bluuebunny/crossref_metadata_2025 huggingface dataset:
Absence of Association between Child Temperament and Early Childhood Caries: A Cross-Sectional Study
Authors: Mariño Rodrigo , Hofer-Durán Paulina , Nuñez-Contreras Javiera , Aravena-Rivas Yanela , Zaror Carlos
Published: February 2023

Early childhood caries (ECC) is a worldwide public health problem. The biological and behavioural determinants that are directly involved in ECC have been well documented; however, evidence on the effects of some psychosocial factors remains conflicting. This study aimed to assess the association between child temperament and ECC in Chilean preschoolers. Prior approval of the protocol was obtained from the ethics committee of Universidad de La Frontera (Folio N° 020_17), and all of those involved in the study provided signed informed consent forms. The cross-sectional study was conducted with 172 children aged 3 to 5 years attending preschools in Temuco, Chile. Each child’s temperament was assessed based on parents’ responses to the Early Childhood Behaviour Questionnaire. The outcomes assessed were caries prevalence and caries experience (dmft scores). The covariates included were socioeconomic position, cariogenic diet, prolonged breastfeeding, presence of dental plaque and hypoplasia. Logistic regression models were used to predict caries prevalence and negative binomial regression for caries experience. The prevalence of ECC was 29.1%, and the most frequent child temperament was ‘effortful control’. Regression model analyses, adjusting for covariates, showed no evidence of an association between any domain of children’s temperament (surgency, negative affect and effortful control) with the prevalence of caries or caries experience. This cross-sectional study found no association between childhood temperament and ECC in preschool children for this population. However, due to the specificity of this population, the association cannot be entirely ruled out. Further studies are needed to help understand the association between temperament and oral health, including the influences of family environment factors and culture.
MALDI-TOF/MS Profiling of Whole Saliva and Gingival Crevicular Fluid in Patients with the Invisalign System and Fixed Orthodontic Appliances
Authors: Bober Peter , Talian Ivan , Mihalik Dávid , Verbová Gabriela , Sabo Ján
Published: February 2023

The movement of teeth by orthodontic treatment with the Invisalign (IN) system and fixed orthodontic appliances (FOA) is characterized by the reconstruction of periodontal ligaments, alveolar bone, and gingiva. A reflection of these phenomena can be found in the composition of gingival crevicular fluid (GCF). A total of 90 samples from 45 participants (45 whole saliva and 45 GCF), including 15 patients with FOA, 15 patients with IN, and 15 patients with oral health, were subjected to matrix-assisted laser desorption/ionization mass spectrometry (MALDI-TOF/MS) analysis. Mass fingerprints were generated for each sample. Three models were tested: a quick classifier (QC), a genetic algorithm (GA), and a supervised neural network (SNN). For both groups of samples (saliva and GCF), the GA model showed the highest recognition abilities of 88.89% (saliva) and 95.56% (GCF). Differences between the treated (FOA and IN) groups and the control group in saliva and GCF samples were determined using cluster analysis. In addition, we monitored the effect of long-term orthodontic treatment (after 6 months) in the lag phase of orthodontic tooth movement. The results show increased levels of inflammatory markers (α-defensins), which may indicate an ongoing inflammatory process even after 21 days from force application.
Community Research Fellows Training Program: Evaluation of a COVID-19-Precipitated Virtual Adaptation
Authors: Ackermann Nicole , Humble Sarah , Coats Jacquelyn V. , Lewis Rhone Carlette , Schmid Craig , Sanders Thompson Vetta , Davis Kia L.
Published: February 2023

Community engagement is important for promoting health equity. However, effective community engagement requires trust, collaboration, and the opportunity for all stakeholders to share in decision-making. Community-based training in public health research can build trust and increase community comfort with shared decision-making in academic and community partnerships. The Community Research Fellows Training (CRFT) Program is a community-based training program that promotes the role of underserved populations in research by enhancing participant knowledge and understanding of public health research and other relevant topics in health. This paper describes the process of modifying the original 15-week in-person training program to a 12-week online, virtual format to assure program continuation. In addition, we provide program evaluation data of the virtual training. Average post-test scores were higher than pre-test scores for every session, establishing the feasibility of virtual course delivery. While the knowledge gains observed were not as strong as those observed for the in-person training program, findings suggest the appropriateness of continuing to adapt CRFT for virtual formats.
Friedman Tongue Position and the Anthropometric Parameters in Adult Patients with Obstructive Sleep Apnea: An Observational Study
Authors: Luzzi Valeria , Altieri Federica , Guaragna Mariana , Pirro Valentina , Marasca Beatrice , Cotticelli Luisa , Mazur Marta , Di Carlo Gabriele , Di Giacomo Paola , Di Paolo Carlo , Brunori Marco , Ierardo Gaetano , Piperno Gabriele , Magliulo Giuseppe , Pace Annalisa , Iannella Giannicola , Palange Paolo , Martini Agnese , Pietrafesa Emma , Polimeni Antonella
Published: February 2023

Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is a relevant public health problem; dentists can play an important role in screening patients with sleep disorders by using validated tools and referring patients to a specialist, thereby promoting an interdisciplinary approach. The aim of the study is to identify if the OSAS severity, measured by the apnea–hypopnea index (AHI), and some anthropometric measurements are associated with the Friedman Tongue Position (FTP) within a population with dysmetabolic comorbidities. Materials and Methods: A questionnaire containing information about clinical data including height, weight, Body Mass Index (BMI), neck circumference, waist circumference, hip circumference and FTP was administered. The AHI value was measured by means of an unattended home polysomnography device. Pearson correlation coefficients were calculated, and Kruskal–Wallis, Kolmogorov–Smirnov (both nonparametric) and independence tests were performed to probe the possible relationships. The significance was set at p ≤ 0.05. Results: A total of 357 subjects were analyzed. The association between the FTP and AHI was not statistically significant. On the contrary, the AHI showed a positive correlation with BMI and neck circumference. A statistically significant association between the number of subjects with a larger neck and an increasing FTP class was found. BMI, neck, hip and waist circumference was associated with the FTP scale. Conclusions: although the FTP was not directly associated with OSAS severity, there was also evidence that an FTP increase is associated with an increase in the considered anthropometric parameters, and FTP can be a clinical tool used in the assessment of risk for OSAS risk factors.
Impact of COVID-19 Pandemic on Caregivers of People with an Intellectual Disability, in Comparison to Carers of Those with Other Disabilities and with Mental Health Issues: A Multicountry Study
Authors: Wormald Andrew , McGlinchey Eimear , D’Eath Maureen , Leroi Iracema , Lawlor Brian , McCallion Philip , McCarron Mary , O’Sullivan Roger , Chen Yaohua
Published: February 2023

Carers supporting people with an intellectual disability often rely on others to manage the burden of care. This research aims to compare the differences between carer groups and understand the predictors of loneliness changes and burden for carers of people with an intellectual disability. Data from the international CLIC study were analysed. In total, 3930 carers responded from four groups; people who care for those with mental health difficulties (n = 491), dementia (n = 1888), physical disabilities (n = 1147), and Intellectual disabilities (n = 404). Cross tabulation and the chi-squared test were used to compare group compositions and binary logistic regression to model predictors within the intellectual disability group. A total of 65% of those caring for people with an intellectual disability experienced increased burden, and 35% of carers of people with an intellectual disability and another condition experienced more severe loneliness. Becoming severely lonely was predicted by feeling burdened by caring (AOR, 15.89) and worsening mental health (AOR, 2.13) Feeling burden was predicted by being aged between 35 and 44 (AOR, 4.24), poor mental health (AOR, 3.51), and feelings of severe loneliness prior to the pandemic (AOR, 2.45). These findings demonstrate that those who were already struggling with caring experienced the greatest difficulties during the COVID-19 lockdowns.
Association between Dairy Consumption and Psychological Symptoms: Evidence from a Cross-Sectional Study of College Students in the Yangtze River Delta Region of China
Authors: Zhao Zhimin , Cai Ruibao , Zhao Yongxing , Hu Yanyan , Liu Jingzhi , Wu Minghao
Published: February 2023

Background: Assessing the dairy consumption and psychological symptoms of Chinese college students as a reference for the mental health of Chinese college students. Methods: A three-stage stratified whole-group sampling method was used to investigate dairy consumption and psychological symptoms among 5904 (2554 male students, accounting for 43.3% of the sample) college students in the Yangtze River Delta region. The mean age of the subjects was 20.13 ± 1.24 years. Psychological symptoms were surveyed using the Brief Questionnaire for the Assessment of Adolescent Mental Health. The detection rates of emotional problems, behavioral symptoms, social adaptation difficulties and psychological symptoms among college students with different dairy consumption habits were analyzed using chi-square tests. The association between dairy consumption and psychological symptoms was assessed using a logistic regression model. Results: College students from the “Yangtze River Delta” region of China participated in the study, of which 1022 (17.31%) had psychological symptoms. The proportions of participants with dairy consumption of ≤2 times/week, 3–5 times/week, and ≥6 times/week were 25.68%, 42.09%, and 32.23%, respectively. Using dairy consumption ≥6 times/week as a reference, multifactor logistic regression analysis showed that college students with dairy consumption ≤2 times/week (OR = 1.42, 95% CI: 1.18, 1.71) were at higher risk of psychological symptoms (p < 0.001). Conclusion: During the COVID-19 pandemic, Chinese college students with lower dairy consumption exhibited higher detection rates of psychological symptoms. Dairy consumption was negatively associated with the occurrence of psychological symptoms. Our study provides a basis for mental health education and increasing knowledge about nutrition among Chinese college students.
Types of Environmental Public Interest Litigation in China and Exploration of New Frontiers
Authors: You Wei , Liang Shan , Feng Lei , Cai Zexuan
Published: February 2023

