bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosis of Alzheimer's disease by analyzing the roughness of the retinal layers
Authors: Salobrar‐Garcia Elena , Jañez‐García L. , Bachtoula O. , López‐Cuenca Inés , Elvira‐Hurtado Lorena , de Hoz Rosa , Jose Salazar Juan , Isabel Ramírez Ana , Jañez‐Escalada Luis , Manuel Ramírez Jose
Published: January 2022

Purpose

Alzheimer’s Disease (AD) is the most common cause of dementia. Retinal thickness changes had been reported in different stages of the disease, being these changes a biomarker of AD progression. There is increasing evidence that thinned and thickened regions are interspersed throughout the retinal layers of AD patients, resulting in the roughness of their bounding surfaces and thickness maps. The aim of this work is to prove the roughness of retinal layers, as assessed by the fractal dimension (FD) of their thickness maps, is an early biomarker of AD.

Methods

A complete ophthalmological exam and cognitive test (Mini Mental State Examination) was carried out in 24 healthy volunteers and 19 patients with mild AD. Total retinal thickness and retinal layers thickness were studied by optical coherence tomography (OCT) and thickness retinal maps were obtained. From the whole retinal area scanned on each subject only a central square region available from all sample subjects was kept for roughness analysis. In this square, the FD of the thickness map of each retinal layer was calculated as an index of its roughness.

Results

The FD of retinal layers is significantly higher (p < 0.05) in the AD group, compared to the healthy group. The correlation of FD with cognitive score, visual acuity and age reaches statistical significance in 7 layers. Nearly all (44 out of 45) FD correlations among layers are positive and half of them (23) reached statistical significance (p  <  0.05). Factor analysis revealed two groups of retinal layers whose roughness evolves independently: the first includes two layers related to the outer segments and may be influenced by dysregulation of the choroidal vascular network; and the second includes the remaining layers, and may be associated with the inflammatory process of the retina.

Conclusions

Roughness is a holistic feature of retinal layers that can be assessed by FD of their thickness maps and is an early biomarker of AD.
Dual angiopoietin‐2/VEGF‐A neutralisation prevents vascular leakage, cell death and subretinal macrophage infiltration in mouse models of retinal ischaemia/reperfusion injury and spontaneous CNV
Authors: Canonica Jérémie , Shanmugam Sumathi , Lin Cheng‐mao , Antonetti David , Foxton Richard , Uhles Sabine , Westenkow Peter , Abcouwer Steve , Garcia Garrido Marina
Published: January 2022

Purpose

Explore impact of dual angiopoietin‐2 (Ang‐2)/vascular endothelial growth factor‐A (VEGF‐A) targeting by faricimab on vessel destabilisation and retinal inflammation in 2 mouse models: retinal ischaemia/reperfusion (I/R) injury model to assess vascular permeability, and JR5558 spontaneous choroidal neovascularisation (sCNV) model to investigate inflammation, in the context of phase 2/3 clinical data on faricimab.

Methods

Antibodies against Ang‐2, VEGF‐A, or both (VA2) and IgG (control) were intravitreally injected 2 days before I/R injury in the I/R model. Vascular permeability and ongoing cell death were assessed by retinal FITC‐BSA accumulation and DNA fragmentation assay, respectively, 48h after injury. JR5558 mice were treated intraperitoneally at postnatal days P45, P52 with mouse cross‐reactive tool antibodies to Ang‐2, VEGF‐A, both (VA2) and IgG. Subretinal inflammatory cell (Iba1+, CD45+, CD11b+) infiltration was evaluated by flat‐mount retinal pigment epithelium (RPE)/choroid histology at 1 (PT1), 3 (PT2), and 5 weeks (PT3) post‐treatment.

Results

Post‐I/R injury, VA2 significantly prevented retinal vascular permeability by 64%; anti–VEGF‐A by 37%; anti–Ang‐2 produced no significant change. VA2 significantly reduced ongoing cell death by 47%; VEGF‐A, Ang‐2 alone had no significant effect. In JR5558 mice, VA2, not anti–VEGF‐A or anti–Ang‐2 alone, significantly reduced Iba1+ microglia/macrophages on RPE/choroid and around lesions versus IgG at PT1 and PT2. At PT3, anti–Ang‐2, VA2, not anti–VEGF‐A, showed significant reductions in Iba1+ cells versus IgG. CD45+, CD11b+ cells on RPE/choroid and around lesions were significantly reduced only with VA2 versus IgG.

Conclusions

Dual Ang‐2/VEGF‐A inhibition synergistically prevented retinal vascular leakage, cell death and inflammation in retinal I/R injury and sCNV mouse models, suggesting that vascular leakage, prolonged inflammation are driven by Ang‐2, and supporting recent phase 2/3 clinical data that demonstrated sustained efficacy of faricimab versus intravitreal anti‐VEGF monotarget therapy and extended durability up to every 16 weeks.
Leopard spot chorioretinopathy revealing late onset sympathetic ophthalmia
Authors: Fehmy Nafaa , Meriem Ouederni , Ben Aoun Safa , Zaienb Gharbi , Wijdene Nabi , Monia Cheour
Published: January 2022

Purpose

To report a case of a very late onset atypical sympathetic ophthalmia presented as a leopard spot retinopathy.

Methods

An observational case report of a 64‐year‐old patient with a history of penetrating ocular trauma of the right eye (RE) at the age of 3‐year‐old who presented with visual blurring of the left eye (LE). The patient underwent complete ophthalmic examination, autofluorescence imaging, fluorescein angiography, Indocyanine Green (ICG) angiography, swept‐source optical coherence tomography (SS‐OCT).

