bluuebunny/crossref_metadata_2025 huggingface dataset:
(514) Are Intracorporal Injections Associated with Difficult Placement of Inflatable Penile Prosthesis Placement?
Authors: Charles D , Mohankumar K , Waldcoh B , Kasson M , Dietrich P , Guise A
Published: May 2023

Introduction

Inflatable penile prosthesis (IPP) is the gold-standard treatment for erectile dysfunction that is refractory to pharmacologic therapies. While complications occur in 1-10% of patients, there remains a paucity of data regarding the impact of intracorporal injections (ICI) on a more difficult IPP placement.

Objective

We sought to demonstrate correlation between prior ICI and increased difficult with IPP placement. We hope to use our data to help guide future pre-procedural planning as well as patient counseling.

Methods

The records of patients who underwent IPP placement via single surgeon between 2016 – 2021 were retrospectively reviewed. Baseline patient demographics in addition to history of priapism, shunt, presence of Peyronie’s disease (PD), ICI use and duration, and intraoperative details including need for multiple corporal dilations and corporal scarring were gathered. Exclusion criteria included patients with re-operative/revision IPPs, patients with 2-piece IPPs, and patients with semi-rigid IPPs. The associations were calculated using Chi-squared analysis and logistic regression.

Results

There were 96 patients that met inclusion criteria, with average age of 62 years. Half (48/96) had history of ICI use, with mean duration of 17.25 months (range 1-65). ICI was not associated with corporal scarring (p=0.51) or need for multiple dilations during IPP placement (p=0.46). Duration of ICI (comparing subgroups of < 20 months and >20 months) was not significantly different with respect to corporal scarring (p=0.343) or need for multiple dilations (p=0.839). History of priapism or shunt was not associated with corporal scarring (p=0.251). Patients with PD were more likely to require multiple dilations (p=0.033).

Conclusions

History of ICI and its duration were not associated with corporal scarring and increased intraoperative difficulty. Patients with a history of Peyronie’s disease were more likely to require multiple dilations. Other studied factors including ICI duration of >20 months, history of priapism, and history of shunt are NOT associated with corporal scarring or need for multiple dilations.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific
(515) A Call to Contraception: Overturn of ROE v. WADE Catalyzes Rise in U.S. Vasectomy Consultations
Authors: Lindsey J , Torres-Anguiano J R , Donato J , Campbell K , Lipshultz L , Kassab J
Published: May 2023

Introduction

On June 24, 2022, the U.S. Supreme Court’s landmark decision on DOBBS v. JACKSON WOMEN'S HEALTH ORGANIZATION leaves abortion rights or restrictions to be defined at the state level. The following week several news outlets reported that urologists across the country are experiencing significant increases in clinical encounters for individuals interested in undergoing a vasectomy.

Objective

To explore the impact of changes to federal protection of abortion rights on the number of individuals seeking vasectomies at two high-impact academic centers and their correlation with Google Web searches.

Methods

A cross-sectional analysis of Google web searches from 1/1/2004-6/30/2022 was performed for the key term ‘vasectomy’ utilizing Google Trends®. One primary outcome was relative search interest in the key term ‘vasectomy’ prior and after the overturn of ROE v. WADE. We calculated the coefficients of determination for the linear search trend of this term. In parallel, cross-sectional analyses were performed utilizing databases from the electronic medical records of two high-impact university hospitals (‘Hospital-1’ and ‘Hospital-2’). in the U.S. focusing on patient encounters for vasectomy consultation coded as ‘vasectomy / vasectomy consult / vasectomy planning/ vasectomy education.’ The observation interval included 06/01/2022 - 06/30/2022. Correlation coefficients were calculated using SPSS.

Results

Web searches for the term ‘vasectomy’ increased 3.6 times the average number of searches for ‘vasectomy’ during the week following the U.S. Supreme Court’s decision on abortion, and it marked the most the term had ever been searched since Google began tracking its searches in 2004. Similarly, office visits for vasectomy consultations for Hospital-1 and Hospital-2 increased by factors of 2.4 and 6.0, respectively. Internet searches for ‘vasectomy’ and the number of clinic vasectomy consultations demonstrated correlation values of r = 0.96 and r = 0.89 for Hospital-1 and Hospital-2, respectively.

Conclusions

Online search interest as well as clinical encounters for vasectomy consultation have increased over the past 30 days coincidentally with - and perhaps as a consequence of - the overturn of ROE v. WADE. Our study has demonstrated marked correlation between the increase in Google searches and office visits for vasectomy consultation. This may mark a watershed moment in the adoption of vasectomy for male contraception.

Disclosure

No
(516) Maximizing Penile Prosthesis Length: Our Technique and Outcomes
Authors: Razdan S , Siegal A , Valenzuela R
Published: May 2023

Introduction

The most common cause of patient regret after penile prosthesis surgery is penile shortening, which has been reported in up to 70% of patients postoperatively.

Objective

We sought to query a national database on average prosthesis length and describe our techniques to maximize cylinder sizes.

Methods

We performed a retrospective review of the Coloplast database of 3-piece penile prosthesis cases performed over the span of 1 year nationally and by a single high volume surgeon and compared average cylinder lengths.

