bluuebunny/crossref_metadata_2025 huggingface dataset:
Propofol partial intravenous anaesthesia with isoflurane alone or in combination with fentanyl and ketamine infusions in three captive chimpanzees (Pan troglodytes) undergoing different diagnostic and surgical procedures
Authors: Gómez Fernández Laura , Pentsou Kyratsoula , Flynn Emma , Potter Joanna , Huuskonen Vilhelmiina
Published: April 2024

Three captive chimpanzees (Pan troglodytes) were scheduled for diagnostic and surgical procedures under general anaesthesia. After premedication with oral midazolam (0.2 mg kg−1) and intramuscular medetomidine (20 µg kg−1) and ketamine (3 mg kg−1), anaesthesia was induced with intravenous propofol (1–4 mg kg−1). The animals were then maintained under general anaesthesia with propofol partial intravenous anaesthesia (0.10–0.17 mg kg−1 min−1) and isoflurane. On four occasions, the anaesthetised animals received fentanyl (1–3 µg kg−1 h−1) and ketamine (5–10 µg kg−1 min−1) infusions for analgesia. All animals recovered uneventfully. This case series details the anaesthetic protocols used, the challenges presented to the anaesthetist by this species and the peri‐anaesthetic complications observed. It also introduces the use of propofol total intravenous anaesthesia as an option for safe transportation of captive chimpanzees between facilities.
Late video‐assisted thoracoscopic surgery versus thoracostomy tube reinsertion for retained hemothorax after penetrating trauma, a prospective randomized control study
Authors: Edu Sorin , Nicol Andrew , Neuhaus Valentin , McPherson Deidre , Navsaria Pradeep H.
Published: April 2024

Background

Early video‐assisted thoracoscopic surgery (VATS) is the recommended treatment of choice for retained hemothorax (RH). A prospective single‐center randomized control study was conducted to compare outcomes between VATS and thoracostomy tube (TT) reinsertion for patients with RH after penetrating trauma in a resource constrained unit. Our hypothesis was that patients with a RH receiving VATS instead of TT reinsertion would have a shorter hospital stay and lesser complications.

Materials and Methods

From January 2014 to November 2019, stable patients with thoracic penetrating trauma complicated with retained hemothoraces were randomized to either VATS or TT reinsertion. The outcomes were length of hospital stay (LOS) and complications.

Results

Out of the 77 patients assessed for eligibility, 65 patients were randomized and 62 analyzed: 30 in the VATS arm and 32 in the TT reinsertion arm. Demographics and mechanisms of injury were comparable between the two arms. Length of hospital stay was: preprocedure: VATS 6.8 (+/−2.8) days and TT 6.6 (+/− 2.4) days (p = 0.932) and postprocedure: VATS 5.1 (+/−2.3) days, TT 7.1 (+/−6.3) days (p = 0.459), total LOS VATS 12 (+/− 3.9) days, and TT 14.4 (+/−7) days (p = 0.224). The TT arm had 15 complications compared to the VATS arm of four (p = 0.004). There were two additional procedures in the VATS arm and 10 in the TT arm (p = 0.014).

Conclusion

VATS proved to be the better treatment modality for RH with fewer complications and less need of additional procedures, while the LOS between the two groups was not statistically different.
Sozioökonomische Deprivation und vorzeitige Sterblichkeit in Deutschland 1998–2021
Authors: Hoebel Jens , Nowossadeck Enno , Michalski Niels , Baumert Jens , Wachtler Benjamin , Tetzlaff Fabian
Published: April 2024

Hintergrund

Das frühere Versterben in sozioökonomisch benachteiligten Bevölkerungsgruppen stellt eine extreme Ausprägungsform gesundheitlicher Ungleichheit dar. Diese Studie untersucht das Ausmaß, die zeitliche Entwicklung und Reduktionspotenziale regionaler sozioökonomischer Ungleichheiten in der vorzeitigen Sterblichkeit in Deutschland.

Methoden

Bundesweite Daten der amtlichen Todesursachenstatistik wurden auf Stadt- und Landkreisebene mit amtlichen Bevölkerungsdaten und dem „German Index of Socioeconomic Deprivation“ (GISD) verknüpft. Altersstandardisierte Mortalitätsraten für unter 75-Jährige wurden stratifiziert nach Geschlecht und Deprivationsquintil berechnet. In einer What-if-Analyse wurde anhand kontrafaktischer Szenarien berechnet, wie viel niedriger die vorzeitige Sterblichkeit insgesamt läge, wenn sozioökonomische Mortalitätsungleichheiten verringert würden.

Ergebnisse

Männer und Frauen im höchsten Deprivationsquintil hatten ein 43 % bzw. 33 % höheres Risiko, vorzeitig zu versterben, als Gleichaltrige im niedrigsten Deprivationsquintil. Höhere Mortalitätsraten mit steigender Deprivation zeigten sich für die Herz-Kreislauf- und Krebsmortalität, aber auch für andere Todesursachen. Die sozioökonomischen Mortalitätsungleichheiten nahmen bereits vor der COVID-19-Pandemie zu und verschärften sich in den ersten Jahren der Pandemie weiter. Hätten alle Regionen die gleiche Mortalität wie jene im niedrigsten Deprivationsquintil, läge die vorzeitige Sterblichkeit insgesamt 13 % niedriger.

