bluuebunny/crossref_metadata_2025 huggingface dataset:
Brolucizumab for Wet Age-Related Macular Degeneration: One-Year Real-World Experience from a Tertiary Center
Authors: Scupola Andrea , Carlà Matteo Mario , Boselli Francesco , Giannuzzi Federico , De Filippis Alessandro , Fossataro Claudia , Minnella Angelo Maria , D'Amico Guglielmo , Coppola Giovanni , Savastano Maria Cristina , Sammarco Maria Grazia , Rizzo Stanislao
Published: February 2023

Introduction: The aim of this study was to explore the early efficacy and safety of treatment with intravitreal injections (IVIs) of brolucizumab in patients presenting with neovascular age-related macular degeneration (nAMD) in a real-world setting. Methods: This retrospective study included 194 eyes of 180 patients with nAMD treated with standard 6-mg IVIs of brolucizumab in our clinic between March 11, 2021, and June 15, 2022. Both treatment-naive (33 eyes) and switch therapy patients (161 eyes) were included in the study. Best corrected visual acuity (BCVA), central subfield thickness (CST), retinal fluid distribution (classified as intraretinal, subretinal, under the pigmented epithelium), treatment intervals, and adverse event rates were collected for analysis. Results: Average follow-up time was 37.2 ± 16.6 weeks. Mean baseline BCVAs were 38.1 ± 4.5 and 41.9 ± 6.7 letters in the treatment-naive and switch therapy groups, with a final gain of 16.0 ± 4.9 (p < 0.0001) and 10.7 ± 5.9 (p < 0.0001) letters in the two groups, respectively. Throughout the study period, CST significantly decreased in both treatment naïve (from 352.0 ± 129.4 to 284.2 ± 93.8 µm; p = 0.0015) and switch therapy (from 369.9 ± 140.5 to 307.4 ± 123.5 µm; p < 0.0001). Significant fluid control rates were achieved at the end of the study period (45% and 27% eyes were completely free of fluid in naïve and switch groups, respectively). Five eyes (2.6%) developed adverse events with different grades of intraocular inflammation and visual outcomes. Conclusion: Brolucizumab IVI showed very good anatomical and functional outcomes in both naive and switch patients in this real-world experience. Nevertheless, even showing a favorable risk/benefit profile, clinicians and patients should be aware of the possibility of a small rate of severe complications.
“E o fuzil, tu vende pra quem?”: Os diferentes significados da corrupção entre candidatos à carreira de policial militar no Rio de Janeiro
Authors: Rodrigues Eduardo de Oliveira
Published: February 2023

A estruturação de diferentes mercados ilegais imprescinde da participação de agentes públicos de segurança na sua operação. No tocante ao Brasil, tal fato é parte daquilo que comumente denomina-se “corrupção policial”. Muitas análises que se debruçaram sobre o tema encaram a corrupção enquanto desvio de certas normas sociais instituídas, que, no caso das polícias, seriam tributárias de problemas ligados à formação recebida pelos policiais e, principalmente, ao saber prático das ruas. O presente artigo, todavia, sugere um olhar diferente sobre o problema, que se constrói a partir de pesquisa etnográfica junto candidatos à carreira de policial militar anteriormente a qualquer contato formal com a corporação. Tomada enquanto resultado de processos de “classificação social”, a corrupção é uma categoria dinâmica nutrida por “moralidades situacionais” que permitem a agência dos sujeitos. Sendo assim, que moralidades informam diferentes significados de corrupção para candidatos à carreira de policial militar no Rio de Janeiro?
Um sistema iroquês amazônico: parentesco e aliança Enawene-Nawe
Authors: Silva Marcio
Published: February 2023

Vocabulários de parentesco iroqueses são um dos temas mais longevos da antropologia social. Este artigo retoma esta longa tradição. Baseado em dados etnográficos de primeira mão, o texto a seguir oferece uma análise das classificações de parentesco de um povo de língua aruaque da Amazônia meridional, os Enawene-Nawe. Como é típico desses vocabulários, o caso em questão não expressa uma regra prescritiva de casamento. O discurso nativo formula apenas duas interdições: uniões entre pessoas do mesmo clã e entre parentes genealogicamente próximos. Por outro lado, os Enawene-Nawe apontam uma fórmula virtuosa de união matrimonial que se manifesta nos planos dos conceitos e das práticas: a troca direta entre duas famílias, vedada a repetição nas gerações seguintes.
Numa terra estranha: sonho, diferença e alteração entre os Tikmũ’ũn (Maxakali)
Authors: Ribeiro Júnior Roberto Romero
Published: February 2023

