groups who are more likely to have worse care outcomes, including nursing home admission. This can inform targeted preventive action to where it is most needed amongst those with MLTC.What is already known on this topicWhile it is established that multiple long-term conditions are linked to an increased risk of hospitalisation, nursing home admission and mortality, no previous research has examined this risk in relation to clusters of MLTC and social care needs in England.What this study addsUsing latent class analysis, this study identified five clusters by multiple long-term conditions and social care needs with distinct characteristics and quantified their relationship with nursing home admission and mortality.How this study might affect research, practice or policyThe findings permit the identification of high-risk groups who are more likely to have worse care outcomes, including nursing home admission in the future. This can inform targeted preventive action to where it is most needed amongst those with MLTC. Recognition of MLTC and SCN clusters may also aid clinicians in moving away from a single disease management approach in older adults.
Somatic structural variation signatures in pediatric brain tumors
Authors: Yang Yang , Yang Lixing 
Published: May 2023

SummaryBrain cancer is the leading cause of cancer-related death in children. Somatic structural variations (SVs), large scale alterations in DNA, remain poorly understood in pediatric brain tumors. Here, we detect a total of 13,199 high confidence somatic SVs in 744 whole-genome-sequenced pediatric brain tumors from Pediatric Brain Tumor Atlas. The somatic SV occurrences have tremendous diversity among the cohort and across different tumor types. We decompose mutational signatures of clustered complex SVs, non-clustered complex SVs, and simple SVs separately to infer the mutational mechanisms of SV formation. Our finding of many tumor types carrying unique sets of SV signatures suggests that distinct molecular mechanisms are active in different tumor types to shape genome instability. The patterns of somatic SV signatures in pediatric brain tumors are substantially different from those in adult cancers. The convergence of multiple signatures to alter several major cancer driver genes suggesting the functional importance of somatic SVs in disease progression.
Accounting for intensity variation in image analysis of large-scale multiplexed clinical trial datasets
Authors: Frei Anja L , McGuigan Anthony , Sinha Ritik RAK , Glaire Mark A , Jabbar Faiz , Gneo Luciana , Tomasevic Tijana , Harkin Andrea , Iveson Tim J , Saunders Mark , Oein Karin , Maka Noori , Pezella Francesco , Campo Leticia , Hay Jennifer , Edwards Joanne , Sansom Owen , Kelly Caroline , Tomlinson Ian , Kildal Wanja , Kerr Rachel S , Kerr David J , Danielsen Håvard E , Domingo Enric ,   TransSCOT consortium, Church David N , Koelzer Viktor H 
Published: May 2023

ABSTRACTMultiplex immunofluorescence (mIF) imaging can provide comprehensive quantitative and spatial information for multiple immune markers for tumour immunoprofiling. However, application at scale to clinical trial samples sourced from multiple institutions is challenging due to pre-analytical heterogeneity. This study reports an analytical approach to the largest multiparameter immunoprofiling study of clinical trial samples to date. We analysed 12,592 tissue microarray (TMA) spots from 3,545 colorectal cancers (CRC) sourced from more than 240 institutions in two clinical trials (QUASAR 2 and SCOT) stained for CD4, CD8, CD20, CD68, FoxP3, pan-cytokeratin and DAPI by mIF. TMA slides were multi-spectrally imaged and analysed by cell-based and pixel-based marker analysis. We developed an adaptive thresholding method to account for inter- and intra-slide intensity variation in TMA analysis. Applying this method effectively ameliorated inter- and intra-slide intensity variation improving the image analysis results compared to methods using a single global threshold. Correlation of CD8 data derived by our mIF analysis approach with single-plex chromogenic immunohistochemistry (IHC) CD8 data derived from subsequent sections indicates the validity of our method (Spearman’s rank correlation coefficients ρ between 0.63 and 0.66, p-value ≪ 0.01) as compared to current gold standard analysis approach. Evaluation of correlation between cell-based and pixel-based analysis results confirms equivalency (ρ > 0.8, p ≪ 0.01, except for CD20 in epithelium region) of both analytical approaches. These data suggests that our adaptive thresholding approach can enable analysis of mIF-stained clinical trial TMA datasets by digital pathology at scale for precision immunoprofiling.
Statin Use And The Risk Of Venous Thromboembolism In Women Taking Hormone Therapy
Authors: Davis John W. , Weller Susan C. , Porterfield Laura , Chen Lu , Wilkinson Gregg 
Published: May 2023

