bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applications of neural networks in urology: a systematic review
Authors: Checcucci Enrico , De Cillis Sabrina , Granato Stefano , Chang Peter , Afyouni Andrew Shea , Okhunov Zhamshid 
Published: September 2020

Purpose of review
Over the last decade, major advancements in artificial intelligence technology have emerged and revolutionized the extent to which physicians are able to personalize treatment modalities and care for their patients. Artificial intelligence technology aimed at mimicking/simulating human mental processes, such as deep learning artificial neural networks (ANNs), are composed of a collection of individual units known as ‘artificial neurons’. These ‘neurons’, when arranged and interconnected in complex architectural layers, are capable of analyzing the most complex patterns. The aim of this systematic review is to give a comprehensive summary of the contemporary applications of deep learning ANNs in urological medicine.

Recent findings
Fifty-five articles were included in this systematic review and each article was assigned an ‘intermediate’ score based on its overall quality. Of these 55 articles, nine studies were prospective, but no nonrandomized control trials were identified.

Summary
In urological medicine, the application of novel artificial intelligence technologies, particularly ANNs, have been considered to be a promising step in improving physicians’ diagnostic capabilities, especially with regards to predicting the aggressiveness and recurrence of various disorders. For benign urological disorders, for example, the use of highly predictive and reliable algorithms could be helpful for the improving diagnoses of male infertility, urinary tract infections, and pediatric malformations. In addition, articles with anecdotal experiences shed light on the potential of artificial intelligence-assisted surgeries, such as with the aid of virtual reality or augmented reality.
The best rules for antimicrobial stewardship in urogenital tract infections
Authors: Kulchavenya Ekaterina 
Published: September 2020

Purpose of review
Urinary tract infections (UTIs) belong to the most common community-acquired and nosocomial infections, but therapy of UTIs is limited by resistance of pathogens and nonoptimal using of antibacterials. Narrative review of recent (2020–2018) literature dedicated to antimicrobial stewardship (AMS) in urological infections has been done.

Recent findings
Analysis of recent 64 articles has shown following principles of AMS for UTIs: selecting the correct drug, correct dose, and shortest clinically effective duration of therapy whenever possible, is a base for optimal antimicrobial stewardship; symptomatic UTIs should be treated with antimicrobials to alleviate symptoms, and in the case of more serious infection, to prevent complications; in both symptomatic and asymptomatic infection, quantitative culture is the gold standard for diagnosis; we have to avoid prescriptions of antibiotics when possible; we have to follow European and National Guidelines; we must avoid prescription of fluoroquinolones as empiric therapy for UTIs by many reasons, one of these is urogenital tuberculosis; the choice of antibiotic for UTI should be based on local level of resistance of uropathogens.

Summary
Studies of antimicrobial stewardship in urology are limited. Nevertheless, there are some golden rules, which may help to reduce inappropriate use of antimicrobials, improve patient outcomes, reduce side effects of antibiotic therapy, decrease the emergence and spread of multidrug-resistant infections, as well as decrease total costs of the therapy.
The Effects of Sensory Enrichment After a Laboratory Stressor on Human Skin Barrier Recovery in a Randomized Trial
Authors: Law Mikaela , Jarrett Paul , Nater Urs M. , Skoluda Nadine , Broadbent Elizabeth 
Published: September 2020

ABSTRACT

Objective
Environmental enrichment (EE) can reduce stress, alter immunity, and speed wound healing in animals. However, it is not known whether these effects translate to humans. This study aimed to investigate whether sensory EE could improve wound healing after a stressor in humans.

Methods
A total of 105 participants underwent a tape-stripping procedure and were then stressed using a laboratory stress paradigm. After this, they were randomized to interact for 30 minutes with one of two possible sensory EE interventions (music as auditory enrichment or a Paro robot as multisensory enrichment) or to a control condition. Skin barrier recovery was measured using transepidermal water loss at baseline, after the stressor, and after the intervention. Stress was measured using self-report, heart rate, blood pressure, and salivary stress-related biological measures. Enjoyment during the intervention was measured by self-report as a possible mediator.