A ideia de que o sonho seja qualquer coisa como uma “viagem da alma” é de uma recorrência etnográfica impressionante. O que se entende por “viagem” e “alma” nos mais variados contextos está longe, contudo, de ser algo evidente. Os Tikmũ’ũn, mais conhecidos como Maxakali (MG), costumam igualmente descrever sua experiência onírica como um deslocamento da “alma” (koxuk) por caminhos tortuosos e perigosos que costumam desembocar nas terras estranhas onde vivem seus parentes mortos e de onde o retorno nem sempre é fácil, se é mesmo possível. Porém, mais do que isso, é curioso notar como a experiência da viagem e do deslocamento, entre eles, possui paralelos com a sua experiência onírica. Desse modo, não somente o sonho é algo como uma “viagem” como suas viagens parecem remeter – bem como a estimular – a experiência onírica. Neste artigo, pretendo explorar estes paralelos entre “sonho” e “viagem”, bem como aqueles entre “sonho”, “corpo”, “doença” e “morte”.
“Ser índio deixou de ser sinônimo de escondido no mato”: uma conversa sobre visibilidade com Ailton Krenak
Authors: Moreira Adriano De Lavor
Published: February 2023

Ailton Alves Lacerda Krenak é uma das vozes indígenas brasileiras de maior visibilidade na atualidade. Ativista, jornalista e escritor, ele nasceu em 1953 na Terra Indígena Krenak, na região do Vale do Rio Doce, na região Sudeste do país. Nos últimos anos, sua presença tem sido bastante requisitada no meio acadêmico e nos espaços midiáticos, principalmente quando estão em pauta os direitos dos povos indígenas e os impactos da ação predatória do homem para o futuro do planeta.
Para além do sonho e da vigilia. O sonho ameríndio e a existência
Authors: Orobitg Gemma
Published: February 2023

Neste artigo analiso a dupla dimensão do sonho ameríndio, como viagem da alma e como ação provocada por outros seres que não o sonhador. O objetivo é discutir algumas interpretações recorrentes do sonho ameríndio e explorar o status ontológico do sonho para traçar uma proposta alternativa àquelas análises da experiência do sonho indígena que reproduzem a dicotomia sonho-vigília. Os estudos etnográficos sobre o sonho ameríndio e minhas pesquisas entre os indígenas Pumé dos Llanos do sudoeste da Venezuela são a base para responder às perguntas: o que é a experiência indígena do sonho? O que é o sonho? Por que o sonho é um estado ontológico, ou seja, representa, por um lado, o princípio da vitalidade da pessoa e, por outro, o fundamento da existência de todas as entidades que povoam o cosmos?
The Burnout Concept as a Theoretical Framework for Investigating the Caregiving Impact of Relatives of Patients with Addictive Disorders
Authors: Shishkova Alexandra M. , Bocharov Victor V.
Published: February 2023

Background. Relatives of patients with addictive disorders often face significant difficulties in their daily lives. Although the burnout concept is currently considered a significant and promising theoretical framework for studying family members who care for chronically ill patients, its application has encountered considerable difficulties in the area of addiction treatment. Objective. This article explores the methodology for studying the psychological issues arising in families affected by addictive disorders. We analyzed the social, economic, and cultural conditions of the different study models developed in this field, and identified the difficulties hindering the acceptance of the burnout concept as a theoretical construct for investigation. Results. There are several main obstacles to the burnout concept’s application to studying the psychology of addictive patients’ families. These obstacles are: 1) a stigmatizing attitude toward the relatives, labelling them as dysfunctional/codependent, or merely passive recipients adjusting to stressful and challenging circumstances; 2) a sole focus on the destructive elements of the “informal caregiver – addicted patient” relationship dynamics; 3) underestimation of relatives’ willingness, experience, and knowledge in the care of their addicted family member and failure to recognize their right to participate in treatment decision-making; and 4) lack of specialized tools for assessing burnout and its opposite pole – the engagement of addicts’ relatives during the patients’ care. Conclusion. Application of the burnout concept as a theoretical framework allows us to reformulate many psychopathological phenomena described in the family members of addicts, and expands the perspective of psychotherapy by providing the opportunity to conduct interventions to improve relatives’ functioning as caregivers. This, in turn, will contribute to the effectiveness of treatment outcomes for both addicts and their families.
Formation of Biologic Plug and Patch Mesh for Use in Perforated Femoral Hernia
Authors: Stolz Michael P. , Chambers James G. , Mahalati Kamran
Published: February 2023

Incarcerated inguinal hernias with contamination frequently lead to an open inguinal hernia primary repair. If no contamination is present, a tension-free repair with mesh is a good option. In this case, we encountered an incarcerated femoral hernia with perforation of the small bowel. We will describe and demonstrate via video how to incorporate a tension-free repair with mesh in a contaminated field with formation of a plug and patch made from biologic mesh.
Centrally-sponsored Schemes and Cooperative Federalism in India: A Case Study of Integrated Child Development Scheme
Authors: Saxena Rekha , Dhingra Alisha , Pathak Rounak
Published: February 2023

