2-year Study Research Articles

Results of patch testing propolis in the European baseline series: A 4-year retrospective study.

Propolis was added to the European baseline series (EBS) in 2019. To investigate the frequency and relevance of positive patch tests to propolis in the EBS and to study co-reactivities. Retrospective study in patients patch tested between June 2019 and November 2023 in a university hospital in Amsterdam, The Netherlands. Of 3134 consecutive patients, 299 (9.5%) had a positive reaction to propolis 10% pet. Only nine reactions (3%) were judged to be clinically relevant. There were significant co-reactivities to Myroxylon pereirae resin (balsam of Peru), colophonium, fragrance mixes 1 and 2, and to limonene and linalool hydroperoxides. A steep increase in rates of positive reactions to propolis was observed from 2020 to 2023. This was highly likely the result of the replacement of Chinese propolis with Brazilian propolis by the manufacturer. Positive patch tests for propolis are very frequent in Amsterdam, but only a few of these reactions are relevant. Most are probably (pseudo-)cross-reactions in patients with fragrance allergies. Propolis in the EBS has very limited value for dermatologists and patients in The Netherlands. Changes in patch test materials should be provided to all users to avoid misinterpretation of patch test results.

Seed Regeneration in Taxus baccata: Unveiling Ecological Restrictions and Paving the Way for Future Studies.

Taxus baccata, commonly known as English yew, is an evergreen tree native to regions ranging from Ireland and Sweden to Morocco, Algeria, and northern Iran. This species is of special concern due to habitat loss from human activities, including forest management, leading to declining populations. A 4-year monitoring study was conducted to investigate the factors behind the poor seed regeneration of yew. We examined seed germination, dormancy, desiccation tolerance, and seed predation as potential contributors to this issue. Our study proposed potential seed predation by frugivores and granivores, along with morphophysiological dormancy, as primary reasons for poor regeneration. Despite high seed production and seed availability in certain years, germination did not improve, likely due to the small size of the yew seed embryos, which prolongs dormancy. Yew seeds are desiccation-tolerant, water-permeable, and lack physical germination barriers, making seed predation a significant limiting factor. In conclusion, the natural regeneration of yew is hampered by potential seed predation, morphophysiological dormancy, and environmental factors such as altered temperature and rainfall patterns, which change the dormancy-breaking process. Further research is needed to quantify seed predation and explore its impact on seedling survival.

Analysis of different factors on dental students' perception of a flipped classroom model: A 6-year follow-up study.

To evaluate different factors affecting two different cohorts of dental students' perceptions with the flipped classroom (FC) model in a preclinical dental course over six years. In 2016 (cohort #1) and 2022 (cohort #2), second-year dental students participated in FC model in a preclinical dental course consisting of pre-class recorded videos and lectures along with classroom interactive exercises. Students then completed an anonymous pen-and-paper survey evaluating three factors influencing students' overall study experience with the FC model. Survey responses from cohort #1 and cohort #2 were compared to assess the effect of generation, student demographics and COVID-19 pandemic on students' perceptions. When asked to rate the FC experience out of 5, the mean ratings of cohort #1 and cohort #2 were 4.3 (±0.9) and 4.0 (±0.8), respectively. Cohort #2 preferred viewing slides and videos prior to class and had a higher agreement that pre-class course materials were beneficial to class preparation. Conversely, cohort #1 had a higher agreement that in-class discussion and exercises helped them to learn course content. From cohort #2, 88.6% of males and 71.6% of females preferred the FC approach over traditional lecture. Both cohorts reported positively with the FC model of teaching. Cohort #2 had higher positive reports with the pre-class work and cohort #1 had a higher positive report with in-class work. Course design should reflect the students' points of view and learning perspectives with careful consideration of the student population in the classroom.

