Baseline Study Research Articles

Age Self Care-Resilience, a medical group visit program targeting pre-frailty: A mixed methods pilot clinical trial.

Pre-frailty is highly prevalent and multimodal lifestyle interventions are effective for preventing transition to frailty. However, little is known about the potential for medical group visits (MGV) to prevent frailty progression. To assess the feasibility and acceptability of the MGV Age Self Care-Resilience. Single-arm mixed methods pilot clinical trial. Virtual MGV delivered in an ambulatory setting at a U.S. academic medical center. Community-dwelling older adults (n = 11; age 65+) with pre- to mild frailty. Age Self Care-Resilience, an 8-week virtual MGV (90-minute sessions once per week) with sessions focused on physical activity, nutrition, social engagement, mind-body practice, and home environment modification. Primary outcomes were feasibility of recruitment, attendance, satisfaction, and feasibility of study measurements, collected via quantitative and qualitative approaches. Exploratory outcomes included frailty, psychosocial health, and physical function. A priori feasibility criteria were met for recruitment, with 15 (48 %) of those screened (31) meeting eligibility criteria, 11 (35 %) enrolling (mean age 74.5 yrs), and recruitment completed in less than one month. The nine participants who completed the study attended a mean of 7.2 of 8 sessions and completed 100 % of baseline and follow-up study measures; participants completed 58 % of the home practice log. Themes from participant interviews included: (1) mixed reactions to the recruitment term "pre-frailty;" (2) finding group participation as meaningful and empowering; and (3) perception that the program positively changed attitudes and lifestyle behaviors. Age Self Care-Resilience is feasible and acceptable to pre- to mildly frail older adults. Next steps include evaluating the efficacy of Age Self Care-Resilience for preventing frailty progression with a fully powered randomized controlled trial.

Clinical validation of the Northstar Response: A novel quantitative methylation ctDNA monitoring assay for advanced GI cancer treatment response.

839 Background: Circulating tumor DNA (ctDNA) is a promising tool for monitoring treatment response but is challenged by pan-cancer quantification and consistent outcome correlations. Northstar Response (NSR) quantifies >500 cancer specific methylated loci, offering a reflection of disease burden and clinical response. Methods: We present a prospective observational study to evaluate the clinical utility of NSR. Patients with advanced GI cancers had serial ctDNA assessed at baseline and during systemic treatment with correlations to radiographic or clinical response. Tumor methylation scores (TMS) were expressed as Log10 values and a mixed-effects model evaluated clinical assessment correlations. Results: 73 patients with locally advanced or metastatic GI cancers were analyzed. Among these, 35 (47.9%) had at least four ctDNA assays and all had radiographic or clinical response assessments. The median age was 66 years (± 8.5), with most being male (67.1%) and White (74.0%). Table 1 shows the case distribution. Baseline TMS had significant variation (p=0.023), but was measurable across all tumor types. CRC exhibited the highest mean TMS-log10 while biliary and pancreatic cancers had the lowest. Cases with both primary and metastatic lesions had a higher mean TMS-log10 than cases with either primary tumors alone or metastatic lesions alone (3.4 vs. 3.0). Compared to stable and responsive disease, TMS changes correlated with progressive disease, with a coefficient of 0.48 at the third collection time point (p=0.05). However, 23/73 (32%) cases were without an on-treatment TMS timepoint (OTT) due to rapid progression (average time to death of 24 vs. 103 days for patients with OTT). In exploratory modeling of TMS relative to RECIST-like treatment response for those with OTT, NSR evaluations were associated with response assessments (p<0.04, Fisher’s Exact Test). Conclusions: TMS was consistently measurable but varied across tumor types and correlated with disease burden. TMS changes appeared associated with response assessments when accounting for rapid progressors. Additional analyses are ongoing and will be presented. Baseline study cohort characteristics. Characteristic HCCN = 25 (34%) BTC N = 12 (16%) EGAN = 12 (16%) CRCN = 11 (15%) PDACN = 8 (11%) Other GI N = 5 (7%) p-value Age Median (25% to 75%) 67 (63 - 76) 68.5 (62.3 – 75.5) 73.5 (62.5 – 75.3) 54 (39.5 – 60) 67.5 (55.5 – 76.3) 60 (57 – 63) 0.008 Baseline TMS Log10 Median (25% - 75%) 3.2 (2.3 – 3.9) 2.5 (2.1 – 3.4) 3.2 (2.2 – 3.8) 4.4 (3.5 – 5) 2.5 (1.9 – 3.3) 4 (3.4 – 5.2) 0.023 Primary tumor present 12 (48%) 8 (66.7%) 12 (100%) 6 (54.5%) 7 (87.5%) 4 (80%) 0.015 First line therapy vs. not 23 (92%) 5 (41.7%) 5 (41.7%) 6 (54.5%) 3 (37.5%) 5 (100%) 0.001 Progressive disease 16 (64%) 4 (33.3%) 9 (75%) 5 (45.5%) 3 (37.5%) 4 (80%) 0.2 Death 13 (52%) 3 (25%) 9 (75%) 7 (63.6%) 3 (37.5%) 2 (40%) 0.2 Kruskal-Wallis rank sum test; Fisher’s exact test.