Results

Between July 1, 2021 and June 27, 2022, 145 three piece penile prosthesis surgeries were performed at our institution. All were performed via a scrotal incision. Nationally, 32.8% were performed infrapubic while 58.1% were performed scrotal. The most prevalent cylinder length in our series was 22cm, compared to the most prevalent nationally of 20cm. (Table 1). Our technique to maximize cylinder length involves circumferential mobilization of the corporal bodies and corporal tissue sparing. After initial scrotal incision and dissection to the level of the penile compartment, circumferential mobilization of the corporal bodies is carried out. In addition, the ventral corporal dartos layer is meticulously peeled away. Corporal tissue sparing is carried out by employing 9” Metzenbaum scissors rather than sequential dilators for corporal tunneling. (Image 1). The benefit of this approach is the ability to create a dorsal compartment to the level of the triangular ligament of the glans, thereby extending the space to the level of the midglans. This maneuver minimizes placement of the prosthesis anteriorly at the level of the fossa navicularis and prevents floppy glans that would otherwise compromise maximum cylinder length.

Conclusions

Three piece penile prosthesis cylinder size can be maximized by circumferential mobilization of the corporal bodies, corporal sparing maneuvers, and the utilization of long Metzenbaum scissors for precise corporal tunneling, ensuring the distal cylinder tips are seated within the tip of the glans rather than at the coronal sulcus. This can help mitigate patient regret after prosthesis surgery.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast
(521) The Impact of Donor Robotic Partial Hepatectomy on Sexual Function in Sexually Active Men: A Prospective Cohort Study
Authors: Seyam R , Almaiman S , Mandourah H , Kattan M , Kattan S , Broering D , Altaweel W
Published: May 2023

Introduction

Donor robotic partial hepatectomy is evolving as a low morbidity method for liver transplantation. However, we have noticed that two of our patients complained of de novo sexual dysfunction following their surgery. Factors that may lead to the dysfunction are liver dysfunction and stress.

Objective

We set out to objectively evaluate the impact of robotic partial hepatectomy on sexual function in sexually active men.

Methods

This prospective study involved a cohort of married men with no prior sexual dysfunction who consecutively presented for a liver donation from Jan 2021 to Mar 2022. Robotic partial hepatectomy was performed using three ports and a Da Vinci XI system, and a small Pfannenstiel incision was used to deliver the specimen. We performed a preoperative assessment of sexual function using the IIEF-15 questionnaire [1], liver function using the CLDQ-29 questionnaire [2], and perceived stress PSS-14 questionnaire [3]. Lab investigations included hormonal profile, liver function, and renal function. The postoperative assessment was repeated after three months. Continuous data were compared using paired t-test. References: 1. Rosen RC, et al (1997) Urology 49:822–830 2. Younossi ZM, et al (1999) Gut 45:295–300. 3. Cohen S, et al (1983) J Health Soc Behav. 24:385-96.

Results

Twenty-eight male donors, with a median age of 31.5 SD 6.2 range 19-42 years, and BMI of 24.2 SD 4.2 range 17.9-33.1 kg were studied. At baseline, all had no sexual dysfunction, liver disease, or comorbidities. Preoperative median morning testosterone was 15.8 SD 4.1 range 10.6-26.6 nmol/L. All patients had normal hepatic and renal function. Three months postoperatively, no patient-reported sexual dysfunction. There was no significant difference in the IIEF-15 erectile function domain pre and postoperative, respectively (mean 27.2 SD 5.3 and 27.7 SD 5.4, p = 0.162). There was no significant change in the desire, orgasmic, or satisfaction domains. There was no significant change in the average CLDQ-29 score (6.9 SD 0.33 and 6.9 SD 0.33, p=0.378) or its domains of abdominal symptoms, fatigue, systemic symptoms, activity, emotional function, and worry. There was no significant change in the stress level before and after surgery, with PSS-14 total scores of 21.6 SD 6.6 and 21.5 SD 6.7, p=0.739, respectively.

Conclusions

In this small prospective cohort, we did not find a significant association between donor robotic partial hepatectomy and the development of sexual dysfunction. However, a study involving a larger number of patients may reveal more subtle changes in sexual function and underlying mechanisms.

Disclosure

No
(525) Challenges in Management of Sexual Disorders in Rwanda
Authors: Nzeyimana n I
Published: May 2023

Introduction

In Rwanda, it is not common to talk about sexual issues but these days there are remarkable increase in sexual disorders consultations especially in men where most are complaining of erectile dysfunction followed by ejaculatory disorders which make about 10% in public and 20% in private urological consultations. Top causes are psychogenic while organic causes include Diabetes mellitus and post chemotherapy and radiotherapy in females. Most patients present late distressed and desperate hence poor quality of life.

Objective

Highlight the challenges in management of sexual disorders in Rwanda

Methods

Narrative opinion. I will discuss in details those challenges from a perspective of a urologist interested in sexual medicine.

Results

There are neither andrologists nor specialized sexual therapist in Rwanda, hence difficulty in treating these patients. Most of patients are exposed to highly mediatized wrong information from practitioners who use herbal medicines to treat them without success in most of them. Others consult general practitioners or gynecologists who refer them to urologists. With the scarcity of urologists in the country (only 10) and lack of psychosexual therapists, limited treatment options (only some PDEIs and antidepressants available) and cultural barriers, there is a big gap in proper management of sexual disorders.

Conclusions

There is high need for capacity building of health professionals, special training of urologists, research, access to evidence-based information and management options to bridge the big gap.

