Minimal Risk Research Articles

The accuracy of ultrasensitive PSA in predicting disease progression after radical prostatectomy

AbstractObjectivesTo assess the role of ultrasensitive PSA values (usPSA) after radical prostatectomy in predicting the subsequent biochemical recurrence (BCR).Material and methodsThe study included 1836 patients who underwent open or robot‐assisted RP at Turku University Hospital between 2003 and 2018. Exclusion criteria involved patients with adjuvant treatments and those who did not reach a PSA nadir <0.1 ng/ml, resulting in a final cohort of 1313 patients. The prognostic impact of the optimal usPSA nadir cut‐off value 6 months after RP was investigated to predict subsequent BCR for the whole cohort (N = 1313). The optimal usPSA cut‐off value was determined for patients at 3–5 years post‐surgery (N = 806) and beyond 5 years (N = 493) of follow‐up. We used the area under the curve (AUC) calculation and the Kaplan–Meier method.ResultsIn a cohort with a median age of 64, primarily featuring Gleason score 7 prostate cancer. uPSA nadir of 0.01 ng/ml (AUC = 0.80) at the first monitoring post‐surgery emerged as the optimal cut‐off for identifying subjects at low (80%) or high (20%) risk of BCR within the first 3 years. Beyond this period, uPSA values during the first 3 [(AUC = 0.89; 3–5 years post‐surgery) and (AUC = 0.81; beyond 5 years)] and 5 post‐surgery years (AUC = 0.85) outperformed uPSA nadir in predicting subsequent BCR. Notably, EAU‐defined high‐risk patients with low uPSA nadir maintained substantial BCR‐free survival.ConclusionIn conclusion, a low usPSA predicts minimal BCR risk over the next 2–3 years post‐measurement. Patients with low usPSA can benefit from reduced post‐surgery PSA monitoring at 2‐ to 3‐year intervals without compromising outcomes. This strategic approach optimizes resource allocation in busy urological outpatient clinics, especially valuable in publicly reimbursed healthcare systems like Finland.

INNOVATIVE BY-PASS SOLUTION FOR IRON GATES I TO RECONNECT THE HISTORICAL MIGRATION ROUTES OF WILD ANADROMOUS STURGEON SPECIES, IN ORDER TO IMPROVE THEIR CONSERVATION STATUS

The anadromous sturgeon species in the lower Danube are currently critically endangered and based on the studies of the INCDPM expert team and the 2022 report of IUCN-SSG (Sturgeon Specialist Group) it appears that the future prospects of these populations are unfavourable. This situation occurs mainly as a result of anthropogenic impacts, especially due to intensive fishing, poaching and hydrotechnical constructions (e.g.: dams, immersed obstacles such as the bottom sill on Bala Branch). The dams interrupted the historical spawning migration routes of these species and the bottom sill can interrupt them in the future. In this context, INCDPM has elaborated an innovative by pass solution for the Iron Gates I, based on the longterm monitoring of ultrasonically tagged sturgeons from the Black Sea to the Iron Gates. This article presents the methodology developed by INCDPM in order to ensure the implementation of the innovative by-pass solution with minimal risk of unseccesful restoration of the historical migration routes. The study aims to present the specific migration conditions and the actual routes, which have been determined by over a decade of in-situ monitoring of ultrasonically tagged specimens. Additionally, simulations of upstream migration will be conducted and GIS maps will be developed to present historical migratory routes, with consideration given to hydrodynamic conditions and climate change scenarios.

