bluuebunny/crossref_metadata_2025 huggingface dataset:
Person‐centred integrated care for people living with Parkinson's, Huntington's and Multiple Sclerosis: A systematic review
Authors: Bartolomeu Pires Sandra , Kunkel Dorit , Kipps Christopher , Goodwin Nick , Portillo Mari C.
Published: December 2023

Introduction

People living with long‐term neurological conditions (LTNCs) have complex needs that demand intensive care coordination between sectors. This review aimed to establish if integrated care improves outcomes for people, and what characterises successful interventions.

Methods

A systematic review of the literature was undertaken evaluating multisectoral integrated care interventions in people living with Parkinson's disease (PD), Multiple Sclerosis (MS) and Huntington's disease (HD). Strength of evidence was rated for the different outcomes.

Results

A total of 15 articles were included, reporting on 2095 patients and caregivers, finding that integrated care can improve people's access to resources and reduce patients' depression. UK studies indicated improvements in patients' quality of life, although the international literature was inconclusive. Few programmes considered caregivers' outcomes, reporting no difference or even worsening in depression, burden and quality of life. Overall, the evidence showed a mismatch between people's needs and outcomes measured, with significant outcomes (e.g., self‐management, continuity of care, care experience) lacking. Successful programmes were characterised by expert knowledge, multisectoral care coordination, care continuity and a person‐centred approach.

Conclusions

The impact of integrated care programmes on people living with LTNCs is limited and inconclusive. For a more person‐centred approach, future studies need to assess integrated care from a service‐user perspective.

Patient and Public Contribution

Thirty people living with LTNCs were involved in this review, through defining research questions, validating the importance of the project, and increasing the researchers' understanding on what matters to service users. A patient and public involvement subgroup of representatives with lived experience on PD, MS and HD identified the need for more person‐centred integrated care, with specific concerns over care fragmentation, care duplication and care continuity. This was key to data analysis and formulating the characteristics of successful and unsuccessful integrated care programmes from the perspective of service users. The discrepancy between service users' needs and the outcomes assessed in the literature point to user‐driven research as the solution to address what matters to patients and caregivers.
An international consensus study to identify “what” outcomes should be included in a core outcome set for endodontic treatments (COSET) for utilization in clinical practice and research
Authors: El Karim Ikhlas , Duncan Henry Fergus , Cushley Siobhan , Nagendrababu Venkateshbabu , Kirkevang Lise‐Lotte , Kruse Casper Lemvig , Chong Bun San , Shah Pratik Kamalkant , Lappin Mark , Lundy Fionnuala T. , Clarke Mike ,   Consensus workshop participants
Published: December 2023

Background

Development of a standardized set of topic‐specific outcomes known as a Core Outcome Set (COS) is important to address issues of heterogeneity in reporting research findings in order to streamline evidence synthesis and clinical decision making.

Aim

The aim of the current international consensus study is to identify “what” outcomes to include in the Core Outcome Set for Endodontic Treatments (COSET). Outcomes of various endodontic treatments (non‐surgical root canal treatment, surgical endodontics, vital pulp treatment and revitalization procedures) performed on permanent teeth were considered.

Methods

A standard validated methodology for COS development and reporting was adopted. The process involved identification of existing outcomes through four published scoping reviews. This enabled creation of a list of outcomes to be prioritized via semi‐structured patient interviews, e‐Delphi process and a consensus meeting with a range of relevant global stakeholders. Outcomes were prioritized using a 1–9 Likert scale, with outcomes rated 7–9 considered critical, 4–6 are important and 1–3 are less important. Outcomes rated 7–9 by ≥70% and 1–3 by <15% of participants were considered to achieve consensus for inclusion in the COS. The outcomes that did not achieve consensus in the first round were considered for further prioritization in the second Delphi round and consensus meeting. Final decisions about the outcomes to include in COSET were made by voting during the consensus panel meeting using the Zoom Poll function.

Results

A total of 95 participants including patients contributed to the COS development process. The consensus panel recommended, with strong consensus, eight outcomes shared across all treatment modalities for inclusion in COSET: pain; signs of infection (swelling, sinus tract); further intervention/exacerbation; tenderness to percussion/palpation; radiographic evidence of disease progression/healing; function; tooth survival; and patient satisfaction. Additional treatment specific outcomes were also recommended.

Discussion

Many of the outcomes included in COSET are patient reported. All should be included in future outcomes studies.

Conclusion

COSET identified outcomes that are important for patients and clinicians and validated these using a rigorous methodology. Further work is ongoing to determine “how” and “when” these outcomes should be measured.
Microstructure and physicochemical properties: effects of different pretreatment combined with dual‐frequency ultrasound on quality of large yellow croaker (Pseudosciaena crocea) during cold storage
Authors: Lan Weiqing , Yan Peiling , Zhao Xinyu , Zhu Shengyun , Pu Tianting , Xie Jing
Published: December 2023