Disclosure

No
(528) Discrimination Against Sexual Diversity in a Public Teaching Hospital in the Northeast of Brazil: The Perception of Medical Students
Authors: Silva A M , Estefan Sobral L N , Vieira A M , Pessôa Neto J A , Leônidas G M , Britto D F , Coelho Peixoto R A
Published: May 2023

Introduction

In Brazil, situations of discrimination and violence experienced by the LGBTQIA+ community in health care services and educational institutions constitute programmatic vulnerability and have repercussions for their health-disease-care process. In the context of health education, topics related to sexual and gender minorities are not effectively explored, and it is not a mandatory part of the curriculum of medical schools.

Objective

To analyze the perception of medical students who identify as LGBTQIA+ about homophobia and transphobia.

Methods

Qualitative cross-sectional study. An online questionnaire was answered anonymously by LGBTQIA+ medical students. They are in the mandatory internship curriculum of Gynecology and Obstetrics in a public maternity school in northeastern Brazil. Responses were categorized, coded, analyzed, and interpreted using Bardin's content analysis method.

Results

Seven LGBTQIA+ medical students participated. Regarding sexual identity, 3 identified themselves as cisgender women, three as cis men, and one person as "questioning" of these five are homosexual, two bisexual, and one asexual. When asked about the qualification of health service professionals regarding LGBT+ people, six respondents commented on the lack of technical training of the medical team. A student believes that most physicians are knowledgeable about the topic and respect LGBT people. All interviewees have already witnessed, as victims or witnesses, situations of homophobia or transphobia. Three of the participants experienced circumstances that involved professionals providing care to patients. Among the actions mentioned to improve the qualification of professionals in serving the LGBT+ community, most participants suggested training,, and mandatory classes on the subject.

Conclusions

There was a significant perception of prejudice against the LGBTQIA+ population in transdisciplinary care and medical training. The solutions embrace the inclusion of topics on sexual and gender minorities in the curriculum of medical schools, as well as spaces and welcoming strategies for students who have experienced LGBTphobia.

Disclosure

No
(541) Health Care Provider Knowledge and Attitudes about Erectile Dysfunction and Penile Implants
Authors: Roshandel R , Ziegelmann M J , Helo S , Kohler T S , Collins C S
Published: May 2023

Introduction

Erectile dysfunction (ED) stems from a variety of etiologies and often requires a multidisciplinary approach to optimize patient care.

Objective

We sought to assess attitudes and confidence regarding the treatment of erectile dysfunction across different provider types.

Methods

Responses were obtained through an anonymous, email-based survey of our institution's providers in the disciplines of urology, internal medicine, and family medicine. We created a novel tool of 25 5-point Likert scale questions regarding ED treatment. Data were analyzed through descriptive statistics and Fisher’s exact test and sorted by respondent specialty. Ethical Committee approval was obtained before study.

Results

138 health care providers returned surveys, including 58 internists (IM), 47 family physicians (FP), and 33 urologists (GU). FP and IM responses showed significant overlap with a few key statistically significant differences. In general, IM was much more positive in VED, penile implant as an option, penile implant satisfaction, and penile implant risk. 37% of IM agreed or strongly agreed inflatable penile prosthesis risk is low vs 6% FP (p = .0032). IM also more strongly supported team-based care and referral to specialists IM 71% vs. 51% FP (p = .0012). (Figures) When comparing GU versus FP + IM 24/25 questions revealed statistically significant differences revealing greater GU confidence and knowledge about ED with only the importance of a team-based approach not differing. Noteworthy points include 46% vs. 18% confidence for a detailed sexual history for GU vs. FP + IM (all other points % and same provider sequence). IIEF usage and familiarity were 61 vs. 3 and 88 vs. 18, respectively. 100 and 85 strongly/agreed that good options remained after pills failed. Regarding inflatable penile prosthesis, agreement or strong agreement for patient willingness to undergo surgery for ED 67 vs. 13; patient satisfaction 91 vs. 25, partner satisfaction 80 vs. 25; and would repeat surgery or recommend to a friend was 82 vs. 17. Finally, and perhaps most notably 83 vs. 11 of providers were aware that Medicare covered implants. (Figures).

Conclusions

Conclusions This survey reveals significant knowledge gaps for treatment options and outcomes for ED. Targeted provider education, particularly about penile prostheses, could optimize patient care.

Disclosure

No
(546) Outcomes of Two Novel Techniques for Low Submuscular Reservoir Placement: Thalia Stich and Transfacial Fixation
Authors: Ahmed M , Khera M , Roshandel R , Ziegelmann M , Helo S , Köhler T
Published: May 2023

Introduction

Penile Implant reservoir complications continue to drive surgical technique innovation to avoid catastrophic complication typically affiliated with theoretical placement in the space of Retzius. The high submuscular technique (versus initially described low submuscular) aimed to reduce migration/herniation. Most high submuscular technique complications are cosmetic, however, unintentional bowel injury and difficulty with extraction of these reservoirs has been reported. Furthermore, reservoirs left via drain and retain technique have been reported to cause significant bowel complications most typically when the reservoir or pressure regulating balloon unknowingly resides intraperitoneally.

Objective

We report outcomes of two surgeons who independently invented and published novel techniques allowing for low submuscular reservoir placement (and thus avoid blind puncture above the arcuate line) to help avoid reservoir complications.

