bluuebunny/crossref_metadata_2025 huggingface dataset:
Sleep as a possible mediator in the association of mental health parameters with cardiovascular health indices in women: exploratory analyses from the Heart SCORE Study
Authors: Fonkoue Ida T. , Silva Milena , Racette Susan B. , Safo Sandra E. , de las Fuentes Lisa , Lowe Dawn , Ebong Imo A. , Buysse Daniel , Reis Steven E. , Saeed Anum
Published: January 2025

Objective

This exploratory study aimed to determine the possible role of sleep in the relationships of depression and anxiety, with early surrogate markers of subclinical atherosclerosis, such as brachial artery (BA) diameter and carotid intima media thickness (CIMT) in women.

Methods

We included 1,075 self-reported postmenopausal women, 45 to 75 years from the Heart Strategies Concentrating on Risk Evaluation Study. Exposure variables were depression and anxiety assessed using the Center for Epidemiologic Studies Depression Scale and the State-Trait Anxiety Inventory, respectively. Outcome variables were BA diameter and CIMT measured using ultrasonography. The mediator, sleep, was assessed with the Pittsburgh Sleep Symptom Questionnaire–Insomnia. Ordinary least squares regression was used for mediation analyses.

Results

Of the 1,075 participants, 56.3% were White and 43.7% were Black. Our analyses revealed significant associations of depression and anxiety with sleep (P < 0.001 for all). After adjusting for confounders, depression was associated with max CIMT (R2 = 0.15, P = 0.004), but not BA diameter (R2 = 0.09, P = 0.083). Although the mediating role of sleep in the association between anxiety and BA diameter was not statistically significant [proportion mediated (CI); 0.41 (−2.77, 4.06); P = 0.219], we observed differential results within each racial group. Sleep appeared to partially mediate the association of anxiety with BA diameter in White [0.21 (0.54, 0.80); P = 0.044] women only.

Conclusions

We found preliminary indications that sleep might mediate the association of anxiety with BA diameter in White women but does not appear to serve as a mediator in all the other relationships we examined.
A randomized controlled trial to evaluate a novel dual laser therapy for vulvar lichen sclerosus: exploratory study assessing the impact of menopausal status
Authors: Zivanovic Irena , Gamper Marianne , Fesslmeier Debra , Bischofberger Helena , Viereck Volker
Published: January 2025

Objective

A randomized controlled trial showed that Neodymium:YAG/Erbium:YAG laser therapy was safe and significantly improved clinical outcomes and subjective symptoms of vulvar lichen sclerosus (LS). Most improvements were similar to those after the recommended first-line therapy with topical steroid. In this exploratory study, we wanted to analyze the impact of menopausal status on perception and treatment outcome.

Methods

Sixty-six women with clinical lichen sclerosus were assigned to the laser or the steroid arm (2:1). Participants of the laser arm received four laser treatments with a follow-up of 6 months after treatment initiation. Clinical objective (LS score) and subjective outcomes (vulvovaginal symptoms questionnaire [VSQ], symptom visual analogue scale [VAS] score, patient satisfaction) were evaluated.

Results

Nineteen of the 66 study participants were premenopausal, 47 postmenopausal. At baseline, premenopausal women were significantly younger (39.4 vs 67.4 yr, P < 0.001), only a few applied local estrogen (16% vs 74%, P < 0.001), and their VSQ score was higher (9.58 vs 7.32, P = 0.015) indicating more severe vulvovaginal symptoms. Laser therapy objectively led to similar clinical improvements for pre- and postmenopausal women (−2.62 vs −2.23, P = 0.437), but subjectively to a significantly higher improvement of the VSQ score in postmenopausal women (−4.13 vs −1.08, P = 0.005). Postmenopausal women were more satisfied with laser therapy than premenopausal women (71% vs 46%, P = 0.002).

Conclusion

Compared to premenopausal women, postmenopausal women experienced a lower subjective burden of the disease and a better subjective improvement after laser therapy. Perceptions and expectations are age-dependent and should be considered when treating women with lichen sclerosus.
Prevalence of urinary tract infections in women with vulvovaginal atrophy and the impact of vaginal prasterone on the rate of urinary tract infections
Authors: Rubin Rachel , Sanaee May , Yee Alyssa , Moyneur Erick , Dea Katherine , Dury Alain Y.
Published: January 2025

Objective

The aims of this study were to assess the prevalence of urinary tract infections (UTI) in women newly diagnosed with vulvovaginal atrophy (VVA) versus women without VVA and to evaluate the potential of vaginal prasterone to be used in postmenopausal VVA women with UTI as prophylaxis to reduce the future UTI risk. As a first subgroup analysis, women using aromatase inhibitors, medications that stop the production of estrogen were analyzed. As a second subgroup analysis, we looked at women with diabetes to investigate whether the same prophylaxis approach should be considered.

Methods

This observational retrospective inception cohort study was conducted using the Integrated Dataverse open-source claims database with data from February 2015 through January 2020.

Results

A total of 22,245 women treated with prasterone for a minimum of 12 weeks were matched to women without any prescribed VVA-related treatment. Overall, women treated with prasterone have a significantly lower UTI prevalence compared to those untreated (6.58% vs 12.3%; P < 0.0001). The highest difference in UTI prevalence among the prasterone treated and untreated women was observed in those aged 65‐74 (7.15% vs 16.2%; P < 0.0001). Among aromatase inhibitor users and women with diabetes, those treated with prasterone have a significantly lower UTI prevalence (4.90% vs 9.79%; P < 0.01 and 14.59% vs 20.48%; P < 0.0001, respectively).

