bluuebunny/crossref_metadata_2025 huggingface dataset:
A Retrospective Cohort Study Comparing Dual Therapy With Ceftaroline With Vancomycin or Daptomycin Monotherapy for High-Grade or Persistent MRSA Bacteremia
Authors: Cabanilla M. Gabriela , Bernauer Michael L. , Briski Matthew J. , Atallah Liana M. , Koury Jason , Thompson Cecilia M. , Rodriguez Chelsea N. , Jakeman Bernadette , Byrd Thomas F.
Published: January 2024

Background: Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is a serious clinical infection associated with a high risk of mortality. Dual therapy is often used in patients with persistent bacteremia. Objective: This study aimed to compare the outcomes of vancomycin or daptomycin monotherapy with those of dual therapy with ceftaroline in high-grade or persistent MRSA bacteremia. Methods: We conducted a retrospective cohort study at a university teaching hospital between January 2014 and June 2021, involving adults initially treated with vancomycin or daptomycin. Patients were categorized into monotherapy and dual therapy groups. The primary outcome was 30-day mortality. Secondary outcomes included microbiological relapse and antibiotic-related adverse events. Results: In a group of 155 patients, 30-day mortality rates were similar between the monotherapy (23.4%) and dual therapy (22.6%) groups, with comparable microbiological relapse rates (6.5%). In inverse probability of treatment weighting analysis, we found no significant association between dual therapy and mortality (adjusted risk ratio [ARR] 1.38, 95% CI 0.64-2.41, P = 0.38) or microbiological relapse (ARR 0.95, 95% CI 0.31-2.73, P = 0.93). Dual therapy was associated with a lower risk of antibiotic-related adverse events (ARR 0.45, 95% CI 0.21-0.89, P = 0.02). Infectious diseases (ID) consultation was associated with a reduced mortality risk (ARR 0.27, 95% CI 0.07-0.95, P = 0.04). Conclusions: Dual therapy with ceftaroline did not reduce mortality risk compared with monotherapy in patients with MRSA bacteremia. However, patients with ID consultations showed a 73% reduction in mortality rates. Large-scale, prospective, and randomized controlled trials are needed to provide conclusive evidence regarding the potential benefits of dual therapy with ceftaroline for MRSA bacteremia.
The relationship between self-perceived fatigue, muscle endurance, and circulating markers of inflammation in participants of the Copenhagen aging and Midlife Biobank (CAMB)
Authors: Bautmans Ivan , Knoop Veerle , Beyer Ingo , Bruunsgaard Helle , Molbo Drude , Mortensen Erik Lykke , Lund Rikke
Published: January 2024

Background

Fatigue, low muscle endurance, muscle weakness and low-grade inflammation are strongly related to frailty at higher age. When signs of self-perceived fatigue and low muscle endurance are interrelated with low-grade inflammation at midlife, they might be used as early markers for frailty. This study investigated whether the interrelationships among self-perceived fatigue, muscle endurance and inflammation can be observed at midlife.

Methods

A total of 965 participants of the Copenhagen Aging and Midlife Biobank (aged 52 ± 4 years, 536 males, 426 females) were assessed for self-perceived fatigue (20-item multidimensional fatigue inventory), muscle endurance (grip work), circulating markers of inflammation (hsCRP, IL-6, IL-10, TNF-alpha and IFN-γ), daily physical activity (PAS-2), body composition (%body fat assessed by bio-impedance) and self-reported health status. Participants were categorised (correcting for age and gender) according to high fatigue and/or low muscle endurance, differences in inflammatory profile between fatigue categories were assessed by ANCOVA (corrected for PAS-2, %body fat and presence of inflammatory conditions).

Results

Overall, muscle endurance, fatigue and inflammatory markers were significantly interrelated. Higher levels of hsCRP (p < 0.001), IL-6 (p < 0.001), IL-10 (p = 0.035) and TNF-alpha (p = 0.028) were observed in participants presenting both low muscle endurance and high fatigue. IFN-γ was highest in those with high fatigue but normal muscle endurance (p = 0.015).

Conclusions

Middle-aged participants with higher fatigue in combination with low muscle endurance show higher levels of inflammation, independently from physical activity, body fat and inflammatory pathology. The underlying mechanisms should be identified and future studies should also investigate whether these individuals show early signs of reduced physiological reserve capacity, which in later life come to full expression by means of frailty.
Measuring public transport accessibility to fixed activities and discretionary opportunities: a space–time approach
Authors: Dianin Alberto , Gidam Michael , Hauger Georg , Ravazzoli Elisa
Published: January 2024

The Space–Time Accessibility (STA) model is broadly used to measure person-based accessibility based on the space, time, and transport constraints experienced at the individual level in connection to the actual modal choices of observed individuals. In this paper, we propose to adjust the STA model (by introducing a so-called PT-STA model) with three core purposes: (1) focusing on public transport accessibility specifically, (2) measuring accessibility to both fixed activities and discretionary opportunities, and (3) integrating travel-time thresholds in the accessibility measurement. These three elements aim to make the PT-STA model a suitable tool to evaluate the impacts of public transport interventions on person-based accessibility and extend the evaluation of public transport accessibility to its fixed and discretionary dimensions. The PT-STA model is tested with a sample of 118 residents of the rural municipality of Mühlwald (South Tyrol, Italy). Results show that the accessibility to fixed activities and discretionary opportunities are limitedly correlated. It is possible to identify people with high accessibility to fixed activities and poor access to discretionary opportunities (typically pensioners and homemakers living in remote locations) and vice versa (e.g. people with articulated rural–urban commutes but daily visiting locations with several amenities). These results preliminarily confirm the importance of combining both accessibility dimensions in the PT-STA model since they tell complementary and not overlapped stories that are relevant for policymakers to evaluate the pros and cons of alternative public transport interventions.
The effect of doxorubicin curcumin co-loaded lipid nanoparticles and doxorubicin on osteosarcoma before surgery
Authors: Lu Xinyan , Zhang Peng , Li Jun , Zhou Yi , Wang Bangjun , Lu Zhaoli
Published: January 2024

Background

The research aims to observe the difference in the effect of preoperative doxorubicin curcumin co-loaded lipid nanoparticles (DOX+CUR LPNs) and doxorubicin (VAD) in the treatment of osteosarcoma.

