bluuebunny/crossref_metadata_2025 huggingface dataset:
Thrombectomy in ischemic stroke patients with large core but minor ischemic changes on non-enhanced computed tomography
Authors: Broocks Gabriel , Kniep Helge , McDonough Rosalie , Bechstein Matthias , Heitkamp Christian , Winkelmeier Laurens , Klapproth Susan , Faizy Tobias D , Schell Maximilian , Schön Gerhard , Hanning Uta , Gellißen Susanne , Kemmling Andre , Papanagiotou Panagiotis , Fiehler Jens , Meyer Lukas
Published: April 2024

Purpose:

The Alberta Stroke Program Early CT Score (ASPECTS) is regularly used to guide patient selection for mechanical thrombectomy (MT). Similarly, penumbral imaging based on computed tomography perfusion (CTP) may serve as neuroimaging tool to guide treatment. Yet, patients with a large ischemic core on CTP may show only minor ischemic changes resulting in a high ASPECTS.

Aim:

We hypothesized twofold: (1) the treatment effect of vessel recanalization in patients with core volume > 50 mL but ASPECTS ⩾ 6 is not different compared to high ASPECTS patients with core volume < 50 mL, and (2) recanalization is associated with core overestimation.

Methods:

We conducted an observational study analyzing ischemic stroke patients consecutively treated with MT after triage by multimodal CT. Functional endpoint was the rate of functional independence at Day 90 defined as modified Rankin Scale (mRS) 0–2. Imaging endpoint was core overestimation, which was considered when CTP-derived core was larger than the final infarct volume assessed on follow-up imaging. Recanalization was evaluated with the extended Thrombolysis in Cerebral Infarction (eTICI) scale. Multivariable logistic regression analysis and propensity score matching (PSM) were used to assess the association of recanalization (eTICI ⩾ 2b) with functional outcome and core overestimation.

Results:

Of 630 patients with ASPECTS ⩾ 6, 91 patients (14.4%) had a large ischemic core. Following 1:1 PSM, the treatment effect of recanalization was not different in patients with large core and ASPECTS ⩾ 6 (+ 25.8%, 95% CI: 16.3–35.4, p < 0.001) compared to patients with ASPECTS ⩾ 6 and core volume < 50 mL (+ 14.9%, 95% CI: 5.7–24.1, p = 0.002). Recanalization (aOR: 3.46, 95% CI: 1.85–6.47, p < 0.001) and higher core volume (aOR: 1.03, 95% CI: 1.02–1.04, p < 0.001) were significantly associated with core overestimation.

Conclusion:

In patients with ASPECTS ⩾ 6, core volumes did not significantly modify outcomes following recanalization. Reperfusion and higher core volume were significantly associated with core overestimation which may explain the treatment effect of MT for patients with a large ischemic core but minor ischemic changes on non-enhanced CT.

Data access statement:

The data analyzed in this study will be available and shared on reasonable request from any qualified researcher for the purpose of replicating the results after clearance by the local ethics committee.
Malignant melanoma in the hand: current evidence and recommendations
Authors: Blessley-Redgrave Natalie , Bowerman Frances , Dafydd Hywel , Hemington-Gorse Sarah , Boyce Dean
Published: April 2024

Malignant melanoma is the leading cause of death from skin cancer. In spite of significant advances in the management of melanoma with the advent of sentinel lymph node biopsy (SLNB) and adjuvant oncological therapies, the death rate continues to increase worldwide. Melanoma in the hand poses additional diagnostic and management challenges. Consequently, these tend to present at a later stage and are associated with a poorer prognosis. It is imperative that hand surgeons treat any pigmented hand lesion with suspicion to ensure rapid diagnosis and treatment. This article outlines the presentation of melanoma, and how to investigate suspicious pigmented lesions of the hand and digits. It guides hand surgeons in their approach to melanoma of the hand, outlining the multidisciplinary team approach as well as current standard surgical and reconstructive options to optimize outcomes.
The Role of the School Nurse in Addressing Climate-Associated Illnesses: Vector-Borne Diseases
Authors: Marquard Samantha , Wade Heather , Oerther Sarah
Published: April 2024

The ecosystems of planet Earth have been subjected to significant changes in climate because of human activities in the last several hundred years. As winters become milder and springs begin earlier each year, many of the most common vectors, including mosquitoes and ticks, have more time to reproduce and are expanding their natural habitats. The purpose of this article is to increase awareness of how mosquitos and ticks impact the health of school-age children. This is the sixth and final article in a series of articles meant to educate school nurses about poor health outcomes related to changes in climate and to provide them with the tools they need to safeguard the well-being of children.
Physical Challenge Interventions and the Development of Transferable Skills for the Workplace: A Systematic Review and Meta-Analysis
Authors: Tyne William P. , Fletcher David , Paine Nicola J. , Stevinson Clare
Published: April 2024

