bluuebunny/crossref_metadata_2025 huggingface dataset:
Time to diagnosis in systemic lupus erythematosus: Associated factors and its impact on damage accrual and mortality. Data from a multi-ethnic, multinational Latin American lupus cohort
Authors: Nieto Romina , Quintana Rosana , Zavala-Flores Ernesto , Serrano Rosa , Roberts Karen , Catoggio Luis J , García Mercedes A , Berbotto Guillermo A , Saurit Verónica , Bonfa Eloisa , Borba Eduardo F , Lavras Costallat Lilian T , Da Silva Nilzio A , Sato Emilia I , Tavares Brenol Joao C , Massardo Loreto , Neira Oscar J , Vázquez Gloria , Guibert Toledano Marlene , Pascual-Ramos Virginia , Sauza del Pozo María J , Barile-Fabris Leonor A , Amigo Mary-Carmen , García De La Torre Ignacio , Acevedo-Vásquez Eduardo M , Segami María I , Chacón-Díaz Rosa , Esteva-Spinetti María H , Alarcón Graciela S , Pons-Estel Bernardo A , Pons-Estel Guillermo J
Published: February 2024

Background

Systemic lupus erythematosus (SLE) often mimics symptoms of other diseases, and the interval between symptom onset and diagnosis may be long in some of these patients. Aims: To describe the characteristics associated with the time to SLE diagnosis and its impact on damage accrual and mortality in patients with SLE from a Latin American inception cohort.

Methods

Patients were from a multi-ethnic, multi-national Latin-American SLE inception cohort. All participating centers had specialized lupus clinics. Socio-demographic, clinical/laboratory, disease activity, damage, and mortality between those with a longer and a shorter time to diagnosis were compared using descriptive statistical tests. Multivariable Cox regression models with damage accrual and mortality as the end points were performed, adjusting for age at SLE diagnosis, gender, ethnicity, level of education, and highest dose of prednisone for damage accrual, plus highest dose of prednisone, baseline SLEDAI, and baseline SDI for mortality.

Results

Of the 1437 included in these analyses, the median time to diagnosis was 6.0 months (Q1–Q3 2.4–16.2); in 721 (50.2%) the time to diagnosis was longer than 6 months. Patients whose diagnosis took longer than 6 months were more frequently female, older at diagnosis, of Mestizo ethnicity, not having medical insurance, and having “non-classic” SLE symptoms. Longer time to diagnosis had no impact on either damage accrual (HR 1.09, 95% CI 0.93–1.28, p = 0.300) or mortality (HR 1.37, 95% CI 0.88–2.12, p = 0.200).

Conclusions

In this inception cohort, a maximum time of 24 months with a median of 6 months to SLE diagnosis had no apparent negative impact on disease outcomes (damage accrual and mortality).
Growth models and social blocs: Taking Gramsci seriously
Authors: May Christian , Nölke Andreas , Schedelik Michael
Published: February 2024

While the recent extension of the Growth Models perspective to advanced peripheral economies is a laudable endeavor, we argue that the utilization of the social bloc concept needs conceptual refining. We contribute to this debate by drawing explicitly on the writings of Antonio Gramsci. First, we demonstrate that Gramsci differentiated between different forms of state-society complexes in peripheral countries vis-à-vis Western core countries. From a Gramscian perspective, therefore, one might need very different analytical instruments when dealing with the political side of growth models in advanced peripheral economies. Secondly, the widely used notion of intellectual hegemony in civil society—very often associated with Gramsci—refers to the state-society complexes of established capitalist countries and may not necessarily be applied with the same analytical currency in more statist state-society complexes. Our analysis of a variety of Gramscian concepts, which are often overlooked, contributes not only to the study of advanced peripheral economies from a growth model perspective but also to the study of the politics of growth models in general.
Forensic mental health issues for women in contact with the criminal justice system
Authors: Haysom Leigh
Published: February 2024

Objective

This review demonstrates that women who encounter the Australian criminal justice system include some of the most disadvantaged and mentally unwell people in society, particularly Aboriginal women. Women in custody are a heterogeneous group and have different psychosocial needs when compared to male prisoners.

Conclusion

The approaches to female offending must address their significant psychosocial and mental health issues at every point of contact with the criminal justice system, be culturally informed and specifically address Indigenous overrepresentation.
Nonsequential Appointment Scheduling With a Random Number of Requests
Authors: Zhu Yan , Liu Zhixin , Qi Xiangtong
Published: February 2024

This article studies an appointment scheduling problem where a service provider dynamically receives appointment requests from a random number of customers. By leveraging the randomness of the number of potential customers, we develop a nonsequential appointment scheduling policy as an alternative to the conventional first-come-first-served (FCFS) policy. This allows for more flexibility in managing appointment scheduling. To calculate the optimal policy, we develop a branch-and-bound algorithm in which the lower bound is estimated using multiple approaches, such as optimality conditions, dynamic programming for calculating FCFS policy, and the shortest path reformulation. Through numerical studies, we observe that nonsequential appointment scheduling is particularly advantageous in systems characterized by highly fluctuating customer numbers or low congestion. In such cases, leaving gaps between appointments for potential future arrivals proves to be a more appropriate strategy. We also evaluate the performance of heuristics proposed in prior literature and provide insights into situations where these heuristics can be effectively applied.
A Dynamic and Inclusive Approach
Authors: Lewis-Hunstiger Marty
Published: February 2024