Conclusions

This study suggests that intravaginal prasterone may be a good candidate for prophylaxis in postmenopausal women with UTI to reduce future UTI risk, including for women taking aromatase inhibitors and women with diabetes. This study is based on real-world evidence and warrants further investigation in a clinical setting.
Using the hospital frailty risk score to assess oesophago-gastric cancer patient outcomes: a retrospective cohort study
Authors: Harris Alexander , Imam Towhid , Konstant-Hambling Rob , Flint Helene , Conroy Simon , Kumar Sacheen , Allum William
Published: January 2025

Background:

The inclusion of clinical frailty in the assessment of patients planned for major surgery has proven to be an independent predictor of outcome. Since approximately half of all patients in the UK diagnosed with oesophagogastric (OG) cancer are over 75 years of age, assessment of frailty may be important in selection for surgery.

Materials and methods:

This retrospective cohort study applied the Hospital Frailty Risk Score to data obtained from the NHS Secondary Uses Service electronic database for patients aged 75 years or older undergoing oesophagectomy and gastrectomy between April 2017 and March 2020. Descriptive statistics were performed to assess the effect of patient frailty on length of stay, 30-day readmission, and 30-day mortality rates. These outcomes were compared with those published by the National Oesophago-Gastric Cancer Audit.

Results:

Over 90% of the 1775 patients identified according to the age and resection criteria exhibited some degree of frailty. The median length of stay and 30-day readmission rate increased as patient frailty increased following both oesophagectomy and gastrectomy, as did the 30-day mortality rate following gastrectomy.

Conclusion:

Frailty is a dynamic state and increasing age alone should not be a barrier to receiving the most appropriate treatment. Introducing standardized assessment of clinical frailty for patients with OG cancer to identify this cohort of patients earlier might enable targeted screening for frailty syndromes. This could facilitate the enhanced delivery of more holistic, frailty-attuned, approaches to person-centred care, and evidence-based treatment pathways for improved patient outcomes.
Construction of a predictive model for type 2 diabetes mellitus with coexisting hypertension: A cross-sectional study
Authors: Zhang Huiling , Yu Shuang , Xia Zheyuan , Meng Yahui , Zhu Dezheng , Wang Xiang , Shi Hui
Published: January 2025

Type 2 diabetes mellitus (T2DM) and hypertension often coexist, raising the risk of cardiovascular events, renal disease, and mortality. Early identification of high-risk patients with T2DM and concurrent HTN is vital for personalized care. This study aims to construct and validate a predictive model for hypertension in T2DM patients to aid early intervention and tailored treatment. A quantitative observational study using multivariable logistic regression analysis was conducted, with results presented in a nomogram. Data from 423 T2DM patients (206 with hypertension and 217 without) hospitalized at a tertiary hospital in Anhui Province between February 2023 and February 2024 were analyzed. Univariate and multivariate logistic regression identified significant predictors, and model performance was evaluated via ROC curves, AUC values, and the Hosmer–Lemeshow test. Age, alcohol use, diabetic nephropathy, coronary heart disease, cerebral infarction, and body mass index were significant predictors. The model showed good performance with an AUC of 0.72, and the Hosmer–Lemeshow test (P = .074) confirmed its fit. The predictive model effectively identifies high-risk T2DM patients for hypertension, aiding early intervention and personalized treatment.
Acute lymphoblastic leukemia first presenting with ascites: A case report
Authors: Yu Fengxue , Tao Zhen , Cheng Cong , Wei Hongxia , Cai Rentian
Published: January 2025

Rationale:

Acute lymphoblastic leukemia (ALL) is known for its tendency to present with extramedullary infiltrates, commonly affecting lymph nodes, the spleen, the central nervous system, the orbit, skin, and testes. Less commonly, leukemia can infiltrate unusual sites such as the cervix, gastrointestinal tract, lungs, and thyroid gland. However, it is exceedingly rare for leukemia to present with ascites as the initial symptom. By reporting this rare case, the study seeks to contribute to a better understanding of ALL’s varied presentations and improve early detection and management strategies, ultimately enhancing patient outcomes.

Patient concerns:

A 30-year-old male was admitted to the hospital with the primary complaint of ascites.

Diagnosis:

ALL.

Interventions:

The patient was initially diagnosed with suppurative peritonitis through abdominal puncture. The abdominal computed tomography scan revealed ileocecal lesions, which were thought to be the source of the purulent peritonitis. Despite receiving antibacterial therapy and undergoing peritoneal effusion drainage, the treatment proved ineffective. The patient chose to discontinue hospitalization and was discharged on June 22. On August 24, he was readmitted to Nanjing First Hospital. A follow-up abdominal computed tomography scan revealed multiple enlarged lymph nodes in the abdomen, raising suspicion of a hematological malignancy. Bone marrow cytology subsequently confirmed the diagnosis of ALL.

Outcomes:

The patient was admitted to the hematology department for further treatment. Unfortunately, despite intervention, the patient passed away.