This article attempts to explore the dynamics of cooperative federalism in India through a case study of the Integrated Child Development Scheme (ICDS), a Centrally Sponsored Scheme initiated by the Government of India in 1975 for the health and nutrition of pregnant and lactating women and children of below six years of age. The study of ICDS provides an interesting case to study vertical and horizontal federalism and its interlinkages and the spirit and working of cooperative federalism in India. The article analyses the performance of ICDS in different states by emphasizing factors, such as party congruence, the commitment of the Chief Minister, awareness of the community, functioning of the NGOs and so on. The study has involved fieldwork in some districts of Gujarat and Punjab and relied on government reports and some secondary literature to understand the functioning of ICDS in other states, such as Odisha, Tamil Nadu, and Jammu and Kashmir. Our fieldwork brought to light the fact that there were variations not only in the success rate but also in the number of actors involved in the implementation of the scheme in different states and the adoption of some innovations by particular states. There were pilot initiatives introduced in some districts, such as the toy bank initiative, School Enrolment Drive, Mobile Anganwadi vans, Insurance scheme for Anganwadi workers and felicitation of Anganwadi workers (Mata Yashoda Awards). The study of multi-level federal structure in India is crucial for a holistic understanding of the implementation of the centrally-sponsored schemes in India including ICDS.
Realistic fabric rendering with yarn models
Authors: Liu Haisang , Kyosev Yordan , Jiang Gaoming , Dong Zhijia
Published: February 2023

Modeling fabrics with yarn models makes the fabric structure more realistic in detail. In this paper, a fiber-level rendering method is proposed to simulate different yarns and fabrics. The fibers are divided into three categories: the ply, the loop hairiness and the short hairiness. Geometric tubes are modeled to match these fibers according to the input yarn parameters. Different fibers can be selected depending on the yarn type, which is flexible to reduce the computation amount. Texture mapping is applied to simulate the yarn surface, reducing the memory and time cost of rendering large numbers of fibers. Several single yarns and fabric with different structures are simulated, demonstrating that this is an effective method for fabric modeling and rendering.
Intensive versus standard blood pressure control in older persons with or without diabetes: a systematic review and meta-analysis of randomised controlled trials
Authors: Seidu Samuel , Willis Harini , Kunutsor Setor K , Khunti Kamlesh
Published: February 2023

Objectives

To assess and compare the benefits and harms of intensive versus standard blood pressure (BP) control in older people with or without diabetes mellitus (DM).

Design

Systematic review and meta-analysis

Setting

Randomised controlled trials comparing intensive versus standard BP control, identified from MEDLINE, Embase, The Cochrane library, Web of Science and a search of bibliographies from inception till August 2022.

Participants

Older people (≥65 years) with or without DM.

Main outcome measures

Study-specific risk ratios (RRs) with 95% confidence intervals (CIs) were pooled for adverse vascular and safety outcomes.

Results

We included six randomised controlled trials (RCTs) comprising 20,985 patients (intensive BP = 10,474 and standard BP = 10,511) with a weighted mean follow-up of 3.1 years. In the general population, the RRs (95% CIs) of intensive versus standard BP control for composite cardiovascular events or major adverse cardiovascular events (CVD/MACE), CVD mortality, coronary heart disease, stroke and heart failure were 0.71 (0.62–0.82), 0.65 (0.49–0.86), 0.75 (0.60–0.95), 0.75 (0.61–0.92) and 0.58 (0.41–0.82), respectively. Intensive BP control did not increase the risk of renal failure or serious adverse events in the general population. Two RCTs reported results for composite CVD/MACE in patients with DM with a pooled estimate of 0.85 (0.67–1.07).

Conclusions

Aggregate trial evidence shows that intensive BP control (<120 to <140 mmHg) reduces the risk of adverse cardiovascular outcomes in older hypertensive patients in the general population with no increase in adverse events. Intensive BP control may confer similar benefits for older patients with DM with no evidence for harm, but this is based on limited data. PROSPERO Registration: CRD42022349791
Using the Lessons of Learning Science to Improve Medical Education in Otolaryngology
Authors: Rosi-Schumacher Mattie , DeGiovanni Jason Conor
Published: February 2023

Objective

This review synthesizes information from original research in the field of learning theory and the psychology of learning in order to provide evidence-based study methods to adult learners in the field of medicine.

Methods

A literature review was conducted and results were synthesized in a narrative fashion.

Results

Deeper levels of analysis produce longer lasting memory; therefore, the concept of creating a “desirable level of difficulty” when it comes to study material and methods has been shown to promote learning. When the learner uses a higher subjective level of effort in processing information, they can maximize the efficacy of their studying efforts. This review describes how memory encoding can be enhanced by applying several theories of learning psychology including the generation effect and the interleaving effect. The use of mnemonics, the “memory palace,” and hand-written notes have also proven useful to enhance information recall. Methods that promote long-term learning including the spacing effect and delayed repetition are reviewed. Learning theory shows that the most effective learners use self-testing and forced recall to retain more information with limited study time.

Conclusions

The application of these learning methods may help to improve information retention and productiveness among adult learners.
What does ‘good’ palliative care look like for children and young people? A qualitative study of parents’ experiences and perspectives
Authors: Fields Diana , Fraser Lorna Katherine , Taylor Jo , Hackett Julia
Published: February 2023

Background:

Worldwide, around 21 million children would benefit from palliative care and over 7 million babies and children die each year. Whilst provision of paediatric palliative care is advancing, there major gaps between what should be done, and what is being done, in clinical practice. In 2017, the National Institute for Health and Care Excellence (NICE) introduced a quality standard, to standardise and improve children’s palliative care in England. However, there is little evidence about what good experiences of palliative care for children are, and how they relate to the quality standard for end-of-life care.

Aim:

This study explored how the NICE quality standard featured in parental experiences of palliative care for children to understand what ‘good’ palliative care is.

