bluuebunny/crossref_metadata_2025 huggingface dataset:
Monotherapy or combination therapy in PsA: current aspects
Authors: Skouvaklidou Elpida , Avgerou Paraskevi , Vassilakis Konstantinos D. , Fragoulis George E. , Kougkas Nikolaos
Published: September 2024

Psoriatic arthritis (PsA) is an immune-mediated inflammatory disease with heterogeneity regarding its clinical features, mainly affecting the skin and the musculoskeletal system; additionally, extra-musculoskeletal manifestations and comorbidities are common, adding complexity to its treatment. In the last decades, a plethora of therapeutic options have been available, including conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs), biological DMARDs (bDMARDs), and targeted synthetic DMARDs (tsDMARDs), and many recommendations have been published regarding the proper use of them in patients with PsA. In rheumatoid arthritis, the combination of conventional with bDMARDs or tsDMARDs is a common and recommended practice, whereas in PsA there is scarce data about the benefit of this combination. This review summarizes all the available data from randomized clinical trials, observational studies, and registries about the value of this therapeutic strategy.
Successful use of a 3D-printed surgical guide to facilitate transiliosacral fixation in a cat with bilateral sacroiliac luxation
Authors: Scortea Radu , Reichardt Fee , Muresan Cosmin , Krauß Maximiljan
Published: September 2024

Case summary

A 7-year-old male castrated domestic shorthair cat was presented for treatment of a bilateral sacroiliac luxation (SIL). CT was performed and the data were extracted in a stereolithography (STL) file, after which a 3D-printed drill guide (3DPDG) was devised, using computer-aided design (CAD) software, and printed. Using an open surgical approach, the guide was used as an aid for drilling the sacrum. The ilial wings were drilled free-hand later and a transiliosacral pin (TP) was inserted to realign and stabilise the SIL. The cat exhibited an early return to normal limb function and a CT scan performed at the postoperative follow-up showed early signs of bone remodelling at the sacroiliac joint.

Relevance and novel information

To the authors’ knowledge, this is the first report using a 3DPDG for implant placement in the feline sacrum without intraoperative imaging.
Scalable intimacy: Rethinking intimate sociality and its problem of scale in digital China
Authors: Gu Jingyi
Published: September 2024

With the development of the Internet in China, people have increasingly turned to digital communication and networking tools for personal connections and social relations. From messaging and dating apps to microblogging and live-streaming platforms, mediated forms of sociality constitute a significant part of people’s intimate lives. Scholarly works on modern and contemporary China have shown how practices and politics of intimacy are formulated and contested against the backdrop of the tensions between the residual culture of Confucianism, the socialist ideological regime, and China’s participation in global capitalism. On the contrary, research on global network societies has foregrounded the role of information and media technologies in mediating intimacy with conceptual frameworks such as programmed sociality and networked intimacy. Bridging these two areas of research, this essay attempts to understand how intimate sociality is configured within China’s burgeoning digital economy and culture. It first provides a review of previous works on forms of intimacy and sociality mediated by network technologies ranging from mobile phones to online dating. Using the popularity of live streaming in current-day China as a case study, this essay then introduces the problem of “scale” to consider how intimacy is mediated at scale with Internet-based media technologies and discuss how scalability shapes intimate lives in Chinese society as a shared rationale behind modernization, network technologies, and new forms of economies. This essay proposes the concept of scalable intimacy to move beyond the platform-centered approach and develop a more contextualized framework for understanding intimate sociality in digital China.
Linking Workplace Unfairness with Urban Withdrawal Intentions: The Moderating Role of Urban Identification
Authors: Gao Ying , Tian Yuxin , Yuan Shaofeng
Published: September 2024

The mobility of skilled employees from developing to developed cities is a prominent phenomenon in China. However, little is known about whether and how micro factors (e.g., unfair treatment) in the workplace affect employees’ cross-city mobility. The aim of this study is thus to investigate the effect of employees’ perceived workplace unfairness on their intentions to withdraw from the city where they work, specifically, to shed light on the moderating role of urban identification in this effect. Through a survey of 453 skilled employees working in developing cities in northeast China, this study reveals that (a) both perceived distributive and procedural unfairness have a positive effect on employees’ urban dissatisfaction, which in turn reinforces their urban withdrawal intention; (b) urban identification can amplify the positive effect of perceived distributive/procedural unfairness on urban dissatisfaction; and (c) the positive joint effect of perceived distributive/procedural unfairness and urban identification on urban dissatisfaction can further carry over to urban withdrawal intentions. This study therefore sheds new lights on how employees’ workplace unfairness shapes their withdrawal intentions toward the city where they work and how their urban identification moderates this process, offering implications for how developing cities and firm managers can retain skilled employees.
Mythologizing of characters: Chinese character archaeology evidence of ancient Chinese totems related to “Yi (一)” cognate
Authors: Ha Youngsam
Published: September 2024

