bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gestational exposure to PM2.5, NO2, and sex steroid hormones: Identifying critical windows of exposure in the Rochester UPSIDE Cohort
Authors: Kahwaji Mariah , Duttweiler Luke , Thurston Sally W. , Harrington Donald , Miller Richard K. , Murphy Susan K. , Wang Christina , Brunner Jessica , Ge Yihui , Lin Yan , Hopke Philip K. , O’Connor Thomas G. , Zhang Junfeng J. , Rich David Q. , Barrett Emily S. 
Published: January 2025

Background:
Sex steroid hormones are critical for maintaining pregnancy and optimal fetal development. Air pollutants are potential endocrine disruptors that may disturb sex steroidogenesis during pregnancy, potentially leading to adverse health outcomes.

Methods:
In the Environmental influences on Child Health Outcomes Understanding Pregnancy Signals and Infant Development pregnancy cohort (Rochester, NY), sex steroid concentrations were collected at study visits in early-, mid-, and late-pregnancy in 299 participants. Since these visits varied by the gestational age at blood draw, values were imputed at 14, 22, and 30 weeks gestation. Daily NO2 and PM2.5 concentrations were estimated using random forest models, with daily concentrations from each 1-km2 grid containing the subject’s residence. Associations between gestational week mean NO2 and PM2.5 concentrations and sex steroid concentrations were examined utilizing distributed lag nonlinear models.

Results:
Each interquartile range (IQR = 9 ppb) increase in NO2 during weeks 0–5 was associated with higher early-pregnancy total testosterone levels (cumulative β = 0.45 ln[ng/dl]; 95% CI = 0.07, 0.83), while each IQR increase in NO2 during weeks 12–14 was associated with lower early-pregnancy total testosterone levels (cumulative β = −0.27 ln[ng/dl]; 95% CI = −0.53, −0.01). Similar NO2 increases during gestational weeks 0–14 were associated with higher late-pregnancy estradiol concentrations (cumulative β = 0.29 ln[pg/ml]; 95% CI = 0.10, 0.49), while each IQR increase in NO2 concentrations during gestational weeks 22–30 was associated with lower late-pregnancy estradiol concentrations (cumulative β = −0.18 ln[pg/ml]; 95% CI = −0.34, −0.02). No associations with PM2.5 were observed, except for an IQR increase in PM2.5 concentrations (IQR = 4 µg/m3) during gestational weeks 5–11 which was associated with lower late-pregnancy estriol levels (cumulative β = −0.16 ln[ng/ml]; 95% CI = −0.31, −0.00).

Conclusions:
Residential NO2 exposure was associated with altered sex steroid hormone concentrations during pregnancy with some indication of potential compensatory mechanisms.
Is Topical Tranexamic Acid Effective in Reducing Hematoma and Seroma in Breast Surgery? A Systematic Review and Meta-analysis
Authors: Hashemi Ammar S.A. , Hussein Sara M. , Alshehab Zainab H. , Al Qurashi Abdullah A. , Kreutz-Rodrigues Lucas , Sharaf Basel A. 
Published: January 2025

Background:
Postoperative fluid-related complications, such as hematoma and seroma formation, are common concerns in breast surgery, adversely affecting surgical outcomes and patient recovery. Topical tranexamic acid (TXA) has emerged as a promising intervention to minimize bleeding while reducing systemic adverse effects linked to intravenous administration. However, evidence on the efficacy of topical TXA in breast surgery remains sparse.

Methods:
This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English-language databases were searched through April 2024 to identify randomized controlled trials and cohort studies assessing the effects of topical TXA on postoperative outcomes in breast surgery, including hematoma, seroma, infection rates, and drain output/duration.

Results:
Six studies, encompassing 823 patients and 1477 breasts, were included. Subgroup meta-analysis demonstrated a statistically significant reduction in hematoma rates in patients who underwent mastectomy (risk ratio [RR] = 0.14; 95% confidence interval [CI], 0.03–0.78; P = 0.02), but not in patients who underwent breast reduction (RR = 0.76; 95% CI, 0.08–7.08; P = 0.24). No significant differences were found in overall hematoma rates (RR = 0.32; 95% CI, 0.08–1.195; P = 0.09), seroma formation (RR = 1.22; 95% CI, 0.99–1.51; P = 0.07), or infection rates (RR = 0.85; 95% CI, 0.46–1.56; P = 0.59).