The quality changes of cold‐stored (4 °C) large yellow croaker (Pseudosciaena crocea) were studied by using stable chlorine dioxide combined with dual‐frequency ultrasound assisted‐slightly acidic electrolysed water (CUSS). The results of microbial indicators demonstrated that CUSS treatment inhibited microbial growth. Moreover, CUSS treatment had lower values of pH, total volatile basic nitrogen (TVB‐N) and thiobarbituric acid (TBA), and higher immobilised water content. CUSS treatment also inhibited the degradation of inosine monophosphate, suppressed the accumulation of hypoxanthine riboside and hypoxanthine. Through the results of texture profile analysis (TPA), protein degradation, and scanning electron microscopy (SEM), CUSS treatment could effectively protect the protein structure and maintain good texture characteristics of large yellow croaker. According to microbial indexes, K‐value, and sensory analysis, compared with dual‐frequency ultrasound treatment, CUSS treatment could prolong the shelf‐life of large yellow croaker for another six days. Therefore, CUSS treatment is a potential solution to preserve large yellow croaker, improving its protein characteristics.
Comparison of the stability of glycoprotein acetyls and high sensitivity C‐reactive protein as markers of chronic inflammation
Authors: Crick Daisy C. P. , Khandaker Golam M. , Halligan Sarah L. , Burgner David , Mansell Toby , Fraser Abigail
Published: December 2023

It has been suggested that glycoprotein acetyls (GlycA) better reflects chronic inflammation than high sensitivity C‐reactive protein (hsCRP), but paediatric/life‐course data are sparse. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) and UK Biobank, we compared short‐ (over weeks) and long‐term (over years) correlations of GlycA and hsCRP, cross‐sectional correlations between GlycA and hsCRP, and associations of pro‐inflammatory risk factors with GlycA and hsCRP across the life‐course. GlycA showed high short‐term (weeks) stability at 15 years (r = 0.75; 95% CI = 0.56, 0.94), 18 years (r = 0.74; 0.64, 0.85), 24 years (r = 0.74; 0.51, 0.98) and 48 years (r = 0.82 0.76, 0.86) and this was comparable to the short‐term stability of hsCRP at 24 years. GlycA stability was moderate over the long‐term, for example between 15 and 18 years r = 0.52; 0.47, 0.56 and between 15 and 24 years r = 0.37; 0.31, 0.44. These were larger than equivalent correlations of hsCRP. GlycA and concurrently measured hsCRP were moderately correlated at all ages, for example at 15 years (r = 0.44; 0.40, 0.48) and at 18 years (r = 0.55; 0.51, 0.59). We found similar associations of known proinflammatory factors and inflammatory diseases with GlycA and hsCRP. For example, BMI was positively associated with GlycA (mean difference in GlycA per standard deviation change in BMI = 0.08; 95% CI = 0.07, 0.10) and hsCRP (0.10; 0.08, 0.11). This study showed that GlycA has greater long‐term stability than hsCRP, however associations of proinflammatory factors with GlycA and hsCRP were broadly similar.
Information intensity and pricing of systematic earnings announcement risk
Authors: Chen Jingjing , Chen Linda H. , Jiang George J.
Published: December 2023

Earnings announcement (EA) poses a non‐diversifiable risk to investors. This study examines whether investors demand higher returns for stocks with high systematic EA risk. We find evidence that systematic EA risk is priced, however, the premium is realized only during periods with intensified cash‐flow news. Specifically, we construct an ex‐ante measure of expected information intensity (EII) and find that in the subsample of high‐EII firms, those with high systematic EA risk earn significantly higher future returns. Controlling for known risk factors, stocks with high systematic EA risk outperform those with low systematic EA risk by 0.43% in monthly Fama–French five‐factor alpha. We also confirm the well‐documented announcement premium, i.e., high‐EII firms outperform low‐EII firms and show that the EA risk premium is distinct from the announcement premium. To exploit both premiums, a feasible strategy of long stocks with both high‐EII and high systematic EA risk and short stocks with low‐EII yields monthly 0.81% five‐factor alpha.
A surfactant‐based dressing can reduce the appearance of Pseudomonas aeruginosa pigments and uncover the dermal extracellular matrix in an ex vivo porcine skin wound model
Authors: Seo Soojung , Yang Qingping , Jeong Sunyoung , Della Porta Alessandra , Kapoor Harris , Gibson Daniel J.
Published: December 2023

From previous studies, we have shown that viable colony forming units of bacteria and bacterial biofilms are reduced after sequential treatment with a surfactant‐based dressing. Here, we sought to test the impact on visible bacterial pigments and the ultrastructural impact following the sequential treatment of the same surfactant‐based dressing. Mature Pseudomonas aeruginosa biofilms were grown on ex vivo porcine skin explants, and an imaging‐based analysis was used to compare the skin with and without a concentrated surfactant. In explants naturally tinted by bacterial chromophores, wiping alone had no effect, while the use of a surfactant‐based dressing reduced coloration. Similarly, daily wiping led to increased immunohistochemical staining for P. aeruginosa antigens, but not in the surfactant group. Confocal immunofluorescent imaging revealed limited bacterial penetration and coating of the dermis and loose pieces of sloughing material. Ultrastructural analysis confirmed that the biofilms were masking the extracellular matrix (ECM), but the surfactant could remove them, re‐exposing the ECM. The masking of the ECM may provide another non‐inflammatory explanation for delayed healing, as the ECM is no longer accessible for wound cell locomotion. The use of a poloxamer‐based surfactant appears to be an effective way to remove bacterial chromophores and the biofilm coating the ECM fibres.
The effect of dexmedetomidine on postoperative wound healing in neurosurgical patients: A meta‐analysis
Authors: Zhu Congying , Cao Donghang , Chen Lingyang , Zheng Xuhang , Lin Danjiang
Published: December 2023

