Treatment with brivaracetam has no apparent long-term effects on body weight in pediatric patients with epilepsy.

OBJECTIVE: The objective of this study is to evaluate possible long-term effects of treatment with brivaracetam (BRV) on body weight in children with epilepsy. METHOD: Post hoc analysis of data from patients (aged 1 month to <17 years) with ≥6 months of BRV treatment in a long-term, open-label trial (N01266 [NCT01364597]). Outcomes included body weight and body mass index (BMI) over time (z-score growth curves), and treatment-emergent adverse events (TEAEs). Previous/ongoing medical conditions that may affect body weight (gastrointestinal and metabolic/nutritional disorders); concomitant antiseizure medications (ASMs) were also evaluated. RESULTS: Two hundred nine patients (mean [standard deviation] age 7.9 [4.6] years) were analyzed. Most (154 [73.7%]) had focal-onset seizures. At study initiation, median (range) BRV dose was 1.0 (0.4-7.5) mg/kg/day. Overall, 189 (90.4%) patients had a previous or ongoing medical condition (gastrointestinal disorders: 43 [20.6%]; metabolism/nutritional disorders: 26 [12.4%]). Most patients followed z-score curves for body weight and BMI during BRV treatment, although there were outliers in both directions. Incidences of appetite/weight-change TEAEs were low. Twenty-three (11.0%) patients had a TEAE of decreased appetite and 14 (6.7%) had a TEAE of weight decreased. SIGNIFICANCE: Long-term adjunctive BRV was well tolerated in growing children with no indication of detrimental effects on body weight. PLAIN LANGUAGE SUMMARY: Brivaracetam is an antiseizure medication (ASM) used to treat seizures in people with epilepsy. Some ASMs can lead to changes in people's appetite and weight. Knowing the effect a drug has on appetite and weight is particularly important in children. We looked at 209 children with epilepsy taking brivaracetam and studied changes in their body weight and body mass index over time. The number of reported side effects related to appetite or weight change was low. There was no apparent long-term effect on their body weight, even when taking their medical history and use of other ASMs into account.

Dynamics of Cognitive Impairment in MCI Patients over a Three-Year Period: The Informative Role of Blood Biomarkers, Neuroimaging, and Genetic Factors.

Given the high growth rates of cognitive decline among the elderly population and the lack of effective etiological treatments, early diagnosis of cognitive impairment progression is an imperative task for modern science and medicine. It is of particular interest to identify predictors of an unfavorable subsequent course of cognitive disorders, specifically, rapid progression. Our study assessed the informative role of various risk factors on the dynamics of cognitive impairment among mild cognitive impairment (MCI) patients. The study included patients with MCI (N = 338) who underwent neuropsychological assessment, magnetic resonance imaging (MRI) examination, blood sampling for general and biochemical analysis, APOE genotyping, and polygenic risk score (PRS) evaluation. The APOE ε4/ε4 genotype was found to be associated with a diminished overall cognitive scores initial assessment and negative cognitive dynamics. No associations were found between cognitive changes and the PRS. The progression of cognitive impairment was associated with the width of the third ventricle and hematological parameters, specifically, hematocrit and erythrocyte levels. The absence of significant associations between the dynamics of cognitive decline and PRS over three years can be attributed to the provided suitable medical care for the prevention of cognitive impairment. Adding other risk factors and their inclusion in panels assessing the risk of progression of cognitive impairment should be considered.

Prevalence, correlates, and health indicators associated with meal-skipping among middle-aged and older adults in Thailand: A national longitudinal study.

