bluuebunny/crossref_metadata_2025 huggingface dataset:
Artificial corneas ‐ Recent developments
Authors: Griffith May
Published: January 2024

Many regenerative medicine technologies have now entered the clinical realm with the help of biomaterials. Biomaterials, in conjunction with therapeutic stem or immune cells or cell products, are used to engineer tissues for in vivo testing platforms (organs‐on‐chips) or clinical use. However, biomaterials can also be used to stimulate in situ tissue regeneration to avoid adverse immune reactions. In ophthalmology, human donor corneas have served well for corneal transplant surgery. However, the massive shortage of suitable donor tissue combined with the expense and technical challenges of eye banking leaves a substantial proportion of the world's population without access to treatment. Here, we discuss the development of novel biomaterials for corneal implants that stimulate in situ tissue regeneration and the pathway to getting these into clinical trials. The results of clinical and pre‐clinical trials will be discussed.
New insights from paediatric electrophysiology
Authors: Thompson Dorothy
Published: January 2024

Visual electrophysiology is uniquely valuable in paediatric practice because it provides objective measures of visual pathway function. The combination of electroretinograms and visual evoked potentials to flashes and patterns enables a functional assessment of the entire pathway, from photoreceptors to striate cortex. This information can be impossible to obtain from children by other means. Electrophysiology complements structural information, often highlighting discrepant structure function relationships.

Objective functional electrophysiology facilitates early diagnosis and can delineate potential treatment windows from the youngest ages. Thus visual electrophysiology findings in children contribute to natural history and deep phenotyping studies that inform clinical trials of new treatments not only for ocular disease, but also systemic diseases that involve the eye.

This talk will describe ways in which ISCEV tests can be adapted and optimized for young children in clinical practice without loss of diagnostic accuracy, and how electrophysiology can distinguish phenotypes and inform genetic analysis. Examples of the value and limitations of electrophysiology in potential gene trials and other ameliorating treatments will be presented and discussed; including inherited retinal disease such as RPE65, neurodegenerations that affecting the eye such as CLN2 and iron brain disorders such as PKAN and ciliopathies such as BBS.

Key words: visual electrophysiology, children, ERG, VEP, ISCEV.
Non infectious ocular surface inflammation: Paediatric GVHD
Authors: Atilla Huban
Published: January 2024

Although ocular findings and treatment for GVHD are described in adult patients, the literature describing this condition in paediatric patients is relatively few. In children, detection of symptoms and diagnosis of ophthalmic findings are more difficult than in adults, as history taking, clinical examination and diagnostic tests such as fluorescein staining or Schirmer tests are difficult to perform due to limited cooperation. Also patients cannot specify their complaints and symptoms especially in younger age group. Follow‐up and frequent ophthalmic evaluation are important in diagnosis and management of children who had bone marrow transplantation. Even though ophthalmic findings are common in children, usually milder than adults but timely diagnosis and management are very important to decrease secondary eye complications such as corneal ulcers and vision loss and also to improve quality of life.

Graft‐versus‐host disease (GVHD) is a major complication of bone marrow transplantation that is performed for haematological malignancies and diseases and seen in 50–70% of cases. It is a complex clinical disease with many organ and system involvement. Acute form is seen in the first 3 months after transplantation, systemic manifestation mainly include hepatitis and skin involvement and chronic form is mostly seen after acute GVHD. Ocular manifestations can be classified as acute and chronic and also as anterior and posterior. Most common ocular finding is dry eye with corneal involvement and seen in 40–90% of patients with chronic GVHD. Corneal vascularization, keratitis and even perforation can be seen. Conservative treatment with topical steroids, autologous serum, lubricant eye drops and ointments should be integrated with topical cyclosporine‐A that might be an effective and safe treatment option in dry eye related to chronic GVHD.
Synthetic solutions for re‐growing human corneas
Authors: Griffith May
Published: January 2024

Cornea blindness is still treated mainly by corneal transplantation, using donated allograft human corneas. However, a severe global shortfall leaves an estimated 12.7 million patients on waiting lists despite methods of using one cornea for two different partial‐thickness grafts. Even more individuals are not on waiting lists because they have no access to transplantation in their countries or regions. However, even if donor tissues were readily available, patients with inflamed, severely damaged corneas are at high risk of rejecting conventional transplantation. Various solutions have been proposed as alternatives to corneal allografting, including the development of keratoprostheses and stem cell grafting. We posited using cell‐free implants that mimic the extracellular matrix of the human cornea to recapitulate the environment during corneal development and stimulate the endogenous cells within the patient's eyes to affect regeneration. We used cell‐free corneal implants made from chemically crosslinked recombinant human collagen to promote in situ tissue regeneration in pathologic corneas, including high‐risk ones. We successfully developed and tested recombinant human solid collagen‐based implants that promoted stable regeneration in inflamed human patient corneas based on phosphorylcholine (MPC). However, solid corneas require a full operating theatre and staffing, which is costly and not accessible to more remote regions in Canada and globally. Burns and severe infections that can lead to perforations are medical emergencies that require immediate methods to seal the eye. In many centres, cyanoacrylate glue is used as a sealant, but this is toxic and kills surrounding cells, often necessitating follow‐on transplantation. We developed a synthetic, biocompatible, and adhesive liquid hydrogel (LiQD Cornea), which would replace these toxic cyanoacrylate glues. LiQD cornea is applied as a liquid but quickly adheres and gels within corneal tissue defects like a dental filling. It can be used to fill ulcers and other damaged areas. Then its similarity at a molecular level to a natural tissue framework promotes tissue regeneration, treating corneal perforations effectively without transplantation. Further, due to the synthetic nature of the material, risks associated with disease transmission are reduced compared to natural products. We see LiQD Cornea potentially used in outpatient clinics instead of operating theatres, maximizing practicality and minimizing health care costs.
Dorothy Tiffany Burlingham and the psychology of the blind child
Authors: Schwartz Stephen G.
Published: January 2024

