bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of weight carriage on work effort in horses
Authors: Munjizun A. , Gluck C. , Walston L. , High K. , Hunter R. , Pratt-Phillips S.
Published: December 2023

Excessive adiposity in horses is associated with equine metabolic syndrome and laminitis, and additional weight due to fat accumulation may cause further stress on the horse. This study aimed to determine the effect of additional weight carriage on work effort in horses, as estimated by changes in heart rate (HR) and body temperature (Temp). Eight mature mixed-breed horses were paired based on body size in a randomised crossover study. Each day tested a pair of horses with one horse carrying additional weight (15% of body weight; to represent approximately 3 body condition scores) and the other horse serving as a control, with treatments reversed the following week. Heart rate was determined before adding the weight, after a 2 h period of stall rest (prior to the exercise bout), and at the end of a 34 min exercise challenge of walking and trotting on an automated exerciser. Temp was recorded prior to exercise and after the horses were removed from the exerciser. Two-way ANOVA was conducted to determine the effect of exercise and weight carriage on HR and Temp, and paired t-tests were used to compare differences in HR and Temp pre- and post-exercise. HR increased with exercise () and was higher following exercise in horses carrying additional weight (). Exercise increased Temp () and the difference in Temp was greater in the weight-carrying group (). This study documents the effect of weight carriage that could be imposed with body fat, in addition to the known health detriments of adiposity.
Research for Peace
Authors: Altekin Okan , Sandal-Wilson Hakan
Published: December 2023

The Diyarbakır-based Cultural Studies for Peace Association (bakad), which was founded in 2021, has been documenting experiences of social inequality with a view to shedding light on the structural and cultural backdrop of these inequalities. Having an explicit intersectional lens, bakad holds a vision of disseminating the culture of peace, and deepening democratic politics in Turkey. This interview, conducted by Hakan Sandal-Wilson, with Okan Altekin on behalf of bakad, provides us with a social and cultural map of Kurdish LGBTI+ inequality and struggles in Diyarbakır and beyond, and their relationship to the complex dynamics of society, peace, conflict, and politics.
First record of the subgenus Hemilepistus (Desertellio) (Isopoda, Agnaridae) from China
Authors: WANG JIN , HONG XINKAI , JIANG CHAO , LI WEICHUN
Published: December 2023

The subgenus Hemilepistus (Desertellio) Verhoeff, 1930 is reported from China for the first time. A new species of the subgenus, H. (D.) gracilentus Li & Jiang sp. nov., is described from Xinjiang Uygur Autonomous Region, northwestern China and H. (D.) ruderalis (Pallas, 1771) is redescribed as a new record for Chinese Fauna, and its polymorphism is verified by using the COI sequences. A key to the worldwide species of the subgenus is provided.
‘Wit’s Wild Dancing Light’
Authors: Hutchings William
Published: December 2023

The book is a chronological reading of Alexander Pope’s poems, from the Pastorals (1709) to the four-book Dunciad (1743). Each of the 26 chapters forming the volume selects examples for detailed scrutiny, demonstrating how close reading can generate understanding of a whole poem and how critical appraisal can build into a creative survey of an entire poetic career. The book’s approach is intended to be both scholarly and accessible and 'Wit's Wild Dancing Light' will be of interest to scholars, students and anybody interested in Pope’s masterful poetry.
4. Windsor Forest
Authors: Hutchings William
Published: December 2023

Chapter 4. Windsor Forest is a contemporary version of georgic poetry, in which, after the model of Virgil, agrarian pursuits are merged with political engagement. Britain’s Norman past and Stuart present contain both destructive and constructive elements, politically resolved by Queen Anne’s voice and the Treaty of Utrecht.
12. An Epistle to Richard Boyle, Earl of Burlington
Authors: Hutchings William
Published: December 2023

Chapter 12. An Epistle to Richard Boyle, Earl of Burlington, is first of the epistles which form the dominant genre of Pope’s work in the 1730s. Its topic is the use of riches, in particular their investment in the arts of buildings and gardens. In agreeably comic manner, the epistle exposes the pursuit of artistic creation to satirical scrutiny by showing how the finest examples of judgement are open to perversion by ‘imitating fools’.
19. Epistle to Dr Arbuthnot
Authors: Hutchings William
Published: December 2023

Chapter 19. The Epistle to Dr Arbuthnot is Pope’s tribute to one of his closest friends, whose medical ‘art and care’ have preserved him through ‘this long disease, my life’. On Arbuthnot’s telling him that his own illness was now terminal, Pope writes what he called ‘the best memorial I can leave, both of my friendship to you, and of my character’. The antithesis in line 32 of ‘foes’ and ‘friends’ defines the old structure of Pope’s apologia for his ‘idle songs’, as he self-depreciatingly calls his poems. His defence of his career is set against devastating expressions of disgust at human malignity. Integrity is found only in private life: the friendship of Arbuthnot, whose character and presence are the poem’s unifying factor, and his own mother and father, the latter characterised by ‘the language of the heart’.
The Unruly Books of Abdisho of Nisibis
Authors: Ingeborg Lied Liv
Published: December 2023

