bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-linear CMB lensing with neutrinos and baryons: FLAMINGO simulations versus fast approximations
Authors: Upadhye Amol , Kwan Juliana , McCarthy Ian G , Salcido Jaime , Helly John C , Kugel Roi , Schaller Matthieu , Schaye Joop , Braspenning Joey , Elbers Willem , Frenk Carlos S , van Daalen Marcel P , Vandenbroucke Bert , Broxterman Jeger C
Published: March 2024

Weak lensing of the cosmic microwave background is rapidly emerging as a powerful probe of neutrinos, dark energy, and new physics. We present a fast computation of the non-linear CMB lensing power spectrum that combines non-linear perturbation theory at early times with power spectrum emulation using cosmological simulations at late times. Comparing our calculation with light-cones from the FLAMINGO 5.6 Gpc cube dark-matter-only simulation, we confirm its accuracy to $1{{\ \rm per\ cent}}$ ($2{{\ \rm per\ cent}}$) up to multipoles L = 3000 (L = 5000) for a νΛCDM cosmology consistent with current data. Clustering suppression due to small-scale baryonic phenomena such as feedback from active galactic nuclei can reduce the lensing power by $\sim 10{{\ \rm per\ cent}}$. To our perturbation theory and emulator-based calculation, we add SP(k), a new fitting function for this suppression, and confirm its accuracy compared to the FLAMINGO hydrodynamic simulations to $4{{\ \rm per\ cent}}$ at L = 5000, with similar accuracy for massive neutrino models. We further demonstrate that scale-dependent suppression due to neutrinos and baryons approximately factorize, implying that a careful treatment of baryonic feedback can limit biasing neutrino mass constraints.
Cosmological and idealized simulations of dark matter haloes with velocity-dependent, rare and frequent self-interactions
Authors: Fischer Moritz S , Kasselmann Lenard , Brüggen Marcus , Dolag Klaus , Kahlhoefer Felix , Ragagnin Antonio , Robertson Andrew , Schmidt-Hoberg Kai
Published: March 2024

Dark matter self-interactions may have the capability to solve or at least mitigate small-scale problems of the cosmological standard model, Lambda cold dark matter. There are a variety of self-interacting dark matter models that lead to distinguishable astrophysical predictions and hence varying success in explaining observations. Studies of dark matter (DM) density cores on various mass scales suggest a velocity-dependent scattering cross-section. In this work, we investigate how a velocity dependence alters the evolution of the DM distribution for frequent DM scatterings and compare to the velocity-independent case. We demonstrate that these cases are qualitatively different using a test problem. Moreover, we study the evolution of the density profile of idealized DM haloes and find that a velocity dependence can lead to larger core sizes and different time-scales of core formation and core collapse. In cosmological simulations, we investigate the effect of velocity-dependent self-interaction on haloes and satellites in the mass range of ≈1011–$10^{14} \, \mathrm{M_\odot }$. We study the abundance of satellites, density, and shape profiles and try to infer qualitative differences between velocity-dependent and velocity-independent scatterings as well as between frequent and rare self-interactions. We find that a strongly velocity-dependent cross-section can significantly amplify the diversity of rotation curves, independent of the angular dependence of the differential cross-section. We further find that the abundance of satellites in general depends on both the velocity dependence and the scattering angle, although the latter is less important for strongly velocity-dependent cross-sections.
Estimating the jet power from Broadband SED modelling of Mkn 501 for different particle distributions
Authors: Bora Hritwik , Khatoon Rukaiya , Misra Ranjeev , Gogoi Rupjyoti
Published: March 2024

We consider the broad-band spectral energy distribution of the high-energy-peaked blazar Mkn 501 using Swift-XRT/UVOT, NuSTAR and Fermi-LAT observations taken between 2013 and 2022. The spectra were fitted with a one-zone leptonic model using synchrotron and synchrotron self-Compton emission from different particle energy distributions such as a broken power law, log-parabola, as well as distributions expected when the diffusion or the acceleration time-scale are energy-dependent. The jet power estimated for a broken power-law distribution was ∼1047(1044) erg s−1 for a minimum electron energy γmin ∼ 10(103). However, for electron energy distributions with intrinsic curvature (such as the log-parabola form), the jet power is significantly lower at a few times 1042 erg s−1 which is a few per cent of the Eddington luminosity of a 107 M⊙ black hole, suggesting that the jet may be powered by accretion processes. We discuss the implications of these results.
The Cosmic Clockwork
Authors: Frost Mike , McLeish Tom
Published: March 2024

This first chapter tackles the underlying dynamic geometry of eclipses from a scientific point of view—when and why do total solar eclipses occur? The cosmic clockwork that creates total solar eclipses essentially consists in Euclidean geometry enhanced with planetary motion: The motion of the orbital dynamics of Earth around the Sun, and that of the Moon around Earth (yet strongly affected by the force of the Sun). The phenomenon in motion provides the glossary with surely its favourite word—‘syzygy’—meaning a lining up of three bodies. A second ingredient to the geometry is constituted by the need to match the periods of cycles of Earth and Moon so that all align, giving rise to the saros cycle known to the ancient world and the more modern inex cycle.
Good Governance and the Partisan Wars: The Effects of Divided Government on Administrative Problem Solving and Oversight Agenda Setting in Congress
Authors: Leavitt Claire
Published: March 2024