Dorothy Tiffany Burlingham (1891–1979) was a granddaughter of Charles Lewis Tiffany, founder of the jewellery empire, and a daughter of Louis Comfort Tiffany, the artist. Despite her great wealth, she suffered from an unhappy marriage and emigrated to Europe seeking psychoanalysis for herself and her children. There, she became a lay psychoanalyst and a lifelong partner, both professional and personal, of Anna Freud (1895–1982). Burlingham founded a day nursery for blind children in London and wrote extensively on the psychological problems facing these children. She discussed an impaired ego development, a need to remain still (both for safety concerns and to better concentrate on their hearing), and complicated relations with their parents and their sighted peers. Her unusual life pathway led her to many important contributions to this field.
Ramón Castroviejo (1904–1987): The father of the modern corneal transplantation
Authors: Ascaso Francisco Javier
Published: January 2024

Ramón Castroviejo Briones was born in 1904 in Logroño, Spain. He received his medical education at the University of Madrid, where he graduated in 1927. In 1929, he received a fellowship to work as assistant in the Ear, Nose, and Throat Hospital and College of Chicago. In 1930, he passed his American Board Examination and returned to Europe to visit the centers where keratoplasty was a fact. He visited the University eye clinics of Madrid, Paris, Vienna, Berlin, and Prague. When he returned to the United States, Castroviejo had a clear idea of what was being done in Europe and what he hoped to achieve. William L. Benedict had offered him a research fellowship at the Mayo Clinic, in Rochester, Minnesota, which Castroviejo accepted. In 1932, Dr. Maynard C. Wheeler granted Castroviejo a Research Fellowship at the new Eye Institute of the College of Physicians and Surgeons of Columbia University. He moved to New York, where he continued his research in animals in the Eye Institute of the Columbia Presbyterian Medical Center, and was an early developer of techniques for transplanting corneal tissue from the eyes of those who had just died to damaged eyes of the living. While not being the first to successfully graft human cornea, he improved the technique of the operation in the 1930s and 1940s, prompting the worldwide adoption of corneal transplantation as a standard way to deal with severe corneal pathology. His keratoplasty technique, creating a rectangular rather than circular “window” in the cornea, was the secret to his successful transplants, and remained standard until more efficient suture materials became available. The surgeon described this technique in 1937 to the American College of Surgeons. He contended that rectangular windows gave better results than the circular ones that had been tried earlier, since their edges could be fitted better to merge with and become a living part of the rest of the eye. Although the medical community was slow to recognize his successes, Castroviejo was eventually lauded for his sight‐saving corneal tissue transplant techniques, which he continued to refine and teach for many years. Castroviejo also promoted the donation of corneal tissue in the United States and designed numerous ophthalmic instruments, including the Castroviejo needle holder ‐an instrument used in eye, dental and other forms of microsurgery‐ Castroviejo callipers and corneal scissors. He became the director of Ophthalmology at St. Vincent's Hospital before he opened his own hospital when he bought the Hammond House in New York. After closing his private hospital he retired as clinical professor of the University of New York and moved permanently to Madrid, where he founded the Instituto Castroviejo, at the Complutense University of Madrid, and organized the Spanish Eye Bank, maintaining extensive clinical activity whenever his health permitted. Ramón Castroviejo died in 1987, at the age of 82, and is widely recognized as one of the 10 most influential people in ophthalmology of the 20th century.
Molecular and cellular changes underlying plasticity and regeneration of intact, injured and aged cold corneal nerves
Authors: Meseguer Victor
Published: January 2024

The peripheral nerve endings from trigeminal neurons that innervate the cornea are key neural structures to detect and encode the features of the physical and chemical external stimuli at the ocular surface. These neurons are functionally diverse and have been classified into polymodal nociceptors, mechano‐nociceptors and cold thermoreceptors. Each functional type evokes qualitative different conscious sensations. The sensory modality that is generated from a nerve ending is determined by the type and specific characteristics of the ion channels involved in stimulus transduction and encoding. Among them, TRPM8 channels transduce both cold and osmotic stimuli in corneal cold nerve terminals. These cold thermoreceptors mediate sensations of ocular surface cooling and dryness, and play an important role in the regulation of basal tearing and blinking. Morphologically, cold thermosensitive neurons display a more complex branching of their peripheral nerve endings innervating the cornea in comparison to the other functional classes of sensory neurons.