A catalogue as a list, more precisely a book list, is the focus of Liv Ingeborg Lied’s contribution. Lied critically engages scholarship on the list of Old Testament books in Abdisho of Nisibis’s (d. 1318) Syriac Catalogue of the Books of the Church. Focusing on the trajectories in scholarship that have focused on the Christian biblical canon and the lost books of early Judaism, she explores the entries that have proven challenging to this scholarship. The unruly entries of Abdisho’s list fall into three categories: writings that are only known by title and which do not survive as extant and available texts, writings known by multiple titles, and entries that do not comply with the scholarly imagination of an Old Testament book. A new look at the epistemological and ontological status of these categories of entries provides a correction to the treatment of book lists by modern and contemporary scholars and a new appreciation of the many ways of knowing (about) books in a manuscript culture.
Determining an Optimal Government Subsidy Scheme for Shared Parking Management via a Bi-Level Programming Approach
Authors: Xiao Yun , Wang Guangmin , Xu Meng
Published: December 2023

A bi-level programming model is formulated to determine a government subsidy scheme for shared parking management. The government, as the upper-level decision-maker, seeks to maximize the social benefit by providing subsidy to the shared parking platform, incentivizing the platform to rent more shared parking slots, which can increase the utilization rate of idle parking slots and reduce the curbside parking cruising time of parking demanders. At the lower-level formulation, the shared parking platform, as a reseller, not only matches shared parking slot demanders but also determines which shared parking slots to rent, which is approached by a two-sided decision-making process. A “one-to-many” matching principle is adopted for the platform to maximize its revenue. A modified genetic algorithm is designed to solve the proposed model. Results indicate that the government subsidy has a positive impact on stimulating the shared parking market. Specifically, from the perspective of the government, the subsidy can increase the number of matched shared parking demanders, improve the supply of parking slots, and reduce curbside parking cruising time. From the perspective of the shared parking platform, the subsidy can lead to higher revenue.
Early versus late removal of the I-Gel in paediatric patients with mild upper respiratory tract symptoms undergoing ambulatory ilioinguinal surgery: A prospective observational study
Authors: Jarraya Anouar , Kammoun Manel , Bouchaira Hasna , Ben Ayed Khadija , Ketata Hend
Published: December 2023

The optimal timing of I-Gel removal in children with mild respiratory symptoms remains controversial. Consequently, we tried to assess the impact of early versus late I-Gel removal on the incidence of perioperative respiratory adverse events among children aged one to five years undergoing ambulatory surgery under general anaesthesia with I-Gel airway ventilation. The anaesthesia protocol was the same for all patients. Children were divided into two groups according to the approach of I-Gel removal (early versus late). The incidence of perioperative respiratory adverse events after the I-Gel removal was the main outcome, and a multivariable regression was performed to investigate the implication of the I-Gel removal in perioperative respiratory adverse events. According to our study, the incidence of perioperative respiratory adverse events was not correlated to the timing of I-Gel removal. However, prolonged postoperative oxygen support can be seen when the I-Gel is removed in anaesthetized children.
Electronic Health Record Stress and Burnout Among Clinicians in Hospital Settings: A Systematic Review
Authors: Alobayli Fatimah , O’Connor Siobhan , Holloway Aisha , Cresswell Kathrin
Published: December 2023

Background

There is growing evidence to suggest that EHRs may be associated with clinician stress and burnout, which could hamper their effective use and introduce risks to patient safety.

Objective

This systematic review aimed to examine the association between EHR use and clinicians’ stress and burnout in hospital settings, and to identify the contributing factors influencing this relationship.

Methods

The search included peer-reviewed published studies between 2000 and 2023 in English in CINAHL, Ovid Medline, Embase, and PsychINFO. Studies that provided specific data regarding clinicians’ stress and/or burnout related to EHRs in hospitals were included. A quality assessment of included studies was conducted.

Results

Twenty-nine studies were included (25 cross-sectional surveys, one qualitative study, and three mixed methods), which focused on physicians (n = 18), nurses (n = 10) and mixed professions (n = 3). Usability issues and the amount of time spent on the EHR were the most significant predictors, but intensity of the working environment influenced high EHR-related workload and thereby also contributed to stress and burnout. The differences in clinicians’ specialties influenced the levels of stress and burnout related to EHRs.

Conclusions

This systematic review showed that EHR use was a perceived contributor to clinicians’ stress and burnout in hospitals, primarily driven by poor usability and excessive time spent on EHRs. Addressing these issues requires tailored EHR systems, rigorous usability testing, support for the needs of different specialities, qualitative research on EHR stressors, and expanded research in Non-Western contexts.
The Effect of the Corona Virus on the Mental State Among Emergency Room Nurses: A Systematic Review
Authors: Abu Ras Ibrahim Abd Alkariem
Published: December 2023

Background

The COVID-19 pandemic has had a considerable influence on the medical field, especially for emergency room nurses who confront particular difficulties in responding to the crisis in Israel, including possible mental health effects. However, the exact effects of the present epidemic on the mental health of emergency room nurses in Israel remain largely unclear.

Aim

This study aimed to fill up this knowledge vacuum and advance our understanding of the pandemic’s consequences on the mental health of emergency room nurses in Israel.

Methods

This study employed the systematic review approach. Only studies published between January 2020 and the time of the search. The studies were searched from various databases such as PubMed, Scopus, CINAHL, Web of Science, and PsycINFO. A thematic analysis technique was used to find common themes among the chosen articles as the systematic review concentrates on the impact of the COVID-19 epidemic on the mental health of emergency room nurses in Israel. A total of 12 studies met the eligibility criteria.

