bluuebunny/crossref_metadata_2025 huggingface dataset:
Inferring human neutral genetic variation from craniodental phenotypes
Authors: Rathmann Hannes , Perretti Silvia , Porcu Valentina , Hanihara Tsunehiko , Scott G Richard , Irish Joel D , Reyes-Centeno Hugo , Ghirotto Silvia , Harvati Katerina
Published: July 2023

There is a growing consensus that global patterns of modern human cranial and dental variation are shaped largely by neutral evolutionary processes, suggesting that craniodental features can be used as reliable proxies for inferring population structure and history in bioarchaeological, forensic, and paleoanthropological contexts. However, there is disagreement on whether certain types of data preserve a neutral signature to a greater degree than others. Here, we address this unresolved question and systematically test the relative neutrality of four standard metric and nonmetric craniodental data types employing an extensive computational genotype–phenotype comparison across modern populations from around the world. Our computation draws on the largest existing data sets currently available, while accounting for geographically structured environmental variation, population sampling uncertainty, disparate numbers of phenotypic variables, and stochastic variation inherent to a neutral model of evolution. Our results reveal that the four data types differentially capture neutral genomic variation, with highest signals preserved in dental nonmetric and cranial metric data, followed by cranial nonmetric and dental metric data. Importantly, we demonstrate that combining all four data types together maximizes the neutral genetic signal compared with using them separately, even with a limited number of phenotypic variables. We hypothesize that this reflects a lower level of genetic integration through pleiotropy between, compared to within, the four data types, effectively forming four different modules associated with relatively independent sets of loci. Therefore, we recommend that future craniodental investigations adopt holistic combined data approaches, allowing for more robust inferences about underlying neutral genetic variation.
ببناء الجاهزية: دراسة حالة للعوامل المهنية التي تؤثر على مستويات ‘السعادة’ لضباط شرطة أبو ظبي
Authors: الكعبي فيصل
Published: July 2023

الملخص

يخوض المجتمع الشرطي والأمني على الصعيد العالمي سباقًا مع الزمن لتطوير استراتيجيات لتحسين رفاهية الصحة العقلية في أوساط المهنة للمهنيين، من خلال المجالات المساهمة المتعددة التي تدعم رفاهية ضباط الشرطة، على سبيل المثال: الأطباء وعلماء النفس والمهنيون الإداريون والموجهون والمدربون والمستشارون، فإنّ فهم العوامل المساهمة من التجربة بالإضافة إلى تصور وإدراك ضباط الشرطة يُعدُّ مجالًا مهمًا في الأبحاث. (بيكر وآخرون، 2020. ديشين وآخرون، 2018. بوربا وديمو، 2019) كان الهدف من الدراسة الواردة في هذه المقالة هو تقييم تأثير عوامل العمل المتصلة بالمكافآت التنظيمية، وخصائص الوظائف، والعوامل المتصلة بالعمل في مؤسسات الخدمات العامة بشأن تصور الضباط للسعادة. تم توزيع استبيان على ضباط الشرطة في أبو ظبي ، مع إجراء تحليل استنتاجي لفحص العلاقات بين عوامل العمل ومستويات سعادة الضباط. حيث حددت النتائج تصور الموظفين للمكافآت التنظيمية، والتحكم في الوظيفة، وأهمية المهمة، وتكرار التعليقات أو الملاحظات، والرغبة في مساعدة الآخرين كأسباب أولية للعمل في الشرطة، والفرص المتاحة لمساعدة الآخرين في المجتمع كلها تنبئ بسعادة الشرطة. تناقش هذه المقالة – تحديدًا - تصور الموظفين للمكافآت في العمل وخصائص الوظيفة كمحددات للسعادة،حيث تساهم النتائج في تطوير استجابة تنظيمية مستقبلية لتعزيز رفاهية الضباط، والأهم من ذلك أنها تُعلِم بناء الجاهزية أمام اضطرابات الصحة العقلية لضباط الشرطة.
تحديد عوامل التمكين والمعوقات لإدارة المعرفة في المؤسسة الشرطية. دراسة حالة لشرطة أبو ظبي
Authors: الظنحاني محمد , النقبي شماء
Published: July 2023

الملخص

قد تكون إدارة المعرفة المستخلصة وفعاليتها حافزاً محتملاً لتحقيق أهداف المشروع لتحقيق النجاح والسرعة الأمثل، أو قد تكون : سببًا رئيسيًا لفشل المشروع عندما تتم إدارة المعرفة بشكل غير كافٍ. تطرقت الأبحاث العلمية الحديثة إلى عدم تسهيل تطبيق آليات إدارة المعرفة في جميع مراحل المشروع بسبب الوضع المؤقت للمشروعات وكذلك أوجه القصور في تطبيق مفهوم المساءلة بين المتخصصين. تتناول هذه الورقة عنصرًاواحدًا من مشروع بحثي أوسع يتم تنفيذه مع شرطة أبوظبي لتحديد العوامل التمكينية والعوائق التي تحول دون إدارة المعرفة في مشاريع الشرطة. كان البحث نوعيًا بطبيعته وركز بشكل مباشر على معالجة آليات وطرق دمج المعرفة الإدارية لتحسين نجاح المشروع وتطوير قدرة رأس المال البشري في العمل الشرطي. حددت نتائج البحث تسعة عوامل تمكينية تدعم إدارة المعرفة الناجحة في المشاريع الشرطية: سياسة لإدارة المعرفة، والقيادة المؤسسية لدعم التواصل المفتوح والتحفيز، تسليط الضوء على قيمة إدارة المعرفة، ربط محتوى إدارة المعرفة بتوصيف الوظائف، إنشاء قنوات محددة للتواصل مع المعنيين في المشروع، الموارد التكنولوجية الكافية، أنظمة الاتصال لإدارة المعرفة بين الفرق في مواقع منفصلة، تمكين التفاعل الاجتماعي لتسهيل عملية إدارة المعرفة في العمليات اليومية، تطبيق عمليات التقييم والقياس في استخدام الشبكات الاجتماعية لإدارة المعرفة.
A fast emergency department triage score based on mobility, mental status and oxygen saturation compared with the emergency severity index: a prospective cohort study
Authors: Riedel H B , Espejo T , Bingisser R , Kellett J , Nickel C H
Published: July 2023

Background

Waiting for triage in overburdened emergency departments (ED) has become an increasing problem, which endangers patients. A fast triage system to rapidly identify low-acuity patients should divert care and resources to more urgent cases.

