Marginal Mean Research Articles

COVID-19-induced changes in the workplace, psychosocial work environment and employee well-being: a longitudinal study.

In many workplaces, the coronavirus disease 2019 pandemic changed work arrangements, but there is scarce longitudinal evidence on whether psychosocial work environment and employee well-being were affected. To examine the psychosocial work environment and employee well-being before, during and after the pandemic in relation to pandemic-induced changes (working from home, change to other tasks and team reorganization). Survey data from a cohort of 20944 public sector employees in Finland were collected before (2016-2018), during (2020) and after the pandemic (2022). Multilevel linear and logistic regression was used to examine group differences between the before-during and during-after periods of the pandemic. Working from home was associated with a small but favourable change in worktime control, organizational justice and social capital (scale 1-5) during the pandemic and after the pandemic (marginal mean difference ranging from 0.02 to 0.09 with 95% confidence intervals [CIs] from 0.01 to 0.10). There was a post-pandemic increase in work time control, even among participants with a transfer into other tasks (0.11, 95% CI 0.07, 0.14) or team reorganization (0.06, 95% CI 0.02, 0.10). The decline in self-rated work ability (scale 0-10) before and during the pandemic was greater in those transferred into other tasks (-0.10, 95% CI -0.13, -0.06) than in those not (-0.05, 95% CI -0.06, -0.04). Working from home during the pandemic was accompanied by small favourable changes in the psychosocial work environment during the pandemic, whereas transition to different tasks was associated with a decline in self-rated work ability.

Prompt Response, Cues-Pause-Point Therapies and Gender on Management of Echolalia among Children with Autism Spectrum Disorder

The repetitive and delayed nature of echolalia can hinder the development of adaptive behaviors and impact the ability to establish rapport with others. This study investigated the effects of prompt response and cues-pause-point therapies on the management of echolalia among children with autism spectrum disorder. A pre-test, post-test, and control group of a 3x2 factorial matrix of quasi-experimental research design was used to assess the effect of the therapies on children with autism spectrum disorder in Ibadan, Nigeria. 90children with autism spectrum disorder were purposively selected using Diagnostic Statistical Manual- V (DSM-V) for ASD (0.70), Gilliam Autism Rating Scale/Third Edition (GARS-3) (in terms of sensitivity= 0.97, ROU/AUC= 0.93). In contrast, the Autism Treatment Evaluation Checklist (ATEC) (0.90) was used for the pretest and posttest to ascertain the presence of echolalia. Participants were assigned to one of three groups: prompt response, cues-pause-point therapies, or control (N = 90, male = 44, female = 46, age range = 3 –5 years old). Twenty-four prompt response and cues-pause-point therapy were held for each experimental group. The findings showed that the main effect of treatment (prompt response and cues-pause-point therapies) (F (2; 72) = 45.519, p<.05, ƞ2 = .558) on the management of echolalia among children with autism was significant, premised on this, the null hypothesis was rejected. The post hoc estimated marginal mean indicates that prompt response treatment was higher than cues-pause-point therapy; however, this difference was statistically significant. The study findings indicated that the impact of gender on managing echolalia in individuals with ASD was not statistically significant. Based on the findings, it is recommended that speech therapists, caregivers, and parents of children with autism spectrum disorder should seek alternative therapy that will take into cognizance other underlying factors associated with the presence of echolalia.

Comparative Feasibility Analysis of Retrograde Double J Stenting, Antegrade Double J Stenting, and Percutaneous Nephrostomy Tube Placement for Ureteric Obstruction Secondary to Pelvic Malignancies

