bluuebunny/crossref_metadata_2025 huggingface dataset:
Codified and reflexive policy coordination: how successful are Dhaka City’s policies for a successful sustainable passenger transport transition?
Authors: Khatoon Tohmina , Kivimaa Paula , Brisbois Marie Claire , Saadi Shah Abdul
Published: August 2024

Critical to achieving the global net zero objective, transport transitions require multi-domain policies to coordinate and cohere. Different policy domains involve actors with diverse priorities and perspectives, complicating coordination. Policy coordination is particularly challenging for the Global South governments given their dependence for external financial and technological resources, and weaker institutions. Drawing on transport transition and policy coordination literature, this research studied the low-emission transport policies of Dhaka City, Bangladesh from 2000 to 2021. The study found that policy frameworks and institutional arrangements were established to enable local and global actors (development partners) to coordinate to support transport transitions. The development partners were engaged in mobilizing resources, transferring low-emission transport technologies and local capacity development. However, these policies were focused on politically prioritized supply-side solutions (e.g. metro-rail), without sufficient coherence with land use and housing policies. Also, they did not adequately consider local need-based low-emission transport alternatives such as walking and cycling; unintended policy effects and boundary-spanning challenges. Based on the findings, we propose codified and reflexive policy coordination concepts to describe discrete but mutually reinforcing mechanisms to support effective policy coordination. Codified coordination is enacted by formal policy frameworks and institutional arrangements and reflexive coordination is by formal evaluation of policy interventions. This framework proposes a new approach to examine coordination between multi-domain policies that are required to cohere to advance transport transitions. In practice, it can potentially guide the adoption of coordinated policies to drive transport transitions.
Conflicts of Interest in Municipal Bond Advising and Underwriting
Authors: Garrett Daniel G
Published: August 2024

When can financial advisor conflicts of interest generate worse outcomes for clients? A regulation following from Dodd-Frank prohibits municipal advisors from simultaneously acting as bond underwriters. Using a difference-in-differences approach and 20,051 bond auctions, I test whether limited advisor privileges affect financial advice and borrower outcomes. Financing costs of bonds with potential dual advisor-underwriters fall by 11.4 basis points after the advisor is no longer allowed to underwrite. The decline follows from increases in standardization, third-party certification, and auction participation, all of which are consistent with limiting the adverse selection that arises from advisors withholding information from the market. (JEL D44, D53, G12, G14, G28, H74)
Subclinical psoriatic arthritis and disease interception—where are we in 2024?
Authors: López-Medina Clementina , McGonagle Dennis , Gossec Laure
Published: August 2024

Psoriatic arthritis (PsA) is a chronic rheumatic disease that usually appears in patients with skin psoriasis, making it a model for detection of joint disease in the pre-clinical phases in a setting where therapy for cutaneous disease may ameliorate or prevent arthritis development. Such PsA prevention appears credible due to the increasingly recognized closely shared immunopathology between the skin and joints, especially the entheses. Recently, several initiatives have explored the concept of pre-clinical PsA, and nomenclatures have been developed with the recent EULAR nomenclature proposing a simplified three stages from psoriasis to clinical PsA development, namely at risk of PsA, subclinical PsA and early PsA. A better comprehension of early PsA and the identification of individuals predisposed to its development could enable interventions to ‘prevent’ the appearance of PsA. Several recent retrospective observational studies have demonstrated disease interception feasibility, i.e. treatment of people with psoriasis may prevent the appearance of PsA, in particular using biologic disease-modifying drugs. However, further data are urgently required due to unexpected findings in some studies where TNF inhibition for psoriasis does not reduce the rate of PsA development. In this review we address the current challenges in early PsA, including comparisons of pre-PsA nomenclature sets, its risk factors and the potential for disease interception.
Altered Use of Context During Visual Perception in Psychotic Psychopathology: A Neurophysiological Investigation of Tuned and Untuned Suppression During Contrast Perception
Authors: Klein Samuel D , Teich Collin D , Pokorny Victor J , Rawls Eric , Olman Cheryl A , Sponheim Scott R
Published: August 2024

Background and Hypothesis

The human visual system streamlines visual processing by suppressing responses to textures that are similar to their surrounding context. Surround suppression is weaker in individuals with schizophrenia (ISZ); this altered use of visuospatial context may relate to the characteristic visual distortions they experience.

Study Design

To understand atypical surround suppression in psychotic psychopathology, we investigated neurophysiological responses in ISZ, healthy controls (HC), individuals with bipolar disorder (IBP), and first-degree relatives (ISZR/IBPR). Participants performed a contrast judgment task on a circular target with annular surrounds, with concurrent electroencephalography. Orientation-independent (untuned) suppression was estimated from responses to central targets with orthogonal surrounds; the orientation-dependence of suppression was estimated by fitting an exponential function to the increase in suppression as surrounds became more aligned with the center.

Results

ISZ exhibited weakened untuned suppression coupled with enhanced orientation-dependence of suppression. The N1 visual evoked potential was associated with the orientation-dependence of suppression, with ISZ and ISZR (but not IBP or IBPR) showing enhanced orientation-dependence of the N1. Collapsed across orientation conditions, the N1 for ISZ lacked asymmetry toward the right hemisphere; this reduction in N1 asymmetry was associated with reduced untuned suppression, real-world perceptual anomalies, and psychotic psychopathology. The overall amplitude of the N1 was reduced in ISZ and IBP.