Results

Examination of the RE showed a phthisis bulbi. Visual acuity of the LE was limited to hand motion. Slit lamp examination revealed +1 cells anterior chamber inflammation, granulomatous keratic precipitates, posterior synechiae, with a mild cataract and +2 vitreous cells. Fundoscopy showed multiple yellowish patchy subretinal lesions. Fluorescein angiography revealed hyperfluorescent nummular areas at early frames without late leakage surrounded by zones of hypofluorescences. Fundus autofluorescence imaging showed a leopard spot pattern with areas of hypoautofluorescence surrounded by hyperautofluorescence. ICG angiography showed no hypofluorescent dark dots. SS‐OCT demonstrated retinal thickening, multiple areas of flat subretinal fluid, irregular hyperreflective spots at the photoreceptor outer segment layer and irregularities of the retinal pigment epithelium. The diagnosis of unilateral diffuse uveal melanocytic proliferation (DUMP) was first made. The patient underwent a systemic workup with full‐body computed tomography scans, cerebral and ocular magnetic resonance imaging and blood tests including tumor markers. All tests were normal. The patient was put on oral prednisone (1 mg/kg/day) during 6 months with a gradual tapering and good initial outcome. Visual acuity increased to 40/200.

Two weeks after stopping steroids, he presented with acute granulomatous anterior uveitis and the diagnosis of very late onset sympathetic ophthalmia was made.

Conclusions

Leopard retinopathy can be an uncommon clinical presentation of a variety of disorders especially sympathetic ophthalmia. The diagnosis could be challenging in case of atypical presentation and very late onset. Treatment outcome and close follow‐up should be considered for a correct diagnosis.
The peripapillary and macular microvasculature in neovascular age‐related macular degeneration in longterm versus recently started anti‐VEGF using a treat‐and‐extend regimen and healthy controls
Authors: Türksever Cengiz , Hoffmann Laura , Hatz Katja B.
Published: January 2022

Purpose

To investigate alterations in the peripapillary and macular microvasculature in eyes with neovascular age‐related macular degeneration (nAMD) in recently started versus long‐term anti‐vascular endothelial growth factor (VEGF) therapy compared to healthy controls using swept‐source optical coherence tomography angiography–based (OCTA) microangiography (OMAGc).

Methods

Eyes with nAMD receiving intravitreal anti‐VEGF injections using a treat‐and‐extend regimen (TER) were assigned to group 1 (<5 injections) or 2 (≥20 injections) whereas group 3 constituted the healthy age‐matched controls. Blood flow signals were acquired using PLEX® Elite 9000 Swept‐Source OCTA in 6x6mm scans centered on the fovea and the optic nerve head (ONH). SD‐OCT scans were obtained of the macular and ONH region and the mean ganglion cell complex (GCC) thickness values (retinal nerve fibre layer + ganglion cell layer + inner plexiform layer) were quantified by manual correction. The subgroups were compared using ANOVA.

Results

A total of 80 eyes whereof 40 eyes in the control group were included. Macular superficial perfusion density in the central 3 and 6mm was significantly reduced in group 1 and 2 compared to controls (p < 0.001; p = 0.010) without a significant difference between groups 1 and 2. The presence of subretinal fluid was associated with a better superficial macular perfusion density in the central 6mm (p = 0.036). Mean peripapillary flux index was significantly lower in group 2 than in controls (p = 0.023) in the absence of a significant correlation with neither IOP elevation after the injection nor the number of anti‐VEGF injections received. The mean GGC in the central 3mm was thicker in group 2 compared to group 1 (103.8 µm versus 97.68 µm; p = 0.093), particularly in the inferior part of the macula. An increased pulse pressure was observed in group 2 in comparison to groups 1 and 3 (p = 0.003; p = 0.012).

Conclusions

Reduced perfusion density of the inner retina might be related to a local vasoconstrictor effect of anti‐VEGF treatment. Neither repeated injections nor postop‐ IOP elevations were correlated to peripapillary microvasculature. The thinning of the IPL observed in nAMD resulting from transsynaptic degeneration of ganglion cell dendrites with photoreceptor loss might regenerate with anti‐VEGF therapy.
One‐year results of photodynamic therapy with chlorin e6‐polyvinylpyrrolidone complex in patients with chronic central serous chorioretinopathy (pilot study)
Authors: Zadorozhnyy Oleg , Nasinnyk Illia , Kustryn Taras , Korol Andrii , Pasyechnikova Nataliya
Published: January 2022

Purpose

To investigate efficacy and safety of photodynamic therapy (PDT) with chlorin e6‐polyvinylpyrrolidone (Ce6‐PVP) complex in patients with chronic central serous chorioretinopathy (CSC).

Methods

In this prospective, interventional, single‐centre clinical pilot study included 28 patients (28 eyes) with chronic CSC. Patients received an intravenous infusion of 3 mg/m2 Ce6‐PVP complex (Photolon, Belmedpreparaty pharmaceutical company, Minsk, Belarus) delivered over a period of 10 min. Exactly 15 min after the start of this infusion, a Ocular Mainster (Standard) Focal/Grid contact lens (Ocular Instruments, Bellevue, Washington, USA) was positioned on the eye, the treatment spot was centered using predefined criteria for fluorescein angiography, and PDT was applied using standard parameters (fluency, 50 J/cm2; wavelength, 662 nm; and treatment duration, 83 seconds). The primary objective was decimal best corrected visual acuity (BCVA) at Month 12. The secondary objectives were central retinal thickness (CRT) in fovea area, complete subretinal fluid (SRF) resolution, number of treatment and safety at Month 12.

