2-year Study Research Articles

Impact of COVID-19 on referrals to paediatric liaison psychiatry at Children's Health Ireland at Crumlin as the pandemic moved to endemic status.

Rates of acute mental health presentations in youth were increasing pre-pandemic internationally. Longitudinal studies following COVID-19 attest to ongoing deterioration in youth mental health, recognising adverse unintended consequences following public health restrictions. To examine whether the initial post-COVID-19 increase in mental health presentations persisted following the reclassification of COVID-19 to endemic status, accompanied by the removal of most restrictions. All referrals to paediatric liaison psychiatry (PLP) between January 2018 and December 2022 in a Dublin tertiary children's hospital were included in the study. An interrupted time series analysis with autoregressive integrated moving average models was conducted, examining referrals with respect to different phases of COVID-19 and application of public health restrictions. Some 1385 referrals to PLP were received over the 5-year study. There was a significant decrease in PLP referrals immediately post-COVID-19, followed by a significant and sustained increase as the pandemic progressed and moved to endemic status. Public health restriction phases had a unique effect on those presenting with suicidal ideation, with a significant increase in the number of referrals. There was no effect of restrictions on other clinical profiles. Increased referrals for youth with mental health difficulties, reported during the COVID-19 pandemic, persisted into the early endemic stage, after COVID-19 public health restrictions ceased. Specific impacts of restrictions on suicidal ideation referrals require further study. Investment in child and adolescent mental health services remains a priority, and future pandemic response strategies need to examine unintended consequences of any enforced public health measure.

Childhood language development and alexithymia in adolescence: an 8-year longitudinal study.

Alexithymia (difficulties identifying and describing feelings) predicts increased risks for psychopathology, especially during the transition from childhood to adolescence. However, little is known of the early contributors to alexithymia. The language hypothesis of alexithymia suggests that language deficits play a primary role in predisposing language-impaired groups to developing alexithymia; yet longitudinal data tracking prospective relationship between language function and alexithymia are scarce. Leveraging data from the Surrey Communication and Language in Education cohort (N = 229, mean age at time point 1 = 5.32 years, SD = 0.29, 51.1% female), we investigated the prospective link between childhood language development and alexithymic traits in adolescence. Results indicated that boys with low language function at ages 4-5 years, and those who later met the diagnostic criteria for language disorders at ages 5-6 years, reported elevated alexithymic traits when they reached adolescence. Parent-reported child syntax abilities at ages 5-6 years revealed a dimensional relationship with alexithymic traits, and this was consistent with behavioral assessments on related structural language abilities. Empirically derived language groups and latent language trajectories did not predict alexithymic traits in adolescence. While findings support the language hypothesis of alexithymia, greater specificity of the alexithymia construct in developmental populations is needed to guide clinical interventions.

Mandibular Implant-Supported Overdentures Using Telescopic Crowns and Immediate Loading Protocol: A 2-Year Prospective Follow-up Study.

Implant-supported overdentures have been an effective treatment method for edentulous mandibles. However, the loading time after implant placement is still controversial. The purpose of this study was to evaluate the outcome of implant-supported overdentures using telescopic crowns for the treatment of edentulous patients with immediate loading protocol. This study was conducted on 22 edentulous mandibular patients visiting the Department of High Technique, National Hospital of Odonto - Stomatology, Ho Chi Minh City, Vietnam for prosthodontic rehabilitation. Each patient received four interforaminal implants. Immediate loading protocol was applied, and Ankylos Syncone copings systems was used to connect the prosthesis and the implants. The survival rate of implants and prostheses, as the primary outcome, were evaluated at 6 months, 01 year, and 02 years post-surgery. Peri-implant tissue condition, peri-implant bone loss, and patient satisfaction were the secondary outcomes. The implant survival rate was 98.9% with 01 failed implant. The peri-implant bone loss changes after 6 months, 01 year, and 02 years were 0.07 ± 0.22 mm, 0.12 ± 0.3 mm, and 0.15 ± 0.2 mm, respectively. No gingival hyperplasia was recorded. The prosthesis survival rate was 86.4% with 1 fractured overdenture, 1 overdenture relining and 1 abutment fracture. Mandibular rehabilitation using implant-supported overdenture with telescopic crowns and immediate loading protocol showed high survival rates of both implant and prosthesis in 2-year follow-up.

