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The study aimed to assess the race performance after injury of the palmar metacarpal tendon region in Thoroughbred and Arabian racehorses. A special scoring system was established to evaluate the performance of the horses for each race after the injury, objectively in this study. Thus, individual total race earnings, the rates of ranking among the top four in at least two and three races and the number of participated races after injury were also analysed. The performance scores after injury were found to be lower in tendinitis cases compared to peritendinitis cases (P=0.0004). It was found that the success rate was lower in cases with tendon lesions than in cases without lesions in terms of race performance after injury (P=0.006). Injuries causing tendon thickening and also tendon echogenicity alterations had negative effects on race performances after injury (P=0.01 and P=0.04, respectively). Also individual total race earnings were lower in cases with tendon thickening compared to those without thickening (P=0.02). According to the results of this study, it is recommended to take prophylactic measures for tendinitis in cases with tendon thickening and echogenicity changes detected by ultrasound in the early stages of tendinitis to be able to display a good race performance after injury.

At the beginning of the COVID-19 pandemic, an ad hoc organisational framework was established between academic, local government and community partners to implement the "Sentinella - Identify, Trace and Prevent" screening programme in Verona, north-east Italy. Between September 2020 and May 2021, key populations not covered by any screening policies at the local and national level were screened for SARS-CoV-2. Target populations were: older adult residents (males >65 years and females >75 years), bus and taxi drivers, social workers, supermarket employees, hospital cleaning and catering staff, researchers working in the local hospitals, students, and people experiencing homelessness (PEH). Five dedicated swab clinics, home testing facilities, and one mobile clinic were activated to collect nasopharyngeal swabs. Molecular analysis was performed for all the subjects; an antigen-rapid diagnostic test (Ag-RDT) was also implemented as a point-of-care test for PEH. Medical follow-up, psychological support, and quarantine facilities were organised for subjects who tested positive for SARS-CoV-2. Overall, 2075 subjects participated in the surveillance programme. Amongst these, 1,572 were residents/workers, whilst 503 were PEH. A total of 127 (6.2%) participants tested positive for SARS-CoV-2. Sixty-nine were residents, 58 PEH. The incidence rate was 4 per 10.000 person/day (95% CI 3.1-5.0). The highest prevalence and incidence rates were found amongst supermarket employees (9.7% and 8.5 per 10.000 person/day, 95% CI 3.81-18.86, respectively), followed by hospital cleaning staff (8.1%, 7.6 per 10.000 person/day, CI 95% 4.9-11.7). Regarding PEH, the prevalence of SARS-CoV-2 was 11.5%. All PEH identified as positive were isolated in dedicated shelter facilities. Amongst the 69 residents/workers who were quarantined, 53 were reached for initial psychological support for assessing the presence of any psychological distress or psychiatric pathology. Amongst the subjects evaluated, 10 (18.9%) presented clinically significant psychological discomfort and accessed the stepped-care psychological intervention. The community partnerships played a pivotal role in optimising early case detection. Promotion of testing helped to prevent and contain more efficiently potential clusters through strategic planning, especially for PEH. Insights from the study highlight the importance of community partnerships in public health emergencies, particularly in the context of highly transmissible diseases pathways., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Tebon, Davis, Savoldi, Soriolo, Walters, Nosè, Barbui, Turrini, Danese, Lippi, Cecchetto, Mazzariol, Gibellini, Caliskan, Marchetti, Verlato, Princivalle, Porru, Tacconelli and De Nardo.)

Despite grey matter atrophy in cortical and subcortical regions has been related to cognitive impairment in multiple sclerosis, only a few studies evaluated its predictive value for alterations in the long-term. We aimed to determine early predictors of cognitive status after 20 years of multiple sclerosis. In this longitudinal retrospective study, participants underwent a 1.5 T MRI scanning at diagnosis (T0) and after two years (T2), which included the evaluation of regional grey matter volume loss patterns. All individuals with multiple sclerosis underwent a comprehensive neuropsychological assessment at the end of the study and were classified considering their global and specific cognitive domains status (memory, attention/information processing speed, executive functioning). Clinical and MRI characteristics were assessed as predictors of long-term cognitive impairment. Analysis of covariance, t -test, unadjusted and adjusted (for age, sex, disease duration, volume of white matter lesions, volume of cortical lesions) logistic regression were conducted. One hundred seventy-five people with multiple sclerosis (118 females; mean ± SD age at the end of study = 47.7 ± 9.4 years) clinically followed for 20 years from onset (mean ± SD = 19.9 ± 5.1) were evaluated. At the end of the study, 81 (47%) were classified as cognitively impaired: 38 as mildly impaired (22%), and 43 as severely impaired (25%). In particular, 46 were impaired in memory (27%), 66 were impaired in attention/information processing speed (38%), and 71 were impaired in executive functioning (41%). Regression models identified precuneus (adjusted odds ratio = 3.37; P < 0.001), insula (adjusted odds ratio = 2.33; P = 0.036), parahippocampal gyrus (adjusted odds ratio = 2.07; P < 0.001) and cingulate (adjusted odds ratio = 1.81; P = 0.009) as the most associated regions with global cognitive impairment and domains-specific cognitive alterations after a mean of 20 years of multiple sclerosis, after adjusting for demographic and clinical variables as well as for focal white matter and grey matter damage. Early grey matter volume loss of specific cortical and deep grey matter regions predicts global and domain cognitive alterations after 20 years from multiple sclerosis diagnosis., Competing Interests: The authors report no competing interests., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Guarantors of Brain.)

