bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.

Summary
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.

Summary
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.

Summary
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 reviewTo correlate the resistance mechanisms and the susceptibility to new antibiotics inPseudomonas aeruginosa.Recent findingsDefinition 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.SummaryCurrent 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

Abstract
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

Abstract
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.
Sterile Draping of Operative Microscopes in Breast Free Flaps and Surgical Site Infections
Authors: Marable Julian K. , Spoer Daisy L. , Harish Varsha , Berger Lauren E. , Song David H. , Fan Kenneth L. 
Published: August 2024

Background
Operative microscopes are traditionally draped in single-use plastic to prevent infection theoretically. The necessity of this routine in breast free flap surgery is unclear. Alternatively, sterile wrapping of microscope handles would reduce operating room waste and provide a more cost-effective and environmentally sustainable approach to sterility. This study aimed to determine whether the draping technique used during abdominally based free flaps (Ab-FF) influenced the rate of surgical site infections.

Methods
We conducted a retrospective review of Ab-FF performed consecutively between March 2017 and August 2022. Patient demographics, comorbidities, perioperative data, and postoperative complications were collected. The primary outcomes included postoperative surgical site infections and environmental impact.

Results
Of the 281 identified breasts reconstructed with Ab-FF, operating microscopes were sterilely covered with microscope drapes (n = 215) or handle covers (n = 66) composed of polyethylene-based plastic. Overall, postoperative infections occurred in 9.3% of cases (n = 26) in either the recipient breast (n = 11, 3.9%) or abdominal donor site (n = 15, 5.3%), primarily due to S. aureus and Streptococcus species. The handle (n = 6, 9.1%) and drape (n = 20, 9.3%) cohorts had similar infection rates with no sequelae of operative complications. In multivariate analysis, radiation was the only independent predictor of postoperative infection, while bilateral reconstructions were independently protective. Replacing a microscope drape with a handle reduces carbon emissions by 1276 grams of CO2 and direct costs by $7.84 per item.

Conclusions
The principles of “Lean and Green” surgery prioritize reducing operating room generated waste to achieve financial and environmental sustainability. This cohort study of 281 breast free flaps demonstrates that switching from whole microscope draping to handle wrapping was not associated with an increased rate or odds of infection. Adopting a microscope handle wrapping protocol decreased the carbon footprint and operative costs. The results of this study offer evidence to support adoption and further exploration of pragmatic, cost-effective, and sustainable approaches to microsurgical breast reconstruction.
Employer-Sponsored Medicare Advantage Plans and the 2018 Therapy Cap Repeal
Authors: Fahmy Joseph N. , Kong Lingxuan , Wang Lu , Chung Kevin C. 
Published: August 2024

Background
Policy impacting traditional Medicare beneficiaries may have unintended effects for privately insured patients. After the repeal of a longstanding $1500 outpatient therapy cap in 2018, we aimed to evaluate if this policy change was associated with differences in use of cost of postoperative therapy after common hand surgeries, including carpal tunnel release, trigger finger release, ganglion cyst excision, De Quervain tenosynovitis release, carpometacarpal arthroplasty, and distal radius fracture open reduction/internal fixation or percutaneous pinning.

Methods
The Medicare Supplement and Coordination of Benefits files from Marketscan were used. Frequency of therapy appointments, overall costs, and out-of-pocket costs were obtained. A segmented interrupted time series with Poisson and log-transformed linear regression was performed.

Results
No significant monthly change in odds of therapy use was found in the postpolicy period for patients who underwent trigger finger release, carpal tunnel release, Ganglion cyst excision, De Quervain tenosynovitis release, carpometacarpal arthroplasty, or distal radius fracture, pinning, or open reduction/internal fixation. Overall cost decreased in the postpolicy period by 2% for comprehensive plans (95% confidence interval [CI]: −0.03 to −0.01, P < 0.001), by 7% for those with exclusive provider organizations (95% CI: −0.10 to −0.04, P < 0.001), by 1% for HMOs (95% CI: −0.01 to 0.002, P = 0.01), and by 3% for preferred provider organizations (95% CI: −0.03 to −0.02, P < 0.001). In the postpolicy period, no monthly change in out-of-pocket cost was observed for patients with comprehensive, exclusive provider organization, health maintenance organization, preferred provider organization, or point of service with capitation insurance plans.

Conclusions
Patients with employer-sponsored Medicare Advantage plans experienced increased out-of-pocket costs for therapy despite lower net costs. These data highlight an urgent need for policy ensuring that patients benefit when overall costs of care decrease.
Course Review
Authors: Gundle Leo 
Published: August 2024

Abstract
Microsurgery is a unique and specific surgical skill, known to have a steep learning curve. Surgical trainees may wish to undertake a microsurgical skills course to learn the rudiments of microsurgery and to direct future practice and skill acquisition. The National Microsurgery Course in Newcastle, United Kingdom, aims to equip early-year surgical trainees with basic microsurgical skills including tissue handling, vessel anastomosis, and nerve coaptation. The course in 2024 gave delegates an excellent opportunity to learn and practice these skills in a well-resourced environment with a high delegate-to-faculty ratio. Overall, the course was an extremely high-quality educational experience with most of the course time allocated to practicing surgical skills. This course is recommended to surgical trainees wishing to learn the basics of microsurgery.