bluuebunny/crossref_metadata_2025_split huggingface dataset:
Holmium Laser Incision of Ejaculatory Duct (HoLIED): Surgical Procedure
Authors: Alkassis Marwan , Lee Adrianna , Raheem Omer A. 
Published: April 2024

Introduction:
Ejaculatory duct obstruction is a well-known cause of infertility and many other symptoms, such as hematospermia and lower urinary tract symptoms. Diagnosis is made based on the medical history and a series of imaging tests identifying the obstructed ducts. Transurethral resection of the ejaculatory ducts is the mainstay treatment to release the obstruction. In this step-by-step surgical video, we will describe a novel technique using the holmium laser to incise the ejaculatory ducts in a patient with chronic lower urinary tract symptoms, hematospermia, and persistent urethral discharge.

Materials and Methods:
A pelvic MRI was obtained in workup of the above issues and identified a complex ejaculatory duct cyst. The patient consented for Holmium Laser Incision of Ejaculatory Duct. A holmium laser fiber was used through a 24F rigid cystoscope to unroof the ejaculatory duct cyst, resulting in the drainage of a dark brown fluid. Following unroofing of the cyst, the ejaculatory ducts were identified using a 17F rigid cystoscope and a 16F Foley catheter was inserted.

Results:
The Foley catheter was removed on POD1, and the patient was able to void. His symptoms improved progressively with time and antibiotics. A repeat MRI was obtained several months postoperatively and showed the resolution of the cystic lesion.

Conclusion:
Holmium Laser Incision of Ejaculatory Duct is safe and feasible procedure allowing to treat ejaculatory duct obstruction without increased risk of complications.
Expert Perspectives on Controversies in Castration-Sensitive Prostate Cancer Management: Narrative Review and Report of the First US Prostate Cancer Conference Part 1
Authors: Crawford E. David , Bryce Alan H. , Hussain Maha H. , Agarwal Neeraj , Beltran Himisha , Cooperberg Matthew R. , Petrylak Daniel P. , Shore Neal , Spratt Daniel E. , Tagawa Scott T. , Antonarakis Emmanuel S. , Aparicio Ana M. , Armstrong Andrew J. , Boike Thomas P. , Calais Jeremie , Carducci Michael A. , Chapin Brian F. , Cookson Michael S. , Davis John W. , Dorff Tanya , Eggener Scott E. , Feng Felix Y. , Gleave Martin , Higano Celestia , Iagaru Andrei , Morgans Alicia K. , Morris Michael , Murray Katie S. , Poage Wendy , Rettig Matthew B. , Sartor Oliver , Scher Howard I. , Sieber Paul , Small Eric , Srinivas Sandy , Yu Evan Y. , Zhang Tian , Koo Phillip J. 
Published: April 2024

Purpose:
Castration-sensitive prostate cancer (CSPC) is a complex and heterogeneous condition encompassing a range of clinical presentations. As new approaches have expanded management options, clinicians are left with myriad questions and controversies regarding the optimal individualized management of CSPC.

Materials and Methods:
The US Prostate Cancer Conference (USPCC) multidisciplinary panel was assembled to address the challenges of prostate cancer management. The first annual USPCC meeting included experts in urology, medical oncology, radiation oncology, and nuclear medicine. USPCC co-chairs and session moderators identified key areas of controversy and uncertainty in prostate cancer management and organized the sessions with multidisciplinary presentations and discussion. Throughout the meeting, experts responded to questions prepared by chairs and moderators to identify areas of agreement and controversy.

Results:
The USPCC panel discussion and question responses for CSPC-related topics are presented. Key advances in CSPC management endorsed by USPCC experts included the development and clinical utilization of gene expression classifiers and artificial intelligence (AI) models for risk stratification and treatment selection in specific patient populations, the use of advanced imaging modalities in patients with clinically localized unfavorable intermediate or high-risk disease and those with biochemical recurrence, recommendations of doublet or triplet therapy for metastatic CSPC (mCSPC), and consideration of prostate and/or metastasis-directed radiation therapy in select patients with mCSPC.

