bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal timing of surgical intervention for penile fracture: a narrative review of the modern literature
Authors: Bernstein Ari P , Shayegh Nader , Piraino Javier , Ziegelmann Matthew 
Published: January 2024

Abstract

Introduction
Penile fracture is traditionally considered a surgical emergency warranting immediate repair with the goal to maximize long-term erectile function and minimize penile curvature. Nonetheless, consensus on the optimal timing for penile fracture repair remains to be elucidated and is the subject of continued research efforts.

Objectives
This review aims to summarize the contemporary literature pertaining to optimal timing of penile fracture repair and associated outcomes.

Methods
We queried PubMed/MEDLINE and Google Scholar for relevant articles published between 2012 and 2022 to evaluate the most recent literature on the queried topic of early vs delayed intervention for penile fracture. All examined review articles were published within the last decade but may have included analyses of studies published prior to 2012. Reference lists of articles and reviews were manually reviewed to identify additional relevant articles.

Results
We identified 16 articles that met inclusion criteria: 12 primary articles and 4 systematic reviews or meta-analyses. Importantly, definitions of early and delayed intervention varied greatly among studies, making quantitative comparison challenging. In summary, 6 primary studies and 2 systematic review articles favored early intervention. There were also 6 primary studies and 2 systematic review articles suggesting equivocal outcomes between early and delayed repair. No articles demonstrated improved outcomes with delayed repair relative to early intervention.

Conclusion
Surgical intervention for penile fracture remains the gold standard, with superior long-term sexual and functional outcomes when compared with conservative management. Optimal timing of penile fracture repair remains to be elucidated with data limited by low incidence, resulting in small case series and a lack of randomized controlled trials. Nonetheless, recent data suggest that a brief delay in surgical intervention for patients presenting with penile fractures does not affect long-term sexual and functional outcomes.
Investigation of protective effect of resveratrol and coenzyme Q10 against cyclophosphamide-induced lipid peroxidation, oxidative stress and DNA damage in rats
Authors: Akbel Erten , Kucukkurt Ismail , Ince Sinan , Demirel Hasan Huseyin , Acaroz Damla Arslan , Zemheri-Navruz Fahriye , Kan Fahriye 
Published: January 2024

Abstract
It is seen that cyclophosphamide, which is used in treating many diseases, especially cancer, causes toxicity in studies, and its metabolites induce oxidative stress. This study aimed to investigate the protective effects of resveratrol and Coenzyme Q10, known for their antioxidant properties, separately and together, against oxidative stress induced by cyclophosphamide. In this study, 35 Wistar albino male rats were divided into five groups. Groups; Control group, cyclophosphamide (CP) group (CP as 75 mg kg i.p. on day 14), coenzyme Q10 (CoQ10) + CP group (20 mg/kg i.p. CoQ10 + 75 mg kg i.p. CP), resveratrol (Res) + CP group (20 mg/kg i.p. Res + 75 mg/kg i.p. CP), CoQ10 + Res + CP group (20 mg/kg i.p Res + 20 mg/kg i.p CoQ10 and 75 mg/kg i.p.CP). At the end of the experiment, the cholesterol, creatinine and urea levels of the group given CP increased, while a decrease was observed in the groups given Res and CoQ10. Malondialdehyde level was high, glutathione level, superoxide dismutase and catalase activities were decreased in the blood and all tissues (liver, kidney, brain, heart and testis) of the CP given group. DNA damage and histopathological changes were also observed. In contrast, Res and CoQ10, both separately and together, reversed the CP-induced altered level and enzyme activities and ameliorated DNA damage and histopathological changes. In this study, the effects of Res and CoQ10 against CP toxicity were examined both separately and together.
Flightless beetles crossed the Pacific Ocean: phylogeny and biogeography of the intertidal genus Diaulota Casey (Coleoptera: Staphylinidae: Aleocharinae)
Authors: Ahn Kee-Jeong , Song Jeong-Hun , Lee Jae-Seok 
Published: January 2024