Congress’s constitutional responsibility to oversee and investigate the executive branch of government demands that instances of waste, fraud, and abuse in the administrative state be checked via both legislation and nonlegislative committee hearings. In this article, I establish an oversight agenda for Congress using the nonpartisan Government Accountability Office's (GAO) biennial identification of the most vulnerable federal agencies and programs. I then assess whether and how government-wide partisanship affects Congress’s ability to address this slate of issues. I find that, when government is divided, Congress is more legislatively productive on high-risk issues, and the House of Representatives is more likely to prioritize investigative hearings on high-risk issues. My results suggest a silver lining to the reality of partisan agenda control: preexisting administrative problems identified by well-positioned and well-informed observers at GAO may get more attention when there is a partisan incentive for the legislature to investigate an opposition-controlled government.
Longitudinal Magnetic Resonance Imaging Tracking of Transplanted Neural Progenitor Cells in the Spinal Cord Utilizing the Bright-Ferritin Mechanism
Authors: Luo Zixiang , Zhuang Keyu , Kim Seong Jun , Vollett Kyle D W , Lou Zijian , Wang Jian , Cheng Hai-Ying Mary , Khazaei Mohamad , Fehlings Michael G , Cheng Hai-Ling Margaret
Published: March 2024

Human neural progenitor cells (hNPCs) hold promise for treating spinal cord injury. Studies to date have focused on improving their regenerative potential and therapeutic effect. Equally important is ensuring successful delivery and engraftment of hNPCs at the injury site. Unfortunately, no current imaging solution for cell tracking is compatible with long-term monitoring in vivo. The objective of this study was to apply a novel bright-ferritin magnetic resonance imaging (MRI) mechanism to track hNPC transplants longitudinally and on demand in the rat spinal cord. We genetically modified hNPCs to stably overexpress human ferritin. Ferritin-overexpressing (FT) hNPCs labeled with 0.2 mM manganese provided significant T1-induced bright contrast on in vitro MRI, with no adverse effect on cell viability, morphology, proliferation, and differentiation. In vivo, 2 M cells were injected into the cervical spinal cord of Rowett nude rats. MRI employed T1-weighted acquisitions and T1 mapping on a 3 T scanner. Conventional short-term cell tracking was performed using exogenous Mn labeling prior to cell transplantation, which displayed transient bright contrast on MRI 1 day after cell transplantation and disappeared after 1 week. In contrast, long-term cell tracking using bright-ferritin allowed on-demand signal recall upon Mn supplementation and precise visualization of the surviving hNPC graft. In fact, this new cell tracking technology identified 7 weeks post-transplantation as the timepoint by which substantial hNPC integration occurred. Spatial distribution of hNPCs on MRI matched that on histology. In summary, bright-ferritin provides the first demonstration of long-term, on-demand, high-resolution, and specific tracking of hNPCs in the rat spinal cord.
No Differences in Clinical, Functional, or Patient-Reported Outcomes Following Trial of Non-operative Management Prior to Open Reduction and Internal Fixation of Humeral Shaft Fractures.
Authors: Patel Urvi J. , Holloway Melissa R. , Carroll Thomas J. , Soin Sandeep P. , Ketz John P.
Published: March 2024

Objectives:

To test the hypothesis that primary osteosynthesis of humeral shaft fractures may lead to more favorable clinical, functional, and patient-reported outcomes than fixation following a trial of nonoperative management.

Methods:

Design:

Retrospective Cohort Review.

Setting:

Academic Level I Trauma Center.

Patient Selection Criteria:

Adult patients who presented with humeral shaft fractures, and ultimately underwent open reduction and internal fixation (ORIF) from 05/2011 to 05/2021. Patients who underwent ORIF within 2 weeks of injury were grouped into the primary osteosynthesis cohort, and patients who underwent ORIF >4 weeks from date of injury were grouped into the trial of nonoperative cohort.

Outcome Measures and Comparisons:

Post-operative complications, elbow arc of motion, time to radiographic union, and patient-reported outcomes were investigated and compared between the primary osteosynthesis and trial of nonoperative management cohorts.

Results: 127 patients fit the study criteria, 84 underwent primary osteosynthesis and 43 trialed initial non-operative treatment. No differences were found in patient demographics between the primary osteosynthesis and trial of non-operative management cohorts, including age (53±19 vs. 57±18; p=0.25), sex (39% vs. 44% male, 61% vs. 56% female; p=0.70), and BMI (30±6 vs. 32±9; p=0.38) . The average time to operative intervention in the primary osteosynthesis group was 4 days (0-14 days), and 105 days (28-332 days) in the trial of non-operative treatment group (p<0.01). No differences were found with regards to intra-operative blood loss, total operative time, time to radiographic union (determined using the RUSHu scoring system), or overall complication rates, including primary and secondary radial nerve injuries (P=0.23 and 0.86, respectively). Patients reported similar PROMIS Pain Interference (PI) (P=0.73), Depression (D) (P=0.99), and Physical Function (PF) (P=0.66) scores at their 6-month post-surgical follow up visits.