After a year of transition to a new publisher, Creative Nursing 2024 will build on our legacy of nurturing novice authors with a Student Article of the Year initiative; presenting courageous discourse as reflected in our overarching theme for the year, The Impact of Social Forces on Nursing and Health; and publishing even more new knowledge in the form of research and discussion of nursing theories and models. This issue's theme, Activism, Advocacy, and Allyship, is exemplified by articles about paths to a nursing workforce that reflect the people we serve, and about concepts such as hygge, dialectical pluralism, acculturative stress, shared decision-making for breast health, nature immersion, iceberg demographics, and self-care in palliative care.
Metastatic pancreatic carcinoma with neuroendocrine differentiation in a cat
Authors: Berto Aline Nochi , de Lemos Gisele Augusta Amorim , Navolar Felipe Martins Negreiros , Di Santis Giovana Wingeter , Zanutto Marcelo de Souza
Published: February 2024

Case summary

This report describes the case of a 7-year-old male neutered domestic mixed-breed cat that was initially referred to the Veterinary Hospital of the State University of Londrina for evaluation of a 2-week history of abdominal distension and a 2-day history of anorexia, infected with feline immunodeficiency virus (FIV). Abdominal ultrasound revealed an expansive mass located around the pancreas and right hepatic lobe. In the transoperative macroscopic observation, multiple white nodules were visualized in the liver, pancreas, mesentery, intestine, stomach and peritoneal wall. Immunohistochemical examination revealed that neoplastic cells demonstrated a strong positivity for AE1/AE3 and CK20. A sparse immunoreactivity to chromogranin A was observed, which demonstrates neuroendocrine cell labeling. The histopathologic changes associated with the immunohistochemical profile confirmed the diagnosis of metastatic carcinoma with neuroendocrine differentiation, originating from the pancreas.

Relevance and novel information

Neuroendocrine tumors of the pancreas are rare and are associated with a poor prognosis in humans. In humans, approximately 7% of neuroendocrine tumors develop in the pancreas, and the 5-year survival rate for a pancreatic neuroendocrine tumor is 53%, according to the American Cancer Society. To our knowledge, only one case has been described in the feline species so far. Due to the rarity of this type of tumor in cats, there is little information about predisposition related to age, sex or breed, as well as the main clinical signs presented, survival time and treatment options.
Leaving post-industrial urban studies behind?
Authors: Luger Jason , Schwarze Tilman
Published: February 2024

In this forum paper, we question the lasting utility of the framework and language of urban post-industrialism. We suggest that, while such conceptual metaphors are useful to understand economic, social and cultural change at specific times, post-industrial may obscure more nuanced explorations of the realities of today's multi-faceted, planetary, and digitally-mediated urban processes and socio-spatialities. Post-industrial speaks primarily to dramatic and violent changes that happened in the twentieth century, and continue to happen today, but, we suggest, the story is more complex. Specifically, we bring forward a few critiques of the post-industrial, that a revitalized agenda might begin to move beyond. Firstly, is that industrialisation is always-ongoing, and not something that can be fixed into place. Where it is absent, it continues to haunt. Second, is that over-use of post-industrial as a descriptor and critical lens can lead to territorial, class, racial/ethnic, political, and world-regional stigmatizations. In particular, it can reinforce colonialist hierarchies of prototype Northern/Western cities versus those in the majority world, and certain assumptions about linearity and path dependencies about industrial trajectories. Thirdly, we suggest post-industrial frameworks can calcify gender binaries and obscure counterhegemonies and fluidities, especially given the realities of global urban industrial labour today. Finally, we propose that moving beyond the post-industrial might open more radical space for vibrant art and politics, from cross-spectrum alliances and solidarities (like revitalized labour movements), to joyful artistic expression that transcends rust, decay, and ruin. We do not propose throwing away post-industrialism, but rather, to invite other possibilities to coexist.
Chloroplast genome analyses of Caragana arborescens and Caragana opulens
Authors: Liu LiE , Li Hongyan , Li Jiaxin , Li Xinjuan , Hu Na , Wang Honglun , Zhou Wu
Published: February 2024

Background

Numerous species within the genus Caragana have high ecological and medicinal value. However, species identification based on morphological characteristics is quite complicated in the genus. To address this issue, we analyzed complete plastid genome data for the genus.