Conclusions

Key measures of symptomatology for ISZ are associated with reductions in untuned suppression. Increased sensitivity for ISZ to the relative orientation of suppressive surrounds is reflected in the N1 VEP, which is commonly associated with higher-level visual functions such as allocation of spatial attention or scene segmentation.
Reconsidering the relationship between undisclosed agency and assignment
Authors: Broadway Luke
Published: August 2024

In Siu Yin Kwan v Eastern Insurance, Lord Lloyd addressed the question of whether assignment can appropriately be analogised with undisclosed agency. His Lordship considered it could not. Although scholars have impliedly (and correctly) identified that this is true as regards statutory assignment, there are compelling parallels between undisclosed agency and equitable assignment that merit further attention. This article inquires into the accuracy of Lord Lloyd’s dictum in relation to equitable assignment, seeking to identify a possible model to conceptualise the flow of rights arising between an undisclosed principal and a third party in undisclosed agency relationships.
From Edinburgh to Rome via The Hague: The International Appeal of the Trusts and Succession (Scotland) Act 2024
Authors: Panico Paolo
Published: August 2024

The Scottish legal system is independent of the English one. Two relevant differences are that the system of property rights in Scotland is based on Roman law, and equity is not a separate source of Scots law. Nonetheless, trusts have been known in Scotland since at least the 16th century. The Trusts and Succession (Scotland) Act 2024, which received Royal Assent last January, is an up-to-date piece of legislation that brings Scotland to the forefront of modern trust legislation. Many solutions that have been devised in leading offshore trust jurisdictions (non-charitable purpose trusts, protectors, etc.) are now fully regulated under Scots law.
The Effect of Lead Exposure on Children’s Learning in the Developing World: A Meta-Analysis
Authors: Crawfurd Lee , Todd Rory , Hares Susannah , Sandefur Justin , Bonnifield Rachel Silverman
Published: August 2024

Around half of children in low-income countries have elevated blood-lead levels. What role does lead play in explaining low educational outcomes in these settings? We conduct a new systematic review and meta-analysis of observational studies on the relationship between lead exposure and learning outcomes. Adjusting for observable confounds and publication bias yields a benchmark estimate of a $-0.12$ standard-deviation reduction in learning per natural log unit of blood lead. As all estimates are non-experimental, we present evidence on the likely magnitude of unobserved confounding, and summarize results from a smaller set of natural experiments. Our benchmark estimate accounts for over a fifth of the gap in learning outcomes between rich and poor countries, and implies moderate learning gains from targeted interventions for highly exposed groups ($\approx$ 0.1 standard deviations) and modest learning gains ($\lt 0.05$ standard deviations) from broader public health campaigns.
Phyllosphere Bacterial Communities in Wheat and Faba Bean Intercropping: Structural and Functional Mechanisms in Response to Stripe Rust Infection
Authors: Mao Lili , Mhaske Pranita , Xiao Jingxiu , Tang Li , Qian Ling , Zheng Yi
Published: August 2024

Crop microbiome-phyllosphere interactions are vital for intercropping disease control. Although evidence suggests that intercropping enhances nutrient efficiency and recruits beneficial bacteria at the root-soil interface, limited research has explored changes in the phyllosphere microbiome in response to foliar diseases. Pot experiments were conducted to investigate how wheat stripe rust, caused by Puccinia striiformis f. sp. tritici ( Pst), affects shoot biomass, total nitrogen, and total potassium content; changes of phyllosphere bacteria; co-occurrence networks; and ecological functions in wheat and faba bean intercropping using 16S amplicon sequencing. Microbial characterization revealed that Pst infection altered the phyllosphere bacteria of wheat and faba bean, reducing evenness and richness, shifting community structure with the emergence of new bacteria, and weakening microbial networks under both planting patterns. Compared with monocropping, intercropping displayed bacterial features of an integrated system, fortified wheat community diversity with new bacteria such as Pseudomonas aeruginosa in wheat and Pantoea and Burkholderia in faba bean, and strengthened the bacterial network of wheat in response to Pst infection. Intercropping enhanced nitrogen and carbon cycling in wheat leaves by improving nitrite respiration and aromatic hydrocarbon degradation. The enriched phyllosphere bacterial structure positively correlated with the crop's performance by balancing shoot biomass, nitrogen, and potassium accumulation between wheat and faba bean upon Pst infection to mitigate the disease index of wheat. Overall, these changes may positively correlate with functions aiding wheat in suppressing wheat stripe rust. The findings provide new insight into understanding how intercropping improves response to pathogen challenge as an effective planting practice.

