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Blau syndrome is an autosomal dominant chronic inflammatory disease, which may begin with skin manifestations in the first months of life, alerting physicians to the diagnosis. This case reports a patient diagnosed jointly by pediatric dermatology and rheumatology consultants at two years of age.

Purpose: The purpose of this study was to establish and understand the provision process and impacts of first mobility aids for children with cerebral palsy (CP) in the United States – specifically orthoses, walkers and gait-trainers. Methods: We performed a mixed-methods study including surveys and semi-structured interviews of caregivers of young children with CP (n = 10) and clinicians who work with young children with CP (n = 29). We used content analysis for the surveys and inductive coding for the interviews. Results: Four themes emerged: (1) first mobility aids have mixed impacts and use patterns, (2) there is varied caregiver education and understanding about mobility aids, (3) clinician knowledge, consistency and connection impact care and (4) numerous access barriers exist for families, and there are still opportunities for improvement across all domains. Conclusions: This research provides insights into the lived experiences of clinicians and caregivers of young children with CP regarding the prescription, provision, use and impact of first mobility aids, specifically ankle foot orthoses and walkers/gait trainers. This study not only provides researchers and clinicians with an understanding of the current status of the prescription and provision process in the United States, but also offers suggestions for improvements of the process and mobility aids themselves. These results have implications for future research, mobility aid, design and the provision process of first mobility aids. Implications for rehabilitation: More detailed education and training during the prescription and early use process of first mobility aids has been highlighted as an unmet need by many families. The current timeline for participants receiving first mobility aids after prescription such as ankle-foot orthoses and walkers ranges from 2 to 9 months, which may delay access to on-time mobility for young children. Clinicians and caregivers highlight benefits of ankle-foot orthoses such as improved gait and standing alignment but also point out these aids can be uncomfortable and inhibit functional floor mobility. Clinicians highlight benefits of walkers such as supporting upright mobility and independence, but also point out challenges with physical barriers in the community and contributions to poor postural habits. Open discussion of these pros and cons with caregivers may be an important part of the provision process. Understanding the impact of different types and levels of clinician education and training regarding first mobility aids on confidence and decision-making during provision processes is valuable to improve practice and device design. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Materials and Methods Results Conclusion To assess the feasibility of immediate (IIP), early (EIP) and delayed implant placement (DIP) for single tooth replacement in the premaxilla on the basis of the complete indication area of each approach in routine practice.Data from 100 patients (59 women, 41 men, all Caucasians) aged between 19 and 81 years old (mean age 51.71) who had been consecutively treated with a single implant in the premaxilla (13–23) in one private periodontal practice were retrospectively collected. Demographic data, diagnostic information and linear measurements were extracted from patient files and CBCTs. The feasibility of IIP, EIP and DIP was assessed for all cases by both authors, based on the following criteria: availability of apical bone, position of the tooth in relation to the morphology of the alveolar process, buccal bone morphology and presence of midfacial recession. The reasons for not being able to perform an approach, and the viable alternatives for each approach were secondary outcomes. DIP was considered to have been preceded by alveolar ridge preservation (ARP).Ninety‐two patients could be treated by means of IIP, EIP or DIP. In eight patients none of these approaches were possible as they required bone augmentation prior to implant placement. Fifty‐two patients (95% CI: 42%–62%) could by treated with IIP, 58 (95% CI: 48%–67%) with EIP and 88 (95% CI: 80%–93%) with DIP. The feasibility proportions of IIP and EIP were significantly lower than the one of DIP (p < 0.001). All patients who could be treated with IIP could also be treated with EIP or DIP. Lack of apical bone for implant anchorage was the main reason for not being able to perform IIP and EIP. Complete loss of the buccal bone wall and the need for bone augmentation prior to implant placement were the reasons for not being able to perform DIP.From the results of this retrospective CBCT analysis, DIP is nearly always possible in contrast to IIP and EIP. Therefore, and since it is much easier than IIP and EIP, inexperienced clinicians should mainly focus on ARP and DIP in clinical practice deferring IIP and EIP until more surgical skills have been acquired. [ABSTRACT FROM AUTHOR]

Simple Summary: Single small primary liver cancers are curable with treatments such as surgical resection, ablation, and liver transplant; however, many patients initially receive trans-arterial chemo-embolisation (TACE), which is generally not considered a curative treatment in itself, and often go on to receive further follow-up treatments. Little is known regarding the outcomes of such patients compared to those who receive upfront ablation. Our real-world multi-centre study demonstrates that key survival outcomes are similar between those initially undergoing TACE and those receiving ablation after controlling for other key clinical variables and allowing for subsequent individualised treatment selection. Percutaneous ablation is recommended in Barcelona Clinic Liver Cancer (BCLC) stage 0/A patients with HCC ≤3 cm as a curative treatment modality alongside surgical resection and liver transplantation. However, trans-arterial chemo-embolisation (TACE) is commonly used in the real-world as an initial treatment in patients with single small HCC in contrast to widely accepted clinical practice guidelines which typically describe TACE as a treatment for intermediate-stage HCC. We performed this real-world propensity-matched multi-centre cohort study in patients with single HCC ≤ 3 cm to assess for differences in survival outcomes between those undergoing initial TACE and those receiving upfront ablation. Patients with a new diagnosis of BCLC 0/A HCC with a single tumour ≤3 cm first diagnosed between 1 January 2016 and 31 December 2020 who received initial TACE or ablation were included in the study. A total of 348 patients were included in the study, with 147 patients receiving initial TACE and 201 patients undergoing upfront ablation. After propensity score matching using key covariates, 230 patients were available for analysis with 115 in each group. There were no significant differences in overall survival (log-rank test p = 0.652) or liver-related survival (log-rank test p = 0.495) over a median follow-up of 43 months. While rates of CR were superior after ablation compared to TACE as a first treatment (74% vs. 56%, p < 0.004), there was no significant difference in CR rates when allowing for further subsequent treatments (86% vs. 80% p = 0.219). In those who achieved CR, recurrence-free survival and local recurrence-free survival were similar (log rank test p = 0.355 and p = 0.390, respectively). Our study provides valuable real-world evidence that TACE when offered with appropriate follow-up treatment is a reasonable initial management strategy in very early/early-stage HCC, with similar survival outcomes as compared to those managed with upfront ablation. Further work is needed to better define the role for TACE in BCLC 0/A HCC. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease (AD) is the most prevalent dementia, showing higher incidence in women. Besides, lipids play an essential role in brain, and they could be dysregulated in neurodegeneration. Specifically, impaired plasma lipid levels could predict early AD diagnosis. This work aims to identify the main plasma lipids altered in early AD female mouse model and evaluate their relationship with brain lipidome. Also, the possible involvement of the estrous cycle in lipid metabolism has been evaluated. Methods: Plasma samples of wild-type (n = 10) and APP/PS1 (n = 10) female mice of 5 months of age were collected, processed, and analysed using a lipidomic mass spectrometry-based method. A statistical analysis involving univariate and multivariate approaches was performed to identify significant lipid differences related to AD between groups. Also, cytology tests were conducted to confirm estrous cycle phases. Results: Three hundred thirty lipids were detected in plasma, 18 of them showed significant differences between groups; specifically, some triacylglycerols, cholesteryl esters, lysophosphatidylcholines, phosphatidylcholines, and ether-linked phosphatidylcholines, increased in early AD; while other phosphatidylcholines, phosphatidylethanolamines, ceramides, and ether-linked phosphatidylethanolamines decreased in early AD. A multivariate approach was developed from some lipid variables, showing high diagnostic indexes (70% sensitivity, 90% specificity, 80% accuracy). From brain and plasma lipidome, some significant correlations were observed, mainly in the glycerophospholipid family. Also, some differences were found in both plasma and brain lipids, according to the estrous cycle phase. Conclusions: Therefore, lipid alterations can be identified in plasma at early AD stages in mice females, with a relationship with brain lipid metabolism for most of the lipid subfamilies, suggesting some lipids as potential AD biomarkers. In addition, the estrous cycle monitoring could be relevant in female studies. [ABSTRACT FROM AUTHOR]