Design:

Qualitative study, employing in-depth, telephone and video-call, semi-structured interviews. Data were analysed using thematic analysis, informed by Appreciative Inquiry.

Setting/participants:

Participants were parents of children and young people (aged 0–17 years) in England, who were receiving palliative care, and parents whose child had died.

Results:

Fourteen mothers and three fathers were interviewed. Seven were bereaved. Parents were recruited via four children’s hospices, one hospital, and via social media. Good palliative care is co-led and co-planned with trusted professionals; is integrated, responsive and flexible; encompasses the whole family; and enables parents to not only care for, but also to parent their child to end of life.

Conclusions:

Findings have implications for informing evidence based practice and clinical guidelines, overall improving experiences of care.
Dyadic Archetypes of Patient Self-Care and Caregiver Contribution to Self-Care in Dyads With Multiple Chronic Conditions: An Observational Study
Authors: De Maria Maddalena , Lee Christopher S. , Matarese Maria , Vellone Ercole , Lorini Silvia , Ausili Davide
Published: February 2023

Self-care of multiple chronic conditions (MCCs) and caregiver contribution to self-care have been theorized as dyadic. However, the different dyadic archetypes are still unknown. This cross-sectional study aimed to identify dyadic archetypes related to how in patient–caregiver dyads manage the patient’s MCCs and to describe other ways in which the dyadic archetypes differ. A sample of 340 MCCs patient–caregiver dyads was enrolled in outpatient and community settings. Patients had a mean age of 76.7 (±7.3) years and were mostly female (54.5%). Caregivers had a mean age of 54.6 (±15.1) years and were mostly female (71.5%). Four dyadic archetypes were observed: “autonomous,” “compensatory,” “balanced,” and “complementary” care. Clinical programs should consider the different characteristics of dyads to support self-care.
A tracking control method for articulated virtual rail train with N-unit based on the dynamic model
Authors: Chen Jun , Zhang Dehua , Zhang Weihua
Published: February 2023

In this paper, an articulated virtual rail train running on an urban road with N-unit is introduced, and a new tracking control system is designed to realize the tracking control of the articulated virtual rail train. First, a dynamic model for the articulated virtual rail train with N-unit is derived with 11N degrees of freedom. Second, based on the dynamic model, a steering control system is designed, which includes the following sub-controllers: a unit 1 front-axle steering controller and a unit 1∼N rear-axle steering controller for approaching the virtual target path, a unit 2∼N front-axle steering controller for coordinating the movement of adjacent units, and a four-wheel-steering (4WS) controller for each unit. Finally, a numerical simulation model of the train with five units is built in MATLAB, and a cross-validation model is built in ADAMS software. The simulation and verification results show that the tracking errors are within 50 mm, and the lateral articulation forces are less than 2 kN, which indicates that the designed control system has a good tracking performance.
Indicators for Modernising the LIS Internship: Evidences from a systematic literature review
Authors: Noor Azizi Nurul Aida , Kaur Kiran
Published: February 2023

This systematic literature review was conducted to analyse the existing literature on the internship programme in library and information science (LIS) education. The review was guided by the RAMESES (Realist and Meta-Narrative Evidence Syntheses: Evolving Standards) method. The data source was Scopus, Web of Science and Google Scholar. In addition to the three main phases of the review process, mainly identification, screening, and eligibility, data abstraction and analysis are also reported. Findings reveal that studies on LIS internship have focused on satisfaction, educational benefits, educational setting, programme design and roles of the stakeholders involved in internship programmes. Modernising the LIS Internship programme requires a focus on the design of the programme structure with an emphasis on the learning outcomes relating to career readiness. Collaborative learning, service-learning and personal objectives are found to be beneficial. However, there is also an increasing demand for needs of the stakeholders and not just the student-centred learning. Further works into the assessment of the learning outcomes is recommended by the literature.
Service Quality in Banking Sector: An Analysis Using the SWARA Methodology
Authors: Gupta Nitin , Vrat Prem , Ojha Ravindra
Published: February 2023

The authors followed a different methodology to validate the hypothesis: Before improving the quality of products and services, the quality of people must improve. The factors were determined using a literature review, followed by a focused group approach for evaluation and a survey technique to arrive at the vital few. The factors were analysed for identifying the importance and weights with the application of the Stepwise Weight Assessment Ratio Analysis (SWARA) methodology. This research article provides an insight that people quality is the most important factor in delivering the right service outcomes in banks. The application of SWARA methodology to service quality assessment in the banking sector has been unique.
Imagining Frontier Spaces: The Frontier Tribal Areas in Imperial Defence in the Northeast of British India
Authors: Jamir Limasenla
Published: February 2023

This article concerns the northeast frontier of British India during the last years of British rule. It explores how the conundrums of the Second World War led to the reconfiguration of the northeast frontier as a strategic space in the empire’s geopolitics. This reconfiguration was pushed by contestation over the frontier spaces by different powers—threatened by the Japanese during the Second World War and, later, the possible post-war reification of Chinese and Tibetan expansionist policy towards India’s northeast frontier and the impending Indian independence. The colonial state’s strategic interest led the frontier officials to reimagine the northeast frontier, whereby the region and its local populations came to be regarded as integral to the preservation of the colonial state’s dominance.
Effect of Medial Closing Wedge Distal Femoral Varization Osteotomy on Coronal Ankle and Hindfoot Alignment
Authors: Nha Kyung Wook , Han Jae Hwi , Chae Su Whi , Choi Jun Young
Published: February 2023

Background:

To date, only a few studies have reported postoperative changes in coronal ankle alignment after valgus knee correction through medial closing wedge distal femoral varization osteotomy (MCWDFO). This study aimed to measure the changes of MCWDFO on coronal ankle and hindfoot alignment.

