Accuracy of augmented reality navigated surgery for placement of zygomatic implants: a human cadaver study
Purpose Placement of zygomatic implants in the most optimal prosthetic position is considered challenging due to limited bone mass of the zygoma, limited visibility, length of the drilling path and proximity to critical anatomical structures. Augmented reality (AR) navigation can eliminate some of the disadvantages of surgical guides and conventional surgical navigation, while potentially improving accuracy. In this human cadaver study, we evaluated a developed AR navigation approach for placement of zygomatic implants after total maxillectomy. Methods The developed AR navigation interface connects a commercial navigation system with the Microsoft HoloLens. AR navigated surgery was performed to place 20 zygomatic implants using five human cadaver skulls after total maxillectomy. To determine accuracy, postoperative scans were virtually matched with preoperative three-dimensional virtual surgical planning, and distances in mm from entry-exit points and angular deviations were calculated as outcome measures. Results were compared with a previously conducted study in which zygomatic implants were positioned with 3D printed surgical guides. Results The mean entry point deviation was 2.43 ± 1.33 mm and a 3D angle deviation of 5.80 ± 4.12° (range 1.39–19.16°). The mean exit point deviation was 3.28 mm (±2.17). The abutment height deviation was on average 2.20 ± 1.35 mm. The accuracy of the abutment in the occlusal plane was 4.13 ± 2.53 mm. Surgical guides perform significantly better for the entry-point (P = 0.012) and 3D angle (P = 0.05); however, there is no significant difference in accuracy for the exit-point (P = 0.143) when using 3D printed drill guides or AR navigated surgery. Conclusion Despite the higher precision of surgical guides, AR navigation demonstrated acceptable accuracy, with potential for improvement and specialized applications. The study highlights the feasibility of AR navigation for zygomatic implant placement, offering an alternative to conventional methods.
Tabernée Heijtmeijer et al. (2024) Accuracy of augmented reality navigated surgery for placement of zygomatic implants: a human cadaver study. PeerJ 12:e18468 https://doi.org/10.7717/peerj.18468
The role of CD47 in immune escape of colon cancer and its correlation with heterogeneity of tumor immune microenvironment
Background Cluster of differentiation 47 (CD47), a transmembrane protein, plays a critical role in regulating cellular functions and maintaining immune homeostasis. Its expression has been shown to influence cancer prognosis. In this study, we investigated the role of CD47 in tumor progression in colon adenocarcinoma (COAD) and evaluated its potential as a target for immunotherapy. Materials and Methods We analyzed surgical samples from 96 COAD patients. Immunohistochemical analysis was performed on 90 samples, while the remaining 6 were subjected to multiplex immunofluorescence. To explore the association between CD47 expression and clinicopathological characteristics, we integrated transcriptome data from The Cancer Genome Atlas and the Gene Expression Omnibus using R software. The Tumor Immune Estimation Resource and Kaplan-Meier plotter were utilized to assess the relationship between CD47 expression, patient prognosis, and immune infiltration. Furthermore, the single-cell Tumor Immune System Interaction Database was used to examine the correlation between CD47 expression and the tumor microenvironment (TME). All included patients gave oral and written informed consent. The study was approved by the Ethics Committee of 3201 Hospital (full name: Medical Ethics Committee of 3201 Hospital). Results CD47 was found to be overexpressed in various tumors, including COAD. Higher CD47 expression was significantly associated with more advanced tumor stages, including TNM staging, T staging, and N staging (P < 0.05). A robust correlation was observed between CD47 expression and immune cell infiltration in COAD. Patients with elevated CD47 expression tended to have longer disease-free intervals, although this benefit was diminished in cases with high infiltration of M1 macrophages. The immunosuppressive function of CD47 primarily acted through the CD47/SIRPα pathway. Additionally, distinct cellular compositions and distributions were identified between primary and metastatic COAD, underscoring the heterogeneity of the TME. CD47 also influenced the TME by modulating cytokine and cytokine receptor interactions. Conclusion CD47 represents a promising prognostic biomarker and a potential target for immunotherapy in COAD. These findings provide new insights into therapeutic strategies aimed at modulating the TME and improving patient outcomes.