Clinical and Radiologic Comparisons Between Oblique Lumbar Interbody Fusion Combined with Percutaneous Pedicle Screw Fixation and Transforaminal Lumbar Interbody Fusion for Adult Isthmic Spondylolisthesis: A 2-year Follow-Up Study

Adult isthmic spondylolisthesis(AIS) results in the anterior translation of the vertebral body with neural encroachment. Although oblique lumbar interbody fusion(OLIF) is minimally invasive technique that use a retroperitoneal plane to achieve indirect decompression compared to transforaminal lumbar interbody fusion(TLIF), research on OLIF for AIS remains limited. Therefore, we aimed to compare the clinical and radiological outcomes of these two surgical techniques for AIS. We analyzed the details of 62patients with AIS who were treated with either OLIF(n=26) or TLIF(n=36) between 2019 and 2022, with a minimum 2-year follow-up. The two surgical techniques were compared in terms of perioperative surgical, radiological, and clinical outcomes. The correlation between the severity of foraminal stenosis and clinical outcomes was evaluated. The OLIF group experienced significantly less blood loss, shorter operative times, and shorter hospital stay than the TLIF group. Radiological assessments showed no significant preoperative differences in disc height or slippage ratios, but postoperative slippage correction was significantly greater in the OLIF group than in the TLIF group(13.5±8.0 versus 5.0±8.9; p<0.001). The clinical outcome improvement ratios did not differ significantly between the two groups. The correlation between preoperative severity of foraminal stenosis and clinical outcomes in the OLIF group was not significant. OLIF is more advantageous than TLIF in terms of blood loss, operative time, hospital stay and anterolisthesis correction. In addition, good clinical outcomes were obtained with indirect decompression alone, regardless of the severity of foraminal stenosis. Therefore, OLIF is a good surgical option for the treatment of AIS.

Intraarticular gold microparticles using hyaluronic acid as the carrier for hip osteoarthritis. A 2-year follow-up pilot study

We recently conducted a pilot study in which we discovered that introducing metallic gold microparticles into the knee joint can help reduce pain caused by osteoarthritis for up to two years. Additionally, we identified significant proteomic changes in the synovial fluid and serum within eight weeks of the procedure. In this study, we aimed to evaluate whether there may be a clinical relevant effect of intra-articular injection of gold microparticles on hip osteoarthritis. A cohort of 22 patients, aged ≥ 18 years, with pain ≥ 3 months, and Kellgren-Lawrence OA grade 2–4, were included. Metallic gold 20 mg, 72.000 pieces, 20–40 µ-meter BerlockMicroImplants (BMI) were injected into the hip joint using hyaluronic acid as the carrier. In total, we treated 26 hip joints. The primary outcome was the Western Ontario and McMaster Universities Arthritis Index (WOMAC). WOMAC pain decreased from 11 (2–20 to 3 (0–8), stiffness from 6 (0–8) to 1 (0–4), and activity from 43 (18–68) to 11 (0–27), all P = 0.0001. When adjusting for the minimally relevant differences, the P-values were 0.0015 for WOMAC pain, 0.26 for stiffness, and 0.011 for activity. Combined intraarticular treatment with metallic gold microparticles and hyaluronic acid may improve hip joint pain and function. Joint stiffness did not improve when assessed against the minimal clinically relevant difference. This study suggests a basis for a future placebo-controlled randomized trial of gold microparticles and hyaluronic acid in hip osteoarthritic patients.

Elevated Plasma High Sensitive C-Reactive Protein and Triglyceride/High-Density Lipoprotein Cholesterol Ratio are Risks Factors of Diabetes Progression in Prediabetes Patients After Kidney Transplant: A 3-Year Single-Center Study in Vietnam.

Determination the rate of developing post-transplant diabetes mellitus (PTDM) in prediabetic patients and the relationship with plasma hs-CRP levels and TG/HDL-C ratio in patients after kidney transplantation from living donors followed for 3 years. A total of 206 post-transplant patients diagnosed with prediabetes by oral glucose tolerance test (OGTT) were included in the study. At the time of diagnosis of prediabetes, all patients were clinically examined, paraclinical tests were performed, plasma hs-CRP was quantified, and the TG/HDL-C ratio was determined. Patients are individualized and given a reasonable diet and exercise regimen. Patients had their fasting blood glucose measured monthly or had an OGTT every 3 months. Patients meeting the criteria for diagnosis of PTDM according to the American Diabetes Association (ADA)-2018 were collected during 3 years of follow-up. The study group had an average age of 39.46 ± 10.26 years old, including 74.8% males and 25.2% females. The rate of patients who had a development of PTDM from prediabetes was 29.6% (61/206 patients). BMI, plasma TG, HDL-C, hs-CRP, and TG/HDL-C ratio at the time of prediabetes diagnosis were factors related to the progression of PTDM, in which hs-CRP and TG/HDL-C ratio were good predictors (with AUC = 0.85 and 0.874, respectively; p < 0.001). After 3 years of follow-up, nearly one-third of prediabetic patients developed PTDM post-living donor kidney transplantation. BMI, plasma TG, HDL-C, hs-CRP, and the TG/HDL-C ratio were linked to DM progression, with hs-CRP and TG/HDL-C being the strongest predictors.

