bluuebunny/crossref_metadata_2025 huggingface dataset:
Orbital cellulitis with panophthalmitis and scleral necrosis – a case report
Authors: Rodriguez Aurora , Ahmed Kamran , Tiwari Nishant , Ramasubramanian Aparna
Published: November 2023

Background

Orbital cellulitis is common in young children and is often secondary to coexisting sinus disease. Coexisting orbital cellulitis and panophthalmitis is a rare clinical event and usually occurs secondary to trauma or from an endogenous source.

Case presentation

A febrile 2-year-old male presented with periorbital inflammation and exudative retinal detachment. Imaging showed acute sinusitis and extensive orbital cellulitis. Because of progressive scleral thinning, the patient underwent enucleation.

Conclusion

We present a case of concurrent orbital cellulitis, panophthalmitis, and scleral necrosis in an immunocompetent pediatric patient. Timely intervention is important to prevent life threatening complications with the rare occurrence of coexistent orbital cellulitis and panophthalmitis.
Comparison of errors in ablation depth calculation after myopic femtosecond laser in situ keratomileusis in patients with different degrees of myopia: a prospective study
Authors: Jiao Yi-Dian , Yan Zhi , Zhao Tian-Qi , Zhao Hai-Xia
Published: November 2023

Background

To investigate the difference between the predicted preoperative corneal ablation depth and the measured ablation depth for femtosecond laser in situ keratomileusis (FS-LASIK) in patients with different degrees of myopia, and to analyze the source of the difference.

Methods

A total of 55 patients (109 eyes) were included in this study. Multiple logistics regression was applied to analyze the sources affecting postoperative refractive outcomes. The difference between the preoperative predicted corneal ablation depth and the 1-day postoperative ablation depth in patients with different degrees of myopia was explored using linear regression. Corneal biomechanical parameters influencing error in ablation depth calculation were examined using multiple linear regression.

Results

One hundred and nine eyes were divided into low to moderate myopia (55 eyes, myopia of 6 D or less), high myopia (45 eyes, myopia ranging from 6 D to a maximum of 9 D), and very high myopia group (9 eyes, myopia greater than 9 D) based on preoperative refractive error (spherical equivalent). Postoperative visual outcomes were comparable among the three groups of patients, with no significant difference in uncorrected visual acuity (UCVA). We did find notable disparities in spherical equivalent (SE) and central corneal thickness (CCT) in patients with different degrees of myopia at 1 day postoperatively (all p < 0.001). Logistic regression analysis showed that error in ablation depth calculation was an independent risk factor for refractive outcomes one day after surgery (OR = 1.689, 95% CI: 1.366 – 2.089). There was a substantial discrepancy in error in ablation depth calculation at 1 day postoperatively between the three groups. The measured ablation depth of the laser platform was lower than the predicted ablation depth in the low to moderate myopia and very high myopia groups, but the opposite was true in the high myopia group. Pre-operative SE (p < 0.001) and corneal front minimum radius of curvature (Front Rmin) (p = 0.007) obviously influenced the error in ablation depth calculation.

Conclusions

Error in ablation depth calculation values vary significantly between patients with different degrees of myopia and correlate highly with preoperative SE and Front Rmin. At the same time, the available evidence suggests that error in ablation depth calculation is an influential factor in postoperative refractive status, so it is imperative to control error in ablation depth calculation.
Relationship between fine particulate matter (PM2.5) concentration and risk of hospitalization due to chronic obstructive pulmonary disease: a systematic review and meta-analysis
Authors: Delavar Mouloud Agajani , Jahani Mohammad ali , Sepidarkish Mahdi , Alidoost Saeide , Mehdinezhad Hamed , Farhadi Zeynab
Published: November 2023

Background

Short-term exposure to PM2.5 has been associated with human health risks. However, evidence on the association between short-term exposure to PM2.5 and the risk of chronic obstructive pulmonary disease (COPD) remains limited and controversial. This study aimed to specifically assess the relationship between exposure to PM2.5 and the risk of hospitalization due to COPD.

Methods

A systematic search was conducted in PubMed, Web of Science, and Google Scholar databases from January 1, 2010 to May 1, 2022. The odds ratio (OR) statistic was calculated as a common measure of effect size. Publication bias was also examined in all eligible studies on COPD hospitalization using funnel plots and Egger’s test, as well as trim-and-fill method for missing studies on COPD hospitalization.

Results

A total of 19 studies were included in this meta-analysis. Random-effects models were plotted to calculate the pooled effect size by measuring OR (χ2 = 349.95; df = 18; I2 = 94.86%; P = 0.007; Z = 2.68; P < 0.001). A 10-mg/m3 daily increase in PM2.5 concentration was associated with a 1.6% (95% CI: 0.4–2.9%) increase in COPD hospitalization. There was no publication bias regarding the association between COPD hospitalization and PM2.5 (bias = 1.508; 95% CI: -1.475, 4.491; t = 1.066; P = 0.301). The subgroups of age ≥ 65 years and Asian countries were associated with an increased risk of COPD hospitalization. Besides, higher risks were estimated in the subgroups of studies performed in the warm season, case-crossover studies, studies with three lag days, and studies without adjustments for humidity and temperature confounders, with very small heterogeneity.

Conclusion

Evidence suggests that short-term exposure to PM2.5 increases COPD hospitalization. Further studies are needed to understand the mechanism of the association between PM2.5 and COPD for reducing air pollution, which can be beneficial for COPD patients.
Associations between exposure to common technology devices and reported neck pain among Iranian school-age adolescents: a cross sectional study
Authors: Azadvari Mohaddeseh , Sarzaeim Mojdeh , Rajabi Sarvin , Yahyaee Alireza , Razavi Seyede Zahra Emami , Haghparast Afarin , Biderafsh Azam , Nakhostin-Ansari Amin , Hosseini Maryam , Ghahvechi Masood
Published: November 2023

Background

The advancement of technology has contributed to a more sedentary lifestyle, and the extensive use of handheld devices among adolescents may potentially result in neck pain. This study aimed to assess the association between exposure to common technology devices and self-reported neck pain in Iranian school-age adolescents.