Trends in antimicrobial resistance amongst Salmonella Typhi in Bangladesh: A 24-year retrospective observational study (1999-2022).

Rising antimicrobial resistance (AMR) in Salmonella Typhi restricts typhoid treatment options, heightening concerns for pan-oral drug-resistant outbreaks. However, lack of long-term temporal surveillance data on AMR in countries with high burden like Bangladesh is scarce. Our study explores the AMR trends of Salmonella Typhi isolates from Bangladesh, drawing comparisons with antibiotic consumption to optimize antibiotic stewardship strategies for the country. The typhoid fever surveillance from 1999 to 2022 included two pediatric hospitals and three private clinics in Dhaka, Bangladesh. Blood cultures were performed at treating physicians' discretion; cases were confirmed by microbiological serological, and biochemical tests. Antibiotic susceptibility was determined following CLSI guidelines. National antibiotic consumption data for cotrimoxazole, ciprofloxacin, and azithromycin was obtained from IQVIA-MIDAS database for comparison. Over the 24 years of surveillance, we recorded 12,435 culture-confirmed typhoid cases and observed declining resistance to first-line drugs (amoxicillin, chloramphenicol, and cotrimoxazole); multidrug resistance (MDR) decreased from 38% in 1999 to 17% in 2022. Cotrimoxazole consumption dropped from 0.8 to 0.1 Daily defined doses (DDD)/1000/day (1999-2020). Ciprofloxacin non-susceptibility persisted at >90% with unchanged consumption (1.1-1.3 DDD/1000/day, 2002-2020). Low ceftriaxone resistance (<1%) was observed, with slightly rising MIC (0.03 to 0.12 mg/L, 1999-2019). Azithromycin consumption increased (0.1 to 3.8 DDD/1000/day, 1999-2020), but resistance remained ≤4%. Our study highlights declining MDR amongst Salmonella Typhi in Bangladesh; first-line antimicrobials could be reintroduced as empirical treatment options for typhoid fever if MDR rates further drops below 5%. The analysis also provides baseline data for monitoring the impact of future interventions like typhoid conjugate vaccines on typhoid burden and associated AMR.

Measurable residual disease assessment prior to allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia and myelodysplastic syndromes: a 20-year monocentric study.

Patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) who undergo allogeneic hematopoietic stem-cell transplantation (alloHSCT) can have divergent survival outcomes while all in morphological complete remission (CR). Techniques of measurable residual disease (MRD) have allowed us to refine their prognosis in two categories: MRD-positive and MRD-negative patients. We conducted a monocentric retrospective study (01/2000-12/2020) to assess the prognosis of pretransplant MRD status measured by multiparametric flow cytometry (MFC) and molecular biology assessed by PCR. 192 patients were included. The median follow-up period was 77months. Among patients undergoing alloHSCT in CR, overall survival (median-OS: 130.6 vs. 16.0months, P < 0.001), disease-free survival (median-DFS: 109.6 vs. 7.1months, P < 0.001) and cumulative incidence of relapse (12-month CIR: 7.3% vs. 33.7%, P < 0.0001) were significantly different between MRD-negative and MRD-positive patients. Patients with discordant intermethod results had intermediate DFS. MRD-negative patients according to molecular PCR-based techniques, WT1 overexpression and MFC had longer median-DFS, compared to MRD-positive patients (P = 0.001, P < 0.001, P < 0.001, respectively). Looking into subgroups, MRD-positive patients among the ELN2017 adverse-category (P < 0.0001), myeloablative and reduced-intensity conditioning regimens (P < 0.0001, P = 0.005), < 60-year patients (P < 0.001) and AML patients (P < 0.001) were associated with lower DFS. This difference was not found in ≥ 60-year patients (P = 0.27) and MDS patients (P = 0.70). MRD-positive patients within the favorable/intermediate ELN2017 category trended toward lower DFS (P = 0.05). We confirmed that MRD status prior to alloHSCT is a strong prognostic factor for OS, DFS and CIR. Combining MFC and molecular-PCR techniques to assess MRD seems primordial as inter-method discordance can be consequential.