[Formula: see text] Copyright © 2025 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Cucurbit Leaf Crumple Virus Is Seed Transmitted in Yellow Squash (Cucurbita pepo)
Authors: Dhadly Dalvir Kaur , Kavalappara Saritha Raman , McAvoy Theodore , Severns Paul M. , Simmons Alvin M. , Srinivasan Rajagopalbabu , Bag Sudeep
Published: August 2024

The traditional understanding of begomovirus transmission exclusively through the whitefly Bemisia tabaci (Gennadius) has shifted with findings of seed transmission in some begomoviruses over the last decade. We investigated the seed transmissibility of cucurbit leaf crumple virus (CuLCrV), a bipartite begomovirus that has recently emerged as a severe constraint for yellow squash (Cucurbita pepo L.) production in the southeastern United States. We found a high concentration of CuLCrV in the male and female flower tissues of infected squash, including the pollen and ovules. The virus infiltrated the fruit tissues, including the endocarp and funiculus, which are anatomically positioned adjacent to the seeds. In seeds, CuLCrV was detected in the endosperm and embryo, where there are no vascular connections, in addition to the seed coat. The virus was detected in the radicle, plumule, cotyledonary leaves, and true leaves of seedlings grown from seeds collected from infected fruits. In the grow-out test conducted, CuLCrV infections ranged from 17 to 56% of the progeny plants. To ensure that partial viral genome fragments were not being mistaken for replicative forms of the virus, we performed rolling circle amplification PCR and amplified complete DNA-A and DNA-B of CuLCrV from seed tissues, seedlings, and progeny plants of CuLCrV-infected squash. Near-complete DNA-A and DNA-B sequences of CuLCrV were recovered from a progeny plant, further validating our findings. Our results demonstrate that CuLCrV can translocate from vegetative to reproductive tissues of yellow squash, persist within the seeds, and subsequently induce infection in progeny plants, confirming its capacity for seed transmission.
Monteggia Fracture Dislocation
Authors: Soderlund Torre , Zipperstein Jacob , Athwal Gurbir S. , Hoekzema Nathan
Published: August 2024

Monteggia fracture is a complex fracture consisting of a proximal ulna fracture with a dislocation of the radial head. This review article highlights the relevant anatomy, clinical evaluation, classification, surgical management, recent innovation, and advancements with treating these injuries. A thorough understanding of these fractures allows for detailed operative plans and reconstitution of normal anatomy.
How the Forearm Works
Authors: Rubio Francisco , Heifner John J. , Lacau Gustavo E.
Published: August 2024

Hand rotation and the ability to apply force and overcome external load are due to the coordinated activity of forearm bones, the interosseous ligament, and involved muscles. The following review is a detailed description of the anatomy and mechanics which illustrates how the forearm works.
Linguistic difference in the effect of organized programs on socioeconomic inequalities in breast cancer screening: ecological study in Switzerland
Authors: Buclin Clement P. , von Arx Martina , Jolidon Vladimir , Sandoval José Luis , Buholzer-Mercier Fabienne , Daverio Justine E. , van der Linden Bernadette W.A. , Wanner Philippe , Guessous Idris , Courvoisier Delphine S. , Cullati Stéphane
Published: August 2024

Objective

The objective of this study is to examine how the effect of organized mammography screening programs on breast cancer screening participation differ between socioeconomic strata and how this relationship may be modified by the context of linguistic differences. Switzerland, marked by its diverse linguistic landscape, reflects cultural variations alongside differences in public health strategies. The goal of this study was to assess potential socioeconomic differences in regional mammography screening programs effectiveness to improve breast cancer screening participation.

Methods

Data on 14 173 women in the regionally adapted breast cancer screening age range was drawn from five cross-sectional waves of the nationally representative Swiss Health Interview Survey (1997–2017). Socioeconomic indicators included education, household income, and employment status. Poisson regression was used to estimate the adjusted prevalence ratios of up-to-date (last 2 years) mammography uptake. Inequality was assessed using relative index of inequality and the slope index of inequality.

Results

Organized screening programs were generally effective and increased up-to-date mammography uptake by close to 20 percentage points in both regions. While in the Latin cantons, screening programs had no impact on socioeconomic inequalities in screening, it reduced inequalities for women with lower education in the German cantons. This modification effect of screening programs was not seen for income and employment-related inequalities and did not differ across linguistic regions.

Conclusions

Public health agencies should consider the different cultural reception of programs as addressing these differences could help ensure that breast cancer screening initiatives are not only effective, but also culturally equitable across different socioeconomic groups.
Cardiac Lymphatics and Therapeutic Prospects in Cardiovascular Disease: New Perspectives and Hopes
Authors: Song Guoyuan , Liu Da , Ma Jianwei , Zhan Yinge , Ma Fangfang , Liu Gang
Published: August 2024

The lymphatic system is the same reticular fluid system as the circulatory system found throughout the body in vascularized tissues. Lymphatic vessels are low-pressure, blind-ended tubular structures that play a crucial role in maintaining tissue fluid homeostasis, immune cell transport, and lipid absorption. The heart also has an extensive lymphatic network, and as research on cardiac lymphatics has progressed in recent years, more and more studies have found that cardiac lymphangiogenesis may ameliorate certain cardiovascular diseases, and therefore stimulation of cardiac lymphangiogenesis may be an important tool in the future treatment of cardiovascular diseases. This article briefly reviews the development and function of cardiac lymphatic vessels, the interaction of cardiac lymphatic vessels with cardiovascular diseases (including atrial fibrillation, coronary atherosclerosis, and heart failure), and finally discusses the therapeutic potential of targeted cardiac lymphatic therapy for cardiovascular diseases.
Don’t Let Your Analysis Go to Seed: On the Impact of Random Seed on Machine Learning-based Causal Inference
Authors: Schader Lindsey , Song Weishan , Kempker Russell , Benkeser David
Published: August 2024