With aging, TRPM8‐expressing cold sensory neurons innervating the mouse cornea experience morphological and functional alterations. These changes occur earlier and are more prominent at the nerve terminal than at the neuron cell body. A drastic reduction of the nerve terminal branching complexity in addition to lower background impulse activity is observed in cold nerves of aged mice. Similarly, after performing photorefractive keratectomy (PRK) in the adult mouse cornea, both the nerve terminal branching and background activity are reduced in a fraction of the cold nerve terminals. An altered morphological configuration along with an aberrant transducing and coding ion channels expression at corneal cold nerve terminals are likely to contribute to the discomfort sensations experienced after corneal surgery and to the age‐related abnormal tearing in the elderly.

(Supported by PID2021‐124460OB‐I00 from DOI: MCIN/AEI/ 10.13039/501100011033, and CIPROM/2021/48 from the Generalitat Valenciana, Spain)
Medical and surgical management of neurotrophic keratopathy
Authors: Dua Harminder S.
Published: January 2024

Neurotrophic Keratopathy (NK) is not a specific disease entity but a consequence of several conditions with varied aetiopathogenesis, of which a loss or reduction in corneal sensitivity is the hallmark. NK is clinically graded as Mild (stage1), Moderate (stage 2) and Severe (stage 3). The grading helps in understanding severity and planning treatment. Management can be considered in two parts. The first is the management of the underlying condition when active, for example herpes virus keratitis, bacterial ulcers and immune mediated ulcerative keratitis; and the second part, which deals with treatment of the non‐healing epithelial defect, stromal melting with or without vascularization and perforation that remains due to epithelial, stromal and corneal nerve pathology.

Management of mild and moderate NK begins with the identification and elimination of any obvious underlying cause such as neuroleptic, antipsychotic, antihistamine and other systemic medications, preservatives in long term topical medications; and treatment of concurrent ocular surface infection. Tear substitutes and anti‐inflammatory agents both steroids and specific immunosuppressors like cyclosporin and lifitegrast should be used early. Antibiotics can be used prophylactically or to treat subclinical or overt infection. Medication with preservatives should be avoided. Prevention of progression to severe (stage 3) NK can be achieved with antiproteases such as citrate, tetracyclines and macrolides. Substrate re‐generating agents like Cacicol and promoters of epithelial regeneration like co‐enzyme Q10 target aspects of the underlying pathology. The introduction of recombinant human nerve growth factor (rh)NGF (Cenegermin/Oxervate) has provided specific therapy that addresses the basic defect related to corneal nerves. Insulin drops are proving to be useful and amniotic membrane extracts/amniotic fluid has also been tried. Autologous and pooled allo serum or plasma drops, which provide a variety of known and unknown factors have also proved useful but may at times aggravate the condition. Usually a combination of two or more of the above are required but rhNGF and insulin hold considerable promise for long term remission.

Medical treatment is often augmented with non‐surgical interventions such as bandage contact lens, padding, punctal plugs, botulinum toxin, frost suture and glue. These are primarily designed to deal with exposure, dry eyes and reduce the abrasive effect of lid blinks, to promote healing. Useful surgical procedures include tarsorrhaphy, amniotic and conjunctival grafts, penetrating and lamellar keratoplasty and limbal stem cell transplants. Surgical interventions are designed to augment effects of the non‐surgical interventions, reduce scarring, deal with complications and restore sight. A key principle is that wound healing after any form of surgery or transplant, is poor if the corneal sensations remain impaired or absent.
Objective and independent measurement of scattering caused by the cornea and crystalline lens
Authors: Vilaseca Meritxell
Published: January 2024

meritxell.vilaseca@upc.edu

There are several methods that provide information on the intraocular scattering. Procedures based on the observation of the lens through the slit lamp from which a gradation of the state of every cataract is assessed (e.g. lens opacities classification system III ‐ LOCS III) are the most widely used in clinics. Nevertheless, they provide information related to the back‐scattered light and not forward scattering, which is responsible for the degradation of vision. To do so, a procedure that assess retinal straylight using a device based on a psychophysical compensation‐comparison approach was proposed, in which the subject's task is a forced‐choice between two half fields to decide which one flickers more intensely. From these measurements, a psychometric function is fitted and used to determine the straylight compensation level log(s) on the basis of a few stimuli responses.

As an alternative approach, some attempts have been made to use the double‐pass as a means of objectively estimating forward scattering. The double‐pass technique is a procedure that is able to capture the complete optical information of the eye, including the effect of higher‐order aberrations and intraocular scattering within a small visual angle. Artal et al. proposed the Objective Scatter Index (OSI) calculated from double‐pass images for estimating scattering with the intention to grade cataracts. This technique was also used successfully to account for scattered light in patients with keratitis and uveitis, and those undergoing refractive surgery. More recently, a new Frequency Scatter Index (FSI3) based on the analysis of double‐pass retinal images in the frequency domain has also been suggested, as a means of minimizing the impact of optical aberrations on the results obtained.

Nevertheless, all of the former methods provide information on the total scattered light in the eye, which consists of the combined contributions originating from different ocular structures. In this regards, we recently proposed a technique for the objective and independent assessment of scattering caused by the cornea and the lens based on the analysis of the contrast of the third and fourth Purkinje images. The technique was preliminarily validated first by using artificial eyes with different levels of corneal and lens scattering; second, it was validated in eyes wearing customized contact lenses to simulate corneal scattering and eyes with nuclear cataracts. Finally, it was tested on a larger population of eyes with cataracts and corneal disorders to prove its clinical usefulness.

