bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring corneal pain in the clinic
Authors: Galor Anat
Published: January 2024

DED is a heterogenous disease with a variety of symptoms and signs. One reality of the disease is that its symptoms (e.g., ocular surface pain described as “dryness”, “irritation”, “aching”, and/or “tenderness”) often do not align with its signs (e.g., decreased tear production, tear instability). New data suggest that corneal nerve abnormalities underlie the noted discordance between symptoms and signs. DED symptoms out of proportion to signs, as is often seen co‐morbid with pain conditions such as migraine and fibromyalgia, may indicate that neuropathic mechanisms contribute to symptoms. DED signs out of proportion to symptoms, as is often seen co‐morbid with diabetes mellitus, may indicate that neurotrophic mechanisms are involved. Given this reality, testing for corneal nerve function is an important, but often overlooked, component of the ocular surface examination. This presentation will review strategies to test corneal nerve function in the clinical arena, and discuss treatments that can be used when corneal nerve abnormalities are detected.
Structure and function of damaged and regenerating corneal nerves
Authors: Rosenblatt Mark
Published: January 2024

We hypothesize that the mechanisms of corneal injury will alter the both the structure and function of corneal nerves. Using models of chemical injury (BAK application) and mechanical injury (epithelial debridement), we investigated changes in corneal nerve structure in mice and rats using transgenic reporters and immunostaining. We also examined corneal nerve function in rats using trigeminal ganglion electrophysiology. We found that subsets of cold‐sensitive neurons were differentially altered in chemical vs. mechanical injury. Chemical injury also resulted in more prolonged changes in corneal nerve morphology. Preliminary data suggests that nerve growth factors can accelerate functional recovery as well as structural recovery of injured corneal nerves.
Big data enabled keratoconus care
Authors: Li Ji‐Peng Olivia
Published: January 2024

Keratoconus is a disorder affecting the cornea in which its normal round shape progressively thins causing a cone‐like bulge to develop. Because the cornea does most of the focusing of the eye, this change in shape causes significant problems with vision. As the disease gets worse, the cornea gets steeper, and vision continues to decline. It is a significant cause of visual loss in the UK, affecting up to 1 in 450 young people and is the commonest indication for corneal transplantation in young people. Corneal cross‐linking (CXL) is the only proven treatment to prevent keratoconus getting worse. However there is limited reports of its long term safety in large numbers and we reported one of the largest series in the world.

We used data from the Early Keratoconus Clinic over the past 10 years to generate our results, looking at how many patients progressed despite treatment. What we also did that was innovative was to create personalized progression threshold definitions. We know that early progression can be quite hard to detect, and in later disease the imaging is poorly repeatable. Therefore a personalized threshold, derived from repeated scans from our dataset, will be able to pick up disease earlier, before more progressive visual loss.

We used real world data from our patients to create a predictive model, a calculator, that predicts when a patient is likely to need treatment. The reason for creating this calculator is that it allows patients to better understand their risks in a visual format, gives clinicians an objective marker for an individual's risk, and also allows the hospital to plan services based on needs.

We were able to also use genetic data to see how it influenced disease progression, based on the gene segments that were identified by the Institute of Ophthalmology and Moorfields. This work has resulted in an open access calculator available on https://beta.moorfieldscxl.com.

This talk will also look at the opportunities and challenges of deploying artificial intelligence algorithms in the management of keratoconus, and how we can adapt our own routine practices to contribute to the development of big datasets that can further train and validate AI algorithms.
In vitro and in vivo evaluation of genetically corrected RPE cells for autologous cell therapy of hereditary retinal dystrophies
Authors: Rodriguez‐Jimenez F. J. , Brymova A. , Mueller B. , Stieger K. , Jendelova P. , Ardan T. , Studenovská H. , Lytvynchuk L. , Straňák Z. , Ellederová Z. , Juhás J. , Motlík J. , Petrovski G. , Erceg Lukovic D.
Published: January 2024

Purpose: The generation of genetically corrected RPE cells from patient‐derived human induced pluripotent stem cells (hiPSCs) may provide a source for autologous therapeutically‐relevant therapy for this rare retinal dystrophy as well to create the human cellular disease models. Recently we generated a faithful RPE model from patient bearing mutation in MERTK gene and genetically corrected these cells using CRISPR/Cas9 system. For further application in humans is necessary in vivo validation for survival.

Methods: The RPE cells from the genetically corrected patient‐derived hiPSC were characterized using immunocytological methods for the differentiation and polarization markers, electronic microscopy, RT‐PCR, TEER measurement, ELISA test, Western Blot and phagocytic assay. The implantations of RPE‐scaffolds were carried out into the minipig eyes. Due to the xenogeneic transplantation of human cells into minipig eyes, tacrolimus immunosuppression therapy was used. At the 2‐week follow‐up from transplantation, non‐invasive OCT and fundus camera examinations of the implanted RPE‐scaffolds were performed. Consequently, euthanasia, histological and immunohistochemical investigations of the implanted retina were performed.

Results: All generated RPE cells exhibit typical features of RPE cells. We demonstrated the reestablishment of the expression of full‐length MERTK protein as well as the reversion of lost phagocyte function of hiPSC‐RPE in vitro, which represents the first example of its kind in this field. Histological and immunohistochemical investigation of the RPE implants and adjacent retina showed structurally healthy RPE‐scaffold implant and neuroretinal cells above the implant.