Premature ejaculation (PE) is a common male sexual dysfunction that can cause significant distress in the patient and partner. This study aimed to compare the current international guidelines on PE to highlight their similarities and differences. We examined the latest guidelines from the European Association of Urology (EAU), American Urological Association/Sexual Medicine Society of North America (AUA/SMSNA), and International Society of Sexual Medicine (ISSM) by comparing definitions, classifications, epidemiology, pathophysiology, and recommendations on diagnosis and therapy. The quality of guidelines was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) Global Rating Scale (GRS). We found significant variations in the definitions of PE and recommendations on management of patients. The EAU guidelines were the most recent, the AUA/SMSNA guidelines lacked detail in some areas, and the ISSM guidelines were the most complete but also the least updated. The search for a unified definition and the development of standardized diagnostic and therapeutic pathways remain concrete issues to improve the management of patients with PE worldwide. [ABSTRACT FROM AUTHOR]

Introduction: Patients with systemic lupus erythematosus (SLE) have variable treatment pathways, including antimalarials, glucocorticoids, immunosuppressants, and/or biologics. This study describes differences in clinical outcomes when initiating belimumab (BEL) before and after immunosuppressant use. Methods: This real-world, retrospective cohort study (GSK Study 217536) used de-identified administrative claims data from January 2015 to December 2022 in the Komodo Health Database. Adults with moderate/severe SLE initiating BEL (index date) were identified from January 2017 to May 2022, allowing a ≥ 24-month baseline period. Patients were stratified into those initiating BEL before immunosuppressant use (no immunosuppressant use within 24 months before index) and those initiating BEL after immunosuppressant use (one immunosuppressant used within 24 months before index). Oral glucocorticoid (OGC) use, SLE flares, new organ damage, and all-cause healthcare resource utilization (HCRU) were analyzed descriptively over a 24-month follow-up. Results: Baseline SLE severity was similar for patients initiating BEL before (n = 2295) versus after (n = 4114) immunosuppressant use (moderate, 83.1% vs 79.0%; severe, 16.8% vs 21.0%). Patients initiating BEL before versus after immunosuppressant use had lower SLE flare rates and OGC use. Post-index, patients initiating BEL before versus after immunosuppressant use discontinued their OGC sooner (moderate baseline SLE, 4.5 vs 8.9 months; severe baseline SLE, 6.2 vs 11.6 months). Patients initiating BEL before versus after immunosuppressant use had lower SLE flare rates per person-year at all time points (especially severe flare rates in patients with severe baseline SLE, 0.70 vs 1.48 through 24 months post-index). Median time to new organ damage occurrence was longer in patients initiating BEL before versus after immunosuppressant use (moderate baseline SLE, 32.1 vs 26.7 months; severe baseline SLE, 22.7 vs 21.6 months). All-cause HCRU was similar between cohorts. Conclusions: These results suggest that patients initiating BEL before versus after immunosuppressant use had more favorable outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The marshalling scheme is the foundation to match the operation mode and passenger flow characteristics of metro in different periods, and it is also the key problem that directly affects the cost of metro planning and construction and low-carbon operation. Based on the comprehensive analysis of the key factors affecting the metro marshalling scheme, a comprehensive evaluation index system and a two-step screening method are established. Based on the analysis of the difference of the impact of each index on the metro marshalling plan, a new evaluation model of the metro marshalling plan in the early and near future based on super-efficiency DEA is proposed. Finally, the feasibility and rationality of the evaluation and comparison model of the early, near and long-term subway marshalling scheme are verified and analyzed by examples. The results show that: (1) The fixed marshalling plan is a cost-energized plan, which requires higher equipment cost and operation input, while the modified marshalling plan is a technology-energized plan; by improving the management and technical level, the effective output of capacity matching and passenger time satisfaction can be achieved. (2) The advantages and disadvantages of modified marshalling scheme and fixed marshalling scheme are dynamic to a certain extent, comprehensive judgment should be made according to the specific conditions of the line, the financial situation of the city or enterprise, the operation management and the technical level. The theoretical method of comparison and selection of early, near and long-term metro marshalling schemes presented in this paper is applicable to many practical scenarios and has certain practicability, which can provide certain theoretical reference for the standardization of comparison and selection of early, near and long-term metro marshalling schemes. [ABSTRACT FROM AUTHOR]

Abstract Background Alzheimer's disease (AD) is the most prevalent dementia, showing higher incidence in women. Besides, lipids play an essential role in brain, and they could be dysregulated in neurodegeneration. Specifically, impaired plasma lipid levels could predict early AD diagnosis. This work aims to identify the main plasma lipids altered in early AD female mouse model and evaluate their relationship with brain lipidome. Also, the possible involvement of the estrous cycle in lipid metabolism has been evaluated. Methods Plasma samples of wild-type (n = 10) and APP/PS1 (n = 10) female mice of 5 months of age were collected, processed, and analysed using a lipidomic mass spectrometry-based method. A statistical analysis involving univariate and multivariate approaches was performed to identify significant lipid differences related to AD between groups. Also, cytology tests were conducted to confirm estrous cycle phases. Results Three hundred thirty lipids were detected in plasma, 18 of them showed significant differences between groups; specifically, some triacylglycerols, cholesteryl esters, lysophosphatidylcholines, phosphatidylcholines, and ether-linked phosphatidylcholines, increased in early AD; while other phosphatidylcholines, phosphatidylethanolamines, ceramides, and ether-linked phosphatidylethanolamines decreased in early AD. A multivariate approach was developed from some lipid variables, showing high diagnostic indexes (70% sensitivity, 90% specificity, 80% accuracy). From brain and plasma lipidome, some significant correlations were observed, mainly in the glycerophospholipid family. Also, some differences were found in both plasma and brain lipids, according to the estrous cycle phase. Conclusions Therefore, lipid alterations can be identified in plasma at early AD stages in mice females, with a relationship with brain lipid metabolism for most of the lipid subfamilies, suggesting some lipids as potential AD biomarkers. In addition, the estrous cycle monitoring could be relevant in female studies.

Abstract Introduction Patients with systemic lupus erythematosus (SLE) have variable treatment pathways, including antimalarials, glucocorticoids, immunosuppressants, and/or biologics. This study describes differences in clinical outcomes when initiating belimumab (BEL) before and after immunosuppressant use. Methods This real-world, retrospective cohort study (GSK Study 217536) used de-identified administrative claims data from January 2015 to December 2022 in the Komodo Health Database. Adults with moderate/severe SLE initiating BEL (index date) were identified from January 2017 to May 2022, allowing a ≥ 24-month baseline period. Patients were stratified into those initiating BEL before immunosuppressant use (no immunosuppressant use within 24 months before index) and those initiating BEL after immunosuppressant use (one immunosuppressant used within 24 months before index). Oral glucocorticoid (OGC) use, SLE flares, new organ damage, and all-cause healthcare resource utilization (HCRU) were analyzed descriptively over a 24-month follow-up. Results Baseline SLE severity was similar for patients initiating BEL before (n = 2295) versus after (n = 4114) immunosuppressant use (moderate, 83.1% vs 79.0%; severe, 16.8% vs 21.0%). Patients initiating BEL before versus after immunosuppressant use had lower SLE flare rates and OGC use. Post-index, patients initiating BEL before versus after immunosuppressant use discontinued their OGC sooner (moderate baseline SLE, 4.5 vs 8.9 months; severe baseline SLE, 6.2 vs 11.6 months). Patients initiating BEL before versus after immunosuppressant use had lower SLE flare rates per person-year at all time points (especially severe flare rates in patients with severe baseline SLE, 0.70 vs 1.48 through 24 months post-index). Median time to new organ damage occurrence was longer in patients initiating BEL before versus after immunosuppressant use (moderate baseline SLE, 32.1 vs 26.7 months; severe baseline SLE, 22.7 vs 21.6 months). All-cause HCRU was similar between cohorts. Conclusions These results suggest that patients initiating BEL before versus after immunosuppressant use had more favorable outcomes.