Results

The main findings are oriented toward the effect of COVID-19 on the mental state of emergency room nurses in Israel. The 12 articles included for this study had various characteristics with majority being cross-sectional studies. Others included multicenter study, questionnaire-based study, and qualitative descriptive study. Using thematic analysis, four dominant themes, such as fear of infection and transmission, increased workload, inadequate support and resources, and coping strategies, emerged from the reviewed literature.

Conclusion

This systematic analysis emphasizes how crucial it is to consider emergency room nurses’ particular mental health demands during the COVID-19 epidemic.
ZAP-70 augments tonic B-cell receptor and CCR7 signaling in IGHV–unmutated chronic lymphocytic leukemia
Authors: Chen Jingyu , Sathiaseelan Vijitha , Reddy Chilamakuri Chandra Sekkar , Roamio Franklin Valar Nila , Jakwerth Constanze A. , D’Santos Clive , Ringshausen Ingo
Published: December 2023

Expression of ZAP-70 in a subset of patients with chronic lymphocytic leukemia (CLL) positively correlates with the absence of immunoglobulin heavy-chain gene (IGHV) mutations and is indicative of a more active disease and shorter treatment-free survival. We recently demonstrated that ZAP-70 regulates the constitutive expression of CCL3 and CCL4, activation of AKT, and expression of MYC in the absence of an overt B-cell receptor (BCR) signal, bona fide functions of BCR activation. We, here, provide evidence that these features relate to the presence of a constitutive tonic BCR signal, exclusively found in IGHV-unmutated CLL and dependent on the ZAP-70–mediated activation of AKT and its downstream target GSK-3β. These findings are associated with increased steady-state activation of CD19 and SRC. Notably this tonic BCR signal is not present in IGHV-mutated CLL cells, discordantly expressing ZAP-70. Results of quantitative mass spectrometry and phosphoprotein analyses indicate that this ZAP-70–dependent, tonic BCR signal regulates CLL cell migration through phosphorylation of LCP1 on serine-5. Indeed, we show that CCL19- and CCL21-induced chemotaxis is regulated by and dependent on the expression of ZAP-70 through its function to enhance CCR7 signaling to LCP1. Thus, our data demonstrate that ZAP-70 converges a tonic BCR signal, exclusively present in IGHV-unmutated CLL and CCR7-mediated chemotaxis.
Heightened TLR7 signaling primes BCR-activated B cells in chronic graft-versus-host disease for effector functions
Authors: Bracken Sonali J. , Suthers Amy N. , DiCioccio Rachel A. , Su Hsuan , Anand Sarah , Poe Jonathan C. , Jia Wei , Visentin Jonathan , Basher Fahmin , Jordan Collin Z. , McManigle William C. , Li Zhiguo , Hakim Frances T. , Pavletic Steven Z. , Bhuiya Nazmim S. , Ho Vincent T. , Horwitz Mitchell E. , Chao Nelson J. , Sarantopoulos Stefanie
Published: December 2023

Chronic graft-versus-host disease (cGVHD) is a debilitating, autoimmune-like syndrome that can occur after allogeneic hematopoietic stem cell transplantation. Constitutively activated B cells contribute to ongoing alloreactivity and autoreactivity in patients with cGVHD. Excessive tissue damage that occurs after transplantation exposes B cells to nucleic acids in the extracellular environment. Recognition of endogenous nucleic acids within B cells can promote pathogenic B-cell activation. Therefore, we hypothesized that cGVHD B cells aberrantly signal through RNA and DNA sensors such as Toll-like receptor 7 (TLR7) and TLR9. We found that B cells from patients and mice with cGVHD had higher expression of TLR7 than non-cGVHD B cells. Using ex vivo assays, we found that B cells from patients with cGVHD also demonstrated increased interleukin-6 production after TLR7 stimulation with R848. Low-dose B-cell receptor (BCR) stimulation augmented B-cell responses to TLR7 activation. TLR7 hyperresponsiveness in cGVHD B cells correlated with increased expression and activation of the downstream transcription factor interferon regulatory factor 5. Because RNA-containing immune complexes can activate B cells through TLR7, we used a protein microarray to identify RNA-containing antigen targets of potential pathological relevance in cGVHD. We found that many of the unique targets of active cGVHD immunoglobulin G (IgG) were nucleic acid–binding proteins. This unbiased assay identified the autoantigen and known cGVHD target Ro-52, and we found that RNA was required for IgG binding to Ro-52. Herein, we find that BCR-activated B cells have aberrant TLR7 signaling responses that promote potential effector responses in cGVHD.
Association between impaired dynamic cerebral autoregulation and BBB disruption in reversible cerebral vasoconstriction syndrome
Authors: Ling Yu-Hsiang , Chi Nai-Fang , Pan Li-Ling Hope , Wang Yen-Feng , Wu Chia-Hung , Lirng Jiing-Feng , Fuh Jong-Ling , Wang Shuu-Jiun , Chen Shih-Pin
Published: December 2023

Background

Half of the sufferers of reversible cerebral vasoconstriction syndrome (RCVS) exhibit imaging-proven blood-brain barrier disruption. The pathogenesis of blood-brain barrier disruption in RCVS remains unclear and mechanism-specific intervention is lacking. We speculated that cerebrovascular dysregulation might be associated with blood-brain barrier disruption in RCVS. Hence, we aimed to evaluate whether the dynamic cerebral autoregulation is altered in patients with RCVS and could be associated with blood-brain barrier disruption.