This article endeavors to elucidate the mechanisms by which vestiges of mythology become embedded in the morphology of Chinese characters. It represents a foundational study aimed at explicating how oral mythological traditions and archaic mythical cognitions manifest themselves through the concrete graphemic structures of Chinese characters. The research focuses on the analysis of the characters “Yi (一),” “Yi (壹),” “Yi (羽/能),” and “Yi (鳦),” which are cognates. Through this examination, the study demonstrates that these graphemes are reflective of ancient Chinese veneration of the gourd, as well as bear and bird totemic traditions. To substantiate these claims, the methodology of “Chinese character archaeology” is employed, which integrates etymological analysis of the characters themselves with traditional textual sources, archaeological findings, and anthropological data. This approach can be extended to encompass a diverse array of totems, including plants, dragons, tigers, and horses. The ancient Chinese characters that encapsulate these totemic traditions are of particular significance as they offer insights into primordial modes of thought that predate the genesis of philosophical literature. Furthermore, this research potentially elucidates, through graphemics, the hypothesis that Chinese ancient civilization originated simultaneously in various regions with distinct totemic traditions, gradually converging into a predominant civilization.
ACE2 deficiency inhibits thoracic aortic dissection by enhancing SIRT3 mediated inhibition of inflammation and VSCMs phenotypic switch
Authors: Jiang Liqing , Lu Linhe , Xue Chao , Sun He , Ren Kai , Zhang Liyun , Zhu Hanzhao , Zhang Bin , Wang Xiaoya , Qiao Xinan , Peng Xiangyan , Liu Jincheng , Duan Weixun
Published: September 2024

Background

Thoracic aortic dissection (TAD) is an irreversible cardiovascular disorder with high mortality and morbidity. However, the molecular mechanisms remain elusive. Thus, identifying an effective therapeutic target to prevent TAD is especially critical. The purpose of this study is to elucidate the potential mechanism of inflammation and vascular smooth muscle cell (VSMCs) phenotypic switch in β-aminopropionitrile fumarate (BAPN)-induced TAD.

Methods

A mouse model of TAD induced by BAPN and IL-1β -stimulated HVSMCs in vivo and in vitro models, respectively. ACE2 Knockdown mice treated with BAPN or without, and the TAD mouse model was treated with or without AAV-ACE2. Transthoracic ultrasound was conducted for assessment the maximum internal diameter of the thoracic aorta arch. RNA sequencing analysis was performed to recapitulate transcriptome profile changes. Western blot were used to detect the expression of MMP2, MMP9, ACE2, SIRT3, OPN, SM22α and other inflammatory markers. The circulating levels of ACE2 was measured by ELISA assay. Histological changes of thoracic aorta tissues were assessed by H&E, EVG and IHC analysis.

Results

We found that circulating levels of and the protein levels of ACE2 were increased in the TAD mouse model and in patients with TAD. For further evidence, ACE2 deficiency decelerated the formation of TAD. However, overexpression of ACE2 aggravated BAPN-induced aortic injury and VSMCs phenotypic switch via lowered SIRT3 expression and elevated inflammatory cytokine expression.

Conclusion

ACE2 deficiency prevented the development of TAD by inhibiting inflammation and VSMCs phenotypic switch in a SIRT3-dependent manner, suggesting that the ACE2/SIRT3 signaling pathway played a pivotal role in the pathological process of TAD and might be a potential therapeutical target.
Vitality at home: a phenomenological study of tele-exercise in women aged 80 and older
Authors: Lee Janet Lok Chun , Chan Karly Oi Wan , Kwan Rick Yiu Cho , Wong Arnold Yu Lok
Published: September 2024

Background

Since the onset of coronavirus 2019, there has been an upsurge of tele-exercise delivery. Previous studies showed old adults find tele-exercise feasible and acceptable. However, there is limited understanding of the oldest-old’s experiences.

Method

This study used the interpretative phenomenological approach. Two semi-structured interviews and home visits were conducted with six oldest-old women, aged between 81 and 91 years, who participated in tele-exercise classes.

Results

Four superordinate themes were identified: ambivalent perception of safety, ease in regular participation, reminded and guided to move the aged body, and technological adaptation.

Conclusion

Our findings indicate that tele-exercise has the potential to assist the oldest-old living in the community in maintaining an adequate activity levels at home, which they perceive as the safest place. Emerging themes provide insights into their lived experiences, enabling service providers to enhance tele-exercise services for this group in the tele-health era.
Outcome of perioperative immune enhancing nutrition in patients undergoing radical cystectomy
Authors: Sultan Sultan Mohamed , Salman Baher , Abdelrazek Eman , Alorabi Ammar , Selim Mohamed
Published: September 2024

Background

Since radical cystectomy is associated with relatively high perioperative morbidity and mortality, this study was conducted to evaluate the efficacy of perioperative immune nutrition in radical cystectomy patients on postoperative outcomes including wound healing, postoperative complications, either infectious or non-infectious, and length of hospital stay.

Patients and methods

This prospective, randomized controlled study was conducted between June 2022 and November 2023. Forty-two patients who had undergone radical cystectomy with ileal conduit were randomized into two groups: the immune nutrition group, which received perioperative immune nutrition, and the conventional group, which did not receive immune nutrition. Patients were followed up for 30 days postoperatively to assess wound healing, infectious and non-infectious complications, and the length of hospital stay.

Results

Patients who received immune nutrition had significantly lower postoperative infectious complications (19.0 vs 61.9%; P = 0.004), shorter hospital stay (16.57 ± 3.74 vs 20.38 ± 5.97; P = 0.01) and shorter ICU stay (2.60 ± 1.07 vs 7.09 ± 7.50; P = 0.029). The proper wound healing was significantly higher in the immune nutrition group (90.5 vs 52.4%; P = 0.006). However, there was no significant difference between both groups in the rate of non-infectious complications (28.5% vs. 57.1%, P = 0.061).

