2-year Study Research Articles

Transition of DNA-HPV over time in HPV-infected women: a 7-year cohort study

BACKGROUND Approximately 99% of cervical cancer cases worldwide are associated with one of the high-risk human papillomavirus (HPV) types. This study aimed to determine the transition rate of DNA-HPV over time in women aged 18–69 years with HPV infection in Can Tho City, Vietnam, from 2013 to 2020. METHODS The 2-phase cohort study was conducted on 213 women between 2013 and 2020. Phase 1 involved a retrospective cohort study (2013–2018), and phase 2 included a prospective cohort study (2018–2020). HPV testing was performed using real-time polymerase chain reaction on cervical fluid. McNemar’s test was employed to compare differences in HPV transition between 2013 and 2020. RESULTS From 2013 to 2018, the transition, clearance, and non-transition rates were 17.1%, 65.8%, and 66.2%, respectively, revealing a significant difference in the number of HPV cases during this period (p = 0.007). From 2018 to 2020, the transition, clearance, and non-transition rates were 9.8%, 44.9%, and 82.2%, respectively. Overall, the DNA-HPV changes from 2013 to 2020 indicated rates of 14.3% for transition, 68.5% for clearance, and 67.1% for non-transition. A significant difference in HPV cases was found between 2013 and 2020 (p = 0.001). CONCLUSIONS The longer duration resulted in a more significant difference in the DNA-HPV transition among HPV-infected women.

Sports-related Mandibular Fractures in the Center of Italy: A Retrospective Study.

The main causes of injuries to the lower and middle third of the facial skeleton are traffic accidents, accidental falls, assaults, and sport. Regarding sports-related maxillofacial trauma, an 8-year retrospective study was conducted at the Department of Oral and Maxillofacial Surgery of the Policlinico Umberto I in Rome, Italy. In all, 329 patients were included, of which we analyzed 35 patients with sports-related mandibular fractures. Specifically, we assessed the type of mandibular fracture reported, age, gender, number of fracture lines, association with other maxillofacial fractures, and treatment options. The causes of sports-related injuries are often multifactorial. Therefore, the aim of our study was to understand the correlation between the type of sport practiced and the most frequently reported pattern of mandibular fracture, highlighting how, depending on the sport, the mechanism of action is different and may correlate with a specific type of mandibular fracture.

One-stage prosthodontically driven jaw reconstruction in patients with benign and malignant pathologies: A 7- to 11-year cohort study.

One stage functional jaw reconstructionis defined as the resection and reconstruction of segmental defects in conjunction with the placement of dental implants in an ideal prosthetic position and loaded with a provisional restoration, during one surgical procedure. The aim of the study is to describe clinical outcomes of patients who underwent one stage functional jaw reconstruction. Patients who underwent one-stage functional jaw reconstruction, from January 2013 to March 2016 were recalled in 2022 and 2023. Planning and execution for the reconstruction utilized either analogue or digital techniques. Outcome parameters recorded were treatment-related outcomes at patient level, implant-related outcomes and patient-reported outcome measures. Eighteen patients underwent one-stage jaw reconstruction with a total of 57 implants. Four patients had maxillary and 14 had mandibular reconstructions. Ten patients underwent postoperative radiotherapy. Ten patients were planned using analogue and eight by digital planning. Three patients had partial flap necrosis, three patients had plate fractures, implant loss was seen in one patient and four patients died during the period. A functional prosthesis was provided in 16 out of the 18 patients. One-stage functional jaw reconstruction is a predictable method for providing rehabilitation with successful outcomes at 7-11 years. However, caution should be exercised when the treatment modality is carried out in patients with malignant pathologies who have undergone radiotherapy.

Hippocampus and striatum show distinct contributions to longitudinal changes in value-based learning in middle childhood

The hippocampal-dependent memory system and striatal-dependent memory system modulate reinforcement learning depending on feedback timing in adults, but their contributions during development remain unclear. In a 2-year longitudinal study, 6-to-7-year-old children performed a reinforcement learning task in which they received feedback immediately or with a short delay following their response. Children’s learning was found to be sensitive to feedback timing modulations in their reaction time and inverse temperature parameter, which quantifies value-guided decision-making. They showed longitudinal improvements towards more optimal value-based learning, and their hippocampal volume showed protracted maturation. Better delayed model-derived learning covaried with larger hippocampal volume longitudinally, in line with the adult literature. In contrast, a larger striatal volume in children was associated with both better immediate and delayed model-derived learning longitudinally. These findings show, for the first time, an early hippocampal contribution to the dynamic development of reinforcement learning in middle childhood, with neurally less differentiated and more cooperative memory systems than in adults.