Sensory impairments associated with cognitive impairment among older adults in China: A community-based, 10-year prospective cohort study.

To address an existing gap in knowledge due to limited and inconclusive evidence, we aimed to investigate the association between sensory impairments and cognitive decline among older Chinese individuals. We retrieved data on 6862 adults aged ≥65 years that were collected through the Chinese Longitudinal Healthy Longevity Study (CLHLS), a nationwide, prospective, community-based elderly cohort study. Visual or hearing impairment in the CLHLS were identified through self-reported questionnaire. Sensory impairments were categorised as no sensory impairment, hearing impairment only, visual impairment only, and dual sensory impairment according to hearing and vision function. Cognitive impairment was defined as having a score <18 on the Chinese version of the Mini Mental State Examination. We used a Cox proportional hazard model to evaluate the relationship between sensory and cognitive impairments. Among 6862 participants, 5.7% had dual sensory impairment, 7.4% had hearing impairment only, and had 17.2% visual impairment only. Compared with participants with no sensory impairment, those with hearing impairment only (adjusted hazard ratio (aHR) = 1.65; 95% confidence interval (CI) = 1.41, 1.92), visual impairment only (aHR = 1.25; 95% CI = 1.11, 1.41), and dual sensory impairment (aHR = 1.47; 95% CI = 1.25, 1.74) were significantly associated with higher risk of cognitive impairment in the fully adjusted model. Our results show that having hearing impairment only, visual impairment only, and dual sensory impairment was significantly associated with a higher risk of cognitive impairment among Chinese older adults aged ≥65 years. This suggest a need for the timely identification and management of sensory impairments for the elderly to reduce dementia risk.

Facilitators and barriers of long-term exercise adherence in healthcare workers formerly suffering from post-COVID-19 syndrome : Aqualitative 1-year follow-up and quantitative pilot study of the COFIT trial.

Early exercise intervention studies showed promising positive effects of physical exercising on post-COVID-19symptoms; however, little is known about long-term training adherence and what influences it. Semi-structured interviews were conducted with 17participants of the 8‑week original exercise intervention study. Facilitators and barriers were identified via thematic analysis and compared between those participants who continued their regular exercise behavior (continuous exercise group, CEG, n = 7) and those who stopped exercising (discontinuous exercise group, DEG, n = 10). Physical performance parameters and questionnaires regarding psychological health dimensions and work ability were assessed analogously to the original study. Qualitative analysis showed that two of the top three facilitators, (improving physical and mental health, sport has high priority) were the same in both groups. The respective third of the top three facilitators was (re)build physical and cognitive performance in the CEG and training in the group in the DEG. The top three barriers (exhaustion, sport has little priority, procrastination) were not only the same in both groups but also in the same order. The strongest post-COVID-19 associated facilitator for long-term exercise adherence is when the need for further reconditioning is felt. The strongest post-COVID-19 associated barrier is exhaustion. Availability of exercising in agroup is akey factor in increasing long-term exercise adherence.

Effects of the COVID-19 Pandemic on Microbial Keratitis: A 5-Year Comparative Study.

To report the clinical and microbiological profiles of microbial keratitis and its antimicrobial resistance before, during, and after COVID-19. This was a retrospective case-note review of all corneal scrape specimens collected from patients with microbial keratitis from January 2018 to December 2023. Case records were analyzed for demographic characteristics, microbiological diagnosis, and antibiograms. All outcome variables were collected, stratified, and compared between 3 periods: the pre-COVID-19 group (January-December 2019), the COVID-19 group (January 2020-December 2022), and the post-COVID-19 group (January-December 2023). A total of 947 corneal cultures from 947 patients were reviewed. Gram-positive bacteria predominated in all periods, with no significant differences in their distribution. Staphylococcus epidermidis was the most frequently identified organism. Pseudomonas aeruginosa was the most common Gram-negative bacterium, with its incidence significantly lower in the post-COVID period. Fungal infections showed a significant increase in the post-COVID group, with Fusarium sp. being the most common fungus and showing a significant increase in incidence in the post-COVID group. Despite a stable incidence of microbial keratitis, this study highlights a concerning trend in antibiotic resistance. Although some pathogens became less common, those that persisted have become increasingly difficult to treat. Understanding the clinical and microbiological profiles of microbial keratitis and antimicrobial resistance patterns before and after the COVID-19 pandemic is crucial for informed treatment decisions.