Conclusions:
CSPC is a diverse disease with many therapeutic options and the potential for adverse outcomes associated with either undertreatment or overtreatment. Future studies are needed to validate and clinically integrate novel technologies, including genomics, AI, and advanced imaging, to optimize outcomes among patients with CSPC.
Brief Report: Can a Fraction of the Dolutegravir Dispersible Tablet Solution be Used to Dose Neonates?
Authors: Phogole Cassius M. , Bekker Adrie , Cressey Tim R. , Ferris William , Decloedt Eric , Kellermann Tracy 
Published: April 2024

Background:
The smallest dolutegravir (DTG) dose approved is 5 mg once-daily in infants ≥4 weeks and weighing ≥3 to <6 kg using a dispersible tablet (DT). Neonates (<28 days of life) may require a lower dose due to immature organ development. We evaluated the aqueous dispersibility of the generic DTG-DT 10-mg scored tablets (Viatris Inc.) to determine the possibility of uniform concentrations that could allow for lower daily doses in neonates.

Methods:
Each 5-mL polypropylene tube had DTG-DT 5 mg dissolved in 5-mL ultrapure water. Tubes were labeled with 3 “zones” (bottom: 0–1 mL; middle: 1–3 mL; top: 3–5 mL). Suspensions were mixed by swirling or swirling with a syringe pump, vortexing, or sonication. DTG concentration in each zone was determined using high-performance liquid chromatography. Tubes were rinsed with 1-mL acetonitrile to determine the residual drug. Acceptable criterion for percentage difference was set at ≤20% according to the European Medicines Agency guidelines.

Results:
Dispersion of DTG-DT in water did not remain homogeneous, resulting in DTG concentrations that varied by over 50% across the 3 zones within the tubes. Rapid sedimentation was observed shortly after mixing. Furthermore, it was found that 24%–35% of the DTG residue remained adhered to the tube after the aqueous dispersion had been eluted, highlighting the importance of the rinse step.

Conclusions:
Aqueous dispersion of the DTG-DT is not uniform and displays a high degree of sedimentation. It is therefore not possible to administer a fraction of the dispersion (lower DTG dose) to neonates by using this formulation.
Differences in the Difficulty of Accessing Various 3-Dimensional Locations Under Mirror-Image Conditions During Laparoscopic Surgery
Authors: Inagaki Yuriko , Kawai Kazushige , Sonoda Hirofumi , Anzai Hiroyuki , Nagai Yuzo , Abe Shinya , Yokoyama Yuichiro , Ozawa Tsuyoshi , Kishikawa Junko , Emoto Shigenobu , Murono Koji , Sasaki Kazuhito , Nozawa Hiroaki , Ishihara Soichiro 
Published: April 2024

Background:
Laparoscopic colon surgery frequently requires performing maneuvers under mirror-images conditions; the complexity differs depending on the surgical site location in the abdominal cavity. However, no previous reports have examined this.

Methods:
Eleven surgeons participated in this study. Operations were performed on 25 points placed at the bottom and sides of a laparoscopic training box under mirror-image conditions. The mean time-point required to operate at each point and variation between surgeons were evaluated.

Results:
When the right hand was used, time-points to touch the right side-superficial ends were 0.50 to 0.58 and 0.27 to 0.45 for the other sites. With the left hand, time-points to touch the left side-superficial ends were 0.58 to 0.63 and 0.28 to 0.51 for the other sites, indicating that the most difficult manipulation was at the proximal site of the surgical port. The variation in the difficulty according to the spots increased with a decrease in the surgeon’s experience (right hand, r=−0.248; left hand, r=−0.491).

Conclusions:
In performing laparoscopic surgery under mirror-image conditions, the technical difficulty varies by location, and operating in locations close to the forceps port is the most difficult.
Vestibular migraine: an update
Authors: Villar-Martinez Maria D. , Goadsby Peter J. 
Published: April 2024

Purpose of review
We performed a narrative review of the recent findings in epidemiology, clinical presentation, mechanisms and treatment of vestibular migraine.

Recent findings
Vestibular migraine is an underdiagnosed condition that has a high prevalence among general, headache and neuro-otology clinics. Vestibular migraine has a bimodal presentation probably associated with a hormonal component in women. These patients could have a complex clinical phenotype including concomitant autonomic, inflammatory or connective tissue conditions that have a higher prevalence of psychological symptoms, which may mistakenly lead to a diagnosis of a functional neurological disorder. A high proportion of patients with postural perceptual persistent dizziness have a migraine phenotype. Independently of the clinical presentation and past medical history, patients with the vestibular migraine phenotype can respond to regular migraine preventive treatments, including those targeting the calcitonin gene-related peptide pathways.

