bluuebunny/crossref_metadata_2025 huggingface dataset:
Pembrolizumab in combination with gemcitabine for patients with HER2-negative advanced breast cancer: GEICAM/2015–04 (PANGEA-Breast) study
Authors: de la Cruz-Merino L. , Gion M. , Cruz J. , Alonso-Romero JL. , Quiroga V. , Moreno F. , Andrés R. , Santisteban M. , Ramos M. , Holgado E. , Cortés J. , López-Miranda E. , Cortés A. , Henao F. , Palazón-Carrión N. , Rodriguez L. M. , Ceballos I. , Soto A. , Puertes A. , Casas M. , Benito S. , Chiesa M. , Bezares S. , Caballero R. , Jiménez-Cortegana C. , Sánchez-Margalet V. , Rojo F.
Published: December 2022

Background

We evaluated a new chemoimmunotherapy combination based on the anti-PD1 monoclonal antibody pembrolizumab and the pyrimidine antimetabolite gemcitabine in HER2- advanced breast cancer (ABC) patients previously treated in the advanced setting, in order to explore a potential synergism that could eventually obtain long term benefit in these patients.

Methods

HER2-negative ABC patients received 21-day cycles of pembrolizumab 200 mg (day 1) and gemcitabine (days 1 and 8). A run-in-phase (6 + 6 design) was planned with two dose levels (DL) of gemcitabine (1,250 mg/m2 [DL0]; 1,000 mg/m2 [DL1]) to determine the recommended phase II dose (RP2D). The primary objective was objective response rate (ORR). Tumor infiltrating lymphocytes (TILs) density and PD-L1 expression in tumors and myeloid-derived suppressor cells (MDSCs) levels in peripheral blood were analyzed.

Results

Fourteen patients were treated with DL0, resulting in RP2D. Thirty-six patients were evaluated during the first stage of Simon’s design. Recruitment was stopped as statistical assumptions were not met. The median age was 52; 21 (58%) patients had triple-negative disease, 28 (78%) visceral involvement, and 27 (75%) ≥ 2 metastatic locations. Progression disease was observed in 29 patients. ORR was 15% (95% CI, 5–32). Eight patients were treated ≥ 6 months before progression. Fourteen patients reported grade ≥ 3 treatment-related adverse events. Due to the small sample size, we did not find any clear association between immune tumor biomarkers and treatment efficacy that could identify a subgroup with higher probability of response or better survival. However, patients that experienced a clinical benefit showed decreased MDSCs levels in peripheral blood along the treatment.

Conclusion

Pembrolizumab 200 mg and gemcitabine 1,250 mg/m2 were considered as RP2D. The objective of ORR was not met; however, 22% patients were on treatment for ≥ 6 months. ABC patients that could benefit of chemoimmunotherapy strategies must be carefully selected by robust and validated biomarkers. In our heavily pretreated population, TILs, PD-L1 expression and MDSCs levels could not identify a subgroup of patients for whom the combination of gemcitabine and pembrolizumab would induce long term benefit.

Trial registration

ClinicalTrials.gov and EudraCT (NCT03025880 and 2016–001,779-54, respectively). Registration dates: 20/01/2017 and 18/11/2016, respectively.
Accuracy of axial length, keratometry, and refractive measurement with Myopia Master in children with ametropia
Authors: Ye Yuhao , Zhao Yu , Han Tian , Zhang Xiaoyu , Miao Huamao , Qin Bing , Zhou Xingtao
Published: December 2022

Purpose

To evaluate the accuracy of axial length, keratometry, and refractive measurement with Myopia Master in ametropic children.

Methods

In this randomized prospective cross-sectional study, 125 children with ametropia (250 eyes) were recruited (55 boys and 70 girls; age range: 3–15 years). All examinations were performed under full cycloplegic conditions. Measurements of axial length (AL), keratometry, and autorefraction acquired with the Myopia Master were compared with those from the IOLMaster 500, IOLMaster 700, Nidek ARK-1, and manifest refraction. The differences between the different methods were analyzed, and their correlation was assessed by interclass correlation coefficients (ICCs), Bland–Altman plot, and correlation test.

Results

The ALs (mm) measured with Myopia Master, IOLMaster 500, and IOLMaster 700 were 23.67 ± 1.26, 23.68 ± 1.26, and 23.70 ± 1.25, respectively. The mean values and standard deviations for AL and keratometry readings from these devices were similar (P ≥ 0.059). The ICC analysis also revealed high consistency between the measurements (ICC ≥ 0.943). Additionally, the correlation coefficients were relatively high (r > 0.9, p < 0.001). Although the results of refraction obtained with the Myopia Master were slightly higher than those with manifest refraction (P ≤ 0.024), the agreement between these two measurements was excellent (ICC ≥ 0.858). The percentage of points outside the limits of agreements was < 5.22% in Bland–Altman plots for all analyses.

Conclusions

Myopia Master could be a highly efficient tool for clinical use as a three-in-one system (AL, keratometry, and refractive measurements) for screening in children with ametropia.
Role of the arts in the life and mental health of young people that participate in artistic organizations in Colombia: a qualitative study
Authors: Gómez-Restrepo Carlos , Casasbuenas Natalia Godoy , Ortiz-Hernández Natalia , Bird Victoria Jane , Acosta María Paula Jassir , Restrepo José Miguel Uribe , Sarmiento Bryan Alexander Murillo , Steffen Mariana , Priebe Stefan
Published: December 2022

Background

Adolescents and young adults are vulnerable to developing mental distress. However, evidence suggests that more than half of the young people with symptoms of depression and anxiety overcome their distress within a year. However, there is little research on the exact resources that young people use and help them to recover. The aim of this study was to explore how arts activities can support the recovery of young people engaged with arts organizations in Bogota.