Methods

68 patients with osteosarcoma who visited the hospital from January 2020 to December 2022 are chosen. They are separated into VAD group and DOX+CUR LPNs group, with 34 cases in each group. VAD and DOX+CUR LPNs groups VAD chemotherapy, and DOX+CUR LPNs treatment, respectively. All patients receive tumor resection. Comparison is made between the two groups before chemotherapy, at the end of chemotherapy and 1 week after surgery on the changes of vascular endothelial growth factor (VEGF), angiopoietin-2 (Ang-2), galectin-3 (Gal-3), renal function indicators cystatin-C (Cys-C), serum creatinine (Scr), blood urea nitrogen (BUN) in the peripheral blood. The clinical efficacy and adverse reactions are determined by observation and follow-up for 1 month.

Results

The VEGF, Ang-2, and Gal-3 in both groups were significantly lower at 1 week after chemotherapy and surgery compared to before chemotherapy (P < 0.05). The VEGF and Gal-3 in the DOX+CUR LPNs group were lower than those in the VAD group in the same period, with P < 0.05. The Cys-C, Scr, and BUN in both groups of patients after chemotherapy and surgery increased compared to before chemotherapy, with P < 0.05. The Cys-C, Scr, and BUN in the DOX+CUR LPNs group were lower than those in the VAD group during the same period, with P < 0.05. Following up for 1 month, the ORR of the DOX+CUR LPNs group was 94.12% (32/34) higher than that of the VAD group, with P < 0.05. The incidence of adverse reactions in the DOX+CUR LPNs group was 47.05% lower than that in the VAD group, with P < 0.05.

Conclusion

Preoperative application of DOX+CUR LPNs enables effective drug delivery to the tumor section by combining the antibacterial, antioxidant and anti-inflammatory effects of curcumin, which is co-wrapped in nanoparticles. It has the effect of promoting angiogenesis and damage repair, inhibiting inflammation-related factors, and protecting renal function, while adriamycin alone has drug resistance problems and toxic side effects, which can damage the patient's liver and kidney. Therefore, DOX+CUR LPNs are more effective than adriamycin alone, indicating that it can improve the therapeutic effect of the drug and reduce the side effects, which is of great significance for improving the survival rate and quality of life of patients.
Difficult airway simulation-based training for anaesthesiologists: efficacy and skills retention within six months
Authors: Bielka Kateryna , Kuchyn Iurii , Fomina Hanna , Khomenko Olena , Kyselova Iryna , Frank Michael
Published: January 2024

Background

The aim of this study was to evaluate how anaesthesiologists manage a “cannot intubate, can ventilate” (CI) and “cannot intubate, cannot ventilate” (CICV) scenarios, and how following simulation training will affect their guideline adherence, skills and decision-making immediately after training and 6 months later.

Methods

A prospective controlled study was conducted from July to December 2022. Anaesthesiologists who applied for the continuous medical education course “Difficult Airway Management” were involved in the study. Each volunteer participated in two simulation scenarios (CI, CICV) with structural debriefing after each scenario. After the first simulation round, volunteers were trained in difficult airway management according to DAS guidelines, using the same equipment as during the simulation. The participants repeated the simulation scenarios the day after the training and six months later. The primary and secondary endpoints were compared between three rounds: initial simulation (Group 1), immediately after training (Group 2), and six months after training (Group 3).

Results

A total of 24 anaesthesiologists consented to participate in the study and completed the initial survey form. During the first session, 83.3% of participants had at least one major deviation from the DAS protocol. During the first CICV scenario, 79% of participants made at least one deviation from the DAS protocol. The second time after simulation training, significantly better results were achieved: the number of anaesthesiologists, who attempted more than 3 laryngoscopies decreased (OR = 7 [1.8–26.8], p = 0.006 right after training and OR = 3.9 [1.06–14.4], p = 0.035 6 month later); the number, who skipped the supralaryngeal device attempt, call for help and failure to initiate surgical airway also decreased. Simulation training also significantly decreases the time to call for help, cricothyroidotomy initiation time, and mean desaturation time and increases the odds ratio of successful cricothyroidotomy (OR 0.02 [0.003–0.14], p < 0.0001 right after training and OR = OR 0.02 [0.003–0.16] 6 months after training).

Conclusions

Anaesthesiologists usually display major deviations from DAS guidelines while managing CI and CICV scenarios. Simulation training improves their guideline adherence, skills, and decision-making when repeating the simulation immediately after training and 6 months later.

