bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Condition Indices of Redheads From Different Wintering Areas
Authors: Skoruppa Mary Kay , Woodin Marc C. , Michot Thomas C.
Published: June 2024

Redheads Aythya americana concentrate annually in traditional wintering areas along the Gulf of Mexico coast from Florida to Tamaulipas, Mexico. We collected 399 redheads during two winters (1988–1989 and 1989–1990) from four traditional wintering areas in the United States: Chandeleur Sound (Louisiana), Redfish Bay (Texas), upper Laguna Madre–Baffin Bay (Texas), and lower Laguna Madre (Texas). Salinity, water depth, and human disturbance differed among these locations. We used metrics of ingesta-free body mass, whole skin mass, flight muscle (breast muscle) mass, and leg muscle mass, all corrected for body size, as indices to compare body condition of birds among the four wintering areas. Ingesta-free body mass and whole skin mass were greatest in the Louisiana and Redfish Bay birds, whereas flight muscle mass was greatest in birds from the upper Laguna Madre–Baffin Bay location. Leg muscle mass was greatest in birds wintering in Louisiana. Mean leg muscle mass was the only measure that did not increase significantly over the winter in any location, and leg muscle mass decreased in birds from two locations (upper Laguna Madre–Baffin Bay and lower Laguna Madre). None of the body condition indices increased over winter for birds from the upper Laguna Madre–Baffin Bay. Our findings demonstrate that redhead body condition indices, and hence nutrient reserves, vary among population segments from different bay and lagoonal systems on the Gulf of Mexico winter range. Consequently, site-specific environmental conditions may affect physical condition and fitness of wintering birds. Specifically, hypersaline conditions, combined with boating disturbance, through their influence on energetic costs from flying, swimming, and osmotic regulation, may explain differences in redhead body condition indices during winter. Failure to consider these factors during development of harvest regulations could be consequential for waterfowl population management.
Effect of Herbivory on the Nutritional Value of Six Hardwood Species for White-Tailed Deer in the Allegheny Forest
Authors: Glover Laurel M. , Volponi Sabrina N. , Royo Alejandro A. , Johnstone-Yellin Tamara L.
Published: June 2024

Herbivores alter plant quantity and quality through direct tissue consumption and indirectly via the structural and chemical allocational strategies plants deploy in response to herbivory. Herein, we examine how browsing by white-tailed deer Odocoileus virginianus alters nutritional quality of six regenerating hardwood species: red maple Acer rubrum, black cherry Prunus serotina, birch Betula spp., pin cherry Prunus pennsylvanica, white ash Fraxinus americana, and American beech Fagus grandifolia. Using an established, large-scale experiment that manipulated deer access to fenced plots, we tested whether browsing altered the nutritional quality and biomass as well as nutritional capacity to support deer of six hardwood species in an early successional hardwood forest of Pennsylvania, USA. Pin cherry was the most nutritious of the six species, with greater dry matter digestibility and digestible protein and lesser neutral detergent fiber. Areas exposed to browsing had less browse biomass of stems and leaves yet greater digestible protein, an effect driven by digestible protein of pin cherry. We found no effect of browsing on neutral detergent fiber or dry matter digestibility. Although deer browsing reduced biomass of the six hardwood species, it did not alter the nutritional capacity to support lactating females in the summer. Our results confirm that browsing limits tree regeneration and available browse and provides conservative conclusions on how deer can alter their diet quality.
Les élevages dans les espaces ouverts métropolitains à Beyrouth
Authors: Lteif Carine
Published: June 2024

L’article examine l’informalité des élevages urbains à Beyrouth à partir d’une enquête de terrain et d’entretiens. Les résultats montrent que l’élevage urbain est permis sous conditions, mais est en réalité encadré par des rapports de pouvoir entre acteurs. Il se maintient sur des parcelles en attente de développement immobilier ou dans des zones industrielles, suivant une distribution dans l’espace qui reproduit la répartition confessionnelle de la population. Il se maintient aussi sur les parcelles waqf abritant des couvents de religieux chrétiens. L’élevage de ruminants, prépondérant par le passé, cède aujourd’hui la place à de nouvelles formes : de plus petits élevages de chiens, d’abeilles, mais surtout de volailles, chez soi.
Innovation dans les services et dynamiques coopétitives : le cas de la distribution d’assurance
Authors: Allam-Firley Débora
Published: June 2024

La coopétition est une dynamique complexe dans laquelle des entreprises concurrentes coopèrent pour atteindre un objectif commun. Les relations entre ces organisations ne sont pas linéaires, et ont un impact sur leurs différentes activités et processus, en particulier l'innovation. En mobilisant les champs théoriques de l'innovation dans les services et de la coopétition, cette étude de cas unique, basée sur une participation observante de deux ans et des entretiens semi-directifs, souligne les difficultés soulevées par cette coopétition informelle. Nos résultats permettent de caractériser les espaces de coopération et de compétition entre l'agent général et la compagnie d'assurance. Ils soulignent également un impact sur les processus et les livrables des projets d'innovation, qui ne permet pas aux acteurs de tirer tous les bénéfices de la coopétition. Ainsi, les formes d'innovation de services constituant un avantage concurrentiel exacerbent les comportements compétitifs, tandis que les formes d'innovation organisationnelles bénéficient de comportements coopératifs. La mise en évidence de ces spécificités contribue à une meilleure compréhension des dynamiques coopétitives entre acteurs dans l'innovation dans les services, et souligne la nécessité de les formaliser dans un secteur en pleine transformation où l'innovation répond à de forts enjeux.
Media, technologies de l’intellect, code numérique. De quelques implications du medium sur le social chez Innis, Goody et Herrenschmidt
Authors: KANE Oumar
Published: June 2024