Conclusion

Perioperative immune nutrition is associated with improved wound healing, reduced infectious complications, and reduced length of hospital stay.

Trial registration clinicaltrials.gov, NCT05822518. Registered 1 April 2023—Retrospectively registered, https://clinicaltrials.gov/study/NCT05822518.
Dioxin-like and estrogenic activity screening in fractionated sediments from a German catchment after the 2021 extreme flood
Authors: Johann Sarah , Düster Moritz , Bellanova Piero , Schwarzbauer Jan , Weber Alexandra , Wolf Stefanie , Schüttrumpf Holger , Lehmkuhl Frank , Hollert Henner
Published: September 2024

Background

The flood in July 2021 is considered one of the largest flood disasters in Western Europe in decades, with massive socio-economic consequences. The potential emission and remobilization of anthropogenic pollutants can lead to additional environmental consequences, which need to be addressed in long-term mitigation strategies. The Inde River and its tributary, the Vichtbach River, form a catchment located at the transition from the low mountain ranges of the Eifel to the lowlands of the Lower Rhine Embayment in Germany. The area has been an industrial and mining hotspot for centuries, making it a high-risk area for flood sediment pollution. The present study provides an ecotoxicological screening of flood sediments of the Vicht–Inde catchment to gain an impression of the degree of contamination by organic pollutants by means of in vitro effect-based method. Sediment samples were collected within days after the flood and fractionated prior to biotesting, and supportive instrumental geochemical analysis was performed.

Results

Flood sediments did not reveal estrogenic potential, which was included in the testing strategy as a relevant endpoint for industrial chemicals and untreated wastewater. In contrast, moderate-to-high dioxin-like activity was observed in 70% of the sediment samples with a peak dioxin-like potential at the restored section of the Inde. Overall, four hotspot samples were identified as at risk, which aligned mostly with the high concentration of organic pollutants including PAHs and PCBs. The fractionation allowed the identification of PAHs and their derivates as the most likely toxicity drivers for dioxin-like activity in the sediments of the Vicht–Inde catchment.

Conclusion

The results provide first information on the prioritization of hotspot locations at risk for a detailed ecotoxicological profiling and a post-flood monitoring of organic contamination. The identified sinks of contamination in the floodplain areas can be considered a source for remobilization of pollution in future flood events, which is highly relevant for the receiving Rur River.
Assessing the impact of the 2021 flood event on the archaeological heritage of the Rhineland (Germany)
Authors: Schmidt Isabell , Boemke Bruno , Herzog Irmela , Koppmann Claudia , Witte Hannah , Sauer Florian , Claßen Erich , Lehmkuhl Frank
Published: September 2024

Background

Archaeological sites are increasingly threatened by climate-related hazards. In response, heritage management authorities initiated projects to document damage and plan risk assessment measures. We present a project initiated after the heavy rainfall and subsequent flood event of July 2021, which involved extensive fieldwork to document the damage to archaeological sites in the Rhineland. We use this database to characterise and assess the damage and investigate site-specific and geospatial factors to identify potential predictive parameters for site damage.

Results

During fieldwork, we found that the flood damaged 19% of the 538 archaeological sites surveyed. The majority of damaged sites are relatively recent, dating from the medieval or modern periods, and are associated with the use of water power. Damage was mainly caused by erosion, floating debris and washout, e.g. mortar. In a case study, we tested the option of comparing pre- and post-disaster Airborne Laser Scanning elevation data to identify damages. It showed that not only the damage detected during fieldwork was found but also additional areas of loss. In general, however, and quantified based on the entire dataset, the ordnance survey Airborne Laser Scanning data were of limited use for monitoring flood-related damage and could not replace fieldwork. Our statistical analysis of possible risk factors, including both site characteristics and geospatial parameters, using Naïve Bayes Modelling and chi-squared tests, showed that no set of parameters could consistently predict the preservation or damage of archaeological sites across all catchments. In contrast, some external geospatial factors correlated with the occurrence of damage.

Conclusions

The study highlights both the strengths and limitations of the approaches used to assess and predict the damage to the archaeological heritage in the 2021 flood zones of the Rhineland. It also demonstrates the complexity of the data and spatial processes involved, which limits generalisation but can still inform decision-making for archaeological site management and on-site protection measures in flood-prone areas. With the prospect of more frequent heavy rainfall due to climate change, the specific needs of the archaeological heritage should be integrated into broader prevention and disaster management plans.
Gravitational change-induced alteration of the vestibular function and gene expression in the vestibular ganglion of mice
Authors: Bazek Murat , Sawa Motoya , Horii Kazuhiro , Nakamura Naotoshi , Iwami Shingo , Wu Chia-Hsien , Inoue Tsuyoshi , Nin Fumiaki , Abe Chikara
Published: September 2024

