Observation Period Research Articles

Prevalence and clinical features of interstitial lung disease in patients with psoriasis

BackgroundDespite the autoimmune nature of psoriasis, the potential association between psoriasis and interstitial lung disease (ILD) remains underexplored. This study aimed to investigate the frequency and clinical features of ILD in patients with psoriasis and propose a new conceptual framework of “ILD associated with psoriasis”.MethodsA retrospective analysis of 117 patients with psoriasis was conducted, excluding those without chest imaging prior to methotrexate or biologic use and those with other comorbidities leading to ILD.ResultsILD was identified in 12 (10%) patients with psoriasis; 6/50 with psoriasis vulgaris and 6/65 with psoriatic arthritis. Three of 12 patients had no history of smoking. Serum Krebs von den Lungen-6 (KL-6) levels were elevated in patients with ILD compared to those in patients without ILD. The indeterminate for usual interstitial pneumonia (UIP) pattern was the most prevalent CT finding. A lung biopsy specimen from a representative case revealed equivalent indeterminate for UIP. Over a median 8.9-year observation period, ILD progressed in only 5 patients, with no cases of respiratory failure or death due to ILD progression, suggesting generally favourable prognoses.ConclusionsILD associated with psoriasis would be present, and its frequency is 10% of patients with psoriasis. We propose that chest radiography and a serum KL-6 test at the initial diagnosis of psoriasis would be useful in screening for the detection of ILD. We also recommend that a physician diagnosing ILD should carefully examine the skin findings, considering if psoriasis could be associated with ILD.Trial registrationNot applicable.

Peri-implantitis, Risk of Recurrence and Implant Loss in Soldiers with Stage III/IV Periodontitis during 20-30 Years of Supportive Periodontal Therapy (SPT).

To help fill the knowledge gaps regarding the long-term effectiveness of peri-implantitis therapy, this retrospective study of soldiers with treated severe periodontitis (stage III gen. / IV) who had been undergoing adherent SPT for at least 20 years aimed to determine the frequency of peri-implantitis and patient-related risk factors for this, as well as the 10-year survival rates of dental implants under peri-implantitis therapy. The observation period was between 1993 and 2023. All patients were referred by their military dentists for specialist dental training and underwent systematic periodontal therapy. A multi-stage peri-implantitis treatment concept was used. In 86 (31%) of 276 patients (total treatment time 23.6 ± 2.8 years, 53.1 ± 20.4 SPT sessions), 296 implant restorations were performed to close gaps or lengthen rows of teeth. In 29 (33%) of the implant patients, peri-implantitis developed on 25% of the implants. As a result, 11% of all implants were lost within 10 years due to peri-implantitis. Peri-implantitis led to implant loss in 59% of affected patients and 45% of implants. The survival time of implants lost later was 8.4 ± 6.2 years. Peri-implantitis and implant loss rates increased statistically significantly in stage IV periodontitis as well as in heavy smokers. Patients with implant loss and peri-implantitis had received systemic antibiotics due to periodontitis recurrence statistically significantly more frequently than patients without peri-implantitis and without implants during the ≥ 20-year SPT (p 0.05). Based on the present results, the early extraction of teeth during SPT in patients with treated generalised periodontitis stage III and stage IV plus replacement with implants is not advantageous.

On the reasons for the long-term variability of the dissolved oxygen concentration in the upper layer of the Black Sea

According to archival data for the period from 1923 to 2022 long-term (interdecadal and interannual) variability of dissolved oxygen concentration and temperature in the surface layer of the Black Sea in the spring hydrological season (from May to June) is analyzed. It was revealed that from 1923 to 1932 on the northwestern shelf and in the open part of the Black Sea, the lowest oxygen concentrations were observed over the entire period of instrumental observations (approximately 100 years). Negative anomalies in dissolved oxygen exceeded (in absolute value) the corresponding anomalies noted during the period of eutrophication of the Black Sea waters in the last decades of the 20th century. The main reason for the extreme anomalies discovered in the 1920s is the increase in the temperature of the surface layer of the Black Sea waters during this period.