This study presents a systematic review and meta-analysis synthesising the existing research on the effectiveness of interventions featuring physical challenges for developing transferable skills and psychological health outcomes. Results from 47 independent samples across 44 studies revealed that the overall proximal effects of the interventions were medium ( g = 0.51) and that effects gradually diminished over time ( g = 0.39). Analyses across individual outcomes revealed interventions positively influenced interpersonal ( g = 0.55), intrapersonal ( g = 0.53), and cognitive skills ( g = 0.53), as well as psychological health outcomes ( g = 0.56). Moderator analyses indicate interventions can be potentially beneficial irrespective of design and participants involved. However, the current state of the literature does not truly allow for thorough conclusions to be made regarding the appropriateness and effectiveness of physical challenge interventions for organizational settings.
Transforming smiles: Aesthetic rehabilitation with layered zirconia veneers and crowns for spaced dentition and faulty crowns—A case report
Authors: Ahmed Naseer , Adil Huda , Batool Uzma , Sakrani Hasnain , Heboyan Artak
Published: April 2024

The objective of this case report was to provide a plan for aesthetic rehabilitation of a patient utilizing layered zirconia restorations to produce a homogeneous, pleasing smile. In this case, a female patient, aged 38 years, presented in dental clinic with a spaced dentition and faulty crowns that were causing functional and aesthetic concerns. She was a banker by profession and socially active. The treatment plan involved layered zirconia indirect restorations to enhance her natural teeth appearance. The aim of this case report was to propose an effective strategy for addressing her concerns, with the potential to achieve a desired aesthetic outcome. Additionally, the implementation of this treatment approach had a positive influence on self-esteem and confidence of the patient.
A unique presentation of the rare Nora’s lesion, symptomatic bizarre parosteal osteochondromatous proliferation: A case report
Authors: Katz Alan , Cohen Joshua , Lishchynovska Tanya , Alberton Joseph , Peyser Amos
Published: April 2024

Bizarre parosteal osteochondromatous proliferations, also known as Nora’s lesions, are rare benign tumors with a high recurrence rate. They are often difficult to identify because of their similar appearance to other tumors. We describe a 25-year-old healthy female patient with bizarre parosteal osteochondromatous proliferations in an uncommon location on the pelvic ilium, presenting with unique clinical findings of abdominal pain and femoral paresthesia and showing atypical radiographic findings. To the best of our knowledge, this is one of the very few cases ever reported in the literature of Nora’s lesion in this particular location and possibly the first case ever with this specific presentation. The lesions’ radiographic images, combined orthopedic and general surgery procedures, and histological analysis are detailed. The patient’s continued 4-year follow-up has demonstrated no symptoms or evidence of recurrence.
Professional Development Program to Develop Teacher Educators’ Technological Pedagogical Content Knowledge
Authors: Çam Şefika Sümeyye , Koç Gürcü
Published: April 2024

This study aimed to prepare, implement and evaluate the effectiveness of a professional development program that develops Technological Pedagogical Content Knowledge (TPACK) of teacher educators. Qualitative research methods were used. The research was carried out with 10 teacher educators from different departments. Pre- and post-interviews were conducted to evaluate the effectiveness of the program. The program was found to have positive effects. Teacher educators stated that while transferring the knowledge they gained to the classroom environment, the methods they used could affect the education positively and attract the attention of students. Therefore, they planned to use the knowledge they acquired later on. They realized that with the knowledge they gained through this program, they would be a role model for the teachers of the future. At the end of the program, each participant’s TPACK development was in line with their own cognitive readiness.
Playing (& Smoking) by the Rules: Sport Media’s Racialized Coverage of Athlete Drug Use
Authors: Crowe Patrick , Peña Vincent
Published: April 2024

Sports media research has often found that athletes are depicted differently based on stereotypes attached to their racialized bodies, and often along a Black/white racial binary. Furthermore, Black men often receive more and harsher penalties for drug use compared to all other racial and gender categories. Using critical discourse analysis, this study explores how NFL athletes who either openly admitted to using illicit drugs or failed National Football League (NFL)-mandated drug tests were covered by sports media. Four NFL athletes (two Black, two white) were selected based on their prominence — Josh Gordon, Randy Gregory, Chris Long, and Aaron Rodgers. The findings tell us that the selected Black athletes were often demonized in coverage by being portrayed as addicts or criminals and objectified as commodities whose value rose and fell with each suspension/return. Additionally, journalists often deployed neoliberal logics to both criticize and defend Black and white athletes. The white athletes in the study were portrayed as intellectuals looking to challenge the NFL’s authority, “good person(s),” and went unpunished for their drug admittance. This study finds that monolithic coverage of athletes is not fair, however the stereotypical notions of the Black/white binary are present when analyzing media discourse on athletic drug use.
The Effect of Osteoporosis on Complications and Reoperation Rates After Surgical Management of Adult Thoracolumbar Spinal Deformity: A Systematic Review and Meta Analysis
Authors: Lechtholz-Zey Elizabeth A. , Gettleman Brandon S. , Ayad Mina , Mills Emily S. , Shelby Hannah , Ton Andy , Shah Ishan , Safaee Michael M. , Wang Jeffrey C. , Alluri Ram K. , Hah Raymond J.
Published: April 2024

Study Design

Systematic Review.

Objectives

While substantial research has explored the impact of osteoporosis on patients undergoing adult spinal deformity (ASD) correction, the literature remains inconclusive. As such, the purpose of this study is to synthesize and analyze existing studies pertaining to osteoporosis as a predictor of postoperative outcomes in ASD surgery.

Methods

We performed a systematic review and meta-analysis to determine the effect that a diagnosis of osteoporosis, based on ICD-10 coding, dual-energy X-ray absorptiometry (DEXA) or computed tomography, has on the incidence of adverse outcomes following surgical correction of ASD. Statistical analysis was performed using Comprehensive Meta-Analysis (Version 2) using a random effects model to account for heterogeneity between studies.