PET Quantification in Healthy Humans of Cyclooxygenase-2, a Potential Biomarker of Neuroinflammation.

Cyclooxygenase-2 (COX-2) is present in a healthy brain at low densities but can be markedly upregulated by excitatory input and by inflammogens. This study evaluated the sensitivity of the PET radioligand [11C]-6-methoxy-2-(4-(methylsulfonyl)phenyl)-N-(thiophen-2-ylmethyl)pyrimidin-4-amine ([11C]MC1) to detect COX-2 density in a healthy human brain. Methods: The specificity of [11C]MC1 was confirmed using lipopolysaccharide-injected rats and transgenic mice expressing the human COX-2 gene, with 120-min baseline and blocked scans using COX-1 and COX-2 selective agents. Twenty-seven healthy participants were injected with [11C]MC1. Ten of these participants received 2 PET scans: a baseline study followed by blockade with celecoxib (600 mg orally), a preferential COX-2 inhibitor. Seventeen participants underwent test-retest imaging. All scans included concurrent arterial sampling. The tissue-to-plasma ratio at equilibrium (i.e., total distribution volume) was determined using a 2-tissue compartment model (2TCM). Results: In humanized transgenic COX-2 mice, 70%-90% of [11C]MC1 brain uptake was blocked by nonradioactive MC1 and celecoxib (a COX-2 selective inhibitor) but not by PS13 (a COX-1 selective inhibitor), thereby confirming specific binding to human COX-2. Radioactivity in the human brain peaked at a concentration of about 4.0 SUV, indicating good passage through the blood-brain barrier. Values for the total distribution volume achieved stability after 80 min, indicating no radiometabolite contamination. Celecoxib reduced radioligand binding in neocortical areas by 25% but had little or no effect in subcortical regions and the cerebellum, which correlated with COX-2 messenger RNA expression levels. Binding site occupancy by celecoxib was virtually complete, as determined by the Lassen plots. Test-retest reliability was moderate (intraclass correlation coefficient, 0.65) but had relatively large variability (absolute retest variability, 20%). Reference tissue methods yielded results comparable to those of 2TCM but reduced retest variability by up to 75% and reduced intersubject variability (coefficient of variation) by about half. Thus, compared with 2TCM, which requires arterial blood, the reference tissue method is expected to significantly reduce the sample sizes required to detect statistically significant differences between groups. Conclusion: [11C]MC1 has adequate sensitivity to measure the low density of COX-2 in a healthy human brain, suggesting it can also quantify the COX-2 elevations expected in human disorders associated with neuroinflammation.