Foliar-applied silicon and zinc nanoparticles improve plant growth, biochemical attributes, and essential oil profile of fennel (Foeniculum vulgare) under different irrigation regimes.

The comparative efficacy of silicon (Si) and zinc (Zn) nanoparticles (NPs) in mitigating drought stress in fennel (Foeniculum vulgare ) remains largely unexplored. This study evaluated the impact of Si NPs and Zn NPs on enhancing plant growth and physiological-biochemical attributes of fennel under varying irrigation regimes. The 2-year study was a split-pot design with irrigation at three irrigation levels (100, 75, and 50% field capacity, FC) and five treatments of foliar application of Si and Zn NPs (control, 1mM Si NP, 2mM Si NP, 1mM Zn NP, 2mM Zn NP). Results showed that drought stress reduced plant performance. Increases in superoxide dismutase (SOD, 131%) and catalase (CAT, 276%) were seen after a 50% FC drought without the use of Si and Zn NPs. Conversely, biological yield (34%), seed yield (44%), chlorophyll a +b (26%), relative water content (RWC, 21%), and essential oil (EO) yield (50%) were all reduced. However, application of Zn and Si, particularly 1mM Si and 2mM Zn, greatly mitigated drought stress via lowering CAT and SOD activity and enhancing plant yield, chlorophyll content, RWC, and EO. The composition of the EO consisted primarily of anethole, followed by limonene, fenchone, and estragole. During drought conditions, monoterpene hydrocarbons increased while oxygenated monoterpenes decreased. The opposite trend was observed for Si and Zn NPs. Our results suggest that applying Zn NPs at 2mM followed by Si NPs at 1mM improved plant resilience and EO yield in fennel plants under water stress.

Clinical Effectiveness and Safety of Dupilumab in Chronic Obstructive Pulmonary Disease Patients: A 7-Year Population-based Cohort Study

BackgroundPrevious randomized controlled trials had established the efficacy of dupilumab among patients with chronic obstructive pulmonary disease (COPD) treated with triple therapy over 52 weeks of follow-up. ObjectiveThis population-based cohort study aimed to explore the long-term clinical effectiveness of dupilumab in COPD patients. MethodsThis population-based cohort study included U.S. patients with COPD between April 2017 and August 2024. Patients initiating dupilumab and therapies that incorporated long-acting β2-agonists (LABA) inhalers were included. Patients with asthma or lung cancer were excluded. The risk of outcomes after the initiation of dupilumab versus LABA-containing therapies was measured. For detailed Methods, please see the Methods section in this article's Online Repository at www.jacionline.org. ResultsA total of 1,521 dupilumab initiators and 1,521 propensity score-matched patients receiving LABA-based therapies were included. Dupilumab recipients were associated with lower all-cause mortality (HR:0.53, 95% CI:0.43-0.65), emergency visits (HR:0.78, 95% CI:0.69-0.89), and acute exacerbation (AE) rates (HR:0.59, 95% CI:0.53-0.65). Dupilumab was also associated with reductions in the requirement of short-acting β2-agonists (HR:0.48, 95% CI:0.43-0.52), short-acting muscarinic antagonists (HR:0.43, 95% CI:0.37-0.49) for symptoms control. Additionally, dupilumab decreased subsequent pneumonia (HR:0.65, 95% CI:0.50-0.86), and COPD-relevant comorbidities including new-onset heart failure (HR:0.69, 95% CI:0.53-0.90) and new-onset anxiety (HR:0.70, 95% CI:0.53-0.93). ConclusionsDupilumab was associated with a lower rate of mortality, emergency visits, reduced risk of AEs, respiratory symptoms, and respiratory infections in COPD patients. More studies are required to validate the effectiveness of dupilumab among patients with COPD across various severities.