Conclusions:
Topical TXA significantly reduced hematoma rates in patients who underwent mastectomy but showed no significant effect on other outcomes. Larger studies with standardized methodologies are required to fully establish the role of topical TXA in optimizing breast surgery outcomes.
Chimeric Osteocutaneous Free Flap Solution to Variation in Vascular Anatomy
Authors: Deering Augustine J. , Harrah Payden A. , Won Brian Wong , Austin John Michael , Khan Mustafa T. , Ferrell Jay K. , Fries C. Anton 
Published: January 2025

Summary:
When squamous cell carcinoma necessitates mandibular resection, the resultant defect can be complex. An osteocutaneous fibula free flap is an effective reconstruction option, typically supplied by the peroneal artery for both the fibula and skin flap. In this case report, an anatomical variation was found: the skin paddle was supplied by soleus musculocutaneous perforators of the posterior tibial artery, whereas the fibula was supplied by the peroneal artery. The posterior tibial artery perforator vessels from the skin paddle were anastomosed to the distal end of the peroneal vessels. The peroneal vessels were anastomosed to the left superior thyroid artery and a branch of the internal jugular vein, with confirmation of adequate blood flow via implantable Doppler signal. Septocutaneous perforators from the peroneal artery are absent in 5%–10% of the population; thus, an approach to anomalous vasculature in the setting of fibula free flap harvest that decreases morbidity and multiple operations is valuable.
Risks of Autologous Abdominal Free Flap Breast Reconstruction in Patients With Elevated Body Mass Index
Authors: Teitler Nathaniel A. , Doherty Courtney J. , Adams Madalyn R. , Podber Anna A. , Granger Peter M. , Samson Kaeli K. , Figy Sean C. , Wong Shannon L. , Hon Heidi H. 
Published: January 2025

Background:
Obesity is widely recognized as a significant risk factor for postoperative complications of breast reconstruction. Despite extensive research, there remains a lack of consensus regarding the specific complications and outcomes experienced by patients with obesity who undergo deep inferior epigastric perforator (DIEP) flap reconstruction. To provide a clearer understanding of the challenges faced by patients with obesity, we present a single-center outcome analysis of individuals who underwent DIEP flap reconstruction.

Methods:
A cohort of 194 patients who underwent at least 1 DIEP flap was retrospectively analyzed at the University of Nebraska Medical Center utilizing electronic medical records. Patients who underwent DIEP flap breast reconstruction were organized into 5 categories using World Health Organization weight status by body mass index (BMI) obtained from the day of surgery. Surgical complications within 120 days and postsurgical complication-related procedural interventions were also evaluated and compared. Comparisons of variables of interest between weight groups were assessed using Mantel–Haenszel chi-square tests or Spearman correlations.

Results:
Increases in patient weight category were associated with increased length of operation (P = 0.003), increased rates of breast fat necrosis (P = 0.04), breast wound dehiscence (P = 0.01), abdominal wound dehiscence (P = 0.02), numbers of abdominal complications (P = 0.001), and rates of requiring an intervention (P = 0.03).

Conclusions:
The findings imply that higher BMI values may lead to a higher likelihood of postoperative complications and the need for intervention. It is crucial for patients with obesity to be aware of the elevated risk associated with rising BMI values.
“Nip and Tuck”: Training the Next Generation of Aesthetic Plastic Surgeons
Authors: Cheung Lok Ka , Skepastianos Vasilios , Kostopoulos Epameinodas , Skepastianos Georgios 
Published: January 2025

Summary:
The demand for aesthetic surgery continues to increase, and it is therefore essential to ensure that the next generation of plastic surgeons are adequately trained. We propose a safe method in aesthetic training in abdominoplasty and facelift, utilizing free deep inferior epigastric perforator (DIEP) flap and parotidectomy for training aesthetic procedures. The trainees’ focus differed between the 2 procedures. In the DIEP cases, the trainees’ focus was the preoperative marking of the abdomen; elevation of the abdominoplasty flap; rectus plication; and quilting of the abdominoplasty flap to the rectus sheath and umbiloplasty. In the parotidectomy cases, the focus was skin flap elevation using the classic face lift incision; superficial musculoaponeurotic system flap elevation; superficial musculoaponeurotic system; and skin redraping. A questionnaire was given to all involved trainees for evaluation after the training exercises in aesthetic surgery, this included how they felt about performing aesthetic procedures afterwards, their level of knowledge, and their confidence in performing abdominoplasty and rhytidectomy. The results of the trainee questionnaires were positive; competence and level of confidence were high. There were minor complications including wound healing problems but no revisions. This training procedure can be safely applied during plastic surgery training under safe conditions.
Dimples as Desired Outcomes: Rethinking Their Role in Thread Lifting Procedures
Authors: Yi Kyu-Ho , Chua Deborah 
Published: January 2025