Methods

This cross-sectional study was conducted between June and October 2021, employing a randomized multi-stage cluster sampling approach. We enrolled 808 adolescent students aged 11 to 19 years old. We asked participants about any neck pain they experienced in the week leading up to the study. Additionally, we gathered demographic information and assessed participants’ use of electronic devices using a questionnaire.

Results

Our study comprised 73.5% female participants with an average age of 15.1 ± 1.7 years and 26.5% male participants with an average age of 14.5 ± 1.5 years. In the regression model, the female gender (p = 0.038), using mobile for more than 6 h (p = 0.04), and using electronic devices while sitting on the floor (p = 0.02) were associated with a higher prevalence of neck pain among participants.

Conclusion

In our study, we observed a relatively high prevalence of neck pain, which was linked to extended daily mobile phone usage and body posture during electronic device use. Policymakers may consider interventions aimed at reducing mobile phone usage and promoting proper body posture while using electronic devices as potential strategies to alleviate the burden of neck pain among Iranian adolescents.
Prediction of biochemical recurrence after laparoscopic radical prostatectomy
Authors: Bejrananda Tanan , Pliensiri Pitchaya
Published: November 2023

Background

Radical prostatectomy (RP) has been considered primary treatment for localized prostate cancer. Biochemical recurrence (BCR) occur approximately 20–30% in five year after RP. We aim to develop a novel nomogram to predict BCR-free survival (BCRFS) and performed external validation using a validation cohort that may help clinicians to make better decision for tailoring adjuvant treatment to specific group of patients.

Materials and methods

This retrospective cohort study included 370 localized and regional prostate cancer patients who underwent laparoscopic radical prostatectomy (LRP) in Songklanagarind hospital between January 2010 and December 2019, the patients were divided into two groups (primary cohort and validation cohort). BCR-free survival was created using Kaplan-Meier curve. Predictive factors for BCR were identified with univariable and multivariable analysis using Cox proportional hazards model. Predictive nomogram was created using these identified factors and developed for the prediction of biochemical recurrence free survival (BCRFS) at 1 and 5 years after LRP.

Results

For primary Songklanagarind cohort, BCR was found in 105 patients (44.7%). Overall 1-year BCR-free survival was 52.8%, and 5-year BCR-free survival was 45.7% with median time to BCR of 18.1 months. Multivariable analysis identified unfavorable factor to BCRRF which are high initial serum PSA (> 20) (p < 0.001; HR 3.2), ISUP Gleason grade group > = 3 (p 0.033; HR 2.2), positive surgical margins (p 0.046; HR 1.5), and seminal vesicle involvement (p < 0.001; HR 5.2) and using for develop a novel nomogram to predict BCR. Concordance index 0.78.

Conclusion

Prostate cancer patients with unfavorable factors, including high initial PSA (> 20), ISUP Gleason grade group > = 3, positive margin and extra-prostatic tumor extension are considered high risks and independent predictors of biochemical recurrence. This predictive models could potentially improve the 1 and 5-year BCR prediction after RP, according to the study’s findings and will aid medical professionals in achieving the goal of clinical prediction and creating a proper management for the localized treatment of prostate cancer underwent laparoscopic radical prostatectomy.
Predictive modeling of postoperative gastrointestinal dysfunction: the role of serum bilirubin, sodium levels, and surgical duration in gynecological cancer care
Authors: He Lijuan , Hu Jun , Han Yun , Xiong Wenli
Published: November 2023

Objective

To elucidate the role of preoperative serum bilirubin and sodium levels, along with the duration of surgery, in predicting postoperative gastrointestinal dysfunction (POGD) following gynecological cancer surgery, informing tailored perioperative strategies.

Methods

We conducted a retrospective analysis of 281 patients undergoing gynecological cancer surgery between 2018 and 2023. This analysis focused on preoperative serum bilirubin and sodium levels and intraoperative factors (surgical duration) as potential predictors of POGD. Logistic regression models were utilized for analysis, controlling for relevant confounders.

Results

Elevated preoperative serum bilirubin was associated with a reduced risk of POGD (mean level in non-POGD cases: 14.172 ± 4.0701, vs. POGD cases: 9.6429 ± 3.5351; p <  0.001), suggesting a protective role. Lower preoperative sodium levels were identified in the POGD group (136.26 mEq/L [IQR: 135.2–137.63]) compared to the non-POGD group (139.32 mEq/L [IQR: 137.7–140.75]; p <  0.001), highlighting its predictive value. Additionally, longer surgical duration was associated with increased POGD incidence, with POGD cases experiencing surgeries lasting 6.1547 ± 1.9426 hours compared to 4.5959 ± 1.5475 hours in non-POGD cases (p <  0.001).

Conclusion

Our findings underscore the importance of serum bilirubin, sodium levels, and surgical duration as significant predictors of POGD in patients undergoing gynecological cancer surgery. These indicators should be integrated into a predictive model, aiding clinicians in identifying high-risk patients, allowing for personalized perioperative care adjustments, potentially mitigating POGD risks.
Assessment of the capacity of ChatGPT as a self-learning tool in medical pharmacology: a study using MCQs
Authors: Choi Woong
Published: November 2023

Background

ChatGPT is a large language model developed by OpenAI that exhibits a remarkable ability to simulate human speech. This investigation attempts to evaluate the potential of ChatGPT as a standalone self-learning tool, with specific attention on its efficacy in answering multiple-choice questions (MCQs) and providing credible rationale for its responses.

