bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of postoperative sexual function on health-related quality of life after robot-assisted radical prostatectomy
Authors: Iwahashi Yuya , Deguchi Ryusuke , Muraoka Satoshi , Wakamiya Takahito , Yamashita Shimpei , Kikkawa Kazuro , Kohjimoto Yasuo , Hara Isao 
Published: September 2023

Abstract

Background
We investigated potential disparities in health-related quality of life, particularly concerning urinary function, between patients with preserved and those with impaired sexual function after robot-assisted radical prostatectomy (RARP).

Materials and methods
Between December 2012 and April 2020, 704 men underwent RARP in our hospital. This study included 155 patients with a preoperative 5-item International Index of Erectile Function (IIEF-5) of ≥12 points and an assessable IIEF-5 at 12 months postoperatively. Health-related quality of life was assessed using the 8-item Short-Form Health Survey and Expanded Prostate Cancer Index Composite (EPIC) preoperatively and at 3, 6, and 12 months postoperatively. A logistic regression analysis and Wilcoxon rank sum tests were performed.

Results
Patients were grouped according to the median IIEF-5 score 12 months after surgery: those with preserved sexual function (n = 71) and those with impaired sexual function (n = 84). The mental component summary of the 8-item Short-Form Health Survey was better in the group with preserved sexual function at 6 months postoperatively than in the group with impaired sexual function (p < 0.01). In the EPIC, the group with preserved sexual function performed better not only in the sexual domain but also in the urinary domain at all time points compared with the group with impaired sexual function (p < 0.01). In the comparison of the urinary subdomains of the EPIC, there were no significant differences in urinary function or incontinence, but there were significant differences in urinary distress and irritative/obstructive scores (p < 0.01).

Conclusions
Patients with preserved postoperative sexual function after RARP showed better urinary function than those with impaired sexual function. Hence, preserved sexual function is closely associated with urinary function.
Impact of PCSK9 inhibitors on coronary atheroma phenotype following myocardial infarction: insights from intravascular imaging
Authors: Abrahams Timothy , Fujino Masashi , Nelson Adam J. , Nicholls Stephen J. 
Published: September 2023

Purpose of review
The aim of this study was to review the impact of combination lipid lowering with statins and proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors on coronary atherosclerosis using serial intravascular imaging.

Recent findings
Early studies using intravascular ultrasound established the ability of increasingly intensive lipid lowering to both slow progression and ultimately promote regression of coronary disease. More recent clinical trials that have employed serial imaging with optical coherence tomography have permitted the ability to evaluate the impact of intensive lipid lowering on compositional features associated with plaque vulnerability. In particular, the combination of intensive statin and PCSK9 inhibitor therapy promotes plaque stability in patients following an acute coronary syndrome.

Summary
More intensive lipid lowering using the combination of statins and PCSK9 inhibitors promote plaque regression in addition to promoting calcification, fibrous cap thickening and reductions in plaque lipid. These plaque-stabilizing effects underscore the benefits of combination therapy on cardiovascular events and highlight the importance of combination lipid-lowering therapy.
Reconsideration of the definition of blanking period and significance of early recurrences after catheter ablation of atrial fibrillation
Authors: Wen Songnan , Liao Yu , Khurana Tejas S. , Bai Rong 
Published: September 2023

Purpose of review
Early recurrence of atrial tachyarrhythmia (ERAT) during blanking period (BP) is not uncommon after catheter ablation of AF. Current guidelines and consensus statements recommend conservative treatment of ERAT. This review summarized recent studies, underlying mechanism and clinical managements of ERAT, and proposed a reconsideration of the definition and clinical significance of BP.

Recent findings
Recent studies have shown that the entity of ERAT in the very early phase of BP (i.e., first 4 weeks of the 3-month period) is different from those ERATs occurring late which is strongly associated with the late recurrence of atrial tachyarrhythmia. The optimal BP duration suggested by clinical observation ranges from 21 to 58 days. Using antiarrhythmic drugs and early electrical cardioversion are the effective management for ERAT, whereas re-ablation is a reasonable strategy although remains controversial.

