bluuebunny/crossref_metadata_2025 huggingface dataset:
The confavreux lecture: The radiologically isolated syndrome diagnosis, prognosis and perspectives
Authors: Lebrun-Frenay Christine
Published: January 2025

Radiologically isolated syndrome (RIS) is the earliest documented stage in the disease continuum of multiple sclerosis (MS). It is discovered incidentally in individuals who are asymptomatic but have typical lesions in the brain or spinal cord suggestive of autoimmune inflammatory demyelination. The revised 2023 RIS criteria aim to secure an accurate and timely diagnosis due to the presence of imaging mimics. These criteria require having at least one T2-weighted hyperintense lesion in one of the four suggestive MS locations along with two of the following three features: spinal cord lesion, cerebrospinal fluid (CSF)-restricted oligoclonal bands, or new T2 or gadolinium-enhancing lesion observed on a subsequent magnetic resonance imaging (MRI) study. Once the diagnosis is confirmed, established risk factors, including age, lesion location and CSF, significantly improve prognostic stratification, which is crucial for immunoactive interventions. Recent clinical trials have shown that oral disease-modifying treatments can delay or prevent the first clinical event in RIS patients. Consulting with an MS team for each RIS case is strongly recommended to enhance care and disease surveillance. The revised 2024 McDonald criteria will classify individuals with additional CSF and advanced MRI biomarkers as having preclinical MS, highlighting the importance of vigilance in this area.
Exploring the factors that influence the delivery of physical education in alternative provision schools in England
Authors: Quarmby Thomas , Maher Anthony J , Hooper Oliver , Wells Vicci , Slavin Lucy
Published: January 2025

There is currently no literature that considers the practicalities of delivering physical education (PE) in alternative provision schools, nor the challenges that this might entail. As such, this paper offers a unique contribution to knowledge by highlighting the key factors that influence the delivery of PE within alternative provision schools in England from the perspectives of practitioners (i.e. those tasked with delivering it). Following a Freedom of Information request, an online survey was distributed to all alternative provision schools in England ( n = 335, 48 responses). A purposive sample of practitioners ( n = 14) was then invited to take part in online semi-structured interviews. Qualitative responses from the survey (extracted into an Excel spreadsheet), along with the transcripts from the interviews, were analysed using inductive and deductive procedures. The data were subsequently mapped to the socio-ecological model ( McLeroy et al., 1988 ) to identify what influenced delivery at multiple levels. This included factors at the intrapersonal level (e.g. staff confidence and competence, their pedagogical and content knowledge and feelings of isolation), interpersonal level (e.g. pupil needs/abilities, their behaviour and trauma, confidence, negative experiences of mainstream PE and lack of motivation), institutional level (e.g. spatial constraints, the facilities and equipment available and class sizes), community level (e.g. stigma and a lack of engagement with National Governing Bodies), and public policy level (e.g. recruitment of staff, financial constraints and attainment pressures). This paper presents a range of intersecting factors that influence what happens and how in PE in the context of alternative provision schooling.
Body satisfaction, problematic smartphone use, sleep deprivation, and psychological well-being in adolescents: A half-longitudinal serial mediation study
Authors: Yildirim-Kurtulus Hacer , Deniz Mehmet Engin , Satici Seydi Ahmet
Published: January 2025

The relationships between body satisfaction, problematic smartphone use, sleep deprivation and psychological well-being have been examined with cross-sectional methods. However, the lack of any longitudinal study in which these variables were examined together made it necessary to conduct this study. In this study, we tested whether problematic smartphone use and sleep deprivation serially mediate the relationship between body satisfaction and psychological well-being. After matching the data obtained from the first (T1) and second waves (T2) of the study, the final sample consisted of 222 Turkish adolescents ( M = 14.08 years, SD = 0.70). For this purpose, a study was conducted in two separate time waves and structural equation modeling was used to test longitudinal serial mediation between variables. According to the results, problematic smartphone use and sleep deprivation play a serial mediating role in the longitudinal relationship between body satisfaction and psychological well-being.
Whole body CT-scan vs. selective CT-scan in geriatric trauma: Systematic review and meta-analysis
Authors: Tang Patrick , Elkington Olivia , Stevens Sean
Published: January 2025

Introduction

Geriatric trauma is a burgeoning public health problem. In Australia and New Zealand, there has been a 21% increase in geriatric major trauma presentations over the past 4 years, with persons over 65 year-of-age now accounting for almost one third of all severely injured patients. Whole-body computed tomography (WBCT) is often used in the emergency department to assess patients for traumatic injuries. Recent studies have suggested more selective use of WBCTs for trauma patients, but the benefit of WBCTs in older persons is undefined. This systematic review aims to identify whether geriatric trauma patients that underwent WBCT have different outcomes compared to those that have selective CT-scans.

Methods

A systematic literature search was conducted on PubMed, MEDLINE and EMBASE according to the PRISMA guidelines for studies about imaging in geriatric trauma from 1946 to June 2023. Outcomes of patients that had WBCT were compared with those that had selective CT scans on presentation.

