bluuebunny/crossref_metadata_2025 huggingface dataset:
Mitigating local bias in equity crowdfunding: a financial ecology perspective
Authors: Cai Wanxiang , Polzin Friedemann , Stam Erik
Published: April 2024

This study analyses the relationship between geographic space, social networks, and financial knowledge in interregional equity crowdfunding flows based on the concept of financial ecology. Using data from a leading Dutch equity crowdfunding platform, we find that interregional crowdfunding investment decreases with geographic distance. Furthermore, the negative effect of distance is weaker if interregional social networks are strong and if the investor region has a high concentration of the financial industry. The results extend the conceptual foundation of financial ecology by explaining how individual behaviors affect the macro-level output of a financial ecology.
BCL2A1 neoepitope–elicited cytotoxic T lymphocytes are a promising individualized immunotherapy of pancreatic cancer
Authors: Lin Shengzhe , Hong Jingwen , Wu Suxin , Zhu Chenlu , Liu Fang , Lin Wansong , Cai Xinran , Ye Yunbin , Chen Yanling
Published: April 2024

Conventional treatments have shown a limited efficacy for pancreatic cancer, and immunotherapy is an emerging option for treatment of this highly fatal malignancy. Neoantigen is critical to improving the efficacy of tumor-specific immunotherapy. The cancer and peripheral blood specimens from an HLA-A0201–positive pancreatic cancer patient were subjected to next-generation sequencing, and bioinformatics analyses were performed to screen high-affinity and highly stable neoepitopes. The activation of cytotoxic T lymphocytes (CTLs) by dendritic cells (DCs) loaded with mutBCL2A111–20 neoepitope targeting a BCL2A1 mutant epitope was investigated, and the cytotoxicity of mutBCL2A111–20 neoepitope–specific CTLs to pancreatic cancer cells was evaluated. The mutBCL2A111–20 neoepitope was found to present a high immunogenicity and induce CTLs activation and proliferation, and these CTLs were cytotoxic to mutBCL2A111–20 neoepitope–loaded T2 cells and pancreatic cancer PANC-1-Neo and A2-BxPC-3-Neo cells that overexpressed mutBCL2A111–20 neoepitopes, appearing to be a targeting neoepitope specificity. In addition, high BCL2A1 expression correlated with a low 5-yr progression-free interval among pancreatic cancer patients. Our findings provide experimental supports to individualized T cell therapy targeting mutBCL2A111–20 neoepitopes, and provide an option of immunotherapy for pancreatic cancer.
Subchronic toxicity study of indium-tin oxide nanoparticles following intratracheal administration into the lungs of rats
Authors: Matsumura Nagisa , Tanaka Yu-ki , Ogra Yasumitsu , Koga Kazunori , Shiratani Masaharu , Nagano Kasuke , Tanaka Akiyo
Published: April 2024

Objectives:

We aimed to analyze the subchronic toxicity and tissue distribution of indium after the intratracheal administration of indium-tin oxide nanoparticles (ITO NPs) to the lungs of rats.

Methods:

Male Wistar rats were administered a single intratracheal dose of 10 or 20 mg In/kg body weight (BW) of ITO NPs. The control rats received only an intratracheal dose of distilled water. A subset of rats was periodically euthanized throughout the study from 1 to 20 weeks after administration. Indium concentrations in the serum, lungs, mediastinal lymph nodes, kidneys, liver, and spleen as well as pathological changes in the lungs and kidneys were determined. Additionally, the distribution of ionic indium and indium NPs in the kidneys was analyzed using laser ablation-inductively coupled plasma mass spectrometry.

Results:

Indium concentrations in the lungs of the 2 ITO NP groups gradually decreased over the 20-week observation period. Conversely, the indium concentrations in the mediastinal lymph nodes of the 2 ITO groups increased and were several hundred times higher than those in the kidneys, spleen, and liver. Pulmonary and renal toxicities were observed histopathologically in both the ITO groups. Both indium NPs and ionic indium were detected in the kidneys, and their distributions were similar to the strong indium signals detected at the sites of inflammatory cell infiltration and tubular epithelial cells.