Methods

Two surgeons’ technique outcomes were assessed. The first surgical technique (T1) involves suturing an additional implant connector collar to the pubic bone with a permanent stitch. This collar acts as a backstop to prevent reservoir herniation or migration into the scrotum. It can also be used to prevent upward migration of drain and retain reservoirs as the retained reservoir is capped. The second surgical technique (T2) involves placing a right angle outside in of the fascia after a pocket is cleared below the muscle and pulling the implant tubing through this defect. This approach stops the prb or reservoir at the puncture site.

Results

T1 was performed 55 times for reservoir fixation and 7 times for drain and retain fixation. Mean follow up is 11 months. One infection occurred necessitating reservoir removal (and cutting of permanent stitch) which was easily accomplished. No other complications or patient complaints from this technique have occurred. Average case time increase is 5-10 minutes. T2 has been performed 31 times for reservoir fixation with no complications or patient complaints. Average case time increase is < 5 minutes.

Conclusions

Although submuscular reservoir techniques decrease catastrophic complications and are widely adopted, they are not without risk. We report success of two independent techniques that demonstrate safety and feasibility with low reservoir placement.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Mayo Clinic – Rochester
Nexus of Religion and Immigration
Authors: Cesari Jocelyne
Published: May 2023

To date, the studies on the religious dimension of immigration across religions and countries are rare. They also have the disadvantage of focusing almost exclusively on the religious identities of Muslim immigrants. This chapter nonetheless identifies two structural components of the nexus between religion and immigration: the disconnection of religious and national identities experienced by migrants and the fact that their religion is in minority in their new country of residence. These structural elements have the following effects on the religious identities of migrants: a) the positive identification to the country of settlement combined with high level of religiosity, b) the religiosity gap between migrants and nationals, and c) the role of transnational religious movements. All three have been deeply affected by the War on Terror, which has resulted in the securitization of immigration policies, the control of clerics and religious organizations and the monitoring of religious practices.
“Inverted Behavior” in South Slavic Ritual and Magic
Authors: Vivod Maria
Published: May 2023

A wide range of forms of behavior relate to magic in the South Slavic Balkans. “Inverted behavior” (Serbian: obrnuto ponašanje), historically analyzed as anti-behavior, is one of the most diverse, irregular, and “shape-shifting” forms of magic; yet it is also one of the least analyzed. It functions not only in magic and ritual connected with incantation (charming) but also in daily communication processes as vernacular formulae devoid of ritual characteristics. As a remnant of more extensive past belief systems, inverted behavior takes place in the everyday folklore of magical thinking as a means to counteract evil forces. Its wide presence in informal practices, well outside of ritual and magic, indicates that its roots are to be found in some deeper belief systems, still largely unexplored. This chapter analyzes inverted behavior as a subcategory of magic and argues for establishing its rightful place in the classification of ritual behaviors.
Lithic Technological Evolution
Authors: Prentiss Anna Marie
Published: May 2023

Hominins have relied upon lithic technology since approximately 3.3 million years ago. Given its importance and durability, lithic technology provides the most extensive record of human technological behaviour. Studies of lithic technological evolution can thus provide insights into broader processes of human biological (e.g. cognition and manual dexterity) and cultural evolution. Lithic technological evolution is reviewed in three parts emphasizing theoretical diversity, the empirical record, and major discussions and debates. Specific topics considered include the earliest use of pebble tools, the persistence of large cutting/core tools (handaxes), the meaning of inter-assemblage variability, processes of microlithization, and the emergence and spread of groundstone technologies. A closing argument suggests that scholars seeking evolutionary explanations draw a logical distinction between models of technological origins versus those of persistence and adaptive radiation.
Craft Traditions
Authors: Buckley Christopher
Published: May 2023

Craft traditions are some of the most durable of human institutions, preserving and transmitting knowledge and skills related to material culture. Their study has relevance to a range of disciplines, including archaeology, art history, and the history of technology. From an evolutionary perspective they offer the opportunity to study culture at a range of scales, from the behaviours of individual craftspeople to broad-scale patterns of culture, and they are an important testing ground for theoretical models of how culture evolves. This chapter begins by reviewing how craft traditions are transmitted at the micro-scale, focussing on apprenticeships and apprenticeship-like processes, then explores the macro-scale consequences of this type of transmission. Three case studies are discussed that offer the opportunity to evaluate cultural evolutionary models in detail, using a mix of classical and phylogenetic approaches. The chapter ends with a brief discussion of the implications for future anthropological research.
Signalling and the Cultural Evolution of Art
Authors: Verpooten Jan
Published: May 2023

Why and how does art evolve? Evolutionary psychology has commonly focused on unravelling evolutionary functions of art and establishing innate cognitive predispositions that might be exploited in art (e.g. attentional preference for animal cues). Cultural evolution research enriches and complements this work. First, studies based on cultural attraction theory establish how such predispositions foster historical convergences in the forms art takes, for instance in renaissance portraiture. Moreover, in line with dual inheritance theory, several lines of evidence indicate a key role for social learning dynamics as well, such as prestige bias driven divergences from innate cognition in contemporary art appreciation. This article points out that, despite their differences, these evolutionary approaches to art have in common that they are grounded in signalling theory. Within this encompassing signalling framework, various art traditions (e.g. the Acheulean hand axe), factors (e.g. ecology and demography), and methods (e.g. phylogenetic comparison) are considered.
The Cultural Macroevolution of Religion
Authors: Watts Joseph
Published: May 2023