Results

Five publications including 14,908 geriatric trauma patients were reviewed for analysis. Analysis of mortality showed that WBCTs are not significantly associated with a reduced risk of mortality (OR: 0.88, 95% confidence interval [CI] 0.46–1.67, p = 0.69). Analysis of hospital length of stay showed that patients investigated with WBCTs had no significant difference to patients that had selective CT scans (MD: −0.39, 95% CI −1.09 to 0.30, p = 0.27). WBCTs also are not associated with a higher likelihood of being discharged home (OR: 1.05, 95% CI 0.56–1.98, p = 0.87).

Conclusion

WBCTs are not associated with reduced mortality, reduced hospital or ICU LOS or discharge destination in geriatric trauma when compared to selective CT-scans. There is presently insufficient evidence to support a routine approach of WBCT in the assessment of geriatric trauma patients.
Envisioning post-growth marketing: A dystopian-optimist’s guide
Authors: Bertilsson Jon , Egan-Wyer Carys
Published: January 2025

This article introduces a mode of thought called dystopian optimism in response to the question of how critical marketing can be made more optimistic. Dystopian optimism counters both the utopian-optimistic belief that the climate crisis can be solved from within the current growth-capitalist system, and the dystopian pessimism of terminal marketing. We propose degrowth as a means to revitalise critical marketing and argue that theorising alternative marketing forms has performative potential. Additionally, we suggest that the transition to a post-growth society can be achieved incrementally rather than through radical upheaval and outline practical ways for critical marketing theory to contribute to this transition.
A rare presentation of neurofibromatosis mimicking leprosy
Authors: Garg Sonika , Rout Arpita Nibedita , Sirka Chandra Sekhar , Priyadharshan Bevan
Published: January 2025

Neurofibromatosis type 1 (NF-1) is a genetic disorder commonly characterized by café-au-lait macules, neurofibromas and axillary freckling. We present the case of a 20-year-old female who had bilateral neck swellings, and these swellings were misdiagnosed as cervical lymphadenopathy, and the patient was started on anti-tubercular therapy (ATT), but the swellings didn’t show any improvement despite 6 months of ATT. Further examination revealed thickening of the greater auricular, supratrochlear and supraorbital nerves, accompanied by an unusual freckling pattern along the thickened nerves, which were suggestive of neurofibromatosis. The patient exhibited café-au-lait macules and palmar, inguinal and axillary freckling but had no cutaneous neurofibromas or hypaesthesic patches typical of leprosy, a key differential diagnosis. History of neurofibromatosis was present in the family. Ultrasound imaging, showed nerve thickening, confirmed the NF-1 diagnosis. This case highlights the need to consider NF-1 in the differential diagnosis of nerve thickening, particularly in regions endemic for leprosy and tuberculosis, to prevent misdiagnosis and inappropriate treatment.
Comparative Histological Assessment of Zinc Oxide Nanoparticles and Low-Power Laser Treatment at 810nm Wavelength on the Recovery of Second-Degree Burn Wounds in Rat Models
Authors: AL-Timimi Zahra , Haddawi S. F. , Nukhailawi Sajjad Abbas Hadi
Published: January 2025

Background: The utilization of zinc oxide nanoparticles is thought to augment wound healing because of their antibacterial characteristics and capacity to stimulate cellular regeneration, especially in instances of minor burn injuries. On the other hand, it has been shown that tissue regeneration is aided by low-power laser therapy via photobiomodulation. Zinc oxide nanoparticles and low-power laser therapy are the two therapeutic modalities that will be compared in this study in order to assess how well they promote healing after burn injury and provide important new information on improved wound care techniques. Methods: For this investigation, thirty male Wistar rats weighing 230 ± 25 grams each were split into three groups. Every rat received general anesthesia before the experiment. A stainless-steel rod was put to the rats’ skin after being heated for 20 min in a boiling water bath to cause superficial second-degree burns. The control group functioned as a reference point for comparison and did not receive any treatment intervention. Over the course of a week, zinc oxide nanoparticles were applied topically to the second group. For one week, the third group received daily therapy with a diode laser at a dosage of 10 J/cm. 1 Histological and clinical exams were performed after the therapy period to evaluate the impact of the therapies. Results: The experimental groups that received low-power laser therapy (third group) and zinc oxide nanoparticles (second group) showed a substantial increase in wound contraction in relation to the control group, based on macroscopic observations. One rat from the second group showed notable indications of full wound healing on day 21. The treated rats showed the highest rate of lesion contraction, indicating that wound treatment happened at least 7 days faster in these rats than in the other groups. After 21 days, the third group's epidermis fully epithelized and formed a layer of keratinization. Furthermore, there was enhanced angiogenesis and significant fibroblast proliferation; large-scale fibrosis was also commonly seen. Conclusion: Zinc oxide nanoparticles promoted wound healing and accelerated connective tissue regeneration faster than other groups when applied to second-degree superficial burns. This research implies that the use of zinc oxide nanoparticles may be a therapeutic approach that shows promise for treating burn injuries and improving patient outcomes.
Debunking the Myth: The Null Effect of Antiseizure Medications on the Functional Outcomes of Acute Symptomatic Seizures
Authors: Feyissa Anteneh M.
Published: January 2025

