bluuebunny/crossref_metadata_2025 huggingface dataset:
Proteomic profiling of longitudinal changes in kidney function among middle-aged and older men and women: the KORA S4/F4/FF4 study
Authors: Lin Jie-sheng , Nano Jana , Petrera Agnese , Hauck Stefanie M. , Zeller Tanja , Koenig Wolfgang , Müller Christian L. , Peters Annette , Thorand Barbara
Published: July 2023

Background

Due to the asymptomatic nature of the early stages, chronic kidney disease (CKD) is usually diagnosed at late stages and lacks targeted therapy, highlighting the need for new biomarkers to better understand its pathophysiology and to be used for early diagnosis and therapeutic targets. Given the close relationship between CKD and cardiovascular disease (CVD), we investigated the associations of 233 CVD- and inflammation-related plasma proteins with kidney function decline and aimed to assess whether the observed associations are causal.

Methods

We included 1140 participants, aged 55–74 years at baseline, from the Cooperative Health Research in the Region of Augsburg (KORA) cohort study, with a median follow-up time of 13.4 years and 2 follow-up visits. We measured 233 plasma proteins using a proximity extension assay at baseline. In the discovery analysis, linear regression models were used to estimate the associations of 233 proteins with the annual rate of change in creatinine-based estimated glomerular filtration rate (eGFRcr). We further investigated the association of eGFRcr-associated proteins with the annual rate of change in cystatin C-based eGFR (eGFRcys) and eGFRcr-based incident CKD. Two-sample Mendelian randomization was used to infer causality.

Results

In the fully adjusted model, 66 out of 233 proteins were inversely associated with the annual rate of change in eGFRcr, indicating that higher baseline protein levels were associated with faster eGFRcr decline. Among these 66 proteins, 21 proteins were associated with both the annual rate of change in eGFRcys and incident CKD. Mendelian randomization analyses on these 21 proteins suggest a potential causal association of higher tumor necrosis factor receptor superfamily member 11A (TNFRSF11A) level with eGFR decline.

Conclusions

We reported 21 proteins associated with kidney function decline and incident CKD and provided preliminary evidence suggesting a potential causal association between TNFRSF11A and kidney function decline. Further Mendelian randomization studies are needed to establish a conclusive causal association.
Initial insights into the impact and implementation of Creating Active Schools in Bradford, UK
Authors: Morris Jade L. , Chalkley Anna E. , Helme Zoe E. , Timms Oliver , Young Emma , McLoughlin Gabriella M. , Bartholomew John B. , Daly-Smith Andy
Published: July 2023

Background

Few whole-school physical activity programmes integrate implementation science frameworks within the design, delivery, and evaluation. As a result, knowledge of the key factors that support implementation at scale is lacking. The Creating Active Schools (CAS) programme was co-designed and is underpinned by the Capability, Opportunity, Motivation and Behaviour (COM-B) model and the Consolidated Framework for Implementation Research (CFIR). The study aims to understand the initial impact and implementation of CAS in Bradford over 9 months using McKay’s et al.’s (2019) implementation evaluation roadmap.

Methods

Focus groups and interviews were conducted with school staff (n = 30, schools = 25), CAS Champions (n = 9), and the CAS strategic lead (n = 1). Qualitative data were analysed both inductively and deductively. The deductive analysis involved coding data into a priori themes based on McKay et al’s implementation evaluation roadmap, using a codebook approach to thematic analysis. The inductive analysis included producing initial codes and reviewing themes before finalising.

Results

Identified themes aligned into three categories: (i) key ingredients for successful adoption and implementation of CAS, (ii) CAS implementation: challenges and solutions, and (iv) the perceived effectiveness of CAS at the school level. This included the willingness of schools to adopt and implement whole-school approaches when they are perceived as high quality and aligned with current school values. The programme implementation processes were seen as supportive; schools identified and valued the step-change approach to implementing CAS long-term. Formal and informal communities of practice provided “safe spaces” for cross-school support. Conversely, challenges persisted with gaining broader reach within schools, school staff’s self-competence and shifting school culture around physical activity. This resulted in varied uptake between and within schools.

Conclusions

This study provides novel insights into the implementation of CAS, with outcomes aligning to the adoption, reach, and sustainability. Successful implementation of CAS was underpinned by determinants including acceptability, intervention complexity, school culture and school stakeholders’ perceived self-efficacy. The combination of McKay’s evaluation roadmap and CFIR establishes a rigorous approach for evaluating activity promotion programmes underpinned by behavioural and implementation science. Resultantly this study offers originality and progression in understanding the implementation and effectiveness of whole-school approaches to physical activity.
Intraparenchymal convection enhanced delivery of AAV in sheep to treat Mucopolysaccharidosis IIIC
Authors: O’Leary Claire , Forte Gabriella , Mitchell Nadia L. , Youshani Amir Saam , Dyer Adam , Wellby Martin P. , Russell Katharina N. , Murray Samantha J. , Jolinon Nelly , Jones Simon A , Stacey Kevin , Davis Daniel M. , Henckaerts Els , Palmer David N. , Kamaly-Asl Ian , Bigger Brian W.
Published: July 2023

Background

Mucopolysaccharidosis IIIC (MPSIIIC) is one of four Sanfilippo diseases sharing clinical symptoms of severe cognitive decline and shortened lifespan. The missing enzyme, heparan sulfate acetyl-CoA: α-glucosaminide-N-acetyltransferase (HGSNAT), is bound to the lysosomal membrane, therefore cannot cross the blood-brain barrier or diffuse between cells. We previously demonstrated disease correction in MPSIIIC mice using an Adeno-Associated Vector (AAV) delivering HGSNAT via intraparenchymal brain injections using an AAV2 derived AAV-truetype (AAV-TT) serotype with improved distribution over AAV9.

Methods

Here, intraparenchymal AAV was delivered in sheep using catheters or Hamilton syringes, placed using Brainlab cranial navigation for convection enhanced delivery, to reduce proximal vector expression and improve spread.