Aim

The objective of this study was to compare the performance of the Kitovu Hospital fast triage (KFT) score with the Emergency Severity Index (ESI), using mortality and hospital admission as proxies for the patients’ acuity.

Design

This is a prospective observational study of consecutive patients presenting to a Swiss academic ED.

Methods

Patients were prospectively triaged into one of five ESI strata and retrospectively assessed by the KFT score, which awards one point each for altered mental status, impaired mobility and oxygen saturation <94%.

Results

The KFT score had a lower discrimination than the ESI for hospital admission, but a higher discrimination for mortality from 24 h to 1 year after ED presentation. A total of 5544 (67%) patients were assigned to the lowest acuity by the KFT score compared with 2374 (28.7%) by the ESI; there was no significant difference in the 24-h mortality of patients who were deemed low acuity by either score.

Conclusion

Compared to the ESI, the KFT score identifies more than twice as many patients at low risk of early death. Therefore, this score might help to identify patients who could be managed through alternative pathways. This may be particularly helpful in situations of ED crowding and access block.
Technology and the Task Content of Jobs across the Development Spectrum
Authors: Caunedo Julieta , Keller Elisa , Shin Yongseok
Published: July 2023

The tasks workers perform on the job are informative about the direction and the impact of technological change. We harmonize occupational task-content measures between two worker-level surveys, which separately cover developing and developed countries. Developing countries use routine-cognitive tasks and routine-manual tasks more intensively than developed countries, but less intensively use non-routine analytical tasks and non-routine interpersonal tasks. This is partly because developing countries have more workers in occupations with high routine content and fewer workers in occupations with high non-routine content. More importantly, a given occupation has more routine content and less non-routine content in developing countries than in developed countries. Since 2006, occupations with high non-routine content gained employment relative to those with high routine content in most countries, regardless of their income level or initial task intensity, indicating the global reaches of the technological change that reduces the demand for occupations with high routine content.
Achilles Tendon Ruptures: Limited Incision Repair
Authors: Schauer Elisabeth , Assal Mathieu
Published: July 2023

Achilles tendon ruptures are a common injury, and a steadily rising incidence has been noted since the middle of the 20th century. Conservative management is a recognized treatment method, but it bears a higher risk of tendon rerupture compared with surgical treatment. Standard open surgery, however, can lead to complications, such as wound complications and surgical site infection. Hence, efforts have been put into the development of alternative surgical techniques to lower the risk of complications. In the 1970s, Ma and Griffith introduced percutaneous tendon repair by limiting the incision to 6 stab wounds. Subsequently, the open and percutaneous approaches have been merged into limited incision procedures, which include the advantages of both: visual control as well as smaller incisions. The primary limited incision approach consisted in using twisted Kirschner wires as suture guides. They were replaced by specific guiding instruments, such as the Achillon and Percutaneous Achilles Repair System (PARS) device, which rendered the limited incision procedure safer and more standardized. The instruments consist of 4 arms: The outer arms facilitate needle introduction by predetermined holes, the inner arms allow for suture passage exclusively underneath the tendon sheath. The minimally invasive procedures may reduce complication rates, especially regarding wound healing and infection. Limited incision techniques also may reduce sural nerve injury.

Level of Evidence: Diagnostic Level V—expert opinion. See Instructions for Authors for a complete description of levels of evidence.
Proliferating Pilar Tumors in the Scalp Over a Period of 23 Years in a General Hospital in Mexico City
Authors: Juan David Dufflart Ocampo , María de los Ángeles Villeda Aguilar , Claudia Ileana Sáenz Corral , María Elisa Vega Memije
Published: July 2023

BACKGROUND

Proliferating pilar tumors are an unusual skin tumor, and they have a cystic component with trichilemmal keratinization and epithelial proliferation. These arise from the outer root sheath of hair follicles. It mainly affects women. The scalp is the most affected area. Diagnosis can be made by biopsy. Surgical excision is the best treatment option.

OBJECTIVE

Report the frequency of proliferating pilar tumors in the scalp in general hospital in Mexico over a period of 23 years.

METHODS

The authors reviewed the database of the dermatopathology service of the General Hospital "Dr Manuel Gea González" from 1999 to August 2022, selecting diagnosticated cases of proliferating pilar tumor, pilar cyst, trichilemmal cyst, or proliferating trichilemmal cyst in the scalp.

RESULTS

The authors discovered 17 cases, 13 were women, the average age was 54.9 years, all the tumors affecting the scalp, and just 3 cases were reported as malignant.

CONCLUSION

In comparison with the existing data, the authors can observe that most of their patients were women and the scalp is the most affected area. Most did not present associated symptoms. As the authors can see, most are benign and long-lasting: however, the authors cannot ignore that a small percentage can be malignant.
Increasing nonalcoholic fatty liver disease–related mortality rates in the United States from 1999 to 2022
Authors: Ilyas Fariha , Ali Hassam , Patel Pratik , Sarfraz Shiza , Basuli Debargha , Giammarino Alexa , Satapathy Sanjaya Kumar
Published: July 2023

Background:

We examined trends in NAFLD-related mortality in the United States from 1999 to 2022, focusing on sex, racial differences, and specific age groups.