Methods:

We retrospectively reviewed the radiographic findings of 27 consecutive patients (34 cases) with knee valgus malalignment who underwent MCWDFO for either lateral knee joint osteoarthritis (OA) or recurrent patellar subluxation/dislocation (RPD). Several radiographic parameters were measured and compared based on the reason for operation, followed by the status of preoperative hindfoot alignment (hindfoot alignment angle [HAA] > 4 degrees, varus; −4 degrees ≤HAA ≤ 4 degrees, neutral; HAA < −4 degrees, valgus) in each group.

Results:

Overall, pre- and postoperative hindfoot alignments were within the neutral alignment range and were not significantly changed after the operation ( P > .05). Nineteen cases were for lateral knee OA and 15 were for RPD, respectively. In both groups, preoperative neutral hindfoot alignments accounted for the largest portion (52.6% in the lateral OA group; 80.0% in the RPD group). Postoperatively, regardless of the reason for operation, hindfoot alignments changed toward the neutral range in all subgroups (ie, no changes in the preoperative neutral group; increased in the valgus group; decreased in the varus group).

Conclusion:

We recommend that surgeons leave the hindfoot untouched when they plan the MCWDFO to correct knee joint valgus malalignment concomitant with hindfoot valgus or varus deviation as the hindfoot malalignment appears to change toward the neutral range postoperatively.

Level of Evidence:

Level III, retrospective comparative study.
Environmental CSR, Customer Equity Drivers, and Travelers’ Critical Outcomes: A Stimulus–Organism–Response Framework
Authors: Vatankhah Sanaz , Sepehrmanesh Ali , Zaeri Ehsan , Altinay Levent
Published: February 2023

While environmental corporate social responsibility (CSR) has gained increased attention in sustainable tourism research, little is known about its impacts on customers in the context of the airlines. This study investigates the impact of environmental CSR on two critical customer outcomes, namely, purchase intention (PI) and switching behavior (SB). In light of the stimulus–organism–response (S-O-R) framework, this study further examines the joint mediating impact of customer equity drivers (CEDs) in the previously mentioned relationships. With a sample of Iranian air travelers, the results of the structural equation model revealed that environmental CSR significantly affects CEDs. While CEDs predict PI, they failed to reduce SB. Hence, CEDs jointly mediate the impact of environmental CSR on PI only. The results of the current study reveal nuances in the service marketing research by extending the impact of environmental CSR on travelers’ PI and SB via CEDs. Theoretical and practical implications are provided.
“I am Not a Macho, I am a Man”: Identity Construction of Trans Men in Santiago, Chile
Authors: Gonzalez Samantha , Bernales Margarita
Published: February 2023

The study of masculinities in Latin America is becoming increasingly relevant; however, trans men (TM) have been highly disregarded. This is problematic, given that the transmasculine population can highlight tension upon the binary gender practices. Latin American research has maintained a biomedical perspective, with emphasis on sexual readjustment treatments, ignoring the subjective experience of TM regarding their identity construction, and the sociocultural implications of experiencing their identity as men, considering Latin American gender patterns and machismo. Under this premise, 14 Chilean TM were interviewed. Results show the heteronormative demands imposed on TM, which determine the expectations and interpretations associated with their transition process. This leads TM to perpetuate stereotypical gender patterns, which is a survival strategy, and at the same time promotes the maintenance of patriarchal privileges. In a transversal manner, it was observed that TM have new perspectives on masculinity, which allow for the questioning of traditional gender roles.
Management of unresolved optic disc pit maculopathy with human amniotic membrane patch implant: A case report
Authors: Boscia Giacomo , Sborgia Giancarlo , Niro Alfredo , Dore Stefano , Landini Luca , Scotti Giacomo , Boscia Francesco
Published: February 2023

Background/Purpose

Inverted Inner Limiting Membrane (ILM)-flap approach can fail in the treatment of Optic disc pit maculopathy (ODPM). We report a surgical technique involving human amniotic membrane (hAM) patch implant to treat unresolved ODPM after inverted (ILM)-flap technique.

Case Report

One patient with decreased visual acuity (1 LogMar) after unsuccessful inverted ILM-flap technique to treat ODPM, underwent hAM patch implant and was evaluated. A surgical approach including a 2 mm size graft patch of hAM implantation over the optic disc pit followed by fluid–air exchange was performed. A gas endotamponade was finally used. The patient was instructed to maintain face-down position for the first three days after surgery. The hAM patch remained detectable over the pit for the entire 6-months follow-up. The ODPM gradually resolved and visual acuity partially recovered to 0.17 LogMar during follow-up. No postoperative complications or recurrence were reported.