Results

We obtained chloroplast genomes of two species, Caragana arborescens and Caragana opulens, using Illumina sequencing technology, with lengths of 129,473 bp and 132,815 bp, respectively. The absence of inverted repeat sequences in the two species indicated that they could be assigned to the inverted repeat-lacking clade (IRLC). The genomes included 111 distinct genes (4 rRNA genes, 31 tRNA genes, and 76 protein-coding genes). In addition, 16 genes containing introns were identified in the two genomes, the majority of which contained a single intron. Repeat analyses revealed 129 and 229 repeats in C. arborescens and C. opulens, respectively. C. arborescens and C. opulens genomes contained 277 and 265 simple sequence repeats, respectively. The two Caragana species exhibited similar codon usage patterns. rpl20-clpP, rps19-rpl2, and rpl23-ycf2 showed the highest nucleotide diversity (pi). In an analysis of sequence divergence, certain intergenic regions (matK-rbcL, psbM-petN, atpA-psbI, petA-psbL, psbE-petL, and rps7-rps12) were highly variable. A phylogenetic analysis showed that C. arborescens and C. opulens were related and clustered together with four other Caragana species. The genera Astragalus and Caragana were relatively closely related.

Conclusions

The present study provides valuable information about the chloroplast genomes of C. arborescens and C. opulens and lays a foundation for future phylogenetic research and molecular marker development.
Generation and characterisation of an Arabidopsis thaliana f3h/fls1/ans triple mutant that accumulates eriodictyol derivatives
Authors: Schilbert Hanna Marie , Busche Mareike , Sáez Vania , Angeli Andrea , Weisshaar Bernd , Martens Stefan , Stracke Ralf
Published: February 2024

Background

Flavonoids are plant specialised metabolites, which derive from phenylalanine and acetate metabolism. They possess a variety of beneficial characteristics for plants and humans. Several modification steps in the synthesis of tricyclic flavonoids cause for the amazing diversity of flavonoids in plants. The 2-oxoglutarate-dependent dioxygenases (2-ODDs) flavanone 3-hydroxylase (F3H, synonym FHT), flavonol synthase (FLS) and anthocyanidin synthase (ANS, synonym leucoanthocyanidin dioxygenase (LDOX)), catalyse oxidative modifications to the central C ring. They are highly similar and have been shown to catalyse, at least in part, each other’s reactions. FLS and ANS have been identified as bifunctional enzymes in many species, including Arabidopsis thaliana, stressing the capability of plants to bypass missing or mutated reaction steps on the way to flavonoid production. However, little is known about such bypass reactions and the flavonoid composition of plants lacking all three central flavonoid 2-ODDs.

Results

To address this issue, we generated a f3h/fls1/ans mutant, as well as the corresponding double mutants and investigated the flavonoid composition of this mutant collection. The f3h/fls1/ans mutant was further characterised at the genomic level by analysis of a nanopore DNA sequencing generated genome sequence assembly and at the transcriptomic level by RNA-Seq analysis. The mutant collection established, including the novel double mutants f3h/fls1 and f3h/ans, was used to validate and analyse the multifunctionalities of F3H, FLS1, and ANS in planta. Metabolite analyses revealed the accumulation of eriodictyol and additional glycosylated derivatives in mutants carrying the f3h mutant allele, resulting from the conversion of naringenin to eriodictyol by flavonoid 3’-hydroxylase (F3’H) activity.

Conclusions

We describe the in planta multifunctionality of the three central flavonoid 2-ODDs from A. thaliana and identify a bypass in the f3h/fls1/ans triple mutant that leads to the formation of eriodictyol derivatives. As (homo-)eriodictyols are known as bitter taste maskers, the annotated eriodictyol (derivatives) and in particular the observations made on their in planta production, could provide valuable insights for the creation of novel food supplements.
Development of a novel multi‑epitope vaccine against the pathogenic human polyomavirus V6/7 using reverse vaccinology
Authors: Salahlou Reza , Farajnia Safar , Bargahi Nasrin , Bakhtiyari Nasim , Elmi Faranak , Shahgolzari Mehdi , Fiering Steven , Venkataraman Srividhya
Published: February 2024

Background

Human polyomaviruses contribute to human oncogenesis through persistent infections, but currently there is no effective preventive measure against the malignancies caused by this virus. Therefore, the development of a safe and effective vaccine against HPyV is of high priority.

Methods

First, the proteomes of 2 polyomavirus species (HPyV6 and HPyV7) were downloaded from the NCBI database for the selection of the target proteins. The epitope identification process focused on selecting proteins that were crucial, associated with virulence, present on the surface, antigenic, non-toxic, and non-homologous with the human proteome. Then, the immunoinformatic methods were used to identify cytotoxic T-lymphocyte (CTL), helper T-lymphocyte (HTL), and B-cell epitopes from the target antigens, which could be used to create epitope-based vaccine. The physicochemical features of the designed vaccine were predicted through various online servers. The binding pattern and stability between the vaccine candidate and Toll-like receptors were analyzed through molecular docking and molecular dynamics (MD) simulation, while the immunogenicity of the designed vaccines was assessed using immune simulation.

Results

Online tools were utilized to forecast the most optimal epitope from the immunogenic targets, including LTAg, VP1, and VP1 antigens of HPyV6 and HPyV7. A multi-epitope vaccine was developed by combining 10 CTL, 7 HTL, and 6 LBL epitopes with suitable linkers and adjuvant. The vaccine displayed 98.35% of the world's population coverage. The 3D model of the vaccine structure revealed that the majority of residues (87.7%) were located in favored regions of the Ramachandran plot. The evaluation of molecular docking and MD simulation revealed that the constructed vaccine exhibits a strong binding (-1414.0 kcal/mol) towards the host's TLR4. Moreover, the vaccine-TLR complexes remained stable throughout the dynamic conditions present in the natural environment. The immune simulation results demonstrated that the vaccine design had the capacity to elicit robust immune responses in the host.

