bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a nomogram to predict negative postoperative behavioral changes based on a prospective cohort
Authors: Li Lijing , Zhang Jianmin , Li Jiayi , Ren Yi , Gao Zhengzheng , Gao Jia , Zhang Fuzhou , Wang Fang , Zheng Tiehua
Published: August 2023

Background

It is believed that negative postoperative behavioral changes (NPOBC) is associated with negative perioperative outcomes in children. The importance of development of a predictive model of NPOBC was noted. This study aims to identify potential risk factors develop a nomogram to predict NPOBC on postoperative day 3 based on a prospective cohort.

Methods

A prospective observational study was conducted on children(American Society of Anesthesiologists I ~ III) aged 2 ~ 12 years who underwent selective surgery under general anesthesia between September 2022 and February 2023. The patient’s clinical data were analyzed. The method of measuring NPOBC is with the The Posthospital Behaviour Questionnaire (PHBQ), and all of children remained hospitalized at the time of assessment. The enrolled patients were categorized into the NPOBC group and the non-NPOBC group according to if children developed NPOBC on postoperative day 3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors and develop the nomogram to predict NPOBC. Internal validation was performed using the parametric bootstrapping method.

Results

One hundred ninety-two patients were enrolled in the study, 44.8% (86/192 patients) of children developed NPOBC on postoperative day 3. Univariate and multivariate logistic regression analysis demonstrated that the Pediatric Anesthesia Behavior (PAB) score (OR: 1.23, 95%CI: 1.14–1.33), cerebral desaturation (OR: 1.16, 95%CI: 1.02–1.32), and postoperative pain score (OR: 1.07, 95%CI: 1.02–1.13) were independent predictors for NPOBC on postoperative day 3 (P < 0.05). They were used to develop the prediction model. The calibration curve demonstrated satisfied discrimination and calibration of the prediction model. The model presented with good discriminative ability (area under the receiver operating characteristic curve: 0.762 [95%CI: 0.691—0.833]). The decision curve analysis also revealed the great clinical utility of the nomogram.

Conclusion

Based on our prospective observational study, pre-anesthesia patients with higher PAB scores, presence of cerebral desaturation, and higher postoperative pain score were more likely to develop NPOBC on postoperative day 3. We established and validated a nomogram for predicting NPOBC, which could help assess patients individually, identify high-risk groups of NPOBC and improve patient prognosis.

Trial registration

Chinese Clinical Trial Registry, ChiCTR‐2,200,059,776. Registered 11 May 2022.
Comment on “Ultrasonographic scores for ileal Crohn’s disease assessment: better, worse or the same as contrast‑enhanced ultrasound?”
Authors: Nylund Kim , Novak Kerri , Wilkens Rune
Published: August 2023

We read with interest the study by Freitas et al. comparing contrast-enhanced ultrasound (CEUS) and parameters from a time-intensity curve (TIC) with the SUS-CD score and IBUS-SAS score in patients with Crohn’s disease (CD) undergoing gastrointestinal ultrasound (GIUS) and ileocolonoscopy. The aim was to compare the accuracy of CEUS and aforementioned scores in predicting terminal ileal inflammatory activity in patients with CD. In this retrospective study of 50 patients, inflammatory activity was defined as a segmental score of SES-CD ≥ 7 in the terminal ileum. The study found 30 patients with active endoscopic disease demonstrating no significant difference between the “inactive” and “active” SUS CD and IBUS-SAS scores. However, the CEUS peak enhancement derived from the TIC was shown to be significantly different. The authors conclude CEUS was superior for detecting inflammation in the terminal ileum, as opposed to ultrasound scores relying on bowel wall thickness and color Doppler.
Reply to comment on “Ultrasonographic scores for ileal Crohn’s disease assessment: better, worse or the same as contrast‑enhanced ultrasound?
Authors: Freitas Marta , de Castro Francisca Dias , Silva Vítor Macedo , Arieira Cátia , Gonçalves Tiago Cúrdia , Leite Sílvia , Moreira Maria João , Cotter José
Published: August 2023

We read the comments by Nylund K et al. regarding our paper “Ultrasonographic scores for ileal Crohn’s disease assessment: Better, worse or the same as contrast‑enhanced ultrasound?”. Intestinal ultrasound has become one of the most valuable developments in the past decade, a non-invasive, well-tolerated exam, with an easy repeatability, and absence of sedation, ionizing radiation, or preparation. Particularly for inflammatory bowel disease, where there is a lack of agreement of patient’s symptoms with disease activity, in an era where the paradigm of mucosal healing is changing to transmural healing, and with the emergence of several therapies leading to repeated imaging surveillance, it is essential to highlight the role of intestinal ultrasound. Although intestinal ultrasound is an increasingly used tool to monitor inflammatory bowel disease activity, there is no widely accepted reproducible activity index, since the methodology for the development of the scores was shown to be insufficient in most studies and none have been adequately validated (Bots et al., J Crohns Colitis 12:920–9, 2018). In our study, we showed that the contrast-enhanced ultrasound (CEUS) peak enhancement derived from the time-intensity curve (TIC) is a promising non-invasive emerging method with a good accuracy to correlate clinical and endoscopic activity in the terminal ileum, superior to intestinal ultrasound scores relying on bowel wall thickness and colour Doppler.
Positive associations between sex hormones, bone metabolism and cognitive impairment in Chinese oldest-old females
Authors: Feng Long , Bian Lihua , Ning Chaoxue , Zhang Pei , Zhao Yali , Gao Zhitao , Ping Ping , Fu Shihui
Published: August 2023

Purpose

With a rapid increase in older adults, progressive impairment in cognitive function has become an increasing concern owing to high social and economic burdens. The current study was designed to investigate the associations of sex hormones and bone metabolism with cognitive impairment (CI) in Chinese oldest-old females.