Methods

The study used 78 test items from the Korean Comprehensive Basic Medical Sciences Examination (K-CBMSE) for years 2019 to 2021. 78 test items translated from Korean to English with four lead-in prompts per item resulted in a total of 312 MCQs. The MCQs were submitted to ChatGPT and the responses were analyzed for correctness, consistency, and relevance.

Results

ChatGPT responded with an overall accuracy of 76.0%. Compared to its performance on recall and interpretation questions, the model performed poorly on problem-solving questions. ChatGPT offered correct rationales for 77.8% (182/234) of the responses, with errors primarily arising from faulty information and flawed reasoning. In terms of references, ChatGPT provided incorrect citations for 69.7% (191/274) of the responses. While the veracity of reference paragraphs could not be ascertained, 77.0% (47/61) were deemed pertinent and accurate with respect to the answer key.

Conclusion

The current version of ChatGPT has limitations in accurately answering MCQs and generating correct and relevant rationales, particularly when it comes to referencing. To avoid possible threats such as spreading inaccuracies and decreasing critical thinking skills, ChatGPT should be used with supervision.
Toward safe dental service: risk perception and practice modification among Egyptian dental students during the COVID-19 pandemic
Authors: Younis Eman Ali , El deep Abdel Aziz farouk , Shalaby Safynaz El Saied , Abdo Sanaa Abd El-Fatah
Published: November 2023

Background

COVID-19 was declared a major public health crisis and a challenge to healthcare systems especially dental services where dentists working close to patients face a greater risk of infection. This cross-sectional study aimed to assess the risk perception and practice modifications of undergraduate dental students at Tanta University to ensure safe dental practice during the COVID-19 pandemic.

Methods

A convenience sample of 450 dental students from practical academic years at Tanta University, Egypt responded to a self-administered pre-designed validated and pretested questionnaire from the 11th of February 2022 to the end of April 2022 to assess some sociodemographic data, risk perception, and their practice during the COVID-19 pandemic.

Results

Females reported significantly higher levels of fear than males concerning; contracting COVID-19 infection from patients (97.3% vs. 93%) (P = 0.028, 95% CI = 95.6(93.2–97.3), anxiety while treating symptomatic patients (95.1% vs. 90.3%) (P = 0.050, 95% CI = 93.1(90.4–95.3), and fear of infecting their families (94.7% vs. 89.8%) (P = 0.049, 95% CI = 92.7(89.9–94.9). More than half of the students (53.7%) had good practice scores, followed by 44% with average practice and 2.2% with poor practice. A good practice score was significantly associated with the age and academic year (P = 0.044, P = 0.044). Significant predictors of a good practice score in the logistic regression analysis were; updating knowledge with current guidelines for cross-infection regarding COVID-19 (P = 0.001, 95% CI = 53.20, 2.733), asking every patient’s travel history before performing treatment (P = 0.021, 95% CI = 21.149, 1.286), deferring patients showing suspicious symptoms (P = 0.042, 95% CI = 20.688, 1.054), following routine universal precautions of infection for every patient (P = 0.016, 95% CI = 36.469, 1.438), using high-volume suction for every patient (P = 0.025, 95% CI = 20.826, 1.226) and using safety glasses or visor (P = 0.036, 95% CI = 21.673, 1.106).

Conclusion

The dental students exhibited anxiety and fear while caring for patients during the COVID-19 pandemic. Additionally, considerable changes in dental practices based on the standard guidelines were observed among the students. It is strongly advised that all dental schools have student counselors who are accessible for in-person and online counseling sessions. Peer support is a great approach to spot problems with stress and anxiety in pupils and start solving them.
A multicenter, randomized controlled study on the efficacy of agomelatine in ameliorating anhedonia, reduced motivation, and circadian rhythm disruptions in patients with major depressive disorder (MDD)
Authors: Guo Ping , Xu Yong , Lv Liang , Feng Min , Fang Yu , Huang Wei-Quan , Cheng Shan-Fei , Qian Min-Cai , Yang Shengliang , Wang Shi-Kai , Chen Huan-Xin
Published: November 2023

Objective

To evaluate the clinical efficacy and safety of Agomelatine in improving symptoms in patients with major depressive disorder (MDD), providing more scientific evidence for the treatment of depression, and offering more effective therapeutic options for patients.

Methods

A total of 180 MDD patients in acute phase from 10 psychiatric hospitals of Grade three in Zhejiang Province were enrolled in this 12-week study with the competitive and consecutive pattern, and they were randomized into two different groups treated with flexible-dosage antidepressants of selective serotonin reuptake inhibitors (SSRI) or agomelatine, respectively. The subjects were evaluated with psychological scales of HAMD-17, HAMA, SHAPS for anhedonia, MFI-20 for fatigue, PQSI for sleep quality and MEQ for disturbances in chronobiologic rhythms at baseline, 2, 4, 8 and 12-weekend points, and TESS was used for side-effect. The results were analyzed with repeated measurement analysis of variance.

Results

The two groups each had 90 participants, and there were no significant differences at baseline. The scores of various assessment scales showed statistically significant time main effects during the visits (P < 0.01). The Agomelatine group demonstrated faster efficacy within 2 weeks, with better improvement in SHAPS, MEQ, and PSQI compared to the SSRIs group. However, the remission rate at 12 weeks was lower in the Agomelatine group than in the SSRIs group (63.3% and 72.2%), but the difference between the groups was not statistically significant. The Agomelatine group had fewer adverse reactions (14.4% and 16.7%), but there was a slightly higher incidence of liver function impairment (6.7% and 4.4%), with no statistically significant difference between the groups.

