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some patients with inflammatory bowel disease (IBD) treated with antiTNF develop drug-induced psoriasis (antiTNF-IP). Several therapeutic strategies are possible. to assess the management of antiTNF-IP in IBD, and its impact in both diseases. patients with antiTNF-IP from ENEIDA registry were included. Therapeutic strategy was classified as continuing the same antiTNF, stopping antiTNF, switch to another antiTNF or swap to a non-antiTNF biologic. IP severity and IBD activity were assessed at baseline and 16, 32 and 54 weeks. 234 patients were included. At baseline, antiTNF-IP was moderate-severe in 60 % of them, and IBD was in remission in 80 %. Therapeutic strategy was associated to antiTNF-IP severity (p < 0.001). AntiTNF-IP improved at week 54 with all strategies, but continuing with the same antiTNF showed the worst results (p = 0.042). Among patients with IBD in remission, relapse was higher in those who stopped antiTNF (p = 0.025). In multivariate analysis, stopping antiTNF, trunk and palms and soles location were associated with antiTNF-IP remission; female sex and previous surgery in Crohn´s disease with IBD relapse. skin lesions severity and IBD activity seem to determine antiTNF-IP management. Continuing antiTNF in mild antiTNF-IP, and swap to ustekinumab or switch to another antiTNF in moderate-severe cases, are suitable strategies. [ABSTRACT FROM AUTHOR]

Few data are available on long-term drug therapy and its potential prognostic impact after Takotsubo syndrome (TTS). Aim of the study is to evaluate clinical characteristics and long-term outcome of TTS patients on Renin Angiotensin system inhibitors (RASi). TTS patients were enrolled in the international multicenter GEIST (GErman Italian Spanish Takotsubo) registry. Median follow-up was 31 (Interquartile range 12-56) months. Comparison of RASi treated vs. untreated patients was performed within the overall population and after 1:1 propensity score matching for age, sex, comorbidities, type of trigger and in-hospital complications. clinicaltrials.gov, NCT04361994, https://clinicaltrials.gov/study/NCT04361994 Of the 2453 TTS patients discharged alive, 1683 (68%) received RASi therapy. Patients with RASi were older (age 71 ± 11 vs 69 ± 13 years, P =.01), with higher prevalence of hypertension (74% vs 53%, P <.01) and diabetes (19% v s15%, P =.01), higher admission left ventricular ejection fraction (LVEF) (41 ± 11% vs 39 ± 12%, P <.01) and lower rates of in-hospital complications (18.9% vs 29.6%, P <.01). At multivariable analysis, RASi therapy at discharge was independently associated with lower mortality (HR 0.63, 95% CI 0.45-0.87, P <.01). Survival analysis showed that at long term, patients treated with RASi had lower mortality rates in the overall cohort (log-rank P =.001). However, this benefit was not found among patients treated with RASi in the matched cohort (log-rank P =.168). Potential survival benefit of RASi were present, both in the overall and matched cohort, in 2 subgroups: patients with admission LVEF ≤ 40% (HR 0.54 95% CI 0.38-0.78, P =.001; HR 0.59, 95% CI 0.37-0.95, P =.030) and diabetes (HR 0.41, 95% CI 0.23-0.73, P =.002; HR 0.41, 95% CI 0.21-0.82, P =.011). Long-term therapy with RASi after a TTS episode was not associated with lower mortality rates at propensity score analysis. However, potential survival benefit can be found among patients with admission LVEF ≤ 40% or diabetes. [Display omitted] [ABSTRACT FROM AUTHOR]

There are sex differences in HF patients. It is not clear whether such differences mainly reflect cultural behaviours and clinical inertia, and the role of sex on clinical outcomes is still controversial. We aimed to investigate the association of sex with in-hospital management and outcomes in patients with HF. We analyzed data of 4016 adult patients hospitalized for HF in 2020 to 2021 and enrolled in a multicentre national registry. Women (n = 1,818 [45%]) were older than men (83 vs 77 years, P <.0001), with a higher prevalence of arterial hypertension (73% vs 69%, P =.011) and atrial fibrillation. Women presented more frequently with HF and preserved ejection fraction -HFpEF (55% vs 32%, P <.001). They were more often hospitalized in internal medicine departments (71% vs 51%), and men in highly specialized cardiology units (49% vs 29%). When considering HF pharmacological treatments at discharge in the subgroup with reduced ejection fraction -HFrEF (n=1525), there were no significant differences (49% of women treated with GDMT [guideline-directed medical therapy] vs 52% of men, P =.197). Sex was not associated either with hospital readmissions (30-days OR [95% CI] = 0.89 [0.71-1.11], P =.304; 1-year OR [95% CI] = 1.02[0.88-1.19], P =.777) or with mortality (in-hospital OR [95% CI] = 1.14 [0.73-1.78], P =.558; 1-year OR [95% CI] = 1.08 [0.87-1.33], P =.478). Similar results were obtained when considering different HF categories based on left ventricular ejection fraction. Women and men exhibited distinct clinical profiles. Although this may have had an impact on hospital pathways (noncardiology/cardiology units) and pharmacological prescriptions, sex per se did not appear as an independent determinant of clinical choices. Moreover, when considering homogeneous groups, women were not undertreated. Finally, female sex was not associated with worse clinical outcomes. Although women and men with heart failure exhibit different phenotypic profiles which in turn may impact on in-hospital management, sex per is not an independent determinant of either the choice of the admitting ward or the prescription of a guideline-directed medical therapy at discharge. Moreover, sex is not independently associated with poor outcomes. [Display omitted] [ABSTRACT FROM AUTHOR]

Genetic polymorphisms who disturb the mineral homeostasis during tooth development and eruption are candidate to clarify the molecular mechanisms involved in changes in the tooth eruption chronology. In this study, we evaluate whether the FokI (rs2228570) and BglI (rs739837) polymorphisms in the Vitamin D receptor (VDR) gene are associated with changes in the chronology of eruption of permanent teeth. This cross-sectional study randomly included 353 biologically unrelated children, both sexes, without systemic impairment or syndromes and history of trauma during the primary dentition. One operator perform the oral clinical examination. The tooth was considered erupted if there was a visible minimum of any tooth surface emerging from the mucosa. Genomic DNA was extracted from buccal epithelial cells from saliva samples. Genotyping was performed by Real-Time Polymerase Chain Reactions using TaqMan® technology. The average of the total number of erupted permanent teeth between the genotypes was compared by the Mann-Whitney test and multivariate Generalized Linear Models (GLM) (α = 5 %). β values with Confidence Interval (CI) 95 % were calculated. The heterozygous adenine-guanine genotype of the FokI significantly decreases the number of erupted permanent teeth (β = −1.15; CI 95 % = −2.22 to −0.07; p = 0.036). In the stratified analysis for maxillary and mandibular teeth, this genotype was associated with a decrease in the number of erupted maxillary permanent teeth (β = −0.65; CI 95 % = −1.22 to −0.09; p = 0.023). BglI was not associated with permanent teeth eruption. The FokI, but not BglI, in the VDR may delay the eruption of permanent teeth. [Display omitted] [ABSTRACT FROM AUTHOR]

