University of Missouri Hospital

ABSTRACT Understanding how the new normal reshapes travelers' behavior is crucial for responding effectively to changing market demand in the aftermath of large‐scale crises. To address this issue, this study develops a framework that captures the dynamic nature of traveler perceptions and adaptive behaviors under a prolonged public health crisis, with particular attention to how these behaviors vary across different crisis phases. Using network analysis to examine co‐occurrence patterns in social media discourse, the study analyzes 84,972 travel‐related tweets. The findings reveal distinct shifts in traveler behavior across crisis waves, with the third wave showing the most pronounced adaptations, characterized by heightened attention to safety considerations, health‐related precautions, and low‐contact travel practices. These results enhance understanding of how travelers recalibrate their behaviors as crisis severity intensifies and provide valuable insights for developing both short‐term response strategies and long‐term recovery planning in tourism under health‐related and biological crisis conditions.

Personality disorders (PDs) and substance use disorders (SUDs) co-occur at high rates. Transdiagnostic mechanisms such as affective processes could improve our understanding of etiology, maintenance, and treatment of co-occurring disorders. We review the role that affective factors play in the overlap between PDs and SUDs and focus on current directions in assessment and evaluation of affective processes. Recent affect-related work informing PD and SUD co-occurrence has focused on conceptualizing PDs dimensionally, testing affective processes as transdiagnostic constructs, issues in affect measurement, using ecological momentary assessment to identify proximal risk pathways, and debate on the role of affect in SUD. Affective changes can be reliably measured in daily life, and evidence supports using dimensional models of PDs compared to categorical diagnoses. Future work should build on these strengths and focus on careful translations of SUD theories to research.

Maxillary transverse discrepancies are routinely addressed by palatal expansion. Nasal septum deviation is suspected to be related to these discrepancies. Current evidence using linear and angular measurements from two-dimensional radiographs on the effect of rapid palatal expansion on the nasal septum is not conclusive. The objective of this study was to apply three-dimensional geometric morphometric analyses to cone-beam computed tomography scans of the nasal septum to investigate changes in response to palatal expansion. Cone-beam computed tomography scans of the nasal septa of 71 subjects (53, expansion and 18, control) from 2 timepoints were segmented on using Mimics™ software. Anatomical landmarks and semilandmarks were digitized using Checkpoint™. Differences in septal deviation between the two timepoints were tested. Generalized Procrustes analysis and principal component analysis assessed overall shape differences and pattern variance in the septum. Least square regression was used to test for correlations. Heat maps visualized which areas exhibited the greatest amount of change. In the control group, none of the septum deviation variables changed significantly between the timepoints, while all were significantly different for the expansion group. Heatmaps showed greater increase in interlandmark distances for the expansion group compared with the controls, with the posterosuperior part of the septum bearing the greatest change and the central, inferior part showing the least change. Findings suggest that the septum does not straighten during expansion but continues to deviate with age.

Purpose: This study reports a case of femtosecond-cut allogenic corneal tissue addition keratoplasty (CTAK) for the management of advanced post-LASIK ectasia in a scleral contact lens–intolerant patient. Methods: A case report of a 45-year-old woman with post-LASIK ectasia and prior corneal cross-linking underwent CTAK using a custom-designed femtosecond-cut allogenic corneal inlay. Results: At 1 month postoperatively, spectacle-corrected visual acuity improved from LogMAR 1.3 to 0.2, with significant corneal flattening (Kmean reduction of 9.7D). Conclusions: CTAK offers a promising surgical option for scleral contact lens–intolerant post-LASIK ectasia patients, potentially delaying or avoiding the need for corneal transplantation while providing significant visual and topographic improvement.

Risk stratification in liver disease includes liver elastography (LE) and portal pressure gradient (PPG) measurement. We examined the efficacy and safety of endoscopic ultrasound (EUS)-liver biopsy (EUS-LB) and the correlation between EUS-PPG and EUS-LE in patients with liver disease. This is a prospective and retrospective, single-center study. Data from patients who underwent concomitant EUS-LE, EUS-PPG, and EUS-LB were analyzed. Histologically, significant fibrosis (SF) was considered F2-F4, non-significant fibrosis (NSF) as F0-F1, advanced fibrosis (AF) as F3-F4, and non-advanced fibrosis (NAF) as F0-F2. In total, 25 patients underwent EUS-PPG measurement; 60% were male (mean age, 60 years). EUS-LE and EUS-LB were performed in 88% and 96% of patients, respectively (the technical success rate was 100%). The mean number of portal tracts was 14.3. Histological diagnosis was achieved in all patients; 67% had SF. The mean EUS-LE was 24.1 kPa, and the mean PPG was 4.6 mmHg. Portal hypertension (PH; PPG >5 mmHg) and clinically significant PH (PPG >10 mmHg) were found in 44% and 12%, respectively. Patients with SF had a higher mean PPG (5.9 vs 2.8 mmHg; p = 0.003) and mean shear wave measurement (SWM; 30.0 vs 15.6 kPa; p = 0.02) compared to the NSF group. Patients with AF had a higher mean PPG (6.0 vs 3.4 mmHg; p = 0.01) and mean SWM (32.0 vs 18.8 kPa; p = 0.04) compared to the NAF group. There were no significant adverse events. Concomitant EUS-LB and PPG is safe. EUS-PPG and EUS-LE correlate with the degree of fibrosis on histology. Larger studies are needed to optimize their values in clinical practice.