bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of the United Kingdom national poisons information service (NPIS) in the diagnosis of death according to neurological criteria in poisoned and non-poisoned patients
Authors: Worthington Jeanie , Cohen Leon , Thomas Ian , Gray Laurence , Sandilands Euan , Moyns Emma
Published: October 2024

The diagnosis of death by neurological criteria (DNC) requires the exclusion of any clinical effect attributable to xenobiotics. We undertook a retrospective analysis of enquiries to the National Poisons Information Service (NPIS) relating to DNC over a 10-year period. Enquiries were categorised as toxicological, where exposure to a non-therapeutically administered xenobiotic was implicated in the clinical presentation and non-toxicological where exposure to the xenobiotic was not the primary cause of the clinical state. The frequency of enquiry to the NPIS regarding xenobiotics and DNC demonstrates that it remains a valuable source of expert advice.
Twenty-Seven-Year Institutional Experience With Surgery for Adults With Congenital Heart Disease
Authors: Hughes Aeleia F. , Herrmann Jeremy L. , Rodefeld Mark D. , Slaven James E. , Turrentine Mark W. , Brown John W.
Published: October 2024

Background

Given improved contemporary survival of adults with congenital heart disease (ACHD), we aimed to evaluate trends in ACHD surgery and outcomes at a single center over a 27-year period.

Methods

Surgical databases were retrospectively queried for patients >18 years old who underwent ACHD surgery between January 1, 1994, and December 31, 2020. A total of 2,195 included patients underwent 2,425 cardiac surgical procedures within the specified time frame. Patients were grouped by era: I, 1994-2000; 2, 2001-2010; and 3, 2011-2020. Trends in primary cardiac diagnosis and surgical management were evaluated.

Results

The median age increased across the eras. The most common primary cardiac diagnoses (n = 2,425) overall were left ventricular outflow tract anomalies (n = 2,019, 83%), atrial septal defect (n = 407, 17%), right ventricular outflow tract anomalies (n = 360, 15%), and ventricular septal defect (n = 110, 4.5%). The most commonly observed procedures overall were operations on the left ventricular outflow tract (n = 1,633, 67%), aorta (n = 675, 28%), coronary arteries (n = 449, 19%), right ventricular outflow tract (n = 323, 13%), and atrial septal defect (n = 264, 11%). Major complications occurred in 10% of cases, and 58 patients died within 30 days of their operation yielding an operative mortality of 2.4%.

Conclusion

To our knowledge, this is the largest single center report on surgery for adults with congenital heart disease. Surgery for ACHD has been performed at our center with relatively low morbidity and mortality over the last few decades.
Poster 266: Sagittal Tibial Tubercle-Trochlear Groove Distance Predicts Patellofemoral Chondral Lesion Size and Is Associated With Postoperative Complications
Authors: Bi Andrew , Triana Jairo , Li Zachary , Campbell Kirk , Alaia Michael , Strauss Eric , Jazrawi Laith , Gonzalez-Lomas Guillem
Published: October 2024

Objectives:

The purpose of this study was to assess the association between sagittal tibial tubercle-trochlear groove (sTT-TG) distance and patellofemoral chondral lesion size in patients undergoing cartilage restoration procedures.

Methods:

A retrospective review of patients who underwent an osteochondral allograft (OCA) transplantation or autologous chondrocyte implantation (ACI) was conducted. Patients were included if they had an articular cartilage lesion located in the patella, trochlea, or both (bipolar lesions). Lesion size of individual patella and trochlear lesions were measured intra-operatively at implantation. Total lesion area was calculated as a sum of all present chondral lesions in the patellofemoral joint. The preoperative sTT-TG distance was measured independently on magnetic resonance imaging (MRI) by 2 authors and an Interclass Correlation Coefficient (ICC) was calculated. Categorical and linear regression models accounting for demographic variables and sTT-TG distance were used to assess the relationship between sTT-TG and lesion size.

Results:

Eighty patients (85 knees) composed of 50 women (mean age: 31.5±10.4 years) were included. Forty-one patients underwent OCA transplantation and 44 underwent ACI. Intra-rater (ICC: 0.99, 0.98) and inter-rater reliability (ICC: 0.96) were excellent for sTT-TG measurements. A bivariate correlation analysis demonstrated that sTT-TG was significantly inversely related to MRI defect size (-0.45, p<0.01). Similarly, sTT-TG was inversely related to patellar lesion size and total lesion area, but not trochlear lesion size (Table 1). When controlling for demographics, a more negative sTT-TG remained an independent predictor of larger defects on MRI and patellar lesions: 9.3 mm2 and 9.8 mm2 lesion size increase on MRI (p<0.001) and intraoperatively (p=0.01), respectively, for every 1 mm decrease in sTT-TG. For every 1 mm increase in sTT-TG, the risk of all complications occurring decreased by 14.1% (ß=0.859, p=0.007).

Conclusions:

In this cohort of patients undergoing patellofemoral cartilage restoration, a more negative sTT-TG distance is a predictor of larger patellar lesions and increased risk for all complications.
Poster 252: Osteochondral Allograft Transplantation After Failed Autologous Chondrocyte Implantation of the Knee: A Matched Cohort Analysis
Authors: Quigley Ryan , Weissman Alexander C. , Yazdi Allen A. , Schick Samuel , Frazier Landon P. , Gilat Ron , Yanke Adam B. , Cole Brian J.
Published: October 2024

Objectives:

Osteochondral allograft transplantation (OCA) is a well-established procedure for the management of osteochondral lesions of the knee. OCA after failed prior cartilage restoration procedures has demonstrated similar improvements in patient-reported outcomes (PROs). Outcomes following OCA after failed autologous chondrocyte implantation (ACI) have been minimally reported in the current literature. The present study aims to compare the clinical outcomes, reoperation rates, and failure rates of OCA following failed ACI with those of a matched cohort of patients undergoing primary OCA.