Study registration

NCT05913492, clinicaltrials.gov, 22/06/2023.
Ethnic differences in disability-free life expectancy and disabled life expectancy in older adults in Chile
Authors: Sandoval Moisés H. , Portaccio Marcela E. Alvear , Albala Cecilia
Published: January 2024

Background

Although about 10% of the Latin American population is indigenous, ethnic differences in disability-free life expectancy (DFLE) and life expectancy with disability (DLE) are unknown.

Objective

To estimate disability-free life expectancy and disabled life expectancy among Mapuche (the largest indigenous group) and non-indigenous older adults aged 60 years or more in Chile.

Method

Disability was measured following a methodology that combines limitations of daily living, cognitive impairment and dependence previously validated in Chile. Finally, the DFLE was estimated using Sullivan’s method combining life tables by ethnicity and disability proportions from the EDES survey designed for the study of ethnic differentials in health and longevity in Chile.

Results

Non-Indigenous people have a higher total and Disability-free life expectancy compared to Mapuche people at all ages. While at age 60 a Mapuche expects to live 18.9 years, of which 9.4 are disability-free, a non-Indigenous expects to live 26.4 years, of which 14 are disability-free. In addition, although the length of life with disability increases with age for both populations, Mapuche who survive to age 80 or 90 expect to live 84% and 91% of their remaining life with disability, higher proportions compared to non-indigenous people (62.9% and 75%, respectively).

Conclusions

This is the first study addressing inequities in DFLE between the Mapuche and non-Indigenous population, reflected in lower total life expectancy, lower DFLE and higher DLE in Mapuche compared to the non-Indigenous population. Our results underscore the need for increased capacity to monitor mortality risks among older people, considering ethnic differences.
Exploring the experience of appetite loss in older age: insights from a qualitative study
Authors: Dismore Lorelle , Sayer Avan , Robinson Sian
Published: January 2024

Background

Poor appetite is common in older age, with estimated prevalence figures ranging between 15–30% in community-dwelling populations. Despite known links between poor appetite and adverse health outcomes, appetite is not routinely assessed and the causes and impact of appetite loss in older age are not well understood. This study aimed to improve understanding of the influences on, and experiences of, appetite loss among older people who have poor appetite and to consider the implications for prevention and treatment strategies.

Methods

Thirteen older adults aged 60–93 years (9 women) identified as having poor appetite (Simplified Nutritional Appetite Questionnaire (SNAQ) scores < 14; ranging from 8–11) took part in semi-structured interviews. Open-ended questions focused on influences on and experiences of appetite and appetite loss in older age. Interviews were transcribed; reflective thematic analysis was conducted using an inductive approach.

Results

The analysis generated three themes: 1) a complex web of influences on appetite loss, that include biological, psychological, and social factors; 2) living with poor appetite—variation in perceptions of poor appetite and attitudes to appetite loss; 3) living with poor appetite—the role and importance of the eating environment and social interactions. The themes highlight marked differences in individual ‘journeys’ to poor appetite, with variation in the balance and role of specific causal influences, that impact on the experience of appetite loss and on coping strategies.

Conclusions

A broad range of influences (including biological, psychological and social factors) and experiences of appetite loss in older age were described. Future research should consider person-centred approaches, that take account of individual narratives of appetite loss, in the design of effective strategies to support older adults.
A regimen based on the combination of trimethoprim/sulfamethoxazole with caspofungin and corticosteroids as a first-line therapy for patients with severe non-HIV-related pneumocystis jirovecii pneumonia: a retrospective study in a tertiary hospital
Authors: Li Hao , Lu Yihe , Tian Guoxin , Wu Yongxing , Chen Tianjun , Zhang Jiangwei , Hu Nan , Wang Xiaoning , Wang Yang , Gao Lan , Yan Jinqi , Zhou Linjing , Shi Qindong
Published: January 2024

Background

Pneumocystis jirovecii pneumonia (PJP) is a life-threatening and severe disease in immunocompromised hosts. A synergistic regimen based on the combination of sulfamethoxazole-trimethoprim (SMX-TMP) with caspofungin and glucocorticosteroids (GCSs) may be a potential first-line therapy for PJP. Therefore, it is important to explore the efficacy and safety of this synergistic therapy for treating non-HIV-related PJP patients.

Methods

We retrospectively analysed the data of 38 patients with non-HIV-related PJP at the First Affiliated Hospital of Xi’an Jiaotong University. Patients were divided into two groups: the synergistic therapy group (ST group, n = 20) and the monotherapy group (MT group, n = 18). All patients were from the ICU and were diagnosed with severe PJP. In the ST group, all patients were treated with SMX-TMP (TMP 15–20 mg/kg per day) combined with caspofungin (70 mg as the loading dose and 50 mg/day as the maintenance dose) and a GCS (methylprednisolone 40–80 mg/day). Patients in the MT group were treated only with SMX-TMP (TMP 15–20 mg/kg per day). The clinical response, adverse events and mortality were compared between the two groups.

Results

The percentage of patients with a positive clinical response in the ST group was significantly greater than that in the MT group (100.00% vs. 66.70%, P = 0.005). The incidence of adverse events in the MT group was greater than that in the ST group (50.00% vs. 15.00%, P = 0.022). Furthermore, the dose of TMP and duration of fever in the ST group were markedly lower than those in the MT group (15.71 mg/kg/day vs. 18.35 mg/kg/day (P = 0.001) and 7.00 days vs. 11.50 days (P = 0.029), respectively). However, there were no significant differences in all-cause mortality or duration of hospital stay between the MT group and the ST group.