Impact of immigration background on feasibility of electronic patient-reported outcomes in advanced urothelial cancer patients

BackgroundElectronic patient-reported outcomes (ePROs) have been shown to enhance healthcare quality by improving patient symptom management or quality of life (QoL). However, ePROs data for urothelial cancer (UC) patients receiving systemic therapies are scarce, and the application of ePROs in this patient cohort may need specific setups. This study tested the feasibility of ePROs for UC patients receiving systemic therapies in the outpatient clinic of a tertiary care center.Patients and MethodsFrom January 2022 to April 2023, 30 UC patients receiving systemic cancer therapies received ePROs based on the Common Terminology Criteria for Adverse Events (CTCAE) and European Organization for Research and Treatment of Cancer Core Quality of Life questionnaires (EORTC QLQ-30) to report their symptoms and QoL during systemic therapy, in total, 125 questions for every therapy cycle. The proportion of patients adherent to the ePROs was assessed to evaluate feasibility, with a preset threshold of 50%. At least half of all treatment cycles with a minimum of two consecutive ePROs (corresponding to two successive therapy cycles) had to be completed to be counted as adherent, and a maximum of six successive therapy cycles was followed by ePROs. Descriptive statistics were calculated for clinical and demographic patient characteristics. T-test and chi-square-test analyses were performed to study the association between ePROs adherence and clinical or demographic factors. The digital process was closely monitored for procedural impediments that could occur.Results21 (70%) of the included 30 patients adhered to the provided ePROs, significantly higher than the predetermined threshold of 50%. Adherence remained above 70% until the end of the observation period. A significant negative effect of immigration background on ePROs compliance was observed (p = 0.006). No other variables were significantly associated with ePROs compliance.ConclusionsIn this study, ePROs were a feasible method to assess symptoms and QoL during the systemic cancer therapy of UC patients at our center. The compliance of patients with immigration backgrounds was the most significant barrier to using ePROs in this setting. However, the study is limited by the exclusion of patients without email access and the lack of assessment of physician compliance with the ePROs data, which may affect the generalizability and implementation of the findings.

Strength of clinical evidence supporting the United States Food and Drug Administration Accelerated Approvals from 2015 to 2022

BackgroundThe Food and Drug Administration (FDA)’s Accelerated Approval (AA) pathway has increasingly used to authorize market approval of new drugs amid controversy. The present study aims to inform the most recent data on the strength of clinical evidence supporting such approvals.MethodsEvidentiary characteristics of pre-approval pivotal clinical studies and regulator-required post-approval confirmatory studies supporting AAs between 2015 and 2022 were extracted from publicly available FDA documents. Descriptive analyses were conducted for each of the characteristic including study design, study phase, primary endpoint, number of participants, and magnitude of effect. Trends of these characteristics over time were documented and accounted for class of drugs, application type, novelty, orphan status, and oncology/non-oncology indications.ResultsDuring 2015–2022, 156 drug-indication pairs received AA. To support these AAs, 77% of pre-approval pivotal trials employed single-arm designs, and 22% were phase I trials, with a median of 92 participants (IQR, 45–125); 61% of post-approval confirmatory studies were required by FDA to use randomized controlled design, 25% to use clinical endpoints, and 33% specified the number of participants requirement. During the 8-year observation period, the pairs approved via AA pathway almost tripled from 20 (2015–2016) to 59 (2019–2020) and fell to 36 (2021–2022); the corresponding proportion to all new drug approvals showed the same trend. Single-arm pre-approval pivotal studies increased from 55% (2015–2016) to 91% (2019–2020) and fell to 69% (2021–2022), while the median number of participants decreased from 106 (2015–2016) to 59 (2019–2020) and rose to 106 (2021–2022). Randomized controlled post-approval confirmatory studies decreased from 75% (2015–2016) to 42% (2019–2020) and rebounded to 75% (2021–2022), while those using surrogate endpoints increased from 50% (2015–2016) to 72% (2021–2022). Analyses adjusting for drug class, application type, novelty, orphan status, and oncology/non-oncology showed similar results.ConclusionsThe number of drug-indication pairs receiving AA increased sharply during 2015–2016 to 2019–2020 but fell in 2021–2022. Meanwhile, the strength of clinical evidence supporting FDA’s AAs appeared to decline from 2015 to 2020 but seems to have improved in 2021–2022. Measures should be taken to further improve the strength of evidence in Accelerated Approvals.