Machine learning techniques for causal effect estimation can enhance the reliability of epidemiologic analyses, reducing their dependence on correct model specifications. However, the stochastic nature of many machine learning algorithms implies that the results derived from such approaches may be influenced by the random seed that is set before model fitting. In this work, we highlight the substantial influence of random seeds on a popular approach for machine learning-based causal effect estimation, namely doubly robust estimators. We illustrate that varying seeds can yield divergent scientific interpretations of doubly robust estimates produced from the same dataset. We propose techniques for stabilizing results across random seeds and, through an extensive simulation study, demonstrate that these techniques effectively neutralize seed-related variability without compromising the statistical efficiency of the estimators. Based on these findings, we offer practical guidelines to minimize the influence of random seeds in real-world applications, and we encourage researchers to explore the variability due to random seeds when implementing any method that involves random steps.
Canagliflozin Mediates Mitophagy Through the AMPK/PINK1/Parkin Pathway to Alleviate ISO-induced Cardiac Remodeling
Authors: Gong Shaolin , Sui Yuan , Xiao Mengxuan , Fu Daoyao , Xiong Zhiping , Zhang Liuping , Tian Qingshan , Fu Yongnan , Xiong Wenjun
Published: August 2024

Heart failure has always been a prevalent, disabling, and potentially life-threatening disease. For the treatment of heart failure, controlling cardiac remodeling is very important. In recent years, clinical trials have shown that sodium–glucose cotransporter-2 (SGLT-2) inhibitors not only excel in lowering glucose levels but also demonstrate favorable cardiovascular protective effects. However, the precise mechanisms behind the cardiovascular benefits of SGLT-2 inhibitors remain elusive. In this research, we assessed the impact of canagliflozin (CANA, an SGLT-2 inhibitor) on cardiac remodeling progression in mice and preliminarily elucidated the possible mechanism of action of the SGLT-2 inhibitor. Our results indicate that the administration of canagliflozin significantly attenuates myocardial hypertrophy and fibrosis and enhances cardiac ejection function in mice with isoprenaline (ISO)-induced cardiac remodeling. Notably, excessive mitophagy, along with mitochondrial structural abnormalities observed in ISO-induced cardiac remodeling, was mitigated by canagliflozin treatment, thereby attenuating cardiac remodeling progression. Furthermore, the differential expression of AMPK/PINK1/Parkin pathway–related proteins in ISO-induced cardiac remodeling was effectively reversed by canagliflozin, suggesting the therapeutic potential of targeting this pathway with the drug. Thus, our study indicates that canagliflozin holds promise in mitigating cardiac injury, enhancing cardiac function, and potentially exerting cardioprotective effects by modulating mitochondrial function and mitophagy through the AMPK/PINK1/Parkin pathway.
Fat Grafting for Forehead Contouring in Facial Feminization
Authors: Sluiter Emily C. , Lane Megan , Morrison Shane D. , Kuzon William M. , Gilman Robert H.
Published: August 2024

For gender-diverse individuals assigned male at birth, postpubertal estrogen and testosterone-lowering therapies alone are often inadequate to reverse the testosterone-related facial characteristics projecting a male sex identity. Facial feminization surgery significantly improves quality-of-life outcomes for gender-diverse patients by relieving this gender incongruence of the face. Because the shape of the forehead is so radically different between men and women, feminization of this area is critical for many individuals. Several techniques are typically used in combination, including hairline advancement, browlift, burring of the supraorbital rims, frontal bone contouring, and anterior table setback. This report describes the use of fat grafting as an adjuvant technique to forehead contouring as means to avoid frontal bone osteotomy, which carries a higher complication profile and often requires hardware placement.
Myopia and Other Refractive Error and Their Relationships to Glaucoma Screening
Authors: Jonas Jost B. , Jonas Rahul A. , Jonas Shefali B. , Panda-Jonas Songhomitra
Published: August 2024

Précis:

A large disk, a large parapapillary delta zone and a long axial length may be used as screening criteria to detect glaucomatous optic neuropathy in highly myopic eyes.

Purpose:

To describe aspects for screening of glaucomatous optic neuropathy in dependence of refractive error, under special consideration of high myopia.

Methods/Results:

Studies on the anatomy of the myopic optic nerve head and results of investigations on the relationship between glaucomatous optic neuropathy and axial myopia were included.