A 14-year longitudinal study of neurofilament light chain dynamics in premanifest and transitional Huntington's disease.

Growing evidence supports the value of neurofilament light (NfL) as a prognostic biomarker in premanifest Huntington's disease (HD). To date, however, there has been no longitudinal study exceeding 3years examining either its serial dynamics or predictive power in HD. We aimed to conduct the first such study. Serum NfL was sampled using ultrasensitive immunoassay at four timepoints across a 14-year period in a cohort of HD gene carriers (n = 21) and controls (n = 14). Gene carriers were premanifest at baseline. Clinical features of HD were evaluated by Unified Huntington's Disease Rating Scale (UHDRS TMS), Montreal Cognitive Assessment (MoCA), Trail A/B task, Symbol Digit Modalities Task and semantic/phonemic fluency tasks. 14/21 HD gene carriers converted to prodromal or manifest disease by the final timepoint ("converters"). At baseline and each subsequent timepoint, NfL levels were higher in converters than in non-converters and controls (p = < 0.001-0.03, ηp2 = 0.25-0.66). The estimated rate of change in NfL was higher in converters than in non-converters (p = 0.03) and controls (p = 0.001). Baseline NfL was able to discriminate converters from non-converters (area under curve = 1.000, p = 0.003). A higher rate of change in NfL was predictive of more severe motor (UHDRS-TMS p = 0.007, β = 0.711, R2 = 0.468) and cognitive deficits (MoCA p = 0.007, β = -0.798, R2 = 0.604; Trail B, p = 0.007, β = 0.772, R2 = 0.567; phonemic fluency p = 0.035, β = -0.632, R2 = 0.345). Our data suggest that (1) NfL longitudinal dynamics in premanifest/transitional HD are non-constant; rising faster in those closer to disease onset, and (2) NfL can identify individuals at risk of conversion to manifest disease and predict clinical trajectory, > 10years from disease onset.

Bridging the Gap in Policy Implementation through a Health Equity Lens: Insights from a 2-Year Study on Measurement Development

Background: Policy implementation measurement lacks an equity focus, which limits understanding of how policies addressing health inequities, such as Universal School Meals (USM) can elicit intended outcomes. We report findings from an equity-focused measurement development study, which had two aims: (1) identify key constructs related to the equitable implementation of school health policies and (2) establish face and content validity of measures assessing key implementation determinants, processes, and outcomes. Methods: To address Aim 1, study participants (i.e., school health policy experts) completed a survey to rate the importance of constructs identified from implementation science and health equity by the research team. To accomplish Aim 2, the research team developed survey instruments to assess the key constructs identified from Aim 1 and conducted cognitive testing of these survey instruments among multiple user groups. The research team iteratively analyzed the data; feedback was categorized into “easy” or “moderate/difficult” to facilitate decision-making. Results: The Aim 1 survey had 122 responses from school health policy experts, including school staff (n = 76), researchers (n = 22), trainees (n = 3), leaders of non-profit organizations (n = 6), and others (n = 15). For Aim 2, cognitive testing feedback from 23 participants was predominantly classified as “easy” revisions (69%) versus “moderate/difficult” revisions (31%). Primary feedback themes comprised (1) comprehension and wording, (2) perceived lack of control over implementation, and (3) unclear descriptions of equity in questions. Conclusions: Through adaptation and careful dissemination, these tools can be shared with implementation researchers and practitioners so they may equitably assess policy implementation in their respective settings.

A 10-year cross-sectional study showed that anti-coagulation therapy was not always of value when treating paediatric cases with septic cerebral venous thrombosis.