Background: Historical data on smoking can enhance our comprehension of the effectiveness of past tobacco control policies and play a key role in developing targeted public health interventions. This study was undertaken to assess trends in smoking initiation and cessation in Australia for the period 1910-2005., Methods: Rates of smoking initiation and cessation were calculated for participants in two population-based cohorts, the Busselton Health Study and the Tasmanian Longitudinal Health Study. The effects of time trends, gender and age group were evaluated., Results: Of the 29,971 participants, 56.8% ever smoked. In males, over the period 1910-1999, the rate of smoking initiation in young adolescents remained high with a peak in the 1970s; in older adolescents it peaked in the 1940s and then declined; in young adults it showed a steady decline. In females, the rate of smoking initiation in young adolescents rose sharply in the 1960s and peaked in the 1970s, in older adolescents it increased throughout the period, and in young adults it declined after 1970. In the period 1930-2005, 27.3% of 9,605 people aged 36-50 years who smoked ceased smoking. Rates of cessation in this age group increased throughout but decreased in males after 1990 and plateaued around 2000 in females., Conclusion: Our findings show substantial variation in the efficacy of tobacco control policies across age groups, with a notable lack of success among the younger population., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 James et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Exposure to air pollution has been proposed as one of the potential risk factors for leukaemia. Work-related formaldehyde exposure is suspected to cause leukaemia., Methods: We conducted a nested register-based case-control study on leukaemia incidence in the Viadana district, an industrial area for particleboard production in Northern Italy. We recruited 115 cases and 496 controls, frequency-matched by age, between 1999 and 2014. We assigned estimated exposures to particulate matter (PM 10 , PM 2.5 ), nitrogen dioxide (NO 2 ), and formaldehyde at residential addresses, averaged over the susceptibility window 3rd to 10th year prior to the index date. We considered potential confounding by sex, age, nationality, socio-economic status, occupational exposures to benzene and formaldehyde, and prior cancer diagnoses., Results: There was no association of exposures to PM 10 , PM 2.5 , and NO 2 with leukaemia incidence. However, an indication of increased risk emerged for formaldehyde, despite wide statistical uncertainty (OR 1.46, 95%CI 0.65-3.25 per IQR-difference of 1.2 μg/m 3 ). Estimated associations for formaldehyde were higher for acute (OR 2.07, 95%CI 0.70-6.12) and myeloid subtypes (OR 1.79, 95%CI 0.64-5.01), and in the 4-km buffer around the industrial facilities (OR 2.78, 95%CI 0.48-16.13), although they remained uncertain., Conclusions: This was the first study investigating the link between ambient formaldehyde exposure and leukaemia incidence in the general population. The evidence presented suggests an association, although it remains inconclusive, and a potential significance of emissions related to industrial activities in the district. Further research is warranted in larger populations incorporating data on other potential risk factors., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Alessandro Marcon reports financial support was provided by ATS della Val Padana. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The aim of the study was to investigate the changes occurring in the mandibular condyle by using mentoplate together with rapid maxillary expansion (MP-RME) treatment in the correction of skeletal class III relationship, using fractal analysis (FA)., Methods: The sample consisted of 30 individuals (8-11 years) diagnosed with skeletal Class III malocclusion who underwent MP-RME treatment. Archival records provided cone-beam computed tomography (CBCT) images taken at two intervals: before MP-RME treatment (T0) and after treatment (T1). The CBCT images were obtained using standardized settings to ensure consistency in image quality and resolution. The trabecular structures in the bilateral condyles at both T0 and T1 were analyzed using FA. The FA was performed on these condylar images using the Image J software. The region of interest (ROI) was carefully selected in the condyle to avoid overlapping with cortical bone, and the box-counting method was employed to calculate the fractal dimension (FD). Statistical analysis was conducted to compare the FD values between T0 and T1 and to evaluate gender differences. The statistical significance was determined using paired t-tests for intra-group comparisons and independent t-tests for inter-group comparisons, with a significance level set at p < 0.05., Results: The analysis revealed no statistically significant differences in the trabecular structures of the condyles between T0 and T1 (p > 0.05). However, a significant gender difference was observed in FA values, with males exhibiting higher FA values in the left condyle compared to females at both T0 and T1 (p < 0.05). Specifically, the FA values in the left condyle increased from a mean of 1.09 ± 0.09 at T0 to 1.13 ± 0.08 at T1 in males, whereas in females, the FA values remained relatively stable with a mean of 1 ± 0.09 at T0 and 1.03 ± 0.11 at T1., Conclusion: The findings indicate that MP-RME therapy does not induce significant alterations in the trabecular structure of the mandibular condyle. These results suggest the treatment's safety concerning the structural integrity of the condyle, although the observed gender differences in FA values warrant further investigation., (© 2024. The Author(s).)

Background: Bone marrow (BM) evaluation is the de facto standard for diagnosis, molecular analysis, risk stratification, and therapy response assessment in acute myeloid leukemia (AML), but in patients with a high number of circulating blast cells, the peripheral blood (PB) sample could provide similar information as BM. However, there is no large-scale molecular study comparing the two specimens in terms of their gene expression profiles, cellular heterogeneities, and ex-vivo drug sensitivity., Methodology: We used (i) the BEAT-AML cohort each with detailed molecular data; (ii) cell-type deconvolution to estimate leukemic and immune cell proportions between specimen types; (iii) differential expression (DE) and drug-cell type association analysis; and (iv) logistic regression models to assess the association between induction therapy response, cell-type composition and first-line drug treatment., Results: Results: We identified 207 patients having BM and 116 patients having PB samples. There was a total of 1271 DE genes (false discovery rate < 0.05) between BM and PB; the top enriched pathways in terms of DE genes belong to the immune system pathways. Aggregated ex-vivo drug response profiles from the two specimens were largely similar, as were the cellular components, except for the GMP-like cell type (17% in BM vs. 5% in PB, p -value = 2 × 10 -7 ). Among the specimen-specific results, the GMP-like subtype was associated with multiple drug resistance in BM and the ProMono-like subtype in PB. Several cell types were associated with the response to induction therapy, but the impact of specimen type on the interaction of cell type and cytarabine-associated induction therapy was not statistically significant for most cell types., Results: Conclusions: Even though there are molecular and cellular differences between BM and PB samples, they show many similarities in ex-vivo drug response profiles, indicating the clinical utility of the substantially less-invasive PB samples., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). eJHaem published by British Society for Haematology and John Wiley & Sons Ltd.)

We compared SARS-CoV-2 positivity between the foreign-born adult working population and Italians living in the Verona area to investigate whether being a foreign-born adult could confer an increased risk of infection or lead to a diagnostic delay. The present study included 105,774 subjects, aged 18-65 years, tested for SARS-CoV-2 by nasopharyngeal swabs and analyzed at the University Hospital of Verona between January 2020 and September 2022. A logistic regression model was used, controlling for gender, age, time of sampling, and source of referral. A higher proportion of SARS-CoV-2 positivity in Italian (30.09%) than in foreign-born (25.61%) adults was reported, with a higher proportion of SARS-CoV-2 positivity in men than women in both cohorts analyzed. The difference in swab positivity among Italian and foreign-born adults was the highest in people aged 18-29 years (31.5% vs. 23.3%) and tended to disappear thereafter. Swab positivity became comparable between Italian and foreign-born adults during the vaccination campaign. Multivariable analysis confirmed the lower risk of swab positivity among foreign-born adults (OR = 0.85, 95% CI 0.82-0.89). In the Verona area, foreign-born adults showed a lower rate of SARS-CoV-2 positivity than the native population, likely because of underdiagnosis. Hence, public health should increase attention toward these particularly vulnerable populations., Competing Interests: The authors declare no conflicts of interest.

Purpose: Diastasis of rectus abdominis (DRA) refers to a separation of the rectus abdominis from the linea alba, which is common in the female population during pregnancy and in the postpartum period. The present study aimed at investigating DRA severity, risk factors and associated disorders., Methods: In the present cross-sectional study, a web-based questionnaire was addressed to the 23,000 members of the Women's Diastasis Association. The questionnaire comprised three parts, dedicated respectively to diastasis characteristics, possible risk factors, and related disorders. Faecal and urinary incontinences were assessed using the Wexner and ICIQ-SF score, respectively. Risk factors for diastasis severity (<3, 3-5, >5 cm) were evaluated by a multinomial regression model., Results: Four thousand six hundred twenty-nine women with a mean age (SD) of 39.8 (6.5) years and a median BMI of 23.7 kg/m 2 (range 16.0-40.0) responded to the questionnaire. Proportion of DRA >5 cm increased from 22.8% in norm weight women to 44.0% in severely obese women, and from 10.0% in nulliparous women to 39.3% in women with >3 pregnancies. These associations were confirmed in multivariable analysis. DRA severity was associated with the risk of abdominal hernia and pelvic prolapse, whose prevalence more than doubled from women with DRA <3 cm (31.6% and 9.7%, respectively) to women with DRA >5 cm (68.2% and 20.2%). In addition, most patients reported postural pain and urinary incontinence, whose frequency increased with DRA severity., Conclusion: The present study confirmed that DRA severity increases with increasing BMI and number of pregnancies. Larger separation between rectal muscles was associated with increased risk of pain/discomfort, urinary incontinence, abdominal hernia and pelvic prolapse. Prospective studies are needed to better evaluate risk factors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Sartori, Tfaily, Botteri, Andreuccetti, Lauro, Caliskan, Verlato and Di Leo.)