Results
The Paro condition had significantly improved skin barrier recovery (mean [M] = 44%, standard error [SE] = 1.92) compared with the control condition (M = 37% SE = 2.01, F
(2,88) = 3.25, p = .043), both with and without controlling for covariates. The music condition did not significantly differ from the other conditions (M = 42%, SE = 1.95, p values > .05). Both objective and subjective stress measures did not significantly differ between conditions. Mediational analysis showed that enjoyment levels during the intervention period significantly mediated the relationship between condition and skin barrier recovery (z = 2.00, p = .046).

Conclusions
Paro, or other companion robots, may be an effective form of enrichment to improve skin barrier recovery in humans after a laboratory stressor, and this effect may be due to enjoyment. Further research with patient groups is required to investigate whether Paro can help heal clinical wounds.

Trial Registration: ACTRN12618000953235, registered at https://anzctr.org.au.
Wide Local Excisions and Pedicled Perforator Flaps in Hidradenitis Suppurativa
Authors: Marchesi Andrea , Amendola Francesco , Garieri Pietro , Steinberger Zvi , Vaienti Luca 
Published: September 2020

Background
Hidradenitis suppurativa (HS) is a chronic skin pathology characterized by the occurrence of inflamed and swollen lesions, with a devastating impact of the disease on patient's quality of life. Wide local excision (WLE) of the affected tissue is the criterion-standard treatment, but there is no general consensus on the best reconstructive technique. The aim of this article is to evaluate the quality of life before and after WLE combined with pedicled perforator flap reconstruction, in patients suffering from HS.

Methods
We analyzed 26 consecutive patients suffering from Hurley stage III HS. Every patient underwent WLE, followed by reconstruction with pedicled perforator flap. Dermatology Quality of Life Index (DLQI) tests were administered to every patient preoperatively and 6 months after surgery, when the clinical condition was considered stable. Dermatology Quality of Life Index scores were compared in terms of means with Student t test. Linear regression studies were used to compare the changes in DLQI score with the surgical and clinical variables.

Results
Axillary area involvement was found in 21 of 27 patients; 6 patients had more than 1 body region involved. Thirty-two pedicled perforator flaps were performed, and 22 were thoracodorsal artery perforator flaps. Mean DLQI test score before the first operation was 21.31 ± 4.79; the average DLQI score after the last follow-up was 5 ± 2.95 (P < 0.0001). Dermatology Quality of Life Index scores were not influenced by complications including reoperation. There were also no correlations found between DLQI score delta and number of reoperation (−0.18) or days of hospital stay (−0.13).

Conclusions
Wide local excision followed by pedicled perforator flap reconstruction allows a radical excision of HS areas with short postoperative healing periods. Dermatology Quality of Life Index scores confirmed high levels of patients' satisfaction. Disadvantages of this technique include difficult learning curve, long operating time, and a nonnegligible complications rate.
Role of Orbicular Oculi Muscle Resection in Double Eyelid Surgery to Correct Ptosis of Young Adults
Authors: Li Tian , Liu Hai-peng , Wang Jia-qi , Zhang Duo 
Published: September 2020

Background
A plump single eyelid with ptosis is the morphological feature of Asians. Orbicularis oculi muscle (OOM) technique can correct ptosis and get a good appearance.

Methods
A retrospective study was conducted in 121 Chinese patients who underwent double eyelid surgery with medial epicanthoplasty using OOM resection technique from December 2016 to December 2019. Preoperatively, all the patients had good or excellent levator function while skin fold overlapping the upper eyelid margin was found. Palpebral fissure height, upper eyelid margin reflex distance, complications, and cosmetic results were evaluated. Comparisons were performed preoperatively and postoperatively.

Results
The study included 121 patients. Mean follow-up time was 12.8 months (range, 6–32 months). Mean margin reflex distance increased from 1.96 ± 0.60 mm preoperatively to 3.74 ± 0.50 mm postoperatively (P < 0.001), mean palpebral fissure height increased from 6.31 ± 0.51 mm preoperatively to 8.33 ± 0.52 mm postoperatively (P < 0.001). Most patients obtained satisfactory results. Only 1 patient was under correction, 2 patients were with mild asymmetry 6 months postoperatively.

