bluuebunny/crossref_metadata_2025_split huggingface dataset:
(267) PEDIATRIC URETHRAL STRICTURES - TREATMENT MODALITIES
Authors: Marjanovic Dr Marko , Kojovic Vladimir , Cvetinovic Dr Ana , Cico Dr Emre , Ilic Predrag 
Published: June 2024

Abstract

Objectives
Pediatric urethral strictures (US) are not a common problem and published series usually include small number of patients with short follow-up. Pediatric urethral reconstruction represents a great challenge due to anatomical characteristics of the pediatric urethra and small number of cases. The aim of this study is to present the surgical approaches for pediatric US.

Methods
From January 2007 until January 2023, 18 boys with US aged between 2 and 18 years were treated. Nine patients had US due to trauma, 7 patients underwent harmful iatrogenic procedures and 2 patients had a stricture of unknown cause. Patients with US due to complications of hypospadias repair were excluded. Stricture was presented on the anterior urethra in 14 and on the posterior urethra in 4 patients. Patients were treated with endoscopic intervention (2), augmentation using buccal mucosa graft (9) or urethrorrhaphy (7). Very short strictures of bulbar urethra were treated endoscopically (internal urethrotomy). More extensive bulbar strictures and obliterative posterior urethral disruption were treated by excision and primary anastomosis. The treatment method of the anterior US was urethral augmentation with buccal mucosa graft.

Results
The patients were followed for 12 to 160 months (mean 42 months). Quality of urinary stream, the presence of urinary tract infections or dysuria were recorded. If any disturbances were reported further exams were performed, uroflowmetry, urethrography and urethroscopy. Sixteen patients (89%) had good outcome, while two patients (11%) underwent redo procedure, one with endoscopic incision, and another with buccal mucosa graft augmentation. Complications as penile curvature, urethral fistula or diverticulum were not reported.

Conclusions
Pediatric US can be successfully treated by open surgery. Repeated dilatation and endoscopic treatment should not be preferred treatment method due to low success rate, possibility for additional injuries and non-compliance of the pediatric patients. For successful outcome of the US surgery individualized approach is required.

Conflicts of Interest
The authors declare no coflict of interest.
(365) THE EFFECTS OF A COLLEGE COURSE IN HUMAN SEXUALITY ON STUDENT’S KNOWLEDGE AND ATTITUDES
Authors: Fejza Prof Hajrullah , Icka Prof Ejona , Alidema Prof Fitim , Ukaj Prof Xhevat 
Published: June 2024

Abstract

Objectives
This article delves into the effects of a college course dedicated to human sexuality on students’ knowledge and attitudes.

Methods
The study was conducted at the UBT College in Pristina. Students (178), at the beginning of the first lecture and at the end of the course, answered 15 questions about their knowledge and attitudes about sexuality in the SKAT test (The Sex Knowledge and Attitude Test). After that, their answers were analyzed and tested with the SPSS before and after the test.

Results
In almost all questions, there is a big difference in their answers before and after the test. These are some of the questions with significant changes before and after the test. In the knowledge section most, relevant effects were shown when they were asked: Sexuality is usually a lifelong need -79.2 % vs 91%. Desire for sex in women can come after adequate stimulation from the partner - 59% vs 81%. Homosexuality is a disease and sexual deviation - 54.5 % vs. 31%. In the attitude section: It is better to start having sex after marriage – 59.6% vs. 39.9%. Contraception is the responsibility of both partners – 80% vs. 92.4%. Prostitution should be legalized – 28.7% vs. 34.8%.

Conclusions
The findings will contribute to the ongoing discourse surrounding the design and implementation of sexual education courses, aiding educators, policymakers, and institutions in refining their approaches to promoting informed and positive sexual attitudes among students.