In this work, we review all the above‐mentioned techniques that have been proposed for objective intraocular scattering assessment, putting especial emphasis on the last one based on Purkinje images, and compare their results and clinical performance.
Long‐term risk of glaucoma after cataract surgery in childhood
Authors: Schmidt Diana Chabané , Eriksson Frank , Bach‐Holm Daniella , Grønskov Karen , Kessel Line
Published: January 2024

Purpose

To examine the long‐term risk of glaucoma after cataract surgery in childhood.

Methods

This study took place from January 2022 until December 2022 and included patients from a large family with hereditary childhood cataract who had cataract surgery before 18 years of age. Patients underwent an ophthalmologic examination to determine the presence of glaucoma or ocular hypertension (OHT). Patients who did not want to participate in the examination could contribute with a medical journal from their treating ophthalmologist. The risk of long‐term glaucoma was determined using survival analysis, and risk factors were assessed using a Cox proportional hazards regression model.

Results

We included 68 patients (133 eyes) with a median age at cataract surgery of 7 years (IQR: 5–10). The median follow‐up time after cataract surgery to glaucoma/OHT or the latest ophthalmologic examination was 35 years (IQR: 15–48). Twelve patients (18 eyes) had glaucoma, and five patients (eight eyes) had OHT, resulting in 15 patients with glaucoma/OHT. The long‐term risk of glaucoma/OHT diagnosed in adulthood was 47.7% (CI: 21.8–70.9) at the age of 70 years of patients who were free of glaucoma before their 18th year. We could not confirm or dismiss an association between glaucoma/OHT and sex, age at surgery, number of ocular interventions before 18 years of age or glaucoma after cataract surgery in a first‐degree relative.

Conclusion

Cataract surgery in childhood is associated with a high risk of late‐onset glaucoma. Regular lifelong follow‐up is important to ensure early diagnosis and prevent extensive vision loss.
A low proportion of undertriage validates the new West coast system for triage—Paediatric
Authors: Sjöstedt Hannah , Kindblom Jenny M. , Celind Jimmy
Published: January 2024

Aim

There is a lack of studies on paediatric triage systems. This study aimed to evaluate patient safety of the Gothenburg‐developed paediatric triage system West Coast System for Triage—Paediatric (WEST‐P).

Method

This study was performed at the paediatric emergency department in Gothenburg, Sweden, October 2020 to April 2021. Included patients were double‐triaged with the WEST‐P, and the established Rapid Emergency Triage and Treatment System—Paediatrics (RETTS‐p). We compared the level of urgency between both systems to identify potentially undertriaged patients. Also, we assessed the patient safety according to clinical assessment at presentation, and pre‐defined criteria.

Results

This study included 2290 (23%) of triaged patients (44% girls, median age: 5.0 years) during the study period. A higher number of patients triaged to low urgency in WEST‐P compared to RETTS‐p (p < 0.0001) was observed, and 497 cases with low WEST‐P and high RETTS‐p urgencies identified. Of these, 29 had a clinical assessment indicating high urgency. After patient safety assessment, seven (0.4%) were determined undertriaged by the new triage system WEST‐P.

Conclusion

Our findings demonstrate a low risk of undertriage in the new WEST‐P. Thus, the WEST‐P has a high degree of patient safety when used in a paediatric emergency department.
SLAG—software for reconstruction of historical smelting processes based on slag properties
Authors: Kupczak Krzysztof , Warchulski Rafał
Published: January 2024

The publication presents the functions of the SLAG software created to recreate historical metallurgical processes. SLAG allows for determining the smelting temperature, the viscosity of the metallurgical melt, and the oxygen and sulfur fugacities during smelting. With software, both liquidus temperature and melt viscosity can be calculated using different models, covering the range of chemical compositions of historical slags as wide as possible. Based on thermodynamic calculations, SLAG allows the performance of O2 and S2 fugacity calculations in the temperature range of 1000–2000 K (727–1727°C). The range of applicability of other properties (viscosity and liquidus temperature) depends only on the limitations of individual models. Using SLAG, it is also possible to create predominance area diagrams (PADs) and diagrams that consider the viscosity's dependence on temperature for slag of a given chemical composition. Based on glass transition temperature (Tg) and melt fragility, it is also possible to reconstruct the conditions that prevailed during the various stages of historical glass manufacturing processes.
The modified R.E.N.A.L. nephrometry score comprising longitudinal tumor localization is better for predicting intraoperative collecting system entry during robot‐assisted partial nephrectomy
Authors: Kobayashi Keita , Ban Yoshimasa , Hiroyoshi Toshiya , Isoyama Naohito , Shiraishi Koji
Published: January 2024

Introduction

During robot‐assisted partial nephrectomy (RAPN) for small renal tumors, intraoperative collecting system entry (CSE) is a factor that defines the surgical complexity (prolonged inhibition time), complications (postoperative urinary leakage), and requirements for intraoperative ureteral catheter insertion.