Tian et al. (2024) The role of CD47 in immune escape of colon cancer and its correlation with heterogeneity of tumor immune microenvironment. PeerJ 12:e18579 https://doi.org/10.7717/peerj.18579
Observation of peri-implant bone loss rates in patients visiting dentist—A retrospective evaluation of patients of a faculty hospital for one year
Background Many studies have been published on the relationship between different parameters with marginal bone loss around implants. The results of these studies vary, but some variables such as smoking or certain systemic conditions are more likely to predispose or exacerbate the resorption around implants. The aim of this study was to determine the rates of implants with radiographically detected marginal bone loss and to determine whether there is a relationship between the severity of destruction and certain risk factors like location of implant, restoration type, systemic condition, age, sex or smoking habits. Materials and Methods Panoramic radiographs obtained for 1 year were examined. Patients with bone loss around the implant were classified according to the region of implant placement, type of restoration on implants, systemic diseases, and smoking habits. The rate of bone loss around the implants was recorded as the resorption score. Double and multiple comparison tests were applied to observe whether the resorption scores were related to the variables. Results Of 17,352 patients, 1,465 had at least one implant, and 1,116 of these had no bone loss. A total of 181 patients (863 implants) included in the study, there was a weak correlation between age (p = 0.017) and resorption rate. Implants supporting bridge restorations had higher resorption scores. Gender, age, and systemic conditions alone are not effective in increasing peri-implant bone loss (p < 0.05); therefore, placing implants in the mandible (p = 0.020) or using implants to support bridge restorations(p = 0.027) may make implants more vulnerable to resorption.
Karadag et al. (2024) Observation of peri-implant bone loss rates in patients visiting dentist—A retrospective evaluation of patients of a faculty hospital for one year. PeerJ 12:e18643 https://doi.org/10.7717/peerj.18643
Evaluation of the effect of a communication skills course on medical students’ attitude towards patient-centered care: a prospective study
Background This study aims to examine whether a communication skills course (Early Clinical Exposure–ECE) might support shaping medical students’ attitudes towards patient-centered care at Taibah University, Saudi Arabia. Attitudes were measured before and after the course using the Patient Practitioner Orientation Scale (PPOS), which assesses students’ orientation towards patient-centeredness. Methods This prospective observational study collected data at two points: the start of year two and the start of year four from the same cohort. The PPOS, divided into the sharing subscale (physician shares information, power, and control with the patient) and the caring subscale (physician considers the patient’s emotions, preferences, and expectations), was used to evaluate students’ attitudes. Mean scores were calculated, and independent sample t-tests were employed to assess statistical significance. Results Of the students targeted, 153 participated at year two (response rate = 93.5%) and 143 at year four (response rate = 89.5%). Significant progress was observed in the sharing subscale, with scores increasing from 3.23 ± 0.53 to 3.40 ± 0.60 (p = 0.015). However, the caring subscale exhibited a significant decline, with scores dropping from 4.06 ± 0.53 to 3.76 ± 0.68 (p < 0.001). As a result, there was no significant overall change in the total PPOS score (p = 0.282). Female students showed more progress in the sharing subscale than males. Conclusions The communication skills course might have had a positive impact on students’ attitudes towards sharing information in decision-making with patients, but notably, the medical students’ caring attitudes declined. This indicates a need for further emphasis on patient-centered communication, especially on the caring aspects, in the medical curriculum.