Conclusions:

In the range from hyperopia to moderate myopia, refractive error is not a strong glaucoma risk factor and may not be included in glaucoma screening strategies. Care should be taken, that in moderate myopia, a shift of Bruch´s membrane opening usually into the temporal direction leads to parapapillary gamma zone and a corresponding shortening of the horizontal disk diameter. In these moderately myopic eyes, a secondarily small optic disk with a correspondingly small optic cup should not lead to an overlooking of intrapapillary glaucomatous changes. Prevalence of glaucomatous or glaucoma-like optic nerve atrophy (GOA) steeply increases with longer axial length in highly myopic eyes (cutoff approximately -8 diopters/axial length 26.5 mm), with prevalences higher than 50% in extremely high myopia. Besides longer axial length, morphological parameters associated with GOA in highly myopic eyes are a secondarily enlarged disk and large parapapillary delta zone. Both parameters, together with long axial length, may be used as screening criteria in high myopia for GOA. The latter is characterized by an abnormal neuroretinal rim shape, that is, vessel kinking close to the intrapapillary disk border. Factors associated with nonglaucomatous optic neuropathy are larger gamma zone and longer axial length, potentially due to an axial elongation-related retinal nerve fiber stretching.
Screening of Glaucoma: Consensus and Directions
Authors: Moghimi Sasan , Weinreb Robert N.
Published: August 2024

Purpose:

Glaucoma is a leading public health concern globally. This summary discusses barriers to glaucoma screening and novel strategies for a cost-effective glaucoma screening.

Methods/Results:

We discuss barriers to glaucoma screening and recent advancements in glaucoma detection and care, including targeted screening approach as well as telemedicine, genetic testing, and artificial intelligence (AI). A major barrier to glaucoma screening is the cost-effectiveness of case finding resulting from the low prevalence of the disease and the complexity of the diagnosis. Targeted–screening, as well as multi-level screening, can reduce the false positive rate and increase the cost-effectiveness of the program. Telemedicine, availability of genetic testing and polygenic risk scores, and AI provide the opportunity for novel glaucoma screening programs in primary care, portable, and home-based settings and will be helpful for lowering the costs, identifying patients in need of urgent treatment and enabling timely diagnosis and early intervention.

Conclusions:

Screening of glaucoma is challenging and changing. Recent advancements in digital technology and genetics have led to the development of tools that are promising for novel screening methodologies. Clinical trials are needed to demonstrate the long-term effect of targeted screening on the burden of glaucoma worldwide.
Global review of publicly available image datasets for the anterior segment of the eye
Authors: Niestrata Magdalena , Radia Meera , Jackson James , Allan Bruce
Published: August 2024

This study comprehensively reviewed publicly available image datasets for the anterior segment, with a focus on cataract, refractive, and corneal surgeries. The goal was to assess characteristics of existing datasets and identify areas for improvement. PubMED and Google searches were performed using the search terms “refractive surgery,” “anterior segment,” “cornea,” “corneal,” “cataract” AND “database,” with the related word of “imaging.” Results of each of these searches were collated, identifying 26 publicly available anterior segment image datasets. Imaging modalities included optical coherence tomography, photography, and confocal microscopy. Most datasets were small, 80% originated in the U.S., China, or Europe. Over 50% of images were from normal eyes. Disease states represented included keratoconus, corneal ulcers, and Fuchs dystrophy. Most of the datasets were incompletely described. To promote accessibility going forward to 2030, the ESCRS Digital Health Special Interest Group will annually update a list of available image datasets for anterior segment at www.escrs.org.
Exploring Perspectives on Stroke Standard Set Data Collection: A Qualitative Descriptive Study
Authors: McIntyre Amanda , Fueta Ovesiri , Janzen Shannon , Smith Alexander , Meyer Matthew
Published: August 2024

BACKGROUND: The International Consortium on Health Outcome Measurement developed a standard set for stroke (SSS) that includes patient-reported outcome measures to help capture patients' perspectives on their poststroke recovery. The objective of this study was to explore the experiences and perspectives of individuals who collected SSS data from patients who were admitted to hospital for a stroke. METHODS: A qualitative descriptive approach was taken. Semistructured, audio-recorded interviews were conducted with individuals employed at 2 acute neurological inpatient units in Southwestern Ontario, Canada. Interviews were transcribed verbatim and written text responses were analyzed directly. Transcripts were coded line by line and then organized into 5 overarching themes: adoption, acceptance, appropriateness, feasibility, and sustainability. RESULTS: Six interviews were conducted with participants from varying roles (eg, nurses, manager, web developer, social worker, medical clerk). Participants reported that patients were receptive to completing the SSS. Follow-up phone calls provided a significant opportunity to monitor patients' recovery postdischarge. Many patients requested medical guidance and help navigating health and social resources for unmet stroke-related needs. Barriers to consistent SSS assessment included high employee turnover and lack of time, space, or capacity for follow-up. To sustain data collection, a dedicated, financially supported neurological nursing role was suggested. CONCLUSION: Participants were supportive of SSS data collection that could provide monitoring, oversight, and follow-up of stroke patients after discharge from acute care. However, the utility of the dataset is heavily dependent on having the data collection process properly resourced.
Dysbiosis of Urinary Microbiome (Urobiome) in Male Children With Nocturnal Enuresis
Authors: Akagawa Shohei , Tsuji Shoji , Urakami Chika , Kaneko Kazunari
Published: August 2024

Purpose:

To determine the characteristics of the urobiome in boys with nocturnal enuresis.