Summary
The definition of BP with a shorter duration, that is, 1 month instead of 3 months post AF ablation, is supported by the observations of latest clinical studies. Recurrent atrial tachyarrhythmia beyond the 1-month time frame is associated with higher risk of late recurrence and may warrant repeat ablation. A revisit to the guideline recommendation on management of ERAT is needed to change clinical practice.
Vertical and horizontal metamorphopsia one year after surgery for macular holes ≤ 500 µm with and without inverted ILM-Flap
Authors: Baumann Carmen , Maier Mathias , Johannigmann-Malek Navid , Gabka Katharina , Schwer Lydia , Kaye Stephen B 
Published: September 2023

Abstract

Purpose:
To investigate the effect of an inverted internal limiting membrane flap (IF) and other factors on metamorphopsia after macular hole surgery

Methods:
Prospective case series of patients undergoing pars-plana vitrectomy with gas tamponade, with either conventional internal limiting membrane (ILM) peeling (CP) or with an inverted ILM-flap (IF), for primary idiopathic macular holes (MH) ≤ 500 µm. Vertical and horizontal metamorphopsia were measured as M-scores (degrees) using M-charts preoperatively and at 2, 6 and 12 months postoperatively.

Results:
Fifty-three eyes of 53 patients were included of whom 27 underwent CP and 26 were treated with an IF. After MH surgery, all patients were pseudophakic. Vertical and horizontal metamorphopsia improved from 1.08 (±0.51) and 0.98 (±0.70) preoperatively to 0.58 (±0.37) and 0.45 (±0.36) at 2 months (p<0.01), with no further significant improvement at 6 months (0.39 (±0.31), p=0.07, and 0.31 (±0.28), p=0.18) or at 12 months (0.37 (±0.30), p=0.72 and 0.28 (±0.28), p=0.99). There was no significant difference in mean vertical and horizontal metamorphopsia between patients with CP and with an IF at 2 months (p=0.063, p=0.10), 6 months (p=0.25, p=0.16) or 12 months (p=0.62, p=0.22). Preoperative vertical M-score improved at 12 months after MH surgery by 61 % and 64% in the CP and IF groups (p=0.84), and the horizontal M-score by 65 % and 71% (p=0.98).

Conclusion:
The use of an IF has no evident bearing on the degree of postoperative metamorphopsia 12 months after surgical repair of MHs ≤ 500 µm.
Vicarious Trauma and Health Outcomes in Forensic Mental Health Nurses
Authors: Newman Claire , Roche Michael , Elliott Doug 
Published: September 2023

ABSTRACT

Background
Nurses working in forensic mental health settings are at risk of vicarious trauma because of their exposure to traumatized patients and distressing material such as the aversive details of patient crimes.

Aim
The aim of this study was to determine the incidence of vicarious trauma and explore its impact on health and absence from work.

Methods
A cross-sectional descriptive correlational study was undertaken. All 205 forensic mental health nurses working in a high-security inpatient facility were invited to participate. An online survey included the Vicarious Trauma Scale and the SF-36v2 to measure mental and physical health. Absence from work was also explored.

Results
Sixty-seven respondents completed the survey. Almost half of respondents had a moderate level of vicarious trauma, and only over one-quarter experienced high levels. Higher levels of vicarious trauma were associated with poorer mental health (r = −0.59, p < 0.000) and absence from work (r = 0.27, p < 0.010).

Conclusions
Forensic mental health nurses are at a greater risk of vicarious trauma than nurses working in mainstream mental health services, given their exposure to aversive details of patients' violent crimes. Adverse mental health consequences of vicarious trauma, and other forms of workplace trauma experienced by forensic mental health nurses, are likely to include trauma-related symptoms, depression, and anxiety. Forensic mental health nurses experiencing vicarious trauma may use sick leave as time away from work to care for their own mental health or a coping mechanism for workplace-induced psychological distress.
Practice Variations in Managing Infantile Hemangiomas
Authors: McLean Thomas W. , Borst Alexandra J. , Hammill Adrienne M. , Iacobas Ionela , Atkinson Autumn , Shah Tishi , Margolin Judith F. , Bayliff Sherry L. , Blatt Julie 
Published: September 2023