Lessons:

Although it is rare for ALL to present initially with ascites, clinicians should consider leukemia as a potential diagnosis in patients presenting with ascites, particularly when conventional treatments for other diagnoses are ineffective.
Periosteal distraction as a new surgical technique for the treatment of senile diabetic foot: A retrospective case analysis
Authors: Yang Rui , Zhou Yue , Hu Yunxiang , Liu Sanmao
Published: January 2025

This study investigates the clinical effect and safety of periosteal distraction in the treatment of senile diabetic foot. The clinical data of 45 patients with diabetic foot treated with periosteal distraction in the Central Hospital of Dalian University of Technology from January 2020 to May 2024 were retrospectively analyzed. Finally, 42 patients were followed up, and 3 patients were lost to follow-up, including 29 males and 13 females, aged (71.17 ± 6.43), (62–84) years respectively. The Wagner grade of the ulcer surface of the affected foot was grade 2 in 25 cases, grade 3 in 13 cases, and grade 4 in 4 cases; the ulcer sites were toes in 18 cases, soles in 14 cases, dorsum of the foot in 8 cases, heels in 1 case, and ankles in 1 case. The toe oxygen saturation, ankle-brachial index (ABI), skin temperature and visual analogue score (VAS) were recorded before operation and at 1 day, 7 days, 14 days, 1 month, 2 months, and 3 months after operation. The therapeutic effect was observed and evaluated in combination with Michigan neurological sign score and lower limb computed tomography angiography. The wound ulcer healing rate, amputation rate and ulcer recurrence were also counted. The toe oxygen saturation, ABI, skin temperature, VAS score and Michigan neurological sign score of all patients were significantly improved after operation compared with those before operation, and the differences were statistically significant (P < .05); After a 3-month post-surgery period, 37 patients were observed to have microcirculation formation in the affected limb, as well as increased and thickened lower extremity arterioles in comparison to pre-surgery conditions, forming an interwoven network. During the follow-up period, 21 patients exhibited healed foot ulcers at 2 months post-surgery, while by the end of the follow-up period, 38 patients had healed foot ulcers, 5 patients had experienced a significant reduction in wound ulcer area, and the overall ulcer healing rate was 90%. Notably, no instances of amputation or ulcer recurrence were observed during treatment. Periosteal distraction is a new surgical method for the treatment of senile diabetic foot ulcer, which can obtain satisfactory short-term efficacy and is worthy of clinical promotion.
Comprehensive treatment strategy for pancreaticopleural fistula: A rare case report and review of 91 cases
Authors: Zhao Chengsi , Yao Weijie , Wang Zuozheng
Published: January 2025

Rationale:

Pancreaticopleural fistula (PPF) is a rare but serious complication of pancreatic disease, typically resulting from the rupture of a pancreatic pseudocyst or ductal injury. The condition often leads to misdiagnosis due to its nonspecific clinical manifestations, including dyspnea and chest pain.

Patient concerns:

A 61-year-old male with a history of alcohol and tobacco use presented with severe dyspnea, chest pain, and cough. He had been diagnosed with acute pancreatitis 9 months prior and intermittently experienced upper abdominal pain and distension post-treatment.

Diagnoses:

PPF.

Interventions:

The patient underwent thoracic drainage, nasopancreatic duct drainage, and pancreatic duct stent placement, along with parenteral nutrition and somatostatin therapy.

Outcomes:

Treatment resulted in resolution of pleural effusion and pseudocyst. The patient had no recurrence during a 5-year follow-up period.

Lessons:

This case demonstrates the effectiveness of a comprehensive treatment strategy combining thoracic and pancreatic drainage for PPF. Long-term follow-up is crucial for monitoring recurrence and assessing treatment efficacy. Future research should focus on optimizing treatment plans, particularly regarding the best timing for intervention and improving long-term outcomes.
Rectal fistula induced artificial vascular graft infection: A case report
Authors: Zhou Honghua , Dai Kanghui , Ju Zhinan , Wan Liqun , Zhou Guangmao , Qiu Jiehua
Published: January 2025

Rationale:

Artificial vascular graft infection (AVGI) is a rare but severe complication in vascular surgery, often associated with high morbidity and mortality. This case report highlights a unique instance of AVGI caused by a rectal fistula, emphasizing the diagnostic challenges and management strategies in such a rare scenario.

Patient concerns:

A 60-year-old female presented with low-grade fever and purulent discharge from an abdominal incision 1 year after antibiotic therapy had failed to resolve the infection. She had a history of aortofemoral dacron graft bypass 6 years prior, complicated by a rectal hematoma due to trauma.

Diagnoses:

The patient was diagnosed with a rectal fistula, AVGI, and perivascular sinus formation. Diagnostic workup revealed the presence of Escherichia coli infection.

Interventions:

The patient underwent graft excision and debridement. No vascular reconstruction was necessary due to the presence of sufficient collateral circulation. This intervention was performed following the failure of conservative antibiotic therapy.

Outcomes:

Postoperative recovery was uneventful, with normalization of inflammatory markers and no signs of limb ischemia upon follow-up. The patient’s symptoms resolved without complications.

Lessons:

This case underscores the importance of early diagnosis using imaging, particularly in patients with vascular prosthetic grafts who may have adjacent organ injuries such as a rectal fistula. It also highlights the need for tailored surgical approaches and the significance of regular follow-up in managing AVGI.
Gamma knife radiosurgery for metastatic brain tumors with contrast media leakage: Case series
Authors: Park Sue-Jee , Park Wan , Kim Yeong Jin , Ahn Kanghee , Moon Kyung-Sub , Kim In-Young , Jung Shin , Marcelina Correia Dircia Canisia , Kim Seul-Kee , Lee Kyung-Hwa , Jung Tae-Young
Published: January 2025

Rationale:

The phenomenon of “contrast media leakage” in metastatic brain tumors, where contrast enhancement of perilesional edema can overestimate actual tumor volume.

Patient concerns and diagnosis:

The radiologic and pathologic characteristics of 3 surgically resected metastatic brain tumors with contrast media leakage were analyzed. Five metastatic tumors were treated with gamma knife radiosurgery (GKRS), deliberately avoiding areas of contrast media leakage.