This meta‐analysis investigates the effect of dexmedetomidine on postoperative wound healing in neurosurgical patients. A thorough literature search resulted in the selection of seven studies from an initial pool of 1546 records. The analysis focused on wound healing outcomes, evaluated by the Redness, Oedema, Ecchymosis, Discharge, Approximation (REEDA) scale and the Manchester Scar Scale (MSS). Results indicated significant improvements in the dexmedetomidine group: the REEDA scale scores at day seven post‐surgery showed a Standardized Mean Difference group (SMD = −16.18, 95% CI: [−22.30, −10.06], p < 0.01), and the MSS scores at 3 months post‐operation demonstrated an (SMD = −8.95, 95% CI: [−14.27, −3.62], p < 0.01). These findings suggest that dexmedetomidine may enhance wound healing and reduce scar formation in neurosurgical patients. Bias assessment indicated a low risk of bias across the studies.
Risk factors for surgical site infection after percutaneous endoscopic lumbar discectomy
Authors: Xiao Bo , Chen Tian‐yi , Zhao Qiang , Zhao Ming , Yang Guo‐qi , Zhong Xiao‐hui , Xu Yin‐zhi
Published: December 2023

The objective of this study was to investigate the risk factors associated with surgical site infection (SSI) after percutaneous endoscopic lumbar discectomy (PELD) in patients with lumbar disc herniation (LDH). A retrospective analysis was performed on a cohort of 335 patients who underwent PELD between January 2016 and January 2023. Data were derived from the Hospital Information System (HIS), and a comprehensive statistical assessment was performed using IBM SPSS Statistics version 25.0. Both univariate and multivariate logistic regression analyses assessed a range of risk determinants, such as age, body mass index (BMI), comorbidities, laboratory test parameters and surgery‐related variables. The incidence of SSI after PELD was 2.7% (9/335). Univariate analysis highlighted BMI, diabetes mellitus, long‐term corticosteroid consumption, surgical time and cerebrospinal fluid leakage as significant predictors of SSI. Multivariate logistic regression identified BMI, diabetes mellitus, long‐term corticosteroid consumption, surgical time and cerebrospinal fluid leakage as significant risk factors for SSI after PELD. High BMI, diabetes mellitus, long‐term corticosteroid consumption, long surgical time and postoperative cerebrospinal fluid leakage are predisposing factors for SSI in patients undergoing PELD. Precise interventions focused on such risk components, including careful preoperative assessment and strategic postoperative care, are essential to reduce the incidence of SSI and improve surgical efficacy.
Do climate risk disclosures matter to financial analysts?
Authors: Ben‐Amar Walid , Herrera Diana Castro , Martinez Isabelle
Published: December 2023

This paper examines whether and when corporate disclosures about a firm's exposure to climate risks matter to financial analysts. More specifically, we investigate the association between climate risk disclosure (CRD) and two properties of financial analysts’ earnings forecasts (accuracy and dispersion). We predict that climate risk financial materiality at the industry level moderates this association. Using a sample of 2184 US nonfinancial firm‐year observations over the period 2010–2016, we show that CRD is associated with higher forecast precision and lower dispersion only when climate risks are perceived by investors as being financially material at the industry level. We also find that while corporate disclosures about transition risks are not associated with financial analyst forecast properties, 10‐K disclosures about climate‐related material physical risks reduce analyst forecast error and dispersion.
Comparative effects of fixed‐dose mitiglinide/voglibose combination and glimepiride on vascular endothelial function and glycemic variability in patients with type 2 diabetes: A randomized controlled trial
Authors: Tanaka Kenichi , Okada Yosuke , Umezu Saeko , Hashimoto Ryoma , Tomoyose Yukiko , Tateyama Rina , Hori Yuri , Saito Momo , Tokutsu Akemi , Sonoda Satomi , Uemura Fumi , Kurozumi Akira , Tanaka Yoshiya
Published: December 2023

Introduction

The aim of this study was to compare the effects of mitiglinide/voglibose with those of glimepiride on glycemic variability and vascular endothelial function in patients with type 2 diabetes.

Materials and Methods

It was a multicenter, open‐label, randomized, crossover study. Hospitalized patients received either mitiglinide/voglibose (three times daily administration of 10 mg mitiglinide and 0.2 mg voglibose) or glimepiride (once‐daily 2 mg) in random order, each for 5 days. The reactive hyperemia index (RHI) and the mean amplitude of glycemic excursions (MAGE) were measured as co‐primary endpoints using reactive hyperemia peripheral arterial tonometry and continuous glucose monitoring.

Results

The analysis included 30 patients (15 in each group). The RHI was 1.670 ± 0.369 during treatment with mitiglinide/voglibose and 1.716 ± 0.492 during treatment with glimepiride, with no significant difference between the two. MAGE was significantly lower in the mitiglinide/voglibose group (47.6 ± 18.5 mg/dL) than in the glimepiride group (100.6 ± 32.2 mg/dL). Although the mean blood glucose levels over the entire 24 h period were comparable between the two groups, the use of mitiglinide/voglibose was associated with a lower standard deviation of mean glucose, coefficient of variation, and mean postprandial glucose excursion compared with glimepiride. The time below range (<70 mg/dL) and the time above range (>180, >200, and 250 mg/dL) were lower in the mitiglinide/voglibose group, while the time in range (70–180 mg/dL) was higher.