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Effects of blood pressure lowering in patients treated with intravenous thrombolysis before endovascular thrombectomy
Authors: Yun Jaeseob , Kim Kwang Hyun , Jung Jae Wook , Kim Young Dae , Heo JoonNyung , Lee Hyungwoo , Choi Jin Kyo , Lim In Hwan , Hong Soon-Ho , Kim Byung Moon , Kim Dong Joon , Shin Na Young , Cho Bang-Hoon , Ahn Seong Hwan , Park Hyungjong , Sohn Sung-Il , Hong Jeong-Ho , Song Tae-Jin , Chang Yoonkyung , Kim Gyu Sik , Seo Kwon-Duk , Lee Kijeong , Chang Jun Young , Seo Jung Hwa , Lee Sukyoon , Baek Jang-Hyun , Cho Han-Jin , Shin Dong Hoon , Kim Jinkwon , Yoo Joonsang , Baik Minyoul , Lee Kyung-Yul , Jung Yo Han , Hwang Yang-Ha , Kim Chi Kyung , Kim Jae Guk , Lee Chan Joo , Park Sungha , Jeon Soyoung , Lee Hye Sun , Kwon Sun U , Lee Il Hyung , Bang Oh Young , Heo Ji Hoe , Nam Hyo Suk
Published: January 2025

Background:

The effects of blood pressure (BP) lowering in patients treated with intravenous tissue plasminogen activator (IV tPA) before endovascular thrombectomy (EVT) are unclear.

Aims:

This study aims to investigate whether intensive and conventional BP management affects outcomes differently, depending on IV tPA administration before EVT.

Methods:

In this subgroup analysis of the Outcome in Patients Treated with Intra-Arterial Thrombectomy–Optimal Blood Pressure Control (OPTIMAL-BP; ClinicalTrials.gov Identifier: NCT04205305) trial, patients were divided into groups based on IV tPA use before EVT. Clinical outcomes of intensive (systolic BP target < 140 mm Hg) or conventional BP management (systolic BP target 140–180 mm Hg) were compared among groups. The primary efficacy outcome was a favorable outcome at 3 months (modified Rankin Scale score of 0–2). Primary safety outcomes included symptomatic intracerebral hemorrhage (sICH) within 36 h and stroke-related death within 3 months.

Results:

Among the 302 patients, the IV tPA group included 98 (32.5%) and the non-IV tPA group comprised 204 subjects (67.5%). In the IV tPA group, intensive BP management significantly lowered the favorable outcome rate (intensive, 27.3% vs. conventional, 51.9%; adjusted odds ratio [aOR], 0.36; 95% confidence interval [CI], 0.13–0.93; p = 0.04). In the non-IV tPA group, the risk difference rate of favorable outcome was not significantly different between intensive and conventional BP management (44.1% vs. 55.9%; aOR, 0.62; 95% CI, 0.31–1.22; p = 0.17). Notably, the proportion of malignant cerebral edema within 36 h in the IV tPA group was significantly higher in the intensive management group (18.2%) than in the conventional management group (1.9%; aOR, 10.72; 95% CI, 1.24–92.29; p = 0.03). sICH and mortality rates were not significantly different between intensive and conventional BP management in either study groups.

Conclusions:

Intensive BP management worsens 3-month functional outcomes after successful EVT without reducing sICH among patients who received IV tPA before EVT, indicating that BP lowering in this population should be cautious.
Individual Differences in the Recognition of Spectrally Degraded Speech: Associations With Neurocognitive Functions in Adult Cochlear Implant Users and With Noise-Vocoded Simulations
Authors: Moberly Aaron C. , Du Liping , Tamati Terrin N.
Published: January 2025

When listening to speech under adverse conditions, listeners compensate using neurocognitive resources. A clinically relevant form of adverse listening is listening through a cochlear implant (CI), which provides a spectrally degraded signal. CI listening is often simulated through noise-vocoding. This study investigated the neurocognitive mechanisms supporting recognition of spectrally degraded speech in adult CI users and normal-hearing (NH) peers listening to noise-vocoded speech, with the hypothesis that an overlapping set of neurocognitive functions would contribute to speech recognition in both groups. Ninety-seven adults with either a CI (54 CI individuals, mean age 66.6 years, range 45–87 years) or age-normal hearing (43 NH individuals, mean age 66.8 years, range 50–81 years) participated. Listeners heard materials varying in linguistic complexity consisting of isolated words, meaningful sentences, anomalous sentences, high-variability sentences, and audiovisually (AV) presented sentences. Participants were also tested for vocabulary knowledge, nonverbal reasoning, working memory capacity, inhibition-concentration, and speed of lexical and phonological access. Linear regression analyses with robust standard errors were performed for speech recognition tasks on neurocognitive functions. Nonverbal reasoning contributed to meaningful sentence recognition in NH peers and anomalous sentence recognition in CI users. Speed of lexical access contributed to performance on most speech tasks for CI users but not for NH peers. Finally, inhibition-concentration and vocabulary knowledge contributed to AV sentence recognition in NH listeners alone. Findings suggest that the complexity of speech materials may determine the particular contributions of neurocognitive skills, and that NH processing of noise-vocoded speech may not represent how CI listeners process speech.
Identifying viable financing mechanisms for post-earthquake housing reconstruction in Canada: Case study of a M7 earthquake in British Columbia
Authors: Costa Rodrigo
Published: January 2025