Cet article établit un dialogue entre l’œuvre de Jack Goody et celles de Harold Innis et Clarisse Herrenschmidt. Les concepts de modes de communication et de technologies de l’intellect élaborés par Goody sont d’abord confrontés aux développements consacrés aux media par Innis. Les catégories de savoir et de pouvoir sont analysées chez les deux auteurs à travers l’accent mis sur la culture lettrée par Goody et sur les monopoles du savoir par Innis. Les conséquences qui en sont tirées relativement à la production du social et aux processus cognitifs montrent tant des convergences que des différences, qui sont passées en revue. L’apport de Goody est ensuite passé au crible des travaux plus récents de Herrenschmidt qui, en pluralisant l’écriture (il est question des écritures) et en l’historicisant, fait émerger la question du code qui est au cœur de l’écriture informatique. Ce dialogue à trois par le biais de la figure médiatrice de Goody permet d’éclairer de manière originale les rapports entre media et société.
Proposition d’une définition et d’une typologie de l’interactivité dans un système avec une interface
Authors: T’KINT Alice
Published: June 2024

L’interactivité est un concept largement discuté dans les sciences de l’information et de la communication sans que sa signification n’ait jamais été stabilisée. Devant le foisonnement des conceptualisations et la dispersion des définitions, nous émettons une nouvelle contribution qui vise à offrir une compréhension générale de l’interactivité. Dans cette publication, nous construisons notre propos autour de trois approches, qu’elles soient définitoires, dichotomiques et typologiques, qui se dégagent de la littérature scientifique, et nous élaborons une réflexion qui débouche sur trois contributions complémentaires : une définition de l’interactivité valable pour les systèmes avec une interface utilisateur; une théorisation de la relation entre l’utilisateur et le concepteur dans un contrat d’interaction; et enfin, une classification des niveaux où s’exécute l’interactivité dans un système informatique.
Le vlogue engagé comme pratique sociale : essai de conceptualisation
Authors: CARON Caroline , LANDRY Normand
Published: June 2024

Le vlogue engagé est un genre médiatique audiovisuel numérique où un usager de la plateforme YouTube s’adresse à la caméra pour s’exprimer, informer ou sensibiliser le public à propos de causes sociales. Malgré sa popularité, il demeure à la marge de l’étude empirique des formes émergentes de « parler en public » médiatisées par la technologie. Pour faciliter la réalisation de travaux sur cet objet de recherche complexe, l’article présente une conceptualisation opératoire du vlogue engagé qui prend pour cadrage général le courant théorique de la pratique (practice theory). Conceptualisé comme une pratique discursive civique, le vlogue engagé fait appel à l’assemblage de trois éléments constitutifs : des matériaux, des compétences et du sens. Ceux-ci s’imbriquent dans une performance technodiscursive qui coordonne quatre actes de communication : une communication publique personnelle, une expression verbale augmentée, une production médiatique multimodale et une présentation de soi.
Planifier le désordre, se préparer à l’imprévisible
Authors: Dubey Gérard
Published: June 2024

Le bloc opératoire, parce qu’on y procède à l’ouverture du corps, exerce sur le commun des mortels un pouvoir d’attraction où se mêlent fascination et répulsion. Rares sont les espaces de travail qui peuvent se targuer d’une telle aura. En anthropologie, les techniques mises en œuvre par les chirurgiens sont le plus souvent rapportées à des pratiques symboliques (rites propitiatoires) destinées à protéger les « officiants » de la proximité d’un danger qui n’est autre que la figure sécularisée du sacré. Toutefois, en chirurgie, la fonction symbolique n’est jamais décorrélée d’un savoir expérientiel acquis sur le temps long. L’article rend compte de ce travail de préparation de l’action en amont de l’intervention au bloc. Pour ce faire, il s’appuie sur les premiers résultats d’une enquête empirique commencée il y a deux ans dans le cadre de la chaire d’innovation de l’APHP-BOPA (Bloc Opératoire Augmenté au CHB Brousse-Villejuif). La principale hypothèse discutée dans cet article est la dimension structurante de l’incertitude dans l’activité préopératoire.
Activité productive et activité cognitive
Authors: Cornu Roger
Published: June 2024

Dans cet article, Roger Cornu évoque ses rencontres à la fois amicales, professionnelles et intellectuelles avec Jean-Pierre Poitou. Il mélange ses souvenirs personnels avec les débats qui eurent lieu durant plus de soixante ans au sein des sciences sociales en soulignant l’importance des engagements politiques et militants mais aussi la volonté de fonder une démarche théorique rigoureuse. Il montre les multiples rapprochements entre des auteurs anthropologues, psychologues et sociologues lorsqu’il s’agit de comprendre le travail, qu’il soit manuel ou intellectuel, dans des bureaux d’études, dans des usines ou des chantiers navals. En s’attachant à comprendre et à restituer la pratique observée sur le terrain, le sociologue nous donne des clés du cheminement théorique qui a permis d’aboutir à la conception de l’anthropologie des connaissances de Jean-Pierre Poitou.
Les expositions de cinéma en Suisse entre 1943 et 1973. Légitimer une cinématographie nationale
Authors: Isoz Natacha
Published: June 2024