Materials and Methods:

We enrolled 25 boys aged 5 to 12 years with untreated nocturnal enuresis (nocturnal enuresis group; median age, 7.4 years) and 17 boys aged 5 to 12 years without nocturnal enuresis (healthy control group; median age, 9.3 years). Among the 25 children with nocturnal enuresis, 15 had monosymptomatic nocturnal enuresis, and 10 had non-monosymptomatic nocturnal enuresis. First morning mid-stream urine samples were collected for deoxyribonucleic acid extraction and 16S ribosomal ribonucleic acid gene sequencing. The diversity and bacterial abundance of the urobiome were compared between the groups and between the monosymptomatic and non-monosymptomatic nocturnal enuresis groups.

Results:

Regarding alpha diversity, Shannon and Simpson indices were significantly lower in the nocturnal enuresis group. Beta diversity differed significantly on the permutational multivariate analysis of variance test. The relative abundance of Ezakiella was significantly greater in the nocturnal enuresis group than the healthy control group; however, in the nocturnal enuresis group, the relative abundance of Peptoniphilus was significantly lower, and predictive functional analyses revealed a greater proportion of bacteria involved in the synthesis of aromatic amino acids. Comparison of the monosymptomatic and non-monosymptomatic groups revealed no significant differences in diversity indices or relative abundance of bacterial taxa at the phylum or genus levels.

Conclusions:

The urobiome differed between the nocturnal enuresis and healthy control groups, with the nocturnal enuresis group exhibiting dysbiosis characterized by decreased microbial diversity, increased abundance of Ezakiella, and decreased abundance of Peptoniphilus.
What are the clinical and research lessons learned from immunomodulators and other therapies during the COVID-19 pandemic?
Authors: Sweeney Daniel A. , Póvoa Pedro
Published: August 2024

Purpose of review

The development and use of immunomodulators and other therapies during the coronavirus disease 2019 (COVID-19) pandemic provided several lessons with respect to these therapies, and to how medical researchers and clinicians should approach the next pandemic.

Recent findings

New or repurposed therapies, particularly immunomodulator treatments, for the treatment of an infectious disease will always be associated with inherent patient risk and this was the case during the COVID-19 pandemic. The concomitant development and use of effective antimicrobial therapies along with close monitoring for secondary infections is paramount for patient safety and treatment success. The development of immunomodulators and other therapies during the COVID-19 pandemic further highlighted the importance of maintaining high standards for medical research for all potential treatment with large double-blind placebo-controlled trials and peer review being the best mode of disseminating medical results rather than social media outlets.

The next new and emerging pandemic will undoubtedly share many of the same challenges posed by COVID-19. It is important that researchers and clinicians learn from this experience, adhere to tried and true clinical care, all the while conducting high quality research aimed at developing definitive treatments.
Using augmented intelligence to improve long term outcomes
Authors: Zahavi Itay , Ben Shitrit Itamar , Einav Sharon
Published: August 2024

Purpose of review

For augmented intelligence (AI) tools to realize their potential, critical care clinicians must ensure they are designed to improve long-term outcomes. This overview is intended to align professionals with the state-of-the art of AI.

Recent findings

Many AI tools are undergoing preliminary assessment of their ability to support the care of survivors and their caregivers at multiple time points after intensive care unit (ICU) discharge. The domains being studied include early identification of deterioration (physiological, mental), management of impaired physical functioning, pain, sleep and sexual dysfunction, improving nutrition and communication, and screening and treatment of cognitive impairment and mental health disorders.

Several technologies are already being marketed and many more are in various stages of development. These technologies mostly still require clinical trials outcome testing. However, lacking a formal regulatory approval process, some are already in use.

Plans for long-term management of ICU survivors must account for the development of a holistic follow-up system that incorporates AI across multiple platforms. A tiered post-ICU screening program may be established wherein AI tools managed by ICU follow-up clinics provide appropriate assistance without human intervention in cases with less pathology and refer severe cases to expert treatment.
Long-chain n-3 polyunsaturated fatty acid supplementation and neuromuscular function in older adults
Authors: Hayman Oliver , Combet Emilie , Witard Oliver C. , Gray Stuart R.
Published: August 2024

Purpose of review

This review aims to explore the latest research investigating the effects of marine-derived long-chain n-3 polyunsaturated fatty acid (LCn-3 PUFA) supplementation on neuromuscular function in older adults.

Recent findings

Ageing results in a decline in skeletal muscle strength and mass. There is growing evidence that LCn-3 PUFA supplementation increases muscle strength and mass in healthy older adults, yet the mechanisms underlying these effects remain elusive. Recent studies investigating LCn-3 PUFA supplementation have demonstrated effects on neuromuscular function such as increases in the compound muscle action potential (M-wave) amplitude and surface electromyography alongside increases in muscular strength. Therefore, evidence suggests that LCn-3 PUFA may elicit a beneficial effect at the neuromuscular junction and possess neuroprotective properties in older adults.

