bluuebunny/crossref_metadata_2025 huggingface dataset:
Significant functional impairment and disability in individuals with psoriatic arthritis and Achilles tendon pain: a cross-sectional observational study
Authors: Patience Aimie , Steultjens Martijn , Siebert Stefan , Hendry Gordon
Published: June 2024

The Achilles tendon (AT) insertion is the most common site of enthesitis in psoriatic arthritis (PsA). The structure and function of the AT in PsA, and the prevalence of mid-portion pathology, is unknown. To compare the structure and function of the AT in people with PsA with self-reported AT pain (PsA + AT), PsA without self-reported AT pain (PsA-AT) and healthy controls. A cross-sectional, observational study was conducted. The ATs were assessed by clinical and US examination (B-mode and Power Doppler), performance-based testing (bilateral heel raise test (HRT) and 10 m walk test), and patient-reported outcome measures (PROMs) (including the Victorian Institute of Sport Assessment-Achilles [VISA-A]). Between-group differences were described using descriptive statistics, Chi-squared testing, parametric (1-way ANOVA) and non-parametric (Mann-Whitney or Kruskal-Wallis) testing. 22 PsA (11 per group) and 11 healthy control participants who were comparable in terms of sex, age, and BMI (PsA-AT = longer PsA disease duration) were recruited. VISA-A scores were significantly worse in the PsA + AT group compared to the PsA-AT group and healthy controls (p < 0.001). Inflammatory US features were significantly more prevalent in the PsA + AT group (p < 0.001). Mid-portion AT pathology was observed in the PsA + AT group, irrespective of entheseal disease. Clinical examination alone missed 5/7 cases of ‘active’ US-confirmed AT enthesitis. AT functional deficits were significant in the PsA + AT group and both PsA groups had lower HRT repetition rates and walked slower compared to healthy controls. Less than 1/3 of the PsA + AT group had received podiatry or physiotherapy care. Significant differences in the structure and function of the AT in PsA were noted. Despite management in line with current guidance, AT pain appears to persist and can result in severe functional impairment.
A clinical practice guideline for the management of the foot and ankle in rheumatoid arthritis
Authors: Ramos-Petersen Laura , Reinoso-Cobo Andres , Ortega-Avila Ana-Belen , Garcia-Campos Jonatan , Bernal Jose-Antonio , Cantero-Tellez Raquel , Martin-Martin Jose-Maria , Caliz-Caliz Rafael , Tejero Sergio , Cano-Garcia Laura , Gijon-Nogueron Gabriel
Published: June 2024

Rheumatoid arthritis causes progressive joint destruction in the long term, causing a deterioration of the foot and ankle. A clinical practice guideline has been created with the main objective of providing recommendations in the field of podiatry for the conservative management of rheumatoid arthritis. Thus, healthcare professionals involved in foot care of adults with rheumatoid arthritis will be able to follow practical recommendations. A clinical practice guideline was created including a group of experts (podiatrists, rheumatologists, nurses, an orthopaedic surgeon, a physiotherapist, an occupational therapist and patient with rheumatoid arthritis). Methodological experts using GRADE were tasked with systematically reviewing the available scientific evidence and developing the information which serves as a basis for the expert group to make recommendations. Key findings include the efficacy of chiropody in alleviating hyperkeratotic lesions and improving short-term pain and functionality. Notably, custom and standardized foot orthoses demonstrated significant benefits in reducing foot pain, enhancing physical function, and improving life quality. Therapeutic footwear was identified as crucial for pain reduction and mobility improvement, emphasizing the necessity for custom-made options tailored to individual patient needs. Surgical interventions were recommended for cases which were non-responsive to conservative treatments, aimed at preserving foot functionality and reducing pain. Moreover, self-care strategies and education were underscored as essential components for promoting patient independence and health maintenance. A series of recommendations have been created which will help professionals and patients to manage podiatric pathologies derived from rheumatoid arthritis.
Application of neurophysiological monitoring during tethered cord release in children
Authors: Guo Junjun , Zheng Xianlan , Leng Hongyao , Shen Qiao , Pu Jialin
Published: June 2024

Objective

The objective of this study was to explore the effect of intraoperative neurophysiological monitoring (IONM) on tethered spinal cord release in children.

Methods

The clinical data of 454 children with tethered cord syndrome who underwent surgery for tethered cord release were retrospectively analyzed. The children were divided into two groups: the non-IONM group and the IONM group. SPSS 26.0 software was used for statistical analysis. The evaluation indices included the effective rate and incidence of new neurological dysfunction.

Results

The short-term results showed that the effective rate of the non-IONM group was 14.8%, while that of the IONM group was 15.2%. Additionally, the incidence of new neurological dysfunction was 7.8% in the non-IONM group and 5.6% in the IONM group. However, there was no significant difference between the two groups (P > 0.05). The medium- to long-term follow-up had significant difference (P < 0.05), the response rate was 32.1% in the IONM group and 23.7% in the non-IONM group, and deterioration rates regarding neurological dysfunction were 3.3% in the IONM group and 8.5% in the non-IONM group.