Since “ecological civilization” was written into the constitution, China has continuously strengthened ecological and environmental protection and innovatively established an environmental public interest litigation system. However, China’s current environmental public interest litigation system is not sound, especially since the types and scope of environmental public interest litigation are unclear, which is the core problem we aim to solve. To explore the types of environmental public interest litigation in China and the possibility of expanding new fields, we first used the normative analysis method to review the legislation of environmental public interest litigation in China and then conducted an empirical analysis of 215 judgment documents of environmental public interest litigation in China, and we concluded that the legal types and scope of application of environmental public interest litigation in China are constantly expanding. To reduce environmental pollution and ecological damage as much as possible, we argue that China should further expand the application of environmental administrative public interest litigation to improve the environmental civil public interest litigation system and adhere to the criteria of “behavior standards first, result standards second” and “prevention first, recovery second”. At the same time, through the internal connection mechanism between procuratorial suggestions and environmental administrative public interest litigation, the external cooperation between environmental organizations, procuratorates, and environmental administrative departments should be strengthened, and a new mechanism for environmental public interest litigation should be established and improved to accumulate useful experience in the judicial protection of China’s ecological environment.
The Eco-Agricultural Industrial Chain: The Meaning, Content and Practices
Authors: Liu Yongwei , Yang Zhenzhen , Zhu Changxiong , Zhang Baogang , Li Hongna
Published: February 2023

Lucid waters and lush mountains are invaluable assets. Resource-saving and environmentally friendly industrial structures, production, and living modes are pursued continuously for sustainable ecological development. According to the Second National Pollution-Source Survey, agricultural non-point pollution is still the most important source of the current water pollution. In order to improve the water environment and control the pollution, the meaning and content of the eco-agricultural industrial chain was introduced. Based on this conception, the eco-agricultural industrial chain, integrating a whole circular system with different sessions of crop farming, animal breeding, agricultural product processing, and rural living, was innovatively put forward to control the agricultural non-point pollution and protect the water environment systematically for the first time in this paper. The sustainable development was realized at a large scale from the reduction and harmlessness at the source, resource utilization in the process, and ecological restoration in the end. Core techniques were innovated based on the integration of agricultural industries to achieve the high-quality and green development of agriculture. The system included ecological breeding technologies, ecological cultivation technologies, as well as rural sewage treatment and recycling technologies, in the principle of reduce, reuse, and resource. Based on this, the agricultural production changed from the traditional mode of “resources–products–wastes” to the circulation pattern of “resources–products–renewable resources–products”. Thus, the final aim could be achieved to realize the material’s multilevel use and energy conversion in the system. The eco-agricultural industrial chain technology was proven to be efficient to achieve both the good control of agricultural non-point pollution and an effective improvement in the water quality.
Game-Based Learning and Service-Learning to Teach Inclusive Education in Higher Education
Authors: Rodríguez-Ferrer José M. , Manzano-León Ana , Aguilar-Parra José M.
Published: February 2023

This study evaluates the impact of game-based learning (GBL) and Service-Learning on the flow and engagement of teacher education students. A quasi-experimental between-group comparison design with pre-test and post-test measures was conducted with a sample of 113 students majoring in childhood education. The results indicate that the experimental group statistically significantly improved their flow and engagement scores compared to the control group. It is concluded that the GBL and SL methodology in initial teacher training allows students to learn about inclusive education in a motivating way and to design different strategies and resources that they will be able to use in their professional future.
Association of Blood Mercury Level with Liver Enzymes in Korean Adults: An Analysis of 2015–2017 Korean National Environmental Health Survey
Authors: Chung Jin-Wook , Acharya Dilaram , Singh Jitendra Kumar , Sakong Joon
Published: February 2023

Increased liver enzymes as a result of exposure to mercury and their toxic effects are not well understood in Korea at the population level. The effect of blood mercury concentration on alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was evaluated after adjusting for sex, age, obesity, alcohol consumption habit, smoking, and exercise parameters in 3712 adults. The risk of abnormal liver function was measured using a multiple logistic regression analysis. Blood mercury concentration was divided into quartiles, and liver enzyme levels were compared for each quartile. ALT and AST levels were 10–20% higher in the second, third, and fourth quartiles compared to the first quartile. The risk of liver dysfunction or elevated liver enzymes was significantly higher in the second, third, and fourth quartiles than in the first quartile. As blood mercury levels increased, liver enzymes and mercury-induced hepatotoxicity increased. The increase in liver enzymes caused by mercury was more pronounced in the low-mercury concentration range. To reduce the long-standing problem of abnormal liver enzymes and liver function in Korea and other similar settings, it is important to decrease exposure to mercury through effective implementation of specific health and environmental strategies.
Co-Creating GIS-Based Dashboards to Democratize Knowledge on Urban Resilience Strategies: Experience with Camerino Municipality
Authors: Villani Maria Luisa , Giovinazzi Sonia , Costanzo Antonio
Published: February 2023

Natural hazards are increasingly threatening our communities; hence it is imperative to provide communities with reliable information on possible impacts of such disasters, and on resilience measures that can be adopted to recover from disasters. To increase the engagement of various stakeholders in decision-making processes related to resilience to natural hazards, problem-specific information needs to be presented to them in a language understandable to non-experts in the field. To this end, this paper illustrates experimentation with low-code platforms for fast digitalization of resilience reports, incorporating the perspectives of various stakeholders in the analysis, thus making informed decision-making practicable. We present a co-creation-based approach to develop GIS-based user-friendly dashboards in support to the identification of resilience strategies against natural hazards; this approach has been developed within the framework of the European project ARCH. Urban areas are regarded as complex social-ecological systems whose various dimensions should be considered in this resilience endeavor, during all phases of the Disaster Risk Reduction and Climate Change Adaptation cycle. The work presented in this paper specifically targets the possible impacts and risks that might affect the cultural heritage subsystems of our cities, generally underrepresented in the international literature related to urban resilience assessment. We describe how we applied our approach to the Camerino municipality, a historic Italian town exposed to seismic risk, which was struck by a severe earthquake sequence in 2016–2017 and discuss the results of our experience.
Influencing Pedestrians’ Route Choice Using Route Shape Simplification
Authors: Ti Peng , Dai Ruyu , Wan Fangyi , Xiong Tao , Wu Hao , Li Zhilin
Published: February 2023