Prevalence of gastric cancer following colorectal endoscopic submucosal dissection for lesions more than 20 mm: A retrospective analysis.

Colorectal endoscopic submucosal dissection (ESD) for large tumors is spreading worldwide. Gastric cancer (GC) sometimes occurs after colorectal ESD. However, its status including frequency and risk factors have not been examined well. In this study, we analyzed the detailed status of GC after colorectal ESD. This was a single-center retrospective study. Patients receiving colorectal ESD between 2010 and 2018 were reviewed. All patients were recommended to receive esophagogastroduodenoscopy (EGD) for screening. Finally, 436 patients receiving EGD, who underwent colorectal ESD for lesions of ≥20 mm were analyzed. The primary outcome was the GC rate after colorectal ESD, including intramucosal cancer. As a control, we compared it to the GC rate in matched Japanese national cancer registry data. The secondary outcome was risk factors for developing GC. The mean age was 66.9 ± 10.6 and 55.3% were males. The GC rate was 5.96% (26/436) with a median observation period of 27 months. It was significantly higher than the mean GC rate in the diagnosed age calculated with the cancer registry (0.26%, observed value/expected value ratio [95% confidence interval]: 22.20 [14.50-32.53], p < 0.01). The comparison between cases with and without GC showed that significant risk factors were male (p = 0.02) and smokers (p < 0.01) and their GC rates were 8.3% and 10.9%. Also, in the limited cases, Helicobacter pylori infection (past and present) and atrophic gastritis were significant and their GC rates were 11.1% and 11.6%. The GC rate was high after resecting colorectal tumors of ≥20 mm, suggesting the necessity of EGD.

Antidepressant and anxiolytic efficacy and tolerability of agomelatine in the treatment of depression after COVID-19 in daily clinical practice (non-interventional study TELESPHOR)

Depression and anxiety are among the most common disorders observed in patients after COVID-19 coronavirus infection.Objective: to evaluate the antidepressant efficacy and tolerability of agomelatine in patients with a depressive episode (DE) after COVID-19 infection in everyday clinical practice.Material and methods. The multicenter observational study TELESPHOR included outpatients aged 18 to 65 years who developed DE (Hamilton Depression Rating Scale (HAMD-17) score of 8–24) within 3 months of the resolution of a laboratory-confirmed COVID-19 infection and started monotherapy with agomelatine. Patients were assessed at enrolment and subsequently at weeks 2, 4 and 8 of the observation period. The primary endpoint was the change in HAMD-17 scores by week 8 of the observation in patients taking agomelatine as an antidepressant. The main secondary outcome variables were the dynamics of scores for items 10 (psychic anxiety) and 11 (somatic anxiety) of the HAMD-17 scale, the proportion of responders and remitters (according to the HAMD-17 scale) and the impact on quality of life (QOL) according to the SF-36 questionnaire. The tolerability of agomelatine was assessed at each visit. Data from all patients who participated in the study and took agomelatine at least once were included in the efficacy and safety analysis. The final analysis included data from 103 patients, including 73 women (70.9%).Results. Treatment with agomelatine was associated with a significant improvement in depression severity: the mean HAMD-17 total score decreased statistically significantly at weeks 2, 4 and 8 from 16.3±4.7 at study inclusion to 13.7±4.5, 9.5±4.9 and 5.4±3.6 points – by 2.6±3.3, 6.7±5.3 and 10.9±4.9 points, respectively, compared to baseline (p&lt;0.0001 for all time points). The average score for item 10 (psychic anxiety) and item 11 (somatic anxiety) of the HAMD-17 scale also decreased significantly from 1.4±0.9 and 1.3±0.8 at baseline to 0.5±0.6 and 0.6±0.6 points by the eighth week of observation (p&lt;0.0001). The indicators of the scales for physical functioning and mental health of the SF-36 questionnaire improved significantly compared to the initial values – from 39.7±8.4 to 50.5±5.7 points (p&lt;0.0001) and from 37.3±8.6 to 58.7±6.9 points (p&lt;0.0001) respectively, by the eighth week. The proportion of responders was 81.4 %, the proportion of remitters was 71.6%. Agomelatine was well tolerated during the entire observation period. No adverse events were recorded that led to discontinuation of the drug. One patient showed inefficacy of the treatment, so he discontinued participation in the study.Conclusion. The treatment of patients with DE after COVID-19 with agomelatine is characterized by significant antidepressant and anxiolytic efficacy, improved QOL and good tolerability.