Results

After application of inclusion and exclusion criteria, 36 and 28 articles were included in the systematic review and meta-analysis, respectively. The meta-analysis identified greater rates of screw loosening amongst osteoporotic patients (70.5% vs 31.9%, P = .009), and decreased bone mineral density in patients who developed proximal junctional kyphosis (PJK) (.69 vs .79 g/cm2, P = .001). The systematic review demonstrated significantly increased risk of any complication, reoperation, and proximal junctional failure (PJF) associated with reduced bone density. No statistical difference was observed between groups regarding fusion rates, readmission rates, and patient-reported and/or functional outcome scores.

Conclusion

This study demonstrates a higher incidence of screw loosening, PJK, and revision surgery amongst osteoporotic ASD patients. Future investigations should explore outcomes at various follow-up intervals in order to better characterize how risk changes with time and to tailor preoperative planning based on patient-specific characteristics.
Using Reflection to Engage with the Affective Domain in Legal Education in the Context of Cultural and Institutional Diversity
Authors: Balan Anil
Published: April 2024

In legal education, the affective domain plays a vital role in shaping future lawyers’ professional identities, values and ethical decision-making capabilities. However, law schools in England and Wales face specific challenges in addressing the affective domain successfully in the context of cultural and institutional diversity. These include the predominant emphasis on doctrinal instruction and analytical thinking, neglecting emotional intelligence and ethical development and the emotional demands placed on law students. Law schools must also address implicit biases, combat discrimination and foster a supportive and inclusive environment. To overcome these challenges, law schools can integrate courses addressing the affective domain, offer opportunities for self-reflection, mentorship and peer support and invest in faculty development programmes. Collaboration with the legal profession can also bridge the theory–practice gap. By understanding and addressing these challenges, law schools can equip students with emotional intelligence, empathy and ethical foundations for successful legal careers.
Servitude in a Princely Establishment: Bhopal, Nineteenth to Early Twentieth Century
Authors: Vanina Eugenia
Published: April 2024

Bhopal, one of the ‘princely states’ and vassals of the British Empire, enjoyed special favour with its sovereign. Throughout a century, it was ruled by women who gained themselves, in India and outside, the glory of enlightened and progressive monarchs. Archival documents and memoirs allow glancing at the hitherto hidden world of domestic servants, who not only ensured the comfortable and luxurious life of the princely family, but also its high status and prestige. Among the numerous servants employed by the Bhopal rulers, freely hired local residents prevailed. However, the natives of some other countries, quite far from India, were present as well. Some of them came to Bhopal by force: The reputation of ‘progressive’ was no obstacle for the Bhopal queens for using slave labour, getting in response mild admonition from their British superiors.
‘But why is a Ghanaian studying Liberia?’ Leveraging positionality for online data collection during the COVID-19 pandemic
Authors: Vaughan Franka
Published: April 2024

This paper explores the significance of my positionality as a Ghanaian interested in a Liberian identity question and examines how it influenced the dialogical process of research design and online data collection. Emphasising the fluidity of the insider/outsider binary, the study unveils its potential to cultivate positive online interview experiences, augmenting the overall depth and quality of interview data. Notably, my dual status as an outsider, owing to Ghanaian nationality and pandemic-induced physical distance, and as an insider, being a racialised Black African like some participants, significantly influenced unique relationships with study participants, facilitating access and contributing to an enriched data collection experience.
The Big Bank Scam: Failure of Corporate Governance
Authors: Mehrotra Shweta , Kolpula Suman
Published: April 2024

The case deliberates the series of events exposing serious shortcomings in corporate governance and risk management practices of one of India’s oldest and most venerable financial institutions but also cast a glaring spotlight on various unfathomable issues of corporate governance such as weak institutionalisation of whistleblowing mechanism, ethical lapses and regulatory oversight within the banking sector. The case provides an opportunity to understand the key components of corporate governance structure and consequences of poor corporate governance. The case highlights the responsibility of the board of directors and audit committee and discusses the changes required in the corporate governance structure necessary to ensure that such incidents do not take place. The case attempts to unearth the weaknesses in the bank’s internal processes that led to a scam of this magnitude and why it remained ongoing and undetected for several years. We found that there is a need for banks to leverage the latest advancements in technology to upgrade their internal functions and processes and make them more accountable and transparent. Further, it also opens the debate on whether public sector banks and other financial institutions should be guided solely by the profit maximisation motive, or they also meet their social obligations.
Guanfacine poisoning resulting in transient ST-segment elevation: a case report
Authors: Hirayama Ichiro , Kamijo Yoshito , Abe Hiroko , Nonaka Minaho , Yano Tetsuhiro , Ishii Mitsuru , Tominaga Yoshiteru
Published: April 2024

Background

Guanfacine is an alpha-2 adrenergic agonist that decreases norepinephrine release and sympathetic outflow. With the increased use of guanfacine for attention-deficit hyperactivity disorder (ADHD), reports of guanfacine poisoning have also risen.