Baseline studies on meiofauna in the Baltic Sea before bottom-trawl fisheries exclusion I: comparison of communities in the Fehmarn Belt (western Baltic Sea), with special reference to the Harpacticoida (Crustacea, Copepoda)

The meiobenthic communities of a protected area and a reference area in the Fehmarn Belt (Baltic Sea, Germany) were compared, with both study areas currently permitting bottom-trawl fisheries. Meiobenthic data were recorded at the major taxon level. Additionally, the Copepoda Harpacticoida were further examined at the species level. This data collection will serve as a baseline for future assessments, after the planned exclusion of bottom-trawl fisheries in the protected area in 2024 to identify potential impacts on meiofaunal communities. In assessing the meiobenthic data in relation to trawling impact, a trawling index derived from multibeam data for the Fehmarn Belt was employed and developed in the early stage of the project. A comparison of major taxonomic levels did not reveal significant differences between the protected and reference areas in terms of taxa composition, abundance values or diversity. However, analysis of the Harpacticoida community at the species level showed that the compared areas differ significantly in species composition and abundance but not in diversity. These differences in the distribution of harpacticoid species indicate a small-scale heterogeneity of different (a)biotic factors. The initial correlation analyses between trawling intensity and both the main taxonomic levels and the Harpacticoida community did not reveal statistically significant results. This finding is attributable to the small number of samples all recovered in a trawling-affected area. Nevertheless, a higher variance in total abundance between replicates was observed with increasing trawling intensity.

P0388 Can intestinal ultrasound guide us in the treatment of inflammatory bowel disease?

Abstract Background Intestinal Ultrasonography (IUS) is a useful method for monitoring inflammatory bowel disease. The role of Shear Wave Elastography (SWE) and the relationship with other parameters indicating activity are not yet well understood. Methods The aim was to describe the ultrasound characteristics observed in a cohort of patients with Crohn’s disease (CD) and the changes in therapeutic attitude derived from the results of this imaging test. To evaluate the usefulness of SWE in patients with intestinal strictures to detect fibrosis in comparison with analytical and ultrasound parameters of inflammatory activity. We conducted a single-center, retrospective, observational study of a baseline study including IUS examinations performed in CD patients between May 2022 and February 2023. Results We included 63 IUS in CD patients (60.9% male; mean age 43 ± 17 years). The mean HBI-score was 2.77 (± 2.6). A change in therapeutic approach was made in 32.8% of cases following IUS. Stricture was found in 22 IUS (34.9%), with a mean length of 5.6 ± 2.59 cm. Fat wrapping was observed in 40.9% of cases, and loss of wall stratification in 9.1%. Median SWE of the stricture was 9.05. Calprotectin is directly related to the Limberg scale (p<0.001) and indirectly with the SWE value (p<0.05). Inverse correlation between Limberg scale and SWE value (p<0.05) was observed. Conclusion intestinal ultrasonography facilitates a proactive monitoring in CD because immediate changes in therapeutic approach can be made. The combination of the Limberg scale and the SWE value allow the definition of intestinal strictures. Comparative studies are needed to clarify the usefulness in predicting the degree of fibrosis.

Genomic characterization of pathotype diversity and drug resistance among generic Escherichia coli isolated from broiler chickens in Canada.

Escherichia coli is a Gram-negative bacterium that is ubiquitous in animals and humans, with some strains capable of causing disease. The aim of this study was to perform a comparative genomic analysis of 2,732 generic E. coli isolates that were recovered from poultry samples collected from six regions in Canada as part of the National Microbiological Baseline study in Broiler Chicken. Isolates were subjected to whole genome sequencing and a subset (1,122/2,732) were tested for phenotypic resistance to fifteen antimicrobials. These E. coli isolates were highly diverse, representing 376 serotypes, 236 Sequence Types and twenty-one pathotypes, of which 19 were hybrid pathotypes. A high concordance (>85%) between resistance phenotype and the presence of antimicrobial resistance genes and point mutations (resistance determinants) was observed for 13/15 antimicrobials. Over 95% of the β-lactam, fluoroquinolone, and phenicol resistance genes were predicted to be plasmid-borne. The number of resistance determinants per genome was highest in Quebec, while resistance genes associated with β-lactam resistance were more frequently detected in isolates from British Columbia. Generic E. coli in Canadian poultry are highly diverse, can carry pathotype-associated virulence factors and resistance determinants of clinical significance with a risk of emerging into pathogenic strains.