Pedestrians’ route choice is critical for several purposes, while deliberately changing map representations can influence map users’ route choice. Simplifying routes’ geometric shapes is one way to achieve this. However, the other geometric characteristics of routes (e.g., the relative distance of different routes, differences in initial orientation, the number of intersections, and the direction changes) also influence pedestrians’ route choice, per relevant research. Hence, this study conducted an experimental investigation to examine the influence of route shape simplification on pedestrians’ route choice, under various geometric characteristics conditions. The results of the statistical tests and correlation analyses showed that (1) route shape simplification has a significant influence on route choice; (2) larger relative distance and direction changes reduce shape simplification’s influence, while the number of intersections and differences in initial orientation have weak effects; (3) 1.3 times the relative distance may be the threshold for the selection of recommended routes, and the improvement of visual continuity at route nodes may prove more influential. The results of this study can support the applicability of shape simplification to influence route choice.
Overview of Lightning Trend and Recent Lightning Variability over Sri Lanka
Authors: Kalapuge Vindhya , Maduranga Dilaj , Alahacoon Niranga , Edirisinghe Mahesh , Abeygunawardana Rushan , Ranagalage Manjula
Published: February 2023

The study was conducted to analyze spatial and temporal variations of lightning activity over Sri Lanka and the surrounding coastal belt region bounded by 5.75–10.00 N and 79.50–89.00 E. Flash data collected by the Lightning Imaging Sensor (LIS) on NASA’s Tropical Rainfall Measuring Mission (TRMM) satellite from 1998 to 2014 and the Lightning Imaging Sensor placed on the International Space Station (ISS) from 2018 to 2021 were used for the study. The Mann-Kendall test and Sen’s slope estimator were applied to annual and seasonal lightning data from 1998 to 2014 to identify the trends in the TRMM dataset. A positive slope of 0.23 was obtained for annual flash densities, while a slope of 0.956 was obtained for First Inter-Monsoon (FIM) seasonal data. Considering the ISS data, the annual variation of lightning activity in 2020 displays the lowest flash density, whereas the highest is represented in 2019 with a value of 10.48 flashes km−2 year−1. The highest mean flash density is observed in Colombo in 2019 at a value of 34.85 flashes km−2 year−1. Overall, April displayed the highest annual flash distribution from 2018 to 2021, whereas the second peak was mostly viewed around September and November. All districts have displayed a significant amount of lightning during April for the period 2018 to 2021. FIM displayed the highest lightning distribution over the country. When considering the seasonal variation, districts belonging to the wet zone and intermediate zone displayed most flashes during the FIM.
RNAi Silencing of the Biomineralization Gene Perlucin Impairs Oyster Ability to Cope with Ocean Acidification
Authors: Schwaner Caroline , Pales Espinosa Emmanuelle , Allam Bassem
Published: February 2023

Calcifying marine organisms, including the eastern oyster (Crassostrea virginica), are vulnerable to ocean acidification (OA) because it is more difficult to precipitate calcium carbonate (CaCO3). Previous investigations of the molecular mechanisms associated with resilience to OA in C. virginica demonstrated significant differences in single nucleotide polymorphism and gene expression profiles among oysters reared under ambient and OA conditions. Converged evidence generated by both of these approaches highlighted the role of genes related to biomineralization, including perlucins. Here, gene silencing via RNA interference (RNAi) was used to evaluate the protective role of a perlucin gene under OA stress. Larvae were exposed to short dicer-substrate small interfering RNA (DsiRNA-perlucin) to silence the target gene or to one of two control treatments (control DsiRNA or seawater) before cultivation under OA (pH ~7.3) or ambient (pH ~8.2) conditions. Two transfection experiments were performed in parallel, one during fertilization and one during early larval development (6 h post-fertilization), before larval viability, size, development, and shell mineralization were monitored. Silenced oysters under acidification stress were the smallest, had shell abnormalities, and had significantly reduced shell mineralization, thereby suggesting that perlucin significantly helps larvae mitigate the effects of OA.
Biomass-Derived Carbon Materials for the Electrode of Metal–Air Batteries
Authors: Lv Xiaodong , Chen Ming , Kimura Hideo , Du Wei , Yang Xiaoyang
Published: February 2023