Conclusion

The multi-parametric analysis revealed that the designed vaccine is capable of inducing sustained immunity against the selected polyomaviruses, although further in-vivo investigations are needed to verify its effectiveness.
Nephrotic syndrome with acute kidney injury due to combination therapy of immune checkpoint inhibitors: a case report and review of the literature
Authors: Saiki Ryosuke , Katayama Kan , Saiki Haruko , Fukumori Ayumi , Tsujimoto Kayo , Yamawaki Masahiro , Tanaka Fumika , Takahashi Daisuke , Oda Keiko , Suzuki Yasuo , Murata Tomohiro , Dohi Kaoru
Published: February 2024

Background

Recent studies have focused on immune checkpoint inhibitors. Renal complications associated with the use of immune checkpoint inhibitors are uncommon compared with other immune-related adverse events. Acute interstitial nephritis accounts for most of these renal complications, with nephrotic syndrome quite rare. We herein report a case of nephrotic syndrome associated with immune checkpoint inhibitors that was more severe than that in previous cases. By comparing this case with previous reports, the possible reasons for the particular severity of this case are discussed.

Case presentation

A 75-year-old man developed nephrotic syndrome with acute kidney injury after the first combination therapy of nivolumab and ipilimumab for malignant pleural mesothelioma. The results of a kidney biopsy indicated minimal change disease with mild atherosclerosis, acute interstitial nephritis, and fusion of nearly all podocyte foot processes. Nivolumab and ipilimumab therapy were stopped, and treatment with corticosteroids was initiated. We investigated previously reported cases of nephrotic syndrome using immune checkpoint inhibitors. Seventeen cases of immune checkpoint inhibitor-related nephrotic syndrome, including ours, have been reported. Two of the 17 patients with immune checkpoint inhibitor-related nephrotic syndrome required hemodialysis treatment for acute kidney injury. Unlike many previously reported cases, the present patient was administered two different immune checkpoint inhibitors, which may be one of the reasons for the development of severe nephrotic syndrome.

Conclusions

In addition to previously reported risk factors, immune checkpoint inhibitor combination therapy can exacerbate nephrotic syndrome compared to immune checkpoint inhibitor monotherapy.
How do postnatal care guidelines in Australia compare to international standards? A scoping review and comparative analysis
Authors: Blair Amanda , Tan Annie , Homer Caroline S. E. , Vogel Joshua P.
Published: February 2024

Background

There is no single national guideline in Australia on the provision of postnatal care, which means there is potential for significant variation in the standard and quality of care. This review aimed to systematically identify, synthesise, and assess the quality of postnatal care guidelines produced for use in Australia. A second aim was to compare postnatal care recommendations in Australian guidelines to the National Institute for Health and Care Excellence’s (NICE) and the World Health Organization’s (WHO) postnatal care recommendations, to identify gaps and areas of disagreement. We focussed on recommendations regarding postnatal assessment of the woman or newborn, infant feeding, discharge planning, or community-based care.

Methods

A scoping review was undertaken informed by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews. A database search and a manual search of state and national government health departments, professional associations and research institute websites was performed to identify relevant guidelines and recommendations. Guideline quality was assessed using the AGREE II tool. Guideline recommendations from Australia were mapped to 67 NICE/WHO recommendations. Recommendations that partially agreed, were modified, or in disagreement underwent further analysis.

Results

A total of 31 Australian postnatal guidelines were identified and overall, these were of moderate- to high-quality. Of the 67 NICE/WHO recommendations, most agreed with the recommendations contained in Australian guidelines. There were five NICE/WHO recommendations with which corresponding Australian recommendations disagreed. There were 12 NICE/WHO recommendations that were commonly modified within Australia’s guidelines. There were three NICE/WHO recommendations that did not appear in any Australian guideline.

Conclusions

Recommendations from postnatal guidelines in Australia have a high level of agreement with corresponding NICE/WHO recommendations. The few disagreements and modifications found in guideline recommendations - both across Australia’s guidelines and between Australia’s and the NICE/WHO guidelines - are worrying and warrant further examination, as they may result in different standards of care across Australia. Identified gaps in guidance should be prioritised for inclusion in new or updated guidelines where appropriate.
Impact of preoperative transcatheter arterial chemoembolization (TACE) on postoperative long-term survival in patients with nonsmall hepatocellular carcinoma: a propensity score matching analysis
Authors: Hu Run , Xu Jie , Wang Hongxiang , Wang Jiaguo , Lei Kai , Zhao Xiaoping , Zhang Huizhi , You Ke , Liu Zuojin
Published: February 2024

Background

The purpose of this propensity score matching (PSM) analysis was to compare the effects of preoperative transcatheter arterial chemoembolization (TACE) and non-TACE on the long-term survival of patients who undergo radical hepatectomy.

