Prognostic Significance of Preoperative NLR or PLR and PASS Score Combinations in Pheochromocytoma and Paraganglioma

ABSTRACT Context Neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) have recently emerged in assessing pheochromocytomas and paragangliomas (PPGLs). However, their combined use with PASS scale has not yet been explored. Objective Our goal was to investigate the prognostic values of NLR and PLR and incorporate the PASS score into our analysis. Methods Data from 74 histologically confirmed pheochromocytomas/paragangliomas across two centres were assessed. Poor prognosis was characterised by the presence of metastasis or disease‐specific mortality. Clinical characteristics such as age, gender, primary tumour size and location, and urinary metanephrine and normetanephrine levels, alongside NLR, PLR, and the PASS score as prognostic markers, were analysed. The prognostic value of the PASS score combined with NLR or PLR was evaluated using Receiver Operating Characteristic Curve (ROC), univariate, and multivariate regression analyses. Results Sixty‐four patients with better prognosis and 10 patients with poor prognosis were included in the analysis, with mean PASS scores of 4 and 9, respectively. Poor prognosis was significantly higher in patients with NLR Á 3.43 (Area Under Curve(AUC) = 0.761; 70% sensitivity, 82.8% specificity, 38.9% PPV and 94.7% NPV) and with PLR > 193.12 (AUC = 0.738; 70% sensitivity, 76.2% specificity, 30% PPV and 94% NPV). The PASS and preoperative NLR or PLR combination predicted poor prognosis significantly in the multivariate models (OR: 125; 95% CI: 6.25–∞; p  = 0.001 for PASS ≥ 6 and NLR > 3.43 and OR: 28.57; 95% CI: 3–250; p  = 0.003 for PASS ≥ 6 and PLR > 193.12). Conclusion As the roles of NLR and PLR in prediction of prognosis is gaining recognition, combining these with PASS score may improve preoperative stratification of prognosis and management of patients.

Impact of Smoking on Macrophage‐Related Chemokines During Initial Peri‐Implantitis: A Prospective Cohort Study

ABSTRACT Objectives Smoking disrupts macrophage chemokine response and delays healing. This study aims to investigate the effect of smoking on peri‐implant crevicular fluid (PICF) levels of macrophage‐related chemokines, C‐C motif chemokine ligand 2 (CCL‐2), C‐C motif chemokine ligand 8 (CCL‐8), C‐X‐C motif chemokine ligand 9 (CXCL‐9), and C‐C motif ligand 3 (CCL‐3), before and after non‐surgical treatment of initial peri‐implantitis. Methods Fifty‐five implants (27 non‐smoking [NSPI] and 28 smoking [SPI]) with initial peri‐implantitis (bleeding on probing [BOP+], probing pocket depth [PPD] of 6–7 mm) were included in the study. Clinical parameters were recorded, and PICF samples were collected before and 4 months after non‐surgical treatment. PICF concentrations of CCL‐2, CCL‐8, CCL‐3, and CXCL‐9 were measured with Luminex assay. The Mann–Whitney U ‐test, Wilcoxon signed‐rank test, and repeated measures analysis of variance test were used to analyze differences between and within the groups. Results Baseline CCL‐2 ( p  < 0.001) and CXCL‐9 ( p  = 0.026) levels (pg/30 s) were significantly lower in smokers compared to non‐smokers, while no difference was observed for CCL‐3 between the two groups ( p  = 0.320). Only CCL‐2 levels (pg/30 s) decreased in the NSPI group in response to non‐surgical treatment ( p  = 0.037). Conclusion Smoking disturbs the expressions of macrophage‐related chemokines in the early phase of peri‐implantitis. These findings may indicate the impaired control of infection during initial peri‐implantitis and explain the accelerated progression of the disease in smokers. This study was not registered prior to participant recruitment. Trial Registration https://clinicaltrials.gov/study/NCT06810401

Development of the Scale of Humanistic Care Competencies for Nursing Students

ABSTRACT Humane care refers to an approach that focuses on people, considers individual differences, and aims to provide ideal care, regardless of the needs of the individual. This approach can also be called the “humanistic approach”. While nurses are among the main practitioners of this understanding, nursing students should also receive education in this direction. The aim of the study conducted in this direction is to develop a scale to assess the humane care competencies of nursing students and to test the validity of this scale. The research was carried out with a methodological design and a total of 323 nursing students were included in the study. The item pool created for the developed scale was first presented to expert opinion; then, a 5‐point Likert‐type scale consisting of 33 items was applied to the students. The data were evaluated using content validity analysis, factor analysis, and Cronbach's alpha reliability coefficient. As a result of Exploratory Factor Analysis, six items were removed from the scale and the scale was structured in five sub‐dimensions with 27 items. The overall Cronbach's alpha reliability coefficient of the scale was found to be 0.922; the alpha values for the sub‐dimensions were calculated as 0.756, 0.826, 0.840, 0.848, and 0.887, respectively. These results reveal that the “Human Care Competency Scale for Nursing Students” is a valid and reliable measurement tool. Trial Registration: ClinicalTrials.gov Identifier: NCT06695390