Methods

There were 396 oldest-old females from the China Hainan Oldest-old Cohort Study (CHOCS). Following standardized procedures, Mini Mental State Examination was effectively completed, and sex hormones and bone metabolism were assessed in these females.

Results

The median age of all females was 101 years (range: from 80 to 116). There were 340 females (86%) with CI. Participants with CI had significantly higher levels of age, progesterone, prolactin and estradiol than those without CI (P < 0.05 for all). Total type I collagen N-terminal elongation peptide [hazard ratio (HR): 1.018, 95%CI: 1.001–1.035] and prolactin (HR: 1.065, 95%CI: 1.005–1.129) levels were positively and significantly associated with CI (P < 0.05 for all).

Conclusions

Prolactin and total type I collagen N-terminal elongation peptide had positive associations with CI in Chinese oldest-old females. Thus, a balance in sex hormones and bone metabolism may have significant effects on cognitive function during the aging process.
Is the association between alcohol use and sickness absence modified by socioeconomic position? findings from the Stockholm public health cohort
Authors: Landberg Jonas , Thern Emelie
Published: August 2023

Background

The distribution of sickness absence tends to be socially patterned less is however known about the underlying mechanisms and pathways of the social gradient found in sickness absence. The present study aims to investigate (i) if the risk function between average volume of alcohol consumption and sickness absence is modified by socio-economic position (SEP), and (ii) whether such an effect modification can be attributed to differences in drinking patterns and other risk factors including other lifestyle behaviours, health status, and working conditions.

Methods

The study was based on data from the Stockholm public health cohort 2006, with an analytical sample of 13 855 respondents aged 18–64 years. Self-reported information on occupational class (a measure of SEP), alcohol consumption, other lifestyle behaviour, health and working conditions was collected from the survey. The outcome of long-term (> 14 days) sickness absence between 2006 and 2008 was obtained from national registers. Negative binomial regression was used to estimate the Incidence Rate Ratios (IRR) with 95% confidence intervals (CI).

Results

In the initial analyses, heavy drinking manual workers had a 5-fold increased risk of long-term sickness absence compared to non-manual employees who were moderate drinkers, and approximately 60% of the excess risk among heavy drinking manual workers was attributable to an interaction between alcohol use and SEP. Adjusting for working conditions was associated with the largest attenuation of the risk estimate, compared to other lifestyle behaviors and health. In the fully adjusted model, the IRR was further attenuated for the manual workers and the joint effect of SEP and heavy drinking remained in the final model with an attributable proportion of 49%.

Conclusions

Individuals in Sweden with lower levels of SEP appear to be more vulnerable to alcohol consumption in relation to sickness absence, where differences in working conditions explained a large part but not all of the differential vulnerability.
Detection of cervical high-grade squamous intraepithelial lesions and assessing diagnostic performance of colposcopy among women with oncogenic HPV
Authors: Li Xiaoxiao , Xiang Fenfen , Zhao Yunzhi , Li Qian , Gu Qing , Zhang Xinpei , Chen Zixi , Zhang Mengzhe , Wang Jun , Liu Rongrong , Kang Xiangdong , Wu Rong
Published: August 2023

Background

HPV screening tests may improve cervical cancer risk stratification and better guide decisions about follow-up with colposcopy/biopsy. This study aimed to estimate the risk of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) among women with oncogenic HPV types and evaluate the performance of colposcopy in the diagnosis of histologic CIN2 + at Putuo Hospital, Shanghai, China.

Methods

This cross-sectional survey was conducted from February 2020 to December 2022 among women who were referred to colposcopy. Women with high-risk (HR) HPV-positive, cytology testing and colposcopy-directed biopsy were included.

Results

Univariate and multivariate analysis indicated that high-grade colposcopic impression ((OR, 17.61%, 95%CI: 11.54–26.85%) was associated with the highest risk for detecting CIN2+, followed by HSIL + cytology (OR, 6.90%, 95%CI: 3.56–13.37%) and HPV16/18 positive (OR, 2.91%, 95%CI: 2.12–3.99%). Overall, CIN2 + was detected in 14.6% of 2007 women. HPV16/18 had higher CIN2 + risks than other HR-HPV genotypes (30.1% vs. 10.2%, P<0.001). Among women with low-grade cytology, 24.1% had CIN2+, and the risks for HPV16/18 (58.2%) were higher than for other HR-HPV(16.8%). For those with high-grade cytology, there was no significant difference between HPV groups ( 75.0% vs. 72.9%, P > 0.05). The diagnostic performance of colposcopy in diagnosis of CIN2 + by senior and junior colposcopists was comparable.