Aim of study was to compare the clinical visual and radiographic diagnostic technique with histological analysis of early proximal carious lesions. Materials and method. Study group included 96 proximal surfaces (48 teeth obtained from dental extractions for orthodontic or periodontal reasons). The proximal surfaces were examined by visual clinical examen and radiographic examen. A histological assessment was performed as gold standard. The sensivity and specificity values were calculated for clinical and radiographic examen. The values were analysed using McNemar test, with significance threshold p < 0.05. Results. Significant statistical differences were obtained when comparing both the sensitivity and specificity of the radiological detection method compared to the clinical method (p=0.0001

Abstract Keratoconus is a common progressive corneal disorder that can be associated with significant ocular morbidity. Various corneal imaging techniques have been used for the diagnosis of established cases. However, in the early stages of the disease, which include subclinical keratoconus and forme fruste keratoconus, detection of such cases can be challenging. The importance of detecting such cases is very important because early intervention can halt disease progression, improve visual outcomes and prevent postrefractive surgery ectasia associated with performing corneal refractive procedures in such patients. This narrative review aimed to examine several established and evolving imaging techniques for the detection of early cases of keratoconus. The utilization of combinations of these techniques may further increase their diagnostic ability.

Aim: Recent evidence challenges the current standard of offering surgery to patients with ileocaecal Crohn's disease (CD) only when they present complications of the disease. The aim of this study was to compare short‐term results of patients who underwent primary ileocaecal resection for either inflammatory (luminal disease, earlier in the disease course) or complicated phenotypes, hypothesizing that the latter would be associated with worse postoperative outcomes. Method: A retrospective, multicentre comparative analysis was performed including patients operated on for primary ileocaecal CD at 12 referral centres. Patients were divided into two groups according to indication of surgery for inflammatory (ICD) or complicated (CCD) phenotype. Short‐term results were compared. Results: A total of 2013 patients were included, with 291 (14.5%) in the ICD group. No differences were found between the groups in time from diagnosis to surgery. CCD patients had higher rates of low body mass index, anaemia (40.9% vs. 27%, p < 0.001) and low albumin (11.3% vs. 2.6%, p < 0.001). CCD patients had longer operations, lower rates of laparoscopic approach (84.3% vs. 93.1%, p = 0.001) and higher conversion rates (9.3% vs. 1.9%, p < 0.001). CCD patients had a longer hospital stay and higher postoperative complication rates (26.1% vs. 21.3%, p = 0.083). Anastomotic leakage and reoperations were also more frequent in this group. More patients in the CCD group required an extended bowel resection (14.1% vs. 8.3%, p: 0.017). In multivariate analysis, CCD was associated with prolonged surgery (OR 3.44, p = 0.001) and the requirement for multiple intraoperative procedures (OR 8.39, p = 0.030). Conclusion: Indication for surgery in patients who present with an inflammatory phenotype of CD was associated with better outcomes compared with patients operated on for complications of the disease. There was no difference between groups in time from diagnosis to surgery. [ABSTRACT FROM AUTHOR]

Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To identify biomarkers in human blood or urine at an early stage of knee osteoarthritis (OA) and to elucidate if any can accurately differentiate between healthy controls and early knee OA patients and be considered as a candidate for widespread clinical use for early diagnosis of the disease. Methods: Medline, Embase and Web of Science were screened to identify comparative studies measuring differences in blood or urine biomarkers between healthy controls and knee OA patients at an early stage (grade 1 or 2 Kellgren–Laurence). Two independent reviewers screened the abstracts for eligibility, reviewed the full texts, assessed the methodological quality and extracted the data. The Joanna Briggs Institute critical appraisal tool for diagnostic test accuracy studies was used to assess the quality of the included studies. Due to relevant heterogeneity, meta‐analysis was not appropriate. Results: Five studies met the eligibility criteria. The examined biomarkers were adropin, collagen type II metabolite, C‐terminal cross‐linked telopeptide of type II collagen, C‐terminal cross‐linked telopeptide of type I collagen, cartilage oligomeric matrix protein, matrix metalloproteinase 3, N‐terminal propeptide of procollagen type IIA, type I procollagen N‐terminal propeptides, N‐terminal osteocalcin, angiopoietin‐2, follistatin, granulocyte colony‐stimulating factor, hepatocyte growth factor, interleukin‐8, leptin, platelet‐derived growth factor‐BB, platelet endothelial cell adhesion molecule‐1, vascular endothelial growth factor and calprotectin and totalling 19 biomarkers. All of the biomarkers were studied only once in the selected papers. Conclusions: There is no reliable biomarker available to differentiate between early knee OA in patients and healthy controls, but a potential role of a cluster of biomarkers to close this gap. There are several limitations, including inappropriate study designs, small sample sizes, nonconsecutive patient groups and inadequate statistical methods for evaluating biomarker performance in studies included. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Purpose: Crohn's disease (CD) is a progressive disorder leading to cumulative bowel damage. The Lémann index is a validated tool that can help in monitoring the progression of the disease and evaluating the effectiveness of different therapies. Our aim was to describe the main radiological findings in incidentally diagnosed CD and to evaluate bowel damage in this subgroup compared to patients diagnosed at later stages. Methods: Patients with an incidental diagnosis of CD during the colorectal cancer screening program were compared to controls with a CD cohort diagnosed after symptomatic onset and matched 1:1 by disease extent. All cross-sectional examinations were centrally read, performing a descriptive analysis of the main findings and calculation of Lémann index. Results: Thirty-eight patients were included: 19 with preclinical CD (median age 55 years (IQR, 54–62), 53% male, 74% non-smokers; 74% B1 and 26% B2) and 19 matched-controls with symptomatic CD. In those with preclinical CD, the most frequent transmural findings on MRE were contrast enhancement (79%), wall thickening (79%), followed by lymphadenopathy (68%), edema (42%), and increased vascularity (42%). Among those with strictures, controls showed a higher rate of preestenotic dilation (100% vs. 0%, p = 0.01). Bowel damage assessment revealed no statistically significant differences in the Lémann index between preclinical CD and controls (p = 0.95). A statistically significant higher score in the colonic/rectum score was observed (p = 0.014). Conclusion: Patients with preclinical CD demonstrate similar radiological findings and degree of bowel damage as new-onset symptomatic CD. [ABSTRACT FROM AUTHOR]

Background: Reactivation of cytomegalovirus (CMV) infection in transplant patients is high because of immunosuppression. We have evaluated the clinical and epidemiological characteristics of early versus late onset of CMV infection among renal transplant recipients. Methods: A single center retrospective observational study was conducted among renal transplant recipients who underwent kidney transplant between January 2002 and December 2021. CMV disease was classified as early or late depending on its detection prior to or after 90 days post-transplantation. Herein, we reported the differences between early and late onset of CMV disease with respect to clinical symptoms, the use of immunosuppression and the impact on graft outcomes. Results: Out of total 2164 renal transplant recipients, 156 patients (7.2%) were diagnosed with CMV disease. Among these 156 patients, 25 patients (16%) had early CMV while 131 patients (84%) had late CMV. Overall, the two groups did not differ with respect to the induction or maintenance of immunosuppressive agents. However, the proportion of CMV syndrome was greater among early (56.0%) than late (26.7%) CMV groups (p = 0.01). In contrast, tissue invasive disease was more frequent among late (73.3%) in comparison to early (44.0%) CMV groups (p = 0.01). Among clinical symptoms, diarrhea was more frequent in late (63.4%) vs. early (36%) CMVaffected patients (p = 0.01). Graft loss occurred in 4.0% of early CMV group vs. 25.2% of late CMV group (p = 0.03). Neither of the clinical groups differed with respect to occurrence of biopsy-proven allograft rejection postinfection. Conclusions: Early CMV disease presents more frequently as CMV syndrome while late CMV disease usually manifests itself as tissue invasive disease. Graft loss is more common in patients with late onset of CMV disease. [ABSTRACT FROM AUTHOR]