Conclusions: The generated hiPSC‐derived RPE in clinical grade conditions display the typical characteristics of mature RPE cells re‐establishing the function of phagocytosis in genetically corrected patient‐derived RPE cells in vitro. Functional in vivo studies in minipigs confirmed the RPE survival as well as survival of adjacent photoreceptors and thus can be employed as a potential treatment for patients.
The importance of having a relevant model system to investigate splicing modulation in the retina: The unforeseen cases of the intronic variants in RPE65 and IMPG2 genes
Authors: Domínguez Irene Vázquez
Published: January 2024

Inherited retinal diseases (IRDs) are clinically and genetically heterogeneous disorders that can be caused by pathogenic variants in one of the more than 270 genes associated with IRDs. Among them, mutations in RPE65 can lead to Leber congenital amaurosis (LCA) whereas mutations in IMPG2 to vitelliform macular dystrophy (VMD).

During my talk, I will provide evidence of the importance of employing the right cellular models to identify disease mechanism(s) and eventually evaluate suitable treatments. For this, I will highlight two intriguing examples of potential splicing defects studied by our group. Such defects are attractive for splicing modulation therapies using antisense oligonucleotides (AONs), a group of versatile molecules that can alter splicing by interacting with the target sequence(s) at pre‐mRNA level. Thus, characterizing the effect of a variant at the RNA level is instrumental to assess the applicability of AON‐based therapeutic intervention.

We explored the effect of the homozygous variant c.11 + 5G>A in RPE65 and a heterozygous complex allele consisting of c.3023‐15T>A and c.3023G>A (p.(Gly1008Asp)) in IMPG2. In silico predictions suggested that these variants lead to a splicing defect. To assess the pathogenic effect of these variants, splice reporter assays using midigenes were conducted in HEK293T cells. Initial results pointed towards a 124‐nt exon elongation for the RPE65 variant and an in‐frame deletion of 48‐nt at the beginning of exon 15 for the complex allele in IMPG2.

To validate these results, blood cells from the patients harbouring these defects were reprogrammed to induced pluripotent stem cells (iPSCs). Subsequently, iPSCs were differentiated to the retinal cells in which these genes are endogenously expressed. For RPE65, iPSCs were differentiated into retinal pigment epithelium (RPE) cells (>90 days differentiation) or, for IMPG2, into photoreceptor precursor cells (PPCs, 30 days differentiation). For the RPE65 variant, a cell specific effect was observed: while a clear exon elongation was observed in the midigene system, in RPE, the expression of the gene was highly reduced. In addition, no protein was detected and the patient‐derived cells showed differences compared to the control line. For IMPG2, the 48‐nt deletion was detected in a lower percentage in patient‐derived PPCs compared to the levels observed in the midigene system. However, aberrantly spliced IMPG2 transcripts were highly elevated in patient‐derived PPCs in comparison to control PPCs.

Overall, our work shows the importance of having the right cellular context to determine the effect of genetic variants on splicing in the retina.
Staging corneal neovascularization to guide treatment
Authors: Romano Vito
Published: January 2024

To describe the diagnostic technique to assess corneal neovascular (CoNV) complexes and identify feeder vessels in ocular surface pathologies. To illustrate the role of corneal angiography in clinical assessment and surgical treatment of patients with complex corneal neovascularization. To compare corneal angiography with non‐invasive diagnostic tests such as OCT angiography and slit lamp camera. A case series of patients with CoNV is presented whose management was guided by indocyanine green (ICG) and fluorescein corneal angiography. Corneal angiography is a useful diagnostic tool to guide medical and surgical management of CoNV by enabling the localization of vessel depth and topography.
Need for new corneal restoration technologies in a post‐COVID world
Authors: Liu Christopher
Published: January 2024

In most countries, the supply of corneal material do not meet the demands for corneal transplantation. This has been exacerbated by COVID‐19. Patients have not been seen during lockdown. Many are presenting late. There has been fewer operations done during the pandemic resulting in a backlog. Even in normal times, there are cases of corneal blindness not amenable to cadaveric corneal transplantation. The clinical and research community have two tasks. One is to develop artificial corneae or contructs through biotechnology to replace cadaveric transplantation. The other is to improve keratoprostheses which are used for vascularised corneae and multiple previous failed grafts (Boston KPro1 and similar) and for dry keratinised ocular surface (the OOKP and alternatives).
Cold plasma to treat therapy‐refractive corneal ulcerations
Authors: Fuchsluger Thomas
Published: January 2024

This talk will present a novel cold plasma technology to bind to treat therapy‐refractive corneal infections. Technology, processing and release will be demonstrated as well as the potential of the technology and future possible use.
Cationic human defence peptides and cornea HSV‐1 infections: Results of a rabbit study
Authors: Asoklis Rimvydas
Published: January 2024