Summary
Vestibular migraine is an underdiagnosed migraine phenotype that shares the pathophysiological mechanisms of migraine, with growing interest in recent years. A thorough anamnesis is essential to increase sensitivity in patients with unknown cause of dizziness and migraine treatment should be considered (see supplemental video-abstract).
Galleria mellonella as a superficial model for Malassezia globosa and its treatment
Authors: Torres Maritza , Diaz-Ortiz Juliana , Davis Michael G , Schwartz James R. , Celis Ramírez Adriana Marcela 
Published: April 2024

Introduction. Malassezia globosa is a yeast species that belongs to the mycobiota of humans and animals, associated with dermatological disorders such as dandruff. This is a chronic scalp skin disorder characterized by flaking and itching. Treatments include commercial shampoo with different formulations that contain antifungal activities like Zinc pyrithione or Piroctone Olamine. The effectiveness of these formulations have been evaluated for decades for dandruff symptom relief of volunteers. To date, non-mammalian, in-vivo methods exist to test formulations of these actives.
Aim. To evaluate in vivo in Galleria mellonella larva, two commercial antifungal shampoos (Shampoo with 1% ZPT & 1.6% Zinc Carbonate and shampoo with 0.5% PO) against this species.
Methodology. G. mellonella larvae were inoculated with M. globosa on abraded cuticular surface. Then, integument cell viability, histological changes, and fungal burden were evaluated.
Results. Larvae inoculated with M. globosa showed higher lesion melanization and tissue damage. In addition, M. globosa population showed to increase over time. Concerning the shampoo’s effectiveness, both formulations significantly reduced M. globosa burden and tissue damage.
Conclusion. G. mellonella larvae were allowed to evaluate M. globosa superficial infection and antifungal effectiveness. Shampoos with ZPT and PO showed a positive effect on inoculated larvae.
<xhtml:span xmlns:xhtml="http://www.w3.org/1999/xhtml" xml:lang="en">Retrospective analysis of&#160;Acinetobacter baumannii&#160;bacteraemia risk factors, complications, and mortality in a tertiary university hospital in Saudi Arabia
</xhtml:span>
Authors: Kaki Reham 
Published: April 2024

Introduction. Acinetobacter baumannii is a nosocomial pathogen of which many isolates are multidrug resistant. A. baumannii is a major cause of healthcare-acquired infections in patients who are critically ill, and A. baumannii bacteraemia (ABB) is associated with high mortality. Several factors are known to play a role in A. baumannii transmission and the emergence of resistance.

Aim. This study aimed to retrospectively analyse ABB cases in Saudi Arabia, where little is known about the prevalence, risk factors, clinical disease, treatment outcomes, and mortality associated with this infection.

Methods. A retrospective chart review was performed from January 1, 2015, until December 31, 2022, to identify all patients 14 years and above with ABB. Demographic and clinical data, as well as results from laboratory analyses, were collected from patients’ electronic charts. Statistical analyses were performed on the data to identify factors associated with 90-day mortality.

Results. In total, 112 ABB cases were identified with a mean age of 58.0 years, of which 66.1% were males. Of these cases, 71 (63.4%) died. The factors that were found to be associated with 90-day mortality were the Charlson comorbidity score, Pitt bacteraemia score, quick Sequential Organ Failure Assessment (qSOFA) score (p < 0.001 for each), hospital ward (p < 0.02), short duration of antibiotic treatment (p < 0.01), and higher age (p < 0.05). The most common source of infection was Central Line-associated Bloodstream Infection in 52.7%. Also associated with mortality were inappropriate antimicrobial therapy (p < 0.02) and empirical use of colistin (p < 0.05). In many patients, ABB was caused by carbapenem-resistant A. baumannii (CRAB) (69.6%), and 74.4% of those patients died.