Methods

A cross-sectional study was conducted from 2019 to 2021 at headache clinics of a national tertiary medical center. Dynamic cerebral autoregulation was evaluated in all participants. The capacity of the dynamic cerebral autoregulation to damp the systemic hemodynamic changes, i.e., phase shift and gain between the cerebral blood flow and blood pressure waveforms in the very-low- and low-frequency bands were calculated by transfer function analysis. The mean flow correlation index was also calculated. Patients with RCVS received 3-dimensional isotropic contrast-enhanced T2 fluid-attenuated inversion recovery imaging to visualize blood-brain barrier disruption.

Results

Forty-five patients with RCVS (41.9 ± 9.8 years old, 29 females) and 45 matched healthy controls (41.4 ± 12.5 years old, 29 females) completed the study. Nineteen of the patients had blood-brain barrier disruption. Compared to healthy controls, patients with RCVS had poorer dynamic cerebral autoregulation, indicated by higher gain in very-low-frequency band (left: 1.6 ± 0.7, p = 0.001; right: 1.5 ± 0.7, p = 0.003; healthy controls: 1.1 ± 0.4) and higher mean flow correlation index (left: 0.39 ± 0.20, p = 0.040; right: 0.40 ± 0.18, p = 0.017; healthy controls: 0.31 ± 0.17). Moreover, patients with RCVS with blood-brain barrier disruption had worse dynamic cerebral autoregulation, as compared to those without blood-brain barrier disruption, by having less phase shift in very-low- and low-frequency bands, and higher mean flow correlation index.

Conclusions

Dysfunctional dynamic cerebral autoregulation was observed in patients with RCVS, particularly in those with blood-brain barrier disruption. These findings suggest that impaired cerebral autoregulation plays a pivotal role in RCVS pathophysiology and may be relevant to complications associated with blood-brain barrier disruption by impaired capacity of maintaining stable cerebral blood flow under fluctuating blood pressure.

Graphical Abstract
Comparing the efficacy of low-load resistance exercise combined with blood flow restriction versus conventional-load resistance exercise in Chinese community-dwelling older people with sarcopenic obesity: a study protocol for a randomised controlled trial
Authors: Zhuang Min , Shi Jinli , Liu Jian , He Xiangfeng , Chen Nan
Published: December 2023

Introduction

Sarcopenic obesity (SO) is characterised by decreased muscle mass, diminished muscle strength and/or reduced physical performance and a high percentage of body fat (PBF). Conventional-load resistance exercise (CRE) may be difficult for older people with SO owing to their declining physical functions. Low-load resistance exercise (LRE) combined with blood flow restriction (BFR; LRE-BFR) is a viable alternative to CRE for improving muscle mass and strength and potential exercise mode for managing SO. This study has two objectives: (1) to comprehensively evaluate the efficacy of CRE and LRE-BFR in improving body composition, muscle strength, physical performance, haematological parameters, cardiovascular disease (CVD) risk factors and quality of life and (2) to compare the efficacy of CRE and LRE-BFR and explore their potential mechanisms.

Methods and analysis

This work is a 12-week assessor-blinded randomised clinical trial that will be conducted thrice a week. Sarcopenia will be defined using the Asian Working Group for Sarcopenia 2019, and obesity will be determined using the criteria developed by the World Health Organization. Community-dwelling older people aged ≥ 65 years will be screened as the participants using inclusion and exclusion criteria. A total of 33 participants will be randomised into a CRE group (n = 11), an LRE-BFR group (n = 11) and a control group that will be given only health education (n = 11). The primary outcomes will be knee extensor strength and PBF, and the secondary outcomes will be body composition, anthropometric measurements, muscle strength of upper limbs, physical performance, haematological parameters, CVD risk factors and quality of life. The outcomes will be measured at the baseline (week 0), end of the intervention (week 12) and follow up (week 24). All the collected data will be analysed following the intention-to-treat principle.

Ethics and dissemination

The Ethics Research Committee has approved this study (approval No. CMEC-2022-KT-51). Changes or developments in this study will be reported at www.chictr.org.cn.

Trial registration

ChiCTR2300067296 (3 January 2023).
IL-1β may be an indicator of peritoneal deterioration after healing of peritoneal dialysis-associated peritonitis
Authors: Hirano Akira , Kadoya Hiroyuki , Yamanouchi Yu , Kishi Seiji , Sasaki Tamaki , Kashihara Naoki
Published: December 2023

Background

Peritoneal dialysis (PD) is an essential lifesaving treatment for end-stage renal disease. However, PD therapy is limited by peritoneal inflammation, which leads to peritoneal membrane failure because of progressive peritoneal deterioration. Peritonitis is the most common complication in patients undergoing PD. Thus, elucidating the mechanism of chronic peritoneal inflammation after PD-associated peritonitis is an urgent issue for patients undergoing PD. This first case report suggests that an increased interleukin-1β (IL-1β) expression in the peritoneal dialysate after healing of peritonitis can contribute to peritoneal deterioration.

Case presentation

A 64-year-old woman was diagnosed with diabetes mellitus 10 years ago and had been started on PD for end-stage renal disease. One day, the patient developed PD-associated acute peritonitis and was admitted to our hospital for treatment. Thus, treatment with antimicrobial agents was initiated for PD-associated peritonitis. Dialysate turbidity gradually disappeared after treatment with antimicrobial agents, and the number of cells in the PD fluid decreased. After 2 weeks of antimicrobial therapy, peritonitis was clinically cured, and the patient was discharged. Thereafter, the patient did not develop peritonitis; however, residual renal function tended to decline, and peritoneal function also decreased in a relatively short period. We evaluated pro-inflammatory cytokine levels before and after PD-associated peritonitis; interestingly, the levels of IL-1β remained high in the PD fluid, even after remission of bacterial peritonitis. In addition, it correlated with decreased peritoneal function.