Diskussion

Die zunehmende Ungleichheit in der vorzeitigen Sterblichkeit zwischen deprivierten und wohlhabenden Regionen verdeutlicht, dass die Herstellung gleichwertiger Lebensverhältnisse im Bundesgebiet auch für die Verringerung der gesundheitlichen Ungleichheit ein wichtiges Handlungsfeld darstellt.
Umfassender Literaturüberblick über die Anwendung der otologisch-chirurgischen Planungssoftware OTOPLAN® bei der Cochleaimplantation
Authors: Müller-Graff Franz-Tassilo , Spahn Björn , Herrmann David P. , Kurz Anja , Voelker Johannes , Hagen Rudolf , Rak Kristen
Published: April 2024

Hintergrund

Die Größe der menschlichen Cochlea, gemessen am Durchmesser der Basalwindung, schwankt zwischen 7 und 11 mm. Im Rahmen einer Hörrehabilitation durch ein Cochleaimplantat ist diese für die individuelle Zuordnung der Frequenzbänder und die Wahl der Elektrodenlänge von Bedeutung. OTOPLAN® (CAScination AG [Bern, Schweiz] in Kooperation mit MED-EL [Innsbruck, Österreich]) ist ein Softwaretool mit CE-Kennzeichnung für klinische Anwendungen in der Cochleaimplantat(CI)-Behandlung, welches die Vorplanung auf Grundlage der cochleären Größenparameter durchführt. Ziel dieser Literaturübersicht ist es, alle veröffentlichten Studien über die Anwendung von OTOPLAN® zu erfassen.

Materialien und Methoden

Die PRISMA-Richtlinien (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) wurden angewandt, um relevante Studien zu identifizieren, die zwischen Januar 2015 und Februar 2023 in der Suchmaschine PubMed veröffentlicht wurden (unter Verwendung der Suchbegriffe „otoplan“ [Titel/Abstract] OR „anatomy-based fitting“ [Titel/Abstract] OR „otological software tool“ [Titel/Abstract] OR „computed tomography-based software AND cochlear“ [Titel/Abstract]).

Ergebnisse

Bei der systematischen Durchsicht der Literatur wurden 32 Studien über den klinischen Einsatz von OTOPLAN® bei der CI-Behandlung gefunden. Die meisten Studien wurden von deutschen Arbeitsgruppen publiziert (7 von 32), gefolgt von Italien (5), Saudi-Arabien (4), USA (4) und Belgien (3). So stammten je 2 Studien aus Österreich und China, gefolgt von jeweils 1 Studie aus Frankreich, Indien, Norwegen, Südkorea und der Schweiz. In den meisten Studien (22) wurde OTOPLAN® zur Beurteilung der Cochleagröße verwendet, gefolgt von der Visualisierung der Elektrodenposition anhand postoperativer Bilder (5), der dreidimensionalen (3-D-)Segmentierung der Felsenbeinstrukturen (4), der Planung der Elektrodeneinführungstrajektorie (3), der Erstellung einer patientenspezifischen Frequenzbandzuordnung (3), der Planung eines sicheren Bohrpfads durch den Recessus facialis (3), und der Messung von Felsenbeinstrukturen (1).

Schlussfolgerung

OTOPLAN® ist bisher der einzige DICOM-Viewer mit CE-Kennzeichnung im CI-Bereich, der prä-, intra- und postoperative Bilder mit den genannten Anwendungen verarbeiten kann.
Sonographie als Gegenstand virtuellen Wissenstransfers zum praktischen Kompetenzerwerb
Authors: Everad F. , Seifert L. , Mansour N. , Hofauer B. , Knopf A. , Offergeld C.
Published: April 2024

Zielsetzung

Während der COVID-19-Pandemie bestand eine besondere Herausforderung bei der Umstellung auf den digitalen Unterricht darin, praktische Fertigkeiten wie die Sonographie der Kopf- und Halsweichteile online zu vermitteln. Ziel dieser Studie war es, den an der Universitäts-HNO-Klinik Freiburg etablierten digitalen Sonographie-Kurs für Studierende der Humanmedizin zu validieren.

Methoden

Teilnehmende waren 178 Studierende der Humanmedizin. Die Studiengruppe simulierte die Sonographie-Untersuchung zu Hause mit einer Schallkopfattrappe anhand der Peyton-Methode unter Anleitung eines Tutors per Videoseminar. In einer anschließenden Lernerfolgskontrolle wurden die Ergebnisse der Studierenden des Online-Kurses mit der Kontrollgruppe verglichen, welche die Sonographie im Präsenzunterricht lernte.

Ergebnisse

Die Studierenden des Online-Kurses konnten vergleichbare Ergebnisse zur Präsenzgruppe erzielen.

Schlussfolgerung

Die Studie zeigt, dass praktische Fertigkeiten, die eine umfangreiche Ausrüstung wie ein Sonographiegerät erfordern, bis zu einem gewissen Grad digital oder zumindest in einer hybriden Form vermittelt werden können.
Semi-confined blast loading: experiments and simulations of internal detonations
Authors: Kristoffersen M. , Casadei F. , Valsamos G. , Larcher M. , Hauge K. O. , Minoretti A. , Børvik T.
Published: April 2024