Objectives: To compare immediate implant placement (IIP) with early implant placement (EIP) for single tooth replacement in the aesthetic area in terms of aesthetic, clinical, and patient‐reported outcomes. Materials and Methods: Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, Embase, and Cochrane databases as well as a manual search to identify eligible clinical studies up to February 2023. Randomized Controlled Trials (RCTs) comparing IIP with EIP were included for a qualitative and quantitative analysis. The primary outcome was vertical midfacial soft tissue change. Secondary outcomes were horizontal midfacial soft tissue change, vertical papillary change, pink esthetic score (PES), implant survival, buccal bone thickness, marginal bone level change, patient discomfort, chair time, and patient satisfaction. Results: Out of 1185 records, 6 RCTs were selected, reporting on 222 patients who received 222 single implants (IIP: 112 implants in 112 patients; EIP: 110 implants in 110 patients) in the anterior maxilla or mandible. Patients had a mean age ranging from 35.6 to 52.6 years and were followed between 8 and 24 months. Two RCTs showed some concerns, and four showed a high risk of bias. Four studies could be included in a meta‐analysis on the primary outcome and three only considered cases with an intact buccal bone wall. Meta‐analysis failed to demonstrate a significant difference in terms of vertical midfacial soft tissue change between IIP and EIP (mean difference: 0.31 mm, 95% CI [−0.23; 0.86], p =.260; I2 = 83%, p <.001). No significant differences were found for PES (standardized mean difference: 0.92, 95% CI [−0.23; 2.07], p =.120; I2 = 89%, p <.001), implant survival (RR: 0.98, 95% CI [0.93, 1.03], p =.480; I2 = 0%, p =.980), and marginal bone level change (mean difference: 0.03 mm, 95% CI [−0.12, 0.17], p =.700; I2 = 0%, p =.470). Insufficient data were available for meta‐analyses of other secondary outcomes. Conclusion: In low‐risk patients with an intact buccal bone wall, there seems to be no difference between IIP and EIP in terms of aesthetic and clinical outcomes. The strength of this conclusion is rated as low since studies showed an unclear or high risk of bias. In addition, state‐of‐the‐art therapy was only delivered in a minority of studies. Future RCTs should also provide data on patient‐reported outcomes since these have been underreported. [ABSTRACT FROM AUTHOR]

Simple Summary: Little is known about the differences in liver cancer care between liver cancer referral centres, with and without an integrated liver transplant program. Even after adjusting for other important factors, such as tumour stage and patient characteristics, we found that liver transplant centres systematically used different local cancer treatments compared to non-transplant centres. Patients managed at liver transplant centres showed improved overall survival, which was evident even after considering the increased rates of transplantation. The management of early-stage hepatocellular carcinoma (HCC) is complex, with multiple treatment strategies available. There is a paucity of literature regarding variations in the patterns of care and outcomes between transplant and non-transplant centres. We conducted this real-world multi-centre cohort study in two liver cancer referral centres with an integrated liver transplant program and an additional eight non-transplant HCC referral centres across Australia to identify variation in patterns of care and key survival outcomes. Patients with stage Barcelona Clinic Liver Cancer (BCLC) 0/A HCC, first diagnosed between 1 January 2016 and 31 December 2020, who were managed at a participating site, were included in the study. Patients were excluded if they had a history of prior HCC or if they received upfront liver transplantation. A total of 887 patients were included in the study, with 433 patients managed at a liver cancer centre with a transplant program (LTC) and 454 patients managed at a non-transplant centre (NTC). Management at an LTC did not significantly predict allocation to resection (adjusted OR 0.75, 95% CI 0.50 to 1.11, p = 0.148). However, in those not receiving resection, LTC and NTC patients were systematically managed differently, with LTC patients five times less likely to receive upfront ablation than NTC patients (adjusted OR 0.19, 95% CI 0.13 to 0.28, p < 0.001), even after adjusting for tumour burden, as well as for age, gender, liver disease aetiology, liver disease severity, and medical comorbidities. LTCs exhibited significantly higher proportions of patients undergoing TACE for every tumour burden category, including those with a single tumour measuring 2 cm or less (p < 0.001). Using multivariable Cox proportional hazards analysis, management at a transplant centre was associated with reduced all-cause mortality (adjusted HR 0.71, 95% CI 0.51 to 0.98, p = 0.036), and competing-risk regression analysis, considering liver transplant as a competing event, demonstrated a similar reduction in risk (adjusted HR 0.70, 95% CI 0.50 to 0.99, p = 0.041), suggesting that the reduced risk of death is not fully explained by higher rates of transplantation. Our study highlights systematic differences in HCC care between large volume liver transplant centres and other sites, which has not previously been well-described. Further work is needed to better define the reasons for differences in treatment allocation and to aim to minimise unwarranted treatment variation to maximise patient outcomes across Australia. [ABSTRACT FROM AUTHOR]

The age of drinking onset is a central concept for both policy and prevention of alcohol-related harm, yet evidence on the predictive value of the age of onset is lacking. This study compares alcohol outcomes of adolescents who started to drink early with those who started later, and tests if associations are moderated by other explanatory factors. Data from a two-wave longitudinal prospective cohort survey with a Swedish nationwide sample of 4,018 adolescents aged 15/16 years at baseline (T1) and 17/18 years at follow-up (T2) were used. Outcome variables at T2 were Alcohol Use Disorders Identification Test (AUDIT)–C, risky drinking, and binge drinking monthly or more often. A vast number of explanatory factors at T1 were controlled for. Early drinking onset predicted later higher AUDIT-C scores (β = 0.57, p value <.001), and higher probability of risky drinking (odds ratio = 1.95, 95% confidence interval = 1.56–2.44), and binge drinking (odds ratio = 1.38, confidence interval = 1.06–1.81), controlled for other explanatory factors. If binge drinking frequency at T1 was included, the associations remained for AUDIT-C and risky drinking, but not for binge drinking at T2. No significant interactions between early drinking onset and the explanatory factors were found. Early drinking onset predicts subsequent higher alcohol consumption in late adolescence. Adolescents who had an early drinking onset drank more after 2 years than their peers who started later. The age of drinking onset is an independent predictor of alcohol use outcomes, beyond the effect of age of binge drinking onset. [ABSTRACT FROM AUTHOR]

Introduction: Acute pancreatitis is a major disease that endangers the health and lives of people. Historically, clinical therapy has recommended. that patients with acute pancreatitis remain nil by mouth. As one of the therapies recommended in recent guidelines, early enteral nutrition support reduces the incidence of infectious complications and reduces the risk of severe conditions. However, early enteral nutrition support has not been optimally implemented within clinical practice for acute pancreatitis inpatients. Objectives: This evidence implementation project aimed to increase compliance with best practice recommendations for early enteral nutrition support, while standardizing the enteral nutrition support process and reducing the incidence of delayed enteral nutrition. Methods: The project was guided by the JBI Evidence Implementation Framework, which is grounded in the audit and feedback process, as well as a seven-stage structured approach to identifying and managing barriers to compliance with recommended practices. Results: In the baseline audit, compliance rates were low for all evidence-based audit criteria. Four of the eight criteria showed 0% compliance. However, after implementation, all eight criteria achieved a minimum compliance rate of 60%, with Site 2 achieving 90% to 100% compliance. In addition, nurses improved their knowledge and skills in early enteral nutrition support. The incidence of delayed enteral nutrition also fell from 86.2% to 20.7% at both study sites. The implementation strategy included a training program, psychological interventions, and financial and human resource support. Conclusion: This project not only significantly improved early enteral nutrition support for acute pancreatitis patients, but also increased nurses' knowledge and practice skills, standardized the process of enteral nutrition support, and reduced the incidence of delayed enteral nutrition. http://links.lww.com/IJEBH/A177 [ABSTRACT FROM AUTHOR]