Methods

From October 2018 to March 2023, 113 consecutive patients who underwent RAPN for clinical T1‐stage renal tumors were included in this single‐center retrospective validation study. Patient and tumor characteristics associated with intraoperative CSE were analyzed to validate the modified R.E.N.A.L. nephrometry score (RNS).

Results

Intraoperative CSE was observed in 54 patients (48%). During the univariate analysis, upper pole tumor location, tumor size, renal sinus invasion, and urinary tract proximity were significant predictors of intraoperative CSE. Subsequent multivariate analysis identified upper pole tumor location (upper vs. lower: odds ratio [OR], 5.36; p = .014) and nearness of the tumor to the collecting system or sinus (>4 but <7 mm vs. ≥7 mm: OR, 4.17; p = .04; ≤4 mm vs. ≥7 mm: OR, 32.71; p < .001) as independent predictors of intraoperative CSE.

Conclusion

The modified RNS, which includes longitudinal tumor localization as a variable instead of polar line‐based tumor location, may be a better risk classification tool than the conventional RNS (area under the receiver‐operating characteristic curve: 0.816 vs. 0.754) for determining the need for intraoperative ureteral catheter insertion and predicting intraoperative CSE and surgical complexity.
The key components of a clinical psychology formulation: A consensus study
Authors: Thrower Naomi E. , Bucci Sandra , Morris Lydia , Berry Katherine
Published: January 2024

Objective

Psychological formulation is a key competency for clinical psychologists. However, there is a lack of consensus regarding the key components and processes of formulation that are hypothesized to contribute to poor reliability of formulations. The aim of this study was to develop consensus on the essential components of a formulation to inform training for clinical psychologists and best practice guidelines.

Methods

A Delphi methodology was used. Items were generated from the literature and discussed and refined with a panel of experts (n = 10). In round one, 110 clinical psychologists in the United Kingdom rated the importance of components of formulation via an online questionnaire. Criteria for consensus were applied and statements were rerated in round two if consensus was not achieved.

Results

Consensus was achieved on 30 items, with 18 statements regarding components of a formulation and 12 statements regarding formulation process. Items that clinicians agreed upon emphasized the importance of integrating sociocultural, biological, strengths and personal meaning alongside well‐established theoretical frameworks. Consensus was not reached on 20 items, including whether a formulation should be parsimonious or adhere to a model.

Conclusion

Our findings provide mixed evidence regarding consensus on the key components of formulation. There was an agreement that formulation should be client‐led and incorporate strengths and sociocultural factors. Further research should explore client perspectives on the key components of formulation and how these compare to the clinicians' perspectives.
Image intensifier‐guided transperineal prostate biopsy for patients without a rectum: novel technique
Authors: McNicholas Daniel P. , Parr Nigel J.
Published: January 2024

Introduction

It is challenging to perform prostate biopsy in men with suspicion of prostate malignancy without a rectum to facilitate prostate biopsy. Nevertheless, such patients are presenting at an earlier stage, due to increased PSA testing in association with improved MRI imaging. We describe a novel technique for prostate biopsy in two such cases.

Technique

The patient is under General Anaesthesia and in lithotomy position. The patient is catheterised and a measured volume of contrast is inserted to the catheter balloon. By using anatomical surface landmarks, placing traction on the catheter to bring the balloon to the level of the bladder neck and using fluoroscopy, the distance to the apical prostate was estimated. This facilitates image intensifier guided trans‐perineal prostate biopsy.

Outcomes

A 67‐year‐old patient, with a history of panproctocolectomy for ulcerative colitis, presented with increasing PSA and a suspicious prostate on MP‐MRI. The prostate couldn’t be visualised on transperineal ultrasound and the patient was offered transperineal biopsy using image intensifier guidance. Several biopsy cores were taken and prostate cancer was diagnosed. The second patient was a 68‐year‐old who presented similarly, but with a history of panproctocolectomy for Crohn's disease. Using the above technique, biopsies were taken with low‐risk prostate cancer diagnosed. Subsequently, due to rising PSA levels, a repeat set of prostate biopsies was taken 13 months later in an identical manner, upstaging his disease. There were no post‐operative complications after any of the procedures.

Conclusion

We review the literature and discuss several techniques available to sample the prostate in this patient cohort. We conclude that we have identified a safe and effective technique, which utilises commonly available equipment, to biopsy the prostate in the post proctectomy patient.
What do we know about sex education of people with intellectual disabilities? An umbrella review
Authors: Pérez‐Curiel Patricia , Vicente Eva , Morán Mª Lucía , Gómez Laura E.
Published: January 2024

Background

Special attention is required when considering any educational intervention aimed at its promotion and development. Our objective is to conduct an umbrella review of systematic reviews that gather evidence from relationships and sex education programmes tailored for individuals with intellectual disabilities.

Methods

The protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐analyses Protocol. Systematic reviews were identified through a search in Web of Science, SCOPUS and PsychINFO, using the descriptors: ‘intellectual disab*’ AND ‘sex*’AND ‘systematic’.

Findings

The results of the nine reviews included in the meta‐review yield relevant outcomes related to 50 sex education interventions carried out with people with intellectual disabilities. This provided the opportunity to delve into the characteristics of these interventions to ascertain the accomplishments achieved to date.