Abstract
The North Pacific distribution of coastal staphylinids may be explained as the result of either dispersal or vicariance. The intertidal rove beetle genus Diaulota is a submarine group that occurs on the Pacific coasts of the Northern Hemisphere. We performed a phylogenetic analysis of Diaulota using molecular characters (3241 bp) to investigate their biogeographic history and patterns. The data were analysed by parsimony, Bayesian, and maximum likelihood methods. Model-based analyses showed the same pattern of Diaulota species relationships, but parsimony analysis resulted in different species relationships for the unresolved clade B. Biogeographical analyses suggested that the common ancestor of Diaulota occurred widely along the East Asian coast with repeated dispersal to the north-eastern Pacific from the north-western Pacific. According to the reconstruction of the ancestral areas, both dispersal (seven events) and vicariance (four events) were important in shaping its current distribution. Although most species underwent stepwise colonization from East Asia via Kamchatka and Alaska to North America along the coast, a single lineage (Diaulota fulviventris and Diaulota harteri) crossed the Pacific Ocean directly from the north-western Pacific to the north-eastern Pacific, possibly via sea surface currents.
Safety and Efficacy of Reduced-Dose Versus Full-Dose Alteplase for Acute Pulmonary Embolism: A Multicenter Observational Comparative Effectiveness Study*
Authors: Melamed Roman , Tierney David M. , Xia Ranran , Brown Caitlin S. , Mara Kristin C. , Lillyblad Matthew , Sidebottom Abbey , Wiley Brandon M. , Khapov Ivan , Gajic Ognjen 
Published: January 2024

OBJECTIVES:
Systemic thrombolysis improves outcomes in patients with pulmonary embolism (PE) but is associated with the risk of hemorrhage. The data on efficacy and safety of reduced-dose alteplase are limited. The study objective was to compare the characteristics, outcomes, and complications of patients with PE treated with full- or reduced-dose alteplase regimens.

DESIGN:
Multicenter retrospective observational study.

SETTING:
Tertiary care hospital and 15 community and academic centers of a large healthcare system.

PATIENTS:
Hospitalized patients with PE treated with systemic alteplase.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Pre- and post-alteplase hemodynamic and respiratory variables, patient outcomes, and complications were compared. Propensity score (PS) weighting was used to adjust for imbalances of baseline characteristics between reduced- and full-dose patients. Separate analyses were performed using the unweighted and weighted cohorts. Ninety-eight patients were treated with full-dose (100 mg) and 186 with reduced-dose (50 mg) regimens. Following alteplase, significant improvements in shock index, blood pressure, heart rate, respiratory rate, and supplemental oxygen requirements were observed in both groups. Hemorrhagic complications were lower with the reduced-dose compared with the full-dose regimen (13% vs. 24.5%, p = 0.014), and most were minor. Major extracranial hemorrhage occurred in 1.1% versus 6.1%, respectively (p = 0.022). Complications were associated with supratherapeutic levels of heparin anticoagulation in 37.5% of cases and invasive procedures in 31.3% of cases. The differences in complications persisted after PS weighting (15.4% vs. 24.7%, p = 0.12 and 1.3% vs. 7.1%, p = 0.067), but did not reach statistical significance. There were no significant differences in mortality, discharge destination, ICU or hospital length of stay, or readmission after PS weighting.

CONCLUSIONS:
In a retrospective, PS-weighted observational study, when compared with the full-dose, reduced-dose alteplase results in similar outcomes but fewer hemorrhagic complications. Avoidance of excessive levels of anticoagulation or invasive procedures should be considered to further reduce complications.
Midlife symptoms and household stress are associated with fingernail cortisol
Authors: Rulu Peteneinuo , Bertone-Johnson Elizabeth R. , Kamilar Jason , Dhall Meenal , Sievert Lynnette Leidy 
Published: January 2024

Abstract

Objective
This study investigates menopausal symptoms, household stressors, and ethnopolitical problems in relation to stress markers, including chronic stress measured by fingernail cortisol, perceived stress measured by the Perceived Stress Scale, and acute stress measured by blood pressure.

Methods
Data from 151 women aged 40 to 55 years were collected from four regions in Nagaland, India, using opportunity sampling. A structured questionnaire was used to collect sociodemographic and lifestyle variables. Symptoms were grouped into emotional instability, vasosomatic symptoms, mood disturbances, and aches and pains using principal component analysis in a previous study, and stress markers included fingernail cortisol, perceived stress, and blood pressure. Community-level, household-level, and midlife symptoms were included to ascertain stressors from different sources.