Summary:
Facial thread lifts, known for being minimally invasive with quick results, can sometimes lead to dimpling. A case report of a 35-year-old Asian man who developed a pleasing unilateral dimple after a thread lift highlights the potential for intentional dimple creation through this method. With surgical dimple creation in demand, as dimples symbolize good luck in Chinese culture and beauty in Arabic traditions, thread lifts may offer a less invasive alternative for those seeking dimples without surgery. The patient in the case report was satisfied and chose not to reduce the dimple, though further studies are needed to ensure safety and improve patient satisfaction.
Adverse effect of Henle fiber layer hemorrhage due to retinal arterial macroaneurysm rupture on retinal sensitivity
Authors: Akatsuka Riku , Kimura Shuhei , Doi Shinichiro , Hosokawa Mio Morizane , Shiode Yusuke , Matoba Ryo , Morita Tetsuro , Morizane Yuki 
Published: January 2025

Purpose:
To investigate the effect of Henle fiber layer hemorrhage (HFLh) on retinal sensitivity (RS) before and after displacement of the submacular hemorrhage (SMH) caused by retinal arterial macroaneurysm (RAM) rupture.

Methods:
This retrospective study included 31 eyes undergoing vitrectomy for SMH. Eyes were grouped based on the presence or absence of HFLh (HFLh [+/-] group). RS was assessed in the fovea and in the area of the HFLh present preoperatively.

Results:
The HFLh (+) and HFLh (-) groups had 21 and 10 eyes, respectively. Both groups showed improved postoperative foveal RS (both P < 0.05), which was significantly higher in the HFLh (-) group (P = 0.02). In the HFLh (+) group, RS was significantly lower in the affected eye when compared to the fellow eye (P < 0.01), whereas in the HFLh (-) group, no significant difference was noted between both eyes (P = 0.58). Despite the significant improvement in the postoperative RS in areas with preoperative HFLh (P < 0.001), it remained lower than the RS of the fellow eye (P < 0.05).

Conclusion:
SMH displacement improved RS regardless of HFLh presence, although the degree of improvement was limited in the presence of HFLh.
What is the phenotype of heterozygous lipoprotein lipase deficiency?
Authors: Hegele Robert A. 
Published: January 2025

Purpose of review
Genetic testing of patients with severe hypertriglyceridemia often identifies a single heterozygous pathogenic variant in the LPL gene. The complex and variable phenotype associated with this genotype is the topic of this review.

Recent findings
Previous research showed that heterozygosity for lipoprotein lipase deficiency is associated with reduced but variable post heparin lipolytic activity alongside inconsistent plasma lipid phenotypes ranging from normal to mild-to-moderate to severe hypertriglyceridemia. Recent research confirms and extends these observations, showing that a heterozygous individual can express a highly variable phenotype over time, depending on the presence of secondary factors. About 10% (range 8–20%) of patients with severe hypertriglyceridemia or multifactorial chylomicronemia syndrome are heterozygous for a rare pathogenic LPL variant, and a clinically relevant minority of these has recalcitrant or sustained hypertriglyceridemia.

Summary
Heterozygosity for lipoprotein lipase deficiency predisposes to hypertriglyceridemia, which is sometimes severe depending on secondary factors, but is typically quite responsive to routine interventions such as diet, lifestyle and existing lipid-lowering therapies. However, many heterozygotes for pathogenic variants in LPL have completely normal plasma lipids.
Evaluation of the Reliability of ChatGPT to Provide Guidance on Recombinant Zoster Vaccination for Patients With Rheumatic and Musculoskeletal Diseases
Authors: Sood Akhil , Moyer Amanda , Jahangiri Pegah , Mar Diane , Nitichaikulvatana Prachaya , Ramreddy Nitya , Stolyar Liya , Lin Janice 
Published: January 2025

Introduction
Large language models (LLMs) such as ChatGPT can potentially transform the delivery of health information. This study aims to evaluate the accuracy and completeness of ChatGPT in responding to questions on recombinant zoster vaccination (RZV) in patients with rheumatic and musculoskeletal diseases.