Methods

PSM analysis was performed for 387 patients with hepatocellular carcinoma (HCC) (single > 3 cm or multiple) who underwent radical resection of HCC at our centre from January 2011 to June 2018. The patients were allocated to a preoperative TACE group (n = 77) and a non-TACE group (n = 310). The main outcome measures were progression-free survival (PFS) and overall survival (OS) since the treatment date.

Results

After PSM, 67 patients were included in each of the TACE and non-TACE groups. The median PFS times in the preoperative TACE and non-TACE groups were 24.0 and 11.3 months, respectively (p = 0.0117). The median OS times in the preoperative TACE and non-TACE groups were 41.5 and 29.0 months, respectively (p = 0.0114). Multivariate Cox proportional hazard regression analysis revealed that preoperative TACE (hazard ratio, 1.733; 95% CI, 1.168–2.570) and tumour thrombosis (hazard ratio, 0.323; 95% CI, 0.141–0.742) were independent risk factors significantly associated with OS.

Conclusions

Preoperative TACE is related to improving PFS and OS after resection of HCC. Preoperative TACE and tumour thrombus volume were also found to be independent risk factors associated with OS.
Smartphone usage and overdependence risk among middle-aged and older adults: a cross-sectional study
Authors: Kim Su Hyun , Kim Young Hoon , Lee Chang-Hyung , Lee YounYoung
Published: February 2024

Background

Previous studies have predominantly focused on smartphone overdependence among adolescents and young adults. However, as smartphone usage has recently surged among South Korean middle-aged and older adults, the risk of smartphone overdependence cannot be overlooked among this population. Therefore, this study was conducted to examine the smartphone usage pattern and the associated risk of overdependence in this specific age group.

Methods

The data for individuals who aged 50 or older were extracted from the dataset of a nationwide survey, “The Survey on Smartphone Overdependence, 2021,” and the usage of each type of smartphone content and risk of smartphone overdependence among individuals in their 50 s and 60 s were investigated. Age-group-based differences in demographic characteristics, Smartphone Overdependence Scale scores, self-awareness of smartphone overdependence, digital literacy, and psychosocial factors were analyzed. Additionally, a multivariable logistic regression analysis was conducted to explore the factors associated with the potential-to-high risk of smartphone overdependence in both age groups.

Results

Individuals in their 50s had significantly higher digital literacy, social relations, life satisfaction, and smartphone overdependence scores than those in their 60s, and the percentage of individuals in the high-risk group was also higher in the 50s age group. For both age groups, the most used content was “messenger,” “news,” and “movies/TV/videos,” whereas the least used content was e-learning, gambling, and adult content. The multivariable analysis indicated that, for individuals in their 50s, having a lower educational level was associated with significantly higher odds, whereas having a job and utilizing e-commerce-related contents on smartphone were associated with significantly lower odds of potential-to-high risk for smartphone overdependence. Concerning individuals in their 60s, having a lower educational level and using adult content or gambling were significantly associated with higher odds of potential-to-high risk for smartphone overdependence.

Conclusion

This study reveals the risk of smartphone overdependence among middle-aged and older adults in South Korea as well as the associated risk factors. This will assist policymakers in developing policies for the appropriate use of smartphones by these age groups.
Effect of no eyeglasses sales on the quality of eye care: an experimental evidence from China
Authors: Wang Nan , Li Yangyuan , Wu Shichong , Liu Yunjie , Nie Jingchun , Wu Junhao , Reheman Zulihumaer , Ye Jinbiao , Yang Jie
Published: February 2024

Background

Eye examinations and eyeglasses acquisition are typically integrated into a cohesive procedure in China. We conducted a randomized controlled trial using incognito standardized patient (SP) approach to evaluate the impact of separating eyeglasses sales on the accuracy of final prescription.

Methods

52 SPs were trained to provide standardized responses during eye examinations, and undergoing refraction by a senior ophthalmologist at a national-level clinical center. SPs subsequently received eye examinations at 226 private optical shops and public hospitals in Shaanxi, northwestern China. The visits were randomly assigned to either control group, where SPs would typically purchase eyeglasses after refraction, or treatment group, where SPs made an advance declaration not to purchase eyeglasses prior to refraction. The dioptric difference between the final prescriptions provided by local refractionists and expert in the better-seeing eye was determined using the Vector Diopteric Distance method, and the completeness of exams was assessed against national standards. Multiple regressions were conducted to estimate the impact of no eyeglasses sales on the accuracy of the final prescription of local refractionists, as well as the completeness of examinations.

Results

Among 226 eye exams (73 in public hospitals, 153 in private optical shops), 133 (58.8%) were randomized to control group and 93 (41.2%) to no eyeglasses sales group. The inaccuracy rate of final prescriptions provided by local refractionists (≥ 1.0 D, experts’ final prescription as the reference) was 25.6% in control group, while 36.6% in no-sale group (P = 0.077). The likelihood of providing inaccurate final prescriptions was significantly higher in no-sale group compared to control group (OR = 1.607; 95% CI: 1.030 to 2.508; P = 0.037). This was particularly evident in private optical shops (OR = 2.433; 95% CI: 1.386 to 4.309; P = 0.002). In terms of process quality, the no-sale group performed significantly less subjective refraction (OR = 0.488; 95% CI: 0.253 to 0.940; P = 0.032) and less testing SP’s own eyeglasses (OR = 0.424; 95% CI: 0.201 to 0.897; P = 0.025). The duration of eye exams was 3.917 min shorter (95% CI: -6.798 to -1.036; P = 0.008) in no-sale group.