SEISMICITY of THE NORTH-EAST of RUSSIA in 2020

The results of seismic monitoring of the Magadan region, Chukotka Autonomous Area and the shelf of adjacent seas (Okhotsk, Chukchi, Bering and East Siberian seas) are considered. There were 12 working seismic stations in the region. The catalog of the Russian North-East earthquakes for 2020 includes information about 327 earthquakes, 114 of them are out of the region and 213 with energy classes KR=6.2–12.2 are within the region borders. As usual, most of 213 regional earthquakes (80 %) are localized in the Kolyma area. The total seismic energy released within the region’s borders was equal ΣЕ=3.4481012 J. The classification of Russian North-East earthquakes was performed using energy classes KР of T.G. Rautian’s scale. The energy representa tiveness map of earthquakes with Кmin=6–10 was built. The Magadan network of stations records without omis sions the earthquakes with Kmin=7 in Magadan oblast, with Kmin=8 in Okhotsk sea, Kmin=10 in the Chukchi. The strongest earthquake of 2020 with KR=12.2 (mb=4.3, Ms=3.7) occurred on November 1, 11h44m in the Bering Sea. Epicenters of Magadan region earthquakes were plotted on the tectonic zoning scheme. Most earthquakes are confined to the largest deep faults in the northwestern and sublatitudinal directions. All hypocenters are located within the earth's crust. In 2020, the seismicity level of the North-East of Russia according to the “SOUS09” scale was assessed as "background average" for the observation period from 1968 to 2020. Spatially, all Russian North-East earthquakes are traditionally con centrated in large seismogenic belts: Chersky, North-Okhotsk and Trans-Beringian.

Social preferences in chickens–effects of domestication and tameness

It has been suggested that evolution of domesticated phenotypes may have evolved as a result of correlated selection responses to reduced fear, a prominent feature in early domestication. To investigate whether domestication changes in social preferences can be attributed to increased tameness, we studied two lines of Red Junglefowl, ancestors of domesticated chickens, bidirectionally selected during 12 generations for high (HF) or low (LF) fear of humans and compared the differences between these lines to those between unselected Red Junglefowl (RJF) and domesticated White Leghorn egg layers (WL). One bird at a time was observed on its own for 12 min in an arena with one adjacent pen behind netting on each side. One of the adjacent pens contained familiar birds, and the other contained unfamiliar birds. Towards the end of the observation period, a sudden stressful stimulus was displayed, and we compared the reactions of the breeds to this as well. Male RJF spent more time close to the unfamiliar birds than WL, and performed more agonistic behaviour, but this was not mirrored in the selected birds. For females, it was WL that performed the most agonistic behaviour. Both LF and WL males showed more non-agonistic social exploration than HF and RJF respectively. Male LF and WL emitted more food calls than HF and RJF respectively. We conclude that several differences between RJF and WL were mirrored in the selection lines, with LF behaving more like domesticated WL. This is in line with the hypothesis that selection for tameness may have driven domestication related changes in social behaviour against conspecifics.