Situé à la croisée de l’histoire des expositions et de l’histoire du cinéma, cet article interroge la manière dont cette dernière fut élaborée (analyse des modalités d’écriture) et véhiculée (étude des dispositifs scénographiques) au sein de trois grandes expositions consacrées à l’histoire générale du cinéma, qui eurent lieu en Suisse : Der Film gestern und heute (Musée des arts et métiers de Bâle, 1943), Der Film. Geschichte, Technik, Gestaltungsmittel, Bedeutung (Musée des arts appliqués de Zurich, 1960) et Images du cinéma (Musée des arts décoratifs de Lausanne, 1973). Alors que l’on ne cesse de répéter – entre les années 1920 et les premiers succès du « nouveau cinéma suisse » au début des années 1970 – que le cinéma suisse n’existe pas, à savoir qu’aucun film de fiction de valeur n’aurait été produit dans le pays, ces trois manifestations intègrent des films et des expôts helvétiques dans leur programmation. Elles contribuent dès lors, chacune à sa manière, à écrire une histoire plurielle de cette cinématographie, qui élargit progressivement les frontières usuelles de la notion de « cinéma national ». Elles participent, en outre, à la lente légitimation et patrimonialisation du cinéma suisse. Cet article, qui se fonde sur l’analyse d’archives inédites, met pour la première fois en lumière ces trois événements d’importance historique.
Deriva social: a conservação do nicho coontogênico no espaço relacional da linguagem
Authors: Vianna Beto
Published: June 2024

Deriva natural é o caminho explicativo proposto pelos biólogos chilenos Humberto Maturana e Jorge Mpodozis para o fenômeno evolutivo, em que o comportamento, ou seja, a dinâmica de encontros organismo-meio, e, não, algum fator externo, ou molécula-mestra, guia a história de mudanças e conservação em uma linhagem. Do mesmo modo, processos coontogênicos em vários níveis, das associações simbióticas até a formação de sistemas sociais, intra e multiespécies, dependem, a cada momento, da conservação de um espaço relacional através da conduta dos organismos envolvidos, fenômeno que chamo de deriva social. Embora reconhecendo os argumentos do excepcionalismo humano na linguagem, proponho, a partir da observação de sistemas sociais multiespécies, que muitos desses sistemas se realizam como nichos coontogênicos em um domínio linguístico, que dura enquanto cada organismo coordenar consensualmente suas ações com outro ou outros organismos (humanos ou não), mudando ou conservando suas disposições de ação (suas emoções) de modo coerente com essa história de interações.
Editorial
Authors: Sita Patricia Coradim
Published: June 2024

É com grande satisfação que apresentamos aos leitores o número 1 do volume 46 da Revista Acta Scientiarum. Human and Social Sciences. Neste volume, contamos com a valorosa colaboração de dois pesquisadores responsáveis por conceber e organizar a edição, integralmente dedicada ao estudo da relação entre seres humanos e outros seres vivos, Eliane Sebeika Rapchan (UEM, Brasil/UC, Portugal) e Fagner Carniel (UEM, Brasil). Esta edição é composta por um total de 9 artigos, precedidos pelo artigo prefácio escrito pelos editores convidados que apresentam a questão central e também os artigos selecionados.
Gostaria de dedicar um agradecimento especial à Eliane Sebeika Rapchan e ao Fagner Carniel pelo excelente trabalho realizado desde o lançamento da proposta até o fechamento da edição.  Agradeço também aos autores e avaliadores que contribuíram com este volume. Boa leitura!
O sistema da transitividade no vocabulário acadêmico de artigos científicos em Português Brasileiro
Authors: Miranda Monique Vieira , Oliveira Ana Larissa Adorno Marciotto
Published: June 2024

O presente artigo se propôs a analisar o sistema da transitividade instanciado pelos verbos acadêmicos mais frequentes em artigos científicos do português brasileiro, baseando-se na proposta de divisão do vocabulário de Webb e Nation (2017) e na Linguística Sistêmico-Funcional (Halliday & Matthiessen, 2014). Para atingir tal propósito, compilou-se um corpus de 12,3 milhões de palavras, contendo artigos científicos de todas as oito Grandes Áreas do conhecimento do CNPq, representativos das diferentes Áreas de Avaliação, de modo a haver variedade de amostras linguísticas suficientes para identificar os lemas verbais acadêmicos. A partir desses resultados preliminares, seguiu-se a análise desses itens sob a perspectiva da Linguística Sistêmico-Funcional. Nessa análise, observou-se que as escolhas dos tipos de processos, associados à configuração da sentença e aos tipos de participantes integrantes, refletem diretamente as características do gênero acadêmico, especificamente a escrita de artigos científicos, principalmente quanto à redação impessoal, ao maior foco nas atividades e nos procedimentos de pesquisa e à objetividade ao reportar análises e resultados. Desse modo, por meio da descrição do sistema da transitividade em verbos acadêmicos frequentes, esperou-se contribuir para uma compreensão mais aprofundada sobre a escrita acadêmica, além de avançar estudos teóricos sob diferentes perspectivas de análise com base em amostras reais da língua em uso.
‘No lo harás en vano’: la lucha, el (des)exilio y la poesía combativa de Mario Benedetti en los tiempos de dictadura
Authors: Franceschini Marcele Aires
Published: June 2024