Religious systems have the key properties of an evolutionary system: they are inherited over time, are subject to change, and differ in their ability to gain and retain members. The cultural macroevolutionary study of religion seeks to identify and understand generalizable patterns of religious change over human history. This chapter is structured around four questions about the macroevolution of religion. First, what are the modes of religion transmission? Second, what is the tempo of religious change? Third, how do religions coevolve with other cultural and environmental traits? Fourth, what factors explain the rise and fall of religious systems in human history? Each topic is explained from an evolutionary perspective, along with an overview of empirical research. This research has been a testing ground for theories of cultural evolution, though many key questions remain unresolved. Further research directed at answering these questions will provide a richer understanding of religion, as well as the dynamics of cultural evolution.
Horizontally Acquired Nitrate Reductase Realized Kleptoplastic Photoautotrophy of Rapaza viridis
Authors: Maruyama Moe , Kagamoto Tsuyoshi , Matsumoto Yuga , Onuma Ryo , Miyagishima Shin-ya , Tanifuji Goro , Nakazawa Masami , Kashiyama Yuichiro
Published: May 2023

While photoautotrophic organisms utilize inorganic nitrogen as the nitrogen source, heterotrophic organisms utilize organic nitrogen and thus do not generally have an inorganic nitrogen assimilation pathway. Here, we focused on the nitrogen metabolism of Rapaza viridis, a unicellular eukaryote exhibiting kleptoplasty. Although belonging to the lineage of essentially heterotrophic flagellates, R. viridis exploits the photosynthetic products of the kleptoplasts and was therefore suspected to potentially utilize inorganic nitrogen. From the transcriptome data of R. viridis, we identified gene RvNaRL, which had sequence similarity to genes encoding nitrate reductases in plants. Phylogenetic analysis revealed that RvNaRL was acquired by a horizontal gene transfer event. To verify the function of the protein product RvNaRL, we established RNAi-mediated knock-down and CRISPR-Cas9-mediated knock-out experiments for the first time in R. viridis and applied them to this gene. The RvNaRL knock-down and knock-out cells exhibited significant growth only when ammonium was supplied. However, in contrast to the wild-type cells, no substantial growth was observed when nitrate was supplied. Such arrested growth in the absence of ammonium was attributed to impaired amino acid synthesis due to the deficiency of nitrogen supply from the nitrate assimilation pathway; this in turn resulted in the accumulation of excess photosynthetic products in the form of cytosolic polysaccharide grains, as observed. These results indicate that RvNaRL is certainly involved in nitrate assimilation by R. viridis. Thus, we inferred that R. viridis achieved its advanced kleptoplasty for photoautotrophy, owing to the acquisition of nitrate assimilation via horizontal gene transfer.
The presence of abnormal septal motion on echocardiography is a predictor of abnormal cardiac magnetic resonance in systemic sclerosis
Authors: Javady-Nejad Zahra , Jamshidi Ahmad-Reza , Aletaha Azadeh , Qorbani Mostafa , Kavosi Hoda , Soltani Akbar , Gharibdoost Farhad
Published: May 2023

Objectives

We aimed to perform a comprehensive analysis of the ECG, two-dimensional echocardiography (2DE) and cardiac MRI (CMR) findings in patients with systemic sclerosis (SSc), and also to investigate correlations between CMR findings and some ECG and echocardiography (ECHO) results.

Methods

We retrospectively analysed data from patients with SSc who were regularly seen at our outpatient referral centre, all assessed with ECG, Doppler ECHO and CMR.

Results

Ninety-three patients were included; mean (s.d.) age of 48.5 (10.3) years, 86% female, 52% diffuse SSc. Eighty-four (90%) of the patients had sinus rhythm. The most common ECG finding was the left anterior fascicular block, recorded in 26 patients (28%). The abnormal septal motion (ASM) was found in 43 (46%) patients on ECHO. Myocardial involvement (inflammation or fibrosis), as assessed by multiparametric CMR, was present in >50% of our patients. The age- and sex-adjusted model showed that ASM on ECHO increased significantly the odds of increased extracellular volume [odds ratio (OR) 4.43, 95% CI 1.73, 11.38], increased T1 Relaxation time (OR 2.67, 95% CI 1.09, 6.54), increased T2 Relaxation time (OR 2.56, 95% CI 1.05, 6.22), increased signal intensity ratio in T2-weighted imaging (OR 2.56, 95% CI 1.05, 6.22), presence of late gadolinium enhancement (OR 3.85, 95% CI 1.52, 9.76) and mid-wall fibrosis (OR 3.64, 95% CI 1.48, 8.96).

Conclusion

This study indicates that the presence of ASM on ECHO is a predictor of abnormal CMR in SSc patients, and a precise assessment of ASM may serve as an important point for selecting the patients that should be evaluated by CMR for early detection of myocardial involvement.
The Use of Eye-tracking Technology in Cleft Lip: A Literature Review
Authors: Plonkowski Alexander T. , Breakey R. William F. , Read Jenny C. A. , Sainsbury David C. G.
Published: May 2023

Background:

Eye-tracking has become an increasingly popular research tool within the field of cleft lip and/or palate (CL+/−P). Despite this, there are no standardized protocols for conducting research. Our objective was to conduct a literature review of the methodology and outcomes of previous publications using eye-tracking in CL+/−P.