Facing the challenges of energy crisis and global warming, the development of renewable energy has received more and more attention. To offset the discontinuity of renewable energy, such as wind and solar energy, it is urgent to search for an excellent performance energy storage system to match them. Metal–air batteries (typical representative: Li–air battery and Zn–air battery) have broad prospects in the field of energy storage due to their high specific capacity and environmental friendliness. The drawbacks preventing the massive application of metal–air batteries are the poor reaction kinetics and high overpotential during the charging–discharging process, which can be alleviated by the application of an electrochemical catalyst and porous cathode. Biomass, also, as a renewable resource, plays a critical role in the preparation of carbon-based catalysts and porous cathode with excellent performance for metal–air batteries due to the inherent rich heteroatom and pore structure of biomass. In this paper, we have reviewed the latest progress in the creative preparation of porous cathode for the Li–air battery and Zn–air battery from biomass and summarized the effects of various biomass sources precursors on the composition, morphology and structure-activity relationship of cathode. This review will help us understand the relevant applications of biomass carbon in the field of metal–air batteries.
Population Density and Host Preference of the Japanese Pine Sawyer (Monochamus alternatus) in the Qinling–Daba Mountains of China
Authors: Nan Junke , Qi Jingyu , Yang Yuexiang , Zhao Mengqin , Liang Chaoqiong , He Hong , Wei Cong
Published: February 2023

Monochamus alternatus is a serious trunk-boring pest and is the most important and effective vector of the pine wood nematode Bursaphelenchus xylophilus, which causes pine wilt disease. The pine wilt disease poses a serious threat to forest vegetation and ecological security in the Qinling–Daba Mountains and their surrounding areas. In order to clarify whether the population density of M. alternatus larvae is related to the host preference of M. alternatus adults, we investigated the population density of M. alternatus overwintering larvae and explored the host preference of M. alternatus adults on Pinus tabuliformis, P. armandii, and P. massoniana. The results show that the population density of M. alternatus larvae was significantly higher on P. armandii than those on P. massoniana and P. tabuliformis. The development of M. alternatus larvae was continuous according to the measurements of the head capsule width and the pronotum width. Adults of M. alternatus preferred to oviposit on P. armandii rather than on P. massoniana and P. tabuliformis. Our results indicate that the difference in the population density of M. alternatus larvae between different host plants was due to the oviposition preference of M. alternatus adults. In addition, the instars of M. alternatus larvae could not be accurately determined, because Dyar’s law is not suitable for continuously developing individuals. This study could provide theoretical basis for the comprehensive prevention and control of the pine wilt disease in this region and adjacent areas.
Reintervention after Thoracic Endovascular Aortic Repair of Uncomplicated Type B Aortic Dissection
Authors: Cheng Li , Xiang Dongqiao , Zhang Shan , Zheng Chuansheng , Wu Xiaoyan
Published: February 2023

Background: Data are scarce regarding the incidence, reasons, potential risk factors, and long-term outcomes of reintervention after thoracic endovascular aortic repair (TEVAR) in patients with uncomplicated type B aortic dissection (TBAD). Methods: Between January 2010 and December 2020, 238 patients with uncomplicated TBAD who received TEVAR were analyzed retrospectively. The clinical baseline data, aorta anatomy, dissection characteristics, and details of the TEVAR procedure were evaluated and compared. A competing-risk regression model was used to estimate the cumulative incidences of reintervention. The multivariate Cox model was used to identify the independent risk factors. Results: The mean follow-up time was 68.6 months. A total of 27 (11.3%) cases of reintervention were observed. The competing-risk analyses showed that the 1-, 3-, and 5-year cumulative incidences of reintervention were 5.07%, 7.08%, and 14.0%, respectively. Reasons for reintervention included endoleak (25.9%), aneurysmal dilation (22.2%), retrograde type A aortic dissection (18.5%), distal stent-graft-induced new entry and false lumen expansion (18.5%), and dissection progression and/or malperfusion (14.8%). Multivariable Cox analysis demonstrated that a larger initial maximal aortic diameter (Hazard ratio [HR], 1.75; 95% Confidence interval [CI], 1.13–2.69, p = 0.011) and increased proximal landing zone oversizing (HR, 1.07; 95% CI, 1.01–1.47, p = 0.033) were the significant risk factors for reintervention. Long-term survival rates were comparable between patients with or without reintervention (p = 0.915). Conclusions: Reintervention after TEVAR in patients with uncomplicated TBAD is not uncommon. A larger initial maximal aortic diameter and excessive proximal landing zone oversizing are associated with the second intervention. Reintervention does not significantly affect long-term survival.
Association of Antiphospholipid Antibodies with Clinical Manifestations in Children with Systemic Lupus Erythematosus
Authors: Petrovic Gordana , Pasic Srdjan , Soldatovic Ivan
Published: February 2023