LCn-3 PUFA supplementation may increase or maintain neuromuscular function throughout the ageing process. Further research is warranted to investigate the long-term effects LCn-3 PUFA supplementation on neuromuscular outcomes such as single motor unit properties and cortical/supraspinal networks, utilizing state-of-the-art techniques in neuromuscular physiology.
Changes in Time Perception and Coping Strategies in Young Adults With Cancer
Authors: Duan Lisi , Tang Chulei , Wang Ting , Hu Jieman , Gao Shijuan , Zhang Liuliu , Zhang Yinan , Xu Qin
Published: August 2024

Background

A cancer diagnosis is a traumatic event. Youths, in the most crucial stage in a person’s life course, are more susceptible to the influence of cancer. The diagnosis disrupts the original life and time plans of young adults with cancer, resulting in a reconstruction of time perception and changes in coping strategies.

Objective

The aim of this study was to explore the changes in time perception and coping strategies in young adults with cancer.

Methods

A phenomenological research methodology was used in the qualitative study. Thirty-one young adults with cancer were recruited. Semistructured interviews were conducted with them, and the interview data were analyzed using Colaizzi’s 7-step analysis method.

Results

The study revealed 3 themes related to changes in time perception: perceived alterations in the speed of time, changes in remaining available time, and shifts in time preferences. Five themes were identified regarding coping strategies for changes in time perception: self-regulation of emotions, establishing spiritual beliefs, planning time effectively, returning to family life, and closure of the inner self.

Conclusions

Identifying changes in time perception among young adults with cancer through the speed of time, remaining available time, and time preference and guiding patients in adopting positive coping strategies can offer more effective cancer support and care for patients.

Implications for Practice

Healthcare professionals should pay attention to the changes in time perception in young adults with cancer and guide them to cope positively.
Using Brainstorming and Affinity Diagramming for Recommending a Care-Based Nursing Workforce Model
Authors: Polancich Shea , Dick Tracey , Ledlow Jennifer , Chambers Amanda , Miltner Rebecca
Published: August 2024

Background:

Nursing care delivery models influence nursing workload.

Problem:

Poorly designed nursing workforce models may lead to lack of satisfaction in practice, inability to recruit staff, and nursing turnover.

Approach:

This paper describes a process that our team undertook to evaluate one nursing unit’s nursing care delivery model and provides a recommendation for a nursing workforce model that ensures practice to top of scope while maintaining a balanced workload. Team brainstorming and affinity diagramming tools were used.

Outcomes:

The team findings resulted in a recommendation for an innovative care-based nursing model pilot.

Conclusions:

The use of brainstorming and affinity diagramming is an effective method for identifying opportunities to improve a nursing workforce model.
Not all carbapenem-resistant Pseudomonas aeruginosa strains are alike: tailoring antibiotic therapy based on resistance mechanisms
Authors: Falcone Marco , Galfo Valentina , Tiseo Giusy
Published: August 2024

Purpose of review

To correlate the resistance mechanisms and the susceptibility to new antibiotics inPseudomonas aeruginosa.

Recent findings

Definition of antibiotic resistance inPseudomonas aeruginosais still debated. Carbapenem-resistantPseudomonas aeruginosa(CRPA) and difficult-to-treat resistantPseudomonas aeruginosa(DTR-PA) are used but which of them better correlate with the risk of mortality remains debated. Mechanisms underlying resistance inPseudomonas aeruginosaare complex and may be combined, resulting in unpredictable phenotype and cross-resistance. Thus, not all CRPA are alike and tailoring antibiotic therapy on resistance mechanisms is challenging.

Current guidelines recommend the use of new antipseudomonal agents for CRPA or DTR-PA infections but they don’t provide specific information on how tailoring antibiotic therapy on underlying resistance mechanisms. This review may be useful to understand which mechanisms are involved in CRPA and may have practical implications helping clinicians to select an appropriate antibiotic regimen. Several antibiotics are now available forPseudomonas aeruginosabut their rational use is important to avoid development of future resistance. The knowledge of local epidemiology and most common resistance mechanisms may guide empirical therapy, but targeted antibiotic therapy should be re-evaluated as soon as susceptibility testing profile is available and selected according toPseudomonas aeruginosaphenotype.
Serial 18F-FDG PET/CT Revealing Mixed Histiocytosis in a Pediatric Patient
Authors: Singh Karan , Lau Loretta , Wegner Eva A. , Rossleigh Monica A. , Shon Ivan Ho
Published: August 2024

A 6-month-old boy presented with a left parietal soft tissue swelling and CT findings of multiple calvarial lytic lesions. 18F-FDG PET/CT demonstrated hypermetabolic lesions in the left parietal, right occipital, and right femoral bones. The left parietal lesion was excised, and pathology was consistent with Langerhans cell histiocytosis. Interim PET assessment following induction chemotherapy demonstrated a “mixed metabolic response” with discordant rise in metabolic activity of the right femoral lesion. Subsequent core biopsy of the femoral lesion revealed a non–Langerhans cell histiocytosis, likely juvenile xanthogranuloma. Here we describe a rare pediatric case of mixed histiocytosis, unveiled by serial 18F-FDG PET/CT.
Localized 131I Uptake in the Deltoid Muscle Bilaterally After Parathyroid Transplantation
Authors: Rao Maohua , Xie Jiajian , Zhang Huihui , Tian Yan , Cai Liang
Published: August 2024