Conclusions

The results indicated that referral to colposcopy is recommended in managing women with HR-HPV positive, and colposcopic impressions provide key clues for identification CIN2+.
Acceptance of a digital therapy recommender system for psoriasis
Authors: Graf Lisa , Tesch Falko , Gräßer Felix , Harst Lorenz , Siegels Doreen , Schmitt Jochen , Abraham Susanne
Published: August 2023

Background

About 2% of the German population are affected by psoriasis. A growing number of cost-intensive systemic treatments are available. Surveys have shown high proportions of patients with moderate to severe psoriasis are not adequately treated despite a high disease burden. Digital therapy recommendation systems (TRS) may help implement guideline-based treatment. However, little is known about the acceptance of such clinical decision support systems (CDSSs). Therefore, the aim of the study was to access the acceptance of a prototypical TRS demonstrator.

Methods

Three scenarios (potential test patients with psoriasis but different sociodemographic and clinical characteristics, previous treatments, desire to have children, and multiple comorbidities) were designed in the demonstrator. The TRS demonstrator and test patients were presented to a random sample of 76 dermatologists attending a national dermatology conference in a cross-sectional face-to-face survey with case vignettes. The dermatologist were asked to rate the demonstrator by system usability scale (SUS), whether they would use it for certain patients populations and barriers of usage. Reasons for potential usage of the TRS demonstrator were tested via a Poisson regression with robust standard errors.

Results

Acceptance of the TRS was highest for patients eligible for systemic therapy (82%). 50% of participants accepted the system for patients with additional comorbidities and 43% for patients with special subtypes of psoriasis. Dermatologists in the outpatient sector or with many patients per week were less willing to use the TRS for patients with special psoriasis-subtypes. Dermatologists rated the demonstrator as acceptable with an mean SUS of 76.8. Participants whose SUS was 10 points above average were 27% more likely to use TRS for special psoriasis-subtypes. The main barrier in using the TRS was time demand (47.4%). Participants who perceived time as an obstacle were 22.3% less willing to use TRS with systemic therapy patients. 27.6% of physicians stated that they did not understand exactly how the recommendation was generated by the TRS, with no effect on the preparedness to use the system.

Conclusion

The considerably high acceptance and the preparedness to use the psoriasis CDSS suggests that a TRS appears to be implementable in routine healthcare and may improve clinical care. Main barrier is the additional time demand posed on dermatologists in a busy clinical setting. Therefore, it will be a major challenge to identify a limited set of variables that still allows a valid recommendation with precise prediction of the patient-individual benefits and harms.
Leveraging university-industry partnerships to optimise postgraduate nursing education
Authors: Theobald Karen A. , Fox Robyn , Burridge Christine , Thomson Bernadette , Fox Amanda
Published: August 2023

Background

Industry and higher education sectors devote considerable, but independent resources to deliver postgraduate nursing education. This leads to duplication, uncertainty among students, and critical gaps in nursing education. Establishing and sustaining meaningful partnerships between invested university and industry stakeholders can strengthen workforce capability and improve patient care.

Methods

To evaluate the feasibility and effectiveness of using a University-Industry Integration Framework to develop a postgraduate nursing education program. Prospective mixed methods cohort study (STROBE). A co-design approach, using an established University-Industry Integration Framework, leveraged expert stakeholder partnerships to contextualise knowledge and service need for developing a postgraduate education program for cancer care nurses.

Results

All participants (n = 46) were 100% satisfied with the online resources, support, and communication processes applied. Qualitative data generated three major analytical interpretations (reciprocity, flexible adaptations, authentic learning), highlighting the experiences and connections and how the partnership evolved. Program participants (n = 15) undertook a six-week cancer education program with eight responding to the survey with overwhelming satisfaction (100%), increasing their knowledge and skills. While barriers were evident, three quarters (n = 6) indicated these were addressed and enabled progress in the program. However, 63% (n = 5) were not satisfied with the program workload.

Conclusions

University and industry partners can apply the University-Industry Integration Framework and deliver a successful postgraduate education program for cancer care services. Within a co-design partnership it is possible to develop strategies and processes to overcome barriers and deliver a program for mutual benefit. The culmination of this successful education program has enhanced collaborations between partners and likely will sustain the offering of future co-design endeavours.
Costs and cost-effectiveness of Shamiri, a brief, layperson-delivered intervention for Kenyan adolescents: a randomized controlled trial
Authors: Kacmarek Corinne N. , Johnson Natalie E. , Osborn Tom L. , Wasanga Christine , Weisz John R. , Yates Brian T.
Published: August 2023

Background

Low- and middle-income countries (LMICs) have the highest socio-economic burden of mental health disorders, yet the fewest resources for treatment. Recently, many intervention strategies, including the use of brief, scalable interventions, have emerged as ways of reducing the mental health treatment gap in LMICs. But how do decision makers prioritize and optimize the allocation of limited resources? One approach is through the evaluation of delivery costs alongside intervention effectiveness of various types of interventions. Here, we evaluate the cost-effectiveness of Shamiri, a group– and school–based intervention for adolescent depression and anxiety that is delivered by lay providers and that teaches growth mindset, gratitude, and value affirmation.

Methods

We estimated the cost-effectiveness of Shamiri using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines for economic evaluations. Changes in depression and anxiety were estimated using the Patient Health Questionnaire (PHQ-8) and Generalized Anxiety Disorder questionnaire (GAD-7) at treatment termination and 7-month follow-up using two definitions of treatment benefit. Cost-effectiveness metrics included effectiveness-cost ratios and cost per number needed to treat.

Results

Base case cost assumptions estimated that delivering Shamiri cost $15.17 (in 2021 U.S. dollars) per student. A sensitivity analysis, which varied cost and clinical change definitions, estimated it cost between $48.28 and $172.72 to help 1 student in Shamiri, relative to the control, achieve reliable and clinically significant change in depression and anxiety by 7-month follow-up.