Purpose: The anatomical position of the lingula is clinically very important to prevent injuries during sagittal split ramus osteotomy. Our study aims to evaluate the localisation of the lingula by cone beam computed tomography (CBCT) and to compare the localisation of the lingula between malocclusion, gender, and lingula types., Methods: A retrospective study was conducted to evaluate the shape and location of the lingula using CBCT. A total of 250 CBCT images were included in this study. The lingula was classified as nodular, assimilated, truncated, or triangular type. Six defined distances from the top of the lingula were measured: anterior border of the ramus (L-A), posterior border of the ramus (L-P), internal oblique ridge (L-IOR), mandibular notch (L-N), and distal surface of the mandibular second molar (L-M2) and occlusal plane (L-OP). The measured distances were compared between gender, malocclusion, and lingula types., Results: The most common type of lingula was nodular (32.4%). The L-N, L-P, L-M2, and L-OP distances between genders were statistically higher in male patients than in female patients. The L-IOR, L-M2, and L-OP distances exhibited statistically significant differences found between malocclusions. No statistically significant difference was found when the distances of the lingula to the anatomical points were compared between the lingula types., Conclusion: These variations in positioning of the lingula depending on the dysmorphoses are developing towards a systematic 3D examination before any mandibular osteotomy to precisely visualize the position and shape of the lingula., (© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Background: The aim of our study is to evaluate the postoperative complications after the extraction of impacted third molar teeth and to investigate the effects of these complications on the quality of life of patients., Methods: Demographic, clinical, and radiological evaluations were conducted, covering factors like age, gender, and tooth position. Clinical measurements, pain and edema assessments, and quality of life evaluations through OHIP-14 scores were performed. Preoperative and postoperative mouth opening, trismus, alveolitis and dehiscence were evaluated., Results: A total of 100 patients were included in our study. No significant gender-based differences were found in measurements, pain, or swelling. There was no statistically significant difference between the preoperative and postoperative results of difference A-C, difference B-E, difference A-D, and difference mouth opening. Procedure duration correlated positively with age, alveolar osteitis, trismus, and swelling. Postoperative quality of life, assessed by OHIP-14, demonstrated a negative correlation with age and trismus. It was observed that the gender and the tooth positions of the patients had no effect on the severity of postoperative pain and edema., Conclusions: As the age of the patients increases and the duration of the procedure increases, the rate of postoperative complications increases and it is concluded that the quality of life decreases significantly., (© 2024. The Author(s).)

Background: We aimed to determine the risk factors that may be associated with colistin-induced acute kidney injury (AKI) to promote the safer use of colistin in the treatment of nosocomial infections caused by multidrug-resistant Gram-negative bacteria in intensive care units., Materials and Methods: This retrospective observational study was conducted among adult patients who received a minimum of 48 h of intravenous colistin from January 2020 to December 2020 at the intensive care unit of a tertiary care hospital. AKI diagnosis and staging were made based on the Kidney Disease Improving Global Outcome Criteria., Results: Of 148 patients who received intravenous colistin at a daily dose of 9 million IU, 54 (36%) developed AKI. In the univariate analysis, age, Charlson comorbidity index, APACHE II score, duration of colistin treatment, basal creatinine level, use of vasopressors, and vancomycin were significantly associated with AKI (p < 0.05). The multivariate analysis revealed that the independent predictor of AKI was the use of vasopressors (OR: 3.14; 95% confidence interval: 1.39-97.07; p = 0.06)., Conclusion: The use of vasopressors in critically ill patients was independently associated with AKI developing during colistin treatment., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: SARS-CoV-2 breakthrough infections (BI) after vaccine booster dose are a relevant public health issue., Methods: Multicentric longitudinal cohort study within the ORCHESTRA project, involving 63,516 health workers (HW) from 14 European settings. The study investigated the cumulative incidence of SARS-CoV-2 BI after booster dose and its correlation with age, sex, job title, previous infection, and time since third dose., Results: 13,093 (20.6%) BI were observed. The cumulative incidence of BI was higher in women and in HW aged < 50 years, but nearly halved after 60 years. Nurses experienced the highest BI incidence, and administrative staff experienced the lowest. The BI incidence was higher in immunosuppressed HW (28.6%) vs others (24.9%). When controlling for gender, age, job title and infection before booster, heterologous vaccination reduced BI incidence with respect to the BNT162b2 mRNA vaccine [Odds Ratio (OR) 0.69, 95% CI 0.63-0.76]. Previous infection protected against asymptomatic infection [Relative Risk Ratio (RRR) of recent infection vs no infection 0.53, 95% CI 0.23-1.20] and even more against symptomatic infections [RRR 0.11, 95% CI 0.05-0.25]. Symptomatic infections increased from 70.5% in HW receiving the booster dose since < 64 days to 86.2% when time elapsed was > 130 days., Conclusions: The risk of BI after booster is significantly reduced by previous infection, heterologous vaccination, and older ages. Immunosuppression is relevant for increased BI incidence. Time elapsed from booster affects BI severity, confirming the public health usefulness of booster. Further research should focus on BI trend after 4th dose and its relationship with time variables across the epidemics., (© 2023. The Author(s).)

Objectives: The outbreak of coronavirus disease 2019, known as COVID-19, has rapidly evolved to a global pandemic. This pandemic represents an unprecedented public health issue not only for the general population but also for patients on the transplant wait list. Multiple organizations around the world have published recommendations for the proper conduct of transplant procedures, including donor and recipient screening and perioperative management. We investigated the efficacy of these new recommendations and the effects of SARS-CoV-2 infection on the deceased donation rate, donor organ management, and the time from family consent to procurement., Materials and Methods: The characteristics of potential donors diagnosed with brain death between July 15, 2019, and November 18, 2020, were evaluated retrospectively.Demographic and clinical features,the time elapsed from the clinical diagnosis until confirmation, and rates of acceptance were recorded. Potential donors diagnosed with brain death before the pandemic and during the pandemic were compared according to these variables., Results: Within the study period, 40 patients were diagnosed with brain death: 13 before the pandemic and 27 during the pandemic. The organs from 2 donors were procured before the pandemic. Organs from 3 of 8 donors were procured during the pandemic (the organs from 5 of these 8 patients were not donated). The organ donation time was 8.5 ± 2.12 hours (minimum-maximum, 7-10 hours) in the period before the pandemic and 54 ± 11.53 hours (minimummaximum, 45-67 hours) during the pandemic., Conclusions: The number of donors decreased significantly in our hospital during the pandemic and was similarto the overallrate inTurkey.The duration of the donation process has been prolonged, and strategies to improve rates of organ donation, including infection control, have become a focus of concern.

Introduction: Detection strategies in vulnerable populations such as people experiencing homelessness (PEH) need to be explored to promptly recognize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks. This study investigated the diagnostic accuracy of a rapid SARS-CoV-2 Ag test in PEH during two pandemic waves compared with gold standard real-time multiplex reverse transcription polymerase chain reaction (rtRT-PCR)., Methods: All PEH ≥ 18 years requesting residence at the available shelters in Verona, Italy, across two cold-weather emergency periods (November 2020-May 2021 and December 2021-April 2022) were prospectively screened for SARS-CoV-2 infection by means of a naso-pharyingeal swab. A lateral flow immunochromatographic assay (Biocredit ® COVID-19 Ag) was used as antigen-detecting rapid diagnostic test (Ag-RDT). The rtRT-PCR was performed with Allplex™ SARS-CoV-2 assay kit (Seegene). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated as measures for diagnostic accuracy., Results: Overall, 503 participants were enrolled during the two intervention periods for a total of 732 paired swabs collected: 541 swabs in the first period and 191 in the second. No significant differences in demographic and infection-related characteristics were observed in tested subjects in the study periods, except for the rate of previous infection (0.8% versus 8%; p < 0.001) and vaccination (6% versus 73%; p < 0.001). The prevalence of SARS-CoV-2 in the cohort was 8% (58/732 swabs positive with rtRT-PCR). Seventeen swabs were collected from symptomatic patients (7%). Among them, the concordance between rtRT-PCR and Ag-RDT was 100%, 7 (41.2%) positive and 10 negative pairs. The overall sensitivity of Ag-RDT was 63.8% (95% CI 60.3-67.3) and specificity was 99.8% (95% CI 99.6-100). PPV and NPV were 97.5% and 96.8%, respectively. Sensitivity and specificity did not change substantially across the two periods (65.1% and 99.8% in 2020-2021 vs. 60% and 100% in 2021-2022)., Conclusions: A periodic Ag-RDT-based screening approach for PEH at point of care could guide preventive measures, including prompt isolation, without referral to hospital-based laboratories for molecular test confirmation in case of positive detection even in individuals asymptomatic for COVID-19. This could help reduce the risk of outbreaks in shelter facilities., (© 2023. The Author(s).)

