bluuebunny/crossref_metadata_2025 huggingface dataset:
Poster 312: Prospective and Randomized Evaluation of Three Different Anterior Cruciate Ligament (ACL) Reconstruction Techniques Including a Lateral Extra-Articular Tenodesis (LET): A Clinical and Radiographic Evaluation at Minimum 20 Years Follow-Up
Authors: Lucidi Gian Andrea , Agostinone Piero , Grassi Alberto , Viotto Marianna , Serra Margherita , Dal Fabbro Giacomo , Di Paolo Stefano , Zaffagnini Stefano
Published: August 2024

Objectives:

Modern lateral extra-articular tenodesis (LET) has shown promising results at short term follow-up but there is a lack of studies investigating the incidence of complication and lateral osteoarthritis (OA) at long-term. The aim of the study was to compare in terms of failure rates, clinical outcomes and OA incidence three different ACL reconstruction techniques including hamstring single-bundle (HS group), patellar tendon (BTB) and hamstring over-the-top with LET (LET group).

Methods:

Seventy-five patients were randomized to receive one of the three ACL reconstruction techniques. At the last follow-up, patients reported outcomes (PROMs), complication and reoperation were collected for every patient. An objective clinical evaluation was performed including anteroposterior laxity measurement (KT-1000) and pivot shift quantification (PS, triaxial-accelerometer). Clinical failures were considered patients with evidence of graft rupture or those with KT-1000 side-to-side > 5mm or with PS side-to-side > >1mm/s2. A radiographic evaluation was performed to assess the incidence of tibiofemoral and patellar OA.

Results:

Final analysis was conducted on 61 patients (81.3%) at an average 23.0 ± 1.1 years follow-up, 38 patients completed the clinical and radiological evaluation. The LET group showed a higher Tegner score compared to the BTB (p=0.026), mean of 4.41 (up to 7) against 3.47 (up to 5). No difference was identified in the other clinical scores among the three groups (p>0.05). Revision rate and clinical failure were respectively 15.8% and 57.1% for the BTB group, 4.6% and 38.5% for the HS group and 4.6% and 18.8% for the LET group (P= 0.09 to 0.8, ns). No difference in the quantitative evaluation of the Pivot Shift were reported, while AP side-to-side difference was lower in the BTB group compared to the HS group (mean -0.1mm vs. +1.5mm). Finally, the BTB group showed a higher rate of patellofemoral OA compared to the other two groups (p=0,009) while the incidence of lateral OA was not increased in the LET group compared to the other techniques (p=0.50).

Conclusions:

Satisfactory clinical outcomes after ACL reconstruction at long-term follow-up could be achieved with different modern surgical techniques. However, the BTB graft was associated with increased incidence of patellofemoral OA when compared with the other techniques. Finally, LET was associated with increased sport participation and similar rate of lateral OA compared to other techniques at long-term follow-up.
Poster 316: Prevalence and Risk Factors for Total Knee Arthroplasty after Cruciate Ligament Surgery: A Study of the UK BioBank
Authors: Inclan Paul , Brophy Robert , Saccone Nancy , Ma Yinjiao , Pham Vy , Yanik Elizabeth
Published: August 2024

Objectives:

The purpose of this study is to determine an individual’s age-specific prevalence of total knee arthroplasty (TKA) and revision TKA after ACL reconstruction (ACLr) and to identify clinical and genetic risk factors associated with undergoing TKA.

Methods:

The UK Biobank – a prospective cohort of 500,000 adults (age 40-69 at time of enrollment) containing health, physical measures, genotyping data, and linked data on hospitalizations – was utilized to identify individuals with a history of ACL surgery (i.e., “cruciate ligament surgery”) during initial health interviews. Individuals were considered to have progressed to end-stage knee osteoarthritis requiring arthroplasty (i.e., “osteoarthritis”) if they endorsed a procedural history of TKA at time of enrollment or underwent hospitalization with a procedural code for TKA after enrollment in the Biobank cohort. To define an individual’s relative risk of TKA following ACLr, age-specific cumulative incidence of TKA was compared between patients WITH and WITHOUT a history of ACLr. To determine clinical risk factors associated with undergoing TKA after ACLr, age-adjusted logistic regression modeling was utilized to calculate odds ratios (OR) for undergoing TKA. A Manhattan plot was constructed to analyze the relationship between single nucleotide polymorphisms and risk of TKA after ACLr.

Results:

A total of 2,576 individuals with a history of ACLr were identified, with 290 (11.3%) undergoing TKA. In patients with prior ACLr, prevalence of TKA was 0.75% at 45 years of age, 9.1% at 65 years of age, and 20.43% at 80 years of age (Figure 1). Patients with prior ACLr were 4.6x more likely to have undergone TKA by age 55. In the ACLr cohort, BMI >30 kg/m2 (odds ratio = 4.01, 95% confidence interval = 2.74–5.87) (Table 1),  a job that always involved heavy manual or physical labor (odds ratio=2.72, 95% confidence interval=1.57-4.71) or walking and standings (odds ratio=2.58, 95% confidence interval=1.58–4.20) were associated with greater TKA prevalence. After adjusting for age, no difference was noted in revision rates between individuals with TKA after ACLr and individuals undergoing TKA without a history of ACLr (Figure 2). No SNP was associated with undergoing TKA after ACLr (Figure 3).