Background: The management of ureteric obstruction secondary to pelvic malignancies (UOPM) presents a significant challenge. Objectives: Our study aimed to assess the factors affecting the feasibility of interventions for patients with UOPM - including retrograde and antegrade double J (DJ) stenting, and percutaneous nephrostomy (PCN) insertion. Methods: We conducted a retrospective analysis of patients who underwent intervention for UOPM over two years, from January 2022 to December 2023. Patients were categorized into groups based on intervention type: Group 1: Retrograde DJ stenting, group 2: Antegrade DJ stenting, and group 3: PCN insertion. Demographic, clinical, radiological, cystoscopic, and laboratory data were compared between the three groups. Analysis of Variance (ANOVA), logistic regression, and marginal mean plots were utilized for statistical analysis. Results: Fifty–nine patients were included in the study, consisting of 14 males and 45 females, and the mean age of the study population was 60.1 ± 10.8 years. Retrograde DJ stenting was successfully achieved in 59.3% of patients, with 10.2% undergoing antegrade DJ stenting and 30.5% needing PCN insertion. Serum albumin (P = 0.04), serum creatinine (P = 0.02), albumin creatinine ratio (P < 0.001), and severity of hydroureteronephrosis (HDUN) (P = 0.02) were significantly associated with intervention outcomes. There was an increased likelihood of PCN insertion in higher serum creatinine and lower serum albumin levels. Multinomial logistic regression with univariate and multivariate analysis revealed significance among the above-mentioned variables. Conclusions: Even though DJ stenting remains common, a significant proportion of patients require PCN insertion. Serum albumin, serum creatinine, albumin creatinine ratio, and HDUN severity are significant predictors of intervention success. Further research is warranted to validate these findings and enhance management strategies for UOPM.

Self-Control Moralization: The Role of Moral Identity and Moral Foundations in Young Adults

Despite the morality and self-control relationship having been studied in the past, there is still not enough information about how different moral variables, and their possible interaction, affect self-control levels; especially when referring to young adulthood, a critical period for development of self-control and morality. Within the framework of self-control moralization, the current study aimed to explore whether self-control scores were affected by levels of moral identity and binding-individualizing foundations through early adulthood. Data were obtained by an online survey from a non-probabilistic sample (n=626) of young adults from Bolivia. Having found significant correlations between variables, hypotheses were tested employing t-tests and an ANCOVA, with age as a covariate. Findings showed that binding foundations, moral identity, age and the interaction between moral identity and both types of moral foundations had a significant effect on self-control scores and marginal means, with small to moderate effect sizes. Finally, finding’s implications within the theoretical framework of self-control moralization are discussed.

Lactated Ringer vs Normal Saline Solution During Sickle Cell Vaso-Occlusive Episodes

Sickle cell disease (SCD), a clinically heterogenous genetic hemoglobinopathy, is characterized by painful vaso-occlusive episodes (VOEs) that can require hospitalization. Patients admitted with VOEs are often initially resuscitated with normal saline (NS) to improve concurrent hypovolemia, despite preclinical evidence that NS may promote erythrocyte sickling. The comparative effectiveness of alternative volume-expanding fluids (eg, lactated Ringer [LR]) for resuscitation during VOEs is unclear. To compare the effectiveness of LR to NS fluid resuscitation in patients with SCD and VOEs. This multicenter cohort study and target trial emulation included inpatient adults with SCD VOEs who received either LR or NS on hospital day 1. The Premier PINC AI database (2016-2022), a multicenter clinical database including approximately 25% of US hospitalizations was used. The analysis took place between October 6, 2023, and June 20, 2024. Receipt of LR (intervention) or NS (control) on hospital day 1. The primary outcome was hospital-free days (HFDs) by day 30. Targeted maximum likelihood estimation was used to calculate marginal effect estimates. Heterogeneity of treatment effect was explored in subgroups. A total of 55 574 patient encounters where LR (n = 3495) or NS (n = 52 079) was administered on hospital day 1 were included; the median (IQR) age was 30 (25-37) years. Patients who received LR had more HFDs compared with those who received NS (marginal mean difference, 0.4; 95% CI, 0.1-0.6 days). Patients who received LR also had shorter hospital lengths of stay (marginal mean difference, -0.4; 95% CI, -0.7 to -0.1 days) and lower risk of 30-day readmission (marginal risk difference, -5.8%; 95% CI, -9.8% to -1.8%). Differences in HFDs between LR and NS were heterogenous based on fluid volume received: among patients who received less than 2 L, there was no difference in LR vs NS; among those who received 2 or more L, LR was superior to NS. This cohort study found that, compared with NS, LR had a small but significant improvement in HFDs and secondary outcomes including 30-day readmission. These results suggest that, among patients with VOEs in whom clinicians plan to give volume resuscitation fluids on hospital admission, LR should be preferred over NS.