Background: The aim of the study is to evaluate the effect of the presence of antiphospholipid antibodies on the clinical and laboratory manifestations, disease activity and outcomes of the disease in patients with childhood-onset systemic lupus erythematosus (cSLE). Methods: We conducted a 10-year cross-sectional study with a retrospective analysis of clinical and laboratory parameters and outcome of the disease (kidney, nervous system involvement, thrombosis). For the purpose of the study, patients were divided into cohort groups based on the presence of antiphospholipid antibodies (aPLA), named the aPLA positive group, or their absence, named the aPLA negative group. Values of aPLA were defined in reference laboratories. The disease activity was measured by the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score, whereas tissue damage degree was measured by Systemic Lupus International Collaborating Clinics/American College of Rheumatology-Damage Index (SLICC/ACR DI; SDI; DI). Results: Research in our center showed that patients with cSLE often had hematological, cutaneous, and non-thrombotic neurological manifestations. Antiphospholipid antibodies may be present transiently or permanently. A significant change in the titer value was observed in the IgG isotype of aCLA. The presence of higher values of IgM β2GP1 at the beginning indicates that higher disease activity can be expected. Higher disease activity correlates with greater tissue damage. Additionally, it has been shown that aPLA positive patients have two and a half times higher risk of tissue damage than aPLA negative ones. Conclusion: Our study shows that the presence of antiphospholipid antibodies in patients with childhood onset systemic lupus erythematosus may indicate a higher risk of tissue damage, but since it is a rare disease in childhood, prospective and multicenter studies are necessary to assess the importance of the presence of these antibodies.
Metastatic Lung Cancer to the Head and Neck: A Clinico-Pathological Study on 21 Cases with Narrative Review of the Literature
Authors: Capodiferro Saverio , d’Amati Antonio , Barile Giuseppe , Dell’Olio Fabio , Limongelli Luisa , Tempesta Angela , Siciliani Rosaria Arianna , Ingravallo Giuseppe , Mastropasqua Mauro , Colella Giuseppe , Boschetti Ciro Emiliano , Copelli Chiara , Maiorano Eugenio , Favia Gianfranco
Published: February 2023

Metastases from lung cancer to the oral cavity and to the head and neck generally are very infrequent and usually manifest in advanced stages of the disease. Even more rarely, they are the first sign of an unknown metastatic disease. Nevertheless, their occurrence always represents a challenging situation both for clinicians, in the management of very unusual lesions, and for pathologists, in the recognition of the primary site. We retrospectively studied 21 cases of metastases to the head and neck from lung cancer (sixteen males and five females, age range 43–80 years; eight cases localized to the gingiva [two of these to the peri-implant gingiva], seven to the sub-mandibular lymph nodes, two to the mandible, three to the tongue, one case to the parotid gland; in eight patients, metastasis was the first clinical manifestation of an occult lung cancer) and proposed a wide immunohistochemical panel for a proper identification of the primary tumor histotype, including CK5/6, CK8/18, CK7, CK20, p40, p63, TTF-1, CDX2, Chromogranin A, Synaptophysin, GATA-3, Estrogen Receptors, PAX8, PSA. Furthermore, we collected data from previously published studies and narratively reviewed the relevant literature.
Electrophysiological Evaluation of Macular Dystrophies
Authors: Chiang Tsun-Kang , Yu Minzhong
Published: February 2023

Macular dystrophies are a heterogeneous group of genetic disorders that often severely threatens the bilateral central vision of the affected patient. While advances in molecular genetics have been instrumental in the understanding and diagnosis of these disorders, there remains significant phenotypical variation among patients within any particular subset of macular dystrophies. Electrophysiological testing remains a vital tool not only to characterize vision loss for differential diagnosis but also to understand the pathophysiology of these disorders and to monitor the treatment effect, potentially leading to therapeutic advances. This review summarizes the application of electrophysiological testing in macular dystrophies, including Stargardt disease, bestrophinopathies, X-linked retinoschisis, Sorsby fundus dystrophy, Doyne honeycomb retina dystrophy, autosomal dominant drusen, occult macular dystrophy, North Carolina macular dystrophy, pattern dystrophy, and central areolar choroidal dystrophy.
Catheter Ablation for Atrial Fibrillation in Structural Heart Disease: A Review
Authors: Brasca Francesco Maria Angelo , Menè Roberto , Perego Giovanni Battista
Published: February 2023

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Patients with structural heart disease (SHD) are at an increased risk of developing this arrhythmia and are particularly susceptible to the deleterious hemodynamic effects it carries. In the last two decades, catheter ablation (CA) has emerged as a valuable strategy for rhythm control and is currently part of the standard care for symptomatic relief in patients with AF. Growing evidence suggests that CA of AF may have potential benefits that extend beyond symptoms. In this review, we summarize the current knowledge of this intervention on SHD patients.
Migraine and Hormonal Contraception in Gynecological Outpatient Care—Cross-Sectional Study among Practicing Gynecologists in Germany
Authors: Fitzek Mira P. , Storch Elisabeth , Overeem Lucas H. , Kull Pia , Terhart Maria , Lange Kristin S. , Reuter Uwe , Raffaelli Bianca
Published: February 2023

Hormonal contraception (HC) can influence the migraine burden and should be considered in the comprehensive management of women with migraine. In this study, we aim to investigate the influence of migraine and migraine aura on the prescribing behavior of combined oral contraception (COC) and progestogen monotherapy (PM) in gynecological outpatient care. From October 2021 to March 2022, we performed an observational, cross-sectional study using a self-administered online-based survey. The questionnaire was distributed by mail and e-mail among 11,834 practicing gynecologists in Germany using the publicly available contact information. A total of 851 gynecologists responded to the questionnaire, of whom 12% never prescribe COC in the presence of migraine. Further 75% prescribe COC depending on the presence of limiting factors such as cardiovascular risk factors and comorbidities. When deciding to start PM, migraine appears to be less relevant, as 82% prescribe PM without restrictions. In the presence of aura, 90% of gynecologists do not prescribe COC at all, while PM is prescribed in 53% without restrictions. Almost all gynecologists reported to be actively involved in migraine therapy by having already initiated (80%), discontinued (96%), or changed (99%) HC due to migraine. Our results reveal that participating gynecologists actively consider migraine and migraine aura before and while prescribing HC. Gynecologists appear cautious in prescribing HC in patients with migraine aura.
Pediatric Laryngopharyngeal Reflux in the Last Decade: What Is New and Where to Next?
Authors: Sofokleous Valentinos , Papadopoulou Anna-Maria , Giotakis Evangelos , Delides Alexander , Kyrodimos Efthymios , Maragoudakis Pavlos , Psarommatis Ioannis
Published: February 2023