Conclusions:

Patients with prior ACLr are 4.6x more likely to undergo TKA by age 55 than the general population. Patients with BMI >30 and jobs that involve heavy manual labor or walking/standing are at greatest risk for undergoing TKA. These data can be used to counsel patients at time of index ACLr on both their life-time risk of TKA and lifestyle modifications that may limit the need for future TKA. After adjusting for age, ACLr was not independently associated with revision TKA. [Figure: see text][Figure: see text][Figure: see text]
Betwixt and Between: An Exercise in Work Identity and Transition
Authors: Chung Helen H. , Chung Nahrie , Ticzon Monique , Harper Jalá
Published: August 2024

This paper aims to provide an inductive exercise on work identity and transitions for management educators to use with adult learners. The exercise leverages Ibarra’s work identity theory and Schlossberg’s transitions theory and has proven effective in helping graduate students and working professionals consider the relationship between transitions and identity. Additionally, this exercise is particularly useful for facilitating a mindfulness practice in the context of identity workspaces (i.e., the management classroom) where participants are invited into identity development. As a result, students will learn to navigate their own transitions more mindfully and develop a praxis to better support themselves and others in the process of change.
Iron deficiency resolution and time to resolution in an American health system
Authors: Cogan Jacob C. , Meyer Julia , Jiang Ziou , Sholzberg Michelle
Published: August 2024

Iron deficiency (ID) is a global health problem with consequences independent of anemia, including impaired cognition and exercise tolerance. The time from laboratory diagnosis to resolution of ID has not been defined. In a retrospective review of electronic medical record data from a Minnesota statewide health system, we identified patients with ID (ferritin level ≤25 ng/mL). Patients with at least 1 follow-up ferritin level within 3 years were included. Patients with a subsequent ferritin of ≥50 ng/mL were classified as having resolved ID. Descriptive statistics and time-to-event analyses were used to determine proportion of ID resolution and time to resolution, and to evaluate characteristics predictive of resolution. We identified 13 084 patients with ID between 2010 to 2020. We found that 5485 (41.9%) had resolution within 3 years of diagnosis, whereas 7599 (58.1%) had no documented resolution. The median time to resolution was 1.9 years (interquartile range, 0.8-3.9). Factors associated with greater likelihood of resolution included age of ≥60 years (adjusted hazard ratio [aHR], 1.56; 95% confidence interval [CI], 1.44-1.69]), male sex (aHR, 1.58; 95% CI, 1.48-1.70]) and treatment with intravenous iron (aHR, 2.96; 95% CI, 2.66-3.30). Black race was associated with a lower likelihood of resolution (aHR, 0.73; 95% CI, 0.66-0.80). We observed a high proportion of persistent ID and prolonged time to resolution overall, with greater risk of lack of resolution among females and Black individuals. Targeted knowledge translation interventions are required to facilitate prompt diagnosis and definitive treatment of this prevalent and correctable condition.
European Respiratory Society guidelines for the diagnosis and management of pulmonary alveolar proteinosis
Authors: McCarthy Cormac , Bonella Francesco , O'Callaghan Marissa , Dupin Clairelyne , Alfaro Tiago , Fally Markus , Borie Raphael , Campo Ilaria , Cottin Vincent , Fabre Aurelie , Griese Matthias , Hadchouel Alice , Jouneau Stephane , Kokosi Maria , Manali Effrosyni , Prosch Helmut , Trapnell Bruce C. , Veltkamp Marcel , Wang Tisha , Toews Ingrid , Mathioudakis Alexander G. , Bendstrup Elisabeth
Published: August 2024

Background

Pulmonary alveolar proteinosis (PAP) is a rare syndrome caused by several distinct diseases leading to progressive dyspnoea, hypoxaemia, risk of respiratory failure and early death due to accumulation of proteinaceous material in the lungs. Diagnostic strategies may include computed tomography (CT) of the lungs, bronchoalveolar lavage (BAL), evaluation of antibodies against granulocyte–macrophage colony-stimulating factor (GM-CSF), genetic testing and, eventually, lung biopsy. The management options are focused on removing the proteinaceous material by whole lung lavage (WLL), augmentation therapy with GM-CSF, rituximab, plasmapheresis and lung transplantation. The presented diagnostic and management guidelines aim to provide guidance to physicians managing patients with PAP.

Methods

A European Respiratory Society Task Force composed of clinicians, methodologists and patients with experience in PAP developed recommendations in accordance with the ERS Handbook for Clinical Practice Guidelines and the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach. This included a systematic review of the literature and application of the GRADE approach to assess the certainty of evidence and strength of recommendations. The Task Force formulated five PICO (Patients, Intervention, Comparison, Outcomes) questions and two narrative questions to develop specific evidence-based recommendations.

Results

The Task Force developed recommendations for the five PICO questions. These included management of PAP with WLL, GM-CSF augmentation therapy, rituximab, plasmapheresis and lung transplantation. Also, the Task Force made recommendations regarding the use of GM-CSF antibody testing, diagnostic BAL and biopsy based on the narrative questions. In addition to the recommendations, the Task Force provided information on the hierarchy of diagnostic interventions and therapy.

