bluuebunny/crossref_metadata_2025 huggingface dataset:
A Reciprocal Relationship between Formal and Informal Social Engagement and Handgrip Strength of Older Adults in South Korea
Authors: Son Joonmo , Sung Pildoo
Published: July 2024

Introduction: The relationship between social engagement and handgrip strength has been underexplored. Further, no prior research examined a plausible reciprocal association between them. Methods: The study employed the seven waves of data (2006–2018) from the Korean Longitudinal Study of Aging (KLoSA) survey (7,927 respondents, mean age: 59 years old at wave 1 [71 years old at wave 7], women: 58%). It used ML-SEM, a cross-lagged panel model with fixed effects fitted by structural equation modeling with maximum likelihood estimation. In particular, the ML-SEM examined whether a reciprocal relationship existed between formal social engagement (number of association memberships and frequency of organizational activities)/informal social engagement (frequency of contact with familiar persons) and handgrip strength (the average of the four dynamometer measurements). Results: The empirical analyses identified a systematic reciprocal association between formal social engagement and handgrip strength. Specifically, formal social engagement was positively associated with handgrip strength over time (the number of association memberships standardized coefficient: 0.012*, the frequency of organizational activities standardized coefficient: 0.022***). Conversely, handgrip strength was positively related to the number of memberships (the handgrip strength standardized coefficient: 0.025*) and the frequency of organizational activities (the handgrip strength standardized coefficient: 0.042**). Conclusion: The study thus supports the social causation proposition that formal social engagement in and through diverse associations may be positively associated with handgrip strength. It also validates the health selection argument that handgrip strength may increase the likelihood of formal social engagement.
“Immunocytochemistry in Cytology: Myth or Reality”: Unraveling the Myth – Immunocytochemistry Applications in Thyroid Lesions
Authors: Hirokawa Mitsuyoshi , Suzuki Ayana
Published: July 2024

Background: Fine-needle aspiration cytology serves as an important preoperative diagnostic tool for thyroid nodules. Despite its excellent diagnostic accuracy, diagnoses based solely on morphological observation can be challenging. Therefore, various ancillary diagnostic techniques have been applied, including immunocytochemistry (ICC). This review discusses the application and evaluation of ICC in thyroid fine needle aspiration. Summary: Currently, three immunostaining preparation methods are available for cytological materials: liquid-based cytology, cell block, and cell transfer. ICC proves valuable in scenarios such as tumour diagnosis, assessment of differentiation and grading of carcinomas, estimation of primary organs in metastatic carcinomas, and detection of gene abnormalities. However, ICC, while useful, is not as accurate as immunohistochemistry and is more difficult to evaluate. Key Messages: If the pitfalls and limitations are understood and effectively navigated, ICC could play a significant role in decreasing the non-diagnostic rate, thus leading to more accurate and valuable diagnoses and reductions in the re-aspiration rate.
Association between Physical Activity and Parkinson’s Disease: A Prospective Cohort Study
Authors: Zhang Qilu , Shi Mengyao , Zhang Jing , Yin Xiangyan , Chen Yi , Wang Xiaoxiao , Zhang Yonghong
Published: July 2024

Background: The burden of Parkinson’s disease (PD) is still increasing, and physical activity is a modifiable factor for health benefits. The benefits of physical activity in PD are not well established. Therefore, this study aimed to investigate the association between various types of physical activity and the risk of developing PD. Methods: Data from 432,497 participants in UK Biobank, who were free of PD at baseline, were analyzed. Physical activity levels were assessed by measuring the duration of walking for pleasure, light and heavy do-it-yourself (DIY) activities, strenuous sports, and other exercises. Physical activity was categorized into daily living activities (walking for pleasure, light DIY, and heavy DIY) and structured exercises (strenuous sports and other exercises). Association between different types of physical activity and PD risk was examined using multivariable adjusted restricted cubic splines and Cox proportional risk models. Results: Over a median follow-up of 13.7 years, 2,350 PD cases were identified. Cubic spline analyses revealed negative linear associations between PD risk and total physical activity, daily living activities, and structured exercise. After multivariable adjustment, the hazard ratios and 95% confidence intervals for incident PD associated with the highest quartile of total physical activity, daily living activities, and structured exercise were 0.72 (0.64–0.81), 0.75 (0.67–0.84), and 0.78 (0.67–0.90), respectively, compared to those in the lowest quartile. Sensitivity analysis confirmed these findings. Conclusions: Higher levels of both daily living activities and structured exercise were associated with a reduced incidence of PD, underscoring the importance of maintaining physical activity to prevent PD.
One-Year Outcomes of Transseptal Mitral Valve-in-Valve in Intermediate Surgical Risk Patients
Authors: Malaisrie S. Chris , Guerrero Mayra , Davidson Charles , Williams Mathew , de Brito Fábio Sândoli , Abizaid Alexandre , Shah Pinak , Kaneko Tsuyoshi , Poon Karl , Levisay Justin , Yu Xiao , Pibarot Philippe , Hahn Rebecca T. , Blanke Philipp , Leon Martin B. , Mack Michael J. , Zajarias Alan ,   on behalf of the PARTNER 3 Mitral Valve-in-Valve Study Investigators
Published: July 2024

BACKGROUND:

Transcatheter mitral valve-in-valve replacement offers a less-invasive alternative for high-risk patients with bioprosthetic valve failure. Limited experience exists in intermediate-risk patients. We aim to evaluate 1-year outcomes of the PARTNER 3 mitral valve-in-valve study.