Hippocampus and striatum show distinct contributions to longitudinal changes in value-based learning in middle childhood.

The hippocampal-dependent memory system and striatal-dependent memory system modulate reinforcement learning depending on feedback timing in adults, but their contributions during development remain unclear. In a 2-year longitudinal study, 6-to-7-year-old children performed a reinforcement learning task in which they received feedback immediately or with a short delay following their response. Children's learning was found to be sensitive to feedback timing modulations in their reaction time and inverse temperature parameter, which quantifies value-guided decision-making. They showed longitudinal improvements towards more optimal value-based learning, and their hippocampal volume showed protracted maturation. Better delayed model-derived learning covaried with larger hippocampal volume longitudinally, in line with the adult literature. In contrast, a larger striatal volume in children was associated with both better immediate and delayed model-derived learning longitudinally. These findings show, for the first time, an early hippocampal contribution to the dynamic development of reinforcement learning in middle childhood, with neurally less differentiated and more cooperative memory systems than in adults.

Incidence of myopia in Swedish schoolchildren: A longitudinal study.

The prevalence of myopia in Scandinavia tends to be lower than in other parts of the world. This study aimed to investigate the incidence of myopia and its predictors in Swedish children to characterise this trend. A 2-year longitudinal study was conducted following a cohort of schoolchildren aged 8-16 years. Myopia was defined as a spherical equivalent refraction (SER) ≤ -0.50 D. The study enrolled 128 participants, 70 (55%) females with a mean age of 12.0 years (SD = 2.4). The cumulative incidence of myopia during the follow-up period was 5.5%, and the incidence rate of myopia was 3.2 cases per 100 person-years. Participants with myopia at baseline exhibited a faster increase in refractive error during the follow-up period. Likewise, participants with two myopic parents exhibited a more marked change towards myopia, regardless of their initial refractive error. In the current study, similar to prevalence, the incidence of myopia was low when compared with other parts of the world. These results lead us to formulate a new hypothesis that the normal emmetropisation process may be protected by low educational pressure practised in Sweden during early childhood. Further research is necessary to test this new hypothesis.

Proton therapy for head and neck cancer therapy: A real-world data case study from Bulgaria

Head and neck cancers (HNC) are one of the most severe types of cancer in Europe, accounting for almost 4.5% of all cancer types, according to GLOBOCAN. The incidence is geographically variable, with higher rates observed in Eastern and Southern Europe than in Northern and Western Europe. Proton and photon therapies are both available treatment approaches for head and neck cancer, as each has its own unique advantages, characteristics, and considerations. Proton therapy is the newest one and is considered safer among both. The current study aims to analyse the available data for patients with head and neck cancer treated with proton therapy in Bulgaria based on real-world data generated through AI-based patient registries and the current availability of strategic policy documents ensuring the affordability of proton therapy on a national level. We wanted to explore the feasibility of building a national proton therapy centre based on available patients’ information and strategic policy documents. We conducted a 3-year (2020–2022) combined non-interventional retrospective database study on head and neck cancer using secondary use of real-world data from dynamic patient registries and desktop analysis of strategic policy documents for capacity and financial affordability for proton therapy in Bulgaria. The results show that Bulgaria has a strategic policy document that focuses on the need and funding possibilities for establishing this treatment within the country. However, the country lacks the political will to ensure appropriate funding for it. Building a national proton centre is a feasible investment but needs additional detailed budget impact analysis.

The Effect of Bowel Anastomosis on Outcomes in Complex Abdominal Wall Reconstruction: A 10-Year Retrospective Cohort Study.