Infantile hemangioma (IH) is the most common benign tumor of infancy. For children with IH who require treatment, propranolol and other beta blockers have been shown to be safe and effective. Although consensus guidelines for managing IH have been published, anecdotal experience suggests that there remain variations in management. This study was performed to document these variations amongst providers and to identify areas for future research. We conducted an Internet-based survey of clinicians who treat patients with IH. Hypothetical cases and management scenarios were presented. Twenty-nine respondents participated in the survey. Most respondents use generic propranolol in infants with growing IH of the head and neck, with a goal dose of 2 mg/kg/d, until ~1 year of age. A variety of management strategies were documented including which patients should be treated, optimal dose and duration of therapy, how patients should be monitored, which patients should get additional workup, how propranolol should best be discontinued, and how often to see patients in follow-up. This study demonstrates wide practice variations in managing patients with IH. Further research is indicated to address these variations and develop additional/updated evidence-based guidelines.
Use of the Interalar Ligament Flap for Tip and Supratip Contouring in Primary Open Structural Rhinoplasty
Authors: Marianetti Tito Matteo , Segreto Francesco , Iademarco Antonio , Rossi Caterina , Persichetti Paolo 
Published: September 2023

Background:
Precise tip contouring is paramount to achieve pleasant cosmetic results in rhinoplasty. Loss of tip projection or rotation, supratip deformities, and long-lasting edema may jeopardize the outcome and lead to patient dissatisfaction or to reintervention. Several approaches have been reported, sometimes with considerable drawbacks or conclusions supported mainly by experience. The aim of this study was to describe the interalar ligament flap for tip and supratip contouring and to comparatively assess its efficacy and safety.

Methods:
The study included 147 patients who underwent primary structured open rhinoplasty and were divided into 2 groups: group 1 underwent harvesting and repositioning of the interalar ligament flap, and group 2 underwent conventional tip dissection. Tip edema, supratip definition, and fullness were blindly scored at 2-, 6-, and 12-month postoperative follow-up. Nasolabial angle was measured at 2 and 12 months postoperatively. Univariate analysis and multivariable regression modeling were performed.

Results:
Supratip definition was significantly higher in group 1 at the 2-, 6-, and 12-month postoperative follow-up visits (P < 0.05, P < 0.01, and P < 0.01, respectively). Tip edema and supratip fullness were significantly lower in group 1 at each time point (P < 0.01). Nasolabial angle, and its modification between 2 and 12 months after intervention, did not differ in the 2 groups. All findings were confirmed when controlled for eventual confounders.

Conclusions:
The interalar ligament flap has proven to be versatile, effective, and consistently reliable in reducing tip edema and improving supratip definition. It may be tailored to the patient, partially folded to improve tip projection, or used to camouflage tip grafts.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Remote Real-Time Training for Sustainable Cleft Operation in Rural Region of West Africa: Effective Webinar in the COVID-19 Pandemic
Authors: Eo Mi Young , Thi Hoang Nguyen Truc , Amponsah Emmanuel K. , Sodnom-Ish Buyanbileg , Frimpong Paul , Yang Hoon Joo , Kim Soung Min 
Published: September 2023

Introduction:
The surgical requirement for cleft lip and palate repair remains unmet in many developing areas of the world, including remote regions of Ghana. This article reviews the utilization of Internet education and online consultation for cleft lip and palate surgical training in Sunyani Regional Hospital (SRH), Ghana.

Methods:
The cleft lip and palate treatment was promoted to patients in remote areas of Sunyani, Ghana region, through a charitable outreach program. These basic designs and settings were managed by local participants such as doctors, residents, nurses, and staff in SRH, Ghana.

Results:
From November 2014 to December 2020, the authors collaborated in surgical treatment for 84 cases that were diagnosed with unilateral cleft lip, bilateral cleft lip, hard and soft palate cleft, and microstomia. The type of surgery has varied and has included cheiloplasty, palatoplasty, and others. The average scores of esthetic outcome evaluation were nasal form=2.4, symmetry of the nose=2.9, and vermillion border=2.9. Through the program, the surgeons and residents became significantly more proficient at cleft lip and palate surgery. The seminar topics have covered essential and sustainable topics based on SRH’s current needs and showed the effectiveness in the current coronavirus disease-19 pandemic situation.