Conclusions

The diagnosis of PAP is based on CT and BAL cytology or lung histology, whereas the diagnosis of specific PAP-causing diseases requires GM-CSF antibody testing or genetic analysis. There are several therapies including WLL and augmentation therapy with GM-CSF available to treat PAP, but supporting evidence is still limited.
LPG 18:0 is a general biomarker of asthma and inhibits the differentiation and function of regulatory T-cells
Authors: Aili Abudureyimujiang , Wang Yuqing , Shang Ying , Zhang Lijiao , Liu Huan , Li Zemin , Xue Lixiang , Chen Yahong , Sun Yongchang , Zhang Xu , Jin Rong , Chang Chun
Published: August 2024

Background

The diagnosis, severity assessment, and development of therapeutic strategies for asthma are crucial aspects of disease management. Since biomarkers are reliable tools in disease management, we aimed to identify and explore asthma-associated biomarkers and investigate their mechanisms.

Methods

Lipidomics was used to profile serum glycerophospholipids in asthmatic patients and controls. The absolute concentration of lysophosphatidylglycerol (LPG) 18:0 was quantified in various asthma subtypes. Mouse asthma models were used to confirm its potential as a biomarker and investigate its mechanismsin vivo.The effects of LPG 18:0 on CD4+T-cell differentiation, proliferation and apoptosis were assessedin vitroby flow cytometry, while mitochondrial dysfunction was evaluated through mitochondrial membrane potential, reactive oxygen species and ATP production measurements. The intracellular mechanism of LPG 18:0 in regulatory T-cells (Tregs) was investigated using small-molecule inhibitors.

Results

The serum glycerophospholipid profile varied between asthmatic patients and control group, with LPG 18:0 levels being notably higher in asthmatic patients, correlating with asthma severity and control level.In vivoandin vitrostudies revealed that LPG 18:0 impaired naïve CD4+T-cell differentiation into Tregs and compromised their suppressive function. Further investigation demonstrated that LPG 18:0 treatment reduced the FOXP3 protein levelviaSIRT1-mediated deacetylation during Treg differentiation.

Conclusions

This study identifies that serum levels of LPG 18:0 are generally elevated in asthmatics and serve as a biomarker for asthma. LPG 18:0 impairs Treg functionviathe NAD+/SIRT1/FOXP3 pathway. Our research reveals the potential of LPG 18:0 as a biomarker for asthma, elucidating its role in asthma diagnosis and treatment.
Optimizing Multi-Row Cam Roller Bearing for Long Fatigue Life of Hydraulic Motors
Authors: Fang Yu , Su Qi , Dong Pengpeng , Yang Yu , Xu Bing , Zhang Chao , Zhang Junhui
Published: August 2024

Cam-lobe radial-piston hydraulic motors are widely used as rotation driving units for various marine machinery owing to their ultrahigh output torque (more than 100 kN m). A multi-row cam roller bearing (MCRB) is the key component that directly determines the fatigue life of a cam-lobe radial-piston hydraulic motor. However, compact geometry and complex loads render MCRB susceptible to fatigue failure, highlighting the need for an optimized MCRB to achieve longer fatigue life and higher reliability. Therefore, this study proposes an innovative geometry optimization method for an MCRB to improve its fatigue life. In this method, a quasi-static model was developed to calculate the load distribution, with the fatigue life of the MCRB calculated using both basic dynamic loading and load distribution. Subsequently, a genetic algorithm was used to obtain the optimized geometry parameters, which significantly improved the fatigue life of the MCRB. Finally, a loading test was conducted on a hydraulic motor installed with both the initial and optimized MCRB to validate the effectiveness of the proposed optimization method. This study provides a theoretical guideline for optimizing the design of MCRB, thereby increasing the fatigue life of hydraulic motors.
Effects of moisture content on the behaviour of Scots pine heartwood and sapwood under impact
Authors: Hassan Vand Mojtaba , Tippner Jan
Published: August 2024

The material properties of sapwood and heartwood vary within various wood species and even they can show significant differences within a single tree. Scots pine (Pinus sylvestris L.), a species that plays a crucial role in timber production for joinery and building construction applications, is among those that show a notable distinction between its heartwood and sapwood. To examine the influence of moisture content (MC) on the impact behaviour of the sapwood and heartwood of pine, we tested specimens with two distinct moisture levels: a low moisture content (LMC) group with 12% MC and a high moisture content (HMC) group with 45% MC. In our study, we investigated deflection, normal strain and force development of the specimens during the short period of an impact, and also calculated the impact bending strength (IBS) of samples, using an impact testing machine equipped with a high-speed camera and digital image correlation method. Our results indicate that the differences between sapwood and heartwood at LMC were insignificant in the case of maximum deflection and normal strain, thus there is no need for differentiation; however, these differences became more pronounced, and non-negligible, with an increase in MC. We also evaluated the IBS of both heartwood and sapwood and found that, at LMC, heartwood had greater impact bending strength than sapwood, making it a preferable choice as a material subjected to impact loadings. Conversely, at HMC, both heartwood and sapwood would be equally strong against impacts, indicating that pine green wood shows no sensitivity to the ratio of sapwood to heartwood in the tree.
Correlations between local geoclimatic variables and hatchling body size in the sea turtles Caretta caretta and Chelonia mydas
Authors: Regalado Fernández Omar Rafael , Parsi-Pour Parima , Nyakatura John A. , Wyneken Jeanette , Werneburg Ingmar
Published: August 2024