Mohamed et al. (2024) Evaluation of the effect of a communication skills course on medical students’ attitude towards patient-centered care: a prospective study. PeerJ 12:e18676 https://doi.org/10.7717/peerj.18676
Genetic diversity of the Khorat snail-eating turtle (Malayemys khoratensis) in Thailand
Introduction Malayemys khoratensis is a freshwater turtle species endemic to northeastern Thailand and Lao PDR. While M. khoratensis is relatively common and widespread in Thailand, its population size and demographic trends remain largely unknown, as direct population estimates are lacking. This species faces significant threats from consumption, exploitation, and trade. Therefore, this study aims to investigate the genetic diversity, population structure, and demographic trends of M. khoratensis in northeastern Thailand, using two mitochondrial DNA genes, Cyt b and ND4. Method We grouped the turtles based on three major river basins in northeastern Thailand: Mun, Chi, and Northeast Mekong to assess population structure and test the isolation-by-basin hypothesis. The Cyt b and ND4 genes of 49 M. khoratensis individuals across 15 provinces in Thailand were sequenced, and 15 sequences from a previous study of Ihlow et al. (2016) were included into the analyses. We constructed a haplotype network from the concatenated sequences and analyzed the population structure with the analysis of molecular variance (AMOVA). Additionally, we used a Bayesian Skyline plot (BSP) analysis to estimate the effective female population size and explore the demographic history of this species. Results Our analysis identified 13 unique haplotypes defined by 26 polymorphic sites from 64 samples. The total haplotype diversity for M. khoratensis was 0.819, while nucleotide diversity was 0.0031. The haplotype network and AMOVA revealed no distinct population structure among the river basins, suggesting gene flow across these regions. The BSP estimated a stable effective female population size of approximately 130,000 individuals since around 100,000 years ago (late Pleistocene). Conclusion Our findings indicated no significant population structure by river basin, which may be due to natural movement between basins or potential human-mediated translocations linked to the turtle trade. The demographic trend of M. khoratensis appears to have been stable over time. However, given the ongoing exploitation of this species, we recommend regular monitoring of population trends to support its long-term survival.
Chaianunporn et al. (2024) Genetic diversity of the Khorat snail-eating turtle (Malayemys khoratensis) in Thailand. PeerJ 12:e18699 https://doi.org/10.7717/peerj.18699
A single-center retrospective study of ectopic lymphoid tissues in idiopathic membranous nephropathy: clinical pathological characteristics and prognostic value
Background In recent years, ectopic lymphoid tissue (ELT) has been increasingly confirmed as a new biomarker for kidney injury or inflammation. However, there is insufficient research on the relationship between ELT grading and the progression of idiopathic membranous nephropathy (IMN). Methods A total of 147 patients with biopsy-proven IMN in our institution from March 2020 to June 2022 were classified into five grades based on the different distribution of lymphocyte subsets in renal tissue (G0: no B cells or T cells, G1: scattered B and T cells, G2: clustered B and T cells, G3: an aggregation region of B and T cells without a central network, G4: highly organized and formed zones of B and T cells with a central network of follicular dendritic cells and scattered macrophages), and were further divided into low-grade group (G0+G1), intermediate-grade group (G2) and high-grade group (G3+G4). The clinicopathological data, induction treatment response and prognosis among the three groups were analyzed and compared retrospectively. Results As the grading of ectopic lymphoid tissues increased, patients were older, with a higher prevalence of hypertension, a higher 24-h urinary protein level, lower baseline hemoglobin and estimated glomerular filtration rate (eGFR) levels, and more severe renal pathological damage. Logistic regression analysis showed that after 6 months of induction treatment, patients in the high-grade group were more likely to be in non-remission than those in the low-grade group (odds ratios [ORs] of the three adjusted models were 4.310, 4.239, and 5.088, respectively, P-values were 0.005, 0.006, and 0.001, respectively). Kaplan-Meier survival analysis indicated that patients in the intermediate- and high-grade groups had significantly lower renal cumulative survival rate than those in the low-grade group (P = 0.025). Univariate Cox analysis showed that the risk of adverse renal outcome was 3.662 times higher in the intermediate- and high-grade groups than in the low-grade group (95% confidence interval [CI] [1.078–12.435]; P = 0.037). Multivariate Cox analysis revealed that failure of remission at the first 6 months (hazard ratio [HR] = 5.769; 95% CI [1.854–17.950]; P = 0.002) remained an independent risk factor for poor renal outcome in patients with IMN. Conclusions Grading of renal ectopic lymphoid tissues correlates with disease activity and severity in IMN patients and can be used as an indicator to assess the risk of IMN progression.