A 49-year-old woman patient with thyroid cancer accepted thyroidectomy and parathyroid transplantation. One month later, localized 131I uptake in the deltoid muscle bilaterally was detected by 131I whole-body imaging performed in 2 days after 131I administration.
Technical Considerations and Outcomes for Panniculectomy in the Setting of Buried Penis Patients
Authors: Barrow Brooke , Laspro Matteo , Brydges Hilliard T. , Onuh Ogechukwu , Stead Thor S. , Levine Jamie P. , Zhao Lee C. , Chiu Ernest S.
Published: August 2024

Background

Often secondary to obesity, adult-acquired buried penis (AABP) is an increasingly common condition. AABP is often detrimental to urinary and sexual function, psychological well-being, and quality of life. Surgical treatment involves resection of excess soft tissue, with adjunct procedures, including a panniculectomy. However, few studies have been conducted investigating the risks of panniculectomy in the context of AABP surgical repair.

Methods

A systematic review of PubMed, Embase, and Cochrane databases was performed, following the PRISMA 2020 guidelines. Descriptive statistics regarding patient demographics, complications, and surgical technique were conducted. After this, an analysis of AABP patients within the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was conducted.

Results

Four studies including 57 patients reported panniculectomy as part of buried penis repair (PBPR). Surgical approaches included a modified trapezoid and traditional transverse incision. All authors utilized postoperative drains. Dehiscence and wound infection were the most frequent complications. Univariate NSQIP analysis revealed that PBPR patients had higher body mass index, more comorbidities, and greater wound complication rates. Multivariate analysis revealed that PBPR did not significantly increase 30-day complications compared to isolated BPR (P > 0.05), while body mass index remained a significant predictor.

Conclusions

Surgical repair of AABP can greatly improve patient quality of life. The available literature and NSQIP-based analysis reveal that concurrent panniculectomy in AABP repair has a comparable complication profile. Future studies are necessary to better characterize the long-term outcomes of this PBPR.
Does Secondary Mechanical Manipulation of Lipoaspirate Enhance the Vasculogenic Potential of Fat Grafts? A Systematic Review
Authors: McSweeney Jared Ethan , Yong Li Yenn , Goddard Naveen Virin , Wong Jason K.
Published: August 2024

Background

Fat grafting is a highly versatile option in the reconstructive armamentarium but with unpredictable retention rates and outcomes. The primary outcome of this systematic review was to assess whether secondary mechanically processed lipoaspirate favorably enhances the vasculogenic potential of fat grafts when compared to unprocessed lipoaspirate or fat grafts prepared using centrifugation alone. The secondary outcome was to assess the evidence around graft retention and improved outcomes when comparing the aforementioned groups.

Methods

A search on MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials was conducted up to February 2022. All human and animal research, which provided a cross-comparison between unprocessed, centrifuged, secondary mechanically fragmented (SMF) or secondary mechanically disrupted (SMD) fat grafts, was included.

Results

Thirty-one full texts were included. Vasculogenic potential was assessed by quantification of angiogenic growth factors and cellular composition. Cellular composition of mesenchymal stem cells, perivascular stem cells, and endothelial progenitor cells was quantified by fluorescence activated cell sorting (FACS) analysis. Fat graft volume retention rates and fat grafting to aid wound healing were assessed. Although the presence of industry-funded studies and inadequate reporting of methodological data in some studies were sources of bias, data showed SMF grafts contain an enriched pericyte population with increased vascular endothelial growth factor (VEGF) secretion. Animal studies indicate that SMD grafts may increase rates of fat graft retention and wound closure compared to centrifuged grafts; however, clinical studies are yet to show similar results.

Conclusions

In this systematic review, we were able to conclude that the existing literature suggests mechanically processing fat, whether it be through fragmentation or disruption, improves vasculogenic potential by enhancing angiogenic growth factor and relevant vascular progenitor cell levels. Whilst in vivo animal studies are scarce, the review findings suggest that secondary mechanically processed fat enhances fat graft retention and can aid with wound healing. Further clinical studies are required to assess potential differences in human studies.
The Gliding Brow Lift
Authors: Şibar Serhat , Erdal Ayhan Işık
Published: August 2024

Introduction

Gliding brow lift (GBL) has become one of the most popular techniques for eyebrow lifting in recent years. Despite the widespread use of the technique, there are a few publications in the literature. This systematic review was conducted to present current data on GBL and determine its place among brow lift procedures.

Method

GBL-related studies were searched in PubMed, Google Scholar, Web of Science, and Scopus databases. The screening was carried out from January 2019 to December 2023. All publications in which GBL was performed alone or in combination with other facial rejuvenation procedures or in which the results related to the technique were included.

Results

Sixty-three publications were evaluated, and four met the review criteria. The total number of patients who underwent GBL was 181. Most studies were retrospective case series and had a low level of evidence. It was observed that the evaluation parameters were mostly subjective. The technique was found to be generally effective and had low complication rates.

Conclusions

Although this systematic review shows that GBL is an effective and low-complication technique for a brow lift, there is a need to share prospective, more extensive case series and objective data of patients with longer follow-up periods.