In this study, we evaluated the potential of LiQD cornea glue supplemented with LL37‐derived peptide GF19, delivered through Silicium nanoparticles (SiNP) to prevent herpes simplex virus type 1 (HSV‐1) infection in a rabbit corneal model. SiNP‐GF19 was synthesized using a hydrophobic core, a hydrophilic shell, and a reactive surface that allowed covalent bonding to the collagen‐like peptides of our developed LiQD Cornea glue. Our results showed that SiNP‐GF19 was able to effectively release GF19 in a sustained manner, with approximately 60% of the peptide being released over 24 h. The remaining 40% of GF19 is trapped in the SiNP and can only be released upon complete degradation of the nanoparticles, which may occur via cellular uptake and enzymatic degradation. This ensures the prolonged release of GF19. The mechanism of action of GF19 against HSV‐1 may involve preventing the binding of the virus to host cells. Previous studies have shown that LL37, from which GF19 is derived, can block HSV‐1 binding to host cells, leading to decreased viral infection. However, in our study, we did not see reduced viral shedding, furthermore, nanoparticles coated with the GF19 peptide or nanoparticles themselves may have an eye irritant effect. Nevertheless, LiQD Cornea supplemented with SiNP‐GF19 or LiQD alone were effective in promoting corneal regeneration and healing. Specifically, it led to the formation of a relatively mature epithelium composed of 2–3 epithelial layers, expressing CK3 in the outermost epithelial layer, compared to the absence of epithelium or a monolayer of unstructured CK3‐negative epithelium in the cyanoacrylate adhesive control group. LiQD Cornea formulation without SiNP‐GF19 also displayed significantly lower α‐SMA staining than the rest of the experimental groups in the implant area, which overexpression is associated with abnormal extracellular matrix deposition and scar formation. In terms of nerve regeneration, all LiQD Cornea formulations showed βIII tubulin expression, indicating immature neuronal microtubule structures. In summary, all three experimental treatment strategies were significantly more effective compared to the cyanoacrylate adhesive control group, significantly smaller scar tissues without ingrown vascular networks were formed, though, only mild antiviral properties of SiNP‐GF19 were observed.
Biomechanical modulation therapy: A novel alternative to stem cell transplantation for limbal stem cell disorders
Authors: Connon Che
Published: January 2024

Previously, we hypothesized that the biomechanical properties of the surface supporting the corneal epithelium plays a fundamental role on the tissue's homeostasis (i.e., the balance between epithelial cell migration, differentiation, proliferation, and desquamation). Here we analyse these biomechanical properties from fresh human corneas at an unprecedented resolution using Brillouin spectro‐microscopy. This non‐contact technique revealed that the different corneal tissues can be clearly distinguished, with significantly different Brillouin frequency shifts forming distinctive bulk modulus patterns between the central cornea and the limbus. Specifically, the highest modulus was observed in the sub‐epithelium matrix of the central cornea (i.e., Bowman's layer), whereas the area with lowest bulk modulus corresponded to the sub‐epithelial matrix surrounding the populations of limbal epithelial stem cells (LESCs). We then showed that, in vitro, high‐density collagen gels softened by the localized application of collagenase are capable of persistently supporting slow‐moving, proliferative CK15+/CK3− corneal epithelial cells. In contrast, untreated gel surfaces elicited quicker differentiation of LESCs. Moreover, the same technique applied in situ allowed the softening of the anterior surface of the central cornea, which was then capable of supporting the re‐epithelialisation of ABCG2+/CK15+/α9‐integrin+/CK3‐ corneal epithelial cells capable of reforming a limbus‐characteristic basement membrane (BM) containing laminin‐γ3. Together, these results support the notion that the phenotype of corneal epithelial cells depends on the mechanical properties of their residence. Following on from this we undertook a series of animal studies to test our hypothesis that the loss of limbal stem cells following alkali burn was attributable to a pathological stiffening of the limbal sub‐epithelial tissue and that a restoration of this stiffness via the pharmacological action of collagenase could reverse the loss of limbal stem cells.
Father Waclaw Szuniewicz, MD – Pioneer of refractive surgery
Authors: Grzybowski Andrzej
Published: January 2024

Father Wacław Szuniewicz (1891–1963) was a missionary, researcher and ophthalmic surgeon and can be considered as one of the pioneers of refractive surgery. In 1931 he began a 19 bed missionary hospital in Xingtai, Hebei Province, China. He personally was able to examine about 145 000 patients and conduct up to 800 cataract extractions per year. When the mission was closed, he moved to New Haven, United States and performed research at the Yale University. In 1952 he moved Brazil, where he continued his pastoral and medical work until his death. Szuniewicz conducted experiments on changing the corneal curvature with anterior, posterior and full‐thickness incisions, however his works were not published during his life.
Corneo‐conjunctival sensory neuron: Types, transduction channels and codification of nerve impulses
Authors: Gallar Juana
Published: January 2024

The cornea and the conjunctiva are innervated by the peripheral projections of a small number of primary sensory neurons whose somata are located at the ophthalmic region of the trigeminal ganglion. Most trigeminal neurons innervating the ocular surface are small and medium size, and contain neuropeptides such as SP and CGRP. Functionally, ocular surface neurons have been classified into five main neuronal types, based on their response to multiple modalities of stimuli (mechanical forces, heat, cold, H+, chemical substances, etc.). Polymodal nociceptors (activated by several modalities of stimulus, mechanical energy, heat, H+, and chemical irritants), mechanonociceptors (activated by mechanical energy), cold thermoreceptors (activated by temperature reductions and hyperosmolarity) are found in the cornea, the sclera and the conjunctiva. Besides, low‐threshold mechanoreceptors (activated by mechanical forces of low intensity) are found in the corneoscleral limbus and the lid border, and pruriceptors (activated by pruritogen substances) have been described in the tarsal conjunctiva, close to the lid margin.