In patients who require complex abdominal wall reconstruction (CAWR), the need for a bowel anastomosis could impact procedure choice and outcome. In this retrospective cohort study, we examine the effect of bowel anastomosis on complications and hernia recurrence. All patients who underwent CAWR between 2011 and 2021 by the senior author were reviewed in a retrospective cohort analysis. Patients were included if they met the above criteria. Patients were excluded if they did not undergo the above procedure or if they underwent a different procedure simultaneously. Univariate analysis was performed for patients who underwent bowel anastomosis, and multiple variable logistic regression analysis was performed with respect to overall complications. A total of 264 patients underwent CAWR over a 10-year interval. A total of 41 patients underwent bowel anastomosis (16%), and 223 patients (84%) underwent CAWR without bowel anastomosis. Mean patient age was 55.50 ± 11.55 years. Mean patient body mass index was 32.36 ± 7.31 kg/m2. Mean follow-up time was 10.20 months. There was a significant difference in hernia repair etiology, with higher rates of recurrent hernia repair among patients receiving bowel anastomosis (odds ratio, 2.98; 95% confidence interval, 1.49-5.95; P = 0.0018). Acellular dermal matrix was used more frequently in patients who required a bowel anastomosis (odds ratio, 3.74; 95% confidence interval, 1.75-8.00; P = 0.0018). Major and minor complications were also significantly higher in this cohort. Regression analysis for overall complications revealed the presence of bowel anastomosis, fascial repair technique, and follow-up time as independent predictors of overall complications. Bowel anastomosis performed at the time of CAWR significantly increased the rate of overall and major complications but did not predict hernia recurrence. Plastic surgeons should utilize this information in counseling patients and in deciding the most appropriate hernia repair technique.

Pursuit and escape drive fine-scale movement variation during migration in a temperate alpine ungulate

Climate change reduces snowpack, advances snowmelt phenology, drives summer warming, alters growing season precipitation regimes, and consequently modifies vegetation phenology in mountain systems. Elevational migrants track spatial variation in seasonal plant growth by moving between ranges at different elevations during spring, so climate-driven vegetation change may disrupt historic benefits of migration. Elevational migrants can furthermore cope with short-term environmental variability by undertaking brief vertical movements to refugia when sudden adverse conditions arise. We uncover drivers of fine-scale vertical movement variation during upland migration in an endangered alpine specialist, Sierra Nevada bighorn sheep (Ovis canadensis sierrae) using a 20-year study of GPS collar data collected from 311 unique individuals. We used integrated step-selection analysis to determine factors that promote vertical movements and drive selection of destinations following vertical movements. Our results reveal that relatively high temperatures consistently drive uphill movements, while precipitation likely drives downhill movements. Furthermore, bighorn select destinations at their peak annual biomass and maximal time since snowmelt. These results indicate that although Sierra Nevada bighorn sheep seek out foraging opportunities related to landscape phenology, they compensate for short-term environmental stressors by undertaking brief up- and downslope vertical movements. Migrants may therefore be impacted by future warming and increased storm frequency or intensity, with shifts in annual migration timing, and fine-scale vertical movement responses to environmental variability.

Seed Availability and Small Mammal Populations: Insights from Mediterranean Forests

Plant–animal interactions play a crucial role in ecosystem functioning, especially through seed dispersal mechanisms. Understanding how small mammal populations respond to seed availability is essential for ecosystem management and biodiversity conservation, especially in the context of habitat loss and climate change. We conducted a 10-year study in mixed Mediterranean oak–beech forests to investigate the population dynamics of common small mammal species in response to seed availability. Our findings revealed distinct responses among species, influenced by life history traits, foraging behaviour, and diet. Wood mice (Apodemus sylvaticus) showed a rapid population increase with seed availability both in the same year of seed fall and the following year, suggesting a flexible foraging strategy and a dependence on arboreal seed producers. Yellow-necked mice (Apodemus flavicollis) revealed immediate population increases in response to seed availability in the autumn, probably because of their arboreal habits and preference for exploiting seeds prior to maturation. Bank voles (Clethrionomys glareolus) showed responses with population peaks in years following high seed availability, indicating a slower demographic response to resource abundance. Surprisingly, the greater white-toothed shrew (Crocidura russula) responded indirectly to seed availability in Mediterranean forests, suggesting complex interactions with seed-associated invertebrates or dependence on other variables not considered. Our findings highlight the importance of understanding how changes in seed availability influence the population ecology of small mammals, with significant implications for the conservation and management of Mediterranean forest ecosystems in the context of climate change and recurrent droughts. These results emphasise the need to consider species interactions, resource availability, and climate change in the conservation and management of evolving ecosystems.