Conflicts of Interest
The authors declare No conflict of interest.
FRET-guided modeling of nucleic acids
Authors: Steffen Fabio D , Cunha Richard A , Sigel Roland K O , Börner Richard 
Published: June 2024

Abstract
The functional diversity of RNAs is encoded in their innate conformational heterogeneity. The combination of single-molecule spectroscopy and computational modeling offers new attractive opportunities to map structural transitions within nucleic acid ensembles. Here, we describe a framework to harmonize single-molecule Förster resonance energy transfer (FRET) measurements with molecular dynamics simulations and de novo structure prediction. Using either all-atom or implicit fluorophore modeling, we recreate FRET experiments in silico, visualize the underlying structural dynamics and quantify the reaction coordinates. Using multiple accessible-contact volumes as a post hoc scoring method for fragment assembly in Rosetta, we demonstrate that FRET can be used to filter a de novo RNA structure prediction ensemble by refuting models that are not compatible with in vitro FRET measurement. We benchmark our FRET-assisted modeling approach on double-labeled DNA strands and validate it against an intrinsically dynamic manganese(II)-binding riboswitch. We show that a FRET coordinate describing the assembly of a four-way junction allows our pipeline to recapitulate the global fold of the riboswitch displayed by the crystal structure. We conclude that computational fluorescence spectroscopy facilitates the interpretability of dynamic structural ensembles and improves the mechanistic understanding of nucleic acid interactions.
Real-World Experience With Maribavir for Treatment of Cytomegalovirus Infection in High-Risk Solid Organ Transplant Recipients
Authors: Ni Bin , Wolfe Cameron R , Arif Sana , Carugati Manuela , Heldman Madeleine R , Messina Julia A , Miller Rachel A , Saullo Jennifer L , Baker Arthur W , Maziarz Eileen K 
Published: June 2024

Abstract
We evaluated use of maribavir (MBV) for treatment of 15 episodes of refractory/resistant cytomegalovirus infection in 13 solid organ transplant recipients. Treatment failure due to treatment-emergent MBV resistance or early virological recurrence after MBV discontinuation occurred in 7 (47%) episodes. Sustained viral clearance was achieved in 6 (40%) episodes.
Therapeutic Myths in Solid Organ Transplantation Infectious Diseases
Authors: Goodlet Kellie J , McCreary Erin K , Nailor Michael D , Barnes Darina , Brokhof Marissa M , Bova Sarah , Clemens Evan , Kelly Beth , Lichvar Alicia , Pluckrose Dawn M , Summers Bryant B , Szempruch Kristen R , Tchen Stephanie 
Published: June 2024

AbstractInfection management in solid organ transplantation poses unique challenges, with a diverse array of potential pathogens and associated antimicrobial therapies. With limited high-quality randomized clinical trials to direct optimal care, therapeutic “myths” may propagate and contribute to suboptimal or excessive antimicrobial use. We discuss 6 therapeutic myths with particular relevance to solid organ transplantation and provide recommendations for infectious diseases clinicians involved in the care of this high-risk population.
Measurement of temperature relaxation in the postshock plasma of the northwestern limb of SN 1006
Authors: Ichihashi Masahiro , Bamba Aya , Kato Yuichi , Katsuda Satoru , Suzuki Hiromasa , Kasuga Tomoaki , Odaka Hirokazu , Nakazawa Kazuhiro 
Published: June 2024

Abstract
Heating of charged particles via collisionless shocks, while ubiquitous in the universe, is an intriguing yet puzzling plasma phenomenon. One outstanding question is how electrons and ions approach an equilibrium after they were heated to different immediate-postshock temperatures. In order to fill the significant lack of observational information of the downstream temperature-relaxation process, we observe a thermal-dominant X-ray filament in the northwest of SN 1006 with Chandra. We divide this region into four layers with a thickness of $15^{\prime \prime }$ or $0.16\:$pc each, and fit each spectrum by a non-equilibrium ionization collisional plasma model. The electron temperature was found to increase toward downstream from 0.52–0.62 to 0.82–$0.95\:$keV on a length scale of $60^{\prime \prime }$ (or $0.64\:$pc). This electron temperature is lower than thermal relaxation processes via Coulomb scattering, requiring some other effects such as plasma mixture due to turbulence and/or projection effects, etc., which we hope will be resolved with future X-ray calorimeter missions such as XRISM and Athena.
Comparison of Operative and Nonoperative Management of Elderly Fragility Pelvic Ring Fractures
Authors: Swenson Riley A. , Paull Thomas Z. , Yates Rob A. , Foster Jeffrey A. , Griffin Jarod T. , Southall Wyatt G.S. , Aneja Arun , Nguyen Mai P. 
Published: June 2024

OBJECTIVES:
To compare outcomes of nonoperative and percutaneous fixation of geriatric fragility lateral compression 1 (LC1) pelvic ring fractures.

METHODS:

Design:
Retrospective.