METHODS:

This prospective, single-arm, multicenter study enrolled symptomatic patients with a failing mitral bioprosthesis demonstrating greater than or equal to moderate stenosis and regurgitation and Society of Thoracic Surgeons score ≥3% and <8%. A balloon-expandable transcatheter heart valve (SAPIEN 3, Edwards Lifesciences) was used via a transeptal approach. The primary end point was the composite of all-cause mortality and stroke at 1 year.

RESULTS:

A total of 50 patients from 12 sites underwent mitral valve-in-valve from 2018 to 2021. The mean age was 70.1±9.7 years, mean Society of Thoracic Surgeons score was 4.1%±1.6%, and 54% were female. There were no primary end point events (mortality or stroke) through 1 year, and no left-ventricular outflow tract obstruction, endocarditis, or mitral valve reintervention was reported. Six patients (12%) required rehospitalization, including heart failure (n=2), minor procedural side effects (n=2), and valve thrombosis (n=2; both resolved with anticoagulation). An additional valve thrombosis was associated with no significant clinical sequelae. From baseline to 1 year, all subjects with available data had none/trace or mild (grade 1+) mitral regurgitation and the New York Heart Association class improved in 87.2% (41/47) of patients.

CONCLUSIONS:

Mitral valve-in-valve with a balloon-expandable valve via transseptal approach in intermediate-risk patients was associated with improved symptoms and quality of life, adequate transcatheter valve performance, and no mortality or stroke at 1-year follow-up.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03193801.
HERMES-24 Score Derivation and Validation for Simple and Robust Outcome Prediction After Large Vessel Occlusion Treatment
Authors: Tanaka Koji , Brown Scott , Goyal Mayank , Menon Bijoy K. , Campbell Bruce C.V. , Mitchell Peter J. , Jovin Tudor G. , Saver Jeffrey L. , Muir Keith W. , White Phil M. , Bracard Serge , Guillemin Francis , Roos Yvo B.W.E.M. , van Zwam Wim H. , Najm Mohamed , Dowlatshahi Dar , Hill Michael D. , Demchuk Andrew M. ,   on behalf of the HERMES Collaborators
Published: July 2024

BACKGROUND:

Clinicians need simple and highly predictive prognostic scores to assist practical decision-making. We aimed to develop a simple outcome prediction score applied 24 hours after anterior circulation acute ischemic stroke treatment with endovascular thrombectomy and validate it in patients treated both with and without endovascular thrombectomy.

METHODS:

Using the HERMES (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials) collaboration data set (n=1764), patients in the endovascular thrombectomy arm were divided randomly into a derivation cohort (n=430) and a validation cohort (n=441). From a set of candidate predictors, logistic regression modeling using forward variable selection was used to select a model that was both parsimonious and highly predictive for modified Rankin Scale (mRS) ≤2 at 90 days. The score was validated in validation cohort, control arm (n=893), and external validation cohorts from the ESCAPE-NA1 (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischaemic Stroke; n=1066) and INTERRSeCT (Identifying New Approaches to Optimize Thrombus Characterization for Predicting Early Recanalization and Reperfusion With IV Alteplase and Other Treatments Using Serial CT Angiography; n=614).

RESULTS:

In the derivation cohort, we selected 2 significant predictors of mRS ≤2 (National Institutes of Health Stroke Scale score at 24 hours and age [β-coefficient, 0.34 and 0.06]) and derived the HERMES-24 score: age (years)/10+National Institutes of Health Stroke Scale score at 24 hours. The HERMES-24 score was highly predictive for mRS ≤2 (c-statistic 0.907 [95% CI, 0.879–0.935]) in the derivation cohort. In the validation cohort and the control arm, the HERMES-24 score predicts mRS ≤2 (c-statistic, 0.914 [95% CI, 0.886–0.944] and 0.909 [95% CI, 0.887–0.930]). Observed provability of mRS ≤2 ranged between 3.1% and 3.4% when HERMES-24 score ≥25, while it ranged between 90.6% and 93.0% when HERMES-24 score <10 in the derivation cohort, validation cohort, and control arm. The HERMES-24 score also showed c-statistics of 0.894 and 0.889 for mRS ≤2 in the ESCAPE-NA1 and INTERRSeCT populations.

CONCLUSIONS:

The post-treatment HERMES-24 score is a simple validated score that predicts a 3-month outcome after anterior circulation large vessel occlusion stroke regardless of intervention, which helps prognostic discussion with families on day 2.
Interhospital Transfer for Endovascular Stroke Treatment in Canada: Results From the OPTIMISE Registry
Authors: Katsanos Aristeidis H. , Poppe Alexandre , Swartz Rick H. , Mandzia Jennifer , Catanese Luciana , Shankar Jai , Yip Samuel , Verreault Steve , Medvedev George , Maran Ilavarasy , Legault Catherine , Ferguson Darren , Archer Brian , Bharatha Aditya , Volders David , Kelly Michael , Carpani Federico , Pikula Aleksandra , Tkach Alexander , Moreau Francois , Beaudry Michel , Appireddy Ramana , Deshmukh Aviraj , Almekhlafi Mohammed , Fahed Robert , Kamal Noreen , Menon Bijoy , Shoamanesh Ashkan , Williams Heather , Yu Amy Y.X. , Heran Manraj K.S. , Hill Michael D. , Sharma Mukul , Earl Karen , Demchuk Andrew M. , Stotts Grant
Published: July 2024

BACKGROUND:

Interhospital transfer for patients with stroke due to large vessel occlusion for endovascular thrombectomy (EVT) has been associated with treatment delays.

