bluuebunny/crossref_metadata_2025_split huggingface dataset:
(130) SHAEER’S HYDRO-DISSECTION OF THE NEURO-VASCULAR BUNDLE
Authors: Shaeer Prof Osama 
Published: June 2024

Abstract

Objectives
Neurovascular bundle mobilization (NVB) is a key-step of many reconstructive penile surgeries. This is a step that requires a lot of experience, patience, and meticulous surgical technique. Otherwise, the patient may end up with sensory deficit due to nerve injury, or arterial insufficiency due to injury of the dorsal artery of the penis. This work described hydro-dissection of the neurovascular bundle (h-NVBm) aiming at a safer and faster procedure.

Methods
H-NVBm was performed in 50 cases with congenital penile curvature or Peyronie’s deformity (h-NVB group, n=50). A matching group was operated upon without hydro-dissection (NVBm group, n=32). In H-NVBm cases, hydro-inflation of Buck’s fascia was performed prior to mobilization using 80% saline and 20% xylocaine (without adrenaline). The mixture was either injected into Buck’s fascia with a butterfly cannula inserted along the longitudinal axis of the shaft at several points, or with the blunt nozzle of a 20ml syringe, superficially applied to the surface of Buck’s fascia. In both groups, NVB was mobilized with alternating sharp and blunt dissection, aided with bipolar diathermy. Both groups were compared as regards time needed for mobilization, and post-operative sensitivity at the 6 month post-operative, subjectively evaluated on a 5-point scale.

Results
Average duration for NVB in the hNVBm group was 3.5 minutes ± 1.4, compared to a duration of 7.3 ± 2 for NVBm group (p&lt;0.001). Sensitivity score was higher in the hNVBm group (4.7±0.5) compared to 4.3±1 in the NVBm group (p&lt;0.001).

Conclusions
Hydro-dissection of the neurovascular bundle renders the procedure relatively safer and faster. While expert surgeons may be content with classic mobilization, hNVBm can be of particular importance to new entants to of penile surgery.

Conflicts of Interest
None.
Early detection of myocardial infarction with reference to baseline levels during health: impact on biological variation of high-sensitivity cardiac troponin
Authors: Wu Alan H B , Graglia Sally 
Published: June 2024

Abstract
A 78-year-old male was seen in the emergency department (ED) with chest pain. Fifteen months earlier, he had presented to the ED with shoulder and elbow pain. High-sensitivity cardiac troponin I (hs-cTnI) testing was conducted at that time, which produced normal results of 10 and 13 ng/L (cutoff &lt;48 ng/L). During the current admission, his electrocardiogram was unremarkable, with a borderline prolonged PR interval noted. The patient’s hs-cTnI results were 25, 47, and 254 ng/L at 0, 1, and 7 hours, respectively. He was diagnosed with demand ischemia and admitted to the hospital. The detection of acute myocardial infarction in this case was made during the first sample collection (t = 0), despite the fact that this result was well within the normal range.
Effect of Pb, Cu and Zn on development and Wnt/β-catenin signaling pathway genes expression of Ctenopharyngodon idella
Authors: Tlenshieva A M , Shalakhmetova T M , Witeska M 
Published: June 2024

Abstract
Pollution of the aquatic environment with heavy metals is a serious environmental problem, since they accumulate in aquatic organisms and can affect their development and worsen their condition. According to the scheme of Fig. 1 zinc (Zn), copper (Cu) or lead (Pb) were studied when exposed to concentrations of: Zn (0.01; 0.1; 1 mg/L), Cu (0.001; 0.01; 0.1 mg/L), Pb (0.006; 0.06; 0.6 mg/L) for 144 h after fertilization (hpf) on the grass carp (Ctenopharyngodon idella), one of the important commercial fish species of Kazakhstan, the activity of superoxide dismutase (SOD) and the expression of genes of the Wnt/β-catenin signaling pathway involved in development. All metals significantly reduced survival, hatching rate, and changed biometric parameters and heart rate of cupid larvae. In addition, these metals (mainly Pb and Cu) inhibited superoxide dismutase (SOD) activity and mRNA transcription of genes encoding genes of the Wnt/β-catenin signaling pathway. These results showed that Pb, Cu and Zn not only affect the survival and development of fish at an early stage of life, but also cause oxidative stress and prevent fish detoxification.
Triple-isotope analysis in tree-ring cellulose suggests only moderate effects of tree species mixture on the climate sensitivity of silver fir and Douglas-fir
Authors: Charlet de Sauvage Justine , Treydte Kerstin , Saurer Matthias , Lévesque Mathieu 
Published: June 2024