Conclusion

This study revealed that the use of IONM does not significantly improve the short-term treatment effect of patients undergoing surgery for tethered cord release or reduce the short-term incidence of postoperative new neurological dysfunction. However, the medium- to long-term prognoses of patients in the IONM group were better than those of patients in the non-IONM group.
Local recurrence rates of superficial versus deep soft tissue sarcoma
Authors: Lin James S. , Coleman Lisa , Voskuil Ryan T. , Malik Azeem , Mayerson Joel L. , Scharschmidt Thomas J.
Published: June 2024

Introduction

Soft tissue sarcomas are a group of malignancies that commonly occur in the extremities. As deep lesions may exist within the confines of the muscular fascia, we postulate that local recurrence rates are higher for superficial soft tissue sarcomas managed by the standard of care.

Materials and methods

A retrospective review was performed on 90 patients who underwent surgical resection of soft tissue sarcomas of the extremity from 2007 to 2015. Patients with minimum 2-year follow-up and adequate operative, pathologic, and clinical outcomes data were included.

Results

Mean age was 54 ± 18 years with 49 (54.4%) patients being male. Lesions in 77.8% of cases were deep, and 22.2% were superficial to fascia. Following the index surgical resection, a total of 33 (36.7%) patients had positive margins. A total of 17 (18.9%) patients had a local recurrence. Overall, 3-year survival was 92.7%, and 5-year survival was 79.0%. Five-year recurrence-free survival of deep sarcomas was 91.1% versus 58.2% of superficial lesions (p = 0.006). Patients with higher tumor depth had lower odds of experiencing a local recurrence (HR 0.26 [95% CI 0.09–0.72]). Local recurence rates was also associated with positive surgical margins on initial resection (33.3% versus 12.3%) (p = 0.027).

Conclusions

In this series, superficial tumor depth was associated with local recurrence of soft tissue sarcomas of the extremity following surgical resection. Positive surgical margins was also associated with local recurrence.
A bidirectional autoimmune cluster between vitiligo and rheumatoid arthritis: a large-scale population-based study
Authors: Cohen Naama Tova , Schonmann Yochai , Kridin Khalaf
Published: June 2024

A knowledge gap exists regarding the association between vitiligo and rheumatoid arthritis (RA) due to the absence of large-scale cohort studies designed to investigate this association. To investigate the bidirectional epidemiological association between vitiligo and RA. A population-based study was conducted using Clalit Health Services (CHS) database (2002–2019) using both a cohort study and a case-control study design. Adjusted hazard ratio (HR) and odds ratio (OR) were calculated by multivariate Cox and logistic regressions, respectively. Overall, 20,851 vitiligo patients and 102,475 controls were included. The incidence of new-onset RA was 4.1 (95% CI 3.0–5.4) and 2.9 (95% CI 2.4–3.3) cases per 10,000 person-years among patients with vitiligo and controls, respectively. Patients with vitiligo had a significantly increased risk of developing new-onset RA (adjusted HR, 1.44; 95% confidence interval [CI], 1.02–2.02, P = 0.036). The likelihood of having vitiligo was significantly elevated after a preexisting diagnosis of RA (adjusted OR, 1.67; 95% CI, 1.38–2.03; P < 0.001). Relative to the remaining patients with vitiligo, those with vitiligo and comorbid RA demonstrated an elevated risk of all-cause mortality (adjusted HR, 1.61; 95% CI, 1.03–2.51; P = 0.037). Our study confirms the bidirectional association between vitiligo and RA. Physicians treating patients with vitiligo should be aware of the association in clinical practice.
Long-pulsed nd: YAG laser treatment of nail psoriasis: clinical and ultrasonographic assessment
Authors: El-Basiony Mohamed Ahmed Salem , El-Komy Mohamed Hussein Medhat , Samy Nevien Ahmed , Aly Dalia Gamal , El-Gendy Hala , Hassan Mohamed Fouad Abdel Salam , El Sayed Hagar , Soliman Mohamed Mohsen
Published: June 2024

Nail psoriasis is a chronic, inflammatory condition which is difficult to treat, linked with greater psoriasis severity, and may be associated with anxiety and significant functional impairment of the quality of life. The 1064 nm Nd: YAG laser was reported to yield satisfactory results in the treatment of nail psoriasis.

The aim of the study was to assess the clinical and ultrasonographic efficacy of long-pulsed 1064 nm Nd: YAG laser in the treatment of fingernail psoriasis and compare its effect to control fingernails.

This intra-patient randomized controlled trial analyzed 86 fingernails collected from 13 patients suffering from cutaneous and nail psoriasis. The nails were randomized into two groups. Group A was treated with Nd: YAG laser once monthly for three sessions while group B served as control. Assessment took place at baseline, 1 and 3 months after the last treatment session. For scoring, the 32-points target NAPSI scoring systems was used. Additionally, two blinded dermatologists’ score of improvement, patients’ pain assessment by visual analogue score and ultrasonographic assessment were all performed.

At the end of follow up, the medians of tNAPSI score, plate definition, matrix thickness, bed thickness and bed vascularity decreased significantly in the Nd: YAG laser treated group in comparison to baseline (p = 0.001, 0.006, 0.039, < 0.001 and 0.010, respectively). While, there was a non-significant reduction in median tNAPSI score in the control group at last follow up, however, ultrasonography recorded a significant reduction in the medians of plate definition, bed thickness and vascularity (p = 0.002, 0.011 and 0.033, respectively) from the baseline. Comparison of the Nd: YAG laser and the control groups showed no significant difference from baseline regarding the medians of tNAPSI, tNAPSI percentile improvement, pits count, blinded evaluation of photographs and ultrasonographic assessments.