Interventions:

The characteristics of these tumors, the administered radiation dosage, and progression-free survival were evaluated.

Outcomes:

The region of “contrast media leakage within edema” showed different signals from tumor boundaries on T2-weighted magnetic resonance imaging, fluid-attenuated inversion recovery, and apparent diffusion coefficient maps. No increased cerebral blood volume and a low transfer coefficient were indicated on perfusion images. Pathologically, these areas showed prominent endothelial proliferation and perivascular lymphocyte infiltration without tumor cell infiltration. Immunohistochemical staining revealed a weak positive for clauidin-5 and a strong positive with antibodies against leukocyte common antigen and cluster of differentiation 68. Five lesions treated with GKRS were adenocarcinomas of lung origin. The median radiation volume was 3.10 cc (range, 2.32–3.78), and the median radiation dose was 22 Gy (range, 20–22). Treatment responses were nearly complete in 1, partial in 3, and stable in 1. There were recurrences at 6.0 and 10.0 months after GKRS. Median progression-free survival was 18.2 months (95% confidence interval: 9.2–27.1), and there was no treatment-related complication.

Lessons:

This study revealed that the region of “contrast media leakage within edema” showed more pronounced blood–brain barrier disruption associated with inflammatory cells. It was effective when the GKRS targeted the actual tumor, excluding the area with contrast media leakage.
Experience in the treatment of giant orbital intraconal teratoma: A case report
Authors: Li Ruimiao , Ren Mingyu , Liu Limin , Zhang Ruina , Guo Wensheng
Published: January 2025

Rationale:

Orbital teratoma is a relatively rare disease in infancy. In the pediatric population undergoing significant growth and development, the presence of giant orbital masses can significantly affect orbital volumes and impair the visual function. Traditional treatments may not yield anticipated effectiveness, often leading to numerous complications. This report aims to present a rare case involving a giant orbital intraconal teratoma. The objective is to analyze the treatment course comprehensively, distill valuable experiences and lessons learned, enhance treatment strategies, and ultimately reduce the incidence of complications associated with these formidable pediatric tumors.

Patient concerns:

A 2-year-old female child was presented exhibiting proptosis and inward and upward eyeball displacement. Enhanced magnetic resonance imaging revealed a well-circumscribed mass, persisting with hypointense signals on T1-weighted images (T1WI) and hyperintense signals on T2-weighted images (T2WI).

Diagnoses:

The diagnosis of teratoma was confirmed finally through histological and immunohistochemical exams.

Interventions:

A transconjunctival approach via the inferior fornix, coupled with canthotomy and cantholysis, was performed. However, a month postsurgery, the patient developed enophthalmos, conjunctival hyperemia, and keratitis upon ocular examination. A second operation involved the implantation of allogeneic sclera into the orbit to increase orbital volume, improve the pitting of the fossa, and restore keratitis to normal.

Outcomes:

No recurrence and other complications were noted during the 1-year follow-up.

Lessons:

Giant orbital teratomas in children are infrequent and pose significant challenges in the field of therapy. The potential consequences of larger orbital masses in childhood, including increased orbital volume and the risk of postoperative enophthalmos and keratitis. The findings emphasize the importance of timely implantation into the orbital after mass excision to enhance orbital volume and reduce the incidence of complications.
Systemic lupus erythematosus complicated by retroperitoneal fibrosis: A case report and literature review
Authors: Cheng Song , Wu Sikai , Wang Neng , Xu Wenjie , Wei Fuquan , Ao Weiqun , Yuan Li , Ning Xiaoxiang , Mao Yichuan , Zhang Xianzhen , Mao Guoqun
Published: January 2025

Rationale:

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organ systems. Retroperitoneal fibrosis (RPF) is a rare condition characterized by the development of fibrous tissue in the retroperitoneal space. The coexistence of SLE and RPF is extremely uncommon, and this report aims to enhance understanding of this complex relationship.

Patient concerns:

A 32-year-old woman presented with sudden-onset syncope. Her medical history revealed a 5-year history of SLE, and imaging studies identified a retroperitoneal mass.

Diagnoses:

A comprehensive diagnostic workup, including magnetic resonance imaging (MRI) and biopsy, confirmed retroperitoneal fibrosis secondary to SLE.

Interventions:

The patient was treated with high-dose corticosteroids, immunosuppressive therapy, and the biologic agent rituximab.

Outcomes:

The patient’s symptoms markedly improved, and follow-up MRI demonstrated significant regression of the retroperitoneal lesion.

Lessons:

RPF associated with SLE is exceptionally rare. This case underscores the importance of early diagnosis and a coordinated multidisciplinary approach in managing such complex conditions. Glucocorticoid therapy remains the cornerstone of treatment, augmented by immunosuppressants and biologic agents when necessary.
Causal relationship between childhood obesity and osteoporosis: A STROBE two-sample Mendelian randomization study
Authors: Zheng Chaoshun , Chen Taiqiu , Zhang Longsheng , Lin Chuchun , He Xuhui
Published: January 2025