METHODS:

We analyzed data from Optimizing Patient Treatment in Major Ischemic Stroke With EVT, a quality improvement registry to support EVT implementation in Canada. We assessed for unadjusted differences in baseline characteristics, time metrics, and procedural outcomes between patients with large vessel occlusion transferred for EVT and those directly admitted to an EVT-capable center.

RESULTS:

Between January 1, 2018, and December 31, 2021, a total of 6803 patients received EVT at 20 participating centers (median age, 73 years; 50% women; and 50% treated with intravenous thrombolysis). Patients transferred for EVT (n=3376) had lower rates of M2 occlusion (22% versus 27%) and higher rates of basilar occlusion (9% versus 5%) compared with those patients presenting directly at an EVT-capable center (n=3373). Door-to-needle times were shorter in patients receiving intravenous thrombolysis before transfer compared with those presenting directly to an EVT center (32 versus 36 minutes). Patients transferred for EVT had shorter door-to-arterial access times (37 versus 87 minutes) but longer last seen normal-to-arterial access times (322 versus 181 minutes) compared with those presenting directly to an EVT-capable center. No differences in arterial access-to-reperfusion times, successful reperfusion rates (85% versus 86%), or adverse periprocedural events were found between the 2 groups. Patients transferred to EVT centers had a similar likelihood for good functional outcome (modified Rankin Scale score, 0–2; 41% versus 43%; risk ratio, 0.95 [95% CI, 0.88–1.01]; adjusted risk ratio, 0.98 [95% CI, 0.91–1.05]) and a higher risk for all-cause mortality at 90 days (29% versus 25%; risk ratio, 1.15 [95% CI, 1.05–1.27]; adjusted risk ratio, 1.14 [95% CI, 1.03–1.28]) compared with patients presenting directly to an EVT center.

CONCLUSIONS:

Patients transferred for EVT experience significant delays from the time they were last seen normal to the initiation of EVT.
Effect of Stroke Etiology on Endovascular Treatment for Acute Basilar-Artery Occlusion: A Post Hoc Analysis of the ATTENTION Randomized Trial
Authors: Yuan Guangxiong , Nguyen Thanh N. , Liu Lei , Li Rui , Xia Hong , Long Chen , Wu Junxiong , Xu Jun , Huang Feng , He Bo , Wu Derong , Wang Hailing , Feng Can , Liang Yong , Zhou Xianghong , Xiao Zhenhua , Luo Li , Hu Yanjuan , Liu Bin , Peng Weibo , Zhang Chao , Cui Tao , Zhao Gaoshan , Xu Lihua , Ma Gaoting , Hu Wei ,   for the ATTENTION Investigators
Published: July 2024

BACKGROUND:

Stroke etiology could influence the outcomes in patients with basilar-artery occlusion (BAO). This study aimed to evaluate the differences in efficacy and safety of best medical treatment (BMT) plus endovascular treatment (EVT) versus BMT alone in acute BAO across different stroke etiologies.

METHODS:

The study was a post hoc analysis of the ATTENTION trial (Trial of Endovascular Treatment of Acute Basilar-Artery Occlusion), which was a multicenter, randomized trial at 36 centers in China from February 2021 to September 2022. Patients with acute BAO were classified into 3 groups according to stroke etiology (large-artery atherosclerosis [LAA], cardioembolism, and undetermined cause/other determined cause [UC/ODC]). The primary outcome was a favorable outcome (modified Rankin Scale score of 0–3) at 90 days. Safety outcomes included symptomatic intracranial hemorrhage and 90-day mortality.

RESULTS:

A total of 340 patients with BAO were included, 150 (44.1%) had LAA, 72 (21.2%) had cardioembolism, and 118 (34.7%) had UC/ODC. For patients treated with BMT plus EVT and BMT alone, respectively, the rate of favorable outcome at 90 days was 49.1% and 23.8% in the LAA group (odds ratio, 3.08 [95% CI, 1.38–6.89]); 52.2% and 30.8% in the cardioembolism group (odds ratio, 2.45 [95% CI, 0.89–6.77]); and 37.5% and 17.4% in the UC/ODC group (odds ratio, 2.85 [95% CI, 1.16–7.01]), with
P
=0.89 for the stroke etiology×treatment interaction. The rate of symptomatic intracranial hemorrhage in EVT-treated patients with LAA, cardioembolism, and UC/ODC was 8.3%, 2.2%, and 3.2%, respectively, and none of the BMT-treated patients. Lower 90-day mortality was observed in patients with EVT compared with BMT alone across 3 etiology groups.

CONCLUSIONS:

Among patients with acute BAO, EVT compared with BMT alone might be associated with favorable outcomes and lower 90-day mortality, regardless of cardioembolism, LAA, or UC/ODC etiologies. The influence of stroke etiology on the benefit of EVT should be explored by further trials.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04751708.
Functional connectivity across the human subcortical auditory system using an autoregressive matrix-Gaussian copula graphical model approach with partial correlations
Authors: Chandra Noirrit Kiran , Sitek Kevin R. , Chandrasekaran Bharath , Sarkar Abhra
Published: July 2024