Conclusion

Agomelatine, as a novel antidepressant, shows certain advantages in improving depression and anxiety symptoms and is comparable to SSRIs in terms of safety. However, its long-term efficacy and safety on MDD or other depressive subtypes still require further observation and research.
Aortic annulus rupture after transcatheter aortic valve replacement: successful management of a dangerous complication
Authors: Jones Andrew , Amirjamshidi Hossein , Knight Peter , Ling Frederick S. , Hisamoto Kazuhiro
Published: November 2023

Objective

Aortic annulus rupture remains one of the most fatal complications of TAVR. While attempts have been made to describe and predict this complication, the data remains insufficient without evidence-based guidelines for management of this rare complication.

Methods

Here we describe a series of 3 aortic annulus ruptures after TAVR which were managed successfully to hospital discharge.

Results

Patient 1 suffered annulus rupture during balloon valvuloplasty prior to TAVR. The patient became hypotensive, and echocardiogram showed pericardial effusion. The patient underwent pericardiocentesis which transiently improved the blood pressure, but bleeding continued. The patient was transitioned to an open surgical aortic valve replacement due to ongoing hemorrhage. The chest was left open with delayed closure on post-op day 2. The patient was discharged on post-op day 15. Patient 2 was undergoing TAVR valve expansion. The patient became hypotensive. An echocardiogram revealed pericardial effusion. Pericardiocentesis yielded 200 mL of blood. SURGIFLO (Johnson & Johnson Wound Management, Somerville, NJ) was injected into the pericardial space. Aortic root angiography confirmed no further contrast extravasation. A pericardial drain was left in place for 2 days, and the patient was discharged on post-op day 7. Patient 3 received a TAVR valve and post-placement dilation due to paravalvular leak. The echocardiogram showed a pericardial effusion. Pericardiocentesis was performed, yielding 500 cc of blood. The patient’s healthcare proxy declined emergent surgery; thus, a pericardial drain was placed. No hemostatic agents were used, and drainage reduced over several hours. The drain was removed on post-op day 3, and the patient was discharged on post-op day 8.

Conclusions

Based on the timelines in these three cases, and interventions used, the following steps may be employed in the event of annulus rupture: identification of hemodynamic instability, echocardiogram to confirm pericardial effusion, emergent pericardiocentesis, pericardial drain placement for evacuation of the pericardial space and use of hemostatic agents, repeat aortogram to rule out ongoing extravasation. If hemostasis is unable to be achieved and/or the patient becomes hemodynamically unstable at any point, rapid transition to emergent surgical management is necessary. This management strategy proved successful for this case series and warrants further investigation.
The relationship between openness and social anxiety: the chain mediating roles of social networking site use and self-evaluation
Authors: Gong Jian , Li Ye , Niu Bingyu , Liu Xiaofei , Wang Yuyan , Zhou Bingping , Hai Man
Published: November 2023

Background

As social networking sites (SNSs) with diverse functions gradually become an important social place for modern people, openness, as a personality trait that represents the willingness to consider diverse things, will be more likely to affect people’s cognitive and emotional experience (e.g., social anxiety) in social interactions. This study examined the relationship between openness and social anxiety and the underlying psychological mechanism in the internet age based on the cognitive-behavioral model of social anxiety.

Methods

This cross‑sectional survey study conducted a questionnaire survey of 522 college students from two provinces in China (191 male; age range 18–25; M = 20.76, SD = 1.34).

Results

The results showed that openness is negatively related to social anxiety. Self-evaluation and passive SNS use independently mediate the relationship between openness and social anxiety, respectively. Moreover, openness is associated with social anxiety both through the chain mediating roles of active SNS use and self-evaluation and through the chain mediating roles of passive SNS use and self-evaluation.

Conclusions

Openness is negatively associated with social anxiety, and the different ways of SNS use and self-evaluation are the underlying mechanisms. These results provide insights into the clinical treatment of social anxiety and how to benefit from online interactions.
Heterogeneity of cortical pTDP-43 inclusion morphologies in amyotrophic lateral sclerosis
Authors: Tan Rachel H. , McCann Heather , Shepherd Claire E. , Pinkerton Monica , Mazumder Srestha , Devenney Emma M. , Adler Gabrielle L. , Rowe Dominic B. , Kril Jillian , Halliday Glenda M. , Kiernan Matthew C.
Published: November 2023

Background

Despite the presence of significant cortical pTDP-43 inclusions of heterogeneous morphologies in patients diagnosed with amyotrophic lateral sclerosis (ALS), pathological subclassification is routinely performed in the minority of patients with concomitant frontotemporal dementia (FTD).

Objective

In order to improve current understanding of the presence and relevance of pathological pTDP-43 subtypes in ALS, the present study examined the pattern of cortical pTDP-43 aggregates in 61 ALS cases without FTD.

Results

Based on the presence, morphology and composition of pTDP-43 pathology, three distinct ALS-TDP subtypes were delineated: (1) A predominant pattern of pTDP-43 granulofilamentous neuronal inclusions (GFNIs) and grains that were immuno-negative for p62 was identified in 18% of cases designated ALS-TDP type E; (2) neuronal cytoplasmic inclusions (NCIs) that were immuno-positive for both pTDP-43 and p62 were observed in 67% of cases assigned ALS-TDP type B; and (3) scarce cortical pTDP-43 and p62 aggregates were identified in 15% of cases coined ALS-TDP type SC (scarce cortical). Quantitative analyses revealed a significantly greater burden of pTDP-43 GFNI and grains in ALS-TDP type E. Principal component analysis demonstrated significant relationships between GFNIs, grains and ALS-TDP subtypes to support the distinction of subtypes E and B. No significant difference in age at death or disease duration was found between ALS-TDP subgroups to suggest that these subtypes represent earlier or later stages of the same disease process. Instead, a significantly higher ALS-TDP stage, indicating greater topographical spread of pTDP-43, was identified in ALS-TDP type E. Alzheimer’s disease neuropathological change (ABC score ≥ intermediate) and Lewy body disease (Braak stage ≥ IV) was more prevalent in the ALS-TDP type SC cohort, which also demonstrated a significantly lower overall cognitive score.