Effects of Single-Joint Type Hybrid Assistive Limb in Knee Rehabilitation on Reduction of Pre-motor Time and Increased Rate of Fast Muscle Activation for Anterior Cruciate Regiment (ACL) Reconstruction.

Changes in muscle characteristics after post-anterior cruciate regiment (ACL) reconstruction are common. Knee robotic-assisted therapy using hybrid assistive limb (HAL) single-joint training for recovery from ACL injury has the potential to optimize muscle activity; however, its neurophysiological effects remain unclear. Thus, this study aimed to explore the electrophysiological parameters. This prospective, nonrandomized, controlled trial was conducted between December 2021 and January 2024. The patients were divided into two groups: the HAL group and the control group, each including five patients who underwent arthroscopic ACL reconstruction. Knee HAL single-joint training was conducted once weekly for three sessions. Three electrophysiological measures were examined related to knee neuromuscular responses pre-motor time, peak amplitude time, and neuromuscular rate of electromyography rise (RER) using surface electromyography (EMG). The pre-motor time and peak amplitude time were assessed in both groups at each session pre- and post-intervention.Bothgroups were evaluated for RERat postoperative weeks 17 and 21. Regarding the interaction of pre-motor time within each group, the interaction of pre-motor time within each group, the effect size of vastus medialis (VM) was larger in the HAL group. The peak amplitude time of EMG, the overall estimated marginal means, and the HAL group exhibited a significant difference in the VM (p=0.019), while vastus lateralis (VL) showed no significant difference but a larger effect size (d=0.61). The RERrevealed a significant difference in semitendinosus-RER30ms in the HAL group (p=0.044). Theknee HAL training for post-ACL reconstruction patients may influence neurophysiological outcomes.

Effect of thermomechanical aging on marginal fit of three CAD-CAM restorative materials: An in vitro study.

The present study assessed the impact of thermomechanical aging on the marginal fit of hybrid ceramic, reinforced composite resin, and lithium disilicate ceramic. Eighteen human upper first premolars freshly extracted for orthodontic purposes were used to fabricate 18 CAD-CAM veneers and divided into three groups based on materials used: group H (n=6): hybrid ceramics (Vita Enamic), group R (n=6): reinforced composite resin (Brilliant crios), and group L (n=6): lithium disilicate ceramic (IPS e-max CAD). Each material's cementation procedure was carried out according to the manufacturer's instructions. The vertical marginal gap between the laminate veneer margin and the prepared tooth finish line was measured to assess the specimens by digital microscopy. Subsequently, all the samples were thermomechanically cycled (TMC) (5 °C to 55 °C, 30 seconds, 75000 cycles). Then, the vertical marginal gap was re-evaluated. The Brilliant crios group displayed a significantly lower vertical marginal gap mean score (31.36±2.82 µm) followed by Vita Enamic (39.27±6.54 µm) and E max (41.39±3.97 µm) groups. Similarly, after thermomechanical aging, the Brilliant crios group displayed a significantly lower vertical marginal gap mean score (41.83±8.28 µm) followed by Vita Enamic (55.47±18.65 µm), and the E max group showed the greatest vertical marginal gap mean score (59.43±16.27 µm). Thermomechanical aging affected the marginal fit of different materials employed in the current research, and these changes were under the established clinical limit.

Executive functions in male and female older adults with aligned levels of VO2max.

Studies have shown a positive relationship between cardiorespiratory fitness (CRF) and executive functioning in older adults. Although this relationship has been well established, there seems to be a gap in the literature on the role of sex differences concerning CRF and executive functions. The current study aimed to assess the effect of sex in the relationship between CRF and cognition in older adults by stratifying the results to examine effects in males and females. Ninety-six older adults (61 females) gave their written, informed consent to participate in this cross-sectional study. All participants underwent a maximal continuous graded exercise test on a cycle ergometer to assess their maximal oxygen uptake (VO<inf>2max</inf>) and a computerized Stroop task (naming, inhibition, and switching) to assess their executive functions. According to VO<inf>2max</inf> test results and the American College of Sports Medicine's guidelines, females and males were classified into higher-fit and lower-fit groups. A general linear model and estimated marginal means analyses were applied. Results showed no significant differences in the naming, inhibition and switching performance tests between male and female older adults (P>0.05). Based on the observed positive relationship between CRF and executive functioning, the data of the current study supports the idea that aerobic exercise, which typically increases CRF, is well-situated to improve executive functioning in older adults, irrespective of sex.