Systematic numerical analysis of the hydraulic parameters responsible for critical flows in anthropogenically modified mountain channels for flood analysis and mitigation

AbstractThe damage potential in river systems due to flood flows has increased as a result of the increased infrastructure and population growth along river corridors, frequently accompanied by an incomplete understanding of flood safety and the impact of climate change. In particular, so‐called catastrophic flood events in alpine areas are generally accompanied by massive channel beds and floodplain erosion with a higher damage potential than inundation only. It has been recently shown that critical flow conditions might be an important driver of uncontrolled erosion and channel avulsion in terms of extraordinary flood events. A systematic analysis, however, of the parameters driving critical flow conditions is lacking. Thus, the aim of this study was to conduct a systematic numerical evaluation of the hydraulic parameters responsible for critical flows in steep mountain channels as a baseline study for future improved flood impact assessment and mitigation measure design. The systematic analysis of standardized river bathymetries revealed that channel slope, roughness and river widening impose decreasing influences on alpine rivers to produce critical flow conditions. However, there is a risk that due to human interventions, altering the natural slope–roughness relationship to increase the discharge capacity for flood safety might promote critical conditions. These findings should be considered in future hydraulic engineering practice.

Baseline assessment of knowledge, attitude, practice, and adherence toward antimicrobials among women living in two urban municipalities in Lalitpur district, Nepal.

Antimicrobial resistance (AMR) is a significant problem in developing, low- and middle-income countries like Nepal. Community engagement can be an important means to address the problem. Knowledge, attitude, practice, and adherence of women regarding antibiotics and AMR was studied. This baseline study was conducted in two urban municipalities of Lalitpur district as preparation for a larger intervention study (Mahalaxmi municipality will be the intervention and Godawari the comparison/control area). The study population was women belonging to the mother's groups of 45 female community health volunteers (FCHVs) from each municipality. The study was done from September 2023 to January 2024. A total of 1207 individuals (580 in Mahalaxmi and 627 in Godawari) were involved. Data on demographics, knowledge, attitude, practice, and adherence was collected using a pre-validated structured questionnaire. The average age, educational status, monthly income, occupation, presence of respiratory disease, chronic diseases and communicable diseases were found to be not different among the two municipalities. Work experience, presence of respiratory disease and of health worker in the household was different in the baseline survey among the two locations. Knowledge was higher in Mahalaxmi municipality, but adherence was higher in Godawari municipality (p <0.0001). No significant difference was seen in attitude and practice scales. Knowledge, attitude, practice and adherence scores among different subgroups of respondents in the two municipalities were found to be significantly different for occupation (p <0.0001), and education (p <0.0001). The attitude scores were also significantly different according to presence/absence of respiratory disease in the household (p = 0.027). At baseline the two study sites were broadly comparable in terms of participants' demographic characteristics. There was higher knowledge and lower adherence in Mahalaxmi municipality. An educational intervention to improve KAP and adherence is required and will be conducted.

Dietary Inflammatory Score and Incident Heart Failure in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.

Inflammation plays a key role in the development of heart failure (HF), and diet is a known modifiable factor that modulates systemic inflammation. The dietary inflammatory score (DIS) is a tool to quantify the inflammatory components of diet. We sought to determine whether the DIS is associated with incident HF events. We examined a total of 17,975 participants without HF at baseline within the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. The main exposure variable was DIS quartile, which was derived from the Food Frequency Questionnaire obtained at baseline study enrollment. The main outcome was incident HF event, defined as HF hospitalization or death. To examine the association between DIS and incident HF events, we conducted Cox proportional hazard regression modeling, adjusting for total energy intake, sociodemographic factors, and pro-inflammatory lifestyle behaviors. The sample mean age was 64 + 9.2 years, 55.8% were female, and 32.3% were Black. Over a median follow-up of 11.1 years, we observed 900 incident HF events, including 752 hospitalizations and 148 HF deaths. In an adjusted model, the highest DIS quartile (Q4) was associated with incident HF (HR 1.26 95% CI 1.03-1.54). Of note, these findings remained even after adjusting for comorbid conditions and physiologic parameters. In an age-stratified analysis, the association was only present among those aged < 65 years (Q4: HR 1.65 95% CI 1.08-2.51). Moreover, the association was present for HFrEF (Q4: HR 1.44 95% CI 1.07-1.94), but not HFpEF. The highest DIS quartile was associated with incident HF events. These findings indicate the potential value of specific dietary pattern to prevent HF.