Conclusion

In summary, the present study demonstrates that ALS-TDP does not represent a single homogenous neuropathology. We propose the subclassification of ALS-TDP into three distinct subtypes using standard immuno-stains for pTDP-43 and p62 in the motor cortex, which is routinely sampled and evaluated for diagnostic neuropathological characterisation of ALS. We propose that future studies specify both clinicopathological group and pTDP-43 subtype to advance current understanding of the pathogenesis of clinical phenotypes in pTDP-43 proteinopathies, which will have significant relevance to the development of targeted therapies for this heterogeneous disorder.
Assessment of the efficacy of various maxillary molar intrusion therapies: a systematic review
Authors: Abu Arqub Sarah , Al-Moghrabi Dalya , Iverson Marissa G. , Farha Philippe , Alsalman Hala Abdullah , Uribe Flavio
Published: November 2023

Aims

To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of intrusion, subsequent vertical movement of mandibular molars, cost effectiveness, compliance, patient reported outcomes and adverse events.

Methods

A pre-registered and comprehensive literature search of published and unpublished trials until March 22nd 2023 with no language restriction applied in PubMed/Medline, Embase, Scopus, DOSS, CENTRAL, CINAHL Plus with Full Text, Web of Science, Global Index Medicus, Dissertation and Theses Global, ClinicalTrials.gov, and Trip (PROSPERO: CRD42022310562). Randomized controlled trials involving a comparative assessment of treatment modalities used to intrude maxillary molars were included. Pre-piloted data extraction forms were used. The Cochrane Risk of Bias tool was used for risk of bias assessment, and The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used for certainty of evidence appraisal.

Results

A total of 3986 records were identified through the electronic data search, of which 24 reports were sought for retrieval. Of these, 7 trials were included. One trial was judged at high risk of bias, while the others had some concerns. Based on individual small sample studies, maxillary molar intrusion was achieved using temporary anchorage devices (TADs) and rapid molar intruder appliance (RMI). It was also observed to a lesser extent with the use of open bite bionator (OBB) and posterior bite blocks. The molar intruder appliance and the posterior bite blocks (spring-loaded or magnetic) also intruded the lower molars. Root resorption was reported in two studies involving TADs. None of the identified studies involved a comparison of conventional and TAD-based treatments for intrusion of molars. No studies reported outcomes concerning stability, cost-effectiveness, compliance and patient-reported outcomes. Insufficient homogeneity between the included trials precluded quantitative synthesis. The level of evidence was very low.

Conclusions

Maxillary molar intrusion can be attained with different appliances (removable and fixed) and with the use of temporary anchorage devices. Posterior bite blocks (spring-loaded or magnetic) and the RMI offer the additional advantage of intruding the mandibular molars. However, stability of the achieved maxillary molar intrusion long term is unclear. Further high-quality randomized controlled trials are needed.
Optimization of laccase from Stenotrophomonas maltophilia E1 by submerge fermentation using coconut husk with its detoxification and biodecolorization ability of synthetic dyes
Authors: Albulaihed Yazeed , Adnan Mohd , Jamal Arshad , Snoussi Mejdi , Patel Kartik , Patel Mitesh
Published: November 2023

Enzymatic degradation of synthetic dyes holds an immense promise for addressing the environmental concerns associated with the textile and dye industries. This study aimed to isolate bacteria capable of producing laccase enzymes from an anthropogenic environment. Subsequently, viability of utilizing cost-effective agricultural residues as substrates for laccase production was assessed. Response Surface Methodology (RSM) and the One Variable at a Time (OVAT) approach was pursued for the optimization of laccase production, followed by pH and temperature stability, dye degradation and decolorization experiments, toxicological studies on the degraded dye metabolites. In results, laccase-producing bacterial strain was identified as Stenotrophomonas maltophilia strain E1 (S. maltophilia). Among variety of substrates, coconut husk exhibited optimal efficacy. In a statistical optimization study, it was found that S. maltophilia was capable of producing laccase 51.38 IU/mL, i.e., three times higher than the amount of laccase produced by unoptimized medium (16.7 IU/mL), and the enzyme activity was found to be steady at an acidic pH, and a mesophilic temperature range. The laccase obtained from S. maltophilia E1 demonstrated proficient dye decolorization capabilities, achieving a notable 92.1% reduction in Malachite green dye coloration at a concentration of 500 ppm. Gas chromatography–mass spectrometry (GC–MS) analysis of the decolorized derivatives of Malachite green revealed a conversion into a distinct compounds. Moreover, after undergoing laccase treatment, Malachite green exhibited decreased phytotoxic effects on Oryza sativa, pointing to enzymatic detoxification. Collectively, insights gained from the present study will contribute to the development of efficient enzymatic approaches for addressing the environmental pollution caused by synthetic dyes.

Graphical Abstract
The role of acute normovolemic hemodilution in reducing allogeneic blood transfusion in glioblastoma surgery: a case–control study
Authors: Chen Ping , Zhang Xin-Huang , Wang Ying , Lin Xian-Zhong , Kang De-Zhi , Lin Qing-Song
Published: November 2023

Background

Acute normovolemic hemodilution (ANH) was first introduced in glioblastoma surgery, and its role in reducing allogeneic blood transfusion was investigated in this study.

Methods

This study enrolled supratentorial glioblastoma patients who received total resection. In the ANH group, the patients were required to draw blood before the operation, and the blood will be transfused back to the patient during the operation. The association between ANH and clinical features was investigated.