Zhang et al. (2024) A single-center retrospective study of ectopic lymphoid tissues in idiopathic membranous nephropathy: clinical pathological characteristics and prognostic value. PeerJ 12:e18703 https://doi.org/10.7717/peerj.18703
Association of vaccine intention against COVID-19 using the 5C Scale and its constructs: a Pima County, Arizona cross-sectional survey
Background Vaccine hesitancy has been ranked as one of the top 10 threats to global health by the World Health Organization. The 5C model (Confidence, Calculation of risk, Complacency, Collective Responsibility, and Constraints) and an accompanying tool to measure vaccine hesitancy, summarize several significant explanatory variables, and move beyond the most common explanatory variable, Confidence. Methods From January to May 2021, we administered a cross-sectional survey among adults in Pima County, Arizona in collaboration with the local health department to assess psychological antecedents to (i.e., psychological factors that lead to) COVID-19 vaccination using the 5C Scale. Participants were recruited virtually for the survey using multiple recruitment methods. Unadjusted and adjusted hierarchical ordinal logistic regressions were conducted to determine if the 5C variables had an association with intention to vaccinate (or intent to vaccinate) against COVID-19. Results Of the 1,823 participants who responded to the survey, 924 (76%) were included in the final analyses. Respondents were White (71%), non-Hispanic (59%), Female (68%), Liberal (37%) and Married (46%). The average age of the participants was 43.9 (±1.3) years. Based on the 5C Scale, Confidence (adjOR:3.64, CI [3.08–4.29]), Collective Responsibility (adjOR:1.94, CI [1.57–2.39]) and Complacency (adjOR:0.64, CI [0.51–0.80]) were significantly associated with intention to vaccinate against COVID-19. Conclusion Three of the five 5C variables were associated with the intention to vaccinate, two positively and one negatively. A limitation of the study was that the sample was not weighted to be representative of Pima County. Future research should focus on determining which interventions can bolster Confidence and Collective Responsibility attitudes in communities, while dampening Complacency, to better promote vaccine uptake.
Block Ngaybe et al. (2024) Association of vaccine intention against COVID-19 using the 5C Scale and its constructs: a Pima County, Arizona cross-sectional survey. PeerJ 12:e18316 https://doi.org/10.7717/peerj.18316
Improvement of contact lens-associated dry eye disease with the use of hydrogen peroxide
Background The dropout rate of contact lens users has not decreased significantly over the years. Despite continuous improvements in contact lens (CL) designs, materials and surface treatments, the number of CL users who drop out remains similar to the number of new CL users. The aim of this study is to analyse the improvement in contact lens-associated dry eye disease (CLADE), quantified with the OSDI questionnaire when changing maintenance system solution from multipurpose solution to hydrogen peroxide. Methods This study included contact lens users for over a year as the multipurpose solution for the maintenance system, suffering from CLADE, and those who scored over 13 in the ocular surface disease index questionnaire, and did not manifest any clinical signs over 3 in the EFRON scale. The non-parametric data distribution was verified with the Kolmogorov-Smirnov test and Wilcoxon signed-rank test, which was used to compare the visual acuity (VA), OSDI score and bulbar redness (EFRON scale) of the follow-up visit against the baseline value. Results Thirty-eight patients were included. Analysing the clinical parameters between the initial and final visit after one month of hydrogen peroxide use, a statistically significant improvement was found in the VA, bulbar hyperemia, OSDI scale and their subscales of the total sample (P < 0.04). Conclusion This study is intended as a first step towards a standardised protocol of actions to improve CLADE in an attempt to reduce contact lens dropout using OSDI as a tool for detection.