Spatial-temporal baseline study of nutrients and trace elements characterization of a large tropical transition system in West Africa

Spatial-temporal baseline study of nutrients and trace elements characterization of a large tropical transition system in West Africa

Examining the Effects of Process-Based Therapy: A Multiple Baseline Study

Examining the Effects of Process-Based Therapy: A Multiple Baseline Study

Bacterial predatory potentials of indigenous Bdellovibrio species in southwest Nigeria: Targeting multidrug-resistant Klebsiella pneumoniae and Enterobacter species isolated from chronic wound infections

Background: Chronic wound infections could become life-threatening conditions when caused by multi-drug-resistant Gram-negative ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp) pathogens. Alternative therapeutic approaches are vital for the therapy of infections caused by these pathogens and one of the biocontrol therapies is the application of Bdellovibrio spp, a Gram-negative bacterium with predatory potential against pathogenic Gram-negative bacteria.Methodology: This study isolated, and phenotypically and genotypically characterized Bdellovibrio spp from environmental sources including soil, pond waters, and faecal materials from cattle and poultry in Osogbo, southwest Nigeria using double-layered agar plating technique, with Klebsiella spp as prey. The prey range and predatory potentials of the isolated Bdellovibrio spp against 25 clinical bacterial isolates including 6 K. pneumoniae and 19 Enterobacter spp, recovered from chronic wound infections, was assessed using the same double-layered agar technique.Results: Five strains of Bdellovibrio isolated formed characteristic plaques on lawns of Klebsiella spp used as prey. At the molecular level, all the five strains, designated UAB, STU, PW2, PW5, and PW6, belonged to the genus Bdellovibrio, however, they exhibited different clustering patterns on the phylogenetic tree. Additionally, the prey range of the five Bdellovibrio strains on the bacterial isolates varied, with UAB, PW6, PW5, and PW2 preying upon 12 (48.0%), 12 (48.0%), 7 (28.0%), and 1 (4.0%) bacterial isolate respectively, while STU did not prey on any of the bacteria isolates.Conclusion: This research presents the first molecular characterization of Bdellovibrio spp in Nigeria, hence serving as a baseline study for future Bdellovibrio research in Nigeria. It also highlights the promising potential of Bdellovibrio spp in control of K. pneumoniae and Enterobacter spp associated with chronic wound infections.

Evaluating the Clinical Reliability and Reference Values of the International Outcome Inventory for Cochlear Implants in the Department of Defense Population.

Hearing loss significantly affects an individual's well-being, communication, social interaction, and quality of life. Cochlear implants serve as a viable management option. Given the variability in the impact of impairment, self-report measures are crucial for evaluating the perceived benefits of management options. The study aims to assess the reliability of the International Outcome Inventory for Cochlear Implants (IOI-CI) and establish evaluative cutoffs. This questionnaire evaluates patient's satisfaction with cochlear implants and contributes to the understanding of their experiences, addressing the increasing interest among cochlear implant clinicians. The design relies on electronic medical databases within the Veterans Affairs and Department of Defense systems. After identification of eligibility, recruitment was based on participants responding to mailed study documents. This research adopts a descriptive approach of the analysis of questionnaire responses as well as quantitatively evaluating the reliability. Forty-nine service members, Veterans, and their dependents, including 32 men and 17 women, participated in the study. The participants had a mean age of 68.0 years, with cochlear implants ranging from 6 months to 2 years postinitial stimulation. The majority had a unilateral cochlear implant with a hearing aid on the contralateral ear. Data collected involved mailing baseline study packets, including the IOI-CI questionnaire, to potential participants identified through medical databases. Participants indicated consent by returning the study packet. Follow-up packets were sent at a later time. Intraclass correlation coefficients were utilized for test-retest reliability and generalized linear models (GLM) for exploring the impact of clinical and demographic factors. Data were analyzed using R. The ICC revealed a good level of agreement (ICC = 0.84) between baseline and follow-up assessments for the IOI-CI total score. The GLM did not identify significant factors influencing IOI-CI scores. Evaluative values were established, indicating total scores between 18 and 35 as within the range of general satisfaction with a cochlear implant for this questionnaire. The study contributes valuable insights into the reliability of the IOI-CI and establishes evaluative cutoffs, aiding clinicians in assessing cochlear implant users' experiences and satisfaction.