Conclusions

In our short‐duration randomized crossover study, although not impacting vascular endothelial function, mitiglinide/voglibose demonstrated potential benefits in reducing glycemic variability, postprandial hyperglycemia, and hypoglycemia in patients with type 2 diabetes.
Impact of age at diagnosis on long‐term prognosis in patients with intestinal Behçet's disease
Authors: Chang Ji Young , Park Soo Jung , Park Jae Jun , Kim Tae Il , Cheon Jae Hee , Park Jihye
Published: December 2023

Background and Aim

Although age at disease onset is considered to be a significant factor in the prognosis of Crohn's disease, little is known about its influence on the long‐term prognosis of those with intestinal Behçet's disease (BD). This study aimed to evaluate the long‐term clinical outcomes of patients with intestinal BD according to age of disease onset.

Methods

Patients diagnosed with intestinal BD at < 18, 18–60, and > 60 years of age were classified into early‐onset, adult‐onset, and late‐onset groups, respectively. The influence of disease onset time on clinical prognosis, including specific medical requirements, BD‐related intestinal surgery, hospitalization, and emergency room visits, was compared using the log–rank test in a large cohort of patients with intestinal BD.

Results

Among 780 patients, 21 (2.7%), 672 (86.2%), and 87 (11.1%) comprised the early‐onset, adult‐onset, and late‐onset groups, respectively. Patients in the early‐onset group were more likely to require immunosuppressants than those in the adult‐onset group (P = 0.048). Nine (42.9%), 158 (23.5%), and 18 (20.7%) patients in the early‐onset, adult‐onset, and late‐onset groups, respectively, underwent intestinal resection. The early‐onset group exhibited a higher risk for intestinal resection than the late‐onset (P = 0.043) and adult‐onset (P = 0.030) groups. The late‐onset group exhibited a higher risk for BD‐related hospitalization than the adult‐onset group (P = 0.023).

Conclusions

Age at diagnosis affected the clinical course of intestinal BD, including intestinal surgery, hospitalization, and specific medical requirements. Different treatment strategies should be established according to age at diagnosis.
Social Support, Parenting Self‐Efficacy, and Postpartum Depression Among Chinese Parents: The Actor‐Partner Interdependence Mediation Model
Authors: Zheng Jie , Han Rongrong , Gao Lingling
Published: December 2023

Introduction

Postpartum depression affects both mothers and fathers. This study aimed to examine the relationships between social support, parenting self‐efficacy, and postpartum depression in Chinese mothers and fathers and assess the mediating effect of parenting self‐efficacy using a dyadic perspective.

Methods

A cross‐sectional study was implemented from December 2020 to July 2021 in Guangzhou, China, with 309 pairs of parents. The Edinburgh Postnatal Depression Scale, Social Support Rating Scale, Parenting Sense of Competence Scale‐Efficacy subscale, and sociodemographic data sheet were completed by both parents. Dyadic analysis was conducted using the actor‐partner interdependence mediation model. An actor effect is the relationship between variables within an individual, whereas a partner effect is the relationship between variables in the individual and the dyadic partner.

Results

In total, 20.7% of mothers and 11.7% of fathers had elevated postpartum depressive symptoms at 6 weeks postpartum. The model revealed 6 actor effects: social support was positively associated with parenting self‐efficacy for mothers (β, 0.39; 95% CI, 0.28‐0.49) and fathers (β, 0.39; 95% CI, 0.30‐0.48) and negatively associated with postpartum depression for mothers (β, −0.22; 95% CI, −0.32 to −0.12) and fathers (β, −0.37; 95% CI, −0.48 to −0.26). Parenting self‐efficacy was negatively associated with postpartum depression in mothers (β, −0.41; 95% CI, −0.53 to −0.29) and fathers (β, −0.24; 95% CI, −0.37 to −0.12). Maternal social support had a partner effect on paternal parenting self‐efficacy (β, 0.14; 95% CI, 0.04‐0.24). Parenting self‐efficacy mediated between social support and postpartum depression for both parents (mothers: β, −0.16; 95% CI, −0.23 to −0.10; fathers: β, −0.10; 95% CI, −0.16 to −0.05).

Discussion

Postpartum depression was a dyadic phenomenon. Increasing mother‐centered social support has the potential to improve the parenting self‐efficacy of both parents and reduce the likelihood of postpartum depression.
Anti‐inflammatory, antioxidant, antiangiogenic, and therapeutic efficacy of neroli oil in rats with endometriotic lesions
Authors: Canday Mujde , Yurtkal Aslıhan , Makav Mustafa , Kuru Mushap
Published: December 2023

Introduction

Endometriosis is a serious health problem among women of reproductive age, with pelvic pain and infertility. Given the limited success of current treatments, this study explores Neroli oil (N.O.) effects on inflammation, oxidation, angiogenesis, and tissue remodeling implicated in endometriosis.

Materials and Methods

Albino Wistar female rats were used to simulate an endometriosis model. Groups were established for comparison: a control, an endometriosis model, a N.O.‐treated group, and a N.O.‐treated group postendometriosis induction. The study focused on Tumor necrosis factor‐alpha (TNF‐α), Interleukin 6, Interleukin 8, vascular endothelial growth factor (VEGF), myeloperoxidase, Matrix metalloproteinase‐1 (MMP‐1), nitric oxide, superoxide dismutase, catalase, and anti‐mullerian hormone values, as well as histopathological evaluations of endometriotic foci.