Conclusion:

Patients who attempted a trial of non-operative management for humeral shaft fractures prior to open reduction and internal fixation had similar clinical, functional, and patient reported outcomes as those who underwent primary osteosynthesis.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Use and Effectiveness of Innovative Virtual Reality Application in Teaching Fetal Development
Authors: Aydın Doğan Reyhan , Yazıcı Saadet
Published: March 2024

Virtual reality-based training is effective. It is increasingly used by multiple disciplines to develop observation and critical skills, including engineering, education, arts, and health. This study was conducted to determine the effectiveness of the application created with Fetal Development Application Created by Virtual Reality Technology, which was developed to teach fetal development. The study was conducted in a single-blind, randomized fashion. Undergraduate midwifery students who took normal pregnancy lessons and learned fetal development were included. Eighty-four students were included in the experimental (n = 42) and control (n = 42) groups. Before the training, a personal information form and a pretest were applied to both groups. After the pretest, the experimental group received Fetal Development Application Created by Virtual Reality Technology, and the control group received 2 hours of theory training. Posttest was applied to both groups 6 weeks after the application. Preintervention scores were similar for the two groups. The posttest score of the experimental group was statistically significant compared with that of the control group (P < .05). The mean cognitive load score of the experimental group was 1.09 ± 0.29, and the application did not create a cognitive load. The innovative application of Fetal Development Application Created by Virtual Reality Technology is an effective and applicable method in teaching fetal development in midwifery education.
Exploring the Usage Effectiveness of a Nursing Charge System
Authors: Nian Nai-Shin , Lee Ting-Ting , Huang Shu-He , Liu Chieh-Yu , Chou Shin-Shang , Liu Ya-Fen , Mills Mary Etta
Published: March 2024

The nursing charge system for inpatient accounting has been utilized in healthcare institutions for years. However, the level of its effectiveness in meeting the needs of nursing services, including further development, has not been systematically evaluated. A cross-sectional study based in Delone and McLean's information system success model was applied to explore the level of effective nursing charge system usage across the five dimensions of system quality, information quality, service quality, user satisfaction, and net benefits. We conducted a survey of the inpatient units of a medical center in Taiwan from June 23, 2021, to July 23, 2021. A total of 214 valid questionnaires were collected. Using a 5-point Likert scale, the dimension with the highest score was information quality (3.71), followed by service quality (3.37), user satisfaction (3.36), net benefits (3.31), and system quality (3.23). Older nurses (r = −0.176) and those with more clinical experience (r = −0.151) viewed the nursing charge system as having less information quality. The comfort level with using the computer was positively associated with system quality (r = 0.396), information quality (r = 0.378), service quality (r = 0.275), user satisfaction (r = 0.417), and net benefits (r = 0.355). The opinions of nurses are vital. User feedback and advice should be investigated regularly to achieve system optimization.
Identifying Main Themes in Diabetes Management Interviews Using Natural Language Processing–Based Text Mining
Authors: Cha EunSeok , Lee Seonah
Published: March 2024

This study aimed to identify the main themes from exit interviews of adult patients with type 2 diabetes after completion of a diabetes education program. Eighteen participants with type 2 diabetes completed an exit interview regarding their program experience and satisfaction. Semistructured interview questions were used, and the interviews were auto-recorded. The interview transcripts were preprocessed and analyzed using four natural language processing–based text-mining techniques. The top 30 words from the term frequency and term frequency–inverse document frequency each were derived. In the N-gram analysis, the connection strength of “diabetes” and “education” was the highest, and the simultaneous connectivity of word chains ranged from a maximum of seven words to a minimum of two words. Based on the CONvergence of iteration CORrelation (CONCOR) analysis, three clusters were generated, and each cluster was named as follows: participation in a diabetes education program to control blood glucose, exercise, and use of digital devices. This study using text mining proposes a new and useful approach to visualize data to develop patient-centered diabetes education.
Academic Electronic Health Record in Mental Health Clinical
Authors: Mountain Carel , Hill Rachel
Published: March 2024

Developing competency in the use of EHRs is essential for entry-level professional nurses. Although nursing education has been encouraged to integrate this technology into nursing curriculum, many students still graduate feeling unprepared in this area. As a result, nursing graduates lack the skills necessary to effectively use EHRs, which may have negative consequences for safe patient care. Use of academic EMRs provides students the opportunity to integrate informatics education, develop critical thinking, and incorporate problem-solving skills in the clinical area.

An academic EMR was introduced to students in the second semester of a baccalaureate degree nursing program. Students completed documentation on one patient from the mental health clinical rotation. A retrospective chart review was conducted, using a rubric to determine charting efficacy.

Data analysis indicated that students struggled with documentation of the mental health assessment, care plan development, and nursing notes. Student documentation was strongest in vital signs and basic information.