Methods

We recruited 38 participants from two arts organizations in Bogotá and conducted six focus groups embedded within artistic workshops. The type of activities in the workshops varied reflecting the different teaching methods of the two organizations. The focus group discussions were recorded and analyzed using thematic analysis.

Results

Five themes explained how arts activities can help young people participating in artistic organizations to overcome mental distress: i) allowing the expression of emotions; ii) helping to manage and transform emotions; iii) distracting from problems; iv) facilitating social support and relationships; and v) contributing to the identity of young people.

Conclusions

For young people who participate in artistic organizations, the arts are a resource for overcoming negative emotions such as anxiety, depression, and sadness. The beneficial role of arts activities includes different process of managing, expressing, and distracting from distress, and it differs depending on whether arts are perceived as a professional vocation or a hobby.
Sleep spindles in people with schizophrenia, schizoaffective disorders or bipolar disorders: a pilot study in a general population-based cohort
Authors: Petit Jean-Marie , Strippoli Marie-Pierre F. , Stephan Aurélie , Ranjbar Serateh , Haba-Rubio José , Solelhac Geoffroy , Heinzer Raphaël , Preisig Martin , Siclari Francesca , Do Kim Q.
Published: December 2022

Background

Sleep spindles have been involved in sleep stabilization and sleep-related memory mechanisms and their deficit emerged as possible biomarker in schizophrenia. However, whether this sleep phenotype is also present in other disorders that share psychotic symptoms remains unclear. To address this gap, we assessed sleep spindles in participants of a prospective population-based cohort who underwent psychiatric assessment (CoLaus|PsyCoLaus) and polysomnographic recording (HypnoLaus).

Methods

Sleep was recorded using ambulatory polysomnography in participants (N = 1037) to the PsyCoLaus study. Sleep spindle parameters were measured in people with a lifelong diagnosis of schizophrenia (SZ), schizoaffective depressive (SAD), schizoaffective manic (SAM), bipolar disorder type I (BP-I) and type II (BP-II). The associations between lifetime diagnostic status (independent variables, SZ, SAD, SAM, BPD-I, BPD-II, controls) and spindle parameters (dependent variables) including density, duration, frequency and maximum amplitude, for all (slow and fast), slow- and fast-spindle were assessed using linear mixed models. Pairwise comparisons of the different spindle parameters between the SZ group and each of the other psychiatric groups was performed using a contrast testing framework from our multiple linear mixed models.

Results

Our results showed a deficit in the density and duration of sleep spindles in people with SZ. They also indicated that participants with a diagnosis of SAD, SAM, BP-I and BP-II exhibited different sleep spindle phenotypes. Interestingly, spindle densities and frequencies were different in people with a history of manic symptoms (SAM, BP-I, and BP-II) from those without (SZ, SAD).

Conclusions

Although carried out on a very small number of participants due to the low prevalence of these disorders in general population, this pilot study brought new elements that argued in favor of a deficit of sleep spindles density and duration in people with schizophrenia. In addition, while we could expect a gradual change in intensity of the same sleep spindle parameters through psychotic diagnoses, our results seem to indicate a more complex situation in which the frequency of sleep spindles might be more impacted by diagnoses including a history of mania or hypomania. Further studies with a larger number of participants are required to confirm these effects.
The determinants of immunization coverage among children aged between 12 and 35 months: a nationwide cross-sectional study in Lao People’s Democratic Republic
Authors: Ichimura Yasunori , Yanagisawa Naoki , Thandar Moe Moe , Pathammavong Chansay , Phounphenghuk Kongxay , Nouanthong Phonethipsavanh , Tengbriacheu Chankham , Khamphaphongphane Bouaphane , Franzel-Sassanpour Lauren Elizabeth , Yang Tae Un , Raaijmakers Hendrikus , Ota Tomomi , Komada Kenichi , Hachiya Masahiko , Miyano Shinsuke
Published: December 2022

Background

Immunization is one of the most important public health interventions for reducing morbidity and mortality in children. However, factors contributing to low immunization coverage are not fully understood in the Lao People’s Democratic Republic (Lao PDR). Therefore, this study aimed to identify factors associated with full immunization coverage among children between 12 and 35 months, providing up-to-date information for immunization programs in Lao PDR.

Methods

We analyzed the subpopulation of a nationwide cross-sectional survey using a multistage cluster sampling procedure to evaluate the measles and rubella seroepidemiology. In addition, we categorized children aged between 12 and 35 months into two groups: “fully immunized” children with a birth dose of Bacillus Calmette and Guérin vaccine, hepatitis B vaccine (Hep B), one and three doses for the measles-containing vaccine (MCV) and pentavalent vaccine and pneumococcal conjugate vaccine (PCV) and “partially immunized” children who missed any dose of vaccine. Immunization coverage was calculated as the ratio of “fully immunized” to the total. We compared the groups’ demographic characteristics and health service utilization as independent variables. Multivariate logistic regression was used to assess the relationship between immunization coverage, various demographic factors, and health service utilization.

Results

Overall, 256 of the 416 targeted pairs were included in the analysis. In total, 67.6% of the children were fully immunized. Childbirth at hospitals or health facilities (adjusted odds ratio: 9.75, 95% confidence interval: 5.72–16.62, p < 0.001) was the predictor of full immunization coverage. The 83 children in the partially immunized groups were attributed to Hep B at birth (46, 55.4%), three doses of PCV (34, 41.0%), and the first dose of the MCV (27, 32.5%).