Far-field blast loading has been studied extensively for decades. Close-in, confined, and semi-confined detonations less so, partly because it is difficult to obtain good experimental data. The increase in computational power in recent years has made it possible to conduct studies of this kind numerically, but the results of such simulations ultimately depend on experimental validation and verification. This work thus aims at using reliable experiments to validate and verify numerical models developed to represent blast loading in general. Test rigs consisting of massive steel cylinders with pressure sensors were used to measure the pressure profiles of semi-confined detonations with different charge sizes. The experimental data set was then used to assess numerical models appropriate for simulating blast loading. In general, the numerical results were in excellent agreement with the experimental data, in both qualitative and quantitative terms. These results may in turn be used to analyse structures exposed to internal blast loads, which constitutes the next phase of this research project.
Quality of Life Analysis of Patients Treated with Percutaneous Hepatic Perfusion for Uveal Melanoma Liver Metastases
Authors: Tong T. M. L. , Fiocco M. , van Duijn-de Vreugd J. J. , Lutjeboer J. , Speetjens F. M. , Tijl F. G. J. , Sitsen M. E. , Zoethout R. W. M. , Martini C. H. , Vahrmeijer A. L. , van der Meer R. W. , van Rijswijk C. S. P. , van Erkel A. R. , Kapiteijn E. , Burgmans M. C.
Published: April 2024

Purpose

Percutaneous hepatic perfusion with melphalan (M-PHP) is a minimally invasive therapy with proven efficacy in patients with uveal melanoma (UM) liver metastases. M-PHP is associated with a short hospital admission time and limited systemic side effects. In this study, we assessed quality of life (QoL) in UM patients treated with M-PHP.

Materials and Methods

A prospective, single-center study including 24 patients treated with M-PHP for UM metastases to the liver. QoL questionnaires were collected at baseline, on day 2/3 after M-PHP, and on day 7 and day 21 after M-PHP, according to study protocol. The results were scored according to EORTC-QLQ C30 global health status (GHS), functional scales, and symptom scales. The difference in scores at baseline and subsequent time points was analyzed with the Wilcoxon signed-rank test and multiple testing Bonferroni correction. Adverse events (AE) were registered up to 30 days after M-PHP according to CTCAE v5.0.

Results

Twenty-four patients (14 males; median age 63.0 years) completed 96 questionnaires. Most scores on all scales declined on day 2/3 after M-PHP. On day 21 after M-PHP, 12 out of 15 scores returned to baseline, including median GHS scores. Three variables were significantly worse on day 21 compared to baseline: fatigue (6–33; p = 0.002), physical functioning (100 vs 86.7; p = 0.003), and role functioning (100 vs 66.7; p = 0.001). Grade 3/4 AEs consisted mainly of hematological complications, such as leukopenia and thrombopenia.

Conclusion

M-PHP causes fatigue and a decline in physical and role functioning in the 1st weeks after treatment, but GHS returns to baseline levels within 21 days.

Level of Evidence 3

Cohort study.

Graphical Abstract
Telemetric ICP monitoring in children: a national questionnaire-based study
Authors: Pedersen Sarah Hornshøj , Henriksen Kasper Amund , Gustafsen Sara Duus , Hansen Torben Skovbo , Guldager Rikke , Juhler Marianne
Published: April 2024

Purpose

Telemetric monitoring of intracranial pressure (ICP) facilitates long-term measurements and home monitoring, thus potentially reducing diagnostic imaging and acute hospital admissions in favour of outpatient appointments. Especially in paediatric patients, telemetric ICP monitoring requires a high level of collaboration and compliance from patients and parents. In this study, we aim to systematically investigate (1) patient and parent perception of telemetric ICP system utility and (2) hospital contact history and thus the potential cost-benefit of telemetric ICP monitoring in paediatric patients with a cerebrospinal fluid disorder.

Methods

We conducted a nationwide questionnaire study, including paediatric patients with either a current or previous telemetric ICP sensor and their parents. Additionally, a retrospective review of electronic health records for all included children was performed.

Results

We included 16 children (age range 3–16 years), with a total of 41 telemetric ICP sensors implanted. Following sensor implantation, the frequency of telephone contacts and outpatient visits increased. No corresponding decrease in hospital admissions or total length of stay was found. The telemetric ICP sensor provided most parents with an improved sense of security and was seen as a necessary and valuable tool in treatment guidance. The size and shape of the sensor itself were reported as disadvantages, while the external monitoring equipment was reported as easy to use but too large and heavy for a child to carry.

Conclusion

Though, in quantitative terms, there was no cost-benefit of the telemetric ICP sensor, it contributed to extended parental involvement and a sense of improved safety.
Genetic predisposition for negative affect predicts mental health burden during the COVID-19 pandemic
Authors: Schowe Alicia M. , Godara Malvika , Czamara Darina , Adli Mazda , Singer Tania , Binder Elisabeth B.
Published: April 2024

The coronavirus disease 2019 (COVID-19) pandemic was accompanied by an increase in mental health challenges including depression, stress, loneliness, and anxiety. Common genetic variants can contribute to the risk for psychiatric disorders and may present a risk factor in times of crises. However, it is unclear to what extent polygenic risk played a role in the mental health response to the COVID-19 pandemic. In this study, we investigate whether polygenic scores (PGSs) for mental health-related traits can distinguish between four resilience-vulnerability trajectories identified during the COVID-19 pandemic and associated lockdowns in 2020/21. We used multinomial regression in a genotyped subsample (n = 1316) of the CovSocial project. The most resilient trajectory characterized by the lowest mental health burden and the highest recovery rates served as the reference group. Compared to this most resilient trajectory, a higher value on the PGS for the well-being spectrum decreased the odds for individuals to be in one of the more vulnerable trajectories (adjusted R-square = 0.3%). Conversely, a higher value on the PGS for neuroticism increased the odds for individuals to be in one of the more vulnerable trajectories (adjusted R-square = 0.2%). Latent change in mental health burden extracted from the resilience-vulnerability trajectories was not associated with any PGS. Although our findings support an influence of PGS on mental health during COVID-19, the small added explained variance suggests limited utility of such genetic markers for the identification of vulnerable individuals in the general population.
The grasp reflex in patients with idiopathic normal pressure hydrocephalus
Authors: Liu Junyan , Kanno Shigenori , Iseki Chifumi , Kawakami Nobuko , Kakinuma Kazuo , Katsuse Kazuto , Matsubara Shiho , Ota Shoko , Endo Keiko , Takanami Kentaro , Osawa Shin-ichiro , Kawaguchi Tomohiro , Endo Hidenori , Mugikura Shunji , Suzuki Kyoko
Published: April 2024

Objective

To investigate the prevalence and intensity of grasp reflexes and to examine changes in these reflexes after shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH).