Conclusion

hAM patch implant may be effective to manage ODPM after unsuccessful inverted ILM-flap.
Digital methods as ‘experimental a priori’ – how to navigate vague empirical situations as an operationalist pragmatist
Authors: Koed Madsen Anders
Published: February 2023

Digitalisation and computation presents us with a vague empirical world that unsettles established links between measurements and values. As more and more actors use digital media to produce data about aspects of the world they deem important, new possibilities for inscribing their lives emerge. The practical work with digital methods thus often involves the production of social visibilities that are misfits in the context of established data practices. In this paper I argue that this dissonance carries the distinct critical potential to design data experiments that (a) uses the act of operationalisation as an engine for creating intersubjective clarity about the meaning of existing concepts and (b) takes advantage of algorithmic techniques to provoke a reassessment of some of the core assumptions that shape the way we pose empirical problems are normally framed. Drawing on the work of Kant, Peirce, Dewey and C.I. Lewis I propose to think of this critical potential as the possibility to practice what I term 'experimental a priori' and I use qualitative vignettes from two years of data experiments with GEHL architects to illustrate what this entails in practice. Faced with the task of using traces from Facebook as an empirical source to produce a map of urban political diversity, the architects found themselves in a need to revisit inherited assumptions about the ontology of urban space and the way it can even be formulated as a problem of diversity. While I describe this as a form of obstructive data practice that is afforded by digital methods, I also argue that it cannot be realised without deliberate design interventions. I therefore end the paper by outlining five design principles that can productively guide collective work with digital methods. These principles contribute to recent work within digital STS on the recalibration of problem spaces and the design of data sprints. However, the concept of ‘experimental a priori’ can also serve as a philosophical foundation for knowledge production within computational humanities more broadly.
Should outpatient hysteroscopy be used in preference to transvaginal ultrasound to identify endometrial pathology in premenopausal women with heavy menstrual bleeding? Revisiting NICE Guideline 88
Authors: Litherland Natasha Christy , Phillips Rita
Published: February 2023

Introduction:

National Institute for Health and Care Excellence Guideline 88 advocates outpatient hysteroscopy in preference to transvaginal ultrasound for premenopausal women with heavy menstrual bleeding, who are suspected of having submucosal fibroids, polyps or endometrial pathology. The guideline, however, analysed outdated studies that provided low-quality evidence. This study aimed to assess the diagnostic accuracy of transvaginal ultrasound in detecting endometrial pathology; and to evaluate the cost-effectiveness of outpatient hysteroscopy if it were to be used in preference to transvaginal ultrasound.

Methods:

A health service evaluation was conducted at a district general foundation trust between 1 January 2019 and 31 March 2019 of all premenopausal women with heavy menstrual bleeding. A cost-effectiveness analysis was also performed to evaluate the financial implication of outpatient hysteroscopy being used in preference to transvaginal ultrasound.

Results:

100 patients were included in the study. For the detection of endometrial pathology, transvaginal ultrasound had a positive predictive value of 65.2%; negative predictive value of 98.5%; sensitivity of 93.75%; specificity of 88.89% and an accuracy of 89.77%. For identifying endometrial polyps, submucosal fibroids and endometrial thickening, transvaginal ultrasound had a positive predictive value of 33.3%, 85.7% and 50%, respectively. It would have cost the Trust 78.7% more if National Institute for Health and Care Excellence’s recommendation was carried out, with a 23.4% increase in workload in the hysteroscopy department, and a decrease of 7.8% transvaginal scans performed.

Conclusion:

Outpatient hysteroscopy is costly and would increase the workload burden in the hysteroscopy department. Transvaginal ultrasound has a high sensitivity, specificity and accuracy in detecting endometrial pathology therefore it should remain as the initial diagnostic investigation.
Telemonitoring With a Connected Glucose Meter Improves Glycemia Among People With Insulin-Treated Type 2 Diabetes
Authors: Rama Chandran Suresh , Tan Hong Chang , Chen Qifan , Lee Phong Ching , Gardner Daphne Su-Lyn , Chin Yun Ann , Lam Amanda Yun Rui , Teh Ming Ming , Bee Yong Mong
Published: February 2023

Background:

Delayed initiation and inadequate titration remain critical challenges to optimizing insulin therapy in type 2 diabetes (T2D). We aimed to study whether hemoglobin A1c (HbA1c) can be lowered in people with insulin-treated T2D using telemonitoring.

Methods:

This single-center study recruited adults with greater than or equal to six months of diabetes, greater than or equal to three months of insulin therapy, HbA1c ≥8.5% and ≤12.5%, and body mass index (BMI) ≤40 kg/m2. All participants received a connected glucose meter and the accompanying smartphone application. Participants sent weekly blood glucose (BG) diary to their primary endocrinologist via email. Adjustments in insulin doses were communicated to the participants. HbA1c, proportion of BG readings in range (70-180 mg/dL, PIR), below range (<70 mg/dL, PBR) and above range (>180 mg/dL, PAR), and glycemic variability as the coefficient of variation (% CV) were measured at baseline, week 12, and week 24 and compared using repeated-measures analysis of variance (ANOVA) or Friedman’s ANOVA.