A Randomized Controlled Trial on the Timing of Soft-Tissue Augmentation in Immediate Implant Placement: Hard-Tissue Changes and Clinical Outcome.

To assess the impact of the timing of soft-tissue augmentation (STA) on mean buccal bone changes following immediate implant placement (IPP) in the anterior maxilla. Patients with a failing tooth and intact buccal bone wall in the anterior maxilla (15-25) were enrolled in this randomized controlled trial. Following single IIP and socket grafting, they were randomly allocated to the control group (immediate STA performed during the same surgical procedure) or the test group (delayed STA performed 3 months later). Implants were placed with a surgical guide and immediately restored with an implant-supported provisional crown. Changes in bone dimensions were assessed using superimposed CBCT images taken prior to surgery and at 1-year follow-up. Clinical outcomes were registered at 1-year follow-up. Twenty patients were randomized to each group (control: 16 females, 4 males, mean age 57.6; test: 9 females, 11 males, mean age 54.2). Ten patients in the control group and 13 patients in the test group had a thick bone wall phenotype. Estimated marginal mean horizontal buccal bone loss at 1 mm below the implant shoulder was -0.553 and -0.898 mm for the control and test group, respectively. The estimated mean difference of 0.344 mm in favour of the control group was not significant (95% CI: -0.415 to 1.104; p = 0.363). Also at all other horizontal and vertical levels, no significant differences could be observed between the groups. The combination of socket grafting and STA enabled counteraction of any buccal soft-tissue loss (≥ 0 mm) at 1 mm below the implant shoulder in 82% of the patients in the control group and in 75% of the patients in the test group (p = 1.000). The clinical outcome was favourable in both groups, yet implants in the control group demonstrated slightly less marginal bone loss (median difference 0.20 mm; 95% CI: 0.00-0.44; p = 0.028). In patients with an intact and mainly thick buccal bone wall in the anterior maxilla, the timing of STA following IIP had no significant impact on mean buccal bone loss. ClinicalTrials.gov identifier: NCT05537545.

Visual pathology reports for improved collaboration at multidisciplinary head and neck tumor board.

Multidisciplinary tumor boards (TB) are the standard for discussing complex head and neck cancer cases. During TB, imaging and microscopic pathology is reviewed, but there is typically no visualization of the resected cancer. A pilot study was conducted to investigate the utility of visual pathology reports at weekly TB for 10 consecutive weeks. Faculty-level participants completed a pre-survey and post-survey to assess understanding of resected cancer specimens. Providers (n = 25) across seven medical specialties completed pre-survey and post-survey. Following intervention, providers reported significant improvement in understanding of anatomic orientation of the specimen and sites of margin sampling (mean 47.4-96.1, p < 0.001), ability to locate the site of a positive margin (mean 69.5-91.1, p < 0.001), and confidence in treatment plans created (mean 69.5-89.2, p < 0.001) with the addition of visual pathology reports. Visual pathology reports improve provider understanding of resected cancer specimens at multidisciplinary TB.

Time to resolution of airway inflammation caused by bronchoalveolar lavage in healthy horses.