Conclusions

This case suggests that inflammasome-derived pro-inflammatory cytokines may contribute to chronic inflammation-induced peritoneal deterioration after PD-related peritonitis is cured.
Determinants of Anishinabeck infant and early childhood growth trajectories in Northwestern Ontario, Canada: a cohort study
Authors: Monteith Hiliary , Mamakeesick Mary , Rae Joan , Galloway Tracey , Harris Stewart B. , Birken Catherine , Hamilton Jill , Maguire Jonathon L. , Parkin Patricia , Zinman Bernard , Hanley Anthony J. G.
Published: December 2023

Background

The Developmental Origins of Health and Disease (DOHaD) paradigm emphasizes the significance of early life factors for the prevention of chronic health conditions, like type 2 diabetes (T2DM) and obesity, which disproportionately affect First Nations communities in Canada. Despite increasing DOHaD research related to maternal health during pregnancy, early childhood growth patterns, and infant feeding practices with many populations, data from First Nations communities in Canada are limited. In partnership with Sandy Lake First Nation, the aims of this project were to characterize birthweights and growth patterns of First Nations infants/children over the first 6 years of life and to study the impact of maternal and infant social and behavioral factors on birthweight and growth trajectories.

Methods

We recruited 194 families through community announcements and clinic visits. Infant/child length/height and weight were measured at 1 and 2 weeks; 1, 2, 6, 12, and 18 months; and 2, 3, 4, 5 and 6 years. Maternal and infant/child questionnaires captured data about health, nutrition, and social support. Weight-for-Age z-score (WAZ), Height-for-Age z-score (HAZ), and BMI-for-Age z-score (BAZ) were calculated using WHO reference standards and trajectories were analyzed using generalized additive models. Generalized estimating equations and logistic regression were used to determine associations between exposures and outcomes.

Results

WAZ and BAZ were above the WHO mean and increased with age until age 6 years. Generalized estimating equations indicated that WAZ was positively associated with age (0.152; 95% CI 0.014, 0.29), HAZ was positively associated with birthweight (0.155; 95% CI 0.035, 0.275), and BAZ was positively associated with caregiver’s BMI (0.049; 95% CI 0.004, 0.090). There was an increased odds of rapid weight gain (RWG) with exposure to gestational diabetes (OR: 7.47, 95% CI 1.68, 46.22). Almost 70% of parents initiated breastfeeding, and breastfeeding initiation was modestly associated with lower WAZ (-0.18; 95% CI -0.64, 0.28) and BAZ (-0.23; 95% CI -0.79, 0.34).

Conclusions

This work highlights early life factors that may contribute to T2DM etiology and can be used to support community and Indigenous-led prevention strategies.
The effectiveness of a 6-week biofeedback gait retraining programme in people with knee osteoarthritis: protocol for a randomised controlled trial
Authors: Wan Yi , McGuigan Polly , Bilzon James , Wade Logan
Published: December 2023

Background

Gait retraining is a common therapeutic intervention that can alter gait characteristics to reduce knee loading in knee osteoarthritis populations. It can be enhanced when combined with biofeedback that provides real-time information about the users’ gait, either directly (i.e. knee moment feedback) or indirectly (i.e. gait pattern feedback). However, it is unknown which types of biofeedback are more effective at reducing knee loading, and also how the changes in gait affect pain during different activities of daily living. Therefore, this study aims to evaluate the acute (6 weeks of training) and chronic (1 month post training) effects of biofeedback based on personalised gait patterns to reduce knee loading and pain in people with knee osteoarthritis, as well as examine if more than one session of knee moment feedback is needed to optimise the gait patterns.

Methods

This is a parallel group, randomised controlled trial in a symptomatic knee osteoarthritis population in which participants will be randomised into either a knee moment biofeedback group (n = 20), a gait pattern biofeedback group (n = 20) or a control group (n = 10). Supervised training sessions will be carried out weekly for six continuous weeks, with real-time biofeedback provided using marker-based motion capture and an instrumented treadmill. Baseline, post-intervention and 1-month follow-up assessments will be performed to measure knee loading parameters, gait pattern parameters, muscle activation, knee pain and functional ability.

Discussion

This study will identify the optimal gait patterns for participants’ gait retraining and compare the effectiveness of gait pattern biofeedback to a control group in reducing knee loading and index knee pain. Additionally, this study will explore how many sessions are needed to identify the optimal gait pattern with knee moment feedback. Results will be disseminated in future peer-reviewed journal articles, conference presentations and internet media to a wide audience of clinicians, physiotherapists, researchers and individuals with knee osteoarthritis.

Trial registration

This study was retrospectively registered under the International Standard Randomised Controlled Trial Number registry on 7th March 2023 (ISRCTN28045513).
Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: a short-term retrospective study
Authors: Feng Da Peng , Liu Ming Quan , Zhang Wei , Wang Jia Qi , Li Zheng Wei
Published: December 2023

Background

Anterior column realignment (ACR) is a novel surgical method for correcting spinal sagittal balance. meanwhile, oblique lumbar interbody fusion (OLIF) and anterior lumbar interbody fusion (ALIF) are considered minimally invasive surgical methods through natural anatomical space. This study aimed to explore the corrective effects and clinical outcomes of OLIF or ALIF combined with ACR technology in patients with adult spinal deformity (ASD).