Conclusion

Our study elucidated that the immunization status among children aged between 12 and 35 months in Lao PDR is satisfactory in improving access to healthcare by strengthening communication with residents regarding health service utilization, and expanding mobile outreach services may play a pivotal role in this endeavor. Further research is warranted to evaluate efforts to increase immunization coverage and target populations with limited access to healthcare.
Social determinants of health associated with COVID-19 severity during pregnancy: a multinational cohort study (in the International Registry of Coronavirus Exposure in Pregnancy)
Authors: Mack Jasmine A , Voss Erica A , Rusu Rada , Hernandez Meg Celine , Hernandez-Diaz Sonia , Wyszynski Diego F , Sylvester Shirley , DiSantostefano Rachael L
Published: December 2022

Background

The COVID-19 pandemic has caused morbidity and mortality, particularly among vulnerable populations. We aimed to assess social and demographic characteristics associated with COVID-19 severity among symptomatic participants during pregnancy.

Methods

The International Registry of Coronavirus Exposure in Pregnancy is a multinational, longitudinal observational cohort study of adult participants tested for SARS-CoV-2 or who received clinical diagnosis of COVID-19 during pregnancy (NCT04366986). Disease severity status of mild, moderate, or severe was determined based on symptoms and healthcare utilization. Stratified by current versus recent pregnancy at enrollment, univariate mixed-effects logistic regression modeling was used to characterize association between social and demographic characteristics with COVID-19 severity, using a cumulative mixed effect model with country as a random effect.

Results

The odds of developing more severe COVID-19 (odds ratio [95% confidence interval]) were higher among participants with lower socioeconomic status (poor: 2.72 [2.01,3.69]; lower-middle class: 2.07 [1.62,2.65] vs wealthy), among participants with lower educational attainment (high school: 1.68 [1.39,2.03]; < high school (1.77 [1.25,2.51] vs graduate education). Participants over 25 years of age had lower odds of severe COVID-19 versus participants < 25 years (25–34: 0.69 [0.56,0.85]; 35–50: 0.62 [0.48,0.80]). Employment in food services was also associated with increased odds of more severe COVID-19, whereas employment in healthcare and within home, and primiparity were associated with lower severity.

Conclusions

Findings suggest that employment setting and economic status have strong associations with COVID-19 severity, which warrants considering social determinants of health in the context of assessing risk factors of more severe COVID-19 during pregnancy.

Trial registration

IRCEP was registered with the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) [EUPAS37360] and clinicaltrials.gov [NCT04366986].
Estimation of national and subnational all-cause mortality indicators in Nepal, 2017
Authors: Pandey Surender Prasad , Adair Tim
Published: December 2022

Background

Despite the civil registration and vital statistics (CRVS) system in Nepal operating for several decades, it has not been used to produce routine mortality statistics. Instead, mortality statistics rely on irregular surveys and censuses that primarily focus on child mortality. To fill this knowledge gap, this study estimates levels and subnational differentials in mortality across all ages in Nepal, primarily using CRVS data adjusted for incompleteness.

Methods

We analyzed death registration data (offline or paper-based) and CRVS survey reported death data, estimating the true crude death rate (CDR) and number of deaths by sex and year for each province and ecological belt. The estimated true number of deaths for 2017 was used with an extension of the empirical completeness method to estimate the adult mortality (45q15) and life expectancy at birth by sex and subnational level. Plausibility of subnational mortality estimates was assessed against poverty head count rates.

Results

Adult mortality in Nepal for 2017 is estimated to be 159 per 1000 for males and 116 for females, while life expectancy was estimated as 69.7 years for males and 73.9 years for females. Subnationally, male adult mortality ranges from 129 per 1000 in Madhesh to 224 in Karnali and female adult mortality from 89 per 1000 in Province 1 to 159 in Sudurpashchim. Similarly, male life expectancy is between 64.9 years in Karnali and 71.8 years in Madhesh and female male life expectancy between 69.6 years in Sudurpashchim and 77.0 years in Province 1. Mountain ecological belt and Sudurpashchim and Karnali provinces have high mortality and high poverty levels, whereas Terai and Hill ecological belts and Province 1, Madhesh, and Bagmati and Gandaki provinces have low mortality and poverty levels.

Conclusions

This is the first use of CRVS system data in Nepal to estimate national and subnational mortality levels and differentials. The national results are plausible when compared with Global Burden of Disease and United Nations World Population Prospects estimates. Understanding of the reasons for inequalities in mortality in Nepal should focus on improving cause of death data and further strengthening CRVS data.
Does it matter how we measure the health of older people in places for associations with labour market outcomes? A cross-sectional study
Authors: Murray Emily T. , Head Jenny , Shelton Nicola , Beach Brian , Norman Paul
Published: December 2022

Background

Inequalities between different areas in the United Kingdom (UK) according to health and employment outcomes are well-documented. Yet it is unclear which health indicator is most closely linked to labour market outcomes, and whether associations are restricted to the older population.