Dynamics of Noctiluca scintillans blooms: A 20-year study in Jangmok Bay, Korea

This 20-year study (2001–2020) conducted in Jangmok Bay, Korea, assessed the intricate relationships between environmental factors and Noctiluca scintillans blooms. Granger causality tests and PCA analysis were used to assess the impact of sea surface temperature (SST), salinity, dissolved oxygen (DO) concentration, wind patterns, rainfall, and chlorophyll-a (Chl-a) concentration on bloom dynamics. The results revealed significant, albeit delayed, influences of these variables on bloom occurrence, with SST exhibiting a notable 2-month lag and salinity a 1-month lag in their impact. Additionally, the analysis highlighted the significant roles of phosphate, ammonium, and silicate, which influenced N. scintillans blooms with lags of 2 to 3 months. The PCA demonstrates how SST and wind speed during spring and summer, along with wind direction and salinity in winter, significantly impact N. scintillans blooms. We noted not only an increase in large-scale N. scintillans blooms but also a cyclical pattern of occurrence every 3 years. These findings underscore the synergistic effects of environmental factors, highlighting the complex interplay between SST, salinity, DO concentration, and weather conditions to influence bloom patterns. This research enhances our understanding of harmful algal blooms (HABs), emphasizing the importance of a comprehensive approach that considers multiple interconnected environmental variables for predicting and managing N. scintillans blooms.

Disparities in Transitions From E-cigarette Use to Other Tobacco Use Patterns Among Sexual Minority Versus Heterosexual Women and Men in the United States.

Despite elevated rates of e-cigarette use among sexual minority versus heterosexual young adults, limited research has examined sexual identity in relation to transitions from e-cigarette use to other tobacco use patterns. We analyzed data from 608 US young adults in a 2-year study (2018-2020) who reported using e-cigarettes in the past 6 months (time period between assessments) but no other tobacco product at baseline (Fall 2018). Multinomial logistic regressions among women and men, separately, examined associations between sexual identity and past 6-month tobacco use in Fall 2020 (nonuse [referent group] vs e-cigarette only, other tobacco product only, e-cigarette and other tobacco product dual use), controlling for age and race/ethnicity. Among women (n = 340; mean [M]age = 23.42; n = 147 [43.4%] sexual minority; 29.4% racial/ethnic minority), 34.4% reported nonuse at follow-up, 26.8% e-cigarette only, 10.3% other tobacco product only, and 28.5% e-cigarette and other tobacco product dual use. Sexual minority (vs heterosexual) women displayed greater odds of e-cigarette-only use, as well as dual use relative to nonuse at follow-up. Among men (n = 244; Mage = 24.30; n = 51 [20.9%] sexual minority; 36.1% racial/ethnic minority), 25.4% reported no use, 20.9% e-cigarette only, 17.2% other tobacco product only, and 36.5% dual use at follow-up. Sexual minority (vs heterosexual) men displayed lower odds of e-cigarette only, other tobacco product only, and dual use relative to nonuse at follow-up. Research is needed to assess and intervene on tobacco/nicotine product perceptions (eg, harm, social acceptability) and reasons for use (eg, mood regulation) associated with high-risk tobacco use patterns and trajectories, particularly among sexual minority young adult women who may have distinct profiles and risks associated with use.

A Predictive Model for Graft Failure in Femtosecond Laser-Assisted Penetrating Keratoplasty Among Chinese Patients: A 2-Year Study.