Methods:

The PubMed, Google Scholar, and Cochrane databases were searched to identify all articles published up to August 2022. All articles were screened by two independent reviewers. Inclusion criteria included using eye-tracking, image stimuli of CL+/−P, and outcome reporting using areas of interest (AOIs). Exclusion criteria included non-English studies, conference articles, and image stimuli of conditions other than CL+/−P.

Results:

Forty articles were identified, and 16 met the inclusion/exclusion criteria. Thirteen studies only displayed images of individuals following cleft lip surgery with three only displaying unrepaired cleft lips. Significant variation was found in study design, particularly in the AOIs used to report gaze outcomes. Ten studies asked participants to provide an outcome score alongside eye-tracking; however, only four compared outcome data to eye-tracking data. This review is primarily limited by the minimal number of publications in this area.

Conclusions:

Eye-tracking can be a powerful tool in evaluating appearance outcomes following CL+/−P surgery. It is currently limited by the lack of standardized research methodology and varied study design. Before future work, a replicable protocol should be developed to maximize the potential of this technology.
P3 Flap: Technique for Fingertip Reconstruction
Authors: Petrella Giovanna , Della Rosa Norman , Adani Roberto
Published: May 2023

Fingertip amputations represent an important spectrum of injuries, and most are avulsions or crush trauma. There is no consensus about one single standard treatment, and a wide number of techniques are available. The authors present the P3 flap as an option for covering fingertip defects with bone exposure, avoiding painful scars in the pulp area, without a donor site. This study included 12 fingertips with amputated segment not available for replantation. Volar oblique fingertip defects and transverse amputations with bone exposure, not more proximal than Hirase Zone IIB, were included. Defects were less than 2 cm. The patients were followed up for an average of 6 months. The aesthetic and functional outcomes and fingertip discrimination recovery were evaluated at 6 months by the static two-point discrimination (2-PD) test and DASH score (quick version). The average postoperative 2-PD test at 6 months was 5.9 mm (range from 5 to 8 mm). The mean healing time of the fingertip was 4 weeks. Nail deformity was reported in three cases with level IIB of amputation. None of the P3 flaps failed, and local infection was not reported. The average DASH score at 6 months was 1.1. The mean time to return to work was 38 days (range from 30 to 53). The P3 flap proposed in this study demonstrates a reliable single-stage technique, performed under local anesthesia, for fingertip defect reconstruction, avoiding skin incision and scars in the pulp region and preserving digital length and nail bed.
Use and Influence of Social Media on the Private Practice of Plastic Surgeons in Saudi Arabia
Authors: Mortada Hatan , AlRajhi Bassam , Hashem Abdullah , Aljaaly Hattan A. , Obeid Faisal M. , Gelidan Adnan G. , Arab Khalid
Published: May 2023

Background:

Today, social media platforms are more popular than ever in Saudi Arabia. Despite the influence of social media on patients’ decisions to undergo cosmetic surgery, it is still unclear how social media platforms affect the private practice of plastic surgeons around Saudi Arabia. This study aimed to assess Saudi plastic surgeons’ use of social media and its impact on their practices.

Methods:

The study was based on a self-administered questionnaire that was built on previous literature and distributed to practicing Saudi plastic surgeons. A survey consisting of 12 items was conducted to assess patterns of social media use and its impact on plastic surgery practice.

Results:

This study included 61 participants. Thirty-four surgeons (55.7%) were using social media platforms in their practice. The use of social media was significantly different among surgeons with different levels of practice in cosmetic surgery (P = 0.004) and reconstructive surgery (P = 0.049). Social media presence was significantly more prevalent among surgeons in private practice (70.6%, P = 0.034). The use of social media in plastic surgery is overall positive for the field (60.7%).

Conclusions:

Despite plastic surgeons’ differing views on social media, its role within the field of plastic surgery is evidently on the rise. The use of social media is not equal across all practice types. Surgeons practicing in private hospitals and specializing in aesthetic surgery are more likely to view social media favorably and use it in their practice.
A Combined DNA/RNA-based Next-Generation Sequencing Platform to Improve the Classification of Pancreatic Cysts and Early Detection of Pancreatic Cancer Arising From Pancreatic Cysts
Authors: Nikiforova Marina N. , Wald Abigail I. , Spagnolo Daniel M. , Melan Melissa A. , Grupillo Maria , Lai Yi-Tak , Brand Randall E. , O’Broin-Lennon Anne Marie , McGrath Kevin , Park Walter G. , Pfau Patrick R. , Polanco Patricio M. , Kubiliun Nisa , DeWitt John , Easler Jeffrey J. , Dam Aamir , Mok Shaffer R. , Wallace Michael B. , Kumbhari Vivek , Boone Brian A. , Marsh Wallis , Thakkar Shyam , Fairley Kimberly J. , Afghani Elham , Bhat Yasser , Ramrakhiani Sanjay , Nasr John , Skef Wasseem , Thiruvengadam Nikhil R. , Khalid Asif , Fasanella Kenneth , Chennat Jennifer , Das Rohit , Singh Harkirat , Sarkaria Savreet , Slivka Adam , Gabbert Charles , Sawas Tarek , Tielleman Thomas , Vanderveldt Hendrikus Dutch , Tavakkoli Anna , Smith Lynette M. , Smith Katelyn , Bell Phoenix D. , Hruban Ralph H. , Paniccia Alessandro , Zureikat Amer , Lee Kenneth K. , Ongchin Melanie , Zeh Herbert , Minter Rebecca , He Jin , Nikiforov Yuri E. , Singhi Aatur D.
Published: May 2023

Objective:

We report the development and validation of a combined DNA/RNA next-generation sequencing (NGS) platform to improve the evaluation of pancreatic cysts.