Durante el período militar en el Uruguay, Mario Benedetti sufrió las consecuencias del régimen violador de las libertades individuales y colectivas. En ese tiempo, en las décadas de 1960, 1970 y 1980, el poeta creó una gran diversidad de temas en su producción, llevando el lector a descubrir, por medio de la literatura, como se estableció el proceso de represión en su país. Para tanto, se eligieron tres fases del poeta, comprendidas en el libro Inventario Uno (1948-1984), a saber: 1) la poesía combativa anterior al exilio, con Contra los puentes levadizos (1965-1966), A ras de sueño (1967), Quemar las naves (1968-1969) y Letras de emergencia (1969-1973); 2) la poesía producida en el exilio, con Poemas de otros (1973-1974), La casa y el ladrillo (1976-1977), Cotidianas (1978-1979) y Viento del exilio (1980-1981); 3) el período conocido como ‘desexilio’, cuñado por el propio poeta, expreso en Geografías (1982-1984). El intento fue mostrar como el yo poético vivenció cada una de las experiencias que movieron su escrita. Para tanto, se ha empleado como teoría las divisiones destacadas por el escritor argentino Pedro Orgambide en la Antología poética de Benedetti (1994); así como distintas biografías. En lo que toca a los apuntes sobre la represión en Uruguay, léanse Caetano y Rilla (1987), Aldrighi (2001), Schelotto (2015), Ruesta (2020). En cuanto a la temática del exilio, la teoría guía ha sido la demanda de reflexiones por Edward Said (2005), sobre todo por su condición de intelectual y exilado, tal cual Benedetti.
Em terras de nativos amazônicos, nem tudo que brilha é ouro: sedução (utopia) e manipulação (distopia)
Authors: Bertolino Linda Maria de Jesus , Lima Rogério da Silva
Published: June 2024

Apresentamos o universo ficcional do amapaense Fernando Canto, como forma de evidenciar e ampliar, em uma perspectiva cruzada (hibrida) concepções políticas entre utopia e distopia. Para isso, em uma concepção histórica, problematizamos no conto O bálsamo (1995) a representação do nativo e do colonizador, nas terras dos homens de um olho só, recepcionada como a floresta amazônica brasileira. Estabelecendo um parâmetro entre sedução, manipulação e resistência, divide-se o artigo em três momentos. No primeiro, pontua-se uma dialética entre pensamento utópico e distópico, para depois situá-lo dentro da ficção narrativa. No segundo, explora-se os elementos poéticos bálsamo e seda - acolhidos como dispositivos de sedução/manipulação, o que abre possibilidade para explorar as categorias poder, opressão e controle. No último momento, aproxima-se a categoria vida nua ao processo de involução dos nativos, e na sequência anuncia-se que, naquelas terras de nativos amazônicos, dizer não fez florescer uma resistência contra narrativa/antidemocrática dos estranhos vestidos de seda. O diálogo teórico se constitui, sobretudo, a partir do pensamento de Michel Foucault, Giorgio Agamben e Teixeira Coelho.
Lipid microcapsule synthesis from Melaleuca alternifolia (tea tree) hydrolate
Authors: Silva Creir da , Moritz Cristiane Mengue Feniman , Bittencourt Paulo Rodrigo Stival , Picolloto Angela Maria , Pinto Leandro Ferreira , Araújo Paulo Cardozo Carvalho de , Sakai Otávio Akira , Valarini Junior Osvaldo
Published: June 2024

This study aimed to use Melaleuca alternifolia hydrolate to produce and optimize microparticles via three microemulsion processes: simple hot; ultrasonic; and double. Surfactants, including stearic acid, lecithin and Tween 80 were utilized in these processes. Experimental diameters were optimized using a 2² factorial planning of response surfaces. The smallest experimental mean diameters were obtained by R4 simple hot microemulsion with lecithin, R7 simple hot microemulsion with Tween 80, R4 ultrasonic microemulsion with lecithin; R4 ultrasonic microemulsion with Tween 80; and R5 double microemulsion. The latter obtained the smallest mean particle diameter of all experiments (0.65 ± 0.10 μm). All particles formed with Melaleuca alternifolia hydrolate obtained an isoelectric point equal to zero at pH 7. Fourier-transform infrared spectroscopy was used to characterize the best conditions of each technique. In conclusion, our findings suggest that as the system receives more energy, the mean particle diameter tends to decrease.
Implementing a Preoperative Anemia Optimization Protocol for Cardiovascular Surgery Patients: A Quality Improvement Project
Authors: Rittenhouse Ashley , Ostendorf Marilyn , Johns Chanice , Gerdisch Marc
Published: June 2024

Background

Patients with anemia have poorer outcomes following cardiac surgery than do those without anemia. To improve outcomes, the Enhanced Recovery After Surgery cardiac recommendations include optimizing patients’ condition, including treating anemia, before surgery.

Local Problem

Despite implementing Enhanced Recovery After Surgery initiatives, a midwestern cardiothoracic surgery group recognized a care gap in preoperative patients with anemia. No standardized protocol was in use.

Methods

An anemia optimization protocol was developed for perioperative care of patients with anemia. Data from retrospective medical record review were analyzed to determine relationships between protocol use and secondary outcomes. The protocol was created using best evidence and expert consensus. Cardiac surgery and hematology specialists revised the protocol and agreed on a final version. The protocol was integrated into the consultation process for cardiac surgery patients.

Results

During the implementation period, 23 of 55 patients with anemia (42%) received interventions via the anemia optimization protocol. The mean quantity of packed red blood cells transfused perioperatively per patient was 1.9 U in the protocol group and 3.5 U in the nonprotocol group. In the subgroup of patients experiencing postoperative acute kidney injury, the mean increase in creatinine level was 0.65 mg/dL in the protocol group and 1.52 mg/dL in the nonprotocol group. Four patients in the protocol group (17%) and 6 patients in the nonprotocol group (19%) experienced postoperative acute kidney injury.