Conclusions:

Our results demonstrate that intratracheal administration of 10 or 20 mg In/kg BW of ITO NPs in male rats produces pulmonary and renal toxicities.
Migrants’ perspectives on environmental change and translocal practices in Morocco, Senegal, and the Democratic Republic of Congo
Authors: Lietaer Samuel , Van Praag Lore , Hut Elodie , Michellier Caroline
Published: April 2024

This qualitative study takes a translocal perspective by considering migrants’ views on environmental change, migration decisions and translocal practices in favour of environmental adaptation. This article addresses the following question: To what extent do migrants’ perceptions of environmental change in their region of origin influence their translocal practices in favour of adaptation to socio-environmental change? Our data show that while environmental change may not be the primary reason that people migrate, nor do they perceive it as such, their translocal practices may have very concrete impacts in environmentally fragile areas, especially with respect to non-migrants in the place of origin. Most practices (e.g. family economic remittances) are spontaneous and unintentionally adaptive to environmental change. In contrast, collective projects initiated through hometown associations, especially in Senegal and Morocco, often have a more intentional and proactive character, resulting in translocal adaptive socio-environmental dynamics.
Hemoadsorption: consensus report of the 30th Acute Disease Quality Initiative workgroup
Authors: Bellomo Rinaldo , Ankawi Ghada , Bagshaw Sean M , Baldwin Ian , Basu Rajit , Bottari Gabriella , Cantaluppi Vincenzo , Clark William , De Rosa Silvia , Forni Lui G , Fuhrman Dana , Goldstein Stuart , Gomez Hernando , Husain-Syed Faeq , Joannidis Michael , Kashani Kianoush , Lorenzin Anna , Mehta Ravindra , Murray Patrick T , Murugan Ragi , Ostermann Marlies , Pannu Neesh , Premuzic Vedran , Prowle John , Reis Thiago , Rimmelé Thomas , Ronco Claudio , Rosner Mitch , Schneider Antoine , See Emily , Soranno Danielle , Villa Gianluca , Whaley-Connell Adam , Zarbock Alexander
Published: April 2024

Adsorption-based extracorporeal therapies have been subject to technical developments and clinical application for close to five decades. More recently, new technological developments in membrane and sorbent manipulation have made it possible to deliver more biocompatible extracorporeal adsorption therapies to patients with a variety of conditions. There are several key rationales based on physicochemical principles and clinical considerations that justify the application and investigation of such therapies as evidenced by multiple ex vivo, experimental and clinical observations. Accordingly, unspecific adsorptive extracorporeal therapies have now been applied to the treatment of a wide array of conditions from poisoning to drug overdoses, to inflammatory states and sepsis, and acute or chronic liver and kidney failure. In response to the rapidly expanding knowledge base and increased clinical evidence, we convened an Acute Disease Quality Initiative consensus conference dedicated to such treatment. The data show that hemoadsorption has clinically acceptable short-term biocompatibility and safety, technical feasibility and experimental demonstration of specified target molecule removal. Pilot studies demonstrate potentially beneficial effects on physiology and larger studies of endotoxin-based hemoadsorption have identified possible target phenotypes for larger randomized controlled trials. Moreover, in a variety of endogenous and exogenous intoxications, removal of target molecules has been confirmed in vivo. However, some studies have raised concerns about harm, or failed to deliver benefits. Thus, despite many achievements, modern hemoadsorption remains a novel and experimental intervention with limited data, and a large research agenda.
The college wage premium in the UK: decline and fall?
Authors: Boero Gianna , Nathwani Tej , Naylor Robin , Smith Jeremy
Published: April 2024

We exploit two longitudinal cohort studies for birth cohorts of 1970 and 1990 to assess the change in the UK college wage premium (CWP) for those aged 25–26 years. After controlling for a rich set of covariates, we find evidence of a decline in the average CWP from 18 per cent to 8 per cent. The extent of the fall is common to men and women; hence, it is not driven by changes in sex composition over this time period. Our results contrast with previous findings of relative stability in the CWP over time. In a complementary analysis, we exploit Labour Force Survey (LFS) data from 1995 to 2019 to explore the timing of the fall in the CWP and to assess whether the decline is specific to particular birth cohorts or age ranges of workers.
The interplay of the innovation cycle, build time, lifetime, and deployment rate of new energy technologies: a case study of nuclear fusion energy
Authors: Lopes Cardozo Niek J , Ward Samuel H
Published: April 2024