AIM: The purpose of this longitudinal study was to evaluate the prevalence and correlates of and the factors contributing to meal-skipping in middle-aged and older adults in Thailand. METHODS: We examined prospective cohort data from three consecutive waves of the Health, Aging and Retirement in Thailand (HART) study (analytic sample size = 2863) for participants 45 years of age and older. Meal-skipping was assessed with a one- and two-day recall of breakfast, lunch, and dinner. We used generalized estimating equations analysis to evaluate the longitudinal relationships between sociodemographic, lifestyle, and health indicators and meal-skipping between 2015 (wave 1), 2017 (wave 2), and 2020 (wave 3). Furthermore, binary logistic regression was used to establish the longitudinal association between meal-skipping and the incidence of multiple chronic conditions. RESULTS: The prevalence of meal-skipping was 6.2% in 2015, 16.2% in 2017, and 13.6% in 2020, and across study years the highest proportion of meal skipping was for lunch (6.0%), followed by breakfast (4.6%), and dinner (2.8%). In the final model, sociodemographic factors (higher education, urban residence, and lower subjective economic status), lifestyle factors (high alcohol use, current smoking, and obesity class II), and health indicators (probable depression and wearing dentures) were positively associated with meal-skipping. In the adjusted logistic regression models, compared with no meal-skipping, meal-skipping in 2-3 study waves was associated with incident obesity and incident probable depression. CONCLUSION: Skipping meals was linked to a number of lifestyle variables and indicators of physical and mental illness. Geriatr Gerontol Int 2024; ••: ••-••.

Long-Term Volumetric Stability of Maxillary Sinus Floor Augmentation Using a Xenograft Bone Substitute and Its Combination with Autologous Bone: A 6+ Year Retrospective Follow-Up Study Using Cone Beam Computed Tomography.

Deproteinised bovine bone (DBB) is widely used as bone substitute in maxillary sinus floor augmentation (MSFA) surgery. No previous studies have shown the long-term volumetric changes in the augmented bone when using DBB. The selected patients had MFSA performed using a lateral window technique and a xenograft, alone or in combination with the patient's autologous bone from the mandible. Cone beam computed tomography (CBCT) images were used to compare the volumetric changes in the augmented bone for patients over a period of 6 or more years. No significant bone reduction was seen in the augmented bone region when comparing MSFA after 7 months and 6 or more years after dental implantation.

Birds of Berlin: Changes in communities and guilds in the urban park "Tiergarten" since 1850.

Urbanization has far-reaching consequences on birds, and knowledge of the impacts on taxonomic and functional diversity is necessary to make cities as compatible as possible for species. Avian diversity in parks in urban centers has been investigated multiple times, but rarely so in long-term studies due to lacking data. The Tiergarten in Berlin is a large-scale park in the city center of great value for people and many species including birds. We compiled bird species lists since 1850 and from monitoring in 2022 in one dataset to investigate how bird communities and guilds have changed over time and how these alterations were influenced by the eventful history of the park's vegetation conditions. Long-term changes in species assemblages were analyzed with an ordination analysis, and changes in guild presence and functional richness were discussed with regard to landscape transitions. A gradual development of species assemblages yet only small changes in guild composition since 1850 was detected, whereas the 1950 community stands out with a drop in species richness and replacement of forest species with an open land community, which reflects the deforestation of the park during World War II. Consideration of habitat, lifestyle, trophic, and migration guilds revealed no sign of functional homogenization over the last 172 years (1850-2022). Despite the high frequentation of the park by humans it still allows for a high bird diversity due to the Tiergarten's sheer size and heterogeneity of vegetation and habitats. We recommend that the park is maintained and managed accordingly to preserve this condition and advise other urban parks to strive for these beneficial features.

The Emergence of the Family Scirtidae (Insecta: Coleoptera) in Lotic Karst Habitats: A Case Study over 15 Years.

Due to ongoing changes and a decline in biodiversity, science today should rely on long-term species-based ecological studies. We have conducted a long-term ecological dynamics study on the water beetle family Scirtidae, which, although it is very abundant in benthic communities, is still poorly studied. The main objective of this study was to investigate the population aspects (composition, diversity, sex ratio) and ecological aspects (emergence patterns, seasonal dynamics and preferences for environmental factors) of the family Scirtidae over 15 years in Plitvice Lakes NP, Croatia. The study was conducted at three sites and in five different substrate types. A total of three taxa with different distributions were recorded in the study area: Hydrocyphon novaki and H. deflexicollis on the tufa barriers and the Elodes sp. in the spring area. The sex ratio was in favour of males in spring and early summer, while it shifted in favour of females towards the end of autumn. The abundance and emergence of the family were primarily determined by the environmental parameters which showed the greatest fluctuations over a period of 15 years: water temperature, water discharge and oxygen saturation. Our results clearly show that Scirtidae can be used as indicators of stream zonation and habitat quality. Based on the methodology and the results of this study, we conclude that Scirtidae should be used in future monitoring and protection measures in karst freshwater habitats in southeastern Europe.