Patients with refractory temporomandibular dysfunction (TMD) despite conservative therapies often require surgical intervention. Although techniques such as arthrocentesis or arthroscopy have been established for years, there remains a dearth of evidence regarding the long-term efficacy of these interventions. This preliminary prospective study aims to elucidate the outcomes of arthroscopic treatment conducted over five years ago in patients with temporomandibular dysfunction. A study involving 31 patients with temporomandibular dysfunction who underwent level II arthroscopic surgery prior to 2019 is presented. The principal objective parameter for joint function was mouth opening, while the primary subjective parameters included pain, which was measured using the visual analogue scale (VAS), and quality of life, assessed using the OHIP-14sp questionnaire. Objective parameters were assessed preoperatively at one year and five years postoperatively, while quality of life was evaluated both preoperatively and five years after the procedure. Subsequently, the long-term status of patients was analysed, including surgical outcomes and the necessity for supplementary techniques such as second arthroscopy or open surgery. The quality-of-life scores significantly improved (p < 0.001) after five years of follow up when compared with preoperative assessments. Pain levels exhibited a statistically significant decrease over the follow-up period (p < 0.001). Significant differences were observed between preoperative and both 12-months' and five-years' follow up (both p < 0.001) but not between the 12-month and five-year marks (p = 0.899). Similar trends were noted for maximum mouth opening, with differences between pre-surgery and both 12-months' and five-years' follow up (p = 0.049 and p = 0.005, respectively) but not between the 12-month and five-year assessments (p = 0.482). Mouth opening at 12 months (p = 0.003) and five years (p = 0.032), as well as OHIP results at five years (p = 0.003), demonstrated statistically significant differences between groups according to the final status. In all cases, poorer clinical outcomes post-surgery (requiring a second arthroscopy or meniscectomy) correlated with decreased mouth opening and worse OHIP results. Arthroscopy emerges as an effective technique in the long-term treatment of temporomandibular joint dysfunction, as parameters such as pain and maximum mouth opening improve, and this improvement remains stable at the five-year follow up. [ABSTRACT FROM AUTHOR]

Failing to address Obstructive Sleep Apnea (OSA) in Down Syndrome (DS) patients can have serious consequences, leading to increased mortality. Moreover, a notable portion of individuals find it challenging to tolerate Continuous Positive Airway Pressure (CPAP). Therefore, this study aims to share our experiences in treating adult DS patients with moderate to severe OSA who don't tolerate CPAP using various surgical approaches. A retrospective analytical study including 20 DS with moderate to severe/very severe OSA who had no tolerance to Continuous Positive Airway Pressure (CPAP) was conducted. Regarding the individual skeletal characteristics of each patient various orthognathic surgery techniques were performed. Two in-hospital polysomnographies (PSG) were undertaken for every patient; one before the surgical procedure, while another was performed between 6 and 60 months of the follow-up post-surgery period. Polysomnographic variables were analyzed in this study such as AHI, ODI, and T90, which all showed statistically significant improvement after surgery with a p value in the Wilcoxon test <0,01. These results have remained stable over time, with no recurrences of OSA observed over the five years of follow-up. Thus, orthognathic surgery may be the only viable option for individuals with DS who are unable to tolerate CPAP. • OSA and DS are strongly associated. • DS patients tolerate CPAP worse than non-syndromic ones. • Soft tissue surgery often leaves residual OSA. • Consider skeletal surgery for DS patients intolerant to CPAP. • Skeletal surgery has no higher morbidity in DS patients. [ABSTRACT FROM AUTHOR]

Adhesive capsulitis, or frozen shoulder, causes pain and reduces glenohumeral joint motion. This study aims to assesses ultrasound-guided hydrodistention with rehabilitation in hospital versus home settings. Forty patients with adhesive capsulitis were split into two groups: one received hydrodistention with hospital-assisted rehabilitation, and the other with home-based rehabilitation, following the same exercise protocol. Clinical assessments included range of motion (ROM), numeric pain rating scale (NPRS), shoulder pain and disability index (SPADI), disability of the arm, shoulder and hand (DASH), and assessment shoulder and elbow scale (ASES) The hospital-based group showed more rapid and substantial improvements in ROM and NPRS scores compared to the home-based group. The hospital-based group had a mean flexion ROM of 104.3 ± 31.6°, which increased to 149.5 ± 20.6° at the final follow-up. The home-based group started with a mean flexion ROM of 103.3 ± 29.2°, improving to 161.3 ± 23.2° by the end of the study. Both groups showed significant improvements, with the home-based group slightly outperforming in flexion ROM by the third follow-up. Initial NPRS scores were 4.7 ± 1.92 for the hospital-based group and 6.6 ± 1.63 for the home-based group. By the six-month mark, the hospital-based group's SPADI score dropped to 17.4 ± 19.5, while the home-based group's score was 10.5 ± 13.03. Both groups demonstrated significant improvements, with the hospital-based group showing slightly better outcomes at various follow-ups. Hydrodistention combined with supervised rehabilitation is optimal for treating frozen shoulder, though home-based therapy is also effective. Both methods significantly benefit from hydrodistention, highlighting its importance in treatment strategies. [ABSTRACT FROM AUTHOR]

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Paracoccidioidomycosis (PCM) is an endemic fungal disease that occurs in Latin America and primarily affects humans. The disease has been rarely documented in non-human primates. This report details a disseminated and fatal case of PCM caused by Paracoccidioides brasiliensis in a western black-handed tamarin (Saguinus niger) under human care. Histopathological examination revealed extensive pyogranulomatous inflammation in the lungs, spleen, liver, lymph nodes, kidneys, epididymis, right testicle, heart, adrenal gland and intestines, associated with characteristic yeast forms consistent with Paracoccidioides spp and confirmed by immunohistochemistry. Molecular analysis indicated a high nucleotide similarity with P. brasiliensis sequences for both the 18S rRNA and gp43 genes. This naturally occurring infection highlights the susceptibility of these animals to PCM and their role in ecoepidemiology warrants further investigation. [ABSTRACT FROM AUTHOR]

To evaluate the prevalence of cardiovascular autonomic neuropathy (CAN) and its associated factors in Brazilian patients with type 1 diabetes (T1D). This cross-sectional, multicentre study was conducted in 14 public clinics in ten Brazilian cities. From 1760 patients, 1712 were included (97.3 %): 953 females (55.7 %), 930 (54.3 %) Caucasians, aged 29.9 ±11.9 years and with diabetes duration of 15.4 ± 9.2 years. CAN was evaluated using cardiovascular autonomic reflex tests. The prevalence of CAN was 23.4 %. Multivariable hierarchical logistic regression showed CAN associated with age, smoking, lower socioeconomic status, higher yearly medical appointments, insulin therapeutic regimens, higher levels of HbA1c, total cholesterol, uric acid, diastolic blood pressure and heart rate, presence of retinopathy, diabetic kidney disease and a tendency to be associated with severe hypoglycemia. Lower health-related quality of life was also found in univariate analysis in these patients. Patients with T1D presented an important prevalence of CAN that was associated with other diabetes-related chronic complications, and also with demographic, clinical and laboratorial traditional risk factors. Considering lack of formal policy, our data could be used for guiding public health approach to awareness and CAN's screening, diagnosis and clinical management in patients with T1D in Brazil. • CAN prevalence was 23 % in Brazilian patients with type 1 diabetes. • CAN is underdiagnosed and associated with cardiovascular morbi-mortality. • CAN is associated with other diabetes-related chronic complications. • Age, HbA1c, total cholesterol, blood pressure, heart rate are risk factors for CAN. [ABSTRACT FROM AUTHOR]

• Graduate nursing students demonstrated high levels of blended learning satisfaction, self-efficacy, and work efficacy. • Graduate nursing students' self-efficacy increases if they are satisfied with the blended learning setup. • Self-efficacy directly influences nursing students' work readiness. • Blended learning satisfaction mediates the influence on nursing students' work readiness via self-efficacy. To determine the relationship between blended learning satisfaction with self-efficacy and the work readiness of nursing graduates. Blended learning is an educational approach to ensuring quality nursing education during the COVID-19 pandemic. However, examining the nursing students' blended learning satisfaction and its association with self-efficacy and work readiness remains underreported during the pandemic. A descriptive-correlational design using a structural equation modeling (SEM) approach. This study was participated by 208 nursing graduates recruited through consecutive sampling. Four self-report tools were used to collect data (Student Learning Satisfaction in a Blended Learning Satisfaction Tool [BLST], Nursing Self-Efficacy Tool [NSET], and Nursing Work Readiness Tool [NWRT]). Data analysis included descriptive statistics and SEM. The results indicated high levels of blended learning satisfaction (M = 2.88; SD = 0.45), self-efficacy (M = 3.25; SD = 0.35), and work readiness (M = 3.34; SD = 0.34). The emerging model demonstrated acceptable model fit indices, with self-efficacy increasing with blended learning satisfaction (p = 0.16) and a direct impact on work readiness (p = 0.73). In addition, blended learning satisfaction does not directly influence work readiness (p = −0.03) but has a mediating effect on work readiness through self-efficacy (p = 0.009). Nursing students who underwent blended learning in their senior year reported high levels of blended learning satisfaction, self-efficacy, and work readiness. Nursing students in a blended learning environment have the potential to be work-ready if they consider themselves self-efficacious and have the support of a suitable blended learning set-up. [ABSTRACT FROM AUTHOR]