Background: Emergency departments (EDs) are typically the first medical contact for seizure patients, and early diagnosis and treatment is primarily the responsibility of emergency physicians., Objectives: Demonstrate the efficacy of bedside ocular ultrasonography for optic nerve sheath diameter (ONSD) measurement in differentiating provoked seizure from unprovoked seizure in the ED., Design: Prospective observational study SETTINGS: Tertiary care hospital PATIENTS AND METHODS: Patients presenting to the ED with seizure were divided into two groups according to medical history, physical examination, laboratory results, cranial computed tomography findings and electroencephalography results. Patients with seizures that did not have a specific cause (unprovoked) were compared with patients who had seizures caused by underlying pathology (provoked). The measurement of the ONSD was taken at the bedside within 30 minutes of arrival. The study compared the ONSD values, age, sex, type of seizure, and Glasgow Coma Score between the two groups., Main Outcome Measure: Efficacy of ONSD to distinguish between provoked and unprovoked seizures., Sample Size: 210 patients RESULTS: One hundred and fourteen (54.3%) patients were in the provoked seizure group and 96 (45.7%) were in the unprovoked seizure group. The ONSD measurements were significantly higher in the provoked seizure group compared with the unprovoked seizure group (median 6.1 mm vs. 5.2 mm, P <.001). The cut-off value of ONSD higher than 5.61 was significantly associated with the prediction of the provoked seizure ( P <.001). The area under the curve value was 0.882 (95% CI: 0.830-0.922) with a sensitivity of 86.5 and specificity of 78.9%., Conclusions: Bedside ONSD measurement by means of ocular ultrasound is an effective method for differentiating provoked seizure from unprovoked seizure., Limitations: Statistical significance of age on ONSD and exclusion of pediatric patients., Conflict of Interest: None.

Background: We described a SARS-CoV-2 thrice-infected case series in health workers (HW) to evaluate patient and virus variants and lineages and collect information on variables associated with multiple infections., Methods: A retrospective analysis of clinical and laboratory characteristics of SARS-CoV-2 thrice-infected individuals was carried out in Verona University Hospital, concurrent with the ORCHESTRA project. Variant analysis was conducted on a subset of available specimens., Results: Twelve HW out of 7368 were thrice infected (0.16%). Symptomatic infections were reported in 63.6%, 54.5% and 72.7% of the first, second and third infections, respectively. Nine subjects were fully vaccinated at the time of the third infection, and five had an additional booster dose. The mean time to second infection was 349.6 days (95% CI, 138-443); the mean interval between the second and third infection was 223.5 days (95% CI, 108-530) ( p = 0.032). In three cases, the second and third infections were caused by the Omicron variant, but different lineages were detected when the second vs third infections were sequenced., Conclusions: This case series confirms evidence of multiple reinfections with SARS-CoV-2, even from the same variant, in vaccinated HW. These results reinforce the need for continued infection-specific prevention measures in previously infected and reinfected HW.

Background: As the world population is progressively ageing, more and more elderly patients will require cancer surgery. Although curative surgery is the treatment of choice for resectable colorectal cancer (CRC), it is still debated whether elderly frail patients should undergo major cancer surgery due to the increased risk of postoperative and long-term mortality. The aim of this retrospective study was to evaluate the impact of age and comorbidities on postoperative mortality/morbidity and long-term outcomes, looking for potential age-related survival differences., Methods: A total of 1,482 patients operated for CRC at our institution between January 2005 and October 2020 were analysed. The independent effect of age and comorbidities on postoperative complications was assessed by a logistic model, while the effect on overall survival (OS) and cancer-related survival (CRS) was estimated by a Cox regression model., Results: The median age in the cohort was 67.8 years. Postoperative mortality was very low in the whole cohort (0.8%) and contained even in older age groups (3.2% in patients aged 80-84 years, 4% in the 85-90-year age group). The cumulative incidence of postoperative complications was doubled in patients with comorbidities (32.8% vs. 15.1%, p = 0.002). With regard to OS, as expected, it exponentially decreased with advancing age. Conversely, differences in CRS were less pronounced between age groups and absent in patients with stage 0-I CRC. Analysis of all causes and cancer-related mortality revealed a peak within 2 years from surgery, suggesting a prolonged impact of surgery. In patients aged 75 years and above, all-cause mortality showed a steep increase 1 year after surgery, while cancer-related mortality plateaued at about 4 years after surgery. On multivariable analysis, OS, but not CRS, was significantly influenced by age., Conclusions: Although acceptable results of surgery in elderly patients, OS is strongly dependent on age: older people die more from competing causes than cancer-related treatments compared to younger age classes. The preoperative identification of risk factors for low OS may help the selection of those elderly patients who would benefit from curative CRC surgery., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Turri, Caliskan, Conti, Martinelli, De Giulio, Ruzzenente, Guglielmi, Verlato and Pedrazzani.)

Introduction: The anti-spike (S) IgG assay is the most widely used method to assess the immunological response to COVID-19 vaccination. Several studies showed that subjects with perivaccination infection have higher anti-S IgG titers. However, a cut-off has not yet been identified so far for distinguishing infected subjects after vaccination. This study thus evaluates the performance of the anti-S IgG assay in identifying subjects with breakthrough infections (BIs) and its potential usefulness for screening healthcare workers (HCWs). Methods: Out of 6400 HCWs of the University Hospital of Verona vaccinated with two doses of BNT162b2, 4462 never infected before subjects who had completed primary vaccination were tested for IgG anti-S 6 to 9 months after the second dose. Of these, 59 (1.3%) had a BI. The discriminant power of IgG anti-S in detecting previous breakthrough infection was tested by constructing receiver operating characteristic (ROC) curves. Results: The discriminant power for BI was rather good (area under the curve (AUC), 0.78) and increased with decreasing time elapsed between antibody titer assessment and previous SARS-CoV-2 infection. Accuracy (AUC) sensitivity increased from 0.78 (95% CI 0.70−0.85) for BI in the previous six months to 0.83 (95% CI 0.67−0.99) for those in the previous two months, and from 0.68 to 0.80, respectively. The specificity (0.86) and optimal cut-off (935 BAU/mL) remained unchanged. However, BI were rather rare (1.3%), so the positive predictive value (PPV) was low. Only 40 of the 664 HCWs with antibody titer > 935 BAU/mL had previously confirmed BI, yielding a PPV of only 6.0%. When adopting as cut-off the 90th percentile (1180 BAU/mL), PPV increased to 7.9% (35/441). Conclusions: The anti-S IgG assay displayed good sensitivity and specificity in discriminating subjects with BI, especially in recent periods. However, BIs were rare among HCWs, so that the anti-S IgG assay may have low PPV in this setting, thus limiting the usefulness of this test as a screening tool for HCWs. Further studies are needed to identify more effective markers of a previous infection in vaccinated subjects.