A fuzzy multi-criteria decision-making for optimizing supply chain aggregate production planning based on cost reduction and risk mitigation

In an increasingly complex and uncertain business environment, decision makers require robust strategies for supply chain aggregate production planning that account for the interdependencies and coordination across multiple echelons of the supply chain network. Traditional approaches often inadequately address the uncertainties and risks inherent in supply chain operations, leading to suboptimal performance and increased costs. This study introduces a business model incorporating open innovation dynamics to achieve cost-effectiveness and resilient supply chain performance in the face of uncertainties. A Multi-Objective Fuzzy Linear Programming model was proposed by integrating the Chance-Constraint Programming and Zimmermann’s approach designed to assist decision makers in optimizing the production plan, material flows and resource allocation across the entire supply chain network. The model focuses on both cost and risk minimization based on unsymmetrical triangular fuzzy numbers. Specifically, it targets the downside risk of uncertainty, aiming to reduce the likelihood of negative outcomes or financial losses due to fluctuations, unpredictability, and unforeseen circumstances, which can drive-up supply chain operation costs. The efficacy of the model is demonstrated through a case study. It highlights various imprecise factors such as costs, customer demands, and machine operating hours. The findings underscore the model's capability to provide decision makers with a comprehensive supply chain aggregate production plan that not only optimizes the supply chain network and enhances operational efficiency and reliability but also significantly reduces costs and mitigates unsymmetrical skewness of risks associated with operational uncertainties.

Research on the Decision-Making Mechanism of Human Capital Investment in the Behavior of “Returning to School for a Master Degree”—An Interview Analysis Based on Grounded Theory

Currently, it has become increasingly common for individuals engaged in social work to pursue a Master’s degree as part of their professional development. Following the qualitative research approach of grounded theory, this study conducted in-depth interviews with six graduate students majoring in education from local universities and performed a three-level coding analysis on the collected data. The motivations behind social candidates’ pursuit of a Master’s degree are primarily driven by material needs, spiritual aspirations, and other factors. Drawing upon the human capital theory, this study examines the investment decision-making behavior of this particular cohort. The decision mechanism underlying this behavior is as follows: the anticipated income level associated with a master’s degree surpasses the current income level; the expected return on investment outweighs the investment cost; while human capital investment in graduate school entails minimal risk, its return rate exceeds that of other investments; substantial hidden benefits are derived from investing in human capital. The research findings can serve as a valuable reference for the reform and adjustment of graduate enrollment and training in higher education institutions.

Состав арктических территорий для государственной поддержки: куда идти?

Due to the fact that currently there are several lists of Arctic territories for state support, the article describes possible options for changing their composition in the forecast period of the next decade: from complete unification of all lists to, on the contrary, extreme diversification (each list has its own tasks of state support). The research question of the article is to determine the benefits and costs of each scenar-io for the “set” of Arctic territories for government support. Main results: 1) four scenarios of evolution of the current system of state support of the Arctic and northern territories according to the geographical factor (composition of territories for support) — a) optimal-administrative; b) anti- district; c) polyphonic; d) limited diversity; 2) radical anti-district and optimal-administrative scenarios, comfortable for federal executive authorities, carry the highest integral risks. The polyphonic “evolutionary” scenario carries minimal risks, when, simultaneously with the preservation of the institution of northern regional guarantees and compensation, institutions of the multifaceted Arctic are established — for resident investors, geostrategic, and entrepreneurial. But it also turns out to be the most expensive for the federal budget; 3) for the integral scenario, it is advisable to take into account the following elements of the described scenarios: multiple lists of Arctic regions for different forms of state support; preservation in a limited form of the former regional institution of social support for the northern and Arctic territories; full support for small and medium-sized manufacturing entrepreneurs in the Arctic and North, primarily in areas with limited delivery times for goods; gradual transformation of support for localities equated to regions of the Far North, from northern and Arctic institutions to all-Russian regional ones; introduction of institutions that encourage the technological transformation of the previous industrial structure and the formation of a new digital structure throughout the Arctic zone of the Russian Federation.