Adopting information and communications technology in the control, prevention, and management of stroke: perspectives from patients and providers in Uganda

ObjectiveThe stroke burden in Uganda ranks ninth among the ten causes of death, a major cause of chronic illnesses, accounting for the top ten causes of hospitalization. This baseline study examined how mobile phones can improve the prevention, management, and treatment of stroke in rural Uganda.MethodsIt was a cross-sectional study that utilized a mixture of methods. Quantitative data was collected from the districts' health information management system while qualitative data were from healthcare providers and patients/caregivers/survivors using a semi-structured guide. Quantitative data was analyzed descriptively while qualitative data was inductively analyzed through creating themes.ResultsAll participants supported the use of mobile phone interventions and suggested three major types of information to be included in this intervention: warning signs and indicators, underlying causes of stroke, and prevention measures. The challenges that might be faced in implementing this intervention are contextual, health system, and economic related.ConclusionThese baseline findings support the possibility of mobile phone intervention as an important instrument to improve stroke prevention, management, and treatment in rural Uganda. Challenges that might accompany the use of ICT have to be addressed as the intervention is designed.

Comparison of safety and efficacy of femoropopliteal arterial disease using different dose drug-coated balloons: Systematic review and meta-analysis.

Endovascular therapy with balloon percutaneous angioplasty (PTA) in the femoro-popliteal segment is frequently performed, however, long-term favorable outcomes and patency remain challenging, with restenosis rates reaching 60% post-standard balloon angioplasty. Drug-coated balloons (DCBs) have shown promise in improving these outcomes; Paclitaxel, used in DCBs, inhibits hyperplasia and smooth muscle cell proliferation, reducing restenosis; however, the optimal dose of Paclitaxel remains unclear, with high-dose (HD-DCB [>3mg/mm2]) and low-dose (LD-DCB [<2.0mg/mm2]) options available. This meta-analysis aims to compare the efficacy and safety of HD-DCB and LD-DCB in treating femoropopliteal arterial disease. We followed PRISMA guidelines and conducted a comprehensive search of PubMed, EMBASE, Cochrane, Scopus, and Mendeley up to May 27, 2024. We included randomized controlled trials and cohort studies comparing HD-DCB and LD-DCB in patients with femoropopliteal arterial disease. Data were extracted on baseline characteristics, outcomes, and study quality. The Newcastle-Ottawa Scale and ROB2 tool were used for bias assessment. Outcomes included overall survival (OS), limb salvage (LS), freedom from clinically driven target lesion revascularization (CD-TLR), and major amputation. Six studies comprising 2563 patients were included. HD-DCB showed a significant benefit in limb salvage at 6 months (RR = 0.38, 95% CI = 0.18-0.78, p = .009) but not at 12 months (RR = 3.08, 95% CI = 0.14-67.13, p = .47). No significant difference was observed in overall survival between HD-DCB and LD-DCB at either 6 months (RR = 1.53, 95% CI = 0.25-9.57, p = .65) or 12 months (RR = 1.21, 95% CI = 0.17-8.84, p = .85). HD-DCB was associated with an increased risk of perioperative complications (RR = 1.90, 95% CI = 1.14-3.17, p = .01) and a higher, though not statistically significant, risk of major amputation (RR = 4.73, 95% CI = 0.54-41.52, p = .16). HD-DCB may offer advantages in limb salvage over LD-DCB in the short term, but this comes with an increased risk of perioperative complications. These findings underscore the need for careful patient selection when considering HD-DCB for femoropopliteal artery disease.