The aim of the present article is to design a robust fractional-order (FO) finite-time (FnT) control able to tackle Hölder disturbances of second-order nonlinear systems. First, a novel sliding manifold with Arc-Tangent function is suggested for second nonlinear systems. It has been proven that the system states globally converge to the origin in FnT using the proposed sliding mode variable. To ensure a FnT stability of the sliding variable, a robust control is developed. By using fractional operators, a uniformly continuous control law is designed to tackle Hölder disturbances. Furthermore, the suggested approach is shown to be resistant to matched Hölder disturbances and uncertainties that are continuous but not necessarily differentiable. Moreover, the FnT stability of quadrotors using the proposed control, that is our second result. The quadrotor simulations analysis demonstrates the practicality of the proposed FnT controller in the presence of Hölder disturbances. • A simple nonlinear manifold design is proposed to ensure a finite-time convergence of quadrotors unlike the existing nonlinear sliding variables (Mousavi et al., 2021). • Hölder disturbances are addressed using fractional switching control law in the design of the proposed control scheme. • Compared to existing rejection disturbances (Ju et al., 2022; Labbadi and Cherkaoui, 2020; Razzaghian, 2022; Mousavi et al., 2021), the proposed FOFTC scheme has a faster convergence speed. [ABSTRACT FROM AUTHOR]

Recent innovations in Drug-Eluting Stents (DES) technology have led to the development of new stents with further reduction in strut width, the ultrathin DES, with struts thinner than 70 µm. Ultrathin DES may further improve the efficacy and safety profile of Percutaneous Coronary Intervention (PCI) by reducing the risk of target-lesion and target-vessel failures compared to the current-generation DES. However, the ultrathin DES metallic platform still presents some associated problems, such as biofilm formation, infection, and migration, all related to the cellular response. The present work aims to produce an ultrathin permanent polymeric platform for a new generation of polymeric drug-eluting stents (PDES). In this work, the cellular response was compared with the traditional stainless steel (SS316L) and polycaprolactone (PCL) to determine whether these polymers could address this challenge. An innovative method of tubular 3D micro stereolithography tubular (ST3DT) was used. Different PDES platforms were fabricated with different polymeric materials (based on polyurethane and urethane dimethacrylate). Subsequently, HFL1 fibroblasts were seeded on the PDES, PCL and SS316L for 3 days. The findings from the assays of cell biocompatibility and proliferation (75%PCL), coupled with the successful fabrication of stent struts below 70 µm using the Surgical Guide resin and the ST3DT method, suggest that resin is a promising candidate for a PDES. [ABSTRACT FROM AUTHOR]

To analyze the magnitude and direction of inter-limb asymmetries in vertical jump, T-test, isokinetic peak torque, and muscle volume in professional female soccer players. Sixteen female soccer players participated in the study (22.7 ± 3.5 years, 60.4 ± 12.7 kg, 164.2 ± 8.7 cm). The following tests were applied; the unilateral countermovement jump (CMJ), T-test (agility), peak torque of concentric knee extensor (PT_Con_Q), concentric and eccentric knee flexor (PT_Con_H; PT_Ecc_H), and muscle volume of quadriceps (MV_Q) and gastrocnemius (MV_G). The interlimb asymmetry magnitude was calculated as the percentage difference between the stronger and weaker limbs. For the direction of asymmetry, a negative sign (−) was assigned when the non-dominant lower limb was the stronger one, and a positive sign (+) when the dominant lower limb was the stronger one. The asymmetry (%) values varied from 0.7 to 11.9%, with the highest values of asymmetry found in the CMJ, PT_Con_Q, PT_Con_H, and PT_Ecc_H tests. Moderate levels of agreement were observed for CMJ - Vol_G (K = 0.53; 75% agreement); PT_Con_Q - PT_Con_H (K = 0.48; 75% agreement); T-test - PT_Ecc_H (K = 0.43; 68.7% agreement). Fair levels of agreement were found between the T-test - Vol_Q (K = 0.21; 62.1% agreement); PT_Con_Q - PT_Ecc_H (K = 0.36; 68.8% agreement); and PT_Con_H - PT_Ecc_H (K = 0.31; 68.8% agreement). We concluded that of greater asymmetries in the vertical jump and isokinetic torque tests. The direction of the asymmetry seems highly variable, however, the isokinetic tests showed greater agreements with the other tests. [ABSTRACT FROM AUTHOR]

To compare 2-year clinical outcomes of primary hip arthroscopy with versus without capsular closure after interportal capsulotomy in patients with cam- or mixed-type femoroacetabular impingement (FAI). Patients with cam- or mixed-type FAI undergoing primary hip arthroscopy with interportal capsulotomy were prospectively enrolled in this randomized controlled trial (RCT) and allocated into either capsular closure or no capsular closure groups. Patients were blinded to group allocation. Clinical outcomes were assessed preoperatively and at 2-year follow-up using the 12-item International Hip Outcome Tool (iHOT-12), modified Harris Hip Score (mHHS), and 6 subsections of the Copenhagen Hip and Groin Outcome Score (HAGOS). Complications and reoperations were noted. Eighty-four patients (100 hips) were enrolled, 49 hips in the capsular closure group and 51 in the no capsular closure group, with no significant differences in age (28.5 ± 7.5 vs 30.4 ± 8.4, P =.261), body mass index (23.5 ± 3.0 vs 23.4 ± 1.9, P =.665), and sex distribution (female: 10.2% vs 13.7%, P =.760). Four patients were lost to follow-up (2.0% vs 5.9%, P =.618) and 6 had reoperations (6.1% vs 5.9%, P = 1.000), which left 45 hips per group for clinical assessment. There were no significant differences between groups in the net change of iHOT-12 (28.3 ± 19.6 vs 32.5 ± 22.7, P =.388), mHHS (7.6 ± 13.1 vs 7.5 ± 10.2, P =.954), and subsections of HAGOS (P >.05). Complication rates were also similar between groups (P >.05). The present RCT compared primary hip arthroscopy with versus without capsular closure after interportal capsulotomy in a male-dominated, non-dysplastic, non-arthritic cohort with cam- or mixed-type FAI and found no significant differences in patient-reported clinical outcomes, complication rates, or reoperation rates. Level I, randomized controlled trial. [ABSTRACT FROM AUTHOR]

Because of the established contribution of social factors to health outcomes, approaches that address upstream determinants of health have increasingly been recognized as cost-effective means to improve population health. Understanding and usage of precise terminology is important to facilitate collaboration across disciplines. Social determinants of health affect everyone, not just the socially and economically disadvantaged, whereas health-related social risks (HRSR) are specific adverse conditions at the individual or family level that are associated with poor health and related to the immediate challenges individuals face. Health-related social needs account for patient preference in addressing identified social risks. The use of validated screening tools is important to capture risk factors in a standardized fashion to support research and quality improvement. There is a paucity of studies that address HRSR in the context of radiology. This review provides an understanding of HRSR and outlines various ways in which radiologists can work to mitigate them. [ABSTRACT FROM AUTHOR]