Heart rate variability as a biomarker for transdiagnostic depressive and anxiety symptom trajectory in adolescents and young adults.

Internalizing psychopathology is associated with abnormalities in heart rate variability (HRV). Lower HRV that reflects reduced parasympathetic nervous system activity has been observed in depressive and anxiety disorders. Existing studies predominantly used categorical rather than dimensional approaches, the latter of which better addresses clinical comorbidity and heterogeneity. Moreover, there is little evidence on the role of HRV in longitudinal symptom trajectory in adolescents and young adults. The current study examined the association between HRV and internalizing symptom trajectory using a dimensional approach-the tri-level model of depression and anxiety. Adolescents and young adults (N = 362) were recruited in a 3-year longitudinal study, where they completed electrocardiogram recordings and self-report symptom questionnaires. Multilevel modeling was conducted with high-frequency power bands (HF power) of interbeat intervals at baseline as the predictor, and tri-level symptom factors over 3 years as the outcome. HF power significantly predicted the trajectory of the broad General Distress symptom factor, but not the intermediate Fears or Anhedonia-Apprehension symptom factors. Higher HF power was associated with a decline in General Distress over time. This association was held when neuroticism, other tri-level symptom factors, and demographic variables were covaried. That is, greater parasympathetic nervous system activity at baseline was significantly associated with a greater decline in the broad internalizing symptom factor, but not symptom factors that are more specific to depressive or anxiety disorders. Parasympathetic activity, therefore, may be a transdiagnostic biomarker for internalizing symptoms in adolescents and young adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Incidence, diagnostics, therapeutic management and outcomes of paediatric intestinal pseudo-obstruction in the Netherlands: A 20-year retrospective cohort study.

To describe incidence, clinical course, diagnostic and therapeutic management and long-term follow-up of paediatric intestinal pseudo-obstruction (PIPO) in the Netherlands between 2000 and 2020. Multicenter, national, retrospective, observational study including patients aged <18 years diagnosed with PIPO and treated between 2000 and 2020 in Dutch academic medical centres. Outcomes included demographics, incidence, symptoms, diagnostic- and treatment methods used during follow-up, number of hospital admissions and mortality. Between 2000 and 2020, 43 children (median age 120 months, range 13 - 301, 54% female) were diagnosed with PIPO in the Netherlands. Mean incidence was 0.008/100,000/years (range 0/100 000-0.029/100 000). Twenty-six patients developed PIPO in the neonatal period. Initial symptoms were vomiting (n = 21/35, 60%) and abdominal distension (n = 14/35, 40%). Diagnostic strategies included imaging, manometry, histopathology, metabolic- and genetic screening, endoscopy and exploratory surgery. Treatment was divided in nutritional support, pharmacotherapy, colonic irrigation and surgical interventions, of which nutrition and surgery were the cornerstones for care. During the observed study period, the median number of hospital admissions was 22.5 (range 1-176) with a median of 157.5 days (range 3-840) during 20-year follow-up. Two patients (6%) died: one from sepsis and one due to a severe underlying neurological disease. Heterogeneity in diagnostic- en treatment methods existed between patients. PIPO is a rare, long-lasting complex disease requiring a high number of diagnostic and therapeutic interventions and hospital admissions. However, mortality rate is relatively low. Based on our results, we recommend centralization and standardization of care for this complex rare disease.

Clinical characteristics of pulmonary cryptococcosis patients with different immune statuses: A 10-year multicenter retrospective study in China

Clinical characteristics of pulmonary cryptococcosis patients with different immune statuses: A 10-year multicenter retrospective study in China

Systemic Immune-Inflammation-Based Biomarker and Fragility Fractures in People Living With HIV: A 10-Year Follow-Up Cohort Study in China.