Conclusions
Ptosis of the upper eyelid can be corrected by the OOM resection technique without any procedure on levator muscle. This technique can be an alternative method for the correction of ptosis of the upper eyelid.
Estimation of Health Utility and Quality Adjusted Life Years in Bilateral Hand Transplantation
Authors: Harijee Ankita , Thankappan Krishnakumar , Sharma Mohit , NageswaraRao Nagesh Noothanapati , Patel Tejal , Bhaskaran Renjitha , Raj Manu , Sundaram Karimassery Ramaiyer , Iyer Subramania 
Published: September 2020

Background
Hand transplantation and advances in the field of prostheses have opened new frontiers in the restoration of hand function among bilateral hand amputees (BHA). There is only scarce literature evaluating the health utility (HU) and quality adjusted life years (QALY) gained by bilateral hand composite tissue allotransplantation (CTA) or prosthesis over amputation. The study was focused on BHA restored with prosthesis or CTA.

Methods
The HU of three different health states (HS) namely, BHA, using prosthesis or with CTA and net QALYs gained by hand transplantation or prosthesis over amputation were computed by time trade-off (TTO) method among 236 study participants.

Results
Among 236 study participants, medical professional (120), general public (89), BHA (23), and bilateral hand transplant recipients (4) were included. The mean HU by TTO method among the study participants (n = 232) as BHA, using prosthesis or CTA was 0.34 (±0.24), 0.50 (±0.26) and 0.69 (±0.26) respectively. Bilateral hand CTA imparted an expected gain of 12.57 (±11.43) mean QALYs over amputation among the study participants. The subgroup analysis displayed higher mean HU in hand CTA recipient HS along with maximum QALY gained by CTA over amputation.

Conclusions
Bilateral hand CTA HS stands above the other 2 HSs, namely BHA and prosthesis, in terms of the health utility. As demonstrated by QALY gain of 12.57, participants' valuation of health utility is notably higher for CTA with acceptance of lifelong immunosuppressant rather than for a state of uncompromised physical health with a bilateral hand amputation.
Ear Deformations in Preterm Newborns: Non-Surgical Treatment
Authors: Olshinka Asaf , Ad-El Dean D. , Yaacobi Dafna (Shilo) , Ashkenazi Moshe 
Published: September 2020

Abstract
Approximately 30% of newborns have some degree of congenital ear anomalies, the minority will resolve spontaneously. Deformations can be treated non-surgically, when diagnosed early, whereas malformations surgically only. The authors use the EarWell system proven to achieve excellent results in treating deformations. Although prematurity might raise the risk of ear-deformations compared to term infants, in our experience, there is a longer time frame until effective treatment is initiated due to the cartilage malleability.
Treatment included splinting with retractors and taping or a custom-made silicone ear-mold if necessary. Patients were examined weekly, and treatment continued until appropriate ear shape was achieved (6–14 weeks).
The authors treated 8 preterm infants during 2018 to 2020 with the above method. Average age of application was 9.25 weeks; treatment was initiated in all patients before the age of 12 weeks. 5/8 had a right-side, 2/8 a left-side, and one a bilateral deformation. Average treatment duration was 10 ± 2.9 weeks. Assessment of satisfaction was made by parents via phone questionnaires; most were pleased with the overall result, while 62% were extremely satisfied.
The authors observed higher compliance and longer-lasting malleability of the cartilage in preterm compared to term-infants. They also had fewer complications than in the term group, maybe due to their older (actual age), and more resistant and durable skin compared to a term-infant of the same age. The authors recommend initiating treatment in preterm infants later than accepted practice as results were excellent, and despite the longer treatment duration, this is a better treatment option than surgery.
Dysregulation of tryptophan catabolism at the host-skin microbiota interface in Hidradenitis Suppurativa
Authors: Guenin-Macé Laure , Morel Jean-David , Doisne Jean-Marc , Schiavo Angèle , Boulet Lysiane , Mayau Véronique , Goncalves Pedro , Duchatelet Sabine , Hovnanian Alain , Bondet Vincent , Duffy Darragh , Ungeheuer Marie-Noëlle , Delage Maïa , Nassif Aude , Di Santo James P , Demangel Caroline 
Published: September 2020