The auditory system comprises multiple subcortical brain structures that process and refine incoming acoustic signals along the primary auditory pathway. Due to technical limitations of imaging small structures deep inside the brain, most of our knowledge of the subcortical auditory system is based on research in animal models using invasive methodologies. Advances in ultrahigh-field functional magnetic resonance imaging (fMRI) acquisition have enabled novel noninvasive investigations of the human auditory subcortex, including fundamental features of auditory representation such as tonotopy and periodotopy. However, functional connectivity across subcortical networks is still underexplored in humans, with ongoing development of related methods. Traditionally, functional connectivity is estimated from fMRI data with full correlation matrices. However, partial correlations reveal the relationship between two regions after removing the effects of all other regions, reflecting more direct connectivity. Partial correlation analysis is particularly promising in the ascending auditory system, where sensory information is passed in an obligatory manner, from nucleus to nucleus up the primary auditory pathway, providing redundant but also increasingly abstract representations of auditory stimuli. While most existing methods for learning conditional dependency structures based on partial correlations assume independently and identically Gaussian distributed data, fMRI data exhibit significant deviations from Gaussianity as well as high-temporal autocorrelation. In this paper, we developed an autoregressive matrix-Gaussian copula graphical model (ARMGCGM) approach to estimate the partial correlations and thereby infer the functional connectivity patterns within the auditory system while appropriately accounting for autocorrelations between successive fMRI scans. Our results show strong positive partial correlations between successive structures in the primary auditory pathway on each side (left and right), including between auditory midbrain and thalamus, and between primary and associative auditory cortex. These results are highly stable when splitting the data in halves according to the acquisition schemes and computing partial correlations separately for each half of the data, as well as across cross-validation folds. In contrast, full correlation-based analysis identified a rich network of interconnectivity that was not specific to adjacent nodes along the pathway. Overall, our results demonstrate that unique functional connectivity patterns along the auditory pathway are recoverable using novel connectivity approaches and that our connectivity methods are reliable across multiple acquisitions.
A nomenclatural and taxonomic review of the names and new combinations published between 1881 and 1930 in the genus Kitchingia, basionym of Kalanchoe subg. Kitchingia (Crassulaceae subfam. Kalanchooideae), by John Gilbert Baker (1834–1920), Otto Stapf (1857–1933), and Alwin Berger (1871–1931)
Authors: SMITH GIDEON F.
Published: July 2024

During a long career as a botanist in the Herbarium of the Royal Botanic Gardens, Kew, United Kingdom, John Gilbert Baker (1834–1920) described one new genus, Kitchingia, in Crassulaceae subfam. Kalanchooideae, and eight species in this genus. He in addition published a new combination in Kitchingia for a species originally published in Kalanchoe. Otto Stapf (1857–1933), Austrian-born Kew botanist, described one new species of Kitchingia, and Alwin Berger (1871–1931), the German-born succulent plant expert, published two new combinations in Kitchingia. The genus Kitchingia was in the past variously upheld in Crassulaceae subfam. Kalanchooideae, but is today recognised in Kalanchoe at the rank of subgenus, as Kalanchoe subg. Kitchingia. The nomenclature and taxonomy of the names published in or transferred to Kitchingia by Baker, Stapf, and Berger are reviewed and discussed in a historical context. Where necessary, the names are typified.
New synonyms and lectotypifications in Sida (Malvaceae-Malveae) reveal the first record and extension of the distribution area of Sida maculata to Brazil
Authors: BARACHO GEORGE SIDNEY , AGRA MARIA DE FÁTIMA
Published: July 2024

New synonyms and lectotypes in Sida sect. Cordifoliae (Malvaceae, Malveae) are proposed here and reveal the first record and extension of the distribution area of Sida maculata to the Brazilian semi-arid region. The species was first described in the 18th century for the Caribbean islands of Cuba and the Dominican Republic and for a long time was confused with S. cordifolia, from which it is unquestionably distinct in its leaves, inflorescences and flowers. In Brazil, S. maculata is widely distributed from Maranhão to the north of Minas Gerais and was identified for almost a century in herbaria and local floristic treatments as S. galheirensis. Discussions and photographs of types of S. maculata and related taxa are presented, as well as an updated map of the species’ geographical distribution.
Measurement Properties of Two Questionnaires Assessing Fear-Avoidance in Patients With Chronic Low Back Pain
Authors: Martins Silva Gabriela Zuelli , de Lira Mariana Romano , Garcêz Luiz Ricardo , George Steven Z. , Neblett Randy , Pezolato Adriano , Lima Thamiris Costa , Chaves Thais Cristina
Published: July 2024

The Fear-Avoidance Components Scale (FACS) and the Fear of Daily Activities Questionnaire (FDAQ) assess fear-avoidance model components. However, the questionnaires are not available in Brazilian Portuguese. This study aimed to translate the original English FACS and FDAQ into Brazilian (Br) Portuguese and assess their measurement properties in patients with Chronic Low Back Pain (CLBP). One hundred thirty volunteers with CLBP participated in this study. Structural validity, internal consistency, test-retest reliability, and hypothesis testing for construct validity were analyzed. Results indicated a 2-factor solution for the FACS-Br, while the FDAQ-Br had a one-factor solution. Internal consistency showed acceptable Cronbach’s alpha (alpha >.8). Suitable reliability was found for the FDAQ-Br (Intraclass Correlation Coefficient [ICC] = .98). For both FACS-Br factors, suitable reliability was found as well (ICC = .95 and .94). Hypothesis testing for construct validity confirmed more than 75% of the hypotheses proposed a priori for the FACS maladaptive pain/movement-related beliefs domain and the FDAQ-Br. In conclusion, the FACS-Br and FDAQ-Br demonstrated acceptable reliability, internal consistency, and structural validity measurement properties and their correlation (r < .50) suggests that the tools are not interchangeable measures.
The role of moral integrity in the association between moral self and moral sensitivity among nurses: A mediation model
Authors: Ne’eman-Haviv Vered , Blau Ayala , Ofri Lani
Published: July 2024