Gravity has profoundly influenced life on Earth, yet how organisms adapt to changes in gravity remains largely unknown. This study examines vestibular plasticity, specifically how the vestibular system responds to altered gravity. We subjected male C57BL/6J mice to hypergravity (2 G) followed by normal gravity (1 G) to analyze changes in vestibular function and gene expression. Mice showed significant vestibular dysfunction, assessed by righting reflex tests, which persisted for days but reversed at 1 G after exposure to 2 G. Gene expression analysis in the vestibular ganglion identified significant changes in 212 genes out of 49,585 due to gravitational changes. Specifically, 25 genes were upregulated under 2 G and recovered at 1 G after 2 G exposure, while one gene showed the opposite trend. Key neural function genes like Shisa3, Slc25a37, Ntn4, and Snca were involved. Our results reveal that hypergravity-induced vestibular dysfunction is reversible and highlight genes critical for adaptation.
Personalized sleep and nutritional strategies to combat adverse effects of night shift work: a controlled intervention protocol
Authors: van der Rhee Maaike , Oosterman Johanneke E. , Wopereis Suzan , van der Horst Gijsbertus T. J. , Chaves Inês , Dollé Martijn E. T. , Burdorf Alex , van Kerkhof Linda W. M. , der Holst Heidi M. Lammers-Van
Published: September 2024

Background

Working during the night interferes with the timing of normal daily activities and is associated with an increased risk of chronic diseases. Under controlled experimental conditions, interventions focusing on sleep and nutrition can mitigate the short-term adverse effects of shift work. However, it is unclear how these results translate to real-life, how they can be targeted to individual conditions, and how they relate to long-term health. Therefore, the current study aims to implement a personalized sleep and nutritional intervention among night shift workers in the field.

Methods

A non-blinded controlled intervention study is used, consisting of a run-in period, an intervention of 3 months, post-intervention measurements, and a follow-up after 12 months. Three study arms are included: sleep intervention, nutritional intervention, and control group (n = 25 each). Participants are healthy 18–60-year male night shift workers, with at least one year of experience in night shift work. Information from the run-in period will be used to personalize the interventions. The main outcomes are sleep measurements and continuous interstitial glucose levels. Furthermore, general health biomarkers and parameters will be determined to further evaluate effects on long-term health.

Discussion

This study aims to mitigate negative health consequences associated with night shift work by introducing two personalized preventive interventions. If proven effective, the personalized interventions may serve as practical solutions that can have a meaningful impact on the sustainable health and employability of night shift workers. This study will thereby contribute to the current need for high–quality data on preventative strategies for night shift work in a real-life context.

Trial registration

This trial has been registered under ClinicalTrials.gov Identifier NCT06147089. Registered 27 November 2023.
Examining gaze behavior in undergraduate students and educators during the evaluation of tooth preparation: an eye-tracking study
Authors: Silvestri Frédéric , Odisho Nabil , Kumar Abhishek , Grigoriadis Anastasios
Published: September 2024

Background

Gaze behavior can serve as an objective tool in undergraduate pre-clinical dental education, helping to identify key areas of interest and common pitfalls in the routine evaluation of tooth preparations. Therefore, this study aimed to investigate the gaze behavior of undergraduate dental students and dental educators while evaluating a single crown tooth preparation.

Methods

Thirty-five participants volunteered to participate in the study and were divided into a novice group (dental students, n = 18) and an expert group (dental educators, n = 17). Each participant wore a binocular eye-tracking device, and the total duration of fixation was evaluated as a metric to study the gaze behavior. Sixty photographs of twenty different tooth preparations in three different views (buccal, lingual, and occlusal) were prepared and displayed during the experimental session. The participants were asked to rate the tooth preparations on a 100 mm visual analog rating scale and were also asked to determine whether each tooth preparation was ready to make an impression. Each view was divided into different areas of interest. Statistical analysis was performed with a three-way analysis of the variance model with repeated measures.

Results

Based on the participants’ mean rates, the “best” and the “worst” tooth preparations were selected for analysis. The results showed a significantly longer time to decision in the novices compared to the experts (P = 0.003) and a significantly longer time to decision for both the groups in the best tooth preparation compared to the worst tooth preparation (P = 0.002). Statistical analysis also showed a significantly longer total duration of fixations in the margin compared to all other conditions for both the buccal (P < 0.012) and lingual (P < 0.001) views.

Conclusions

The current study showed distinct differences in gaze behavior between the novices and the experts during the evaluation of single crown tooth preparation. Understanding differences in gaze behavior between undergraduate dental students and dental educators could help improve tooth preparation skills and provide constructive customized feedback.
Lasting effects of transcranial direct current stimulation on the inducibility of synaptic plasticity by paired-associative stimulation in humans
Authors: Vestring Stefan , Wolf Elias , Dinkelacker Johanna , Frase Sibylle , Hessling-Zeinen Carolin , Insan Shrabon , Kumlehn Maral M. , Feige Bernd , Domschke Katharina , Normann Claus , Frase Lukas
Published: September 2024

Background

Transcranial direct current stimulation (tDCS) is capable of eliciting changes in cortical neuroplasticity. Increasing duration or repetition of tDCS during the after-effects of a first stimulation has been hypothesized to enhance efficacy. Computational models suggest sequential stimulation patterns with changing polarities to further enhance effects. Lasting tDCS effects on neural plasticity are of great importance for clinical applications.

Objective

The study systematically examined the influence of different tDCS paradigms on long term potentiation (LTP)-like plasticity in humans, focusing on stimulation duration, repetition frequency and sequential combinations of changing polarities as the underlying characteristics.