Does bird life-history influence the prevalence of ticks? A citizen science study in North East Spain.

After mosquitoes, ticks are among the most important vector of pathogens of concern for animal and public health, but unless mosquitoes ticks remain attached to their hosts for long time periods providing an opportunity to analyse their role in the dispersal and dynamics of different zoonotic pathogens. Given their interest in public health it is important to understand which factors affect their incidence in different hosts and to stablish effective surveillance programs to determine the risk of transmission and spill-over of zoonotic pathogens. Taking benefit of a large network of volunteer ornithologists, we analysed the life-history traits associated to the presence of ticks using information of 620,609 individuals of 231 avian species. Bird phylogeny, locality and year explained a large amount of variance in tick prevalence. Non-colonial species non breeding in grasslands and non-spending the non-breeding season as gregarious groups or isolated individuals (e.g. thrushes, quails and finches) had the higher prevalence of ticks and appear as good candidates for zoonosis surveillance programs based on the analyses of ticks collected from wild birds. Ringers underestimated tick prevalence but can be considered as an important source of information of ticks for public and animal health surveillance programs if properly trained for the detection and collection of the different tick development phases.

Effect of long-term exposure of mixture of ZnO and CuO nanoparticles on Scenedesmus obliquus.

The present study investigated the possible toxic effect of ZnO and CuO nanoparticles (NPs) on freshwater microalgae, Scenedesmus obliquus at environmentally- relevant nanoparticle concentration (1 mg/L) and high concentration (10 mg/L) in BG-11 medium under white light LED-illumination over 35 days. The effect of time on the stability of media, nanoparticles, and their relation to toxicity to algae was also studied. The transmission electron microscopy indicated structural damage to algae due to the presence of a mixture of nanoparticles (at 10 mg/L). FTIR (Fourier Transform infrared) analysis of a sample containing a mixture of nanoparticles showed an addition of bonds and a difference in the peak location and its intensity values. The inhibition time for biomass was observed between 14 days and 21 days at 10 mg/L NPs. At 1 mg/L, the order of toxicity of NPs to algae was found to be: CuO NPs (highest toxicity) > ZnO NPs>ZnO + CuO NPs (least toxicity). During exposure of algae cells to a mixture of NPs at 10 mg/L NP concentration, a smaller value of metal deposition was observed than that during exposure to individual NPs. Antagonistic toxic effects of two NPs on dry cell weight of algae was observed at both concentration levels. Future work is needed to understand the steps involved in toxicity due to mixture of NPs to algae so that environmental exposures of algae to NPs can be managed and minimized.

Harvester ant colonies differ in collective behavioural plasticity to regulate water loss.

Collective behavioural plasticity allows ant colonies to adjust to changing conditions. The red harvester ant (Pogonomyrmex barbatus), a desert seed-eating species, regulates foraging activity in response to water stress. Foraging ants lose water to evaporation. Reducing foraging activity in dry conditions sacrifices food intake but conserves water. Within a year, some colonies tend to reduce foraging on dry days while others do not. We examined whether these differences among colonies in collective behavioural plasticity persist from year to year. Colonies live 20-30 years with a single queen who produces successive cohorts of workers which live only a year. The humidity level at which all colonies tend to reduce foraging varies from year to year. Longitudinal observations of 95 colonies over 5 years between 2016 and 2021 showed that differences among colonies, in how they regulate foraging activity in response to day-to-day changes in humidity, persist across years. Approximately 40% of colonies consistently reduced foraging activity, year after year, on days with low daily maximum relative humidity; approximately 20% of colonies never did, foraging as much or more on dry days as on humid days. This variation among colonies may allow evolutionary rescue from drought due to climate change.