Conclusions

Shamiri appears to be a low-cost intervention that can produce clinically meaningful reductions in depression and anxiety. Lay providers can deliver effective treatment for a fraction of the training time that is required to become a licensed mental health provider (10 days vs. multiple years), which is a strength from an economic perspective. Additionally, Shamiri produced reliable and clinically significant reductions in depression and anxiety after only four weekly sessions instead of the traditional 12–16 weekly sessions necessary for gold-standard cognitive behavioral therapy. The school setting, group format, and economic context of a LMIC influenced the cost per student; however, broader conclusions about the cost-effectiveness of Shamiri have yet to be determined due to limited economic evaluations of mental health programs in LMICs.

Trial registration

This study was registered prior to participant enrollment in the Pan-African Clinical Trials Registry (PACTR201906525818462), registered 20 Jun 2019, https://pactr.samrc.ac.za/Search.aspx.
Comparison of two sedation protocols for long electroretinography in horses using the Koijman electrode
Authors: Ignacio Corradini , del Mar López-Murcia María , Marta Barba , Sina Zebarjadian , Vicent Rodilla , Aloma Mayordomo-Febrer
Published: August 2023

Background

In modern times, horses are utilized not only for labour and transportation purposes but also for recreational activities such as competition and pleasure riding. In these various pursuits, the role of vision plays a crucial role. Electroretinography is the most used test to diagnose diseases of the retinal outer segment. There is a wide variety of devices to perform the electroretinography differing one from each other in the corneal electrode and the light stimulation. The Koijman electrode has been tested in dogs but not in horses. The main purpose of this study was to compare electroretinography parameters from horses sedated with detomidine alone or in combination with butorphanol, during a standardized protocol using the Koijman electrode and RETI-port® system. Seven mares were allocated to the detomidine and detomidine plus butorphanol group in a randomised, controlled, crossover study. Friedman and Willcoxon-signed ranked tests were used to compare the electroretinogram parameters. A Student’s t-test was used to compare differences in the number of artefacts to valid values ratio obtained under both sedation protocols.

Results

Dark adaptation peaked after 16 min under scotopic conditions in both groups. No significant differences in electroretinogram parameters between groups were observed. During the mixed rod and cone response evaluation under scotopic conditions, all mares made a movement of the head resulting in a high number of artefacts. The detomidine plus butorphanol group showed a non-significant tendency to have fewer artefacts and a longer duration of sedation compared to the detomidine group.

Conclusions

Detomidine alone or combined with butorphanol may be suitable to use Koijman electrode and the RETI-port® to perform a standardized long protocol in horses with some adaptations.
Consumer expectations, drug effects, price and purity of heroin and cocaine purchased at drug consumption rooms
Authors: Dahm Georges , Roschel Karin , Marson Claude , Bourmaud Adèle , Macedo Jennifer , Lupo Mauro , Fauchet Lionel , Allar Claudia , Schaaf Raoul , Schneider Serge
Published: August 2023

Background

Drug consumption rooms offer heroin and cocaine consumers a secure and hygienic environment including medical and social guidance. Despite the support and mentoring, only sparse information is available about how drug quality, drug prices and user expectations match at these locations. The present study reports analysis of these three parameters in two drug consumption rooms in Luxembourg.

Methods

Drug users were invited to participate in the project by handing in a few milligrams of the product they planned to consume for chemical analysis and filling out a short questionnaire about the price and their expectations. After consumption, they were asked to report the experienced effects. Drug quality was accessed using LC-Q-ToF and HPLC–UV, and a statistical analysis was carried out of the questionnaires that were correctly filled out.

Results

A total of 513 drug samples have been analyzed. Most consumers were looking for the relaxing/calming effects of heroin and the stimulating effects of cocaine, but they generally overestimated heroin potency and underestimated cocaine potency. No strong correlation based on Spearman’s ρ between drug user estimations, drug prices and drug quality was found.

Conclusion

To the best of our knowledge, this study is the first to combine drug analysis with heroin and cocaine user feedback about expectation, drug prices and drug effects. The analytical results were of great interest for users and the staff working at the drug consumption rooms. They may be a strong supplementary communication tool for health care workers when discussing effects and risks of highly toxic substance consumption.
The high-risk features and effect of postoperative radiotherapy on survival for patients with surgically treated stage IIIA-N2 non-small cell lung cancer
Authors: Zhu Minxia , Li Shaomin , Yuan Liyue , Liu Shiyuan , Li Jianzhong , Zhang Danjie , Chen Jia , Jiang Jiantao , Xu Zhengshui
Published: August 2023

Objectives

Although postoperative radiotherapy (PORT) could reduce the incidence of local recurrence in patients with IIIA-N2 non-small cell lung cancer (NSCLC), the role of PORT on survival in patients with surgically treated stage IIIA-N2 NSCLC remains controversial. Therefore, this study was designed to evaluate the effect of PORT on survival for patients with surgically treated stage IIIA-N2 NSCLC.

Materials and methods

This study population was chosen from the Surveillance, Epidemiology, and End Results database. The Cox proportional hazards regression analysis was used to determine significant contributors to overall survival (OS) and cancer special survival (CSS) outcomes. To balance baseline characteristics between the non-PORT group and PORT group, propensity score matching (PSM) with 1:1 propensity nearest-neighbor match by 0.001 matching tolerance was conducted by R software. Furthermore, a Kaplan–Meier curve was used to visualize the OS and CSS between the PORT group and non-PORT group survival probability.