Results

Hamilton syringes gave improved AAV-GFP distribution, despite lower vector doses and titres. AAV-TT-GFP displayed moderately better transduction compared to AAV9-GFP but both serotypes almost exclusively transduced neurons. Functional HGSNAT enzyme was detected in 24-37% of a 140g gyrencephalic sheep brain using AAV9-HGSNAT with three injections in one hemisphere.

Conclusions

Despite variabilities in volume and titre, catheter design may be critical for efficient brain delivery. These data help inform a clinical trial for MPSIIIC.
One-hole split endoscope technique for migrated lumbar disc herniation: a single-centre, retrospective study of a novel technique
Authors: Zhang Yuhong , Feng Bo , Ning Huaxiu , Dai Guohua , Su Weiliang , Lu Huaiwang , Hu Peng
Published: July 2023

Background

Lumbar disc herniation (LDH) is one of the most common diseases of the spine, and migrated LDH is a more serious type, associated with nerve root function injury or abnormality. Regarding the increasing surgery adoption of treating migrated LDH, we aimed to investigate the clinical efficacy and safety of discectomy with a novel technique–one-hole split endoscope (OSE) technique.

Methods

This was a retrospective analysis of migrated LDH treated between December 2020 and September 2021. Hospitalization time, operative duration, intraoperative blood loss, number of fluoroscopy exposures, incision length, postoperative facet preservation rate, number of excellent–good cases, lower back and leg visual analogue score (VAS), Oswestry Disability Index (ODI) and surgical complications were compared between high-grade migration group (82 cases) and low-grade migration group (148 cases). The Macnab criteria was used to evaluate the clinical outcome. The Shapiro‒Wilk test was used to test measurement data, and the χ2 test was used to test counting data.

Results

There was no significant difference in hospitalization time, operative duration, intraoperative blood loss, number of fluoroscopy exposures, incision length or postoperative facet preservation rate between the two groups by independent sample t test or nonparametric test. At any time point, the lower back and leg VAS and ODI of the two groups were significantly improved compared to those before the operation, but there was no significant difference between the two groups at the same time point by two-way repeated measures ANOVA. There were two cases of postoperative nerve root stimulation symptoms in the high-grade migration group and three cases in the low-grade migration group. There was one patient reoperated in the high-grade migration group. There was no significant difference in number of excellent–good cases between the two groups. The overall excellent–good rate was 89.6%.

Conclusion

The OSE technique has the advantages of less trauma, faster recovery, complete removal of the nucleus pulposus and a satisfactory early clinical efficacy in the treatment of migrated LDH.
Preoperative computed tomography-guided transscapular sens-cure needle localization for pulmonary nodule located behind the scapula
Authors: Lu Zi-Wei , Liu Yue-Yue , Li Yong-Gang , Lv Lu-Lu
Published: July 2023

Background

Video-assisted thoracoscopic surgery (VATS) is an approach that is commonly used to resect pulmonary nodules (PNs). However, when these PNs are located behind the scapula, a transscapular access approach is generally required. In this study, the safety, efficacy, and feasibility of preoperative computed tomography (CT)-guided Sens-cure needle (SCN) localization was assessed for PNs located behind the scapula.

Methods

From January 2020 - June 2022, a total of 122 PN patients in our hospital underwent preoperative CT-guided SCN localization and subsequent VATS resection, of whom 12 (9.8%) exhibited PNs behind the scapula necessitating a transscapular approach for this localization procedure.

Results

This study included 12 patients, each of whom had one PN located behind the scapula. The CT-guided transscapular SCN localization approach was successful in all patients, and no complications near the operative site were observed. The median localization time was 12 min, and 2 (16.7%) and 1 (8.3%) patients respectively developed pneumothorax and pulmonary hemorrhage after the localization procedure was complete. Wedge resection procedures for these PNs achieved technical success in all cases. Four patients were diagnosed with invasive adenocarcinomas and subsequently accepted lobectomy and systematic lymph node dissection. The median VATS duration and the median blood loss was 80 min and 10 mL, respectively. In total, 3, 5, and 4 PNs were respectively diagnosed as benign, mini-invasive adenocarcinomas, and invasive adenocarcinomas.

Conclusion

Preoperative CT-guided transscapular SCN localization represents a safe, straightforward, and effective means of localizing PNs present behind the scapula.
Regional cerebral tau predicts decline in everyday functioning across the Alzheimer’s disease spectrum
Authors: Dubbelman Mark A. , Mimmack Kayden J. , Sprague Emily H. , Amariglio Rebecca E. , Vannini Patrizia , Marshall Gad A. ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: July 2023

Background

Emerging difficulty performing cognitively complex everyday tasks, or ‘instrumental activities of daily living’ (IADL) may be an early clinical sign of Alzheimer’s disease (AD). We aimed to investigate how changes over time in everyday functioning relate to cerebral tau burden across the AD clinical spectrum.

Methods

We included 581 participants (73.9 ± 7.6 years old; 52% female) from the Alzheimer’s Disease Neuroimaging Initiative who underwent tau positron emission tomography (PET) and completed at least two assessments of the Functional Activities Questionnaire (FAQ). Participants were classified as cognitively normal (n = 334) or symptomatic (n = 247). We analyzed the association between longitudinal FAQ scores and baseline tau in six temporal, parietal, and frontal brain regions in mixed-effects models. Models were run in the entire sample, as well as stratified by diagnostic group (cognitively normal or symptomatic). We additionally investigated tau-PET adjusted for, as well as interacting with, amyloid-β.

Results

Greater tau burden in several frontal, temporal, and parietal regions was associated with steeper decline over time in everyday functioning. These findings remained when adjusting for baseline global cortical amyloid-β; amyloid-β itself was only associated with change over time in FAQ scores when tau was not included in the model. When stratifying by diagnostic group, most associations between tau and everyday functioning, adjusted for amyloid-β, were present only in the symptomatic group.