Aim: This study aimed to investigate the relationship between moral self, moral integrity, and moral sensitivity in decision-making among nurses. Background: nurses face moral dilemmas almost on a daily basis. Studies have demonstrated that nurses with high moral sensitivity make thoughtful decisions and exhibit professional responsibility. The current study seeks to examine personality variables that may be related to moral sensitivity among nurses. Design: A cross-sectional study. Ethical considerations: This study was approved by the IRB of the authors University’s ethics committee (number: AU-HEA-LO-20220317). Written consent was obtained from all participants. Methods: A structured questionnaires were administered to a sample of 187 Israeli nurses. Results: The degree of nurses’ moral self, moral integrity and moral sensitivity was relatively high. “Patient-centered care” was found to be the most significant component of moral sensitivity. The next component is “Using knowledge bases,” followed by “Exercising professional judgment.” While the concept of patient-centered care was found to be related to the nurses’ moral self, the other components were found to be related to their moral integrity. The mediation model found that moral integrity mediates and even strengthens the moral self in its connection with moral sensitivity. Conclusions: Understanding the role of moral self and moral integrity in explaining moral sensitivity, can contribute to achieving a desirable combination of “the good and the right” in nursing practice, thereby enhancing nurses’ work. From a practical perspective, these findings are also relevant to nursing education. Nursing education plays a pivotal role in fostering moral and ethical decision-making in both clinical aspects and ethical moral sensitivity. Strengthening the moral self and moral integrity among nursing students can aid in making balanced and morally sensitive decisions while also building moral and ethical support systems to assist students in distressing and emergency situations.
Longitudinal Analysis of Cancer Family Caregiver Perception of Sleep Difficulty During Home Hospice
Authors: Hull William , Donaldson Gary , Cloyes Kristin G. , Ellington Lee , Lee Kathryn , Mooney Kathleen
Published: July 2024

Background

Sleep difficulty in caregivers is associated with poor physical and psychological outcomes. The purpose of this study was to describe family caregivers’ perception of sleep difficulty through the hospice trajectory after a cancer diagnosis as predicted by age, sex, self-report of anxiety or depression, and cohabitation.

Methods

We conducted a secondary analysis of longitudinal data using multilevel modeling with nested model comparisons. Beginning with an unconditional growth model, predictors were added to nested models to test differential impact.

Results

Caregivers (n = 164) were predominately white (n = 160; 97%) and female (n = 113, 69%). We hypothesized that age, sex, history of anxiety or depression, and cohabitation would predict sleep difficulty. The cohabitation predictor model was a statistically significant model for caregiver perception of sleep difficulty that worsened throughout hospice caregiving ( b = .184, [Formula: see text]2 = 7.199, P = 0.027) but age, sex, and history of depression or anxiety did not improve model fit.

Conclusion

Our findings indicate that family caregivers who cohabitate exhibit increased perception of sleep difficulty over the course of hospice. Future studies and interventions for hospice family caregivers’ sleep should consider cohabitation between the patient and the caregiver as a significant predictor of sleep difficulty to observe and potentially mediate the negative outcomes associated with caregiver sleep difficulty. Further, determining the underlying reasons for sleep difficulty in cohabitation (e.g., patient symptoms or treatments) should be explored.
Efferent pathways from the suprachiasmatic nucleus to the horizontal limbs of diagonal band promote NREM sleep during the dark phase in mice
Authors: Chen Lei , Chen Changfeng , Jin Qiaoling , Liang Yue , Wu Jian , Zhang Pingping , Cheng Juan , Wang Liecheng
Published: July 2024

The regulation of circadian rhythms and the sleep–wake states involves in multiple neural circuits. The suprachiasmatic nucleus (SCN) is a circadian pacemaker that controls the rhythmic oscillation of mammalian behaviors. The basal forebrain (BF) is a critical brain region of sleep–wake regulation, which is the downstream of the SCN. Retrograde tracing of cholera toxin subunit B showed a direct projection from the SCN to the horizontal limbs of diagonal band (HDB), a subregion of the BF. However, the underlying function of the SCN–HDB pathway remains poorly understood. Herein, activation of this pathway significantly increased non–rapid eye movement (NREM) sleep during the dark phase by using optogenetic recordings. Moreover, activation of this pathway significantly induced NREM sleep during the dark phase for first 4 h by using chemogenetic methods. Taken together, these findings reveal that the SCN–HDB pathway participates in NREM sleep regulation and provides direct evidence of a novel SCN-related pathway involved in sleep–wake states regulation.
Clinical outcomes of conjunctivochalasis treatment with a new ophthalmic radiofrequency device
Authors: Kim Bokyung , Lee Yongwoo , Son Hyeck-Soo , Choi Chul Young
Published: July 2024

Purpose

To investigate the safety and efficacy of a new micro-controlled radiofrequency device for treatment of conjunctivochalasis (Cch).

Methods

Data of 127 patients (230 eyes) who underwent ophthalmic radiofrequency treatment for Cch from January 2020 to June 2023 were analyzed retrospectively. Cch coagulation was performed with a radiofrequency electrode tip (OcuRF®, Ilooda, Korea) and a high-frequency radio-wave electric unit (0.6 ~ 0.8 watts, 2 MHz, Acutron™, Ilooda, Korea). Pre- and postoperative Cch grading, slit-lamp photography, tear film break-up time (TBUT), and bulbar conjunctival hyperemia using Keratograph 5 M (Oculus, Wetzlar, Germany) were evaluated. Cch grade 0 or 1 after surgery was regarded as ‘success’. Complications, recurrence, and additional treatment rates were analyzed.