Recent efforts by the Federal Government of Canada have devoted resources to mitigating disaster risk and identifying sustainable solutions for post-disaster housing reconstruction financing. In 2023, Canada committed funding to set up its National Flood Insurance Program. In parallel, the Department of Finance and Public Safety Canada plans industry engagement on solutions to earthquake insurance. In anticipation of the need to rethink post-earthquake housing reconstruction financing for single-family homes, the present study evaluates the feasibility of implementing three novel financing mechanisms in Canada, drawing inspiration from existing US and New Zealand programs. The proposed mechanisms include a grants program targeting low-to-moderate-income households, a low-interest loan program, and an affordable insurance program. Simulations of the impacts of M7 earthquake in the Strait of Georgia, British Columbia, are used to compare the post-earthquake uninsured losses in the status quo and if each new mechanism was in place before the event. Benefits are assessed through the reduction in uninsured losses, while opportunity losses measure the costs of each program. Results indicate that a loan program with an interest rate above 3.5% could offer benefits surpassing its opportunity cost, albeit with substantial initial expenses. In addition, introducing an affordable insurance program and a disaster fund shows promise but requires robust capitalization in its initial years. A combination of affordable insurance and low-interest loans could alleviate long-term debt for homeowners, particularly for earthquakes causing moderate losses.
Metabolic pathways of eicosanoids—derivatives of arachidonic acid and their significance in skin
Authors: Biernacki Michał , Skrzydlewska Elżbieta
Published: January 2025

The skin is a barrier that protects the human body against environmental factors (physical, including solar radiation, chemicals, and pathogens). The integrity and, consequently, the effective metabolic activity of skin cells is ensured by the cell membrane, the important structural and metabolic elements of which are phospholipids. Phospholipids are subject to continuous transformation, including enzymatic hydrolysis (with the participation of phospholipases A, C, and D) to free polyunsaturated fatty acids (PUFAs), which under the influence of cyclooxygenases (COX1/2), lipoxygenases (LOXs), and cytochrome P450 (CYPs P450) are metabolized to various classes of oxylipins, depending on the type of PUFA being metabolized and the enzyme acting. The most frequently analyzed oxylipins, especially in skin cells, are eicosanoids, which are derivatives of arachidonic acid (AA). Their level depends on both environmental factors and endogenous metabolic disorders. However, they play an important role in homeostasis mechanisms related to the structural and functional integrity of the skin, including maintaining redox balance, as well as regulating inflammatory processes arising in response to endogenous and exogenous factors reaching skin cells. Therefore, it is believed that dysregulation of eicosanoid levels may contribute to the development of skin diseases, such as psoriasis or atopic dermatitis, which in turn suggests that targeted control of the generation of specific eicosanoids may have diagnostic significance and beneficial therapeutic effects. This review is the first systemic and very detailed approach presenting both the causes and consequences of changes in phospholipid metabolism leading to the generation of eicosanoids, changes in the level of which result in specific metabolic disorders in skin cells leading to the development of various diseases. At the same time, existing literature data indicate that further detailed research is necessary to understand a clear relationship between changes in the level of specific eicosanoids and the pathomechanisms of specific skin diseases, as well as to develop an effective diagnostic and therapeutic approach.
Childhood cancer and parental mental health: role of disease severity, socioeconomic status, and social dynamics
Authors: Ibrahim Hawkar , Ismail Azad Ali , Rahim Narin Ahmed , Iffland Benjamin , Neuner Frank
Published: January 2025

Background

The impact of childhood cancer extends beyond the affected child, significantly influencing the mental health of their families. Since research in psycho-oncology has been carried out almost exclusively in high-income countries, little is known about the impact of childhood cancer on the family level in low- and middle income countries (LMICs). This is a notable gap in the evidence-base, as many LMICs are collectivist cultures, where social and family networks are crucial elements of health care.

Methods

This prospective, cross-sectional study examined the mental health of 307 Kurdish parents of children undergoing cancer treatment in the Kurdistan Region of Iraq (KRI). Data were collected through structured interviews at two major oncology hospitals in the KRI, utilizing standardized instruments to assess mental health symptoms, socioeconomic status, and social constraints. The study focused on understanding the effects of socioeconomic challenges, disease severity, and social support limitations on parental mental health.

Results

Significant mental health challenges were observed among parents, with mothers experiencing higher symptom levels than fathers. Lower socioeconomic status was linked to poorer parental mental health. Additionally, parents of children with more severe cancer and those reporting their child’s reduced engagement in daily activities experienced heightened mental health symptoms. Social constraints on expressing feelings about the child’s illness further intensified parental stress, underscoring the cumulative impact of economic strain, disease severity, and limited social support on parental mental health.

Conclusions

The study highlights the intricate relationship between socioeconomic factors, the disease severity of the child, and social dynamics in shaping parental mental health in the context of pediatric cancer. Psychosocial interventions that target these specific stressors may aid in better supporting families, particularly those in low-resource settings.
Potentially probiotic NPL 1334 strain of Enterococcus durans benefits rats with diet-induced hypercholesterolemia
Authors: Rashid Hannan , Anwar Haseeb , Baig Fakhir Mehmood , Mukhtar Imran , Muhammad Tariq , Zaidi Arsalan
Published: January 2025

Purpose

To study the potential of a candidate probiotic strain belonging to the Enterococcus durans species in alleviating hypercholesterolemia and improving the microbial milieu of rat gut.