Methods

Amplitude changes of motor evoked potentials (MEP) were measured in response to paired associative stimulation (PAS) 6 h after application of different tDCS protocols. In total, 36 healthy participants completed the study, randomised into three groups with different stimulation protocols (N = 12 each).

Results

tDCS was able to display lasting modulatory effects on the inducibility of LTP-like plasticity in the human motor cortex 6 h after stimulation. TDCS with the anode on primary motor cortex significantly increased MEP amplitudes following PAS induction. Further analyses highlighted single stimulation block duration to be of higher importance than repetitive protocols for efficacy of effects.

Conclusions

tDCS is capable of inducing lasting changes in the brain’s capability to interact with future stimuli. Especially, effects on the inducibility of LTP-like plasticity might only be detectable with specific tests such as PAS and might otherwise be overlooked. Refined tDCS protocols should focus on higher current and duration of single stimulations instead of implementing complex repetitive schedules.
Clinical and genetic characteristics of 100 consecutive patients with Birt-Hogg-Dubé syndrome in Eastern Chinese region
Authors: Hu Daiju , Wang Rui , Liu Jinli , Chen Xianmeng , Jiang Xianliang , Xiao Jun , Ryu Jay H. , Hu Xiaowen
Published: September 2024

Background

Although an increasing number of patients with Birt-Hogg-Dubé syndrome (BHD) are being recognized in China, clinical and genetic characteristics are not well-defined. In addition, revised diagnostic criteria for the Chinese population was proposed in 2023, we aimed to explore their utility in clinical practice at a rare lung disease center.

Methods

We retrospectively analyzed the data of 100 consecutive patients with BHD diagnosed according to the revised Chinese BHD criteria, encountered at the First Affiliated Hospital of University of Science and Technology of China from Jan 2017 to June 2023.

Results

There were 100 patients (including 63 females) from 65 unrelated families in Eastern China, mostly Anhui Province. The common manifestations were pulmonary cysts (99%), pneumothorax (60%), and skin lesions (77%). Renal cancer and renal angiomyolipoma were detected in 5 patients each. 37% of patients had no family history of BHD. In total, 25 FLCN germline mutations were detected, including 6 novel mutations. In addition to hotspot mutation c.1285delC/dupC (17%), the most common mutations were c.1015 C > T (16%), c.1579_1580insA (14%), and exons 1–3 deletion (11%) in FLCN. Higher risk of pneumothorax was associated with exons 1–3 deletion mutation and c.1177-5_1177-3de1CTC compared to the hotspot mutation c.1285dupC (91% [95% CI: 0.31, 46.82, p = 0.015] and 67% [95% CI: 0.35, 71.9, p = 0.302] vs. 30%, respectively). The average delay in diagnosis was 7.6 years after initial symptoms. Chinese diagnostic criteria were mostly consistent with typical pulmonary presentations with supportive genetic evidence.

Conclusion

In the Eastern Chinese region, patients with BHD present most commonly with pulmonary cysts associated with pneumothorax and skin lesions. However, low incidence of renal cancer along with unexpected renal angiomyolipoma was observed. Genotypic spectrum differed from that reported from other global regions, and genotype association of pneumothorax warrants further research. The revised Chinese criteria for BHD seem more appropriate in diagnosing BHD in Chinese patients.
Patients' use of Danish emergency medical services before and during the COVID-19 pandemic: a register-based study
Authors: Lindskou Tim Alex , Bogh Søren Bie , Kløjgaard Torben Anders , Fløjstrup Marianne , Folke Fredrik , Væggemose Ulla , Christensen Helle Collatz , Christensen Erika Frischknecht , Brabrand Mikkel , Mikkelsen Søren
Published: September 2024

Background

During the COVID-19 pandemic, disturbing images of ambulances unable to respond to the demands for prehospital assistance appeared from several parts of the world. In Denmark, however, a notion occurred that the demands for emergency medical assistance declined. The purpose of this study was to compare the patients' use of the Danish Emergency Medical Services (EMS) before and during the COVID-19 pandemic. Furthermore, we investigated the overall mortality of the ambulance population, the main reason for calling the emergency medical dispatch centre, and the diagnosis assigned to the admitted patients.

Methods

The study was a nationwide registry-based cohort study based on the national prehospital medical records and the Danish National Patient Registry. The primary outcome was the requested number of ambulances. Secondary outcomes included the primary reason for contact with the dispatch centre (reflected by the dispatch criteria), patient mortality, and the diagnoses assigned to the patients transported to the hospital by ambulance during the COVID-19 pandemic in Denmark in March–December 2020. Comparisons were made using a similar period in 2019 before the pandemic.

Results

In comparison with the baseline values before the pandemic, the total number of patients treated by the EMS was reduced by 4.5% during the COVID-19 pandemic. The number of patients transported to the hospital during the pandemic was similarly reduced by 3.5%. Compared with baseline values, fewer were patients hospitalised with respiratory diseases during the pandemic (a reduction of 53.3% from April 2019 to April 2020).

Compared to the baseline period, there were significant increases in both the 48-h mortality (from 1.4% to 1.5%) and the 30-day mortality (from 4.9% to 5.4%) (p < 0.03 and p < 0.001, respectively), in patients hospitalised during the pandemic.