AbstractHidradenitis Suppurativa (HS) is a chronic skin disorder of unknown etiology that manifests as recurrent, painful lesions. Cutaneous dysbiosis and unresolved inflammation are hallmarks of active HS, but their origin and interplay remain unclear. Our metabolomic profiling of HS skin revealed an abnormal induction of the kynurenine pathway (KP) of tryptophan catabolism in dermal fibroblasts correlating with the release of KP-inducing cytokines by inflammatory cell infiltrates. Notably, over-activation of the KP in lesional skin was associated with local and systemic depletion in tryptophan. Yet the skin microbiota normally degrades host tryptophan into indoles regulating tissue inflammation via engagement of the Aryl Hydrocarbon Receptor (AHR). In HS skin lesions, we detected contextual defects in AHR activation coinciding with impaired production of bacteria-derived AHR agonists and decreased incidence of AHR ligand-producing bacteria in the resident flora. Dysregulation of tryptophan catabolism at the skin-microbiota interface thus provides a mechanism linking the immunological and microbiological features of HS lesions. In addition to revealing metabolic alterations in HS patients, our study suggests that correcting AHR signaling would help restore immune homeostasis in HS skin.
Survival and 30-days hospital outcome in hospitalized COVID-19 patients in Upper Egypt: Multi-center study
Authors: Hussein Aliae AR Mohamed , Galal Islam , Mohamed Mohammed Mustafa Abdel Rasik , Eltaher AA Ibrahim Mohamed , Ahmed Shazly B 
Published: September 2020

AbstractBackgroundDefining the clinical features and associated outcomes of patients diagnosed with corona virus disease (COVID-19) is fundamental to improving our understanding and adequate management of this illness. The aim of this study was to identify the demographic data, underlying comorbidities and the mortality related factors of hospitalized patients with COVID-19 in Upper Egypt.Patients and methods1064 cases consecutively admitted to isolation hospitals in Upper Egypt. All cases had confirmed COVID-19 infection. The electronic records of the patients were retrospectively revised and the demographic data, clinical manifestations, qSOFA score on admission and 30 days-outcome (ICU admission, death, recovery, referral or still in hospital) were analyzed. Overall cumulative survival in all patients and those > or < 50 years were calculated.Results49.2% of the study population were males and 50.8% were females with mean age 49.4±17.8 years-old. On admission, 83.9% were stable with qSOFA score <1, 3% required non-invasive mechanical ventilation, and 2.1% required O2 therapy. Within 30 days, 203 cases (19.1%) required admission to ICU. Death was recorded in 11.7% of cases, 28.7% recovered, 40.5% referred and 19.2% were still under treatment. Determinants of ICU admission and survival in the current study were age > 50, respiratory rate > 24/minute, SaO2 < 89%, qSOFA >1 and need for O2 therapy or NIV. The cumulative survival was 75.3% with the mean survival was 28.1, and 95.2% overall survival was recorded in those aged ≤50 years.ConclusionsAge older than 50 years old, those with pre-existing DM, initial qSOFA score, requirement for O2 therapy and NIV from the first day of hospital admission may be associated with unfavorable 30 days- in hospital outcome of COVID-19.
Genomic epidemiology of COVID-19 in care homes in the East of England
Authors: Hamilton William L. , Tonkin-Hill Gerry , Smith Emily , Aggarwal Dinesh , Houldcroft Charlotte J. , Warne Ben , Brown Colin S. , Meredith Luke W. , Hosmillo Myra , Jahun Aminu S. , Curran Martin D. , Parmar Surendra , Caller Laura G. , Caddy Sarah L. , Khokhar Fahad A. , Yakovleva Anna , Hall Grant , Feltwell Theresa , Pinckert Malte L. , Georgana Iliana , Chaudhry Yasmin , Brown Nicholas M. , Gonçalves Sónia , Amato Roberto , Harrison Ewan M. , Beale Mathew A. , Chapman Michael Spencer , Jackson David K. , Johnston Ian , Alderton Alex , Sillitoe John , Langford Cordelia , Dougan Gordon , Peacock Sharon J. , Kwiatkowski Dominic P. , Goodfellow Ian , Török M. Estée ,   COVID-19 Genomics Consortium UK
Published: September 2020