The causal relationship between childhood obesity and osteoporosis is not yet clear. Two-sample randomized Mendelian analysis was applied to examine the causal relationship between childhood obesity and osteoporosis. This study employs a two-sample Mendelian randomization (MR) approach. The single-nucleotide polymorphisms associated with childhood obesity and summary-level data for osteoporosis were selected from publicly published genome-wide association study. The childhood obesity dataset includes individuals under the age of 18 with a body mass index exceeding the 95th percentile, representing both male and female European children. The osteoporosis dataset includes individuals with osteoporosis from the European population (age 0–70), encompassing both genders. MR analysis was primarily conducted via inverse-variance weighted analysis. Quality of our study was assessed according to STROBE-MR guidelines. MR analysis revealed a statistically significant association between childhood obesity and osteoporosis via the inverse-variance weighted method (odds ratio 0.9985, 95% CI [0.9974, 0.9996], P = .0087). Other MR analysis methods also confirmed this result. The heterogeneity analysis and sensitivity analysis show the accuracy and robustness of our results. Our MR study revealed a significant causal relationship between childhood obesity and osteoporosis, indicating that childhood obesity can reduce the incidence of osteoporosis.
Prevalence of under-nutrition and associated factors among patients with liver cirrhosis at a tertiary hospital in Ethiopia
Authors: Mulugeta Biruk , Fisseha Henok , Argaw Abel Mureja , Kassu Rodas , Desalegn Hailemichael
Published: January 2025

Liver cirrhosis is a major health burden, resulting in over 1 million deaths per year worldwide. Nutritional imbalance often complicates the course of liver diseases, particularly of cirrhosis and has been linked to increased mortality. Despite the high disease burden, there is paucity of literature regarding the magnitude of under-nutrition in patients with cirrhosis and its associated factors in Ethiopia and sub-Saharan Africa. The study aimed to assess the prevalence of under-nutrition and its associated factors among adult out-patients with liver cirrhosis. A hospital-based cross-sectional study was conducted among 136 adult out-patients with cirrhosis who visited the hepatology clinic of St. Paul’s Hospital Millennium Medical College. Data were obtained through patient interviews, medical record reviews, anthropometric and handgrip strength measurements and collected using a structured checklist and analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0. Body mass index with cutoff points adjusted for the degree of ascites were used to diagnose under-nutrition. Descriptive statistical tools and binary and multivariable logistic regression analyses were employed, and statistical significance was set at <0.05. The mean age of study participants was 39.5 years (standard deviation: ±11.2) and 62.5% were males. Chronic hepatitis B virus infection (57.4%) was the most common cause of liver cirrhosis, followed by alcohol-associated liver cirrhosis (12.5%). The majority (70.6%) of the study participants were undernourished. The factors found to have statistically significant association with under-nutrition were, rural area of residence (adjusted odds ratios [AOR]: 5.65, 95% confidence interval [CI]: 1.98–16.1), presence of ascites (AOR: 2.43, 95% CI: 1.03–5.7) and the disease severity, as measured by the child–pugh class (AOR, 1.11; 95% CI: 0.45–2.7). Under-nutrition was found to be a common problem among out-patients with liver cirrhosis and patients from rural areas and those with advanced disease were disproportionately affected. It is imperative to implement routine nutritional screening and plan on appropriate interventions for patients with liver cirrhosis.
Orthotists' perspectives on the adjustment of 3D printed ankle foot orthoses: A mixed methods feasibility study
Authors: Leith Jessie , Andrysek Jan , Kuspinar Ayse
Published: January 2025

Background:

An important part of the orthotic treatment process includes performing adjustments to the shape or design of the orthosis to improve its fit and function. However, the ability to adjust 3D printed (3DP) materials is not well understood.

Objectives:

(1) To evaluate the usability of completing adjustments on 3DP ankle foot orthoses (AFOs) vs. traditionally-fabricated AFOs, and (2) to explore orthotists' perspectives on the advantages, disadvantages, and similarities of adjusting 3DP materials and identify potential solutions for disadvantages.

Study design:

Mixed-methods cross-sectional study.

Methods:

Ten participating certified orthotists performed a sequence of predetermined adjustment tasks on 3DP AFOs. The Single Ease Question and the System Usability Scale (SUS) were compared between traditional vs. 3DP AFO adjustments. Semistructured interviews were conducted, and a thematic analysis identified key themes.

Results:

Single Ease Question scores were significantly lower for 3DP adjustments in 50% of tasks. The mean SUS total score was significantly lower (p < 0.001) for tasks completed on 3DP AFOs compared with traditional AFOs. The thematic analysis identified challenges related to aesthetics, heating, grinding, brittleness, and timing of adjustments. Several similarities and some minor benefits were also noted. Despite challenges, orthotists demonstrated optimism about the 3DP material and proposed several solutions for improvement including optimizing techniques and introducing postprocessing.

Conclusions:

3D printed orthoses were more difficult to adjust and had lower usability for adjustment compared with traditional ones. However, orthotists felt that they would be able to use the material in clinical practice if some of the proposed solutions were implemented.
Outcome measures used in the evaluation of adult upper-limb prostheses - kinematic and functional aspects: A scoping review
Authors: de Avellar Natália Batista Castilho , de Oliveira Rebeca Cunha , Dutra Rina Mariane Alves , Vimieiro Claysson Bruno Santos , Lopes Fernanda Márcia Rodrigues Ferreira , Van Petten Adriana Maria Valladão Novais
Published: January 2025