Abstract
Disentangling the factors influencing the climate sensitivity of trees is crucial to understanding the susceptibility of forests to climate change. Reducing tree-to-tree competition and mixing tree species are two strategies often promoted to reduce the drought sensitivity of trees, but it is unclear how effective these measures are in different ecosystems. Here, we studied the growth and physiological responses to climate and severe droughts of silver fir and Douglas-fir growing in pure and mixed conditions at three sites in Switzerland. We used tree-ring width data and carbon (δ13C), oxygen (δ18O) and hydrogen (δ2H) stable isotope ratios from tree-ring cellulose to gain novel information on water relations and the physiology of trees in response to drought and how tree species mixture and competition modulate these responses. We found significant differences in isotope ratios between trees growing in pure and mixed conditions for the two species, although these differences varied between sites, e.g. trees growing in mixed conditions had higher δ13C values and tree-ring width than trees growing in pure conditions for two of the sites. For both species, differences between trees in pure and mixed conditions regarding their sensitivity to temperature, precipitation, climatic water balance and vapor pressure deficit were minor. Furthermore, trees growing in pure and mixed conditions showed similar responses of tree-ring width and isotope ratios to the past severe droughts of 2003, 2015 and 2018. Competition had only a significantly negative effect on δ13C of silver fir, which may suggest a decrease in photosynthesis due to higher competition for light and nutrients. Our study highlights that tree species mixture may have only moderate effects on the radial growth and physiological responses of silver fir and Douglas-fir to climatic conditions and that site condition effects may dominate over mixture effects.
Integration of a Community Opioid Treatment Program Into a Federally Qualified Health Center
Authors: Neeb Christine , McQuade Brianna M. , Lesondak Linda , Madrid Samantha , Schlaeger Judith M. , Watson Dennis P. , Karnik Niranjan , Huerta Noami , Bhatia Simar , Fleurimont Judes , Li Nicole , Hammerdahl Elsa , Pesantez Ricky , Gastala Nicole 
Published: June 2024

Objectives
With the increasing rates of opioid overdose deaths in the United States, barriers to treatment access for patients seeking medications for opioid use disorder (OUD), and challenges of initiating buprenorphine in patients who use fentanyl, it is essential to explore novel approaches to expanding access to methadone treatment. An opioid treatment program (OTP) and a federally qualified health center (FQHC) partnered to develop and implement an innovative integrated methadone and primary care treatment model. The process for integrating an OTP and FQHC to provide methadone treatment in the primary care setting will be discussed.

Methods
An OTP methadone dispensing site was co-located in the FQHC, utilizing a staffing matrix built on the expertise of each stakeholder. The OTP managed DEA and state regulatory processes, whereas the FQHC physicians provided medical treatment, including methadone treatment protocols, treatment plans, and primary care. Patient demographics, medical history, and retention data for those who entered the program between January 2021 and February 2023 were collected through chart review and analyzed with descriptive statistics.

Results
A total of 288 OTP-FHQC patients were enrolled during the study. Retention rates in methadone treatment at 90 and 180 days were similar to partner clinics.

Conclusions
Collaboration between FQHCs and OTPs is operationally feasible and can be achieved utilizing the current staffing model of the FQHC and OTP. This model can increase access to treatment for OUD and primary care for an urban, underserved patient population.
Operative Treatment of Distal Tibial Fractures in Children Managed With Epiphyseal Screws: A Comparison of Outcomes When Screws Are Retained Versus Removed Following Fracture Union
Authors: Zimmerman Remy , Rupp Garrett , Barger Kurt , Fang William , Thomas Evelyn , Bastrom Tracey , Pennock Andrew , Schlechter John 
Published: June 2024

Background:
Fractures of the distal tibial epiphysis in children are often accompanied by articular surface disruption. With increased displacement, internal fixation is frequently performed with an epiphyseal screw to close the fracture gap. Despite limited, high-level clinical evidence to support implant removal, epiphyseal screws are commonly removed after fracture healing due to potentially increased contact forces on the tibiotalar joint. The purpose of this study was to investigate and compare outcomes and complications in children that underwent surgical treatment of distal tibial epiphyseal fractures with placement of an epiphyseal screw(s) and had the implant(s) retained versus removed at a minimum of 2-year postoperative follow-up.