Methods
A cross-sectional study was conducted using 20 prompts based on information from the Centers for Disease Control and Prevention (CDC), the Advisory Committee on Immunization Practices (ACIP), and the American College of Rheumatology (ACR). These prompts were inputted into ChatGPT 3.5. Five rheumatologists independently scored the ChatGPT responses for accuracy (Likert 1 to 5) and completeness (Likert 1 to 3) compared with validated information sources (CDC, ACIP, and ACR).

Results
The overall mean accuracy of ChatGPT responses on a 5-point scale was 4.04, with 80% of responses scoring ≥4. The mean completeness score of ChatGPT response on a 3-point scale was 2.3, with 95% of responses scoring ≥2. Among the 5 raters, ChatGPT unanimously scored with high accuracy and completeness to various patient and physician questions surrounding RZV. There was one instance where it scored with low accuracy and completeness. Although not significantly different, ChatGPT demonstrated the highest accuracy and completeness in answering questions related to ACIP guidelines compared with other information sources.

Conclusions
ChatGPT exhibits promising ability to address specific queries regarding RZV for rheumatic and musculoskeletal disease patients. However, it is essential to approach ChatGPT with caution due to risk of misinformation. This study emphasizes the importance of rigorously validating LLMs as a health information source.
Women at the receiving end: Exploring Couples’ experiences of infertility challenges in Nigeria
Authors: Esan Deborah Tolulope , Nnamani Kelechukwu Queendaline , Olajide Adetunmise Oluseyi , Akingbade Oluwadamilare , Oluwade David Bamidele , Olawade David Bamidele , Ramos Carlos Guillermo 
Published: January 2025

AbstractBackgroundInfertility remains a significant global health issue with profound emotional and social consequences, particularly in patriarchal societies. This study explores the lived experiences of infertile couples in Nigeria, focusing on societal perceptions, gendered blame, and the role of spirituality.MethodsA qualitative exploratory design was adopted, with data collected from purposively sampled infertile couples attending the Federal Teaching Hospital, Ido-Ekiti, Nigeria. Semi-structured interviews were conducted, and thematic analysis was used to identify recurring patterns and themes.ResultsThematic analysis identified two main themes and seven sub-themes. The first theme, Couples’Perception of Infertility, included five sub-themes: definition of infertility, perceived causes, perceived types, infertility as a feminine issue, and the role of spirituality. The second theme, Challenges of Couples Experiencing Infertility, comprised two sub-themes: women at the receiving end and poor societal support.ConclusionThe findings shows the interplay of medical, cultural, and spiritual dimensions in shaping infertility perceptions. The study highlights the disproportionate burden on women and inadequate societal support, calling for public health interventions to address stigma and promote gender-inclusive reproductive health education.
The impact of Indigenous American-like ancestry on risk of acute lymphoblastic leukemia in Hispanic/Latino children
Authors: Langie Jalen , Chan Tsz Fung , Yang Wenjian , Kang Alice Y. , Morimoto Libby , Stram Daniel O. , Mancuso Nicholas , Ma Xiaomei , Metayer Catherine , Lupo Philip J. , Rabin Karen R. , Scheurer Michael E. , Wiemels Joseph L. , Yang Jun J. , de Smith Adam J. , Chiang Charleston W.K. 
Published: January 2025

AbstractAcute lymphoblastic leukemia (ALL) is the most common childhood cancer, with Hispanic/Latino children having a higher incidence of ALL than other racial/ethnic groups. Genetic variants, particularly ones found enriched in Indigenous American (IA)-like ancestry and inherited by Hispanics/Latinos, may contribute to this disparity. In this study, we characterized the impact of IA-like ancestry on overall ALL risk and the frequency and effect size of known risk alleles in a large cohort of self-reported Hispanic/Latino individuals. We also performed genome-wide admixture mapping analysis to identify potentially novel ALL risk loci. We found that global IA ancestry was positively associated with ALL risk, but the association was not significant after adjusting for socio-economic indicators. In a series of local ancestry analyses, we uncovered that at known ALL risk loci, increasing copies of the IA-like haplotype were positively and significantly associated with ALL case-control status. Further, the IA-like haplotype had ∼1.33 times the odds of harboring the risk allele compared to non-IA-like haplotypes. We found no evidence of interaction between genotype and ancestry (local or global) in relation to ALL risk. Admixture mapping identified association signals on chromosomes 2 (2q21.2), 7 (7p12.2), 10 (10q21.2), and 15 (15q22.31); however, only the variants at 7p12.2 and 10q21.2 replicated in additional cohorts. Taken together, our results suggest that increased risk of ALL in Hispanic/Latino children may be conferred by higher frequency of risk alleles within IA-like ancestry, which can be leveraged as targets of new precision health strategies and therapeutics.
Unveiling the influence of salt concentration on the different stages of the catalytic cycle of a halophilic enzyme
Authors: Vallejos-Baccelliere Gabriel , Kaufman Sergio B. 
Published: January 2025