Methods:

A retrospective matched cohort analysis was conducted on 22 patients who underwent OCA following failed ACI between January 2001 and January 2021, with a minimum 2-year clinical follow-up. Patients were included regardless of concomitant procedures. These patients were matched by age, sex, body mass index, defect location, and defect size to a control group of patients who underwent primary OCA without prior ACI with a similar 2-year clinical follow-up. PROs, defect characteristics, reoperations, and failure rates were analyzed individually and compared between the 2 groups.

Results:

Twenty-two patients (100% follow-up) were included in the study group with an average follow-up of 5.72 ± 4.2 years (range: 2.0-14.5). The average age was 31.2 ± 6.4 years. Sixteen patients were female (73%) and 6 were male (27%). Patients did not differ in the number of previous surgeries, preoperative baseline PROs, or types of concomitant procedures between the study group and the matched cohort. Both cohorts demonstrated statistically significant postoperative improvements for all PROs including Lysholm, International Knee Documentation Committee, and Knee Injury and Osteoarthritis Outcome Score subscales (p < 0.05). There was no statistical difference between both groups when comparing improvements in PROs, number of reoperations, and failure rates (p > 0.05). Ten patients (45%) in the study group required a reoperation. Four patients (18%) failed OCA following an ACI due to significant graft delamination and disease progression at an average 2.4 ± 2.1 years. Two patients required further revision OCA and 2 underwent significant chondral debridement. All 4 patients were clinically asymptomatic at a final follow-up of 5.9 years.

Conclusions:

OCA is an excellent treatment option for patients after prior failed ACI. OCA following ACI demonstrates favorable clinical outcomes, comparable reoperation rates, and an acceptable failure rate, similar to OCA performed without prior OCA.
Poster 277: Increased Kinesiophobia Leads to Lower Return to Sport Rate and Clinical Outcomes Following Osteochondral Allograft Transplantation of the Knee
Authors: Triana Jairo , DeClouette Brittany , Montgomery Samuel R. , Avila Amanda , Shankar Dhruv S. , Alaia Michael J. , Strauss Eric J. , Campbell Kirk A.
Published: October 2024

Objectives:

Previous studies suggest that psychological readiness influences patients’ ability to return to sport (RTS) after surgery. The purpose of this study is to describe the postoperative psychological state of patients following osteochondral allograft (OCA) transplantation in the knee and to determine whether patient-perceived kinesiophobia is associated with the rate of RTS.

Methods:

A retrospective review of the electronic medical record at a single institution was conducted for all patients that underwent OCA transplantation from January 2010 to January 2020. Patient-reported outcomes including the Visual Analog Scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Tampa Scale of Kinesiophobia-11 (TSK-11) were collected. Patients were surveyed regarding their postoperative RTS status.

Results:

A total of 38 patients (52.6% female) were included in our analysis. Overall, RTS rate was 63.2% (n=24), with 50% (n=12) of these patients returning at a lower level of play. When comparing patients that RTS to those that did not, patients that RTS had significantly superior KOOS pain (p=0.019) and KOOS QOL (p=0.011). Measures of kinesiophobia (TSK-11) were significantly higher among patients that did not RTS (p=0.014), while satisfaction (p=0.410) and pain intensity (p=0.327) were comparable between groups. Logistic regression models controlling for demographic factors, VAS pain scores, and lesion size showed that for every one-point increase in TSK-11 kinesiophobia score, patients were 1.33 times more likely to return to sport at a lower level (p=0.009). For every one-point increase in TSK-11 scores KOOS QOL decreased by 2.39 points (p<0.001).

Conclusions:

Fear of reinjury decreases the likelihood that patients will return to their pre-operative level of sport after OCA transplantation. Patients that do not RTS report significantly greater fear of reinjury and inferior clinical outcomes, despite similar levels of satisfaction and pain compared to those that RTS.
Poster 283: Revision Patellofemoral Surgery: A Retrospective Cohort Analysis
Authors: Yalcin Sercan , Poirier Sarah E. , Farrow Lutul D.
Published: October 2024

Objectives:

To report demographic and radiologic data, and clinical outcomes of patients undergoing revision surgery for patellar instability

Methods:

This is a retrospective cohort study. We included patients undergoing revision surgery for patellar instability between January 2010 and January 2022 in our institution. Exclusion criteria included patients with missing information regarding their primary surgery, patients with congenital disorders and patients with a history of distal femoral or proximal tibial osteotomy. Statistical analysis was performed using SPSS v. 20.