Purpose: To investigate new intrastromal histological structures that develop after myopic human lenticular implantation in keratoconus with femtosecond laser-assisted small incision lenticule extraction (SMILE) surgery using transmission electron microscopy., Methods: Sixty eyes with advanced keratoconus indicated for corneal transplantation were included in this study. Fresh myopic lenticular implants were placed in all eyes through SMILE surgery. Lenticular implants were extracted from patients with myopic refractive errors of the cornea, untreated keratoconus, and treated keratoconus following 1, 2, and 3 years of surgery. These five lenticular samples were examined under the electron microscope and compared., Results: Disorganized and thinned collagen fibers were observed in the stroma with degenerative stromal cells (telocyte-like cells and keratocytes) in the keratoconic cornea. Apoptotic bodies and cell debris were easily observed near the disorganized fibers. In contrast, the myopic refractive error of the control and treatment groups demonstrated well-organized parallel lamellar structures. Healthy keratocytes and telocyte-like cells were observed in samples obtained 1, 2, and 3 years after lenticular implantation. Thus, telocyte-like cells may be activated by appropriate stimuli, such as stem cells, and be involved in stromal regeneration., Conclusions: Fresh myopic intrastromal lenticular implantation is a safe, economical, and reliable technique that leads to increased corneal thickness, improved visual acuity, and the regeneration of healthy keratocytes and telocyte-like cells that are involved in stromal regeneration. [ J Refract Surg . 2022;38(8):520-528.] .

Objective: Even though the treatment of the original variant was not fully determined, variants of COVID-19 emerged. Whether the clinic of COVID-19 has changed because of variation is controversial. The present study aimed to examine the COVID-19 severity and treatment responsiveness of critically ill patients between the original virus and emergent variations with a more comprehensive set of measures., Patients and Methods: Treatment responses, laboratory findings, and clinical conditions of critically ill patients with COVID-19 who were identified with variants between February 1st, and May 30th, 2021, were examined in two medical Intensive Care Units (ICUs) in tertiary care centers. Each patient received treatment in the ICU for at least one week., Results: Sixty-five (30 patients with the original variant: POV) critically ill patients were included in the study. SOFA scores, blood glucose, total bilirubin, urea-creatinine and lactate dehydrogenase levels decreased significantly in POV (p=.031, p=.002, p=.002, p=.008, and p=.007, respectively). Overall, patients with emergent variants (PEV) (M = 76.58, SD = 8.64) had lower partial-pressure-of-oxygen/fraction-of-inspired-oxygen ratios (P/F) than POV (M = 123.16, SD = 9.49). Use of the prone position and steroid therapy did not result in significant improvements in oxygenation of critically ill PEV. Hypertension was identified as the common comorbidity in PEV (OR=5.287)., Conclusions: We showed that the state of PEV was more severe than POV at the time of ICU admission. However, the prone position and steroids were not efficient in improving the P/F ratios. P/F ratios of PEV were significantly lower in non-invasive ventilation. These results suggest that early intubation might be necessary for PEV.

Background: The purpose was to evaluate the role and impact of the rhinoplasty outcome evaluation (ROE) in rhinoplasty., Objectives: To systematically review the ability of ROE to assess rhinoplasty outcome in the very recent surgical approaches., Data Sources: Searching MESH terms "rhinoplasty" and "rhinoplasty and ROE" on PubMed, Scopus, Embase, Google Scholar, and other major literature databases., Study Eligibility Criteria: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses model was adopted for eligibility criteria., Participants and Interventions: A first large screening on 1,660 papers allowed the final retrieval of 896 reports, of which only 101 were eligible for all the inclusion criteria, which allowed finally to select a group of 12 reports published in the time range 2018-2021., Study Appraisal and Synthesis Methods: Meta-regression with Durbin-Watson test, checking of meta-analysis bias with Rosenthal's estimator, and heterogeneity through the I 2 statistics were performed. The analysis included a Mantel-Haenszel test and associated or meta-analysis., Results: Twelve eligible and qualified papers were included in the meta-analysis, out of 1,263 patients, from 1,660 papers. ROE confirmed previous reports about its ability to discriminate preoperative from postoperative outcome (50/100), as from the different rhinoplasty approaches, a value very close to the functional Nasal Obstruction Symptom Evaluation scale. This study strengthens the role of ROE in the evaluation of rhinoplasty outcomes encouraging further research to improve ROE scale on different cultural habits and geographical areas., Limitations: The main limitations were due to the weak inclusion and exclusion criteria, methodological flaws with the statistical analysis, and poor data synthesis and evaluation in many papers about ROE., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Annals of Maxillofacial Surgery.)

Patients with concomitant features of asthma and chronic obstructive pulmonary disease (COPD) have a heavy disease burden.Using data collected prospectively in the European Community Respiratory Health Survey, we compared the risk factors, clinical history and lung function trajectories from early adulthood to late sixties of middle-aged subjects with asthma+COPD (n=179), past (n=263) or current (n=808) asthma alone, COPD alone (n=111) or none of these (n=3477).Interview data and pre-bronchodilator forced expiratory volume in 1 s (FEV 1 ) and forced vital capacity (FVC) were obtained during three clinical examinations in 1991-1993, 1999-2002 and 2010-2013. Disease status was classified in 2010-2013, when the subjects were aged 40-68 years, according to the presence of fixed airflow obstruction (post-bronchodilator FEV 1 /FVC below the lower limit of normal), a lifetime history of asthma and cumulative exposure to tobacco or occupational inhalants. Previous lung function trajectories, clinical characteristics and risk factors of these phenotypes were estimated.Subjects with asthma+COPD reported maternal smoking (28.2%) and respiratory infections in childhood (19.1%) more frequently than subjects with COPD alone (20.9% and 14.0%, respectively). Subjects with asthma+COPD had an impairment of lung function at age 20 years that tracked over adulthood, and more than half of them had asthma onset in childhood. Subjects with COPD alone had the highest lifelong exposure to tobacco smoking and occupational inhalants, and they showed accelerated lung function decline during adult life.The coexistence between asthma and COPD seems to have its origins earlier in life compared to COPD alone. These findings suggest that prevention of this severe condition, which is typical at older ages, should start in childhood., Competing Interests: Conflict of interest: A. Marcon has nothing to disclose. Conflict of interest: F. Locatelli has nothing to disclose. Conflict of interest: S.C. Dharmage has nothing to disclose. Conflict of interest: C. Svanes has nothing to disclose. Conflict of interest: J. Heinrich has nothing to disclose. Conflict of interest: B. Leynaert has nothing to disclose. Conflict of interest: P. Burney has nothing to disclose. Conflict of interest: A. Corsico has nothing to disclose. Conflict of interest: G. Caliskan has nothing to disclose. Conflict of interest: L. Calciano has nothing to disclose. Conflict of interest: T. Gislason has nothing to disclose. Conflict of interest: C. Janson has nothing to disclose. Conflict of interest: D. Jarvis has nothing to disclose. Conflict of interest: R. Jõgi received grants from the Estonian Research Council (Personal Research Grant n. 562), and personal fees for consultancy and lecturing from GSK, Boehringer and Novartis, and for travels/accommodation/meetings from GSK and Boehringer. Conflict of interest: T. Lytras has nothing to disclose. Conflict of interest: A. Malinovschi has nothing to disclose. Conflict of interest: N. Probst-Hensch has nothing to disclose. Conflict of interest: K. Toren has nothing to disclose. Conflict of interest: L. Casas has nothing to disclose. Conflict of interest: G. Verlato has nothing to disclose. Conflict of interest: J. Garcia-Aymerich has nothing to disclose. Conflict of interest: S. Accordini has nothing to disclose., (Copyright ©The authors 2021.)