Bronchoalveolar lavage (BAL) is a common procedure for evaluation of the equine lower airways. Time to resolution of post-BAL inflammation has not been clearly defined. Residual inflammation, evident by changes in immune cell populations and inflammatory cytokines, will resolve by 72 hours after BAL. Six adult, healthy, institution-owned horses. Randomized, complete cross-over design. Each horse underwent 3 paired BALs, including a baseline and then 48, 72, and 96 hours later, with a 7-day washout between paired BALs. Each sample underwent cytological evaluation and cytokine concentrations were determined by a commercially available multiplex bead immunoassay. Statistical analysis was performed by multilevel mixed-effects Poisson regression analysis. Data are reported as marginal means and 95% confidence interval (CI). Neutrophil, eosinophil and mast cell percentages were not significantly different at any time points. Macrophage percentages were higher at 72 hours (45.0 [95% CI, 41.6-48.4]%) and 96 hours (45.3 [95% CI, 42.9-47.7]%) vs baseline (37.4 [95% CI, 33.5-41.4]%; P < .001 and P = .01, respectively), and at 72 hours and 96 hours vs 48 hours (31.9 [95% CI, 28.1-35.6]%; P < .001). Neutrophil percentage was not significantly increased at 48 hours (P = .11). Interleukin (IL)-6 concentration was increased at 72 hours (5.22 [95% CI, 3.44-6.99] pg/mL) vs 48 hours (4.38 [95% CI, 2.99-5.78] pg/mL; P < .001). Significant lung inflammation was not detected at 72 and 96 hours, suggesting that repeating BAL at 72 hours or more can be done without concern of residual inflammation.

Intermittent Energy Restriction for Adolescents With Obesity

Adolescent obesity requires effective and accessible treatment. Intensive dietary interventions have the potential to be used as adjunctive therapy for behavioral weight management. To examine the effectiveness of 2 diet therapies, delivered as part of an intensive behavioral weight management intervention, in adolescents with metabolic complications associated with obesity. This multisite, 52-week randomized clinical trial was conducted from January 31, 2018, to March 31, 2023, at 2 tertiary pediatric centers in Australia. Adolescents (aged 13-17 years) with obesity and 1 or more associated complications were included. Intensive behavioral interventions, delivered by a multidisciplinary team, comparing intermittent energy restriction (IER) or continuous energy restriction (CER), with 3 phases: very low-energy diet (weeks 0-4), intensive intervention (weeks 5-16), and continued intervention and/or maintenance (weeks 17-52). The primary outcome was body mass index (BMI) z score at 52 weeks in the IER vs CER group. Anthropometry, body composition, and cardiometabolic health were assessed at baseline and 52 weeks. The BMI z score and percentiles were determined using Centers for Disease Control and Prevention growth charts. Insulin resistance, dyslipidemia, and elevated hepatic function were assessed. A total of 141 adolescents (median [IQR] age, 14.8 [12.9-17.9] years; 71 male [50.4%]) were enrolled, 71 in the IER group and 70 in the CER group, and 97 (68.8%) completed the intervention, 43 in the IER group and 54 in the CER group. At week 52, both groups had reduced BMI z scores (estimated marginal mean change, -0.28 [95% CI, -0.37 to -0.20] for IER and -0.28 [95% CI, -0.36 to -0.20] for CER) and reduced BMI expressed as a percentage of the 95th percentile (estimated marginal mean change, -9.56 [95% CI, -12.36 to -6.83] for IER and -9.23 [95% CI, -11.82 to -6.64] for CER). No differences were found in body composition or cardiometabolic outcomes between the groups. Both groups had a reduction in the occurrence of insulin resistance (from 52 of 68 [76.5%] to 32 of 56 [57.1%] in the IER group and from 59 of 68 [86.8%] to 31 of 60 [57.1%] in the CER group) at week 16; however, at week 52, this effect was observed in the CER group only (from 59 of 68 [86.7%] to 30 of 49 [61.2%]). The occurrence of dyslipidemia was unchanged between baseline and week 52 (60 of 137 [42.6%] and 37 of 87 [42.5%], respectively), with a small improvement in occurrence of impaired hepatic function tests (37 of 139 [27.0%] and 15 of 87 [17.2%], respectively). No differences were found in dyslipidemia or hepatic function between groups. These findings suggest that for adolescents with obesity-associated complications, IER can be incorporated into a behavioral weight management program, providing an option in addition to CER and offering participants more choice. http://anzctr.org.au Identifier: ACTRN12617001630303.

Singlestick purchases: a comparative cross-country analysis in 10 African countries, Global Adult Tobacco Survey, 2012-21.