Results
Our results revealed a significant positive association between a composite measure of emotional instability and stress assessed by fingernail cortisol (β = 0.46, P < 0.001). In addition, there was a positive association between mood disturbances and fingernail cortisol (β = 0.24, P < 0.05). This relationship persisted after controlling for body mass index, socioeconomic status, and menopausal status. In addition, household problems were positively associated with fingernail cortisol (β = 0.25, P = 0.01).

Conclusions
These findings highlight the potential health impacts of the psychosocial stress response associated with domestic stressors such as financial strain and concerns about children and health.
Surgical Site Infection Prevention Using “Strike Teams”: The Experience of an Academic Colorectal Surgical Department
Authors: Hatharaliyadda Buddhi , Schmitz Michelle , Mork Anne , Osman Fauzia , Heise Charles , Safdar Nasia , Pop-Vicas Aurora 
Published: January 2024

ABSTRACT
Surgical site infections (SSIs) are healthcare-acquired infections with substantial morbidity. Surgical site infection persist because of low adherence to prevention bundles comprising multiple infection control elements. We propose the “Strike Team” as an implementation strategy to improve adherence and reduce SSI in colorectal surgery. At an academic medical center, a multidisciplinary Strike Team met monthly to review colorectal SSI cases, audit and discuss barriers to adherence to SSI prevention bundle, and propose actionable feedback. The latter was shared with frontline clinicians by the Strike Team's surgical leaders in everyday practice. Colorectal SSI rates and bundle adherence data were disseminated quarterly via the hospital intranet and reviewed with surgeons at departmental meetings. Trends in adherence and SSI rates were analyzed by regression analysis using a time series model. While the Strike Team was active, adherence to antibiotic prophylaxis, maintenance of normoglycemia, and standardized intraoperative skin preparation significantly increased (p < .05). There was a trend toward statistically significant reduction in SSI (p = .07), although it was not maintained once the Strike Team activity was disrupted by the COVID-19 pandemic. Colorectal SSI prevention requires a resource-intensive, multidisciplinary approach with numerous strategies to improve adherence to infection control bundles, as illustrated by our SSI Strike Team experience.
Does Rounding Order Bias Discharge Efficiency? Predictors of Discharge Timing on an Academic Urology Service
Authors: Paul Charles J. , Erickson Bradley A. , Nepple Kenneth G. , Tracy Chad R. 
Published: January 2024

ABSTRACT
No previous works have analyzed whether the order in which surgical teams see patients on morning rounds affects discharge efficiency at teaching hospitals. We obtained perioperative urologic surgery timing data at our academic institution from 2014 to 2019. We limited the analysis to routine postoperative day 1 discharges. Univariate and multivariate analyses were performed to determine whether various hospital and patient factors were associated with discharge timing. We analyzed 1,494 patients. Average discharge order time was 11:22 a.m. and hospital discharge 1:24 p.m. Univariate regression revealed earlier discharge order time for patients seen later in rounds by 4 minutes per sequential room cluster (p = .013) and by 12 minutes per cluster when excluding short-stay patients. Multivariate analysis revealed discharge order placement did not vary significantly by rounding order. However, time of hospital discharge did (p < .001), likely due to speed of discharge in the designated short-stay units. Attending physician was the most consistent predictor in variations of discharge timing, with statistical significance across all measured outcomes. Patients seen later in rounding progression received earlier discharge orders, but this relationship does not remain in multivariate modeling or translate to earlier discharge. These findings have helped guide quality improvement efforts focused on discharge efficiency.
Interferon gamma in the pathogenesis of hypertension − recent insights
Authors: Benson Lance N. , Mu Shengyu 
Published: January 2024

Purpose of review
The mounting body of evidence underscores the pivotal role of interferon gamma (IFNγ) in the pathogenesis of hypertension, prompting exploration of the mechanisms by which this cytokine fosters a pro-inflammatory immune milieu, subsequently exacerbating hypertension. In this review, we delve into recent preclinical and clinical studies from the past two years to elucidate how IFNγ participates in the progression of hypertension.