Methods

We retrospectively analyzed patients with sagittal imbalance who received OLIF and/or ALIF and ACR treatment from 2018 to 2021. Surgical time and intraoperative bleeding volume are recorded, the corrective effect is determined by the intervertebral space angle (IVA), lumbar lordosis (LL), the sagittal vertical axis (SVA), clinical outcome is evaluated by preoperative and final follow-up visual analog pain score (VAS), Japanese orthopedic association scores (JOA) and complications.

Results

Sixty-four patients were enrolled in the study, average age of 65.1(range, 47–82) years. All patients completed 173 fusion segments, for 150 segments of ACR surgery. The operation time of ALIF-ACR was 50.4 ± 22.1 min; The intraoperative bleeding volume was 50.2 ± 23.6 ml. The operation time and intraoperative bleeding volume of single-segment OLIF-ACR was 66.2 ± 19.4 min and 70.2 ± 31.6 ml. At the follow-up of 6 months after surgery, the intervertebral space angle correction for OLIF-ACR and ALIF-ACR is 9.2° and 12.2°, the preoperative and postoperative lumbar lordosis were 16.7° ± 6.4°and 47.1° ± 3.6° (p < 0.001), VAS and JOA scores were improved from 6.8 to 1.8 and 7.8 to 22.1 respectively, statistically significant differences were observed in these parameters. The incidence of surgical related complications is 29.69%, but without serious complications.

Conclusion

ACR via a minimally invasive hybrid approach for ASD has significant advantages in restoring local intervertebral space angulation and correcting the overall sagittal balance. Simultaneously, it can achieve good clinical outcomes and fewer surgical complications.
Correlation between physical activity and adolescent idiopathic scoliosis: a systematic review
Authors: Qi Xiang , Peng Chao , Fu Pinting , Zhu Aiyuan , Jiao Wei
Published: December 2023

Background

The multifactorial aetiology of scoliosis is well known. Physical activity is considered both a treatment and causative factor for idiopathic scoliosis; however, evidence for a causal relationship between physical activity levels and idiopathic scoliosis in adolescents is conflicting. Therefore, we aimed to summarise the current evidence regarding the association between adolescent idiopathic scoliosis and physical activity and further to assess whether the relationship is dose dependent.

Methods

PubMed, Cochrane, Scopus, and Web of Science databases were searched from 1991 to July 2022 using the following main keywords: adolescent idiopathic scoliosis, physical activity, and risk factors, supplemented with manual searches, secondary citations, and reference searches. The quality of the included literature was evaluated using the Scale for Reporting Observational Studies in Enhanced Epidemiology guidelines.

Results

Eight studies were included in this review, of which six reported an association between adolescent idiopathic scoliosis and physical activity levels and two reported no association. One British study reported reduced physical function early in life as a new risk factor for scoliosis onset.

Conclusions

Physical activity is strongly associated with adolescent idiopathic scoliosis. Physical activity should be encouraged as it plays an important role in the prevention of adolescent idiopathic scoliosis. Further research is needed to determine the dose-dependent relationship between physical activity and prevention of adolescent idiopathic scoliosis.
Alveolar bone loss and tooth loss contribute to increase in cancer mortality among older patients
Authors: Qian Yifeng , Cai Binxin , Chi Fangfang , Yao Chunxia , Zhang Lei , Qi Lei , Jiang Yonggen , Wang Xudong
Published: December 2023

Background

Both cancer and periodontitis are more prevalent with age. Information on their relationship in older patients is limited. This study aims to examine whether periodontitis is associated with increased risk of cancer mortality with a ≥ 75-year age group cohort.

Methods

A retrospective cohort study was conducted on 1146 patients who had digital radiographic examinations. Alveolar bone loss and loss of teeth were measured as indicators of periodontitis. Hazard ratio (HR) with 95% confidence interval (CI) were taken as the effect size to summarize the associations between periodontitis and risks of cancer mortality using the multivariate adjusted cox proportional hazards model and competing risk hazard model.

Results

Totally, 104 total cancer, 28 lip, oral cavity and pharynx (LOP) cancer, 39 digestive cancer and 13 respiratory cancer cases were documented over 10 years of follow-up. Total cancer (HR 1.27, 95% CI 1.06–1.53) displayed statistically significant associations with alveolar bone loss and tooth loss after adjusting for relevant confounding variables. We also observed borderline significant association between alveolar bone loss and LOP cancer (HR 1.45, 95% CI 0.99–2.12). The above associations were consistent with the results observed from the competing risk hazard models.

Conclusion

Our results indicate that older patients suffering from tooth loss or alveolar bone loss are at increased risks of cancer mortality, especially for total cancer and LOP cancer.
Household smoking impact on the oral health of 5- to 7-years-old children
Authors: Arafa Abla
Published: December 2023

Background

Children’s exposure to secondhand smoke, particularly by their parents, could adversely affect their oral health. Thereby, this study aimed to assess the oral health status of children subjected to household smoking and the impact of smoking patterns on the severity of oral health deterioration.