Results

Mean decimal BCVA showed significant increase from 0.6 ± 0.3 to 0.8 ± 0.4 (p = 0.001), mean CRT decreased significantly from 289 ± 72 to 202 ± 48 µm (p = 0.001), comparing baseline and Month 12. During all follow‐up period mean number of PDT treatments was 1.2 ± 0.5. In 77% (20 eyes) were noted complete SRF resolution during observation period. There were no any systemic adverse events and ocular side effects.

Conclusions

Our pilot study demonstrates the efficacy and safety of PDT with Ce6‐PVP complex for chronic CSC during the 12‐month follow‐up. This finding provides key insight into developing new practice for treating chronic CSC. Futures studies in larger numbers of patients and with longer follow‐up are planned to further assess the efficacy and safety of PDT with Ce6‐PVP complex for chronic CSC.
Effect of Sei and Fin whale Müller glia in the survival and neurite growth of RGCs in vitro
Authors: Pereiro Xandra , Ruzafa Noelia , Beriain Sandra , Vecino Elena
Published: January 2022

Purpose

Müller cells are crucial in retinal homeostasis. In zebrafish and lower vertebrates, spontaneous retinal regeneration was observed. In the mammalian retina, there is no such evidence. However, recent studies have been demonstrated that Müller cells promote the survival and the neurite outgrowth of RGCs in vitro. Here, the effect of Müller cells from two of the largest mammals in the world, Fin and Sei whales, was analyzed on RGCs survival and neurite outgrowth.

Methods

The retinas of beached Balaenoptera physalus and Balaenoptera borealis whales, 24 hr post‐mortem, were studied. Cultures of Müller cells were grown and, once whale Müller cells reached confluence, adult rat RGCs were seeded on Müller cells. The cells were cultured during six days. The number and length of the neurites of the RGCs were quantified. The conditioned media (CM) from whale Müller cells was analysed by mass spectrometry to identify and quantify proteins. Results were compared to the CM from pig Müller cells. NELL2, SEMA3F, CD56, NRCAM, OGN and PEDF were selected as candidate factors to promote neurite outgrowth and tested in pure rat RGCs cultures.

Results

RGCs survival increased 60% when cultured with whale Müller cells. The length of the neurites (>200 μm) increased 90% and the length of the longest neurites (>1000 μm) increased more than 500%. Proteomic analysis from whale Müller cells CM showed that the function of the 10% of the most represented proteins detected was related to neurite outgrowth, compared to only 2% of the proteins in pig CM. The selected proteins induced an increase in the percentage of RGCs with long neurites (>200 μm) and an increase of 200% in RGCs with very long neurites (>1000 μm).

Conclusions

Whale Müller cells increase RGCs neurite growth, suggesting that whale Müller cells secrete a combination of neurotrophic factors promoting regeneration of RGCs. Besides, the selected proteins from the CM increase neurite outgrowth, confirming the capacity of the factors secreted by whale Müller cells to regenerate RGCs.

Supported by ELKARTEK (KK‐2019/00086), MINECO‐Retos (PID2019‐111139RB‐I00) Grupos UPV/EHU (GIU2018/50).
Morphological characterization of the whale retina
Authors: Ruzafa Noelia , Pereiro Xandra , Vecino Elena
Published: January 2022

Purpose

The retina of the largest adult mammal in the world, the whale, was analysed morphologically by immunohistochemistry. The eye of these aquatic mammals have been poorly studied, thus, the aim of this study was to examine the different neurons and glial cells in the whale retina using a range of molecular markers.

Methods

The eyes of beached whales (n = 2, Balaenoptera physalus and Balaenoptera borealis) were obtained, and after dissection and fixation of the retinas, whole‐mount preparations and cryostat sections were immunostained. The neurons and glial cells in these tissues were analysed using different antibodies to label RGCs, photoreceptors, bipolar cells, amacrine cells, microglia, astrocytes and Müller cells. Thioflavin S was also used to label misfolded proteins.

Results

Most of the molecular markers used labelled their specific structures in the whale retinas as in terrestrial mammalian retinas. However, whale cones do not express cone markers (M/L and S opsin, and cone arrestin). It is important to highlight the large size of whale RGCs and there is a heterogeneity in NFs expression. It is also noteworthy that intrinsically photosensitive RGCs labelled with melanopsin form an extraordinary network in the whale retina, where these cells are more abundant in the centre, and different subtypes of melanopsin positive cells were identified. Thioflavin S is weakly labelled of some RGCs in a punctuate pattern and it could easily represent an early sign of neurodegeneration. In addition, degenerative neuritic beading has been observed in RGCs when the retina was analysed after 48 hr postmortem.

Conclusions

In conclusion, there are some notable differences in the retina of the whales when compared with that of terrestrial mammals. Their rod‐monochromatic vision due to an evolutionary loss of cone photoreception and the well‐developed melanopsin‐positive RGCs network could in part be responsible for their perception in the deep sea.

Supported by ELKARTEK (KK‐2019/00086), MINECO‐Retos (PID2019‐111139RB‐I00) Grupos UPV/EHU (GIU2018/50).
Long‐term evolution of juvenile X‐linked retinoschisis
Authors: Boned‐Murillo Ana , Dolores Diaz Maria , El Bakkali Ismael Bakkali , Pérez Rivasés Guillermo , Cisneros Pablo , Núñez Moscarda Eva Josefina , Orejudo Derivas Marta , Ascaso Francisco , Pinilla Lozano Isabel
Published: January 2022

Purpose

To present long‐term evolution of congenital retinoschisis, also called juvenile or X‐linked retinoschisis (CXLRS), is a very rare disease with a prevalence of approximately 1: 120 000 and usually unknown, being one of the most common causes of macular degeneration in young men. It is a consequence of the mutation in the RS1 gene that encodes retinoschisis, manifesting with visual deficit, strabismus and nystagmus. In general, its evolution is rapid during the first five years of life, secondary to an increase in schisis, and later it slows down, in some cases the retinoschisis area may return partially spontaneously.