The ability to respond to the different modalities of stimulus lies in the types of transducing channels that each type of neuron expresses at its peripheral nerve endings. Sensory transduction involves the conversion of the physical or chemical stimuli acting on the nerve terminal into electrical energy, that is, into a local change of membrane potential that, if it is large enough, will generate action potentials that will travel along the axon to be processed by the CNS. So that, nerve terminals with TRPV1 channels are directly gated by heat, H+, and several chemical irritants such as capsaicin; nerve terminals with Piezo2 channels will be activated by mechanical forces; TRPM8 channels provide nerve terminals sensitivity to cold and osmolarity increases; et cetera.

Ocular sensory neurons also express other ion channels that contribute to coding, that is to help the sensory neuron to establish a correspondence between the characteristics of the stimulus (intensity, temporal course, etc.) and specific parameters of the firing it induces. Voltage‐gated Ca2+, Na+ and K+ channels as well as cyclic nucleotide‐gated channels, among others, contribute to define the firing frequency and pattern to encode the traits of the stimulus. Thus, the ion channels present in the nerve terminals of each class of ocular sensory neuron provide the neurons the ability to detect and encode one or several modalities of stimulus, which constitutes the origin of the different sensations evoked on the ocular surface.

(Supported by PID2020‐115934RB‐I00 from DOI: MCIN/AEI/10.13039/50110001103, and CIPROM/2021/48 from the Generalitat Valenciana, Spain)
Clinical applications of confocal microscopy to corneal innervation
Authors: del Castillo José Benitez
Published: January 2024

In vivo corneal confocal microscopy (IVCM) is a non‐invasive ophthalmic imaging technique that provides images of the cornea at the cellular level. Despite the uses in ocular surface pathologies, in the last decades IVCM has been used to provide more knowledge in refractive surgery wound healing (LASIK and PRK), dry eye disease, and in some corneal infections (amoebas and filamentous fungi). The observation of the corneal cells, both normal and inflammatory, and the possibility of quantification of the corneal nerve density and quality with manual or automated tools, makes IVCM have a significant potential to improve the diagnosis and prognosis in several systemic and corneal conditions. Neuropathic pain has multiple aetiologies, but a major feature is small fibre dysfunction or damage. IVCM has been utilized to show small nerve fibre loss in patients with diabetic and other neuropathies. IVCM has comparable diagnostic utility to intraepidermal nerve fibre density for diabetic neuropathy, fibromyalgia and amyloid neuropathy and predicts the development of diabetic neuropathy. Moreover, in clinical intervention trials of patients with diabetic and sarcoid neuropathy, corneal nerve regeneration occurs early and precedes an improvement in symptoms and neurophysiology. Corneal nerve fibre loss also occurs and is associated with disease progression in multiple sclerosis, Parkinson's disease, and dementia. Patients with small fibre neuropathy have IVCM nerve changes. In conclusion, IVCM has good diagnostic and prognostic capability and fulfils the criteria as an end point for clinical trials in corneal, and peripheral and central neurodegenerative diseases.
Ruthenium‐ 106 brachytherapy in the treatment of central choroidal melanoma
Authors: Grajewski Luise , Lothar Krause
Published: January 2024

Aims/Purpose: Choroidal melanoma is the most common ocular malignancy. Depending on the size of the tumour and its location in relation different treatment options are available. Brachytherapy with β‐emitting Ruthenium‐ 106 plaque is an effective and widely used treatment. The treatment of juxtapapillary and juxtafoveolar choroidal melanoma is challenging because it involves the macula and optic nerve. Studies have shown that central choroidal melanomas have a high recurrence rate.

Methods: A total of 56 eyes of 56 patients with central choroidal melanoma were included in this retrospective study and treated with Ru‐106 brachytherapy between January 2011 and July 2020 in our institution. As central choroidal melanomas were defined all juxtafoveolar melanomas with a posterior edge touching an optic disc‐ fovea‐ radius around the fovea (about 5 mm). We measured visual acuity, recurrence, radiation related side effects and metastasis. The mean follow‐ up time was 66 (6–136) months.

Results: Of the 56 eyes, 8 eyes (14%) showed a recurrence during the follow‐ up period. It was shown that the choroidal melanomas closer to the optic disc have a higher recurrence rate than the once close to the macula (69% vs. 95%). A radiation retinopathy was detected in 7 eyes (13%), a radiation opticopathy in 7 eyes (13%) and a radiation maculopathy in 10 eyes (17.9%). 6 eyes (11%) had to be enucleated because of recurrence or radiation complication.

Conclusions: Ruthenium brachytherapy is an effective therapy for central choroidal melanoma with a rate of preserving the eye of 89%. The localization of the choroidal melanoma near the optic disc goes ahead with a higher rate of complications and recurrences.
Blunt dissection method using HiQ+ soft coagulation system for laparoscopic cholecystectomy in acute cholecystitis
Authors: Kawai Hironari , Omura Nobuo , Yamasawa Kaito , Tsukazaki Yuhei , Hirabayashi Tsuyoshi , Kawahara Hidejiro
Published: January 2024

Introduction

During laparoscopic cholecystectomy for acute cholecystitis, it is often difficult to keep the surgical view dry because of inflammation‐related tissue fragility and susceptibility to bleeding. The resulting inadequate surgical view can lead to bile duct or vascular injury. Soft coagulation systems are used to achieve hemostasis during various surgeries; however, the usefulness of soft coagulation during laparoscopic cholecystectomy for acute cholecystitis is unclear. We here demonstrate the usefulness and feasibility of blunt dissection and soft coagulation during this procedure.