Conclusion

Preoperative anemia is associated with poorer cardiac surgical outcomes. Incorporating the anemia optimization protocol into practice may mitigate the risk of postoperative complications for patients with anemia. Continued use of the protocol is recommended.
Proceedings of the 69th Congress of the Italian Embryological Group-Italian Society of Development and Cell Biology (GEI-SIBSC) - Naples, 11-14 June 2024
Authors: Committee The Scientific
Published: June 2024

Proceedings of the 69th Congress of the Italian Embryological Group-Italian Society of Development and Cell Biology (GEI-SIBSC) - Naples, 11-14 June 2024
Evaluating the effect of Perfluoropropane assisted pneumatic vitreolysis in cases of symptomatic focal vitreomacular traction
Authors: Elnaggar Osama R. , Ahmed Islam S.H. , Gomaa Amir R. , Elhady Amr M.
Published: June 2024

Purpose

The aim of this study was to evaluate the effect of pneumatic vitreolysis (PVL) in the management of symptomatic focal vitreomacular traction (VMT).

Patients and methods

This prospective non-comparative interventional study was conducted on 21 eyes of 20 patients with isolated focal VMT detected by optical coherence tomography (OCT). All patients were symptomatic complaining of decreased vision and/or metamorphopsia with persistence of VMT for at least 3 months before intervention. All patients received a single intravitreal injection of 0.3 ml pure perfluoropropane (C3F8) and were followed up for 6 months post-injection. During the follow up period, the patients were evaluated regarding the occurrence of release of VMT as detected by OCT, the change in best corrected visual acuity (BCVA), and the change in central macular thickness (CMT) by OCT.

Results

The single intravitreal gas injection of C3F8 resulted in the release of VMT in 16 (76.2%) eyes. The mean BCVA significantly improved from 0.71±0.16 LogMAR (range: 1–0.5) at baseline to 0.38±0.22 LogMAR (range: 1.0–0.2) by the final visit at 6 months postoperatively (P<0.001). In addition, the mean CMT significantly decreased from 461.67±68.60 µm (range: 318–573 µm) at baseline to 331.55±90.27 µm (range: 278–568 µm) at 6 months postoperatively (P<0.001). One patient developed a retinal break and was treated by retinopexy, and one patient developed a full-thickness macular hole that was treated by vitrectomy.

Conclusions

PVL was found to be an effective method for treatment of symptomatic VMT.
Liver
Authors: Yun Ho Jun , Ding Yuchuan
Published: June 2024

Ischemic stroke occurs with disruption of blood perfusion to the brain. Damages from ischemia result in inflammation of the brain cells. Biologics and immunomodulators have been developed to mitigate neuroinflammation after ischemic stroke. Several druggable targets have been identified, including microglia/macrophages, receptors of the complement pathway, inhibition of tumor necrosis factor-ɑ, and others. However, the efficacy of the immunomodulators is in their infant stage largely due to our incomplete understanding of neuroinflammation. Hypothermia has been utilized to alleviate systemic inflammation though its negative effects have been reported. The roles of the liver in systemic inflammation and its association to ischemic stroke are fairly well-known. Local hypothermic induction to the liver may be a desirable treatment option for ischemic stroke while minimizing the systemic side effects of hypothermia. In this mini-review, we briefly summarize the current understanding of the involvement of active inflammatory response in ischemic stroke and the associated organs, particularly the liver.
Noninvasive Diagnostic Approach to a Rare Variant of Takotsubo Syndrome
Authors: D'Angelo Tommaso , Carerj Maria Ludovica , Zito Concetta , Mazziotti Silvio
Published: June 2024

Takotsubo syndrome is found in about 5%–6% of patients presenting with suspected ST-elevation myocardial infarction. Coronary angiography with left ventriculography is currently considered the modality of choice for the diagnosis. However, improvements of noninvasive diagnostic techniques have been allowing for definite assessment of ventricular function and anatomy. In this setting, the combined use of coronary computed tomography angiography and cardiac magnetic resonance may play a pivotal role for a complete noninvasive diagnosis and management of these patients. We present a case of a 52-year-old woman who presented to our department complaining chest pain and showing left ventricular systolic dysfunction, electrocardiography abnormalities, and mild elevation of cardiac-specific serum enzymes.
Medical emergencies and comorbidities in the elderly and very elderly patients in North India
Authors: Poddar Aastha , Selvam Suresh , Saroch Atul , Pannu Ashok Kumar , Mathen Prannoy George , Kumar Mohan , Dhibar Deba Prasad , Sharma Navneet
Published: June 2024

Objective:

Older patients are rapidly increasing in the emergency department in low-middle-income countries and have poor outcomes. The present study aimed to find the spectrum of comorbidities, medical emergencies, and prognosis in geriatric patients and compare the elderly with very elderly patients in North India.

Methodology:

A prospective cohort study was conducted on patients aged ≥60 years admitted at Postgraduate Institute of Medical Education and Research, Chandigarh (India). The elderly and very elderly age was defined as 60–74 years and ≥75 years, respectively.

Results:

Of 935 enrolled patients, 763 (81.6%) were elderly, and 172 (18.4%) were very elderly. Very elderly more frequently required admission in the red area (65.7% vs. 57.4%, P = 0.045). 85.2% (n = 796) of patients had preexisting comorbidities, hypertension (44.5%) and diabetes (34.8%) being the most common. The most comorbidities and the Charlson comorbidity index score distribution were similar to the two age groups; however, hypertension was more in the elderly (52.3% vs. 42.7%, P = 0.022). Overall, gastrointestinal (25.7%), neurological (20.7%), and cardiovascular (19.0%) emergencies were common; however, the very elderly patients more frequently had neurological illnesses (30.8% vs. 18.5%, P < 0.001). Pulmonary infections were the most prevalent infections in both age groups. The frequency of urinary tract infections was higher in the very elderly (17.5% vs. 6.1%, P = 0.023). In-hospital survival was 82.7% (n = 773) and significantly low in the very elderly (76.7% vs. 84.0%, P = 0.023). The survival was predicted by quick sequential organ failure assessment but not by the Charlson comorbidity index.