Castro et al. (2024) Improvement of contact lens-associated dry eye disease with the use of hydrogen peroxide. PeerJ 12:e18482 https://doi.org/10.7717/peerj.18482
The motivation to inform others: a field experiment with wild chimpanzees
Background Accumulating evidence indicates that some ape species produce more alarm behaviors to potential dangers when in the presence of uninformed conspecifics. However, since previous studies presented naturalistic stimuli, the influence of prior experience could not be controlled for. Method To examine this, we investigated whether apes (wild chimpanzees of the Budongo Forest, Uganda) would communicate differently about a novel danger (an unusually large spider) depending on whether they were with an uniformed conspecific. We tested nine adult males, four of which were exposed to the danger twice alone (Non-Social group), while the remaining five were exposed to the danger first alone and then in the presence of conspecifics (Social group). Results We found that both alarm calling and gaze marking (i.e., persistent gaze after stimulus detection) were more persistent in the Social than Non-Social group, although the effect of condition only reached statistical significance for gaze marking, nonetheless suggesting that chimpanzees tailored their warning behavior to the presence of others, even if they were already familiar with the potential threat.
Taylor et al. (2024) The motivation to inform others: a field experiment with wild chimpanzees. PeerJ 12:e18498 https://doi.org/10.7717/peerj.18498
A review of fossil scorpion higher systematics
Scorpions (Arachnida: Scorpiones) are a diverse and widespread arachnid order with a rich and deep fossil record. Here we review the, sometimes complex, historical development of fossil scorpion higher classification. We present a chronological account of family and genus names, together with an overview of higher taxa as potential clade names. In 1884 Thorell & Lindström divided scorpions based on whether the legs were short and pointed (Apoxypoda) or ended in paired claws (Dionychopoda). Pocock in 1911 used the morphology of the ventral mesosomal sclerites, which could either be bilobed (Lobosterni) or of a modern configuration (Orthosterni). Petrunkevitch in 1949 attached importance to a putative first opisthosomal tergite being present (Protoscorpionina) or absent (Euscorpionina). Kjellesvig-Waering in 1986 recognised four major groups (Holosternina, Meristosternina, Lobosternina and Bilobosternina) based on the shape of the ventral mesosomal sclerites. The Stockwell/Jeram schemes from the 1980s and 1990s proposed a cladistic progression from early branching lineages, for which the names Protoscorpiones and Palaeoscorpiones were used, towards Scorpiones sensu stricto defined by the presence of book lungs and coxapophyses. Scorpiones was further divided into Mesoscorpionina and Neoscorpionina. Neoscorpions were characterised by a reduced number of lateral eye lenses and comprise the paleosterns, with marginal lung spiracles, and orthosterns with spiracles in the middle of the sternite. We briefly discuss the merits of these alternatives and present a summary of the current higher classification of scorpions. Forty-three extinct family groups are currently recognised, and of the 24 living families seven have fossil representatives. Including incertae sedis taxa, there are 76 extinct genera and five extant genera with fossil representatives. Both modern parvorders, Buthida and Iurida, were potentially present in the Triassic. Buthidae, Chaerilidae, Chactidae and perhaps Hormuridae have been reported from the Cretaceous. Euscorpiidae are known from the Palaeogene and Scorpionidae has potential (but unconfirmed) records from the Neogene. Given the complexity of this history and the present taxonomy of the group, we hope this contribution provides a first step towards simplifying fossil scorpion systematics.
Dunlop et al. (2024) A review of fossil scorpion higher systematics. PeerJ 12:e18557 https://doi.org/10.7717/peerj.18557