Methods

We enrolled 147 patients with probable iNPH. A standard procedure was used to determine the presence of grasp reflexes, and the intensity of these reflexes was assessed using a four-category classification. Clinical rating scales and their correlation with grasp reflexes were also evaluated. Grasp reflexes were reassessed in 72 patients 1 year after surgery.

Results

We found that approximately 50.3% of patients with iNPH exhibited a positive grasp reflex. Among these patients, 69% exhibited bilateral positivity, while the remaining patients showed unilateral positivity. Furthermore, the intensity of the grasp reflex was significantly correlated with the severity of gait and with cognitive, urinary, motor, and behavioural symptoms. Surgical interventions led to a reduction (41.7%) or maintenance (30.6%) of the reflex intensity in 72.3% of iNPH patients. The changes in reflex intensity showed significant positive correlations with changes in the number of steps of the Timed Up and Go test and Trail Making Test-A scores but not with changes in total scores on the iNPH Grading Scale.

Conclusion

This retrospective study identified grasp reflexes as a highly prevalent phenomenon in patients with iNPH. These reflexes can assist in evaluating the severity of various symptoms, including cognitive, gait, urinary, motor and emotional symptoms.
Accelerated long-term forgetting reveals everyday memory deficits in early-stage multiple sclerosis
Authors: Stalter J. , Pars K. , Witt K.
Published: April 2024

Background

Patients with multiple sclerosis (MS) patients report subjective memory impairment (SMI) escaping routine neuropsychological testing. Accelerated long-term forgetting (ALF) refers to above average loss of information over an extended period of time (e.g., 7 days). This study investigates ALF in mildly affected MS patients and relates long-term memory performance to SMI.

Methods

This prospective study included 30 patients with early MS (mean EDSS ± SD = 1.1 ± 0.9) and 30 healthy controls (HC) matched for age and education. Participants underwent ALF testing [word list (RAVLT), geometric figure (RCF), logical memory (WMS)] at three time points (baseline, 30 min, 7 days). Cognition (Montreal Cognitive Assessment), depression, SMI and fatigue were assessed. The primary outcome (PO) was defined as the quotient of the 7-day score and the 30-min memory score for the verbal (RAVLT, WMS) and figural (RCF) memory tests. The study was approved by the local ethics committee and is registered in the German Register of Clinical Studies (DRKS00025791).

Results

MS patients showed impairments in PORAVLT (MS 0.66 ± 0.13 vs HC 0.82 ± 0.16; p < 0.001), whereas POWMS (MS 0.88 ± 0.15 vs HC 1.01 ± 0.12; p = 0.02) showed only a tendency. Regression analysis revealed significant associations for PORAVLT and fatigue (p = 0.034), and PORAVLT and SMI (p = 0.01) in patients but not in HC.

Conclusion

The ALF test quantifies SMI in MS-patients. With fatigue as a relevant associated factor, this fills the gap in objectifying SMI in MS for diagnostic purposes.
Role of plasma EBV-DNA load and EBER status on newly diagnosed peripheral T-cell lymphoma
Authors: Chen Jing , Zhou Jie , Cheng Fei , Chen Donghe , Guan Fangshu , Zhang Enfan , He Jingsong , Cai Zhen , Zhao Yi
Published: April 2024

Purpose

To explore the prognostic and therapeutic role of Epstein-Barr Virus (EBV) on peripheral T-cell lymphoma (PTCL).

Methods

Totally 262 newly diagnosed PTCL patients who were hospitalized from January 2014 to December 2022 were retrospectively enrolled. Molecular analysis included 31 eligible patients. EBV-encoded RNA (EBER) presence in tumor tissue and EBV DNA levels in patients at baseline (DNA1) and after 4 cycles of chemotherapy (DNA4) were assessed.

Results

Our findings revealed that the EBER-positive cohort exhibited significant differences compared to counterparts in overall survival (OS, P = 0.047) and progression-free survival (PFS, P = 0.009). Both DNA1 and DNA4 were significantly associated with inferior OS. Multivariate analysis demonstrated that DNA4 independently affected PTCL prognosis for OS (hazard ratio = 5.1617; 95% confidence interval 1.1017–24.1831; P = 0.037). Treatment with the cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus azacytidine regimen showed a better OS compared to CHOP or CHOP plus etoposide for patients with partially positive EBER and EBER positive statuses (P = 0.192), although the improvement was not statistically significant. This study delineated the genetic paradigm of PTCL, comparing genetic differences by EBV status and found that EBER partially positive plus positive patients were more likely to have DNMT3A (P = 0.002), RHOAG17V (P = 0.023), and TET2 mutations (P = 0.032).

Conclusion

EBER, DNA1, and DNA4 emerged as sensitive markers for prognosis. CHOP plus azacytidine might present a preferable option for PTCL patients with DNA methylation due to EBV infection.
Safety and clinical efficacy of immune checkpoint inhibitors in advanced gastric cancer in the real world
Authors: Hao Wen , Liu Wenjing , Chang Ruimin , Yang Mi , Xin Kai , Liu Jingxin , Wang Yibing , Ren Meijin , Xie Jiaqi , Yang Yang
Published: April 2024

Background

To evaluate the clinical efficacy and safety of immune checkpoint inhibitors in patients with advanced gastric cancer in the real world.