In conclusion, Nd: YAG laser showed clinical and ultrasonographic improvement in fingernail psoriasis. Ultrasonography is a useful noninvasive tool in diagnosing and monitoring the clinical and even the subclinical changes in nail psoriasis. Nail psoriasis although difficult to treat, may show spontaneous improvement.
Antistreptococcal treatment of psoriasis: a systematic review
Authors: Sitton Beau , Walker Trent , Mital Rohan , Varra Vamsi , Kaffenberger Jessica
Published: June 2024

Streptococcal infections may contribute to psoriasis development, and antistreptococcal treatments are considered potential therapies, but their effectiveness remains uncertain due to limited systematic evidence. Our objective was to analyze antistreptococcal therapies' effectiveness in improving psoriasis. We conducted a systematic review following PRISMA guidelines, evaluating antistreptococcal treatment efficacy in psoriasis patients from PubMed, Scopus, and Embase databases until August 14, 2022. Eligible studies included psoriasis patients undergoing antistreptococcal therapy, regardless of demographics or psoriasis type. 50 studies (1778 patients) were analyzed, with penicillins/aminopenicillins as the most studied antibiotics (21 studies), showing mixed outcomes, some reporting significant improvement in guttate psoriasis, while others showed no significant difference. Rifampin demonstrated positive results in most of ten studies, and macrolides showed varying effectiveness in two studies. Tonsillectomy in 14 studies (409 patients) mainly focusing on guttate and chronic plaque psoriasis showed positive outcomes, indicating improved symptoms and quality of life. Limitations include heterogeneous studies, sampling bias, and quality of evidence. This systematic review reveals limited and varied evidence for systemic antibiotic therapy efficacy in psoriasis treatment, while tonsillectomy emerges as a potentially beneficial antistreptococcal option, urging further well-designed, controlled studies with larger sample sizes and standardized protocols for better comparisons.
Comparative study between efficacy of Excimer light with topical Tacrolimus 0.1% versus excimer light with topical Bimatoprost 0.01% in treatment of facial Vitiligo
Authors: Zaky Mohamed S. , Atallah Rabie B. , El Abasy Nada Taha, Ali , Elsaie Mohamed L.
Published: June 2024

Loss and absence of melanocytes due to a number of factors is responsible for vitiligo; known to be the commonest disorder of pigmentation. The aim of the current work was to compare the efficacy and safety of excimer light with topical tacrolimus ointment 0.1% versus excimer light with topical bimatoprost gel 0.01% in treatment of facial vitiligo. The study was carried out on 48 patients presented with facial vitiligo. The patients were divided randomly using sealed envelope method into two groups (24 patients each). Group 1 were treated with excimer light plus topical tacrolimus ointment 0.1% and group 2 treated with excimer light plus topical bimatoprost gel 0.01%. Clinical improvement based on the quartile grading scale at the end of treatment did not show any statistically significant difference between groups. The majority of subjects in both groups experienced good to excellent improvement. Only 20.9% of patients in group 1 and 33.3% of subjects in group 2 achieved less than 50% repigmentation (p = 0.889). Our study demonstrated that 0.01% topical bimatoprost gel in combination with excimer light is considered safe and effective as treatment of nonsegmental facial vitiligo with comparable results to 0.1% tacrolimus.
Aberrant expression of B7-H4 and B7-H5 contributes to the development of cutaneous squamous cell carcinoma
Authors: Chen Lu , Zhou Bin , Tang Minhui , Yao Yuxu , Zhao Yue , Hu Ying , Lin Yuxin , Ji Jiang , Jiao Qingqing
Published: June 2024

Cutaneous squamous cell carcinoma (CSCC) is the second most common malignant tumor of the skin. B7 homolog 4 (B7-H4) and B7-H5 (B7 homolog 5) are associated with a variety of tumors. Investigate the potential role of B7-H4 and B7-H5 in regulating the tumorigenesis and progression of CSCC. B7-H4 and B7-H5 transcriptome data were collected from GEO and TCGA databases and subjected to bioinformatical analysis by protein–protein interaction (PPI) network, functional enrichment analysis, immune analysis, and drug–gene interaction prediction analysis. We characterized the expression of B7-H4 and B7-H5 in carcinoma tissues of CSCC patients by immunohistochemistry. Meanwhile, the clinical correlation of B7-H4 and B7-H5 in CSCC was explored by statistical analysis. B7-H4 and B7-H5 genes were under-expressed in CSCC and correlated with tumor staging. According to GO and KEGG Pathway enrichment analysis, B7-H4, and B7-H5 can regulate the proliferation and activation of T cells, lymphocytes, and monocytes, and the expression of cytokines, such as IL-6 and IL-10, in CSCC. B7-H4 and B7-H5 are also jointly involved in the occurrence and development of CSCC via the JAK-STAT and Notch signaling pathways. We found that B7-H4 and B7-H5 proteins were abnormally highly expressed in CSCC tissue and correlated with tumor size and stage. Our findings offer new insights into the pathogenesis of CSCC and suggest that B7-H4 and B7-H5 are novel tissue biomarkers and promising therapeutic targets for CSCC.
Effectiveness and safety of secukinumab updosing in patients with moderate to severe plaque psoriasis: data from the PURE registry
Authors: Papp Kim A. , Gooderham Melinda , Lynde Charles , Brassard Danielle , Al-Mohammedi Faisal , Prajapati Vimal H. , Delorme Isabelle , Albrecht Lorne , Haydey Richard , Alam Maryam Shayesteh , Beecker Jennifer , Siddha Sanjay , Maguin Marie , Farag Mahmoud S. , Vieira Antonio , Rihakova Lenka , Langley Richard G.
Published: June 2024

