bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple sclerosis patients treated with cladribine tablets: expert opinion on practical management after year 4
Authors: Centonze Diego , Amato Maria Pia , Brescia Morra Vincenzo , Cocco Eleonora , De Stefano Nicola , Gasperini Claudio , Gallo Paolo , Pozzilli Carlo , Trojano Maria , Filippi Massimo
Published: July 2023

Multiple sclerosis (MS) is a chronic, progressive neurological disease involving neuroinflammation, neurodegeneration, and demyelination. Cladribine tablets are approved for immune reconstitution therapy in patients with highly active relapsing–remitting MS based on favorable efficacy and tolerability results from the CLARITY study that have been confirmed in long-term extension studies. The approved 4-year dosing regimen foresees a cumulative dose of 3.5 mg/kg administered in two cycles administered 1 year apart, followed by 2 years of observation. Evidence on managing patients beyond year 4 is scarce; therefore, a group of 10 neurologists has assessed the available evidence and formulated an expert opinion on management of the growing population of patients now completing the approved 4-year regimen. We propose five patient categories based on response to treatment during the first 4-year regimen, and corresponding management pathways that envision close monitoring with clinical visits, magnetic resonance imaging (MRI) and/or biomarkers. At the first sign of clinical or radiological disease activity, patients should receive a highly effective disease-modifying therapy, comprising either a full cladribine regimen as described in regulatory documents (cumulative dose 7.0 mg/kg) or a comparably effective treatment. Re-treatment decisions should be based on the intensity and timing of onset of disease activity, clinical and radiological assessments, as well as patient eligibility for treatment and treatment preference.
Lobular Endocervical Glandular Hyperplasia, a mimicker and potential pitfall for HPV-independent well differentiated Gastric-type Endocervical Adenocarcinoma: Case report and literature review focusing on histology, immunophenotype, and molecular findings
Authors: Molero Aida , Parra Alejandro , Blanco Isabel , Ascensión Alfonso , Ortega Pilar
Published: July 2023

Lobular glandular endocervical hyperplasia is an uncommon benign entity within the spectrum of gastric-type endocervical lesions. We report a case of a 48-year-old woman who presented with a palpable mass and watery vaginal discharge. Ultrasound revealed an 8 cm × 4 cm × 3 cm multicystic mass affecting the cervix, and hysterectomy was performed. The well-delimited multicystic, mucinous mass distorted the entire cervix. Microscopically, endocervical glandular proliferation with a lobular architecture was observed. The glands were lined with a single layer of tall, mucin-rich, columnar cells with basal and bland nuclei. The lesion was positive for MUC6 marker and hormonal receptors were negative, while P53 expression was normal. Three years later, the patient remained disease free. Here, we discuss the differential diagnosis between lobular glandular endocervical hyperplasia and similar conditions, particularly gastric-type endocervical adenocarcinoma, and review the literature focusing on the molecular pathways underlying gastric-type endocervical lesions. This case highlights the importance of accurate diagnosis to ensure favorable outcomes.
ICT Engineering Students’ Perceptions on Project-Based Online Learning in Community of Inquiry (CoI)
Authors: Mielikäinen Maisa , Viippola Essi
Published: July 2023

Industry and higher education are increasingly utilizing online environments due to digitalization. As a result, the learning experiences in these new digital learning ecosystems as communities must be re-examined critically. This study incorporates the second cycle of the design-based research (DBR) study developing the design principles and theoretical framework for a digital learning ecosystem in Information and Communication Technology (ICT) engineering education in Lapland University of Applied Sciences (UAS), Finland. This cycle examines students’ learning experiences in a project and Industry 4.0-based approach in a digital learning ecosystem with authentic industry assignments and involvement. The study examines the learning experiences of ICT engineering students in a project and Industry 4.0-based approach in a digital environment with authentic industry assignments and involvement. The study was carried out using the Community of Inquiry (CoI) approach. Rasch Rating Scale Model was used to analyse first-, second-, and third-year students’ responses to a translated and adapted CoI questionnaire. Open-ended questions were added to the questionnaire, which was then analysed using content analysis. The results indicate that students perceived project-based learning in an online setting positively. However, the findings point to issues with social interactions and the actual application of learnt knowledge and skills. Challenges in task management and scheduling, as well as receiving feedback, had a somewhat negative impact on the learning experience, particularly during the first year of study. Finally, this paper concludes by presenting a visual model summarizing the design framework developed through a broader DBR study informed by the previous DBR cycles. The findings may benefit practitioners in developing similar communities and ecosystems.
Responses to News Overload in a Non-Partisan Environment: News Avoidance in China
Authors: Ni Tianchang , Zhu Runping , Krever Richard
Published: July 2023

Studies conducted in Western democratic countries with privately owned press presenting news from different ideological perspectives have found the phenomenon of news overload causes stress in media users (affective load) and this leads to news avoidance behavior. This study, conducting a structural equation modeling using AMOS 27, investigates the relationships between news overload, affective load, and consequent news avoidance behavior in China. The findings suggest, consistent with studies in Western democratic jurisdictions, that news overload and affective load influence users’ news avoidance behavior. However, in contrast to studies outside of China, this study found demographic variables of age, gender, education, and occupation had no statistically significant influence on avoidance behavior by Chinese social media news consumers. The results suggest that either social attributes and responses by media users in China are significantly different from those in Western countries or ideology plays an important role in avoidance behavior and the impact of ideology is different across different demographic groups in Western jurisdictions.
A Systematic Review of Chinese Character Size Tests From 1930 to 2021
Authors: Zhang Haiwei , Sun Peijian Paul , Zhang Xueyan , Fan Silin , Zhang Yunji
Published: July 2023