Case presentation

A 15-year-old male (height: 170 cm, weight: 48 kg), who was taking 2 mg/day of guanfacine for ADHD, was brought to our emergency department after ingesting 40 tablets of guanfacine due to poor exam results. He presented with impaired consciousness and sinus bradycardia on an electrocardiogram (ECG), leading to diagnosis of guanfacine poisoning. Gastric lavage (5 L) was performed, and activated charcoal was administered. Although his consciousness gradually recovered, he developed ST-segment elevation on the ECG. Despite the absence of chest pain and elevated myocardial enzymes, coronary artery stenosis was not observed on coronary artery computed tomography. As his blood guanfacine level decreased, his ECG returned to normal.

Conclusions

This case highlights the need for careful monitoring of guanfacine poisoning patients due to the potential for various cardiovascular events.
Impacts of continuous cropping on the rhizospheric and endospheric microbial communities and root exudates of Astragalus mongholicus
Authors: Zhou Qin , Wang Yun , Yue Liang , Ye Ailing , Xie Xiaofan , Zhang Meilan , Tian Yuan , Liu Yang , Turatsinze Andéole Niyongabo , Constantine Uwaremwe , Zhao Xia , Zhang Yubao , Wang Ruoyu
Published: April 2024

Astragalus mongholicus is a medicinal plant that is known to decrease in quality in response to continuous cropping. However, the differences in the root-associated microbiome and root exudates in the rhizosphere soil that may lead to these decreases are barely under studies. We investigated the plant biomass production, root-associated microbiota, and root exudates of A. mongholicus grown in two different fields: virgin soil (Field I) and in a long-term continuous cropping field (Field II). Virgin soil is soil that has never been cultivated for A. mongholicus. Plant physiological measurements showed reduced fresh and dry weight of A. mongholicus under continuous cropping conditions (i.e. Field II). High-throughput sequencing of the fungal and bacterial communities revealed differences in fungal diversity between samples from the two fields, including enrichment of potentially pathogenic fungi in the roots of A. mongholicus grown in Field II. Metabolomic analysis yielded 20 compounds in A. mongholicus root exudates that differed in relative abundance between rhizosphere samples from the two fields. Four of these metabolites (2-aminophenol, quinic acid, tartaric acid, and maleamate) inhibited the growth of A. mongholicus, the soil-borne pathogen Fusarium oxysporum, or both. This comprehensive analysis enhances our understanding of the A. mongholicus microbiome, root exudates, and interactions between the two in response to continuous cropping. These results offer new information for future design of effective, economical approaches to achieving food security.
Transcriptome profiles reveal response mechanisms and key role of PsNAC1 in Pinus sylvestris var. mongolica to drought stress
Authors: Zhou Chengcheng , Bo Wenhao , El-Kassaby Yousry A. , Li Wei
Published: April 2024

Background

Drought stress severely impedes plant growth, and only a limited number of species exhibit long-term resistance to such conditions. Pinus sylvestris var. mongolica, a dominant tree species in arid and semi-arid regions of China, exhibits strong drought resistance and plays a crucial role in the local ecosystem. However, the molecular mechanisms underlying this resistance remain poorly understood.

Results

Here, we conducted transcriptome sequence and physiological indicators analysis of needle samples during drought treatment and rehydration stages. De-novo assembly yielded approximately 114,152 unigenes with an N50 length of 1,363 bp. We identified 6,506 differentially expressed genes (DEGs), with the majority being concentrated in the heavy drought stage (4,529 DEGs). Functional annotation revealed enrichment of drought-related GO terms such as response to water (GO:0009415: enriched 108 genes) and response to water deprivation (GO:0009414: enriched 106 genes), as well as KEGG categories including MAPK signaling pathway (K04733: enriched 35 genes) and monoterpenoid biosynthesis (K21374: enriched 27 genes). Multiple transcription factor families and functional protein families were differentially expressed during drought treatment. Co-expression network analysis identified a potential drought regulatory network between cytochrome P450 genes (Unigene4122_c1_g1) and a core regulatory transcription factor Unigene9098_c3_g1 (PsNAC1) with highly significant expression differences. We validated PsNAC1 overexpression in Arabidopsis and demonstrated enhanced drought resistance.

Conclusions

These findings provide insight into the molecular basis of drought resistance in P. sylvestris var. mongolica and lay the foundation for further exploration of its regulatory network.
Adequate antiviral treatment lowers overall complications of cytomegalovirus colitis among inpatients with inflammatory bowel diseases
Authors: Hsieh Ching-Reigh , Wu Ren-Chin , Kuo Chia-Jung , Yeh Pai-Jui , Yeh Yuan-Ming , Chen Chyi-Liang , Chiu Cheng-Tang , Chiu Cheng-Hsun , Pan Yu-Bin , Tsou Yung-Kuan , Le Puo-Hsien
Published: April 2024

Background

Cytomegalovirus (CMV) colitis significantly complicates the course of inflammatory bowel disease (IBD), frequently leading to severe flare-ups and poor outcomes. The role of antiviral therapy in hospitalized IBD patients with CMV colitis is currently under debate. This retrospective analysis seeks to clarify the influence of antiviral treatment on these patients.

Methods

We retrospectively reviewed IBD patients diagnosed with CMV colitis via immunohistochemistry staining from colonic biopsies at a major tertiary center from January 2000 to May 2021. The study focused on patient demographics, clinical features, risk factors, prognostic indicators, and antiviral treatment outcomes.