Simple Summary: Non-small cell lung cancer (NSCLC), even in early stages, has been a fatal diagnosis and a leading death cause worldwide for decades. The aim of this review is to analyze the steps towards immunotherapy in the pre-, post-, and perioperative setting of resectable lung cancer while highlighting the challenges that have arisen and the future considerations to take into account in order to optimize the therapeutic results. Non-small cell lung cancer, even when diagnosed in early stages, has been linked with poor survival rates and distant recurrence patterns. Novel therapeutic approaches harnessing the immune system have been implemented in early stages, following the designated steps of advanced NSCLC treatment strategies. Immune-checkpoint inhibitor (ICI) regimens as monotherapy, combinational, or alongside chemotherapy have been intensely investigated as adjuvant, neoadjuvant, and, more recently, perioperative therapeutic strategies, representing pivotal milestones in the evolution of early lung cancer management while holding great potential for the future. The subject of current ongoing research is optimizing treatment outcomes for patient subsets with different needs and identifying biomarkers that could be predictive of response while translating the trials' endpoints to survival rates. The aim of this review is to discuss all current treatment options with the pros and cons of each, persistent challenges, and future perspectives on immunotherapy as illuminating the path to a new era for resectable NSCLC. [ABSTRACT FROM AUTHOR]

Myotoxicity is an important toxidrome that can occur with envenoming from multiple Australian snake types. Early antivenom administration is an important strategy to reduce the incidence and severity of myotoxicity. The current gold standard biomarker, serum creatine kinase activity, does not rise early enough to facilitate early antivenom administration. Several other skeletal muscle biomarkers have shown promise in other animal models and scenarios. The aim of this study was to examine the predictive values of six skeletal muscle biomarkers in a rat model of Australian snake myotoxicity. Sprague-Dawley rats were anaesthetised and administered either Pseudechis porphyriacus (red-bellied black snake) or Notechis scutatus (tiger snake) venom, or normal saline via intramuscular injection. Blood samples were collected. Assays were performed for serum creatine kinase skeletal muscle troponin-I concentration, skeletal muscle troponin-C concentration, myoglobin activity, skeletal muscle myosin light chain-1 concentration, and creatine kinase-MM activity. Serum markers were plotted against time, with comparison of area under the concentration (or activity)-time curve. The predictive values of six skeletal muscle biomarkers were examined using receiver operating characteristic curves. There was no difference in area under the serum creatine kinase activity-time curve between venom and control groups. Serum creatine kinase-MM activity rose early in the venom treated rats, which had a significantly greater area under the serum activity-time curve. No difference in area under the serum concentration-time curve was demonstrated for the other biomarkers. Creatine kinase-MM activity had a superior predictive values than creatine kinase activity at 0–4 hours and 0–10 hours after venom administration, as indicated by area under the receiver operating characteristic curves (95 per cent confidence intervals) of 0.91 (0.78–1.00) and 0.88 (0.73–1.00) versus 0.79 (0.63–0.95) and 0.66 (0.51–0.80). The limitations of serum creatine kinase activity in early detection of myotoxicity were demonstrated in this rat model. Serum creatine kinase-MM activity was superior for early detection of Australian myotoxic snake envenoming. [ABSTRACT FROM AUTHOR]

Blau syndrome is an autosomal dominant chronic inflammatory disease, which may begin with skin manifestations in the first months of life, alerting physicians to the diagnosis. This case reports a patient diagnosed jointly by pediatric dermatology and rheumatology consultants at two years of age. [ABSTRACT FROM AUTHOR]

This study aims to analyze the national early childhood curricula of South Korea and Sweden through the perspective of education for sustainable development (ESD) and determine the ways of implementing ESD into the curriculum of South Korea. Therefore, frequency-inverse document frequency and network analysis are conducted on the texts of South Korea's 'Nuri curriculum' and Sweden's 'Curriculum for Preschool Lpfö 98' using the R program. The results are as follows: First, South Korea's curriculum emphasizes attitudes and values, while the Swedish curriculum focuses on practice and action. This highlights the need to add action- and practice-oriented dimensions to the contents of South Korea's curriculum. Second, the analysis of the degree centrality reveals that, in South Korea, the network takes the form of an intensive connection. In contrast, in Sweden, the network has a wide distribution of words from the socio-cultural, economic, and environmental sectors. This difference suggests that the contents of ESD should be reinforced in South Korea through an integrated approach. Third, South Korea's contains texts related to students' interactions with others, while Sweden's highlights agency. This suggests that South Korea's curriculum needs to be redesigned to emphasize agency to find an effective way of connecting it to ESD. [ABSTRACT FROM AUTHOR]

AbstractIntroductionAimMethodsResultsConclusionIn patients with traumatic intracranial haemorrhage (tICH) there is significant risk of both venous thromboembolism (VTE) and haemorrhage progression. There is a paucity of literature to inform the timing of pharmacological thromboprophylaxis (PTP) initiation.This meta-analysis aims to summarise the current literature on the timing of PTP initiation in tICH.This meta-analysis followed the Methodological Expectations of Cochrane Intervention Reviews checklist and the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Following the literature search, studies were matched against the criteria for inclusion. Data from included studies was pooled, analysed using random-effect analysis and presented as forest plots of risk ratios, except one result reported as difference of means. The ROBINS-I tool was used to assess the risk of bias in the studies. The GRADE approach was taken to assess the quality of included studies. Heterogeneity of studies was assessed using Tau∧2. Funnel plots were generated and used in conjunction with Harbord’s test and Rucker’s arcsine to assess for small-study effect including publication bias.A total of 9927 ICH patients who received PTP were included from 15 retrospective observational cohort studies, 4807 patients received early PTP, the remaining 5120 received late PTP. The definition of early was dependent on the study but no more than 72-hours after admission. The mean age of the included cohort was 45.3 (std dev ±9.5) years, and the proportion of males was 71%. Meta-analysis indicated that there was a significant difference between early and late groups for the rate of VTE (RR, 0.544; p = 0.000), pulmonary embolus (RR, 0.538; p = 0.004), deep vein thrombosis (RR, 0.484; p = 0.000) and the intensive care unit length of stay (difference of means, −2.021; 95% CI, −2.250, −1.792; p = 0.000; Tau∧2 = 0.000), favouring the early group. However, the meta-analysis showed no significant difference between the groups for the rate of mortality (RR, 1.008; p = 0.936), tICH progression (RR, 0.853; p = 0.157), and neurosurgical intervention (RR, 0.870; p = 0.480).These findings indicated that early PTP appears to be safe and effective in patients with tICH. [ABSTRACT FROM AUTHOR]

Objective: To compare the long-term outcomes of immediate drainage versus the postponed-drainage approach in patients with infected necrotizing pancreatitis. Background: In the randomized POINTER trial, patients assigned to the postponed-drainage approach using antibiotic treatment required fewer interventions, as compared with immediate drainage, and over a third were treated without any intervention. Methods: Clinical data of those patients alive after the initial 6-month follow-up were re-evaluated. The primary outcome was a composite of death and major complications. Results: Out of 104 patients, 88 were re-evaluated with a median follow-up of 51 months. After the initial 6-month follow-up, the primary outcome occurred in 7 of 47 patients (15%) in the immediate-drainage group and 7 of 41 patients (17%) in the postponed-drainage group (RR 0.87, 95% CI 0.33–2.28; P =0.78). Additional drainage procedures were performed in 7 patients (15%) versus 3 patients (7%) (RR 2.03; 95% CI 0.56–7.37; P =0.34). The median number of additional interventions was 0 (IQR 0–0) in both groups (P =0.028). In the total follow-up, the median number of interventions was higher in the immediate-drainage group than in the postponed-drainage group (4 vs. 1, P =0.001). Eventually, 14 of 15 patients (93%) in the postponed-drainage group who were successfully treated in the initial 6-month follow-up with antibiotics and without any intervention remained without intervention. At the end of follow-up, pancreatic function and quality of life were similar. Conclusions: Also, during long-term follow-up, a postponed-drainage approach using antibiotics in patients with infected necrotizing pancreatitis results in fewer interventions as compared with immediate drainage and should therefore be the preferred approach. Trial registration: ISRCTN33682933 [ABSTRACT FROM AUTHOR]

