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Clinical outcome of pediatric and young adult subclinical varicoceles:a single-institution experience

Asian Journal of Andrology 2021年第6期23卷 611-615页

作者： Patricia S Cho Richard N Yu Harriet J Paltiel matthew a migliozzi Xiaoran Li Alyssia Venna David A Diamond Department of Urology University of Massachusetts Medical SchoolWorcesterMA 01655USA Department of Urology Boston Children's HospitalBostonMA 02115USA Department of Radiology Boston Children's HospitalBostonMA 02115USA

Subclinical varicocele represents an abnormality of veins of the pampiniform plexus on scrotal ultrasound(US)without a clinically palpable *** significance remains *** guidelines do not recommend surgical intervention,clinical management is *** there is limited information on long-term outcome of subclinical varicoceles due to challenges in diagnosis and management,we performed a single-institution,retrospective review of patients from October 1999 to October 2014 with subclinical varicocele and with available US studies reviewed by a single *** varicocele was defined as dilation of the pampiniform venous plexus on US involving≥2 vessels with diameter>2.5 mm,without clinical varicocele on physical examination or prior inguinal ***-six of 98 patients identified were confirmed as having a subclinical varicocele and *** mean age at initial visit was 15.5 years,with a mean follow-up of 26.5 *** majority were right-sided(69.4%,n=25),usually with a contralateral clinical *** asymmetry(>20%volume difference of the affected side by testicular atrophy index formula)was assessed in 9 patients with unilateral subclinical varicocele without contralateral clinical or subclinical varicocele and observed in 1 *** 17 patients with follow-up,3(17.6%)progressed to clinical varicocele without asymmetric testicular volume,as most remained subclinical or resolved without *** our experience,subclinical varicoceles appeared unlikely to progress to clinical varicoceles,to affect testicular volume,or to lead to *** our study is limited in numbers and follow-up,this information may aid clinical management strategies and guide future prospective studies.

关键词： adolescent pediatric subclinical varicocele

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Alterations of SARS-CoV-2 Evolutionary Dynamics by Pharmaceutical Factors

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Infectious Diseases & Immunity 2024年第1期4卷 35-40页

作者： matthew Halma EbMCsquared CIC Bath BA24BLUnited Kingdom

The outbreak of SARS-CoV-2(severe acute respiratory syndrome coronavirus 2)has been influenced by the human response to the *** responses have undoubtedly impacted the evolutionary dynamics of the virus in ways distinct from a scenario lacking a widespread *** important pharmaceutical interventions,vaccination and the utilization of medications,particularly molnupiravir,known to have mutagenic properties,were the focus of this *** impact of molnupiravir on human health was evaluated through 3 mechanisms:viral resistance,mutagenesis of SARS-CoV-2,and mutagenesis occurring in patients undergoing ***,as well as the impact of vaccination,have inadvertently given rise to unforeseen challenges in the management of the COVID-19 *** a systems view in future pandemic responses,and taking into account the evolution of the pandemic virus,may be critical to ending the pandemic at an earlier date.

关键词： COVID-19 SARS-CoV-2 Evolution Spike protein Molnupiravir Mutagenesis

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Evaluation of a software positioning tool to support SMEs in adoption of big data analytics

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Journal of Electronic Science and Technology 2024年第1期22卷 13-24页

作者： matthew Willetts Anthony S.Atkins Faculty of Digital TechnologyInnovationand BusinessStaffordshire UniversityStoke-on-TrentST42DEUnited Kingdom

Big data analytics has been widely adopted by large companies to achieve measurable benefits including increased profitability,customer demand forecasting,cheaper development of products,and improved stock *** and medium sized enterprises(SMEs)are the backbone of the global economy,comprising of 90%of businesses ***,only 10%SMEs have adopted big data analytics despite the competitive advantage they could *** research has analysed the barriers to adoption and a strategic framework has been developed to help SMEs adopt big data *** framework was converted into a scoring tool which has been applied to multiple case studies of SMEs in the *** paper documents the process of evaluating the framework based on the structured feedback from a focus group composed of experienced *** results of the evaluation are presented with a discussion on the results,and the paper concludes with recommendations to improve the scoring tool based on the proposed *** research demonstrates that this positioning tool is beneficial for SMEs to achieve competitive advantages by increasing the application of business intelligence and big data analytics.