Results

Among 118 inpatients, 42 had CMV colitis. Risk factors included hypoalbuminemia and antibiotic use. IBD patients with CMV colitis receiving < 14 days of antiviral therapy had higher complication (72% vs. 43%, p = 0.028) and surgery rates (56% vs. 26%, p = 0.017) compared to those without CMV. Adequate antiviral therapy (≥ 14 days) significantly reduced complications in the CMV group (29% vs. 72%, p = 0.006), especially in Crohn’s disease (20% vs. 100%, p = 0.015). Independent predictors of IBD-related complications were CMV colitis (Odds Ratio [OR] 3.532, 90% Confidence Interval [CI] 1.012–12.331, p = 0.048), biological treatment failure (OR 4.953, 95% CI 1.91-12.842, p = 0.001), and adequate antiviral therapy (OR 0.108, 95% CI 0.023–0.512, p = 0.005).

Conclusion

CMV colitis and a history of biological treatment failure increase complication risks in IBD patients. Adequate antiviral therapy significantly mitigates these risks, highlighting its importance in managing IBD patients with CMV colitis.
Association between maternal health service utilization and under-five mortality rate in China and its provinces, 1990–2017
Authors: Zhang Jingya , Li Haoran , Wei Bincai , He Rongxin , Zhu Bin , Zhang Ning , Mao Ying
Published: April 2024

Background

The United Nations (UN) Sustainable Development Goal − 3.2 aims to eliminate all preventable under-five mortality rate (U5MR). In China, government have made efforts to provide maternal health services and reduce U5MR. Hence, we aimed to explore maternal health service utilization in relation to U5MR in China and its provinces in 1990–2017.

Methods

We obtained data from Global Burden of Disease 2017, China Health Statistics Yearbook, China Statistical Yearbook, and Human Development Report China Special Edition. The trend of U5MR in each province of China from 1990 to 2017 was analyzed using Joinpoint Regression model. We measured the inequities in maternal health services using HEAT Plus, a health inequity measurement tool developed by the UN. The generalized estimating equation model was used to explore the association between maternal health service utilization (including prenatal screening, hospital delivery and postpartum visits) and U5MR.

Results

First, in China, the U5MR per 1000 live births decreased from 50 in 1990 to 12 in 2017 and the average annual percentage change (AAPC) was − 5.2 (p < 0.05). Secondly, China had a high maternal health service utilization in 2017, with 96.5% for prenatal visits, 99.9% for hospital delivery, and 94% for postnatal visits. Inequity in maternal health services between provinces is declining, with hospital delivery rate showing the greatest decrease (SII, 14.01 to 1.87, 2010 to 2017). Third, an increase in the rate of hospital delivery rate can significantly reduce U5MR (OR 0.991, 95%CI 0.987 to 0.995). Postpartum visits rate with a one-year lag can reduce U5MR (OR 0.993, 95%CI 0.987 to 0.999). However, prenatal screening rate did not have a significant effect on U5MR.

Conclusion

The decline in U5MR in China was associated with hospital delivery and postpartum visits. The design and implementation of maternal health services may provide references to other low-income and middle-income countries.
Demographic and clinical characteristics associated with advanced stage colorectal cancer: a registry-based cohort study in Saudi Arabia
Authors: Alsadhan Norah , Alhurishi Sultana A , Pujades-Rodriguez Mar , Shuweihdi Farag , Brennan Cathy , West Robert M
Published: April 2024

Background

In Saudi Arabia, approximately one-third of colorectal cancer (CRC) patients are diagnosed at an advanced stage. Late diagnosis is often associated with a worse prognosis. Understanding the risk factors for late-stage presentation of CRC is crucial for developing targeted interventions enabling earlier detection and improved patient outcomes.

Methods

We conducted a retrospective cohort study on 17,541 CRC patients from the Saudi Cancer Registry (1997–2017). We defined distant CRCs as late-stage and localized and regional CRCs as early-stage. To assess risk factors for late-stage CRC, we first used multivariable logistic regression, then developed a decision tree to segment regions by late-stage CRC risk, and finally used stratified logistic regression models to examine geographical and sex variations in risk factors.

Results

Of all cases, 29% had a late-stage diagnosis, and 71% had early-stage CRC. Young (< 50 years) and unmarried women had an increased risk of late-stage CRC, overall and in some regions. Regional risk variations by sex were observed. Sex-related differences in late-stage rectosigmoid cancer risk were observed in specific regions but not in the overall population. Patients diagnosed after 2001 had increased risks of late-stage presentation.

Conclusion

Our study identified risk factors for late-stage CRC that can guide targeted early detection efforts. Further research is warranted to fully understand these relationships and develop and evaluate effective prevention strategies.
Association of DOK3 and infiltrated tumor-associated macrophages with risk for the prognosis of Porphyromonas gingivalis-infected oral cancer: a 12-year data analysis of 200 patients from a tertiary teaching hospital, Urumqi, China
Authors: Li Chenxi , Li Muqiu , Wei Wei , Wang Zhengye , Yu Jingwen , Gong Zhongcheng
Published: April 2024

Background

While there is an understanding of the association between the expression of Porphyromonas gingivalis (P. gingivalis) and prognosis of oral squamous cell carcinoma (OSCC), significance specially to address the relevance between different immunohistochemical intensities of P. gingivalis and tumor-associated macrophages (TAMs) in OSCC tissue and related clinicopathologic characteristics has not been well investigated. The present study aimed to investigate the pathological features related to M2-TAM in P. gingivalis-infected OSCC and ascertain its clinical relevance with patients’ prognosis.