Conclusion:

Very elderly patients more frequently have hypertension, neurological emergencies, urinary tract infections, and poor outcomes.
Effectiveness of educational interventions on knowledge and behavioral practices of adolescents for prevention of noncommunicable diseases in low- and middle-income countries: A systematic review protocol
Authors: Jauhari Sugandha , Pandit Pratyaksha , Agarwal Monika , Bajpai Prashant Kumar , Singh Abhishek , James D. Christopher
Published: June 2024

Introduction:

The rising burden of noncommunicable diseases (NCDs) is a dominating public health crisis, globally causing 38 million of 57 million deaths annually, with 85% of these deaths occurring in low- and middle-income countries (LMICs). However, while addressing NCDs, adolescents have been largely overlooked, who have a notable share in the NCD burden globally. Adolescents are vulnerable for developing high-risk behaviors, which puts them at high risk of NCDs such as ischemic heart diseases, diabetes, and stroke.

Objective:

The objective of this systematic review will be to identify the effectiveness of educational interventions on the knowledge and behavioral practices of adolescents for the prevention of NCDs in LMICs.

Methodology:

Five electronic databases such as PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Embase, and Scopus will be utilized for generating pooled evidence. Two reviewers will individually screen the titles and abstracts for eligibility, and in case of any disagreement, the help of a third reviewer will be taken. Recognized studies will be critically appraised for methodological quality using the Cochrane risk-of-bias tool. Data will be extracted from the studies included in the review for author’s name, year of study, study setting, study design, study participants and their age, sample size in the intervention group, NCD domain covered by the study intervention, intervention details, measure of outcome, etc. For data synthesis, studies will be pooled using RevMan software and effect sizes will be depicted using forest plots. The Grading of Recommendations, Assessment, Development, and Evaluation approach to grade the certainty of evidence will be followed for assessing the quality of evidence. Publication bias will also be checked using funnel plots and Egger’s test.

Clinical Relevance:

To the best of our knowledge, this will be the first systematic review that will assess the empirical evidence and evaluate the effectiveness of educational interventions for the prevention of NCDs among adolescents of LMICs. This review will assist the public health experts and policymakers in designing effective intervention for preventing NCDs among adolescents.

Results and Conclusion:

The results of this systematic review will provide an in-depth insight of the existing country-specific educational policies and interventions for the prevention of NCDs among adolescents in various LMICs. This will help in the replication of such cost-effective educational models or interventions in other LMICs followed by advocacy in their school policy reforms and other related programs focusing on NCDs.
Pretransplant hemodialysis: Lived experiences
Authors: Priya  , Kenwar Deepesh Benjamin , Dutta Monika
Published: June 2024

Introduction:

End-stage renal disease (ESRD) is a rapidly increasing global health problem where the kidney damage is irreversible. Worldwide, hemodialysis is the most common kidney replacement therapy which increases longevity but is not the ultimate cure, and at the same time, there are multiple complications associated with this treatment modality making life miserable for these patients. Plenty of literature is available on patient education, side effects, and complications of hemodialysis, but very few attempts have been made to understand patients’ experiences living on dialysis.

Materials and Methods:

A phenomenological research design was adopted to explore lived experiences of patients on hemodialysis. Using purposive sampling technique, adult (60 years) posttransplant patients who had hemodialysis at least for 6 months during pretransplantation phase were enrolled. Data were collected through semi-structured interviews, analyzed using descriptive statistics for quantitative and Colaizzi’s method for qualitative data.

Results:

The most common medical diagnosis was unknown chronic glomerulonephritis, and the prevalent comorbid condition was hypertension. Based on participants’ verbatim, total 5 themes and 13 subthemes were extracted after data analysis. The main themes emerged were disease- and dialysis-associated problems, emotional turmoil, financial burden, social isolation, and changes in lifestyle.

Conclusion:

The present study concluded that ESRD patients on haemodialysis experienced physiological disturbances, emotional distress and financial burden. Social isolation, financial constraints, and changes in lifestyle were major challenges faced by patients. Professionals need empathic attitude to deal with patients on hemodialysis to minimize their sufferings.
Consanguinity and Increased Risk of Congenital Ptosis
Authors: Khalili Mohammad Reza , Owji Naser , Zarei Elahe , Nazari Mohammadreza
Published: June 2024

Purpose:

To assess consanguinity as a probable risk factor for congenital ptosis.

Methods:

In this case–control study, 97 patients with congenital ptosis and 97 participants as the control group were included. The age, sex, and residence area of the control group were matched with the cases. The inbreeding coefficient (F) was calculated for each participant, and the mean of the inbreeding coefficient (α) was calculated for each group.

Results:

The prevalence of consanguineous marriage in parents of cases with congenital ptosis and those of the control group was 54.6% and 30.9%, respectively (P < 0.002). The mean of the inbreeding coefficient (α) in patients with ptosis was 0.026, whereas it was 0.016 in the control group (T = 2.51, degree of freedom = 192, P = 0.0129).