Cerebral venous thrombosis (CVT) is a rare complication of ear, nose and throat (ENT) infections. Although recent guidelines recommend the systematic use of anti-coagulation therapy (ACT) in the treatment of these CVT, literature data are scarce. The present study's objective was to determine the value of ACT in achieving recanalisation after thrombosis and its effect on patient outcomes. All paediatric patients with CVT and a concomitant ENT infection who attended Lille University Hospital (Lille, France) between January 2012 and December 2021 were retrospectively included. We included 43 children (63% boys), with a mean age of 4 years. The most frequent infection was mastoiditis (54%). ACT was initiated in 23 patients (53%), one of whom had an intracranial haemorrhage. Partial or full recanalisation was observed in 33 (80%) of the 41 survivors. In patients with no neurological signs and symptoms on admission and in patients with mastoiditis-related CVT, the clinical and radiological outcomes were favourable and did not differ according to the administration of ACT. Likewise, ACT did not appear to influence the recanalisation rate or sequelae. ACT was not necessary for all patients with mastoiditis-related CVT and those with no neurological signs and symptoms on admission.

Adenocarcinoma of the esophagogastric junction: characteristics of female patients and young adult patients based on a 12-year retrospective and prospective multicenter clinicoepidemiological cohort study in Japan

BackgroundAdenocarcinoma of the esophagogastric junction (AEGJ) is most common in men and the elderly, but the disease is becoming more common in female and young adult persons. We have investigated the clinicoepidemiological characteristics of female and young adult patients with AEGJ and the 12-year trends in the Kurashiki area for young adult patients with AEGJ.MethodsPatients diagnosed with AEGJ in 12 hospitals between January 2008 and December 2019 were included in this study. Patients were divided into three groups by age (young adult [≤50 years], middle-aged [51 to 70 years], and elderly [>70 years]). Factors associated with AEGJ such as obesity, smoking, hiatal hernia and male, which were reported in our previous study, were identified.ResultsOne hundred and eighty-eight AEGJ patients, including 36 females and 20 young adults, were characterized. There was no significant change in the annual incidence of AEGJ among female (p=0.078) and young adult patients (p=0.89). Female patients without any associated factors, accounting for 53% (19/36) of the female patients and young adult patients, had significantly more histologically undifferentiated cancers than patients with at least one associated factor (58% [11/19] vs. 30% [50/169], p=0.025) and middle-aged and elderly patients (60% [12/20] vs. 30% [25/83] vs. 28% [24/85], p =0.026). Smoking was significantly less common in women than in men (8% [3/36] vs. 57% [87/152], p < 0.01). There were no significant differences between ages in the proportions of these associated factors.ConclusionsHistologically undifferentiated AEGJ cancers were more frequent in female patients without any associated factors and in young adult patients. Factors associated with AEGJ may differ between women and men, but they are similar in young adults and older adults. No increase in young adult patients with AEGJ was observed in the 12-year study.

Recurrence rates after healing in patients with neuroischemic diabetic foot ulcers healed with and without sucrose octasulfate-impregnated dressings: A 1-year comparative prospective study.

To compare recurrence rates after a 1-year follow-up period of healed neuroischemic diabetic foot ulcers after treatment with or without sucrose octasulfate impregnated dressing. A 1-year prospective study with two arms was conducted between April 2021 and April 2023 on 92 patients with healed neuroischemic diabetic foot ulcers. Patients were divided into two groups; the treatment group, that includes patients healed with a sucrose octasulfate-impregnated dressing, and the control group, which includes patients treated with other local treatments different from sucrose octasulfate-impregnated dressings. After healing, patients were prospectively followed up during 1-year and assessed monthly in the specialised outpatient clinics. The main outcome of the study was ulcer recurrence after wound healing within 1 year follow-up. Secondary outcomes were minor or major amputation and all causes of death. Fifty patients in the treatment group and 42 patients in the control group were included. Fourteen (28%) patients suffered from a reulceration event in the treatment group compared to 28 (66.7%) in the control group, p < 0.001. Time to recurrence in the treatment group was 10 (16.26-2.75) and 11.50 (30.75-5.25) weeks in the control group, p = 0.464. There were no observed differences in the minor amputation rates between the two groups: 15.2% (n = 7) in the treatment group and 7.1% (n = 3) in the control group (p = 0.362). Major amputations and death outcomes were exclusively observed in the treatment group. Specifically, four major amputations (8.7%) in the treatment group were complications arising from recurring events complicated by infection during the SARS-CoV-2 period. Seven patients died due to complications not related with local therapy. The relative risk of recurrence was 20.18 times higher in the control group compared with those treated with octasulfate dressing (p < 0.001). Treatment with sucrose octasulfate-impregnated dressings can decrease recurrence rates of neuroischaemic diabetic foot ulcers more effectively than neutral dressings. Besides, it may enhance the foot's clinical properties in patients with poor microcirculation, which could aid in preventing future recurrences.