Methods

We used the Office for National Statistics (ONS) Longitudinal Study (LS) to analyse which measures of health-in-a-place were cross-sectionally associated with three employment outcomes in 2011: not being in paid work, working hours (part-time, full-time), and economic inactivity (unemployed, retired, sick/disabled, other). Seven health indicators from local-authority census and vital records data were chosen to represent the older working age population (self-rated health 50-74y, long-term illness 50-74y, Age-specific mortality rate 50-74y, avoidable mortality, life expectancy at birth and 65 years, disability-free life expectancy at 50 years, and healthy life expectancy at 50 years). An additional two health indicators (life expectancy at birth and infant mortality rate) were included as test indicators to determine if associations were limited to the health of older people in a place. These nine health indicators were then linked with the LS sample aged 16-74y with data on employment outcomes and pertinent demographic and individual health information. Interactions by gender and age category (16-49y vs. 50-74y) were also tested.

Findings

For all health-in-a-place measures, LS members aged 16–74 who resided in the tertile of local authorities with the ‘unhealthiest’ older population, had higher odds of not being in paid work, including all four types of economic inactivity. The strongest associations were seen for the health-in-a-place measures that were self-reported, long-term illness (Odds Ratio 1.60 [95% Confidence Intervals 1.52, 1.67]) and self-rated health (1.60 [1.52, 1.68]). Within each measure, associations were slightly stronger for men than women and for the 16-49y versus 50-74y LS sample. In models adjusted for individual self-rated health and gender and age category interactions, health-in-a-place gradients were apparent across all economic inactivity’s. However, these same gradients were only apparent for women in part-time work and men in full-time work.

Conclusion

Improving health of older populations may lead to wider economic benefits for all.
Prevalence, risk factors and quality of life impact of work-related musculoskeletal disorders among school teachers in Cairo, Egypt
Authors: Fahmy Viviane Farid , Momen Mohamed Abdel Maguid Tolba , Mostafa Nayera Samy , Elawady Mohamed Yehia
Published: December 2022

Background

School teachers constitute an occupational group which reported a high prevalence of work-related musculoskeletal disorders (WRMSDs). Different individual, occupational and psychosocial factors have been identified to influence the complex process of WRMSDs. WRMSDs represent an important and costly occupational health problem being responsible for a poor quality of life (QOL) of teachers. This study aimed to determine the prevalence, the risk factors, and the impact of WRMSDs on the QOL of teachers.

Methods

310 full-time teachers from 15 public schools were surveyed using an interview questionnaire about their sociodemographic and occupational characteristics, the Nordic Musculoskeletal Questionnaire and the SF-36 Health Survey (SF-36).

Results

Self-reported prevalence of WRMSDs at any body part over the past 12 months among teachers was 66.77%. Neck pain (56.1%) was the most prevalent WRMSD followed by shoulders (53.2%), low back (53.2%) and knees (50.6%) pain. Female gender, body mass index, the number of students per classroom, the number of classes per week, different adapted awkward postures and the lack of enough supervisor’s psychological support at work were among the risk factors positively associated with WRMSDs. WRMSDs had a negative impact on the physical and mental QOL of teachers with WRMSDs as reflected by their lower scores on all scales of the SF-36 compared to their counterparts without WRMSDs (p ˂ 0.05).

Conclusion

WRMSDs were a highly prevalent problem among teachers in Cairo, Egypt and negatively influencing their physical and mental QOL. Different individual, occupational and psychosocial factors had been shown to be significant predictors for the occurrence of WRMSDs reflecting their complex nature and multifactorial etiology.
Impact of solid fuel usage on respiratory symptoms among reproductive aged women: a cross-sectional study in Sri Lanka
Authors: Pathirathna Malshani Lakshika , Dematawewa Chandraratne Mahinda Bandara , Sekijima Kayako , Sadakata Mieko , Muramatsu Yoshiyuki , Fujiwara Naoshi
Published: December 2022

Background

Worldwide, around 3 billion people rely on solid fuel for their daily energy needs. Household air pollution secondary to solid fuel burning is a major risk factor for respiratory mobility among vulnerable populations. This study aimed to investigate the respiratory symptoms associated with solid fuel usage, the level of kitchen fuel smoke exposure and its association with respiratory symptoms among reproductive-aged women in Sri Lanka, where most households exclusively use firewood as the primary cooking fuel.

Methods

A descriptive cross-sectional study was conducted among 403 reproductive-aged women (15 to 49 years) in the Central Province, Sri Lanka. A structured interviewer-administered questionnaire was used to collect data, and an exposure assessment was done using a breath carbon monoxide monitor.

Results

After adjusting for potential confounding factors by the logistic regression models, the odds ratios (OR) of the liquid petroleum gas-only users for at least one respiratory symptom relevant to cough (OR: 0.39; 95% confidence interval [CI]: 0.20–0.78), wheezing (OR: 0.47; 95% [CI]: 0.26–0.87), and dyspnea (OR: 0.44; 95% CI: 0.24–0.84) were significantly lower compared to firewood-only users. The mean of expired air carbon monoxide and estimated carboxyhemoglobin levels of liquid petroleum gas-only users (2.84 ± 2.85 ppm; 1.08 ± 0.46%) were significantly lower than those of firewood-only users (5.27 ± 4.64 ppm; 1.47 ± 0.74%).

Conclusions

The use of firewood increased the risk of respiratory symptoms among reproductive-aged women in Sri Lanka. Health education focused on positive behavioral changes and effective and efficient clean energy policies are recommended to mitigate the risk associated with solid fuel smoke exposure.
Impact of initiation of amikacin liposome inhalation suspension on hospitalizations and other healthcare resource utilization measures: a retrospective cohort study in real-world settings
Authors: Aksamit Timothy , Wu Jasmanda , Hassan Mariam , Achter Emily , Chatterjee Anjan
Published: December 2022

Background

Mycobacterium avium complex lung disease (MAC-LD) is an infection that is increasing in frequency, associated with substantial disease burden, and often refractory to treatment. Amikacin liposome inhalation suspension (ALIS) is the first therapy approved for refractory MAC-LD. In the CONVERT study of adult patients with refractory MAC-LD, adding ALIS to a multidrug background regimen showed evidence of MAC infection elimination in sputum by month 6, which was maintained in most patients through the end of treatment (≤ 12 months post-conversion). This study assessed changes in healthcare resource utilization (HCRU) among patients initiating ALIS in real-world settings.