Seminal vesicles play a crucial role in the male reproductive system, as they are responsible for secreting a fluid that forms most of the ejaculate. Seminal vesicles' pathology can present with non-specific symptoms, making imaging diagnosis essential for proper patient management. Various imaging modalities can be used to evaluate these glands, with MRI beneficial in illustrating the spectrum of seminal vesicle disease. Typical seminal vesicles appear as elongated fluid-containing structures, but congenital anomalies, inflammatory conditions, and neoplastic disorders can alter their appearance. Furthermore, differentiating mimics from actual pathology can be challenging but crucial for proper management. This article aims to provide an overview of the typical imaging appearance of the seminal vesicles and illustrate the principal imaging characteristics of conditions involving these structures. It will review the imaging characteristics of common and uncommon lesions involving the seminal vesicles by exploring congenital, infectious, and neoplastic in detail. As the seminal vesicles are often evaluated incidentally during prostate imaging, radiologists should be aware of the variability of normal findings and recognize the principal pathologies affecting these structures to ensure proper patient management. [ABSTRACT FROM AUTHOR]

The FAST-Forward scheme is an adjuvant radiotherapy protocol for breast cancer treatment. In this study, we analyze a patient database treated with this scheme to demonstrate its non-inferiority to the standard protocol in terms of local tumor control and safety regarding toxicity. Our findings support the continued use of the FAST-Forward scheme in clinical practice. Additionally, we employ machine learning techniques to identify subgroups of patients with similar characteristics and uncover clinically relevant patterns. These algorithms have enabled us to define three distinct patient profiles based on treatment regimen, molecular subtype, and toxicity outcomes. Furthermore, we observed a correlation between maximum skin dose and long-term induration, as well as the impact of breast volume on short-term hyperpigmentation. [ABSTRACT FROM AUTHOR]

The aim of this study was to present the development of a database (dataset) of panoramic radiographs. Three radiologists labeled an image set consisting of 936 panoramic radiographs. Labeling includes tooth numbering (including teeth present and missing) and annotation of dental conditions (e.g., caries, dental restoration, residual root, endodontic treatment, implant, fixed prosthesis, incisal wear). The annotation process was performed in a Picture Archive and Communication System software customized for the study purposes using a small bounding box to delimit the entire tooth and items for radiographic diagnosis and a large bounding box to simultaneously delimit the 2 dental arches (maxilla and mandible). A JSON file was generated for each annotation. The database encompassed 23,619 annotations; disagreement between radiologists occurred in 0.7% of the notes. This work aimed to inform researchers about the importance of the labeling process, in addition to providing the scientific community with a bank of labeled images to implement artificial intelligence systems in clinical practice. [ABSTRACT FROM AUTHOR]

Simulation-based learning experiences allow undergraduate nursing students to develop competence and confidence through deliberate practice with immediate feedback on the learner's performance through debriefing. With the transition to competency-based nursing education, nursing faculty need more guidance in implementing competency-based evaluations in the simulation setting. This Delphi study aims to inform the future development of a competency-based tool – SimComp – based on the American Association of Colleges of Nursing (AACN) Essentials. A Delphi framework was used to recruit expert nursing faculty to complete the surveys via an online platform. Data analysis occurred through open-ended questions and quantitative methods to ensure that the responses from expert panelists were used to form the results. After four rounds of this Delphi study, a consensus was achieved on 111 appropriate items for assessing competence in the simulation-based learning environment. While further research is warranted, this study provides insight for nursing institutions considering implementing or increasing the use of simulation within their program for competency-based evaluations. • Simulation-Based Experiences allow learners to develop competence and confidence. • Consensus was reached among experts on 111 items for assessing competence in SBE. • The results serve as a basis for evaluating entry-level nursing competence in SBE. [ABSTRACT FROM AUTHOR]

The pathogenesis of recurrent chronic dislocation of the temporomandibular joint has been attributed to multiple factors, such as hyperlaxity of the soft tissues or alterations in the size of the temporal eminence. When there are no bone alterations, the injection of sclerosing solutions is an effective treatment that can be performed using a blind technique or with arthroscopy. This study presents an innovative technique for injecting ethoxysclerol into the posterior ligament through single puncture arthroscopy. This approach offers a safe and effective alternative for surgeons without experience in high-complexity arthroscopy who want to ensure precise injection of the agent into the desired anatomical areas. [ABSTRACT FROM AUTHOR]

The management of infected temporomandibular joint prostheses presents a surgical challenge. In certain instances, an intermediate approach involving biofilm debridement and local antibiotic instillation may obviate the need for prosthesis removal. This technical note describes an update of the technique outlined by Wolford for managing infections, in which improved materials are used to implement the technique. [ABSTRACT FROM AUTHOR]

Due to the complex nature of coastal dynamics, several models were developed to estimate longshore sediment transport (LST) rates. The Coastal Engineering Research Center (CERC), Kamphuis, and Bayram models are among the most used and were applied to three east–west oriented sandy urban beaches from Rio de Janeiro (southeastern Brazil): Macumba, Recreio, and Barra da Tijuca. The wave record from oceanographic buoys and the WaveWatch III (WW3) model were used to identify fairweather periods and increased storminess between 2016 and 2018. Eastwards, median sediment grain-size grades from coarse to medium sand, and is associated with decreasing beach slopes in the same direction. The magnitude of the estimated LST rates varied significantly between the models (Δ ≈ 1,000 m3/day, p < 0.001), although the time-averaged LST rates obtained from the four models indicate eastward transport. The four models identified areas of convergence and divergence of sediment transport with increasing rates to the east. The modeling results may support effective coastal management initiatives when integrated with topographic profiles, numerical modeling, satellite imagery, and historical information. [ABSTRACT FROM AUTHOR]

[Display omitted] Airflow limitation is a hallmark of chronic obstructive pulmonary disease, which can develop through different lung function trajectories across the life span. There is a need for longitudinal studies aimed at identifying circulating biomarkers of airflow limitation across different stages of life. This study sought to identify a signature of serum proteins associated with airflow limitation and evaluate their relation to lung function longitudinally in adults and children. This study used data from 3 adult cohorts (TESAOD [Tucson Epidemiological Study of Airway Obstructive Disease], SAPALDIA [Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults], LSC [Lovelace Smoker Cohort]) and 1 birth cohort (TCRS [Tucson Children's Respiratory Study]) (N = 1940). In TESAOD, among 46 circulating proteins, we identified those associated with FEV 1 /forced vital capacity (FVC) percent (%) predicted levels and generated a score based on the sum of their z -scores. Cross-sectional analyses were used to test the score for association with concomitant lung function. Longitudinal analyses were used to test the score for association with subsequent lung function growth in childhood and decline in adult life. After false discovery rate adjustment, serum levels of 5 proteins (HP, carcinoembryonic antigen, ICAM1, CRP, TIMP1) were associated with percent predicted levels of FEV 1 /FVC and FEV 1 in TESAOD. In cross-sectional multivariate analyses the 5-biomarker score was associated with FEV 1 % predicted in all adult cohorts (meta-analyzed FEV 1 decrease for 1-SD score increase: −2.9%; 95% CI: −3.9%, −1.9%; P = 2.4 × 10−16). In multivariate longitudinal analyses, the biomarker score at 6 years of age was inversely associated with FEV 1 and FEV 1 /FVC levels attained by young adult life (P =.02 and.005, respectively). In adults, persistently high levels of the biomarker score were associated with subsequent accelerated decline of FEV 1 and FEV 1 /FVC (P =.01 and.001). A signature of 5 circulating biomarkers of airflow limitation was associated with both impaired lung function growth in childhood and accelerated lung function decline in adult life, indicating that these proteins may be involved in multiple lung function trajectories leading to chronic obstructive pulmonary disease. [ABSTRACT FROM AUTHOR]