关键词： Big data analytics Evaluation Small and medium sized enterprises (SMEs) Strategic framework

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Refining safety considerations for intradialytic blood flow restriction exercise. Commentary on “Concerns on the application of blood-flow restriction resistance exercise and thrombosis risk in hemodialysis patients”

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Journal of Sport and Health Science 2024年第4期13卷 455-456页

作者： matthew J.Clarkson Institute for Health and Sport Victoria UniversityMelbourneVIC 8001Australia

I read with great interest the article“Concerns on the application of blood flow restriction resistance exercise and thrombosis risk in hemodialysis patients”by Correa et al.1 The study presents complementary data from a previous randomized controlled trial,2 exploring the application of intradialytic blood flow restriction exercise for hemodialysis patients.

关键词： patients hemodialysis

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Description of a novel robotic early post-prostatectomy anastomotic repair technique and institutional outcomes

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Asian Journal of Urology 2024年第3期11卷 366-372页

作者： David Strauss Eric Cho matthew Loecher matthew Lee Daniel Eun Department of Urology Lewis Katz School of MedicineTemple UniversityPhiladelphiaPAUSA

Objective:A vesicourethral anastomotic leak(VUAL)is a known complication following robotic-assisted radical *** natural history of a VUAL has been well described and is frequently managed with prolonged *** increasing emphasis on patient reported outcomes,catheter duration and VUAL are associated with significant short-term quality of life *** aimed to present a case series of our robotic early post-prostatectomy anastomotic repair technique,defined as revision within 6 weeks from index ***:A single institution prospective database identified eleven patients with a VUAL from July 2016 to October 2022 who underwent robotic early post-prostatectomy anastomotic repair by a single *** were diagnosed with a VUAL on pre-operative CT urogram or CT/fluoroscopic *** primary outcome was resolution of the anastomotic leak,defined as no contrast extravasation on post-operative *** outcomes included post-repair catheter duration and continence on the last follow-up defined as pad(s)per ***:The mean time to intervention after robotic-assisted radical prostatectomy was 21 *** of the eleven(72.7%)patients had no evidence of extravasation on postrepair *** range from intervention to first cystogram was 7e20 *** median catheter duration for those with successful intervention was 10 *** median catheter duration for those with the leak on initial post-operative cystogram was 20 *** a mean follow-up time of 25 months,eight(72.7%)patients reported using no pads per day,and three(27.3%)patients reported one pad per ***:Management of a VUAL has traditionally relied on prolonged catheter drainage and the tincture of *** the role of robotic reconstruction has been shown to be a viable modality for management of bladder neck contracture,it is important to reconsider prior dogmas of urologic *** case series suggests that an early repair is saf

关键词： Minimallyinvasive surgery Vesicourethral anastomotic leak Robotic-assisted laparoscopic reconstruction

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Water quality, habitat, and fish assemblage relationships in middle-order agriculture and forest streams of the Mississippi Alluvial Plain

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Ecological Processes 2024年第01期13卷 217-236页

作者： matthew L.Skoog Michael A.Eggleton Yushun Chen Department of Aquaculture and Fisheries University of Arkansas at Pine Bluff Minnesota Department of Natural Resources State Key Laboratory of Freshwater Ecology and Biotechnology Institute of Hydrobiology Chinese Academy of Sciences University of Chinese Academy of Sciences