Transparent internal human-machine interfaces in highly automated shuttles to support the communication of minimal risk maneuvers to the passengers

In Highly Automated Vehicles (HAVs) without operators on-board, user interaction with the vehicle automation plays an important role for a safe and inclusive use of these services. Especially when Minimal Risk Maneuvers (MRM) are performed by the system, passengers are faced with uncertain situations. A possibility to deepen passenger’s understanding and predictability of these systeḿs and reduce their uncertainties is to enhance automation transparency. However, literature shows a lack regarding enhancing system transparency of HAVs during MRMs. Therefore, we investigated the impact of “observability” and “reasoning” as transparency influencing factors. In an online study, participants evaluated multiple internal Human-Machine Interfaces (iHMI) as shuttle passengers. The presented iHMIs varied regarding their level of transparency by giving different information about what the vehicle’s “perception” and its “reasoning” is. Results show significant differences in the passengers’ understanding between different iHMI variants providing evidence that information regarding the “perception” and “reasoning” of HAVs enhance system transparency. Results of the study may provide first insights into passengers’ informational needs when using HAV. They highlight the potential benefits of system transparency when designing interfaces for HMIs of automated vehicles.

Two-stage and purely sequential minimum risk point estimation of the scale parameter of a family of distributions under modified LINEX loss plus sampling cost

Two-stage and purely sequential minimum risk point estimation of the scale parameter of a family of distributions under modified LINEX loss plus sampling cost

Harnessing machine learning algorithms to unveil energy efficiency investment archetypes

Increasing transparency about the performance of different projects is crucial to reducing the heterogeneity in the energy efficiency services market, thereby upscaling investments. In this context, machine learning algorithms could assist in identifying and analyzing energy efficiency project archetypes, although this field has so far been explored with a limited view in the literature. This paper aims to address this gap by identifying energy efficiency investment families and the determinant factors of the classification scheme, using machine learning. In this effort, it hinges on a wide range of indicators from implemented projects around Europe and the USA, including investment profitability, initial investment, risk of failure, intervention type, life measure, region of implementation and building type. The analysis employs two clustering approaches, namely Partitioning Around Medoids (PAM) and K-means, determining the number of clusters based on the Silhouette index and total within–cluster sum of squares. The results indicate that energy efficiency investments can be classified into three categories: (i) “junk investments”, characterized by low–profitability (IRR∼10%), moderate risk, and extended horizons; (ii) “safe profitability”, distinguished by high profitability (IRR∼30%) and minimal risk; and (iii) “high stakes”, described by exceptionally high profitability (IRR∼40%), coupled with a substantial risk. Next to profitability and risk of failure, also energy efficiency intervention and building type (sector) emerge among the most influential factors in the classification scheme. Feature importance shows a significant sensitivity to the chosen classification model.

Portfolio Optimization Using LSTM for Five Selected Stocks

Portfolio construction is very critical in the financial markets as it assists investors in achieving maximum returns with minimum risks through diversification. In this paper, Long Short-Term Memory (LSTM) models are employed to predict stock prices and optimize investment portfolios. Historical adjusted closing prices from Yahoo Finance for the period from January 1, 2023, to March 1, 2024, were used to predict the future stock prices of Apple Inc. (AAPL), Microsoft Corporation (MSFT), BlackRock Inc. (BLK), JPMorgan Chase & Co. (JPM), and Tesla Inc. (TSLA) using LSTM models. Portfolios were constructed using mean-variance optimization based on these predictions, and Monte Carlo simulations were employed to capture the uncertainty around the estimates. The results are treasured for investors in financial markets as they spotlight the limitations and capability risks of depending totally on gadget learning predictions for portfolio optimization. This emphasizes the want for a greater comprehensive method to investment decision-making that considers more than one factors and methodologies.

Comparative chemometric modeling of fresh and dry cannabis inflorescences using FT-NIR spectroscopy: Quantification and classification insights.