Methods

A prospective cohort study was designed to comparatively analyze 200 patients from June 2008 to June 2020. Bioinformatics analyses were implemented to identify DOK3 as a key molecule and to appraise immunocyte infiltration using Gene Expression Omnibus and The Cancer Genome Atlas databases. Immunohistochemical evaluation was performed to analyze the association between the expression levels of P. gingivalis, DOK3, and M2-TAM and clinicopathological variables using Fisher’s exact test or Pearson’s chi-square test. Cox analysis was used to calculate hazard ratios (HR) with corresponding 95% confidence interval (CI) for various clinicopathological features. The Kaplan–Meier approach and log-rank test were used to plot the survival curves.

Results

The expression level of P. gingivalis was positively associated with DOK3 and M2-TAMs expression level (P < 0.001). Parameters, including body mass index, clinical stage, recurrence, tumor differentiation, and P. gingivalis, DOK3, and M2-TAM immunoexpression levels, affected the prognosis of patients with OSCC (all P < 0.05). In addition, P. gingivalis (HR = 1.674, 95%CI 1.216–4.142, P = 0.012), DOK3 (HR = 1.881, 95%CI 1.433–3.457, P = 0.042), and M2-TAM (HR = 1.649, 95%CI 0.824–3.082, P = 0.034) were significantly associated with the 10-year cumulative survival rate.

Conclusions

Elevated expression of P. gingivalis and DOK3 indicates M2-TAM infiltration and unfavorable prognosis of OSCC, and could be considered as three novel independent risk factors for predicting the prognosis of OSCC.
Associations of the circulating levels of cytokines with the risk of myeloproliferative neoplasms: a bidirectional mendelian-randomization study
Authors: Xiong Hao , Zhang Huitao , Bai Jun , Li Yanhong , Li Lijuan , Zhang Liansheng
Published: April 2024

Objective

In the pathogenesis of myeloproliferative neoplasms (MPN), inflammation plays an important role. However, it is unclear whether there is a causal link between inflammation and MPNs. We used a bidirectional, two-sample Mendelian randomization (MR) approach to investigate the causal relationship between systemic inflammatory cytokines and myeloproliferative neoplasms.

Methods

A genome-wide association study (GWAS) of 8293 European participants identified genetic instrumental variables for circulating cytokines and growth factors. Summary statistics of MPN were obtained from a GWAS including 1086 cases and 407,155 controls of European ancestry. The inverse-variance-weighted method was mainly used to compute odds ratios (OR) and 95% confidence intervals (Cl).

Results

Our results showed that higher Interleukin-2 receptor, alpha subunit (IL-2rα) levels, and higher Interferon gamma-induced protein 10 (IP-10) levels were associated with an increased risk of MPN (OR = 1.36,95%CI = 1.03–1.81, P = 0.032; OR = 1.55,95%CI = 1.09–2.22, P = 0.015; respectively).In addition, Genetically predicted MPN promotes expression of the inflammatory cytokines interleukin-10 (IL-10) (BETA = 0.033, 95% CI = 0.003 ~ 0.064, P = 0.032) and monokine induced by interferon-gamma (MIG) (BETA = 0.052, 95% CI = 0.002–0.102, P = 0.043) and, on activation, normal T cells express and secrete RANTES (BETA = 0.055, 95% CI = 0.0090.1, P = 0.018).

Conclusion

Our findings suggest that cytokines are essential to the pathophysiology of MPN. More research is required if these biomarkers can be used to prevent and treat MPN.
Comparatively analysing the postoperative optical performance of different intraocular lenses: a prospective observational study
Authors: Guo Shuanglin , Huang Hao , Li Bowen , Huang Mansha , Gao Lu , Chen Jingyi , Zeng Yuying , Yang Ye , Liu Lin , Cheng Lu , Yao Siyang , Cheng Hao
Published: April 2024

Background

Postoperative performance, including best corrected distance visual acuity (BCDVA) and optical metrics (from the OQAS and iTrace devices), was compared among 4 different intraocular lenses (IOLs).

Methods

This prospective observational study included 104 eyes from 104 subjects who underwent cataract surgery combined with implantation of 4 different IOLs: monofocal (Mon) IOLs, segmental refractive (SegRef) IOLs, diffractive (Dif) IOLs and extended depth of focus (EDoF) IOLs. Postoperative BCDVA and optical metrics were collected at the 6th month. The OQAS optical metrics included the objective scattering index (OSI), Strehl ratio (SR), modulation transfer function (MTF) cut-off frequency, and predicted visual acuity (PVA); the iTrace optical metrics included blur/double vision, glare/halo, starburst, mixed focus, night myopia, and night hyperopia.

Results

There was no significant difference in BCDVA among the 4 groups (P = 0.059; power = 70.3%). Differences were observed in all OQAS optical metrics among the groups (all P < 0.001). Overall, Mon IOLs and EDoF IOLs exhibited better performance than Dif IOLs and SegRef IOLs. Starburst was the only iTrace optical metric that differed among the groups (P < 0.001): SegRef IOLs caused more starbursts than Mon IOLs (P = 0.001), Dif IOLs (P = 0.006) and EDoF IOLs (P < 0.001). Spearman rank correlation analysis was used to determine the relationships among the iTrace optical metrics, OQAS optical metrics and BCDVA: starburst was negatively correlated with BCDVA, PVA at contrasts of 100% and 20%, OSI, and MTF cut-off frequency (all P ≤ 0.001); mixed focus was positively correlated with BCDVA, PVA at contrasts of 100% and 20%, OSI, and MTF cut-off frequency (all P ≤ 0.001).