Conclusion

During the first wave of the COVID-19 pandemic, the Danish EMS experienced an overall reduction in the requests for and the use of ambulances and, especially, in the number of patients admitted to hospitals for respiratory diseases. Despite the overall reduction in EMS requests, the mortality of the ambulance population increased, indicating that despite the reduced ambulance use, the prehospital population was more severely ill during the pandemic.
Effects of hippotherapy on motor function of children with cerebral palsy: a systematic review study
Authors: Plotas Panagiotis , Papadopoulos Angelos , Apostolelli Evangelia-Maria , Vlachou Eleni , Gazou Foteini , Zogopoulou Ioanna , Katsaidoni Ioanna , Panagiotopoulou Ioanna , Paparouna Sofia Paraskevi , Silavou Nikolina , Fragkiadaki Katerina , Tsiamaki Eirini , Fouzas Sotirios , Sinopidis Xenophon , Trimmis Nikolaos
Published: September 2024

Cerebral palsy includes a spectrum of neurodevelopmental disorders caused by brain damage, leading to impairment of movement, posture, and balance for a lifetime. There are many therapeutic interventions for cerebral palsy. One of them is hippotherapy, an alternative physical therapy. It is a type of equine-assisted activity and therapy where children with cerebral palsy and motor function skills interact with a horse. We aimed to study the effects of hippotherapy, as an alternative therapy, on the motor function of children with cerebral palsy. We performed a review of the latest literature on hippotherapy and cerebral palsy. The criteria we used were specific keywords, publication date, age of the subjects/studied population, and article type. The outcome of our research resulted in ten relevant studies. The findings demonstrate improvements in various aspects of motor function – more specifically in gross motor function skills, balance, coordination, gait parameters, and muscle strength. Two of ten studies used the Horse-Riding Simulator with significant improvements in postural control in sitting, motor function, and hip abduction range of motion. Hippotherapy can improve motor function skills of children between 2 and 14 years of age with cerebral palsy, affecting their well-being and overall quality of life. It can have a positive effect either as a standalone treatment or as a part of other traditional therapies. Extended research is needed to assess whether hippotherapy may present significant long-term changes in motor skills in children with cerebral palsy.
Neonatal birth asphyxia and associated factors among newborns delivered and admitted to NICU in selected public hospitals, under Addis Ababa City Administration Health Bureau, Addis Ababa, Ethiopia, A cross-sectional study
Authors: Tarko Dawit , Zewdu Tesfu , Tesfaye Shewamene , Gerezihear Abel , Haile Azeb
Published: September 2024

Background

In developing countries birth asphyxia is a major cause of neonatal morbidity and mortality. Despite the implementation of various strategies and interventions to combat neonatal mortality rates, birth asphyxia remains the main public health concern in Ethiopia. Moreover, limited studies have been conducted, especially in the study area and there are no multicenter analyses available to generate evidence for action. Therefore, this study aimed to assess the burden and associated factors of birth asphyxia among newborns in the selected public hospitals of the Addis Ababa City Administration Health Bureau.

Methods

Three hundred forty-three mother-child pairs who used delivery services and gave birth in the selected public hospitals were included in the study, and institution based cross sectional study design was employed. A systematic random sampling technique was used to select the study participants. A pretested, structured interviewer administered questionnaire was used to collect the data. The physician’s/health care professionals diagnosis of an Apgar score less than 7 within the first five minutes of life led to the confirmation of the diagnosis of birth asphyxia. SPSS version 24 was used for analysis after the data were exported from Epi Info version 7.2. Multivariate logistic regression analysis included variables which had P-values less than 0.25 in the bivariable logistic regression analysis. The study findings were expressed using adjusted odds ratio with a 95% confidence interval, and P-value less than 0.05 was used to declare the statistical significance.

Results

The magnitude of birth asphyxia was found to be 17.1% [95% CI; (13.2–21.5)] at the first 5 min. In the multivariable logistic regression analysis cord accident [AOR = 6.24: 95% CI; (1.24–31.32)], prolonged duration of labor [AOR = 2.49: 95% CI; (1.93–10.89)], and meconium-stained amniotic fluid [AOR = 3.33: 95% CI; (1.73–6.41)] were the predictors of birth asphyxia.

Conclusions

The findings of this research indicate that birth asphyxia is a prevalent neonatal problem at the study area. Therefore, the Addis Ababa Health Bureau must prioritize integrated mitigation interventions targeting high-risk pregnancies to achieve national and international commitment to sustainable changes in newborn health.
Association between subcortical nuclei volume changes and cognition in preschool-aged children with tetralogy of Fallot after corrective surgery: a cross-sectional study
Authors: Hu Liang , Wu Kede , Li Huijun , Zhu Meijiao , Zhang Yaqi , Fu Mingcui , Tang Minghui , Lu Fan , Cai Xinyu , An Jia , Patel Nishant , Lin Ye , Zhang Zhen , Yang Ming , Mo Xuming
Published: September 2024

Background

Neurocognitive disorders frequently occur in patients with cyanotic congenital heart disease (CCHD) because of the hemodynamic abnormalities induced by preoperative cardiac structural changes. We aimed to evaluate subcortical nuclei volume changes and cognition in postoperative tetralogy of Fallot (TOF) children, and analyze their relationship with preoperative cardiac structural changes.

Methods

This case-control study involved thirty-six children with repaired TOF and twenty-nine healthy controls (HCs). We utilized three-dimensional (3D) T1-weighted high-resolution structural images alongside the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV) to evaluate the cognitive differences between the TOF and HC group.