Cannabis sativa L. inflorescences are rich in cannabinoids and terpenes. Traditional chemical analysis methods for cannabinoids and terpenes, such as liquid and gas chromatography (using UV or MS detectors), are expensive and time-consuming. This study explores the use of Fourier transform near-infrared (FT-NIR) spectroscopy combined with chemometric approaches for classifying cannabis chemovars and predicting cannabinoid and terpene concentrations for the first time in freshly harvested (wet) cannabis inflorescence. The study also compares the performance of FT-NIR spectroscopy on wet versus dry cannabis inflorescences. Spectral data from 187 samples across seven cannabis chemovars were analyzed using partial least squares-discriminant analysis (PLS-DA) and partial least squares-regression (PLS-R) models. The PLS-DA models effectively classified chemovars and major classes using only two latent variables (LVs) with minimal overfitting risk, with sensitivity, specificity, and accuracy values approaching 1. Despite the high water content in wet cannabis inflorescence, the PLS-R models demonstrated good to excellent predictive capabilities for nine cannabinoids and eight terpenes using FT-NIR spectra for the first time, achieving cross-validation and prediction R-squared values greater than 0.7, ratio of performance to interquartile range (RPIQ) exceeding 2, and a RMSECV/RMSEC ratio below 1.24. However, the low-cannabidiolic acid submodel and (-)-Δ9-trans-tetrahydrocannabinol model showed poor predictive performance. Some cannabinoid and terpene prediction models in wet cannabis inflorescence exhibited lower predictive capabilities compared with previously published models for dry cannabis inflorescence. These findings suggest that FT-NIR spectroscopy can be a viable rapid on-site analytical tool for growers during the inflorescence flowering stage.

Efficiency gains from the implementation of Research IDs for data linkage: A case study from Population Data BC and the Data Innovation Program in British Columbia, Canada

Objective and ApproachPopulation Data BC (PopData) transitioned to Research IDs from Study IDs for the Data Innovation (DI) Program, with the objective of improving efficiency of data preparation, linkage, and provisioning while maintaining privacy standards. Study IDs are person-specific encrypted identifiers unique to each study, preventing Researchers from combining records from different projects, in turn reducing risk of re-identification. Research IDs are also person-specific encrypted identifiers, except they are not project specific. Advancements in technology and changes in data provisioning models have reduced utility of Study IDs. ResultsImplementing Research IDs instead of Study IDs decreased: processing, setup/review, per transfer effort, errors/omissions, storage requirements, staff training/knowledge, licenses, record keeping, specialized knowledge, and per project data tracking. There was a marginally higher risk of re-identification with Research IDs, counter-acted by a higher degree of technological security and stronger procedural and ethical frameworks, resulting in the ability to provide more data to more users. ConclusionsAdopting Research IDs has allowed PopData and the DI Program to access established data resources faster, more efficiently, with less per project person effort and reduced storage requirements without a net risk change. The benefits of adopting Research IDs, counter a potential minimal risk gain arising from replacement of Study IDs with Research IDs. ImplicationsEfficiency gains from the use of Research IDs allows PopData and the DI Program to redistribute operational and staff resources, in turn increasing their ability to scale, to provide data in more diverse formats and improve service provision.

Comparing Line-Field Confocal Optical Coherence Tomography and Reflectance Confocal Microscopy on the In Vivo Healing Process of Lesions Induced by Fractional Photothermolysis.

The advent of ablative fractional photothermolysis has revolutionized laser dermatology by providing a method to produce well-standardized, precise, and repeatable microscopic lesions. These wounds typically heal within 1-3 weeks, depending on the body site, with a minimal risk of permanent scarring. This positions ablative fractional photothermolysis as an exemplary in vivo model for studying the skin's wound healing processes. This study aims to evaluate and compare the effectiveness of two noninvasive imaging techniques, reflectance confocal microscopy (RCM) and line-field confocal optical coherence tomography (LC-OCT), in assessing skin wound healing following microscopic injuries induced by ablative fractional photothermolysis. The forearms of participating volunteers were treated and ablated with a CO2-Laser in a fractional pattern using varying power settings (2.5-10 mJ/MTZ). In vivo RCM and LC-OCT images were obtained at predefined time intervals post-laser treatment, ranging from 6 h to 14 days. Vertical visualization of the lesions through both imaging modalities revealed a healing process characterized by the upward and outward movement of microscopic epidermal necrotic debris, thereby reducing the depth of the injury while forming an external crust. LC-OCT imaging demonstrated more comprehensive results with fewer movement artifacts. Conversely, horizontal visualization with both techniques highlighted a gathering of keratinocytes around the wounds, indicating the initiation of the regenerative process. RCM provided superior image clarity in this horizontal plane. RCM and LC-OCT offer valuable and complementary noninvasive alternatives to conventional biopsy methods for the assessment and characterization of the skin's wound healing process post-ablative fractional photothermolysis. These findings underscore the potential of such imaging techniques in enhancing our understanding of the wound healing process. ClinicalTrials.gov identifier: NCT05614557.