This article examines different diagnostic methods for detecting early proximal carious lesions. The study compares clinical visual and radiographic techniques with histological analysis. The results show that radiographic methods are more effective in detecting these lesions compared to clinical methods. The article emphasizes the importance of using both visual examination and radiography for diagnosing carious lesions. Additionally, the article discusses the use of radiographic examinations, such as bitewing radiography and orthopantomography, in detecting carious lesions in children and patients with increased cariogenic risk. However, there are differing opinions on the effectiveness of orthopantomography in detecting non-cavitated carious lesions. Overall, the article concludes that radiographic methods have higher validity in detecting early proximal carious lesions compared to clinical methods. [Extracted from the article]

Dramatherapy is not a standard treatment pathway within Early Intervention in Psychosis (EIP), but it appears evident that it has a place in locations where treatment options are insufficient for some within this population. To review service evaluation data following an 8-year period of Dramatherapy in EIP. We wanted to understand how Dramatherapy was relevant to recovery from the client's perspective and evaluate the specific change ingredient present in Dramatherapy interventions. We carried out a thematic analysis upon 47 client feedback questionnaires following a period of Dramatherapy. The analysis illustrated two main themes; clients' "experience of Dramatherapy" and "the process of change". Findings indicated the importance of a place to reflect using theatrical techniques. They valued the method of co-produced sessions which prioritised shared experience engendering peer support which enabled clients to gain new perspectives together. Dramatherapy supported clients to become more communicative with others, more able to engage in activities and develop new perspectives. Dramatherapy is a much-required additional intervention for those experiencing psychosis and for EIP settings which are dominated by cognitive approaches. Client perspectives have been able to demonstrate the value of dramatic techniques in their recovery. [ABSTRACT FROM AUTHOR]

La spondyloarthrite axiale est une maladie inflammatoire chronique qui touche le rachis et les articulations sacro-iliaques et peut entraîner des dommages structuraux irréversibles. Il est extrêmement important de la diagnostiquer et de démarrer un traitement rapidement pour prévenir ces lésions dans le temps, améliorer la qualité de vie et atténuer le fardeau de la maladie. Le concept de « fenêtre d'opportunité » suggère qu'une intervention précoce dans la phase réversible de la maladie peut améliorer les résultats à long terme. Cependant, on ne sait pas si ce concept peut être appliqué à la spondyloarthrite axiale. Des progrès récents dans la prise en charge de cette forme de la maladie, notamment le recours à l'IRM diagnostique ou à des thérapies avancées, semblent capables d'améliorer les résultats. Or, les conclusions des études sur l'éventualité d'une fenêtre d'opportunité dans la spondyloarthrite axiale évaluant l'impact d'un traitement précoce sur les résultats cliniques ne sont pas concluantes. L'une des raisons est l'absence de définition standardisée de la spondyloarthrite axiale débutante. Le projet ASAS (Assessment of Spondyloarthritis International Society)-SPEAR (SPondyloarthritis EARly) travaille à l'élaboration d'une définition consensuelle. Des essais comparatifs randomisés ont spécifiquement comparé un traitement mis en place dans les phases débutante et tardive de la maladie, et une définition standardisée de la spondyloarthrite axiale débutante est indispensable pour mieux comprendre les possibles bénéfices d'un traitement précoce sur l'issue clinique. De plus, il serait intéressant d'évaluer les résultats à long terme d'un traitement intervenant dans la phase débutante, notamment en ce qui concerne les dommages structuraux, pour mieux circonscrire la notion de fenêtre d'opportunité dans la spondyloarthrite axiale. Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that affects the spine and sacroiliac joints, that can lead to irreversible structural damage. Early detection and timely intervention are crucial for preventing long-term structural damage, improving quality of life, and reducing the burden of the disease. The concept of a window of opportunity suggests that an early intervention in the reversible stage of the disease can lead to improved long-term outcomes. However, it is unclear whether this concept applies in axSpA. Recent advances in axSpA management, including the use of diagnostic techniques such as magnetic resonance imaging as well as the use of advanced therapies, have shown promise in improving outcomes. However, studies investigating the potential window of opportunity in axSpA by assessing the impact of an early treatment on clinical outcomes have yielded inconclusive results. One of the reasons behind this is the lack of a standardized definition of early axSpA. The Assessment of Spondyloarthritis International Society (ASAS)-SPEAR (SPondyloarthritis EARly) project has set the ground for it by working on a consensus definition of early axSpA. Randomized controlled trials specifically focused on the comparison between treating axSpA in the early and late stages of the disease and using the standardised definition of early axSpA are essential to understand better the potential benefits of an early treatment on clinical outcomes. Additionally, it would be relevant to assess the long-term outcomes of early axSpA treatment, especially regarding structural damage, to better grasp the concept of the window of opportunity in axSpA. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyse the performance of technical–tactical actions in two different types of tournaments and the influence of biological age on the performance of young basketball players. Thirty-seven under-13 male basketball players (age = 12.91 ± 0.57 years) were selected from four southeast Spanish teams to participate in two different tournaments on two consecutive days. The following technical–tactical variables were analysed: (a) Ball Obtained; (b) Ball Handler Player Actions; (c) Ball Handler Player Finished Actions; and (d) Ball Handler Shooting Performance. The results showed that reduced basket height and a closer three-point line promoted a higher number of balls obtained, 1 vs. 1 situations, finished ball player actions, shots, and the efficacy of offence phases. There was a significant increase in the number of balls obtained, 1 vs. 1 situations played, the number of plays finished with a lay-up or shot, number of received personal fouls, number of plays finished in 1 vs. 2, and those finished in equality and inferiority with a high defence opposition. The modified version presented a higher number of technical–tactical actions in Late Maturity players. The authors of this study believe that it is necessary to conduct more experimental studies and use bio-banding strategies in young basketball competitions. [ABSTRACT FROM AUTHOR]

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In 2021, the Australian Government commissioned a review and update of My Time Our Place, its curriculum framework for School-Age Care services for primary-age children. One update trialled was the introduction of passive leisure. Whilst children's passive use of leisure time is recognised as a right, it is often problematised and associated with negative health outcomes. This article explores a trial of passive leisure provision. It provides hopeful evidence that passive leisure spaces can be interactive, conversational and restful. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs), such as abuse, neglect, and household dysfunction, contribute to long-term systemic toxic stress and inflammation that may last well into adulthood. Such early-life stressors have been associated with increased susceptibility to multiple sclerosis (MS) in observational studies and with the development of experimental autoimmune encephalomyelitis in animal models. In this review, we summarize the evidence for an ACE-mediated increase in MS risk, as well as the potential mechanisms for this association. ACEs dysregulate neurodevelopment, stress responses, and immune reactivity; they also alter the interplay between the immune system and neural networks. All of this may be relevant for MS risk. We further discuss how ACEs induce epigenetic changes and how the toxic stress caused by ACEs may reactivate the Epstein-Barr Virus (EBV), a key risk factor for MS. We conclude by suggesting new initiatives to obtain further insights into this topic. [ABSTRACT FROM AUTHOR]