Background and Aims:

Despite a multidisciplinary approach, pancreatic cyst classification, such as a cystic precursor neoplasm, and the detection of high-grade dysplasia and early adenocarcinoma (advanced neoplasia) can be challenging. NGS of preoperative pancreatic cyst fluid improves the clinical evaluation of pancreatic cysts, but the recent identification of novel genomic alterations necessitates the creation of a comprehensive panel and the development of a genomic classifier to integrate the complex molecular results.

Methods:

An updated and unique 74-gene DNA/RNA-targeted NGS panel (PancreaSeq Genomic Classifier) was created to evaluate 5 classes of genomic alterations to include gene mutations (e.g., KRAS, GNAS, etc.), gene fusions and gene expression. Further, CEA mRNA (CEACAM5) was integrated into the assay using RT-qPCR. Separate multi-institutional cohorts for training (n=108) and validation (n=77) were tested, and diagnostic performance was compared to clinical, imaging, cytopathologic, and guideline data.

Results:

Upon creation of a genomic classifier system, PancreaSeq GC yielded a 95% sensitivity and 100% specificity for a cystic precursor neoplasm, and the sensitivity and specificity for advanced neoplasia were 82% and 100%, respectively. Associated symptoms, cyst size, duct dilatation, a mural nodule, increasing cyst size, and malignant cytopathology had lower sensitivities (41–59%) and lower specificities (56–96%) for advanced neoplasia. This test also increased the sensitivity of current pancreatic cyst guidelines (IAP/Fukuoka and AGA) by >10% and maintained their inherent specificity.

Conclusions:

PancreaSeq GC was not only accurate in predicting pancreatic cyst type and advanced neoplasia but also improved the sensitivity of current pancreatic cyst guidelines.
Fecal Microbiota Transplant in Pediatric Solid Organ Transplant Recipients
Authors: Rodig Nancy M. , Weatherly Madison , Kaplan Abby L. , Ballal Sonia Arora , Elisofon Scott A. , Daly Kevin P. , Kahn Stacy A.
Published: May 2023

Background.

Fecal microbiota transplant (FMT) is an effective treatment for recurrent Clostridioides difficile infection (CDI). Safety concerns around FMT are increased in immunocompromised populations, such as solid organ transplant (SOT) recipients. Outcomes among adult SOT recipients suggest FMT is efficacious and safe; however, pediatric SOT data are lacking.

Methods.

We describe the efficacy and safety of FMT among pediatric SOT recipients in a single-center retrospective study from March 2016 to December 2019. Successful FMT was defined as no recurrence of CDI within 2 mo of FMT. We identified 6 SOT recipients ages 4–18 y who received FMT a median of 5.3 y post-SOT.

Results.

Success after a single FMT was 83.3%. One liver recipient did not achieve cure after 3 FMTs and remains on low-dose vancomycin. One serious adverse event (SAE) occurred; cecal perforation and bacterial peritonitis occurred following colonoscopic FMT coordinated with intestinal biopsy in a kidney transplant recipient. He achieved full recovery and CDI cure. There were no other SAEs. There were no adverse events related to immunosuppression or transplantation status including: bacteremia, cytomegalovirus activation or reactivation, allograft rejection, or allograft loss.

Conclusions.

In this limited series, efficacy of FMT in pediatric SOT is comparable to efficacy in the general pediatric recurrent CDI population. There may be an increased risk of procedure-related SAE in SOT patients and larger cohort studies are needed.
Cortical thickness and cognitive decline in Parkinson patients with deep brain stimulation in the MARK-PD study
Authors: Schulz Robert , Uyar Merve , Graterol Perez José A. , Pötter-Nerger Monika , Buhmann Carsten , Gerloff Christian , Choe Chi-un
Published: May 2023

Advanced Parkinson’s disease (PD) and deep brain stimulation (DBS) are associated with cognitive impairment. We aimed to evaluate whether regional cortical thickness is associated with cognitive decline in patients with advanced PD treated with DBS. From the MARK-PD study, 32 patients with DBS implantation were included. Cortical thickness of 148 brain areas and cognitive function were assessed with MRI data using the FreeSurfer pipeline and Montreal Cognitive Assessment at baseline and follow-up (median 17 months), respectively. Adjusted linear and Cox regression models were calculated. Thinner orbitofrontal, cingulate, and occipito-temporal cortices as well as cuneus is related to significant cognitive decline. Moreover, lower thickness of these cortices is also associated with faster cognitive decline. Our study suggests that PD patients treated with DBS and lower cortical thickness in multiple brain regions develop at stronger and faster cognitive decline during the later course of the disease.
Synthesis and crystal structure of 2-[(2,3,5,6-tetrafluoropyridin-4-yl)amino]ethyl methacrylate
Authors: Overstreet Shayla M. J. , Genzia Ian M. , Nguyen Alexander , Auleciems Zachary J. , Jennings Abby R. , Peloquin Andrew J.
Published: May 2023