Results:

Ninety-six patients underwent revision surgery for patellofemoral instability. Eight patients were excluded based on exclusion criteria (Figure 1). Of the 88 patients included in final analysis, 44 (50%) had their primary surgery in our institution and revision rate in our institution was 3.8%. Primary surgeries included lateral retinacular release (LRR):18, medial patellofemoral ligament (MPFL) reefing: 19, MPFL reconstruction (MPFLR): 33, Tibial tubercle osteotomy (TTO): 24 (Table 1). Revision surgeries included: Lateral patellofemoral ligament reconstruction for iatrogenic medial instability: 6, MPFL release for persistent pain: 3, MPFLR: 36, MPFLR with Patellar tendon shortening: 5, MPFLR with Trochleoplasty: 4, Revision of femoral screw: 1, TTO: 19, TTO+MPFLR: 10, TTO+Trochleoplasty: 1, TTO+MPFLR+Trochleoplasty: 3 (Table 2). Patients having LRR as primary surgery had more female patients and higher patellar tilt, MPFLR patients had higher incidence of trochlear dysplasia, MPFL reefing patients were younger (Table 1). In our cohort of patients undergoing revision surgery for patellar instability, the mean tibial tubercle-trochlear groove (TT-TG) distance was 17.2 mm and the mean Caton-Deschamps Index (CDI) was 1.42. The incidences of trochlear dysplasia and skeletally immature patients were 61% and 68.2%, respectively (Table 1). The Median follow up period after revision surgery was 81 months. The overall complication rate after revision surgery was 12.5% (11/88) and occurred at a median of 31.5 months. Ten patients had recurrent patellar instability and one patient had tibial tubercle fracture (Table 3).

Conclusions:

The overall incidence of revision surgery was 3.8 after a primary surgery for patellar instability at a median of 31.5 months. Complications occur in 12.5% of patients after the revision surgery with the majority (10/11) being recurrent patellar instability. In our cohort, CDI and the incidences of trochlear dysplasia and skeletally immature patients were increased while the mean TT-TG distance was not.
Poster 299: Culturing Osteochondral Explants Under Rotatory Shaking or After Removing Bone Marrow Elements Increase Explant Cellular Viability
Authors: Leite Chilan , Ormsby Renee , Mekhail Julie , Charles Julia , Gortz Simon , Merkely Gergo , Lattermann Christian M.
Published: October 2024

Objectives:

Reduced viability in the deepest zones of osteochondral allografts (OCAs) can weaken the subchondral interface, potentially causing graft delamination and failure. This reduction may result from nutritional imbalances due to uneven media distribution or interference from bone marrow elements. This study aims to investigate whether culturing OCAs using a rotatory shaker or removing the bone marrow elements increase graft cellular viability.

Methods:

Bovine osteochondral (OC) explants were stored for 28 days at 4°C under three different conditions (n = 6 explants/group): static (control group), rotatory shaker at 150 rpm (shaker group), and static after removing bone marrow elements using a waterpik device (waterpik group). Chondrocyte viability was assessed using live/dead staining across the entire tissue and in each zone (superficial, middle, deep zone). Subchondral bone viability was assessed using tunel staining by detecting apoptotic cells.

Results:

The use of a rotatory shaker (p = 0.010) or waterpik (p = 0.005) significantly increased chondrocyte viability compared to the static control. When analyzing by zone, both the shaker and the waterpik groups displayed higher cellular viability in the middle (p < 0.001) and deep zone (p = 0.018, shaker; p = 0.025, waterpik) when contrasted with the control group. Furthermore, shaker and waterpik groups demonstrated reduced levels of subchondral bone apoptotic cells compared to control (p = 0.018 and p = 0.007, respectively). Notably, no significant differences were observed between the shaker and waterpik groups in any of the analyses.

Conclusions:

These findings indicate that both rotatory shaking and removing bone marrow elements during osteochondral explants storage lead to higher cellular viability at the middle and deep zones of the graft compared to the static storage condition. Enhancing nutrition delivery to the graft could improve its quality, potentially improving outcomes of OCA transplantation. [Figure: see text][Figure: see text][Figure: see text][Figure: see text]
Developing and Evaluating a Program to Support Preparation for Aging: A Case Study from Phuket Province, Thailand
Authors: Luevanich Chayanit , Kane Ros , Naklong Aimorn , Surachetkosom Prapaipim
Published: October 2024

Introduction: Thailand’s aging population is increasing. While the societal impact of aging is recognized, formal programs to support pre-retirement planning are currently lacking. This study aimed to develop and evaluate a program specifically designed to address this gap and support individuals to prepare for a healthy and fulfilling later life. Methods: We employed a quasi-experimental, one-group pre-test/post-test design to evaluate a newly developed program focused on pre-retirement preparation. The program consisted of four, 3-hr modules delivered weekly. Voluntary participants ( N = 25) were aged 50 to 59 years, physically active, and committed to attending all modules. Participants’ knowledge and self-reported preparedness for aging were assessed before and after program completion. Results: The program led to a statistically significant increase in participants’ overall knowledge of aging ( z = −2.010, p < .05). While specific areas of preparation did not show statistically significant individual differences, mean scores improved across all aspects of preparation. This may reflect the existing health knowledge of some participants and their proactive approach to aging preparation (80% reported some prior preparation). Conclusion: This study demonstrates the effectiveness of a pre-retirement preparation program in enhancing knowledge and self-reported preparedness for aging. Findings suggest that such programs can stimulate middle-aged adults to plan for their future well-being. This study underscores the need for a more holistic approach to pre-retirement preparation. Future programs should consider incorporating content beyond health and finances, potentially including social life planning as identified in this research. Future research could explore program modifications, such as extended formats and content tailored to specific needs.
Dynamic Analysis of Geared Rotor System with Hybrid Uncertainties
Authors: Feng Wei , Wu Luji , Liu Yanxu , Liu Baoguo , Liu Zongyao , Zhang Kun
Published: October 2024