SEISMICITY of the NORTHERN CAUCASUS in 2020

Seismic monitoring of the territory of the Northern Caucasus in 2020 was carried out by a seismic network of 63 stations. The seismic network provided representative registration of earthquakes with KR≥7.0 in most of the territory, in its central (including the Greater Sochi region) and eastern parts – with KR≥6.0, and in some local zones – with KR≥5.5. In general, 3685 earthquakes were recorded in the region and its environs. 16 earthquakes were felt in the Caucasus settlements, 26 of them occurred in the North Caucasus region. The maximum shaking intensity Imax=5–6 according the MSK-64 was noted from the earthquake on December 12 with KR=12.9 on the territory of the Chechen Republic (Tersk-Caspian forward trough). On the territory of Ossetia (Greater Caucasus), the Verkhne Fiagdon earthquake of January 26 with KR=11.1 occurred. It was felt in populated areas up to I=4–5. Two notice able earthquakes were registered in the Black Sea: on September 1 with KR=10.8 and on December 12 with KR=10.5. They were felt in Krasnodar Region with intensity up to I=5 and I=4–5 respectively. In accordance with the seismicity level scale "SOUS-09", seismicity of the North Caucasus in 2018–2019 is set as a "background average" for the observation period from 1962 to 2020.

Determining the PM10 Pollution Sources near the Copper Smelter in Bor, Serbia

The EPA Positive Matrix Factorization (PMF) 5.0 model was applied to determine the sources and characteristics of PM10 collected near the copper smelter in Bor, Serbia, from September 2009 to July 2010. For a better understanding of the industrial sources of PM10 pollution, the dataset was divided into four observation periods: heating season (HS), non-heating season (NHS), copper smelter in work (SW), and copper smelter out of work (SOW). The daily limit for the PM10 fraction of 50 μg/m3 was exceeded on one-sixth of days in the NHS, about half the days in the HS, and about one-third of days during the SOW and SW period. The nine different sources of PM10 were identified: fuel combustion, industrial dust, dust from tailings, storage and preparation of raw materials, secondary nitrate, Cu smelter, traffic, cadmium, and plant for the production of precious metals. The contribution of factors related to the activities in the copper smelter complex to the total mass of PM10 was 83.1%. When the copper smelter was out of work the contribution of all the factors related to PM10 pollution from the copper smelter to the total mass of the PM10 was 2.3-fold lower, 35.8%, compared with the period when the copper smelter was in work. This study is the first attempt to use PMF receptor modeling to determine the air pollution sources and their contribution to ambient air pollution in the city of Bor, Serbia.

Infection Rate and Risk Factors of SARS-CoV-2 Infection in Retail Workers at the Onset of the COVID-19 Pandemic, Quebec, Canada

Background/Objectives: During the pandemic, client-facing workers were perceived to be at greater risk of SARS-CoV-2 infection. This study investigated the risk factors for SARS-CoV-2 infection among a cohort of 304 retail workers in the Quebec City metropolitan area. Methods: After providing consent, participants were interviewed to gather information on demographic, socioeconomic, behavioural, and occupational variables. They were subsequently followed for up to five visits, scheduled every 12 ± 4 weeks. The study covered critical periods before and during the emergence of the Omicron variants and included retrospective reporting of COVID-19 symptoms and virus detection tests to capture the pandemic’s early stages. Results: During the observation period, 173 (57%) participants experienced a first episode of COVID-19. Serological evidence of recent infection was detected in 160 participants (53%), while 117 (38%) reported a positive virus detection test. In adjusted analyses, risk factors for infection included younger age, a diagnosis of lung disease, longer weekly working hours, more frequent social gatherings, and having received fewer than three doses of vaccine. Notably, the increased risk associated with younger age and longer working hours was observed only after the relaxation of public health measures in the spring of 2022. Conclusions: These data suggest that during the early years of the pandemic when strict public health measures were in place, retail work was not a significant risk factor for SARS-CoV-2 infection in Quebec City metropolitan area. These findings highlight the complex dynamics of COVID-19 transmission and the effectiveness of workplace protective measures.