Methods

A previously isolated and characterized E. durans strain NPL 1334 was further screened in vitro for its bile salt hydrolyzation and cholesterol assimilation ability. An in vivo trial using diet-induced hypercholesterolemic rats was conducted to evaluate the effects of the administered test probiotic strain on the animal’s blood biochemical parameters such as total cholesterol (TC), high-density lipopolysaccharides (HDL), low-density lipopolysaccharides (LDL), triglycerides (TG), on body weight, oxidative stress markers, and its impact on intestinal and fecal microbiota as well as a histopathological examination of the test animal’s livers.

Results

E. durans strain showed good bile salt hydrolyzing ability and ample cholesterol assimilation in vitro. Probiotic-fed hypercholesterolemic rats showed significantly lowered cholesterol, triglyceride and LDL levels. The body weight of probiotic-fed rats was reduced as compared to the control. E. durans also stimulated the growth of beneficial LAB in the intestine of experimental rats and did not harm the liver of the experimental rats.

Conclusion

E. durans can be a natural therapeutic alternative to manage diet-induced hypercholesterolemia and may eventually enhance anti-cholesterolemic therapies.
Peri-implant soft tissue conditioning of immediate posterior implants by CAD-CAM socket sealing abutments: a randomized clinical trial
Authors: Elgendi Mai Mohamed , Hamdy Iman Salah Eldin , Sallam Hanaa Ibraheem
Published: January 2025

Background

Anatomically formed healing abutments were suggested in literature to address many of the issues associated with immediate posterior implant insertion such as large extraction sockets that are extremely hard to seal without reflecting the mucoperiosteal flap, extraction sockets anatomy that are not suitable for regular healing abutment placement, and potentially high occlusal stresses when planning a temporary implant supported prothesis to improve the conditioning of supra implant tissue architecture and the emergence profile of the implant supported restorations.

Purpose

To clinically evaluate the peri-implant soft tissue profile of single posterior implant retained restorations and to assess patient related outcomes of the implant restorations that were conditioned immediately by CAD-CAM socket sealing abutments (SSA) versus those conditioned by Titanium (Ti) standard healing abutments (SHA).

Methods

Twenty participants received twenty-two single maxillary immediate implants after flapless minimally invasive tooth extraction and 3D guided implant placement in the posterior area (premolar and molar) and allocated randomly into two groups (n = 11), the intervention group: patients received PEEK SSA and the control group: the patients received Ti SHA. Modified Pink Esthetic Score (PES) was evaluated at 3 observation periods: Baseline T0 (immediate after implant supported crown insertion), 6 months T1 and 1 year of clinical performance T2. Patient satisfaction was assessed one week and one year after crown insertion using visual analogue scale (VAS).

Results

At base line, after six as well as 12 months, SSA group showed statistically significant higher total modified PES scores than SHA group (P-value < 0.001). At the 2 clinical observation periods (baseline and after one year), SSA group showed statistically significantly higher overall satisfaction score than SHA group (P-value < 0.001).

Conclusion

After one year of clinical observation period, CAD-CAM PEEK socket sealing abutments together with flapless minimally invasive tooth extraction and 3D guided implant placement provided superior outcomes compared to Ti SHA in terms of peri-implant soft tissue profile.

Trial registration

This study was registered on clinicaltrials.gov with ID no. NCT05276765 on 03/03/2022.
Retention of CAD-CAM locator retentive attachment insert in mandibular implant overdenture
Authors: Diab Mai Hassan , Abdelaziz Medhat Sameh , Kamal Eldin Mohamed Hatem
Published: January 2025

Background

The continuous development in digital prosthodontics allowed the customization of attachments and retentive inserts which offers an easy and cheap solution for regular maintenance of locator overdentures during daily practice. The present study compared the change in retention values of the fully digitally manufactured custom-made locator attachment retentive insert with the ready-made ones after insertion, removal, and masticatory cycles.

Methods

A complete denture was constructed over a mandibular edentulous epoxy model. Two implants were inserted into the model between the laterals and canines following the prosthetically driven implant protocol. Locator retentive attachment inserts were digitally designed using free-form modeling software and milled from PEEK (Poly Ether Ether Ketone). After the pick-up of the ready- and custom-made retentive inserts, an insertion, removal, and masticatory cycles test simulating 1 year of patient usage was performed. The change in retention values was recorded at baseline, 6 months, and after one year of simulated clinical use. An independent sample t-test was used to compare the data between the two studied groups.

Results

There were statistically significant differences in retention values between the custom-made and ready-made locator inserts at baseline and after 6 months. (p = 0.001*). On the other hand, there was no significant difference in retention after 1 year of simulated use. (p = 0.083, NS)

Conclusions

The custom-made milled locator retentive attachment insert can be used as an alternative to the ready-made one due to their comparable retention values after 1 year of simulated use.
Therapeutic potential of boric acid as a local drug delivery agent in periodontitis: a comprehensive systematic review and meta-analysis
Authors: Abdel-Fatah Reham , Elhusseiny Ghada A. , Saleh Wafaa
Published: January 2025

Objective

This systematic review and meta-analysis aim to evaluate the therapeutic potential of boric acid as a local drug delivery agent in the treatment of periodontitis.