Methods

We report the case of a 32‐year‐old man diagnosed with X‐linked juvenile retinoschisis at 22 years of age in context of a possible convergent strabismus associated with hyperopia of +5.50 Right Eye (RE) and +6.50 Left Eye (LE).

Results

At the time of diagnosis of his disease, his corrected visual acuity (BCVA) was 20/40 in RE and 20/32 in LE. Radial distribution to the fovea macular cysts was observed in both eyes (OC), associated to macular area and the supero‐temporal quadrant RE retinoschisis and LE macula and the superior and temporal quadrants of the peripheral retina retinoschisis. Optical coherence tomography (OCT) reveals macular schisis that extends from the outer nuclear layer (NEC) to the outer plexiform layer (EPC) as well as a certain cystic component in OC. There was also an increased foveal autofluorescence. Ten Years follow‐up was performed and nowadays his BCVA is 20/50 in OC, with almost total regression of the macular cysts. Examination reveals the regression with foveal atrophy in OCT and an increase in the Foveal Avascular Zone (FAZ) AO in the OCT‐A.

Conclusions

Juvenile X‐linked retinoschisis is a slowly progressive condition. Optical coherence tomography (OCT) allows the study of retinoschisis in real time, being useful in the follow‐up and disease evolution. Although there is no current treatment, gene therapy could be a therapeutic option in the future.
Specific changes of zinc and metallothioneins during the in vitro maturation and ageing of a retinal pigment epithelium cellular model
Authors: Alvarez‐Barrios Ana , Álvarez Lydia , García Montserrat , Emri Eszter , Lengyel Imre , Pereiro Rosario , González‐Iglesias Héctor
Published: January 2022

Purpose

During ageing, the retinal pigment epithelium (RPE) undergoes several morphological and physiological alterations such as loss of melanin, formation of extracellular deposits and metal dyshomeostasis. We examined the age‐related changes in the transcriptome and metallome (metal content in cellular cytosol, membrane and culture media) of the ageing RPE to give an insight into the origin of risk factors linked with neurodegenerative eye diseases like AMD.

Methods

We established a primary human RPE cells culture model to study the maturation (10, 21 and 59 days in culture) and ageing (91 and 133 days in culture) of cells in vitro. We analyzed the transcriptome by RNA sequencing (RNAseq) and determined the metallome by inductively coupled plasma mass spectrometry (ICP‐MS). Localization of specific proteins was carried out by immunocytochemistry.

Results

RPE differentiation markers increased significantly from 10 to 59 days in culture, followed by a decrease from 91 days onwards, as determined by RNAseq and immunocytochemistry assays. After 59 days in culture, there was an alteration in the expression of genes associated with essential biological processes, some of them being phosphorylation, oxidation‐reduction and ion transport. Metal content (i.e., Na, P, Mg, Ca, Cu and Zn) in the cellular cytosol and membranes showed mixed tendencies with time. Interestingly, cytosolic zinc levels decreased from 10 to 59 days (maturing RPE) but increased at 91 and 133 days (ageing RPE). This biphasic change was mirrored by the gene expression changes of specific isoforms of the zinc‐binding metallothioneins including MT1G and MT2A.

Conclusions

Gene expression and metal content showed time‐dependent changes in the in vitro RPE cell culture model. We observed a specific association between zinc levels and metallothionein expressions during maturation and ageing that, if confirmed by further evidences, may shed light for the metal dyshomeostasis observed during AMD.
Effects of catechine and epicatechine on visual function and retinal perfusion
Authors: Kirkova Radina , Tanev Ivan
Published: January 2022

Purpose

The aim of our study is to evaluate the effects of flavonoids catechine and epicatechine ot visual function, contrast sensitivity and retinal perfusion.

Methods

It’s a prospective cohort study. A total of 30 patients are subdivided into two cohorts. Group A: patients with no ophthalmic pathology and, Group B: patients with neovascular age‐related macular degeneration /nAMD/. We performed a full ophthalmic examination /best corrected visual acuity for distance and near, assessment of contrast sensitivity – Pelli Robson test, tonometry, biomicroscopy, ophthalmoscopy and optic coherence tomography – angiography OCT‐A/ before and two hours after consumption of 50 g dark chocolate with 100% cocoa content.

Results

Results of all the exams /visual acuity, contrast sensitivity, OCT‐A indexes for retinal perfusion/ are statistically processed.

Conclusions

High content of flavonoids catechine and epicatechine in dark chocolate has beneficial impact on visual function, contrast sensitivity and retinal perfusion I Group A and Group B, with slight variation between two groups.
External limiting membrane disruption predicts long‐term outcome in strict Treat‐and‐Extend Regimen in neovascular age‐related macular degeneration
Authors: Hoffmann Laura , Katja Hatz
Published: January 2022

Purpose

To determine long‐term outcomes and outcome predicting factors in patients with neovascular age‐related macular degeneration (nAMD) applying a strict treat‐and‐extend regimen (TER).

Methods

Up to 8‐year retrospective follow‐up of treatment‐naïve subjects with nAMD starting treatment with either ranibizumab or aflibercept in a TER without loading dose but with predefined exit criteria. Spectral‐domain Optical Coherence Tomography scans were acquired in a follow‐up mode and evaluated following a standardized protocol.