Long-term evaluation of the safety and efficacy of a novel 20% oxybutynin hydrochloride lotion for primary palmar hyperhidrosis: An open-label extension study.

The long-term safety and efficacy of 52-week application of oxybutynin hydrochloride 20% lotion (20% OL) for the treatment of primary palmar hyperhidrosis (PPHH) in Japanese patients aged ≥12 years were evaluated in an open-label extension (OLE) of a 4-week, randomized, double-blind (DB) study. The OLE included 114 patients who completed the DB study and wished to continue treatment and 12 new patients. In the safety analysis population (125 patients), the incidence of adverse events (AEs) and adverse drug reactions (ADRs) was 79.2% and 36.0%, respectively. Serious AEs were observed in two patients but were considered unrelated to the investigational drug. The incidence of AEs that led to study discontinuation was 1.6%. The incidence of application site AEs and ADRs was 35.2% and 26.4%, respectively. The severity of most events was mild. The incidence of anticholinergic AEs related to dry mouth was 3.2% for thirst and 0.8% for dry throat. The long-term efficacy of 20% OL was confirmed by a long-lasting reduction in sweat volume and improvement in the Hyperhidrosis Disease Severity Scale and Dermatology Life Quality Index. This study has several limitations: First the results may include some bias because most of the participants were from the prior DB study; second, the results may not be generalizable because only a few participants were in the age group most susceptible to PPHH (i.e., < 15 years old); and third, the study did not obtain safety information from treatment for more than 52 weeks, so this information must be collected in clinical practice in the future. No reduced therapeutic effect was observed in patients with PPHH in this study after 52-week application of 20% OL. Also, few patients experienced serious AEs or AEs that led to study treatment discontinuation.

Age-specific impacts of vegetation functional traits on gastrointestinal nematode parasite burdens in a large herbivore.

Gastrointestinal nematode (GIN) parasites play an important role in the ecological dynamics of many animal populations. Recent studies suggest that fine-scale spatial variation in GIN infection dynamics is important in wildlife systems, but the environmental drivers underlying this variation remain poorly understood. We used data from over two decades of GIN parasite egg counts, host space use, and spatial vegetation data from a long-term study of Soay sheep on St Kilda to test how spatial autocorrelation and vegetation in an individual's home range predict parasite burden across three age groups. We developed a novel approach to quantify the plant functional traits present in a home range to describe the quality of vegetation present. Effects of vegetation and space varied between age classes. In immature lambs, strongyle parasite faecal egg counts (FEC) were spatially structured, being highest in the north and south of our study area. Independent of host body weight and spatial autocorrelation, plant functional traits predicted parasite egg counts. Higher egg counts were associated with more digestible and preferred plant functional traits, suggesting the association could be driven by host density and habitat preference. In contrast, we found no evidence that parasite FEC were related to plant functional traits in the host home range in yearlings or adult sheep. Adult FEC were spatially structured, with highest burdens in the north-east of our study area, while yearling FEC showed no evidence of spatial structuring. Parasite burdens in immature individuals appear more readily influenced by fine-scale spatial variation in the environment, highlighting the importance of such heterogeneity for our understanding of wildlife epidemiology and health. Our findings support the importance of fine-scale environmental variation for wildlife disease ecology and provides new evidence that such effects may vary across demographic groups within a population.

Complex relationships between climate and reproduction in a resident montane bird.

Animals use climate-related environmental cues to fine-tune breeding timing and investment to match peak food availability. In birds, spring temperature is a commonly documented cue used to initiate breeding, but with global climate change, organisms are experiencing both directional changes in ambient temperatures and extreme year-to-year precipitation fluctuations. Montane environments exhibit complex climate patterns where temperatures and precipitation change along elevational gradients, and where exacerbated annual variation in precipitation has resulted in extreme swings between heavy snow and drought. We used 10 years of data to investigate how annual variation in climatic conditions is associated with differences in breeding phenology and reproductive performance in resident mountain chickadees (Poecile gambeli) at two elevations in the northern Sierra Nevada mountains, USA. Variation in spring temperature was not associated with differences in breeding phenology across elevations in our system. Greater snow accumulation was associated with later breeding initiation at high, but not low, elevation. Brood size was reduced under drought, but only at low elevation. Our data suggest complex relationships between climate and avian reproduction and point to autumn climate as important for reproductive performance, likely via its effect on phenology and abundance of invertebrates.