Conclusion. CRAB is a growing threat in hospitals in Saudi Arabia especially in the critical care setting and carries a very high risk of mortality. Future studies should focus on novel ways of preventing CRAB infections and on the assessment of promising new antimicrobials such as cefiderocol or sulbactam-durlobactam and other treatment options such as bacteriophages.
Effects of the Covid-19 pandemic on the continuity of sexual and reproductive health care in the maternity ward of a health and social promotion centre in Burkina Faso: a qualitative study
Authors: Ngangue Patrice , Mahamat Mariam Ahmat , Sandra Yopa Danièle , Maxime Kiki Gbètogo , Bationo Nestor , Massom Douglas Mbang , Seu Josiane , Ly Birama Apho 
Published: April 2024

AbstractBackgroundThe COVID-19 pandemic has significantly impacted the continuity of maternity care in Burkina Faso. This study aimed to compare the volumes of in-person visits and to explore the experiences of healthcare providers and users regarding the continuity of healthcare in the maternity ward of a Health and Social Promotion Center (HSPC) before, during and after the lockdown during the COVID-19 pandemic in Ouagadougou, Burkina Faso.MethodsWe conducted a multimethod, cross-sectional exploratory study with a phenomenological approach. Monthly health administrative data regarding family planning visits, antenatal visits, deliveries, and postnatal care before, during, and after COVID-19 were collected and compared. Qualitative data were collected through semi-structured interviews with family healthcare providers and users and thematically analyzed.ResultsThe study found that the pandemic led to a decline in the demand for healthcare, as people were afraid of contracting COVID-19. This was particularly true for pregnant women who had recently given birth. The study also found that the pandemic disrupted the supply of essential medicines and medical supplies, which made it difficult for healthcare providers to provide quality care.The qualitative analysis allowed us to highlight three themes: the representation of respondents on COVID-19, their perception of the effectiveness of barrier measures and their analysis of the continuity of care in times of COVID-19: the picture of respondents on COVID-19, their perception of the efficacy of barrier measures and their analysis of the continuity of care in times of COVID-19. Despite these challenges, the study found that healthcare providers and users could find ways to maintain continuity of care.ConclusionThe study concludes that the COVID-19 pandemic has significantly impacted the continuity of maternity care in Burkina Faso. However, healthcare providers and users have found ways to maintain continuity of care, and the study provides recommendations for improving continuity of care in the future.
Exploring the barriers and enablers of oral health care utilization and safe oral sex behaviour among Transgender women of Malaysia: a qualitative study
Authors: Telang Lahari A , Rashid Abdul , Cotter Aoife G 
Published: April 2024

ABSTRACTBackgroundTransgender women in Malaysia are vulnerable and marginalized. They experience unique social and interpersonal challenges that contribute to relatively unmet health care needs thereby increasing their risk of acquiring HIV and sexually transmitted infections (STIs). With research pertaining to oral health of transgender women being sparse in literature, this study aimed to understand their experiences by exploring the barriers and enablers of oral health care utilization as well as safe sexual behaviour relating to oral transmission of STIs among Transgender women.MethodsSemi structured in-depth interviews (n=20) with a group of urban dwelling transgender women (mean age= 39.8 years) in Northern Malaysia and Focus group discussion (n=7) with key informants was conducted to gain insights into the needs of the community. Participants were recruited through a snow-balling method of sampling with the help of transgender women community workers. The data obtained was coded and transcribed and subjected to thematic analysis to interpret and derive major themes and subthemes. Community advocates were involved in planning of the study.ResultsAll of participants reported experiencing high levels of stigma and discrimination in daily life. Routine engagement in oral sex practices (100%, n=20) was reported with multiple partners (60%, n=12) with a perceived low level of risk of transmission of STIs through this practice (80%, n=16). Nighty percent (n=18) never used barriers or inconsistently used them during oral sexual practices. Additionally, low utilization of dental services was reported with 80% (n=16) not having visited a dentist in the past 12 months or seeking self-medication or unprofessional care. The themes that emerged from the qualitative analysis were key to understanding the experiences of the community.ConclusionThe results identified gaps in awareness of oral transmission of STIs among the transgender women. The importance of social support in positively influencing health promotion as well as improving health care and dental care utilization was highlighted. The development of an educational intervention is proposed as an instrument to address these gaps and provide support.
Neurovascular coupling and briefCO2interrogate distinct vascular regulations
Authors: Tournissac Marine , Chaigneau Emmanuelle , Pfister Sonia , Aydin Ali-Kemal , Goulam Houssen Yannick , O’Herron Philip , Filosa Jessica , Collot Mayeul , Joutel Anne , Charpak Serge 
Published: April 2024