Cardiac resynchronization therapy (CRT) with biventricular pacing (BVP) is a well-established therapy in patients with reduced left ventricular ejection fraction, heart failure, and left bundle branch block. Left bundle branch area pacing (LBBAP) has recently been shown to be a feasible and effective alternative to BVP. Comparative data on the risk of complications between LBBAP and BVP among patients undergoing CRT are lacking. The aim of this study was to compare the long-term risk of procedure-related complications between LBBAP and BVP in a cohort of patients undergoing CRT. This prospective, multicenter, observational study enrolled 668 consecutive patients (mean age 71.2 ± 10.0 years; 52.2% male; 59.4% with New York Heart Association class III-IV heart failure symptoms) with left ventricular ejection fraction 33.4% ± 4.3% who underwent BVP (n = 561) or LBBAP (n = 107) for a class I or II indication for CRT. Propensity score matching for baseline characteristics yielded 93 matched pairs. The rate and nature of intraprocedural and long-term post-procedural complications occurring during follow-up were prospectively collected and compared between the 2 groups. During a mean follow-up of 18 months, procedure-related complications were observed in 16 patients: 12 in BVP (12.9%) and 4 in LBBAP (4.3%) (P =.036). Compared with patients who underwent LBBAP, those who underwent BVP showed a lower complication-free survival (P =.032). In multivariate analysis, BVP resulted an independent predictive factor associated with a higher risk of complications (hazard ratio 3.234; P =.042). Complications related to the coronary sinus lead were most frequently observed in patients who underwent BVP (50.0% of all complications). LBBAP was associated with a lower long-term risk of device-related complications compared with BVP in patients with an indication for CRT. [ABSTRACT FROM AUTHOR]

The long-term effectiveness of prostatic artery embolization (PAE) can be hampered by the recanalization of the previously embolized prostatic arteries (PA). The use of a liquid embolic agent (LEA) could limit this risk. The purpose of this study was to assess the safety and efficacy of repeat PAE (rePAE) using a LEA (Squid Peri) coupled with microspheres in patients experiencing recurring symptoms after initial embolization. This retrospective single-center study included all consecutive patients who underwent rePAE using Squid Peri coupled with microspheres. Angiographic patterns of prostatic revascularization were identified. Outcomes were assessed at the 3-month follow-up using the International Prostate Symptom Score (IPSS) and the Quality of Life (QoL) score. The primary endpoint was clinical success defined as an IPSS < 18 with > 25% decrease and a QoL score ≤ 3 with ≥ 1 point decrease. Safety was assessed by using the modified Clavien–Dindo classification. 30 consecutive men (mean age: 67.1 ± 9.5 years) were included. Recanalization of the previously embolized PA was found in 83.3% of patients. Technical success was 93.3%. Median follow-up was 4.9 months [IQR: 3.9 – 9.8]. Clinical success rate was 76.7%, with a mean decrease in IPSS of −9.3 ± 7.3 (p < 0.001) and a median decrease in QoL of −2 [IQR: − 4 – − 1] (p < 0.001). One patient presented with an acute urinary retention requiring readmission (grade IIIa complication). Repeat PAE using Squid Peri coupled with microspheres is safe and effective for patients with recurring symptoms after initial embolization. [ABSTRACT FROM AUTHOR]

There are limited real-world data on the extended prognosis of patients with drug-induced type 1 Brugada electrocardiogram (ECG). We assessed the clinical outcomes and predictors of life-threatening arrhythmias in patients with drug-induced type 1 Brugada ECG. This multicenter retrospective study, conducted at 21 Italian and Swiss hospitals from July 1997 to May 2021, included consecutive patients with drug-induced type 1 ECG. The primary outcome, a composite of appropriate ICD therapies and sudden cardiac death, was assessed along with the clinical predictors of these events. A total of 606 patients (mean age 49.7 ± 14.7 years; 423 [69.8%] men) were followed for a median of 60.3 months (interquartile range 23.0–122.4 months). Nineteen patients (3.1%) experienced life-threatening arrhythmias, with a median annual event rate of 0.5% over 5 years and 0.25% over 10 years. The SCN5A mutation was the only predictor of the primary outcome (hazard ratio 4.54; P =.002), whereas a trend was observed for unexplained syncope (hazard ratio 3.85; P =.05). In patients who were asymptomatic at presentation, the median annual rate of life-threatening arrhythmias is 0.24% over 5 years and increases to 1.2% if they have inducible ventricular fibrillation during programmed ventricular stimulation. In patients with drug-induced type 1 Brugada ECG, the annual risk of life-threatening arrhythmias is low, with the SCN5A mutation as the only independent predictor. Unexplained syncope correlated with worse clinical outcomes. Ventricular fibrillation inducibility at programmed ventricular stimulation significantly increases the median annual rate of life-threatening arrhythmias from 0.24% to 1.2% over 5 years. [Display omitted] [ABSTRACT FROM AUTHOR]

The growing threat from pre-extensively drug-resistant tuberculosis (pre-XDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) poses a major public health concern in Latin America and the Caribbean (LAC). Therefore, this study aimed to summarize the available evidence on the prevalence of pre-XDR-TB and XDR-TB among patients with multidrug-resistant tuberculosis in LAC. A systematic review was conducted in the following databases on June 3, 2023: PubMed, Scopus, Ovid Medline, Web of Science, Scielo and LILACS. We estimated pooled proportions using a random effects model (Dersimonian and Laird). The 95% confidence intervals (95% CI) were calculated using the binomial exact method (Clopper-Pearson Method). Subgroup (by time period and country) and sensitivity analyses were performed. Twenty-nine studies were eligible for qualitative synthesis and 27 for meta-analysis (n = 15,565). The pooled prevalence of XDR-TB in the study participants was 5% (95% CI: 3%-6%), while that of pre-XDR-TB was 10% (95% CI 7%-14%). Cuba (6%, 95% CI 0%-17%) and Peru (6%, 95% CI 5%-7%) had the highest pooled prevalence of XDR-TB. Regarding pre-XDR-TB, Brazil (16%, 95% CI 11%-22%) and Peru (13%, 95% CI: 9%-16%) showed the highest prevalence. The pooled prevalence of pre-XDR-TB and XDR-TB in LAC was 10% and 5%, respectively. Governments should strengthen drug-resistance surveillance and TB programs. • The pooled prevalence of XDR-TB in LAC was 5%, being higher in Cuba and Peru. • The pooled prevalence of pre-XDR-TB in LAC was 10%, being higher in Brazil and Peru. • The highest prevalence of pre-XDR-TB was 12% between 2014 and 2020. • There was significant heterogeneity and high risk of bias in most of included studies. [ABSTRACT FROM AUTHOR]

Sandblasting is a standard procedure used for treating dental implant (DI) surfaces to enhance the osseointegration with known clinical success. This clinical study aimed to evaluate the long-term clinical outcomes of DIs with external hexagon connections and a surface sandblasted with calcium phosphate. Two hundred and seventy-five Mg-osseous™ (Mozo-Grau™) screw DIs were placed in 86 patients using a two-stage surgical technique and conventional loading protocol (at three months). Dental implants and prosthetic clinical findings were evaluated during a 17-year follow up. Four DIs were lost during the healing period, and 108 prostheses were placed over the 271 DIs left: 58 unitary implant-supported prosthesis (ISP), 31 partially ISP, 14 full-arch ISP, and five overdentures. Fourteen DIs were lost during the follow-up period. Clinical results indicated a DI survival rate of 93.50%. A total of 11.80% of DIs showed peri-implantitis as the primary biological complication. The mean (SD) marginal bone loss was 1.78 (0.40) mm, ranging from 0.90 to 2.80 mm. The most frequent complication was mechanical prosthodontic complications (24.40%). Sandblasted surface DIs inserted in both maxillary and mandibular areas produce favourable long-term (17-year follow up) outcomes and stable tissue conditions when a delayed loading protocol is followed. [ABSTRACT FROM AUTHOR]