Secukinumab is a fully human IgG1 antibody that selectively binds to and neutralizes the proinflammatory cytokine interleukin-17A. Secukinumab is an effective and well-tolerated treatment for plaque psoriasis. There is a limited real-word evidence for dose optimisation of secukinumab based on clinical response. PURE is a multi-national, prospective, observational study in patients with moderate to severe chronic plaque psoriasis in Canada and Latin America, assessing the real-world safety and effectiveness of secukinumab and other indicated therapies. The aim of the current snapshot analysis was to evaluate the effectiveness and safety of on-label dose and updosed secukinumab in patients with plaque psoriasis enrolled in the PURE study. At the time of analysis, 676 patients received secukinumab, of which 84.6% (n = 572) remained on the on-label dose, while 15.4% (n = 104) were updosed. With on-label secukinumab, the absolute Psoriasis Area and Severity Index (PASI) score was reduced from 13.6 at baseline to 1.2 over 36 months, with treatment persistence of 73% at 40 months. At Month 36, 73.2% of the patients receiving on-label secukinumab achieved Investigator’s Global Assessment (IGA) 0/1. With updosed secukinumab (300 mg every 2 weeks, 300 mg every 3 weeks, 450 mg every 4 weeks, or 450 mg every 3 weeks), 57.9% of the patients showed improvement in the absolute PASI score at the first visit after updosing, with treatment persistence of 50% at 12 months after updosing. At Month 15, 40% of patients receiving updosed secukinumab achieved IGA 0/1. Patients with previous biologic exposure (odds ratio [OR]: 3.25; 95% confidence interval [CI]: 2.03, 5.18, p < 0.0001) were more likely to be updosed while those with a body weight < 90 kg (OR: 0.49; 95% CI [0.31, 0.77], p = 0.0019) were less likely to be updosed. Previous biologic exposure (HR [hazard ratio]: 1.47; 95% CI [1.24, 1.75], p < 0.0001) and current biologic exposure (secukinumab vs. other indicated therapies: HR 0.57; 95% CI [0.43, 0.75], p = 0.0001) were significantly associated with time to secukinumab updosing. No new or unexpected safety signals were observed with updosed secukinumab. Secukinumab updosing was efficacious and well-tolerated in patients with psoriasis who failed to respond to the approved on-label regimen, suggesting that updosing may be a useful therapeutic option for approved dose non-responders.
Patient-reported burden in adults with atopic dermatitis: an international qualitative study
Authors: Wollenberg Andreas , Gooderham Melinda , Katoh Norito , Aoki Valeria , Pink Andrew E. , Binamer Yousef , Silverberg Jonathan I.
Published: June 2024

The objective was to study a large, international, ethnically diverse population of patients with atopic dermatitis (AD) to support the creation of patient-centric recommendations for AD management. Qualitative data were generated from 45-min, 1:1 telephone interviews conducted across 15 countries in each patient’s native language. Interviews explored the impact of AD on patients’ lives, patients’ most important symptoms, treatment expectations, and treatment decision-making. Participants were also questioned on their current knowledge of AD scoring systems and what was most important to include in these tools. In total, 88 adult patients (≥ 18 years old) receiving treatment for AD were recruited through a market research database, clinician referrals, and local advertising. All patients were screened to ensure a balanced and diverse sample in terms of age, gender, educational level, employment status, geographic location, and AD severity. Patients involved in market research or activities supporting advocacy groups within the previous 6 months or affiliated with or employed by pharmaceutical companies were excluded. AD had a substantial impact on patients’ lives. Itch, skin redness, and dry/flaky skin were the most frequently reported symptoms, with > 75% of patients experiencing these symptoms every 1–3 days. Mental health issues were common and resulted in the greatest negative impact on patients’ daily lives. Patients perceived clinicians to underestimate the burden of their AD. Patients had little awareness of AD scoring systems and indicated a preference for these to be more clearly incorporated in clinical practice. For an ideal scoring system, patients favored using a combination of patient-reported and clinician-reported outcomes to reflect disease burden and ensure consistency across all settings. This global study generated diverse patient perspectives on the disease burden of AD, their expectations of treatment, and their views on AD scoring methods. These data provide evidence to support the development of patient-centric recommendations for AD management.
Antibiotic treatment after appendectomy for acute complicated appendicitis to prevent intrabdominal abscess and wound infections
Authors: Laverde Bruno Leonardo Bancke , Maak Matthias , Langheinrich Melanie , Kersting Stephan , Denz Axel , Krautz Christian , Weber Georg F. , Grützmann Robert , Brunner Maximilian
Published: June 2024

Introduction

The purpose of this analysis was to investigate the most appropriate duration of postoperative antibiotic treatment to minimize the incidence of intraabdominal abscesses and wound infections in patients with complicated appendicitis.