Recent findings
IFNγ promotes renal CD8+ T cell accumulation by upregulating tubular PDL1 and MHC-I, intensifying cell-to-cell interaction. Intriguingly, a nucleotide polymorphism in LNK, predisposing towards hypertension, correlates with augmented T cell IFNγ production. Additionally, anti-IFNγ treatment exhibits protective effects against T cell-mediated inflammation during angiotensin II infusion or transverse aortic constriction. Moreover, knockout of the mineralocorticoid receptor in T cells protects against cardiac dysfunction induced by myocardial infarction, correlating with reduced IFNγ and IL-6, decreased macrophage recruitment, and attenuated fibrosis. Interestingly, increased IFNγ production correlates with elevated blood pressure, impacting individuals with type 2 diabetes, nondiabetics, and obese hypertensive patients.

Summary
These revelations spotlight IFNγ as the critical mediator bridging the initial phase of blood pressure elevation with the sustained and exacerbated pathology. Consequently, blocking IFNγ signaling emerges as a promising therapeutic target to improve the management of this ‘silent killer.’
Early prediction of distant metastasis in patients with uterine cervical cancer treated with definitive chemoradiotherapy by deep learning using pretreatment [18F]fluorodeoxyglucose positron emission tomography/computed tomography
Authors: Wu Kuo-Chen , Chen Shang-Wen , Hsieh Te-Chun , Yen Kuo-Yang , Chang Chao-Jen , Kuo Yu-Chieh , Chang Ruey-Feng , Chia-Hung Kao 
Published: January 2024

Objectives
A deep learning (DL) model using image data from pretreatment [18F]fluorodeoxyglucose ([18F] FDG)-PET or computed tomography (CT) augmented with a novel imaging augmentation approach was developed for the early prediction of distant metastases in patients with locally advanced uterine cervical cancer.

Methods
This study used baseline [18F]FDG-PET/CT images of newly diagnosed uterine cervical cancer patients. Data from 186 to 25 patients were analyzed for training and validation cohort, respectively. All patients received chemoradiotherapy (CRT) and follow-up. PET and CT images were augmented by using three-dimensional techniques. The proposed model employed DL to predict distant metastases. Receiver operating characteristic (ROC) curve analysis was performed to measure the model’s predictive performance.

Results
The area under the ROC curves of the training and validation cohorts were 0.818 and 0.830 for predicting distant metastasis, respectively. In the training cohort, the sensitivity, specificity, and accuracy were 80.0%, 78.0%, and 78.5%, whereas, the sensitivity, specificity, and accuracy for distant failure were 73.3%, 75.5%, and 75.2% in the validation cohort, respectively.

Conclusion
Through the use of baseline [18F]FDG-PET/CT images, the proposed DL model can predict the development of distant metastases for patients with locally advanced uterine cervical cancer treatment by CRT. External validation must be conducted to determine the model’s predictive performance.
Long-term assessment of clinical parameters and positron emission tomography parameters in predicting recurrence in uterine cervical cancer patients receiving definitive chemoradiotherapy
Authors: Onal Cem , Guler Ozan Cem , Torun Nese , Reyhan Mehmet 
Published: January 2024

Objective
The objective of this study was to assess the prognostic value of clinical factors and metabolic parameters measured using fluorodeoxyglucose PET (FDG-PET/CT) in predicting disease recurrence, as well as distant metastasis-free survival (DMFS), local recurrence-free survival (LRFS), and overall survival (OS) in patients with uterine cervical cancer who received definitive chemoradiotherapy.

Methods
The clinical data and FDG-PET parameters, including standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of 194 patients with biopsy-confirmed squamous cell carcinoma of cervical cancer were retrospectively analyzed. Univariate and multivariate analyses were used to ascertain prognostic factors associated with DMFS, LRFS, and OS.

Results
With a median follow-up of 12.5 years, 96 patients (49.5%) presented with disease recurrence, at a median of 9.9 months after chemoradiotherapy. Patients who experienced recurrence had significantly higher values for all FDG-PET parameters compared to patients who did not. In multivariate regression analysis, lymph node metastasis, MTV, and SUVmean were significantly correlated with distant metastasis, while local recurrence was only predicted by SUVmax. Lymph node metastasis, high MTV, SUVmean, and TLG predicted shorter DMFS, while only the primary tumor SUVmax predicted LRFS. Age, regional nodal metastasis, and higher MTV independently predicted shorter OS in multivariate analysis.