It has been widely demonstrated that air and sand temperatures influence the anatomy of sea turtle hatchlings. We examined the impact of precipitation during the nesting season on the hatchling body size of loggerhead and green turtles from 37 beaches worldwide. Longitudinal data collected between 2012 and 2018 from Florida (US) and from a sample on Bõa Vista Island (Cabo Verde) carried out in 2019 showed that loggerhead body size at hatching was negatively correlated with precipitation, while precipitation was not correlated with hatchling body size in green turtles. A meta-analysis revealed that precipitation is positively correlated with hatchling mass in loggerhead turtles, while it is positively correlated with straight carapace length and width in green turtle hatchlings. The strongest influence of precipitation was found in the middle of the incubation period of loggerhead turtles in Cabo Verde, and we posit that this is due to an increase in the uptake of water for embryonic growth. These findings highlight the great importance of understanding the correlated effects of regional environmental variables, such as precipitation, on the development of sea turtle hatchlings and will have an impact on the evaluation of ongoing conservation and climate change discussions.
The impact of filamentous plant pathogens on the host microbiota
Authors: Flores-Nunez Victor M. , Stukenbrock Eva H.
Published: August 2024

When a pathogen invades a plant, it encounters a diverse microbiota with some members contributing to the health and growth of the plant host. So far, the relevance of interactions between pathogens and the plant microbiota are poorly understood; however, new lines of evidence suggest that pathogens play an important role in shaping the microbiome of their host during invasion. This review aims to summarize recent findings that document changes in microbial community composition during the invasion of filamentous pathogens in plant tissues. We explore the known mechanisms of interaction between plant pathogens and the host microbiota that underlie these changes, particularly the pathogen-encoded traits that are produced to target specific microbes. Moreover, we discuss the limitations of current strategies and shed light on new perspectives to study the complex interaction networks between filamentous pathogens and the plant microbiome.
Overall and cause-specific mortality among patients diagnosed with gastric precancerous lesions in Sweden between 1979 and 2014: an observational cohort study
Authors: Sun Yawen , Yin Li , Nesheli Dariush Nasrollahzadeh , Yu Jingru , Franzén Joar , Ye Weimin
Published: August 2024

Background

The Correa’s cascade, encompassing chronic non-atrophic gastritis, atrophic gastritis, intestinal metaplasia, and dysplasia, represents the well-recognized pathway for the development of non-cardia gastric cancer. Population-based studies on all-cause and cause-specific mortalities among patients with gastric lesions in Correa’s cascade are scarce.

Methods

We compiled a cohort of 340 744 eligible patients who had undergone endoscopy with biopsy for non-malignant indications during the period 1979–2011, which was followed up until 2014. Standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) provided estimation of the relative risk, using the general Swedish population as reference. Cox regression model was used to estimate hazard ratios (HRs) of death for internal comparison.

Results

A total of 306 117 patients were included in the final analysis, accumulating 3,049,009 person-years of follow-up. In total 106,625 deaths were observed during the study period. Compared to the general population, excess risks of overall mortality were noted in all subgroups, with SMRs ranging from 1.11 (95% CI 1.08–1.14) for the normal mucosa group to 1.54 (95% CI 1.46–1.62) for the dysplasia group. For cause-specific mortalities, mortality from gastric cancer gradually increased along Correa’s cascade, with excess risk rising from 105% for patients with chronic gastritis to more than 600% for the dysplasia group. These results were confirmed in the comparison with the normal mucosa group. For non-cancer conditions, increased death risks were noted for various diseases compared to the general population, especially among patients with more severe gastric precancerous lesions. But the results were confirmed only for “infectious diseases and parasitic diseases”, “respiratory system diseases”, and “digestive system disease”, when using the normal mucosa group as reference.

Conclusions

Increased mortality from gastric cancer suggests that early recognition and intervention of gastric precancerous lesions probably benefit the patients. Excess mortality due to non-cancer conditions should be interpreted with caution, and future studies are warranted.
Meldonium, as a potential neuroprotective agent, promotes neuronal survival by protecting mitochondria in cerebral ischemia–reperfusion injury
Authors: Yang Weijie , Lei Xiuxing , Liu Fengying , Sui Xin , Yang Yi , Xiao Zhenyu , cui Ziqi , Sun Yangyang , Yang Jun , Yang Xinyi , Lin Xueyang , Bao Zhenghao , Li Weidong , Ma Yingkai , Wang Yongan , Luo Yuan
Published: August 2024

Background

Stroke is a globally dangerous disease capable of causing irreversible neuronal damage with limited therapeutic options. Meldonium, an inhibitor of carnitine-dependent metabolism, is considered an anti-ischemic drug. However, the mechanisms through which meldonium improves ischemic injury and its potential to protect neurons remain largely unknown.

Methods

A rat model with middle cerebral artery occlusion (MCAO) was used to investigate meldonium’s neuroprotective efficacy in vivo. Infarct volume, neurological deficit score, histopathology, neuronal apoptosis, motor function, morphological alteration and antioxidant capacity were explored via 2,3,5-Triphenyltetrazolium chloride staining, Longa scoring method, hematoxylin and eosin staining, terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay, rotarod test, transmission electron microscopy and Oxidative stress index related kit. A primary rat hippocampal neuron model subjected to oxygen–glucose deprivation reperfusion was used to study meldonium’s protective ability in vitro. Neuronal viability, mitochondrial membrane potential, mitochondrial morphology, respiratory function, ATP production, and its potential mechanism were assayed by MTT cell proliferation and cytotoxicity assay kit, cell-permeant MitoTracker® probes, mitochondrial stress, real-time ATP rate and western blotting.