Materials and methods

In this retrospective study, which included 396 adult patients who underwent appendectomy for complicated appendicitis between January 2010 and December 2020 at the University Hospital Erlangen, patients were classified into two groups based on the duration of their postoperative antibiotic intake: ≤ 3 postoperative days (group 1) vs. ≥ 4 postoperative days (group 2). The incidence of postoperative intraabdominal abscesses and wound infections were compared between the groups. Additionally, multivariate risk factor analysis for the occurrence of intraabdominal abscesses and wound infections was performed.

Results

The two groups contained 226 and 170 patients, respectively. The incidence of postoperative intraabdominal abscesses (2% vs. 3%, p = 0.507) and wound infections (3% vs. 6%, p = 0.080) did not differ significantly between the groups. Multivariate analysis revealed that an additional cecum resection (OR 5.5 (95% CI 1.4–21.5), p = 0.014) was an independent risk factor for intraabdominal abscesses. A higher BMI (OR 5.9 (95% CI 1.2–29.2), p = 0.030) and conversion to an open procedure (OR 5.2 (95% CI 1.4–20.0), p = 0.016) were identified as independent risk factors for wound infections.

Conclusion

The duration of postoperative antibiotic therapy does not appear to influence the incidence of postoperative intraabdominal abscesses and wound infections. Therefore, short-term postoperative antibiotic treatment should be preferred.
Development of the neonatal pain response variable set: a mixed methods consensus process
Authors: Zhu Nanxi , Long Bingjie , Zhan Xinling , Zhang Lanxin , Wang Zechuan , Wang Lianhong , Huang Yi , Chen Juan , Huang Chi , Xiong Lu , Fu Zhenyan , Deng Renli
Published: June 2024

While over 40 neonatal pain assessment scales have been published, owing to a lack of consensus and standardized metrics, there are more than 100 assessment indicators with varying descriptors and quality differences. This study aims to reach a consensus on optimal and comprehensive variables for neonatal pain assessment, leading to the development of a multidimensional neonatal pain response variable set. This study consisted of three phases: (1) A literature review was conducted to identify influencing factors and assessment indicators of neonatal pain response. (2) Panel meetings involving neonatal healthcare professionals evaluated and screened factors and indicators to develop an initial draft of the variable set. (3) Through two rounds of Delphi study achieved consensus, and determined the neonatal pain response variable set. Through a literature review and a panel meeting, the identified factors and indicators were categorized into contextual, physiological, and behavioral variables, forming an initial draft of the variable set. Sixteen professionals participated in two rounds of the Delphi study, with response rates exceeding 70%, and authority coefficients surpassing 0.7 in both rounds. The final iteration of the variable set includes 9 contextual variables, 2 physiological variables, and 5 behavioral variables.

   Conclusion: Neonatal pain response variable set developed in this study is scientific, comprehensive, and multidimensional, aligning with the characteristics of neonatal pain response and clinically applicable. The inclusion of contextual variables enhances the ability to confront the complexity of clinical environments and individual differences. It can provide a practical and theoretical basis for clinical research on neonatal pain assessment.

What is Known:• Neonatal pain assessment relies on scales used by healthcare professionals currently. But there is no “gold standard” for neonatal pain assessment.• While over 40 neonatal pain assessment scales have been published, owing to a lack of consensus and standardized metrics, there are more than 100 assessment indicators with varying descriptors and quality differences. Most of scales overlook the clinical environment complexity individual differences in pain responses, diminishing the accuracy and applicability.

What is New:• In addition to the commonly used physiological and behavioral variables in the scales, we have incorporated contextual variables to better address the complexity of clinical environments and individual differences in pain responses.• Through an evidence-based approach, developed a neonatal pain response variable set comprising 9 contextual variables, 2 physiological variables, and 5 behavioral variables.
New T staging recommendations for recurrent nasopharyngeal carcinoma
Authors: Zhu Mingjing , Li Pian , Zhang Huisi , Wu Lanhua , Min Kang
Published: June 2024

Objective

The International Union for Cancer Control/American Joint Committee on Cancer (UICC/AJCC) rT staging is not clinically practical for recurrent nasopharyngeal carcinoma (rNPC). The aim of this study was to establish a new rT staging to guide the treatment of rNPC.

Methods

We conducted a retrospective analysis of 175 patients diagnosed with rNPC between January 2012 and December 2020, using ROC curve analysis to evaluate its effectiveness.

Results

We analyzed the overall survival (OS) and progression-free survival(PFS) of patients diagnosed with rNPC according to the 8th (UICC/AJCC) rT staging, and found that the overall survival of rT1 and rT2 patients (OS; 29.98% vs. 27.09%, p = 0.8059) and progression-free survival (PFS; 28.48% vs. 26.12%, p = 0.4045) had no significant difference. In rT1 and rT2 patients of this study, overall survival(OS; 30.44% vs. 24.91%, p = 0.0229) and progression-free survival(PFS 29.12% vs. 24.03%, p = 0.0459) had a significant difference. Smoking, family history, and time interval of initial recurrence were independent prognostic factors for OS and PFS.