Abstract Purpose To identify biomarkers in human blood or urine at an early stage of knee osteoarthritis (OA) and to elucidate if any can accurately differentiate between healthy controls and early knee OA patients and be considered as a candidate for widespread clinical use for early diagnosis of the disease. Methods Medline, Embase and Web of Science were screened to identify comparative studies measuring differences in blood or urine biomarkers between healthy controls and knee OA patients at an early stage (grade 1 or 2 Kellgren–Laurence). Two independent reviewers screened the abstracts for eligibility, reviewed the full texts, assessed the methodological quality and extracted the data. The Joanna Briggs Institute critical appraisal tool for diagnostic test accuracy studies was used to assess the quality of the included studies. Due to relevant heterogeneity, meta‐analysis was not appropriate. Results Five studies met the eligibility criteria. The examined biomarkers were adropin, collagen type II metabolite, C‐terminal cross‐linked telopeptide of type II collagen, C‐terminal cross‐linked telopeptide of type I collagen, cartilage oligomeric matrix protein, matrix metalloproteinase 3, N‐terminal propeptide of procollagen type IIA, type I procollagen N‐terminal propeptides, N‐terminal osteocalcin, angiopoietin‐2, follistatin, granulocyte colony‐stimulating factor, hepatocyte growth factor, interleukin‐8, leptin, platelet‐derived growth factor‐BB, platelet endothelial cell adhesion molecule‐1, vascular endothelial growth factor and calprotectin and totalling 19 biomarkers. All of the biomarkers were studied only once in the selected papers. Conclusions There is no reliable biomarker available to differentiate between early knee OA in patients and healthy controls, but a potential role of a cluster of biomarkers to close this gap. There are several limitations, including inappropriate study designs, small sample sizes, nonconsecutive patient groups and inadequate statistical methods for evaluating biomarker performance in studies included. Level of Evidence Level III.

Abstract Objective To evaluate the association between traditional laboratory findings and death, and to find risk factors for death in infants with early onset sepsis (EOS). Study design This was a single-center, case–control, retrospective trial conducted between January 2020 and August 2021. Infants with EOS were enrolled and divided into two groups based on outcome before hospital discharge: non-survivors (Mortality group) and survivors (Survival group). Results Out of 556 eligible neonates, there were 38 (6.8%) deaths. After univariate analysis and ROC curve analysis, there were a total of 12 values with significant differences (p 0.001), septic shock (OR = 6.15, 95% CI [2.52, 15.00], p 0.001), serum lactic acid (OR = 0.82, 95%CI[0.75, 0.90], p 0.001) could be regarded as risk factors for death with 94.0% correct predictions. Conclusions The factors affecting the prognosis of EOS in neonates were BW, PPHN, septic shock, heart failure, serum lactic acid, and AST. Timely correction of these modifiable risk factors for death may decrease the mortality of EOS in neonates.

Premature ejaculation (PE) is a common male sexual dysfunction that can cause significant distress in the patient and partner. This study aimed to compare the current international guidelines on PE to highlight their similarities and differences. We examined the latest guidelines from the European Association of Urology (EAU), American Urological Association/Sexual Medicine Society of North America (AUA/SMSNA), and International Society of Sexual Medicine (ISSM) by comparing definitions, classifications, epidemiology, pathophysiology, and recommendations on diagnosis and therapy. The quality of guidelines was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) Global Rating Scale (GRS). We found significant variations in the definitions of PE and recommendations on management of patients. The EAU guidelines were the most recent, the AUA/SMSNA guidelines lacked detail in some areas, and the ISSM guidelines were the most complete but also the least updated. The search for a unified definition and the development of standardized diagnostic and therapeutic pathways remain concrete issues to improve the management of patients with PE worldwide.

AbstractSystemic chemotherapy is the backbone of therapeutic management in small cell lung cancer (SCLC) and delay of treatment may lead to adverse patient outcomes. This study was conducted to determine the time elapsed between pathological diagnosis and initiation of chemotherapy in SCLC patients and to evaluate its clinical significance. A total of 323 pathologically confirmed SCLC patients were enrolled in the study and analyzed retrospectively. The median value of the patients’ time to treatment was used as the cut-off value in distinguishing between early and late chemotherapy. The median (range) of the time interval between the pathological diagnosis and the initiation of chemotherapy was 18 days (1–257). Compared with other clinical variables, only the performance status of patients was significantly associated with the time from diagnosis to initiation of chemotherapy; patients with poor prognostic factors received chemotherapy earlier than other patients (32.9 vs 18.9%, p = 0.004, and 14.5 vs 19 days, p = 0.006). Although patients who received early treatment were found to live less, there was no statistically significant difference in overall survival in patients according to the timing of chemotherapy administration (p = 0.08). In conclusion, there are controversial results about the timing of chemotherapy administration to SCLC patients. More standardized definitions and guides for calculation of the time interval between diagnosis and treatment are needed to better understand the delays in the treatment of patients with clinically rapidly disseminating SCLC. [ABSTRACT FROM AUTHOR]

Introduction: Influence of early atrial fibrillation (AF) ablation, particularly cryoballoon ablation (CBA), on clinical outcome during long‐term follow‐up has not been clarified. The objective was to determine whether an early CBA (diagnosis‐to‐ablation of ≤6 months) strategy could affect freedom from AF recurrence after index CBA. Methods: The study included 2605 patients from Korean CBA registry data with follow‐up >12 months after de novo CBA. The primary outcome was recurrence of atrial tachyarrhythmias (ATs) of ≥30‐s after a 3‐month blanking period. Results: Compared to patients in early CBA group, patients in late CBA group had higher prevalence of diabetes, congestive heart failure, and chronic kidney disease, and higher mean CHA2DS2‐VAS score. During mean follow‐up of >21 months, ATs recurrence was detected in 839 (32.2%) patients. The early CBA group showed a significantly lower 2‐year recurrence rate of ATs than the late CBA group (26.1% vs. 31.7%, p = 0.043). In subgroup analysis, the early CBA group showed significantly higher 1‐year and 2‐year freedom from ATs recurrence than the late CBA group only in paroxysmal atrial fibrillation (PAF) patients in overall and propensity score matched cohorts. Multivariate analysis showed that early CBA was an independent factor for preventing ATs recurrence in PAF (hazard ratio: 0.637; 95% confidence intervals: 0.412–0.984). Conclusion: Early CBA strategy, resulting in significantly lower ATs recurrence during 2‐year follow‐up after index CBA, might be considered as an initial rhythm control therapy in patients with paroxysmal AF. [ABSTRACT FROM AUTHOR]

OnTrackNY provides early intervention services to young people with early psychosis throughout New York State. This report describes the impact of the COVID-19 pandemic on community participation of OnTrackNY program participants and their families. Thirteen participants and nine family members participated in five focus groups and three individual semi-structured interviews. Data were analyzed using a summary template and matrix analysis approach. Major themes highlight the negative impacts of the pandemic with reports of decreased socializing or using online means to connect, unemployment, challenges with online learning and a decrease in civic engagement. Positive impacts include more time to deepen connections with family and valued friendships and engage in activities that promote wellness and goal attainment. Implications for coordinated specialty care programs include adapting services to promote mainstream community integration and creating new strategies for community involvement of young people within a new context brought forth by the pandemic. [ABSTRACT FROM AUTHOR]

Objectives: to study risk factors for mortality in SAM children within the first 72 hours of hospitalization. Methods: We conducted a retrospective study on data from 0-59-month-old SAM children hospitalized from June 1th, 2016, to May 31th, 2019, at CHUSourô Sanou of Bobo-Dioulasso. A logistic regression was performed to determine risk factors for death. Variables with odds ratio (OR) > 1, and p <0.05 were predictors of death. Results: Of 646 SAMs included, most were 12-23-monthyearold (34.83%). Death rate was 19.04%. Deep coma [OR :27.2, 95%IC: 9.62-91.1], OAP [OR :16.3, 95%IC: 1.58-383], Signs of in particular low pulse volume [OR :5.45, 95%IC: 1.74-17. 1], cold extremities [OR :4.66, 95%IC: 1.03-20.8], capillary refilling time (CRT) >3seconds [OR :3.55, 95%IC: 1.50-8.27], sepsis[OR :3.39, 95%IC: 1.33-8.50]were the risk factors predictive of mortality. Conclusion: Training and ongoing supervision of healthcare staff in the management of paediatric emergencies, the use of the WHO SAM management protocol and the availability of emergency kits could improve SAM management. [ABSTRACT FROM AUTHOR]