Chalazia: A Scoping Review to Identify the Evidence Behind Treatments.

Current treatment approaches aimed at resolving a chalazion vary greatly among practice settings and practitioners. Our objective is to provide a review of existing literature on treatment modalities aimed at resolving a chalazion. We conducted a review of existing peer-reviewed publications that described treatment methods aimed at resolving chalazia in patients of any age. Literature searches were conducted using PubMed, Embase, and Cochrane. A 3-stage review process was conducted by 2 trained reviewers, including an initial screening, a full-text review, and data extraction. Articles were assessed for baseline study identifiers, study design, country of origin, number of patients, demographic characteristics, types and number of treatments administered, and resolution rates. Publications were graded using the Oxford Centre for Evidence-Based Medicine levels of evidence table. A total of 2814 articles were initially identified based on database queries; 39 studies met inclusion criteria for full-text review. The most represented study design was case series (15), followed by randomized controlled trials (14). Twenty-five publications discussed intralesional corticosteroid injections, 18 discussed incision or excision and curettage, 5 discussed conservative treatments, and 8 discussed topical antibiotic±steroid treatments. Both the definition of chalazion resolution and resolution rates for each treatment modality varied widely between publications. Procedural management of chalazia, including corticosteroid injections and surgical management, is most often studied in the literature. Fewer publications exist on the efficacy of conservative and topical treatments.

Biological Age Affecting Attrition and Tooth Loss in a Follow-up Study

In population-based longitudinal studies, bias caused by nonresponse among eligible participants and attrition during follow-up thwarts conclusions. As this issue is not commonly addressed in dental studies, it is the aim of this study to examine the consequences of attrition with respect to tooth loss and mortality in a 10-y follow-up study. From the Study of Health in Pomerania (SHIP-0), a biological age (BA) score was constructed from 10 systemic biomarkers and related to one’s actual chronological age (CA). The 3,417 dentate participants were stratified according to their BA-CA scores into tertiles: individuals with younger BA than their CA, those with concurrent BA and CA, and those with older BA than their CA. Baseline characteristics and propensity of leaving or remaining in the study were compared across these tertiles. We compared the characteristics within BA strata in the remainers of SHIP-2 (10-y follow-up) and their impact on tooth loss. Besides dropout by those who died, the attrition propensity of baseline study participants was dose dependent as related to BA-CA scores and socioeconomic factors. BA younger participants were underrepresented in dropouts but overrepresented in remaining follow-up participants. BA younger participants had a more favorable risk profile, better oral health, and a lower mortality rate than BA older participants. For the BA older participants, the opposite was observed. Remainers attaining the follow-up SHIP-2 were healthier and more health conscious. After 10 y, their tooth retention was still directed by BA constructed at baseline. The results support the assumption that individual risk profiles aggregated in BA constitute characteristic susceptibility patterns affecting perseverance or attrition in long-term follow-up studies. Attrition, which is common to follow-up studies, changes the study composition of participants depending on their BA and hence the transferability of results to the baseline population. The baseline BA gradient persists even after a long time.

Baseline Study of Ultra-Clean Air Change Rate, Number, and Type of Microorganisms and Level of Particles During Trauma Surgery.