Methods

A total of 210 healthy children were enrolled in this case-control study and allocated into children subjected to household smoking (HS) and control groups. Participants’ guardians were asked to complete a questionnaire regarding sociodemographic characteristics and parental smoking habits. All participants were subjected to clinical dental examination to assess dental caries (ICDAS), hypomineralized primary molars (HSPM), and gingival status (GI). Stimulated saliva samples were collected to assess saliva composition and characteristics. Urine samples were collected and analyzed for cotinine concentration. Data were analyzed using SPSS (v.25) software at a test value of p ≤ 0.05. The t-student test was used to find significant differences between participants’ age, gingival index score, saliva pH, flow rate, sIgA, and cotinine level. The Chi-square test was used to test for the significance of parental employment, number of rooms, gender, sweets consumption, brushing frequency, and HMPM. The correspondence analysis was used to test for significance of parents’ levels of education, type of house ventilation, ICDAS score, smoking form, frequency, and smoking pattern. The correlation between cotinine level and sIgA was tested for association using Bivariate correlation test.

Results

The HS group showed a significantly increased risk for dental caries (p < 0.000), HSPM lesions (p = 0.007), and GI score (p < 0.000). A significant reduction in salivary flow rate, saliva pH, and sIgA were evident in HS group (p < 0.000). Parental consumption of more than 20 cigarettes/day was accompanied by increased dental caries activity (p < 0.000) and higher risk for increased severity of gingival inflammation (p < 0.000) of children in the HS group. Children of parents who smoke cigarettes and use the hubble/bubble anywhere in the house found to have greater distribution of HSPM (p < 0.000). Reduced sIgA values were found to be significantly associated with increased cotinine concentrations in HS children (p < 0.000).

Conclusions

Frequent exposure to household smoking could be associated with an increased risk of dental caries progression, enamel hypomineralization, gingival inflammation, and saliva characteristics changes in children.
The fusion of keratinized epithelium, an indication of early implant placement in the aesthetic area: an animal study
Authors: Ren Chengyan , Chen Weihui , Chen Jiangping , Mao Chuanqing , Liao Caiyu , Liu Jianan
Published: December 2023

Background

In the period of the early implant placement, the socket is mainly occupied by provisional matrix (PM). Keratinized epithelium (KE) is critical for primary wound closure. Although both KE and PM are important, the detailed relationship among migrating KE, PM formation and indication of the early implant placement is still unclear.

Objective

This research aimed to locate a healing stage of KE with highest osteogenic PM formation after tooth extraction, which could be treated as the optimal time point for early implant placement.

Material and methods

Mice were sacrificed on days 1, 2, 3, 4 and 6 after incisor extraction. Clinical, histological, and immunohistochemical evaluations of the extraction sockets were performed, and statistical analyses were conducted. We then inserted implants into the PM with the greatest bioactivity and observed its osseointegration pattern for 3, 10, 17 and 30 days.

Result

When KE fusion was reached, sockets were dominated by PM with the greatest expression of osteocalcin (OC, P < 0.05) and high levels of CD34 and Runx2. OC and Runx2 expression were positively correlated with KE coverage (P < 0.05). When the implant was inserted at 4 days’ healing, the PM maintained its osteogenic ability, and osseointegration proceeded perfectly.

Conclusion

The migration of KE was correlated with the formation of highly osteogenic and angiogenic PM. And the fusion of KE could be treated as an indication for early implant placement.
Compositional and functional changes in the salivary microbiota related to oral leukoplakia and oral squamous cell carcinoma: a case control study
Authors: Lan Qingying , Zhang Chang , Hua Hong , Hu Xiaosheng
Published: December 2023

Background

Oral squamous cell carcinoma (OSCC) is one of the most common malignant tumours with increasing incidence, and oral leukoplakia (OLK) has a strong tendency to undergo malignant transformation. The oral microbiota may influence oral cancer progression, but the salivary bacterial composition and functional changes in OSCC and OLK have not been comprehensively elucidated. Therefore, we compared salivary bacteria in OLK and OSCC patients with healthy controls (HC).

Methods

Metagenomic sequencing was used to compare the bacterial composition and functional changes of 18 OSCC patients, 21 OLK patients and 21 HC. Spearman correlation was used to identify possible associations between functions and bacteria.

Results

Gemella was the most differentially enriched genus in OSCC. At the species level, Streptococcus sp. NPS 308, Streptococcus agalactiae, Gemella haemolysans and Gemella morbillorum were slightly increased in OLK and OSCC. Kyoto Encyclopedia of Genes and Genomes (KEGG) results showed that OSCC was mainly associated with metabolism functions, including lipid metabolism, carbohydrate metabolism and glycan biosynthesis and metabolism. The synthesis and degradation of ketone bodies, cysteine and methionine metabolism and glycerolipid metabolism differed significantly among the three groups, and were highest in OSCC and lowest in HC. And G. haemolysans was significantly associated with these selected metabolic pathways.

Conclusions

Metagenomic analysis revealed significant differences in the salivary microbiota among OSCC, OLK and HC. Thus, salivary microbiota composition and functional changes may be associated with OSCC progression. Metabolism of nonessential amino acids such as cysteine and methionine in bacteria may play an important role in oral oncogenesis, and more studies of the mechanism between metabolisms of bacteria and oral oncogenesis are needed in the future.
An acceptance analysis of a sexual health education digital tool in resource-poor regions of Kenya: an UTAUT based survey study
Authors: Soehnchen Clarissa , Weirauch Vera , Schmook Rebecca , Henningsen Maike , Meister Sven
Published: December 2023

Background

Unplanned pregnancies and sexually transmitted diseases are a concern in Sub-Saharan Africa, particularly in low-income areas. Access to sexual health information is limited, partly due to the absence of comprehensive sex education in the national school curriculum and social taboos. In response to these challenges, this study introduces a web-based prototype, designed to provide essential sexual health information, targeting 18 to 35-year-old Kenyans, focusing on contraception, menstruation, and female genital mutilation.