Methods:

We analyzed age-adjusted mortality rates (AAMRs) for NAFLD-related deaths using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database and assessed differences between sex and racial groups.

Results:

Between 1999 and 2022, NAFLD-related mortality rose from an age-adjusted mortality rate (AAMR) of 0.2 to 1.7 per 100,000, with an average annual percent change (AAPC) of 10.0% (p < 0.001). In all, 85.4% of the cases were reported after 2008. Females (0.2–2 per 100,000, AAPC: 11.7%, p < 0.001) saw a steeper increase than males (0.2–1.3 per 100,000, AAPC: 9.3%, p < 0.001). White individuals’ AAMR rose from 0.2 to 1.9 per 100,000 (AAPC: 10.8%, p < 0.001). Asian or Pacific Islanders (AAPI) increased from 0.2 in 2013 to 0.5 in 2022 (AAPC: 12.13%, p = 0.002), and American Indians or Alaska Natives (AI/AN) from 1 in 2013 to 2.2 in 2022 (AAPC: 7.9%, p = 0.001). African Americans (AA) showed an insignificant change (0.3–0.5 per 100,000, AAPC: 0.7%, p = 0.498). Regarding age, individuals 45–64 saw AAMR rise from 0.3 to 1.2 per 100,000 (AAPC: 6.5%, p < 0.001), and those 65+ from 0.2 to 6 per 100,000 (AAPC: 16.5%, p < 0.001). No change was observed in the 25–44 age group (AAMR: 0.2 per 100,000, AAPC: 0.0%, p = 0.008).

Conclusion:

We report increased NAFLD-related mortality among both sexes and certain racial groups. The mortality rate increased for older populations, emphasizing the need for targeted public health measures and evidence-based interventions.
Extended Dehydration of Corneal Allogenic Intrastromal Ring Segments to Facilitate Insertion: The Corneal Jerky Technique
Authors: Awwad Shady T. , Jacob Soosan , Assaf Jad F. , Bteich Yara
Published: July 2023

Purpose:

The aim of this study was to describe a new technique to facilitate the insertion of corneal allogenic intrastromal ring segments.

Methods:

A single-segment corneal allogenic intrastromal ring segment (CAIRS) was trephined from donor corneas and allowed to markedly dehydrate for 75 minutes before the start of the procedure with a room humidity of 35% to 45%. The duration of the insertion step and the intrastromal segment size at 1 week as measured by optical coherence tomography were compared with previously performed single-segment CAIRS procedures using the conventional technique.

Results:

A total of 41 eyes of 36 patients underwent 1-segment CAIRS insertion of the same trephination size (750 µm). Fifteen eyes underwent the conventional insertion procedure, and 26 eyes had a dehydrated segment inserted. The time taken to insert the CAIRS analyzed by surgical video recording starting after the femtosecond tunnel creation and initiation of the insertion to the segment ironing step was 282 ± 103 and 97 ± 23 seconds for the conventional and the dehydrated segment technique, respectively (P < 0.001). Anterior segment optical coherence tomography performed 1 week postoperatively revealed similar segment thickness and width of 471.3 ± 54.1 μm and 1285.1 ± 191.0 μm for the conventional allogenic segments and 483.4 ± 58.3 μm and 1227.2 ± 165.2 μm for the dehydrated segments (P = 0.515 and 0.314, respectively).

Conclusions:

Markedly dehydrated corneal allogenic segments are easier and faster to insert than the nondehydrated ones while maintaining similar sizes intrastromally. This dehydration technique makes the procedure similar to the one with synthetic segments and hence reduces the learning curve.
Rare Case of Thygeson Superficial Punctate Keratitis After COVID-19 Vaccination
Authors: Hutchinson Kelly Ann , Peretz Daniel , Darvish Mahshad , Talajic Julia , Choremis Johanna
Published: July 2023

Purpose:

The aim of this study was to elucidate a rare corneal association of the coronavirus disease 2019 (COVID-19) vaccine. Although cases of corneal involvement after vaccination have been reported, we present the first case of Thygeson superficial punctate keratitis (TSPK) linked to the COVID-19 vaccine.

Methods:

This study is a case report.

Results:

A 25-year-old woman was assessed in the ophthalmology clinic for recurrent ocular surface symptoms after receiving the COVID-19 vaccine. She was followed in clinic and was found to have a remitting and recurring pattern of bilateral intraepithelial corneal opacities with associated subepithelial haze primarily overlying the pupillary area. These corneal lesions responded well to topical corticosteroid ophthalmic drops. Based on the clinical appearance, the response to treatment, negative herpes simplex virus serology, and the temporal relationship between vaccination and ocular findings, a diagnosis of COVID-19 vaccine-induced TSPK was suspected.

Conclusions:

Although the COVID-19 vaccine remains overwhelmingly safe, clinicians should be aware of possible corneal side effects, including TSPK. Prompt ophthalmic assessment in those presenting with ocular symptoms after vaccination is encouraged.
Evaluation of long-term clinical outcomes after toric implantable collamer lens implantation
Authors: Shiga Suguru , Kojima Takashi , Horai Rie , Nakamura Tomoaki
Published: July 2023

Purpose:

To evaluate the long-term (8-10 years) outcomes of toric implantable collamer lens (TICL) surgery.

Setting:

Nagoya Eye Clinic, Nagoya, Aichi, Japan.

Design:

Retrospective observational study.

Methods:

Patients who underwent TICL surgery from 2005 to 2009 to correct myopia and myopic astigmatism were enrolled. The safety, efficacy, predictability, astigmatism correction efficacy, and complications were evaluated using preoperative, 1-year postoperative, and final examination data.