Precise Orbit Determination of Mars-crossing Asteroids

This study investigates the orbit determination of the Mars-crossing asteroids (MCAs) with a focus on the possibility of detecting their Yarkovsky signals. We analyze the influences of force model uncertainties on MCA orbits, including the uncertainty of the main asteroid belt, and the uncertainty of the major planets’ ephemeris. The main asteroid belt is modeled using 343 asteroids and a ring structure. The Yarkovsky effect’s quadratic nature allows it to dominate over extended observation periods. To address dynamical errors and potential interactions with the main asteroid belt, we employ not only a traditional seven-dimensional differential corrector but also a nine-dimensional differential corrector that considers radial, vertical, and transversal forces. Comparison shows that the latter approach enhances the fit to observational data. However, the reliability of the Yarkovsky parameter is not enhanced because the estimation of the radial component is physically unacceptable. Despite incorporating precise Gaia data, our analysis does not conclusively detect a Yarkovsky effect on MCAs due to uncertainties in the force model. Nevertheless, our research advances our understanding of MCA dynamics, identifying five potential candidates whose Yarkovsky effect may be observable.

Stratification and internal temperature oscillations near a coastal inlet

ABSTRACT A vertical array of fast-response temperature sensors was deployed to investigate interior ocean temperature and thermal stratification variability during Spring, 2018 near an inlet entrance on the Otago inner continental shelf (15 m water depth). Over the 24-day observation period, the background water column structure evolved from supporting a near-surface pycnocline, to being characterised by a deep surface mixed layer. Periods of mostly low stratification due to atmospheric- and surface wave-driven mixing are also observed. Time-varying normal-mode projection demonstrates that the vertical structure of semi-diurnal temperature oscillations evolves in response to this background stratification in a manner consistent with the interpretation of internal waves. At higher frequencies (supratidal) the projection is less consistent as vertically coherent oscillations from non-linear internal solitons co-exist with non-coherent oscillations, a potential signature of stratified mixing. Although both processes are likely important contributors to the transport of coastal tracers and inlet-ocean exchange, further measurements are needed to determine the origin and fate of internal waves on the Otago continental shelf.

A retrospective single cohort study on the 5-13 year clinical outcomes of implant-supported cross-arch fixed dental prostheses with monolithic zirconia-based frameworks.

To investigate the mid-to-long term clinical outcomes of the implant-supported cross-arch fixed dental prostheses (IFCDPs) with monolithic zirconia-based frameworks and related risk factors of success and survival. This retrospective study encompassed individuals exhibiting terminal dentition or edentulism in the maxilla and/or mandible who underwent treatment involving IFCDPs with monolithic zirconia frameworks. Inclusion criteria required a documented follow-up period of at least five years post-definitive prosthesis delivery. Evaluation of outcomes focused on the survival rates of implant and prosthesis, along with the incidence of biological and technical complications. The mixed-effects Cox regression model was employed to analyze the risk factors associated with prosthesis failure and peri-implantitis. A cohort of 47 patients, consisting of 14 women and 33 men with a mean age of 55.2 ± 12.5 years (range: 25-83), was included in this study. The mean follow-up period was 71.6 ±13.2 months (mean ± SD, range: 60-147). A total of 51 cross-arch prostheses supported by 302 implants, distributed between the maxilla (27 prostheses) and mandible (24 prostheses), were assessed. By the end of the follow-up period, 289 (97.64%) of the 302 implants remained functional. Peri-implantitis was observed in 27 implants (24 in mandible), yielding an overall implant-related success rate of 91.06%. Nine frameworks experienced fractures (eight in mandible), resulting in an overall prosthesis-related survival rate of 82.35%. Subsequent analysis revealed the mandible to be a significant risk factor for framework fracture (HR = 11.64, p = 0.024) and peri-implantitis (HR = 10.88, p = 0.003). The implant-supported cross-arch fixed dental prostheses featuring monolithic zirconia-based frameworks demonstrated favorable clinical outcomes throughout a 5-13-year observation period. Notably, in the design of monolithic zirconia-based framework prostheses, the mandible emerged as a significant risk factor for framework fractures and an independent risk factor for peri-implantitis.