This article analyses how a forced transition to low-carbon energy impacts the innovation of new energy technologies. We apply the insights to nuclear fusion, potentially a large provider of carbon-free energy currently attracting billions in private investments. We discuss the ‘fastest-feasible-growth (FFG)’ curve for transitions: exponential growth followed by linear growth, where the rate of latter is limited by the inverse lifetime of the installation. We analyse how innovation is affected if, during rapid deployment, a technology progresses through several generations. We identify key timescales: the learning time, the generation time, the build time, and the exponential growth time of the early deployment phase and compare these for different energy technologies. We distinguish learning rate-limited and generation-time-limited innovation. Applying these findings to fusion energy, we find that a long build time may slow deployment, slow learning, and promote early technology lock-in. Slow learning can be remedied by developing multiple concepts in parallel. Probabilistic analysis of value implies that the optimal strategy is to parallelize the development of many concepts. This concurs with the present surge in private investment in multiple concepts. For this strategy to be successful, the build time of the power plant must be minimized. This requirement favours concepts that lend themselves to modularization and parallelization of production and assembly.
Stranded? The IMF in a world of rising economic nationalism
Authors: Woods Ngaire
Published: April 2024

The International Monetary Fund (IMF) is entering a period of unprecedented challenge. Countries need its assistance to deal with debt distress, the post-Covid development crisis, new threats of financial instability, and the fallout of a decade of unconventional monetary policy. But the IMF faces two challenges of its own. As powerful countries ‘reset’ the rules on which the IMF’s work proceeds, it must build a new paradigm for advising its borrowers. Equally, as those same powerful countries show less willingness to cooperate with each other in international organizations, the IMF must keep them involved and working together within the institution.
Existing wetland conservation programs miss nutrient reduction targets
Authors: Zuidema Shan , Wollheim Wilfred M , Kucharik Christopher J , Lammers Richard B
Published: April 2024

Restoring wetlands will reduce nitrogen contamination from excess fertilization but estimates of the efficacy of the strategy vary widely. The intervention is often described as effective for reducing nitrogen export from watersheds to mediate bottom-level hypoxia threatening marine ecosystems. Other research points to the necessity of applying a suite of interventions, including wetland restoration to mitigate meaningful quantities of nitrogen export. Here, we use process-based physical modeling to evaluate the effects of two hypothetical, but plausible large-scale wetland restoration programs intended to reduce nutrient export to the Gulf of Mexico. We show that full adoption of the two programs currently in place can meet as little as 10% to as much as 60% of nutrient reduction targets to reduce the Gulf of Mexico dead zone. These reductions are lower than prior estimates for three reasons. First, net storage of leachate in the subsurface precludes interception and thereby dampens the percent decline in nitrogen export caused by the policy. Unlike previous studies, we first constrained riverine fluxes to match observed fluxes throughout the basin. Second, the locations of many restorable lands are geographically disconnected from heavily fertilized croplands, limiting interception of runoff. Third, daily resolution of the model simulations captured the seasonal and stormflow dynamics that inhibit wetland nutrient removal because peak wetland effectiveness does not coincide with the timing of nutrient inputs. To improve the health of the Gulf of Mexico efforts to eliminate excess nutrient, loading should be implemented beyond the field-margin wetland strategies investigated here.
Unlocking Patient Voices: Advancing Physical Therapist Practice With Discrete Choice Experiments
Authors: Rauseo Carla , Cheng Mingshun Samuel
Published: April 2024