Methods

This retrospective cohort study of the All-Payer Claims Database (October 2018–April 2020) included patients aged ≥ 18 years with ≥ 1 pharmacy claim for ALIS and ≥ 12 months of continuous health plan enrollment pre- and post-ALIS initiation. Respiratory disease-related (and all-cause) HCRU (hospitalizations, length of stay [LOS], emergency department [ED] visits, and outpatient office visits) were compared 12 months pre- and post-ALIS initiation. Outcomes were reported at 6-month intervals; 0–6 months pre-ALIS initiation was the reference period for statistical comparisons.

Results

A total of 331 patients received ALIS, with HCRU highest in the 6 months pre-ALIS initiation. Compared with 26.9% during the reference period, respiratory-related hospitalizations decreased to 19.3% (P < 0.01) and 15.4% (P < 0.0001) during 0–6 and 7–12 months post-ALIS initiation, respectively. Mean number of respiratory disease-related hospitalizations per patient/6-month period decreased from 1.0 (reference period) to 0.6 (P < 0.0005) at both timepoints post-ALIS initiation. A similar pattern was observed for all-cause hospitalizations and hospitalizations per patient/6-month period (both P < 0.005). Reductions in all-cause and respiratory disease–related LOS post-ALIS initiation were significant (both P < 0.05). ED visits were few and unchanged during the study. Significant reductions per patient/6-month period in all-cause and respiratory-related outpatient office visits were observed post-ALIS initiation (all P < 0.01).

Conclusions

In this first real-world study of ALIS, respiratory disease-related (and all-cause) hospitalizations and outpatient visits were reduced in the 12 months following ALIS initiation. The results of this study provide HCRU-related information to better understand the impact of initiating ALIS treatment.

Trial registration

Not appliable.
Pneumonic-type invasive mucinous adenocarcinoma and infectious pneumonia: clinical and CT imaging analysis from multiple centers
Authors: Zhang Shuai , Yu Xinxin , Huang Yong , Nie Pei , Deng Yan , Mao Ning , Li Sha , Zhu Baosen , Wang Li , Wang Bo , Wang Ximing
Published: December 2022

Background

Pneumonic-type invasive mucinous adenocarcinoma (IMA) was often misdiagnosed as pneumonia in clinic. However, the treatment of these two diseases is different.

Methods

A total of 341 patients with pneumonic-type IMA (n = 134) and infectious pneumonia (n = 207) were retrospectively enrolled from January 2017 to January 2022 at six centers. Detailed clinical and CT imaging characteristics of two groups were analyzed and the characteristics between the two groups were compared by χ2test and Student’s t test. The multivariate logistic regression analysis was performed to identify independent predictors. Receiver operating characteristic curve analysis was used to determine the diagnostic performance of different variables.

Results

A significant difference was found in age, fever, no symptoms, elevation of white blood cell count and C-reactive protein level, family history of cancer, air bronchogram, interlobular fissure bulging, satellite lesions, and CT attenuation value (all p < 0.05). Age (odds ratio [OR], 1.034; 95% confidence interval [CI] 1.008–1.061,p = 0.010), elevation of C-reactive protein level (OR, 0.439; 95% CI 0.217–0.890,p = 0.022), fever (OR, 0.104; 95% CI 0.048–0.229,p < 0.001), family history of cancer (OR, 5.123; 95% CI 1.981–13.245,p = 0.001), air space (OR, 6.587; 95% CI 3.319–13.073,p < 0.001), and CT attenuation value (OR, 0.840; 95% CI 0.796–0.886,p < 0.001) were the independent predictors of pneumonic-type IMA, with an area under the curve of 0.893 (95% CI 0.856–0.924,p < 0.001).

Conclusion

Detailed evaluation of clinical and CT imaging characteristics is useful for differentiating pneumonic-type IMA and infectious pneumonia.
Psychosocial work characteristics and low back pain in daycare (nursery) workers in Japan: a prospective cohort study
Authors: Shi Xuliang , Aoshima Megumi , Iida Tadayuki , Hiruta Shuichi , Ono Yuichiro , Ota Atsuhiko
Published: December 2022

Background

Low back pain (LBP) is one of the most common musculoskeletal problems affecting daycare (nursery) workers. We aimed to identify the psychosocial factors influencing LBP in daycare workers.

Methods

We conducted a prospective cohort study with a one-year observation period. The baseline sample was a convenience sample of 444 daycare workers from 34 daycare facilities in Nagoya, Japan, and its suburbs. All the data were collected through a questionnaire survey. The question “Where are you currently feeling LBP?” was used to determine whether the subjects suffered from LBP. We examined the prospective relationships of the psychosocial work characteristics, i.e., high job strain, low social support, effort-reward imbalance, and overcommitment, at baseline and LBP after one year. We used multiple logistic regression analyses to calculate the odds ratios of psychosocial work characteristics for the persistence and onset of LBP, adjusted for age, sex, body mass index, smoking, employment status, occupation, and working schedule.