We utilized Global Adult Tobacco Survey data to examine singlestick purchases and related demographic characteristics in 10 African countries (Botswana, Cameroon, Ethiopia, Kenya, Nigeria, Mauritania, Senegal, South Africa, Uganda and Tanzania). Results show the weighted percentages and prevalence ratios with predicted marginal means to evaluate significant differences between groups (P < 0.05). The prevalence of singlestick purchases among the 10 African countries ranged from 48.4% in South Africa to 92.0% in Tanzania. Across countries, the incidence of singlestick purchases was higher in urban areas than rural areas in Kenya; among those aged 15-24 years versus those aged 45 years and older in Botswana, Ethiopia, Mauritania, Nigeria and South Africa; and among those aged 25-44 years versus those aged 45 years and older in Botswana, South Africa and Tanzania. The incidence in Botswana was higher among adults with no formal or primary education than among those with secondary or higher education. In South Africa, the incidence was higher among adults in the middle or lower wealth index than among those in the high or highest wealth index. The findings suggest opportunities for strengthening efforts to prevent singlestick purchases through effective legislation and enforcement in line with Article 16 of the World Health Organization Framework Convention on Tobacco Control.

Meal Duration and Obesity-Related Indicators among Adolescents: Insights from the EHDLA Study.

This paper aims to examine the association between meal duration and obesity indicators among Spanish adolescents. We conducted a cross-sectional analysis using data from the Eating Healthy and Daily Life Activities (EHDLA) project involving 755 adolescents aged 12 to 17 years (54.8% girls) from three secondary schools in the Valle de Ricote Region of Murcia, Spain. To evaluate overall meal duration, participants were asked how long (on average) breakfast, morning snacks, lunch, afternoon snacks, and dinner typically last. Subsequently, global meal duration was measured, and the participants were categorized into tertiles. Obesity-related indicators, including body mass index (BMI) z score, waist circumference (WC), and skinfold thickness, were assessed. The analyses were adjusted for potential confounders such as sex, age, socioeconomic status, physical activity, sedentary behavior, diet quality, and energy intake. Concerning meal duration status, adolescents with long meal durations had the lowest estimated marginal means of BMI z score, WC, and body fat percentage (using the sum of triceps and calf skinfolds). However, significant differences between adolescents with a long meal duration and those with a short meal duration were observed only for BMI z score (p = 0.008), and WC (p = 0.020). Furthermore, significant differences in BMI z score (p = 0.017) between adolescents with a long meal duration and those with a moderate meal duration were identified. These findings underscore the importance of promoting slower eating habits as part of obesity prevention strategies. Future studies should explore the causality of this association and its potential for behavioral interventions.

What Is the Relationship between Chronotype and Disordered Eating in Adolescents? The EHDLA Study.

Evidence assessing the relationship between chronotype and disordered eating in adolescents is scarce. The current study tried to evaluate the association between chronotype and disordered eating in a sample of Spanish adolescents. This secondary cross-sectional study analyzed data from the Eating Healthy and Daily Life Activities (EHDLA) study. The sample consisted of 703 adolescents (56.3% girls) aged between 12 and 17 years from the Valle de Ricote (Region of Murcia, Spain). Chronotype was assessed using the Morningness/Eveningness Scale in Children (MESC). Disordered eating was evaluated by two psychologists using the Sick, Control, One, Fat, and Food (SCOFF) questionnaire. Adolescents with an eveningness chronotype showed a higher SCOFF score (estimated marginal mean [M] = 1.1; 95% confidence interval [CI] 0.7 to 1.5) in comparison with adolescents with a morningness chronotype (M = 0.7; 95% CI 0.5 to 0.8) (p = 0.010), as well as with those with an intermediate chronotype (M = 0.6; 95% CI 0.5 to 0.8) (p = 0.032). A higher predictive probability of having disordered eating was identified in adolescents with an eveningness chronotype (39.5%; 95% CI 22.8% to 59.1%), compared to adolescents with an intermediate chronotype (14.9%; 95% CI 10.8% to 20.1%) (p = 0.008) and with their counterparts with a morningness chronotype (16.9%; 95% CI 11.6% to 24.0%) (p = 0.021). This study reveals that adolescents with an eveningness chronotype are more likely to exhibit disordered eating behaviors compared to those with morningness or intermediate chronotypes. These findings highlight the importance of considering chronotype in adolescent health, particularly in developing targeted interventions to prevent eating disorders.