Background: Laryngopharyngeal reflux may affect people of any age; still, most of the accumulated knowledge concerns adults, and evidence regarding pediatric populations remains relatively restricted. This study aims to review the most recent and emerging aspects of pediatric laryngopharyngeal reflux from the last ten years. It also attempts to identify gaps in knowledge and highlight discrepancies that future research should urgently address. Methods: An electronic search of the MEDLINE database was conducted, limited to January 2012 through December 2021. Non-English language articles, case reports, and studies that concerned a purely or predominantly adult population were excluded. The information from the articles with the most relevant contribution was initially categorized by theme and subsequently synthesized into a narrative form. Results: 86 articles were included, of which 27 were review articles, eight were surveys, and 51 were original articles. Our review systematically maps the research done in the last decade and provides an updated overview and the current state-of-the-art in this subject. Conclusions: Despite discrepancies and heterogeneity in accumulating research, evidence gathered so far endorses a need for refining an escalating multiparameter diagnostic approach. A step-wise therapeutic plan appears to be the most reasonable management approach, starting with behavioral changes for mild to moderate, uncomplicated cases and escalating to personalized pharmacotherapy options for severe or nonresponsive cases. Surgical options could be considered in the most severe cases when potentially life-threatening symptoms persist despite maximal medical therapy. Over the past decade, the amount of available evidence has been gradually increasing; however, its strength remains low. Several aspects remain markedly under-addressed, and further adequately powered, multicenter, controlled studies with uniformity in diagnostic procedures and criteria are urgently needed.
The Role of Aromatase Inhibitors in Male Prolactinoma
Authors: Akirov Amit , Rudman Yaron
Published: February 2023

Background: dopamine agonists are the recommended treatment for male prolactinomas, but some patients may develop dopamine-agonist-resistant hyperprolactinemia, leading to persistent hypogonadism that requires treatment with testosterone. However, testosterone replacement therapy may be associated with a decrease in the efficacy of dopamine agonists due to the aromatization of testosterone to estradiol, which can stimulate the proliferation and hyperplasia of lactotroph cells in the pituitary, inducing resistance to dopamine agonists. Objective: this paper systematically reviewed the role of aromatase inhibitors for men with prolactinoma and dopamine-agonist-resistant or persistent hypogonadism following treatment. Method: we performed a systematic review of all studies (according to PRISMA guidelines), assessing the role of aromatase inhibitors, including anastrozole and letrozole, for male prolactinoma. An English-language search for relevant studies was conducted on PubMed from its inception to 1 December 2022. The reference lists of the relevant studies were also reviewed. Results: our systematic review identified six articles (nine patients), including five case reports and a single case series, on the use of aromatase inhibitors for male prolactinomas. Reducing estrogen levels with an aromatase inhibitor improved sensitivity to dopamine agonists, as the addition of anastrozole or letrozole improves the control of prolactin levels and may lead to the shrinkage of tumors. Conclusion: aromatase inhibitors are of potential value to patients with dopamine-agonist-resistant prolactinoma, or when hypogonadism persists while using high-dose dopamine agonists.
Can Liquid Biopsy Based on ctDNA/cfDNA Replace Tissue Biopsy for the Precision Treatment of EGFR-Mutated NSCLC?
Authors: Li Yi-Ze , Kong Sheng-Nan , Liu Yun-Peng , Yang Yue , Zhang Hong-Mei
Published: February 2023

More and more clinical trials have explored the role of liquid biopsy in the diagnosis and treatment of EGFR-mutated NSCLC. In certain circumstances, liquid biopsy has unique advantages and offers a new way to detect therapeutic targets, analyze drug resistance mechanisms in advanced patients, and monitor MRD in patients with operable NSCLC. Although its potential cannot be ignored, more evidence is needed to support the transition from the research stage to clinical application. We reviewed the latest progress in research on the efficacy and resistance mechanisms of targeted therapy for advanced NSCLC patients with plasma ctDNA EGFR mutation and the evaluation of MRD based on ctDNA detection in perioperative and follow-up monitoring.
A Comparative Study on Outcomes of Partial Meniscectomy for Horizontal Cleavage Tear of Medial Meniscus: Complete versus Partial Resection of Inferior Leaf
Authors: Jeon Sang Woo , Choi Chong Hyuk , Kim Sung-Hwan , Kim Sung-Jae , Kang Kyutae , Jung Min
Published: February 2023