Methods

Following PRISMA guidelines, we registered a comprehensive protocol with PROSPERO. By employing PICOS criteria, we evaluated randomized controlled trials assessing the effects of subgingival boric acid application alongside non-surgical periodontal therapy in treatment of periodontitis. Studies were systematically searched across multiple databases, with establishment of the eligibility criteria. Data extraction and risk of bias assessment were conducted independently by reviewers.

Results

Among 1,640 records screened, 6 studies met the inclusion criteria, comprising 281 participants aged 18–65 years. At 1-month, boric acid demonstrated significant improvements in probing pocket depth (PPD), but insignificant differences were observed in clinical attachment level (CAL), and gingival index (GI). However, at 3 and 6 months, we found significant reductions in PPD while at 6 months, a significant increase in CAL gain were observed favoring boric acid. No significant changes in GI were noted at any follow-up duration.

Conclusion

Boric acid adjunctive therapy in non-surgical periodontal treatment shows promising efficacy in improving clinical parameters, particularly PPD and CAL, over time. While early outcomes may not show significance, sustained benefits are evident at longer follow-up periods. These findings underscore the potential of boric acid as a valuable addition to periodontal therapy, demanding further investigation to reveal its precise mechanisms and optimize clinical application.
Caregiver alignment with triage acuity levels and drivers for discrepancy between caregiver assessment and triage acuity levels: a cross-sectional questionnaire based study
Authors: Lengeler Noelie , Starvaggi Carl Alessandro , Jaboyedoff Manon , Affentranger Sophie , Keitel Kristina
Published: January 2025

Background

Caregiver concern is the main driver to paediatric emergency departments visits. Understanding caregiver worries is crucial to guide patients to the most appropriate healthcare setting. Previous research shows mixed findings on the accordance between caregiver assessment and professional triage.

Methods

We assessed data from two questionnaire-based studies conducted over 27 months in two tertiary paediatric emergency departments in Switzerland to compare caregiver perception of their child’s medical acuity and standard nurse triage. Furthermore, we examined socioeconomic factors associated with caregiver perception.

Results

Our study of 2,126 children seen in the two paediatric emergency departments showed that caregiver assessment aligned well with the acuity assigned by professional triage in 89% (1,901/2,126) of cases. In 142 cases (7%, 142/2,126), caregivers rating their child’s severity higher than nurse’s triage while in 83 cases (4%, 83/2,126), they rated it lower. In an univariable analysis, we found that family’s difficulties paying bills (20% vs. 12%) and low maternal education (19% vs. 10%) were associated with a higher percentage of caregiver rating their child’s severity higher than nurse’s triage. Fever as the main complaint was associated with caregiver rating their child’s severity lower than nurse’s triage.

Conclusions

This questionnaire-based study shows that caregiver’s assessment of the severity of the child and nurse triage are concordant in most situations. Our study sheds light on the association between caregiver assessment and professional triage in two paediatric emergency departments in Switzerland, revealing some of the factors leading to discordance. These factors most probably reflect health illiteracy. It is important that healthcare professionals recognize and address factors influencing caregiver assessments to facilitate accurate decision-making and enhanced paediatric emergency care outcomes.
Mobile health clinics in a rural setting: a cost analysis and time motion study of La Clínica in Oregon, United States
Authors: Higgins Abigail , Tilghman Middy , Lin Tracy Kuo
Published: January 2025

Background

Mobile Health Clinics (MHCs) are an alternate form of healthcare delivery that may ameliorate current rural–urban health disparities in chronic diseases and have downstream impacts on the health system by reducing costs. Evaluations of providers’ time allocation on MHCs are scarce, hindering knowledge transfer related to MHC implementation strategies.

Methods

Retrospective economic cost was assessed using business ledgers and expert assessments in 2023 US Dollar (USD) from 2022 to 2023. Time motion observational study assessed nurse practitioner (NP) and community health worker (CHW) time allocation and compared them between patients residing in isolated rural areas (hereafter isolated rural patients) and patients experiencing houselessness (PEH) sub-populations. Procedure codes were assessed retrospectively for each patient encounter (n = 1,981) over one year (April 2022 to April 2023). We used statistical significance tests (chi-square and Fisher’s Exact) to evaluate difference across sub-populations.

Results

Intervention start-up and operational costs totaled 275,000USD and 308,000USD, respectively, with the largest allocations to the modified recreational vehicle (RV) unit and labor. NP attributed 32% of time on direct care (mean = 153.00 min (SD = 37.80 min)), 38% on indirect care (186.0 (53.40)), and 21% on MHC tasks (104.00 (23.94)). CHW spent 47% of time on MHC tasks (182.00 (29.46)), 22% on medical care tasks (85.01 (SD 81.97)), and 22% on social needs tasks (87.70 (86.71 min)). NP time allocation did not differ significantly between isolated rural patients and PEH (p > 0.01), but CHW time did (p < 0.01). Of all procedures, 31.3% were vaccinations (N = 438), 27.0% were Covid-19 related (N = 377), 12.8% were outside referrals (N = 179), and 11.8% were point of care testing. Healthcare utilization varied between patient sub-populations, with Isolated Rural patient use dominated by Covid-19 and Influenza vaccines whereas PEH use was dominated by point of care testing (p < 0.01).