Results

Of all evaluated cases, 4511 with IIIA-N2 NSCLC were eligible for inclusion, of which 1920 were enrolled into the PORT group. On univariate analysis and multivariate analysis, sex, age, year of diagnosis, race, histologic type, T stage, PORT, use of chemotherapy, and positive regional nodes were significantly associated with OS and CSS in IIIA-N2 NSCLC (P < 0.05). However, PORT was not significantly associated with OS (univariate HR = 0.92, 95%CI 0.85–0.99, P = 0.02; multivariate HR = 1.01, 95%CI 0.93–1.08, P = 0.91) and CSS (univariate HR = 0.92, 95%CI 0.85–1.01, P = 0.06; multivariate HR = 1.103 95%CI 0.94–1.12, P = 0.56) in IIIA-N2 NSCLC. Meanwhile, after PSM, neither OS nor CSS did differ significantly between the non-PORT group and PORT group (OS HR = 1.08, 95%CI 0.98–1.19, P = 0.12; CSS HR = 1.10, 95%CI 0.99–1.23, P = 0.07).

Conclusion

PORT did not contribute to a survival benefit in patients with surgically treated stage IIIA-N2 NSCLC.
Trends in black fly density, parity and infection rates from riverside to villages of the Bafia Health District in Cameroon: implication for onchocerciasis vector control
Authors: Domche André , Nana-Djeunga Hugues C. , Nwane Philippe B. , Njitchouang Guy R. , Dzune-Fossouo Dirane C. , Fesuh Betrand Nono , Njiokou Flobert , Kamgno Joseph
Published: August 2023

Background

Reducing contact between humans and black flies can lead to interruption of onchocerciasis transmission. The Esperanza Window Trap (EWT) has been shown to be an effective tool for reducing black fly densities. Several shape-based improvements to this trapping system have been made to optimise its effectiveness, but optimisation of this trapping system has been based most often on the shape of the trap, collection in areas of high black fly density and the addition of attractants, without considering transmission potentials and parity rates. This study aims to investigate the differences in biting rates and transmission potential between three catch points along a transect to guide the choice of EWT placement.

Methods

Monthly black fly collection was carried out over a 1-year study period using the human landing method at three catch points along a transect from the riverside toward the centre of two first-line villages (Biatsota and Bayomen), in the Mbam valley in Cameroon. All female black flies caught were counted and dissected, and entomological indicators were computed and compared between the catch points and villages.

Results

A total of 80,732 black flies were caught, of which 57,517 were dissected; of the latter, 2743 (4.8%) were parous and 44 (1.6%) were infective. Regarding the distance to the river, a vector density gradient was observed, with the highest annual biting rates being recorded at the riverside. The highest annual transmission potentials were also recorded at the riverside (165 vs 255 infective larvae/man/year in Bayomen and Biatsota, respectively). Overall, the highest parity rates were recorded at the riverside in Biatsota (5.1%) where various human activities are frequent and at the centre of Bayomen village (6.3%).

Conclusion

The results of this study reveal that entomological parameters were the highest at the riverside catch sites and indicate that riverside locations should be prioritised for EWTs or other trapping systems to achieve optimal performance in onchocerciasis control.

Graphical abstract
Transgenic disruption of endogenous glucocorticoid signaling in osteoblasts does not alter long-term K/BxN serum transfer-induced arthritis
Authors: Maleitzke Tazio , Wiebe Edgar , Huscher Dörte , Spies Cornelia M. , Tu Jinwen , Gaber Timo , Zheng Yu , Buttgereit Frank , Seibel Markus J. , Zhou Hong
Published: August 2023

Background

Disruption of glucocorticoid (GC) signaling in osteoblasts results in a marked attenuation of acute antibody-induced arthritis. The role of endogenous GCs in chronic inflammatory arthritis is however not fully understood. Here, we investigated the impact of endogenous GC signaling in osteoblasts on inflammation and bone integrity under chronic inflammatory arthritis by inactivating osteoblastic GC signaling in a long-term K/BxN serum transfer-induced induced arthritis (STIA) model.

Methods

Intracellular GC signaling in osteoblasts was disrupted by transgenic (tg) overexpression of 11beta-hydroxysteroid dehydrogenase type 2 (11ß-HSD2). Inflammatory arthritis was induced in 5-week-old male tg mice and their wild type (WT) littermates by intraperitoneal (i.p.) injection of K/BxN serum while controls (CTRLs) received phosphate-buffered saline (PBS). In a first cohort, K/BxN STIA was allowed to abate until  the endpoint of 42 days (STIA). To mimic rheumatic flares, a second cohort was additionally injected on days 14 and 28 with K/BxN serum (STIAboost). Arthritis severity was assessed daily by clinical scoring and ankle size measurements. Ankle joints were assessed histopathologically. Systemic effects of inflammation on long bone metabolism were analyzed in proximal tibiae by micro-computed tomography (μCT) and histomorphometry.

Results

Acute arthritis developed in both tg and WT mice (STIA and STIAboost) and peaked around day 8. While WT STIA and tg STIA mice showed a steady decline of inflammation until day 42, WT STIAboostand tg STIAboostmice exhibited an arthritic phenotype over a period of 42 days. Clinical arthritis severity did not differ significantly between WT and tg mice, neither in the STIA nor in the STIAboostcohorts. Correspondingly, histological indices of inflammation, cartilage damage, and bone erosion showed no significant difference between WT and tg mice on day 42. Histomorphometry revealed an increased bone turnover in tg CTRL and tg STIAboostcompared to WT CTRL and WT STIAboostanimals, respectively.