Results

At baseline, 270 (60.8%) subjects suffered from LBP. Of 208 who also gave information on LBP one year later, 176 (84.6%) suffered from the persistence of LBP. Low social support at baseline was significantly related to persistent LBP one year later. The incidence of persistent LBP was 89.9% and 80.0% among those with and without low social support at baseline, respectively. The adjusted odds ratio (95% confidence interval) of low social support at baseline for the persistence of LBP was 2.43 (1.01–5.87). Of 150 who were without LBP at baseline and provided information on LBP one year later, 45 (30.0%) suffered from the onset of LBP. None of the psychosocial work characteristics showed significant relationships with the onset of LBP one year later.

Conclusion

Low social support was related to the persistence, but not to the onset of LBP in a prospective cohort analysis among daycare workers in Japan. High job strain, ERI, or overcommitment did not show a significant prospective effect on LBP.
Real-time three-dimensional fluoroscopy-navigated percutaneous pelvic screw placement for fragility fractures of the pelvis in the hybrid operating room
Authors: Takaesu Mika , Nakasone Satoshi , Miyata Yoshihide , Nishida Kotaro
Published: December 2022

Background

The prognosis of conservative treatment for fragility fracture of the pelvis (FFP) in the older patients remains poor. Percutaneous pelvic screw placement (PPSP), which aids in the treatment of FFP, can be challenging to perform using fluoroscopy alone because of the proximity of blood vessels and neuroforamina. Hence, this study aimed to investigate the accuracy and clinical outcomes of PPSP using real-time 3D fluoroscopic navigation for FFP in the hybrid operating room.

Methods

This study included 41 patients with FFP who underwent PPSP in a hybrid operating room between April 2016 and December 2020. Intraoperative C-arm cone-beam CT was performed under general anesthesia. Guidewire trajectory was planned using a needle guidance system. The guidewire was inserted along the overlaid trajectory using 3D fluoroscopic navigation, and a 6.5 mm cannulated cancellous screw (CCS) was placed. The clinical outcomes and accuracy of the screw placement were then investigated.

Results

A total of 121 screws were placed. The mean operative time was 84 ± 38.7 minutes, and the mean blood loss was 7.6 ± 3.8 g. The mean time to wheelchair transfer was 2 days postoperatively. Pain was relieved in 35 patients. Gait ability from preoperative and latest follow-up after surgery was maintained in 30 (73%) patients. All 41 patients achieved bone union. Of the 121 screws, 119 were grade 0 with no misplacement; only 2 patients had grade 1 perforations.

Conclusion

PPSP using real-time 3D fluoroscopic navigation in a hybrid operating room was accurate and useful for early mobilization and pain relief among older patients with FFP with an already-installed needle biopsy application.
Enthesitis-related arthritis: the clinical characteristics and factors related to MRI remission of sacroiliitis
Authors: Li Jiaoyu , Zhu Yaju , Guo Guimei
Published: December 2022

Background

To describe the clinical characteristics and explore the factors related to the MRI remission of sacroiliitis in patients with enthesitis-related arthritis (ERA).

Methods

Patients with ERA from 2018–2022 in our medical center were retrospectively reviewed, which identified according to Pediatric Rheumatology International Trials Organization (PRINTO) criteria. Demographics, clinical characteristics, examinations, and treatments were described. Univariate and multivariate logistic regression models were used to analyze the factors related to MRI remission of sacroiliitis in ERA.

Results

This retrospective study included 160 ERA patients (51.9% male) with a mean onset age of 9.2 ± 3.0 years. There were 144 cases (81.9%) with peripheral arthritis, and the hip, knee, and ankle joints were the most commonly involved joints. Enthesitis occurred in 48 cases (30.0%), and sacroiliitis occurred in 142 cases (88.5%) at diagnosis. Human leukocyte antigen (HLA)-B27 was positive in 33 cases (17.1%), and acute uveitis occurred in 3 cases (1.9%). The majority of patients (93.7%) were treated with disease-modifying anti-rheumatic drugs (DMARDs), and 60% with biologics. Among 62 patients with MRI-defined sacroiliitis, 27 (43.5%) cases showed improvement in the sacroiliac joint lesion after treatment. Multivariate logistic regression analysis showed that duration from onset to diagnosis of less than 3 months (OR = 3.609, 95% CI: 1.068–12.192) and active joints of more than 4 (OR = 4.916, 95% CI: 1.006–24.037) were independent factors.

Conclusion

We highlighted differences in ERA clinical characteristics. Patients with a shorter diagnosis time and more joint involvement improved more significantly in sacroiliac joint lesions after treatment.
A comparative study of bone union and nonunion during distraction osteogenesis
Authors: Liu Qi , Liu Ze , Guo Hongbin , Wang Min , Liang Jieyu , Zhang Yi
Published: December 2022

Background

The clinical characteristics of bone nonunion during distraction osteogenesis (DO) were rarely discussed. This study was employed to specify the difference between bone union and nonunion during DO.

Methods

The patients with bone lengthening were recruited in our study. The bone union cases indicated the ones that remove the external fixator successfully, whereas the bone nonunion represented the bridging callus did not appear even after 9 months (an absence of bridging callus for at least three out of four cortices on plain radiographs) that needs autogenous bone transplantation. The differences in the pixel value ratio (PVR) growth of regenerated callus, lengthening index (LI), healing index (HI), external fixation index (EFI) and blood biochemical indexes between bone union and nonunion were analyzed.