ABSTRACTImportanceWhile hormone therapy (HT) in perimenopausal women can increase risk for venous thromboembolism (VTE), it is unclear to what extent statins may reduce HT-related risk.ObjectiveTo estimate VTE risk in 50–64-year-old women taking HT with or without statins and by statin intensity.DesignA nested case-control study.SettingA US, commercially insured claims database.ParticipantsWomen aged 50-64 with at least one year of continuous membership between 2008-2019.ExposureFilled prescriptions for estrogens, progestogens, and statins were recorded in 12 months prior to index. Recent HT was defined as any estrogen or progestogen exposure within 60 days before the index date. Current statin exposure was defined as 90 or more days of continuous exposure prior to and including the index date. Statin intensity was defined by the statin exposure 30 days prior to index.Main Outcomes and MeasuresCases were identified with VTE diagnoses (ICD codes) preceded by at least 12 months without VTE and followed within 30 days by anticoagulation, an inferior vena cava filter placement, or death. Controls were matched to cases (10:1) on date and age. Conditional logistic regression models estimated risk for HT and statin exposures with odds ratios (OR), adjusted for comorbidities.ResultsThe total sample (mean age 57.5) included 20,359 cases and 203,590 matched controls; 9% had recent HT exposure and 16% had current statin exposure. In adjusted models, the OR for any recent HT exposure was 1.51 (95%CI:1.43-1.60) compared to no recent HT exposure. The OR for current statin therapy was 0.88 (95%CI:0.84-0.93) compared to no current statin exposure. The OR was 1.53 (95%CI:1.44-1.63) for those with HT without statins, 1.25 (95%CI:1.10-1.43) with HT with statins, and 0.89 (95%CI:0.85-0.94) with statins without HT compared to no recent HT and no current statins. HT with statin therapy had a 18% significantly lower OR than HT without statins (OR=0.82,95%CI:0.71-0.94) and greater risk reduction with higher intensity statins.Conclusions and RelevanceIn this case-control study, statin therapy was associated with reduced risk of VTE in women taking HT with greater risk reduction with high-intensity statins.Key PointsQuestionWhat is the impact of statin therapy in perimenopausal women exposed to hormone therapy?FindingsIn this case-control study of approximately 225,000 women aged 50-64, the VTE odds ratio was 53% higher in women recently exposed to HT without current statin therapy and 25% higher with recent HT exposure and current statin therapy compared to women without recent HT and current statin exposures,MeaningThese findings suggest statins may reduce risk of VTE in women exposed to HT and further, HT may not be contraindicated in women taking statins.
Tumor microenvironment exploration and therapeutic target identification in bladder cancer based on Cuproptosis signature and chemotherapy-resistant model: results from bioinformatics and experimental validation
Authors: Gu Jun , Shi Zhen-duo , Pang Kun , Hao Lin , Wang Wei , Han Cong-hui 
Published: May 2023

AbstractBackgroundThe discovery of cuproptosis provides a new way to make full use of the pathophysiological effects of copper for anticancer therapy and could help identify a therapeutic target in bladder cancer.MethodsIn this study, 411 BLCA tumor samples from the Cancer Genome Atlas (TCGA) cohort were obtained. Differentially expressed genes (DEGs) between chemotherapy-sensitive and chemotherapy-resistant mouse bladder cancers were also obtained. Sixteen genes were defined as cuproptosis-related genes (CRGs), and the cutoff score was calculated based on LASSO Cox regression. CCK-8 and Transwell assays were used to detect the migration and proliferation of 5637 and T24 cells, respectively. Liarozole dihydrochloride (L-D), a mild P450, inhibits the expression of CYP26B1. Multiple immunohistochemistry analyses were used to explore the association between the immune microenvironment and CRGs.ResultsA higher Cuproptosis score was significantly associated with worse overall survival in BLCA (p<0.0001, HR=2.32). Single-cell transcriptional data were used to assess the function ofCYP26B1andCYP26B1may be negatively associated with DNA damage and repair. In vitro experiments indicated that overexpression of CYP26B1 enhanced the migration and proliferation of BLCA cells, while L-D inhibited the migration and proliferation of BLCA cells. A higher expression level of Dihydrolipoamide S-Succinyltransferase (DLST) serves could as a risk factor in patients treated with atezolizumab and higher expression ofDLSTsuggest an immunosuppressive microenvironment.ConclusionsCYP26B1may be a therapeutic target for bladder cancer, and the higher expression of DLST may suggest an immunosuppressive microenvironment in BLCA.Key MessagesCuproptosis may be associated with the chemotherapy-resistance of bladder cancer and our findings may provide new ideas for the treatment of bladder cancer.