Conclusions

The findings serve as foundation to propose and promote new research on this important area of life, addressing the inequalities identified concerning the sexuality and affective‐sexual education of people with intellectual disabilities. It offers valuable information for the educational, social and healthcare fields, facilitating the design of more effective and rights‐respecting initiatives.
Triggers, clinical manifestations and assessment of paediatric fixed drug eruptions: A systematic review of the literature
Authors: Mathieu Audrey , de Grandmont Mathilde , Fernandes Carolina Lucena , Kechichian Elio
Published: January 2024

Fixed drug eruption (FDE) is a cutaneous drug reaction characterised by recurrent skin lesions occurring at the same site after each exposure to a causative agent. There is currently limited evidence in the paediatric population. The objective of this systematic review is to investigate the clinical features, causative agents and management of paediatric FDE. A systematic search of the English and French literature on paediatric FDE was conducted using the Medline and Embase databases. After full‐text article review, 92 articles were included, representing a total of 233 patients. Antibiotics were the most frequent triggering agents, mainly sulfonamides (65.0% of antibiotics). Systemic symptoms were rare, and most patients only received supportive therapy. One hundred and six patients (106) performed a test to confirm the causative agent. Of these, 72.6% had oral provocation tests (OPTs) and 28.3% had patch tests. The patient's age, presence of bullous lesions and mucosal lesions were similar between tested and untested patients. It did not seem to influence the decision to perform OPTs. Paediatric FDE is a non‐severe skin drug reaction. Antibiotics were the most reported triggering agents. Drug testing, including oral provocation test, was safely performed in the paediatric population.
Liver, renal, genitourinary and diabetic ketoacidosis risks among new users of empagliflozin versus dipeptidyl peptidase‐4 inhibitors in patients with type 2 diabetes: Post‐authorization safety study based on multinational cohorts
Authors: Rebordosa Cristina , Thomsen Reimar W. , Tave Arlene K. , Madsen Morten , Beachler Daniel C. , Martinez David , Garcia‐Esteban Raquel , Plana Estel , Tormos Anita , Farsani Soulmaz Fazeli , Perez‐Gutthann Susana , Pladevall‐Vila Manel
Published: January 2024

Aim

To estimate risks of diabetic ketoacidosis (DKA), acute liver injury (ALI), acute kidney injury (AKI), chronic kidney disease (CKD), severe complications of urinary tract infection (UTI) and genital infection (GI) among patients with type 2 diabetes initiating empagliflozin versus those initiating a dipeptidyl peptidase‐4 (DPP‐4) inhibitor.

Materials and Methods

In this large multinational, observational, new‐user cohort study in UK, Danish and US healthcare data sources, patients initiated empagliflozin or a DPP‐4 inhibitor between August 2014 and August 2019, were aged ≥18 years, and had ≥12 months' continuous health plan enrolment. Incidence rates by exposure and incidence rate ratios, adjusted for propensity‐score deciles, were calculated.

Results

In total, 64 599 empagliflozin initiators and 203 315 DPP‐4 inhibitor initiators were included. There was an increased risk [pooled adjusted incidence rate ratios (95% confidence interval)] of DKA [2.19 (1.74‐2.76)] and decreased risks of ALI [0.77 (0.50‐1.19) in patients without predisposing conditions of liver disease; 0.70 (0.56‐0.88) in all patients] and AKI [0.54 (0.41‐0.73)]. In the UK data, there was an increased risk of GI [males: 4.04 (3.46‐4.71); females: 3.24 (2.81‐3.74)] and decreased risks of CKD [0.53 (0.43‐0.65)] and severe complications of UTI [0.51 (0.37‐0.72)]. The results were generally consistent in subgroup and sensitivity analyses.

Conclusions

Compared with DDP‐4 inhibitor use, empagliflozin use was associated with increased risks of DKA and GI and decreased risks of ALI, AKI, CKD and severe complications of UTI. These associations are consistent with previous studies and known class effects of sodium‐glucose cotransporter 2 inhibitors, including renoprotective effects and beneficial effects on alanine aminotransferase levels.
Two years with GIOIA ‘Effects of gliflozins and gliptins on markers of cardiovascular damage in type 2 diabetes’: A prospective, multicentre, quasi‐experimental study on sodium‐glucose cotransporter 2 and dipeptidyl peptidase‐4 inhibitors in diabetes clinical practice
Authors: Longo Miriam , Caruso Paola , Scappaticcio Lorenzo , Maiorino Maria Ida , Bellastella Giuseppe , Capuano Annalisa , Esposito Katherine , Giugliano Dario
Published: January 2024

Aim

To assess and compare the metabolic and vascular effectiveness of sodium‐glucose cotransporter 2 inhibitors (SGLT‐2i) and dipeptidyl peptidase‐4 inhibitors (DPP‐4i) in the clinical practice of patients with type 2 diabetes in Italy.

Materials and Methods

GIOIA is a 2‐year prospective, multicentre, quasi‐experimental study that enrolled patients with type 2 diabetes initiating SGLT‐2i or DPP‐4i for inadequate glycaemic control [glycated haemoglobin (HbA1c) >7%] between March 2018 and March 2021. The primary endpoints were changes in markers of organ damage [carotid intima‐media thickness (CIMT), albuminuria, myocardial function] and HbA1c from baseline to year 2.