Results

Two hundred‐eleven (211) eyes of 187 patients with a mean follow‐up of 60.3 ± 20.9 months were included. Real‐life follow‐up adherence was high (e.g. 88% at 3 years, 64% at 5 years) with the major part of discontinuations of TER being due to success. During follow‐up, 30.3% of eyes reached the predefined exit criteria, whereof 79.7% in the first five years. Mean BCVA increased from initially 63.9 ± 15.5 ETDRS letters (20/55) to 70.0 ± 14.7 (20/40) after one year (+6.1 letters, p < 0.001) and to 68.5 ± 18.1 (20/43) (+4.6 letters, p = 0.028) at 5 years. A worse BCVA (p = 0.001) and a better external limiting membrane (ELM) disruption score at baseline predicted (p = 0.019) BCVA gain at 5 years. The probability of reaching the exit criteria was significantly associated with a low central retinal thickness (CRT) (p = 0.025), a better ELM disruption score (p = 0.044) and the absence of a central pigment epithelial detachment (PED) (p = 0.05) at baseline.

Conclusions

Significant visual gains were sustained in a long‐term TER in a real‐world setting. Integrity of ELM at baseline predicted BCVA gain at 5 years and the potential for TER exit due to success.
Intravitreal ranizumab in exudative symptomatic retinal arterial macroaneurysms
Authors: Falcon Roca Rocio , Tapia Quijada Hugo E. , Sanchez Garcia Mariel
Published: January 2022

Purpose

To assess the anatomical and functional results in exudative symptomatic retinal arterial macroaneurysms (RAM) treated with anti‐VEGF.

Method

Observational retrospective study including 10 patients with 10 eyes with diagnosis of exudative symptomatic retinal arterial macroaneurysm. Given that the RAMs were located within the superior and inferior temporal arcades, they were treated with intravitreal ranizumab (Lucentis ®). Patients received a loading dose of 3 monthly injections of ranibizumab (0.5 mg/0.05 ml) followed by an additional injection if necessary. Best corrected visual acuity (BCVA) and central macular thickness (CMT) was assessed both prior to the treatment as well as posteriorly in the follow‐up visits.

Results

10 patients were included, of whom 5 were men and 5 were women. The average age was 72.9 years. The average follow‐up period was 7.9 ± 2 months, during which there was a remarkable visual and anatomical recovery (all patients improved their BCVA 3 or more Snellen lines). BCVA improved significantly compared to baseline BCVA from 0.21 ± 0.2 to 0.6 ± 0.28. The average decrease after treatment in CMT measured with OCT was also significant, decreasing from 590.2 ± 163.8 μm previous to treatment to 291.6 ± 61.4 μm after treatment. No complications were observed with the intravitreal injection of ranizumab.

Conclusion

Injections of anti‐vascular endothelial growth factor may be a therapeutic option in cases of symptomatic exudative RAM. Other types of studies are needed to recommend this treatment in this entity.

Bibliography

Russell SR, Folk JC. Branch retinal artery occlusion after dye yellow photocoagulation of an arterial macroaneurysm. Am J Ophthalmol 1987; 104:186–187.

Wenkstern AR, Petersen H. Intravitreal ranibizumab in retinal macroaneurysm. Graefes Arch Clin Exp Ophthalmol 2010; 248:1667–1670.

Zweifel SA, Tönz MS, Pfenninger L, et al. Intravitreal anti‐ VEGF therapy for retinal macroaneurysm. Klin Monbl Augen‐ heilkd 2013; 230:392–395.

Erol MK, Dogan B, Coban DT, et al. Intravitreal ranibizumab therapy for retinal arterial macroaneurysm. Int J Clin Exp Med 2015; 8:11572–11578.

Chatziralli I, Maniatea A, Koubouni K, et al. Intravitreal ranibizumab for retinal arterial macroaneurysm: long‐term results of a prospective study. Eur J Ophthalmol 2017; 27:215–219.
Self‐poling and electromechanical response of crystallographically textured PMN‐32PT prepared by templated grain growth
Authors: Kong Scarlet , Moriana Alain , Zhang Shujun , Checchia Stefano , Daniels John E.
Published: January 2022

Crystallographic texturing of ferroelectrics is known to improve the piezoelectrics response due to the alignment of optimal grain orientations in polycrystalline materials. Using high‐energy x‐ray diffraction, a ferroelastic self‐poling effect was observed in crystallographically textured 0.68 Pb(Mg1/3Nb2/3)O3− 0.32PbTiO3 ceramic. It is shown that the BaTiO3 platelet templates used to induce crystallographic texture imposed a biaxial strain causing ferroelastic domains to re‐orient parallel to the template plate normal. In‐situ high‐energy x‐ray diffraction was then used to characterize the response mechanisms of the material with applied electric fields. The textured ceramic produced a (111) lattice strain of 0.13% in the remanent state, and a 0.16% (111) unipolar lattice strain at 2 kV/mm while the untextured ceramic had a higher (111) lattice strain of 0.18% in the remanent state and a smaller (111) unipolar lattice strain at 2 kV/mm of 0.096%. This contrast in the strain magnitudes can be linked to the self‐poling effect. A strain mechanism incorporating the self‐poling effect is proposed, furthering our understanding of how crystallographic texture impacts the piezoelectric properties and providing a pathway for engineering the self‐poling effect to further enhance material response.
Influence of sintering temperature on the crystallization and mechanical properties of BN‐MAS composites
Authors: Wang Haoyi , Cai Delong , Yang Zhihua , Duan Xiaoming , Wang Bingzhu , Wang Bo , Li Daxin , Jia Dechang , Zhou Yu
Published: January 2022