Conclusion

The new rT staging of this study has a better predictive value for survival of rNPC patients than the 8th (UICC/AJCC) rT staging.
COVID-19 pandemic and the consumption of self-care products for pediculosis capitis in Portugal: an interrupted time-series analysis
Authors: Almeida Diogo , Rodrigues Antonio Teixeira , Guerreiro Jose Pedro , Bałkowiec-Iskra Ewa , Vander Stichele Robert , Sepodes Bruno , Torre Carla
Published: June 2024

This study aims to assess the effect of the COVID-19 pandemic on the consumption of self-care products for pediculosis capitis management, in Portugal. A segmented regression analysis of interrupted time series (March 2020) was performed from January 2017 to August 2023 to analyze the short- and long-term impact of the COVID-19 pandemic on the consumption of pediculicides and related products. Monthly rates of absolute consumption were estimated by community pharmacies’ dispensing records. Portuguese municipalities were organized into quintiles according to their purchasing power index and percentage of youth, to study the association of these social and demographic variables on the sale of these products. COVID-19 pandemic significantly reduced the sales of products indicated for pediculosis. Since the start of the pandemic, an absolute decrease of 21.0 thousand packages was observed in the monthly average consumption (p < 0.0001) compared to the pre-pandemic period. After this reduction, the average monthly trend increased in the pandemic period in comparison with the previous period, although not significant (267.0 packages per month, p = 0.1102). Regions with higher disposable income and more young people were associated with higher sales of these products. The outbreak of the COVID-19 pandemic has had a notable impact on the sales of self-care products for pediculosis capitis in Portugal, in the short term. The lockdowns and other isolation measures implemented to control the spread of the virus may have led to a decrease in the number of head lice cases, consequently resulting in a reduction in sales of products.
Reconstructing the Belbaşhanı Pumice Plinian eruption, Hasandağ Volcano, Turkey
Authors: Özsoy Rengin , Sunyé-Puchol Ivan , Pedrazzi Dario , Akkaş Efe , Costa Antonio , Massaro Silvia , Tavazzani Lorenzo , Nazzari Manuela , Bachmann Olivier , Scarlato Piergiorgio , Miggins Daniel P. , Kaya Simge , Mollo Silvio
Published: June 2024

Hasandağ volcano (Central Anatolia, Turkey) has recently underwent an increase in local seismicity and fumarolic activity since 2013. In the past, this volcano has produced multiple large explosive eruptions during the last million years. The Belbaşhanı Pumice is the product of a sub-Plinian to Plinian eruption dated at ~ 417 ± 20.5 ka (40Ar/39Ar). Here, we present a complete volcanological study including stratigraphy, glass chemistry, pumice morphology, geochronology, and eruption source parameters with the associated uncertainties, to characterize the Belbaşhanı Pumice eruption. The eruption involved a column of 18–29 km in height, with the main dispersal axis towards the northeast. A pumice layer up to ~ 17-m-thick accumulated in proximal deposits along the Belbaşhanı path, and up to 2-m-thick in medial-distal areas (~ 18 km northeast from the vent). The high and tubular vesicularity of the pumice clasts indicates that the Belbaşhanı eruption was predominantly magmatic. The bulk volume of the Belbaşhanı Pumice fallout deposit has been estimated as 0.5 and 8 km3(with ~ 2 km3being the mean value), which corresponds to Volcanic Explosivity Index (VEI) of at least 4 and up to 6. Both isopach and isopleth maps indicate that the volcanic vent may have been located at the intersection of the Tuz Gölü fault and Ulukışla caldera, within the Hasandağ volcanic complex. The glass composition of Belbaşhanı Pumice confirms that the eruption belongs to the Hasandağ magmatic system. The reconstruction of the Belbaşhanı Pumice eruption represents an essential baseline in providing volcanological constraints for further investigations of tephra fallout hazard assessment in Central Anatolia, especially considering that a new Plinian eruption cannot be ruled out at Hasandağ volcano in the future. The chemical and geochronological datasets presented here could aid in refining tephrochronological correlations, with the goal of synchronizing paleoenvironmental and paleoclimatic records alongside archaeological sites.
Morphological changes and their associations with clinical parameters in children with nephropathic cystinosis and chronic kidney disease prior to kidney replacement therapy over 25 years
Authors: Brügelmann Malina , Müller Sophia , Bohlen Alina V. , Hohenfellner Katharina , Büscher Anja , Kemper Markus J. , Fröde Kerstin , Kanzelmeyer Nele , Oh Jun , Billing Heiko , Gellermann Jutta , Müller Dominik , Weber Lutz T. , Acham-Roschitz Birgit , Arbeiter Klaus , Tönshoff Burkhard , Hagenberg Martina , Žebec Mislav S. , Haffner Dieter , Zivicnjak Miroslav
Published: June 2024

Background

Infantile nephropathic cystinosis (INC) is a rare lysosomal storage disorder, mostly and often firstly affecting the kidneys, together with impaired disharmonious growth and rickets, eventually resulting in progressive chronic kidney disease (CKD). With the introduction of cysteamine therapy, most pediatric patients reach adulthood with no need for kidney replacement therapy. Still, detailed changes in INC patients’ clinical and morphological presentation over the past decades have not yet been thoroughly investigated.