Fragility fractures are a significant concern among people living with HIV(PLWH) due to the combined effects of chronic inflammation, immune dysregulation, and antiretroviral therapy. Traditional biomarkers have limited predictive value for fragility fractures in this population. This study aims to evaluate the systemic immune inflammation-based scores as novel biomarkers for predicting fragility fractures in PLWH in China. We conducted a cohort study of PLWH in the orthopedic department of Beijing Ditan Hospital from January 2011 to September 2023. We monitored fragility fractures and collected data on demographics, clinical characteristics, and laboratory parameters. Multivariate Cox and logistic regression models were used to assess the predictive value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) for fragility fractures. Restricted cubic splines (RCS) were employed to explore potential nonlinear relationships, and subgroup analyses were conducted to examine the stability of these associations. During a median follow-up of 5.5 years, our study included 1148 PLWH patients, and 204 patients (17.8%) experienced fragility fractures. After adjusting for all covariates, SII and SIRI were identified as independent risk factors for fragility fractures in PLWH, whereas NLR, PLR, and MLR were not. Patients with higher levels of SII and SIRI had a significantly increased risk of fragility fractures compared to those with lower levels (HR: 1.96, 95% CI: 1.24-3.10, p = 0.004; HR: 1.83, 95% CI: 1.16-2.88, p = 0.009). RCS analysis indicated a stable linear relationship between SIRI and fragility fractures. Furthermore, KM curves demonstrated that patients with higher SII and SIRI scores had a higher likelihood of experiencing fragility fractures. Our research shows that SII and SIRI are promising biomarkers for predicting fragility fractures in PLWH. Clinicians should consider incorporating SIRI into clinical practice to improve fracture risk stratification and guide preventive strategies for this vulnerable population.

Biochemical analysis of soft tissue infectious fluids and its diagnostic value in necrotizing soft tissue infections: a 5-year cohort study

BackgroundNecrotizing soft tissue infections (NSTI) are rapidly progressing and life-threatening conditions that require prompt diagnosis. However, differentiating NSTI from other non-necrotizing skin and soft tissue infections (SSTIs) remains challenging. We aimed to evaluate the diagnostic value of the biochemical analysis of soft tissue infectious fluid in distinguishing NSTIs from non-necrotizing SSTIs.MethodsThis cohort study prospectively enrolled adult patients between May 2023 and April 2024, and retrospectively included patients from April 2019 to April 2023. Patients with a clinical suspicion of NSTI in the limbs who underwent successful ultrasound-guided aspiration to obtain soft tissue infectious fluid for biochemical analysis were evaluated and classified into the NSTI and non-necrotizing SSTI groups based on their final discharge diagnosis. Common extravascular body fluid (EBF) criteria were applied.ResultsOf the 72 patients who met the inclusion criteria, 10 patients with abscesses identified via ultrasound-guided aspiration were excluded. Based on discharge diagnoses, 39 and 23 patients were classified into the NSTI and non-necrotizing SSTI groups, respectively. Biochemical analysis revealed significantly higher albumin, lactate, lactate dehydrogenase (LDH), and total protein levels in the NSTI group than in the non-necrotizing SSTI group, and the NSTI group had significantly lower glucose levels and pH in soft tissue fluids.In the biochemical analysis, LDH demonstrated outstanding discrimination (area under the curve (AUC) = 0.955; p < 0.001) among the biochemical markers. Albumin (AUC = 0.884; p < 0.001), lactate (AUC = 0.891; p < 0.001), and total protein (AUC = 0.883; p < 0.001) levels also showed excellent discrimination. Glucose level (AUC = 0.774; p < 0.001) and pH (AUC = 0.780; p < 0.001) showed acceptable discrimination. When the EBF criteria were evaluated, the total scores of Light’s criteria (AUC = 0.925; p < 0.001), fluid-to-serum LDH ratio (AUC = 0.929; p < 0.001), and fluid-to-serum total protein ratio (AUC = 0.927; p < 0.001) demonstrated outstanding discrimination.ConclusionBiochemical analysis and EBF criteria demonstrated diagnostic performances ranging from acceptable to outstanding for NSTI when analyzing soft tissue infectious fluid. These findings provide valuable diagnostic insights into the recognition of NSTI. Further research is required to validate these findings.

Treatment Outcomes of Four-Implant-Retained Maxillary Palateless Overdenture: A 5-Year Observational Study.