Conclusions

In contrast to the previously reported modulating effects of endogenous GC signaling in osteoblasts during acute K/BxN STIA, this effect seems to perish during the chronic inflammatory and resolution phase. These findings indicate that endogenous GC signaling in osteoblasts may mainly be relevant during acute and subacute inflammatory processes.
Value of the HFA-PEFF diagnostic algorithms for heart failure with preserved ejection fraction to the inflammatory myopathy population
Authors: Shi Yunjing , Zhang Hao , Qiu Zeping , Chen Yanjia , Su Xiuxiu , Chi Huihui , Feng Tienan , Sun Yue , Liu Honglei , Cheng Xiaobing , Ye Junna , Shi Hui , Hu Qiongyi , Zhou Zhuochao , Meng Jianfen , Teng Jialin , Yang Chengde , Su Yutong , Jin Wei
Published: August 2023

Objectives

The HFA-PEFF score has been validated to hold great diagnostic and prognostic utility for heart failure with preserved ejection fraction (HFpEF). Idiopathic inflammatory myopathy (IIM) is recognized as one of the potential etiologies underlying HFpEF. Here, we intended to investigate the real prevalence of HFpEF in IIM via the HFA-PEFF score and explore the prognostic value of this score.

Methods

Two hundred twenty IIM patients were enrolled for assessment. The cohort was divided into low, intermediate and high tertiles of the HFA-PEFF score. Spearman’s correlation analysis was used to explore the association between the score and disease activity. Chi-square test was applied to investigate the distribution discrepancy of HFA-PEFF tertiles among patients with different myositis-specific antibodies (MSAs) or myositis-associated antibodies (MAAs). Univariate and multivariate ordinal regression analyses were performed to screen risk factors for high HFA-PEFF scores. Survival curves were obtained using the Kaplan–Meier method and log-rank tests.

Results

In total, 79 (35.9%), 107 (48.6%) and 34 (15.5%) patients were rated low, intermediate and high probability of HFpEF, respectively. The HFA-PEFF score correlated well with disease activity. Patients with positive AMA-M2 scored higher in the HFA-PEFF score (p = 0.011). During follow-up, patients with positive AMA-M2 or anti-SRP antibody developed an inclination towards concentric hypertrophy on echocardiography. Additionally, palpitation symptom, AMA-M2 positivity and elevated serum levels of LDH, cTnI were independent risk factors for high HFA-PEFF scores. Finally, a high-tertile HFA-PEFF score was related to lower overall survival rate (p < 0.001). Patients with positive AMA-M2 had poorer outcomes (p = 0.002).

Conclusion

HFpEF was prevailing in IIM patients according to the HFA-PEFF score. The HFA-PEFF score correlated well with disease activity and held significant prognostic value. Patients with AMA-M2 antibody were prone to have poor outcomes.
Development of muscle weakness in a mouse model of critical illness: does fibroblast growth factor 21 play a role?
Authors: Vankrunkelsven Wouter , Thiessen Steven , Derde Sarah , Vervoort Ellen , Derese Inge , Pintelon Isabel , Matheussen Hanne , Jans Alexander , Goossens Chloë , Langouche Lies , Van den Berghe Greet , Vanhorebeek Ilse
Published: August 2023

Background

Critical illness is hallmarked by severe stress and organ damage. Fibroblast growth factor 21 (FGF21) has been shown to rise during critical illness. FGF21 is a pleiotropic hormone that mediates adaptive responses to tissue injury and repair in various chronic pathological conditions. Animal studies have suggested that the critical illness-induced rise in FGF21 may to a certain extent protect against acute lung, liver, kidney and brain injury. However, FGF21 has also been shown to mediate fasting-induced loss of muscle mass and force. Such loss of muscle mass and force is a frequent problem of critically ill patients, associated with adverse outcome. In the present study, we therefore investigated whether the critical illness-induced acute rise in FGF21 is muscle-protective or rather contributes to the pathophysiology of critical illness-induced muscle weakness.

Methods

In a catheterised mouse model of critical illness induced by surgery and sepsis, we first assessed the effects of genetic FGF21 inactivation, and hence the inability to acutely increase FGF21, on survival, body weight, muscle wasting and weakness, and markers of muscle cellular stress and dysfunction in acute (30 h) and prolonged (5 days) critical illness. Secondly, we assessed whether any effects were mirrored by supplementing an FGF21 analogue (LY2405319) in prolonged critical illness.

Results

FGF21 was not required for survival of sepsis. Genetic FGF21 inactivation aggravated the critical illness-induced body weight loss (p = 0.0003), loss of muscle force (p = 0.03) and shift to smaller myofibers. This was accompanied by a more pronounced rise in markers of endoplasmic reticulum stress in muscle, without effects on impairments in mitochondrial respiratory chain enzyme activities or autophagy activation. Supplementing critically ill mice with LY2405319 did not affect survival, muscle force or weight, or markers of muscle cellular stress/dysfunction.