The abandonment rates of upper-limb (UL) prostheses are concerning and are related to limitations in the functional and kinematic aspects of the UL prosthesis. Evaluating the usability of prostheses is essential to make improvements in relation to these aspects and develop effective equipment and inform clinical results relevant to rehabilitation. The purpose of this scoping review is to explore the current state of the literature, the characteristics of studies on the topic, and the main parameters and instruments used to evaluate UL prosthesis, regarding kinematic and functional aspects. The search was performed in 7 databases using descriptors related to “Prosthesis,” “Outcome Measures,” and “Upper Limb.” Specific data were extracted from full-text articles included in the final sample. A literature search identified 1122 articles. After analyzing the articles using predetermined inclusion and exclusion criteria, 121 relevant articles were included in the final review. Most of the studies found originated from the United States and United Kingdom, predominating quasi-experimental studies and case studies. The predominant level of disability was transradial, and the most cited type of prosthesis was electric/myoelectric. The studies predominated in the clinical context and focused on the use of functional assessments. About 101 assessment instruments in total were found, 82 (81.2%) of which were related to functionality and 19 (18.8%) related to kinematic aspects. Kinematic focus is still scarce on the evaluation of users of UL prostheses. Combining kinematic and functional assessments expands the approach and data collection with the target population. There is a need to develop instruments specifically aimed at this audience.
Comparison of Ultrasound Characteristics of Peripapillary Hyperreflective Ovoid Mass-Like Structures (PHOMS) and Optic Disc Drusen in Children
Authors: Bhagat Dhristie , Garcia Arielle , Ying Gui-Shuang , Liu Grant T. , Avery Robert A.
Published: January 2025

Background:

In children, pseudopapilledema is frequently caused by peripapillary hyperreflective ovoid mass-like structures (PHOMS) or optic disc drusen (ODD). While enhanced depth imaging (EDI) OCT can identify both, lack of cooperation, especially from younger children due to the duration of testing, often necessitates the use of B-scan ultrasound (BSUS). This study investigated whether PHOMS are hyperreflective on BSUS and if BSUS can differentiate PHOMS from ODD.

Methods:

Pediatric patients referred by a neuro-ophthalmologist to the diagnostic ultrasound clinic for optic nerve head elevation between March 2019 and May 2021 were eligible. Subjects who underwent BSUS and EDI-OCT and were diagnosed with pseudopapilledema based on examination, imaging findings, stability on follow-up, and, in some cases, normal CSF opening pressure were included. ODD were identified on EDI-OCT as structures above the lamina cribrosa with a hyporeflective core and hyperreflective margin prominent superiorly. Hyperreflective horizontal lines (HHL) above the lamina cribrosa without ODD were identified. PHOMS were defined as ovoid, hyperreflective structures above Bruch's membrane external to the optic disc, with similar reflectivity to the retinal nerve fiber layer on OCT and upward deflection of other retinal layers. The BSUSs were read by a separate, masked evaluator who graded the size and reflectivity.

Results:

Two hundred thirty-nine eyes (120 patients; 58.3% female; mean age = 11.6 years) with pseudopapilledema were included. EDI-OCT mostly demonstrated PHOMS only (58.1%), followed by PHOMS and HHL (12.6%), and then PHOMS and ODD (11.7%). A combination of PHOMS, ODD, and HHL was found in 8.8%, 1.7% had HHL only, 0.8% had ODD and HHL, and 0.4% had ODD only. 5.9% of eyes were normal on OCT. On BSUS, 78.4% of eyes with only PHOMS demonstrated low or intermediate reflectivity, while 92.9% of eyes with both PHOMS and ODD demonstrated high reflectivity. When HHL was present with or without other findings, a majority demonstrated high reflectivity.

Conclusions:

Though PHOMS are hyperreflective on BSUS, ODD are more highly reflective, which may allow clinicians to differentiate between the two if EDI-OCT is unavailable. Eyes with both PHOMS and HHL have similar characteristics to those with ODD, supporting current theories that these lines may be early indicators of evolving drusen.
Genome sequences of pathogenic and non-pathogenic Pantoea ananatis strains in maize (Zea mays L.)
Authors: Moura Duin Izabela , Yumi Baba Viviane , D'Amico-Willman Katherine M. , Neves Paduan Fernanda , Sugahara Rodrigues Vanessa , Huguet-Tapia Jose , Jones Jeffrey , Giovanetti Canteri Marcelo , Pereira Leite Júnior Rui , Balbi-Peña Maria Isabel
Published: January 2025

We performed genome sequencing and comparative analysis of Pantoea ananatis strains isolated from corn leaves expressing typical bacterial leaf streak (BLS) and maize white spot (MWS) symptoms to confirm bacterial identity and to understand the relationship among these strains and P. ananatis strains isolated from different plant hosts in Brazil. In pathogenicity tests, strains 4.2 and 13.3 isolated from symptomatic BLS leaves  were non-pathogenic on corn. In contrast, strain B13 isolated from MWS diseased leaf tissue caused symptoms typical of MWS. Our comparative analysis revealed that all three strains are very genetically similar. The G+C (%) content of the strains 4.2 and 13.3 was 53.5%, while B13 was 53.7%. Average nucleotide identity (ANI) analysis showed that strains B13 and 13.3, B13 and 4.2, and 4.2 and 13.3 shared ANIs of 99.17%, 99.15%, and 99.99%, respectively. Strains 13.3, B13 and 4.2 shared ~99% ANI with P. ananatis type strain LMG 2665. To our knowledge, these are the first genome sequences of P. ananatis strains isolated from corn in Brazil.
Transplant immunosuppressant therapies induce unique functional changes in lymph node and re-shape gut immune homeostasis
Authors: Wu Long , Kensiski Allison , Gavzy Samuel J , Song Yang , Lwin Hnin Wai , France Michael , Kong Dejun , Li Lushen , Lakhan Ram , Saxena Vikas , Piao Wenji , Shirkey Marina W. , Mas Valeria , Lohmsr Brendan , Bromberg Jonathan S , Ma Bing
Published: January 2025