Conclusions:
The shortage of orofacial cleft surgeons working in rural areas like Sunyani, Ghana, remains an obstacle that poses a challenge to any effort to improve health care quality in these rural communities. Sustainable remote education is essential for the training of local cleft surgeons to fill this local need; our collaborative and charitable program could be a recommended education design for cleft surgeons and institutes for their sustainable education.
Immune Correlates of Hyperglycemia and Vaccination in a Non-human Primate Model of Long-COVID
Authors: Palmer Clovis S , Perdios Chrysostomos , Abdel-Mohsen Mohamed , Mudd Joseph , Datta Prasun , Maness Nicholas J. , Lehmicke Gabrielle , Golden Nadia , Hellmer Lihn , Coyne Carol , Green Kristyn Moore , Midkiff Cecily , Williams Kelsey , Tiburcio Rafael , Fahlberg Marissa , Boykin Kyndal , Kenway Carys , Russell-Lodrigue Kasi , Birnbaum Angela , Bohm Rudolf , Blair Robert , Dufour Jason , Fischer Tracy , Saied Ahmed A , Rappaport Jay 
Published: September 2023

AbstractHyperglycemia, and exacerbation of pre-existing deficits in glucose metabolism, are major manifestations of the post-acute sequelae of SARS-CoV-2 (PASC). Our understanding of lasting glucometabolic disruptions after acute COVID-19 remains unclear due to the lack of animal models for metabolic PASC. Here, we report a non-human primate model of metabolic PASC using SARS-CoV-2 infected African green monkeys (AGMs). Using this model, we have identified a dysregulated chemokine signature and hypersensitive T cell population during acute COVID-19 that correlates with elevated and persistent hyperglycemia four months post-infection. This persistent hyperglycemia correlates with elevated hepatic glycogen, but there was no evidence of long-term SARS-CoV-2 replication in the liver and pancreas. Finally, we report a favorable glycemic effect of the SARS-CoV-2 mRNA vaccine, administered on day 4 post-infection. Together, these data suggest that the AGM metabolic PASC model exhibits important similarities to human metabolic PASC and can be utilized to assess therapeutic candidates to combat this syndrome.
Survey of white-footed mice in Connecticut, USA reveals low SARS-CoV-2 seroprevalence and infection with divergent betacoronaviruses
Authors: Earnest Rebecca , Hahn Anne M. , Feriancek Nicole M. , Brandt Matthew , Filler Renata B. , Zhao Zhe , Breban Mallery I. , Vogels Chantal B.F. , Chen Nicholas F.G. , Koch Robert T. , Porzucek Abbey J. , Sodeinde Afeez , Garbiel Alexa , Keanna Claire , Litwak Hannah , Stuber Heidi R. , Cantoni Jamie L. , Pitzer Virginia E. , Olarte Castillo Ximena A. , Goodman Laura B. , Wilen Craig B. , Linske Megan A. , Williams Scott C. , Grubaugh Nathan D. 
Published: September 2023

AbstractDiverse mammalian species display susceptibility to and infection with SARS-CoV-2. Potential SARS-CoV-2 spillback into rodents is understudied despite their host role for numerous zoonoses and human proximity. We assessed exposure and infection among white-footed mice (Peromyscus leucopus) in Connecticut, USA. We observed 1% (6/540) wild-type neutralizing antibody seroprevalence among 2020-2022 residential mice with no cross-neutralization of variants. We detected no SARS-CoV-2 infections via RT-qPCR, but identified non-SARS-CoV-2 betacoronavirus infections via pan-coronavirus PCR among 1% (5/468) of residential mice. Sequencing revealed two divergent betacoronaviruses, preliminarily namedPeromyscus coronavirus-1and-2. Both belong to theBetacoronavirus 1species and are ∼90% identical to the closest known relative,Porcine hemagglutinating encephalomyelitis virus. Low SARS-CoV-2 seroprevalence suggests white-footed mice may not be sufficiently susceptible or exposed to SARS-CoV-2 to present a long-term human health risk. However, the discovery of divergent, non-SARS-CoV-2 betacoronaviruses expands the diversity of known rodent coronaviruses and further investigation is required to understand their transmission extent.
Incidence and Predictors of Mortality among Neonates Admitted for Congenital Heart Disease in Public Comprehensives Specialized Hospitals, Amhara Region, Ethiopia 2023
Authors: Ayfokru Abatwoy , Shewasinad Sisay , Ahmed Fuad , Tefera Mitku , Nigusie Genet , Getaneh Emawaysh 
Published: September 2023