Methods:
Children younger than 18 years from two urban tertiary care centers who underwent operative management of distal tibia Salter-Harris III and IV fractures using epiphyseal screws (2013-2020) were divided into two cohorts: retained epiphyseal screws and implant removed. Demographics, intraoperative, postoperative, and radiographic data were collected. Patient-reported outcomes (PROs) using the Foot and Ankle Ability Measure (FAAM) and Single Assessment Numeric Evaluation (SANE) questionnaires were collected at the final follow-up. Statistical analysis, including power analysis, was performed.

Results:
Fifty-two children were included (30 males, 22 females) with a mean age of 13.3 years at the time of injury (range, 7.7-16.4 years). Thirty-five children retained the implants; seventeen had implants removed. All completed the FAAM questionnaires at a mean follow-up of 4.4 ± 1.9 years, while 29 completed the SANE questionnaire at a mean follow-up of 4.4 ± 1.7 years. No statistically significant difference in patient demographics, surgical variables, or PROs was observed. Six children experienced complications from the initial surgery, including infections and complex regional pain syndrome, with no difference in complication rates between the cohorts (P=0.08). Furthermore, no complication was observed as a result of implant removal.

Conclusions:
Children with retained epiphyseal implants have similar functional outcomes as compared with those who had implants removed after distal tibial epiphyseal fracture fixation and union.

Level of Evidence:
Level III—Retrospective comparative study.
Iron metabolism and arthritis: Exploring connections and therapeutic avenues
Authors: Zhuo Dachun , Xiao Wenze , Tang Yulong , Jiang Shuai , Geng Chengchun , Xie Jiangnan , Ma Xiaobei , Zhang Qing , Tang Kunhai , Yu Yuexin , Bai Lu , Zou Hejian , Liu Jing , Wang Jiucun 
Published: June 2024

Abstract
Iron is indispensable for the viablility of nearly all living organisms, and it is imperative for cells, tissues, and organisms to acquire this essential metal sufficiently and maintain its metabolic stability for survival. Disruption of iron homeostasis can lead to the development of various diseases. There is a robust connection between iron metabolism and infection, immunity, inflammation, and aging, suggesting that disorders in iron metabolism may contribute to the pathogenesis of arthritis. Numerous studies have focused on the significant role of iron metabolism in the development of arthritis and its potential for targeted drug therapy. Targeting iron metabolism offers a promising approach for individualized treatment of arthritis. Therefore, this review aimed to investigate the mechanisms by which the body maintains iron metabolism and the impacts of iron and iron metabolism disorders on arthritis. Furthermore, this review aimed to identify potential therapeutic targets and active substances related to iron metabolism, which could provide promising research directions in this field.
Midperipheral retinal thickening on wide field OCT in a patient with a mutation in the NR2E3 gene
Authors: Pott Jan Willem R. , Huiskamp E. Angela , Verheij Joke B.G.M. 
Published: June 2024

Purpose:
To report typical retinal findings in a girl with the presumed diagnosis of ESCS, attributed to the presence of a homozygous likely pathogenic variation in the NR2E3 gene.

Methods:
A retrospective case report with multimodal imaging studies

Results:
Wide field OCT examination at the age of 11 years showed increased thickening of the midperipheral retina. In the area of retinal thickening delineation of retinal architecture was coarse, and photoreceptor outer segments thinned and disrupted. The retinal pigment epithelium appeared to be normal on autofluorescence imaging. In retrospect the retinal thickening was already apparent on conventional OCT at the age of 3 years.