Conclusions

Compared with SMZ/TMP monotherapy, synergistic therapy (SMZ-TMP combined with caspofungin and a GCS) for the treatment of non-HIV-related PJP can increase the clinical response rate, decrease the incidence of adverse events and shorten the duration of fever. These results indicate that synergistic therapy is effective and safe for treating severe non-HIV-related PJP.
Interpregnancy interval and adverse birth outcomes: a population-based cohort study of twins
Authors: Dhamrait Gursimran , O’Donnell Melissa , Christian Hayley , Taylor Catherine L. , Pereira Gavin
Published: January 2024

Background

To investigate associations between interpregnancy intervals (IPIs) and adverse birth outcomes in twin pregnancies.

Methods

This retrospective cohort study of 9,867 twin pregnancies in Western Australia from 1980–2015. Relative Risks (RRs) were estimated for the interval prior to the pregnancy (IPI) as the exposure and after the pregnancy as a negative control exposure for preterm birth (< 37 weeks), early preterm birth (< 34 weeks), small for gestational age (SGA: < 10th percentile of birth weight by sex and gestational age) and low birth weight (LBW: birthweight < 2,500 g).

Results

Relative to IPIs of 18–23 months, IPIs of < 6 months were associated with a higher risk of early preterm birth (aRR 1.41, 95% CI 1.08–1.83) and LBW for at least one twin (aRR 1.16, 95% CI 1.06–1.28). IPIs of 6–11 months were associated with a higher risk of SGA (aRR 1.24, 95% CI 1.01–1.54) and LBW for at least one twin (aRR 1.09, 95% CI 1.01–1.19). IPIs of 60–119 months and ≥ 120 months were associated with an increased risk of preterm birth (RR 1.12, 95% CI 1.03–1.22; and (aRR 1.25, 95% CI 1.10–1.41, respectively), and LBW for at least one twin (aRR 1.17, 95% CI 1.08–1.28; and aRR 1.20, 95% CI 1.05–1.36, respectively). IPIs of ≥ 120 months were also associated with an increased risk of early preterm birth (aRR 1.42, 95% CI 1.01–2.00). After negative control analysis, IPIs ≥ 120 months remained associated with early preterm birth and LBW.

Conclusion

Evidence for adverse associations with twin birth outcomes was strongest for long IPIs.
Radical cystectomy or trimodality therapy for muscle-invasive bladder cancer: a qualitative study exploring patient priorities and counselling needs when making a treatment choice
Authors: Verghote Flor , Van Praet Charles , Berquin Camille , Lumen Nicolaas , Decaestecker Karel , Vanneste Ben , Rammant Elke , Fonteyne Valérie
Published: January 2024

Background

This study aims to explore the priorities and counselling needs of patients with muscle-invasive bladder cancer faced with a decision between radical cystectomy and trimodality therapy.

Methods

We performed a qualitative study according to the phenomenological approach. Sixteen muscle-invasive bladder cancer survivors who underwent radical cystectomy or trimodality therapy completed a semi-structured interview between May 2022 and February 2023. Patients were recruited via Ghent University Hospital and a patient organisation. Data were analysed with inductive thematic analysis by a multi-disciplinary team using an iterative approach and investigators’ triangulation.

Results

Four main priorities determining the treatment decision were identified. (1) curing the disease; (2) health-related quality of life (physical, mental and social); (3) confidence in the treatment, which was mainly based on trust in the clinician; and (4) personal attributes. Trust in the clinician can be achieved by fulfilling the patient’s information needs (accurate, complete, clear, impartial, personalised, realistic, and transparent information), ensuring accessibility of the clinician, and creating a clear and personalised treatment plan, involving patients to the extend they desire. Many patients considered a patient decision aid as a valuable asset in this process.

Conclusion

Priorities vary between patients with muscle-invasive bladder cancer. Identifying individual priorities and offering personalised information about them is crucial for ensuring trust in the clinician and confidence in the treatment. Use of a patient decision aid can be beneficial in this process.
Prevalence of dry eye and Meibomian gland dysfunction in Central and South America: a systematic review and meta-analysis
Authors: Chen Hongan , McCann Paul , Lien Tiffany , Xiao Mengli , Abraham Alison G. , Gregory Darren G. , Hauswirth Scott G. , Qureshi Riaz , Liu Su-Hsun , Saldanha Ian J. , Li Tianjing
Published: January 2024

Background

Dry eye is one of the most common ophthalmic conditions and can significantly impact quality of life. Meibomian gland dysfunction (MGD) is a major cause of evaporative dry eye.

We sought to conduct a systematic review and meta-analysis to estimate the prevalence and incidence of dry eye and MGD in Central and South America and to identify factors associated with disease burden.

Methods

Data sources Ovid MEDLINE and Embase.

Study selection

A search conducted on August 16, 2021, identified studies published between January 1, 2010, and August 16, 2021, with no restrictions regarding participant age or language of publication. Case reports, case series, case–control studies, and interventional studies were excluded.

Data extraction and synthesis

The review was based on a protocol registered on PROSPERO (CRD42021256934). Risk of bias was assessed in duplicate using a risk of bias tool designed for the purposes of descriptive epidemiological studies. Data were extracted by one investigator and verified by another for accuracy. Prevalence of dry eye and MGD were grouped based on study participant characteristics.

Main outcomes and measures

Prevalence and incidence of dry eye and MGD in Central and South America. Summary estimates from meta-analysis with 95% confidence intervals (CI).