Results

We observed notable differences in subcortical nuclei volume between the TOF and HC group, specifically in the left amygdala nucleus (LAM, TOF: 1292.60 ± 155.57; HC: 1436.27 ± 140.62, p < 0.001), left thalamus proper nucleus (LTHA, TOF: 6771.54 ± 666.03; HC: 7435.36 ± 532.84, p < 0.001), and right thalamus proper nucleus (RTHA, TOF: 6514.61 ± 715.23; HC: 7162.94 ± 554.60, p < 0.001). Furthermore, a diminished integrity of LAM ( β:-19.828, 95% CI: -36.462, -3.193), which showed an inverse relationship with the size of the preoperative ventricular septal defect (VSD), correlated with lower working memory indices in children with TOF.

Conclusions

Our findings indicate that subcortical nuclei structural injuries possibly potentially stemming from cardiac anatomical abnormalities, are associated with impaired working memory in preschool-aged children with TOF. The LAM in particular may serve as a potential biomarker for neurocognitive deficits in TOF, offering predictive value for future neurodevelopmental outcomes, and shedding light on the neurophysiological mechanisms of these cognitive impairments.
Ongoing transmission of onchocerciasis in the Pru District of Ghana after two decades of mass drug administration with ivermectin and comparative identification of members of the Simulium damnosum complex using cytological and morphological techniques
Authors: Chikezie Friday Maduka , Veriegh Francis Balunnaa Dhari , Armoo Samuel , Boakye Daniel Adjei , Taylor Mark , Osei-Atweneboana Mike Yaw
Published: September 2024

Background

Human onchocerciasis remains a public health problem in Ghana. Mass drug administration (MDA) with ivermectin (IVM) has reduced disease morbidity and prevalence, but the transmission of onchocerciasis remains ongoing in several endemic foci. We investigated parasite transmission in some endemic communities in Ghana that had received > 18 rounds of annual MDA with IVM and determined the species composition of black fly (Simulium damnosum) vectors in these areas.

Methods

Adult female black flies were collected using human landing catches and identified as either forest or savanna species using morpho-taxonomic keys. The adult flies underwent dissection to determine their parity and detect any O. volvulus larvae, followed by the calculation of entomological indices. Simulium damnosum s.l. larvae were collected and preserved in freshly prepared Carnoy’s fixative and were later used for cytotaxonomic studies.

Results

A total of 9,983 adult flies were caught: 6,569 and 3,414 in the rainy and dry seasons respectively. Black fly biting activities over the study period showed bimodal or trimodal patterns. The highest monthly biting rate (MBR) of 10,578.75 bites/person/month was recorded in July in Beposo, while the highest monthly transmission potential of 100.69 infective bites/person/month was recorded in Asubende in August. Morphological analysis of 2,032 flies showed that 99.8% (2,028) of the flies were savanna species, with only 4 (0.2%) adult flies being of the forest species. Cytogenetic studies on 114 black fly larvae revealed three cytospecies (Simulium damnosum s.s., S. sirbanum and S. sanctipauli) in the study area.

Conclusions

The present studies confirmed an ongoing transmission of onchocerciasis in the study communities except Abua-1. It also provides further information on biting behaviors and onchocerciasis transmission indices in the study communities. Further, our data confirmed the savanna species (S. damnosum s.s. and S. sirbanum) of the S.damnosum s.l. to be the major vectors of onchocerciasis in the study areas, with only an occasional influx of forest cytotypes.

Graphical Abstract
Helminth co-infections have no additive detrimental impact on milk yield and milk quality compared to mono-infections in German dairy cows
Authors: May Katharina , Hecker Anna Sophie , König Sven , Strube Christina
Published: September 2024

Background

Infections with (tricho-)strongyles, Dictyocaulus viviparus or Fasciola hepatica have been shown to reduce milk production in dairy cows. However, the current published studies focused on one single helminth infection by neglecting helminth co-infections and their possible (additive) effects on host performance. Hence, for the first time, we investigated differences in the impact of patent helminth co-infections versus mono-infections on milk production parameters in individual cows.

Methods

A total of 1583 dairy cows from 27 herds were included in this study. Faecal samples were examined in 2015 and 2021/2022 to determine the number of eggs/larvae per gram faeces for (tricho-)strongyles, D. viviparus, F. hepatica and rumen flukes. The cows were classified as non-infected, mono-infected and co-infected. Linear mixed models were applied to analyse the association between infection status (non-infected vs. mono-infected vs. co-infected) with milk yield, milk protein and milk fat content by including potential confounders.

Results

Infections with (tricho-)strongyles, D. viviparus, F. hepatica and rumen flukes were detected in 100%, 28.6%, 50.0% and 21.4% of herds, and 27.4%, 2.6%, 10.8% and 0.8% of faecal samples in 2015, while 100%, 0.0%, 86.7% and 60.0% of herds and 52.3%, 0.0%, 13.3% and 26.8% of faecal samples were positive in 2021/2022. Co-infections with two or more helminth taxa were detected in 74.4% of herds and 5.0% of faecal samples in 2015, and in 93.3% of herds and 21.7% of faecal samples in 2021/2022. The correlations between strongyle EPG, D. viviparus LPG and F. hepatica EPG were significantly positive in 2015. Significantly higher mean EPGs were identified in 2015 in faecal samples presenting co-infections with F. hepatica and one or two other helminth taxa than in faecal samples presenting F. hepatica mono-infections (P = 0.013). Although expected, the infection status (mono- or co-infected) had no significant impact on milk yield, milk protein and milk fat content in the linear mixed model analyses based on individual faecal examinations.