Conclusion:
Wide field OCT is a valuable new tool in assessing typical retinal abnormalities in patients with NR2E3 mutations, by showing an abnormal but very characteristic thickening of the midperipheral retina.
Child Maltreatment-Focused Intervention Research
Authors: Banerjee Rashida , Movahedazarhouligh Sara , Ghosh Ekta 
Published: June 2024

Child maltreatment is a significant public health concern that affects children’s health and well-being throughout their life. Children who are maltreated are at an increased risk of developing a disability or delay and are more vulnerable to a range of mental health-related problems, including depression, anxiety, substance abuse, criminality, and other forms of poorly regulated emotional behavior. Children with disabilities are also at a higher risk for maltreatment, and their needs often go unmet. This systematic literature review aimed to identify, analyze, and summarize the preventive programs and intervention practices between 2009 and 2021, addressing maltreatment in children from birth through 8 years of age. The initial search identified 616 peer-reviewed articles on the topic. Seventeen intervention studies met inclusion criteria and were reviewed and coded using systematic procedures. The findings suggest that home visiting and parent education are the most highly investigated educational intervention programs, with parents and caregivers as the primary recipients of the interventions. Studies of maltreatment interventions in children with disabilities are limited, with inadequate methodological rigor. We recommend future robust and wide-ranging investigations to prevent and mitigate the effects of maltreatment of children, particularly children with disabilities, and replications of studies that show promise.
Predictors of Moderate-High Posttraumatic Growth in Parents of Children With Cancer
Authors: Meral Buket , Bulut Hacer Kobya 
Published: June 2024

Background
Parents of children with cancer may experience posttraumatic growth (PTG). In clinical practice, this parental enhancement is more likely to be seen with a moderate-high PTG.

Objective
The aim of this study was to determine the moderate-high PTG prevalence of parents of children diagnosed with cancer at least 6 months and to investigate its relationship with hope, social support, and patient-parent characteristics.

Methods
This cross-sectional study was conducted with the parents of children with cancer admitted to the pediatric hematology-oncology unit using the Parent-Child Characteristic Questionnaire, Posttraumatic Growth Inventory, Multidimensional Scale of Perceived Social Support and Dispositional Hope Scale. Univariate and multivariate logistic regression analyses were performed to investigate the variables associated with moderate-high PTG.

Results
One hundred one parents were enrolled in this study, and the prevalence of the moderate-high PTG was 79.2%. There was a statistically significant difference between moderate-high PTG and children’s age (P = .037). Multivariate logistic regression analysis showed that social support from significant others (odds ratio = 1.138, 95% confidence interval = 1.030–1.257, P = .011) was a predictor of moderate-high PTG.

Conclusions
Moderate-high PTG is common among parents of children diagnosed with cancer. Perceived social support from healthcare professionals and other patient parents is a predictive factor.

Implications for Practice
Interventions that encourage the support of health professionals and interaction with the parents of other patients, such as peer counseling, group-based interventions, and expanding the social support network, seem to be clinically promising in helping parents to improve from the cancer experience.
Framingham Stroke Risk Profile Score and White Matter Disease Progression
Authors: Youssef Hossam , Demirer Mutlu , Middlebrooks Erik H. , Anisetti Bhrugun , Meschia James F. , Lin Michelle P. 
Published: June 2024

Objectives:
To evaluate the relationship between Framingham Stroke Risk Profile (FSRP) score and rate of white matter hyperintensity (WMH) progression and cognition.

Methods:
Consecutive patients enrolled in the Mayo Clinic Florida Familial Cerebrovascular Diseases Registry (2011-2020) with 2 brain-MRI scans at least 1 year apart were included. The primary outcome was annual change in WMH volume (cm3/year) stratified as fast versus slow (above vs. below median). Cognition was assessed using a Mini-Mental State Exam (MMSE, 0-30). FSRP score (0 to 8) was calculated by summing the presence of age 65 years or older, smoking, systolic blood pressure greater than 130 mmHg, diabetes, coronary disease, atrial fibrillation, left ventricular hypertrophy, and antihypertensive medication use. Linear and logistic regression analyses were performed to examine the association between FSRP and WMH progression, and cognition.

Results:
In all, 207 patients were included, with a mean age of 60±16 y and 54.6% female. FSRP scores risk distribution was: 31.9% scored 0 to 1, 36.7% scored 2 to 3, and 31.4% scored ≥4. The baseline WMH volume was 9.6 cm3 (IQR: 3.3-28.4 cm3), and the annual rate of WMH progression was 0.9 cm3/year (IQR: 0.1 to 3.1 cm3/year). A higher FSRP score was associated with fast WMH progression (odds ratio, 1.45; 95% CI: 1.22-1.72; P<0.001) and a lower MMSE score (23.6 vs. 27.1; P<0.001). There was a dose-dependent relationship between higher FSRP score and fast WMH progression (odds ratios, 2.20, 4.64, 7.86, 8.03 for FSRP scores 1, 2, 3, and ≥4, respectively; trend P<0.001).