As health care moves away from volume-based to value-based delivery, the role of the patient in determining value in health care is now paramount. Thus, health care should be aligned with what matters most to patients. Ascertaining patient preferences is therefore critical if we are to provide patients with care that is meaningful to them. However, preferences are difficult to measure and traditional methods of preference measurement in physical therapy face challenges when attempting to measure such. This perspective makes a case for greater use of the discrete choice experiment (DCE) in physical therapy as a research method to measure patient preferences. The DCE is a research method used to elicit preferences for services or goods. This article addresses the importance of eliciting patient preferences as part of person-centered care in the value-based space, the challenges faced in preference measurement in physical therapy, and how the DCE can alleviate some of those challenges. It also provides examples of the DCE in health care and suggests ways in which it can be effectively used in physical therapist practice to improve the delivery of meaningful rehabilitation services to patients. Implementing greater use of the DCE in physical therapy can improve person-centered physical therapist service delivery and inform policy development that creates cost-effective care which is meaningful to patients. It can further help to highlight the value of physical therapy to population health, and to policy makers as health care moves toward more value-based models.
Nonlinear neutral modes in zero-mass-flux Plane poiseuille-couette flow
Authors: Walton A G , Barnes C C
Published: April 2024

Plane Poiseuille–Couette flow with zero mean advection velocity, a flow well known to be linearly stable, is analysed at asymptotically large Reynolds number R. A nonlinear neutral mode structure is uncovered which is self-sustained due to the interaction of the viscous wall layers with a predominantly inviscid nonlinear internal critical layer. The O(1) phase speed and wavenumber of the disturbance are computed as functions of the O(R−1/3) wave amplitude, with the formula for the amplitude determined analytically. Two distinct coherent structures are found: one involving a single critical layer and a second with two critical layers. The single critical layer case has a long wavelength/small amplitude limit for which an analytical solution exists, while the dual critical layer structure possesses two solution branches and exists above a threshold amplitude. Both states distort the mean flow by an O(R−1/6) amount, and in the long wavelength limit the distortion becomes comparable in size with the original basic flow. The relevance of this work to the experimental observation of self-sustained states in this flow is discussed.
British Society for Rheumatology guideline on management of adult and juvenile onset Sjögren disease
Authors: Price Elizabeth J , Benjamin Stuart , Bombardieri Michele , Bowman Simon , Carty Sara , Ciurtin Coziana , Crampton Bridget , Dawson Annabel , Fisher Benjamin A , Giles Ian , Glennon Peter , Gupta Monica , Hackett Katie L , Larkin Genevieve , Ng Wan-Fai , Ramanan Athimalaipet V , Rassam Saad , Rauz Saaeha , Smith Guy , Sutcliffe Nurhan , Tappuni Anwar , Walsh Stephen B
Published: April 2024

Sjögren disease (SD) is a chronic, autoimmune disease of unknown aetiology with significant impact on quality of life. Although dryness (sicca) of the eyes and mouth are the classically described features, dryness of other mucosal surfaces and systemic manifestations are common. The key management aim should be to empower the individual to manage their condition—conserving, replacing and stimulating secretions; and preventing damage and suppressing systemic disease activity. This guideline builds on and widens the recommendations developed for the first guideline published in 2017. We have included advice on the management of children and adolescents where appropriate to provide a comprehensive guideline for UK-based rheumatology teams.
Perioperative Methadone for Spine Surgery: A Scoping Review
Authors: Nunn Kieran P. , Velazquez Ahida A. , Bebawy John F. , Ma Kan , Sinedino Bruno Erick , Goel Akash , Pereira Sergio M.
Published: April 2024

Complex spine surgery is associated with significant acute postoperative pain. Methadone possesses pharmacological properties that make it an attractive analgesic modality for major surgeries. This scoping review aimed to summarize the evidence for the perioperative use of methadone in adults undergoing complex spine surgery. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A search was performed using MEDLINE, CINAHL, Cochrane Library, Scopus, Embase, and Joanna Briggs between January 1946 and April 2023. The initial search identified 317 citations, of which 12 met the criteria for inclusion in the review. There was significant heterogeneity in the doses, routes of administration, and timing of perioperative methadone administration in the included studies. On the basis of the available literature, methadone has been associated with reduced postoperative pain scores and reduced postoperative opioid consumption. Though safety concerns have been raised by observational studies, these have not been confirmed by prospective randomized studies. Further research is required to explore optimal methadone dosing regimens, the potential synergistic relationships between methadone and other pharmacological adjuncts, as well as the potential long-term antinociceptive benefits of perioperative methadone administration.
Evolution of the Language in the Science of Unitary Human Beings
Authors: Fawcett Jacqueline , Alligood Martha Raile
Published: April 2024