Graft failure is a major challenge in femtosecond laser-assisted penetrating keratoplasty (Fs-PKP). This study focuses on the development and validation of a clinical predictive model aimed at identifying the risk of graft failure in individuals undergoing Fs-PKP in China, offering a tailored approach to improve surgical outcomes. This retrospective cohort study at Nanjing First Hospital involved 238 patients and followed the TRIPOD statement. The cohort was divided into a training set (n = 166) and a validation set (n = 72) in a 7:3 ratio. It analyzed 23 predictor variables related to recipient, donor, and surgical factors, defining graft failure as "visually significant and irreversible corneal stromal edema, haze, or scarring." A comprehensive nomogram was created using univariate and multivariate Cox regression analyses and assessed by concordance index (C-index), time-dependent receiver operating characteristics (ROC) curve, calibration plots, and decision curve analysis (DCA). Five critical risk factors were identified: recipients' history of systemic autoimmune disorders, ocular trauma, prior penetrating keratoplasty (PKP) history, donors' diabetes history, and the endothelial cell density of the donor cornea. The nomogram showed a C-index of 0.72 (95% CI 0.65-0.79) in the training group and 0.66 (95% CI 0.55-0.76) in the validation group, indicating robust predictive accuracy. Time-dependent ROC curves, calibration plots, and DCA consistently validated the model's reliability, predictive power, and clinical utility across both training and validation cohorts. Our study developed and validated a model incorporating five key factors, enhancing preoperative prediction and management for Chinese patients with Fs-PKP graft failure.

Monogenic diabetes in a Chinese population with young-onset diabetes: A 17-year prospective follow-up study in Hong Kong.

Asians have a high prevalence of young-onset diabetes, but the pattern of monogenic diabetes is unknown. We aimed to determine the prevalence of monogenic diabetes in Chinese patients with young-onset diabetes and compare the clinical characteristics and outcome between patients with and without monogenic diabetes. We sequenced a targeted panel of 33 genes related to monogenic diabetes in 1021 Chinese patients with non-type 1 diabetes diagnosed at age ≤40years. Incident complications including cardiovascular disease (CVD), end-stage kidney disease (ESKD) and all-cause death were captured since enrolment (1995-2012) until 2019. In this cohort (mean±SD age at diagnosis: 33.0±6.0years, median[IQR] diabetes duration 7.0[1.0-15.0] years at baseline, 44.9% men), 22(2.2%, 95% confidence interval[CI] 1.4%-3.2%) had monogenic diabetes. Pathogenic (P) or likely pathogenic (LP) variants were detected in GCK (n=6), HNF1A (n=9), HNF4A (n=1), PLIN1 (n=1) and PPARG (n=2), together with copy number variations in HNF1B (n=3). Over a median follow-up of 17.1years, 5(22.7%) patients with monogenic diabetes (incidence rate 12.3[95% CI 5.1-29.4] per 1000 person-years) versus 254(25.4%) without monogenic diabetes (incidence rate 16.7[95% CI 14.8-18.9] per 1000 person-years) developed the composite outcome of CVD, ESKD and/or death (p=0.490). The multivariable Cox model did not show any difference in hazards for composite events between groups. In Chinese with young-onset non-type 1 diabetes, at least 2% of cases were contributed by monogenic diabetes, over 80% of which were accounted for by P/LP variants in common MODY genes. The incidence of diabetes complications was similar between patients with and without monogenic diabetes.

A new species of Populus and the extensive hybrid speciation arising from it on the Qinghai-Tibet Plateau

While the diversity of species formation is broadly acknowledged, significant debate exists regarding the universal nature of hybrid species formation. Through an 18-year comprehensive study of all Populus species on the Qinghai-Tibet Plateau, 23 previously recorded species and 8 new species were identified. Based on morphological characteristics, these can be classified into three groups: species in section Leucoides, species with large leaves, and species with small leaves in section Tacamahaca. By conducting whole-genome re-sequencing of 150 genotypes from these 31 species, 2.28 million single nucleotide polymorphisms (SNPs) were identified. Phylogenetic analysis utilizing these SNPs not only revealed a highly intricate evolutionary network within the large-leaf species of section Tacamahaca but also confirmed that a new species, P. curviserrata, naturally hybridized with P. cathayana, P. szechuanica, and P. ciliata, resulting in 11 hybrid species. These findings indicate the widespread occurrence of hybrid species formation within this genus, with hybridization serving as a key evolutionary mechanism for Populus on the plateau. A novel hypothesis, “Hybrid Species Exterminating Their Ancestral Species (HSEAS),” is introduced to explain the mechanisms of hybrid species formation at three different scales: the entire plateau, the southeastern mountain region, and individual river valleys.