Methods

Two groups with a respective total of 64 children with INC and 302 children with CKD, both treated conservatively and aged 2 to 18 years, were prospectively observed in the time span from 1998 to 2022 with 1186 combined annual clinical and morphological examinations clustered into two measurement periods (1998 to 2015 and ≥ 2016).

Results

In INC patients, thoracic proportion indices remained markedly increased, whereas body fat stores remained decreased over the past 25 years (+ 1 vs. below ± 0 z-score, respectively). Their CKD peers presented with overall improved growth, general harmonization of body proportions, and improved body fat stores, while INC patients only presented with an isolated significant increase in leg length over time (∆0.36 z-score). eGFR adjusted for age did not significantly change over the past 25 years in both groups. Alkaline phosphatase (ALP) showed a significant decrease in CKD patients over time, while remaining above normal levels in INC patients.

Conclusions

Disproportionate thoracic shape and impaired body fat stores remain the most characteristic morphological traits in INC patients over the past 25 years, while causal mechanisms remain unclear.

Graphical Abstract
Less restrictions in daily life: a clinical practice guideline for children with cancer
Authors: Stavleu Debbie C. , Mulder Renée L. , Kruimer Demi M. , Kremer Leontien C. M. , Tissing Wim J. E. , Loeffen Erik A. H. ,   On behalf of the social restrictions guideline panel, Beek Laura R. , Evers Janneke H. P. , Hagleitner Melanie M. , Martens Daniëlle H. J. , Noordzij Jeroen G. , Ophorst Ida , Ottens Janneke R. , Plieger Willemijn , Quaak Marjolijn S. W. , Schuerhoff Tirza , Spijkerman Judith , van der Steeg Alida F. W. , van de Wetering Marianne D. , Wolfs Tom F. W.
Published: June 2024

Purpose

In current clinical practice, recommendations regarding restrictions in daily life for children with cancer are often lacking or not evidence-based. Critically reviewing the evidence and formulating recommendations are therefore of great importance as social restrictions (e.g., swimming, school attendance, sports) can impair the quality of life of these children severely. Therefore, our aim was to develop a clinical practice guideline for clinicians, children, and their parents regarding social restrictions in children with cancer.

Methods

A comprehensive multidisciplinary panel was assembled, comprising 21 professionals and patient representatives. A systematic literature review was performed, including dual appraisal of all citations. The GRADE methodology was used to extract, summarize, and assess the evidence. Multiple in-person meetings were held to rank outcomes, discuss evidence, complete evidence-to-decision frameworks, and formulate recommendations. Final recommendations were unanimously supported by all panel members.

Results

Six studies, including 758 children, formed the evidence base for the recommendations. Given the scarcity of the available evidence and various designs of studies in children with cancer, additional evidence was extracted from adult oncology guidelines, and shared expert opinions were utilized. In total, 14 recommendations were formulated of which multiple result in changes in current policy and standard of practice in the Netherlands. Topics covered in this guideline are swimming, having pets, visiting the zoo or farm, performing sports or high-velocity events, attending school or kindergarten, and use of public transport. This guideline is not intended to provide recommendations for patients after end of treatment, for palliative care settings, or for children undergoing a stem cell transplantation.

Conclusions

In this clinical practice guideline, we provide recommendations regarding restrictions in daily life in children with cancer. These include evidence-based recommendations and, in the absence of sufficient evidence, recommendations based on expert evidence. With these recommendations, we provide guidance for clinicians, children, and parents and contribute to improving quality of life for children with cancer.
Advancements in diagnosing oral potentially malignant disorders: leveraging Vision transformers for multi-class detection
Authors: Vinayahalingam Shankeeth , van Nistelrooij Niels , Rothweiler René , Tel Alessandro , Verhoeven Tim , Tröltzsch Daniel , Kesting Marco , Bergé Stefaan , Xi Tong , Heiland Max , Flügge Tabea
Published: June 2024

Objectives

Diagnosing oral potentially malignant disorders (OPMD) is critical to prevent oral cancer. This study aims to automatically detect and classify the most common pre-malignant oral lesions, such as leukoplakia and oral lichen planus (OLP), and distinguish them from oral squamous cell carcinomas (OSCC) and healthy oral mucosa on clinical photographs using vision transformers.

Methods

4,161 photographs of healthy mucosa, leukoplakia, OLP, and OSCC were included. Findings were annotated pixel-wise and reviewed by three clinicians. The photographs were divided into 3,337 for training and validation and 824 for testing. The training and validation images were further divided into five folds with stratification. A Mask R-CNN with a Swin Transformer was trained five times with cross-validation, and the held-out test split was used to evaluate the model performance. The precision, F1-score, sensitivity, specificity, and accuracy were calculated. The area under the receiver operating characteristics curve (AUC) and the confusion matrix of the most effective model were presented.

Results

The detection of OSCC with the employed model yielded an F1 of 0.852 and AUC of 0.974. The detection of OLP had an F1 of 0.825 and AUC of 0.948. For leukoplakia the F1 was 0.796 and the AUC was 0.938.

Conclusions

OSCC were effectively detected with the employed model, whereas the detection of OLP and leukoplakia was moderately effective.