Current research on the dynamics and vibrations of geared rotor systems primarily focuses on deterministic models. However, uncertainties inevitably exist in the gear system, which cause uncertainties in system parameters and subsequently influence the accurate evaluation of system dynamic behavior. In this study, a dynamic model of a geared rotor system with mixed parameters and model uncertainties is proposed. Initially, the dynamic model of the geared rotor-bearing system with deterministic parameters is established using a finite element method. Subsequently, a nonparametric method is introduced to model the hybrid uncertainties in the dynamic model. Deviation coefficients and dispersion parameters are used to reflect the levels of parameter and model uncertainty. For example, the study evaluates the effects of uncertain bearing and mesh stiffness on the vibration responses of a geared rotor system. The results demonstrate that the influence of uncertainty varies among different model types. Model uncertainties have a more significant than parametric uncertainties, whereas hybrid uncertainties increase the nonlinearities and complexities of the system’s dynamic responses. These findings provide valuable insights into understanding the dynamic behavior of geared system with hybrid uncertainties.
Real-world evidence study on the impact of SPECT MPI, PET MPI, cCTA and stress echocardiography on downstream healthcare utilisation in patients with coronary artery disease in the US
Authors: Pelletier-Galarneau Matthieu , Cabra Arturo , Szabo Erika , Angadageri Santosh
Published: October 2024

Background

Coronary artery disease (CAD) is associated with a large clinical and economic burden. However, consensus on the optimal approach to CAD diagnosis is lacking. This study sought to compare downstream healthcare resource utilisation following different cardiac imaging modalities, to inform test selection for CAD diagnosis.

Methods

Claims and electronic health records data from the Decision Resources Group Real-World Evidence US Data Repository were analysed for 2.5 million US patients who underwent single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI), positron emission tomography myocardial perfusion imaging (PET MPI), coronary computed tomography angiography (cCTA), or stress echocardiography between January 2016 and March 2018. Patients were stratified into nine cohorts based on suspected or existing CAD diagnosis, pre-test risk, and prior events or interventions. Downstream healthcare utilisation, including additional diagnostic imaging, coronary angiography, and cardiac-related health system encounters, was compared by cohort and index imaging modality.

Results

Among patients with suspected CAD diagnosed within 3 months of the index test, PET MPI was associated with lower downstream utilisation; 25–37% of patients who underwent PET MPI required additional downstream healthcare resources compared with 40–49% of patients who received SPECT MPI, 35–41% of patients who underwent cCTA, and 44–47% of patients who received stress echocardiography. Patients who underwent PET MPI experienced fewer acute cardiac events (5.3–9.4%) and generally had lower rates of healthcare encounters (0.8–4.1%) and invasive coronary angiography (ICA, 15.4–24.2%) than those who underwent other modalities. SPECT MPI was associated with more downstream ICA (31.3–38.2%) and a higher rate of cardiac events (9.5–13.2%) compared with PET MPI (5.3–9.4%) and cCTA (6.9–9.9%). Across all cohorts, additional diagnostic imaging was 1.6 to 4.7 times more frequent with cCTA compared with PET MPI.

Conclusion

Choice of imaging modality for CAD diagnosis impacts downstream healthcare utilisation. PET MPI was associated with lower utilisation across multiple metrics compared with other imaging modalities studied.
Development and validation of a prediction model for people with mild chronic kidney disease in Japanese individuals
Authors: Miki Takahiro , Sakoda Toshiya , Yamamoto Kojiro , Takeyama Kento , Hagiwara Yuta , Imaizumi Takahiro
Published: October 2024

Background

Chronic kidney disease (CKD) poses significant health risks due to its asymptomatic nature in early stages and its association with increased cardiovascular and kidney events. Early detection and management are critical for improving outcomes.

Objective

This study aimed to develop and validate a prediction model for hospitalization for ischemic heart disease (IHD) or cerebrovascular disease (CVD) and major kidney events in Japanese individuals with mild CKD using readily available health check and prescription data.

Methods

A retrospective cohort study was conducted using data from approximately 850,000 individuals in the PREVENT Inc. database, collected between April 2013 and April 2023. Cox proportional hazard regression models were utilized to derive and validate risk scores for hospitalization for IHD/CVD and major kidney events, incorporating traditional risk factors and CKD-specific variables. Model performance was assessed using the concordance index (c-index) and 5-fold cross-validation.

Results

A total of 40,351 individuals were included. Key predictors included age, sex, diabetes, hypertension, and lipid levels for hospitalization for IHD/CVD and major kidney events. Age significantly increased the risk score for both hospitalization for IHD/CVD and major kidney events. The baseline 5-year survival rates are 0.99 for hospitalization for IHD/CVD and major kidney events are 0.99. The developed risk models demonstrated predictive ability, with mean c-indexes of 0.75 for hospitalization for IHD/CVD and 0.69 for major kidney events.