Results

Meldonium markedly reduced the infarct size, improved neurological function and motor ability, and inhibited neuronal apoptosis in vivo. Meldonium enhanced the morphology, antioxidant capacity, and ATP production of mitochondria and inhibited the opening of the mitochondrial permeability transition pore in the cerebral cortex and hippocampus during cerebral ischemia–reperfusion injury (CIRI) in rats. Additionally, meldonium improved the damaged fusion process and respiratory function of neuronal mitochondria in vitro. Further investigation revealed that meldonium activated the Akt/GSK-3β signaling pathway to inhibit mitochondria-dependent neuronal apoptosis.

Conclusion

Our study demonstrated that meldonium shows a neuroprotective function during CIRI by preserving the mitochondrial function, thus prevented neurons from apoptosis.
Handwriting speed in juvenile idiopathic arthritis using the detailed assessment of speed of handwriting
Authors: Marchak C. A. , James S. , Davidson I. , Brown J. , Houghton K.
Published: August 2024

Background

Handwriting is a commonly reported functional limitation for children with juvenile idiopathic arthritis (JIA). The aim of this study was to evaluate handwriting in children with JIA.

Findings

Twelve children (mean age 13.0 years, SD = 1.9; range 9.1 to 15.6 years) with JIA completed the Detailed Assessment of Speed of Handwriting (DASH). The presence of hand and wrist arthritis, grip strength, disability, pain, and quality of life (QOL) was also assessed. The mean DASH score was 34.5th percentile (SD = 22.5). Eight (75%) scored below the 50th centile. DASH scores were negatively associated with grip strength (r = -0.31).

Conclusions

Handwriting difficulties are common in children with JIA. Handwriting assessment may be helpful to direct treatments, and advocate for support and accommodations in school.
Long-term safety and influence on growth in patients receiving sirolimus: a pooled analysis
Authors: Wang Yang-Yang , Zou Li-Ping , Xu Kai-Feng , Xu Wen-Shuai , Zhang Meng-Na , Lu Qian , Tian Xin-Lun , Pang Ling-Yu , He Wen , Wang Qiu-Hong , Gao Yang , Liu Li-Ying , Chen Xiao-Qiao , Ma Shu-Fang , Chen Hui-Min , Dun Shuo , Yang Xiao-Yan , Luo Xiao-Mei , Huang Lu-Lu , Li Yu-Fen
Published: August 2024

Background

Sirolimus is increasingly utilized in treating diseases associated with mTOR pathway overactivation. Despite its potential, the lack of evidence regarding its long-term safety across all age groups, particularly in pediatric patients, has limited its further application. This study aims to assess the long-term safety of sirolimus, with a specific focus on its impact on growth patterns in pediatric patients.

Methods

This pooled analysis inlcudes two prospective cohort studies spanning 10 years, including 1,738 participants (aged 5 days to 69 years) diagnosed with tuberous sclerosis and/or lymphangioleiomyomatosis. All participants were mTOR inhibitor-naive and received 1 mg/m²/day of sirolimus, with dose adjustments during a two-week titration period to maintain trough blood concentrations between 5 and 10 ng/ml (maximum dose 2 mg). Indicators of physical growth, hematopoietic, liver, renal function, and blood lipid levels were all primary outcomes and were analyzed. The adverse events and related management were also recorded.

Results

Sirolimus administration did not lead to deviations from normal growth ranges, but higher doses exhibited a positive association with Z-scores exceeding 2 SD in height, weight, and BMI. Transient elevations in red blood cell and white blood cell counts, along with hyperlipidemia, were primarily observed within the first year of treatment. Other measured parameters remained largely unchanged, displaying only weak correlations with drug use. Stomatitis is the most common adverse event (920/1738, 52.9%). In adult females, menstrual disorders were observed in 48.5% (112/217).

Conclusions

Sirolimus’s long-term administration is not associated with adverse effects on children’s physical growth pattern, nor significant alterations in hematopoietic, liver, renal function, or lipid levels. A potential dose-dependent influence on growth merits further exploration.

Trial registration

Pediatric patients: Chinese clinical trial registry, No. ChiCTR-OOB-15,006,535. Adult patients: ClinicalTrials, No. NCT03193892.
Severe and invasive bacterial infections in infants aged less than 90 days with and without SARS-CoV-2 infection
Authors: Brigadoi Giulia , Tirelli Francesca , Rossin Sara , Casotto Veronica , Riello Francesca , Gallinaro Giulia , Donà Daniele , Bressan Silvia , Da Dalt Liviana
Published: August 2024

Background

Fever in children represents one of the most common causes of medical evaluation. Infants younger than 90 days of age are at higher risk of severe and invasive bacterial infections (SBI and IBI). However, clinical signs and symptoms of viral and bacterial infections in young infants are frequently similar, and several studies have shown that the risk of SBIs remains non-negligible even in the presence of a positive point-of-care viral test. Our study aims to evaluate whether the proportion of SBIs and IBIs in febrile infants younger than 90 days during the COVID-19 pandemic was higher than that in the pre-pandemic period, and to describe the proportion of SBIs and IBIs in infants with and without SARS-CoV-2 infection.

Methods

This was a retrospective single-center cohort study conducted at the Children's Hospital of the University of Padua in Italy, involving febrile young infants evaluated in the Pediatric Emergency Department (PED) and admitted to Pediatric Acute Care Unit (PACU) between March 2017 to December 2022. Infants admitted before the COVID-19 pandemic were compared to infants admitted during the pandemic period and SARS-CoV-2 positive patients to the negative ones.