Conclusions

The rate of change in everyday functioning is related to baseline tau burden in various brain regions, more strongly so than global cortical amyloid-β, specifically in cognitively symptomatic individuals. Longitudinal studies in incident dementia populations are needed to better understand functional changes in response to AD pathology across the disease.
Virtual biopsy using CT radiomics for evaluation of disagreement in pathology between endoscopic biopsy and postoperative specimens in patients with gastric cancer: a dual-energy CT generalizability study
Authors: Liu Yiyang , Zhao Shuai , Wu Zixin , Liang Hejun , Chen Xingzhi , Huang Chencui , Lu Hao , Yuan Mengchen , Xue Xiaonan , Luo Chenglong , Liu Chenchen , Gao Jianbo
Published: July 2023

Purpose

To develop a noninvasive radiomics-based nomogram for identification of disagreement in pathology between endoscopic biopsy and postoperative specimens in gastric cancer (GC).

Materials and methods

This observational study recruited 181 GC patients who underwent pre-treatment computed tomography (CT) and divided them into a training set (n = 112, single-energy CT, SECT), a test set (n = 29, single-energy CT, SECT) and a validation cohort (n = 40, dual-energy CT, DECT). Radiomics signatures (RS) based on five machine learning algorithms were constructed from the venous-phase CT images. AUC and DeLong test were used to evaluate and compare the performance of the RS. We assessed the dual-energy generalization ability of the best RS. An individualized nomogram combined the best RS and clinical variables was developed, and its discrimination, calibration, and clinical usefulness were determined.

Results

RS obtained with support vector machine (SVM) showed promising predictive capability with AUC of 0.91 and 0.83 in the training and test sets, respectively. The AUC of the best RS in the DECT validation cohort (AUC, 0.71) was significantly lower than that of the training set (Delong test, p = 0.035). The clinical-radiomic nomogram accurately predicted pathologic disagreement in the training and test sets, fitting well in the calibration curves. Decision curve analysis confirmed the clinical usefulness of the nomogram.

Conclusion

CT-based radiomics nomogram showed potential as a clinical aid for predicting pathologic disagreement status between biopsy samples and resected specimens in GC. When practicability and stability are considered, the SECT-based radiomics model is not recommended for DECT generalization.

Critical relevance statement

Radiomics can identify disagreement in pathology between endoscopic biopsy and postoperative specimen.

Graphical abstract
Report of a phase 1 clinical trial for safety assessment of human placental mesenchymal stem cells therapy in patients with critical limb ischemia (CLI)
Authors: Shirbaghaee Zeinab , Heidari Keshel Saeed , Rasouli Mehdi , Valizadeh Majid , Hashemi Nazari Seyed Saeed , Hassani Mohammad , Soleimani Masoud
Published: July 2023

Background

Critical limb ischemia (CLI) is associated with increased risk of tissue loss, leading to significant morbidity and mortality. Therapeutic angiogenesis using cell-based treatments, notably mesenchymal stem cells (MSCs), is essential for enhancing blood flow to ischemic areas in subjects suffering from CLI. The objective of this study was to evaluate the feasibility of using placenta-derived mesenchymal stem cells (P-MSCs) in patients with CLI.

Methods

This phase I dose-escalation study investigated P-MSCs in nine CLI patients who were enrolled into each of the two dosage groups (20 × 106and 60 × 106cells), delivered intramuscularly twice, two months apart. The incidence of treatment-related adverse events was the primary endpoint. The decrease in inflammatory cytokines, improvement in the ankle-brachial pressure index (ABI), maximum walking distance, vascular collateralization, alleviation of rest pain, healing of ulceration, and avoidance of major amputation in the target leg were the efficacy outcomes.

Results

All dosages of P-MSCs, including the highest tested dose of 60 × 106cells, were well tolerated. During the 6-month follow-up period, there was a statistically significant decrease in IL-1 and IFN-γ serum levels following P-MSC treatment. The blood lymphocyte profile of participants with CLI did not significantly differ, suggesting that the injection of allogeneic cells did not cause T-cell proliferation in vivo. We found clinically substantial improvement in rest pain, ulcer healing, and maximum walking distance after P-MSC implantation. In patients with CLI, we performed minor amputations rather than major amputations. Angiography was unable to demonstrate new small vessels formation significantly.

Conclusion

The observations from this phase I clinical study indicate that intramuscular administration of P-MSCs is considered safe and well tolerated and may dramatically improve physical performance and minimize inflammatory conditions in patients with CLI.

Trial registration: IRCT, IRCT20210221050446N1. Registered May 09, 2021.
Machine learning predicts lung recruitment in acute respiratory distress syndrome using single lung CT scan
Authors: Pennati Francesca , Aliverti Andrea , Pozzi Tommaso , Gattarello Simone , Lombardo Fabio , Coppola Silvia , Chiumello Davide
Published: July 2023

Background

To develop and validate classifier models that could be used to identify patients with a high percentage of potentially recruitable lung from readily available clinical data and from single CT scan quantitative analysis at intensive care unit admission. 221 retrospectively enrolled mechanically ventilated, sedated and paralyzed patients with acute respiratory distress syndrome (ARDS) underwent a PEEP trial at 5 and 15 cmH2O of PEEP and two lung CT scans performed at 5 and 45 cmH2O of airway pressure. Lung recruitability was defined at first as percent change in not aerated tissue between 5 and 45 cmH2O (radiologically defined; recruiters: Δ45-5non-aerated tissue  > 15%) and secondly as change in PaO2 between 5 and 15 cmH2O (gas exchange-defined; recruiters: Δ15-5PaO2  > 24 mmHg). Four machine learning (ML) algorithms were evaluated as classifiers of radiologically defined and gas exchange-defined lung recruiters using different models including different variables, separately or combined, of lung mechanics, gas exchange and CT data.

Results

ML algorithms based on CT scan data at 5 cmH2O classified radiologically defined lung recruiters with similar AUC as ML based on the combination of lung mechanics, gas exchange and CT data. ML algorithm based on CT scan data classified gas exchange-defined lung recruiters with the highest AUC.