The extent to which resection of unstable leaf should be performed in horizontal cleavage meniscus tear has not yet been elucidated. The purpose of this study was to compare the clinical outcomes of partial meniscectomy for horizontal cleavage tear of medial meniscus between complete resection of inferior leaf including the periphery up to the joint capsule and partial resection leaving stable peripheral torn meniscal tissue. A total of 126 patients who underwent partial meniscectomy for horizontal cleavage tear of medial meniscus were divided into two groups: group C (n = 34), treated with the complete resection of the inferior leaf; and group P (n = 92), treated with partial resection of the inferior leaf. The minimum follow-up duration was 3 years. Functional outcomes were evaluated using the Lysholm knee scoring scale, International Knee Documentation Committee (IKDC) subjective knee evaluation form, and knee injury and osteoarthritis outcome score (KOOS). Radiologic assessments were performed using the IKDC radiographic assessment scale and measurement of the height of the joint space in the medial compartment of the tibiofemoral joint. The functional outcomes including the Lysholm knee, IKDC subjective score, activities of daily living and sport and recreation subscale of KOOS were worse in group C than in group P (p < 0.001). The radiologic outcomes including postoperative IKDC radiographic scale (p = 0.003) and the postoperative joint space on the affected side (p < 0.001) were also worse in group C than in group P. In the horizontal cleavage tear of medial meniscus, complete resection of the inferior leaf including the periphery up to the joint capsule showed inferior clinical outcomes compared with partial resection leaving stable peripheral rim of torn meniscus at minimum 3-year follow-up. If the peripheral part of the inferior leaf is stable in horizontal cleavage tear of medial meniscus, partial resection of the inferior leaf preserving peripheral rim can be recommended.
Reverse Total Shoulder Arthroplasty with a Cementless and Metaphyseal Stem Fixation Is a Viable Option for the Treatment of Proximal Humeral Fractures with Calcar Involvement
Authors: Garofalo Raffaele , Fontanarosa Alberto , Lassandro Nunzio , De Crescenzo Angelo
Published: February 2023

Background: The purpose of the study was to evaluate the suitability of reverse total shoulder arthroplasty (RTSA) with a cementless and metaphyseal stem fixation as a treatment for complex proximal humeral fractures (PHFs) with a calcar fragment when this may be fixed with a steel wire cerclage. Clinical and radiographic outcomes were compared with the same RTSA for PHFs without a calcar fragment at a minimum of five-year follow-up. Methods: A retrospective analysis was performed on acute PHFs “with a medial calcar fragment” (group A) and “without a calcar fragment” (group B) treated with a RTSA and cementless metaphyseal stem fixation. Results: At an average follow-up of 6.7 years (5–7.8 years), no statistical difference was observed comparing group A (18 patients) to group B (50 patients) for active anterior elevation (141 ± 15° vs. 145 ± 10°, p = 0.67), active external rotation ER1 (49 ± 15° vs. 53 ± 13°, p = 0.55), and active internal rotation (5 ± 2 vs. 6 ± 2, p = 0.97). Similarly, a comparison of ASES score (89.2 ± 10 vs. 91.6 ± 9, p = 0.23) and Simple Shoulder Test score (91.1 ± 11 vs. 90.4 ± 10, p = 0.49) revealed no significant difference. Conclusion: RTSA with a cementless and metaphyseal stem fixation represents a safe and feasible treatment for complex PHFs with a medial calcar fragment when this may be fixed with a steel wire cerclage.
TIcagrelor in Rotational Atherectomy to Reduce TROPonin Enhancement: The TIRATROP Study, A Randomized Controlled Trial
Authors: Lhermusier Thibault , Motreff Pascal , Bataille Vincent , Cayla Guillaume , Farah Bruno , Roncalli Jerome , Elbaz Meyer , Boudou Nicolas , Campello-Parada Fransisco , Bouisset Frederic , Souteyrand Geraud , Berard Emilie , Bongard Vanina , Carrie Didier
Published: February 2023

Background: Because rotational atherectomy (RA) is associated with arterial trauma and platelet activation, patients treated with RA may benefit from more potent antiplatelet drugs. The aim of this trial was to assess the superiority of ticagrelor over clopidogrel in reducing post procedure troponin release. Methods: TIRATROP (TIcagrelor in Rotational Atherectomy to reduce TROPonin enhancement) is a multicenter double-blind randomized controlled trial that included 180 patients with severe calcified lesions requiring RA who received either clopidogrel (300 mg loading dose, then 75 mg/d) or ticagrelor (loading dose 180 mg then 90 mg twice daily). Blood samples were collected at the beginning (T0), and 6, 12, 18, 24 and 36 h after the procedure. Primary end point was troponin release within the first 24 h using area under the curve analysis (troponin level as a function of time). Results: The mean age of patients was 76 ± 10 years, 35% had diabetes. RA was used to treat 1, 2 or 3 calcified lesions in 72%, 23% and 5% of patients, respectively. Troponin release within the first 24 h was similar in both the ticagrelor (adjusted mean ±SD of ln AUC 8.85 ± 0.33) and the clopidogrel (8.77 ± 0.34, p = 0.60) arms. Independent predictors for troponin enhancement were acute coronary syndrome presentation, renal failure, elevated C-Reactive protein and multiple lesions treated with RA. Conclusion: Troponin release did not differ among treatment arms. Our results suggest that greater platelet inhibition does not affect periprocedural myocardial necrosis in the setting of RA.