Setting:
Two level 1 trauma centers.

Patient Selection Criteria:
Included were patients who were 60 years or older with an isolated LC1 pelvic ring fracture managed nonoperatively or those who failed mobilization and were managed operatively with percutaneous sacral fixation. Patients with high-energy mechanisms of injury or polytrauma were excluded.

Outcome Measures and Comparisons:
The primary outcome was pain as measured by using the visual analog scale (VAS) after treatment. Secondary outcomes included length of stay, discharge disposition, mortality, readmission rates, and complications.

RESULTS:
In total, 231 patients were included with a mean age of 79.5 years (range 60–100). One hundred eighty-five (80.0%) patients were female. Sixty-two (26.8%) patients received percutaneous sacral fixation after failed mobilization, and 169 (73.2%) were managed nonoperatively. In the operative group, the median time to surgery was hospital day 4. Nonoperative patients were older (81.5 ± 10.0 years vs. 74.2 ± 9.4 years, P < 0.01) and had a shorter hospital length of stay (4.8 ± 6.2 days) than the operative group (10.6 ± 9.5 days, P < 0.01). Patients in the operative group had more pain (VAS 7.9 ± 3.0) than those in the nonoperative group (VAS 6.6 ± 3.0) (P = 0.01) on admission but had similar pain control postoperatively (VAS 4.4 ± 3.0) compared with the nonoperative group (VAS 4.5 ± 3.6) on the equivalent hospital day (P = 0.91). Thus, patients in the operative group experienced more improvement in pain (VAS 3.3 ± 2.7) compared with the nonoperative group (VAS 1.9 ± 3.9) after treatment (P = 0.02). Ninety-day mortality (P = 0.21) and readmission rates (P = 0.27) were similar for both groups. Two patients in the operative cohort sustained nerve injuries, whereas 1 patient in the nonoperative group had a nonunion and underwent surgery.

CONCLUSIONS:
Patients who undergo percutaneous surgical fixation for low-energy LC1 injuries have similar discharge disposition, mortality, complication rates, and readmission rates compared with patients treated nonoperatively. Percutaneous surgical fixation may provide significant pain relief for patients who failed conservative management.

LEVEL OF EVIDENCE:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Glass Tracing Alignment Method: A Novel, Low-Cost Coronal and Sagittal Alignment Transfer Method for Lower-Limb Prostheses
Authors: Habecker Matthew J. 
Published: June 2024

ABSTRACT

Introduction
There are numerous ways to transfer the alignment of a lower-limb prosthesis that have been used and adapted over the last several decades. The proposed glass tracing alignment method (GTAM) allows for a convenient and rapid transfer of prosthetic alignment in the coronal and sagittal planes with minimal equipment requirements.

Objective
The aim of this article is to share a novel method for coronal and sagittal plane prosthetic alignment transfer, which may be done with minimal time, materials, and expense.

Materials and Methods
Prosthetic alignment may be transferred in part or in whole by tracing the prosthesis in both the coronal and sagittal planes. The prosthesis must first be stabilized on a surface that allows for the prosthetic foot to be traced and is adjacent to a wall surface that allows for tracing of the prosthesis proximal to the foot. The line of progression (LOP) of the prosthesis should be parallel to the edge of the table it is traced upon and in a vertical orientation when tracing the entire prosthesis in the sagittal plane. When tracing the coronal plane alignment, the foot should be oriented vertically and placed in the LOP. Sagittal and coronal tracings should include as much of the prosthesis as possible to insure the most accurate alignment transfer of components. The GTAM was developed to be a clinical complement to traditional alignment transfer methods, which may include use a vertical or horizontal prosthetic alignment transfer jig.

Results
Use of the described alignment tracing technique allows for the rapid alignment transfer of prosthetic componentry for a variety of applications.

Conclusions
The GTAM proposed is an easy way for a busy practitioner to certify that alignment transfers have been performed correctly or to preserve alignment when replacing elements of a prosthesis for clinical and/or research applications.

Clinical Relevance
It is expected that the GTAM will improve the clinical control, versatility, and scope of procedures related to referenced prosthetic and/or orthotic alignment to enhance the quality and consistency of patient outcomes.
Posterior tongue tie: that is a thing?
Authors: Black Kaelan 
Published: June 2024

Purpose of review
The purpose of this review is to examine the current research of the posterior tongue tie and how it relates to breast feeding, solid feeding, and speech.