AbstractBackgroundCongenital heart disease is typically defined as a structural abnormality of the heart and great vessels present at birth. The incidence and mortality of congenital heart disease in neonates vary worldwide and it is the leading cause of birth defects, morbidity and mortality.Objectiveto assess incidence and predictors of mortality among neonates admitted for congenital heart disease in public comprehensives specialized hospitals Amhara region, Ethiopia a Retrospective follow-up study 2023MethodInstitution-based retrospective follow-up study was conducted among 583 neonates with congenital heart disease admitted to Amhara region public comprehensive specialized hospitals from January 1st2018 to December 30th, 2022. The study subjects was selected using simple random sampling techniques. Data were entered into EPI data version 4.6, then exported to STATA version 16. The log-rank test and Kaplan Meier failure curve was used to estimate and compare the probability of death. First bivariable then multivariable regression was done. After computing a hazard ratio with a 95% confidence interval, variables with a p-value of 0.05 or lower was considered to be significant predictors of mortalityResultsOut of 583 congenital heart disease neonate 9.9% were developed death. The incidence rate of mortality among congenital heart disease neonates was 11.9% per 1000 with 4844 person-days of observation (95% CI;-0.009-0.015). In this study were found to be Sepsis(AHR:2.24(95%CI:-1.184.23),Cyanoticcongenital heart disease(AHR:3.49(95%CI:1.93-6.28), Home delivery(AHR:1.9(95%,CI:1.06-3.6), had maternal history of Gestational diabetes multiuse (AHR: 1.94 (95% CI 1.04-3.61). Neonates having another congenital malformations. (AHR 2.49(1.33-4.67). neonates have been Airway resuscitation needed during delivery (AHR: 0.43(95%CI: 0.18-0.98). were found to be a significant predictors of Congenital heart disease neonatal mortality.Conclusion and recommendationThe incidence rate of neonatal mortality among congenital heart disease neonate was high as compared to findings of other studies. sepsis, cyanotic congenital heart disease, home delivery, maternal history of gestational diabetes malts, others congenital malformation and Airway resuscitations needed during delivery were significant predictors of mortality for neonates with congenital heart disease. Hence, giving special attention to patients with identified predictors should be better
Prognostic Insights from Longitudinal Multicompartment Study of Host-Microbiota Interactions in Critically Ill Patients
Authors: Kitsios Georgios D. , Sayed Khaled , Fitch Adam , Yang Haopu , Britton Noel , Shah Faraaz , Bain William , Evankovich John W. , Qin Shulin , Wang Xiaohong , Li Kelvin , Patel Asha , Zhang Yingze , Radder Josiah , Cruz Charles Dela , Okin Daniel A , Huang Ching-Ying , van Tyne Daria , Benos Panayiotis V. , Methé Barbara , Lai Peggy , Morris Alison , McVerry Bryan J. 
Published: September 2023

AbstractCritical illness can disrupt the composition and function of the microbiome, yet comprehensive longitudinal studies are lacking. We conducted a longitudinal analysis of oral, lung, and gut microbiota in a large cohort of 479 mechanically ventilated patients with acute respiratory failure. Progressive dysbiosis emerged in all three body compartments, characterized by reduced alpha diversity, depletion of obligate anaerobe bacteria, and pathogen enrichment. Clinical variables, including chronic obstructive pulmonary disease, immunosuppression, and antibiotic exposure, shaped dysbiosis. Notably, of the three body compartments, unsupervised clusters of lung microbiota diversity and composition independently predicted survival, transcending clinical predictors, organ dysfunction severity, and host-response sub-phenotypes. These independent associations of lung microbiota may serve as valuable biomarkers for prognostication and treatment decisions in critically ill patients. Insights into the dynamics of the microbiome during critical illness highlight the potential for microbiota-targeted interventions in precision medicine.