Conclusions

ML based on a single CT data at 5 cmH2O represented an easy-to-apply tool to classify ARDS patients in recruiters and non-recruiters according to both radiologically defined and gas exchange-defined lung recruitment within the first 48 h from the start of mechanical ventilation.
Performances of Concrete Columns with Modular UHPC Permanent Formworks Under Axial Load
Authors: Yang Yibo , Chen Baixi , Chen Yong , Zhou Huanyang , Liu Fucai , Xie Xiangming , Chen Junsheng , Guo Wenying , Wang Hengchang
Published: July 2023

This research proposed the modular prefabricated permanent formwork system made of ultra-high-performance concrete (UHPC). Two kinds of modular formwork shapes were designed: the flat formwork and the ribbed. The experimental investigation on the axial compression performance of the composite columns that consist of the normal strength concrete (NSC) core and the modular UHPC permanent formwork was demonstrated. Compared with the flat formwork, the ribbed formwork exhibited better bonding with the NSC core. As observed from the test results, the composite column with the ribbed formwork presented a similar axial behavior as the NSC column with a slight improvement in ultimate loads. Therefore, the modular UHPC ribbed permanent formwork could be regarded as the additional cover to the conventional NSC column. In addition, the finite element analysis (FEA) model was also developed to simulate the composite columns numerically. The predicted capacities agreed with the experimental results, which validated the numerical models. The crack pattern estimated by the FEA model revealed that the interaction between the permanent formwork and the inner concrete introduced many tiny cracks to the concrete core. However, as protected by the UHPC permanent formwork, the overall durability of the composite columns can still be enhanced.
Long-term treatment outcomes with zygomatic implants: a systematic review and meta-analysis
Authors: Brennand Roper Matthew , Vissink Arjan , Dudding Tom , Pollard Alex , Gareb Barzi , Malevez Chantal , Balshi Thomas , Brecht Lawrence , Kumar Vinay , Wu Yiqun , Jung Ronald
Published: July 2023

Purpose

The purpose of this study was to perform a systematic review with meta-analysis on the long-term survival rates of zygomatic implants (ZI). ZI success, prostheses survival and success, sinus pathology and patient reported outcomes were also investigated.

Methods

Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed. Embase and OvidMedline databases were searched alongside the grey literature. The systematic review was recorded in PROSPERO (CRD42022358024). Studies reporting titanium/titanium alloy ZI survival data, ZI-supported prosthesis data, ZIs directly compared to any other implant therapy including grafted sites, a minimum follow-up time of 3 years and a minimum number of 10 patients were included. All study designs were considered if they met the inclusion criteria. Studies not involving ZIs, ZIs not made from titanium/titanium alloy, a follow-up time of < 3 years or < 10 patients, animal studies and in vitro studies were excluded. Long-term follow-up has not been defined in the literature. A minimum of 3 years follow-up was considered acceptable to capture survival after initial healing, alongside in-function prosthesis data via delayed or immediate load protocols. ZI success, was predominantly defined as ZI survival without biological or neurological complications. Meta-analyses were performed for ZI survival, ZI failure incidence, ZI success, loading protocol, prosthesis survival, and prevalence of sinusitis using random effects models. Descriptive analysis was used for ZI success, prosthesis success and patient reported outcome measures.

Results

Five hundred and seventy-four titles were identified, of which 18 met the inclusion criteria. Eligible studies included 1349 ZIs in 623 patients. Mean follow-up period was 75.4 months (range 36–141.6). The mean survival of ZIs was 96.2% [95% CI: 93.8; 97.7] at 6 years. Mean survival for delayed loading was 95% [95% CI: 91.7; 97.1] and 98.1% [95% CI: 96.2; 99.0] for immediate loading (p = 0.03). Annual incidence rate of ZI failure was 0.7% [95% CI 0.4; 1.0]. Mean ZI success was 95.7% [95% CI 87.8; 98.6]. Mean prosthesis survival was 94% [95% CI 88.6; 96.9]. Sinusitis prevalence was 14.2% [95% CI 8.8; 22.0] at 5 years. Patients’ reported increased satisfaction with ZIs.

Conclusions

ZIs have long-term survival comparable to conventional implants. Immediate loading showed a statistically significant increase in survival over delayed loading. Prosthesis survival was similar to that of prostheses supported by conventional implants, with similar complications. Sinusitis was the most frequently encountered biological complication. Patients reported improved outcome measures with ZI use.

Graphical Abstract
A rare spontaneous breast abscess due to Mycobacterium chelonae: a case report
Authors: Sakatoku Yayoi , Okada Yoshito , Takahashi Yohei
Published: July 2023

Background

Mycobacterium chelonae, a nontuberculous mycobacterium, commonly causes skin, soft tissue, eye, pulmonary, catheter-related, and post-surgical infections in patients with immunosuppression or trauma. M. chelonae breast infections are rare, and most cases occur following cosmetic surgery. Here, we report the first case of spontaneous breast abscess due to M. chelonae.

Case presentation

A 22-year-old Japanese woman presented at our hospital with swelling and pain in the right breast for the past 2 weeks without any fever. She had a 19-month-old child and stopped breastfeeding 1 month after giving birth. The patient had no history of trauma or breast surgeries, no family history of breast cancer, and was not immunocompromised. Breast ultrasonography revealed a heterogeneous hypoechoic lesion with multiple fluid-filled areas suspected to be abscesses. Dynamic contrast-enhanced magnetic resonance imaging revealed a 64 × 58 × 62 mm, ill-defined, high-signal-intensity lesion with multiple ring enhancements in the upper half of the right breast. The first diagnosis was inflammatory breast cancer or granulomatous mastitis with abscess. A core needle biopsy led to drainage of pus. Gram staining did not reveal any bacteria in the pus, but the colonies from the biopsy grew on blood and chocolate agar cultures. Mass spectrometry detected M. chelonae in these colonies. Histopathological findings revealed mastitis without malignancy. The patient's treatment regimen was oral clarithromycin (CAM) based on susceptibility. Three weeks later, although the pus had reduced, the induration in the breast did not resolve; therefore, multidrug antibiotic treatment was initiated. The patient received amikacin and imipenem infusion therapy for 2 weeks, followed by continuation of CAM. Three weeks later, tenderness in the right breast recurred with slight pus discharge. Hence, minocycline (MINO) was added to the treatment. The patient stopped CAM and MINO treatment 2 weeks later. There was no recurrence 2 years after treatment.