Chinese character size is the number of characters that a person can recognize and has been well documented as a critical measure of Chinese literacy. A variety of Chinese character size tests have been developed since the 1930s. However, systematic reviews have not yet been conducted on Chinese character size tests. The purpose of this article is to provide a comprehensive review of Chinese character size tests conducted between 1930 and 2021 among native Chinese-speaking children and Chinese language learners. There are three main findings. First, most character size tests were constructed using a frequency-based stratified-sampling method to select target characters, a mixed method focusing on both pronunciation and meaning to test target characters, and a holistic method to score the test-takers’ responses. Second, the majority of tests used Classical Testing Theory (CTT) for checking the item quality, reliability, and validity, and only two tests employed both CTT and Item Response Theory. Third, most tests estimated character sizes using CTT, while only three tests constructed character size norms. It is suggested that future studies address cross-group investigation, determine the most robust construction and estimation methods, develop computer-assisted tests, and apply character size tests to classroom settings.
The Right to Belong in School: A Critical, Transdisciplinary Conceptualization of School Belonging
Authors: Kuttner Paul J.
Published: July 2023

Belonging is a critical factor for supporting student success and well-being in school. Unfortunately, the work of fostering belonging at school for all students continues to face significant challenges. One reason is that the field of education is working from a limited conception of school belonging, based mainly in the discipline of psychology. Belonging is more than just a psychological sense—it is also a social, cultural, and even political process. In this article, Paul Kuttner explores six aspects of belonging that are underemphasized in the school belonging literature, arguing that we should think of school belonging as agentic, intersectional, systemic, political, place-based, and a right. Kuttner proposes a definition of belonging that encompasses these aspects and uses it to suggest future directions for research and practice.
Arguing for the Opposition: A Position Commitment Shock to Overcome Confirmation Bias
Authors: Warner Alfred G.
Published: July 2023

Confirmation bias is a common cognitive error that emerges when people seek and use information that supports existing beliefs rather than more critically assessing evidence and potentially changing that belief. It often arises when considering controversial topics. Management classes in organizational behavior, ethics, international business, and strategy often cover issues that can be polarizing for students and stimulate a confirmation bias response. One approach to helping students remedy this problem is through debiasing interventions or helping people into slower, more deliberate reasoning. The debiasing technique described here has organizational behavior students commit to a position on a controversial issue in discrimination, then surprises them by having them write a paper from the opposite perspective. It also requires a critique of the argument they built and then reflection on what could prompt them to make a similar cognitive effort in other topics. Supplemental materials for the students include discussions on identifying good sources and assumptions about merit.
Safety and effectiveness of IV Thrombolysis in retinal artery occlusion: A multicenter retrospective cohort study
Authors: Baumgartner Philipp , Kook Lucas , Altersberger Valerian L , Gensicke Henrik , Ardila-Jurado Elena , Kägi Georg , Salerno Alexander , Michel Patrik , Gopisingh Kiran M , Nederkoorn Paul J , Scheitz Jan F , Nolte Christian H , Heldner Mirjam R , Arnold Marcel , Cordonnier Charlotte , Della Schiava Lucie , Hametner Christian , Ringleb Peter A. , Leker Ronen R , Jubran Hamza , Luft Andreas R , Engelter Stefan T , Wegener Susanne ,   For the Thrombolysis in Stroke Patients (TRISP) Collaborators
Published: July 2023

Background:

Retinal artery occlusion (RAO) may lead to irreversible blindness. For acute RAO, intravenous thrombolysis (IVT) can be considered as treatment. However, due to the rarity of RAO, data about IVT safety and effectiveness is limited.

Methods:

From the multicenter database ThRombolysis for Ischemic Stroke Patients (TRISP), we retrospectively analyzed visual acuity (VA) at baseline and within 3 months in IVT and non-IVT treated RAO patients. Primary outcome was difference of VA between baseline and follow up (∆VA). Secondary outcomes were rates of visual recovery (defined as improvement of VA ⩾ 0.3 logMAR), and safety (symptomatic intracranial hemorrhage (sICH) according to ECASS II criteria, asymptomatic intracranial hemorrhage (ICH) and major extracranial bleeding). Statistical analysis was performed using parametric tests and a linear regression model adjusted for age, sex and baseline VA.

Results:

We screened 200 patients with acute RAO and included 47 IVT and 34 non-IVT patients with complete information about recovery of vision. Visual Acuity at follow up significantly improved compared to baseline in IVT patients (∆VA 0.5 ± 0.8, p < 0.001) and non-IVT patients (∆VA 0.40 ± 1.1, p < 0.05). No significant differences in ∆VA and visual recovery rate were found between groups at follow up. Two asymptomatic ICH (4%) and one (2%) major extracranial bleeding (intraocular bleeding) occurred in the IVT group, while no bleeding events were reported in the non-IVT group.