Evaluation of Plant Growth and Flowering Performance of Florida Native and Non-native Ornamentals under Varying Irrigation

Pollinator gardening has gained momentum with an increased consumer interest in selecting native rather than non-native plant species to reduce water dependence and maximize the biodiversity value in both public greenspaces and residential gardens. Native plant species can enhance biological control and benefit ecosystems and wildlife. Often, they are also better-adapted to local environmental conditions, including temperature and rainfall, thus increasing their survival and reducing associated maintenance costs, primarily by requiring less water. Commercially available pollinator-friendly plant mixes often include both native and non-native species. A 2-year study was conducted to determine the main effects of plant provenance (native or non-native) and irrigation (full or partial irrigation) on landscape performance and flowering of 20 plants, including 10 congeneric pairs of native and non-native taxa that were planted in two locations (north and northcentral Florida). Native and non-native taxa were paired by genus to analyze the effect of the plant native status on vegetative and floral traits while controlling for variations in leaf and floral morphologies, growth habits, and blooming periods, which was a key and novel component of our study design. Represented native species included Spanish needles (Bidens alba), false rosemary (Conradina grandiflora), tickseed coreopsis (Coreopsis leavenworthii), blanket-flower (Gaillardia pulchella), swamp rosemallow (Hibiscus grandiflorus), inkberry (Ilex glabra), spotted beebalm (Monarda punctata), azure blue sage (Salvia azurea), Florida scrub skullcap (Scutellaria arenicola), and Walter's viburnum (Viburnum obovatum). Non-native taxa paired with native congeners included Beedance® painted red bidens (Bidens ferulifolia) or Goldilocks Rocks® bidens (Bidens ferulifolia ‘BID 16101’), barbeque rosemary (Salvia rosmarinus ‘Barbeque’), Jethro Tull coreopsis (Coreopsis × ‘Jethro Tull’), Arizona sun blanket-flower (Gaillardia ×grandiflora ‘Arizona Sun’), Ruffled Satin® rose of Sharon (Hibiscus syriacus ‘SHIMCR1’), dwarf Burford holly (Ilex cornuta ‘Dwarf Burford’), pardon my pink beebalm (Monarda didyma ‘Pardon My Pink’), big blue salvia (Salvia longispicata × S. farinacea ‘PAS1246577’), Malaysian skullcap (Scutellaria javanica), and Sandankwa viburnum (Viburnum suspensum). Overall, the results revealed that native plants outperformed non-native plants and exhibited greater survival, more vegetative growth, and greater floral abundance regardless of the irrigation treatment. Although there was no overall effect of irrigation on plant size or flower abundance, there were some species-specific responses, especially during the establishment year, and plants under full irrigation had greater survival in the establishment year. Thus, in general, the effects of plant provenance were stronger and more consistent across years than irrigation. Additional studies are underway to determine the floral rewards of these species and their attraction to diverse pollinators.

Long-term effectiveness of tonsillotomy versus tonsillectomy: A 12-year follow-up study.

To evaluate the long-term effectiveness of tonsillotomy (TT) compared to tonsillectomy (TE) with respect to disease-specific quality of life (QOL), sleep-disordered breathing symptoms, throat infections, and rate of reoperations over a median follow-up period of 12years. All patients < 16years of age who underwent tonsil surgery between 2010 and 2011 at Helsinki University Hospital, Finland, were included in the study. In 2023, the patients answered a questionnaire concerning tonsil-related issues and a modified Tonsil and Adenoid Health Status Instrument (disease-specific QOL). Information about possible revisits and reoperations was gathered. The study population consisted of 189 respondents, of which 87 had undergone TT and 102 TE. The median follow-up was 11.8years in the TT group and 12.4years in the TE group. The disease-specific QOL was equally good in both groups. Throat infections had not been an issue for the vast majority of patients and occurred to the same extent after TT and TE. The majority of participants (79.0% TT, 86.9% TE) were satisfied with the surgery, with no significant differences between the groups. After TT and TE, there were only a few revisits due to tonsil-related problems, and the reoperation rate was 6.9% and 1.0%, respectively. Long-term clinical effectiveness of TT seems excellent. Compared to TE, with TT, equal disease-specific QOL can be achieved with a less invasive surgical method. Over a median follow-up period of 12-years, TT was not shown to be associated with an increased risk of tonsil infection problems.