Palateless overdentures (PLODs) provide advantages of improved taste perception and retention over conventional dentures. We aimed to evaluate 5-year outcomes of four implant maxillary PLODs. In this prospective observational study, edentulous participants were enrolled. A new conventional maxillary denture was prepared followed by implant placement and insertion of four implant retained maxillary PLOD. Oral health quality of life was assessed using the 49-item Oral Health Impact Profile (OHIP-49) at multiple intervals over 5 years along with biological and mechanical outcomes. Nine patients were evaluated at year 5. The mean age was 68 years, and six of the nine patients were males. The cumulative survival rate of implants was 100% while the implant success rate was 86%. Nylon retentive replacement was the most common encountered complication noted approximately four times per patient over 5 years. From a mean OHIP-49 severity score of 71.2 at baseline, severity scores decreased to 23.9 (p < 0.001) at year 1, denoting a clinically meaningful and statistically significant improvement in oral health quality of life. The lowered OHIP-49 severity scores remained stable throughout 5 years of follow-up. Four implant supported maxillary overdenture appears to have good patient perceived, biological and mechanical outcomes over 5 years. Fully powered studies are needed to replicate these findings.

Surgical Castration as an Alternative to Improve Systemic Treatment for Advanced Prostate Cancer: A Window of Opportunity for Developing Countries.

The Brazilian Public Health System (BPHS) serves approximately 71,730 patients with prostate cancer (PC) every year for which androgen deprivation therapy (ADT) is the primary treatment for patients with advanced hormone-sensitive prostate cancer (aHSPC). Androgen receptor pathway inhibitors (ARPIs) are not accessible through the BPHS. Using the BPHS as a model, this study assesses the long-term economic effect of surgical versus medical castration in aHSPC treatment to strategize cost reduction and the incorporation of ARPI in developing countries. Data of patients with aHSPC (ie, TxN1M0 ineligible for local treatment or TxNxM1) from the BPHS database were analyzed from January 1, 2011, to December 31, 2021, using the TECHTRIALS artificial intelligence platform. The main outcomes were quantitative and descriptive analyses as well as a cost analysis of surgical versus chemical castration. Of the 274,519 patients with aHSPC who received active treatment during the 11-year study period, 90% (n = 246,683) underwent chemical castration and 10% (n = 27,836) underwent bilateral subcapsular orchiectomy (BSO). The median duration of chemical castration was 28 months. The BPHS spent an estimated total of $665,552,091.40 US dollars (USD) on chemical castration and $5,939,348.47 USD on BSO, respectively. The cost per patient was $2,698 USD and $213.37 USD for chemical castration and BSO, respectively. Hypothetically, if all patients with aHSPC had undergone BSO, the total direct cost for the BPHS would have been $42,774,832.20 USD, saving $622,777,259.20 USD over 11 years, making it possible to offer low-dose abiraterone to 65% of aHSPC patients. On the basis of this extensive financial analysis from the world's largest public health system database, BSO appears to be a valuable alternative to chemical castration for treating aHSPC. In resource-limited environments, the cost savings from using BSO may allow access to drugs that will improve survival such as ARPIs.

Measuring transboundary disease spread - ASF in wild boars straddling Piedmont and Liguria

The aim of this paper is to describe the impact, dynamics and risk factors of the incursion of the African Swine Fever (ASF) virus detected in early 2022 in the wild boar population straddling Piedmont and Liguria, 24 months after its emergence.A study area of 4,162.2 square kilometres, comprising 234 municipalities in Liguria and Piedmont (north-western Italy), along with an external buffer zone, was considered. The epidemiological units were wild boars tested for ASF using real-time PCR between late December 2021 and December 31, 2023. The data were obtained from passive and active surveillance. Conventional methodologies were applied in the analysis of time series of tests, cases, or prevalence rates of positive animals. Maps were used to visualise and compare the monitoring activities, the location of cases and municipal standardised prevalence ratios. Clustering of high and low trends was studied by semester using a space-time permutation model. Risk factors analysis was based on multivariate Poisson regression modelling.Over the 2-year study period, the epidemic's spread was closely monitored by testing 10,412 wild boars (25% of them from passive surveillance). Probability of disease detection was 10.9 times higher among found dead animals compared with animals tested in active surveillance. Difficulties in carcass searching led to heterogeneities in surveillance sensitivity achieved locally and inherent uncertainties. A total of 1,165 wild boars that tested positive for ASF have been detected in 125 municipalities across three provinces. The outbreak has expanded over time and exhibited an increasing trend, with an epidemic doubling time of 10.7 months. There was seasonality, with an increasing trend from summer to spring. Prevalence rates followed the same temporal pattern. Significant low and high clusters respectively indicated endemic episodes in the interior areas of virus circulation and an ongoing invasion of surrounding regions.The characteristics of this outbreak align with the cycle of wild boar habitat transmission observed in other outbreaks across Europe. The measures implemented were not sufficient to stop the epidemic: however, targeted interventions such as depopulation campaigns, reinforcement of physical barriers and increased biosecurity measures have prevented local spillover to domestic pigs and partially hindered the advance of the disease. In addition, the shown seasonality of the disease, likely can enhance control measures. The ongoing studies of the local wild boar populations and the evolution the epidemic along with the lessons learned so far will improve the efficiency and effectiveness of efforts to limit and ultimately eradicate the disease.