This article presents a discussion of the evolution of the language of the Science of Unitary Human Beings from the terms used by Martha Rogers in her 1970 book to changes in terms Rogers introduced in her publications over the ensuing years to new terms and language offered by Rogerian scholars before and after Rogers’ death in 1994. The article follows from Rogers’ insistence that the language of a science, which evolves from general language, should be specific to the level of abstraction of the relevant concepts.
Extended Use of Proximal Humeral Locking Plates in Pediatric Femur Fractures and Osteotomies
Authors: Singh Sanjeev Kumar , Agrawal Tushar , Jain Deepak , Velankar Ameya
Published: April 2024

Objective:

To assess the extended use of proximal humeral locking plates in paediatric femur fractures and osteotomies.

Background:

Pediatric fractures and deformity correction pose unique challenges in orthopedic surgery. The utilization of the proximal humerus locking plates (PHLPs) in the pediatric population remains a relatively unexplored area. This manuscript presents a case-based analysis of the extended use of PHLP in pediatric femur fractures and osteotomies. Four distinct cases involving the use of PHLP are discussed, demonstrating its versatility and efficacy in addressing a variety of orthopedic conditions in the pediatric age group.

Methods:

We retrospectively reviewed the medical records of 4 pediatric patients who underwent surgical interventions utilizing PHLP at our institution. Case 1 involved a 9-year-old girl with a neglected neck of femur fracture, managed with in situ screw fixation and valgus osteotomy and stabilization using a PHLP. Case 2 featured a 10-year-old boy with a distal femur fracture, managed with a PHLP. Case 3 highlighted a 12-year-old girl with genu valgum, who underwent medial closing wedge osteotomy stabilized with a PHLP. Lastly, case 4 presented an 11-year-old boy with a subtrochanteric femur fracture, also managed using a PHLP. Surgical techniques, postoperative care, and outcomes were analyzed.

Results:

All 4 cases maintained satisfactory stability and alignment at final follow-up. All of them returned to preinjury status within 6 months.

Conclusion:

The extended use of proximal humeral locking plates in pediatric femur fractures and osteotomies presents a viable option for orthopedic surgeons. These cases illustrate the versatility and positive outcomes associated with PHLP in the pediatric population.
Ischiorectal Fossa Tumors: Thirty-Year Single Institution Experience
Authors: Peponis Thomas , Perry William R.G. , Kelley Scott R.
Published: April 2024

BACKGROUND:

Primary tumors of the ischiorectal fossa are rare and comprise a wide array of pathologies with varying malignant potential. Due to the low prevalence, there is a paucity of data in the literature. This paper presents a case-series on the management of ischiorectal fossa tumors.

OBJECTIVE:

To present a 30-year experience managing ischiorectal fossa tumors.

DESIGN:

Retrospective single center analysis.

SETTINGS:

A quaternary referral academic healthcare center.

PATIENTS:

All patients treated for ischiorectal fossa tumors.

INTERVENTIONS:

All patients underwent surgical management of their disease.

MAIN OUTCOME MEASURES:

Disease recurrence and overall survival.

RESULTS:

A total of 34 patients (53% female) were identified with a median follow-up of 23 months. Twenty-one patients (62%) were diagnosed with benign and 13 (38%) with malignant tumors. All underwent surgical resection. Median tumor size was 8.4 cm. R0 resection was obtained in 28 patients. Twelve (35%) developed recurrence (nine following R0 resection) with a median time of 6.5 months. There were no surgical related mortalities.

LIMITATIONS:

Limitations to the study include its retrospective nature, single center experience, and small patient sample size.