Conclusions

Postoperative BCDVA and optical metrics varied among the different IOLs, which should be taken into account in the selection and management of IOLs for cataract patients.

Trial registration

This study was approved by the First Affiliated Hospital of Guangzhou Medical University Ethical Review Board (No. 50 2022).
New-onset or relapse of uveitis after rapid spreading of COVID-19 infection in China and risk factor analysis for relapse
Authors: Wang Kaixuan , Li Jiawen , Guo Kailei , Zhang Xiaomin
Published: April 2024

Background

The aim of this study was to report the clinical profile of new-onset and relapse of uveitis following rapid spreading of coronavirus disease 2019 (COVID-19) infection due to change of anti-COVID-19 policies in China and investigate potential risk factors for inflammation relapse.

Methods

In this retrospective case-control study, patients with new-onset or a history of uveitis between December 23, 2022, and February 28, 2023, were included to assess the influence of COVID-19 infection on uveitis. Detailed information on demographic data, clinical characteristics, treatment measures, treatment response, and ocular inflammatory status before and after COVID-19 infection was collected.

Results

This study included 349 patients with a history of uveitis. The uveitis relapse rate was higher (28.8%, n = 288) in those with COVID-19 infection than in patients without COVID-19 infection (14.8%, n = 61) (P = 0.024). Among the relapse cases, 50.8% experienced a relapse of anterior uveitis, while 49.2% had a relapse of uveitis involving the posterior segment. Multivariable regression analysis indicated a positive correlation between disease duration and uveitis relapse, while the last relapse exceeding one year before COVID-19 infection and the use of methotrexate during COVID-19 infection were negatively correlated with relapse of uveitis. Thirteen patients who developed new-onset uveitis following COVID-19 infection were included; among them, three (23.1%) had anterior uveitis and 10 (76.9%) had uveitis affecting the posterior segment. Regarding cases involving the posterior segment, four patients (30.8%) were diagnosed with Vogt-Koyanagi-Harada disease.

Conclusions

COVID-19 infection increases the rate of uveitis relapse. Long disease duration is a risk factor, while time since the last relapse more than 1 year and methotrexate use are protective factors against uveitis relapse.
Changes in adolescents’ daily-life solitary experiences during the COVID-19 pandemic: an experience sampling study
Authors: Bamps Eva , Achterhof Robin , Lafit Ginette , Teixeira Ana , Akcaoglu Zeynep , Hagemann Noëmi , Hermans Karlijn S. F. M. , Hiekkaranta Anu P. , Janssens Julie J. , Lecei Aleksandra , Myin-Germeys Inez , Kirtley Olivia J.
Published: April 2024

Background

Adolescent solitude was drastically impacted by the COVID-19 pandemic. As solitude is crucial for adolescent development through its association with both positive and negative developmental outcomes, it is critical to understand how adolescents’ daily-life solitary experiences changed as a result of the pandemic.

Methods

Using three waves of Experience Sampling Method data from a longitudinal study, we compared adolescents’ daily-life solitary experiences in the early (nT1=100; MAge=16.1; SDAge=1.9; 93% girls) and mid-pandemic (nT2=204; MAge=16.5; SDAge=2.0; 79% girls) to their pre-pandemic experiences.

Results

We found that adolescents with lower levels of pre-pandemic social support and social skills reported wanting to be alone less and feeling like an outsider more at both time points during the pandemic. In the mid-pandemic wave, adolescents with higher levels of pre-pandemic social support and social skills reported decreases in positive affect compared to the pre-pandemic wave.

Conclusion

This study shows that adolescents’ daily-life solitary experiences worsened throughout the COVID-19 pandemic. There should be continued concern for the wellbeing of all adolescents, not only those already at risk, as effects of the pandemic on mental health might only manifest later.
Health and health behaviours in adolescence as predictors of education and socioeconomic status in adulthood – a longitudinal study
Authors: Koivusilta Leena K. , Acacio-Claro Paulyn Jean , Mattila Ville M. , Rimpelä Arja H.
Published: April 2024

Background

The positive association of health with education level and socioeconomic status (SES) is well-established. Two theoretical frameworks have been delineated to understand main mechanisms leading to socioeconomic health inequalities: social causation and health selection but how these work in adolescence is poorly known. We studied if adolescent health and health behaviours predict higher education and higher SES in adulthood and if family background and school performance in adolescence explain these associations.

Methods

Surveys on health and health behaviours were sent to representative samples of 12–18-year-old Finns in 1981–1997 every second year (response rate 77.8%, N = 55,682). The survey data were linked with the respondents’ and their parents’ socioeconomic data from the Finnish national registries. Both latent variables, namely, health (perceived health, health complaints, chronic disease), health-compromising behaviours (smoking status, drunkenness frequency), and family background (parents’ occupation-based SES, education, family type) and variables directly measuring health-enhancing behaviours (toothbrushing, physical activity) and school performance were used to predict higher education and higher occupation-based SES at age 34. Logistic regression analysis and structural equation models (SEM) were used.