Conclusions:
This study demonstrated an association between higher FSRP scores and accelerated WMH progression, as well as lower cognition.
International Travel for Organ Transplantation: A Survey of Professional Experiences and Attitudes Toward Data Collection and Reporting
Authors: Irish Georgina L. , Fadhil Riadh A.S. , Rondeau Eric , Nagral Sanjay , Ahmadipour Mohammadali , Coates P. Toby , Martin Dominique E. 
Published: June 2024

Background.
Lack of data regarding international travel for organ transplantation (ITOT) hampers efforts to evaluate, understand, and respond to trends in ITOT activities, such as those suggestive of organ trafficking or “transplant tourism.” This study aimed to assess transplant professionals’ experience of ITOT and their attitudes toward reporting ITOT data to a global registry.

Methods.
An international cross-sectional anonymous survey of transplant professionals was conducted online (from October to December 2022). The English language questionnaire assessed professional experiences in providing care to individuals who had traveled to or from a country for living donation or transplantation, and attitudes toward reporting of ITOT data. Data were analyzed with descriptive statistics.

Results.
Two hundred thirty-nine individuals from 68 countries completed the entire questionnaire, of whom 79% had provided care for ≥1 patient who had traveled internationally for donation or transplantation. Of these, 60.8% of individuals (n = 115) had cared for ≥1 person who engaged in ITOT between 2019 and 2022, with the most recent case experiences involving 89 countries and 157 unique routes of international travel. Predominant concerns regarding reporting of ITOT data to a global registry related to prevention of harm and protection of patient privacy; most (52.7%; n = 126) respondents expressed a preference for anonymous reporting of ITOT data.

Conclusions.
ITOT is a global phenomenon and transplant professionals’ experience with ITOT cases is more common than anticipated. Systems for the collection of ITOT activity data should be carefully designed to address potential ethical concerns of transplant professionals which may influence reporting practices.
Mycophenolate Dose Reduction in Tacrolimus-based Regimens and Long-term Kidney Transplant Outcomes in Australia and New Zealand
Authors: Lee Darren , Polkinghorne Kevan R. , Pilmore Helen , Mulley William R. 
Published: June 2024

Background.
Mycophenolate dose reduction (MDR) is associated with acute rejection and transplant failure in kidney transplant recipients (KTRs). The optimal dose to prevent rejection and reduce complications remains poorly defined in tacrolimus-based regimens.

Methods.
We assessed adult KTRs from 2005 to 2017 initiated on mycophenolate mofetil 2 g/d, tacrolimus, and prednisolone from the Australia and New Zealand Dialysis and Transplant Registry. KTRs with rejection within the first 30 d posttransplant were excluded. The primary outcome was time to first rejection between 30 d and 2 y posttransplant. Mycophenolate dose was modeled as a time-varying covariate using Cox proportional hazards regression. Secondary outcomes included assessment of early MDR to <1.5 g/d within the first 6 mo posttransplant and subsequent patient and death-censored graft survival.

Results.
In the primary analysis, 3590 KTRs were included. Compared with mycophenolate dose of ≥2 g/d, both 1.0–<1.5 and <1 g/d were associated with an increased risk of rejection during the 2 y posttransplant (hazard ratio [HR] 1.67; 95% confidence interval [CI], 1.29-2.16; P < 0.001 and HR 2.06; 95% CI, 1.36-3.13; P = 0.001, respectively) but not 1.5–<2 g/d (HR 1.20; 95% CI, 0.94-1.53; P = 0.14). Early MDR to <1.5 g/d occurred in 45.3% of KTRs and was an independent risk factor for death-censored graft failure (HR 1.32; 95% CI, 1.05-1.66; P = 0.016) but not death (HR 1.18; 95% CI, 0.97-1.44; P = 0.10), during a median follow-up of 5.0 (interquartile range, 2.6–8.5) y.

Conclusions.
Early MDR was a risk factor for subsequent rejection and graft failure in KTRs receiving contemporary tacrolimus-based regimens.