Background: Coronavirus disease 2019 (COVID-19) is a disease that affects many organs, especially the lung, and may lead to multiorgan failure. Studies describing neurological dysfunctions involving the central and peripheral nervous systems have emerged. In our study, we aimed to evaluate the neurological signs and symptoms in hospitalized patients with COVID-19., Methods: The data of 290 patients admitted to our center (ward and intensive care unit) who received a diagnosis of COVID-19 were analyzed retrospectively. Patients' demographic, clinical and laboratory data, and their neurological diseases, symptoms, and complications were compared., Results: Male sex, heart disease, chronic obstructive pulmonary disease and having a history of neurological disease were associated with increased mortality in patients with COVID-19. Seizures and altered consciousness were also found to be more common in patients who died. In addition, lower platelet counts (P=0.001), higher C-reactive protein levels (P<0.001) and higher D-dimer levels (P=0.003) were associated with increased risk of mortality., Conclusions: We believe that close monitoring of any possible neurological manifestations is mandatory in hospitalized patients at the onset of COVID-19 and during disease progression. Clinical findings such as neurological symptoms and acute phase reactants are important in the follow-up and treatment of the disease., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: In this study, we determine the validity and reliability of the Muscularity Oriented Eating Test (MOET) among Turkish university students, thereby creating the MOET-TR. Methods: First, the MOET was translated by using the translation-back translation method for cultural equivalence. Then, the validity and reliability analyses were performed on 460 university students. To analyze the stability of the scale over time, the MOET-TR was applied to approximately 20% of the sample number for a second time after 2-4 weeks. Results: The one-factor structure of the MOET-TR demonstrated a good agreement with the fix index values. Cronbach's for the MOET-TR was 0.88, and the ICC value was 0.84. In addition, we found a positive statistically significant relationship between the total scores obtained from the DMS, EAT-40, REZZY, and IPAQ-Short forms used to evaluate the convergent divergent validity of the MOET-TR (p < .05). Conclusions: The MOET-TR is suitable for the Turkish culture and can be used to identify individuals who have muscularity oriented eating disorders, who are uncomfortable with their body shape, and who turn their body shapes into a social phobia.

Background: Hyperopia is a kind of refractive error in which incoming light is focused behind, instead of on, the retina wall due to insufficient accommodation by the lens. It is likely affected by ethnicity, geography, and a family history of hyperopia or accommodative esotropia and is categorized as low (≤ 2.00D), moderate (2.00-4.00 D), and high (> 4.00D). Beyond hyperopia refractive error, patients may have poor accommodative function or visual perceptual skills., Objective: This study aimed to present the latest approaches to planning trifocal intraocular lens (IOL) and toric trifocal IOL implantation for residual refractive errors in young adults with high astigmatism and hyperopia and increase the patients' best visual outcome and satisfaction using Small Incision Lenticule Extraction (SMILE) after implantation., Methods: Eighty eyes of 40 consecutive patients who underwent refractive lensectomy were included in this retrospective study. It included patients aged 20-45 years seeking spectacle independence with pre-operative high spherical hypermetropia of 4D or higher and astigmatism of 3D or higher. Patients' treatment status was categorized as trifocal IOL (n=40) and toric trifocal IOL (n=40).The mean patient follow-up time was six months after IOL implantation. First, we assessed visual acuity and satisfaction for both groups and then examined laser vision correction results of patients who were dissatisfied after IOL implantation (trifocal IOL group) and underwent SMILE surgery to increase satisfaction level., Results: There were no statistically significant differences between trifocal IOL and toric trifocal IOL for near (UNVA), intermediate (UIVA), and distance (UDVA) uncorrected visual acuity. Comparisons related to patient satisfaction six months after IOL implantation were statistically significant for using a computer and night driving. In the trifocal IOL group, compared to pre-operative values, sphere and cylinder at six months were significantly improved., Conclusion: In young adults, toric trifocal and trifocal IOL provided sufficient results in visual acuity; however, patients were dissatisfied after implantation. This study reported patient satisfaction levels, including quality of life and life without glasses by using Small Incision Lenticule Extraction (SMILE) surgery., Competing Interests: There are no conflicts of interest., (© 2021 Faruk Semiz, Anita Syla Lokaj,Gulser Caliskan2, Giuseppe Verlato, Njomza Hima Musa, CerenEce Semiz, Zekeriya Alp Demirsoy.)

#ERSCongress 2019: highlights from Best Abstract awardees http://bit.ly/2XWlD7Y., Competing Interests: Conflict of interest: L.E. Latimer has nothing to disclose. Conflict of interest: M. Duiverman reports grants from Philips BV, RESMED Ltd, and Fisher and Paykel Ltd, and grants and speaking fees from Vivisol BV, outside the submitted work. Conflict of interest: M.I. Abdel-Aziz has nothing to disclose. Conflict of interest: G. Caliskan has nothing to disclose. Conflict of interest: S.M. Mensink-Bout has nothing to disclose. Conflict of interest: A. Mendoza-Valderrey has nothing to disclose. Conflict of interest: A. Justet has nothing to disclose. Conflict of interest: J. Omura has nothing to disclose. Conflict of interest: K. Srikanthan has nothing to disclose. Conflict of interest: J. De Brandt has nothing to disclose., (Copyright ©ERS 2019.)

Background and Objectives: The optic nerve is a component of the central nervous system, and the optic nerve sheath is connected to the subarachnoid space. For this reason, intracranial pressure (ICP) increases are directly transmitted to the optic nerve sheath. Knowing the normal optic nerve sheath diameter (ONSD) range in a healthy population is necessary to interpret this measurement as a sign of intracranial pressure in clinical practice and research. In this study, we aimed to determine the standard ONSD value in healthy adultsaged65 years of age or older who had not previously been diagnosed with a disease that could increase the ICP., Materials and Methods: The right and left ONSD values and ONSD differences were compared, according to the gender of the patients. The patients were divided into 3 groups, according to their age. The age groups were assigned as follows: Group 1: 65-74 years of age; Group 2: 75-84 years of age; and Group 3: 85 years of age or older. The ONSDs and the ONSD difference between the left and right eyes of Group 1, Group 2 and Group 3 were compared., Results: The study included 195 volunteers. The mean ONSD of both eyes was 4.16±0.69 mm, and the difference between the ONSD of the left and right eyes was 0.16±0.18 mm. There was no difference between genders in terms of right ONSD, left ONSD, mean ONSD and ONSD difference between the left and right eyes. There was no correlation between age and ONSD and ONSD difference. When the age groups and ONSD were compared, no difference was found between the groups., Conclusions: In conclusion, the ONSDs of both eyes do not vary with age in healthy adults aged65 years or older. ONSD does not vary between genders. The calculation of ONSD difference can be used to determine ICP increase.