Materials and Surgical Technique

We used blunt dissection and soft coagulation when performing laparoscopic cholecystectomy on two patients with acute cholecystitis. As with conventional laparoscopic cholecystectomy, four ports were inserted. After cutting the serosa by electrocautery, blunt dissection using soft coagulation was performed, exposing the inner subserosa. Maintaining this layer using blunt dissection with soft coagulation achieved a sufficiently clear view for safety. After resecting the cystic artery and duct, the gallbladder bed was also dissected by blunt dissection with soft coagulation. Blood loss was <20 mL in both patients.

Discussion

Blunt dissection with soft coagulation may be a useful and feasible means of keeping the surgical view dry and minimizing blood loss during laparoscopic cholecystectomy for acute cholecystitis.
Unleashing digital superheroes: Unravelling the empathy factor in digital competence and online teacher autonomy support
Authors: Chen Anni , Li Wei , Fu Weidong
Published: January 2024

Considerable research has been dedicated to studying teachers' digital competence, yet limited insights have been gained regarding its impact on online teacher autonomy support. Based on the Technological Pedagogical Content Knowledge (TPACK) framework, this study utilized a multiple regression analysis model to explore how teachers' digital competence affects online teacher autonomy support. Drawing on data from 652 Chinese primary school teachers, the study revealed that teachers' digital competence positively influenced online teacher autonomy support via teachers' cognitive empathy. Teachers' emotional empathy strengthened the direct effect of cognitive empathy on online teacher autonomy support, and its indirect effect on teachers' digital competence on online teacher autonomy support. The findings inform TPACK framework development and practical considerations in online teaching, deepening understanding of the impact of digital competence on online teacher autonomy support.

Practitioner notes

What is already known about this topic

Previous research has recognized the importance of teachers' digital competence in supporting learners' autonomy and enhancing their online learning experiences.

Existing studies have explored different dimensions of teachers' digital competence, including technological proficiency, pedagogical knowledge and content expertise.

Studies have also examined the role of empathy in online teaching and learning, emphasizing its importance in fostering positive teacher–student relationships and promoting student engagement and motivation.

What this paper adds

This study introduces digital competence as a novel and comprehensive assessment of technology integration in teaching, bridging an existing gap in the literature.

This study recognizes the importance of socio‐emotional skills in online teaching by including teachers' empathic traits within the expanded TPACK framework.

Teachers' cognitive empathy acts as a mediator and emotional empathy functions as a moderator in the relationship between digital competence and online teacher autonomy support, offering new insights into the underlying mechanisms.

Implications for practice and/or policy

Teacher educators should find ways to support teachers' digital competence in facilitating learners' autonomy in online learning environments effectively.

Teacher educators should incorporate teacher empathy development into teachers' professional development programmes for online teaching, offering tailored interventions to differentiate and enhance both cognitive and emotional empathy.
Co‐designing interventions for a continuum of care for children with cerebral palsy
Authors: KC Ashish
Published: January 2024

This commentary is on the original article by Williams et al. on pages 1074–1083 of this issue.
Terrorism, counter‐terrorism, and voting: The case of Turkey
Authors: Yardimci M. Akif
Published: January 2024

This paper empirically tests the impact of terrorism and counter‐terrorism on voting by focusing on the two 2015 general elections in Turkey ‐ and the 2011 general election. This period offers a unique case because, after the first election, the ongoing peace process between the incumbent party (AKP), the political party associated with the perpetrators (pro‐Kurdish political party, HDP), and the imprisoned leader of the terrorist organization (PKK) was canceled. Instead, terror attacks recurred and curfews were implemented as counter‐terrorism measures. This enables the impact of curfews and terror attacks on electoral outcomes to be analysed in a difference‐in‐differences setting. Terror attacks are estimated to reduce the incumbent's vote share by 3.2% points, while increasing the vote share of the party associated with the perpetrators by 3.6% points. Curfews are estimated to cancel out the impact of terror attacks in attacked municipalities and decrease the incumbent's vote share by 4.7% points in non‐attacked municipalities.
The evolution of cnidarian stinging cells supports a Precambrian radiation of animal predators
Authors: Sierra Noémie C. , Gold David A.
Published: January 2024