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Development and Validation of an Artificial Intelligence–Assisted Patient Education Material for Ostomy Patients: A Methodological Study

ABSTRACT Aim To develop and test the validity of an artificial intelligence–assisted patient education material for ostomy patients. Design A methodological study. Methods The study was carried out in two main stages and five steps: (1) determining the information needs of ostomy patients, (2) creating educational content, (3) converting the educational content into patient education material, (4) validation of patient education material based on expert review and (5) measuring the readability of the patient education material. We used ChatGPT 4.0 to determine the information needs and create patient education material content, and Publuu Online Flipbook Maker was used to convert the educational content into patient education material. Understandability and applicability scores were assessed using the Patient Education Materials Assessment Tool submitted to 10 expert reviews. The tool inter‐rater reliability was determined via the intraclass correlation coefficient. Readability was analysed using the Flesch–Kincaid Grade Level, Gunning Fog Index and Simple Measure of Gobbledygook formula. Results The mean Patient Education Materials Assessment Tool understandability score of the patient education material was 81.91%, and the mean Patient Education Materials Assessment Tool actionability score was 85.33%. The scores for the readability indicators were calculated to be Flesch–Kincaid Grade Level: 8.53, Gunning Fog: 10.9 and Simple Measure of Gobbledygook: 7.99. Conclusions The AI‐assisted patient education material for ostomy patients provided accurate information with understandable and actionable responses to patients, but is at a high reading level for patients. Implications for the Profession and Patient Care Artificial intelligence–assisted patient education materials can significantly increase patient information rates in the health system regarding ease of practice. Artificial intelligence is currently not an option for creating patient education material, and their impact on the patient is not fully known. Reporting Method The study followed the STROBE checklist guidelines. Patient or Public Contribution No patient or public contributions.

Consensus Report of the 20th European Workshop on Periodontology: Contemporary and Emerging Technologies in Periodontal Diagnosis

ABSTRACT Background This Consensus Workshop dealt with diagnostic methodologies in the context of surveillance, screening, assessment of stage and grade, prognosis, monitoring and prediction of periodontal status. Several elements provided the impetus for the workshop, including the limited quality of available research on diagnostic tests, the rapid development of new technologies, the implementation of the 2018 classification and the declarations of the World Health Organisation on diagnosis and oral health. Aim To update and evaluate the evidence on diagnostic methods, considering recent advances in knowledge and the implementation of the 2018 classification. Methods The European Workshop Committee of the European Federation of Periodontology guided the development of a consensus report after commissioning eight systematic reviews within three working groups. The reviews were discussed during the in‐person consensus meeting involving 70 participants from 21 different countries. Results Working Group 1 discussed innovations in traditional diagnostic approaches, justified manual probing as the reference standard and assessed the value of image‐based methods. Working Group 2 analysed diagnostic tests based on microbial and host biomarkers and genetic diagnostic tests. Working Group 3 covered emerging technologies to be used within dental and non‐dental clinical settings, focusing principally on the impact of questionnaire‐based assessments and artificial intelligence systems (AIS) in interpreting different data modalities. Conclusion Although manual periodontal probing is firmly established as the reference standard, additional approaches based on imaging, biomarkers, host genetics, questionnaires and the development of emerging applied data science methods (e.g., AIS) are increasingly integrated in periodontal diagnostics.

Genetic Loci Associated With Periodontitis: The FinnGen Study Based on National Health Registers

ABSTRACT Aim To perform a genome‐wide association study (GWAS) for periodontitis in the FinnGen cohort, as genetic factors contribute to periodontitis. Materials and Methods We included nearly 250,000 Finnish individuals who had visited a dentist in the public healthcare sector for a clinical oral examination. We designed three periodontitis phenotypes based on diagnosis and procedure codes and CPI indexes in national health registers. Results We identified 11 independent genetic loci associated with periodontitis, among which 6 were common and novel. A locus near the FST gene was associated with two phenotypes, whereas other lead SNPs were located near ARL15 , MFHAS1 , DEFB130A and APOE . Additionally, all phenotypes in the discovery and replication cohorts were associated with genetic variations in the HLA region. Furthermore, imputed HLA allele frequencies identified independent associations between HLA‐DRB1 , HLA‐DPB1 and HLA‐DQA1 and periodontitis. Based on single‐cell RNA sequencing, the expression of genes near our lead SNPs across all three phenotypes was particularly enriched in gingival cell lineages important in the pathogenesis of periodontitis. Phenotypical and genetic correlations revealed associations between periodontitis and bacterial diseases, as well as autoimmune and cardiometabolic phenotypes. Conclusions Our GWAS suggests that genetic variation contributing to immune dysregulation is involved in the pathogenesis of periodontitis, which has considerable genetic similarity with other complex traits.