Results

In total, 1150 patients were enrolled in the study (SGLT‐2i n = 580, DPP‐4i n = 570). Patients initiated on SGLT‐2i were younger (about 6 years) and heavier (about 11 kg), had higher HbA1c level (1% more), more albuminuria and cardiovascular events (16% more) than patients initiated on DPP‐4i. CIMT and echocardiographic parameters were not significantly different. Propensity score matching yielded two groups, each consisting of 155 patients with diabetes with similar baseline characteristics. Despite a significant similar reduction in HbA1c levels in both groups (−0.8%), more patients on SGLT‐2i had regression of CIMT and albuminuria (22% and 10%, respectively, p < .001 vs. DPP‐4i); more patients on DPP‐4i had progression of CIMT and albuminuria (23% and 28%, respectively, p < .001 vs. SGLT‐2i). Left ventricular ejection fraction improved slightly (3%, p = .043) on SGLT‐2i only.

Conclusions

In a real‐world setting, both SGLT‐2i and DPP‐4i improve glycaemic control persisting after 2 years of treatment, with a robust effect on both CIMT and albuminuria regression for SGLT‐2i as compared with DPP‐4i in the propensity score matching.
Afromontane understory birds increase in body size over four decades
Authors: Neate‐Clegg Montague H. C. , Tingley Morgan W. , Newmark William D.
Published: January 2024

Of the myriad responses to climate change, an emerging trend is the widespread decrease in animal body size with warming temperatures. Birds, in particular, have been shown to be decreasing in body size in several areas – most notably the Amazon Basin and temperate North America – but trends in much of the world remain unexplored. Here, we analyze temporal trends and climatic associations of body mass for 42 resident bird species over 36 years in the Usambara Mountains of Tanzania, a tropical montane global biodiversity hotspot. In addition, we assess trends in wing length and mass:wing ratio over 21 years. Finally, we examine whether species‐specific trends in body mass are related to average body size or to trends in apparent survival. Overall, species' average body mass in the Usambara Mountains increased by 0.023 g decade‐1, amounting to increases of 4.1% over 36 years. These long‐term shifts in body mass were strongly and positively associated with annual mean temperature but showed no relationship with precipitation. Wing length increased on average by 2.0% over a 21‐year period, yet there was mixed evidence for trends in mass:wing ratio, suggesting that body size in general is increasing. While percentage trends in body mass were not related to trends in apparent annual survival, smaller species did display greater proportional increases in body mass. Although the drivers of increased body size remain unclear – and climate change cannot be ruled out – such increases among Afrotropical montane birds provide an intriguing counterpoint to observed declines in body mass elsewhere and suggest that trends in body mass in tropical birds may be mediated by biogeography or other abiotic or biotic drivers.
Knowledge of emergency dental management among a localized sample of athletic trainers
Authors: Wenger K. , Williamson A. , McNally M. , Dutta E.
Published: January 2024

Background/Aims

Athletic trainers are often the point person when sports‐related traumatic dental injuries (TDIs) occur. The aim of this study was to assess knowledge levels of the management of TDIs among athletic trainers in the Midwest United States, as well as evaluate variables that may influence knowledge levels.

Material and Methods

A survey was sent to athletic trainers licensed in Minnesota, Nebraska, and Iowa. The survey included 28 multiple‐choice and fill in the blank questions split into three sections. The three sections included background, emergency management of TDIs, and opinion questions.

Results

Of the participants, 100% recalled receiving medical first aid training. However, only 71% recalled receiving formal training on emergency management of dental injuries. Although 75% were confident in managing a dental injury, over 63% of participants scored less than 70% in the knowledge score section. Majority of the participants (98.4%) reported that they believe training on the management of TDIs is important. Athletic trainers working with contact sports were more likely to have experienced managing TDIs more recently than those working in noncontact sports.

Conclusions

This study shows the gaps in knowledge among athletic trainers pertaining to management of TDIs and emphasizes the importance of sports community having adequate education on emergency management of such dental injuries.
Short‐latency afferent inhibition is reduced in people with multiple sclerosis during fatiguing muscle contractions
Authors: Brotherton Emily J. , Sabapathy Surendran , Dempsey Lisa M. , Kavanagh Justin J.
Published: January 2024

Understanding how inhibitory pathways influence motor cortical activity during fatiguing contractions may provide valuable insight into mechanisms associated with multiple sclerosis (MS) muscle activation. Short‐latency afferent inhibition (SAI) reflects inhibitory interactions between the somatosensory cortex and the motor cortex, and although SAI is typically reduced with MS, it is unknown how SAI is regulated during exercise‐induced fatigue. The current study examined how SAI modulates motor evoked potentials (MEPs) during fatiguing contractions. Fourteen people with relapsing–remitting MS (39 ± 6 years, nine female) and 10 healthy individuals (36 ± 6 years, six female) participated. SAI was induced by stimulation of the median nerve that was paired with TMS over the motor representation of the abductor pollicis brevis. A contraction protocol was employed that depressed force generating capacity using a sustained 3‐min 15% MVC, immediately followed by a low‐intensity (15% MVC) intermittent contraction protocol so that MEP and SAI could be measured during the rest phases of each duty cycle. Similar force, electromyography and MEP responses were observed between groups. However, the MS group had significantly reduced SAI during the contraction protocol compared to the healthy control group (p < .001). Despite the MS group reporting greater scores on the Fatigue Severity Scale and Modified Fatigue Impact Scale, these scales did not correlate with inhibitory measures. As there were no between‐group differences in SSEPs, MS‐related SAI differences during the fatiguing contractions were most likely associated with disease‐related changes in central integration.
The alleged preaching ban in southern Gaul, 431–529: a reassessment of the arguments and evidence
Authors: Lovell Michael A.
Published: January 2024