Conclusion

Patient sub-populations require varying provider time in different tasks and variable economic resources for interventions. As local policy makers balance resources and community health needs, a complete understanding of the resources required to operate an MHC and use of provider time is essential for informed decision making and successful implementation in underserved communities.
Knowledge, attitudes, and beliefs regarding acute coronary syndrome in patients with type 2 diabetes: a cross-sectional study
Authors: Amerzadeh Mohammad , Bahrami Mahdie , Senmar Mojtaba , Hosseinkhani Zahra , Shafiei Kisomi Zahra
Published: January 2025

Introduction

Cardiovascular diseases are one of the leading causes of mortality and disability among individuals with diabetes. Cardiac mortality in these patients is often associated with the prevalence of silent ischemia. Increasing awareness and changing patient behaviors and attitudes can reduce disease-related mortality. Therefore, this study aimed to determine the knowledge, attitudes, and beliefs regarding acute coronary syndrome in patients with type 2 diabetes mellitus (T2DM).

Methods

This cross-sectional study was conducted on 303 diabetic patients attending the Velayat and Bou Ali hospitals in Qazvin, Iran, in 2024. Inclusion criteria included a willingness to participate in the study, mental health status (based on existing records), and no history of myocardial infarction (MI). Data collection tools comprised a demographic questionnaire and the ACS Response questionnaire. Data analysis was performed using descriptive and analytical statistics, with a significance level of <0.05 for all tests.

Results

The mean (standard deviation) scores for knowledge, attitudes, and performance of patients with T2DM were 67.46 (6.3), 62.11 (28.2), and 97.22 (5.4), respectively. In the knowledge section, the highest percentage of correct responses was related to awareness of facilities in the hospital to reduce heart attack-related damages (62.3%) and familiarity with the symptoms of arm or hand numbness (43.41%). Patients had a low attitude towards heart disease, with approximately 36.4% being somewhat or completely confident in their ability to assist others with a heart attack. Regarding performance, 45.7% of individuals believed that they should promptly go to the hospital during a heart attack. Additionally, 44.2% preferred others to transport them to the hospital during a heart attack instead of using an ambulance.

Conclusion

Our findings indicate that patients with T2DM lack sufficient knowledge, attitudes, and beliefs regarding the symptoms of acute coronary syndrome (ACS). Although ACS manifests through various symptoms, patients in this study primarily identified chest pain, arm pain, and shortness of breath as indicators of ACS. At the same time, over half of the participants were unaware of other symptoms. Therefore, it is essential to educate individuals about the full range of potential ACS symptoms.
The perception of fairness in the division of labor around first childbirth in Germany
Authors: Hornung Maria , Comolli Chiara Ludovica
Published: January 2025

The transition to parenthood is a pivotal life course event that impacts well-being, relationship quality and the distribution of housework and paid work. In Germany, during the transition to first-time parenthood, women often reduce their involvement in paid work and take on a larger share of housework, leading to a more gendered division of labor. This shift could influence perceptions of fairness in the division of labor inducing both men and women to perceive the division as being more fair to themselves or more fair to their partner. Using data from the German Panel Analysis of Intimate Relationships and Family Dynamics (pairfam) and fixed effects models, we examine how women’s and men’s perception of fairness of the division of labor varies around first childbirth conceptualizing different phases spanning from 5 years before until 5 years after the first childbirth. Relative to baseline, mothers (-to-be) reported a fairer division of labor (less under-benefitting) from around conception to right after childbirth. Yet, already from 6 months after childbirth mothers’ perception of fairness becomes less fair to them again and the perception of under-benefitting continues as the child ages. For fathers-to-be, perceptions of fairness did not vary substantially around childbirth. We further found that neither the change in the division of housework, nor in the division of paid work, explained changes in fairness perceptions during the transition to parenthood.
Broadband negative refraction based on a pair of anti-parity-time structures
Authors: Fei Zhonghan , Gong Menyang , Shi Fan , Liu Xiaozhou
Published: January 2025

An anti-parity-time (A-PT) symmetric system, of which the refractive index satisfies

, can present intriguing scattering properties like continuous coherent perfect absorption (CPA) spectrum and laser spectrum, which are symmetric to each other in the parameter space. In this work, an acoustic parity-time (PT) symmetric system consisting of two A-PT symmetric structures is introduced to realize a broadband negative refraction. When the two A-PT symmetric structures are at their CPA mode and laser mode, respectively, the PT symmetric system can display its unidirectional negative refraction property. As the two A-PT structures we design here have a broadband CPA and laser modes, the PT symmetric negative refraction system will be broadband. Besides, the exceptional point (EP) of the proposed PT symmetric system corresponds to the CPA point and laser point of its two components, and it is unidirectionally transparent on broadband as well.
Decreasing miR-433-3p Activity in the Osteoblast Lineage Blunts Glucocorticoid-mediated Bone Loss
Authors: Thakore Prachi , Karki Sangita , Hrdlicka Henry C , Garcia-Munoz John , Pereira Renata C , Delany Anne M
Published: January 2025