Conclusions:

The rate of consanguineous marriage was significantly higher among the parents of patients with congenital ptosis. It implies a probable recessive pattern in the etiology of congenital ptosis.
Tessier Number 9 Craniofacial Cleft Associated with Goldenhar Syndrome and Its Surgical Management: A Report of a Rare Case
Authors: Bagheri Abbas , Feizi Mohadeseh , Tavakoli Mehdi
Published: June 2024

Purpose:

To report surgical repair of a rare case of Tessier number 9 craniofacial cleft.

Methods:

Case report.

Results:

Tessier number 9 craniofacial cleft is the rarest cleft anomaly. This article reports a congenital eyelid coloboma in a 21-year-old woman that involved the lateral third of the left upper eyelid and extended to the lateral canthus, consistent with number 9 craniofacial cleft Tessier classification. The additional findings included a fibrotic band between the globe and the remnant of the upper lid, which caused a small-angle exotropia. There were also skin appendages in the preauricular area and the inner surface of the nasal columella consistent with Goldenhar syndrome. The eyelid coloboma was repaired by releasing the adhesions and using a composite graft of the hard palate to repair the posterior lamella. The anterior lamella was repaired by creating a skin advancement flap. The esthetic and functional outcomes were acceptable in the 2-year postoperative follow-up period.

Conclusion:

The composite hard palate graft can be used to repair posterior lamella defect in the case of Tessier number 9 craniofacial cleft.
Minimal Invasive Procedures in Strabismus Surgery: A Narrative Review
Authors: Mojon Daniel S. , Kiarudi Mohammad Yaser , Sabermoghaddam Aliakbar , Razavi Mohammad Etezad , Heidarzadeh Hamid Reza
Published: June 2024

Purpose:

To review the principles and different techniques of minimally invasive procedures in strabismus surgery.

Methods:

This is a narrative review on minimally invasive procedures in strabismus surgery including general aspects and different new modifications on conventional strabismus surgery. We reviewed 24 articles published between 1993 and 2020.

Results:

Minimal invasive procedures could be categorized into two subsets: one which minimizes conjunctival opening size and another which minimizes the muscle manipulations. Different conjunctival approaches have been introduced, such as Cul-de-sac and minimally invasive strabismus surgery incisions. Furthermore, there are different techniques for extraocular muscle weakening, strengthening, and transposition, such as mini-tenotomy, plication, mini-plication, Nishida, and modified Nishida procedures. Moreover, there are some techniques for handling strabismus in heavy eyes with high myopia and using adjustable sutures for strabismus correction.

Conclusions:

Minimally invasive procedures in strabismus surgery consist of surgical procedures that minimize tissue disruption, speed up rehabilitation, and often ultimate better outcomes. These techniques could be replaced traditional methods to reduce conjunctival and lid swelling in the direct postoperative period.
Impact of Coronavirus Disease 2019 Pandemic on the Epidemiology of Intravitreal Injections
Authors: Mirghorbani Masoud , Riazi-Esfahani Hamid , Bazvand Fatemeh , Bahar Mohammadreza Mehrabi , Yaseri Mehdi , Zarei Mohammad
Published: June 2024

Purpose:

To evaluate the epidemiologic pattern of intravitreal injections (IVIs) during Coronavirus Disease 2019 (COVID-19) pandemic.

Methods:

The records of patients receiving IVIs in two 12-month periods immediately before and after the beginning of the COVID-19 epidemic were included. Age, province of residency, indication, number of injections, and number of operating room (OR) visits were analyzed.

Results:

Compared to pre-COVID period, a 37.6% decrease in the number of patients receiving IVI in COVID period was seen (10518 vs. 6569). There was a parallel decrease in the number of OR visits (25590 vs. 15010: 41.4%) and injections (34508 vs. 19879: 42.4%). Regarding IVI indication, age-related macular degeneration (AMD) showed the highest decrease in IVI rate (46.3%) which was significantly higher than decrease in other indications (P < 0.001). Retinopathy of prematurity (ROP) patients showed no change after epidemic. Mean overall age in AMD group was the highest (67.7 ± 13.2 years) compared to other indication groups (excluding ROP) (P < 0.001); while the mean age of the other indications was not significantly different from each other (excluding ROP).

Conclusions:

COVID pandemic decreased the number of IVIs significantly. While previous studies suggested that the AMD patients had the highest risk of visual loss due to failure to receive IVIs in a timely manner, this very same group showed the highest decrease in the IVI number after pandemic. The health systems should devise strategies to protect this most vulnerable group of patients in future similar crises.
Identification of a Missense Mutation in GJA8 Gene in an Iranian Family with Autosomal Dominant Congenital Cataract
Authors: Asghari Mahla , Abedini Soheila , Farshidianfar Melika , Tajbakhsh Amir , Derakhshan Akbar , Pasdar Alireza
Published: June 2024

Purpose:

To identify the causative mutations of autosomal dominant (AD) congenital cataracts in a large Iranian family.

Methods:

The complete and accurate family history and clinical information of participants were collected. A total of 51 family members, including 22 affected and 29 unaffected individuals, were recruited in this study. We performed whole exome sequencing to reveal pathogenic mutation. We used amplification refractory mutation system polymerase chain reaction and Sanger sequencing techniques to confirm segregation in patients and also to rule it out in the healthy participants.

Results:

A known missense mutation, c.827C>T (S276F), in GJA8 was identified. This mutation was confirmed in all patients. Neither all healthy family members nor 100 healthy individuals who served as controls from general population had this mutation.