For over one hundred years, scholars have argued that there was a ban on presbyterial preaching in southern Gaul throughout the fifth century. This ban was purportedly lifted at the Council of Vaison (529) at the behest of Caesarius of Arles in order to preach the gospel in the countryside. While scholars have called the effectiveness of the ban into question, this article makes a stronger critique, arguing that there was neither a ban nor a unified local preaching tradition. It further suggests that presbyterial preaching was a critical and highly regulated component of the church’s power in fifth‐century Gaul.
Risk factors for severe hearing loss in Susac syndrome: A national cohort study
Authors: Peyre Marion , Mageau Arthur , Henry Feugeas Marie‐Cécile , Doan Serge , Halimi Caroline , Klein Isabelle , Goulenok Tiphaine , François Chrystelle , Chauveheid Marie‐Paule , Papo Thomas , Sacré Karim ,   the French Susac Study Group
Published: January 2024

Background

Nonreversible hearing loss (HL) is the main sequelae of Susac syndrome (SuS). We aimed to identify risk factors for HL in SuS.

Methods

The CARESS study is a prospective national cohort study that started in December 2011, including all consecutive patients with SuS referred to the French reference center. The CARESS study was designed with a follow‐up including fundoscopy, audiometry, and brain magnetic resonance imaging at 1, 3, 6, and 12 months after diagnosis and then annually for 5 years. The primary outcome was the occurrence at last follow‐up of severe HL defined as the loss of 70 dB in at least one ear on audiometry or the need for hearing aids.

Results

Thirty‐six patients (female 66.7%, median age 37.5 [range 24.5–42.5] years) included in the clinical study were analyzed for the primary outcome. Thirty‐three patients (91.7%) had cochleovestibular involvement at SuS diagnosis including HL >20 dB in at least one ear in 25 cases. At diagnosis, 32 (88.9%), 11 (30.6%), and 7 (19.4%) patients had received steroids, intravenous immunoglobulin, and/or immunosuppressive (IS) drugs, respectively. After a median follow‐up of 51.8 [range 29.2–77.6] months, 19 patients (52.8%) experienced severe HL that occurred a median of 13 [range 1.5–29.5] months after diagnosis. Multivariable analysis showed that the odds of severe HL were lower in patients who received IS drugs at diagnosis (OR 0.15, 95% CI 0.01–1.07, p = 0.058).

Conclusions

Severe HL in SuS is associated with the absence of IS drugs given at diagnosis. Our findings support the systematic use of IS drugs in SuS.
The future of gender research in small‐scale fisheries: Priorities and pathways for advancing gender equity
Authors: Rice Emma D. , Gondwe Edith , Bennett Abigail E. , Okanga Patrick Asango , Osho‐Abdulgafar Nimah F. , Fakoya Kafayat , Oloko Ayodele , Harper Sarah , Kawaye Patrick Chimseu , Chuku Ernest O. , Smith Hillary
Published: January 2024

This paper presents an agenda for the future of gender research in small‐scale fisheries (SSF). Building on expert insight from scholars who gathered during the 4th World Small‐Scale Fisheries Congress Africa (4WSFC) with a synthesis of existing literature, we identify six topics that warrant future investigation in SSF, along with methodological considerations for addressing them. Research priorities include identifying pathways towards (1) equitable participation in governance and decision‐making, (2) valuing all actors' contributions to aquatic food systems, (3) increasing access to financial services, (4) inclusive infrastructural development, (5) livelihood diversification and (6) reducing occupational health hazards. Several important methodological considerations include (i) using multiple methodologies, (ii) applying participatory methods, (iii) collecting gender‐disaggregated data, (iv) integrating gender into a food systems approach in fisheries, (v) engaging an intersectional approach and (vi) operationalising equity.
Desire discrepancy in long‐term relationships: A qualitative study with diverse couples
Authors: Arenella Katherine , Girard Abby , Connor Jennifer
Published: January 2024

Sexual desire discrepancy is one of the most common, and potentially distressing, aspects of couples' sexual health. There are gaps in the literature exploring desire discrepancy specifically in distressed couples, as well as in queer (sexual and/or gender minority) couples. This study sought to gather qualitative data regarding long‐term couples' experiences with distressing desire discrepancy. Semi‐structured interviews were conducted with both heterosexual and queer partners of varying gender identities (n = 26) to fill these research gaps. Interviews included couple interviews, as well as individual interviews with partners. Data analysis was conducted with thematic analysis, which yielded four primary themes across the course of relationships: Sexual and relationship satisfaction; Changes in sexual frequency, desire, and behavior; Changes in barriers to sex; and Coping with desire discrepancy. Findings can inform clinical interventions focused on desire discrepancy, as well as future research investigating couple's sexual health.