Methods

The retrospective analysis was conducted on the clinical records of 402 patients with advanced gastric cancer who were admitted to the Nanjing Drum Tower Hospital between December 2017 and April 2022 and who had received immunotherapy. Observation target: drug use, treatment, adverse reaction type and grade, objective response rate (ORR), disease control rate (DCR), progression free survival (PFS), and overall survival (OS).

Results

By retrospectively analyzing the data of patients with advanced gastric cancer treated with ICIs previously admitted to our medical center, we found some clinical characteristic factors associated with the occurrence of irAEs as well as the efficacy and prognosis: the presence or absence of hypertension, whether or not to receive targeted therapies can predict the occurrence of immune-related adverse events (irAEs), and the more the presence of irAEs, the better the prognosis. These can help clinicians in clinical drug selection.

Conclusions

The results of this paper show that the occurrence of irAEs is associated with patients’ OS. irAEs occurrence can prolong patients’ OS. irAEs occurrence may serve as a surrogate marker for ICIs.
Development and physical characteristics of the Irish shelf-edge Macnas Mounds, Porcupine Seabight, NE Atlantic
Authors: Krueger Erica Terese , Mouchi Vincent , Monteys Xavier , McCarron Stephen , Lim Aaron , Crowley Quentin G.
Published: April 2024

Modern cold-water corals (CWCs) occur in a wide range of water depths, with Desmophyllum pertusum being one of the most common species. Pleistocene, Holocene, and modern coral mound formation by living CWC reefs have previously been described in the Porcupine Seabight from water depths greater than 700 m in the vicinity of the transitional zone between the Eastern North Atlantic Water and Mediterranean Outflow Water. Here we document occurrence of fossil corals retrieved from two cores at 370 m depth in the Macnas Mounds, a relatively shallow occurrence for mounds on the Irish shelf-edge. Both cores feature D. pertusum restricted to the upper two metres, immediately overlying an erosive surface and a coeval major down-core change in grain size from sand to mud. Radiocarbon dating of coral specimens indicates the CWC mounds initiated 7.82 Cal ky BP. Our study unequivocally documents the existence of Holocene shelf-edge coral mounds in the eastern Porcupine Seabight and highlights the possibility of other occurrences of CWCs in similar settings elsewhere in the northeast Atlantic. Given that no living CWCs were encountered in the study area, we suggest that the area previously experienced more favourable conditions for CWC mound initiation and development along the shelf-edge margin, possibly due to differing conditions in the European Slope Current which flows northward along the continental slope from south of the Porcupine Bank to the Faroe-Shetland Channel.

Graphical Abstract
Tissue response following implantation with the posterior dynamic distraction device (PDDD) in adolescent idiopathic scoliosis (AIS)
Authors: Richard Olivia Kristina , Liens Aléthéa , Muirhead DesiRae , Weber Klaus
Published: April 2024

Purpose

The PDDD is a ratchet-based, unidirectional expandable rod to treat adolescent idiopathic scoliosis (AIS), primarily by correcting scoliotic deformity without full spinal fusion. We hypothesized that the device will be fully tolerated by the host and, if aseptic screw loosening occurs, it will be unrelated to wear particle formation.

Methods

This study comprised tissue samples from seven patients from a prospective study (NCT04296903) to assess the PDDD’s safety and benefits, reoperated due to complications. Host response was assessed from histological slides (four levels/implant) in accordance with GLP and ISO10993-6:2016. The elementary chemical composition of wear particles present in tissue sections was quantified by energy dispersive X-ray spectroscopy (EDX).

Results

Host reaction was minor, characterized by low levels of diverse inflammatory cells, mild fibrosis, occasional small necrotic foci, neovascularization, hemorrhage, and, rarely, small bone fragments. Twenty-four of 28 tissue sections displayed varying degrees of wear particles (black discoloration), and most sections (17) were scored as 1 (< 25% of the sample). The discoloration observed corresponded to black-appearing, fine granular pigment. EDX analysis confirmed particles were composed of titanium, aluminum, and vanadium. Twenty-six of 28 samples were scored zero for necrosis and 2/28 were scored 1. Eleven samples were scored zero for fibrosis, 12 as 1, and five as 2. No aseptic screw loosening occurred.

Conclusion

The PDDD induced minimal host reaction with little or no degeneration, inflammation or fibrosis. No changes present could be expected to promote device failure. The PDDD implant for treating AIS is well-tolerated and locally safe.
Seasonal influence of tropical Pacific and Atlantic sea surface temperature on streamflow variability in the patia river basin
Authors: Canchala Teresita , Carvajal-Escobar Yesid , Alfonso-Morales Wilfredo , Torres Wilmar Alexander , Sánchez-Torres Luis Darío , Cerón Wilmar L.
Published: April 2024