Results

AMH values showed a significant increase in the endometriosis group treated with N.O. compared with the endometriosis group (p < 0,01).A statistically significant decrease was found in MMP‐1 level in the endometriosis group that underwent N.O. (p < 0.001). Increased CAT (p < 0.0001) and decrease in nitric oxide (p < 0.01) are found in N.O.‐treated endometriosis group. TNF‐α levels in the endometriosis group showed a statistically significant increase in the endometriosis group when compared with the control and sham group (p < 0.001, p < 0.01 respectively). In our study, a statistically significant increase was observed in VEGF levels (p < 0.001) in endometriosis group and significant decrease in the N.O. administered endometriosis model group. Groups treated with N.O. showed decreased inflammation and congestion scores. Histopathological assessments demonstrated reduced inflammation and tissue remodeling signs in endometriotic foci.

Conclusion

This study highlights the potential of N.O. in the treatment of endometriosis, owing to its anti‐inflammatory, antioxidant, and antiangiogenic properties that can disrupt chronic processes. Our findings lend support to utilization of herbal remedies for the management of endometriosis, thereby emphasizing the necessity for additional comprehensive investigations in the future.
Multi‐centre arousal scoring agreement in the Sleep Revolution
Authors: Pitkänen Henna , Nikkonen Sami , Rissanen Marika , Islind Anna Sigridur , Gretarsdottir Heidur , Arnardottir Erna Sif , Leppänen Timo , Korkalainen Henri
Published: December 2023

We investigated arousal scoring agreement within full‐night polysomnography in a multi‐centre setting. Ten expert scorers from seven centres annotated 50 polysomnograms using the American Academy of Sleep Medicine guidelines. The agreement between arousal indexes (ArIs) was investigated using intraclass correlation coefficients (ICCs). Moreover, kappa statistics were used to evaluate the second‐by‐second agreement in whole recordings and in different sleep stages. Finally, arousal clusters, that is, periods with overlapping arousals by multiple scorers, were extracted. The overall similarity of the ArIs was fair (ICC = 0.41), varying from poor to excellent between the scorer pairs (ICC = 0.04–0.88). The ArI similarity was better in respiratory (ICC = 0.65) compared with spontaneous (ICC = 0.23) arousals. The overall second‐by‐second agreement was fair (Fleiss’ kappa = 0.40), varying from poor to substantial depending on the scorer pair (Cohen's kappa = 0.07–0.68). Fleiss’ kappa increased from light to deep sleep (0.45, 0.45, and 0.53 for stages N1, N2, and N3, respectively), was moderate in the rapid eye movement stage (0.48), and the lowest in the wake stage (0.25). Over a half of the arousal clusters were scored by one or two scorers, and less than a third by at least five scorers. In conclusion, the scoring agreement varied depending on the arousal type, sleep stage, and scorer pair, but was overall relatively low. The most uncertain areas were related to spontaneous arousals and arousals scored in the wake stage. These results indicate that manual arousal scoring is generally not reliable, and that changes are needed in the assessment of sleep fragmentation for clinical and research purposes.
Outcomes of surgically and conservatively managed thoracolumbar and lumbosacral intervertebral disc herniations in cats
Authors: Amey Jack A. , Liatis Theofanis , Cherubini Giunio Bruto , De Decker Steven , Foreman Max H.
Published: December 2023

Background

Limited information is available regarding intervertebral disc herniation (IVDH) and its treatment in cats.

Objectives

Describe outcomes after surgical or conservative treatment of cats with thoracolumbar and lumbosacral IVDH.

Animals

Ninety‐two cats from 2 referral populations (2012‐2022) with compressive IVDH between the T3 and S1 vertebrae.

Methods

Retrospective cohort study evaluating outcomes of surgical (49 cats) and conservative (36 cats) management of IVDH; 7 cats were euthanized at diagnosis. Outcome was assessed using hospital and referring veterinarian records and client questionnaires. Successful outcome was defined as regained or improved ambulation, urinary and fecal continence, and no requirement for analgesic medication.

Results

Incidence of IVDH during the study period was 0.44% (92/20849). Surgical treatment resulted in 62% (6 weeks) and 74% success (6 months). Conservative treatment resulted in 54% (6 weeks) and 65% success (6 months). Neurological grade at presentation was higher in cats treated surgically (median, 2; range, 1‐5) than in those treated conservatively (median, 2; range, 0‐4; P = .001). Regardless of treatment type, cats suffering trauma were more likely to have a successful outcome 6 weeks after treatment compared with those without history of trauma (odds ratio, 5.3; 95% confidence interval, 1.05‐26.78; P = .04). Neurological deficits remained in the majority of cats for both treatment types (92%, conservative; 86%, surgical at 6 weeks). Acute‐on‐chronic IVDH with characteristics of both extrusion and protrusion were identified in 10% of cats.

Conclusions and Clinical Importance

Conservative treatment could be as effective as surgical decompression in cats with thoracolumbar or lumbosacral IVDH.
The ontogeny of disparity in Cupressaceae seed cones
Authors: Huntsman Stepfan V. , Leslie Andrew B.
Published: December 2023

Ontogenetic shape change has long been recognized to be important in generating patterns of morphological diversity and may be especially important in plant reproductive structures. We explore how seed cone disparity in Cupressaceae changes over ontogeny by comparing pollination‐stage and mature cones.

We sampled cones at pollen and seed release and measured cone scales using basic morphometric shape variables. We used multivariate statistical methods, particularly hypervolume overlap calculations, to measure morphospace occupation and disparity.