Conclusion

We report a case of M. chelonae breast infection and abscess formation in a 22-year-old Japanese woman without obvious risk factors. M. chelonae infection should be considered in cases of intractable breast abscess, even in patients without immunosuppression or trauma.
Mid-phase pinpoint hyperfluorescent spots on fundus fluorescein angiography in acute central retinal artery occlusion – a novel imaging finding
Authors: Mangla Rubble , Venkatesh Ramesh , Prabhu Vishma , Acharya Isha , Handa Ashit , Thadani Atul , Joshi Aishwarya , Yadav Naresh Kumar , Chhablani Jay
Published: July 2023

Purpose

To describe the development and outcome of mid-phase pinpoint hyperfluorescent spots (MPHS) on fundus fluorescein angiography (FFA) in acute (< 7-day symptom onset) central retinal artery occlusion (CRAO) patients.

Methods

This retrospective study included acute CRAO patients who underwent multimodal imaging utilizing optical coherence tomography (OCT) and FFA between June 2017 and January 2023. The correlation of FFA images with the OCT images in various stages and severity of CRAO were studied.

Results

Twenty-three FFA studies on 23 patients with acute CRAO were included. In 11 (48%) cases, an important finding noted on FFA was the presence of single or multiple MPHS with adjacent minimal late vascular leakage. Of these 11 cases, eight (73%) were males and median age was 41 years (inter quartile range: 33–55 years). Visual acuity ranged from ‘light perception’ to 6/18, and these patients presented anytime on the same day to seven days after symptom onset. On OCT, three eyes had severe CRAO, seven eyes had moderate CRAO, and one eye had mild CRAO. MPHS were primarily observed at the posterior pole and more frequently observed in moderate CRAO severity. During follow-up, the MPHS and retinal vessel staining on FFA disappeared as the CRAO showed signs of resolution.

Conclusion

MPHS at the posterior pole on FFA in acute CRAO patients could indicate a more severe occlusion and poor visual outcomes, even after treatment. This finding is most likely caused by red blood cell aggregation or rouleaux formation.

Trial registration number

Not applicable.
Clinically important change for the FACIT-Fatigue scale in paroxysmal nocturnal hemoglobinuria: a derivation from international PNH registry patient data
Authors: Cella David , Johansson Peter , Ueda Yasutaka , Tomazos Ioannis , Gustovic Philippe , Wang Alice , Patel Ami S. , Schrezenmeier Hubert
Published: July 2023

Background

Fatigue is the most common symptom associated with paroxysmal nocturnal hemoglobinuria (PNH). The objective of this analysis was to estimate values that would suggest a clinically important change (CIC) for the functional assessment of chronic illness therapy-fatigue scale (FACIT-Fatigue) in patients with PNH.

Methods

Adults with PNH who initiated eculizumab within 28 days of enrollment in the International PNH Registry as of January 2021 with baseline FACIT-Fatigue scores were included in the analysis. Distribution-based estimates of likely difference were calculated using 0.5 × SD and SEM. Anchor-based estimates of CIC considered the European Organization for Research and Treatment of Cancer (EORTC) global health status/quality of life summary score and the EORTC Fatigue Scale score. Changes in anchors and high disease activity (HDA) shift from start of eculizumab treatment to each follow-up visit were then assessed by FACIT-Fatigue score change (≤ 1 CIC, no change, or ≥ 1 CIC).

Results

At baseline, 93% of 423 patients had fatigue documented in their medical history. The distribution-based estimates for FACIT-Fatigue were 6.5 using 0.5 × SD and 4.6 using SEM; internal consistency was high (α = 0.87). For anchor-based estimates, the FACIT-Fatigue CIC ranged from 2.5 to 15.5, and generally supported 5 points as a reasonable lower end of the value for meaningful individual change. The percentage of patients who changed from having HDA at baseline to no HDA at eculizumab-treated follow-up visits increased over time.

Conclusion

These results support the use of 5 points as the CIC for FACIT-Fatigue in patients with PNH, which is within range of the CICs reported in other diseases (3–5 points).
Spinal cord injury without radiologic abnormality: an updated systematic review and investigation of concurrent concussion
Authors: Dudney William P. , Sherburn Eric W.
Published: July 2023

Study design

Systematic review.

Objectives

The objectives were to systematically review the literature since the most recent systematic reviews for both adult and pediatric spinal cord injuries without radiologic abnormality (SCIWORA) in order to provide an update on the condition’s epidemiology and characteristics and investigate the relationship between SCIWORA and concurrent concussion.

Methods

A review was conducted according to the 2020 guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The databases PubMed and OvidSP were searched on February 27, 2022. Inclusion criteria were individuals of any age, diagnosis of SCIWORA with or without abnormalities on MRI, and articles published from 2013 to 2014 (adults only) and 2014–present (all ages). Exclusion criteria were any spinal fracture or dislocation, studies that were narrative reviews, letters, book chapters, or editorials. Risk of bias was assessed using tools from the Clinical Advances Through Research and Information Translation Group at McMaster University and the Joanna Briggs Institute. Collected data were synthesized using Microsoft Excel.

Results

Since the most recent systematic reviews, a total of 61 studies were identified, resulting in 2788 patients with SCIWORA. 69.55% of patients were pediatric, 30.45% adult. The most prevalent reported mechanism of injury was sports-related (39.56%) followed by fall-related (30.01%) and vehicle-related (27.23%). The vast majority of injuries occurred at the level of the cervical spine (82.59%). Of the 61 included studies, only 5 reported cases of concurrent concussion and/or TBI.