Conclusions

This prediction model offers a practical tool for early identification of Japanese individuals with mild CKD at risk for hospitalization for IHD/CVD and major kidney events, facilitating timely interventions to improve patient outcomes and reduce healthcare costs. The models stratified patients into risk categories, enabling identification of those at higher risk for adverse events. Further clinical validation is required.
“The patient as teacher” - thematic analysis of undergraduate medical students’ experiences with an experiential learning project in palliative care
Authors: Stocklassa Stephanie , Block Susan , Paal Piret , Elsner Frank
Published: October 2024

Background

Experiential learning holds high potential for medical students’ education in palliative care. At RWTH Aachen University in Germany, medical students can participate in the course “The Patient as Teacher” offering a one-to-one exchange with a terminally ill patient over a period of several weeks complemented with four supervision sessions and writing of a reflective essay. The course had run from 2005 to 2020 before it was paused due to the Covid-19 pandemic. This study aimed to assess the course’s value as a palliative care teaching tool by investigating students’ motivation and experiences over the years 2005–2020.

Methods

A stratified sample of 24 essays was taken from all submitted essays (n = 78), eight essays from the years 2005–2009, 2010–2014, and 2015–2020. Subsequently, a thematic analysis of the selected essays was conducted.

Results

The students felt motivated by the opportunity to gain more experience in palliative care, to improve their communication skills and to decrease insecurities in interaction with terminally ill patients. They learned about the patient’s biography and medical history, and encountered physical, psychological, social, and spiritual dimensions of living with a life-limiting disease. Moreover, they experienced relationship building and communication with a terminally ill patient outside their role as future doctors. Ultimately, they considered their participation as a beneficial experience on both a personal and professional level.

Conclusions

The course “The Patient as Teacher” presents a valuable tool for experiential learning in palliative care, which has elicited an unceasingly positive response among the students who participated over the years. It has facilitated medical students in overcoming insecurities in dealing with terminally ill patients and supported them in further developing their professional identity.
Mental health on two continua: mental wellbeing and common mental disorders in a community-based cross-sectional study with women in urban informal settlements in India
Authors: Kanougiya Suman , Daruwalla Nayreen , Osrin David
Published: October 2024

Background

We considered the suggestion that mental health is the product of two intersecting continua: psychological distress and mental wellbeing.

Objectives

To understand prevalences of low mental wellbeing, depression and anxiety, and examine associations between them and with sociodemographic variables.

Methods

In a cross-sectional survey in informal settlements, 4906 women aged 18–49 years answered questions on mental wellbeing (Short Warwick-Edinburgh Mental Wellbeing Scale: SWEMWBS) and symptoms of depression (Patient Health Questionnaire: PHQ-9) and anxiety (Generalised Anxiety Disorder: GAD-7). We used regression models to examine associations of lower mental wellbeing with symptoms suggesting moderate-to-severe depression and anxiety, and with sociodemographic characteristics.

Results

About 15% of women reported symptoms of low wellbeing, 9% symptoms of moderate-to-severe depression, and 6% symptoms of moderate-to-severe anxiety. Women with low wellbeing did not necessarily report symptoms suggesting anxiety or depression, and women with anxiety or depression did not necessarily report low wellbeing. In adjusted models, poorer and less educated women were more likely to report low wellbeing. Symptoms of anxiety or depression were more likely to be reported by widowed, separated, or divorced women, women who were in paid employment, and women who used drugs or alcohol themselves or whose partners did. Women with low wellbeing had at least double the odds of reporting symptoms of moderate-to-severe depression or anxiety than women who reported greater wellbeing.

Conclusion

The findings support the idea of two continua of mental health. How individual women cope with mental illness and nevertheless enjoy a state of wellbeing deserves more study.
Depressive symptoms, conduct problems and alcohol use from age 13 to 19 in Norway: evidence from the MyLife longitudinal study
Authors: Brunborg Geir Scott , Bang Lasse , Skogen Jens Christoffer , Burdzovic Andreas Jasmina
Published: October 2024

Background

Even though mental health problems and alcohol use remain major challenges facing adolescents, our understanding of their developmental progressions primarily stems from cohorts coming 1 of age in the early 2000’s. We aimed to examine and describe normative developmental trajectories of depression, conduct problems, and alcohol use across adolescent years among more recent cohorts of Norwegian youth born in the 21st century.

Methods

Multilevel mixed linear models for symptoms of depression and conduct disorder, and multilevel mixed logistic models for depressive disorder, conduct problems, any alcohol use, and risky drinking, were estimated with longitudinal data from a nationwide sample N = 3436 (55% girls) of Norwegian adolescents (mean age 14.3 [SD = 0.85] in 2017). We compared models with linear, quadratic, and cubic change with age, and models that tested moderation by sex and centrality (rural vs. urban communities).

Results

Average symptoms and the rate of depressive disorder increased sharply from age 13 to age 19, but both the initial levels and the rates of change were greater for girls than for boys. Average symptoms of conduct disorder and the rate of conduct problems increased in early adolescence and were greater for boys than girls. The rates of any alcohol use and risky drinking both increased sharply from age 14, but there were no notable sex differences either in the initial levels or rates of change over time. Adolescents from more rural communities had greater rates of any drinking in mid-adolescence, but there were no other effects of centrality.