Results

Fourteen studies (11,594 total participants) were included. The population prevalence of dry eye was 13% (95% CI, 12%-14%) in Brazil and 41% (95% CI, 39%-44%) in Mexico based on one study each. Meta-analyses suggested that dry eye prevalence was 70% among indoor workers (95% CI, 56%-80%; I2, 82%; 3 studies), 71% among students (95% CI, 65%-77%; I2, 92%; 3 studies), and 83% in general ophthalmology clinics (95% CI, 77%-88%; I2, 88%; 2 studies). MGD prevalence ranged from 23% among indoor workers (95% CI, 16%-31%; 1 study) to 68% in general ophthalmology clinics (95% CI, 62%-72%; 1 study). No studies reported incidence of dry eye or MGD.

Conclusions

This systematic review and meta-analysis demonstrated considerable variation in the published prevalence of dry eye and MGD among the general population and subpopulations in Central and South America. Local and subpopulation estimates of dry eye disease burden may be valuable to assist needs assessments and implementation of measures to mitigate the condition.
Differences in bacterial taxa between treatment-naive patients with major depressive disorder and non-affected controls may be related to a proinflammatory profile
Authors: Knudsen Julie Kristine , Bundgaard-Nielsen Caspar , Leutscher Peter , Hjerrild Simon , Nielsen René Ernst , Sørensen Suzette
Published: January 2024

Background

Major depressive disorder (MDD) is characterized by sadness and anhedonia, but also physical symptoms such as changes in appetite and weight. Gut microbiota has been hypothesized to be involved in MDD through gut-brain axis signaling. Moreover, antidepressants display antibacterial properties in the gastrointestinal tract. The aim of this study was to compare the gut microbiota and systemic inflammatory profile of young patients with MDD before and after initiation of antidepressant treatment and/or psychotherapy in comparison with a non-depressed control group (nonMDD).

Methods

Fecal and blood samples were collected at baseline and at follow-up after four and twelve weeks, respectively. Patients started treatment immediately after collection of the baseline samples. The gut microbiota was characterized by 16 S rRNA gene sequencing targeting the hypervariable V4 region. Plasma levels of 49 unique immune markers were assessed using Mesoscale.

Results

In total, 27 MDD patients and 32 nonMDD controls were included in the study. The gut microbiota in the baseline samples of MDD versus nonMDD participants did not differ regarding α- or β-diversity. However, there was a higher relative abundance of the genera Ruminococcus gnavus group, and a lower relative abundance of the genera Desulfovibrio, Tyzzerella, Megamonas, Olsenella, Gordonibacter, Allisonella and Rothia in the MDD group compared to the nonMDD group. In the MDD group, there was an increase in the genera Rothia, Desulfovibrio, Gordinobacteer and Lactobacillus, while genera belonging to the Firmicutes phylum were found depleted at twelve weeks follow-up compared to baseline. In the MDD group, IL-7, IL-8 and IL-17b levels were elevated compared to the nonMDD group at baseline. Furthermore, MDI score in the MDD group was found to correlate with Bray-Curtis dissimilarity at baseline, and several inflammatory markers at both baseline and after initiation of antidepressant treatment.

Conclusion

Several bacterial taxa differed between the MDD group and the nonMDD group at baseline and changed in relative abundance during antidepressant treatment and/or psychotherapy. The MDD group was furthermore found to have a pro-inflammatory profile compared to the nonMDD group at baseline. Further studies are required to investigate the gut microbiota and pro-inflammatory profile of patients with MDD.
Gender differences in prevalence and associations between cognitive symptoms and suicidal ideation in patients with recurrent major depressive disorder: findings from the Chinese NSSD study
Authors: Mao Ruizhi , Wang Chenglei , Cui Lvchun , Mellor David , Wu Zhiguo , Fang Yiru
Published: January 2024

Background

This study aimed to explore gender differences in associations between cognitive symptoms and suicidal ideation (SI) among patients with recurrent major depressive disorder (MDD).

Methods

We recruited 1222 patients with recurrent MDD from the National Survey on Symptomatology of Depression (NSSD), a survey designed to investigate the symptoms experienced during current major depressive episodes in China. A four-point Likert questionnaire was used to assess the frequency of cognitive symptoms and SI in the past two weeks.

Results

Gender differences in clinical features and cognitive symptoms of participants with recurrent MDD were found. Specifically, male patients had a higher prevalence of memory loss, decreased verbal output, indecisiveness, and impaired interpersonal relationships, while female patients exhibited a higher prevalence of impaired social and occupational functioning (all P < 0.05). No significant difference in SI prevalence was found between male and female patients. The logistic regression analysis revealed that in male patients, SI was associated with indecisiveness and impaired interpersonal relationships. In female patients, reduced verbal output and impaired social and professional functions were also associated with SI in addition to the above-mentioned variables.

Conclusion

The findings of gender differences in associations between cognitive symptoms and SI highlight the need to carefully assess gender-specific cognitive predictors of SI in patients with recurrent MDD. This has further implications for more targeted prevention and treatment strategies for SI based on gender.
Gender differences in the association between healthy eating index-2015 and hypertension in the US population: evidence from NHANES 1999–2018
Authors: Weng Jiayi , Mao Yukang , Xie Qiyang , Sun Kangyun , Kong Xiangqing
Published: January 2024

Background

Diet has long been recognized as an important modifiable risk factor for hypertension. Herein, our research goal was to decipher the association of healthy eating index-2015 (HEI-2015) with hypertension, and to explore potential gender differences.