Results:

133 eyes of 77 patients were included. At the final visit, the mean uncorrected and corrected visual acuities were −0.01 ± 0.2 and −0.17 ± 0.05, respectively. The mean safety and efficacy indices were 0.91 ± 0.26 and 0.68 ± 0.21, respectively. The manifest astigmatism was −0.45 ± 0.43 diopters (D). The mean corneal astigmatism change from 1 year postoperatively to the final visit was 0.40 ± 0.26 D. Of the 38 eyes with a change in corneal astigmatism ≥0.5 D, 30 eyes (78.9%) changed to against-the-rule (ATR) astigmatism, 1 (2.6%) changed to oblique astigmatism, and 7 (18.4%) changed to with-the-rule (WTR) astigmatism. The mean manifest astigmatism change from 1 year postoperatively to the final visit was 0.43 ± 0.52 D. Of the 60 eyes with a change in manifest astigmatism ≥0.5 D, 25 (41.7%) changed to ATR astigmatism, 18 (30.0%) changed to oblique astigmatism, and 17 (28.3%) changed to WTR astigmatism. During follow-up, 8 (6.0%) of 133 eyes developed anterior subcapsular cataracts, among which 4 (3.0%) underwent TICL removal and phacoemulsification and aspiration. No vision-threatening complications occurred.

Conclusions:

TICL surgery showed good long-term astigmatism-correcting effects, although the long-term uncorrected visual acuity decreased. The procedure was effective in correcting myopia and astigmatism.
Multimodality imaging in cardiogenic shock: state-of-the art
Authors: Tavazzi Guido , Corradi Francesco , Vandenbriele Christophe , Alviar Carlos L.
Published: July 2023

Purpose of review

There is emerging evidence on the role of the multimodality imaging in the setting of cardiogenic shock. The utility of different imaging modalities, along with their pitfalls and limitations, and their integration in a multiparametric approach are discussed in the current review.

Recent findings

The evaluation of congestion and perfusion in patients with shock has allowed a better understanding of the underlying physiopathological mechanisms. Integration of echocardiography, using more physiological parameters, with lung ultrasound, as well as the Doppler evaluation of abdominal blood flow dynamics, has led to a better stratification in patinas with hemodynamic instability.

Although validation of the integrated approaches and single parameters are needed, the physiopathological-driven approach using ultrasound in patients with cardiogenic shock on top of the clinical and biochemical evaluation, may aid to a quicker and more detailed evaluation of patient's phenotype.
The impact of concomitant metabolic dysfunction-associated fatty liver disease on adverse outcomes in patients with hepatitis B cirrhosis: a propensity score matching study
Authors: Wang Xinyu , Wei Shuhang , Wei Yingnan , Wang Xueqi , Xiao Feng , Feng Yuemin , Zhu Qiang
Published: July 2023

Background and aims

In cirrhotic patients, the clinical relevance of metabolic dysfunction-associated fatty liver disease (MAFLD) is unclear. We aimed to research the relationship between MAFLD and adverse clinical outcomes in patients with hepatitis B cirrhosis.

Methods

A total of 439 patients with hepatitis B cirrhosis were enrolled. Abdominal MRI and computed tomography were used to calculate liver fat content in order to evaluate steatosis. The Kaplan–Meier method was implemented to generate survival curves. The independent risk factors for prognosis were identified by multiple Cox regression. Propensity score matching (PSM) was used to reduce the influence of confounding factors. This study explored the relevance between MAFLD and mortality, first decompensation and further decompensation.

Results

In our study, most patients were decompensated cirrhosis (n = 332, 75.6%) and the ratio of decompensated cirrhosis patients in non-MAFLD to MAFLD group was 199 : 133. Compared to the non-MAFLD group, patients with MAFLD had worse liver function which mainly reflected that there were more Child–Pugh C patients and higher model for end-stage liver disease score in the MAFLD group. A total of 207 adverse clinical events occurred in the total cohort during a median follow-up of 47 months, including 45 deaths, 28 hepatocellular carcinoma, 23 first decompensation and 111 further decompensation. Cox multivariate analysis showed that MAFLD was an independent risk factor for death [hazard ratio (HR) 1.931; 95% confidence interval (CI) 1.019–3.660; P = 0.044 HR 2.645; 95% CI, 1.145–6.115; P = 0.023] and further decompensation (HR 1.859; 95% CI, 1.261–2.741; P = 0.002 HR 1.953; 95% CI, 1.195–3.192; P = 0.008) before and after PSM. In decompensated group with MAFLD, diabetes had a more significant effect on adverse prognosis than overweight or obesity and other metabolic risk factors.

Conclusion

In patients with hepatitis B cirrhosis, concomitant MAFLD can predict a higher risk of further decompensation and death among decompensated individuals. According to patients among MAFLD, diabetes may be a major factor in the occurrence of adverse clinical events.
Clinical value of combined serum MMP-2, MMP-9 and TIMP-1 for the prognosis of perianal fistula patients who received minimally invasive surgery
Authors: Du Chang-Liang , Zhang Xuehui , Yang Haichun
Published: July 2023

Objective

This study aimed to investigate the clinical value of combined serum matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) for the prognosis of perianal fistula patients.

Methods

Patients diagnosed and treated for perianal fistula by minimally invasive surgery (MIS) were enrolled. The concentrations of serum MMP-2, MMP-9 and TIMP-1 were measured at 24 h after surgery. Different levels of wound secretion, growth of granulation tissue and wound pain were used as criteria to evaluate surgical incision healing. The receiver operating characteristic curve was used to analyze the predicted assessment value.

Results

The concentrations of serum MMP-2 and MMP-9 were significantly higher, while the concentrations of serum TIMP-1 at 24 h after surgery were significantly lower in the poor healing group than in the good healing group. It was further found that high levels of serum MMP-2 and MMP-9 were risk factors for poor healing, while high concentrations of serum TIMP-1 at 24 h after surgery were protective factors for poor healing.