The influence of COVID-19 on attention-deficit/hyperactivity disorder diagnosis and treatment rates across age, gender, and socioeconomic status: A 20-year national cohort study

Infection and lockdowns resulting from COVID-19 have been suggested to increase the prevalence and treatment rates of Attention Deficit/Hyperactivity Disorder (ADHD). To accurately estimate the pandemic's effects, pre-pandemic data can be used to estimate diagnosis and treatment rates during the COVID-19 years as if the COVID-19 pandemic did not occur. However, accurate predictions require a broad dataset, both in terms of the number of cases and the pre-pandemic timeframe. In the current study, we modeled monthly ADHD diagnosis and treatment rates over the 18 years preceding the COVID-19 pandemic. The dataset included ∼3 million cases for individuals aged 6 to 18 from the Clalit Health Services' electronic database. Using a trained model, we projected monthly rates for post-lockdown and post-infection periods, enabling us to estimate the expected diagnosis and treatment rates without the COVID-19 pandemic. We then compared these predictions to observed data, stratified by age groups, gender, and socioeconomic status. Our findings suggest no influence of the COVID-19 pandemic on ADHD diagnosis or treatment rates. We show that a narrower timeframe for pre-COVID-19 data points can lead to incorrect conclusions that COVID-19 affected ADHD diagnosis rates. Findings are discussed, given the assumed impact of the COVID-19 pandemic on ADHD.

Osteoporosis management in adults with schizophrenia following index hip fracture event: a 10-year population-based retrospective cohort study, Ontario, Canada.

Evidence suggests that individuals with schizophrenia may be more likely to experience hip fractures than the general population; however, little is known about osteoporosis management in this disadvantaged subpopulation. Our study objective was to compare bone mineral density (BMD) testing and pharmacologic treatment in hip fracture patients with versus without schizophrenia. This was a retrospective population-based cohort study leveraging health administrative databases, and individuals aged 66-105 years with hip fracture between fiscal years 2009 and 2018 in Ontario, Canada. Schizophrenia was ascertained using a validated algorithm. The outcome was a composite measure of (1) pharmacologic prescription for osteoporosis; or (2) a BMD test. Inferential analyses were conducted using Fine-Gray subdistribution hazard regression, with mortality as the competing event. A total of 52,722 individuals aged 66 to 105 years who sustained an index hip fracture in Ontario during the study period were identified, of whom 1890 (3.6%) had schizophrenia. Hip fracture patients with vs without schizophrenia were more likely to be long-term care residents (44.3% vs. 18.1%; standardized difference, 0.59), frail (62.5% vs. 36.5%; standardized difference, 0.54) and without a primary care provider (9.2% vs. 4.8%; standardized difference, 0.18). In Fine-Gray models, schizophrenia was associated with a lower incidence of testing or treatment (0.795 (0.721, 0.877)). In this population-based retrospective cohort study, a schizophrenia diagnosis among hip fracture patients was associated with a lower incidence of testing or treatment, after accounting for mortality, and several enabling and predisposing factors. Further research is required to investigate barriers to osteoporosis management in this disadvantaged population.

Socioeconomic Disadvantage and Youth Mental Health During the COVID-19 Pandemic Lockdown