Results:

We recruited 40 people (55% women). Mean age was 57.9 years, BMI 27.8 kg/m2, and baseline HbA1c 9.8% (83.7 mmol/mol). Mean HbA1c improved by 1.7%, % CV reduced from 32.9% to 30.7%, PIR increased from 58.8% to 67.1% (all P <.01) by week 24, without any change in PBR. This was achieved with a 0.04 U/kg/d median increase in total daily dose of insulin and 0.9 kg weight gain over 24 weeks.

Conclusion:

Telemonitoring and titration of insulin using a connected glucose meter resulted in significant improvements in glycemia, characterized by a reduction in HbA1c, increase in PIR, and reduction in glycemic variability without any increase in hypoglycemia.
Diagnostic Accuracy of Perception Threshold Tracking in the Detection of Small Fiber Damage in Type 1 Diabetes
Authors: Røikjer Johan , Croosu Suganthiya Santhiapillai , Sejergaard Benn Falch , Hansen Tine Maria , Frøkjær Jens Brøndum , Søndergaard Chris Bath , Petropoulos Ioannis N. , Malik Rayaz A. , Nielsen Esben , Mørch Carsten Dahl , Ejskjaer Niels
Published: February 2023

Aim:

An objective assessment of small nerve fibers is key to the early detection of diabetic peripheral neuropathy (DPN). This study investigates the diagnostic accuracy of a novel perception threshold tracking technique in detecting small nerve fiber damage.

Methods:

Participants with type 1 diabetes (T1DM) without DPN (n = 20), with DPN (n = 20), with painful DPN (n = 20) and 20 healthy controls (HCs) underwent perception threshold tracking on the foot and corneal confocal microscopy. Diagnostic accuracy of perception threshold tracking compared to corneal confocal microscopy was analyzed using logistic regression.

Results:

The rheobase, corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), and corneal nerve fiber length (CNFL) (all P < .001) differed between groups. The diagnostic accuracy of perception threshold tracking (rheobase) was excellent for identifying small nerve fiber damage, especially for CNFL with a sensitivity of 94%, specificity 94%, positive predictive value 97%, and negative predictive value 89%. There was a significant correlation between rheobase with CNFD, CNBD, CNFL, and Michigan Neuropathy Screening Instrument (all P < .001).

Conclusion:

Perception threshold tracking had a very high diagnostic agreement with corneal confocal microscopy for detecting small nerve fiber loss and may have clinical utility for assessing small nerve fiber damage and hence early DPN.

Clinical Trials:

NCT04078516
Disparities in Deceased Donor Kidney Offer Acceptance: A Survey of Canadian Transplant Nephrologists, General Surgeons and Urologists
Authors: Vinson A. J. , Cardinal H. , Parsons C. , Tennankore K. K. , Mainra R. , Maru K. , Treleaven D. , Gill J.
Published: February 2023

Background:

Significant variability in organ acceptance thresholds have been demonstrated across the United States, but data regarding the rate and rationale for kidney donor organ decline in Canada are lacking.

Objective:

To examine decision making regarding deceased kidney donor acceptance and non-acceptance in a population of Canadian transplant professionals.

Design:

A survey study of theoretical deceased donor kidney cases of increasing complexity.

Setting:

Canadian transplant nephrologists, urologists, and surgeons making donor call decisions responding to an electronic survey between July 22 and October 4, 2022.

Participants:

Invitations to participate were distributed to 179 Canadian transplant nephrologists, surgeons, and urologists through e-mail. Participants were identified by contacting each transplant program and requesting a list of physicians who take donor call.

Measurements:

Survey respondents were asked whether they would accept or decline a given donor, assuming there was a suitable recipient. They were also asked to cite reasons for donor non-acceptance.

Methods:

Donor scenario-specific acceptance rates (total acceptance divided by total number of respondents for a given scenario and overall) and reasons for decline were determined and presented as a percentage of the total cases declined.

Results:

In all, 72 respondents from 7 provinces completed at least one question of the survey, with considerable variability between acceptance rates for centers; the most conservative center declined 60.9% of donor cases, whereas the most aggressive center declined only 28.1%, P-value < .001. There was an increased risk of non-acceptance with advancing age, donation after cardiac death, acute kidney injury, chronic kidney disease, and comorbidities.

Limitations:

As with any survey, there is the potential for participation bias. In addition, this study examines donor characteristics in isolation, however, asks respondent to assume there is a suitable candidate available. In reality, whenever donor quality is considered, it should be considered in the context of the intended recipient.

Conclusion:

In a survey of increasingly medically complex deceased kidney donor cases, there was significant variability in donor decline among Canadian transplant specialists. Given relatively high rates of donor decline and apparent heterogeneity in acceptance decisions, Canadian transplant specialists may benefit from additional education regarding the benefits achieved from even medically complex kidney donors for appropriate candidates relative to remaining on dialysis on the transplant waitlist.
Contemporary Outcomes of Tracheostomy in Patients With Single Ventricle Heart Lesions
Authors: Zanaboni Dominic , Yu Sunkyung , Lowery Ray , Vitale Carolyn , Sood Vikram , Schumacher Kurt R.
Published: February 2023

Objectives

Approximately 0.2% to 2.7% of children with congenital heart disease require a tracheostomy after cardiac surgery with the majority having single ventricle (SV) type heart lesions. Tracheostomy in SV patients is reported to be associated with high mortality. We hypothesized that short- and long-term survival of patients with SV heart disease would vary according to tracheostomy indication.