Methods

We collected the cross-sectional data of 42,391 participants of the National Health and Nutrition Examination Survey (NHANES) 1999–2018. The association of HEI-2015 with hypertension was estimated using weighted multivariate logistic regression, with restricted cubic spline (RCS) regression being adopted to examine the nonlinearity of this association in both genders, and the stability of the results were examined by sensitivity analysis. We also performed subgroup analysis to detect potential difference in the link between HEI-2015 and hypertension stratified by several confounding factors.

Results

After eliminating potential confounding bias, the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for hypertension across higher HEI-2015 quartiles were 0.93 (0.85–1.03), 0.84 (0.77–0.93), and 0.78 (0.72–0.86) compared to the lowest quartile, respectively. HEI-2015 was nonlinearly and inversely associated with hypertension in all participants. The gender-specific RCS curves presented a U-shaped correlation in males, while showed a linear and inverse correlation in females. Besides, subgroup analyses showed a lower risk of hypertension in participants who were females, younger than 40 years, Whites, obese, and diabetic patients.

Conclusions

We determined a nonlinear and inverse association between HEI-2015 and hypertension in the US general population, and revealed a remarkable gender difference when adhering to a HEI-2015 diet for preventing hypertension.
Diagnoses and prescription patterns among users of medications for obstructive airway diseases in Finland
Authors: Juntunen Pekka , Salmela Petri , Pakkasela Johanna , Karjalainen Jussi , Lehtimäki Lauri
Published: January 2024

Background

Asthma and chronic obstructive pulmonary disease (COPD) are common diseases mostly treated in primary care. However, the usage patterns of drugs for obstructive airway diseases (R03 drugs) at the national level are not known.

Objective

The aims of this study were to describe (1) for which diagnoses each class of R03 drugs were used, (2) the usage pattern of different drug classes for asthma and COPD, and (3) how often these medications were used without a diagnosis of asthma or COPD in Finland.

Methods

We sent questionnaires that included questions on physician-diagnosed asthma and COPD to a random sample of 2000 Finnish subjects who had been dispensed R03 medications in the previous year. Details of R03 medications dispensed were retrieved from national registries.

Results

Altogether, 803 subjects (40.6%) responded. Of these, 61.6% had asthma, 5.7% had both asthma and COPD, 5.1% had COPD, and 27.5% had neither asthma nor COPD. Among subjects with asthma or asthma and COPD, inhaled corticosteroids (ICS) were the most frequently dispensed class of drugs (93.7% and 97.8%, respectively). Even among subjects with COPD, ICS were dispensed as frequently (68.3%) as long-acting bronchodilators (70.7%). Antileukotrienes were dispensed mainly to asthmatic individuals only (18.4%) but far less frequently than ICS. The use of theophylline and roflumilast was rare.

Conclusions

R03 medications are dispensed far more frequently for asthma than for COPD and often also for subjects without asthma or COPD. In line with guidelines, asthma is treated mainly with ICS, but there seems to be overuse of ICS for COPD.
Comparison of the effect between cefazolin/cefuroxime and broad-spectrum antibiotics in preventing post-operative pulmonary infections for smoking patients receiving video-assisted thoracoscopic lung surgery: a propensity score-matched retrospective cohort study
Authors: Wu Guangjie , Lu Jianhua , Li Meng , Liu Dong , He Yan
Published: January 2024

Background

The selection of prophylactic antibiotics for preventing post-operative pulmonary infections in smoking patients undergoing video-assisted thoracoscopic lung surgery (VATLS) is not clear.

Methods

In this retrospective cohort study, the outcomes of 572 smoking patients undergoing VATLS with prophylactic cefazolin/cefuroxime or other antibiotics were analyzed. Patients were classified as cefazolin/cefuroxime group and the control group. A 1:1 propensity score matching was also performed.

Results

The primary outcome of the incidence of post-operative pulmonary infection did not differ significantly between the two groups (23.7% vs 30.5%, RR = 0.777, 95%CI 0.564 ~ 1.070 p = 0.113). Similarly, secondary outcomes including the incidence of post-operative fever, the white blood cell count and neutrophils on the 3rd day after the surgery, and time for blood routine test recovery were all found without significant difference between the two groups. In the multivariate logistic regression model, no association was found between prophylactic use of cefazolin/cefuroxime and post-operative pulmonary infections after controlling other possible confounding factors (OR = 0.685, 95%CI 0.441 ~ 1.065, p = 0.093).

Conclusions

Prophylactic use of cefazolin/cefuroxime was not associated with more adverse clinical outcomes among smoking populations undergoing VATLS when compared with broad-spectrum antibiotics and the two drugs are still feasible for peri-operative prophylactic use for smoking population before the surgery.
Self-assessment of dental health status, behaviours and oral health risk factors among adolescents from public schools in Maputo City-Mozambique
Authors: Mepatia Amália Issufo , Myburgh Neil , Barrie Robert , Kimmie-Dhansay Faheema
Published: January 2024

Self-assessment of dental health status may have an impact on the oral health behaviour of adolescents which could impact their oral health. Oral health has been linked to various medical health conditions, thus eliminating oral health diseases can improve general health. The present study aimed to assess the association between behaviours and risk factors (oral hygiene habits, sugar intake, urban/rural status) and negative self-perception of dental health status among adolescents attending public schools in Maputo City.