Conclusion

High concentrations of serum MMP-2 and MMP-9 and low concentrations of serum TIMP at 24 h after surgery are risk factors for poor healing in perianal fistula patients who receive MIS, and the combined test has a higher predictive value.
Sodium-glucose cotransporter-2 inhibitors improve FibroScan-aspartate aminotransferase scores in patients with nonalcoholic fatty liver disease complicated by type 2 diabetes
Authors: Ogawa Yutaro , Nakahara Takashi , Ando Yuwa , Yamaoka Kenji , Fujii Yasutoshi , Uchikawa Shinsuke , Fujino Hatsue , Ono Atsushi , Murakami Eisuke , Kawaoka Tomokazu , Miki Daiki , Yamauchi Masami , Tsuge Masataka , Imamura Michio , Oka Shiro
Published: July 2023

Background and aim

Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease caused by excessive lipid accumulation in the liver, and its global incidence is increasing. Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are oral antidiabetes drugs that promote glucose excretion into the urine and have been reported to exert therapeutic effects in NAFLD, but liver stiffness measurements (LSMs) determined by transient elastography are inconsistent. In addition, the effects of SGLT2is on the FibroScan-aspartate aminotransferase (FAST) scores have not been reported. We evaluated the effect of SGLT2is on patients with NAFLD complicated by type 2 diabetes using biochemical tests, transient elastography, and FAST scores.

Methods

Fifty-two patients with type 2 diabetes complicated by NAFLD who started SGLT2i treatment between 2014 and 2020 at our hospital were selected from the database. Pre- and post-treatment serum parameters, transient elastography, and FAST scores were compared.

Results

After 48 weeks of SGLT2i treatment, body weight, fasting blood glucose, hemoglobin A1c, AST, alanine aminotransferase, gamma-glutamyltransferase, uric acid, fibrosis-4 index, and AST to platelet ratio index improved. Median LSM decreased from 7.0 kPa to 6.2 kPa (P = 0.023) and the median controlled attenuation parameter decreased from 304 dB/m to 283 dB/m (P = 0.022). Median FAST score decreased from 0.40 to 0.22 (P < 0.001), and the number of cases with a cutoff value of ≥0.35 decreased from 15 to 6 (P = 0.001).

Conclusion

SGLT2i use not only improves weight loss and blood glucose levels but also improves hepatic fibrosis by ameliorating hepatic steatosis and inflammation.
Baseline albumin-bilirubin score: a predictor for HBeAg clearance in patients with chronic hepatitis B after nucleos(t)ide analogue treatment
Authors: Zhang Yao , Gu Yan , Yin Shengxia , Wang Jian , Zhang Zhiyi , Liu Yilin , Chen Yun , Zhan Jie , Xue Ruifei , Yan Xiaomin , Zhang Shaoqiu , Ding Weimao , Chen Yuxin , Li Jie , Huang Rui , Wu Chao
Published: July 2023

Background

Serum biomarkers for predicting HBeAg clearance in patients with chronic hepatitis B (CHB) virus infection during antiviral therapy remain lacking. This study aimed to investigate baseline albumin-bilirubin (ALBI) score for assessing HBeAg clearance in HBeAg-positive CHB patients treated with nucleos(t)ide analogues (NAs).

Methods

Six hundred and ninety-nine HBeAg-positive CHB patients treated with first-line NAs were retrospectively included. Kaplan–Meier curves were used to compare the possibility of HBeAg clearance and HBeAg seroconversion in different ALBI groups. Cox regression models were used to identify factors associated with HBeAg clearance and HBeAg seroconversion.

Results

Of the patients, 69.8% were male, with a median age of 36.0 years. 174 (24.9%) patients achieved HBeAg clearance after a median of 92.0 (interquartile range 48.0–134.0) weeks of antiviral treatment and 108 (15.5%) patients achieved HBeAg seroconversion. 74.0% and 26.0% of patients were classified as ALBI grade 1 and ALBI grade 2-3, respectively. ALBI grade 2-3 was identified as an independent predictor of HBeAg clearance (hazard ratio 1.570, 95% confidence interval 1.071–2.301, P = 0.021). The cumulative incidence of HBeAg clearance and HBeAg seroconversion was significantly higher in ALBI grade 2-3 group than group of ALBI grade 1 (P < 0.001). Similar results were observed in different subgroups with different antiviral drugs, cirrhosis status, and ALT levels.

Conclusion

Baseline ALBI score may be a valuable indicator for predicting antiviral response in HBeAg-positive CHB patients treated with NAs.
Effect of aspirin use on survival in patients with hepatocellular carcinoma
Authors: Aktan Hakan , Ozdemir Asena Ayca , Karaoğullarindan Ümit
Published: July 2023

Background

Hepatocellular carcinoma (HCC) is the seventh most prevalent cancer globally and is the third leading cause of cancer-related mortality.

Aim

The aim of this study was to evaluate the effect of aspirin use on the survival rates of individuals diagnosed with HCC.

Methods

The patients were divided into two groups: those who used aspirin and those who did not. Aspirin use was defined as individuals who had used aspirin either before or after the diagnosis of HCC. Aspirin usage was determined based on prescription records. The criteria for aspirin use were defined as a minimum of 3 months and a minimum daily dose of 100 mg. Survival time; The time elapsed after the diagnosis of HCC was calculated as ‘months’

Result

Of the 300 cohorts studied in our study, 104 (34.6%) were using aspirin, while 196 (65.4%) were not. It was observed that bleeding occurred only in the patient group taking aspirin (P = 0.002). When evaluated in terms of survival time, it was observed that it was significantly higher in the patient group using aspirin (P = 0.001). Aspirin use was identified as factors that significantly impact survival (P < 0.05). Aspirin use was identified as independent risk factors that significantly impact of survival (P < 0.05).