Cone scales at both pollination and maturity exhibit substantial variability, although the disparity is greater at maturity. Mature cone scales are also more clustered in trait space, showing less overlap with other taxa than at pollination. These patterns reflect two growth strategies that generate closed cones over maturation, either through thin laminar scales or relatively thick, peltate scales, resulting in two distinct regions of morphospace occupation.

Disparity patterns in Cupressaceae seed cones change over ontogeny, reflecting shifting functional demands that require specific patterns of cone scale growth. The evolution of Cupressaceae reproductive disparity therefore represents selection for trajectories of ontogenetic shape change, a phenomenon that should be widespread across seed plants.
Virucidal effect of mouthwash on acyclovir‐resistant herpes simplex virus
Authors: Bar Ilan M. , Dovrat S. , Cohen R. , Georgaki M. , Papadopoulou E. , Nikitakis N. G. , Yarom N.
Published: December 2023

Objectives

The symptoms of herpes simplex viruses type 1 (HSV‐1) infections might be severe and persistent in immunocompromised patients in whom they reactivate at a high frequency. The development of Acyclovir (ACV) resistant strains due to long‐term treatment with antiviral agents in those patients is not uncommon. The aim of the present study was to assess the virucidal effect of commercially available mouthwashes against ACV‐resistant HSV‐1 strains.

Materials and Methods

Two acyclovir‐resistant HSV‐1 strains were exposed for 30 s to essential oil‐based (Listerine Fresh Burst® and Listerine Zero®), chlorhexidine gluconate 0.2% (Hexidyl®) and povidone‐iodine 7.5% (Betadine Gargle®) mouthwashes. Loss of virus infectivity was determined by means of plaque reduction assays in a cell culture system.

Results

All 4 of the tested solutions significantly reduced virus infectivity, with the essential oil‐based and povidone‐iodine mouthwashes being slightly more efficacious, compared to chlorhexidine.

Conclusion

The findings of this analysis revealed that the tested oral rinses demonstrated in‐vitro antiviral activity against ACV‐resistant HSV. Comparative clinical trials are required to establish the clinical effectiveness of daily use of oral rinses in reducing the appearance of oral HSV lesions in immunocompromised patients.
Fibrocyte: A missing piece in the pathogenesis of fibrous epulis
Authors: Zhu Yi‐fei , Wan Mei‐chen , Gao Peng , Shen Min‐juan , Zhu Yi‐na , Hao Jia‐xin , Lu Wei‐cheng , Wang Chen‐yu , Tay Franklin , Ehrlich Hermann , Niu Li‐na , Jiao Kai
Published: December 2023

Objectives

To explore the role of fibrocytes in the recurrence and calcification of fibrous epulides.

Methods

Different subtypes of fibrous epulides and normal gingival tissue specimens were first collected for histological and immunofluorescence analyses to see if fibrocytes were present and whether they differentiated into myofibroblasts and osteoblasts upon stimulated by transforming growth factor‐β1 (TGF‐β1). Electron microscopy and elemental analysis were used to characterize the extracellular microenvironment in different subtypes of fibrous epulides. Human peripheral blood mononuclear cells (PBMCs) were subsequently isolated from in vitro models to mimic the microenvironment in fibrous epulides to identify whether TGF‐β1 as well as the calcium and phosphorus ion concentration in the extracellular matrix (ECM) of a fibrous epulis trigger fibrocyte differentiation.

Results

Fibrous epulides contain fibrocytes that accumulate in the local inflammatory environment and have the ability to differentiate into myofibroblasts or osteoblasts. TGF‐β1 promotes fibrocytes differentiation into myofibroblasts in a concentration‐dependent manner, while TGF‐β1 stimulates the fibrocytes to differentiate into osteoblasts when combined with a high calcium and phosphorus environment.

Conclusions

Our study revealed fibrocytes play an important role in the fibrogenesis and osteogenesis in fibrous epulis, and might serve as a therapeutic target for the inhibition of recurrence of fibrous epulides.
Determinants of belief in conspiracy theories about the war in Ukraine among youth
Authors: Schuster Johannes , Fobel Lea , Kolleck Nina
Published: December 2023

Conspiracy theories are particularly prevalent in times of crisis and pose a major threat to democracy. Young people are especially susceptible to conspiracy theories, as this period is characterized by high social vulnerability and constant reflection on one's position in society. However, to date little is known about the determinants of young people's belief in conspiracy theories in general and in times of crisis in particular. In this study, we address this research gap by investigating the belief of young people in Germany (N = 2437, aged 16 to 29) in conspiracy theories about the war in Ukraine. Drawing on Douglas and colleagues’ (2017) taxonomy, we find that epistemic (e.g., political self‐efficacy), existential (e.g., political trust), and social (e.g., social exclusion) motives influence belief in conspiracies about the war among young people. However, while the taxonomy suggests equal influence of the three motives, the effects of feelings of social exclusion on war‐related conspiracy beliefs among youth are mainly mediated by a strong influence of political distrust. In this way, our findings contribute to a better understanding of conspiracy beliefs among young people and highlight the importance of increasing young people's political trust to prevent the spread of conspiracy theories.
Long‐term changes in soil phosphorus in response to fertilizer application and negative phosphorus balance under grass rotation in mineral soils in Nordic conditions
Authors: Louhisuo Arja , Yli‐Halla Markku , Termonen Maarit , Kykkänen Sanna , Järvenranta Kirsi , Virkajärvi Perttu
Published: December 2023