AbstractCOVID-19 poses a major challenge to care homes, as SARS-CoV-2 is readily transmitted and causes disproportionately severe disease in older people. Here, 1,167 residents from 337 care homes were identified from a dataset of 6,600 COVID-19 cases from the East of England. Older age and being a care home resident were associated with increased mortality. SARS-CoV-2 genomes were available for 700 residents from 292 care homes. By integrating genomic and temporal data, 409 viral clusters within the 292 homes were identified, indicating two different patterns - outbreaks among care home residents and independent introductions with limited onward transmission. Approximately 70% of residents in the genomic analysis were admitted to hospital during the study, providing extensive opportunities for transmission between care homes and hospitals. Limiting viral transmission within care homes should be a key target for infection control to reduce COVID-19 mortality in this population.Impact statementSARS-CoV-2 can spread efficiently within care homes causing COVID-19 outbreaks among residents, who are at increased risk of severe disease, emphasising the importance of stringent infection control in this population.
Automated COVID-19 Detection from Chest X-Ray Images: A High Resolution Network (HRNet) Approach
Authors: Ahmed Sifat , Hossain Tonmoy , Hoque Oishee Bintey , Sarker Sujan , Rahman Sejuti , Shah Faisal Muhammad 
Published: September 2020

AbstractThe pandemic, originated by novel coronavirus 2019 (COVID-19), continuing its devastating effect on the health, well-being, and economy of the global population. A critical step to restrain this pandemic is the early detection of COVID-19 in the human body, to constraint the exposure and control the spread of the virus. Chest X-Rays are one of the non-invasive tools to detect this disease as the manual PCR diagnosis process is quite tedious and time-consuming. In this work, we propose an automated COVID-19 classifier, utilizing available COVID and non-COVID X-Ray datasets, along with High Resolution Network (HRNet) for feature extraction embedding with the UNet for segmentation purposes. To evaluate the proposed dataset, several baseline experiments have been performed employing numerous deep learning architectures. With extensive experiment, we got 99.26% accuracy, 98.53% sensitivity, and 98.82% specificity with HRNet which surpasses the performances of the existing models. Our proposed methodology ensures unbiased high accuracy, which increases the probability of incorporating X-Ray images into the diagnosis of the disease.
Predictors of healthcare worker burnout during the COVID-19 pandemic
Authors: Ferry Amy V , Wereski Ryan , Strachan Fiona E , Mills Nicholas L 
Published: September 2020

AbstractObjectiveWe aim to provide a ‘snapshot’ of the levels of burnout, anxiety, depression and distress among healthcare workers during the COVID-19 pandemic.Design, setting, participantsWe distributed an online survey via social media in June 2020 that was open to any UK healthcare worker. The primary outcome measure was symptoms of burnout as measured using the Copenhagen Burnout Inventory (CBI). Secondary outcomes of depression, anxiety and distress as measured using the Patient Health Questionnaire-9, General Anxiety Scale-7, and Impact of Events Scale-Revised were recorded along with subjective measures of stress. Multivariate logistic regression analysis was performed to identify factors associated with burnout, depression, anxiety and distress.ResultsOf 539 persons responding to the survey, 90% were female, and 26% were aged 41-50 years, 53% were nurses. Participants with moderate-to-severe burnout were younger (49% [206/424] versus 33% [38/115] under 40 years, P=0.004), and more likely to have pre-existing comorbidities (21% versus 12%, P=0.031). They were twice as likely to have been redeployed from their usual role (22% versus 11%; adjusted odds ratio [OR] 2.2, 95% confidence interval [CI] 1.5-3.3, P=0.042), or to work in an area dedicated to COVID-19 patients (50% versus 32%, adjusted OR 1.6, 95% CI 1.4-1.8, P<0.001), and were almost 4-times more likely to have previous depression (24% versus 7%; adjusted OR 3.6, 95% CI 2.2-5.9, P=0.012). A supportive workplace team and male sex protected against burnout reducing the odds by 40% (adjusted OR 0.6, 95% CI 0.5-0.7, P<0.001) and 70% (adjusted OR 0.3, 95% CI 0.2-0.5, P=0.003), respectively.ConclusionIndependent predictors of burnout were younger staff, redeployment to a new working area, working with patients with confirmed COVID-19 infection, and being female or having a previous history of depression. Evaluation of existing psychological support interventions is required with targeted approaches to ensure support is available to those most at risk.