In the title compound, C11H10F4N2O2, the conformation about the N—C—C—O bond is gauche [torsion angle = 61.84 (13)°]. In the crystal, N—H...O hydrogen bonds link the molecules into [010] chains, which are cross-linked by C—H...F and C—H...π contacts. Hirshfeld surface analysis was conducted to aid in the visualization of these various influences on the packing. This analysis showed that the largest contribution to the surface contacts arises from F...H/H...F interactions (35.6%), followed by O...H/H...O (17.8%) and H...H (12.7%).
Multiple organizational capabilities for effective business model innovation and increased performance
Authors: Kafetzopoulos Dimitrios , Samara Elpida Tryfon , Theodorakioglou Ypatia
Published: May 2023

Purpose

The main purpose of this study is to provide a relatively integrated perspective on the role of market orientation, strategic flexibility and technological capability as multiple organizational capabilities and their potential effectiveness in promoting business model innovation (BMI) and business performance.

Design/methodology/approach

To achieve this objective, an empirical survey was conducted among 379 firms in Greece. Initially, exploratory factor analysis and then confirmatory factor analysis were applied. Finally, the structural relationships among the latent factors were determined through structural equation modeling.

Findings

The results show the positive effect of market orientation on strategic flexibility and technological capability. Strategic flexibility drives firms to BMI and then business performance. Furthermore, it is essential that firms build up technological capability to be effective in BMI and business performance.

Research limitations/implications

Data were collected at only one point in time from one country, Greece. This might pose limitations on the generalizability of our results. Future research could also explore how organizations develop strategic flexibility and BMI capabilities in different environmental contexts and organizational structures.

Practical implications

This study sends the message that companies focusing on market orientation and technological capability can led to higher strategic flexibility and BMI capabilities, which in turn act as a catalyst for business improvement.

Originality/value

The proposed model provides plausible guidelines that advance the research on multiple organizational capabilities in companies.
Coerced work during parole: Prevalence, mechanisms, and characteristics
Authors: Augustine Dallas
Published: May 2023

Coerced work on parole occurs when people are required to work under the threat of criminal legal repercussions. In the face of barriers to “good” work for people after prison, coercion helps to funnel parolees into positions at the bottom of the labor market. Parolee workers in these positions experience issues common to precarious, low‐wage work (low pay, hazardous working conditions, and labor law violations), as well as heightened vulnerability to predatory employers and exposure to parole‐prohibited activities. Because of the threat‐backed requirements to work, however, parolees must choose to either accept this “bad” work or face potential sanctions. Using mixed‐methods, including a novel form of respondent‐driven sampling I call “Hybrid‐RDS,” this article documents the prevalence of coerced work for people on parole in Los Angeles County, identifies the mechanisms through which coercive work operates, and illustrates the problematic employment conditions of coerced work after prison.
The rough‐toothed dolphin genome provides new insights into the genetic mechanism of its rough teeth
Authors: HUANG Xin , FAN Huizhong , ZHOU Wenliang , YANG Guang , WEI Fuwen
Published: May 2023

The rough‐toothed dolphin (Steno bredanensis) is characterized by having teeth covered in finely wrinkled vertical ridges, which is a general manifestation of amelogenesis imperfecta. The rough surfaces are hypothesized to be an evolutionary morphological trait of feeding adaptation to increase the dolphin's grip on prey. Here, we assembled a rough‐toothed dolphin genome and performed the comparative genomic analysis to reveal the genetic basis of the special enamel. Results showed that genes related to enamel development or dental diseases have undergone diversified adaptive changes that may shape the special enamel morphology of this dolphin species, including positive selection (CLDN19, PRKCE, SSUH2, and WDR72), rapid evolution (LAMB3), or unique amino acid substitutions (AMTN, ENAM, MMP20, and KLK4). Meanwhile, the historical demography of rough‐toothed dolphin indicated several distinct population fluctuations associated with climate change. The genome‐wide heterozygosity of this dolphin is in the middle of all published data for cetaceans. Although the population is considerable, there may be population or subspecies differentiation, and with the global warming and the increasing disturbance of human activities, we should pay more attention to protection in the future. Together, our study brings new insights into the genetic mechanisms that may have driven the evolution of the special enamel morphology in rough‐toothed dolphins and provides the first results of genetic heterozygosity and population historical dynamics of this species, which have important guiding implications for the conservation of this dolphin species.
Defining, collecting, and sharing perishable disaster data
Authors: Adams Rachel M. , Evans Candace M. , Peek Lori
Published: May 2023

Researchers across disciplines have long sought to collect ‘perishable data’ in the context of disasters. Yet, this data type is neither consistently defined nor discussed in specific detail in the literature. To address this gap, this paper defines perishable data and provides guidance on ways to improve both how it is collected and shared. Here, perishable data is conceptualised as highly transient data that may degrade in quality, be irrevocably altered, or be permanently lost if not gathered soon after it is generated. Perishable data may include ephemeral information that must be collected to characterise pre‐existing hazardous conditions, near‐miss events, actual disasters, and longer‐term recovery processes. This data may need to be gathered at multiple points in time across varying geographic scales to accurately characterise exposure, susceptibility to harm, or coping capacity. The paper considers ethical and logistical challenges and discusses opportunities to advance equitable perishable data collection and dissemination.