Conclusion:

The missense mutation c. 827C>T in the GJA8 gene is associated with AD congenital lamellar cataract with complete penetrance in a six-generation Iranian family.
Double Retina Sign: A New Optical Coherence Tomography Finding in Combined Hamartoma of the Retina and Retinal Pigment Epithelium
Authors: Naseripour Masood , Sedaghat Ahad , Gordiz Arzhang , Mirshahi Reza
Published: June 2024

Purpose:

To describe a case of combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) with peculiar optical coherence tomography (OCT) findings.

Methods:

Case report.

Results:

A 7-year-old girl with a history of decreased visual acuity in the left eye since early childhood presented with pigmented epiretinal membrane in favor of CHRRPE based on clinical and paraclinical findings. In OCT images, an area of retinal defect was noted, and the retina doubled up on itself near the defect (double retina sign).

Conclusion:

Careful examination of OCT images in patients with CHRRPE can reveal new findings.
The Ability of Antibody against Truncated Matrix Metalloproteinase 9 Peptide to Evaluate the Native Protein on Tear Drops of Dry Eye Disease Patients by a Point-of-Care Diagnostic System
Authors: Afshari Zahra , Rasaee Mohammad Javad , Paknejad Maliheh , Khalili Saeed , Baradaran-Rafii Alireza
Published: June 2024

Purpose:

To obtain a reactive and specific antibody against truncated matrix metalloproteinase 9 (MMP-9), that has reactivity toward the native protein. Precision, accuracy, specificity, and sensitivity were evaluated using a point-of-care test.

Methods:

An in silico study was used to confirm the anti peptide truncated MMP-9 is against native MMP-9. After an antibody titer assessment, purification, and characterization, the anti MMP-9 was assessed. The cut-off value was determined using the purified gelatinases of the supernatant HCT 116 cell line. The supernatant was purified by preparative native-polyacrylamide gel electrophoresis based on charge and size of the proteins. Furthermore, quality control (QC) of the results were performed following standard densitometry methods.

Results:

A truncated MMP-9 is the major epitope peptide that can trigger the immune system to scavenge for a specific and reactive antibody against the native MMP-9. The MMP-9 native protein is purified from the supernatant of the HCT 116 cell line and the commercially available, full-length MMP-9. The cut-off value was estimated at 30 μg/mL. QC results indicated that the specificity was 80%, sensitivity was 96.7%, accuracy was 91%, and precision was 91.66%. The area under curve was 0.827 (P < 0.001). The positive predictive value was 83%, and the negative predictive value was 96%.

Conclusions:

The antibody against the synthetic epitope peptide can detect the native MMP-9. Native MMP-9 is considered the main biomarker in an immunoassay POCT and is used to diagnose dry eye disease (DED). In accordance with QC results, MMP-9 point of care test can be utilized for screening patients suffering from DED.
Off-Label Uses of Ranibizumab and Aflibercept for Age-Related Macular Degeneration in Turkey
Authors: Yilmaz Mevlut , Citirik Mehmet , Rahmanlar Hanife , Alkan Ali , Gursoz Hakki
Published: June 2024

Purpose:

To evaluate the clinical and demographic aspects of off-label drug use applications for age-related macular degeneration (AMD) in Turkey.

Methods:

Applications for off-label drug use in the treatment of AMD to the Turkish Medicines and Medical Devices Agency (TITCK) in 2018 were retrospectively analyzed. Demographic characteristics, requested drugs, previous treatment regimens, and reasons for applications were evaluated.

Results:

The mean age of the patients (n = 209) was 64.9 ± 15.7 years, of which 48.8% were male and 51.2% were female. Ranibizumab (n = 113) comprised 54.1% and aflibercept (n = 96) 45.9% of off-label use applications. No application was made for bevacizumab. The most frequent reasons for application were switchback (49.3%), nonreimbursement of indicated drugs in cases under 50 years of age (24.4%), and failure to complete the loading dose (14.4%).

Conclusions:

Ranibizumab was the most requested off-label drug for AMD. There was no application for off-label bevacizumab since its use does not require approval from TITCK. In Turkey, new rules were established for the reimbursement of intravitreal drugs for AMD in 2019. Three doses of intravitreal bevacizumab were required initially for aflibercept and ranibizumab to be covered for reimbursement. There is not enough data in the English literature regarding the off-label use of ranibizumab and aflibercept for AMD. This study provides information about drug regulations and the off-label treatment options preferred by physicians for AMD in Turkey.
Orbital Cholesterol Granuloma: Report of Two Cases
Authors: Etezad-Razavi Mohammad , Shekarchian Farid , Raoufi Fereshteh , Khazaei Sahel
Published: June 2024

Purpose:

To report two rare cases of orbital cholesterol granuloma (CG) presenting with ptosis and proptosis.

Methods:

The first case was a 31-year-old male presented with progressive ptosis of the left eye (LE) during the past year and the second case was a 35-year-old male presented with proptosis of the right eye (RE) for 5 months ago. Orbital computed tomography revealed a cystic well-demarcated lesion in the superotemporal orbit with adjacent bone erosion in the LE of the first case and the RE of the second case.

Results:

In both cases, the tumor was excised completely through an anterolateral orbitotomy approach. Histopathological evaluation showed fibroconnective tissue with cholesterol clefts surrounded by granulomatous inflammation consistent with the diagnosis of CG. The symptoms of patients were resolved after surgery.

Conclusions:

CG of the orbit is a rare lesion that commonly occurred in the superotemporal area. Erosive bone expansion is the characteristic finding of this lesion that can be mistaken with lacrimal gland malignancies. Hence, it is essential to keep CG in mind in the differential diagnosis of lacrimal gland masses.