Clinical relevance

Oral cancer is often detected in advanced stages. The demonstrated technology may support the detection and observation of OPMD to lower the disease burden and identify malignant oral cavity lesions earlier.
Reliability and validity of surface EMG assessments combined with isometric muscle strength testing in patients with abdominal rectus diastasis and asymptomatic controls
Authors: Swedenhammar E. , Wahlström O. , Brandt J. D. , Strigård K. , Häger C. , Stark B. , Nyberg A.
Published: June 2024

Purpose

Patients with abdominal rectus diastasis (ARD) may have muscular functional impairments, but clinics lack appropriate objective assessment tools. The aim was to establish the relative and absolute reliability, and convergent validity, of muscular activity using Surface Electromyography (SEMG) during isometric abdominal muscle strength testing in patients with ARD and controls without ARD.

Methods

Twenty-six patients with ARD were matched for age, sex and BMI with controls without ARD. Participants were tested twice during isometric muscular contractions using SEMG located on six abdominal sites. Mean amplitude, fatigue, and recruitment order were analyzed. Relative reliability was evaluated with Intraclass Correlation Coefficients (ICC), while absolute reliability was estimated by calculating the Standard Error of Measurement and Minimal Detectable Change. Convergent validity was addressed in relation to participant characteristics, functional ability, and symptoms.

Results

Mean SEMG amplitude for all abdominal wall muscle contractions showed moderate to excellent relative test–retest reliability, with ICC values ranging from 0.46 to 0.97. In contrast, fatigue and recruitment order displayed poor to moderate relative reliability in both groups. Absolute reliability measures were generally high. A moderate to high convergent validity (ARD: rho-value 0.41–0.70; Controls: rho-value 0.41–0.75) was observed for mean amplitude in relation to a functional sit-to-stand test, abdominal circumference, BMI, back pain, and quality-of-life.

Conclusions

The results of applying SEMG during isometric abdominal muscle support practicing the method in clinics, although additional development is needed with further standardization and more functional testing. Furthermore, the method demonstrates construct validity in patients with ARD and in age- and sex-matched controls.
A block quaternion GMRES method and its convergence analysis
Authors: Şimşek Sinem
Published: June 2024

We consider the quaternion linear system $$AX = B$$

A
X
=
B

for the unknown matrix X, where A, B are given $$n\times n$$

n
×
n

, $$n\times s$$

n
×
s

matrices with quaternion entries, motivated by applications that arise from fields such as quantum mechanics and signal processing. Our primary concern is the large-scale setting when n is large so that direct solutions are not feasible. We describe a block Krylov subspace method for the iterative solution of these quaternion linear systems. One difference compared to usual block Krylov subspace methods over complex Euclidean spaces is that the multiplication of quaternion scalars is not commutative. We describe a block quaternion Arnoldi process, taking noncommutativity features of quaternions into account, to generate an orthonormal basis for the quaternion Krylov space $$\text {blockspan} \{ R_0, A R_0, \dots , A^k R_0 \}$$

blockspan
{

R
0

,
A

R
0

,
⋯
,

A
k

R
0

}

, where $$R_0 = B - A X_0$$

R
0

=
B
-
A

X
0

and $$X_0$$

X
0

is an initial guess for the solution. Then the best solution of $$AX = B$$

A
X
=
B

in the least-squares sense is sought in the generated Krylov space. We explain how these least-squares problems over quaternion Krylov spaces can be solved efficiently by means of Householder reflectors. Most notably, we analyze rigorously the convergence of the proposed block quaternion GMRES approach when A is diagonalizable, and in the more general setting when A is not necessarily diagonalizable by making use of the Jordan form of A. Finally, we report numerical results that confirm the validity of the deduced theoretical convergence results, in particular illustrate that the proposed block quaternion Krylov subspace method converges quickly when A has clustered eigenvalues.
Mental simulation of colour properties during language comprehension: influence of context and comprehension stages
Authors: Liu Donglin , Wang Lijuan , Han Ying
Published: June 2024

Many studies have shown that mental simulation may occur during language comprehension. Supporting evidence is derived from the matching effects in the sentence-picture verification (SPV) task often used to assess mental simulations of object properties, such as size, orientation, and shape. However, mixed results have been obtained regarding object colour, with researchers reporting matching or mismatching effects. This study investigated the impact of colour information clarity within sentences on the process of mental simulation during language comprehension. Employing the SPV task and using novel objects, we examined whether there is a mental simulation of colour after excluding typical/atypical colour bias and how varying levels of colour information clarity in sentences influence the emergence of matching effects at different stages of comprehension. To address these issues, we conducted two experiments. In Experiment 1, the participants read normal sentences and subsequently engaged in picture verification with a novel object after a 500 ms delay. In Experiment 2, the participants encountered sentences containing both clear and unclear colour information and, after either a 0 ms or 1500 ms interval, completed picture verification tasks with a novel object. Null effects were found in the 500 ms condition for normal sentences and the 0 ms condition for unclear colour information sentences. A mismatching effect appeared in the 0 ms condition after clear colour information sentences, and a matching effect appeared in the 1500 ms condition for all sentences. The results indicated that after excluding colour bias, the participants still formed mental simulations of colour during language comprehension. Our results also indicated that ongoing colour simulation with time pressure impacted the participant responses. The participants ignored unclear colour information under time pressure, but without time pressure, they constructed simulations that were as detailed as possible, regardless of whether the implicit colour information in the sentence was clear.