Conclusion:

Our study provides real-life data from the largest cohort of IVT treated RAO patients published so far. While there is no evidence for superiority of IVT compared to conservative treatment, bleeding rates were low. A randomized controlled trial and standardized outcome assessments in RAO patients are justified to assess the net benefit of IVT in RAO.
Physical and brain frailty in ischaemic stroke or TIA: Shared occurrence and outcomes. A cohort study
Authors: Taylor-Rowan Martin , Hafdi Melanie , Drozdowska Bogna , Elliott Emma , Wardlaw Joanna , Quinn Terence J
Published: July 2023

Background:

There is increasing interest in the concept of frailty in stroke, including both physical frailty and imaging-evidence of brain frailty. We aimed to establish the prevalence of brain frailty in stroke survivors as well as the concurrent and predictive validity of various frailty measures against long-term cognitive outcomes.

Methods:

We included consecutively admitted stroke or transient ischaemic attack (TIA) survivors from participating stroke centres. Baseline CT scans were used to generate an overall brain frailty score for each participant. We measured frailty via the Rockwood frailty index, and a Fried frailty screening tool. Presence of major or minor neurocognitive disorder at 18-months following stroke or TIA was established via a multicomponent assessment. Prevalence of brain frailty was established based upon observed percentages within groups defined by frailty status (robust, pre-frail, frail). We assessed the concurrent validity of brain frailty and frailty scales via Spearman’s rank correlation. We conducted multivariable logistic regression analyses, controlling for age, sex, baseline education and stroke severity, to evaluate association between each frailty measure and 18-month cognitive impairment.

Results:

Three-hundred-forty-one stroke survivors participated. Three-quarters of people who were frail had moderate-severe brain frailty and prevalence increased according to frailty status. Brain frailty was weakly correlated with Rockwood frailty (Rho: 0.336; p < 0.001) and with Fried frailty (Rho: 0.230; p < 0.001). Brain frailty (OR: 1.64, 95% CI = 1.17–2.32), Rockwood frailty (OR: 1.05, 95% CI = 1.02–1.08) and Fried frailty (OR: 1.93, 95% CI = 1.39–2.67) were each independently associated with cognitive impairment at 18 months following stroke.

Conclusions:

There appears to be value in the assessment of both physical and brain frailty in patients with ischaemic stroke and TIA. Both are associated with adverse cognitive outcomes and physical frailty remains important when assessing cognitive outcomes.
Risk Factors for Failure After Surgery in Patients With Diabetic Foot Syndrome
Authors: Anwander Helen , Vonwyl David , Hecht Verena , Tannast Moritz , Kurze Christophe , Krause Fabian
Published: July 2023

Background:

In the present study, we aimed to identify risk factors for failure (defined as reoperation within 60 days) after debridement or amputation at the lower extremity in patients with diabetic foot syndrome and to develop a model using the significant risk factors to predict the success rate at different levels of amputation.

Methods:

Between September 2012 and November 2016, we performed a prospective observational cohort study of 174 surgeries in 105 patients with diabetic foot syndrome. In all patients, debridement or the level of amputation, need for reoperation, time to reoperation, and potential risk factors were assessed. A cox regression analysis, dependent on the level of amputation, with the endpoint reoperation within 60 days defined as failure and a predictive model for the significant risk factors were conducted.

Results:

We identified the following 5 independent risk factors: More than 1 ulcer (hazard ratio [HR] 3.8), peripheral artery disease (PAD, HR 3.1), C-reactive protein >100 mg/L (HR 2.9), diabetic peripheral neuropathy (HR 2.9), and nonpalpable foot pulses (HR 2.7) are the 5 independent risk factors for failure, which were identified. Patients with no or 1 risk factor have a high success rate independent of the level of amputation. A patient with up to 2 risk factors undergoing debridement will achieve a success rate of <60%. However, a patient with 3 risk factors undergoing debridement will need further surgery in >80%. In patients with 4 risk factors a transmetatarsal amputation and in patients with 5 risk factors a lower leg amputation is needed for a success rate >50%.

Conclusion:

Reoperation for diabetic foot syndrome occurs in 1 of 4 patients. Risk factors include presence of more than 1 ulcer, PAD, CRP > 100, peripheral neuropathy, and nonpalpable foot pulses. The more risk factors are present, the lower the success rate at a certain level of amputation.

Level of Evidence:

Level II, prospective observational cohort study.
Effect of cycloplegic agents (1% cyclopentolate hydrochloride and 1% tropicamide) on anterior segment parameters
Authors: Duran Mustafa , Cevher Selim
Published: July 2023

Background:

Cycloplegic drops are commonly used in ophthalmology practice. Changes in anterior segment parameters may occur after cycloplegia. These changes can be evaluated with corneal topography.

Objective:

This study aimed to compare the effects of 1% cyclopentolate hydrochloride and 1% tropicamide on anterior segment parameters using the Sirius Scheimpflug imaging technique.

Design:

A cross-sectional study.

Methods:

One hundred twenty eyes of sixty healthy volunteers with spherical equivalent (SE) values of 0 to ±1 diopter (D) were studied. The right eye of each subject had instillation of cyclopentolate hydrochloride 1% (Group 1) and the left eye of each subject had instillation of tropicamide 1% (Group 2). SE, intraocular pressure, and corneal topography measurements were performed before and 40 min after instillation were compared.