Glucocorticoid excess causes bone loss due to decreased bone formation and increased bone resorption; miR-433-3p is a microRNA (miRNA) that negatively regulates bone formation in male mice by targeting Runx2 as well as RNAs involved in Wnt, protein kinase A, and endogenous glucocorticoid signaling. To examine the impact of miR-433-3p on glucocorticoid-mediated bone loss, transgenic mice expressing a miR-433-3p tough decoy inhibitor in the osteoblast lineage were administered prednisolone via slow-release pellets. Bone loss was greater in control mice treated with prednisolone compared with miR-433-3p tough decoy mice due to higher osteoclast activity in the controls. In whole femurs, Rankl was significantly higher in prednisolone-treated controls compared with miR-433-3p tough decoy mice. Surprisingly, negative regulators of Wnt signaling Sost and Dkk1 were higher in miR-433-3p tough decoy mice and were unaffected by prednisolone. Luciferase- 3′-untranslated region reporter assays demonstrated that Sost is a novel miR-433-3p target, whereas Dkk1 is a previously validated miR-433-3p target. miR-433-3p levels are lower in matrix-synthesizing osteoblasts than in more osteocytic cells; thus the impact of miR-433-3p on the osteoblast lineage may be dependent on cell context: it is a negative regulator in matrix-depositing osteoblasts by targeting RNAs important for differentiation and function but a positive regulator in osteocytes, due to its ability to target prominently expressed negative regulators of Wnt signaling, Sost and Dkk1. The mechanisms by which miR-433-3p indirectly regulates glucocorticoid-mediated osteoclastogenesis remain unknown. However, we speculate that this regulation may be mediated by miR-433-3p activity in osteocytes, which play an important role in controlling osteoclastogenesis.
A New Leydig Cell–Exclusive Cre Line Allows Lineage Tracing of Fetal and Adult Leydig Cell Populations in the Mouse
Authors: Robert Nicholas M , Ferrier-Tarin Shirley , Tremblay Jacques J
Published: January 2025

Leydig cells produce hormones that are required for male development, fertility, and health. Two Leydig cell populations produce these hormones but at different times during development: fetal Leydig cells, which are active during fetal life, and adult Leydig cells, which are functional postnatally. Historically, our ability to understand the origin and function of Leydig cells has been made difficult by the lack of genetic models to exclusively target these cells. Taking advantage of the Leydig cell–exclusive expression pattern of the Insl3 gene, we used a CRISPR/Cas9 gene-editing strategy to knock-in iCre recombinase into the mouse Insl3 locus. To demonstrate the Leydig cell–exclusive nature of our iCre line, lineage-tracing experiments were performed by crossing Insl3iCre mice with a Rosa26LoxSTOPLox-TdTomato reporter. iCre activity was restricted to male offspring. TdTomato fluorescence was detected both in fetal and adult Leydig cells and colocalized with CYP17A1, a classic Leydig cell marker. Prior to birth, fluorescence was observed in fetal Leydig cells beginning at embryonic day 13.0. Fluorescence was also detected in adult Leydig cells starting at postnatal day 5 and continuing to the mature testis. Fluorescence was not detected in any other fetal or adult tissue examined, except for the unexpected finding that the adrenal cortex contains some Insl3-expressing Leydig-like cells. Our Leydig cell–exclusive iCre line therefore constitutes an invaluable new tool to study not only the origin of Leydig cells but also to target genes that have been long-proposed to be important for the development and functioning of these critical endocrine cells.
FLCN Variants in Parathyroid Carcinoma and Atypical Parathyroid Tumors
Authors: Burke Callie Shea , Bellizzi Justin , Costa-Guda Jessica , Arnold Andrew
Published: January 2025

Parathyroid carcinoma (PC) and atypical parathyroid tumors (APT) are incompletely understood and pose challenges in definitive diagnosis. FLCN sequence variants have recently been linked to PC and APT. Inactivating mutations in the ubiquitously expressed FLCN tumor suppressor gene, encoding folliculin, cause Birt-Hogg-Dubé syndrome (BHD), a rare tumor predisposition syndrome. Germline inactivating FLCN variants, accompanied by somatic allelic loss, were reported in 2 unrelated patents with PC, both with clinical features, but no diagnosis, of BHD. Somatic frameshift variants of likely pathogenicity were reported in 1 patient with PC and 1 with APT. On the other hand, neither PC nor APT has been reported in sizeable BHD series. To better understand the frequency of FLCN variants in PC and APT, we analyzed a series of 10 patients with sporadic PC and 14 with APT by direct Sanger DNA sequencing. We identified no inactivating FLCN mutations in any of the PC or APT samples examined. A germline missense variant (p.Gly325Val), predicted as benign/tolerated, was seen in 1 PC and a synonymous variant in 1 APT. The absence of pathogenic mutations detected in our series of PC and APT further suggests that FLCN variants are rare in these tumors. Nevertheless, the potential roles of FLCN in the pathogenesis of PC and APT merits further consideration and study.