Considerable amounts of residual fertilizer phosphorus (P) have accumulated in the agricultural soils of Finland since the 1960s, and the P fertilizer application recommendations have been lowered. It is unknown how much P intensively managed silage grass can obtain from the accumulated reserves without a loss of yield. In two field experiments on sandy loam conducted in 2003–2020, four consecutive grass (70% timothy, 30% fescue) rotations were performed (4 or 5 years each, including the establishment year). The grass received mineral P fertilizers (PF; 16 kg P ha−1 year−1), cattle slurry (PS; 11 kg P ha−1 year−1) or no P (P0). The organic P (Po) and inorganic P (Pi) pools in 2003 and 2020 samples were determined following the Hedley procedure using H2O, NaHCO3, NaOH and HCl as sequential extractants. Soil test P (STP) was monitored annually using ammonium acetate extraction. The results showed that the cumulative P balance (P0: −344 to −412 kg ha−1; PF and PS: −101 to −198 kg ha−1) was highly negative, resulting in declining STP. Still, after 18 years, the grass showed no consistent yield response to P fertilizer application. The most significant Pi decline occurred in the Pi–NaHCO3 (~30%) and Pi–NaOH (~50%) pools, while the changes in Po were negligible. This study and international comparisons, Mehlich‐3, degree of P saturation and the result of Hedley in other studies, suggest that these soils, initially above the critical STP level, contain plenty of legacy P and can provide perennial grass with sufficient P for a long time.
Ultrasound appearance and targeted therapy of symptomatic neural lesions in the breast and chest wall after breast cancer surgery
Authors: Steyerova Petra , Zimovjanova Martina , Lambert Lukas , Burgetova Andrea
Published: December 2023

Aim. To evaluate the feasibility of ultrasound (US) in identification of nerve lesions after breast cancer surgery in patients with neuropathic pain and assess the effect of a targeted US-guided therapy.Material and methods. Patients with neuropathic pain after breast cancer surgery underwent US examination. Nerve lesions identified by US were treated by a US-guided application of a mixture of local anesthetics and corticoids. The patients reported pain relief on a 100-point scale (0% = no effect, 100% = complete relief) and its duration in the next 18 months.Results. We performed 17 interventions in 11 women. A neuroma was observed in 2 patients, edema of the nerve in 5 patients, and scarring across the nerve in 4 patients. The affected nerves were the intercostobrachial nerve (5 patients), the long thoracic nerve (4), cutaneous branch of the pectoral nerve (1), and both the intercostobrachial and the long thoracic nerve (1). After 15 (88%) interventions, the patients reported relief (55±32%) with a median duration of 3 months (0.5-18 months).Conclusion. In patients after breast cancer surgery, ultrasound can reliably identify small painful neural lesions which can be efficiently treated by ultrasound-guided intervention.
An Investigation Into the Attitudes of Virtual Cycling Participants Regarding Avatar Bodyweight Manipulation and Weight Doping
Authors: Dyer Bryce , Taylor Jacqui
Published: December 2023

This study aimed to investigate the viewpoints and attitudes about virtual e-cycling apps with respect to the manipulation of an avatar’s stated body weight. An adaptation of the Performance Enhancement Attitude Scale delivered in the form of an online questionnaire was created to assess the act of intentional avatar weight manipulation in e-cycling apps. The level of agreement to 12 items was measured on a 5-point Likert scale, and 638 responses were received. Content analysis was performed on the responses to two open-ended questions. The respondent’s disagreed with nine of the 12 Performance Enhancement Attitude Scale statements suggesting that they saw no value to the practice of intentional avatar weight manipulation. The qualitative analysis revealed that many respondents appeared to accept that e-doping was common practice, and that prevention measures and punishment were ineffective. The results of the Performance Enhancement Attitude Scale questionnaire and content analysis by the majority of the respondents support that the act of avatar weight manipulation in virtual cycling esport sees similar results, feedback, and undesirability to other forms of sporting fraud such as the use of performance-enhancing drugs. It is, therefore, proposed that the act of avatar weight manipulation should be treated as an illicit, deceptive, or wholly negative practice.
Primary cardiac large B cell lymphoma
Authors: Arun Kumar Sumukh , Mishra Rahul , Malempati Sarat Chandra , Bindal Poorva
Published: December 2023

A female patient in her mid-60s presented with progressive shortness of breath, pleuritic chest pain and bilateral leg swelling for 1 week. Initial diagnostic workup revealed pericardial effusion, and a localised pericardial tubular mass on CT chest. Pericardial fluid analysis showed elevated white cells, with predominance of medium-large sized atypical lymphoid cells. Atypical lymphocytes stained positive for CD79a, CD10, PAX-5, BCL-2 and BCL6. Fluorescence in situ hybridisation testing demonstrated MYC and BCL6 rearrangements without BCL2 gene rearrangement. The overall morphological, immunohistochemical and cytogenetic findings supported a diagnosis of high-grade B cell lymphoma with MYC and BCL6 rearrangements. After extensive staging workup, localised disease involving the pericardium with a diagnosis of primary cardiac large B cell lymphoma was established. She was treated with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab chemotherapy. Rituximab was discontinued owing to largely absent CD20 expression. Interim positron emission tomography-CT after three cycles revealed a complete response, and the patient completed six cycles of therapy.
Initiation of China Alliance of Research in High Myopia (CHARM): protocol for an AI-based multimodal high myopia research biobank
Authors: He Hai-Long , Liu Yi-Xin , Song Hao , Xu Tian-Ze , Wong Tien-Yin , Jin Zi-Bing
Published: December 2023

Introduction

High myopia is a pressing public health concern due to its increasing prevalence, younger trend and the high risk of blindness, particularly in East Asian countries, including China. The China Alliance of Research in High Myopia (CHARM) is a newly established consortium that includes more than 100 hospitals and institutions participating across the nation, aiming to promote collaboration and data sharing in the field of high myopia screening, classification, diagnosis and therapeutic development.