This research presents a seasonal analysis of the variability of streamflows in the Patía River Basin (PRB) between 1984 and 2018 and the influence exerted by the large-scale climate variability using non-linear principal component analysis (NLPCA), Pearson's correlation, and composite analysis. The study was conduced during the minimum (July–August–September, JAS) and maximum (October–November–December, OND) streamflow periods. The NLPCA depicted a single significant mode of variability for each season with explained variances greater than 75%. The correlation analysis between the main mode of variability during OND and climate indices showed significant results, mainly with the Pacific Ocean and El Niño-Southern Oscillation (ENSO). In contrast, for JAS, the correlations were significant for the indices linked to the Atlantic Ocean. Finally, the composite analysis indicated that the positive (negative) events during JAS, which show the increase (decrease) of streamflow in PRB, are related to negative (positive) anomalies in the Tropical Northern Atlantic band, including the Caribbean Sea and the Gulf of Mexico. In comparison, the positive (negative) events during OND are related to negative (positive) sea surface temperature (SST) anomalies in the tropical Pacific, corresponding to La Niña (El Niño) events. The results provide evidence of the strong influence of climate indices and tropical Pacific and Atlantic SST on seasonal streamflow in the PRB and establish the foundations for seasonal streamflow modelling, relevant for prevention and risk management as well as for adequate planning and management of water resources in the region.
Impact of the tilted cloud vertical structure on a northward-progress episode of the East Asian summer monsoonal precipitation belt
Authors: Li Yunying , Sun Guorong , Zhang Zhiwei , Zhang Chao , Li Laurant
Published: April 2024

Impact of cloud vertical structure (CVS) on a northward-progressing rainfall episode of the East Asian summer monsoon (EASM) is explored using the Weather Research and Forecasting model, in which CloudSat observation-based vertical structure of cloud liquid water content (LWC) can be imposed. Composite LWC anomaly from CloudSat data shows a northward tilted structure from the upper to the lower troposphere. Compared to the control simulation (without modification of LWC), the one with LWC imposed, but without tilted structure, doesn’t show significant changes. When LWC is introduced and northward tilted, the geopotential height (HGT) decreases in the north of the convective center, which increases the meridional wind and provides favorable conditions for the northward shift of the precipitation belt. When LWC is southward tilted, HGT decreases in the middle and lower troposphere in the south of the convective center and increases in the north, which slows down the northward shift of the precipitation belt. Adding cloud water leads to increase in humidity and decrease in temperature, causing significant increase in stratiform clouds and related precipitation. In the configuration of northward tilted LWC, low-temperature and high-humidity area is located on the north side of the convective center, favorable for the occurrence and northward shift of the precipitation belt. Deep convection is weakened with convective precipitation reduced, while shallow convection enhances the latent heat release in the lower troposphere. Therefore, more water vapor and energy are transported from boundary layer to free atmosphere, promoting the northward shift of the precipitation belt.
Exploring genetic testing requests, genetic alterations and clinical associations in a cohort of children with autism spectrum disorder
Authors: Garrido-Torres Nathalia , Marqués Rodríguez Renata , Alemany-Navarro María , Sánchez-García Javier , García-Cerro Susana , Ayuso María Irene , González-Meneses Antonio , Martinez-Mir Amalia , Ruiz-Veguilla Miguel , Crespo-Facorro Benedicto
Published: April 2024

Several studies show great heterogeneity in the type of genetic test requested and in the clinicopathological characteristics of patients with ASD. The following study aims, firstly, to explore the factors that might influence professionals’ decisions about the appropriateness of requesting genetic testing for their patients with ASD and, secondly, to determine the prevalence of genetic alterations in a representative sample of children with a diagnosis of ASD. Methods: We studied the clinical factors associated with the request for genetic testing in a sample of 440 children with ASD and the clinical factors of present genetic alterations. Even though the main guidelines recommend genetic testing all children with an ASD diagnosis, only 56% of children with an ASD diagnosis were genetically tested. The prevalence of genetic alterations was 17.5%. These alterations were more often associated with intellectual disability and dysmorphic features. There are no objective data to explicitly justify the request for genetic testing, nor are there objective data to justify requesting one genetic study versus multiple studies. Remarkably, only 28% of males were genetically tested with the recommended tests (fragile X and CMA). Children with dysmorphic features and organic comorbidities were more likely to be genetic tested than those without. Previous diagnosis of ASD (family history of ASD) and attendance at specialist services were also associated with Genetically tested Autism Spectrum Disorder GTASD. Our findings emphasize the importance of establishing algorithms to facilitate targeted genetic consultation for individuals with ASD who are likely to benefit, considering clinical phenotypes, efficiency, ethics, and benefits.
Hematological indices in psoriatic enthesopathy: relation to clinical and ultrasound evaluation
Authors: Amer Arwa S. , Al Shambaky Ahmed Y. , Ameen Seham G. , Sobih Amira Khalil
Published: April 2024

Background

Enthesopathy is considered a crucial aspect of assessment and outcome in psoriatic arthritis (PsA). Musculoskeletal ultrasound (MSUS) is a critical tool for accurately detecting enthesitis. Recent research focuses on identifying simple biomarkers for detecting and monitoring psoriatic enthesopathy. Red cell distribution width (RDW), mean platelet volume (MPV), and neutrophil/lymphocyte ratio (NLR) are components of a complete blood count (CBC) and are reliable bio-inflammatory markers in various rheumatic diseases.

Aim of work

To measure MPV, RDW, and NLR in psoriatic enthesopathy and determine their relationship to disease activity and MSUS findings.

Patients and methods

This study focused on 30 people with psoriatic arthritis (PsA) as per CASPAR criteria, along with 20 control subjects. Enthesopathy was evaluated clinically using the Leeds Enthesitis Index (LEI). The modified Disease Activity Index of Psoriatic Arthritis (DAPSA28) was calculated, and RDW, MPV, NLR, CRP, and ESR were measured. Each enthesis in LEI was radiologically assessed using plain radiography and MSUS according to OMERACT definitions.