Conclusions

Separating eyeglasses sales from optical care could lead to worse quality of eye care. Policy makers should carefully consider the role of economic incentives in healthcare reform.
The impact of a health promotion program on toddlers’ socio-emotional development: a cluster randomized study
Authors: Duarte Ana , Martins Silvana , Augusto Cláudia , Silva Maria José , Lopes Luís , Santos Rute , Rosário Rafaela
Published: February 2024

Background

The first 3 years of life are a critical period for the development of socio-emotional skills, highlighting the importance of socio-emotional development in early childhood. This study aimed to evaluate the effectiveness of a health promotion intervention program on the socio-emotional development of children aged 12 to 42 months during the COVID-19 pandemic.

Methods

A total of 344 children from 15 childcare centers participated in this study, with six centers in the intervention group and nine in the control group. Childcare teachers in the intervention group received a 6-month training program aimed at promoting healthy lifestyles, including topics such as diet, sleep, physical activity, and sedentary behavior. Sociodemographic and anthropometric measures were assessed at baseline, and socio-emotional development was assessed using the Bayley Scales of Infant and Toddler Development – Third Edition (Bayley-III) at baseline and post-intervention.

Results

After the intervention, a significant difference in socio-emotional development was observed between children with mothers of varying education levels. Specifically, children whose mothers had lower education levels demonstrated significantly greater socio-emotional development (B = 19.000, p = 0.028) compared to the control group. In contrast, there was no significant difference in socio-emotional development among children with mothers from higher education levels.

Conclusion

These findings suggest that intervention programs for childcare teachers can effectively promote healthy socio-emotional development in children from socioeconomically disadvantaged backgrounds. Future intervention programs should consider tailoring their approaches to target disadvantaged populations.

Trial registration

This cluster randomized controlled trial was registered in the Clinical Trials database/platform on 09/09/2019 (number NCT04082247).
A rare case of intervertebral disc calcification combined with ossification of the posterior longitudinal ligament in a child: a case report and literature review
Authors: Ye Cheng , Shi Mingliang , Xie Dong , Wu Hao , Chen Qing , Yang Lili
Published: February 2024

Background

Intervertebral disc calcification (IDC) combined with calcification in children has been sporadically reported, while ossification of the posterior longitudinal ligament (OPLL) in the cervical spine in pediatric patients is exceedingly rare. The aim of this study is to investigate the potential prognosis and outcomes associated with this condition.

Case presentation

We present an unusual case involving a 10-year-old Chinese child diagnosed with calcified cervical disc herniation and ossification of the posterior longitudinal ligament. Conservative treatment measures were implemented, and at the 1-month and 6-month follow-up, the patient's pain exhibited significant improvement. Subsequent cervical MRI and CT scans revealed the complete disappearance of OPLL and substantial absorption of the calcified disc. During the three-month follow-up, CT demonstrated slight residual disc calcification, however, the patient remained asymptomatic with no discernible limitation in cervical motion.

Conclusions

We conducted a comprehensive review of several cases presenting with the same diagnosis. It is noteworthy that IDC combined with OPLL in children constitutes a rare clinical entity. Despite imaging indications of potential spinal canal occupation, the majority of such cases demonstrate complete absorption following conservative treatment, with OPLL exhibiting a faster absorption rate than calcified discs.
Opioids and fibromyalgia: frequency of use and factors associated with increased consumption in patients remitted to a tertiary care center
Authors: Rivera Javier , Molina-Collada Juan , Martínez-Barrio Julia , Serrano-Benavente Belén , Castrejón Isabel , Vallejo Miguel A. , Álvaro-Gracia Jose María
Published: February 2024

Background

Opioids are not recommended for fibromyalgia.

Objective

To investigate the frequency of opioid use in a large cohort of fibromyalgia patients and to identify factors associated with opioid consumption.

Methods

A retrospective, observational study of a large fibromyalgia cohort in a tertiary care center. We assessed fibromyalgia severity, functional capacity, anxiety, depression, drugs consumption and the patient’s impression of change. We compared strong opioid consumers (SOC) and non-SOC. Inferential statistical and logistic regression analysis were used to identify factors associated with opioid consumption, and ANOVA for repeated measurements.

Results

We found a prevalence of 9.2% of SOC (100 patients) among 1087 patients in the cohort. During the last four years there was a significant increase on the incidence of SOC up to 12.8% (p = 0.004). There were no differences in demographic variables between SOC and non-SOC. Clinical variables were significantly more severe in SOC, and they consumed more non-opioid drugs (p < 0.0001). Opioid consumption was independently associated with other non-opioid drugs (Odds ratio 1.25, CI: 1.13–1.38), but not with the fibromyalgia severity. At three months, 62% of the patients had opioid withdrawal. There were no statistical differences in the fibromyalgia severity at the initial evaluation, or the patient’s impression of change compared with those patients who continued opioids. Coping strategies were better in those patients who withdrew opioids (p = 0.044).