Students need practice documenting on the critical aspects of nursing care. Utilization of an academic EMR for clinical charting provides an opportunity for students to practice documentation and develop necessary skills for clinical practice.
Metastatic Tonsil Squamous Cell Carcinoma: An Important Consideration in the Differential Diagnosis of Malignant Basaloid Neoplasms in the Skin: Case Report and Review of the Literature
Authors: Thigpen Bradley T. , Johnston Ronald B. , Giubellino Alessio , Mogrovejo Diana O. , Jethwa Ashok R. , Patino Willmar D.
Published: March 2024

Malignant basaloid neoplasms of the skin are frequent, and their accurate diagnosis holds paramount importance for treatment and prognosis. However, these neoplasms can present diagnostic challenges because of their extensive differential diagnosis, which encompasses cutaneous metastasis among many other possibilities. We present a case of a 74-year-old man with a history of p16-positive palatine tonsil squamous cell carcinoma (SCC) treated with surgery and adjuvant radiation with no prior evidence of recurrence who presented to the dermatologist with 2 chin papules. The initial histopathologic evaluation of these lesions showed poorly differentiated malignant basaloid neoplasms. Subsequently, these biopsies were compared with the previous biopsies from his tonsil and lymph node, which showed similar findings including positive p16 staining and positive molecular testing for human papillomavirus-16, confirming the diagnosis of cutaneous metastasis from his previously diagnosed human papillomavirus–related tonsil SCC. Additional imaging studies found metastases to internal organs including the brain, and he was started on chemotherapy, immunotherapy, and radiation therapy. Cutaneous metastases from tonsil SCC are exceedingly rare, and only 5 cases have been described. Furthermore, this is the first case confirming the presence of high-risk human papillomavirus by molecular studies within the cutaneous metastases. The presented case underscores the importance of recognizing this unusual manifestation of tonsil SCC metastatic to the skin along with a good clinical patient history, ensuring accurate and prompt diagnosis and treatment of this condition.
Practical Review on the Contemporary Diagnosis and Management of Compartment Syndrome
Authors: Davidson Amelia L. , Sutherland Mason A. , Siska Robert C. , Janis Jeffrey E.
Published: March 2024

Acute compartment syndrome (ACS) is a limb-threatening pathology that necessitates early detection and management. The diagnosis of ACS is often made by physical examination alone; however, supplemental methods such as compartment pressure measurement, infrared spectroscopy, and ultrasound can provide additional information that support decision-making. This practical review aims to incorporate and summarize recent studies to provide evidence-based approaches to compartment syndrome for both resource-rich and -poor settings among several patient populations.
Safety and Outcomes in Multiplane Facial Rejuvenation with Tranexamic Acid: A Cohort Study
Authors: Ziegler Rodríguez Otto Rolando , De la Cruz Ku Gabriel , Chávez Díaz Marcelo , Ziegler Rodríguez Gonzalo Javier , Ziegler Gutiérrez Otto Enrique
Published: March 2024

Background:

Tranexamic acid (TXA) has demonstrated promising outcomes in plastic surgery. Our aim was to assess the effect of TXA in intraoperative bleeding, operative time, and complications among patients undergoing facial surgical procedures.

Methods:

A retrospective cohort study of patients who underwent multiplane facial rhytidectomy from January 2018 to September 2022 at the Clinica Ziegler, Lima, Peru. Patients were divided into two groups according to the use of intravenous plus local infiltration of TXA. We performed the chi square test to assess associations among categorical variables, the Student t test and Mann–Whitney U test for categorical with continuous variables, and Pearson correlation for quantitative variables.

Results:

A total of 100 patients were included with 50 patients in each group. The median age was 59.5 years and the majority were women (88%). The median operative time was 288.5 minutes. The TXA group presented less intraoperative bleeding (40 versus 90 mL, P < 0.05) and shorter operative time (237 versus 353 minutes, P < 0.05); no differences in the development of hematoma (2% versus 12%, P = 0.11), less ecchymosis (2% versus 36%, P < 0.05), edema (2% versus 100%, P < 0.05), and time to drain removal (3 versus 6 days, P < 0.05).

Conclusions:

TXA improves the short- and long-term outcomes of patients who undergo multiplane facial rhytidectomy. It also decreases intraoperative bleeding by more than half and reduces the operative time by one third. Moreover, patients receiving TXA presented significantly less ecchymosis, edema, and time to drain removal.
Concussion Management in Older People: A Scoping Review
Authors: Elias Josh , Sutherland Emma , Kennedy Ewan
Published: March 2024

Objective:

To map existing literature about concussion management in older people, identifying and analyzing gaps in our understanding.

Context:

Concussion injuries affect older people, yet little guidance is available about how to approach concussion management with older people. Research does not always include older populations, and it is unclear to what extent standard concussion management is appropriate for older people.

Design:

Scoping review.

Method:

A structured literature search was conducted using 4 databases to identify existing literature relating to concussion management in older people. Studies that assessed outcomes relating to the management of concussion/mild traumatic brain injury in those 65 years or older were included and mapped according to the main themes addressed.

Results:

The search yielded a total of 18 articles. Three themes related to early management (use of anticoagulants n = 6, intracranial lesions n = 3, and service delivery for older people n = 5), and 1 theme related to general management (cognitive issues n = 4). A lack of articles exploring general management in older people was observed.