Impact of childhood trauma history on premenstrual syndrome in women of reproductive age: A cross‐sectional study

Abstract Aim Premenstrual syndrome is a women's health problem affecting women of reproductive age. Early traumas may have negative effects on women's health. Childhood traumas are thought to be an important risk factor for the emergence of premenstrual syndrome. The aim of this study was to investigate the relationship between premenstrual syndrome and childhood traumas in women. Method This is a cross‐sectional study. This study was conducted online between September 2023 and January 2024. The sample of the study consisted of 437 women of reproductive age, between the ages of 18–49, who did not have any obstacles to participating in the study. Personal Information Form, Premenstrual Syndrome Scale and Childhood Trauma Scale were used to collect the data. SPSS statistical program was used to analyze the data. [Correction added on 28 December 2024, after first online publication: In the preceding sentence, ‘SPPS’ has been corrected to SPSS.] Results The prevalence of premenstrual syndrome was 55.6%. Emotional neglect, physical abuse, emotional abuse and sexual abuse levels were found to be higher in women with premenstrual syndrome ( p  < 0.05). It was determined that childhood traumas increased the level of premenstrual syndrome in women (ß = 0.266). Childhood trauma explained 6.8% of the total change in premenstrual syndrome level (R 2  = 0.068). Emotional neglect (ß = 0.163) and physical abuse (ß = 0.121) increased the level of premenstrual syndrome. Conclusion Childhood traumas were found to be an important factor affecting the occurrence of premenstrual syndrome and exacerbating its symptoms. Early detection of childhood traumas may prevent long‐term problems that may occur in individuals.

Does Cigarette Smoke Affect Permanent Resin‐Based Crown Materials?

ABSTRACT Objective The purpose of this study was to investigate how cigarette smoking affects the surface roughness ( R a ) and stainability of additively and subtractively manufactured resins. Materials and Methods Two additively manufactured definitive resins (Dentafab, DF and Formlabs, FL) and a subtractively manufactured resin nanoceramic (Cerasmart, CS) were used to fabricate 60 specimens (14 × 12 × 1 mm). After taking baseline R a and color measurements (Δ E 00 ), they were divided into two groups ( n  = 10). Using a programmable cigarette smoking simulation device, the study groups smoked 10 cigarettes a day for 30 days. The control groups were kept in artificial saliva for 30 days. The R a and Δ E 00 were performed again. Scanning electron microscope images were taken. Kruskal–Wallis test, Mann–Whitney U , Bonferroni, and Wilcoxon Signed Rank tests were used for statistical analyses ( α  = 0.05). Result Significantly less discoloration was observed in the FL group compared with the other groups ( p  < 0.001). The R a of the DF study groups was statistically significantly higher than the control groups ( p  = 0.005). Conclusion All the tested materials had moderately unacceptable color change when previously reported threshold values were considered. There was not found to be any linear correlation between the R a of materials and smoking‐induced discoloration. Clinical Significance The discoloration and surface roughness of three‐dimensional (3D)‐produced SLA definitive resin because of smoking are at acceptable levels. Optimized physical and chemical properties of definitive resins are clinically important to extend the life of the restoration. The application of 3D definitive resin can be recommended in clinical practice.

Nonthermal Magnetic Field Processing of Egg Yolk: A Novel Alternative to Conventional Pasteurization

ABSTRACT This study aims to evaluate the effectiveness of magnetic field application as a sustainable hurdle technology with minimal adverse biological effects and no toxic effects in ensuring the microbiological safety of liquid egg yolk. Additionally, the effect of applied magnetic fields on the stability of liquid egg yolk, as well as its physicochemical and technofunctional properties, has been investigated. A magnetic field was applied to the yolk under two distinct intensities and durations, and the samples were maintained for 21 days. The physicochemical and microbiological characteristics of the processed and raw samples were compared throughout the study period. The implementation of magnetic fields decreased the pH, water activity, firmness, cohesiveness, color values, and microbiological outcomes of the samples. Conversely, they showed an upward effect on brix, emulsion stability, consistency, and viscosity index values. On the final day of storage, samples subjected to a 240 mT magnetic field intensity for 60 min exhibited the lowest recorded values: pH (6.10), water activity (0.810), firmness (10.61 g), cohesiveness (−4.22 g), L * (33.52), a * (1.01), b * (18.96), and total counts of aerobic mesophilic bacteria (1.21 log cfu/g), aerobic psychrophilic bacteria (1.09 log cfu/g), total coliform group bacteria (0.34), and coagulase‐positive Staphylococcus species (0.87 log cfu/g). Conversely, the samples exposed to the same parameters exhibited the highest values: % Brix (46.15), % emulsion stability (85.43), consistency (54.25 g s), and viscosity index (−0.52 g s). Furthermore, both the magnetic field intensity and application duration affected the resultant effects on the products.