Recent findings
Recent findings show that the posterior tongue tie may play a role in effective breast feeding.

Summary
Ankyloglossia is the term used for the restriction of the movement of the tongue that impairs certain functions such as breastfeeding or bottle feeding, feeding with solids, and speech. Cadaver studies have shown that there can be a restriction of the tongue and oral tissues in some people relative to others. In some breast-feeding studies, releasing the posterior tie has been shown to improve certain aspects of tongue movement. There is little evidence for or against posterior tongue ties contributing to other problems such as speech and solid feeding. This article goes into depth about the current studies on posterior ankyloglossia.
Longitudinal viral load outcomes of adults with HIV after detectable viremia on tenofovir, lamivudine, and dolutegravir
Authors: Sodeke Olutomi , Milligan Kyle , Ezeuko Ijeoma , Oladipo Ademola , Emeh Anuri , Bashorun Adebobola , Orisawayi Oluwaniyi , Danjuma Sanda , Onotu Dennis , Boyd Adetinuke Mary , Abutu Andrew , Chun Helen , Vallabhaneni Snigdha 
Published: June 2024

Background:
To inform optimal management of HIV viremia on tenofovir, lamivudine, and dolutegravir (TLD), we examined viral load (VL) outcomes of a large cohort of adult PWH on TLD in Nigeria.

Methods:
We conducted a retrospective study of adult PWH who had ≥1 VL after initiating TLD during January 2017–February 2023. VLs were categorized as undetectable (≤50 copies/ml), low low-level viremia (LLV, 51–199 copies/ml), high LLV (200–999 copies/ml), virologic nonsuppression (VLNS, ≥1000 copies/ml), and virologic failure (VF, ≥2 consecutive VLNS results). Among patients with ≥2 VLs on TLD, we described how viremia changed over time and examined virologic outcomes after VF. We identified predictors of subsequent VLNS using mixed-effects logistic regression and conducted planned contrasts between levels of VL result and regimen types.

Results:
Analysis of 82,984 VL pairs from 47,531 patients demonstrated viral resuppression to ≤50 copies/ml at follow-up VL in 66.7% of those with initial low LLV, 59.1% of those with initial high LLV, and 48.9% of those with initial VLNS. Of 662 patients with a follow-up VL after VF, 94.6% stayed on TLD; of which 57.8% (359/621) were undetectable at next VL without regimen change. Previous low LLV [adjusted odds ratio (aOR) 1.74, 1.56–1.93], high LLV (aOR 2.35, 2.08–2.65), and VLNS (aOR 6.45, 5.81–7.16) were associated with increasingly higher odds of subsequent VLNS, whereas a previously undetectable VL (aOR 1.08, 0.99–1.71) on TLD was not.

Conclusions:
Despite increased odds of subsequent VLNS, most PWH with detectable viremia on TLD, including those with VF, will resuppress to an undetectable VL without a regimen change.
Immune Checkpoint Inhibitors–Associated Generalized Lipodystrophy: Reconstructive Challenges of an Emerging and Distinct Form of Lipodystrophy
Authors: Kreutz-Rodrigues Lucas , Cherukuri Sai , Rames Jess D. , Chen Austin , Meira Pazelli Alexandre , Mardini Samir , Gibreel Waleed 
Published: June 2024

Total and permanent loss of facial and nonfacial fat is a rare side effect of immune checkpoint inhibitors (ICIs). Consequently, effective treatment modalities for patients remain undefined. Here, we discuss the surgical treatment of a patient with both ICI-related acquired generalized lipodystrophy (AGL). We additionally performed a comprehensive literature review (Cochrane, Embase, and MEDLINE) to summarize what is known about ICI-related lipodystrophy and available treatments for this rare complication. A 66-year-old female diagnosed with metastatic lung adenocarcinoma started ICI (pembrolizumab) treatment. She developed generalized lipodystrophy 13 months after her first cycle. Her primary concern was the loss of facial fat volume, which significantly aged her appearance. The patient underwent a 2-staged restoration of her facial fat compartments using dermal grafts from the lower abdomen and medial thighs. The patient recovered uneventfully and was satisfied with the aesthetic improvement at 18 months of follow-up. The authors identified 8 case reports with patients with ICI-AGL. The mean age was 53.63 years, and the mean BMI was 36.72 kg/m2. The average onset of symptoms was 7.44 months after ICI initiation. None of the studies described any sort of surgical or nonsurgical options to restore the volume of the facial fat compartments. The management of combined facial and nonfacial lipodystrophy remains challenging due to the lack of suitable autologous fat donor sites. In this report, the authors demonstrate that staged volume restoration can be achieved using autologous dermal grafts from the thigh, making it a viable reconstructive option in this subset of patients.
An Enhanced Role of Innate Immunity in the Immune Response After Kidney Transplant in People Living With HIV: A Transcriptomic Analysis
Authors: Zarinsefat Arya , Dobi Dejan , Kelly Yvonne M. , Szabo Gyula , Henrich Timothy , Laszik Zoltan G. , Stock Peter G. 
Published: June 2024