Cnidarians—the phylum including sea anemones, corals, jellyfish, and hydroids—are one of the oldest groups of predatory animals. Nearly all cnidarians are carnivores that use stinging cells called cnidocytes to ensnare and/or envenom their prey. However, there is considerable diversity in cnidocyte form and function. Tracing the evolutionary history of cnidocytes may therefore provide a proxy for early animal feeding strategies. In this study, we generated a time‐calibrated molecular clock of cnidarians and performed ancestral state reconstruction on 12 cnidocyte types to test the hypothesis that the original cnidocyte was involved in prey capture. We conclude that the first cnidarians had only the simplest and least specialized cnidocyte type (the isorhiza) which was just as likely to be used for adhesion and/or defense as the capture of prey. A rapid diversification of specialized cnidocytes occurred through the Ediacaran (~654–574 million years ago), with major subgroups developing unique sets of cnidocytes to match their distinct feeding styles. These results are robust to changes in the molecular clock model, and are consistent with growing evidence for an Ediacaran diversification of animals. Our work also provides insight into the evolution of this complex cell type, suggesting that convergence of forms is rare, with the mastigophore being an interesting counterexample.
Comfort and wearability properties of custom‐made and boil‐and‐bite mouthguards among basketball players: A randomized parallel arm clinical trial
Authors: Doğan Özgür , Sönmez Hayriye , Doğan Suat Serhan Altıntepe
Published: January 2024

Background/Aim

Thermoplastic mouthguards have been a reliable means of protection against impacts and shocks for a century. Although orofacial injuries are prevalent among basketball players, many athletes still avoid using mouthguards due to concerns regarding impaired breathing, speech interference, and nausea. This study aims to compare basketball players' subjective assessments of two different thicknesses of custom‐made mouthguards (MGs) with boil‐and‐bite MGs (B&B MG).

Material and Methods

A total of 60 systematically healthy male professional basketball players, without active orthodontic treatment, were enrolled and randomly assigned to three groups: Group 1 (received B&B MGs; n = 20), Group 2 (received custom‐made MGs with a 3 mm thickness [ethyl vinyl asetat]; n = 20), and Group 3 (received custom‐made MGs with a 5 mm thickness; n = 20). To evaluate MG comfort and usability, 12 key factors, including comfort, fit, stability, tiredness, thirsting, oral dryness, nausea, speaking, breathing, drinking, ease of wear and removal, and inclination to chew, were assessed. The athletes were made to rate these factors using a 10 cm‐long Visual Analog Scale, measured at three‐time intervals, and the values for both inter‐group and intra‐group were compared.

Results

Data from 48 basketball players were retrieved, and data analysis revealed that B&B MGs had the least favorable parameter values. Among the B&B MG group, stability was reported to be poorer during the initial measurement (p < .05). In the second measurement, B&B MGs showed significantly lower values for comfort, stability, tiredness, speaking, and inclination to chew (p < .05). During the third measurement, the B&B MG group exhibited significantly reduced values for comfort, breathing, drinking, and speaking (p < .05). In contrast, no statistically significant difference was observed between 3 and 5 mm thickness MGs in these measurements.

Conclusions

Custom‐made MGs with different thicknesses consistently outperformed B&B MGs in all measurements, indicating the potential to tailor MG thickness based on sport, age, professional level of athlete, and presence of other protective equipment. While custom‐made mouthguards are considered the gold standard, dentists who provide B&B MGs can lead to cost savings while maintaining protection and encouraging athletes to use higher‐quality custom‐made mouthguards.
Effect of root immaturity and depth of intrusion on spontaneous re‐eruption and healing complications: A retrospective analysis
Authors: Singhal Ruchi , Negi Shefali , Namdev Ritu , Kakran Anisha
Published: January 2024

Background/Aims

Dental trauma resulting in tooth intrusion is a severe injury of permanent dentition, with a prevalence of 0.5%–1.9% among traumatic dental injuries. Currently, treatment guidelines for intruded permanent teeth depend on root development and the degree of intrusion. However, the categorization of tooth maturity as mature or immature simplifies a complex continuum of root development stages. This study aims to investigate the impact of various stages of root development on the success of spontaneous re‐eruption (SRE) of intruded teeth.

Materials and Methods

This retrospective study analysed data from 80 children (125 teeth) aged 6–12 years who experienced dental intrusion between 2018 and 2022. Root maturation was classified based on Cvek's classification, eight were categorized as stage 1, 29 as stage 2, 44 as stage 3, 25 as stage 4, and 19 as stage 5. Intruded teeth with immature roots (Cvek's class 1–4) underwent SRE, while mature teeth (Cvek's class 5) were treated with SRE, orthodontic repositioning, or surgical repositioning based on the degree of intrusion. Primary outcome measures were successful re‐eruption and secondary outcomes included observed complications during follow‐up.

Results

Regression analysis revealed that the patient's age, degree of root maturation, and degree of intrusion significantly affected spontaneous re‐eruption (p < .05). SRE was more successful in teeth with Cvek's stages 1 and 2 compared to stages 3 and 4. Complications were associated with the treatment method, degree of root immaturity, and degree of intrusion.

Conclusion

The study demonstrates that as root maturation progresses, the likelihood of re‐eruption decreases, and the risk of pulp necrosis and infection increases. Therefore, teeth in later stages of immaturity (Cvek stage 4) should be repositioned orthodontically or surgically without waiting for spontaneous re‐eruption.
Electroencephalographic β‐band oscillations in the sensorimotor network reflect motor symptom severity in amyotrophic lateral sclerosis
Authors: Dukic Stefan , Fasano Antonio , Coffey Amina , Buxó Teresa , McMackin Roisin , Chipika Rangariroyashe , Heverin Mark , Bede Peter , Muthuraman Muthuraman , Lowery Madeleine , Carson Richard G. , Hardiman Orla , Nasseroleslami Bahman
Published: January 2024

Background and purpose

Resting‐state electroencephalography (EEG) holds promise for assessing brain networks in amyotrophic lateral sclerosis (ALS). We investigated whether neural β‐band oscillations in the sensorimotor network could serve as an objective quantitative measure of progressive motor impairment and functional disability in ALS patients.