Results

A total of 8 bone nonunion and 27 bone union subjects were included in this study. The PVR growth in bone nonunion was significantly lower than that in bone union (0.19 ± 0.06 vs. 0.32 ± 0.16, P = 0.048). Interestingly, the HI and EFI in bone nonunion was significantly higher than that in bone union (62.0 ± 31.4 vs. 37.0 ± 27.4, P = 0.036; 75.0 ± 30.9 vs. 49.9 ± 16.1, P = 0.006). However, no significant difference with regard to LI was identified (0.76 ± 0.52 vs. 0.77 ± 0.32, P = 0.976). Moreover, the circulating level of urea and lymphocyte count in bone union was significantly lower than that in bone nonunion (4.31 ± 1.05 vs. 5.17 ± 1.06, P = 0.049; 2.08 ± 0.67 vs. 2.73 ± 0.54, P = 0.018). On the contrary, the circulating level of magnesium in bone union was significantly higher than that in bone nonunion (0.87 ± 0.07 vs. 0.80 ± 0.07, P = 0.014).

Conclusion

Compared to the bone union, the PVR growth was significantly lower, whereas the HI and EFI was significantly higher in the bone nonunion. Moreover, the circulating level of urea, magnesium and lymphocyte count was also different between these two. Therefore, the PVR, HI and EFI seems to be reliable and sensitive indicators to reflect the bone nonunion during DO, which might be considered in bone lengthening. Further prospective studies are still needed to elaborate the concerned issues.
Stress as worsening of the signs and symptoms of the geographic tongue during the COVID-19 pandemic: a pilot study
Authors: Sarruf Miriam Beatriz Jordão Moreira , Quinelato Valquiria , Sarruf Guilherme Jordão Moreira , Oliveira Henrique Eduardo , Calasans-Maia Jose Albuquerque , Quinelato Hilka , Aguiar Telma , Casado Priscila Ladeira , Cavalcante Larissa Maria Assad
Published: December 2022

Background

Geographic Tongue (GT) is a benign inflammatory disorder of unknown etiology, which is characterized by the loss of epithelium due to the atrophy of filiform papillae. It usually occurs on the dorsum of the tongue and may extend to its lateral edges. It appears as an erythematous area surrounded by whitish and slightly elevated margins. In most cases, the condition is asymptomatic, although some individuals may report symptoms that include a burning sensation of the tongue.

Objective

Assess whether there was a change in the clinical aspect of Geographic Tongue (GT) during the COVID-19 pandemic.

Methods

Thirty-two participants were recruited from Dentistry School Universidade Federal Fluminense. Anamnesis and oral examination were performed to collect medical history. The participants were split into two groups: control group (no GT) n = 20 and test group (with GT) n = 12. In the second step, nine participants from a 12 (75%) of the test group were contacted by phone and answered a questionnaire about changes in the signs and symptoms of GT during the pandemic. The subjects were subdivided into two groups: GT with and without signs and symptoms exacerbation.

Results

In the first phase of the research, no statistical difference between control and test groups was observed regarding clinical criteria such as age (p + 0.72), gender (p = 0.24), and systemic diseases (p = 0.58). In the second phase, there was a statistical difference between GT groups with or without symptom exacerbation in terms of age and stress as a factor of the oral symptoms (p = 0.3 and 0.2), respectively. Younger patients showed a worsening of the oral lesions related to GT (p = 0.3) and reported stress during the pandemic (p = 0.02).

Conclusion

Younger patients were more susceptible to stress and presented more exacerbation of the oral lesions related to GT.
Dental anxiety and oral health following stroke: a pilot study
Authors: Nangle Matthew R. , Adams Alexandra G. , Henry Julie D.
Published: December 2022

Background

Oral health is often poorer in people living with acquired brain injury relative to non-clinical controls. However, although anxiety disorders become more common following stroke, no study to date has tested whether dental anxiety might contribute to stroke survivors’ increased vulnerability to poorer oral health. This pilot study reports the first test of whether the anxiety disturbances that commonly present following stroke extend to dental anxiety, and if dental anxiety in this group is linked to poorer oral health.

Materials and methods

First-time stroke survivors (N = 35) and demographically matched controls (N = 35) completed validated measures of dental anxiety, oral health, negative affect, and life satisfaction.

Results

Stroke survivors did not differ from controls in their overall levels of dental anxiety or oral health, but uniquely for the stroke group, dental anxiety was strongly associated with poorer oral health, and this effect remained significant even after controlling for negative affect and life satisfaction.

Conclusion

Stroke survivors who have higher levels of dental-related anxiety may be at increased risk of poorer oral health.
Three-dimensional position changes of unopposed molars before implant rehabilitation: a short-term retrospective cohort analysis
Authors: Wang Anqi , Cao Jie , Zhang Haoyun , Zhang Bo , Yang Gang , Hu Wenjie , Chung Kwok‑Hung
Published: December 2022

Objective

To investigate the spatial changes of unopposed molars within the period between the antagonist extraction and the final implant restoration using data from cone beam computed tomography.

Methods

A total of 59 patients with 68 unopposed molars were included in this study. Three-dimensional models reconstructed from cone beam computed tomography data before and after loss of the antagonist were superimposed to measure the spatial changes. The overeruption and tipping of target teeth were calculated by coordinate values.

Results

The result of overeruption over the study period (9.2 ± 4.3 months) was expressed by two values: the mean overeruption of molar cups (0.432 mm) and the maximum overeruption of cusps (0.753 mm), which were statistically significant compared to the baseline level (p < 0.001). The average tipping was 1.717 degrees in the buccal direction.