Background: The objective of an operating room (OR) ultra-clean ventilation system is to eliminate or reduce the quantity of dust particles and colony-forming units per cubic meter of air (CFU/m3). To achieve this, ultra-clean goal high air change rates per hour are required to reduce the particle load and number of CFU/m3. Aim: To determine the air quality in an ultra-clean OR during surgery, in terms of the number and type of microorganism and quantity of dust particles in order to establish a benchmark. Methods: Number of CFUs and the quantity of dust particles were measured. For measuring the CFUs, sterile extraction hoses were positioned at the incision, the furthest away positioned instrument table, and the periphery. At these locations, air was extracted to determine the quantity of dust particles. Findings: The number of CFU/m3 and particles was on average at wound level ≤1 CFU/m3 resp. 852.679 particles, at instrument table ≤1 CFU/m3 resp. 3.797 particles and in the periphery ≤8 CFU/m3, resp. 4.355 particles. Conclusion: The number of CFUs in the ultra-clean area is below the defined ultra-clean level of ≤10 CFU/m3 for ultra-clean surgery. The quantity of dust particles measured during surgery was higher than the defined ISO 5.

Are there trends towards compression of morbidity for dementia? Evidences from four international population‐based cohorts

AbstractBackgroundDementia is a major contributor to loss of autonomy in the elderly. Every year spent with dementia results in significant medical and societal costs. Understanding secular trends of life expectancy with and without dementia would enable us to better anticipate future needs. To date, only a few studies have attempted to decipher the scenarios that occurred over the last few decades concerning the life expectancy (LE) with dementia, but heterogeneity in methods hampered comparison of results. A concerted effort for harmonized methods is essential to investigate whether a decline in dementia incidence is also associated with a compression of morbidity, i.e. a lower duration of LE with dementia.MethodsWe leveraged data from four population‐based studies: PAQUID, Three‐City (3C), the Rotterdam Study (RS), and the Framingham Heart Study (FHS). These studies have ascertained dementia cases and vital status over up to 30 years. Five birth cohorts of participants aged 55 years and older were included in the analysis: 1910‐1915, 1915‐1920, 1920‐1925, 1925‐1930, and 1930‐1935. Illness‐death models were used to compute risk of dementia, risk of death among participants with and without dementia, total LE, dementia‐free LE and LE with dementia. We used age as the time scale and models were adjusted for sex.ResultsResults displayed relate to French cohorts. We included 11450 participants, who were dementia‐free at baseline, from both PAQUID and 3C studies (mean age 75 years, 60% female). On average, the follow‐up duration was 11 years and 2003 incident dementia cases were identified. Overall risks of dementia and risk of death decreased by respectively 44% and 47% in participants from birth cohort 1930‐1935, compared to the 1910‐1915 one. From birth cohorts 1910‐1915 to 1930‐1935, total LE at age 70 rose from 16.3 to 20.3 years, and dementia‐free LE rose from 14.2 to 18.5 years. The risk of death among participants with dementia remained stable.ConclusionResults from French cohorts showed an increase in dementia‐free LE over 20 years, while LE with dementia remained stable, which indicates a compression of morbidity. We are replicating these analyses in RS and FHS, and will combine results.

Characterizing thyroid follicles histogenesis in the human fetuses: A morphological approach.

Thyroid gland which is responsible for the maintenance of metabolism and growth is derived from thyroglossal duct, an outpocketing of foregut. The microscopic study of thyroid gland during development in first, second and third trimesters has utmost significance to understand the several developmental thyroid disorders metabolically and structurally. This study is descriptive observational study carried in tissue sections taken from thyroid gland of still birth and spontaneously aborted human fetuses of first, second and third trimester. The processed thyroid gland tissues were sectioned and conventional haematoxylin and eosin stain was used to study the detail histomorphology of this gland during these trimesters. Multiple shapes (round, oval and irregular) of thyroid follicles with variation in vascularity and fibrous capsule were observed in human fetuses during their development. Dimensions of epithelial cells (height and weight), outer and inner boundaries of thyroid follicles and number of parafollicular cells were increased as age progresses from first to third trimester whereas diameters, radius, perimeter, area and colloid volume of follicles were decreased as age progresses from first to third trimester. But the area of cytoplasm with nuclei (Anc), cytoplasmic area (Ac) and nuclear-to-cytoplasmic (N/C) ratio were increased from first to second trimester thereafter decreased in third trimester. This study can act as baseline study to understand histomorphological differences in developing human fetal thyroid gland and to understand associated thyroid gland related disorders during its development.