A type of boron nitride–magnesium aluminum silicate (BN‐MAS) composite ceramics was fabricated by hot‐press sintering at different sintering temperatures. The relationship between the sintering temperature and microstructure was investigated by analyzing the interaction between hexagonal boron nitride (h‐BN) and the MAS phase. The main MAS phase in the composite ceramics is the α‐cordierite phase at a sintering temperature of 1300°C. At temperatures above 1400°C, the inhibitory effect of h‐BN on the crystallization of the MAS system is significant, and MAS mainly exists in the form of an amorphous phase. The composite sintered at 1700°C exhibited the highest bending strength of 218MPa. h‐BN and MAS were co‐enhanced. MAS can be used as an effective liquid‐phase sintering aid to assist in the sintering of h‐BN, whereas h‐BN can absorb the fracture energy of the composite ceramics through the pull‐out and bridging effect of the particles.
Conceptualizing the Regulator‐Buyer State in the European Union for the Exercise of Socially Responsible Public Procurement in Global Production Networks
Authors: Raj‐Reichert Gale , Staritz Cornelia , Plank Leonhard
Published: January 2022

Labour rights violations and poor working conditions are rife in global production networks (GPNs). Until now research on labour governance in GPNs has been dominated by private measures. We ignite discussions on the role of the state in governing labour conditions in GPNs by focusing on a less well‐known public governance instrument – socially responsible public procurement (SRPP). SRPP is the inclusion of social criteria on working conditions in public procurement contracts. Revised European Union (EU) directives on public procurement widened the space to exercise SRPP including for outsourced and offshored production. Understanding how states can exercise SRPP as a labour governance instrument requires a conceptualization of state powers. We present a conceptualization of the hybrid regulator‐buyer state and show that an effective SRPP approach requires both strong regulator powers, differentiated as legislative, institutional, judicial and discursive, and buyer power which depend on purchasing volumes and supplier and market characteristics.
Spiritual aspects of the family caregivers’ experiences when caring for a community‐dwelling adult with severe mental illness: A systematic review of qualitative evidence
Authors: Casaleiro Tiago , Caldeira Sílvia , Cardoso Daniela , Apóstolo João
Published: January 2022

Accessible Summary

What is known on the subject?

Being a caregiver of a relative with severe mental illness often impacts the quality of life, physical and mental health.

The use of coping strategies related to spirituality can enhance physical and mental well‐being.

What the paper adds to existing knowledge?

This review found 26 primary studies that refer to spiritual aspects of the experience of caring for a relative with mental health problems.

Caregivers express spiritual needs, such as hope and finding meaning in life, and spiritual or religious practices that help to cope with stressful situations.

What are the implications for practice?

Spiritual needs and spiritual coping strategies of family caregivers of a relative with severe mental illness should be included in mental health nursing care.

A spiritually sensitive approach should be used when promoting coping strategies of the family caregivers of a relative with severe mental illness.

Introduction

Deinstitutionalization of individuals with severe mental illness transferred the responsibility of care to the relatives who need to adapt their personal life. Caregivers often develop coping strategies which involve the relationship with oneself, others, or the transcendent/God or nature and may include religious/spiritual practices.

Question/Aim

This review aims to identify the spiritual aspects of the family caregivers’ experiences when caring for a community‐dwelling adult with severe mental illness.

Method

The review was conducted in accordance with the Joanna Briggs Institute methodology for systematic reviews of qualitative evidence. Search was conducted in March 2019, updated in August 2020, limited to English, Spanish and Portuguese.

Results

A total of 26 studies were included. Two synthesized findings emerged: spiritual coping strategies are used by family caregivers; spiritual needs are expressed by family caregivers. The findings are based on the experiences of 467 caregivers, from 14 countries.

Discussion

In stressful times, family caregivers question the meaning in life and acknowledge hopelessness. To cope, caregivers mention a turn to the sacred and the use of spiritual/religious practices.

Implications for practice

Spirituality should be considered according to caregivers’ individual beliefs and needs, as may represent important resources for the sense of meaning and overall well‐being.
Understory plant community responses to widespread spruce mortality in a subalpine forest
Authors: Carter Trevor A. , Fornwalt Paula J. , Dwire Kathleen A. , Laughlin Daniel C.
Published: January 2022

Aims

Spruce beetles (Dendroctonus rufipennis) are causing widespread spruce (Picea spp.) mortality in subalpine forests in western North America. Spruce beetles are changing forest structure and composition by killing a dominant overstory species, but we know little about how the understory community responds to the increase in resource availability brought about by spruce mortality, what mechanisms drive its response, or how its response affects other forest properties and processes.

Location

Glacier Lakes Ecosystem Experiments Site, Medicine Bow Mountains, Wyoming, USA.

Methods

We measured understory community cover and richness in 75 permanent plots during and 10 years after an epidemic spruce beetle outbreak, and measured trait values for 46 common understory species. We used linear regression to determine how the understory community has changed over time and along a gradient of spruce mortality, and to evaluate the relative support for two mechanisms contributing to species responses.

Results

Understory cover nearly doubled between sampling periods and increased the most where spruce mortality was most severe. Understory richness doubled and showed a weak positive trend with spruce mortality. Understory species with the largest increases in cover were the most frequent across the landscape before the disturbance, were the tallest at maturity and had the lowest leaf turgor loss points. Fir seedling density decreased over time, with decreases lessening with increases in understory cover. Changes in spruce seedling density were not predicted by changes in understory cover.