Conclusions

Endogenous FGF21 is not required for sepsis survival, but may partially protect muscle force and may reduce cellular stress in muscle. Exogenous FGF21 supplementation failed to improve muscle force or cellular stress, not supporting the clinical applicability of FGF21 supplementation to protect against muscle weakness during critical illness.
Medication overdose data analysis: a review of medication error reports in the FDA adverse event reporting system (FAERS)
Authors: Ni Jiaqi , Tang Xinru , Chen Li
Published: August 2023

Background

drug overdose is a common type of medication error, which caused significant patient injuries and economic losses. To determine which drugs are reported most frequently in association with drug overdose, a comprehensive search was conducted in the FDA Adverse Event Reporting System (FAERS) database. The study also sought to determine the top 10 drugs reported with drug overdose.

Methods

FAERS database was searched for drug overdose records submitted from the first quarter of 2017 to the fourth quarter of 2021. Descriptive analyses were conducted based on the total counts and percentages of reports associated with the drug. Subgroup analyses were performed on drugs of different pharmacological classifications.

Results

A total of 170,424 drug overdose reports were retrieved. The results revealed that antipyretics and analgesics took the highest risk for overdose, with 63,143 (37.05%) cases reported. Among them, opioids were associated with the most drug overdose events. The top 10 drug classes relating to drug overdose in FAERS were opioid analgesic, anilide antipyretic analgesic, 5-HT reuptake inhibitors, bronchodilators, monoclonal antibodies and antibody-drug conjugates, benzodiazepines, antipsychotics, GABA derivatives, antimanic agents, and propionic acid derivatives.

Conclusion

to reduce the occurrence of drug overdose events, some methods could be considered including applying a pre-prescription review system, drug safety education, developing warning lists, etc.
Child abuse: knowledge, awareness, and experience among dentists in India
Authors: J Bhagya , Cherian Latha Mary , Sathyan Pradeesh , Sudharani  , P C Rasla , Sanil Swathi
Published: August 2023

Background

Medical child abuse and neglect are part of a spectrum of conditions that can lead to significant morbidity and mortality in children. Recognition of these forms of child maltreatment is crucial to prevent harm. Dentists should have familiarity with the framework for diagnosing and reporting child abuse as the orofacial complex is the prime anatomical region to show any signs of abuse. AIM: The purpose of this cross-sectional study was to assess the knowledge, awareness, and experience of dentists in India on child abuse and their role as primary responders. METHODS: A self-administered questionnaire comprising 16 questions was distributed among dentists in India and responses were collected. The questionnaire included questions on the knowledge, awareness, and experience of dentists in child abuse identification, reporting, legal proceedings, and proposals for the betterment of the current scenario. The data collected were statistically analyzed.

Results

A total of 203 dentists responded to the questionnaires through online platforms. Among them, 78.3% were females, and 65.3% had an institutional practice. While the majority (72.4%) were confident in identifying the indicators of child abuse, the knowledge on reporting was alarming. 98% of participants expressed their need for comprehensive education and training.

Conclusion

The gap between the knowledge about indicators and the confidence to report suspicious cases are notable in this study. Adequate interventions in the hour of need require the involvement of support agencies and funding at both government and local levels.
The maize preligule band is subdivided into distinct domains with contrasting cellular properties prior to ligule outgrowth
Authors: Neher Wesley R. , Rasmussen Carolyn G. , Braybrook Siobhan A. , Lažetić Vladimir , Stowers Claire E. , Mooney Paul T. , Sylvester Anne W. , Springer Patricia S.
Published: August 2023

The maize ligule is an epidermis-derived structure that arises from the preligule band (PLB) at a boundary between the blade and sheath. A hinge-like auricle also develops immediately distal to the ligule and contributes to blade angle. Here, we characterize the stages of PLB and early ligule development in terms of topography, cell area, division orientation, cell wall rigidity and auxin response dynamics. Differential thickening of epidermal cells and localized periclinal divisions contributed to the formation of a ridge within the PLB, which ultimately produces the ligule fringe. Patterns in cell wall rigidity were consistent with the subdivision of the PLB into two regions along a distinct line positioned at the nascent ridge. The proximal region produces the ligule, while the distal region contributes to one epidermal face of the auricles. Although the auxin transporter PIN1 accumulated in the PLB, observed differential auxin transcriptional response did not underlie the partitioning of the PLB. Our data demonstrate that two zones with contrasting cellular properties, the preligule and preauricle, are specified within the ligular region before ligule outgrowth.
Wnt7b expressed by hypertrophic chondrocytes is a stimulatory factor for endochondral ossification that is regulated by Smad4 activity
Authors: Tsukamoto Sho , Kuratani Mai , Tanaka Shinya , Jimi Eijiro , Oda Hiromi , Katagiri Takenobu
Published: August 2023

Endochondral ossification contributes to longitudinal skeletal growth. Osteoblasts, which are bone-forming cells, appear close to terminally differentiated hypertrophic chondrocytes during endochondral ossification. We established mice with conditional knockout (cKO) of Smad4, an essential co-activator for transforming growth factor β family signaling. The mice showed a marked increase in bone volume in the metaphysis as a result of increased bone formation by osteoblasts, in which β-catenin, an effector of canonical Wnt signaling, accumulated. We identified Wnt7b as a factor with increased expression in growth plate cartilage in Smad4 cKO mice. Wnt7b mRNA was expressed in differentiated chondrocytes and suppressed by BMP4 stimulation. Ablation of Wnt7b blunted the increase in bone in adult Smad4 cKO mice and reduced skeletal growth in juvenile mice. Overall, we conclude that Wnt7b is a crucial factor secreted from hypertrophic chondrocytes to initiate endochondral ossification. These results suggest that Smad4-dependent BMP signaling regulates the Wnt7b–β-catenin axis during endochondral ossification.
Liebe Freundin Melpo.... Η σχέση της Μέλπως Αξιώτη με την Anna Seghers: αδημοσίευτες επιστολές
Authors: Αντωνοπούλου Αναστασία
Published: August 2023