114P Epidemiology and therapeutic outcomes of patients with spinal muscular atrophy: results from a 12-year real-world study based on the French National Healthcare database (SNDS)

114P Epidemiology and therapeutic outcomes of patients with spinal muscular atrophy: results from a 12-year real-world study based on the French National Healthcare database (SNDS)

Comprehensive Management of Degloving Soft Tissue Injuries of the Extremity: A 12-year Retrospective Study

BackgroundDegloving soft tissue injuries (DSTIs) of the extremities, which are often underestimated in terms of their severity, present significant challenges to reconstructive surgeons. We propose a comprehensive management protocol to standardize the reconstructive approach, aiming for successful treatment of these devastating injuries. MethodsWe retrospectively analyzed data from consecutive patients with extremity DSTIs over a 12-year period. Patients were categorized into three age groups (0–17, 18–65, and > 65 years) to highlight the different treatment options based on age. Various surgical techniques were employed depending on the injury pattern. Treatment strategies for each patient were individualized based on age, underlying conditions, and injury type. Wound healing, complications, and functional outcomes were recorded. ResultsOf the hospitalized patients, 20 were lost to follow-up, and 105 were included in the analysis. The mean age at the time of injury was 40 ± 44.9 years, with a mean follow-up of 30.1 ± 12.7 months. Furthermore, 19% of patients were aged 0–17 years, 61% were aged 18–65 years, and 20% were aged > 65 years. Treatment plans were personalized based on injury characteristics, with numerous patients being treated with a combination of multiple surgical techniques. Older patients had significantly longer wound healing times and delayed return to activities of daily living compared to the other age groups. Overall, patients were generally satisfied with their outcomes. The total complication rate was 46.7%, with 79.5% being categorized as major complications. Each complication was addressed with a tailored treatment plan. ConclusionThe management of DSTIs should be individualized, taking into account the specific characteristics of each injury. Age and medical fitness play crucial roles in determining both the surgical approach and prognosis. An accurate initial evaluation and thorough debridement are essential for optimal outcomes.

Moderate physical activity and higher frequency are inversely associated with incidence of frailty in middle-aged and older population: a 4-year longitudinal study in Europe.

Global aging is leading to an increase in frailty patients, and physical activity (PA) may have an impact on frail in middle-aged and older population. This study aimed to explore the relationship between the frequency of different PA intensities and the incidence and prevalence of frailty in middle-aged and older adults based on the Survey of Health, Ageing, and Retirement in Europe (SHARE). Self-reported questionnaires were used to obtain information on demographics and PA, and frailty was assessed using the SHARE Frailty Instrument (SHARE-FI). Cox regression and logistic regression models were used to explore the association between PA and frailty and stratified according to middle or old age. Among 6315 baseline non-frail participants aged 44-96years, 16.1% developed frailty over 4years, with higher incidence and prevalence in women (P < 0.05). Women accounting for 55.80% of the sample. The frequency of participants participating in sports decreased over 4years (P < 0.05). Compared with participants who engaged in PA more than once a week, participants who engaged in moderated PA less frequently had a higher risk of new-onset frailty (HR: 3.174-6.115), and participants who engaged in vigorous PA 1-3 times a month had a higher risk of new-onset frailty (HR: 1.335). Participation in low-frequency moderate PA and vigorous PA 1-3 times per month were positively associated with the prevalence of frailty (P < 0.05). Physical activity frequency decreases with age in middle-aged and older adults. Those adults who engage in moderate PA more than once a week have a lower risk of incidence of frailty, compared to those with more sedentary life-styles. Additionally, women need to pay more attention to frailty management.