Conclusion:

Existing literature indicates that specific management strategies are needed for older people with concussion, especially in early management. This review highlights that good evidence is available about early management and this is reflected in some guidelines, yet little evidence about general management is available and this gap is not acknowledged in guidelines. Distinct approaches to early management in older people are clearly recommended to mitigate the risk of poor outcomes. In contrast, general concussion management for older people is poorly understood, with older people poorly represented in research. A better understanding is needed because—as observed in early management—older people have distinct characteristics that may render standard management approaches unsuitable.
Persistent and Severe Mpox Keratitis Despite Systemic and Topical Treatment
Authors: Domínguez García Laura , Gutierrez-Arroyo Almudena , Miguel-Buckley Rosa , Martin Ucero Ana , Cantizani Juan , Boto-de-los-Bueis Ana
Published: March 2024

Purpose:

The purpose of this study was to report a case of peripheral ulcerative keratitis in a patient diagnosed with corneal polymerase chain reaction (PCR) and a positive mpox culture.

Methods:

This is a case report.

Results:

An immunocompetent 54-year-old man was diagnosed with conjunctivitis in his left eye 15 days after being diagnosed with mucocutaneous monkeypox. He received treatment with dexamethasone 0.1% and tobramycin 0.3% eye drops for 2 weeks. Two weeks after discontinuing this treatment, he developed peripheral ulcerative keratitis and a paracentral epithelial defect. Mpox keratitis was diagnosed by corneal culture and PCR. Corneal inflammation persisted for more than 6 months, manifested as corneal epithelial defect, limbitis, endotheliitis, neurotrophic changes, and trabeculitis. This persistence was observed alongside positive corneal PCR results, despite undergoing 2 courses of trifluorothymidine, 2 courses of oral tecovirimat, and intravenous cidofovir. An amniotic membrane transplantation was then performed.

Conclusions:

Persistent corneal pain and replication are possible with the mpox virus, even in immunocompetent patients. Having received treatment with topical corticosteroids before antiviral treatment for the pox virus may have contributed to the severity and persistence of the clinical condition. Cycle threshold PCR values can be used to support the diagnosis and monitor treatment effectiveness.
Punctal and Canalicular Stenosis Following Topical 1% 5-Fluorouracil Eye Drop Therapy for Ocular Surface Squamous Neoplasia
Authors: Alvarez Osmel P. , Zein Mike , Serrano Andres , Galor Anat , Karp Carol L.
Published: March 2024

Purpose:

To present the first known cases of punctal and canalicular stenosis following topical 5-fluorouracil (5-FU) eye drops for ocular surface squamous neoplasia (OSSN).

Methods:

A retrospective chart review of patients with OSSN receiving topical 1% 5-FU eye drops as a primary or adjuvant treatment between 2013 and 2021 was performed. Individuals diagnosed with punctal or canalicular stenosis during or after topical 5-FU use were included in this study. Four individuals met these criteria; we report clinical findings and treatment course for each patient.

Results:

We reviewed 303 patients (316 eyes) with OSSN. All patients were treated with topical 1% 5-FU eye drops in cycles, given 4 times daily for 1 week with 3 weeks off. Four patients (5 eyes) developed punctal stenosis, for a frequency of 1.3%. The mean age at 5-FU initiation in the 4 individuals was 61 years (range 53–69). Most individuals were male (75%), White (75%), and non-Hispanic (100%). The most common presenting symptom of stenosis was epiphora, noted 4.6 ± 3 months after initiating topical 5-FU (after 4.9 ± 2.0 cycles). This occurred in 4 eyes while on therapy (3, 2, 4, and 4 months since 5-FU initiation) and in 1 eye after stopping therapy (10.3 months since 5-FU initiation). In 1 eye, punctal stenosis and epiphora resolved spontaneously after stopping 5-FU. Punctal dilation led to symptom resolution in 2 eyes. Surgical intervention (punctoplasty and external dacryocystorhinostomy) was needed in 2 eyes for punctal and canalicular stenosis, respectively.

Conclusions:

Punctal or canalicular stenosis is a rare and previously unreported adverse effect of topical 5-FU that may require surgical treatment.
Demographic and Psychiatric Associations With Dry Eye in a Medicare Population
Authors: Li Gavin , Garzon Catalina , Klawe Janek , Akpek Esen Karamursel , Ahmad Sumayya
Published: March 2024

Purpose:

The purpose of this study was to investigate the impact of demographic characteristics and psychiatric comorbidity on the prevalence of dry eye disease in the American geriatric population.

Methods:

Data were collected from a 2011 nationwide sample of Medicare beneficiaries aged 65 years and older (N = 1,321,000). Age, sex, race/ethnicity, residential area, climate region, and income, along with psychiatric comorbidities including depression and anxiety, were collected. Multivariable logistic regression models were used to assess the relationship between demographic and psychiatric factors and the prevalence of dry eye disease.

Results:

Among 21,059 patients with clinically significant dry eye, women had higher odds of having dry eye compared with men [odds ratio (OR) 2.03, 95% confidence interval (1.97–2.10)]. Asian and Native American patients had increased odds of having dry eye compared with White patients [OR 1.85 (1.69–2.02) and OR 1.51 (1.19–1.93)], while Black patients were less likely to have dry eye [OR 0.83 (0.79–0.87)]. Patients aged 75 to 84 years and 85+ were more likely to have dry eye compared with those aged 65 to 74 years [OR 1.49 (0.45–1.53) and OR 1.54 (1.48–1.60)]. Having both depression and anxiety were associated with higher odds of having dry eye [OR 2.38 (2.22–2.55)] compared with having depression alone [OR 1.95 (1.86–2.04)] or anxiety alone [OR 2.22 (2.10–2.35)].