The Laser Metal Deposition (LMD) is emerging among the additive manufacturing (AM) technologies of metals for its versatility. It takes advantage of the flexibility of a laser source and a powder flow to fabricate or repair components with very complex features. The challenging process conditions that characterize the processing of metallic materials (temperatures and stresses) underlie the occurrence of several defects that plague such AM processes. Thus, the necessity to develop monitoring systems that can comprehensively analyze the production phase arises. In the present work, an innovative off-axis optical system consisting of three cameras with appropriate filters is proposed for the monitoring of LMD process. The peculiarity of this system lies in the capability of monitoring the spatial evolution of the melt pool, enabling eventually a complete control of the deposition process. In fact, through the use of properly developed image processing algorithms, the system enables the tridimensional definition of the size and shape of the melt pool and at the same time the reconstruction of each deposited layer. The potential of the monitoring system was tested on a series of thin-walled components. Subsequently, the analysis results were validated by comparison with 3D scanning of the parts and analyses performed using a coaxial monitoring system. [ABSTRACT FROM AUTHOR]

Laser Metal Deposition (LMD) is one of the most promising Additive Manufacturing (AM) technologies for the fabrication, coating and repair of metal components. Although, due to the high number of factors influencing the process, defects may arise, as geometrical and dimensional inaccuracies, high residual stresses and internal voids, with effects on the quality and the mechanical performances of the produced parts. Thus, the need for in-process monitoring systems capable of timely detecting the onset of defects and process anomalies emerged. In this work, an in-process monitoring system suitable for LMD was presented. It consisted of an industrial CMOS camera placed in the LMD machine chamber and set for the acquisition of images showing the melt pool area. Through the use of properly developed image processing algorithms, the monitoring system was capable to extract in-process the melt pool 2D spatial coordinates and to depict the geometry of the fabricated samples. Moreover, specific indexes related to the deposited height were computed in order to evaluate the quality of the process/product. The potentiality of such monitoring method lies in the simplicity of the equipment, and, mostly, in the possibility of monitoring the spatial evolution of the melt pool without interrupting the process and enabling, eventually, a further control of the LMD process. The monitoring system was tested on two 316L thin-walled components and results were validated by comparing the data obtained from the monitoring with a consolidated post-process 3D scanning method. [ABSTRACT FROM AUTHOR]

In recent years, improvement of Health-Related Quality of Life (HRQoL) in Ulcerative colitis (UC) has become a relevant measure for treatment efficacy. We report results from a multicenter prospective study in Italy investigating HRQoL in adult patients with UC treated with golimumab (GLM). Patients who had shown clinical response after a 6-week induction phase (w0), were followed for an additional 48 weeks (w48) (total 54-week treatment). Of the 159 patients enrolled 90 completed the study. Compared to values at the beginning of treatment (n = 137), significant improvements were observed for mean total Inflammatory Bowel Disease Questionnaire (IBDQ) scores at w0 (168.5) and w48 (181.7). Patients with baseline PMS above the median tended to have greater improvements in IBDQ at w0 (OR 2.037, p = 0.033) and w48 (OR 3.292, p = 0.027). Compared to beginning of GLM treatment, the mean Full Mayo Score (FMS) decreased by 5.9 points at w48, while mean Partial Mayo Score (PMS) decreased by 3.9 points at w0 and by 4.9 points at w48. GLM improved HRQoL, disease activity and inflammatory biomarkers in UC patients with moderate-to-severely active disease. The greater the burden of disease activity at baseline, the greater the improvement of HRQoL after 24 and 48 weeks of treatment. [ABSTRACT FROM AUTHOR]

The goal of our study is to compare the stability of the anatomic reconstruction of the anterior talofibular ligament (ATFL) with direct repair of the ATFL, in a cadaver model. We performed the following techniques in 18 cadaveric ankles: the intact ATFL was cut, after which a direct repair using 2 anchors was performed. The repair was sectioned, and anatomic reconstruction was then performed with a tendon autograft. We measured angular displacement in 3 anatomic planes (axial, coronal, sagittal) for each situation in response to the anterior drawer test (ADT), talar tilt test (TTT) and pivot test (PT), using a specifically constructed arthrometer. The sectioned ATFL was inferior to the intact ATFL in the axial plane with the ADT (p =.012), in the axial plane with the PT (p =.001) and in the axial and coronal planes with the TTT (p =.013 and p =.016, respectively). Direct anatomic repair was inferior to the intact ATFL in the axial plane upon the PT (p =.009). No differences could be found between anatomic graft reconstructions and the intact ATFL with any manoeuver, nor when comparing anatomic graft reconstruction and direct repair with 2 anchors. We were able to conclude that anatomic graft reconstruction of the ATFL reproduces angular stability of the native ligament in a cadaver model. While we could not detect if anatomic graft reconstruction was superior to direct repair, the latter proved to be less stable in the axial plane upon internal rotation (pivot test) versus the intact ATFL. [ABSTRACT FROM AUTHOR]

Range of motion (ROM) is an outcome measure commonly used when treating acute and chronic hand injuries and conditions. Increased adoption of telehealth service provision in hand therapy practice, influenced by the advent of COVID-19, has led to the need for a valid and reliable approach to measure the range of motion of the digits of the hand when providing hand therapy services using telehealth. To determine if performing manual goniometry during a livestream teleconsultation is reliable and clinically useful to measure the range of motion of the fifth digit when providing hand therapy services using telehealth. Clinical measurement, repeated-measures study. According to a measurement protocol, 12 independent raters (who currently provide hand therapy services) each obtained several screen-based goniometric range of motion measurements of the fifth digit at 2-time points. Raters were surveyed on the clinical utility of the telehealth-based goniometry approach. Measures of relative and absolute reliability were calculated to evaluate test-retest and inter-rater reliability. Free-text responses were analyzed using content analysis. Inter-rater reliability was excellent for all flexion and extension measures (intraclass correlation coefficient [ICC] ≥ 0.89) but poor for the arc of motion (ICC ≤ 0.67). Test-retest reliability was poor (ICC ≤ 0.43). No statistically significant differences between test and retest measurements were observed (P ≥ 0.24). The overall coefficient of variation indicated good precision (14.69%). Measurement error (≤6.07º) and limits of agreement (≤6.33) had acceptable levels to support clinical use. Content analysis revealed several practical considerations. This study suggests that performing manual goniometry during a livestream teleconsultation is unreliable for measuring the range of motion of the fifth digit. However, when combined with patient-reported and functional outcomes, this approach may be suitable to facilitate a range of motion assessment for certain functions of telehealth service provision in hand therapy practice. • A telehealth-based goniometry approach facilitates virtual hand therapy assessment. • This method has acceptable measurement error (<5º) but poor test-retest reliability. • Inter-rater reliability varies among 12 hand therapy clinicians (ICC, 0.98–0.19). • Telehealth use in hand therapy has decreased following the height of COVID-19. • Comparison with a valid reference standard is recommended for future research. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Children with low income and minority race and ethnicity have worse hospital outcomes due partly to systemic and interpersonal racism causing communication and system barriers. We tested the feasibility and acceptability of a novel inpatient communication-focused navigation program. METHODS: Multilingual design workshops with parents, providers, and staff created the Family Bridge Program. Delivered by a trained navigator, it included 1) hospital orientation; 2) social needs screening and response; 3) communication preference assessment; 4) communication coaching; 5) emotional support; and 6) a post-discharge phone call. We enrolled families of hospitalized children with public or no insurance, minority race or ethnicity, and preferred language of English, Spanish, or Somali in a single-arm trial. We surveyed parents at enrollment and 2 to 4 weeks post-discharge, and providers 2 to 3 days post-discharge. Survey measures were analyzed with paired t tests. RESULTS: Of 60 families enrolled, 57 (95%) completed the follow-up survey. Most parents were born outside the United States (60%) with a high school degree or less (60%). Also, 63% preferred English, 33% Spanish, and 3% Somali. The program was feasible: families received an average of 5.3 of 6 components; all received > 2. Most caregivers (92%) and providers (81% [30/37]) were "very satisfied." Parent-reported system navigation improved from enrollment to follow-up (+8.2 [95% confidence interval 2.9, 13.6], P = .003; scale 0-100). Spanish-speaking parents reported decreased skills-related barriers (-18.4 [95% confidence interval -1.8, -34.9], P = .03; scale 0-100). CONCLUSIONS: The Family Bridge Program was feasible, acceptable, and may have potential for overcoming barriers for hospitalized children at risk for disparities. [ABSTRACT FROM AUTHOR]