AbstractEnzymes from halophilic organisms have adapted to function in salt concentrations near saturation, making them an interesting model for studying the effect of salt on enzyme catalysis. The main insights into the effect of ionic strength on enzyme catalysis come primarily from enzymes with positively charged surfaces interacting with negatively charged substrates (e.g., ribonucleases), whose activity decreases at high salt concentrations. In this study, we investigated the effect of salt on the kinetics of Glucose-6-phosphate dehydrogenase (G6PDH) from the halophilic archaeonHaloferax volcanii(HvG6PDH), which has optimal activity conditions at concentrations exceeding 2 M KCl. The enzyme catalyzes the NAD+-dependent oxidation of G6P, a negatively charged substrate, and glucose, a non-charged substrate. Using steady-state kinetics, we determined that the enzyme follows an ordered-sequential kinetic mechanism, with NAD+ being the first substrate to bind and NADH being the last released product. Through steady-state kinetic experiments, we found that the main effect of salt is on the KMfor G6P, which decreased approximately 50-fold. For glucose dehydrogenase (glcDH) activity, the main effects were a 10-fold increase in kcatand a roughly 10-fold increase in kcat/KMfor glucose. To analyze the effect of salt on the different stages of the catalytic cycle, we performed pre-steady-state experiments for both activities. We found that KCl did not affect the catalytic step in G6PDH activity, but it did increase the rate of catalysis in glcDH. Using a minimal model that accounts for substrate binding, chemical transformation, and product release, we determined that the main effect on G6PDH activity was an increase in the rate of G6P association. In contrast, for glcDH activity, the main effect was an increase in the rates of catalysis and product release. The results show that charge screening plays an essential role in the effect of salt on catalysis. Furthermore, it suggests differences in ion penetration to the active site between the two activities.
Predicting ADC Map Quality from T2-Weighted MRI: A Deep Learning Approach for Early Quality Assessment to Assist Point-of-Care
Authors: Brender Jeffrey R. , Ota Mitsuki , Nguyen Nathan , Ford Joshua W. , Kishimoto Shun , Harmon Stephanie A. , Wood Bradford J. , Pinto Peter A. , Krishna Murali Cherukuri , Choyke Peter L. , Turkbey Baris 
Published: January 2025

AbstractPurposePoor quality prostate MRI images, especially ADC maps, can lead to missed lesions and unnecessary repeat scans. To address this issue, we aimed to develop an automated method to predict ADC map quality from T2 images acquired earlier in the scanning process.Materials and MethodsA paired multi-site image corpus of T2-weighted images and ADC maps was constructed from 486 patients imaged in-house and at 62 external clinics. A senior radiologist assigned 1-3 quality ratings to each image set, later converted to a binary “non-diagnostic” or “diagnostic” scale. A deep learning model and a rectal cross-sectional area measurement approach were developed to predict ADC image quality from T2 images. Model performance was evaluated retrospectively by accuracy, sensitivity, negative and positive predictive value, and AUC.ResultsNo single acquisition parameter in the metadata was statistically associated with image quality for either T2 or ADC maps. Quality scores of the same modality showed low correlation across sites (r∼0.2). In the challenging task of predicting ADC quality from prior T2 images, our model achieved performance comparable to current single-site models directly using ADC maps, with 83% sensitivity and 90% negative predictive value. The model showed stronger performance on in-house data (94±2% accuracy) despite being trained exclusively on multicenter external data. Rectal cross-sectional area on T2 images provided an interpretable quality metric (AUC 0.65).ConclusionThe probability of low quality, uninterpretable ADC maps can be inferred early in the imaging process by neural network approach, allowing corrective action to be employed.