Discussion

Since the most recent previous systematic reviews, there has been a 64% increase in reported cases of SCIWORA, likely as the result of advances in imaging technology and better awareness of SCIWORA. Still, SCIWORA remains a diagnosis most prevalent in children and young adults, the most common cause being sports-related injury. With the pathogenesis of SCIWORA sharing a predisposition to concussion, the significant lack of reporting of SCIWORA with concurrent concussion suggests that there have been missed diagnoses of either SCIWORA with concurrent concussion or vice versa, leading to longer recovery times, unrecognized and/or untreated underlying pathology, and possibly additional unnecessary morbidity. When the diagnosis of either SCIWORA or concussion is suspected, the other should additionally be considered in order to minimize the possible extended recovery time and related comorbidities. Limitations included the prevalence of lower quality studies such as case reports/series, insufficient reporting of study characteristics, and variability among neurologic impairment scales used and how SCIWORA was defined.
Application and validation of machine vision inspection for efficient in-process monitoring of complex biomechanical device manufacturing
Authors: Guha Bikash , Moore Sean , Huyghe Jacques M.
Published: July 2023

A technique is presented for shifting the manufacturing quality control of complex biomechanical catheters away from destructive testing of finished parts. This technique uses a more efficient real-time in-process monitoring through the application of machine vision inspection of patient critical quality parameters. The approach acknowledges the challenge of this industry operating in a strict regulated environment. The higher standards of built-in quality are achieved by developing automated inspection solutions that are more accurate and repeatable. Machine vision system and associated inspection job tools are developed and used to detect defects at crucial stages of manufacturing. The vision system is then tested for its robustness using a statistical approach to ensure its measurement capability is within the allowable process range and tolerances. The integrated solution developed is proven to be robust and highly precise in maintaining the manufacturing process stable. It enabled the manufacturing process to move away from a destructive double sampling plan with a standard LTPD of 5% to an otherwise real-time 100% non-destructive verification of units. This technique provides an alternative to otherwise cost-inefficient quality control inspections utilized in regulated manufacturing environment. It gives confidence to these conservative industries to move towards adopting digital manufacturing and Industry 4.0 practices.
Removal of Foreign Body in the Rafe Pterigomandibular: Case Report
Authors: Santos Matheus Souza Vilas Boas , Gomes Nilvia Maria Lima , Antunes Rebeca Santos Pereira , Gomes Leandro Silvestre de Oliveira , Junior Wilton Magalhães da Silva , Dultra Fátima Karoline Araújo Alves
Published: July 2023

Introduction: Penetrating lesions in the oral cavity, caused by foreign bodies, is an event of significant clinical relevance and presents itself as an important etiological factor, especially in pediatric patients. Several objects are related to this type of trauma, such as knife blades, nails, pencils, wood, firearm projectile, and glass, among others. Case Report: This report describes a case of removal of a pencil lodged in the left pterygomandibular raphe of a pediatric patient, as well as all the conduct adopted by the team of surgeons. Discussion: Pterygomandibular raphe has an intimate relationship with noble structures, and injuries by penetrating instruments in this region can result in important clinical repercussions. Due to this, it is necessary to have an efficient clinical-anamnesis examination, with adequate analysis of the affected structures, in order to provide a fast and effective treatment. Conclusion: For this, it is essential to have qualified professionals, adequate equipment available, and the proper management of the victim.
Rehabilitation and clinical evolution aspects in a case of Osteoid Osteoma
Authors: Ilut Silvina , Dogaru Gabriela , Muresan Oana , Muresanu Dafin F.
Published: July 2023

Introduction. Osteoid osteoma represents about 3% of all primary bone tumors and 11% of all benign bone tumors. Data from the literature suggest that a neuromuscular rehabilita-tion program after osteoid osteoma surgery is very beneficial and improves the general quality of life.
Material and methods. A 30-year-old male patient with intermittent right shoulder pain radiating to the right hand, and recurrent myalgias in the past year presented to our neuro-logical department. The neurological examination highlighted limitation of the abduction of the right upper limb. The paraclinical investigations included plain radiography of the right upper limb and electroneurography, which were normal, and native cervical MRI which revealed discrete C5 disc overflow, without visible signs of compression. The patient presented limited initial response to NSAIDs, so his treatment was changed to corticoster-oid therapy. Further, the patient was guided to undergo a rheumatological examination where a musculoskeletal ultrasound was performed, showing no any specific modifica-tion. Additionally, we indicated a native right shoulder MRI, which revealed a signal mod-ification of the proximal humeral diaphysis. We further indicated an MRI scan with con-trast of the upper right limb, which revealed a nidus at the top one-third of the humerus. Additionally, a CT scan with contrast of the same region displayed images that were high-ly suggestive of osteoma. The patient was referred to the orthopedics department, where a complete resection of the tumor was performed, and the pathology report confirmed the fi-nal diagnosis of osteoid osteoma.
Conclusions. Recovery after osteoid osteoma surgery is more beneficial if the neuromuscu-lar rehabilitation program, that has an important role in increasing muscle strength, is combined with orthopedic devices and pain medication.
Μελέτη δεικτών εκτίμησης μικρο- και μακροαγγειοπάθειας σε ασθενείς με οικογενή μεσογειακό πυρετό
Authors: Βαμπερτζή Όλγα
Published: July 2023