Results

There was a significant relationship between clinical tenderness, the presence of enthesophytes on plain radiography, and MSUS findings at entheses sites (p < 0.001 for each). Psoriatic patients had higher levels of RDW and MPV (p < 0.001 and 0.01, respectively) than controls, with no significant differences in NLR (p = 0.189) between the two groups. RDW and MPV levels were positively correlated with the DAPSA28 score.

Conclusion

Monitoring PsA disease activity can be improved by considering RDW and MPV as reliable indicators and using them to screen for psoriatic enthesopathy with MSUS indices.

Key points

• Clinically identifying enthesitis in patients with PsA can be challenging. Imaging MSUS indices hold promise for objective analysis, but there is no consensus on which indices to use in clinical trials and daily practice.• Patients with psoriatic enthesopathy have higher RDW and MPV levels, which are positively correlated with DAPSA28 score.• RDW and MPV can be considered in the turn of improved screening of psoriatic enthesopathy with MSUS scores.
Is food self-sufficiency possible for Reunion Island?
Authors: Billen Gilles , Garnier Josette , Pomet Alexandre , Bonnet Bernard
Published: April 2024

In the context of political and economic instability, food self-sufficiency of countries and territories is becoming a burning issue. Reunion Island is a densely populated small French territory isolated in the middle of the Indian Ocean. The previously developed GRAFS model, allowing consistent balances to be established using nitrogen (N) as a common metric for all crops and foodstuffs, has been applied to Reunion Island, considering 11 sub-regions to account for landscape variety. Reunion Island dedicates 87% of its crop production in terms of harvested proteins to the exportation of sugar and tropical fruits, while it imports 67% of its food supply, 54% of livestock feed, and 57% of all fertilizing N inputs to agricultural soils. Overall, the supply of 1 tonne of N as food requires the import of 2.7 tonnes of N as food, feed, and fertilizers. The model also demonstrated that the simultaneous operation of three levers of change would make it possible to reach self-sufficiency in terms of food, feed, and fertilizer: (1) the generalization of agro-ecological crop rotations alternating grain and forage legumes, cereal, and other food crops; (2) the reconnection of livestock with crop farming and a better recycling of manure as well as of human excreta; (3) a drastic reduction of animal-based food in the Reunionese diet, down to 20% of animal products in the total per capita protein intake, instead of the 60% current share. The area dedicated to sugarcane cultivation should be reduced to 15–25% of its current value.
Exploratory analysis of serum HER2 extracellular domain for HER2 positive gastric cancer treated with SOX plus trastuzumab
Authors: Wakatsuki Takeru , Ishizuka Naoki , Hironaka Shuichi , Minashi Keiko , Kadowaki Shigenori , Goto Masahiro , Shoji Hirokazu , Hirano Hidekazu , Nakayama Izuma , Osumi Hiroki , Ogura Mariko , Chin Keisho , Yamaguchi Kensei , Takahari Daisuke
Published: April 2024

Background

The aim of this study was to explore the clinical utility of serum HER2 extracellular domain (sHER2 ECD) using data from a clinical trial evaluating trastuzumab combined S-1 plus oxaliplatin (SOX) in HER2 positive gastric cancer.

Methods

sHER2 ECD were prospectively measured at baseline and subsequent treatment courses. Based on each quantile point of baseline sHER2 ECD levels and its early changes, patients were divided into two groups and compared clinical outcomes.

Results

43 patients were enrolled, and 17 patients (39.5%) were positive for baseline sHER2 ECD. Higher baseline sHER2 ECD levels tended to have lower hazard ratios (HRs). When divided into two groups by baseline sHER2 ECD of 19.1 ng/ml, median progression-free survival (PFS) and overall survival (OS) was longer in the higher group (mPFS: 16.8 vs 8.7 months, p = 0.359. mOS: 35.5 vs 20.6 months, p = 0.270), respectively. After initiation of treatment, sHER2 ECD significantly decreased up until the third cycle. Higher reduction rates of sHER2 ECD within 3 cycles also tended to have lower HRs. When divided into two groups by reduction rate of 42.5%, mPFS and mOS was longer in the higher reduced group (mPFS: 17.2 vs 8.7 months, p = 0.095. mOS: 65.0 vs 17.8 months, p = 0.047), respectively. Furthermore, higher reduction rates could surrogate higher objective response rates (ORR) (ORR: 90% vs 63.2% for 29.5%, p = 0.065. 100% vs 70% for 42.5%, p = 0.085), respectively.

Conclusions

Baseline sHER2 ECD levels and its early decline may be useful biomarkers for SOX plus trastuzumab efficacy in HER2 positive gastric cancer.
Treatment for middle cerebral artery bifurcation aneurysms: in silico comparison of the novel Contour device and conventional flow-diverters
Authors: Lyu Mengzhe , Torii Ryo , Liang Ce , Peach Thomas W. , Bhogal Pervinder , Makalanda Levansri , Li Qiaoqiao , Ventikos Yiannis , Chen Duanduan
Published: April 2024