Background Agriculture has greatly influenced water quality, habitats, and fish assemblages in streams of the Mississippi Alluvial Plain(MAP) ecoregion. However, MAP streams have historically been understudied compared to streams in other agricultural regions of the USA. In this study, water quality, habitat, and fish assemblage composition were assessed seasonally(spring, summer, and fall) in eight representative MAP streams located across three U.S. states. The study design included four streams containing highly agricultural watersheds(herein termed “agriculture” streams) and four streams containing mostly forested watersheds(herein termed “forest” streams), which were intended to represent reference conditions for MAP *** In general, forest streams contained significantly better instream and riparian habitats than agriculture streams(P = 0.010–0.040) whereas agriculture streams contained significantly greater levels of primary nutrients(P < 0.001–0.010). Differences between agriculture and forest streams with respect to other physical and chemical variables were intermittent and season dependent. Fish assemblages in agriculture and forest streams were structured primarily along an environmental gradient reflecting instream habitat conditions, water nutrient concentrations, and benthic chlorophyll-a production. Structurally, fish assemblages in both stream types contained many regionally common species, though some species appeared to exhibit affinities for a particular stream type. Functionally, fish assemblages in agriculture streams contained more tolerant species, more omnivores, and fewer insectivores compared to forest stream assemblages, which were nearly all insectivores. Overall, one-third of the fish specimens collected in forest streams classified as intolerant *** Our results suggested that stream water quality, habitat, and fish assemblages differed between agriculture and forest streams in the MAP, with fish assemblages e

关键词： Agriculture Stream Land use Water quality Habitat Fish Multivariate statistics Mississippi Alluvial Plain

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Runx2 regulates peripheral nerve regeneration to promote Schwann cell migration and re-myelination

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Neural Regeneration Research 2024年第7期19卷 1575-1583页

作者： Rong Hu Xinpeng Dun Lolita Singh matthew C.Banton School of Traditional Chinese Medicine Department of Traditional Chinese MedicineNanfang HospitalSouthern Medical UniversityGuangzhouGuangdong ProvinceChina The Co-innovation Center of Neuroregeneration Nantong UniversityNantongJiangsu ProvinceChina Faculty of Health University of PlymouthPlymouthUK

Runx2 is a major regulator of osteoblast differentiation and function;however,the role of Runx2 in peripheral nerve repair is unclea ***,we analyzed Runx2expression following injury and found that it was specifically up-regulated in Schwann ***,using Schwann cell-specific Runx2 knocko ut mice,we studied peripheral nerve development and regeneration and found that multiple steps in the regeneration process following sciatic nerve injury were *** observed in Runx2 knoc kout mice include increased prolife ration of Schwann cells,impaired Schwann cell migration and axonal regrowth,reduced re-myelination of axo ns,and a block in macrophage clearance in the late stage of *** together,our findings indicate that Runx2 is a key regulator of Schwann cell plasticity,and therefore peripheral nerve ***,our study shows that Runx2 plays a major role in Schwann cell migration,re-myelination,and peripheral nerve functional recovery following injury.

关键词： macrophage clearance migration peripheral nerve injury regeneration re-myelination Runx2 Schwann cells

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Role of buccal mucosa graft ureteroplasty in the surgical management of pyeloplasty failure

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Asian Journal of Urology 2024年第3期11卷 373-376页

作者： matthew Lee Elizabeth Nagoda David Strauss matthew Loecher Michael Stifelman Lee Zhao Department of Urology Lewis Katz School of MedicineTemple UniversityPhiladelphiaPAUSA Department of Urology Hackensack Meridian School of MedicineHackensack University Medical CenterHackensackNJUSA Department of Urology New York University Grossman School of MedicineNew York University Langone Health SystemNew YorkNYUSA

Objective:Secondary pyeloplasty for recurrent ureteropelvic junction obstructions may be a safe and feasible surgical option for *** study aimed to demonstrate outcomes of utilizing a non-transecting buccal mucosa graft ureteroplasty for management of recurrent ureteropelvic junction obstruction after prior failed ***:We performed a retrospective review of our Collaborative of Reconstructive Robotic Ureteral Surgery database for all consecutive patients who underwent buccal mucosa graft ureteroplasty between April 2012 and June 2022 for management of recurrent ureteropelvic junction obstructions after prior failed *** primary outcome included surgical success which was defined as the absence of flank pain and no obstruction on ***:Overall,ten patients were included in our *** median stricture length was 2.5(interquartile range[IQR]1.8-4.0)*** median operative time was 230.5(IQR 199.5-287.0)min and median estimated blood loss was 50.0(IQR 28.8-102.5)*** a median follow-up of 10.3(IQR 6.2-14.8)months,80%of patients were surgically successful and there were no major(ClavieneDindo Grade>2)***:Buccal mucosa graft ureteroplasty is a valuable non-transecting surgical option for patients with recurrent ureteropelvic junction obstructions who failed prior pyeloplasty and has comparable outcomes to the literature regarding standard transecting techniques.