Current immunosuppressants effectively suppress adaptive and innate immune responses, but their broad, antigen-non-specific effects often result in significant complications. Here, we conducted a systematic investigation of drug effects on gut microbiome, metabolic pathways, lymphoid architecture and lymphocyte trafficking of four major immunosuppressants classes including tacrolimus, prednisone, mycophenolate mofetil (MMF), and Fingolimod (FTY). We show that immunosuppressants induced progressive alterations in the gut microbiome and metabolic pathways, where initial drug-specific effects converged by day 30 into a common dysbiotic state enriched in Muribaculaceae. Gut transcriptome analyses revealed minimal overlap in differentially expressed genes between early and late time points, indicating transient early effects and marked late-stage changes induced by these drugs. These microbiome and metabolic shifts were accompanied by time-dependent changes in lymph node (LN) organization and cellular composition, transitioning between pro-tolerogenic and pro-inflammatory states. Under alloantigen-stimulated conditions, MMF and FTY suppressed inflammation through dual regulation of regulatory T cells and LN remodeling, mediated through LN stromal cell-derived laminins. Together, our findings highlight previously underappreciated temporal dynamics in immunosuppressant mechanisms, linking immune tissue organization, gut microbiome and intestinal responses to long-term immunosuppression and metabolic complications in transplant patients.
Brief disruption of the microbiome has age-dependent effects on morphine reward and gene expression in the medial prefrontal cortex of adolescent and adult mice
Authors: Hofford Rebecca S. , Sens Jonathon P. , Shipman Ava L. , Kimble Violet M. , Coric Christina , Meckel Katherine R. , Kiraly Drew D.
Published: January 2025

Adolescence is a critical period for the initiation of problematic drug use, which significantly increases the risk of developing substance use disorders later in life. This heightened vulnerability is partly attributed to the immaturity of the prefrontal cortex, a brain region both essential for decision-making and implicated in drug reward. During adolescence, peripheral systems, such as the gut microbiome, also undergo substantial changes. Emerging evidence suggests that disruptions to the gut microbiome can influence gene expression and drug reward behaviors in rodent models. In this study, we investigated the effects of microbiome disruption on morphine reward and prefrontal cortical gene expression in adolescent and adult mice. Using oral antibiotics to transiently disrupt the microbiome, we found that short-term antibiotic exposure reduced morphine place preference specifically in adolescent mice. In a separate cohort, we observed that antibiotic treatment altered the transcriptomic response to morphine in the medial prefrontal cortex across all age groups. Notably, the transcriptomic changes induced by antibiotics and morphine were age-specific, with distinct gene expression patterns observed in adolescents compared to adults. These findings establish a foundation for future research into the role of the gut microbiome in opioid reward and highlight potential gene pathways underlying age-dependent differences in opioid sensitivity.
Declarative Memory Through the Lens of Single-Trial Peaks in High-Frequency Power
Authors: Dede Adam J.O. , Cross Zachariah R. , Gray Samantha M. , Kelly Joseph P. , Yin Qin , Vahidi Parisa , Asano Eishi , Schuele Stephan U. , Rosenow Joshua M. , Wu Joyce Y. , Lam Sandi K. , Raskin Jeffrey S. , Lin Jack J. , McManus Olivia Kim , Sattar Shifteh , Shaikhouni Ammar , King-Stephens David , Weber Peter B. , Laxer Kenneth D. , Brunner Peter , Roland Jarod L. , Saez Ignacio , Girgis Fady , Knight Robert T. , Ofen Noa , Johnson Elizabeth L.
Published: January 2025

Declarative memory depends on the coordination of local processing, indexed by high-frequency broadband (HFB) activity, with global network organization, indexed by theta oscillations. However, theta and HFB exhibit asynchronous timing, raising the question of how results of local processing are communicated throughout the network. Using intracranial EEG in patients performing a recognition memory task, we examined this coordination across the medial temporal lobe (MTL) and prefrontal cortex (PFC). HFB peak activity was earlier in the MTL than PFC. Anchoring analyses of theta phase clustering and connectivity to HFB peaks revealed strong phase clustering locked to HFB peaks in the PFC, as well as connectivity between the PFC and MTL that predicted individual memory performance. Graph analysis revealed specific connections amidst sparse network connectivity during memory success. This study demonstrates that transient brain states linked to internal physiological events support memory and refines our understanding of local and network-level process interactions.

Highlights

Memory-linked theta activity is time-locked to internal brain events

Network connectivity changes dynamically during memory processing

Sparse network connectivity supports successful memory

Specific sequences of transient states may be critical for declarative memory
Estimating the clinical and economic burden of medically attended influenza in South Korea, stratified by age and comorbidity: A five-season hospital-based surveillance data, 2014/15-2018/19
Authors: Choi Min Joo , Choi Won Suk , Song Joon Young , Cheong Hee Jin , Noh Ji Yun , Wie Seong-Heon , Lee Jin Soo , Lee Jacob , Kim Hyo Youl , Kim Shin-Woo , Park Kyong-Hwa , Kim Woo Joo
Published: January 2025

Objectives

To estimate the nationwide clinical and economic burden of influenza across five seasons (2014/15–2018/19) in South Korea, stratified by age and comorbidity, using data from the Hospital-based Influenza Morbidity & Mortality (HIMM) surveillance network.

Methods

Data were collected from eight university hospitals, including adults (≥20 years) with laboratory-confirmed influenza. The catchment population was calculated using hospital and national statistical data. Economic costs were evaluated from a societal perspective.