Background and objectives: In this study, the accuracy of point-of-care ultrasonography (POCUS) was compared to radiography (XR) in the diagnosis of fractures, the determination of characteristics of the fractures, and treatment selection of fractures in patients admitted to the emergency department (ED) due to trauma and suspected long bone (LB) fractures. Materials and Methods: The patients were included in the study, who were admitted to ED due to trauma, and had physical examination findings suggesting the presence of fractures in LB (humerus, radius, ulna, femur, tibia, and fibula). The patients were evaluated by two emergency physicians (EP) in ED. The first EP examined LBs with POCUS and the second EP examined them with XR. LBs were evaluated on the anterior, posterior, medial, and lateral surfaces and from the proximal joint to the distal one (shoulder, elbow, wrist, hip, knee, and ankle joint) in both longitudinal and transverse axes with POCUS. Results: A total of 205 patients with suspected LB fractures were included in the study. LB fractures were determined in 99 patients with XR and in 105 patients with POCUS. The sensitivity, specificity, positive predictive value, negative predictive value of POCUS in determining the fractures were 99%, 93%, 93%, and 99%, respectively, compared to XR. Compared to XR, POCUS was able to determine 100% of fissure type fractures (kappa (κ) value: 0.765), 83% of linear fractures (κ: 0.848), 92% of fragmented fractures(κ: 0.756), 67% of spiral fractures (κ:0.798), 75% of avulsion type fractures (κ: 0.855), and 100% of full separation type fractures (κ: 0.855). Conclusions: This study has demonstrated that POCUS has a high sensitivity in diagnosing LB fractures. POCUS has a high sensitivity in identifying fracture characteristics. POCUS can be used as an alternative imaging method to XR in the diagnosis of LB fractures and in the determination of fracture characteristics.

The TFIIH subunit XPB is involved in combined Xeroderma Pigmentosum and Cockayne syndrome (XP-B/CS). Our analyses reveal that XPB interacts functionally with KAT2A, a histone acetyltransferase (HAT) that belongs to the hSAGA and hATAC complexes. XPB interacts with KAT2A-containing complexes on chromatin and an XP-B/CS mutation specifically elicits KAT2A-mediated large-scale chromatin decondensation. In XP-B/CS cells, the abnormal recruitment of TFIIH and KAT2A to chromatin causes inappropriate acetylation of histone H3K9, leading to aberrant formation of transcription initiation complexes on the promoters of several hundred genes and their subsequent overexpression. Significantly, this cascade of events is similarly sensitive to KAT2A HAT inhibition or to the rescue with wild-type XPB. In agreement, the XP-B/CS mutation increases KAT2A HAT activity in vitro. Our results unveil a tight connection between TFIIH and KAT2A that controls higher-order chromatin structure and gene expression and provide new insights into transcriptional misregulation in a cancer-prone DNA repair-deficient disorder.

Bassoon is a large scaffolding protein of the presynaptic active zone involved in the development of presynaptic terminals and in the regulation of neurotransmitter release at both excitatory and inhibitory brain synapses. Mice with constitutive ablation of the Bassoon (Bsn) gene display impaired presynaptic function, show sensory deficits and develop severe seizures. To specifically study the role of Bassoon at excitatory forebrain synapses and its relevance for control of behavior, we generated conditional knockout (Bsn cKO) mice by gene ablation through an Emx1 promoter-driven Cre recombinase. In these animals, we confirm selective loss of Bassoon from glutamatergic neurons of the forebrain. Behavioral assessment revealed that, in comparison to wild-type littermates, Bsn cKO mice display selectively enhanced contextual fear memory and increased novelty preference in a spatial discrimination/pattern separation task. These changes are accompanied by an augmentation of baseline synaptic transmission at medial perforant path to dentate gyrus (DG) synapses, as indicated by increased ratios of field excitatory postsynaptic potential slope to fiber volley amplitude. At the structural level, an increased complexity of apical dendrites of DG granule cells can be detected in Bsn cKO mice. In addition, alterations in the expression of cellular maturation markers and a lack of age-dependent decrease in excitability between juvenile and adult Bsn cKO mice are observed. Our data suggest that expression of Bassoon in excitatory forebrain neurons is required for the normal maturation of the DG and important for spatial and contextual memory.

Objective: Water resistance retention (WRR) is the third performance attribute of sunscreens. Today, the standardized method for testing WRR is performed in vivo. For screening purposes, an in vitro method is highly preferable. Up to now, however, available methods have failed in accurately predicting in vivo WRR. In this study, we examine a novel in vitro approach aimed at enhancing in vivo prediction of WRR., Methods: We investigated two approaches, including a traditional procedure referred to as the 'plate method', which involves measuring in vitro sun-protection factor (SPF) before and after water immersion, and a new approach termed the 'solution method'. The latter employed a computational method to calculate the SPF using UV transmittance measurements of a sunscreen solution, obtained by rinsing the substrate without water immersion and with water immersion. It also had a model function for describing film irregularity. The aim was to avoid the effect of substrate-to-product affinity on the film distribution, which impacts the measured absolute value of the in vitro SPF occurring in the conventional approach. For both methodologies, we assessed two substrates for the sunscreen application based on different polymers, the widely used polymethylmethacrylate (PMMA) and the ethylene methacrylate acid copolymer (EMA)., Results: The agreement between in vivo and in vitro WRR values obtained from each of the four test conditions was analysed using different sunscreens. No correlation was found between in vivo and in vitro WRR using the plate method, independently of the plate type. In contrast, the solution method, using EMA plates, revealed a significant correlation between in vivo and in vitro results, with an especially high correlation for in vivo non-water-resistant sunscreens. The results of two operators were comparable. The solution method was unsuitable for PMMA plates., Conclusion: Despite the small discrepancy remaining between WRR values obtained from the in vitro solution method and in vivo method, which itself shows variability in results, this work provided a new insight into the in vitro testing of water resistance of sunscreens., (© 2018 Society of Cosmetic Scientists and the Société Française de Cosmétologie.)

General Control Non-derepressible 5 (GCN5) and Alteration/Deficiency in Activation 2 and 3 proteins (ADA2 and ADA3, respectively) are subunits of the Histone AcetylTransferase (HAT) module of SAGA- and ATAC-type co-activators. We previously reported four new interacting partners of human ADA3 identified by screening a human fetal brain cDNA library using yeast two hybrid technology. One of these partners was Apoptosis-Antagonizing Transcription Factor (AATF), also known as Che-1, an RNA polymerase II-binding protein with a number of roles in different cellular processes including regulation of transcription, cell proliferation, cell cycle control, DNA damage responses and apoptosis. Che-1/AATF is a potential therapeutic target for cancer treatments. In this study, we aimed to identify whether besides ADA3, other components of the HAT modules of SAGA and ATAC complexes, human ADA2 and GCN5 also interact with Che-1/AATF. Co-immunoprecipitation and co-localization experiments were used to demonstrate association of AATF both with two ADA2 isoforms, ADA2A and ADA2B and with GCN5 proteins in human cells and yeast two-hybrid assays to delineate domains in the ADA2 and GCN5 proteins required for these interactions. These findings provide new insights into the pathways regulated by ADA-containing protein complexes.

Background: Platelet-rich plasma (PRP) is increasingly being used in the treatment of chronic wounds, pathologies of the musculoskeletal system, and in cosmetic medicine; however, the preparation of platelet-rich plasma is both time-consuming and requires invasive intervention. Additional costs are introduced if special equipment is used during preparation. The aim of the present study is to test whether autologous platelet-rich plasma (PRP) preserves the feature of growth factor release when stored at -20 °C after preparation., Method: Autologous PRP concentrates were prepared using whole blood samples obtained from 20 healthy subjects and divided into three parts to form three groups. Epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), platelet derived growth factor-AB (PDGF-AB), insulin-like growth factor 1 (IGF-1), transforming growth factor-beta (TGF-β), and P-Selectin levels were immediately analysed in the control group. The other groups were defined as the experimental groups and were stored at -20 °C and analysed on the 7th and the 14th days. The same growth factors were tested in the experimental groups., Results: The growth factors (EGF, VEGF, PDGF-AB, IGF-1, TGF-β) and P-selectin levels were significantly decreased in the autologous PRP samples stored at -20 °C compared to the control group., Conclusion: The growth factor levels on days 7 and 14 suggest that autologous PRP can be stored at -20 °C without preservative agents, although in vivo studies are required in order to evaluate the clinical efficacy of the detected growth factor levels.