Endovascular treatment has become the standard therapy for cerebral aneurysms, while the effective treatment for middle cerebral artery (MCA) bifurcation aneurysms remains a challenge. Current flow-diverting techniques with endovascular coils cover the aneurysm orifice as well as adjacent vessel branches, which may lead to branch occlusion. Novel endovascular flow disruptors, such as the Contour device (Cerus Endovascular), are of great potential to eliminate the risk of branch occlusion. However, there is a lack of valid comparison between novel flow disruptors and conventional (intraluminal) flow-diverters. In this study, two in silico MCA bifurcation aneurysm models were treated by specific Contour devices and flow-diverters using fast-deployment algorithms. Computational fluid dynamic simulations were used to examine the performance and efficiency of deployed devices. Hemodynamic parameters, including aneurysm inflow and wall shear stress, were compared among each Contour device, conventional flow-diverter, and untreated condition. Our results show that the placement of devices can effectively reduce the risk of aneurysm rupture, while the deployment of a Contour device causes more flow reduction than using flow-diverters (e.g. Silk Vista Baby). Besides, the Contour device presents the flow diversion capability of targeting the aneurysm neck without occluding the daughter vessel. In summary, the in silico aneurysm models presented in this study can serve as a powerful pre-planning tool for testing new treatment techniques, optimising device deployment, and predicting the performance in patient-specific aneurysm cases. Contour device is proved to be an effective treatment of MCA bifurcation aneurysms with less daughter vessel occlusion.
The transcriptomic signature of respiratory sensitizers using an alveolar model
Authors: Gibb Matthew , Liu James Y. , Sayes Christie M.
Published: April 2024

Environmental contaminants are ubiquitous in the air we breathe and can potentially cause adverse immunological outcomes such as respiratory sensitization, a type of immune-driven allergic response in the lungs. Wood dust, latex, pet dander, oils, fragrances, paints, and glues have all been implicated as possible respiratory sensitizers. With the increased incidence of exposure to chemical mixtures and the rapid production of novel materials, it is paramount that testing regimes accounting for sensitization are incorporated into development cycles. However, no validated assay exists that is universally accepted to measure a substance’s respiratory sensitizing potential. The lungs comprise various cell types and regions where sensitization can occur, with the gas-exchange interface being especially important due to implications for overall lung function. As such, an assay that can mimic the alveolar compartment and assess sensitization would be an important advance for inhalation toxicology. Some such models are under development, but in-depth transcriptomic analyses have yet to be reported. Understanding the transcriptome after sensitizer exposure would greatly advance hazard assessment and sustainability. We tested two known sensitizers (i.e., isophorone diisocyanate and ethylenediamine) and two known non-sensitizers (i.e., chlorobenzene and dimethylformamide). RNA sequencing was performed in our in vitro alveolar model, consisting of a 3D co-culture of epithelial, macrophage, and dendritic cells. Sensitizers were readily distinguishable from non-sensitizers by principal component analysis. However, few differentially regulated genes were common across all pair-wise comparisons (i.e., upregulation of genes SOX9, UACA, CCDC88A, FOSL1, KIF20B). While the model utilized in this study can differentiate the sensitizers from the non-sensitizers tested, further studies will be required to robustly identify critical pathways inducing respiratory sensitization.

Graphical Abstract

Graphical headlines/headlights

Pollutants may trigger lung allergies, but no universal method measures respiratory sensitization potential.

In vitro systems can detect respiratory sensitizers, aiding in anticipating and reducing the risks of new materials.

Sensitizers and non-sensitizers can be distinguished through transcriptome investigation.

The sensitizers tested induced cell differentiation and proliferation pathways while inhibiting immune defense and functionality.
Analytical Model for Non-linear $$\user2{M - }\,\,{\varvec{\theta}}$$ Relationships of Dowel-Type Timber Connections Exposed to Fire
Authors: Nakayama Yukito , Kikuchi Takayuki , Totsuka Marina , Hirashima Takeo
Published: April 2024

Recent experimental evidence has shown that wood–steel–wood dowel-type connections exhibit a semi-rigid behaviour even after 90 min of fire exposure. Because a semi-rigid behaviour influences the bending moment distribution among structural members, considering the moment–rotation relationships within frame analyses in which structural members are modelled as beam elements can enable a realistic fire response analysis that is significantly simpler than the three-dimensional finite element method. This study proposes an analytical methodology that accounts for the thermo-mechanical behaviour of timber and dowels, enabling the simulation of the non-linear moment–rotation relationships under fire conditions. The proposed analytical model divides dowels into a series of elements on an elastoplastic foundation and performs a direct stiffness method in a time-incremental procedure using an element stiffness matrix derived from beam-on-elastic-foundation theory. This study also presents the results of load-carrying tests on timber frames with dowel-type connections performed under ambient and fire conditions. The analytical results were consistent with the fire test results. Additionally, the analyses were also performed under three conditions in which the dowels were rigid, linear elastic, and elastoplastic bodies. These three results converged to the same value after 65 min of heating, which suggests that the ultimate states of beams with dowel-type connections exposed to fire can be modelled by assuming that dowels are rigid bodies.
Corneal endothelial changes seven years after phacoemulsification cataract surgery
Authors: Lundberg Björn
Published: April 2024

Purpose

To evaluate long-term postoperative corneal changes after phacoemulsification cataract surgery.

Methods

Twenty patients who participated in a previous study regarding corneal endothelial changes after phacoemulsification cataract surgery were examined after 7 years. The patients were divided in three groups based on their initial increase in central corneal thickness day one after the surgery: < 5% increase, 6–20% increase and ≥ 20% increase. The primary outcome measures were corneal endothelial cell loss (ECL), endothelial cell count (ECC) and endothelial morphology.

Results

After 7 years, a difference in cell loss between the groups was observed, except for groups 1 and 2. Endothelial cell count (ECC) differed significantly between groups 1 and 3 at 3 months. At 7 years, there was no difference in ECC between the three groups. Cell loss was found exclusively in group 1 between 3 months and 7 years. Endothelial cell morphology showed a converging pattern between 3 months and 7 years.

Conclusion

After phacoemulsification cataract surgery, long-term ECC and morphology appear to converge towards a comparable steady state regardless of initial corneal swelling and endothelial cell loss.