Conclusion
We found that metabolic parameters derived from FDG-PET/CT could serve as surrogates for disease recurrence in patients with cervical cancer who were treated with definitive chemoradiotherapy. Patients at high risk of distant metastasis could be defined using SUVmean and MTV, and for local recurrence, by using SUVmax.
Free mebrofenin clearance
Authors: Parker J. Anthony , Tahir Muhammad M. , Whitmarsh Suzanne R. , Sarwar Ammar 
Published: January 2024

Objectives
To determine if three new simplified equations for measurement of free mebrofenin clearance give similar results to the equations defined by Ekman et. al., and to evaluate the properties of all four methods. Regional mebrofenin clearance has been used to predict future remnant liver function and liver failure after regional liver therapy, such as partial hepatic resection.

Methods
The means, standard deviations, and correlations of the free mebrofenin clearance measured by the Ekman method and the three simplified methods were compared in a consecutive series of 26 studies in 20 patients. The fractional change in the blood and free mebrofenin activities were compared, and integrals of normalized blood and free mebrofenin (“effective times”) were compared.

Results
The average percent free mebrofenin clearance for the Ekman and the first, second and third simplified methods were 13.62 ± 2.88%/min, 12.98 ± 2.97%/min, 12.52 ± 2.81%/min and 15.03 ± 2.27%/min, respectively. The correlations of the new methods with Ekman were 0.97, 0.93 and 0.93. The fractional changes during the measurement interval for the blood and free mebrofenin activities were 0.381 ± 0.065 and 0.329 ± 0.062, difference 0.052, P < 0.5. The integrals of normalized blood and free mebrofenin activities were 2.566 ± 0.160 min and 2.661 ± 0.158 min, difference of 0.094 min and P < 0.05.

Conclusions
The results of the three new methods were similar to the Ekman method. The first simplified method was identified as the lead method for clinical validation in a larger population.
68Ga-Pentixafor PET/CT for in-vivo mapping of CXCR4 receptors as potential radiotheranostic targets in soft tissue and bone sarcoma: preliminary results
Authors: Jena Santosh Ranjan , Watts Ankit , Aggarwal Piyush , Bachhal Vikas , Kaur Harneet , Dhingra Kirti , Singh Harmandeep , Bal Amanjit , Singh Baljinder 
Published: January 2024

Objective
To evaluate the diagnostic utility of 68Ga-Pentixafor PET/CT for in vivo imaging of CXCR4 receptors in soft tissue/bone sarcoma.

Methods
Ten (7M: 3F; mean age = 24.7 ± 14.2 years) consecutive patients with clinical and radiological evidence of bone/soft tissue sarcoma were recruited prospectively whole body 68Ga-Pentixafor PET/CT imaging was performed at 60-min after tracer administration. After performing standard CT, PET acquisition from head to toe was done (3 min/bed position) in a caudocranial direction. PET/CT data was reconstructed and SUVmax, SUVmean values, target-to-background ratio (TBR) and active tumor volume (cc) were computed for the tracer avid lesions. Histopathological and IHC analysis was performed on the surgically excised primary tumors. CXCR4 receptors’ intensity was evaluated by visual scoring.

Results
The mean SUVmax and SUVmean values in the primary tumors were 4.80 ± 1.0 (3.9–7.7) and 2.40 ± 0.60 (0.9–4.0). The mean TBR and tumor volume (cc) were 1.84 ± 1.3 and 312.2 ± 285. Diagnosis of osteosarcoma in 7, chondrosarcoma, leiomyosarcoma and synovial sarcoma in 1 patient each was confirmed on HP analysis. Distant metastatic lesions were seen in 3/10 patients. Nuclear CXCR4 receptors’ positivity was seen in 5, cytoplasmic in 4 and both pattern seen in 1 patient. The mean CXCR4 receptors’ intensity was found to be 7.6 ± 2. The highest SUVmax value of 7.7 was observed in the patient having both cytoplasmic and nuclear CXCR4 expression. SUVmax was found to be poorly correlated (r = 0.441) with CXCR4 expression.

Conclusion

68Ga-Pentixafor PET/CT detects CXCR4 receptors over-expressed in sarcoma, its radio-theranostics potential needs detailed evaluation.