Conclusions

We observed an increase in opioid prescriptions during the last four years. Opioid consumption was associated with concomitant use of non-opioid drugs, but it was not associated with fibromyalgia severity.
A modified method for precise anastomosis during laparoscopic low anterior resection for rectal cancer: the first clinical experience and application
Authors: Zheng Bobo , Wang Ben , Li Zeyu , Qu Yaqi , Qiu Jian
Published: February 2024

Background

There is no criterion to guide and evaluate the anastomosis of laparoscopic low anterior resection (LAR). We developed a new technique for precise anastomosis. This study endeavored to evaluate the effectiveness and safety of this new technology.

Methods

Patients with mid-low rectal cancer who underwent laparoscopic LAR in our department were enrolled retrospectively between January 1, 2021 and July 1, 2023. During the LAR, the distance between the sacral promontory and the rectal stump was measured and used to determine the length of the sigmoid colon, which was preserved for anastomose. The demographic characteristics and short-term outcomes were analyzed.

Results

Forty-nine patients (26 men, 23 women) with low and middle rectal cancer were retrospectively enrolled in the study. The distance of the tumor from the anal verge was 6.4 ± 2.7 cm. The operative time was 193 ± 42 min. All patients underwent precise anastomosis, among which 12 patients underwent freeing of the splenic flexure of the colon. According to our criteria, there was no redundant or tense state of the colon anterior to the sacrum after the anastomosis. Only one patient had a postoperative anastomotic leak (Grade B). All 15 patients receiving neoadjuvant chemoradiotherapy underwent terminal ileostomy. No postoperative death occurred within 30 days of the surgery. The median follow-up time in our study was 12 months. One patient developed a single metastasis in the right lobe of the liver in the eighth month after surgery and underwent microwave radiofrequency ablation, which did not recur in the four months of postoperative follow-up, and the rest of the patients survived disease-free without recurrence of metastasis.

Conclusions

Precise measurement of the proximal colon of the anastomosis can ensure accurate and convenient colorectal anastomosis and this may be a technique worthy of clinical application. However, its effectiveness needs to be further verified in a multicenter clinical trial.
Immediate implant placement in the posterior mandibular region was assisted by dynamic real-time navigation: a retrospective study
Authors: Geng Ningbo , Ren Jing , Zhang Chi , Zhou Tianren , Feng Chongjin , Chen Songling
Published: February 2024

Background

Efficient utilization of residual bone volume and the prevention of inferior alveolar nerve injury are critical considerations in immediate implant placement (IIP) within the posterior mandibular region. Addressing these challenges, this study focuses on the clinical efficacy and implant accuracy of dynamic real-time navigation, an emerging technology designed to enhance precision in implantation procedures.

Methods

This study included 84 patients with 130 implants undergoing immediate placement in the posterior mandibular region. Stratified into dynamic navigation, static guide plate, and freehand implant groups, clinical indicators, including initial stability, distance to the inferior alveolar nerve canal, depth of implant placement, and various deviations, were systematically recorded. Statistical analysis, employing 1- or 2-way ANOVA and Student’s t-test, allowed for a comprehensive evaluation of the efficacy of each technique.

Results

All 130 implants were successfully placed with an average torque of 22.53 ± 5.93 N.cm. In the navigation group, the distance to the inferior alveolar nerve and the depth of implant placement were significantly greater compared to the guide plate and freehand groups (P < 0.05). Implant deviation was significantly smaller in both the navigation and guide plate groups compared to the freehand group(P < 0.05). Additionally, the navigation group exhibited significantly reduced root and angle deviations compared to the guide plate group(P < 0.05), highlighting the superior precision of navigation-assisted immediate implant placement.

Conclusions

It is more advantageous to use dynamic navigation rather than a static guide plate and free-hand implant insertion for immediate posterior mandibular implant implantation.
Evaluation of digital and manual orthodontic diagnostic setups in non-extraction cases using ABO model grading system: an in-vitro study
Authors: Shakr Sherwet , Negm Ibrahim , Saifeldin Hatem
Published: February 2024

Background

To evaluate the outcome quality of manual and digital orthodontic diagnostic setups in non-extraction cases according to the American Board of Orthodontics model grading system and to calculate the laboratory time needed for orthodontic diagnostic setup construction.

Methods

The sample consisted of 60 pretreatment models of non-extraction orthodontic cases with age ranges of 18–30. The study models were duplicated and scanned with 3Shape R-750 scanner. Digital and manual diagnostic setups were constructed according to their respective treatment plans. Digital diagnostic setups were 3D printed and then both manual and digital setups were assessed using the modified American Board of Orthodontics Cast Radiograph evaluation score (ABO CRE), which includes alignment, marginal ridge, buccolingual inclination, occlusal contacts, occlusal relationships, interproximal contacts, and overjet. The laboratory time needed for orthodontic setups was measured in minutes.