Studying the prevalence of chronic general somatic diseases among medical workers based on a cross-sectional epidemiological study

Introduction. Obtaining objective data on the long-term consequences of health disorders of medical workers who have suffered COVID-19 while performing professional duties is an important problem of occupational health. The establishment of background indicators of the health status of medical workers before their contact with infectious patients in the performance of professional duties is the first stage of monitoring the long-term consequences of coronavirus infection. The study aims to assess the prevalence of chronic general somatic diseases among medical workers of various industrial and professional groups for further monitoring of their health status. Materials and methods. The object of the study was the medical staff of the regional clinical hospital. The authors have analyzed the results of periodic medical examinations. The total number of medical workers amounted to 495 people. Experts have formed three production and professional groups: doctors, nursing staff, and junior medical staff. The authors performed a cross-sectional epidemiological study, during which they studied the prevalence of chronic general somatic diseases in medical professionals. The reliability of the results obtained was assessed by the Student's coefficient. Results. In the course of a cross-sectional epidemiological study, scientists found that the prevalence of chronic diseases in individual industrial and occupational groups is at the same level. In the structure of chronic general somatic diseases of medical workers, the first two places are occupied by diseases of the circulatory system and diseases of the musculoskeletal system and connective tissue. Diseases of the endocrine system, eating disorders and metabolic disorders occupy the third place. Chronic diseases of the musculoskeletal system and connective tissue are equally common among medical workers of various professional groups and amount to 63.0±2.2 (per 100 employees). The prevalence of chronic diseases of the circulatory system among medical workers is 50.7±2.2 per 100 employees. When comparing the indicators between professional groups, the authors found that the prevalence of diseases of the system of this class of diseases among doctors (38.6±3.2) was significantly (p&lt;0.05) lower compared with employees of the average (55.2±3.9) and junior (63.2±4.2) medical personnel. The prevalence of diseases of the endocrine system, eating disorders and metabolism among medical workers is 32.1±2.1 per 100 employees. At the same time, the lowest rate was noted among doctors, which is 25.9±3.1 per 100 employees and is significantly lower compared to the group of junior medical personnel (41.4±4.3). Limitations. The study is limited to the observation period. Conclusion. The data obtained as a result of a cross-sectional epidemiological study allowed us to establish that among doctors the prevalence of diseases of the circulatory and endocrine systems, eating disorders and metabolic disorders is significantly lower compared with medical professionals of other professional groups. Ethics. All medical staff have given informed consent to the use of personal data for statistical processing.

Long-term efficacy of on-demand vonoprazan treatment for mild reflux esophagitis: success rates and predictors of treatment failure.

Concerns surrounding long-term proton pump inhibitor use have prompted the exploration of alternative treatments for reflux esophagitis (RE). We previously demonstrated that 24weeks of on-demand treatment with vonoprazan, a potassium-competitive acid blocker, effectively managed mild RE (Los Angeles classification grade A/B) in more than 80% of patients. However, its long-term efficacy remains unknown. Therefore, the present study investigated sustained effectiveness. We conducted a retrospective observational study on 30 participants with mild RE from our previous research. Participants with recurrent RE or symptom exacerbation were excluded and considered as treatment failure. Participants with the remission of RE and reflux symptoms under on-demand treatment until the clinic visit between October 2023 and February 2024 were regarded as treatment success. Predictors of treatment failure were analyzed. During the observation period, 5 participants failed treatment due to symptom exacerbation and 6 due to recurrent RE. Five participants were excluded from analyses due to non-GERD causes. Fourteen participants (56.0%) successfully continued on-demand treatment for 91.5months [89.3-92.8]. Age > 67years significantly predicted treatment failure with a sensitivity of 72.7% and specificity of 85.7%. Although none of the patients with RE grade A had recurrent RE, it was not a significant difference. Approximately 50% of patients with mild RE successfully continued on-demand treatment for more than 7years. Age > 67years was identified as a predictor of treatment failure. Prospective multi-center studies are warranted to validate these results.