Results

442 febrile infants younger than 90 days were evaluated in Padua PED and admitted to the wards. The proportion of SBIs and IBIS did not significantly change over the study periods, ranging between 10.8% and 32.6% (p = 0.117) and between 0% and 7.6%, respectively (p = 0.367). The proportion of infants with a diagnosis of SBIs and IBIs was higher in the SARS-CoV-2 negative group (30.3% and 8.2%, respectively) compared to the positive group (8.5% and 2.8%, respectively) (p < 0.0001). The most common diagnosis in both groups was UTI, mainly caused by E. coli. A similar proportion of blood and urine cultures were performed, whereas lumbar puncture was more frequently performed in SARS-CoV-2 negative infants (40.2% vs 16.9%, p = 0.001).

Conclusions

Although the risk of concomitant serious bacterial infection with SARS-CoV-2 is low, it remains non-negligible. Therefore, even in SARS-CoV-2-positive febrile infants, we suggest that the approach to screening for SBIs remains cautious.
Bone stress injuries in athletics (track and field) championships: findings from a prospective injury surveillance conducted across 24 international championships with 29,147 registered athletes
Authors: Hoenig Tim , Tenforde Adam S. , Hollander Karsten , Junge Astrid , Branco Pedro , Vinther Anders , Edouard Pascal
Published: August 2024

Background

Athletics (track and field) athletes are prone to develop bone stress injuries (BSIs) but epidemiological data on BSIs from top-level sports events are scarce.

Objective

To describe the incidence and characteristics of BSIs during 24 international athletics championships held from 2007 to 2023.

Methods

BSI-related data were prospectively collected during 24 international athletics championships, including the Olympic Games (n = 3), World Outdoor Championships (n = 4), European Outdoor Championships (n = 6), World Indoor Championships (n = 3) and European Indoor Championships (n = 8). Descriptive and comparative statistics were used to assess the epidemiological characteristics of BSIs.

Results

BSIs accounted for 1.5% of all reported injuries (n = 36; 1.2 per 1000 registered athletes (95%CI 0.8 to 1.6)). No significant difference of BSI incidence was detected between female (2.0 per 1000 athletes (95%CI: 0.9 to 2.3)) and male athletes (0.9 per 1000 athletes (95%CI: 0.4 to 1.4)) (relative risk (RR) = 1.73, 95%CI: 0.88 to 3.40). BSI incidence was significantly higher during outdoor championships (1.6 per 1000 registered athletes (95%CI: 1.0 to 2.1)) as compared to indoor championships (0.2 per 1000 registered athletes (95%CI: 0.0 to 0.5)) (RR = 10.4, 95%CI: 1.43 to 76.0). Most BSIs were sustained in the foot (n = 50%) or leg (n = 33%). BSIs were reported in athletes participating in endurance disciplines (52.8%) or in explosive disciplines (47.2%).

Conclusions

BSIs represent a small portion of injuries sustained during international athletics championships. Collective results suggest that injury rates are higher in outdoor competitions as compared to indoor competitions. The most common injury locations comprise the foot and leg.

Clinical Trial Number

Not applicable.
Right-to-left shunt due to iatrogenic atrial septal defect manifested by aorto-caval fistula: a case report
Authors: Kimura Takuya , Okada Takuya , Obata Norihiko , Motoyama Yasushi , Nagae Masaharu
Published: August 2024

Background

An aorto-caval fistula is a rare but critical complication of abdominal aortic aneurysm (AAA) rupture, leading to high-output heart failure and increased venous pressure. The anesthetic management of such cases, particularly when complicated by an intraoperative right-to-left shunt, is seldom reported.

Case presentation

A 71-year-old man with a history of atrial fibrillation and catheter ablation presented with heart failure and abdominal pain, leading to cardiac arrest. Imaging revealed an AAA rupture into the inferior vena cava. During emergency surgery, severe venous bleeding was managed using intra-aortic balloon occlusion (IABO). Transesophageal echocardiography (TEE) identified a right-to-left shunt due to an iatrogenic atrial septal defect.

Conclusion

Early TEE recognition and timely IABO intervention were crucial in managing this complex case, underscoring the importance of these techniques in similar emergency scenarios.
Association between serotonin transporter gene polymorphism and obsessive–compulsive disorder in the Egyptian population
Authors: Mehrez Sara , Neamatallah Mustafa Ahmed , Gomaa Zeinab , El-Gilany Abdel-Hady , Shahda Mohammed , Elsaied Hiam F
Published: August 2024

Background

Obsessive–compulsive disorder (OCD) is a debilitating disorder that has multifactorial etiology including genetic, neurobiological, cognitive, and environmental influences. Genetic studies have focused on the genes of the serotonin system. This study aimed to look for the possible relation between the polymorphism in the promotor region of the serotonin transporter gene and obsessive–compulsive disorder in the Egyptian population.

Results

This study included 94 OCD patients and 116 healthy control individuals. Blood samples were collected from all participants for DNA extraction and genotyping. The assessment of patients was done by application of the structured clinical interview according to DSM-V, the dimensional Yale-Brown Obsessive–Compulsive Scale. There was an association between serotonin transporter gene polymorphism and OCD development. The carriage of the short allele was a risk factor for having OCD.