AbstractNeurovascular coupling (NVC), which mediates rapid increases in cerebral blood flow in response to neuronal activation, is commonly used to map brain activation or dysfunction. Here we tested the reemerging hypothesis that CO2generated by neuronal metabolism contributes to NVC. We combined functional ultrasound and two-photon imaging in the mouse barrel cortex to examine specifically the onsets of local changes in vessel diameter, blood flow dynamics, vascular/perivascular/intracellular pH, and intracellular calcium signals along the vascular arbor in response to briefCO2, a short and strong hypercapnic challenge (10 s, 20%) and whisker stimulation. We report that briefCO2reversibly acidifies all cells of the arteriole wall and the periarteriolar space 3-4 seconds prior to the arteriole dilation. During this prolonged lag period, NVC triggered by whisker stimulation is not affected by the acidification of the entire neurovascular unit. As it also persists under condition of continuous inflow of CO2, we conclude that CO2is not involved in NVC.
Nanoparticle-mediated delivery of placental gene therapy via uterine artery catheterization in a pregnant rhesus macaque
Authors: Schmidt Jenna K. , Wilson Rebecca L. , Davenport Baylea N. , Hacker Timothy A. , Fitz Casey , Simmons Heather A. , Schotzko Michele L. , Golos Thaddeus G. , Jones Helen N. 
Published: April 2024

AbstractNanoparticles offer promise as a mechanism to non-invasively deliver targeted placental therapeutics. Our previous studies utilizing intraplacental administration demonstrate efficient nanoparticle uptake into placental trophoblast cells and overexpression of humanIGF1(hIGF1). Nanoparticle-mediated placental overexpression ofhIGF1in small animal models of placental insufficiency and fetal growth restriction improved nutrient transport and restored fetal growth. The objective of this pilot study was to extend these studies to the pregnant nonhuman primate and develop a method for local delivery of nanoparticles to the placenta via maternal blood flow from the uterine artery. Nanoparticles containinghIGF1plasmid driven by the placenta-specificPLAC1promoter were delivered to a mid-gestation pregnant rhesus macaque via a catheterization approach that is clinically used for uterine artery embolization. Maternal-fetal interface, fetal and maternal tissues were collected four days post-treatment to evaluate the efficacy ofhIGF1treatment in the placenta. The uterine artery catheterization procedure and nanoparticle treatment was well tolerated by the dam and fetus through the four-day study period following catheterization. Nanoparticles were taken up by the placenta from maternal blood as plasmid-specifichIGF1expression was detected in multiple regions of the placenta via in situ hybridization and qPCR. The uterine artery catheterization approach enabled successful delivery of nanoparticles to maternal circulation in close proximity to the placenta with no concerns to maternal or fetal health in this short-term feasibility study. In the future, this delivery approach can be used for preclinical evaluation of the long-term safety and efficacy of nanoparticle-mediated placental therapies in a rhesus macaque model.HighlightsNovel method to deliver therapeutics to maternal-fetal interfaceDelivery of nanoparticles to the placenta via maternal catheterization
Microglia drive diurnal variation in susceptibility to inflammatory blood-brain barrier breakdown
Authors: Lawrence Jennifer H. , Patel Asha , King Melvin W. , Nadarajah Collin J. , Daneman Richard , Musiek Erik S. 
Published: April 2024

AbstractThe blood-brain barrier (BBB) is critical for maintaining brain homeostasis but is susceptible to inflammatory dysfunction. Permeability of the BBB to lipophilic molecules shows circadian variation due to rhythmic transporter expression, while basal permeability to polar molecules is non-rhythmic. Whether daily timing influences BBB permeability in response to inflammation is unknown. Here, we induced systemic inflammation through repeated lipopolysaccharide (LPS) injections either in the morning (ZT1) or evening (ZT13) under standard lighting conditions, then examined BBB permeability to a polar molecule, sodium fluorescein. We observed clear diurnal variation in inflammatory BBB permeability, with a striking increase in paracellular leak across the BBB specifically following evening LPS injection. Evening LPS led to persisting glia activation and inflammation in the brain that was not observed in the periphery. The exaggerated evening neuroinflammation and BBB disruption were suppressed by microglial depletion or through keeping mice in constant darkness. Our data show that diurnal rhythms in microglial inflammatory responses to LPS drive daily variability in BBB breakdown and reveals time-of-day as a key regulator of inflammatory BBB disruption.