Conclusions:

Significant racial and regional disparities in dry eye prevalence were found. Psychiatric association with dry eye varied with age, sex, race, and residence region. Further research is needed to comprehend the underlying mechanisms, implications, and to address disparities in the diagnosis and management of dry eye.
Unregulated Decorative Lenses: A Brief Definitive Review
Authors: Han Elaine , Rhee Michelle K.
Published: March 2024

Contact lenses are US Food and Drug Administration-regulated medical devices that are a safe and effective method for the correction of refractive error. They are worn by an estimated 45 million Americans. Decorative contact lenses (DCLs) can be used for patients with medical conditions such as failed corneas or aniridia. However, DCLs have also gained popularity in the young, contact lens-naïve population. DCL users often buy lenses through unregulated sources without a clinical examination and education on proper use by an eye care professional. These lenses have a significantly higher risk of infection when compared with contact lenses for the correction of refractive error. To reduce the incidence of microbial keratitis, regulators and eye care professionals must make coordinated efforts to generate and disseminate prevention messages to all contact lens users. In addition, physician and patient reporting of contact lens-related complications to regulatory agencies enhances the pathway to risk reduction. This article reviews DCL use and supply, with a specific focus on the increased risk of contact lens-related complications in unsupervised DCL use.
Therapeutic Response to Treatment of a Papillomatous Ocular Surface Squamous Neoplasia With Intramuscular Human Papillomavirus Vaccine
Authors: Zein Mike , De Arrigunaga Sofia , Amer Mona M. , Galor Anat , Nichols Anna J. , Ioannides Tim , Dubovy Sander R. , Karp Carol L.
Published: March 2024

Purpose:

The purpose of this study was to describe the response of a papillomatous ocular surface squamous neoplasia (OSSN) to the intramuscular (IM) 9-valent human papillomavirus (HPV) vaccine after failed medical and surgical interventions.

Methods:

A 79-year-old White man with a conjunctival lesion underwent a biopsy which revealed OSSN and positivity for high-risk HPV. Initially treated with medical therapy and surgical excisions, the patient developed a recurrence and refused further surgery. He was given 4 doses of IM HPV vaccine at the 6-week interval.

Results:

A dramatic reduction in lesion size and reduced epithelial thickening and hyperreflectivity was noted on slitlamp examination and high-resolution anterior segment optical coherence tomography after receiving the IM HPV vaccine. Although lesion size was markedly reduced, the therapy did not achieve total resolution, resulting in further treatment with topical 1% 5-fluorouracil (5-FU) eye drops and later 0.04% mitomycin C eye drops. The patient then elected to discontinue further treatment and solely observe.

Conclusions:

This case report adds to the growing literature demonstrating the potential therapeutic use of vaccines in cancer treatment. Although HPV vaccination is currently approved for prophylaxis, the use of HPV vaccines as a therapeutic option for various HPV-mediated diseases, including OSSN, should be further explored. The HPV vaccine yielded significant initial improvement in this patient who refused further surgical interventions. The use of IM HPV vaccine as an adjunctive treatment of papillomatous OSSN may represent a potential therapeutic option in cases refractory to standard treatment modalities.
Phase 3 Safety and Immunogenicity Study of a Three-dose Series of Twenty-valent Pneumococcal Conjugate Vaccine in Healthy Infants and Toddlers
Authors: Korbal Piotr , Wysocki Jacek , Jackowska Teresa , Kline Mary , Tamimi Noor , Drozd Jelena , Lei Lanyu , Peng Yahong , Giardina Peter C. , Gruber William , Scott Daniel , Watson Wendy
Published: March 2024

Background:

Global pediatric immunization programs with pneumococcal conjugate vaccines (PCVs) have reduced vaccine-type pneumococcal disease, but a substantial disease burden of non-PCV serotypes remains.

Methods:

This phase 3, randomized (1:1), double-blind study evaluated safety and immunogenicity of 20-valent PCV (PCV20) relative to 13-valent PCV (PCV13) in healthy infants. Participants received 2 infant doses and a toddler dose of PCV20 or PCV13, with diphtheria-tetanus-acellular pertussis combination vaccine at all doses and measles, mumps, rubella and varicella vaccines at the toddler dose. Primary pneumococcal immunogenicity objectives were to demonstrate noninferiority (NI) of PCV20 to PCV13 for immunoglobulin G geometric mean concentrations after infant and toddler doses and percentages of participants with predefined serotype-specific immunoglobulin G concentrations after infant doses. Safety endpoints included local reactions, systemic events and adverse events.

Results:

Overall, 1204 participants were vaccinated (PCV20, n = 601; PCV13, n = 603). One month after the toddler dose, 19/20 serotypes met NI for immunoglobulin G geometric mean concentrations; serotype 6B narrowly missed NI [PCV20/PCV13 geometric mean ratio: 0.57 (2-sided 95% confidence interval: 0.48–0.67); NI criterion: lower 2-sided 95% confidence interval >0.5]. Sixteen/twenty serotypes met NI for ≥1 primary objective after 2 infant doses. PCV20 induced robust opsonophagocytic activity, and boosting responses were observed for all vaccine serotypes, including those missing statistical NI. The safety/tolerability profile of PCV20 was like that of PCV13.