“I think we just saw happier residents”: nursing home provider reported readiness assessment of the individualized positive psychosocial interaction (IPPI) program

Objectives This study assessed the readiness of The Individualized Positive Psychosocial Interaction (IPPI) program in the nursing home (NH) setting from the perspective of NH providers implementing the IPPI. The evidence-based IPPI program is designed to help remediate distress and improve mood for residents living with dementia. NH staff are trained to engage residents in brief (i.e. 10-min) one-to-one, preference-based activities to alleviate emotional distress and enhance quality of life. Method NH providers (n = 15) who championed the IPPI implementation completed an exit interview based on the nine domains of the Readiness Assessment for Pragmatic Trials (RAPT). Interviews were audio-recorded, transcribed, and coded by RAPT domains, then scored by the research team to reflect an average for each domain. Results Providers rated the IPPI program’s readiness high on the domains of alignment, impact, risk, implementation protocol, evidence, cost, and acceptability. The domains of measurement and feasibility scored lower, likely due to broader contextual issues and require particular attention. Conclusion Results illustrate that the IPPI program successfully aligns with stakeholder priorities, is a safe intervention with minimal risk, and has beneficial outcomes. The IPPI’s low cost, design, and alignment with organizational goals also facilitated implementation while measuring outcomes and staffing considerations impacted organizational capacity for implementation.

Flap-Based Reconstruction in Patients with Autoimmune Disease: An Institutional Experience with the Deep Inferior Epigastric Perforator Flap and Review of the Literature.

Autoimmune diseases are associated with characteristic chronic inflammation, aberrations in tissue perfusion, and hypercoagulability, and thus have considerable implications for local and free-flap reconstruction. We seek to summarize the current evidence on outcomes of flap-based reconstruction in patients with pre-existing autoimmune disease and present our experience with autologous breast reconstruction in this population. PubMed, Embase, Scopus, Cochrane, and Web of Science were searched for relevant articles, and pertinent data were presented qualitatively. Institutional data were queried for patients who underwent autologous breast reconstruction with deep inferior epigastric perforator (DIEP) flaps between 2015 and 2024. A retrospective review was conducted to identify DIEP patients with a history of autoimmune disease. Data on patient demographics, medication history, flap outcomes, and perioperative complications were collected. The majority of existing studies found no increased independent risk of flap complications. However, other complications, predominantly wound dehiscence, were independently associated with autoimmune disease. Regarding immunosuppressant therapy, the literature demonstrated that perioperative glucocorticoid use was consistently associated with all complications, including seroma, infection, wound disruption, and partial flap loss.Our 13-patient institutional experience identified no cases of total flap loss or microvascular thrombotic complications. There was one case of partial flap necrosis further complicated by abdominal site cellulitis, and one case of recipient-site dehiscence managed with local wound care. No patients required re-operation for flap or donor-site complications. The literature suggests that flap reconstruction can be performed safely in patients with autoimmune conditions, which was also supported by our institutional experience. While there is likely minimal risk of microsurgical complications in the context of free tissue transfer, donor-site morbidity and wound dehiscence remain major concerns for patients with a history of autoimmune disease. Limiting the use of immunosuppressive agents, especially corticosteroids, may potentially improve outcomes of flap reconstruction.