Conclusions

Unopposed molars displayed overeruption throughout the study period (9.2 ± 4.3 months), which indicates that the clinicians should pay attention to the possibilities of overeruption and make appropriate interventions in their clinical practice. The establishment of three-dimensional measuring methods using cone beam computed tomography data helps analyze spatial changes.
Gene expression analysis of toll like receptor 2 and 4, Dectin-1, Osteopontin and inflammatory cytokines in human dental pulp ex-vivo
Authors: Hasan Arshad , Roome Talat , Wahid Mohsin , Ansari Shazia Akbar , Akhtar Hira , Jilani Syeda Neha Ahmed , Kiyani Amber
Published: December 2022

Background

Toll like receptors (TLR) 2 and 4 present on innate immune cells of the dental pulp detect cariogenic bacteria. Along with bacteria, C. albicans may also be present in dental caries. The presence of C. albicans can be detected by Dectin-1 a C type Lectin receptor. Expression of Dectin-1 in human pulpits has not been reported. Similarly, cytokines are released as a consequence of dental pulp inflammation caused by cariogenic bacteria. The T helper (Th) 1 inflammatory response leads to exacerbation of inflammation and its relationship with Osteopontin (OPN) is not known in pulp inflammation.

Objective

The aim of this study was to observe the expression of Dectin-1, TLR-2, OPN and pro-inflammatory cytokines in irreversibly inflamed human dental pulp and to observe relationship between Dectin-1/TLR-2 and OPN/Pro-inflammatory cytokines in the presence of appropriate controls.

Methods

A total of 28 subjects diagnosed with irreversible pulpitis were included in this ex-vivo study. Fifteen samples were subjected to standard hematoxylin and Eosin (H&E) and immunohistochemistry staining. Whereas, gene expression analysis was performed on 13 samples to observe mRNA expression of pro-inflammatory cytokines; tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1 beta (ß), IL-6 Dectin-1, OPN, TLR-2 and TLR-4. SPSS version 21 was used for statistical analysis. One way analysis of variance (ANOVA), Pearson correlation and Chi-square test were used at p ≤ 0.05.

Results

Gene expressions of Dectin-1, TLR-2 and TLR-4 were observed in all samples. Dectin-1 and TLR-2 expressions were significantly correlated (r = 0.5587, p = 0.0002). Similarly, OPN and TNF-α expression showed a significant correlation (r = 0.5860, p = 0001). The agreement between histologic and clinical diagnosis was 69.2% in the cases of irreversible pulpitis.

Conclusion

Dectin-1 was expressed by inflamed human dental pulp. Dectin-1 and TLR-2 expression pattern was suggestive of a collaborative receptor response in inflamed pulp environment. OPN and TNF-α expressions showed a positive correlation indicating a possible relationship.
The efficacy of EndoActivator, passive ultrasonic irrigation, and Ultra X in removing calcium hydroxide from root canals: an in-vitro study
Authors: Adl Alireza , Razavian Alireza , Eskandari Fateme
Published: December 2022

Background

This study aimed to compare the efficacy of EndoActivator, passive ultrasonic irrigation, and Ultra X in removing calcium hydroxide from the artificial grooves in root canal walls.

Methods

The root canals of 50 extracted human maxillary incisors were instrumented by using the ProTaper rotary system up to #F4 (size 40/0.06 ProTaper) and the teeth were split longitudinally. Lateral grooves were created in the apical and coronal parts of one half and the middle part of the other half. Calcium hydroxide paste was applied to the grooves and the root halves were reassembled. After seven days, the calcium hydroxide was removed from the canal by using one of the EndoActivator, passive ultrasonic irrigation, and Ultra X devices; one group went without irrigation (control group). The CH remnants in the grooves were scored at 20× magnification. The data were analyzed by using the Kruskal–Wallis, Dunn’s post hoc, and Friedman tests.P < 0.05 was considered to be statistically significant.

Results

No statistically significant difference existed among the experimental groups at the coronal and middle grooves (P > 0.05). However, Ultra X was significantly more effective than passive ultrasonic irrigation at the apical grooves (P = 0.023).

Conclusion

Within the limitations of this study, Ultra X can be reported to remove the calcium hydroxide from the apical third more efficiently than passive ultrasonic irrigation.
Primary ovarian endometrioid stromal sarcoma presenting with reno-ureteral colic
Authors: Moral Ana Isabel Bueno , Jiménez José Carlos Vilches , Bañón Carmen Martínez , Díaz Huesca Manuel Jesús , González Miriam Valenzuela , López Jesús S. Jiménez
Published: December 2022

Background

Endometrioid Stromal Sarcomas are an infrequent group of mesenchymal tumors that we must take into account in the differential diagnosis despite representing only 0.2% of tumors of the female genital tract, as they can go unnoticed until advanced stages.

Case presentation

Fifty-fourth year-old woman referred from the Urology department due to incidental finding of adnexal mass in MRI during examination after renoureteral colic, in the case of a 50 mm solid cystic mass in LE. MT were within the normal range, and the CT scan observed this mass in contact with the left ureter. The surgery was completed with hysterectomy and contralateral adnexectomy without incident and chemotherapy treatment was not added. The pathological result was ovarian tissue with low-grade endometrial sarcoma. Currently, after two years of follow-up, the patient remains stable without any recurrence of disease.

Conclusions

Endometrioid stromal sarcomas are rare tumors that originate in the endometrial stroma, the ovarian location being rare. Management lies in surgical treatment, and adjuvant therapy is sometimes necessary in advanced stages.