Results

During the study period, the incidence per 100,000 persons of medically attended influenza occurrence ranged from 113.1 to 220.7, with hospitalization at 35.5 to 76.8, intensive care unit admission at 4.2 to 9.2, and deaths at 1.4 to 3.6 among the adult population. The total socioeconomic costs ranged from $156 to $316 million annually, primarily due to indirect costs associated with early death, peaking during the 2017/18 season, which had the largest outbreak scale, particularly among older adults. In contrast, the per capita average costs, ranging from $2,747 to $4,072, were highest in the 2018/19 season, followed by the 2015/16 season. For at-risk individuals, the per capita average socioeconomic costs were 1.5–2.3 times higher than that of the general adult population.

Conclusions

Influenza poses a substantial economic burden in South Korea. Additional strategies are needed to alleviate morbidity and mortality in older adults and to protect at-risk individuals who are not currently covered by the National Immunization Program.
Sexual dimorphism in human muscle ageing
Authors: Fieldsend Thomas W. , O’Neill Callum R. , Shrivastava Akshita , Ogden Helen E. , Dand Nick , Hughes Simon M.
Published: January 2025

Sex differences in human muscle strength, size, and quality are well characterised, but their alteration with age is less clear. Here we report a novel and striking sexual dimorphism in arm muscle ageing in 478,438 UK Biobank participants aged 40–82 yr. While there was a modest sex difference in age-related strength decline, muscle mass loss was considerably more pronounced in males, both in absolute and percentage terms. We also introduce a novel measure of muscle quality, which showed substantially greater age-related decline in females. These trends held across independent analyses of separate cross-sectional and longitudinal participant groups, and persisted after accounting for systematic size differences between the sexes. Furthermore, sex differences were apparent irrespective of female menopause status or HRT usage history. Defining sarcopenia on the basis of muscle mass is therefore inappropriate, particularly for females. Our findings demonstrate that sex-specific criteria based on muscle function, not mass, should be used to diagnose sarcopenia, and prompt consideration of sex-specific interventions.
The Future of HIV: Challenges in meeting the 2030Ending the HIV Epidemic in the U.S. (EHE)reduction goal
Authors: Bleichrodt Amanda M , Okano Justin T , Fung Isaac Ch , Chowell Gerardo , Blower Sally
Published: January 2025

Objective(s)

To predict the burden of HIV in the United States (US) nationally and by region, transmission type, and race/ethnicity through 2030.

Methods

Using publicly available data from the CDC NCHHSTPAtlasPlusdashboard, we generated 11-year prospective forecasts of incident HIV diagnoses nationally and by region (South, non-South), race/ethnicity (White, Hispanic/Latino, Black/African American), and transmission type (Injection-Drug Use, Male-to-Male Sexual Contact (MMSC), and Heterosexual Contact (HSC)). We employed weighted (W) and unweighted (UW)n-sub-epidemic ensemble models, calibrated using 12 years of historical data (2008-2019), and forecasted trends for 2020-2030. We compared results to identify persistent, concerning trends across models.

Results

We projected substantial decreases in incident HIV diagnoses nationally (W: 27.9%, UW: 21.9%), and in the South (W:18.0%, UW: 9.2%) and non-South (W: 21.2%, UW: 19.5%) from 2019 to 2030. However, concerning non-decreasing trends were observed nationally in key sub-populations during this period: Hispanic/Latino persons (W: 1.4%, UW: 2.6%), Hispanic/Latino MMSC (W: 9.0%, UW: 9.9%), people who inject drugs (PWID) (W: 25.6%, UW: 9.2%), and White PWID (W: 3.5%, UW: 44.9%). The rising trends among Hispanic/Latino MMSC and overall PWID were consistent across the South and non-South regions.

Conclusions

Although the forecasted national-level decrease in the number of incident HIV diagnoses is encouraging, the US is unlikely to achieve theEnding the HIV Epidemic in the U.S.goal of a 90% reduction in HIV incidence by 2030. Additionally, the observed increases among specific subpopulations highlight the importance of a targeted and equitable approach to effectively combat HIV in the US.
What adults in rural South Asia eat and when they eat it: evidence from Bangladesh, India, and Nepal
Authors: Scott Samuel , Patwardhan Sharvari , Ruel Marie , Chakrabarti Suman , Neupane Sumanta , Manohar Swetha , Moursi Mourad , Menon Purnima
Published: January 2025

Background

Poor diets pose a threat to all forms of malnutrition and diet-related noncommunicable diseases (NCDs). Data on dietary patterns are scarce in South Asia.

Objectives

We sought to describe overall diet quality, intake of foods and food groups, and eating occasions among adults in rural South Asia.

Methods

Data were from five districts across Bangladesh (n=2,802 individuals), India (n=1,672), and Nepal (n=1,451). The Global Diet Quality Score (GDQS) application was used to measure intake of foods on the previous day, with each food tagged to an eating occasion. Diet quality and the risk of diet-related noncommunicable diseases (NCDs) were described using GDQS total (0–49), GDQS positive (0–32) and GDQS negative (0–17) metrics for overall, healthy, and unhealthy food intake respectively.

Results

Diet quality was low, with similar scores across countries for GDQS total (17-19 depending on country), GDQS positive (7–8) and GDQS negative (10–12), indicating low intake of healthy foods as the main contributor to poor diets. Over 90% of adults had levels of GQDS scores associated with moderate/high risk for diet-related NCDs, with the proportion at high risk in Bangladesh being 2-3x higher than other countries. Across sites, intake of refined grains (white rice), sweets (sugar, biscuits), and white tubers (potatoes) was common. One-third of adults did not eat breakfast in Nepal, and snacking was twice as common in males (63%) versus females (33%) in Bangladesh.

Conclusions

These findings highlight the need to improve diets in rural South Asia and may help inform interventions targeting food intake patterns.