Update to the study protocol: minimisation of dialysis risk in hospital patients with chronic kidney disease (MinDial): a multicentre, stepped-wedge, cluster-randomised controlled trial

This document reports a brief update to the previously published protocol of the MinDial study.Trial registration German Clinical Trials Register DRKS00029691. Registered on 12 Sept. 2022, https://drks.de/search/en/trial/DRKS00029691.

En-bloc resection of non-muscle invasive urinary bladder tumors using low power Holmium laser-A new promise.

Urinary bladder tumors are one of the most common urological malignancies. Traditionally, it has been initially managed with conventional trans-urethral resection of urinary bladder tumors (cTURBT) which has certain drawbacks and complications. Efforts have been made to find newer methods for management. In this study, we have used low power Holmium laser en-bloc resection and have assessed its safety, efficacy and feasibility. Forty patients have been included in this prospective observational study who underwent low power Holmium laser en-bloc resection of urinary bladder tumor after taking Institutional ethical committee clearance and informed consent from all the patients. Intra-operative and post-operative data were collected. The average tumor size was 21.68 ± 9.55 mm. Out of those, 65% of the patients had a tumor less than 3 cm in size. Fourteen patients (35%) had tumors at multiple sites. The average duration of resection per tumor was 24.84 ± 6.83 min. None of the cases required conversion to cTURBT. There was no obturator reflex or urinary bladder perforation in any of the cases. Detrusor muscle was present in the histopathology reports of 92.5% patients. The average duration of catheterization was 1.82 ± 0.61 days. For NMIBC's, low power Holmium laser en-bloc resection is a safe procedure with minimum risk of complications. High rate of detrusor-positive specimens indicates its efficacy and feasibility.

Online imbalance learning with unpredictable feature evolution and label scarcity

Recently, online learning with imbalanced data streams has aroused wide concern, which reflects an uneven distribution of different classes in data streams. Existing approaches have conventionally been conducted on stationary feature space and they assume that we can obtain the entire labels of data streams in the case of supervised learning. However, in many real scenarios, e.g., the environment monitoring task, new features flood in, and old features are partially lost during the changing environment as the different lifespans of different sensors. Besides, each instance needs to be labeled by experts, resulting in expensive costs and scarcity of labels. To address the above problems, this paper proposes a novel Online Imbalance learning with unpredictable Feature evolution and Label scarcity (OIFL) algorithm. First, we utilize margin-based online active learning to selectively label valuable instances. After obtaining the labels, we handle imbalanced class distribution by optimizing F-measure and transforming F-measure optimization into a weighted surrogate loss minimization. When data streams arrive with augmented features, we combine the online passive-aggressive algorithm and structural risk minimization to update the classifier in the divided feature space. When data streams arrive with incomplete features, we leverage variance to identify the most informative features following the empirical risk minimization principle and continue to update the existing classifier as before. Finally, we obtain a sparse but reliable learner by the strategy of projecting truncation. We derive theoretical analyses of OIFL. Also, experiments on the synthetic datasets and real-world data streams to validate the effectiveness of our method.

Contemporary short-term peri-operative outcomes of open primary retroperitoneal lymph node dissection.

To provide current peri-operative outcomes and short-term complication rates for open primary retroperitoneal lymph node dissection (RPLND), with analysis of risk factors for complications. Using the Indiana University Testicular Cancer database, we performed a retrospective analysis of all patients who underwent open primary RPLND over the study period (2018-2021). The primary outcomes of interest were the preoperative profile of patients undergoing surgery, complication rates, and identification of risk factors associated with complications. We used chi-squared, Fisher's exact and unpaired t-tests in our analyses. A total of 165 patients were identified. The median body mass index (BMI) was 28.6 kg/m2. Patients most often had clinical stage IIA (39%) or IIB testicular cancer (36%). The median estimated blood loss was 150 mL, with no transfusions required. Higher BMI was noted in patients that sustained any complication vs those with normal recovery (34.95 vs 28 kg/m2; P = 0.0042). The median length of hospital stay was 3 days. The overall complication rate was low (8.48%), with two major postoperative complications, including one case of chylous ascites (0.6%), and no deaths in the 30-day period. The study was limited by its retrospective design and short-term follow-up. We found that open primary RPLND has an acceptable morbidity profile, even among a predominantly overweight cohort. Low blood loss, short hospital stay, minimal chylous ascites risk, and rare major postoperative complications should be the benchmark for retroperitoneal lymph node dissection.