Conclusion

Obsessive–compulsive disorder is associated with serotonin transporter gene polymorphism. This will contribute to considering the genetic information of patients for the prediction of best drug response and tolerability by personalizing the choice of treatment.
Middle ear-acquired cholesteatoma diagnosis based on CT scan image mining using supervised machine learning models
Authors: Ouattassi Naouar , Maaroufi Mustapha , Slaoui Hajar , Benateya Andaloussi Taha , Zarghili Arsalane , El Amine El Alami Mohamed Nouredine
Published: August 2024

Background

Distinguishing between middle ear cholesteatoma and chronic suppurative otitis media (CSOM) is an ongoing challenge. While temporal bone computed tomography (CT) scan is highly accurate for diagnosing middle ear conditions, its specificity in discerning between cholesteatoma and CSOM is only moderate. To address this issue, we utilized trained machine learning models to enhance the specificity of temporal bone CT scan in diagnosing middle ear cholesteatoma. Our database consisted of temporal bone CT scan native images from 122 patients diagnosed with middle ear cholesteatoma and a control group of 115 patients diagnosed with CSOM, with both groups labeled based on surgical findings. We preprocessed the native images to isolate the region of interest and then utilized the Inception V3 convolutional neural network for image embedding into data vectors. Classification was performed using machine learning models including support vector machine (SVM), k-nearest neighbors (k-NN), random forest, and neural network. Statistical metrics employed to interpret the results included classification accuracy, precision, recall, F1 score, confusion matrix, area under the receiver operating characteristic curve (AUC), and FreeViz diagram.

Results

Our training dataset comprised 5390 images, and the testing dataset included 125 different images. The neural network, k-NN, and SVM models demonstrated significantly higher relevance in terms of classification accuracy, precision, and recall compared to the random forest model. For instance, the F1 scores were 0.974, 0.987, and 0.897, respectively, for the former three models, in contrast to 0.661 for the random forest model.

Conclusion

The performance metrics of the presented trained machine learning models hold promising prospects as potentially clinically useful aids.
Sex Differences in “Life’s Essential 8” Cardiovascular Health and Type 2 Diabetes Mellitus Risk Across Menopause Stages
Authors: Cheng Wenke , Geng Shanshan , Li Yukun , Chen Rundong , Du Zhongyan
Published: August 2024

Context

Existing guidelines often lack sex-specific prevention strategies for type 2 diabetes mellitus (T2DM). Life’s Essential 8 (LE8) highlights the role of health behaviors in influencing cardiovascular health (CVH). Due to inherent sex differences, the impact of CVH on T2DM risk may vary between men and women, especially across menopausal stages.

Objective

The purpose of this paper is to explore sex-based differences in CVH and the incidence of T2DM among women at different menopausal stages and men.

Methods

A prospective cohort study was conducted, involving 126 818 participants without preexisting T2DM from the UK Biobank. CVH was assessed using the LE8. Absolute risks (ARs) and hazard ratios (HRs) were separately employed to assess the association between increased CVH and T2DM risk. The accelerated failure time model assessed the effect of CVH on the time to T2DM onset.

Results

Over a mean follow-up of 168 months, 4315 cases of T2DM were documented. In men, each 1-point increase in CVH was associated with a 0.268% decrease in AR and a 6.4% decrease in HR for T2DM. In premenopausal, perimenopausal, and postmenopausal women, each unit increase in CVH resulted in a 0.105%, 0.180%, and 0.166% decrease in AR and a 7.7%, 5.2%, and 6.4% decrease in HR of T2DM. The adjusted median time to T2DM onset was delayed by 12.46, 9.83, 11.5, and 21.43 months in the highest quintile of men, premenopausal, perimenopausal, and postmenopausal women, respectively, compared with the lowest CVH quintile.

Conclusion

As CVH improved, the reduction in AR for T2DM was more prominent in men than in women. HR trends for CVH and T2DM were similar in men and postmenopausal women. Increased CVH delayed the onset of T2MD both in men and women, with the most significant delay observed in postmenopausal women.
Shaping the Skeleton: Impact of GnRH Analogue and Sex Hormone Therapy on Skeletal Dimensions in Transgender Individuals
Authors: Boogers Lidewij Sophia , Sikma Boukje Teatske , Bouman Mark-Bram , van Trotsenburg Adrianus Sarinus Paulus , den Heijer Martin , Wiepjes Chantal Maria , Hannema Sabine Elisabeth
Published: August 2024

Context

Skeletal dimensions vary between sexes. Men typically have broader shoulders and women a wider pelvis. Whether gender-affirming hormone therapy (GAHT) with or without prior puberty suppression (PS) alters these dimensions in transgender individuals remains unclear.

Objective

To investigate impact of PS and GAHT on skeletal dimensions.

Methods

This retrospective cross-sectional study, conducted at a gender identity clinic, included transgender individuals assigned male at birth (AMAB) and assigned female at birth (AFAB) who underwent dual-energy x-ray absorptiometry (DXA) scanning between ages 18 and 28 years and who were divided into 4 groups: Early PS (Tanner G/B2-3) + GAHT, Late PS (Tanner G/B4-5) + GAHT, GAHT-only, and untreated. Shoulder and pelvis dimensions measured by DXA were compared between groups, with adjustment for height.

Results

A total of 121 individuals AMAB and 122 AFAB were included. Only individuals AMAB who underwent early PS had smaller shoulders compared to untreated individuals AMAB (−1.3 cm; 95% CI −2.1; −0.5). In individuals AMAB from both the Early and Late PS groups, pelvic inlet, pubic symphysis width, and interischial distance were greater compared to untreated individuals AMAB, resulting in dimensions comparable to untreated individuals AFAB. Only in Early PS AFAB was pelvic inlet width smaller compared to untreated individuals AFAB (−1.0 cm; 95% CI −1.5; −0.6), and comparable to untreated individuals AMAB.