Osteoarthritis is one of the most common chronic diseases and associated with increased cardiovascular comorbidity and deaths. Elastic properties of aorta are closely associated with cardiovascular mortality and morbidity. In our study, we aimed to evaluate aortic stiffness in primary osteoarthritis patients. A total of 160 patients including 80 patients with primary knee osteoarthritis and 80 controls without osteoarthritis were included in the study. Additionally, osteoarthritis patients were divided into four subgroups according to the severity of the disease. Aortic parameters were evaluated by using transthoracic echocardiography method. While measurements of aortic stiffness of osteoarthritis group were higher compared to the control group (p < 0.01), aortic strain and aortic distensibility measurements of osteoarthritis group are lower than the control group (p < 0.01). Additionally, it was determined that as the severity of osteoarthritis increased also aortic stiffness increased highly significantly (p = 0.001). Presence and severity of osteoarthritis are closely associated with elastic properties of aorta, which are correlated with cardiovascular mortality and morbidity., (© The Author(s) 2015.)

Osteoarthritis (OA) is one of the most common chronic diseases seen in the elderly, and it is associated with increased cardiovascular morbidity and mortality. The cause of this association is not fully known. We aimed to investigate the relationship between epicardial fat and the presence and the grade of primary knee OA for analyzing the relationship between visceral adiposity and primary OA, thereby revealing the increased subclinical atherosclerosis and cardiovascular risk in OA patients. In this cross-sectional study, subjects with primary knee osteoarthritis and a control group were compared with regard to epicardial fat thickness through transthoracic echocardiography. In addition, OA was divided into four stages and the relationship between the grade of OA and epicardial fat thickness was analyzed. Eighty subjects with primary knee OA and 50 controls were analyzed. There was no difference between groups with regard to age, gender and BMI. Epicardial fat thickness was greater in patients in the primary OA group compared to the control group (3.73±1.08 vs 3.30±0.61, respectively, P=0.005). In-group comparison of OA patients revealed that epicardial fat thickness was detected to increase as the grade of OA increased (P=0.001). A relationship was detected between the presence of OA and epicardial fat thickness and CRP levels in multivariate logistic analysis (P=0.017, P=0.047, respectively). There is a significant relationship between primary OA and epicardial fat thickness, which is a part of visceral adipose tissue. These results may indicate the relationship between OA and visceral fat tissue and, consequently, cardiovascular risk, so body weight alone may not be an identifying co-factor.

Background: The aim of this study was to evaluate the long-term functional and cosmetic results as well as the sagittal and coronal plane remodeling of displaced supracondylar humerus fractures treated with open reduction and internal fixation., Methods: In total, 49 patients (11 boys and 38 girls) with Gartland type III supracondylar humerus fractures treated with open reduction and cross-pin fixation were retrospectively evaluated. The mean follow-up time was 22.4 years (range, 10.6-37.5 years). The Flynn criteria were used to assess the cosmetic and functional outcomes. Baumann's angle, the lateral rotational percentage, the humerus-elbow-wrist angle, and the humeral condylar angle were obtained from follow-up radiographs. The flexion and extension deficits compared with the uninjured side were measured at the last follow-up., Results: According to the Flynn criteria, the cosmetic outcomes were satisfactory in 93.9% of the patients, and the functional outcomes were satisfactory in 83.7% of the patients. The average flexion deficit was 5° ± 8°, and the average extension deficit was 4° ± 5°. At the final follow-up, the mean difference in the humerus-elbow-wrist angle and the humeral condylar angle between the injured and uninjured sides was -4° ± 7° and 0° ± 3°., Conclusions: We identified the remodeling in the sagittal plane in supracondylar humerus fractures that had been united in flexion. Satisfactory functional and cosmetic results were obtained with the open reduction and internal fixation of displaced supracondylar fractures of the humerus, and no degenerative changes were observed at the long-term follow-up., (Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

Background: Cell-based strategies that combine in vitro- expanded autologous chondrocytes with matrix scaffolds are currently preferred for full-thickness cartilage lesions of the knee ≥2 cm(2). Although this approach is reasonable, continuing advances in the field of cartilage repair will further expand the options available to improve outcomes., Hypothesis/purpose: In the present clinical study, we compared the outcomes of matrix-induced autologous mesenchymal stem cell implantation (m-AMI) with matrix-induced autologous chondrocyte implantation (m-ACI) for the treatment of isolated chondral defects of the knee., Study Design: Prospective, single-site, randomized, single-blind pilot study., Methods: Fourteen patients with isolated full-thickness chondral lesions of the knee >2 cm(2) were randomized into two treatment groups: m-AMI and m-ACI. Outcomes were assessed pre-operatively and 3, 6, 12 and 24 months post-operatively., Results: Clinical evaluations revealed that improvement from pre-operation to 24 months post-operation occurred in both groups (p < 0.05). At all follow-up intervals, m-AMI demonstrated significantly better functional outcomes (motion deficit and straight leg raise strength) than did m-ACI (p < 0.05). At all follow-up intervals, m-AMI demonstrated significantly better subjective sub-scale scores for pain, symptoms, activities of daily living and sport and recreation of the knee injury and osteoarthritis outcome score (KOOS) than did m-ACI (p < 0.05). Additionally, m-AMI demonstrated significantly better (p < 0.05) scores than m-ACI for the quality of life sub-scale of the KOOS and visual analog scale (VAS) severity at the 6-month follow-up. The Tegner activity score and VAS frequency were not significantly different between the two groups. Graft failure was not observed on magnetic resonance imaging at the 24-month follow-up. m-AMI and m-ACI demonstrated very good-to-excellent and good-to-very good infill, respectively, with no adverse effects from the implant, regardless of the treatment., Conclusion: For the treatment of isolated full-thickness chondral lesion of the knee, m-AMI can be used effectively and may potentially accelerate recovery. A larger patient cohort and follow-up supported by histological analyses are necessary to determine long-term outcomes.

The mechanisms that regulate the strength of synaptic transmission and intrinsic neuronal excitability are well characterized; however, the mechanisms that promote disease-causing neural network dysfunction are poorly defined. We generated mice with targeted neuron type-specific expression of a gain-of-function variant of the neurotransmitter receptor for glycine (GlyR) that is found in hippocampectomies from patients with temporal lobe epilepsy. In this mouse model, targeted expression of gain-of-function GlyR in terminals of glutamatergic cells or in parvalbumin-positive interneurons persistently altered neural network excitability. The increased network excitability associated with gain-of-function GlyR expression in glutamatergic neurons resulted in recurrent epileptiform discharge, which provoked cognitive dysfunction and memory deficits without affecting bidirectional synaptic plasticity. In contrast, decreased network excitability due to gain-of-function GlyR expression in parvalbumin-positive interneurons resulted in an anxiety phenotype, but did not affect cognitive performance or discriminative associative memory. Our animal model unveils neuron type-specific effects on cognition, formation of discriminative associative memory, and emotional behavior in vivo. Furthermore, our data identify a presynaptic disease-causing molecular mechanism that impairs homeostatic regulation of neural network excitability and triggers neuropsychiatric symptoms.