Results

Sixty supratentorial glioblastoma patients were enrolled in this study, 25 patients were allocated in the ANH group, and another 35 patients were included in the control group. ANH dramatically reduced the need for allogeneic blood transfusion (3 [12%] vs 12 [34.3%], P = 0.049), and the blood transfusion per total of patients was dramatically decreased by the application of ANH (0.40 ± 1.15 units vs 1.06 ± 1.59 units, P = 0.069). Furthermore, ANH also markedly reduced the requirement of fresh frozen plasma (FFP) transfusion (2 [8%] vs 11 [31.4%], P = 0.030) and the volume of FFP transfusion per total of patients (32.00 ± 114.46 mL vs 115.71 ± 181.00 mL, P = 0.033). The complication rate was similar between the two groups.

Conclusions

ANH was a safe and effective blood conservation technique in glioblastoma surgery.
Sterols and flavonoids in strawberry calyx with free radical scavenging, anti-inflammatory, and molecular dynamic study
Authors: El‑Feky Amal M. , El-Rashedy Ahmed A.
Published: November 2023

Background

The phytochemical constitution and biological capabilities of Fragaria ananassa's calyx have not been extensively investigated before. Consequently, the research study pointed for characterization, isolation, and identification of the sterols and flavonoids as the major active constituents in the calyx of F. ananassa and evaluation for their impacts as free radicals scavenger and anti-inflammatory agent.

Results

GC/MS investigation for the lipoidal constitutions of F. ananassa's calyx was performed to identify twenty-six compounds signifying 83.08%, as well as isolation of campesterol, stigmast-4-en-3-one, and β-sitosterol-d-glucoside by column chromatography technique. Additionally, quantification and identification of the flavonoids in the ethyl acetate extract was carried out by HPLC/DAD technique beside to isolation and structure elucidation of 5-hydroxy-7, 4′-dimethoxy flavone and Chrysin. The free radicals scavenging and anti-inflammatory activities of both non-polar and polar extracts have been tested against (DPPH and ABTS radicals) and (COX-1, COX-2, and 5-LOX enzymes), correspondingly. The results illustrated significant effects of the polar extract of F. ananassa calyx greater than non-polar one. The dynamic natures, binding interactions, and protein–ligand stabilities have also been investigated using the molecular dynamics (MD) simulation research. The MD simulation revealed that Chrysin's chromen ring was extended to catalytic position of COX-1 receptor, producing Pi-Pi T-shaped contact with Tyr 354 and Trp 356. In addition, Chrysin's chromen ring has formed a Pi-alkyl bond with Val 318 and Leu 321. However, due to the huge size of ꞵ-sitosterol-d-glucoside, the glycoside ring can form a hydrogen bond with Tyr 317. The cyclopentyl phenanthrene ring also possesses Pi-alkyl interactions with Ile 58, Leu 62, Val 85, Val 318, Tyr 324, Leu 326, Ala 496, and Leu 500.

Conclusions

The findings of our study are crucial in establishing the molecular bases for Chrysin and ꞵ-sitosterol-d-glucoside action against anti-inflammatory targets and for developing more effective selective inhibitors. The discovery of the binding location for ATP can pave the door for development unique, structure-based approach for natural anti-inflammatory medications.
Extra-corporeal shock wave therapy versus local corticosteroid injection in treatment of chronic trigger finger in diabetic patients
Authors: El-Leithy Sally A. , Adly Nahla Nader , Taha Rana Mohamed , El-Gharbawy Nermin H.
Published: November 2023

Background

Trigger finger is one of the most common causes of pain and dysfunction. The aim of our study was to compare the effectiveness of shock wave therapy versus local corticosteroid injection in the treatment of trigger finger in diabetic patients.

Results

The two groups were matched on age, HbA1c, VAS score, and grip force at week zero. There was statistically significant improvement in both groups after treatment. In comparing the two groups after 6 weeks of starting treatment either by shockwave therapy or by local corticosteroid injection, there was a statistically significant improvement in group 1 as regards VAS pain score (p = 0.012), clinical signs (finger extension and locking) (p = 0.018), hand grip dynamometer (p < 0.001), and musculoskeletal ultrasound findings in comparison to group 2.

Conclusion

Trigger finger is a common complication of DM. Shockwave therapy was able to reduce pain and improve hand functional level and quality of life. Shockwave is an effective, safe, non-invasive method for conservative management of trigger finger.
Antecedents, clinical and psychological characteristics of a large sample of individuals who have self-harmed recruited from primary care and hospital settings in Pakistan
Authors: Husain Muhammad Omair , Chaudhry Nasim , Kiran Tayyeba , Taylor Peter , Tofique Sehrish , Khaliq Ayesha , Naureen Amna , Shakoor Suleman , Bassett Paul , Zafar Shehla Naeem , Chaudhry Imran B. , Husain Nusrat
Published: November 2023

Background

Suicide is one of the leading causes of mortality worldwide, and the majority of suicide deaths occur in low- and middle-income countries.

Aims

To evaluate the demographic and clinical characteristics of individuals who have presented to health services following self-harm in Pakistan.

Method

This study is a cross-sectional baseline analysis of participants from a large multicentre randomised controlled trial of self-harm prevention in Pakistan. A total of 901 participants with a history of self-harm were recruited from primary care clinics, emergency departments and general hospitals in five major cities in Pakistan. The Beck Scale for Suicide Ideation (BSI), Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS) and Suicide Attempt Self Injury Interview assessment scales were completed.