Method An analytic cross-sectional study, conducted in three Primary public schools from urban and peri-urban areas in Maputo City selected by convenience due to their geographic location was included. The size of the sample was 236 12-year-olds. Data was collected using a self-completion questionnaire designed by the World Health Organization (WHO). Chi-square tests or Fishers’ Exact tests were used for associations. A simple and multiple logistic regression was used to determine the strength of these associations using backward elimination (p < 0.05). Results: The sample consisted of 221 adolescents, with 114 (51.6%) residing in urban areas and 107 (48.4%) in peri-urban areas. More than half of the participants (111 individuals) reported having a negative perception of their dental health. In the urban location, a higher percentage of participants had a “negative” perception of dental health (57.9%, n = 66), while in the peri-urban location, more participants perceived their dental health as “positive” (57.9%, n = 62). Participants residing in an urban setting were 82% more likely to have a negative perception of dental health (AOR = 1.82 [95% C.I.: 1.05 to 3.14]). Those who had experienced dental pain tended to report a higher proportion of negative dental perception (57.2%, n = 91), with 2.7 times more likely to report a negative perception of dental health (AOR = 2.72 [95% C.I.: 1.46 to 5.08]). The majority (n = 139; 63.2%) claimed to clean their teeth twice a day.

Conclusion There was a higher negative perception of dental health in urban areas. The need to strengthen oral health promotion in urban schools is high since schools play such a significant role in oral health promotion.
Preparation of PDA-GO/CS composite scaffold and its effects on the biological properties of human dental pulp stem cells
Authors: Li Yaoyao , Huang Xinhui , Fu Weihao , Zhang Zonghao , Xiao Kuancheng , Lv Hongbing
Published: January 2024

Reduced graphene oxide (rGO) is an graphene oxide (GO) derivative of graphene, which has a large specific surface area and exhibited satisfactory physicochemical characteristics. In this experiment, GO was reduced by PDA to generate PDA-GO complex, and then PDA-GO was combined with Chitosan (CS) to synthesize PDA-GO/CS composite scaffold. PDA-GO was added to CS to improve the degradation rate of CS, and it was hoped that PDA-GO/CS composite scaffolds could be used in bone tissue engineering. Physicochemical and antimicrobial properties of the different composite scaffolds were examined to find the optimal mass fraction. Besides, we examined the scaffold’s biocompatibility by Phalloidin staining and Live and Dead fluorescent staining.

Finally, we applied ALP staining, RT-qPCR, and Alizarin red S staining to detect the effect of PDA-GO/CS on the osteogenic differentiation of human dental pulp stem cells (hDPSCs). The results showed that PDA-GO composite was successfully prepared and PDA-GO/CS composite scaffold was synthesized by combining PDA-GO with CS. Among them, 0.3%PDA-GO/CS scaffolds improves the antibacterial activity and hydrophilicity of CS, while reducing the degradation rate. In vitro, PDA-GO/CS has superior biocompatibility and enhances the early proliferation, migration and osteogenic differentiation of hDPSCs. In conclusion, PDA-GO/CS is a new scaffold materialsuitable for cell culture and has promising application prospect as scaffold for bone tissue engineering.
A novel simplified approach for endodontic retrograde surgery in short single-rooted teeth
Authors: Zheng Chen , Wu Wenzhi , Zhang Yulian , Tang Zhenhang , Xie Zhijian , Chen Zhuo
Published: January 2024

Background

High technical thresholds, long operative times, and the need for expensive and specialized equipment impede the widespread adoption of endodontic microsurgery in many developing countries. This study aimed to compare the effects of a simplified, cost-effective, and time-efficient surgical approach involving orthograde obturation using biological ceramic material greater than 6 mm combined with apicoectomy for single-rooted teeth with short lengths with those of the conventional and current standard methods.

Materials and methods

Forty-five premolars equally categorized into three groups: conventional surgery group, standard surgery group, and modified surgery group. A µCT scan was used to calculate the volume of voids. A micro-leakage test and scanning electron microscope (SEM) were performed to assess the sealing effect. Additionally, four cases of chronic periapical periodontitis in the anterior region were selected, and the patients received either the modified approach or the standard surgery for endodontic microsurgery.

Results

The volumes of voids in the apical 0–3 mm of the modified group and the standard group were comparable. The micro-leakage test and SEM examination demonstrated closely bonded fillings in the dentinal walls in both the modified surgery group and standard surgery group. The outcomes of the preliminary application of this modified procedure on patients were successful at the time of the follow-up cutoff.

Conclusions

The modified surgery group exhibited similar root canal filling and apical sealing abilities with the standard procedure for single-rooted teeth with short lengths (< 20 mm). The preliminary application of this modified surgical procedure achieved favorable results.
Comparison of light transmittance and color changes between polyurethane and copolyester retainer materials after staining and destaining
Authors: Viana Grace , Virji Insia , Susarchick Laurie , Allareddy Veerasathpurush , Lown Sullivan , Gruber Max , Lukic Henry , Megremis Spiro , Atsawasuwan Phimon
Published: January 2024

Background

Retainers are the only effective approach to prevent orthodontic relapse. The aim of this study was to compare the changes in color and light-transmittance of rough and smooth thermoformed polyurethane and copolymer retainer samples after staining in different solutions and destaining with different approaches.

Methods

Four hundred copolyester (Essix® ACE) and 400 polyurethane (Zendura®) samples with different surface textures, smooth and rough, were stained in 4 different solutions (n = 100 per solution) over 28 days. Each of the four groups of 100 stained samples of each material was subdivided into 5 groups of 20 samples and subjected to different destaining solutions. Light transmittance and color changes were evaluated using a spectrometer and a spectrophotometer. Mean differences were compared using a two-way analysis of variance (ANOVA) and posthoc multiple comparison tests at P = 0.05.