Results

In 227 (98.7%) eyes, the radiofrequency treatment led to marked improvement of Cch, with 224 (97.4%) eyes achieving grade 0 or 1 at 2 months postoperatively. Eight eyes (3.5%) received additional treatment. TBUT improved from 3.17 ± 0.82 s to 5.28 ± 1.10 s after surgery (P < 0.001). The total bulbar conjunctival hyperemia value showed an improvement from 1.7 ± 0.6 to 1.4 ± 0.6 postoperatively (P < 0.05). No serious complications were observed.

Conclusion

The novel ophthalmic radiofrequency device led to a marked improvement of Cch with no serious adverse events during the entire follow-up period. Our results suggest that the radiofrequency device presents a safe and efficacious treatment option for Cch.
Early intraocular lens explantations: 10-year database analysis
Authors: Friedrich Maximilian , Son Hyeck-Soo , Hassel Oliver , Teich Lilly , Augustin Victor Aristide , Khoramnia Ramin , Auffarth Gerd Uwe , Yildirim Timur Mert
Published: July 2024

Background

The aim of this study was to analyze the causes and characteristics of IOL explantation within the first year after primary implantation.

Methods

In this retrospective, cross sectional database study, a database consisting of over 2500 IOL explants sent from 199 national and international doctors over the past 10 years was analyzed. All IOLs explanted within the first year after implantation were included in this analysis. Explants with insufficient information as well as phakic and Add-on IOLs were excluded. Main outcome measures were the reason for explantation, the time between implantation and explantation, as well as IOLs’ and patients’ characteristics. Additionally, the explanted IOLs were microscopically and histologically analyzed, as required.

Results

Of all explanted IOLs from the database, 1.9% (n = 50) were explanted within the first year after implantation. The most frequent reasons for early IOL explantation were IOL dislocation (32%), visual intolerance (26%), opacification (20%), and intraoperative complications (16%). The time between implantation and explantation was the shortest in cases with intraoperative complications (1.5 ± 3.1 days), followed by IOL dislocation (90.9 ± 103.9 days), visual intolerance (98.3 ± 86.5 days), opacifications (253.5 ± 124.0 days) and other indications (249.7 ± 124.0 days). Calcification of hydrophilic IOLs was the main type of opacification (80%). Notably, seven IOLs required immediate intraoperative exchange due to an intraoperative crack in the optic or a torn off haptic.

Conclusion

Indications for early IOL explantation were IOL dislocation, visual intolerance, opacification, and intraoperative complications. Especially intraoperative damages to the IOL and early calcification show a potential for improvement of affected IOLs and implantation systems.
A longitudinal examination of the measurement properties and invariance of the Sleep Condition Indicator in Chinese healthcare students
Authors: Meng Runtang , Ying Yiwei , Luo Yi , Huang Mengyi , Miller Christopher B. , Xie Yuhuan , Jia Yuxin , Fan Lianxia , Chen Wukang , Yi Jiayu , Yang Nongnong , Xu Jiale , Jiang Chen , Lu Liping , Ma Haiyan , Spruyt Karen , Lau Esther Yuet Ying
Published: July 2024

Background

The Sleep Condition Indicator (SCI), an insomnia measurement tool based on the updated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria with sound psychometric properties when applied in various populations, was evaluated here among healthcare students longitudinally, to demonstrate its measurement properties and invariance in this particularly high-risk population.

Methods

Healthcare students of a Chinese university were recruited into this two-wave longitudinal study, completing the simplified Chinese version of the SCI (SCI-SC), Chinese Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration (RU_SATED-C) scale, Chinese Patient Health Questionnaire-4 (PHQ-4-C), and sociodemographic variables questionnaire (Q-SV) between September and November 2022. Structural validity, measurement invariance (MI), convergent and discriminant validity, internal consistency, and test–retest reliability of the SCI-SC were examined. Subgroups of gender, age, home location, part-time job, physical exercise, and stress-coping strategy were surveyed twice to test cross-sectional and longitudinal MI.

Results

We identified 343 valid responses (62.9% female, mean age = 19.650 ± 1.414 years) with a time interval of seven days. The two-factor structure was considered satisfactory (comparative fit index = 0.953–0.989, Tucker–Lewis index = 0.931–0.984, root means square error of approximation = 0.040–0.092, standardized root mean square residual = 0.039–0.054), which mostly endorsed strict invariance except for part-time job subgroups, hence establishing longitudinal invariance. The SCI-SC presented acceptable convergent validity with the RU_SATED-C scale (r ≥ 0.500), discriminant validity with the PHQ-4-C (0.300 ≤ r < 0.500), internal consistency (Cronbach’s alpha = 0.811–0.835, McDonald’s omega = 0.805–0.832), and test–retest reliability (intraclass correlation coefficient = 0.829).

Conclusion

The SCI-SC is an appropriate screening instrument available for assessing insomnia symptoms among healthcare students, and the promising measurement properties provide additional evidence about validity and reliability for detecting insomnia in healthcare students.
Compliance with tobacco advertising and promotion laws at points-of-sale in Ethiopia: an observational study in 10 cities
Authors: Deressa Wakgari , Hirpa Selamawit , Argefa Terefe Gelibo , Kifle Awgichew , Kassa Selam Abraham , Kitonyo-Devotsu Rachel , Awuor Winnie , Mdege Noreen Dadirai
Published: July 2024

Background

Ethiopia enacted a comprehensive tobacco control law in 2019, which bans tobacco advertising and promotion activities. However, compliance with these laws at points-of-sale (PoS) has not been studied, resulting in a lack of research evidence on how the regulations are implemented. The purpose of the study was to assess compliance with tobacco advertising and promotion laws at PoS in 10 cities in Ethiopia.