Orofacial clefts in Costa Rica, 1996-2021: Analysis of surveillance data.

Orofacial clefts (OFCs) are among the most common birth defects (BD). In 2008, a series of improvements began in the Costa Rican Birth Defect Register Center (CREC). We aim to explore trends between 1996 and 2021. A trend analysis of OFCs from 1996 to 2021 and a descriptive analysis of OFCs from 2010 to 2021 were performed based on data from the CREC, the national BD surveillance system. Prevalence at birth was calculated according to the type: cleft palate (CP), cleft lip with or without CP (CL ± P), and presentation (isolated, multiple non-syndromic, or syndromes). We used joinpoint regression to identify if a significant change in trend occurred; the average annual percent change (AAPC) was determined. Marginal means and prevalence ratios by subperiod (1996-2009 as referent and 2010-2021) were estimated using Poisson regression and compared using Wald's chi-square tests (α ≤.05). We found a significant AAPC for OFCs prevalence of +1.4: +0.6 for isolated, +2.9 for multiple non-syndromic, and +7.7 for syndromes (p < .05). When comparing the OFC's prevalence of the subperiod 2010-2021 (11.86 per 10,000) with 1996-2009 (9.36 per 10,000) the prevalence ratio was 1.3 (p < .01): 1.1 (p < .05) for isolated, 1.6 (p < .01) for multiple non-syndromic, and 3.3 (p < .01) for syndromes. The prevalence of OFCs from 2010 to 2021 was 9.1 for CL ± P and 2.8 for CP. Seventy-one percent of the OFCs were isolated, 22% multiple non-syndromic, and 7% syndromes. The trend in OFCs' prevalence is toward increasing, mainly due to improvements in the surveillance system.

Effects of Rheopheresis in dialysis patients with peripheral artery disease and diabetic foot ulcers: A multicentric Italian study.

Peripheral artery disease (PAD) in hemodialysis (HD) patients has a significant social impact due to its prevalence, poor response to standard therapy and dismal prognosis. Rheopheresis is indicated by guidelines for PAD treatment. Twenty-five HD patients affected by PAD stage IV Lerichè-Fontaine and ischemic ulcer 1C or 2C according to the University of Texas Wound Classification System (UTWCS), without amelioration after traditional medical therapy and/or revascularization, were selected and underwent 12 Rheopheresis sessions in 10 weeks. Improvements in pain symptoms using Numerical Rating Scale (NRS), healing ulcers and laboratory hemorheological parameters have been evaluated. A clinically and statistically significant mean value reduction and of relative percentage differences between estimated marginal means (Δ), calculated at each visits, of NRS was observed, with a maximum value (-48.5%) between the first and last visit. At the end of the treatment period 14.3% of ulcers were completely healed, 46.4% downgraded, 53.6% were stable. Overall, no ulcers upgraded. A statistically significant reduction of the Δ, between the first and last visit, for fibrinogen (-16%) was also observed. Rheopheresis reduced overall painful symptoms; data suggest that it could heal or improve ulcers and hemorheological laboratory parameters in HD patients with PAD and ischemic ulcers resistant to standard therapies.

Reduced Cervical Muscle Fat Infiltrate Is Associated with Self-Reported Recovery from Chronic Idiopathic Neck Pain Over Six Months: A Magnetic Resonance Imaging Longitudinal Cohort Study.

Background: It is unclear why neck pain persists or resolves, making assessment and management decisions challenging. Muscle composition, particularly muscle fat infiltrate (MFI), is related to neck pain, but it is unknown whether MFI changes with recovery following targeted interventions. Methods: We compared muscle composition quantified from fat-water magnetic resonance images from the C3 to T1 vertebrae in individuals with and without chronic idiopathic neck pain at two times 6 months apart. Those with neck pain received six weeks of intervention (physiotherapy or chiropractic) after their baseline MRI; at 6 months, they were classified as recovered (≥3 on the 11-point Global Rating of Change scale) or not recovered. Results: At 6 months, both asymptomatic and recovered individuals had decreased MFI compared to baseline (asymptomatic estimated marginal mean difference -1.6% 95%; CI -1.9, -1.4; recovered -1.6; -1.8, -1.4; p < 0.001) whereas those classified as not recovered had increased MFI compared to baseline (0.4; 0.1, 0.7; p = 0.014), independent of age, sex and body mass index. Conclusions: It appears MFI decreases with recovery from neck pain but increases when neck pain persists. The relationship between cervical MFI and neck pain suggests MFI may inform diagnosis, theragnosis and prognosis in individuals with neck pain. Future development of a clinical test for MFI may assist in identifying patients who will benefit from targeted muscle intervention, improving outcomes.