Conclusion

The aspirin group had a similar metabolic and liver reserve as the other group and had a longer survival despite being older and more comorbid diseases.
The diagnostic accuracy of endoscopic ultrasound vs. contrast-enhanced computed tomography in local staging of pancreatic adenocarcinoma: a bi-national multicenter study
Authors: Sbeit Wisam , Salman Mahmoud , Khalaileh Abed , Zoabi Ahmad , Bramnik Zakhar , Hovel David , Mahamid Mahmud , Israeli Eran , Katz Lior , Khoury Reem , Mubariki Nama , Lisotti Andrea , Awadie Halim , Khoury Tawfik
Published: July 2023

Background

Identification of pancreatic cancer (PC) local invasion is crucial to optimize patients’ selection for surgery.

Aims

To determine the diagnostic accuracy of contrast-enhanced computed tomography (CECT) and endoscopic ultrasound (EUS) in local staging of PC.

Methods

We performed a multicenter study including all patients with PC who underwent surgery.

Results

One hundred twelve patients were included. Surgical findings of peri-pancreatic lymph nodes (LN), vascular and adjacent organ involvement were seen in 67 (59.8%), 33 (29.5%) and 19 patients (17%), respectively. The diagnostic performance of EUS was better than CECT in peri-pancreatic LN. The sensitivity, specificity, positive predictive value (PPV) and negative predictive (NPV) of CECT vs. EUS were 28.4%, 80%, 67.9% and 42.9% vs. 70.2%, 75.6%, 81% and 63%, respectively. For vascular and adjacent organ involvement, the sensitivity, specificity, PPV and NPV were 45.5%, 93.7%, 75%, 80.4% and 31.6%, 89.2%, 37.5% and 86.5% for CECT, respectively, vs. 63.6%, 93.7%, 80.8%, 86.1% and 36.8%, 94.6%, 58.3% and 88% for EUS, respectively. Combining both CECT and EUS, the sensitivity for peri-pancreatic LN, vascular and adjacent organ involvement improved (76.1%, 78.8% and 42%), respectively.

Conclusion

EUS was superior to CECT in local staging. Combined EUS and CECT had a higher sensitivity than either alone.
Immunotherapy combinations for metastatic castration-resistant prostate cancer – failed trials and future aspects
Authors: Slovin Susan F.
Published: July 2023

Purpose of review

Immunotherapy, a treatment modality currently synonymous with immune checkpoint blockade remains a challenge for prostate cancer. Despite multiple phase 3 trials using checkpoint inhibitors in combinatorial approaches, there have been no benefits to date in overall survival or radiographic progression free survival. However, newer strategies prevail that are directed to a variety of unique cell surface antigens. These strategies include unique vaccines, chimeric antigen receptor (CAR) T, bispecific T cell engager platforms, and antibody-drug conjugates.

Recent findings

New antigens are being targeted by various immunologic strategies. These antigens are pan-carcinoma as they may be expressed on a variety of cancers but remains effective targets for therapeutic attack.

Immunotherapy with checkpoint inhibitors alone or in combination with a variety of agents such as chemotherapy, poly-ADP ribose polymerase (PARP) inhibitors or novel biologics have met with failure in the endpoints of overall survival (OS) and radiographic progresson-free survival (rPFS). Despite these efforts, other immunologic efforts to develop unique tumor-targeted strategies should be continued.
Pediatric ERCP: Factors for Success and Complication—A 17-Year, Multisite Experience
Authors: Lorio Eric , Moreau Chris , Hernandez Brian , Rabbani Tebyan , Michaud Kristina , Hachem Jack , Aggarwal Pankaj , Stolow Eugene , Brown Landon , Michalek Joel Edmund , Patel Sandeep
Published: July 2023

Objectives:

Endoscopic retrograde cholangiopancreatography (ERCP) is an increasingly utilized procedure in pediatric populations. A lack of dedicated pediatric research has led endoscopists to extrapolate adult risk factors and preventative strategies to children. The aim of this multisite, retrospective study was to identify risks for adverse events, procedure failure, and prolonged courses in pediatric patients undergoing ERCP.

Methods:

Pediatric patients who had an ERCP at one of our academic centers were identified by query of their electronic medical records. Pre-procedure and post-procedure data were collected with ERCP-related adverse events defined according to the consensus criteria developed by Cotton et al 2010.

Results:

Between January 2004 and January 2021, 287 children had a total of 716 ERCPs. The procedure success rate was 95.5% with no mortality and an adverse event rate of 12.7%. Younger age was associated with increased case complexity, increased adverse events, and an increased rate of repeat ERCP. Case complexity score correlated with increased procedure time (P < 0.001) and increased adverse events (tau 0.24, P < 0.01); stent removal and pancreatic stenting were more likely to precede an adverse event. Pancreatitis, pancreatic divisum, and pancreatic stricture/stenosis were associated with increased adverse events and rates of repeat ERCP.

Conclusions:

Pediatric ERCP adverse event rates are higher than adults. The complexity grading system proposed by the Cotton et al appears to have applicability to pediatric patients. Young age and interventions affecting the pancreatic duct are associated with adverse ERCP outcomes in pediatrics.
Psychic Pain Among Men: Factor Structure, Psychosocial Correlates, and Mediation of Social Connectedness and Suicidal Ideation
Authors: Kealy David , Chartier Gabrielle B. , Walther Andreas , Rice Simon M. , Seidler Zac E. , Oliffe John L. , Ogrodniczuk John S.
Published: July 2023