Conclusions:

PCV20 3-dose series in infants was safe and elicited robust immune responses. Based on these results and PCV13 experience, PCV20 3-dose series is expected to be protective for all 20 vaccine serotypes. NCT04546425.
Aggressiveness in systemic anticancer therapy at the end of life in an oncology center
Authors: Ferraz-Gonçalves José António , Silva Inês , Redondo Patrícia , Luís Michael Sapateiro
Published: March 2024

Introduction:

An increasing aggressiveness in cancer treatment at the end of life (EoL) has been reported in several, but not all, countries. This study aimed to see how aggressive cancer treatment is at the EoL in an oncology center.

Methods:

Retrospective study of patients 18 years or older with a solid cancer diagnosis who died in 2017. The focus was systemic anticancer therapy (SACT), excluding hormonotherapy.

Results:

In 2017, 2024 patients with solid tumors died. Of those patients, 1262 (62%) were male, and the median age was 69 (range 19–97) years. The most frequent primary cancer was lung cancer, followed by colorectal and stomach cancers, and 740 (37%) patients had metastatic disease. The median interval between SACT and death was 61 days. Of the patients undergoing SACT, 216 (27%) did it in the last month of life, 174 (22%) between 8 and 30 days from death, and 42 (5%) in the last week. On multivariable analysis, head and neck, colorectal, breast, and melanoma primaries; age group (older than 65 years); and metastatic disease had statistical significance associated with SACT. Of these variables, only metastatic disease is more likely to undergo SACT.

Conclusion:

This study confirms the relatively frequent aggressiveness in cancer treatment at the EoL. Taking into consideration previously published data, it can be tentatively concluded that the use of SACT increased in the last month and the last week of life.
On Merit and Equity in Admission to US Physical Therapist Education Programs: A Qualitative Analysis of Faculty Habitus
Authors: Nuciforo Matthew A.
Published: March 2024

Introduction.

In contrast to the increased diversity of the US population, historically excluded racial and ethnic groups remain underrepresented in the physical therapist profession. As decision-makers, faculty exert direct influence on enrollment through evaluating applications and determining which applicants are deserving of admission to physical therapist programs.

Review of Literature.

Faculty decision-making in admissions is a cultural process which can reproduce inequities and perpetuate underrepresentation if faculty fail to recognize systemic disparities in legitimized forms of merit. No studies within physical therapist education have directly investigated faculty habitus and patterns of thought and behavior which reinforce admissions decision-making. The purpose of this study was to describe patterns of faculty habitus which influence judgments of admission merit and equity in US physical therapist education programs.

Subjects.

Sixteen physical therapy faculty across 3 physical therapist education programs.

Methods.

Using interpretative research methodology and a constructivist approach, semistructured interviews were conducted with each participant. Faculty social actions were also observed during field observations. Thematic analysis using Bourdieu's social reproduction theory was used for coding and establishment of themes.

Results.

Two predominant patterns of faculty habitus with corresponding themes emerged from the data: Transformative habitus oriented faculty toward a sense of responsibility to promote equity, construct a more contextualized understanding of merit, and formulate compelling applicant storylines; gatekeeping habitus positioned faculty to support a meritocratic process, reinforce traditional notions of academic rigor, and support the necessity of adjusting standards to address underrepresentation.

Discussion and Conclusion.

Findings revealed contrasting patterns of faculty habitus which legitimized certain criteria, knowledge, and experiences on which decisions of merit were based. Attention to the individual dispositions of faculty decision-makers in addition to criteria and processes used in holistic review may shape equitable access to physical therapist education programs.
Probiotics combined with Budesonide and Ipratropium bromide for chronic obstructive pulmonary disease: A retrospective analysis
Authors: Chen Chen , Wu LingBo , Wang LiJun , Tang XinHeng
Published: March 2024

To explore the effect of probiotics combined with budesonide and ipratropium bromide in the treatment of chronic obstructive pulmonary disease (COPD) on lung function and gut microbiota. This was a retrospective study of prospectively collected clinical data of 118 patients with COPD admitted to our hospital between January 2020 and December 2022. According to the treatment records, 59 patients received budesonide and irpratropium bromide (control group), and 59 patients received probiotics combined with budesonide and irpratropium bromide (observation group). The lung function, inflammatory factor levels, airway remodeling, and gut microbiota before and after treatment were compared between the 2 groups. After treatment, FVC, MMEF, PEF, and FEV1 in the 2 groups were higher than before treatment, and the values in the observation group were higher than those in the control group (P < .05). After treatment, the serum levels of TNF-α, IL-6, and PCT in the 2 groups were lower than before treatment, and the levels in the observation group were lower than those in the control group (P < .05). After treatment, the levels of serum MMP-9, VEGF, basic fibroblast growth factor, and NGF in the 2 groups were lower than before treatment, and the levels in the observation group were lower than those in the control group (P < .05). After treatment, the levels of lactobacilli and bifidobacteria in the 2 groups increased compared to those before treatment, and the observation group had a higher level, while the levels of Enterobacteriaceae and Enterococcus were lower in the observation group than those before treatment (P < .05). Based on budesonide and irpratropium bromide, probiotic treatment of COPD is more conducive to reducing the degree of inflammatory reactions, inhibiting airway remodeling, regulating the level of gut microbiota, and promoting the recovery of lung function.
The impact of teach-back training method (TBTM) on treatment adherence in hemodialysis patients: a randomized controlled trial
Authors: Alilu Leyla , Pazirofteh Sonia , Habibzadeh Hossein , Rasouli Javad
Published: March 2024

Introduction:

Ensuring adherence to treatment is vital for individuals undergoing haemodialysis. The demanding treatment frequency and duration often present challenges for patients in maintaining a consistent routine. Non-adherence can result in adverse health effects and an increased risk of hospitalization. This study aimed to evaluate the impact of teach-back training on treatment adherence among haemodialysis patients.