Patients with cancer who receive allogeneic red blood cell transfusions are at risk of adverse reactions of varying severity. One of these reactions is immunomodulation, also known as transfusion-related immunomodulation. With the exact mechanism of transfusion related immunomodulation being unclear, storage lesions (both the cellular and cytokine component) are considered a major contributor. Leucocytes are believed to be implicated in storage lesions and immunomodulation. However, the efficacy of leucodepletion in reducing immunomodulation is controversial. The theoretical link between these three interconnected events - storage lesions, immunomodulation and cancer progression remain controversial and poorly understood. This article summarizes the available evidence on efficacy of leucodepletion, storage lesions and transfusion related immunomodulation, while rationalizing the possible association between an immunomodulation triggering transfusion 'dose' in cancer patients and subsequent cancer recurrence. [ABSTRACT FROM AUTHOR]

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Myocardial infarction (MI) with non-obstructed coronary arteries (MINOCA) is an increasingly recognized condition with challenging management. Some MINOCA patients ultimately experience recurrent acute MI (re-AMI) during follow-up; however, clinical and angiographic factors predisposing to re-AMI are still poorly defined. In this retrospective multicenter cohort study we enrolled consecutive patients fulfilling diagnostic criteria of MINOCA according to the IV universal definition of myocardial infarction; characteristics of patients experiencing re-AMI during the follow-up were compared to a group of MINOCA patients without re-AMI. 54 patients (mean age 66 ± 13) experienced a subsequent re-AMI after MINOCA and follow-up was available in 44 (81%). Compared to MINOCA patients without re-AMI (n = 695), on first invasive coronary angiography (ICA) MINOCA patients with re-AMI showed less frequent angiographically normal coronaries (37 versus 53%, p = 0.032) and had a higher prevalence of atherosclerosis involving 3 vessels or left main stem (17% versus 8%, p = 0.049). Twenty-four patients (44%) with re-AMI underwent a new ICA: 25% had normal coronary arteries, 12.5% had mild luminal irregularities (<30%), 20.8% had moderate coronary atherosclerosis (30–49%), and 41.7% showed obstructive coronary atherosclerosis (≥50% stenosis). Among patients undergoing new ICA, atherosclerosis progression was observed in 11 (45.8%), 37.5% received revascularization, only 4.5% had low-density lipoprotein cholesterol (LDL_C) under 55 mg/dL and 33% experienced a new cardiovascular disease (CVD) event (death, AMI, heart failure, stroke) at subsequent follow-up. In the present study, only a minority of MINOCA patients with re-AMI underwent a repeated ICA, nearly one out of two showed atherosclerosis progression, often requiring revascularization. Recommended LDL-C levels were achieved only in a minority of the cases, indicating a possible underestimation of CVD risk in this population. [ABSTRACT FROM AUTHOR]

• What is the primary question addressed by this study? In previous research studies, is there evidence of a link between post-traumatic stress disorder (PTSD) and risk for a subsequent degenerative synucleinopathy, i.e., Parkinson's disease (PD) and related disorders? • What is the main finding of this study? Our systematic literature search identified six articles containing seven unique study samples (total n = 1,747,378); five of these articles were registry-based. Meta-analysis of hazard ratios (HR) from four retrospective cohort studies supported the hypothesis that PTSD was associated with incident Parkinson's disease and Lewy body dementia (pooled HR 1.88, 95% C.I. 1.08–3.24; p = 0.035). • What is the meaning of the finding? This preliminary evidence for an association between adult-onset PTSD and later development of PD and related degenerative synucleinopathies provides a basis for understanding how presence of certain psychiatric conditions affects risk for neurodegenerative diseases and development of interventions that mitigate that risk. A systematic review was conducted to answer whether adult-onset post-traumatic stress disorder (PTSD) is associated with increased risk of Parkinson's disease (PD) and related synucleinopathies. A systematic search of Medline (Ovid), Embase (Elsevier), PsycInfo (Ovid), Cochrane Library (Wiley), and Web of Science (Clarivate) was performed using MeSH headings and equivalent terms for PTSD, PD, DLB, and related disorders. No restrictions. Eligible articles were published in peer-reviewed journals, sampled adult human populations, and treated PTSD and degenerative synucleinopathies as exposures and outcomes, respectively. Extracted data included diagnostic methods, sample characteristics, matching procedures, covariates, and effect estimates. Bias assessment was performed with the Newcastle-Ottawa scale. Hazard ratios were pooled using the random effects model, and the Hartung-Knapp adjustment was applied due to the small number of studies. A total of six articles comprising seven unique samples (total n = 1,747,378) met eligibility criteria. The risk of PD was reported in three retrospective cohort studies and one case-control study. Risk of DLB was reported in one retrospective cohort, one case-control, and one prospective cohort study. No studies addressed potential relationships with multiple system atrophy or pure autonomic failure. Meta-analysis of hazard ratios from four retrospective cohort studies supported the hypothesis that incident PTSD was associated with PD and DLB risk (pooled HR 1.88, 95% C.I. 1.08–3.24; p = 0.035). The sparse literature to-date supports further investigations on the association of mid- to late-life PTSD with Parkinson's and related neurodegenerative disorders. [ABSTRACT FROM AUTHOR]

This study assessed flavored tobacco use among adolescent e-cigarette, cigarette, cigar, hookah, and smokeless tobacco users; specific e-cigarette flavor preferences; risk profiles of youth that use various flavors; and the impact of survey question wording on prevalence. Cross-sectional data from 4,956 California adolescent participants (aged 12–17 years) in the Teens, Nicotine, and Tobacco 2021–2022 online panel survey estimated the survey-weighted prevalence of flavored tobacco use. An embedded randomized experiment assessed survey wording effects (i.e., any vs. "usual" flavor use). Qualitative data from four contemporaneous cycles of Teens, Nicotine, and Tobacco focus groups with California adolescents (N = 63) added themes relevant to the quantitative findings. 88.1% of current any tobacco users reported flavored tobacco use in the past 30 days. Flavor use was lowest for cigarettes (66.7%) and highest for hookah (92.8%). Fruit was the most popular e-cigarette flavor (51.6% any use; 28.8% usual use). E-cigarette users also commonly reported use of candy and cooling flavors. Sweet flavors were used most often among adolescents otherwise at low risk of tobacco use. Survey item format did not meaningfully affect overall prevalence of flavored product use but did impact reports of specific e-cigarette flavors. Focus group participants described sweet and fruity flavors as a motivating factor in their own e-cigarette use and as designed to appeal to children. Despite local policies, flavored tobacco use remains common among California adolescents. Survey items asking about any flavor use rather than usual use provide more information without affecting the overall prevalence of flavored tobacco use. [ABSTRACT FROM AUTHOR]