The Psychic Pain Scale (PPS) measures a form of mental pain involving overwhelming negative affect and loss of self-control. Understanding psychic pain among men is needed to advance efforts for preventing male suicide. The present study examined the factor structure and psychosocial correlates of the PPS among 621 online help-seeking men. Confirmatory factor analysis indicated a higher-order factor comprising affect deluge and loss of control factors. Psychic pain evinced significant associations with general psychological distress, r = 0.64; perceived social support, r = −0.43; social connectedness, r = −0.55; and suicidal ideation, r = 0.65 (all p’s < 0.001)—the latter three remained significant after controlling for general distress. Psychic pain also mediated the association between social disconnection and suicidal ideation (standardized indirect effect = −0.14 [−0.21, −0.09]), after controlling for social support and distress. Findings support the PPS as a promising measure for investigating psychic pain among men and indicate psychic pain as a link between social disconnection and suicidal ideation.
Two-Wave Stability of Grandiose and Vulnerable Narcissism During Adolescence
Authors: Fontana Andrea , Cianfanelli Beatrice , Verbaro Roberta , Cuzzocrea Gaia , Benzi Ilaria Maria Antonietta , Sideli Lucia
Published: July 2023

Literature suggests that narcissistic traits may affect socio-affective development from early adolescence. Two interrelated narcissistic domains have been identified, i.e., narcissistic grandiosity (NG) and narcissistic vulnerability (NV). This study aims to prospectively assess NG and NV during adolescence and to investigate the mediating role of empathy on the stability of narcissistic traits. One-hundred fifty-six adolescents (47.5% females) participated in a longitudinal prospective study. NG, NV, and empathy were assessed at baseline and 24-month follow-up. Compared with NG traits, NV showed a mean-level increasing pattern, albeit with a small effect size. Different empathy domains mediated the developmental trajectories of NG and NV. Specifically, the “fantasy” empathy domain partially mediated the stability of NG, whereas the “personal distress” domain partially mediated the mild increase of NV. The findings suggest that grandiose fantasies and negative activation to others' distress are crucial factors in shaping developmental trajectories of narcissistic traits during adolescence.
Is There Any Association between Nutrition and Myopia?: A Systematic Review
Authors: Chamarty Sruthi , Gupta Satish K. , Dhakal Rohit , Verkicharla Pavan K.
Published: July 2023

Significance

This systematic review indicates that the current evidence shows no association of nutrition with myopia.

Purpose

We systematically reviewed the outcomes of the studies that previously investigated the association between nutrition and myopia.

Methods

Embase, MEDLINE, and PubMed were searched by two independent authors to identify cross-sectional, cohort, retrospective, or interventional studies that assessed the association of nutrition with myopia from inception to the year 2021. Further, the reference list of the included articles was screened. The data from the included studies were extracted and qualitative analysis was performed. Quality assessment for non-interventional studies and interventional trials was performed using the Newcastle-Ottawa scale and Cochrane RoB 2 respectively.

Results

Twenty-seven articles were included in the review. Most of the nutrients and dietary elements investigated in non-interventional studies showed inconsistencies in their association with myopia with the majority indicating no association. Nine studies showed a significant association of diverse nutrients and dietary elements with either an increase (Odds ratio: 1.07) or a decrease (Odds ratio: 0.5 to 0.96) in the risk of myopia development. However, the majority of these studies have minimal odds ratios with wider or overlapping confidence intervals, implicating weaker associations. All three nutrients and dietary elements assessed in the interventional trial had implications for myopia control, with two trials indicating a clinically minimal effect.

Conclusions

This review implies that there is some evidence to indicate a potential influence of specific nutrients and dietary elements in myopia development which are supported by several theories. However, given the vast, diverse, and complex nature of nutrition, more systematic investigation is warranted to comprehend the extent to which these specific nutrients and dietary elements are associated with myopia through longitudinal studies by subduing the limitations in the existing literature.
Central Visual Attention in Primary Open-angle Glaucoma
Authors: Béal Louis , Garric Clémentine , Rouland Jean-François , Lenoble Quentin
Published: July 2023

Significance

To better understand the implication of a potential cognitive change in glaucoma, patients were stimulated in central visual areas considered functionally normal to discard an effect due to the loss of vision during an attentional task. The outcome might improve the follow-up on the impact of the pathology.

Purpose

This study aimed to evaluate the effect of primary open-angle glaucoma on the visual attention system by recording responses of behavioral and oculomotor strategies.

Methods

We included 20 individuals with primary open-angle glaucoma (62.1 ± 7.2 years old), 18 age-matched controls (58.4 ± 7.2 years old) and 20 young controls (25.7 ± 3.5 years old). The procedure consisted of visual (eye-tracking recordings) and manual detection of a target. All participants had to detect a square with a vertical bar within distractors (squares, triangles and circles with a horizontal or vertical bar) of identical size of 1.6x1.6° visual angle. The shapes were displayed concentrically on a radius of 5° of visual angle. All participants were tested to ensure that their visual field sensitivity was normal within ±5° central vision.

Results

In responding manually, glaucoma participants were slower than aged-matched controls ((1723 ± 488 ms vs 1263 ± 385 ms) p < .01). Eye-tracking recordings showed that glaucoma participants found the target within the same timeframe as age-matched controls. Compared to the young group, the scanpath length and average fixation duration on distractors were significantly longer for the glaucoma patients (+235 pixels, +104 ms) and the aged-matched control participants (+120 pixels, +39 ms). Impaired contrast sensitivity was correlated with longer response time, longer scanpath and longer fixation on distractors.