Effect of landraces on Musa micropropagation

This work aimed at assessing the performance of two landraces of Musa spp in micropropagation. Tissues from Owom and Efol were sterilized by soaking the explants in 70 % ethanol for 30 sec, 8 % NaOCl for 5 min, 5 g/L benlate for 5 min, and in 1.2 g/L HgCl2 for 10 min before being thoroughly washed with distilled water. Tissue exposure to U. V. light for 5 min was done before they were cultured in a shooting MS-based culture medium supplemented with 5.00 mg/L concentration of 6-Benzylaminopurine, and later to a rooting MS-based culture medium supplemented with indoleacetic acid (IAA) of 2.00 mg/l concentration. Data were collected on number of shoots, shoot height, shoot’s health, days to rooting, root number, and root length. The result from shooting medium showed that the plants’ heights were highly significantly different at P ≤ 0.01, with Owom producing marginal mean heights of 3.59 cm and 5.05 cm at 3 and 5 weeks respectively, after initiation. A very high significant difference was observed with plant health at P ≤ 0.001 whereby Owom landrace reduced in health status as the week increased, unlike Efol which increased in health status across the weeks. For rooting medium, significant differences at P ≤ 0.05 for days to rooting, root length, health performance, and plant height were observed. While high significant difference was observed for the number of roots at P ≤ 0.01. Owom performed significantly better than Efol and has shown value for commercial production and breeding programs.

Longitudinal metabolite and protein trajectories prior to diabetes mellitus diagnosis in Danish blood donors: a nested case–control study

Aims/hypothesisMetabolic risk factors and plasma biomarkers for diabetes have previously been shown to change prior to a clinical diabetes diagnosis. However, these markers only cover a small subset of molecular biomarkers linked to the disease. In this study, we aimed to profile a more comprehensive set of molecular biomarkers and explore their temporal association with incident diabetes.MethodsWe performed a targeted analysis of 54 proteins and 171 metabolites and lipoprotein particles measured in three sequential samples spanning up to 11 years of follow-up in 324 individuals with incident diabetes and 359 individuals without diabetes in the Danish Blood Donor Study (DBDS) matched for sex and birth year distribution. We used linear mixed-effects models to identify temporal changes before a diabetes diagnosis, either for any incident diabetes diagnosis or for type 1 and type 2 diabetes mellitus diagnoses specifically. We further performed linear and non-linear feature selection, adding 28 polygenic risk scores to the biomarker pool. We tested the time-to-event prediction gain of the biomarkers with the highest variable importance, compared with selected clinical covariates and plasma glucose.ResultsWe identified two proteins and 16 metabolites and lipoprotein particles whose levels changed temporally before diabetes diagnosis and for which the estimated marginal means were significant after FDR adjustment. Sixteen of these have not previously been described. Additionally, 75 biomarkers were consistently higher or lower in the years before a diabetes diagnosis. We identified a single temporal biomarker for type 1 diabetes, IL-17A/F, a cytokine that is associated with multiple other autoimmune diseases. Inclusion of 12 biomarkers improved the 10-year prediction of a diabetes diagnosis (i.e. the area under the receiver operating curve increased from 0.79 to 0.84), compared with clinical information and plasma glucose alone.Conclusions/interpretationSystemic molecular changes manifest in plasma several years before a diabetes diagnosis. A particular subset of biomarkers shows distinct, time-dependent patterns, offering potential as predictive markers for diabetes onset. Notably, these biomarkers show shared and distinct patterns between type 1 diabetes and type 2 diabetes. After independent replication, our findings may be used to develop new clinical prediction models.Graphical