Results:

In Group 1, SE, aqueous depth, anterior chamber depth, iridocorneal angle (ICA), anterior chamber volume (ACV), and pupil size (PS) values were significantly increased ( p < 0.001, p = 0.01, p < 0.001, p = 0.03, p < 0.001, and p < 0.001, respectively). In Group 2, SE, ICA, ACV, and PS were significantly increased ( p < 0.001 for all). Keratometric values (K1 and K2) and central corneal thickness changed insignificantly in both groups ( p > 0.05). The effects of the two administered agents on all parameters were similar ( p > 0.05).

Conclusions:

Cyclopentolate hydrochloride and tropicamide affected SE, ICA, ACV, and PS values significantly. These parameters are important in intraocular lens (IOL) power calculations. PS is also important in refractive surgery and cataract surgery with multifocal IOL implantation. Although there was an insignificant difference between the agents, the effects of tropicamide on the parameters were smaller than those of cyclopentolate.
Potassium-Competitive Acid Blockers for the Treatment of Gastroesophageal Reflux Disease
Authors: Kothadia Jiten P. , Howden Colin W.
Published: July 2023

Current treatments for gastroesophageal reflux disease (GERD) and other acid-related disorders either block stimulation of the parietal cell (H2-receptor antagonists) or inhibit gastric H+/K+-ATPase (proton pump inhibitors; PPIs). PPIs are usually very effective in healing esophageal erosions and improving heartburn in patients with GERD. However, the PPIs have a slow onset of action and do not provide complete symptom resolution in all patients. Therefore, there is a need for agents that offer a fast onset of action and sustained acid suppression to maximize both mucosal healing and symptom control. Potassium-competitive acid blockers (P-CABs) are a relatively novel class of acid suppressants showing potential for the management of GERD and other acid-related disorders. This article focuses on the likely role of P-CABs for treating GERD.
Unravelling transmission ratio distortion across the bovine genome: identification of candidate regions for reproduction defects
Authors: Id-Lahoucine Samir , Casellas Joaquim , Suárez-Vega Aroa , Fonseca Pablo A. S. , Schenkel Flavio S. , Sargolzaei Mehdi , Cánovas Angela
Published: July 2023

Background

Biological mechanisms affecting gametogenesis, embryo development and postnatal viability have the potential to alter Mendelian inheritance expectations resulting in observable transmission ratio distortion (TRD). Although the discovery of TRD cases have been around for a long time, the current widespread and growing use of DNA technologies in the livestock industry provides a valuable resource of large genomic data with parent–offspring genotyped trios, enabling the implementation of TRD approach. In this research, the objective is to investigate TRD using SNP-by-SNP and sliding windows approaches on 441,802 genotyped Holstein cattle and 132,991 (or 47,910 phased) autosomal SNPs.

Results

The TRD was characterized using allelic and genotypic parameterizations. Across the whole genome a total of 604 chromosomal regions showed strong significant TRD. Most (85%) of the regions presented an allelic TRD pattern with an under-representation (reduced viability) of carrier (heterozygous) offspring or with the complete or quasi-complete absence (lethality) for homozygous individuals. On the other hand, the remaining regions with genotypic TRD patterns exhibited the classical recessive inheritance or either an excess or deficiency of heterozygote offspring. Among them, the number of most relevant novel regions with strong allelic and recessive TRD patterns were 10 and 5, respectively. In addition, functional analyses revealed candidate genes regulating key biological processes associated with embryonic development and survival, DNA repair and meiotic processes, among others, providing additional biological evidence of TRD findings.

Conclusions

Our results revealed the importance of implementing different TRD parameterizations to capture all types of distortions and to determine the corresponding inheritance pattern. Novel candidate genomic regions containing lethal alleles and genes with functional and biological consequences on fertility and pre- and post-natal viability were also identified, providing opportunities for improving breeding success in cattle.
Real-world use of remdesivir for the treatment of patients admitted to Italian hospitals with COVID-19: the nationwide retrospective FADOI-RECOVER study
Authors: Pieralli Filippo , Pomero Fulvio , Dentali Francesco , Norbiato Claudio , Attardo Tiziana , Vicari Susanna , Magnani Elena , Marzilli Maria Antonietta , Piccolo Paola , Valerio Antonella , Manfellotto Dario ,   on behalf of FADOI RECOVER Study Group, Brugiotti Elena , Carella Vincenzo , Coppo Martina , Ferrando Francesca , Lauritano Marta. , Marchetti Bruno , Vitale Francesco , Gasperina Daniela Dalla , Baroni Elena , Boccatonda Andrea , Giorgini Enrico , Milite Teresa , Montaguti Luca , Cagnoni Elisa , Mogavero Giulia , Capoccetta Giovanni , De Giovanni Raffaella , Martelli Francesca , Guazzini Giulia , Grassi Alberto , Romani Laura , Gnerre Paola , Mastroianni Franco , D’Onofrio Fabiana , Berra Sergio , Pozzoli Simona , Bobbio Flavio , Bianco Sara , Re Azzurra , Liberato Nicola , Job Sara , Antonucci Giancarlo , Para Ombretta , Ferrara Gino , Giordano Antonietta , Falco Olga , Manetti Roberto , Bologna Carolina , Buscaglia Sandra , Oliviero Cristina , Amitrano Maria , Iorio Valeria , Tibullo Loredana , Ferrari Giovanni , Brandolini Micaela , Leone Giovanna , Usai Carlo , Manzoni Noemi Elisabetta , Di Stefano Rita , Renna Eusapia
Published: July 2023

Background

Remdesivir is widely used for treatment of SARS-CoV-2 pneumonia. The aim of this study was to evaluate the characteristics of patients with moderate-to-severe COVID-19 treated with remdesivir, and their outcomes during hospitalization.