Methods

Resting‐state EEG was recorded in 18 people with ALS and 38 age‐ and gender‐matched healthy controls. We estimated source‐localized β‐band spectral power in the sensorimotor cortex. Clinical evaluation included lower (LMN) and upper motor neuron scores, Amyotrophic Lateral Sclerosis Functional Rating Scale–Revised score, fine motor function (FMF) subscore, and progression rate. Correlations between clinical scores and β‐band power were analysed and corrected using a false discovery rate of q = 0.05.

Results

β‐Band power was significantly lower in people with ALS than controls (p = 0.004), and correlated with LMN score (R = −0.65, p = 0.013), FMF subscore (R = −0.53, p = 0.036), and FMF progression rate (R = 0.52, p = 0.036).

Conclusions

β‐Band spectral power in the sensorimotor cortex reflects clinically evaluated motor impairment in ALS. This technology merits further investigation as a biomarker of progressive functional disability.
Efficacy and safety of narrowband ultraviolet B versus combined ultraviolet A/narrowband ultraviolet B phototherapy in the treatment of chronic atopic dermatitis: A randomised double‐blind study
Authors: Lee Rayson Rui Sheng , Cai Sophie Carrie‐Shan , Wong Yisheng , Yew Yik Weng , Oon Hazel H. , Chong Wei‐Sheng , Tey Hong Liang , Tan Eugene Sern‐Ting
Published: January 2024

Phototherapy is a useful treatment modality for atopic dermatitis (AD). This is a prospective randomised double‐blind study comparing the clinical efficacy of combined ultraviolet‐A (UVA)/narrowband ultraviolet‐B (NBUVB) versus NBUVB phototherapy in the treatment of chronic AD. Patients with moderate‐to‐severe AD were randomised to receive either UVA/NBUVB or NBUVB phototherapy twice weekly over 12 weeks. At baseline, weeks 6 and 12, Eczema Area And Severity Index (EASI), itch score and adverse effects were assessed. At baseline and week 12, disease‐related quality of life was evaluated using the Dermatology Life Quality Index (DLQI). Nine patients were randomised to receive UVA/NBUVB and 10 received NBUVB. At week 12, both groups showed significant improvement in EASI and itch scores (p < 0.05). Significant improvement in DLQI was seen in the UVA/NBUVB arm (p = 0.009) with a trend towards improvement in the NBUVB arm (p = 0.11). The efficacy of both modalities were comparable, as were reported adverse effects aside from skin dryness which was higher in the NBUVB arm (40% vs. 0%, p = 0.033). Combined UVA/NBUVB and NBUVB phototherapy have comparable clinical efficacy and safety in the treatment of chronic AD. NBUVB may induce greater skin dryness.
Assessment of the floodplain fishery of Tonle Sap Lake in Cambodia
Authors: Thapa Jyoti , English Megan , Ou Chouly , Lanoue Julia , Walker Richard H.
Published: January 2024

Across the globe, fish stocks have been in decline due to industrialization of fisheries resources, overfishing, pollution, and climate change, thereby warranting more fisheries assessments. The floodplain fishery of Tonle Sap Lake near the Kampong Khleang stilted community in the Chamkar Youn village in Cambodia was evaluated by: (1) characterizing fish assemblage structure and function, (2) highlighting temporal differences in fish assemblage, and (3) assessing potential indicators of fishing‐down‐the‐food‐web by the fishery. Fish trap data from the wet season were used to characterize fish abundance, diversity, species richness, and functional feeding guilds from fish catches in 2014 and 2019. Fish abundance declined 62% and species richness declined between 2014 and 2019. Smaller‐bodied, lower‐trophic level fishes dominated the catch. Our limited findings add insight into the status of a globally important fishery and highlight the need for more local collaborative fishery assessments.
Biomass yield potential on U.S. marginal land and its contribution to reach net‐zero emission
Authors: He Yufeng , Jaiswal Deepak , Long Stephen P. , Liang Xin‐Zhong , Matthews Megan L.
Published: January 2024