Ecological genetics of local adaptation in Arabidopsis: An 8-year field experiment.

There is considerable evidence for local adaptation in nature, yet important questions remain regarding its genetic basis. How many loci are involved? What are their effect sizes? What is the relative importance of conditional neutrality versus genetic trade-offs? Here we address these questions in the self-pollinating, annual plant Arabidopsis thaliana. We used 400 recombinant inbred lines (RILs) derived from two locally adapted populations in Italy and Sweden, grew the RILs and parents at the parental locations, and mapped quantitative trait loci (QTL) for mean fitness (fruits/seedling planted). We previously published results from the first 3 years of the study, and here add five additional years, providing a unique opportunity to assess how temporal variation in selection might affect QTL detection and classification. We found 10 adaptive and one maladaptive QTL in Italy, and six adaptive and four maladaptive QTL in Sweden. The discovery of maladaptive QTL at both sites suggests that even locally adapted populations are not always at their genotypic optimum. Mean effect sizes for adaptive QTL, 0.97 and 0.55 fruits in Italy and Sweden, respectively, were large relative to the mean fitness of the RILs (approximately 8 fruits/seedling planted at both sites). Both genetic trade-offs (four cases) and conditional neutrality (seven cases) contribute to local adaptation in this system. The 8-year dataset provided greater power to detect QTL and to estimate their locations compared to our previous 3-year study, identifying one new genetic trade-off and resolving one genetic trade-off into two conditionally adaptive QTL.

Cracking Behavior and Deflections in Recycled-Aggregate Beams Reinforced with Waste Fibers Subjected to Long-Term Constant Loading.

This report presents the results of long-term tests on concrete beams reinforced with steel cord. In this study, natural aggregate was wholly replaced with waste sand or with wastes from the production of ceramic products and ceramic hollow bricks. The amounts of individual fractions used were determined in accordance with guidelines for reference concrete. A total of eight mixtures were tested; these differed in terms of the type of waste aggregate used. Elements with various fiber-reinforcement ratios were made for each mixture. Steel fibers and waste fibers were used in amounts of 0.0%, 0.5%, and 1.0%. Compressive strength and modulus of elasticity were determined experimentally for each mixture. The main test was a four-point beam bending test. Beams with dimensions of 100 mm × 200 mm × 2900 mm were tested on a stand, which was specially prepared so that three beams could be tested simultaneously. Fiber-reinforcement ratios were 0.5% and 1.0%. Long-term studies were conducted for 1000 days. During the testing period, beam deflections and cracks were measured. The obtained results were compared with values calculated using several methods, considering the influence of dispersed reinforcement. The results enabled the best methods for calculating individual values for mixtures with different types of waste materials to be determined.

Prognostic factors in radiotherapy of anaplastic thyroid carcinoma: a single center study over 31 years.

BACKGROUND: Anaplastic thyroid carcinoma has a very poor prognosis. We analyzed the effect of surgery, radiotherapy and chemotherapy on survival time and side effects in patients with ATC. METHODS: We retrospectively analyzed all patients (n = 63) with histologically confirmed ATC who presented at our clinic between 1989 and 2020. We analyzed the survival with Kaplan-Meier curves and cox proportional hazard models and acute toxicities with logistic regression models. RESULTS: Out of 63 patients, 62 received radiotherapy, 74% underwent surgery and 24% received combined chemotherapy. A median radiation dose of 49 Gy (range 4-66 Gy) was applied. In 32% of the cases opposing-field technique was used, in 18% 3D-conformal, in 27% a combination of opposing field and 3D-conformal technique and 21% obtained IMRT (intensity modulated radiotherapy) or VMAT (volumetric modulated arc radiotherapy). Median overall survival (OS) was 6 months. We identified five predictive factors relevant for survival: absence of distant metastases at the time of diagnosis (OS 8 months), surgery (OS 9.8 months), resection status R0 (OS 14 months), radiation dose of 50 Gy or higher (OS 13 months) and multimodal therapy (surgery, radiotherapy and chemotherapy) with a median OS of 9.7 months. CONCLUSION: In spite of the dismal outcome, longer survival can be achieved in some patients with ATC using surgery and radiotherapy with a high radiation dose. Compared to our previous study, there are no significant advantages in overall survival. Trial registration Retrospectively registered.