Background.
Although kidney transplantation (KT) has become the standard of care for people living with HIV (PLWH) suffering from renal failure, early experiences revealed unanticipated higher rejection rates than those observed in HIV− recipients. The cause of increased acute rejection (AR) in PLWH was assessed by performing a transcriptomic analysis of biopsy specimens, comparing HIV+ to HIV− recipients.

Methods.
An analysis of 68 (34 HIV+, 34 HIV−) formalin-fixed paraffin-embedded (FFPE) renal biopsies matched for degree of inflammation was performed from KT recipients with acute T cell-mediated rejection (aTCMR), borderline for aTCMR (BL), and normal findings. Gene expression was measured using the NanoString platform on a custom gene panel to assess differential gene expression (DE) and pathway analysis (PA).

Results.
DE analysis revealed multiple genes with significantly increased expression in the HIV+ cohort in aTCMR and BL relative to the HIV− cohort. PA of these genes showed enrichment of various inflammatory pathways, particularly innate immune pathways associated with Toll-like receptors.

Conclusions.
Upregulation of the innate immune pathways in the biopsies of PLWH with aTCMR and BL is suggestive of a unique immune response that may stem from immune dysregulation related to HIV infection. These findings suggest that these unique HIV-driven pathways may in part be contributory to the increased incidence of allograft rejection after renal transplantation in PLWH.
Proximity-based activation of AURORA A by MPS1 potentiates error correction
Authors: Leça Nelson , Barbosa Francisca , Rodriguez-Calado Sergi , Moura Margarida , Pedroso Paulo D. , Pinto Inês , Verza Arianna E. , Bange Tanja , Sunkel Claudio E. , Barisic Marin , Maresca Thomas J. , Conde Carlos 
Published: June 2024

SUMMARYFaithfull cell division relies on mitotic chromosomes becoming bioriented with each pair of sister kinetochores bound to microtubules oriented toward opposing spindle poles. Erroneous kinetochore-microtubule attachments often form during early mitosis, but are destabilized through the phosphorylation of outer kinetochore proteins by centromeric AURORA B kinase (ABK) and centrosomal AURORA A kinase (AAK), thus allowing for re-establishment of attachments until biorientation is achieved. MPS1-mediated phosphorylation of NDC80 has also been shown to directly weaken the kinetochore-microtubule interface in yeast. In human cells, MPS1 has been proposed to transiently accumulate at end-on attached kinetochores and phosphorylate SKA3 to promote microtubule release. Whether MPS1 directly targets NDC80 and/or promotes the activity of AURORA kinases in metazoans remains unclear. Here, we report a novel mechanism involving communication between kinetochores and centrosomes, wherein MPS1 acts upstream of AAK to promote error correction. MPS1 on pole-proximal kinetochores phosphorylates the C-lobe of AAK thereby increasing its activation at centrosomes. This proximity-based activation ensures the establishment of a robust AAK activity gradient that locally destabilizes mal-oriented kinetochores near spindle poles. Accordingly, MPS1 depletion fromDrosophilacells causes severe chromosome misalignment and erroneous kinetochore-microtubule attachments, which can be rescued by tethering either MPS1 or constitutively active AAK mutants to centrosomes. Proximity-based activation of AAK by MPS1 also occurs in human cells to promote AAK-mediated phosphorylation of the NDC80 N-terminal tail. These findings uncover an MPS1-AAK cross-talk that is required for efficient error correction, showcasing the ability of kinetochores to modulate centrosome outputs to ensure proper chromosome segregation.