The longitudinal retention of STEM students through a multifaceted mentoring and tutoring program

ABSTRACT This 4-year longitudinal study identified the impact of a multifaceted mentoring and tutoring program on the retention and graduation rates of a diverse body of undergraduate college students enrolled in high-risk science courses. Findings revealed that the program was successful in increasing the retention and graduation rates of students who participated in the program. All student cohorts tutored through the program demonstrated significantly higher survival rates when they increased their usage of tutoring, threby demonstrating greater survival to retention. Notably, cohorts with high as well as those with low academic competencies achieved the highest 4-year retention survival probabilities when they participated in six or more tutoring sessions. Additionally, through further analysis, a predictive model derived from this research offers a valuable tool that can be strategically utilized to improve retention and/or graducation outcomes of at-risk populations and underrepresented populations in STEM education.

Characteristics of Children with an Undesirable Motor Competence Development During the Transition from Early to Middle Childhood: Results of a 2-Year Longitudinal Study

Objective: Motor competence development from early to middle childhood is accompanied by great variance. This course can be influenced by many factors in the ecosystem. The objective of this study was to examine which individual characteristics are associated with an undesirable motor competence development during the transition from early to middle childhood. Methods: A longitudinal study was conducted between February 2020 and May 2022. Actual and perceived motor competence and the potential determinants physical activity enjoyment, weight status, and organized sports participation of children (49% boys) aged 4–6 years old at T0 (N = 721) were measured at two points in time, separated by a two-year interval. Associations between potential determinants and AMC, including interactions with time, were analyzed using linear mixed-effect regression models with continuous motor quotient scores as outcome variables. Results: Overweight, obesity, and lack of organized sports participation were associated with lower motor quotient scores over time. Multivariate analyses showed that associations of weight status (overweight and obesity) and sports participation with motor quotient scores remained significant after adjustment for variations in perceived motor competence and physical activity enjoyment. Conclusions: Excessive body weight and lack of sports participation from early childhood are associated with an increased risk of an undesirable motor competence development over time.

Unravelling self-regulation in early childhood: protocol for the longitudinal SPROUTS study

BackgroundEnough is known about self-regulation to establish it as a priority target for education and intervention efforts beginning in early childhood, yet not enough to meaningfully and reliably alter developmental trajectories. Rather than resigning our aspirations, we need more nuanced and integrative understanding of self-regulation abilities and change.MethodsLaunching in 2024, SPROUTS is a 3-year longitudinal study of early self-regulation, beginning in the pre-school period (3–5 years old at Wave 1) with retrospective data back to birth and annual data collection across the transition to school period (ages 5–7 years at Wave 3). Data will be collected on children’s self-regulation, related abilities, outcomes, as well as prior and current contexts. One nested study within each Wave–that contributes complementary insights via supplementary and in-depth methods and data–will enable further exploration of contemporary issues related to self-regulation.DiscussionInsights generated can potentiate more effective intervention and education efforts by: improving intervention cost-benefit ratios; identifying likely mechanisms of change; easing burdens of unhealthy and antisocial behaviours associated with low self-regulation; and, most importantly, contributing to giving children the best early start to life. These benefits are timely in the context of intense policy and educational interest in fostering children’s self-regulation.Trial RegistrationOpen Science Framework: osf.io/maqdg. Date of registration: 26 Sep 2024.