Methods

This retrospective observational multicenter study included consecutive patients, hospitalized for moderate-to-severe COVID-19 (September 2020—September 2021), who were treated with remdesivir.

Results

One thousand four patients were enrolled, all with onset of symptoms occurring less than 10 days before starting remdesivir; 17% of patients had 4 or more concomitant diseases. Remdesivir was well tolerated, adverse drug reactions (ADRs) being reported in 2.3% of patients. In-hospital death occurred in 80 patients (8.0%). The median timing of the first remdesivir dose was 5 days after symptom onset. The following endpoints did not differ according to the time span from the onset of symptoms to the first dose: length of hospitalization, in-hospital death, composite outcome (in-hospital death and/or endotracheal intubation). Advanced age, number of comorbidities ≥ 4, and severity of respiratory failure at admission were associated with poor in-hospital outcomes.

Conclusion

In a real-world setting, remdesivir proved to be a safe and well-tolerated treatment for moderate-to-severe COVID-19. In patients receiving remdesivir less than 3 or 5 days from the onset of SARS-CoV-2 symptoms, mortality and the need for mechanical ventilation did not differ from the rest of the sample.
Fetal congenital gastrointestinal obstruction: prenatal diagnosis of chromosome microarray analysis and pregnancy outcomes
Authors: Ni Mengyao , Zhu Xiangyu , Liu Wei , Gu Leilei , Zhu Yujie , Cao Peixuan , Gu Yan , Xu Yan , Dai Chenyan , Wu Xing , Yang Ying , Zhou Chunxiang , Li Jie
Published: July 2023

Objective

The aim of this study was to investigate the incidence of chromosome anomalies in different types of congenital gastrointestinal obstruction and assess pregnancy outcomes of fetuses with congenital gastrointestinal obstruction.

Methods

A total of 64 cases with gastrointestinal obstruction between January 2014 and December 2020 were enrolled in this study. They were divided into three groups according to sonographic images. Group A: isolated upper gastrointestinal obstruction; Group B: isolated lower gastrointestinal obstruction; Group C: non-isolated gastrointestinal obstruction. The rate of chromosome anomalies in different groups was calculated. Pregnant women with amniocentesis were followed up by medical records and telephone. The follow-up included pregnancy outcomes and development of the live born infants.

Result

From January 2014 to December 2020, there were 64 fetus with congenital gastrointestinal obstruction underwent chromosome microarray analysis(CMA), the overall detection rate of CMA testing was 14.1%(9/64). The detection rate of Group A, B and C were 16.2%, 0 and 25.0% respectively. 9 fetuses with abnormal CMA results were all terminated. Among 55 fetuses with normal chromosomes, 10(18.2%) fetuses were not found to have any gastrointestinal obstruction after birth. 17(30.9%) fetuses were diagnosed with gastrointestinal obstruction and underwent surgical treatment after birth, one of which had lower gastrointestinal obstruction combined with biliary obstruction and died due to liver cirrhosis. 11(20.0%) pregnancy were terminated due to multiple abnormalities. 5(9.1%) fetuses were intrauterine death. 3(5.5%) fetuses were neonatal deaths. 9(16.4%) fetuses were lost to follow-up.

Conclusion

It is crucial to understand whether the gastrointestinal tract abnormality is isolated or associated to other findings. The risk of chromosomal abnormalities in fetuses with isolated lower gastrointestinal obstruction is lower than upper gastrointestinal obstruction. While genetic abnormalities excluded, a promising prognosis is expected for fetuses with congenital gastrointestinal obstruction.
Periventricular nodular heterotopias is associated with mutation at the FLNA locus-a case history and a literature review
Authors: Yang Lin , Wu GuangSheng , Yin HuiMei , Pan MengLan , Zhu YaFei
Published: July 2023

Background

Periventricular nodular heterotopia (PNH), associated with FLNA mutations, is a rare clinical condition potentially associated with multiple systemic conditions, including cardiac, pulmonary, skeletal, and cutaneous diseases. However, due to a paucity of information in the literature, accurate prognostic advice cannot be provided to patients with the disease.

Case presentation

We report a 2-year-old female whose PNH was associated with a nonsense mutation in the q28 region of the X chromosome, in exon 31 of FLNA (c.5159dupA). The patient is currently seizure-free and has no congenital heart disease, lung disease or skeletal or joint issues, and her development is normal.

Conclusions

FLNA-associated PNH is a genetically-heterogeneous disease, and the FLNA mutation, c.5159dupA (p.Tyr1720*) is a newly identified pathogenic variant. FLNA characterization will help the clinical diagnosis and treatment of PNH and provide individualized genetic counseling for patients.
Relationship between gait parameter and spinal sagittal profiles in asymptomatic subjects
Authors: Wilartratsami Sirichai , Nathasiri Lopburi , Vanadurongwan Bavornrat , Santipas Borriwat , Suvithayasiri Siravich , Luksanapruksa Panya
Published: July 2023

Background

To study the gait parameters in asymptomatic volunteers and investigate the correlation between the gait and several radiographic sagittal profiles.