Bioenergy with carbon capture and geological storage (BECCS) is considered one of the top options for both offsetting CO2 emissions and removing atmospheric CO2. BECCS requires using limited land resources efficiently while ensuring minimal adverse impacts on the delicate food‐energy‐water nexus. Perennial C4 biomass crops are productive on marginal land under low‐input conditions avoiding conflict with food and feed crops. The eastern half of the contiguous U.S. contains a large amount of marginal land, which is not economically viable for food production and liable to wind and water erosion under annual cultivation. However, this land is suitable for geological CO2 storage and perennial crop growth. Given the climate variation across the region, three perennials are major contenders for planting. The yield potential and stability of Miscanthus, switchgrass, and energycane across the region were compared to select which would perform best under the recent (2000–2014) and future (2036–2050) climates. Miscanthus performed best in the Midwest, switchgrass in the Northeast and energycane in the Southeast. On average, Miscanthus yield decreased from present 19.1 t/ha to future 16.8 t/ha; switchgrass yield from 3.5 to 2.4 t/ha; and energycane yield increased from 14 to 15 t/ha. Future yield stability decreased in the region with higher predicted drought stress. Combined, these crops could produce 0.6–0.62 billion tonnes biomass per year for the present and future. Using the biomass for power generation with CCS would capture 703–726 million tonnes of atmospheric CO2 per year, which would offset about 11% of current total U.S. emission. Further, this biomass approximates the net primary CO2 productivity of two times the current baseline productivity of existing vegetation, suggesting a huge potential for BECCS. Beyond BECCS, C4 perennial grasses could also increase soil carbon and provide biomass for emerging industries developing replacements for non‐renewable products including plastics and building materials.
Concordance between metabolic dysfunction‐associated steatotic liver disease and nonalcoholic fatty liver disease
Authors: Suzuki Keito , Tamaki Nobuharu , Kurosaki Masayuki , Takahashi Yuka , Yamazaki Yudai , Uchihara Naoki , Tanaka Yuki , Miyamoto Haruka , Yamada Michiko , Keitoku Taisei , Okada Risa , Higuchi Mayu , Takaura Kenta , Tanaka Shohei , Maeyashiki Chiaki , Yasui Yutaka , Tsuchiya Kaoru , Nakanishi Hiroyuki , Izumi Namiki
Published: January 2024

Aim

A multisociety consensus group proposed a new nomenclature for metabolic dysfunction‐associated steatotic liver disease (MASLD). Although patients with nonalcoholic fatty liver disease (NAFLD) are expected to be reclassified as patients with MASLD under the new nomenclature, the concordance between MASLD and NAFLD remains unclear. Moreover, waist circumference could be adjusted by ethnicity for diagnosing MASLD; however, there are limited data on the optimal waist circumference in the Japanese population.

Methods

This cross‐sectional study was conducted on 3709 Japanese patients with NAFLD. The primary endpoint was the prevalence of MASLD in patients with NAFLD. The difference between the original waist circumference criteria (>94 cm for men and >80 cm for women) and the Japanese metabolic syndrome criteria (≥85 cm for men and ≥90 cm for women) for concordance between NAFLD and MASLD was also investigated.

Results

According to the original criteria, the prevalence of MASLD in patients with NAFLD was 96.7%. Similarly, according to the Japanese waist circumference criteria, 96.2% of patients with NAFLD could be reclassified as those with MASLD. The concordance rate was significantly higher in the original criteria than in the Japanese criteria (p = 0.02).

Conclusions

NAFLD could be considered MASLD using the original MASLD criteria in the Japanese population, and insights from NAFLD research could be applied to MASLD.
The psychosocial beliefs, experiences and expectations of children living with obesity
Authors: Newson Lisa , Sides Nicola , Rashidi Amineh
Published: January 2024

Background

Childhood obesity has been shown to impair psychological health. However, psychological factors are often overlooked in both research evaluations and treatment interventions, and children's perspectives on managing obesity are underexplored. Neglecting psychosocial factors might undermine interventions. This research explored the psychological beliefs, expectations and experiences of children living with obesity (range 7–13) and attending a weight management programme (WMP).

Methods

Thirty‐four participants (19 females, 15 males, average age 9.5 years) completed a semistructured interview. Recorded interviews were transcribed verbatim and analysed using thematic analysis.

Results

Four overarching themes were developed: (1) defining health and self‐recognition; (2) external influence; feedback, stigma and comparison; (3) recognising emotions and (4) future expectations: obesity is a reality. These themes interact to influence the children's psychosocial status.

Conclusions

This study highlights a range of psychosocial and emotional difficulties that children living with obesity experience and suggests that these remain regardless of their attendance at a WMP. Interventions for children living with obesity should address psychosocial factors, including stress management, peer victimisation and handling feedback from others.

Patient or Public Contribution

As proposed by the two young people acting as patient and public involvement and engagement representatives, the utilisation of scrapbooks as a preinterview tool was particularly helpful in aiding discussion during the interviews. This innovative approach could be considered a valuable methodological technique for investigating sensitive topics with children in future research.
Rapid assessment of the dependence of flexural elastic modulus on temperature through in‐situ image analysis
Authors: Li Junfeng , Ma Delong , Bao Yiwang
Published: January 2024

This study aimed to develop a method for rapid and precise measurement of the elastic modulus at high temperatures. High‐temperature in‐situ microscopy was used in conjunction with a testing apparatus to measure the deformation of a specimen in three‐point bending test. The bending deflection was determined in situ by measuring the relative change between the test point on the specimen and a fixed reference point. The deflection was correlated with the elastic modulus to obtain the dependence of the elastic modulus on temperature. The ratio between high‐ and room‐temperature deflection of the bending beam was measured using the relative method and image analysis, with an identical scene and focal length for each photograph and a resolution of less than 1 µm. The deflection ratio was then converted into the ratio between high‐ and room‐temperature elastic modulus, enabling the high‐temperature modulus to be quickly derived. The experiments were performed on a sample made of silicon carbide fiber braided layered composite. The results showed that the elastic modulus changed little within 1100°C, remaining between 80 and 84 GPa. Contrarily, constant‐load tests indicated that the creep of this material was noticeable, making it difficult to obtain reliable elastic modulus.