Visual analysis of postmortem interval estimation trends and collaborative networks: a 15-year study (2006-2020).

Utilizing a visual analysis of the literature on postmortem interval (PMI) estimation indexed by Web of Science (WOS), this study investigates developmental trends and research hot points across each 5-year period from 2006 to 2020. Additionally, collaborative efforts among authors, countries, and institutions were examined. Research hot points, high-frequency keywords, authors, countries and institutions in relevant papers were analyzed using CiteSpace.5.7.R2 information visualization analysis software over the past 15 years. The literature related to PMI estimation has witnessed consistent growth over time. In the keyword co-occurrence network, several impactful terms stand out, including blowfly, mitochondrial DNA, and emerging concepts like virtual autopsy. Technological advancements, such as RNA stability analysis and virtual autopsy tools, have played a pivotal role in shaping the direction of PMI research. Scientific research institutions dominate the high-frequency affiliations within the institutional cooperative network. Additionally, the country cooperative network exhibits a trend of co-occurrence and multi-clustering. As science and technology continue to advance, traditional PMI estimation methods mature while novel interdisciplinary approaches drive innovation. By identifying emerging trends and research hotspots, this study provides a roadmap for future investigations, guiding researchers toward new opportunities in PMI estimation.

Association between renal function and the Treatment of Diabetic Macular Edema in Long-Term Cohort Study

To determine the correlation between the severity of chronic kidney disease (CKD) and treatment of diabetic macular edema (DME). The retrospective 2-year cohort study included eyes with DME confirmed using spectral-domain optical coherence tomography in Taipei Veterans General Hospital, Taiwan, between 2010 and 2020. All the eyes were treated with an intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) during regular follow-up around 2 years. They were categorized into 3 different groups: an estimated glomerular filtration rate ≥ 60 (mL/min per 1.73 m2) (group A), < 60 (group B), and patients undergoing hemodialysis (group C). The main outcome measures were (1) visual improvement, (2) structural improvement, and (3) the injection frequency of anti-VEGF in the different groups. In this study, 167 eyes from 120 patients were enrolled. Compared with groups B and C, the eyes in group A experienced the only significant visual improvement at month 3, month 6, and month 12 (P = 0.0001, 0.0002, 0.0013, respectively). The presence of subretinal fluid and intraretinal cysts was significantly decreased in groups A and B. In the treatment frequency analysis, the number of injections was the highest in group A and lowest in group C during the study period (P = 0.04). The severity of CKD had an impact on the DME treatment. The less severe CKD was, the greater the visual improvement that could be achieved. In addition, relatively poor renal function required a lower anti-VEGF injection frequency. The active prevention of the progression of CKD may play a key role in DME treatment.

Paediatric cerebral palsy in South Africa: Prevention and care gaps at hospital level.

Population-based data show high proportions of severe cases of cerebral palsy (CP) in resource-poor regions such as sub-Saharan Africa, where most children have potentially preventable risk factors (factors that may increase the likelihood of CP occurrence but can be mitigated through medical interventions). This study aimed to describe the demographic and clinical profile of children living with CP accessing services at Tygerberg Hospital over a period of 10 years (2010-2020), identify the potential gaps in care (proportion of individuals in a country requiring but not receiving suboptimal or inadequate care), and comparison with a similar study at the same centre two decades ago. This 10-year retrospective study investigated causes and morbidities in children with CP, attending a central hospital in the Western Cape, South Africa. A total of 613 children with CP were identified. Perinatal causes were predominant, especially in 57.7% (n = 354) of the cohort: perinatal asphyxia (41.1%) and preterm birth (16.6%). Postnatal causes constituted 15.2% (n = 93), which included tuberculous meningitis (3.6%) and bacterial meningitis (3.6%). The most common complications were intellectual impairment (61.8%; n = 379); epilepsy (30.8%; n = 189) and visual impairment (54.7%; n = 234). A third of the cohort had severe CP, classified as Gross Motor Function Classification System IV and V (38%). Most of the previously documented main drivers of CP are still present and the implementation of healthcare prevention strategies remains inadequate. This study provides longitudinal evidence to confirm that CP in a South African setting is associated with a high burden of potentially preventable causes.