Results

In logistic regression analyses, good health, health-enhancing behaviours, and lack of health-compromising behaviours were related to higher education and SES, also after controlling for family background and school performance. In the SEM analyses, good health, health-enhancing behaviours, and lack of health-compromising behaviours directly predicted higher SES and higher education, although the standardised coefficients were low (from 0.034 to 0.12). In all models, health, lack of health-compromising behaviours, and health-enhancing behaviours predicted school performance, which in turn, predicted the outcomes, suggesting indirect routes to these. Good socioeconomic prospects in terms of family background predicted good health, healthy behaviours, and good school performance in adolescence and higher SES and higher education in adulthood.

Conclusion

Health and health behaviours in adolescence predicted education and SES in adulthood. Even though the relationships were modest, they support the health selection hypotheses and emphasise the importance of adolescence for health inequalities during the life-course. Health and health behaviours were strongly associated with school performance and family background which together modified the paths from health and health behaviours to the outcomes.
Comparison of radiological and clinical outcomes of cervical laminoplasty versus lateral mass screw fixation in patients with ossification of the posterior longitudinal ligament
Authors: Liu Tao , Zhang Jianzhou , Deng Longlian , He Mengzi , Tian Shuo , Ding Wenyuan , Wang Zheng , Yang Dalong
Published: April 2024

Purpose

This study aimed to compare cervical sagittal parameters and clinical outcomes between patients undergoing cervical laminoplasty(CL) and those undergoing lateral mass screw fixation(LMS).

Methods

We retrospectively studied 67 patients with multilevel ossification of the posterior longitudinal ligament (OPLL) of the cervical spine who underwent lateral mass screw fixation (LMS = 36) and cervical laminoplasty (CL = 31). We analyzed cervical sagittal parameters (C2-7 sagittal vertical axis (C2-7 SVA), C0-2 Cobb angle, C2-7 Cobb angle, C7 slope (C7s), T1 slope (T1s), and spino-cranial angle (SCA)) and clinical outcomes (visual analog scale [VAS], neck disability index [NDI], Japanese Orthopaedic Association [JOA] scores, recovery rate (RR), and minimum clinically significant difference [MCID]). The cervical sagittal parameters at the last follow-up were analyzed by binary logistic regression. Finally, we analyzed the correlation between the cervical sagittal parameters and each clinical outcome at the last follow-up after surgery in both groups.

Results

At the follow-up after posterior decompression in both groups, the mean values of C2-C7 SVA, C7s, and T1s in the LMS group were more significant than those in the CL group (P ≤ 0.05). Compared with the preoperative period, C2-C7 SVA, T1s, and SCA gradually increased, and the C2-C7 Cobb angle gradually decreased after surgery (P < 0.05). The improvement in the JOA score and the recovery rate was similar between the two groups, while the improvement in the VAS-N score and NDI score was more significant in the CL group (P = 0.001; P = 0.043). More patients reached MCID in the CL group than in the LMS group (P = 0.036). Binary logistic regression analysis showed that SCA was independently associated with whether patients reached MCID at NDI postoperatively. SCA was positively correlated with cervical NDI and negatively correlated with cervical JOA score at postoperative follow-up in both groups (P < 0.05); C2-7 Cobb angle was negatively correlated with cervical JOA score at postoperative follow-up (P < 0.05).

Conclusion

CL may be superior to LMS in treating cervical spondylotic myelopathy caused by OPLL. In addition, smaller cervical SCA after posterior decompression may suggest better postoperative outcomes.
A scoping review of guidelines on caries management for children and young people to inform UK undergraduate core curriculum development
Authors: Campbell Faith , Rogers Helen , Goldsmith Rachel , Rowles Kathryn , Raggio Daniela Prócida , Innes Nicola
Published: April 2024

Background

Current evidence in cariology teaching is not consistently reflected in paediatric dentistry in the United Kingdom (UK). Many dental schools are not consistently teaching biological approaches to caries management, with outdated or complex methods being taught outwith the purview of general dental practitioners. This scoping review aimed to map current guidelines on the management of caries in children and young people. This is part of a work package to inform the consensus and development of a UK-wide caries management curriculum for paediatric dentistry.

Methods

A search of electronic databases for peer reviewed literature was performed using Cochrane Library, MEDLINE via PubMed, TRIP Medical Database and Web of Science. Hand searching was undertaken for grey literature (citations of sources of evidence, websites of global organisations and Google Web Search™ (Google LLC, California, USA). Results from databases were screened independently, concurrently by two reviewers. Full texts were obtained, and reviewers met to discuss any disagreement for both database and hand searching.

Results

This review identified 16 guidelines suitable for inclusion. After quality appraisal, eight were selected for synthesis and interpretation. Key themes included the shift towards selective caries removal and avoidance of complete caries removal unless in specific circumstances in anterior teeth. For “early lesions” in primary and permanent teeth with and without cavitation, several guidelines recommend biological management including site specific prevention and fissure sealants.

Conclusions

This review mapping current cariology guidelines for children and young people found gaps in the literature including classification of early carious lesions and management of early cavitated lesions. Areas identified for further exploration include integration of biological caries management into treatment planning, selective caries removal and whether pulpotomy is specialist-level treatment, requiring referral. These results will inform consensus recommendations in the UK, using Delphi methods.