Conclusions

Patent helminth co-infections had no additive detrimental impact on milk production parameters in the present study. This might be a result of presumably low worm burdens, but should be confirmed in future studies.

Graphical Abstract
A novel cystatin in Psoroptes ovis var. cuniculi: molecular characterization, serodiagnostic potential, and its anti-inflammatory property on rabbit peripheral blood mononuclear cells
Authors: Gu Xiaobin , Yang Fusheng , Wang Ce , Xu Jing , Li Yane , Liang Youping , Fan Je , Wu Fangyan , He Ran , Wang Hui , Xie Yue
Published: September 2024

Background

The ectoparasite Psoroptes ovis var. cuniculi causes substantial economic losses to the global rabbit industry. Currently, microscopy for identifying Psoroptes mite in skin scrapings, as the “diagnosis gold standard,” remains a challenge owing to its poor sensitivity in detecting low-level and/or early stage mite infestations. Additionally, Psoroptes infestations rapidly trigger cutaneous inflammation, thus the mites might produce some molecules to deal with the harmful effects of inflammation for their long-time survival on the host skin, but these molecules are still mostly unknown.

Methods

To seek a sensitive diagnostic method and illuminate the new antiinflammatory molecules, we characterized a novel cystatin of P. ovis var. cuniculi (PsoCys) using bioinformatics and molecular biology methods.

Results

The results showed that PsoCys comprised the classical features of the type II cystatin superfamily including an N-terminal glycine residue, a central QXVXG motif, and a C-terminal LW motif. In mixed stages of mites, the transcription level of PsoCys was significantly higher in “fed” mites than in “starved” mites (P < 0.001), and among the different life-cycle stages of “fed” mites, the expression of PsoCys was higher in adult males than in larva, nymph, and adult females (P < 0.001). The established indirect ELISA based on recombinant PsoCys (rPsoCys-iELISA) presented 95.4% sensitivity and 95.7% specificity. The area under the receiver operating characteristic curve (AUC) for this method was 0.991, indicating its excellent diagnostic performance. Moreover, rPsoCys-iELISA had advantages over microscopy for detecting low-level and/or early stage mite infestations (90% versus 40% in artificial infestation cases at 3 weeks post-infestation; 61.9% versus 22.6% in clinical cases). In addition, rPsoCys could inhibit the activity of papain and cathepsin B in vitro, and significantly suppressed mRNA levels of toll-like receptors (TLR 1, 2, 4, and 6) and downstream molecules (NF-κB, p38, MyD88, IL-10, and IFN-γ) in LPS-stimulated rabbit PBMCs, indicating its anti-inflammatory property.

Conclusions

Our findings indicated that PsoCys was a novel type II cystatin of Psoroptes mites, and it served as a potential serological diagnostic antigen for detecting low-level and/or early stage mite infestations, as well as a novel anti-inflammatory molecule of Psoroptes mites.

Graphical abstract
Association of education attainment, smoking status, and alcohol use disorder with dementia risk in older adults: a longitudinal observational study
Authors: Tang Huilin , Shaaban C. Elizabeth , DeKosky Steven T. , Smith Glenn E , Hu Xia , Jaffee Michael , Salloum Ramzi G. , Bian Jiang , Guo Jingchuan
Published: September 2024

Background

Previous research on the risk of dementia associated with education attainment, smoking status, and alcohol use disorder (AUD) has yielded inconsistent results, indicating potential heterogeneous treatment effects (HTEs) of these factors on dementia risk. Thus, this study aimed to identify the important variables that may contribute to HTEs of these factors in older adults.

Methods

Using 2005–2021 data from the National Alzheimer’s Coordinating Center (NACC), we included older adults (≥ 65 years) with normal cognition at the first visit. The exposure of interest included college education or above, current smoking, and AUD and the outcome was all-cause dementia. We applied doubly robust learning to estimate risk differences (RD) and 95% confidence intervals (CI) between exposed and unexposed groups in the overall cohort and subgroups identified through a decision tree model.

Results

Of 10,062 participants included, 929 developed all-cause dementia over a median 4.4-year follow-up. College education or above was associated with a lower risk of all-cause dementia in the overall population (RD, -1.5%; 95%CI, -2.8 to -0.3), especially among the subpopulations without hypertension, regardless of the APOE4 status. Current smoking was not related to increased dementia risk overall (2.8%; -1.5 to 7.2) but was significantly associated with increased dementia risk among men with (21.1%, 3.1 to 39.1) and without (8.4%, 0.9 to 15.8) cerebrovascular disease. AUD was not related to increased dementia risk overall (2.0%; -7.7 to 11.7) but was significantly associated with increased dementia risk among men with neuropsychiatric disorders (31.5%; 7.4 to 55.7).

Conclusions

Our studies identified important factors contributing to HTEs of education, smoking, and AUD on risk of all-cause dementia, suggesting an individualized approach is needed to address dementia disparities.