Methods

Asymptomatic volunteers (20–50 years of age) were included and allocated into three subgroups depending on pelvic incidence (low, normal, and high). Standing whole spine radiographs and gait analysis data were obtained. The Pearson Coefficient Correlation was used to determine the relationship between the gait and radiographic profiles.

Results

A total of 55 volunteers (28 male and 27 females) were included. The mean age was 27.35 ± 6.37 years old. The average sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), and PI-LL mismatch (PI-LL) were 37.78 ± 6.59, 14.51 ± 9.19 degrees, and 52.29 ± 10.87 degrees and − 0.36 ± 11.41, respectively. The mean velocity and stride of all the volunteers were 119.00 ± 30.12 cm/s and 130.25 ± 7.72 cm, correspondingly. The correlation between each of the radiographical and gait parameters was low (ranging from − 0.24 to 0.26).

Conclusion

Gait parameters were not differenced significantly between each of the PI subgroups in asymptomatic volunteers. Spinal sagittal parameters also showed a low correlation with gait parameters.
Simultaneous adrenal and retroperitoneal myelolipoma resected by laparoscopic surgery: a challenging case
Authors: Kamran Hooman , Haghpanah Abdolreza , Dabbaghmanesh Mohammad Hossein , Defidio Lorenzo , Bazrafkan Maryam , Dehghani Anahita , Shirazi Mehdi , Naderi Nima , Dehghanian Amirreza
Published: July 2023

Background

Myelolipoma is a benign neoplasm of the adrenal cortex, composed of fat and hematopoietic cells. Although myelolipoma is benign, differentiation from adrenocortical cancer may be difficult. The presence of adrenal and extra-adrenal myelolipomas simultaneously is sporadic, making it a challenging case, especially when the preoperative diagnosis is ambiguous.

Case presentation

A 65-year-old man was referred to our clinic due to a mass in the adrenal fossa. In the abdominopelvic computed tomography (CT), a well-circumscribed fat-containing 78 × 61 × 65 mm bi-lobulated mass was reported in the left adrenal fossa. The first differential diagnosis was myelolipoma. The patient was then referred to our clinic for a mass excision. He was asymptomatic and was scheduled to undergo laparoscopic-assisted adrenalectomy. After adrenalectomy and mass dissection, surprisingly, another mass was detected in the retroperitoneal area. The second mass was also dissected. The final diagnosis was myelolipoma for both masses. The patient has been symptom-free for nine months after the operation.

Conclusion

Simultaneous adrenal and extra-adrenal myelolipoma should be considered as one of the differential diagnoses. However, because this situation is extremely rare, the probability of malignancy should be highly regarded, and we suggest an obsessive approach when approaching this condition. It is essential to manage these cases on a case-by-case basis and tailor the management concerning intraoperative biopsy, the intraoperative appearance of tumors, and the location of extra-adrenal masses.
Cone-beam computed tomographic analysis of maxillary sinus septa among Yemeni population: a cross-sectional study
Authors: Altayar Bassam A. , Al-Tayar Barakat , Lin Weimin , Al-wesabi Saddam N. , Al-shujaa Eissa A. , Sakran Karim , Yuan Quan , Lyu Mingyue
Published: July 2023

Background

Maxillary sinus septa increase perforation risk of Schneiderian membrane during the sinus floor elevation (SFE). Cone Beam Computed Tomography (CBCT) allows for a more precise assessment of the septal position; thus, preoperative CBCT analysis is substantial to avoid possible complications. This study aims to investigate the 3D characteristics of the maxillary sinus septa based on CBCT images. To our knowledge, no study reported the CBCT-based investigation for the sinus septa among Yemeni population.

Materials and methods

This is a retrospective cross-sectional analysis of 880 sinus CBCT images 440 patients. The septa prevalence, locations, orientations, morphology, and associated factors were analyzed. The effect of age, gender, and dental status on the sinus septa and the relationship between sinus membrane pathology and sinus septa were also analyzed. Anatomage (Invivo version 6) was used for CBCT images analysis. Descriptive and analytical statistics were performed, and a P-value < 0.05 was significantly considered.

Results

The maxillary sinus septa were found among 63.9% of patients and 47% of sinuses. The average septa height was 5.2 mm. 15.7% of patients had septa in the right maxilla, 18% in the left, and 30.2% in both. Gender, age, and dental condition had no influence on the presence of septa, and septa presence did not influence sinus membrane pathology. Many septa originated from the floor (54.5%), located in the middle (43%), with coronal orientation (66%) and complete configuration (58.2%).

Conclusion

Based on our findings, the septa prevalence, locations, orientations, and morphology were significant and equivalent to the highest recorded in the literature yet. Thus, when sinus floor elevation is planned, CBCT imaging of the maxillary sinus is recommended for safe dental implantation.
Evaluation of bacterial leakage and marginal adaptation of the bioceramics pulp dressing materials: an invitro study
Authors: Snigdha Niher Tabassum Siddiqua , Kamarudin Aimi , Baharin Fadzlinda , Ghani Nik Rozainah Nik Abdul , bin Yhaya Mohd Firdaus , Ahmad Wan Muhamad Amir W , Karobari Mohmed Isaqali
Published: July 2023

Objective

To compare the sealing ability and marginal adaptation of three calcium silicate-based cement (Biodentine, Pro root MTA, MTA Angelus) using a bacterial leakage model and scanning electron microscope (SEM).