Method:

A randomized controlled trial involved 60 end-stage kidney disease patients undergoing haemodialysis. Participants were randomly assigned to either the control or intervention group. Data were collected using the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), assessing adherence in four dimensions: HD incidence, medication use, fluid restriction, and diet recommendations. The intervention group received feedback-based training on diet and fluid restriction during four 45–60-min sessions, while the control group received regular indoor training.

Result:

Following the intervention, significant differences in mean scores for HD frequency, medication use, and fluid restriction were observed between the two groups (P<0.001). However, there was no significant difference in the mean score for food recommendations (P=0.108).

Conclusion:

The teach-back training method (TBTM) is an effective communication strategy that enhances treatment adherence in haemodialysis patients. This intervention has the potential to improve patient outcomes and overall quality of life by simplifying medical information and encouraging patient engagement.
Canadian Anatomic Kidney Score: Quantitative Macroscopic Assessment of Donor Kidney Quality for Transplantation
Authors: Matti Danny , Offerni Juliano , Roshanov Pavel S. , Lu Jirong , Guo Yanbo , Lebedeva Victoria , Ai Li Erica , Abed Haider , Luke William , Sener Alp , Luke Patrick P.
Published: March 2024

Background.

The Canadian Anatomic Kidney Score (CAKS) is a novel 6-point grading system that standardizes the gross description of a donor kidney across 3 components—vessels, anatomy, and sticky fat. We hypothesized that the CAKS predicts allograft functional outcomes and provides additional information to the Kidney Donor Profile Index (KDPI) and histologic assessment of the donor kidney.

Methods.

Single-center cohort of 145 patients who underwent renal transplantation with CAKS analysis between 2018 and 2021. CAKS was prospectively determined before transplantation. Preimplantation core biopsies were assessed according to the Remuzzi score (RS). The primary outcome was 1-y allograft function represented by an estimated glomerular filtration rate (eGFR).

Results.

Linear regression without adjustment for KDPI or RS showed a significant association between the CAKS and 1-y eGFR (−8.7 mL/min/1.73 m2 per point increase in CAKS; 95% CI, −13.0 to −4.4; P < 0.001). Most of that association was attributed to the vessel component (−12.1; −19.4 to −4.8; P = 0.002). Adjustment for KDPI and RS attenuated the relationship between 1-y function and CAKS (−4.6; −9.5 to 0.3; P = 0.065) and vessel component (−7.4; −15.2 to 0.5; P = 0.068).

Conclusions.

Anatomic assessment of donor kidneys at the time of transplantation associates with allograft function at 1 y. Vascular assessment appears to make the dominant contribution.
Dual targeting of EZH2 and Histone Deacetylases in hematological malignancies promotes transcriptional and metabolic deregulation leading to ferroptosis
Authors: Veloso Alexandra , Slegers Thomas , Schoenaker Jente , Demeyer Sofie , den Bergh Stef Van , Aertgeerts Margo , Verhoeft Krista , Schoenmaekers Yilke , Meeuws Nienke , Bischops Ilan , Renard Félicien , Boogaerts Lien , Mentens Nicole , Gielen Olga , Jacobs Kris , Segers Heidi , Cools Jan , Dierickx Daan , Bempt Marlies Vanden
Published: March 2024

The methyltransferase EZH2 functions as the enzymatic component of the PRC2 complex, which deposits methyl groups on H3K27, leading to chromatin condensation and gene repression. Recent studies have shown that EZH2 can also act as a transcriptional modulator outside of the PRC2 complex and thus, independent of its methyltransferase activity. In this study, we first aimed to investigate the effects of EZH2 enzymatic inhibition versus protein degradation in hematological malignancies. We demonstrate that EZH2 degradation is more effective in blocking cellular proliferation compared to EZH2 enzymatic inhibition, and that EZH2 targeting upregulates the cholesterol biosynthesis pathway. Secondly, combined targeting of EZH2 and HDACs showed synergistic effects in a broader spectrum of hematological malignancies. Mechanistically, combined targeting of EZH2 and HDACs induced increased levels of H3K27 acetylation and strong upregulation of cholesterol biosynthesis. This leads to metabolic stress due to acetyl-CoA depletion, ultimately inducing ferroptotic cell death.

Statement of significance

We show that combined EZH2 and HDAC targeting is a promising therapeutic strategy for a broad spectrum of hematological malignancies. We uncover that EZH2 targeting induces upregulation of cholesterol biosynthesis, which is crucial for the synergistic effect with HDAC inhibition, ultimately leading to ferroptosis induction.