关键词： Ureteral obstruction Buccal mucosagraft Pyeloplasty Robotic Stricture

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Designing a medical ethics curriculum in ophthalmology

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Annals of Eye Science 2024年第1期9卷 4-9页

作者： matthew D.Gearinger Flaum Eye Institute University of Rochester Medical CenterRochesterNYUSA

Ethical principles form a bedrock to medical practice in any specialty,guiding physicians to appropriate attitudes and behaviors.A formal ethics curriculum can be difficult to generate de novo in an ophthalmology training program.A number of barriers exist in most ophthalmology departments:trainees may think ethics is of secondary importance compared to core basic and clinical science topics;most ophthalmology faculty have no formal degree in medical ethics;there is limited didactic time with competing academic,clinical,and surgical priorities;work-hours regulations may limit the time available to deliver“para-professional”lectures;and there is a belief that the medical ethics lectures during medical school is a sufficient amount of coursework to last through a physician’s career with no need for continuing professional *** four pillars of medical ethics are beneficence,non-maleficence,autonomy,and *** addition,morals,ethics,and professionalism are important aspects of sound medical practice.A curriculum specific to medical ethics in ophthalmology can be developed in any of our sub-specialties and include lectures,curated readings,case rounds,and clinic wrap-up *** considerations are part of everyday clinical practice,and a structured ethics curriculum can be incorporated into ophthalmology training *** concept of backward design can be used to structure the curriculum,starting with the expected outcome,then designing authentic assessments,and finally putting together a learning plan that has students actively involved in ethical *** paper will provide a guide to developing an ethics curriculum for an ophthalmology training program utilizing the concept of backwards design and guide the reader through the process of developing expected learning outcomes,authentic assessments,and a unified learning plan.

关键词： Medical ethics curriculum design medical education

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Risk mapping of wildlife-vehicle collisions across thestate of Montana,USA:a machine-learning approach forimbalanced data along rural roads

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Transportation Safety and Environment 2024年第3期6卷 124-132页

作者： matthew Bell Yiyi Wang Rob Ament Western Transportation Institute Montana State University2327 University WayBozemanMT 59717USA School of Engineering San Francisco State University1600 Holloway AveSan FranciscoCA 94132USA

Wildlife-vehicle collisions(WVCs)with large animals are estimated to cost the USA over 8 billion USD in property damage,tens of thousands of human injuries and nearly 200 human fatalities each *** WVCs occur on rural roads and are not collected evenly among road segments,leading to imbalanced *** are a disproportionate number of analysis units that have zero WVC cases when investigating large geographic areas for collision *** units with zero WVCs can reduce prediction accuracy and weaken the coefficient estimates of statistical learning *** study demonstrates that the use of the synthetic minority over-sampling technique(SMOTE)to handle imbalanced WVC data in combination with statistical and machine-learning models improves the ability to determine seasonal WVC risk across the rural highway network in Montana,*** array of regularized variables describing landscape,road and traffic were used to develop negative binomial and random forest models to infer WVC rates per 100 million vehicle miles *** random forest model is found to work particularly well with SMOTE-augmented data to improve the prediction accuracy of seasonal WVC ***-augmented data are found to improve accuracy when predicting crash risk across fine-grained grids while retaining the characteristics of the original *** analyses suggest that SMOTE augmentation mitigates data imbalance that is encountered in seasonally divided WVC *** research provides the basis for future risk-mapping models and can potentially be used to address the low rates of WVCs and other crash types along rural roads.

关键词： wildlife-vehicle collisions machine learning SMOTE negative binomial risk mapping

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