Conclusions

Our findings highlight some of the diverse ways in which understory communities can be altered by spruce beetle outbreaks, and how the direction and magnitude of change can depend on the amount of spruce mortality as well as on priority effects and traits of pre‐disturbance species. Our findings also highlight how understory community changes can have implications for other forest properties and processes, such as tree regeneration and forest recovery.
Implementation of an Uncontrolled, Real‐World Task: Vocabulary Learning Opportunities and Students’ Perceptions
Authors: KIM YOUJIN , KANG SANGHEE , D'ARIENZO MEREDITH
Published: January 2022

Task‐based research has shown the benefits of using tasks in various instructional contexts across different age groups. Although task‐based language teaching promotes language learning through authentic real‐world tasks, previous research has mainly used controlled pedagogic tasks. The current exploratory, intact‐classroom, multi‐case study examined the extent to which 13 Korean adolescent learners of English used and learned new English lexical items while carrying out an uncontrolled, real‐world, multimodal, video‐creation task. It further investigated students’ perceptions of performing such a task. Target items included 93 English lexical items that appeared in realia at a historical site in Korea. The video‐creation task was carried out over 5 days and included pretask planning, a field trip to the Korean historical site, and creation of a travel guide video for the site in a computer lab. Students’ interactions were recorded digitally. Results revealed that the degree of target‐item production varied by participant, but overall target lexical items were not greatly used by students. Students’ perceptions of the benefits of the uncontrolled, real‐world task seemed to relate to task‐as‐process, which was directly influenced by learner‐generated workplans. Pedagogical implications for designing and implementing real‐world tasks requiring task performance inside and outside of the classroom are discussed.
Adverse pregnancy outcomes and occlusal traits in the primary dentition: A prospective cohort (BRISA)
Authors: Silva Júnior Antonio Carlos , Alves Cláudia Maria Coelho , Martins Rafiza Félix Marão , Rodrigues Vandílson Pinheiro , Souza Soraia de Fátima Carvalho , Ribeiro Cecília Cláudia Costa , Thomaz Erika Barbara Abreu Fonseca
Published: January 2022

Objectives

This study aimed to analyse the relationship between adverse pregnancy outcomes (APO) and occlusal traits in the primary dentition, checking for different mediation paths.

Setting and Sample Population

Children evaluated at birth (T1), between 12 and 24 months (T2), and between 24 and 36 months (T3) were included. Two hundred and seventeen children who participated in T1 and T2 were randomly selected to perform the occlusion examination.

Materials and Methods

This is a prospective cohort study (BRISA). The theoretical model was tested by structural equation modelling (SEM), estimating standardized coefficients (Coeff.) (α = 0.05). The primary exposure was APO—a latent variable manifested from three health problems at birth: low birthweight (LBW), pre‐term birth (PTB) and intrauterine growth restriction (IUGR), evaluated in T1. The outcomes were four different occlusal traits assessed in T3: overjet, anterior and posterior crossbite, and crowding. Each outcome's direct and indirect effects were tested, mediated by growth, breathing, breastfeeding, and pacifier use.

Results

There was no direct association between APO and any of the outcomes: overjet (Coeff. = −0.163,P = .241), anterior crossbite (Coeff. = −0.696,P = .065), posterior crossbite (Coeff. = −0.087,P = .589) and crowding (Coeff. = 0.400,P = .423). The indirect (total and specifics) effects tested also showed no association (P > .05). However, APO was associated with lower child growth in all models; breastfeeding was associated with higher child growth in all models, and pacifier use was associated with overjet (Coeff. = 0.184,P < .001) and posterior crossbite (Coeff. = 0.373,P = .011).

Conclusion

APO was not a risk factor for overjet, crossbite and crowding in an early stage of the primary dentition by direct and indirect pathways. However, growth has been lower in children with APO and higher in children breastfed. Also, the harmful effects of using a pacifier in dental occlusion are highlighted.
Prognostic biomarkers of cutaneous melanoma
Authors: Ding Liang , Gosh Alexandra , Lee Delphine J. , Emri Gabriella , Huss Wendy J. , Bogner Paul N. , Paragh Gyorgy
Published: January 2022

Background/purpose

Melanomas account for only approximately 4% of diagnosed skin cancers in the United States but are responsible for the majority of deaths caused by skin cancer. Both genetic factors and ultraviolet (UV) radiation exposure play a role in the development of melanoma. Although melanomas have a strong propensity to metastasize when diagnosed late, melanomas that are diagnosed and treated early pose a low mortality risk. In particular, the identification of patients with increased metastatic risk, who may benefit from early adjuvant therapies, is crucial, especially given the advent of new melanoma treatments. However, the accuracy of classic clinical and histological variables, including the Breslow thickness, presence of ulceration, and lymph node status, might not be sufficient to identify such individuals. Thus, there is a need for the development of additional prognostic melanoma biomarkers that can improve early attempts to stratify melanoma patients and reliably identify high‐risk subgroups with the aim of providing effective personalized therapies.

Methods

In our current work, we discuss and assess emerging primary melanoma tumor biomarkers and prognostic circulating biomarkers.

Results

Several promising biomarkers show prognostic value (eg, exosomal MIA (ie, melanoma inhibitory activity), serum S100B, AMLo signatures, and mRNA signatures); however, the scarcity of reliable data precludes the use of these biomarkers in current clinical applications.