A 23-Year Observational Follow-Up Clinical Evaluation of Direct Posterior Composite Restorations.

The purpose of this observational follow-up clinical study was to observe the quality of posterior composite restorations more than 23 years after application. A total of 22 patients, 13 male and 9 female (mean age 66.1 years, range 50-84), with a total of 42 restorations attended the first and second follow-up examinations. The restorations were examined by one operator using modified FDI criteria. Statistical analysis was performed with the Wilcoxon Mann-Whitney U test and Wilcoxon exact matched-pairs test with a significance level of p = 0.05. Bonferroni-Holm with an adjusted significance level of alpha = 0.05 was applied. With the exception of approximal anatomical form, significantly worse scores were seen for six out of seven criteria at the second follow-up evaluation. There was no significant difference in the first and second follow-up evaluations in the grades of the restorations with regard to having been placed in the maxilla or mandible, as well as for one-surface or multiple-surface restorations. The approximal anatomical form showed significantly worse grades at the second follow-up when having been placed in molars. In conclusion, the study results show that significant differences regarding FDI criteria in posterior composite restorations occur after more than 23 years of service. Further studies with extended follow-up time and at regular and short time intervals are recommended.

Delayed egg-laying in Red-backed Shrike Lanius collurio in relation to increased rainfall in east-central Poland.

Climate change has affected the breeding parameters of many animal species. In birds, most studies have focused on the effects of temperature on clutch phenology and clutch size. The long-term influence of other weather factors, including rainfall, on breeding parameters have been analysed much less often. Based on a 23-year dataset and 308 broods, we documented shifts in the timing of breeding, clutch size and mean egg volume in a long-distance migrant, the Red-backed Shrike Lanius collurio, from a central European population. We found a 5-day shift towards delayed breeding, but no differences in brood size or egg volume during those 23 years. The GLM analysis showed that the mean May temperature had a positive influence on the clutch initiation date, whereas the number of days with rain delayed laying. During the period 1999-2021, there was no change in the mean May temperature, but total precipitation and the number of days with rain in May increased. Thus, delayed nesting in this population was probably due to the increase in rainfall during this period. Our results provide a rare example of delayed nesting in birds in recent years. Predicted changes in the climate make it difficult to assess the long-term impact of global warming on the viability of Red-backed Shrike populations in east-central Poland.

Alien species and climate change drive shifts in a riverine fish community and trait compositions over 35 years.

Alien fish substantially impact aquatic communities. However, their effects on trait composition remain poorly understood, especially at large spatiotemporal scales. Here, we used long-term biomonitoring data (1984-2018) from 31 fish communities of the Rhine river in Germany to investigate compositional and functional changes over time. Average total community richness increased by 49 %: it was stable until 2004, then declined until 2010, before increasing until 2018. Average abundance decreased by 9 %. Starting from 198 individuals/m2 in 1984 abundance largely declined to 23 individuals/m2 in 2010 (-88 %), and then consequently increased by 678 % up to 180 individuals/m2 until 2018. Increases in abundance and richness starting around 2010 were mainly driven by the establishment of alien species: while alien species represented 5 % of all species and 0.1 % of total individuals in 1993, it increased to 30 % (7 species) and 32 % of individuals in 2018. Concomitant to the increase in alien species, average native species richness and abundance declined by 26 % and 50 % respectively. We identified increases in temperature, precipitation, abundance and richness of alien fish driving compositional changes after 2010. To get more insights on the impacts of alien species on fish communities, we used 12 biological and 13 ecological traits to compute four trait metrics each. Ecological trait dispersion increased before 2010, probably due to diminishing ecologically similar native species. No changes in trait metrics were measured after 2010, albeit relative shares of expressed trait modalities significantly changing. The observed shift in trait modalities suggested the introduction of new species carrying similar and novel trait modalities. Our results revealed significant changes in taxonomic and trait compositions following alien fish introductions and climatic change. To conclude, our analyses show taxonomic and functional changes in the Rhine river over 35 years, likely indicative of future changes in ecosystem services.