Methods

Multi-stage cluster sampling was used to select 1468 PoS (supermarkets, minimarkets, merchandise stores, regular shops, permanent kiosks, khat shops, street vendors, and food and drink wholesalers). Data were collected using standardized observational checklists. Tobacco advertising and promotion indicators were used to compute indoor and outdoor compliance. Poisson regression models with log link function and robust variance were used to assess factors associated with open display of cigarette packages and indoor non-compliance.

Results

The average indoor compliance rate was 92.9% (95% CI:92.3–93.5). Supermarkets had the highest compliance (99.7%), while permanent kiosks showed the lowest compliance (89.8%). The highest average indoor compliance was observed at PoS in Addis Ababa (98.0%). About 60% of PoS were fully compliant in indoors. Indoor open display of cigarette packages was prevalent (32.5%, 95% CI:30.0-35.1). The average outdoor compliance was 99.6% (95% CI:99.5–99.7). Outdoor full compliance was 96.5%. Open display of cigarettes was significantly higher in permanent kiosks (adjusted prevalence ratio (adjPR) 6.73; 95% CI: 3.96–11.42), regular shops (adjPR 5.16; 95% CI: 3.05–8.75), and khat shops (adjPR 2.06; 95% CI: 1.11–3.83), while indoor non-compliance was significantly higher in these same types of PoS.

Conclusions

While outdoor compliance rates were relatively high, the lower indoor compliance rates particularly due to the high prevalence of open cigarette package displays indicates a major area for improvement in enforcing anti-tobacco advertising and promotion laws.
Early-phase factors associated with pediatric severe dengue in the Thai–Myanmar cross-border region
Authors: Aung May Thu Thu , Tangpukdee Noppadon , Limkittikul Kriengsak , Keeratiwasin Ramparat , Sukharom Rungrat , Hattasingh Weerawan , Sirinam Salin
Published: July 2024

Background

Dengue disease is caused by dengue virus, which is transmitted by Aedes mosquitoes in tropical and subtropical regions worldwide. Although most infected individuals have benign febrile illness or no apparent symptoms, a small percentage develop severe dengue, a potentially fatal condition that occurs after a febrile stage. Many studies have identified factors predicting dengue severity among different populations and time courses. To help find practical approaches applicable in remote settings, we focused on the investigation of early factors associated with severe dengue in Thai–Myanmar cross-border region.

Methods

This retrospective case-control study was performed to determine factors contributing to severe dengue in the pediatric population. We reviewed the hospital records of patients with dengue infection aged 0–19 years who were admitted to Maesot General Hospital, situated near the Thai–Myanmar cross-border region, between 2017 and 2022. Medical data during the first 5 days of illness and outcomes were collected and analyzed.

Results

This study included 144 patients with a serologically confirmed diagnosis of dengue infection, with 43 severe and 101 non-severe cases. Among biological factors, being an infant and belonging to an ethnic group in Myanmar showed a significant association with severe dengue in the univariable analysis. Multivariable logistic regression revealed that the presence of mucosal bleeding (adjusted OR 5.39, 95% CI 1.06–27.52, P = 0.043), a change in hematocrit ≥ 10% (adjusted OR 3.68, 95% CI 1.15–11.74, P = 0.028), and serum albumin < 35 g/L (adjusted OR 8.10, 95% CI 2.55–25.72, P < 0.001) during the first 5 days of illness were significantly associated with developing severe dengue.

Conclusions

This study supports the use of certain WHO warning signs and hematocrit change during febrile phase to predict pediatric severe dengue in low-resource settings. Potential factors such as very young age and ethnic groups warrant further exploration to identify risks contributing to severe dengue infection.
Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral photography methods
Authors: Kargozar Sanaz , Jadidfard Mohammad-Pooyan
Published: July 2024

Background

Dental caries is a global public health concern, and early detection is essential. Traditional methods, particularly visual examination, face access and cost challenges. Teledentistry, as an emerging technology, offers the possibility to overcome such barriers, and it must be given high priority for assessment to optimize the performance of oral healthcare systems. The aim of this study was to systematically review the literature evaluating the diagnostic accuracy of teledentistry using photographs taken by Digital Single Lens Reflex (DSLR) and smartphone cameras against visual clinical examination in either primary or permanent dentition.

Methods

The review followed PRISMA-DTA guidelines, and the PubMed, Scopus, and Embase databases were searched through December 2022. Original in-vivo studies comparing dental caries diagnosis via images taken by DSLR or smartphone cameras with clinical examination were included. The QUADAS-2 was used to assess the risk of bias and concerns regarding applicability. Meta-analysis was not performed due to heterogeneity among the studies. Therefore, the data were analyzed narratively by the research team.

Results

In the 19 studies included, the sensitivity and specificity ranged from 48 to 98.3% and from 83 to 100%, respectively. The variability in performance was attributed to factors such as study design and diagnostic criteria. Specific tooth surfaces and lesion stages must be considered when interpreting outcomes. Using smartphones for dental photography was common due to the convenience and accessibility of these devices. The employment of mid-level dental providers for remote screening yielded comparable results to those of dentists. Potential bias in patient selection was indicated, suggesting a need for improvements in study design.

Conclusion

The diagnostic accuracy of teledentistry for caries detection is comparable to that of traditional clinical examination. The findings establish teledentistry’s effectiveness, particularly in lower income settings or areas with access problems. While the results of this review is promising, conducting several more rigorous studies with well-designed methodologies can fully validate the diagnostic accuracy of teledentistry for dental caries to make oral health care provision more efficient and equitable.