Results

Most participants recruited were females (n = 544, 60.4%) in their 20s. Compared with males, females had lower educational attainment and higher unemployment rates and reported higher severity scores on BSI, BDI and BHS. Interpersonal conflict was the most frequently cited antecedent to self-harm, followed by financial difficulties in both community and hospital settings. Suicide was the most frequently reported motive of self-harm (N = 776, 86.1%). Suicidal intent was proportionally higher in community-presenting patients (community: N = 318, 96.9% v. hospital: N = 458, 79.9%; P < 0.001). The most frequently reported methods of self-harm were ingestion of pesticides and toxic chemicals.

Conclusions

Young females are the dominant demographic group in this population and are more likely to attend community settings to seek help. Suicidal intent as the motivator of self-harm and use of potentially lethal methods may suggest that this population is at high risk of suicide.
Assessing professionalism in mental health clinicians: development and validation of a situational judgement test
Authors: Aylott Lauren M. E. , Finn Gabrielle M. , Tiffin Paul A.
Published: November 2023

Background

Situational judgement test (SJT) scores have been observed to predict actual workplace performance. They are commonly used to assess non-academic attributes as part of selection into many healthcare roles. However, no validated SJT yet exists for recruiting into mental health services.

Aims

To develop and validate an SJT that can evaluate procedural knowledge of professionalism in applicants to clinical roles in mental health services.

Method

SJT item content was generated through interviews and focus groups with 56 professionals, patients and carers related to a large National Health Service mental health trust in England. These subject matter experts informed the content of the final items for the SJT. The SJT was completed by 73 registered nurses and 36 allied health professionals (AHPs). The primary outcome measure was supervisor ratings of professionalism and effectiveness on a relative percentile rating scale and was present for 69 of the participating nurses and AHPs. Personality assessment scores were reported as a secondary outcome.

Results

SJT scores statistically significantly predicted ratings of professionalism (β = 0.31, P = 0.01) and effectiveness (β = 0.32, P = 0.01). The scores demonstrated statistically significant incremental predictive validity over the personality assessment scores for predicting supervisor ratings of professionalism (β = 0.26, P = 0.03).

Conclusions

These findings demonstrate that a carefully designed SJT can validly assess important personal attributes in clinicians working in mental health services. Such assessments are likely to represent evidence based, cost-effective tools that can support values-based recruitment to mental health service roles.
Opportunity Strikes for Reducing Cancer Drug Waste: Bortezomib as an Example of Vial Mis-Sizing in Oncology
Authors: Abrams Hannah R. , Chen Ashley W. , Banerjee Rahul
Published: November 2023

Mis-sized packaging leads to millions of dollars in drug waste annually. Now is the time to act.
The Concept of Cultural Revolution, and Its Indian Ocean Travels during the Cold War
Authors: Burgess G. Thomas
Published: November 2023

For most of the 1960s, Kweupe served as the official printed mouthpiece of the Zanzibari Revolution. Appearing in Swahili, the newspaper repeatedly claimed the revolution would only succeed if islanders were willing to transform their thoughts, values, and routines. Through analysis of such rhetoric, this article sheds new light upon the relationship between nationalism and socialism in the Indian Ocean during the Cold War. It argues that nationalists frequently perceived in socialism a series of anchoring principles by which to obtain meaningful as opposed to illusory sovereignty. And while socialism proposed ways to resist and reshape global structures faulted for perpetuating neocolonial domination and inequality, it also presented cultural solutions to poverty and powerlessness on the world stage. Indeed, the socialist concept of cultural revolution appealed to nationalists of the 1960s because its effectiveness appeared to be indisputable—and because the concept licensed nationalists to critically evaluate inherited cultural norms in terms of their perceived conduciveness to national progress and sovereignty. Such critique was not exceptional to nationalists of the Indian Ocean searching for means by which to complete the process of decolonization. Rather, it was inherent to nationalist thought since at least the early nineteenth century and was inspired by a series of sentiments and emotions that call for further scholarly examination.
Δυναμική απάντηση του εγκεφάλου στην εφαρμογή μέσων για την μείωση της ενδοκράνιας υπέρτασης
Authors: Ρίζος Δημήτριος
Published: November 2023