Long term surgical outcomes of vaginal colposuspension using the Uphold Lite™ mesh system vs. vaginal vault uterosacral ligament suspension for treatment of apical prolapse.

OBJECTIVE: The aim of this study is to compare long-term outcomes (7-10 years) between vaginal hysterectomy with uterosacral ligament suspension (VHUSLS) and sacrospinous hysteropexy with the Uphold™ Lite mesh System (SHU) for management of apical prolapse. METHODS: Patients undergoing VHUSLS or SHU from 2008 to 2012 at a single tertiary referral center were included. Patients were contacted, asked to return for physical examination, and to complete the Pelvic Floor Distress Inventory (PFDI-20) questionnaire. Our primary outcome was anatomic failure defined as Stage 2 POP or higher of any compartment. The secondary outcome was subjective changes in symptoms based upon PFDI-20 responses. RESULTS: Two-hundred and two women were identified to have undergone the index surgeries from 2008 to 2012. Sixty-three agreed to return for follow up symptom evaluation and examination (30 VHUSLS and 33 SHU). Baseline characteristics were similar between groups. Clinical cure was high for both groups reaching 93.4 % and 94.0 % for the VHUSLS and SHU groups, respectively (p = 0.721). Anatomical success was lower with 44.7 % and 66.7 % of patients in the VHUSLS and SHU groups, respectively, meeting criteria for success (p = 0.138). There were no mesh complications among patients returning for exams. However, two patients who were contacted and were not interested in this study reported mesh complications and need for additional surgeries. Anterior vaginal wall support was noted to be significantly better supported for SHU (Ba -2.03 ± 0.75 vs -1.42 ± 0.92, p = 0.008). There were no differences between groups for overall PFDI-20 scores postoperatively. However, SHU patients reported higher rates of stress urinary incontinence compared to VHUSLS patients. CONCLUSION: In women with apical prolapse, VHUSLS and SHU afford similar long-term outcomes. SHU patients reported higher rates of stress urinary incontinence.

A 19-Year Study of Dental Needlestick and Sharps Injuries in Japan.

BACKGROUND: Needlestick and sharps injuries (NSIs) are serious problems for dental health care workers (DHCWs) because they are at risk for occupational blood-borne infections. In this study, risk factors for NSIs in DHCWs at Tohoku University Hospital (TUH) in Japan over 19 years were analysed. METHODS: NSI data of DHCWs at TUH from April 2002 to March 2020 were collected from the Exposure Prevention Information Network (EPINet) and statistically analysed. RESULTS: A total of 195 NSIs occurred during the 19-year study period. Approximately 58.5% of NSIs occurred in DHCWs with less than 5 years of experience. Injection needles were the most frequent cause of NSIs (19.0%) followed by suture needles (13.3%) and ultrasonic scaler chips (12.8%). Needle injuries occurred mainly on the left hand, whereas ultrasonic scaler chip and bur injuries occurred on the right hand and other body parts whilst DHCWs were placing the instruments back on the dental unit hanging holder without removing the sharps. NSIs from other instruments primarily occurred on both hands and foot insteps during cleanup. No case of occupational blood-borne infection caused by NSIs was observed during the study period at TUH. CONCLUSIONS: NSIs occurred in DHCWs with less experience, and there were associations between the instruments, timing of use, and NSI site. EPINet was considered a valuable tool for monitoring NSIs in order to develop future strategies for minimising NSIs.