Adolescence is a period in which mental health problems emerge. Research suggests that the COVID-19 lockdown may have worsened emotional and behavioral health. To examine whether socioeconomic status was associated with mental health outcomes among youths during the COVID-19 pandemic. The Adolescent Brain Cognitive Development (ABCD) Study is a multisite 10-year longitudinal study of youth neurocognitive development in the US. Recruitment was staggered where the baseline visit (ages 9 to 10 years) occurred from 2016 to 2018, and visits occurred yearly. The COVID-19 lockdown halted research collection during the 2-year follow-up visits (ages 11 to 12 years), but eventually resumed. As some youths already underwent their 2-year visits prior to lockdown, this allowed for a natural experiment-like design to compare prepandemic and intrapandemic groups. Thus, data were gathered from the 1-year follow-up (pre-COVID-19 lockdown for all youths) and the 2-year follow-up, of which a portion of youths had data collected after the lockdown began, to compare whether a period of near social isolation was associated with mental health symptoms in youths. The prepandemic group consisted of youths with a 2-year follow-up visit collected prior to March 11, 2020, and the intrapandemic group had their 2-year follow-up visit after lockdown restrictions were lifted. Assessments included measures on income-to-needs ratio (INR; derived from total household income), the Child Behavior Checklist (a measure of mental health symptomology), and the Family Environmental Scale. The final sample included 10 399 youths; 3947 (52.3%) were male; 2084 (20.3%) were Latinx/Hispanic; 6765 (66.0%) were White; 4600 (44.2%) reported caregiver education levels below a 4-year college degree; and 2475 (26.2%) had INR either below 100% (indicating poverty) or between 100% and less than 200% (near poverty). Among youths in the intrapandemic group, worse mental health symptoms (eg, more total problems, greater depression, and greater anxiety) over time were associated with being from a household with higher socioeconomic status (eg, when comparing individuals who differed by 1 unit on INR between prepandemic and intrapandemic groups from 1-year to 2-year follow-up, their expected difference in total problems score was 0.79 [95% CI, 0.37-1.22]; false discovery rate-corrected P < .001). This cohort study found that the COVID-19 lockdown was associated with disproportionately negative mental health outcomes among youths from higher socioeconomic status backgrounds. Although this study does not shed light on the direct mechanisms driving these associations, it does provide some support for positive outcomes for youths. Future studies are needed to understand whether these associations persist over longer periods of time.

Drug-coated balloons versus conventional percutaneous transluminal angioplasty for treatment-naïve dysfunctional arteriovenous fistulas.: A 10-year single center retrospective study.

To compare the primary patency and restenosis rates in treatment naieve dialysis arteriovenous fistulas (AVFs) after drug-coated balloons (DCB) versus plain balloon angioplasty (PTA). This retrospective study included 157 patients who underwent AVF angioplasty for treatment-native AVF stenosis between January 2012 to 2022. The fistulas were Brachiocephalic (75%), Brachiobasilic (17%), and radiocephalic (8%). The index intervention was with either DCB or percutaneous transluminal angioplasty (PTA) with subsequent follow up. Patients with central venous stenosis, thrombosed fistula, fistula stents, AV graft or surgical intervention after the index procedure were excluded. Arteriovenous fistula angioplasty was done in 28 patients using DCB and in 129 patients using PTA. A total of 108 patients presented with a single stenosis, 42 with 2 stenoses, and 7 with 3 stenoses. The location of these stenoses was in the venous outflow (57%), the juxta anastomotic segment (31%), and cephalic arch (12%). The median time to re-intervention for the PTA was 216 days compared to 304 days for the DCB (p=0.079). Primary patency at 6 months was 60.4% for PTA and 75% for DCB (p=0.141) CONCLUSION: Although DCB angioplasty of treatmentnaïve dysfunctional AVF tends to improve the time to intervention and 6-month primary patency compared to PTA, this difference did not reach statistical significance.

Phenomenological memory characteristics and impact of near-death experience in critically ill survivors: Observations at discharge and after a 1-year follow-up

BackgroundIt is not rare that intensive care unit (ICU) patients report unusual subjective experiences, ranging from a feeling of harmony with the environment to complex phenomena such as near-death experience (NDE). This 1-year follow-up study investigates the characteristics and potential global impact of the NDE memories recalled by ICU survivors. MethodWe prospectively enrolled 126 adult survivors of a prolonged (>7days) ICU stay (all etiologies), including 19 (15 %) who reported a NDE as identified by the Greyson NDE scale. The NDE group underwent a semi-structured interview one month later evaluating their memory characteristics and the associated life-threatening situation. One year after inclusion, all patients (regardless of whether they recalled an NDE) were contacted for a follow-up Greyson NDE scale assessment and questions about their ICU experience and opinions on death since discharge. ResultsThe Greyson NDE scale revealed that the most frequently reported features were altered time perception, heightened senses and life review, and the Greyson total scores did not evolve over time. NDE memories persisted, with a consequent number of phenomenological characteristics (e.g., visual details, emotions). One year post-ICU, two patients (18 %) of the NDE group and 12 (24 %) of the non-NDE group were less afraid of death. ConclusionsResults emphasize the clinical importance of interviewing all ICU patients to explore any memory after an ICU stay.