Methods

This is a single center, 20-year, retrospective review of all patients with SV heart disease who underwent tracheostomy. Demographic, cardiac anatomy, surgical, intensive care unit, and hospital course data were collected. The primary outcome was survival following tracheostomy. Secondary outcome was the completion of staged palliation to Fontan.

Results

In total, 25 patients with SV heart disease who underwent tracheostomy were included. Indications for tracheostomy included one or more of the following: tracheobronchomalacia (n = 8), vocal cord paralysis (n = 7), tracheal/subglottic stenosis (n = 6), primary respiratory insufficiency (n = 4), diaphragm paralysis (n = 3), suboptimal hemodynamics (n = 2), and other upper airway issues (n = 1). Survival at six months, one year, five years, and ten years was 76%, 68%, 63%, and 49%, respectively. Most patients completed Fontan palliation (64%). Patients who underwent tracheostomy for suboptimal hemodynamics and/or respiratory insufficiency had a higher mortality risk compared to those with indications of upper airway obstruction or diaphragm paralysis (hazard ratio 4.1, 95% confidence interval 1.2-13.7; P = .02).

Conclusions

Mortality risk varies according to tracheostomy indication in patients with SV heart disease. Tracheostomy may allow staged surgical palliation to proceed with acceptable risk if it was indicated for anatomic or functional airway dysfunction.
Emerging From a Two-Year-Long Quarantine: A Retrospective Study on Life Satisfaction Trajectory and Depression Among Young LGBTQ+ Students in the Philippines
Authors: Cleofas Jerome Visperas , Alibudbud Rowalt C.
Published: February 2023

Background

Evidence suggests that lesbian, gay, bisexual, trans, queer, and other gender and sexual minorities (LGBTQ+) may experience heightened mental health disparities during the COVID-19 pandemic. Since long periods of confinement and physical restriction due to disease outbreaks can adversely affect mental health, there is a need to explore their effects among LGBTQ+ youth as society recovers from the pandemic.

Aims

This study determined the longitudinal association between depression and life satisfaction trajectory from the beginning of the COVID-19 pandemic in 2020 to pandemic-induced community quarantine in 2022 among young LGBTQ+ students.

Methods

This study surveyed 384 conveniently sampled youths (18–24 years old) who identify as LGBTQ+ from locales under two-year-long community quarantine in the Philippines. Respondents’ life satisfaction trajectory was measured for 2020, 2021, and 2022. Post-quarantine depression was measured using the Short Warwick Edinburgh Mental Wellbeing Scale.

Results

One out of four respondents has depression. Those from less than high-income households had a higher risk for depression. Repeated measures analysis of variance revealed that those with more pronounced improvements in life satisfaction throughout and after community quarantine among respondents have a lower risk of depression.

Conclusion

Life satisfaction trajectory can influence the risk for depression among young LGBTQ+ students during extended periods of crisis, such as the COVID-19 pandemic. Thus, there is a need to improve their living conditions as society reemerges from the pandemic. Likewise, additional support should be given to LGBTQ+ students from lower-income households. Moreover, continuous monitoring of LGBTQ+ youths’ life conditions and mental health post-quarantine is recommended.
Educator’s views on suicide prevention in high schools and what they need
Authors: Bevilacqua Miranda Lynne
Published: February 2023

Background:

Suicide is the leading cause of death among youth. Although school-aged youth are surrounded by educators and professionals, little is known about what educators want to know regarding suicide.

Objective and Design:

The purpose of this qualitative study was to explore the perceived learning needs of high school educators in Northwestern Ontario (NWO) regarding suicide prevention using semi-structured interviews.

Results:

The results yielded educators prefer learning based on a mixture of styles that is relevant to their student needs; noting that time constraints are a barrier. Educators are interested in knowing what to say; however, limited by the unknown legalities involved. Educators expressed being comfortable talking about suicide and understood basic warning signs.

Conclusions:

The findings can assist mental health professionals and school board administration in supporting educators regarding suicide prevention. Future research can include the creation of a suicide prevention program that is targeted exclusively for high school educators.
How I approach optimization of patients at risk of cardiac and pulmonary complication after CAR-T cell therapy
Authors: Gutierrez Cristina , Neilan Tomas , Grover Natalie S.
Published: February 2023

Chimeric antigen receptor (CAR)-T cells have transformed the care of patients with hematologic malignancies. Patients treated with CAR-T cells may experience cardiovascular and pulmonary complications which primarily occur in the setting of cytokine release syndrome. In addition, many patients considered for CAR-T cell therapy have pre-existing cardiac and pulmonary comorbidities. In patients with good functional status, these conditions should not prevent patients from being offered these life-saving therapies. In this "How I Treat" article, we use a case-based approach to discuss how we evaluate and optimize patients with cardiac and pulmonary risk factors prior to CAR-T cell therapy and how we manage cardiac and pulmonary complications that may arise with treatment.