Εισαγωγή: Τα εγκεφαλικά συμβάματα είναι αρκετά συχνά και σχετίζονται με αυξημένη θνητότητα και σημαντικό βαθμό αναπηρίας. Ένας κύριος στόχος της αντιμετώπισης αυτών των ασθενών είναι αντιμετώπιση της ενδοκράνιας υπέρτασης με στόχο την βελτίωση της έκβασης. Ο σκοπός της μελέτης είναι να απομονωθούν παράγοντες και να συσχετιστούν με την δυναμική απάντηση του εγκεφάλου στα μέσα θεραπείας για την μείωση της ενδοκράνιας πίεσης. Ως μέτρο εκτίμησης της δυναμικής απάντησης του εγκεφάλου στις θεραπείες που εφαρμόστηκαν ορίστηκε η έκβαση των ασθενών δηλαδή έξοδος από την ΜΕΘ ή θάνατος τον ασθενών. Μεθοδολογία: Πρόκειται για μία αναδρομική μελέτη που διεξήχθη στην ΜΕΘ του Γενικού Νοσοκομείου Ιωαννίνων Γ Χατζηκώστα στην διετία 2011- 2012. Δείγμα της μελέτης αποτέλεσαν ασθενείς που νοσηλεύτηκαν με εγκεφαλικά συμβάματα , αγγειακό εγκεφαλικό ή κρανιοεγκεφαλική κάκωση (ΚΕΚ). Κατά την εισαγωγή μετρήθηκαν οι εξής παράμετροι : S100, IL6 και PCT, η θερμοκρασία εισαγωγής καθώς και εργαστηριακοί βιοχημικοί δείκτες (γλυκόζη εισαγωγής) αιματολογικοί (λευκά αιμοσφαίρια, αιμοσφαιρίνη) καθώς και ο πηκτικός έλεγχος (PTAPTTINR ινωδογόνο) των ασθενών. Όλοι οι ασθενείς υποβλήθηκαν σε νευροαπεικονιστική εξέταση του εγκεφάλου (CT). Πραγματοποιήθηκε στατιστική ανάλυση προκειμένου να διερευνηθεί η συσχέτιση αυτών των παραγόντων με την έκβαση των ασθενών. Αποτελέσματα: Συνολικά στην μελέτη συμπεριελήφθησαν 29 ασθενείς. Με βάση τα αποτελέσματα της στατιστικής ανάλυσης , σε ασθενείς οι οποίοι εισάγονται στην ΜΕΘ με παθολογία από τον εγκέφαλο η πρωτεΐνη εισαγωγής S100 συσχετίζεται ισχυρά με την έκβαση των ασθενών. Υπάρχει επίσης συσχέτιση μεταξύ των επιπέδων S100 και γλυκόζης εισαγωγής. Δεν βρέθηκε συσχέτιση μεταξύ των υπόλοιπων παραγόντων που μελετήθηκαν και τις έκβασης των ασθενών.Συμπεράσματα: Σε ασθενείς οι οποίοι εισάγονται στην ΜΕΘ με παθολογία από τον εγκέφαλο η πρωτεΐνη εισαγωγής S100 (εντός 6 ωρών από το συμβάν) συσχετίζεται ισχυρά με την έκβαση των ασθενών. Υπάρχει επίσης συσχέτιση μεταξύ των επιπέδων S100 και γλυκόζης εισαγωγής. Οι μετρήσεις της S100 μπορούν να χρησιμοποιηθούν ως προγνωστικός δείκτης σε ασθενείς με εγκεφαλικά συμβάματα που νοσηλεύονται σε γενική ΜΕΘ. Θα πρέπει να αναφερθεί ότι στην μελέτη μας υπήρχε ο εξής περιορισμός. Το δείγμα της μελέτης μας είναι μικρό. Προφανώς απαιτούνται περισσότερες μελέτες σε μεγαλύτερα δείγματα ασθενών για να αποσαφηνιστεί η πιθανή προγνωστική αξία της πρωτεΐνης S100 σε ασθενείς με εγκεφαλικά συμβάματα.
Ο ρόλος του Notch στον μη-μικροκυτταρικό καρκίνο του πνεύμονα
Authors: Νικολακόπουλος Αχιλλέας
Published: November 2023

Ο καρκίνος του πνεύμονα είναι από τις συχνότερες διαγνωσθείσες κακοήθειες, καθώς και η συχνότερη αιτία θανάτου από κακοήθειες παγκοσμίως. Ταξινομείται σε μικροκυτταρικό και μη μικροκυτταρικό καρκίνο πνεύμονα (ΜΜΚΠ). Το εξελικτικά συντηρημένο μονοπάτι μεταγωγής σήματος του Notch διαδραματίζει ουσιαστικό ρόλο στην διαδικασία της εμβρυογένεσης, της οργανογένεσης και της ομοιόστασης των ιστών. Ο ρόλος του στην παθογένεια του ΜΜΚΠ δεν είναι απόλυτα ξεκάθαρος, καθώς έχουν δημοσιευθεί εργασίες με αντιφατικά αποτελέσματα. Στην παρούσα διατριβή αξιολογήθηκε η επίδραση της αναστολής του μονοπατιού του Notch σε κυτταρικές διεργασίες-«κλειδιά», όπως ο πολλαπλασιασμός, η μεταναστευτικότητα, η απόπτωση, η νέκρωση και η έκφραση πρωτεϊνών που ευοδώνουν ή αναστέλλουν τις παραπάνω διεργασίες. Επιπλέον, μελετήθηκε η αλληλεπίδραση με το μονοπάτι του EGFR, που κατέχει καλά μελετημένο και καθιερωμένο ρόλο στην παθογένεια του ΜΜΚΠ. Τα αποτελέσματα έδειξαν μείωση του κυτταρικού πολλαπλασιασμού, και του σχηματισμού συσσωματωμάτων με την αναστολή τόσο του μονοπατιού του Notch όσο και του EGFR, χωρίς να παρατηρηθεί φαινόμενο συνέργειας με την ταυτόχρονη αναστολή τους. Δεν παρατηρήθηκε ενίσχυση του φαινομένου της απόπτωσης. Αντίθετα, η ταυτόχρονη αναστολή και των δυο μονοπατιών οδήγησε σε μείωση της μεταναστευτικής ικανότητας, που οδηγεί στην υπόθεση αλληλεπίδρασης των δυο μονοπατιών, ειδικά κατά την διαδικασία της μετανάστευσης-μετάστασης. Η παραπάνω αλληλεπίδραση δεν φάνηκε να διενεργείται μέσω αλλαγής της έκφρασης του υποδοχέα του Notch1. Τα παραπάνω δεδομένα δίνουν το έναυσμα και το κίνητρο για περαιτέρω μελέτη της αλληλεπίδρασης των δύο μονοπατιών στον ΜΜΚΠ.
The genome sequence of the Barred Red, Hylaea fasciaria (Linnaeus, 1758)
Authors: Boyes Douglas , Mallick Tista ,   University of Oxford and Wytham Woods Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life programme,   Wellcome Sanger Institute Scientific Operations: DNA Pipelines collective,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: November 2023

We present a genome assembly from an individual male Hylaea fasciaria (the Barred Red; Arthropoda; Insecta; Lepidoptera; Geometridae). The genome sequence is 327.9 megabases in span. Most of the assembly is scaffolded into 31 chromosomal pseudomolecules, including the Z sex chromosome. The mitochondrial genome has also been assembled and is 17.18 kilobases in length. Gene annotation of this assembly on Ensembl identified 17,216 protein coding genes.