Methods

Recently extracted lower first premolars were randomly categorized into three experimental groups (n = 15 samples), positive control (n = 5 samples), and negative control group (n = 5 sample). Samples from the experimental groups and positive control group were subject to cavity Class I occlusal preparation followed by modified coronal pulpotomy. Different types of bioceramic dressing material were placed in 3 mm thickness accordingly, group 1 (Biodentine), group 2 (MTA Angelus), and group 3 (ProRoot MTA). No dressing material was placed in the positive control group (group 4). All samples were placed in the incubator for 24 h at 37℃, 100% humidity, for the materials to be completely set. The final restoration was placed using the Z350 resin composite. A double layer of nail varnish was applied over all the sample surfaces except the occlusal site. Whereas the samples’ surfaces in the negative control, were completely covered. A 3 mm length was measured from the root apex of the samples from each group, before proceeding with the resection. The bacterial leakage test was performed using Enterococcus faecalis TCC 23,125, and a sample from each experimental group was randomly chosen for SEM. Data analysis was conducted under the One-way ANOVA test, completed by Tukey’s post hoc test.

Results

There is a significant difference in sealing ability and marginal adaptation between the groups. (p < 0.05). The study showed that Pro Root MTA had the superior sealing ability and marginal adaptation compared to Biodentine and MTA Angelus.

Conclusion

The ProRoot MTA as a coronal pulpotomy pulp dressing material, was found to have a better marginal adaptation and sealing ability compared to three other bioceramics materials. The material would be the better choice during clinical settings and procedures.
CD8 + T-cell marker genes reveal different immune subtypes of oral lichen planus by integrating single-cell RNA-seq and bulk RNA-sequencing
Authors: Zhang Jinhao , Peng Gaoge , Chi Hao , Yang Jinyan , Xie Xixi , Song Guobin , Tran Lisa Jia , Xia Zhijia , Tian Gang
Published: July 2023

Background

Oral lichen planus (OLP) is a local autoimmune disease induced by T-cell dysfunction that frequently affects middle-aged or elderly people, with a higher prevalence in women. CD8 + T cells, also known as killer T cells, play an important role in the progression and persistence of OLP. In order to identify different OLP subtypes associated with CD8 + T cell pathogenesis, consensus clustering was used.

Methods

In this study, we preprocessed and downscaled the OLP single-cell dataset GSE211630 cohort downloaded from Gene Expression Omnibus (GEO) to finally obtain the marker genes of CD8 + T cells. Based on the expression of marker genes, we classified OLP patients into CMGs subtypes using unsupervised clustering analysis. The gene expression profiles were analyzed by WGCNA using the “WGCNA” R package based on the clinical disease traits and typing results, and 108 CD8 + T-cell related OLP pathogenicity-related genes were obtained from the intersection. Patients were once again classified into gene subtypes based on intersection gene expression using unsupervised clustering analysis.

Results

After obtaining the intersecting genes of CD8 + T cells related to pathogenesis, OLP patients can be precisely classified into two different subtypes based on unsupervised clustering analysis, and subtype B has better immune infiltration results, providing clinicians with a reference for personalized treatment.

Conclusions

Classification of OLP into different subtypes improve our current understanding of the underlying pathogenesis of OLP and provides new insights for future studies.
A comparative study of three-dimensional cone-beam CT sialography and MR sialography for the detection of non-tumorous salivary pathologies
Authors: Bertin Hélios , Bonnet Raphael , Le Thuaut Aurélie , Huon Jean-François , Corre Pierre , Frampas Eric , Langlois Emmanuelle Mourrain , Chesneau Anne-Sophie Delemazure
Published: July 2023

Background

Imaging of the salivary ductal system is relevant prior to an endoscopic or a surgical procedure. Various imaging modalities can be used for this purpose. The aim of this study was to compare the diagnostic capability of three-dimensional (3D)-cone-beam computed tomography (CBCT) sialography versus magnetic resonance (MR) sialography in non-tumorous salivary pathologies.

Methods

This prospective, monocenter, pilot study compared both imaging modalities in 46 patients (mean age 50.1 ± 14.9 years) referred for salivary symptoms. The analyses were performed by two independent radiologists and referred to identification of a salivary disease including sialolithiasis, stenosis, or dilatation (primary endpoint). The location and size of an abnormality, the last branch of division of the salivary duct that can be visualized, potential complications, and exposure parameters were also collected (secondary endpoints).

Results

Salivary symptoms involved both the submandibular (60.9%) and parotid (39.1%) glands. Sialolithiasis, dilatations, and stenosis were observed in 24, 25, and 9 patients, respectively, with no statistical differences observed between the two imaging modalities in terms of lesion identification (p1 = 0.66, p2 = 0.63, and p3 = 0.24, respectively). The inter-observer agreement was perfect (> 0.90) for lesion identification. MR sialography outperformed 3D-CBCT sialography for visualization of salivary stones and dilatations, as evidenced by higher positive percent agreement (sensitivity) of 0.90 [95% CI 0.70–0.98] vs. 0.82 [95% CI 0.61–0.93], and 0.84 [95% CI 0.62–0.94] vs. 0.70 [95% CI 0.49–0.84], respectively. For the identification of stenosis, the same low positive percent agreement was obtained with both procedures (0.20 [95% CI 0.01–0.62]). There was a good concordance for the location of a stone (Kappa coefficient of 0.62). Catheterization failure was observed in two patients by 3D-CBCT sialography.