Results

No significant differences in light transmittance were found between both untreated materials. Both materials were stained in a similar fashion and showed no significant differences between two materials after staining. Coffee and tea stained both materials more significantly than wine, but there was a significant difference of changes of color and light transmittance between rough and smooth surfaces during the destaining in coffee- and tea-stained samples of copolyester material. All destaining solutions were effective at removing all stains on the samples. The surface roughness of the material plays a significant role in the ability of the materials to be destained, demonstrating a more significant greater effect on cleaning rough samples for improvements in light-transmittance and greater changes in color.

Conclusions

This study concluded that the surface of materials plays a significant role in the material destaining and staining. In addition, the different polymers used for retainer fabrication exhibited different responses during the destaining process depending on types of stains.
Detection of periodontal bone loss patterns and furcation defects from panoramic radiographs using deep learning algorithm: a retrospective study
Authors: Kurt-Bayrakdar Sevda , Bayrakdar İbrahim Şevki , Yavuz Muhammet Burak , Sali Nichal , Çelik Özer , Köse Oğuz , Uzun Saylan Bilge Cansu , Kuleli Batuhan , Jagtap Rohan , Orhan Kaan
Published: January 2024

Background

This retrospective study aimed to develop a deep learning algorithm for the interpretation of panoramic radiographs and to examine the performance of this algorithm in the detection of periodontal bone losses and bone loss patterns.

Methods

A total of 1121 panoramic radiographs were used in this study. Bone losses in the maxilla and mandibula (total alveolar bone loss) (n = 2251), interdental bone losses (n = 25303), and furcation defects (n = 2815) were labeled using the segmentation method. In addition, interdental bone losses were divided into horizontal (n = 21839) and vertical (n = 3464) bone losses according to the defect patterns. A Convolutional Neural Network (CNN)-based artificial intelligence (AI) system was developed using U-Net architecture. The performance of the deep learning algorithm was statistically evaluated by the confusion matrix and ROC curve analysis.

Results

The system showed the highest diagnostic performance in the detection of total alveolar bone losses (AUC = 0.951) and the lowest in the detection of vertical bone losses (AUC = 0.733). The sensitivity, precision, F1 score, accuracy, and AUC values were found as 1, 0.995, 0.997, 0.994, 0.951 for total alveolar bone loss; found as 0.947, 0.939, 0.943, 0.892, 0.910 for horizontal bone losses; found as 0.558, 0.846, 0.673, 0.506, 0.733 for vertical bone losses and found as 0.892, 0.933, 0.912, 0.837, 0.868 for furcation defects (respectively).

Conclusions

AI systems offer promising results in determining periodontal bone loss patterns and furcation defects from dental radiographs. This suggests that CNN algorithms can also be used to provide more detailed information such as automatic determination of periodontal disease severity and treatment planning in various dental radiographs.
Immune checkpoint inhibitors in cancer: the increased risk of atherosclerotic cardiovascular disease events and progression of coronary artery calcium
Authors: Gong Bingxin , Guo Yusheng , Li Yi , Wang Jing , Zhou Guofeng , Chen Yong-hao , Nie Tong , Yang Ming , Luo Kun , Zheng Chuansheng , Pan Feng , Liang Bo , Yang Lian
Published: January 2024

Background

Immune checkpoint inhibitors (ICIs) have contributed to a significant advancement in the treatment of cancer, leading to improved clinical outcomes in many individuals with advanced disease. Both preclinical and clinical investigations have shown that ICIs are associated with atherosclerosis and other cardiovascular events; however, the exact mechanism underlying this relationship has not been clarified.

Methods

Patients diagnosed with stages III or IV non-small cell lung cancer (NSCLC) at the Wuhan Union Hospital from March 1, 2020, to April 30, 2022, were included in this retrospective study. Coronary artery calcium (CAC) volume and score were assessed in a subset of patients during non-ECG-gated chest CT scans at baseline and 3, 6, and 12 months after treatment. Propensity score matching (PSM) was performed in a 1:1 ratio to balance the baseline characteristics between the two groups.

Results

Overall, 1458 patients (487 with ICI therapy and 971 without ICI therapy) were enrolled in this cardiovascular cohort study. After PSM, 446 patients were included in each group. During the entire period of follow-up (median follow-up 23.1 months), 24 atherosclerotic cardiovascular disease (ASCVD) events (4.9%) occurred in the ICI group, and 14 ASCVD events (1.4%) in the non-ICI group, before PSM; 24 ASCVD events (5.4%) occurred in the ICI group and 5 ASCVD events (1.1%) in the non-ICI group after PSM. The CAC imaging study group comprised 113 patients with ICI therapy and 133 patients without ICI therapy. After PSM, each group consisted of 75 patients. In the ICI group, the CAC volume/score increased from 93.4 mm3/96.9 (baseline) to 125.1 mm3/132.8 (at 12 months). In the non-ICI group, the CAC volume/score was increased from 70.1 mm3/68.8 (baseline) to 84.4 mm3/87.9 (at 12 months). After PSM, the CAC volume/score was increased from 85.1 mm3/76.4 (baseline) to 111.8 mm3/121.1 (12 months) in the ICI group and was increased from 74.9 mm3/76.8 (baseline) to 109.3 mm3/98.7 (12 months) in the non-ICI group. Both cardiovascular events and CAC progression were increased after the initiation of ICIs.

Conclusions

Treatment with ICIs was associated with a higher rate of ASCVD events and a noticeable increase in CAC progression.