Results

The total ABO CRE score of the digital diagnostic setup group (5.93 ± 2.74) was significantly lower than that of the manual diagnostic setup group (13.08 ± 3.25). The manual diagnostic setup had significantly larger scores in marginal ridge, overjet, overbite, buccolingual inclination, occlusal relationship, and total scores (P < 0.01). However, the digital diagnostic setup had a statistically larger occlusal contacts score than the manual diagnostic setup (P < 0.01). There was no significant difference between the alignment and the interproximal contacts scores in either group. The manual diagnostic setup needed significantly longer laboratory time (187.8 ± 14.22) than the digital setup (93.08 ± 12.65) (P < 0.01). Comparison between broken teeth was performed by using the chi-square test which found no significant difference between different tooth types.

Conclusions

Digital diagnostic setup is a reliable tool for orthodontic diagnostic setup construction providing excellent quality setup models. Manual diagnostic setup is time consuming with a technique-sensitive laboratory procedure.
Building climate resilience: awareness of climate change adaptation in German outpatient medical practices
Authors: Litke Nicola Alexandra , Poß-Doering Regina , Fehrer Valeska , Köppen Martina , Kümmel Stephanie , Szecsenyi Joachim , Wensing Michel
Published: February 2024

Background

Climate change is seen as the biggest health threat of the twenty-first century. Making outpatient medical practices resilient is therefore crucial to protect vulnerable groups and maintain quality of care. Awareness is a precondition for action. This study aims to explore awareness (knowledge, experience and attention) of climate change adaptation among stakeholders of outpatient medical practices.

Methods

Semi-structured interviews and focus groups with stakeholders of outpatient medical practices were conducted. The qualitative data were analysed in a two-step Thematic Analysis process.

Results

In total, n = 40 stakeholders participated in two focus groups and 26 interviews. The findings show a mixed degree of awareness in outpatient medical practices. The spectrum ranged from a passive role with curative acting only, handing over responsibility to others and a low perceived self-efficacy to a proactive and responsible implementation of adaptation strategies. Participants who saw the need and responsibility of climate change adaptation in medical practices perceived low additional workload. In general, implementation of climate change adaptation measures and general awareness of climate change adaptation appeared to be depending on a certain tension for change and a higher self-efficacy.

Conclusion

Medical practices, and specifically primary care, plays a crucial role in climate change adaptation, and awareness needs to be increased further in order to cope with consequences of climate change. To facilitate this, there should be a strong emphasis on climate change adaptation strategies being part of outpatient care provider roles rather than being perceived as an “add-on” to already high workloads.
Circulating exosomal mir-16-2-3p is associated with coronary microvascular dysfunction in diabetes through regulating the fatty acid degradation of endothelial cells
Authors: Liu Yihai , Zhong Chongxia , Chen Shan , Xue Yanan , Wei Zhonghai , Dong Li , Kang Lina
Published: February 2024

Background

Coronary microvascular dysfunction (CMD) is a frequent complication of diabetes mellitus (DM) characterized by challenges in both diagnosis and intervention. Circulating levels of microRNAs are increasingly recognized as potential biomarkers for cardiovascular diseases.

Methods

Serum exosomes from patients with DM, DM with coronary microvascular dysfunction (DM-CMD) or DM with coronary artery disease (DM-CAD) were extracted for miRNA sequencing. The expression of miR-16-2-3p was assessed in high glucose-treated human aortic endothelial cells and human cardiac microvascular endothelial cells. Fluorescence in situ hybridization (FISH) was used to detect miR-16-2-3p within the myocardium of db/db mice. Intramyocardial injection of lentivirus overexpressing miR-16-2-3p was used to explore the function of the resulting gene in vivo. Bioinformatic analysis and in vitro assays were carried out to explore the downstream function and mechanism of miR-16-2-3p. Wound healing and tube formation assays were used to explore the effect of miR-16-2-3p on endothelial cell function.

Results

miR-16-2-3p was upregulated in circulating exosomes from DM-CMD, high glucose-treated human cardiac microvascular endothelial cells and the hearts of db/db mice. Cardiac miR-16-2-3p overexpression improved cardiac systolic and diastolic function and coronary microvascular reperfusion. In vitro experiments revealed that miR-16-2-3p could regulate fatty acid degradation in endothelial cells, and ACADM was identified as a potential downstream target. MiR-16-2-3p increased cell migration and tube formation in microvascular endothelial cells.

Conclusions

Our findings suggest that circulating miR-16-2-3p may serve as a biomarker for individuals with DM-CMD. Additionally, miR-16-2-3p appears to alleviate coronary microvascular dysfunction in diabetes by modulating ACADM-mediated fatty acid degradation in endothelial cells.
When to anatomically excise a benign lung tumor-correspondence regarding the article: “large mesenchymal cystic and chondroid pulmonary hamartoma mimicking lung cancer: case report”
Authors: Tsolaki Fani , Tagarakis Georgios I. , Tagarakis Ioannis
Published: February 2024

The decision of whether to perform a large anatomic resection for a lung mass that is not definitely malignant comes often forward in the everyday practice of the thoracic surgeon. The general characteristics of the tumor as well as of the patient and the instinct and experience of the surgeon are the ones that dictate the final choice. Such a decision was made in the case of a large pulmonary hamartoma where a right middle lobectomy was performed with the postoperative course justifying the surgeons’ choice.