Conclusion

Further research is needed on several promising biomarkers for melanoma. Large‐scale studies are warranted to facilitate the clinical translation of prognostic biomarker applications for melanoma in personalized medicine.
Prediction of 2000‐m on‐water rowing performance with measures derived from instrumented boats
Authors: Holt Ana C. , Siegel Rodney , Ball Kevin , Hopkins William G. , Aughey Robert J.
Published: January 2022

Purpose

Rowing instrumentation systems provide measures of stroke power, stroke rate, and boat velocity during rowing races, but how well these measures predict race performance has not been reported previously.

Methods

Data were collected per stroke from 45 2000‐m races using Peach PowerLine and OptimEye S5 GPS units. The boat classes assessed were nine male singles, eight female singles, three male pairs, and six female pairs. Random effects and residuals from general linear mixed modeling of stroke velocity adjusted for stroke power, stroke rate, and mean headwind provided measures interpreted as technical efficiency, race conditions, and stroke‐velocity variability. These measures, along with mean race power, mean stroke rate, and mean headwind were then included in multiple linear regressions to predict race velocity from official race times. Effects were assessed for 2 SD changes in predictors and interpreted using interval hypothesis tests.

Results

Effects of mean race power, mean stroke rate, and mean headwind on race velocity ranged from small to extremely large and were mostly decisively substantial. Effects of technical efficiency and race conditions ranged from trivial to extremely large but were generally unclear, while stroke‐velocity variability had trivial‐small and mostly unclear effects. Prediction error was small to moderate and decisively substantial. Men's pairs lacked sufficient data for analysis.

Conclusion

On‐water rowing race performance can be predicted with mean race values of power, stroke rate, and headwind. Estimates from stroke data are potentially useful predictors but require impractical numbers of boats and races to reduce their uncertainty.
HIV self‐testing and repeat testing in pregnancy and postpartum in Northern Nigeria
Authors: Iliyasu Zubairu , Galadanci Hadiza S. , Musa Abubakar H. , Iliyasu Bilkisu Z. , Nass Nafisa S. , Garba Rayyan M. , Jibo Abubakar M. , Okekenwa Sonia C. , Salihu Hamisu M. , Aliyu Muktar H.
Published: January 2022

Objective

Incident HIV infections in pregnant and breastfeeding mothers pose significant challenges to prevention of mother‐to‐child HIV transmission efforts in sub‐Saharan Africa. We identified the predictors of willingness to self‐test for HIV when retesting in pregnancy and postpartum among antenatal clients in a tertiary hospital in Northern Nigeria.

Methods

Structured and validated questionnaires were administered to a cross section of antenatal attendees (n = 370) in March 2021. Willingness to self‐test and adjusted odds ratios of potential predictors were generated from logistic regression models.

Results

Of the 317 respondents who agreed to repeat HIV test during pregnancy, 29.3% (n = 93) were willing to self‐test. Similarly, of those (n = 350) willing to retest after delivery, 27.4% (n = 96) were willing to self‐test. Willingness to self‐test during pregnancy was higher among respondents who were multiparous (2–4 births) (adjusted odds ratio, aOR = 2.40, 95% confidence interval CI, 1.14–6.43), employed (aOR = 1.49, 95% CI, 1.13–4.53) and those with at least secondary education (aOR = 2.96, 95% CI, 1.43–11.47). In contrast, willingness to self‐test was lower among those who were unaware of the husband's HIV status (aOR = 0.05, 95% CI, 0.02–0.13). Willingness to self‐test after delivery was higher among respondents who were married (aOR = 15.41, 95% CI, 3.04–78.2), multiparous (aOR = 2.01, 95% CI, 1.27–5.63), employed (aOR = 1.59, 95% CI, 1.08–2.35) and had at least to secondary education (aOR = 6.12, 95% CI, 1.36–27.47). In contrast, willingness to self‐test postpartum was lower among those who booked late (≥29 weeks) (aOR = 0.11, 95% CI, 0.022–0.52), those who were unaware of the risk of HIV transmission during breastfeeding (aOR = 0.29, 95% CI, 0.12–0.68) and participants who were unaware of the husband's HIV status (aOR = 0.076, 95% CI, 0.03–0.19).

Conclusion

Willingness to self‐test for HIV in pregnancy and postpartum was low in this population and was influenced by risk perception, socio‐demographic and obstetric attributes. Communication interventions and training of potential mentor mothers among early adopters could improve self‐testing in this group and similar settings.
Experiments with rectangular supersonic jets with potential noise reduction technology
Authors: Scupski N. , Akatsuka J. , McLaughlin D. K. , Morris P. J.
Published: January 2022

This paper describes the aeroacoustics experiments conducted with supersonic jets, exhausting from rectangular nozzles with an aspect ratio of 2, to examine the jet noise reduction by two different methods. The first method involves the use of fluid inserts, which are produced by distributed air blowing into the diverging section of a convergent-divergent exhaust nozzle. The second method involves the integration of fluid shields in dual flow rectangular jets. In the dual flow nozzle, a single shield below the exit is augmented with fluid shields extending on both sides of the rectangular jet. The purpose of the extended bypass flow is to reduce the noise radiated to the sides of a jet aircraft. In addition to the nozzles with the two noise reduction configurations, acoustic measurements are performed with a single flow rectangular jet, referred to as the baseline. In all cases, the jets are operated as overexpanded, shock-containing jets. In some cases, the jets are operated with the core flow mixtures of helium and air to simulate high temperature jets. The far-field noise measurements are performed on an arc with the microphones approximately 70 equivalent nozzle diameters from the nozzle exit. For the purposes of assessing the noise reduction capability of the dual stream jet, comparisons are made with a baseline rectangular jet on an equal thrust per unit exit area basis. The nondimensional acoustic spectra and overall sound pressure level directivities are shown and compared.