Conclusions

This study provides a much-needed update concerning normative developmental trajectories of depression, conduct problems, and alcohol use among millennium cohorts. Consistent with prior studies, we observed significant increases in all outcomes across adolescence, with depression being both greater and more prevalent among girls and conduct problems being both greater and more prevalent among boys. Consistent with the emerging evidence, we observed no sex differences in alcohol use. Finally, there were no differences in the examined developmental trajectories as a function of centrality. These findings underscore the importance of early prevention and treatment of mental health and substance use problems.
Enhancer looping protein LDB1 modulates MYB expression in T-ALL cell lines in vitro by cooperating with master transcription factors
Authors: Li Yan , Zhang Zimu , Yu Juanjuan , Yin Hongli , Chu Xinran , Cao Haibo , Tao Yanfang , Zhang Yongping , Li Zhiheng , Wu Shuiyan , Hu Yizhou , Zhu Frank , Gao Jizhao , Wang Xiaodong , Zhou Bi , Jiao Wanyan , Wu Yumeng , Yang Yang , Chen Yanling , Zhuo Ran , Yang Ying , Zhang Fenli , Shi Lei , Hu Yixin , Pan Jian , Hu Shaoyan
Published: October 2024

Background

Despite significant progress in the prognosis of pediatric T-cell acute lymphoblastic leukemia (T-ALL) in recent decades, a notable portion of children still confronts challenges such as treatment resistance and recurrence, leading to limited options and a poor prognosis. LIM domain-binding protein 1 (LDB1) has been confirmed to exert a crucial role in various physiological and pathological processes. In our research, we aim to elucidate the underlying function and mechanisms of LDB1 within the background of T-ALL.

Methods

Employing short hairpin RNA (shRNA) techniques, we delineated the functional impact of LDB1 in T-ALL cell lines. Through the application of RNA-Seq, CUT&Tag, and immunoprecipitation assays, we scrutinized master transcription factors cooperating with LDB1 and identified downstream targets under LDB1 regulation.

Results

LDB1 emerges as a critical transcription factor co-activator in cell lines derived from T-ALL. It primarily collaborates with master transcription factors (ERG, ETV6, IRF1) to cooperatively regulate the transcription of downstream target genes. Both in vitro and in vivo experiments affirm the essential fuction of LDB1 in the proliferation and survival of cell lines derived from T-ALL, with MYB identified as a significant downstream target of LDB1.

Conclusions

To sum up, our research establishes the pivotal fuction of LDB1 in the tumorigenesis and progression of T-ALL cell lines. Mechanistic insights reveal that LDB1 cooperates with ERG, ETV6, and IRF1 to modulate the expression of downstream effector genes. Furthermore, LDB1 controls MYB through remote enhancer modulation, providing valuable mechanistic insights into its involvement in the progression of T-ALL.
Molecular xenomonitoring reveals Anopheles funestus and An. rivulorum as the primary vectors of lymphatic filariasis in coastal Kenya
Authors: Bartilol Brian , Babu Lawrence , Garama Karisa , Karisa Jonathan , Kamau Alice , Mwandawiro Charles , Wanjiku Caroline , Mbogo Charles , Maia Marta , Mwangangi Joseph , Rono Martin Kibet
Published: October 2024

Background

Lymphatic filariasis (LF) is an infectious neglected tropical disease caused by mosquito-borne nematodes such as Wuchereria bancrofti, Brugia malayi, and Brugia timori. Globally, LF affects 51 million people, with approximately 863 million at risk in 47 countries. In Kenya, filariasis is endemic along the entire coastal strip, and more recently, at the Kenya–Ugandan border. The World Health Organization (WHO) recommends mass drug administration to reduce disease transmission and morbidity. Monitoring the effectiveness of such interventions relies on robust surveillance, achieved through microscopic examination of microfilariae in nighttime blood, detection of circulating filarial antigens (CFA), and molecular xenomonitoring. We focused on molecular xenomonitoring along the Kenyan coast due to its noninvasive nature and the opportunity to identify new vectors.

Methods

In 2022, mosquitoes were collected from Kilifi, Kwale, and Taita-Taveta counties located within the LF endemic region in Kenya. Subsequently, genomic deoxyribonucleic acid (gDNA) was extracted from these mosquitoes for speciation and analysis of Wuchereria bancrofti infection rates. The impact of sociodemographic and household attributes on infection rates was assessed using generalized estimating equations.

Results

A total of 18,121 mosquitoes belonging to Culicinae (63.0%, n = 11,414) and Anophelinae (37.0%, n = 6707) subfamilies were collected. Morphological identification revealed that Anopheline mosquitoes were dominated by An. funestus (45.4%, n = 3045) and An. gambiae (42.8%, n = 2873). Wuchereria bancrofti infection rates were highest in Kilifi (35.4%; 95% CI 28.0–43.3%, n = 57/161) and lowest in Taita Taveta (5.3%; 95% CI 3.3–8.0%, n = 22/412). The major vectors incriminated are An. rivulorum, An. funestus sensu stricto, and An. arabiensis. Mosquitoes of the An. funestus complex were significantly associated with LF transmission (OR 18.0; 95% CI 1.80–180; p = 0.014). Additionally, a higher risk of transmission was observed outdoors (OR 1.74; 95% CI 1.08–2.82; p = 0.024) and in homesteads that owned livestock (OR 2.00; 95% CI 1.09–3.66; p = 0.025).

Conclusions

In this study, we identified An. funestus s.l. sibling species, An. rivulorum and An. funestus s.s., as the primary vectors of lymphatic filariasis along the Kenyan coast. These findings also highlight that a significant portion of disease transmission potentially occurs outdoors where indoor-based vector control tools, including long-lasting insecticidal nets and indoor residual spray, may not be effective. Therefore, control measures targeting outdoor resting mosquitoes such as zooprophylaxis, larval source management, and attractive sugar baits may have potential for LF transmission reduction.