Microplastics in the Olfactory Bulb of the Human Brain

Microplastic (MP) pollution is an emerging environmental and health concern. While MPs have been detected in various human tissues, their presence in the human brain has not been documented, raising important questions about potential neurotoxic effects and the mechanisms by which MPs might reach brain tissues. To determine the presence of MPs in the human olfactory bulb and to analyze their characteristics such as size, morphology, color, and polymeric composition. This case series study used a cross-sectional design involving the analysis of olfactory bulb tissues obtained from deceased individuals during routine coroner autopsies. The sampling procedures were conducted at São Paulo City Death Verification Service, with laboratory analysis carried out at the Brazilian Synchrotron Light Laboratory (LNLS). Participants included 15 adult individuals who had been residents of São Paulo for more than 5 years and underwent coroner autopsies. Exclusion criteria included previous neurosurgical interventions. Data analysis was performed in April 2024. The primary exposure assessed was the presence of MPs in the olfactory bulb, analyzed through direct tissue examination and digested tissue filtration followed by micro-Fourier transform infrared spectroscopy. The main outcomes were the identification and characterization of MPs within the olfactory bulb, including their size, morphology, color, and polymeric composition. The median age of the 15 deceased individuals was 69.5 years, ranging from 33 to 100 years, with 12 males and 3 females. MPs were detected in the olfactory bulbs of 8 out of 15 individuals. A total of 16 synthetic polymer particles and fibers were identified, with 75% being particles and 25% being fibers. The most common polymer detected was polypropylene (43.8%). Sizes of MPs ranged from 5.5 μm to 26.4 μm for particles, and the mean fiber length was 21.4 μm. Polymeric materials were absent in procedural blank and negative control filters, indicating minimal contamination risk. This case series provides evidence of MPs found in the human olfactory bulb, suggesting a potential pathway for the translocation of MPs to the brain. The findings underscore the need for further research on the health implications of MP exposure, particularly concerning neurotoxicity and the potential for MPs to bypass the blood-brain barrier.

"A diamond-shaped" penoplasty technique with or without concurrent suprapubic liposuction for adult-acquired buried penis: clinical outcomes and patient satisfaction rates.

Various techniques have been described for reconstructing the skin of the penile shaft; however, no universally accepted standard exists for correcting buried penis in adults. We aimed to describe a new technique for correcting an adult-acquired buried penis through a diamond-shaped incision at the penopubic junction. We retrospectively analyzed data from patients treated with our technique between March 2019 and June 2023 in the Department of Andrology, Nanjing Drum Tower Hospital (Nanjing, China). Forty-two adult males with buried penises, with a mean (±standard deviation [s.d.]) age of 26.6 (±6.6) years, underwent surgery. All patients were obese, with an average (±s.d.) body mass index of 35.56 (±3.23) kg m-2. In addition to phalloplasty, 32 patients concurrently underwent circumcision, and 28 underwent suprapubic liposuction. The mean (±s.d.) duration of the operation was 98.02 (±13.28) min. The mean (±s.d.) duration of follow-up was 6.71 (±3.43) months. The length in the flaccid unstretched state postoperatively was significantly greater than that preoperatively (mean ± s.d: 5.55±1.19 cm vs 1.94±0.59 cm, P < 0.01). Only minor complications, such as wound disruption (7.1%) and infection (4.8%), were observed. The mean (±s.d.) score of patient satisfaction was 4.02 (±0.84) on a scale of 5. This technique provides excellent cosmetic and functional outcomes with a minimal risk of complications. However, additional clinical studies are needed to evaluate the long-term effects of this procedure.