Registration

This study was registered with PROSPERO (CRD42023417437).
Endothelial microRNAs in INOCA patients with diabetes mellitus
Authors: Ferrone Marco , Ciccarelli Michele , Varzideh Fahimeh , Kansakar Urna , Guerra Germano , Cerasuolo Federica Andrea , Buonaiuto Antonietta , Fiordelisi Antonella , Venga Enzo , Esposito Mafalda , Rainone Antonio , Ricciardi Roberto , Del Giudice Carmine , Minicucci Fabio , Tesorio Tullio , Visco Valeria , Iaccarino Guido , Gambardella Jessica , Santulli Gaetano , Mone Pasquale
Published: July 2024

Ischemia with non-obstructive coronary artery (INOCA) is a common cause of hospital admissions, leading to negative outcomes and reduced quality of life. Central to its pathophysiology is endothelial dysfunction, which contributes to myocardial ischemia despite the absence of significant coronary artery blockage. Addressing endothelial dysfunction is essential in managing INOCA to alleviate symptoms and prevent cardiovascular events. Recent studies have identified diabetes mellitus (DM) as a significant factor exacerbating INOCA complications by promoting endothelial impairment and coronary microvascular dysfunction. MicroRNAs (miRNAs) have emerged as potential biomarkers and therapeutic targets in various biological processes, including endothelial dysfunction and cardiovascular diseases. However, research on miRNA biomarkers in INOCA patients is sparse. In this study, we examined a panel of circulating miRNAs involved in the regulation of endothelial function in INOCA patients with and without DM. We analyzed miRNA expression using RT-qPCR in a cohort of consecutive INOCA patients undergoing percutaneous coronary intervention. We detected a significant dysregulation of miR-363-5p and miR-92a-3p in INOCA patients with DM compared to those without DM, indicating their role as biomarkers for predicting and monitoring endothelial dysfunction in INOCA patients with DM.
Comparing cranial-caudal-medial and medial–lateral approaches for laparoscopic right hemicolectomy: a propensity score-matched analysis
Authors: Wang Jie , Zhou Jiajie , Cheng Yifan , Zhao Shuai , Li Ruiqi , Zhang Chenkai , Fu Yayan , Sun Longhe , Ren Jun , Wang Daorong
Published: July 2024

Background

The cranial-caudal-medial approach (CCMA) has been proposed for laparoscopic right hemicolectomy nowadays. This study aimed to investigate the safety and oncological efficacy of CCMA in the treatment of right-sided colon cancer compared to the medial–lateral approach (MLA).

Methods

Patients diagnosed with right-sided colon cancer were included from February 2015 to June 2018, retrospectively, dividing into the CCMA group and the MLA group. We compared the basic characteristics and the short-term and long-term outcomes in two groups.

Results

Two hundred and ninety-six patients were included in this study. The baseline characteristics were similar in two groups. Compared with MLA group, CCMA group exhibited shorter operation time (136.3 ± 25.3 min vs. 151.6 ± 21.5 min, P < 0.001), lower estimated blood loss (44.1 ± 15.2 ml vs. 51.4 ± 26.9 min, P = 0.010), and more harvested lymph nodes (18.5 ± 7.1 vs. 16.5 ± 5.7, P = 0.021). The 5-year overall survival (OS) rate for the CCMA group was 76.5%, and the 5-year disease-free survival (DFS) rate was 72.3%, both of which were not inferior to the MLA group. No significant difference was found between two groups in terms of other clinical parameters.

Conclusion

The CCMA in laparoscopic right hemicolectomy is safe and feasible, making the anatomical plane clearer. This approach can shorten the operation time, reduce intraoperative blood loss, harvest more lymph nodes, and yield satisfactory oncological outcomes.
Comparison of dynamic compression system versus multiple cancellous screws in the treatment of femoral neck fractures in young adults
Authors: Aljasim Omar , Yener Can , Özkayın Nadir
Published: July 2024

Introduction

Femoral neck fractures have posed a significant global healthcare challenge and had notable impacts on the quality of life. Current treatment strategies for femoral neck fractures in young individuals have varied, emphasizing the need for optimal fixation methods. This study compared the clinical and radiological outcomes of the dynamic compression system (DCS) and multiple cancellous screws (MCS) methods.

Methods

This retrospective study included a total of 275 young adults with fresh femoral neck fractures treated with DCS and MCS. A matching analysis with a 1:1 ratio based on age, gender, fracture classification, and reduction quality was conducted. Demographic data were recorded, and comparisons were made according to follow-up time (FUT), hospitalization period, operation duration, femoral neck shortening, caput-collum-diaphysis (CCD) angle, Harris Hip Score (HHS), and post-operative complications.

Results

A total of 42 fractures were matched with a median age of 42 years (range, 22–48). In the DCS group, vertical neck shortening (median 1.92) was significantly lower than that in the MCS group (median 4.53) (P < 0.05). In the DCS group, horizontal femoral neck shortening, resultant femoral neck shortening, the amount of change in CCD angle, and HHS were 0.57 mm (0.43, 4.74 mm), 1.82 mm (0.40, 3.53 mm), 0.13° (-0.78°, 1.80°), and 91 (85–93), respectively. They were all non-significant than 1.00 mm (0.56, 6.23 mm), 2.74 mm (1.59, 6.71 mm), -0.18° (-1.11°,1.85°), and 91 (75, 93) in the MCS group, respectively (P > 0.05). There was no statistical difference in FUT, hospitalization period, operation time, and post-operative complications at the latest follow-up (P > 0.05). There were no complications such as pulmonary embolism, deep vein thrombosis, and incision infection reported.

Conclusion

DCS and MCS demonstrated effectiveness in treating femoral neck fractures in young adults. The DCS implant provides additional stability in the vertical axis. A prospective randomized controlled study with a large sample size was needed to validate these findings.