Στην παρούσα διδακτορική διατριβή, έγινε μελέτη της πιθανής μικρο- και μακροαγγειοπάθειας σε διαφορετικά αγγειακά πεδία που δύναται να παρατηρηθεί στους ασθενείς με Οικογενή Μεσογειακό Πυρετό (ΟΜΠ) από την παιδική ακόμα ηλικία. Κύριος σκοπός της μελέτης αυτής, αποτελεί η προσπάθεια αξιολόγησης του καρδιαγγειακού συστήματος σε ασθενείς που πάσχουν από ΟΜΠ εκτιμώντας πιθανές μορφολογικές και λειτουργικές διαταραχές των μικρών και μεγάλων αγγείων τους. Δευτερεύοντα στόχο της μελέτης αποτελεί η αναζήτηση πιθανών συσχετίσεων των αγγειακών βλαβών με εργαστηριακά ευρήματα σχετιζόμενα με αυξημένο καρδιαγγειακό κίνδυνο σε ασθενείς με ΟΜΠ.Σε ασθενείς πάσχοντες από ΟΜΠ με χαμηλά επίπεδα συστηματικής φλεγμονής όπως οι ασθενείς που συμπεριλήφθησαν στη μελέτη, η προσβολή των μεγάλων αγγείων, όπως αξιολογείται με την αορτική σκληρία (PWV και AIx), την υποκλινική αθηροσκλήρωση των καρωτίδων (cIMT) και το υπερηχογράφημα της καρδιάς δεν ήταν εμφανής. Οι ασθενείς μας είναι ιδιαίτερα συμμορφωμένοι στην αγωγή τους με κολχικίνη και η συντριπτική πλειοψηφία τους εμφανίζει κλινικά χαμηλή προς μέτρια ενεργότητα της νόσου. Επιπλέον, το νεαρό της ηλικίας στην πλεινότητα του πληθυσμού της μελέτης μας, συνέβαλε στην απουσία εύρεσης παθολογικών ευρημάτων στους δείκτες εκτίμησης των μεγάλων αγγείων σε σχέση με τον υγιή πληθυσμό. Παρόλα αυτά, στην παρούσα μελέτη ανιχνεύθηκαν αλλοιώσεις των μικρών αγγείων στους ασθενείς με ΟΜΠ (σοβαρή ελίκωση αγγείων του αμφιβληστροειδούς στο βυθό του οφθαλμού) αλλά και σημαντικές διαφορές σε εργαστηριακούς παραμέτρους (ΑΙΡ, δείκτες φλεγμονής, παράγοντες που προάγουν τη θρόμβωση) που προδιαθέτουν σε καρδιαγγειακή νόσο σε σχέση με τον υγιή πληθυσμό. Καταλήγουμε στο συμπέρασμα ότι η υποκλινική συστηματική φλεγμονή συνεχίζει να υφίσταται στην νόσο του ΟΜΠ ακόμα και σε ασθενείς παιδικής και νεανικής ηλικίας με ικανοποιητική ρύθμιση της νόσου. Αποτελεί λοιπόν επιτακτική ανάγκη η συστηματική παρακολούθηση αυτών των ασθενών και η συμμόρφωσή τους στην αγωγή με κολχικίνη, έτσι ώστε να επιβραδυνθούν οι πιθανότητες εμφάνισης καρδιαγγειακών επιπλοκών που εμφανίζουν σε σχέση με τον υγιή πληθυσμό.
Ανδρικές προσωποποιήσεις στον αρχαίο ελληνικό κόσμο
Authors: Μπούζα Λαμπρινή
Published: July 2023

Θέμα της παρούσας διατριβής είναι οι ανδρικές προσωποποιήσεις στον αρχαίο ελληνικό κόσμο, φυσικά και κοσμικά και στοιχεία, πολιτικές και θεσμικές ιδέες, ηθικές και κοινωνικές αξίες, φιλολογικές και χρονικές έννοιες. Εξετάζεται η παρουσία τους στην τέχνη, ανάλογα με τη φύση και τον συμβολισμό τους πρωτίστως στη γλυπτική, στη νομισματική, στα ψηφιδωτά και στις τοιχογραφίες και δευτερευόντως και συγκριτικά στη μικροτεχνία, στους πολύτιμους λίθους και στην αγγειογραφία, με παράλληλο έλεγχο των φιλολογικών πηγών, από τις απαρχές τους στην τέχνη μέχρι την απήχησή τους στα αυτοκρατορικά χρόνια, προκειμένου να κατανοηθεί η εξελικτική εικονογραφική πορεία τους, να διαπιστωθεί η χρονολογική και γεωγραφική κατανομή των μνημείων τους ανά είδος προσωποποίησης και ο συμβολισμός τους σε σχέση με το ιστορικό, πολιτικό, θρησκευτικό και κοινωνικό κλίμα. Με αφετηρία τον 7ο αι. π.Χ. πιθανότερα και την απεικόνιση του Αχελώου στην αγγειογραφία η ανδρική προσωποποιία αναπτύσσεται και εξελίσσεται αδιάκοπα στην τέχνη και στην ανθρώπινη αντίληψη δυναμικά ως την ύστερη ρωμαϊκή περίοδο. Προσωποποιήσεις ποταμών, κοσμικών στοιχείων, ανέμων και ηθικών εννοιών εντοπίζονται στην τέχνη τον 6ο αι. π.Χ. με βεβαιότητα, όπως του Αχελώου, Ωκεανού, Βορέα, Φόβου, πολιτικών εννοιών τον 5ο αι. π.Χ., όπως του Δήμου, χρονικών τον 4ο αι. π.Χ., όπως του Αιώνα και των Μηνών, ορέων τον 3ο αι. π.Χ. και φιλολογικών τον 2ο αι. π.Χ. Στην αρχαϊκή και κλασική τέχνη παραστάσεις των Αχελώου, Αλφειού, Κλάδεου, Δήμου, Ειρήνης και Πλούτου, και στην ελληνιστική τέχνη ο βωμός της Περγάμου, το κολοσσικό άγαλμα του ανακεκλιμένου Νείλου και το άγαλμα του Ορόντη με την Τύχη του Ευτυχίδη θέτουν τις βάσεις της προσωποποιίας φυσικών στοιχείων, ιδεών και εννοιών σημαντικών στην ανθρώπινη θεώρηση, τόσο ισχυρών, ώστε υιοθετούνται, αναπαράγονται, αναπτύσσονται και εμπνέουν τη ρωμαϊκή τέχνη, επίσημη και ιδιωτική. Σε όλη την αρχαιότητα διαπιστώνεται στη γλυπτική και τη νομισματική πληθώρα προσωποποιήσεων όλων των ειδών. Προσωποποιήσεις στην αγγειογραφία εντοπίζονται κυρίως στην αρχαϊκή και κλασική περίοδο, ενώ στα ψηφιδωτά και τις τοιχογραφίες κατά τη ρωμαϊκή κυρίως. Ο συμβολισμός των προσωποποιήσεων είναι μυθολογικός, θεϊκός– λατρευτικός, πολιτικός–προπαγανδιστικός, διδακτικός, γεωγραφικός και συχνά πολυδιάστατος αποδεικνύοντας τη σημασία των ανδρικών προσωποποιήσεων στον αρχαίο κόσμο.
The evolution of counterinsurgency doctrine
Authors: Τανταλάκης Ευριπίδης
Published: July 2023