Methods and analysis

The CHARM project is an ongoing study, and its initiation is distinguished by its unprecedented scale, encompassing plans to involve over 100 000 Chinese patients. This initiative stands out not only for its extensive scope but also for its innovative application of artificial intelligence (AI) to assist in diagnosis and treatment decisions. The CHARM project has been carried out using a ‘three-step’ strategy. The first step involves the collection of basic information, refraction, axial length and fundus photographs from participants with high myopia. In the second step, we will collect multimodal imaging data to expand the scope of clinical information, for example, optical coherence tomography and ultra-widefield fundus images. In the final step, genetic testing will be conducted by incorporating patient family histories and blood samples. The majority of data collected by CHARM is in the form of images that will be used to detect and predict the progression of high myopia through the identification and quantification of biomarkers such as fundus tessellation, optic nerve head and vascular parameters.

Ethics and dissemination

The study has received approval from the Ethics Committee of Beijing Tongren Hospital (TREC2022-KY045). The establishment of CHARM represents an opportunity to create a collaborative platform for myopia experts and facilitate the dissemination of research findings to the global community through peer-reviewed publications and conference presentations. These insights can inform clinical decision-making and contribute to the development of new treatment modalities that may benefit patients worldwide.

Trial registration number

ChiCTR2300071219.
Unemployed and disabled for work: identifying 3-year labour market pathways from the beginning of a sickness absence using sequence and cluster analyses in a register-based longitudinal study in Finland
Authors: Perhoniemi Riku , Blomgren Jenni , Laaksonen Mikko
Published: December 2023

Objectives

This study followed the labour market pathways of unemployed persons who started a sickness absence (SA) spell. We aimed to unravel subgroups based on altering labour market states and to identify covariates of these subgroups.

Design

Register-based longitudinal study, with nine labour market states and 36-month units.

Setting and participants

All Finnish persons aged 18–59 years with an SA in 2016 who were unemployed at the start of the SA spell (N=12 639).

Outcome measures

Sequence analysis was used to study transitions between nine labour market states based on monthly register data on permanent and temporary (full and partial) disability pensions (DP), rehabilitation, all-cause SA, unemployment and employment. Individuals were grouped into clusters based on cluster analysis and intersequence distances. Multinomial regression analysis was used to examine covariates of cluster memberships.

Results

Six clusters with the following pathway identities were found: (1) recurring unemployment (44%); (2) employment after a short SA (18%); (3) rehabilitation, recurring SA and unemployment (12%); (4) unknown sources of income (11%); (5) permanent DP after a prolonged SA (9%) and (6) temporary DP after a prolonged SA (7%).

Compared with the reference cluster 2, all other clusters were associated with less employment days and having a chronic illness before the SA spell, SA based on a mental disorder and a rejected DP application during the follow-up. In addition, the clusters had some unique covariates.

Conclusions

Unemployed persons starting an SA are a heterogeneous group, with different labour market pathways. For many, the combination of unemployment and work disability means low chances for employment or regained work ability during the following years. Unemployed persons with poorer health, long history outside employment, older age, low educational level, a rejected DP application and a mental disorder could benefit from targeted support.
Exploration of pain assessment and management processes in oncology outpatient services with healthcare professionals: a qualitative study
Authors: Robinson Olivia C , Pini Simon , Flemming Kate , Campling Natasha , Fallon Marie , Richards Suzanne H , Mayland Catriona R , Boland Elaine , Swinson Daniel , Hurlow Adam , Hartup Sue , Mulvey Matthew R
Published: December 2023

Objectives

This study explored cancer pain management practices and clinical care pathways used by healthcare professionals (HCPs) to understand the barriers and facilitators for standardised pain management in oncology outpatient services (OS).

Design

Data were collected using semistructured interviews that were audio-recorded and transcribed. The data were analysed using thematic analysis.

Setting

Three NHS trusts with oncology OS in Northern England.

Participants

Twenty HCPs with varied roles (eg, oncologist and nurse) and experiences (eg, registrar and consultant) from different cancer site clinics (eg, breast and lung). Data were analysed using thematic analysis.

Results

HCPs discussed cancer pain management practices during consultation and supporting continuity of care beyond consultation. Key findings included : (1) HCPs’ level of clinical experience influenced pain assessments; (2) remote consulting impeded experienced HCPs to do detailed pain assessments; (3) diffusion of HCP responsibility to manage cancer pain; (4) nurses facilitated pain management support with patients and (5) continuity of care for pain management was constrained by the integration of multidisciplinary teams.

Conclusions

These data demonstrate HCP cancer pain management practices varied and were unstructured. Recommendations are made for a standardised cancer pain management intervention: (1) detailed evaluation of pain with a tailored self-management strategy; (2) implementation of a structured pain assessment that supports remote consultations, (3) pain assessment tool that can support both experienced and less experienced clinicians. These findings will inform the development of a cancer pain management tool to integrate within routine oncology OS.