Conclusion

The study results suggest that skeletal dimensions are only altered by GAHT if endogenous puberty has not yet been completed at start of PS. These findings enhance our understanding of hormonal effects on the skeleton and may hold clinical relevance for body image as well as for forensic anthropology. Future research should evaluate clinical implications for surgical or obstetrical outcomes in transgender individuals.
The Impact of Smoking and Hypertension on Cataract Development in Diabetic Patients
Authors: Jaaz Muataz H. , Al-Nasrawi Ahmed N
Published: August 2024

Background Cataracts are a leading cause of visual impairment and blindness globally, with a particularly high incidence in diabetic patients due to the complex interplay of metabolic dysregulation and hyperglycemia-induced oxidative stress. Diabetic cataract development is influenced by several modifiable risk factors including smoking and hypertension, which may exacerbate lens opacity through various biological mechanisms. This study aims to determine the effects of smoking and hypertension on cataract development in diabetic patients. Methods Conducted from December 2022 to November 2023, this cross-sectional study at a specialized diabetes and ophthalmology healthcare facility involved 60 diabetic patients. The participants were divided into two groups: those with cataracts (n=32) and those without (n=28). Data collection focused on demographics, smoking history, hypertension status, and cataract presence, using structured interviews and medical record reviews. Logistic regression was employed to analyze the association between cataracts and potential risk factors, adjusting for age, diabetes duration, and glycemic control. Results Age and genderfi were not significantly different between the two groups, with mean ages of 50.21±14.34 years in the cataract group and 49.41±12.15 years in the non-cataract group (P=0.087). The prevalence of smoking was similar between those with cataracts (14.3%) and without (15.6%), showing no significant association (P=0.885). Hypertension was more prevalent in the cataract group (71.4%) compared to the non-cataract group (53.1%), although this difference was not statistically significant (P=0.146). Logistic regression analysis indicated that smoking had a minimal effect on cataract development (OR=1.187; 95% CI=0.264-5.33; P=0.823), and while hypertension showed a stronger association (OR=2.277; 95% CI=0.749-6.92), it also lacked statistical significance (P=0.147). Conclusion Neither smoking nor hypertension showed significant associations with cataract development. These findings suggest that the influence of these factors on cataract progression may differ in diabetic individuals due to the complex interplay of metabolic and vascular changes associated with the condition.
Produção e registro de dados em pesquisas interventivas
Authors: Paro do Nascimento Andréia , Tonatto Zibetti Marli Lúcia
Published: August 2024

Nas pesquisas interventivas, principalmente aquelas realizadas como parte dos cursos de Mestrado e doutorado, o/a pesquisador/a está envolvido/a na condução das atividades e, também, é responsável pela realização dos registros das intervenções, objeto da investigação em curso. Esse duplo papel demanda conhecimentos teóricos e práticos sobre os instrumentos a serem utilizados na produção de dados. Assim, o texto discute as possibilidades e dificuldades do uso do diário de campo e da filmagem como técnicas de registro de dados em pesquisas interventivas. Trata-se de um estudo teórico em que se recorre às contribuições de diferentes autores sobre o tema, com o intuito de sistematizar recomendações úteis aos pesquisadores que precisam fazer uso desses procedimentos em pesquisas nas quais são desafiados a atuar como formadores/professores e também como pesquisadores. Como resultados, evidenciou-se que as técnicas de produção de dados, diário de campo e filmagem em vídeo-gravação, podem ser instrumentos que ajudam a refletir sobre a própria intervenção e analisar o objeto de estudo e as relações entre os participantes em seu contexto objetivo e subjetivo. Intervenções didáticas em contextos educativos permitem reunir muitas informações, uma vez que documentam ações realizadas, diálogos travados e processos de ensino e de aprendizagem no campo empírico, demandando dos pesquisadores planejamento cuidadoso do uso dessas técnicas. Conclui-se que tais técnicas são instrumentos importantes em pesquisas interventivas, que podem contribuir para as mudanças possíveis a partir de uma visão crítica e reflexiva sobre o ambiente pesquisado.
Micro-histórias comparadas da violência sexual sobre sujeitos infantis:
Authors: Ripe Fernando Cezar , Marin Alves Marcelo
Published: August 2024

A análise histórica sobre processos criminais envolvendo o abuso sexual de crianças permite a compreensão dos processos e dos regimes de educabilidade em uma determinada sociedade que, a sua época, lidava com essa violenta prática. A partir de um estudo inscrito no campo da História da Educação e da Infância, apresentamos uma análise comparada dos desdobramentos de duas queixas-crime envolvendo crianças como vítimas. Para tanto, opera-se com os conceitos foucaultianos de sexualidade, violência e anormalidade, bem como com a micro-história da violência sexual, subsidiada por horizontes metodológicos advindos, respectivamente, dos estudos de Carlo Ginzburg e Boris Fausto. Ao descrever e analisar as queixas-crime, percebemos que, embora fossem previstos nos códigos penais da época, os casos de violência sexual contra crianças derivam de múltiplos determinantes sociais, o que os torna passíveis de análise histórica e potencialmente originais para investigações interseccionais na História da Educação brasileira. Ao problematizarmos a circularidade da violência sexual, concluímos que o violador adulto se vale de uma estrutura simbólica de poder para oprimir e controlar os corpos infantis.