Ενώ ο Ελληνικός εμφύλιος πόλεμος συχνά μελετάται ως ένα ιστορικό γεγονός, η σημασία του ως στάδιο στην ανάπτυξη του αντιαντάρτικου δόγματος έχει παραβλεφθεί. Το σημείο εκείνο που τον καθιστά σημαντικό είναι ότι προσέφερε στις ξένες στρατιωτικές δυνάμεις, οι οποίες συνέδραμαν τον Ελληνικό Εθνικό Στρατό, την ευκαιρία να εφαρμόσουν παραδοσιακές και νέες τακτικές ενάντια στους Έλληνες Κομμουνιστές αντάρτες, και να αποκομίσουν πολύτιμα διδάγματα ως προς την ανάπτυξη αντιαντάρτικου δόγματος. Η παρούσα διατριβή εξετάζει τον αντίκτυπο του ελληνικού εμφυλίου στην ανάπτυξη του Αμερικάνικου δόγματος, αναδεικνύωντας, για πρώτη φορά, δύο νέες πτυχές αυτού του πολέμου. Πρώτον, εξετάζει την ικανότητα της Αμερικάνικης στρατιωτικής αποστολής να αξιοποιήσει διδάγματα από την εμεπιρία της στον ελληνικό εμφύλιο. Δεύτερον, εξετάζει ποια από αυτά τα διδάγματα μεταφέρθηκαν στο υπό διαμόρφωση αμερικάνικο μεταπολεμικό αντιαντάρτικο δόγμα. Η παρούσα έρευνα υποστηρίζει ότι η αμερικάνικη αποστολή επέδειξε την απαραίτητη διανοητική περιέργεια και υγειή σκεπτικισμό ώστε να επιτρέπει την προσαρμογή σε αλλαγές εν μέσω πολεμικών επιχειρήσεων, ενώ αρκετά διδάγματα, τακτικής και στρατηγικής φύσεως, από την ελληνική εμπειρία, αξιοποίηθηκαν και μεταφέρθηκαν στο αμερικάνικο δόγμα. Εντούτοις, η ουσία αυτού του αντίκτυπου εντοπίζεται στην πρακτική εμεπιρία κατά της διάρκεια του εμφυλίου, η οποία επικύρωσε εκείνες τις αρχές του ανταρτοπόλεμου, οι οποίες εν τέλει ενσωματώθηκαν στο αμερικάνικο δόγμα.
Αντίξοες εμπειρίες κατά την παιδική ηλικία: προεκτάσεις για ένα ευαισθητοποιημένο σχολείο στις ψυχοκοινωνικές και μαθησιακές ανάγκες των μαθητών
Authors: Τουλουμάκου Άννα K. , Αδαμοπούλου Ειρήνη , Τσιτιρίδου-Ευαγγέλου Μαρία
Published: July 2023

Οι αντίξοες εμπειρίες κατά την παιδική ηλικία (ΑΕΠΗ) περιλαμβάνουν μια ομάδα δυσμενών εμπειριών, όπως η παραμέληση, που αφορούν μεγάλο αριθμό παιδιών σε μια τάξη σήμερα. Συνδέονται με δυσκολίες σε όλους τους τομείς της ανάπτυξης και της σχολικής επίδοσης, καθώς και με προβλήματα στη σωματική και στην ψυχολογική υγεία στην παιδική και ενήλικη ζωή. Σε αυτό το άρθρο παρουσιάζονται, μέσα από βιβλιογραφική ανασκόπηση, οι διαφορετικές θεωρητικές προσεγγίσεις των ΑΕΠΗ καθώς και οι απόψεις ή/ και εμπειρικά δεδομένα για τη σύνδεσή τους αθροιστικά και ξεχωριστά με διάφορα ζητήματα στην ανάπτυξη, τη μάθηση και την (ψυχική) υγεία. Τέλος, γίνεται συζήτηση για τη σχολική κοινότητα ως ένα ευαισθητοποιημένο και υποστηρικτικό πλαίσιο στις ψυχοκοινωνικές και μαθησιακές ανάγκες παιδιών με αντίξοες εμπειρίες οι οποίες μπορεί να είναι στρεσογόνες ή/και τραυματικές.
Approaching intersectionality in gender psychology research
Authors: Sakka Despina , Athanasiades Christina
Published: July 2023

The present special section constitutes the first systematic attempt to present the concept of intersectionality in Greek psychological research and specifically in gender research. Consequently, it aims to highlight the ways in which gender intersects with other identificatory categories, shaping the experiences of individuals, especially those belonging to disadvantaged groups. The papers presented in the issue demonstrate that intersectionality reflects the reality of life while being at the same time, an important 'tool' for understanding the complexity of the human experience. It is expected that the special section will contribute, both at a research and clinical level, to a critical review of traditional theories and methods in Psychology, providing an impetus for further research which will take into consideration both cultural (e.g., social norms, stereotypes, etc.) and social (e.g., power structures) contexts in the study of individual behavior and experience.