Conclusions

Both imaging procedures warrant being part of the diagnostic arsenal of non-tumorous salivary pathologies. However, MR sialography may be more effective than 3D-CBCT sialography for the identification of sialolithiasis and ductal dilatations.

Trial registration

NCT02883140.
Retrospective study of pathogens involved in vaginitis among Chinese women
Authors: Pan Zhengmei , Wu Yanzhi , Li Yan , Hu Xi , Zhao Yiyue , Liu Yang
Published: July 2023

Background

To explore the pathogen distribution in Chinese females with vaginitis.

Methods

This retrospective study included Chinese females with vaginitis admitted at the outpatient department of the Gynecology Clinic of the Second Affiliated Hospital of Kunming Medical University between January 2013 and June 2013. Data on the vaginal pathogens and inflammation were analyzed.

Results

The vaginal secretions from 15,601 gynecologic outpatients were abnormal, including 8547 (54.78%) with vaginal infection and 7054 (45.22%) without. In patients with vaginal infections, a single infection was observed in 69.72% (5959/8547) of them, and mixed infection was observed in 30.28% (2588/8547). The differences in age and inflammation grade between the infection and no-infection groups were statistically significant (allP < 0.001). In addition, multiple types of vaginitis could be diagnosed in patients with mixed infections.

Conclusions

About half of the Chinese women with abnormal vaginal secretions are positive for pathogens in the study period. Patients’ age and inflammation grade are associated with co-infection. From the public health perspective, this study suggests that the importance of vaginal hygiene should be enforced in Chinese women.
The effect of bovine milk lactoferrin-loaded exosomes (exoLF) on human MDA-MB-231 breast cancer cell line
Authors: Ramezani Reihaneh , Mohammadian Mozhdeh , Hosseini Elaheh Sadat , Zare Mehrak
Published: July 2023

Background

Cancer is still the most challenging disease and is responsible for many deaths worldwide. Considerable research now focuses on targeted therapy in cancer using natural components to improve anti-tumor efficacy and reduce unfavorable effects. Lactoferrin is an iron-binding glycoprotein found in body fluids. Increasing evidence suggests that lactoferrin is a safe agent capable of inducing anti-cancer effects. Therefore, we conducted a study to evaluate the effects of the exosomal form of bovine milk lactoferrin on a human MDA-MB-231 breast cancer cell line.

Methods

The exosomes were isolated from cancer cells by ultracentrifugation and incorporated with bovine milk lactoferrin through the incubation method. The average size of the purified exosome was determined using SEM imaging and DLS analysis. The maximum percentage of lactoferrin-loaded exosomes (exoLF) was achieved by incubating 1 mg/ml of lactoferrin with 30 µg/ml of MDA-MB-231 cells-derived exosomes. Following treatment of MDA-MB-231 cancer cells and normal cells with 1 mg/ml exoLF MTT assay applied to evaluate the cytotoxicity, PI/ annexin V analysis was carried out to illustrate the apoptotic phenotype, and the real-time PCR was performed to assess the pro-apoptotic protein, Bid, and anti-apoptotic protein, Bcl-2.

Results

The average size of the purified exosome was about 100 nm. The maximum lactoferrin loading efficiency of exoLF was 29.72%. MTT assay showed that although the 1 mg/ml exoLF treatment of MDA-MB-231 cancer cells induced 50% cell growth inhibition, normal mesenchymal stem cells remained viable. PI/ annexin V analysis revealed that 34% of cancer cells had late apoptotic phenotype after treatment. The real-time PCR showed an elevated expression of pro-apoptotic protein Bid and diminished anti-apoptotic protein Bcl-2 following exoLF treatment.

Conclusion

These results suggested that exoLF could induce selective cytotoxicity against cancer cells compared to normal cells. Incorporating lactoferrin into the exosome seems an effective agent for cancer therapy. However, further studies are required to evaluate anti-tumor efficacy and the underlying mechanism of exoLF in various cancer cell lines and animal models.
'Learning by doing', a model for improving the promotion of healthy lifestyles by student nurses
Authors: Pérez-Rivas Francisco Javier , Rico-Blázquez Milagros , López-López Candelas , Domínguez-Fernández Silvia , Cobos-Serrano José Luis , Ajejas Bazán María Julia
Published: July 2023

Background

'Learning by doing' is a learning model based on performing actions and gaining experience. The 'nursing process' is a systematic, rational method for providing nursing care. During their university education, nursing students need to acquire the ability to promote healthy lifestyles.

Objective

To determine the effectiveness of a learning strategy based on learning by doing and grounded in the use of the nursing process, on the lifestyle of nursing students.

Methods

This quasi-experimental intervention (before-after), performed over 2011–2022, involved 2300 nursing students at a university nursing school in Spain. The risk factors for chronic diseases—being a smoker, being overweight, or having high blood pressure—to which each student was exposed were recorded. Those positive for at least one risk factor selected companion students as 'support nursing students' who became responsible for designing an individualised care plan to reduce the risk(s) faced. To ensure the correct use of the nursing process, teachers approved and monitored the implementation of the care plans. Whether risk-reduction objectives were met was determined three months later.

Results

The students with risk factors largely improved their lifestyles (targets for reducing smoking/body weight were met) with the help of their supporting peers.

Conclusions

The learning by doing method demonstrated its effectiveness, improving the lifestyle of at-risk students via the use of the nursing process.