Graphical Abstract
Assessment of the supraspinatus muscle fiber architecture with diffusion tensor imaging in healthy volunteers
Authors: Marth Adrian Alexander , Sommer Stefan , Kajdi Georg Wilhelm , Goller Sophia Samira , Feiweier Thorsten , Sutter Reto , Nanz Daniel , von Deuster Constantin
Published: October 2024

Objectives

This study presents a framework for the calculation of supraspinatus (SSP) muscle pennation angles (PAs) from diffusion tensor imaging (DTI).

Materials and methods

Ten healthy individuals (five females and five males; age 32.0 ± 4.7 years) underwent three sessions of 3-T MRI, including a stimulated echo acquisition mode DTI sequence. The imaging plane of the DTI sequence was angled along the intramuscular part of the SSP tendon. A custom-built software was developed and implemented to compute DTI-based PAs of the anterior and posterior SSP in relation to the orientation of the tendon. Subsequently, three readers measured PAs from the post-processed images. Test-retest reliability, inter-reader agreement, and intra-reader agreement of PA measurements were evaluated with intraclass correlation coefficients (ICCs).

Results

The mean PA in the anterior SSP was 15.6 ± 2.1° and 10.7 ± 0.9° in the posterior SSP. MRI-derived PAs showed good to excellent test-retest reliability (ICC: 0.856–0.945), inter-reader agreement (ICC: 0.863–0.955), and intra-reader agreement (ICC: 0.804–0.955).

Conclusion

PAs derived from DTI demonstrated good to excellent test-retest reliability, inter-reader agreement, and intra-reader agreement. We successfully implemented a highly standardized technique for evaluating PAs of the SSP muscle.

Critical relevance statement

This proposed low-complex method might facilitate the increased use of the PA as a biomarker for pathological conditions of the rotator cuff.

Key Points

A low-complex method for measuring PAs of the SSP might help identify pathology early.

The mean PA was 15.6 ± 2.1° and 10.7 ± 0.9° in the anterior and posterior SSP, respectively.

ICCs were ≥ 0.856 for test-retest reliability, ≥ 0.863 for inter-reader agreement, and ≥ 0.804 for intra-reader agreement.

Graphical Abstract
[18F]FDG whole-body PET-MR including an integrated breast MR protocol for locoregional and distant staging in breast cancer patients—a feasibility study
Authors: van Nijnatten Thiemo J. A. , de Mooij Cornelis M. , Mitea Cristina , Houwers Janneke , de Boer Maaike , Smidt Marjolein L. , Mottaghy Felix M. , Wildberger Joachim E.
Published: October 2024

Purpose

To investigate in a feasibility study the combination of [18F]FDG whole-body (WB) positron emission tomography-magnetic resonance (PET-MR), including an integrated breast MR within a single protocol for locoregional and distant staging in breast cancer patients.

Methods

Consecutive patients with breast cancer diagnoses according to conventional imaging modalities (full-field digital mammography (FFDM) and ultrasound (US)) were prospectively included. All patients underwent [18F]FDG WB PET-MR, including an integrated dedicated breast MR (prone position) and WB PET-MR (supine position) protocol. Results of [18F]FDG WB PET-MR, including integrated breast MR, versus conventional imaging modalities were compared.

Results

From April 2021–April 2022, 28 patients were included. On conventional imaging, cT1-2 breast cancer was present in 22 (FFDM) and 23 (US) out of 28 patients. With regard to clinical nodal status, eight patients were considered cN0, eighteen cN1 (1-3 suspicious lymph nodes), and two patients were cN2 (four suspicious axillary lymph nodes/internal mammary lymph node metastasis). [18F]FDG WB PET-MR, including an integrated breast MR protocol, upstaged clinical tumor status in two patients and clinical nodal status in nine patients according to both [18F]FDG WB PET-MR and breast MR findings. In addition, distant metastases were detected in three patients (liver/bone), and another patient was diagnosed with a synchronous primary tumor (lung cancer).

Conclusion

[18F]FDG WB PET-MR, including an integrated breast MR within a single protocol in breast cancer patients, is feasible and provides a promising new approach in breast cancer patients with regard to locoregional and distant staging.

Critical relevance statement

[18F]FDG whole-body PET-MR, including an integrated breast MR protocol, is feasible and allows locoregional and distant staging within a single imaging exam in breast cancer patients.

Key Points

[18F]FDG PET-MR allows the combination of breast MR and whole-body staging.

Therefore, a single protocol of whole-body [18F]FDG PET-MR, including an integrated breast MRI, is investigated.

[18F]FDG PET-MR, including an integrated breast MR is feasible and can be considered in daily clinical practice.

Graphical Abstract
A highly variable habitat selection in moose across diel and seasonal scales
Authors: Borowik Tomasz , Kowalczyk Rafał , Ratkiewicz Mirosław , Maślanko Weronika , Duda Norbert , Żmihorski Michał
Published: October 2024

Purpose

Habitat selection in animals is a hierarchal process that operates across multiple temporal and spatial scales, adapting to changes in environmental conditions, human disturbances, and predation risks. Despite its significance, previous research often oversimplifies temporal dynamics by categorizing them into broad seasonal and diel patterns, overlooking the continuous nature of temporal variability and habitat specificity.