Method

Aiming to investigate young adults’ behavioral intention to use a digital tool for sexuality education, by analyzing factors affecting acceptance and usability in low-income and resource-poor regions in Kenya. To explore the acceptability and use of the developed digital tool, this study used a modified version of the Unified Theory of Acceptance and Use of Technology (UTAUT), complemented by the System Usability Scale (SUS) questionnaire. For statistical analysis, a Structural Equation Model (SEM) including Confirmatory Factor Analysis (CFA) and Linear Regression was used. Regarding the reporting of the E-survey results, the Checklist for Reporting Results of Internet E-surveys (CHERRIES), was considered.

Results

Survey information from 77 persons (69 female, 7 male, 1 diverse) were collected. A modified UTAUT appears as an appropriate model for measuring the constructs and integrating evidence-based approaches to advanced and safe sexual healthcare information. Results from the SEM showed perceived usefulness, attitude towards healthcare integrated evidence technology, and usability as well as having a significant positive impact on the acceptance, the intention to use as well as wellbeing. Having the resources and knowledge necessary for the usage of a digital tool turns out to have a significant negative impact. A SUS score of 67.3 indicates the usability of the tool for sexual health information, assessed as okay.

Conclusions

The study adopts validated methods to assess the acceptability and usability of a digital sexual health education tool in Kenya. Emphasizing its potential effectiveness and highlighting the influence of cultural and contextual factors on technology adoption.
Opportunities to improve the adoption of health-related quality of life evidence as part of the French Health Technology Assessment process
Authors: Larose Hugo , Lee Myrto , Grueger Jens , Anota Amélie , Naïditch Nicolas , Falissard Bruno , Di Palma Mario , Chassany Olivier , Khalfallah-Neelz Laura , Palazuelos-Muñoz Sarah , Tetafort Aymeric
Published: December 2023

Objectives

Patient’s health-related quality of life (HRQoL) is an important outcome measure that is considered by many payers and health technology assessment (HTA) bodies in the evaluation of treatments. We aimed to identify opportunities for HRQoL to be further incorporated into the assessment of the French HTA by comparing three health systems. We put forward recommendations that could bring further innovations to French patients.

Methods

We reviewed methodologies by the French, German and British HTA, and conducted a systematic review of all French (n = 312) and German (n = 175) HTA appraisals from 01 January 2019 to 31 December 2021. We also setup an advisory board of 11 ex-HTA leaders, payers, methodologists, healthcare providers and patient advocates, from France, Britain and Germany, to discuss opportunities to improve acceptance and adoption of HRQoL evidence in France.

Results

Our systematic review of HTA appraisals showed a higher HRQoL data rejection rate in France: in > 75% of cases the HRQoL evidence submitted was not accepted for the assessment (usually for methodological reasons, for example, data being considered exploratory; 16–75% of the appraisals mentioned HRQoL evidence, varying by therapeutic area). Overall, we found the French HTA to be more restrictive in its approach than IQWiG.

Conclusions

Based on these findings we articulate collaborative proposals for industry and the HAS to improve acceptance of HRQoL evidence and create a positive feedback loop between HAS and industry along four dimensions (1) patient perception, (2) testing hierarchy, (3) trial design and (4) data collection.
Molecular characterization of a tetra segmented ssDNA virus infecting Botrytis cinerea worldwide
Authors: Ruiz-Padilla Ana , Turina Massimo , Ayllón María A.
Published: December 2023

Background

Family Genomoviridae was recently established, and only a few mycoviruses have been described and characterized, and almost all of them (Sclerotinia sclerotiorum hypovirulence-associated DNA virus 1, Fusarium graminearum gemyptripvirus 1 and Botrytis cinerea gemydayirivirus 1) induced hypovirulence in their host. Botrytis cinerea ssDNA virus 1 (BcssDV1), a tetrasegmented single-stranded DNA virus infecting the fungus Botrytis cinerea, has been molecularly characterized in this work.

Methods

BcssDV1 was detected in Spanish and Italian B. cinerea field isolates obtained from grapevine. BcssDV1 variants genomes were molecularly characterized via NGS and Sanger sequencing. Nucleotide and amino acid sequences were used for diversity and phylogenetic analysis. Prediction of protein tertiary structures and putative associated functions were performed by AlphaFold2 and DALI.

Results

BcssDV1 is a tetrasegmented single-stranded DNA virus. The mycovirus was composed by four genomic segments of approximately 1.7 Kb each, which are DNA-A, DNA-B, and DNA-C and DNA-D, that coded, respectively, for the rolling-circle replication initiation protein (Rep), capsid protein (CP) and two hypothetical proteins. BcssDV1 was present in several Italian and Spanish regions with high incidence and low variability among the different viral variants. DNA-A and DNA-D were found to be the more conserved genomic segments among variants, while DNA-B and DNA-C segments were shown to be the most variable ones. Tertiary structures of the proteins encoded by each segment suggested specific functions associated with each of them.

Conclusions

This study presented the first complete sequencing and characterization of a tetrasegmented ssDNA mycovirus, its incidence in Spain and Italy, its presence in other countries and its high conservation among regions.