„Liebe Freundin Melpo …“. Zum Verhältnis von Melpo Axioti und Anna Seghers: unveröffentlichte BriefeDer Aufsatz untersucht das Verhältnis von Melpo Axioti und Anna Seghers anhand von unveröffentlichten Briefen, die sich im Archiv Akademie der Künste in Berlin befinden, ergänzt durch Materialien aus dem Anna-Seghers-Museum (Berlin). Der Aufsatz beschreibt zunächst die bereits in der Forschung dokumentierte Bekanntschaft der beiden Schriftstellerinnen in Paris im Jahr 1949, fokussiert jedoch auf die unerforschten Jahre des Ostberliner Exils von Axioti (1950-1952 und 1957-1964), in denen die Beziehung der beiden Autorinnen intensiver wurde, aber auch auf die letzten Lebensjahre Axiotis nach ihrer Repatriierung in Griechenland (1964-1973). Die Briefe, die die beiden Frauen in diesem Zeitraum wechseln, sind ein wichtiges Zeugnis für das Netz von Schriftsteller*innen in der Zeit des Kalten Krieges mit Schwerpunkt die griechischen exilierten Autoren wie Axioti. Zugleich dokumentieren sie die großen Schwierigkeiten, mit denen die Repatriierten in ihren Heimatländern konfrontiert werden. Beeindruckend ist dabei, wie die Dokumente zeigen, die Bereitschaft von Anna Seghers, der griechischen Freundin Melpo Axioti Hilfe zu leisten.
The Sound of Translation: Godot in a Translator's Anatomy
Authors: Fylaktaki Panagiota
Published: August 2023

An overview of one of the most translated Anglosaxon plays into Greek from a socio-political and cultural perspective and the way translation is a two-way reflection of the linguistic and social milieu of every era
Η ποιητική του φόνου
Authors: Σέββα Ηλιούλα
Published: August 2023

Το αντικείμενο διερεύνησης της συγκεκριμένης διατριβής, είναι ο φόνος και η αναπαράστασή του στα Νεοελληνικά μυθιστορήματα των περιόδων του μοντερνισμού και του μεταμοντερνισμού. Συγκεκριμένα, η παρούσα διατριβή προσπαθεί να διερευνήσει τις λογοτεχνικές αναπαραστάσεις του φόνου όπως τις αναδεικνύουν αφενός το πολιτισμικό περιβάλλον και οι πολιτισμικές συνιστώσες που τον εγκυμονούν και αφετέρου οι τεχνικές της αφήγησης που παρουσιάζουν την πράξη του φόνου. Μελετήθηκαν αρκετάμυθιστορήματα και επιλέχθηκαν εκείνα των οποίων οι συμβάσεις και η θεματολογία εκπροσωπούν μια ικανή συνθήκη έρευνας. Ειδικότερα, επισημάνθηκαν πάνω στα κείμενα αφενός οι αφηγηματικές τεχνικές του μοντερνισμού και του μεταμοντερνισμού και αφετέρου οι πολιτισμικές εγγραφές του φόνου που οδηγούν στη μοντέρνα ή μεταμοντέρνα αναπαράστασή του. Βασική υπόθεση εργασίας είναι η διερεύνηση των τρόπων εκείνων μέσω των οποίων οι μεταβολές της θεματικής του φόνου στα λογοτεχνικά κείμεναεπηρεάζουν και μεταβάλλουν τις λογοτεχνικές συμβάσεις των κειμένων, όπως και η μεταβολή των λογοτεχνικών συμβάσεωνσυμπλέει ή προκαλεί την μεταβολή της θεματικής του φόνου. Η διατριβή δομήθηκε σε δύο μέρη: Η πάσχουσα κοινωνία και Ο πάσχων άνθρωπος, μέρη τα οποία διαιρέθηκαν σε κεφάλαιακαι υποστυλώθηκαν από το κατάλληλο υλικό της Θεωρίας της Λογοτεχνίας. Σε κάθε κεφάλαιο ο στόχος ήταν η ταυτόχρονη καταγραφή-ανάλυση της θεματικής σε συνδυασμό με τις αφηγηματικές τεχνικές που την υποστήριξαν. Το πρώτο μέρος,Η πάσχουσα κοινωνία, διερευνά θέματα σχετικά με το κοινωνικό σύστημα, την έμφυλη ταυτότητα, τη λεγόμενη «νόμιμη» βία, τον πόλεμο, το ιερό και την εξουσία του, την τρέλα, την αυτοκτονία και τη συνθήκη του Ύστερου καπιταλισμού στην εποχή της Μετανεωτερικότητας. Το δεύτερο μέρος, Ο πάσχων άνθρωπος, διερευνά τον ψυχισμό του ανθρώπου που διακρίνεται από παθογένεια και καταλήγει στον φόνο και ειδικότερα θέματα ταυτότητας και ετερότητας, φόνου και τέχνης και τέλος τη σημασία της επιθυμίας και των ενορμήσεων.