Methods

We investigated the temporal patterns in habitat selection of moose (Alces alces) in highly heterogenous landscapes at the southwestern edge of their European range using step-selection functions. Utilizing over 700,000 GPS locations from 34 adult moose, we aimed to assess seasonal and diel patterns in their selectivity for both natural and human-related habitats.

Results

Our findings revealed significant overall temporal variation in moose habitat selection at both seasonal and diel scales. Moose selectivity toward different habitats showed low repeatability over time, with 35% of cases displaying negative correlation between selectivity in different time windows. Diel changes were more pronounced, showing 5.6-fold difference in cumulative selectivity, compared to 1.4-fold difference in seasonal dynamics. Notably, moose exhibited lower selectivity during nighttime hours throughout the year compared to daytime hours. The study also highlighted distinct habitat selection patterns across different habitat types: natural habitats (deciduous forests, coniferous forests, wetlands) exhibited pronounced seasonal variation, while anthropogenic habitats (grasslands, arable land, roads and settlements) showed more diel variability. Moose generally avoided human-related habitats during daytime hours, but their preferences during nighttime varied depending on the habitat type and time of year.

Conclusion

This research advances our understanding of the complex temporal patterns in habitat selection by large herbivores and underscores the importance of considering temporal dynamics in habitat selection modelling.
Efficacy of neuroendoscopy-assisted surgery in the treatment of chronic subdural hematoma: a meta-analysis
Authors: Liu Hou-Qiang , Bai Xue , Xiong Fang-Ling , Gao Ming-Ming , Zhang Huai-Bing , Liu Bao-Hua
Published: October 2024

Background

Chronic subdural hematoma (CSDH) is one of the most common diseases in neurosurgery. It is the result of chronic intracranial hemorrhage that converges between the dura mater and arachnoid three weeks after externally injuring the head. Chronic subdural hematomas are a common complication in neurosurgery. With the gradual increase in the amount of hematoma, the surrounding brain tissue is pushed and compressed, resulting in corresponding clinical symptoms and signs. It is reported that the overall incidence rate of CSDH is 1.72 to 20.6 per 100,000 people every year, and the incidence rate of the elderly is particularly high.

Methods

The computer retrieves eight databases to obtain controlled trials at home and abroad on the effects of neuroendoscopy-assisted surgery in patients with chronic subdural hematoma. After a rigorous literature quality evaluation, data analysis was performed using RevMan 5.3 software.

Results

Twenty studies were ultimately included in this meta-analysis. Seventeen studies reported the Recurrence rate of the test group and the control group, which was significantly lower (OR 0.27; 95% Cl 0.18, 0.38; P < 0.01) than the control group, Recovery rate (OR 1.18; 95% Cl 1.01, 1.38; P = 0.03), Total effective rate (OR 1.11; 95% Cl 1.04, 1.17; P < 0.01), Operative time (SMD 15.78; 95% Cl 9.69, 21.86; P < 0.01), Hospital stay (SMD − 1.66; 95% Cl − 2.17, − 1.14; P < 0.01) and Complications (OR 0.48; 95% Cl 0.30, 0.78; P < 0.01).

Conclusion

The results of this study suggest that neuroendoscopy-assisted surgery may be effective in patients with chronic subdural hematoma, as evidenced by recurrence rate, recovery rate, total effective rate, operative time, hospital stay, complications, and the above conclusions need to be verified by more high-quality studies.
Impacts of a short-interval severe fire on forest structure and regeneration in a temperate Andean Araucaria-Nothofagus forest
Authors: Arroyo-Vargas Paola , Busby Sebastian , Veblen Thomas T. , González Mauro E. , Holz Andrés
Published: October 2024

Background

Warmer climate conditions are altering fire regimes globally, eroding the capacity of forest ecosystems to resist and recover from natural disturbances like wildfire. Severe and rapidly repeated wildfires are promoting tree regeneration failure of obligate-seeders and/or fire-sensitive species in temperate forests of the Southern Hemisphere. We collected post-fire field data to evaluate whether forest structure and tree regeneration responses varied between two Andean forest study areas dominated by the threatened Gondwanan conifer Araucaria araucana and Nothofagus species (southern beeches) — one area burned once, the other reburned after 13 years.

Results

Tree mortality was high across species after a single high severity and/or repeated wildfire, although some A. araucana trees were able to survive both events. Post-fire seedling regeneration of A. araucana and Nothofagus spp. was poor in areas affected by severe wildfires, and the latter was absent from reburned plots. A key driver of this regeneration failure was increasing distance to live seed source trees, which was negatively correlated with these species’ post-fire seedling abundances. In contrast, species with the capacity to regenerate via resprouting (A. araucana, N. alpina, N. obliqua) did so after a single high severity fire; however, only a single Nothofagus species (N. alpina) resprouted abundantly after a reburn.

Conclusions

Our findings suggest that high severity and short-interval fires can drastically change the structure of and limit post-fire tree regeneration in Araucaria-Nothofagus forests, promoting alternative post-fire forest ecosystem trajectories. Resprouting species of the Nothofagus genus, especially N. alpina, exhibit the greatest resilience to these emerging fire patterns. These forests are currently facing an unprecedented climatic shift toward greater fire activity, where resprouting is the favored regeneration strategy. If the occurrence of severe and short-interval fires increases in the coming decades, as predicted, we expect Araucaria-Nothofagus forests to shift toward a drier, more flammable shrubland ecosystem state.