Exploring Spatiotemporal Patterns of Cardiovascular Disease in Greece: Insights from the ATTICA Study (2002-2022)

The objective of this study was to investigate spatiotemporal variability of cardiovascular disease (CVD) occurrence and identify spatial clusters on Attica region (Greece), over a 20-year period (2002-2022). The 10- and 20-year occurrence of fatal and non-fatal cardiovascular disease was obtained from the ATTICA study, which was conducted between 2002 and 2022. The sample used in this analysis included 1,935 (49,8% males) and 1,902 participants (49.5% males), respectively. CVD occurrence rate at the municipality level were mapped, and spatial autocorrelation analysis was performed to identify statistically significant clusters and outliers in the Attica region. The mapping of CVD occurrence rates revealed an observable increase in most municipalities during the observation period. In addition, a statistically significant clustering of high CVD occurrence rates was found in the most urbanized municipalities of the study area over the period under study. These findings underscore the need for targeted interventions, focusing on urban populations, to effectively address this trend.

PENGARUH FEE AUDIT, FINANCIAL DISTRESS, KOMISARIS INDEPENDEN, DAN KOMITE AUDIT TERHADAP INTEGRITAS LAPORAN KEUANGAN

This research aims to examine the influence of audit fees, financial distress, independent commissioners and audit committees on the integrity of financial reports. Audit fees are measured using the natural logarithm of professional fees, financial distress is measured using the debt to equity ratio, independent commissioners are measured using the ratio of the number of members of the company's independent commissioners to the number of members of the company's board of commissioners, audit committees are measured using the comparison of the number of audit committees that come from from the independent committee with the number of audit committee members and the integrity of the financial reports as measured using the market to book ratio. This type of research is quantitative. Based on purposive sampling, the number of sample companies was 29 companies with an observation period of 5 years, so the total sample was 145 data on the property and real estate sectors listed on the Indonesia Stock Exchange (BEI) during the 2018-2022 period. The data analysis used in this research is a panel data regression model using E-Views 12. The results of this research show that partially audit fees and audit committees have no effect on the integrity of financial reports. Financial distress and independent commissioners have a significant effect on the integrity of financial reports. Meanwhile, simultaneously audit fees, financial distress, independent commissioners and audit committees influence the integrity of financial reports. Keywords: Financial Statement Integrity, Audit Fees, Financial Distress, Independent Commissioner, Audit Committee.

Wound formation in patients with Rutherford category IV disease after endovascular therapy: rates and risk factors

BackgroundLower limb peripheral artery disease classified as Rutherford category IV, is characterized by lower limb ischemic pain both during exertion and at rest. This disease has an unclear course. We aimed to evaluate outcome predictors in this patient group after endovascular therapy. This single-center, retrospective, observational study included 234 consecutive patients (264 limbs), between April 2007 and December 2020. We investigated the disease clinical course after endovascular therapy. The primary endpoint was the wound formation rate 3 years after endovascular therapy.ResultsThe mean observation period was 48.2 ± 8.9 months. The patients (61.9% male; mean age, 76 ± 10 years) presented with diabetes (64.1%), and received hemodialysis with chronic kidney disease (35.0%) and ambulatory treatment (85.0%). The average ankle-brachial index before endovascular therapy was 0.69 ± 0.23. Skin perfusion pressure on the dorsal and plantar sides was 38 ± 13 mmHg and 36 ± 12 mmHg, respectively. The wound incidence rates at 1, 2, and 3 years after endovascular therapy were 8.3%, 11.4%, and 14.4%, respectively. Multivariate analysis revealed the following factors associated with wound formation: P2 in inframalleolar/pedal disease category in the Global Limb Anatomical Staging System (hazard ratio: 1.73, 95% confidence interval: 1.22–2.83, P = 0.01), non-ambulatory status (hazard ratio: 1.09, 95% confidence interval: 1.11–1.36, P = 0.02), intervention up to infrapopliteal lesion (hazard ratio: 1.55, 95% confidence interval: 1.17–2.46, P = 0.03), and patient with chronic kidney disease on hemodialysis (hazard ratio: 1.61, 95% confidence interval: 1.32–2.18, P = 0.03).ConclusionsThe 3-year incidence of wound onset in this study was 14.4%. Factors associated with this outcome included P2 in the Global Limb Anatomical Staging System, non-ambulatory status, intervention up to infrapopliteal lesion, and patient with chronic kidney disease on hemodialysis.