Under-age marriage is linked mainly to the socio-economic status of the family, the educational level, and the legislative awareness of the girl. Boys may have the choice while girls are forced to engage in such marriage. This study aims at gaining a deep understanding of different reasons behind early marriage, and its impacts and provide solutions for underage marriage in Morocco. The study's respondents are females and males aged between 15 and 52 years from different rural villages in Tafilalet. 62,3 % of them are females and 37,7 % are males. 63% of the respondents are aged between 15 and 25, 24% are aged between 25 and 30 and 13% have more than 30 years old. 52,4% of the participants are undergraduates while 47,6% are graduates. The data of this study were gathered through the use of both qualitative and quantitative datacollecting procedures including interviews and questionnaires. The findings of the study indicate that poor girls and non-educated ones are more likely to engage in underage marriage in Morocco. The quantitative results illustrate that 73% of the respondents agreed that non-educated girls are more likely to marry at an early age. While highly educated and economically independent females are not engaged in such marriages. Only a few respondents (8%) consider early marriage not common at all, while 18 % believe that it is nearly common, and 20% think that it is very common in the area. [ABSTRACT FROM AUTHOR]

Simple Summary: Cure is the goal of treatment in early primary liver cancer with surgical resection and ablation therapy being the two most common modalities used. This real-world multi-centre Australian study demonstrates that surgical treatment results in superior outcomes. We observed a significantly reduced risk of death from any cause and of recurrent liver cancer after controlling for factors such as initial tumour burden, liver disease severity and other medical comorbidities. Our study provides compelling evidence to recommend surgery for suitable patients to achieve the best possible outcomes. The optimal treatment approach in very-early and early-stage hepatocellular carcinoma (HCC) is not precisely defined, and there is ambiguity in the literature around the comparative efficacy of surgical resection versus ablation as curative therapies for limited disease. We performed this real-world propensity-matched, multi-centre cohort study to assess for differences in survival outcomes between those undergoing resection and those receiving ablation. Patients with Barcelona Clinic Liver Cancer (BCLC) 0/A HCC first diagnosed between 1 January 2016 and 31 December 2020 who received ablation or resection as initial treatment were included in the study. A total of 450 patients were included in the study from 10 major liver centres including two transplant centres. Following propensity score matching using key covariates, 156 patients were available for analysis with 78 in each group. Patients who underwent resection had significantly improved overall survival (log-rank test p = 0.023) and local recurrence-free survival (log rank test p = 0.027) compared to those who received ablation. Based on real-world data, our study supports the use of surgical resection in preference to ablation as first-line curative therapy in appropriately selected BCLC 0/A HCC patients. [ABSTRACT FROM AUTHOR]

Despite the effective antivirals and vaccines, COVID-19 remains a public health concern. The mutations that occurred during the early stage of the pandemic can be valuable in assessing the viral fitness and evolutionary trajectory. In this study, we analyzed a panel of 2969 spike sequences deposited in GISAID before April 2020 and characterized nine representative spike single-point mutants in detail. Compared with the WA01/2020, most (8 out of 9) mutants demonstrated an equivalent or diminished protein expression or processing, pseudovirus infectivity, and cell–cell fusion. Interestingly, most of the mutants in native form elicited minimum antibody responses in mice despite unaltered CD4+ and CD8+ T cell responses. The mutants remained sensitive to the antisera and the type I interferon. Taken together, these data suggest that the early emerging mutants are virologically divergent, and some of which showed transmission fitness. Our findings have important implications for the retrospective tracing of the early SARS-CoV-2 transmission and future pandemic preparedness. [ABSTRACT FROM AUTHOR]

Objectives: The aim was to explore the correlations between Jumping to Conclusions (JtC) tendency and neuropsychiatric features in patients with early Parkinson's disease (PD). Background: According to few reports, PD patients with impulsive–compulsive behaviors (ICBs) are prone to working memory difficulties including JtC bias. The correlation of psychotic features and JtC tendency remains still unclear. Methods: Healthy controls and patients within 3 years of PD onset were recruited. Participants were examined for psychotic symptoms using a 10 question PD-specific psychosis severity scale. JtC was measured by a probalistic reasoning scenario (beads task). In PD group, medication use, motor and non-motor symptoms were documented. Impulsivity was evaluated using the Questionnaire for Impulsive–Compulsive Disorders in PD (QUIP). Results: The prevalence of JtC bias was 9% (6/70) in healthy individuals, compared to 32% (22/68) of PD group [p = 0.001]. No association was detected between the presence of JtC tendency and PD-associated psychosis (p = 0.216). Patients with JtC had shorter duration of PD, more tremor-dominant PD subtype and higher QUIP scores, regardless of the dopaminergic therapy (p = 0.043, p = 0.015, p = 0.007, respectively). A trend towards attention and inhibition control deficit was noticed in JtC patients. Conclusions: We found a high prevalence of JtC bias in early, cognitively intact PD population and a potential link between subthreshold ICBs and poor performance on beads task. Additional studies are needed to confirm our results and elaborate on the mechanisms that correlate impulsivity with JtC tendency, which are likely to be different from those mediating psychotic features in early PD. [ABSTRACT FROM AUTHOR]

Topical glaucoma medications are effective and safe, but they have numerous well-documented limitations that diminish their long-term utility and sustainability. These limitations can include high rates of nonadherence (with associated glaucoma progression), concerning side effects, inconsistent circadian intraocular pressure (IOP) control, complex dosing regimens, difficulty with self-administration, costs, and decreased quality of life. Despite these limitations, topical medications traditionally have been first-line in the glaucoma treatment algorithm, as no other minimally invasive treatment alternatives existed. In recent years, however, novel interventional therapies—including sustained-release drug-delivery platforms, selective laser trabeculoplasty, and micro-invasive glaucoma surgery procedures—have made it possible to intervene earlier without relying on topical medications. As a result, the topical medication-first treatment approach is being reevaluated in an overall shift toward earlier more proactive interventions. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association between traditional laboratory findings and death, and to find risk factors for death in infants with early onset sepsis (EOS). Study design: This was a single-center, case–control, retrospective trial conducted between January 2020 and August 2021. Infants with EOS were enrolled and divided into two groups based on outcome before hospital discharge: non-survivors (Mortality group) and survivors (Survival group). Results: Out of 556 eligible neonates, there were 38 (6.8%) deaths. After univariate analysis and ROC curve analysis, there were a total of 12 values with significant differences (p < 0.05) between two groups, which included birth weight (BW), weight on admission, gestational age, age on admission, mode of delivery, septic shock, heart failure, respiratory failure, pulmonary hypertension, hypothermia, serum lactic acid, and aspartate aminotransferase (AST). Moreover, after multivariate analysis performed for those 12 values, the binary logistic regression analysis showed that taking death as a reference, the BW (OR = 1.00, 95% CI[1.001, 1.002], p < 0.001), PPHN (OR = 2.60, 95% CI[1.04, 6.52], p > 0.001), septic shock (OR = 6.15, 95% CI [2.52, 15.00], p < 0.001), heart failure (OR = 6.22, 95% CI[0.90, 43.05], p > 0.001), serum lactic acid (OR = 0.82, 95%CI[0.75, 0.90], p < 0.001), and AST (OR = 1.00, 95% CI[0.99, 1.00], p > 0.001) could be regarded as risk factors for death with 94.0% correct predictions. Conclusions: The factors affecting the prognosis of EOS in neonates were BW, PPHN, septic shock, heart failure, serum lactic acid, and AST. Timely correction of these modifiable risk factors for death may decrease the mortality of EOS in neonates. [ABSTRACT FROM AUTHOR]