Chorioamnionitis is an adverse condition in human pregnancy caused by many bacterial pathogens including Escherichia coli (E. coli); which has been associated with higher risk of preterm birth. We recently reported that human maternal decidua (MDec) tissue responds to E. coli infection by secreting extracellular heat-shock proteins (e Hsp)-60, −70 and interlukin-1β (IL-1β). Previous studies have shown that progesterone (P4) regulates the immune response, but it is unknown whether P4 inhibits the secretion of e Hsp. The aim of this investigation was to determine the role of P4 on the secretion of e Hsp-27, -60, −70 and IL-1β in MDec after 3, 6, and 24 h of E. coli infection. Nine human feto-maternal interface (HFMi) tissues were included and mounted in the Transwell culture system. Only the maternal decidua (MDec) was stimulated for 3, 6 and 24 h with E. coli alone or in combination with progesterone and RU486. After each treatment, the HFMi tissue was recovered to determine histological changes and the culture medium recovered to evaluate the levels of e Hsp-27, -60, −70 and IL-1β by ELISA and mRNA expression by RT-PCR. No structural changes were observed in the HFMi tissue treated with P4 and RU486. However, stimulation with E. coli produces diffuse inflammation and ischemic necrosis. E. coli induced infection decreases, in time- and dose-dependent manner, e Hsp-27 and increases e Hsp-60, e Hsp-70 and IL-1β levels. In contrast, incubation of HFMi tissue with E. coli + P4 reversed e Hsp and IL-1β secretion levels relative to E. coli stimulation group but not relative to the control group. The same profile was observed on the expression of e Hsp-27 and e Hsp-60. we found that progesterone modulates the anti-inflammatory (e Hsp-27) and pro-inflammatory (e Hsp-60 and e Hsp-70) levels of e Hsp induced by E. coli infection in human choriodecidual tissue. e Hsp-60 and e Hsp-70 levels were not completely reversed; maintaining the secretion of IL-1β, which has been associated with adverse events during pregnancy. [Display omitted] • Establish whether P4 regulates eHsp and IL-1β induced by E. coli infection in human choriodecidual tissue. • P4 increases secretion of eHsp-27 and reduces eHsp-60 and eHsp-70. • The secretion of Hsp-60 and -70 favor the IL-1β pathway. • These results provide an insight on P4 lack of effectiveness to reduce IL-1β levels described in clinical trials. [ABSTRACT FROM AUTHOR]

The problem of state observation in incommensurate fractional order systems has been poorly studied. Currently some observers that have been proposed are based on a copy of the system, which causes them to be highly dependent on the system parameters, additionally they are redundant (estimate variables that are available). So this paper proposes a novel fractional observer against parametric uncertainties for a certain type of incommensurate fractional order systems. The fractional observer design is based on a property concerning observability in incommensurate fractional order systems which allows us to construct the observer only considering the available output and its fractional derivatives. On the other hand, the convergence analysis of the observation error is carried out using a particular approach of fractional order systems related to the Global Mittag-Leffler boundedness. We prove that there is a compact set GMLA (Globally Mittag-Leffler Attractive, according to Definition 4) where the system that represents the observation error dynamics is attractive and we also prove that the observation error is uniformly bounded. Additionally, the fractional observer is model-free i.e., a system copy is not required, this gives robustness in spite of parametric uncertainties and it is also reduced order therefore one observer must be designed for each variable that we want to estimate consequently the observer is non-redundant (no estimation of variables that are already available). Moreover, our proposed fractional observer can be designed for commensurate fractional order systems and we also show that if we consider integer derivative order, the proposed fractional observer presents certain properties. Finally, in order to show the effectiveness of the proposed fractional observer, an incommensurate fractional order Rössler hyperchaotic system is considered as a numerical example and an incommensurate fractional model of the COVID-19 pandemic as a real-world application. • A fractional PI observer for incommensurate fractional order systems is presented. • Fractional systems with parametric uncertainty are considered. • The observation error dynamics is Globally Mittag-Leffler bound. • The proposed fractional observer is model-free, no copy of the system is required. • Development of a non redundant fractional observer. [ABSTRACT FROM AUTHOR]

Arthroscopy of the temporomandibular joint is a minimally invasive surgical procedure. Nowadays, 3 levels are described depending on the complexity. Level I involves a single puncture with an anterior irrigating needle for outflow. Level II involves a double puncture using triangulation in order to be able to perform minor operative maneuvers. Subsequently, it is possible to progress to Level III and perform more advanced techniques, through multiple punctures, involving the arthroscopic canula and 2 or more working cannulas. However, in cases of advanced degenerative pathology or re-arthroscopy, it is common to observe advanced fibrillation, severe synovitis, adhesions, or articular obliteration which makes conventional triangulation difficult. On these cases, we propose a simple and effective technique that facilitates approach to the intermediate space by means of triangulation with transillumination reference. [ABSTRACT FROM AUTHOR]

Physical activity (PA), social networks, and social support have been associated with decreased mortality and improved quality of life among breast cancer survivors (BCS). This study used social network analysis to understand the social co-benefits of a community-based PA program for BCS in Colombia. Two types of social support networks emerged from the program: friendship (the number of edges increased by 90 %) and PA support (35 % of participants practiced PA together after the program). Using egocentric and socio-centric analysis we show the presence of homophily for friendship and PA support relations and the BCS's roles in their networks. • Friendship and physical activity support networks emerged from a physical activity program. • Physical activity programs help breast cancer survivors expand their support networks. • Homophily is driven by the enrollment source and the network structure. • Friendship and physical activity support networks have different dynamics. [ABSTRACT FROM AUTHOR]

This systematic review investigated the dosimetric parameters used in preclinical studies. Searches were performed in 3 databases (PubMed, Scopus, and Embase) and gray literature to identify studies for review. In vitro and ex vivo studies that examined the effect of radiation on human permanent teeth were included. The modified Consolidated Standards Of Reporting Trials checklist of items for reporting preclinical in vitro studies was used to assess the risk of bias. In total, 32 studies met the inclusion criteria. The average radiation dose of in vitro studies was 53 (±22) Gy and in ex vivo studies was 69 (±1) Gy. Twenty-two studies used 5 different fractionation schemes. Twenty-two of the included studies did not report the radiotherapy modality of those reporting. Twenty studies used linear accelerators, and 7 used Cobalt-60 with the source-surface-distance of radiation ranging from 1.5 to 100 cm. Distilled water was the storage solution for the dental structure used most commonly. Biases were observed, including small sample sizes, lack of randomization, and blinding processes. The dosimetric parameters used in the preclinical studies, including radiation dose, radiotherapy modality, fractionation regime, and the storage solutions used did not support the hypothesis of direct effects of radiation on the dental structure. [ABSTRACT FROM AUTHOR]

Hydroelectric power is a renewable and sustainable approach in energy production. However, hydro power generation is almost exclusively used at large scale (>10 kW). On a micro scale, it is still being assessed as a viable alternative to produce energy, even though this generation process seems to require lower installation and maintenance costs. The main aim of this work is the performance assessment of a micro hydro power station integrated into a rainwater harvesting system based on the optimal dimensioning of the turbine geometry. This project proposes different hydraulic heads for a sustainable model that uses the potential energy to generate electrical power in urban areas. As case of study, the system was set up for an industrial facility in the Toluca Metropolitan Zone, Mexico. A methodology was developed in order to: a) determine hydraulic setting-up based on the precipitation regime and operational requirements of the generator; b) assess an efficiency indicator under size variation of main geometric elements through Computational Fluid Dynamic (CFD); and c) validate the prototype throughout a 3D model. Due to the nature of the rainwater harvesting system, the type of the turbine selected was a Pelton turbine. Afterwards, hydraulic characteristics were defined, such as initial size of turbine, as well as the number and diameter of conduit pipes, nozzles, valves, and gates. Besides, the fluid behavior (velocity and pressure fields) in the turbine was analyzed by CFD to define a suitable geometry. Numerical modeling of the turbine allowed to estimate expected system efficiency according to the variation of a coefficient based on inlet and outlet velocities w 2 w 1. By means of an electronic circuit, which measured number of revolutions per minute and power generation (voltage and electrical current) of the system, efficiency and energy produced by the system were analyzed under both controlled conditions and real-time rainfall conditions. In general, the hydro power station managed to generate electrical energy using rainwater harvesting system which achieved up to 81.13% of efficiency. • A Pelton turbine is adapted within a rainwater harvesting system to produce electrical energy. • The design of turbine is based in two geometrical parameters: Length and height of the bucket. • Numerical modeling allowed to estimate turbine efficiency according to inlet and outlet velocities. • An efficiency of the system of up to 81.13 % is estimated simulating regimen of rainwater harvesting system. [ABSTRACT FROM AUTHOR]