Conclusions

Glaucoma affects the manual response times in a visual attention task, but patients can visually detect the target as quickly as age-matched controls. Different clinical factors predicted the performances. The age of the patients was associated with longer scanpath. The visual field loss (mean deviation - MD) was linked with longer visual response time. The loss of contrast sensitivity predicted the behavioral change on fixation duration to the distractors, global response time, visual response time and scanpath length.”
Expression and Significance of MTA2 and CPNE1 in Cervical Squamous Cell Carcinoma
Authors: Wang Lixin , Chen Gang , Zhou Chen , Wu Chao , Jiang Jingui
Published: July 2023

The aim of this study was to investigate the expression and clinical significance of MTA2 and CPNE1 proteins in cervical squamous cell carcinoma. In this study, high-risk human papillomavirus (HPV) typing was performed on cervical cancer tissues. Reverse transcription polymerase chain reaction and immunochemical EliVision method were used to examine the expressions of MTA2 and CPNE1 in the cervix, and their relationship with clinicopathologic features. We found that it is mainly distributed in these types, namely HPV-16 (23.8%), HPV-18 (20.9%), HPV-53 (17.1%), HPV-52 (15.5%), HPV-82 (11.7%), HPV-56 (10.8%). The expressions of MTA2 and CPNE1 in cervical squamous cell carcinoma tissues were significantly higher than those in normal tissues (P<0.01). The expressions of MTA2 and CPNE1 were correlated with FIGO stage, degree of differentiation, and lymph node metastasis of cervical cancer (P<0.05), but not with the patient’s age (P>0.05). The rank correlation coefficient of MTA2 and CPNE1 protein expression in cervical squamous cell carcinoma was 0.668 (P<0.01), and the 2 expressions were positively correlated. MTA2 and CPNE1 are closely related to the occurrence and development of cervical squamous cell carcinoma and may play a synergistic role in the evolution of cervical squamous cell carcinoma.
A moving target: impacts of lowering viral load suppression cutpoints on progress towards HIV epidemic control goals
Authors: Rosen Joseph G. , Reynolds Steven J. , Galiwango Ronald M. , Kigozi Godfrey , Quinn Thomas C. , Ratmann Oliver , Ndyanabo Anthony , Nelson Lisa J. , Nakigozi Gertrude , Nalugemwa Margaret , Rucinski Katherine B. , Kennedy Caitlin E. , Chang Larry W. , Kagaayi Joseph , Serwadda David , Grabowski M. Kate
Published: July 2023

Redefining viral load suppression (VLS) using lower cutpoints could impact progress towards the United Nations Programme on HIV/AIDS 95–95–95 targets. We assessed impacts of lowering the VLS cutpoint on achieving the ‘third 95’ in the Rakai Community Cohort Study. Population VLS would fall from 86% to 84% and 76%, respectively, after lowering VLS cutpoints from <1000 to <200 and <50 copies/ml. The fraction of viremic persons increased by 17% after lowering the VLS cutpoint from <1000 to <200 copies/ml.
Treatment Delays in Nonsyndromic Craniosynostosis
Authors: Lake Isabel V. , Lopez Christopher D. , Karius Alexander K. , Niknahad Ava , Khoo Kimberly H. , Girard Alisa O. , Yusuf Cynthia T. , Hopkins Elizabeth , Lopez Joseph , Redett Richard J. , Yang Robin
Published: July 2023

Background

Patients with nonsyndromic craniosynostosis (NSC) generally undergo corrective surgery before 1 year of age to the mitigate morbidities and risks of delayed repair. The cohort of patients who receive primary corrective surgery after 1 year and factors associated with their gaps to care is poorly characterized in literature.

Methods

A nested case-control study was conducted for NSC patients who underwent primary corrective surgery at our institution and affiliates between 1992 and 2022. Patients whose surgery occurred after 1 year of age were identified and matched 1:1 by surgical date to standard-care control subjects. Chart review was conducted to gather patient data regarding care timeline and sociodemographic characteristics.

Results

Odds of surgery after 1 year of age were increased in Black patients (odds ratio, 3.94; P < 0.001) and those insured by Medicaid (2.57, P = 0.018), with single caregivers (4.96, P = 0.002), and from lower-income areas (+1% per $1000 income decrease, P = 0.001). Delays associated with socioeconomic status primarily impacted timely access to a craniofacial provider, whereas caregiver status was associated with subspecialty level delays. These disparities were exacerbated in patients with sagittal and metopic synostosis, respectively. Patients with multisuture synostosis were susceptible to significant delays related to familial strain (foster status, insurer, and English proficiency).

Conclusions

Patients from socioeconomically strained households face systemic barriers to accessing optimal NSC care; disparities may be exacerbated by the diagnostic/treatment complexities of specific types of craniosynostosis. Interventions at primary care and craniofacial specialist levels can decrease health care gaps and optimize outcomes for vulnerable patients.
The Effect of Mandibular Impacted Third Molar on Fracture of Mandibular Angle and Condyle: An Observational Study
Authors: Ayana Pushkaran , Dain Chacko P.
Published: July 2023

Objective:

The factors that may increase the risk of mandibular angle fractures are the abrupt change in angulation and its association with impacted teeth. Condyle, a common mandibular fracture site, is spared if the impact is absorbed in the angle. The study aimed to determine the relationship between the status of impacted mandibular third molars and mandibular angle and condylar fractures in patients with a history of road traffic accidents, within the age group of 18 to 50 years.

Methods:

In this observational study, 136 patients were examined clinically to diagnose mandibular angle and/or condylar fractures which were confirmed using an orthopantomogram. The status of the mandibular third molars was assessed radiographically.

Results:

Among the 173 fracture sites detected, 43 were diagnosed at the angle and 130 at the condyle. The demographic assessment demonstrated an age predisposition between 31 and 50 years (44%) in males and 21 and 30 years (47%) in females, with an overall peak incidence in the age group of 21 to 30 years (45%). There was a significant relationship between the status of impacted third molars and the occurrence of angle (P<0.01) and condylar fractures (P=0.05). The incidence of angle and condylar fractures in patients with/without associated impacted mandibular third molars were found to be 91% and 64% and 9% and 36%, respectively.

Conclusions:

The presence of impacted third molars had a significant relationship with the high incidence of angle fractures and the low incidence of condylar fractures. Knowledge about the common fracture patterns associated with impacted mandibular third molars would alert the clinician to contemplate fractures based on the anatomic distribution.