CONCLUSIONS:

Ischiorectal fossa tumors are primarily benign, however they are associated with high recurrence rates even in the setting of an R0 resection. Treatment should be approached in a multidisciplinary fashion and preferably in centers with experience treating these tumors. Close post treatment surveillance is imperative. See Video Abstract.
Digital working process in diagnosis, treatment planning and fabrication of personalized orthodontic appliances
Authors: Zhang Mengyuan , Ning Nan , Hong Yaya , Zhou Mengqi , Gong Xinyi , Zeng Li , Wu Yongjia , Ye Hengni , Kang Ting , Chen Xuepeng
Published: April 2024

Until recently, the working process of personalized orthodontic appliances (POAs) is performed digitally with the use of virtual systems including diagnosis, treatment planning and remote monitoring. Based on the exponential development of digital technologies such as imaging systems, computer-aided design and computer-aided manufacturing (CAD/CAM) systems, three-dimensional (3D) printing and artificial intelligence (AI), orthodontists want to go further and create an almost automatic intelligent orthodontic procedure containing big data to assist orthodontists in clinical treatment and reduce therapy duration. Here, we review the latest studies illustrating the application of digital technologies during treatment and manufacturing process of POAs. In addition, we highlight the current challenges and future directions of digital technology in POAs to call for more attention to the (I) AI applications for image analysis and treatment designation, and (II) 3D printing technologies for precise fabrication of POAs like clear aligner, accessories of fixed orthodontic appliances.
Application and prospect of mixed reality technology in orthopedics
Authors: Yang Jiaming , Zhang Jiayao , Zeng Cheng , Fang Ying , Xue Mingdi , Wang Honglin , Zhou Hong , Xie Yi , Liu Pengran , Ye Zhewei
Published: April 2024

In recent years, mixed reality (MR) technology has emerged as a new digital visualization tool and has been increasingly used in orthopedics. In comparison to traditional methods, MR provides a deeper integration of virtual information with the real world, offering users an intuitive display of anatomical details and facilitating the transition from two-dimensional to three-dimensional imaging data. With these significant features, MR has the potential to play a vital role in orthopedics. This article outlines the unique characteristics of MR and explores its technical advantages in doctor-patient communication, medical education, and surgical navigation within the field of orthopedics. This paper aims to inspire greater use of MR technology in the era of intelligent medicine.
A review of the text-to-speech synthesizer for human robot interaction for patients with Alzheimer's disease
Authors: Yu Junxiao , Yao Yihao , Feng Rui , Liang Tao , Wang Wei , Li Jianqing
Published: April 2024

With the rapid growth of eldering process worldwide, the number of people with mild cognitive impairment (MCI) has also been largely increased. To ease the problem that not all the patients get diagnosed and treated properly in time, intelligent robot that additionally equipped with cognitive rehabilitation functions are widely researched and gradually applied to either clinics or families. Speech interaction acts as an indispensable part in human robot interaction (HRI) process, speech quality used during which directly affects the HRI efficiency and users' experience. Studies indicate that high-fidelity speeches that can be clearly and naturally expressed are more likely to be received and understood by MCI patients. Also, using voices that are either familiar or appeared to patients, along with positive expression, largely improves emotional accompany and mental consolation for them, which enhance the cognitive rehabilitation process. The real-time voice synthesizer provides sufficient technical support for the development of cognitive robots, which show significance for families, societies, and clinics. This article reviews the research status of the development of text-to-speech (TTS) synthesizers, including the state-of-arts expressive TTS and voice cloning models. In addition, this paper pays attention to the current challenges and prospects of cognitive rehabilitation robots.
Dorsal brain activity reflects the severity of menopausal symptoms
Authors: Nakamura Kohei , Hoshi Hideyuki , Kobayashi Momoko , Fukasawa Keisuke , Ichikawa Sayuri , Shigihara Yoshihito
Published: April 2024

Objective

The severity of menopausal symptoms, despite being triggered by hormonal imbalance, does not directly correspond to hormone levels in the blood; thus, the level of unpleasantness is assessed using subjective questionnaires in clinical practice. To provide better treatments, alternative objective assessments have been anticipated to support medical interviews and subjective assessments. This study aimed to develop a new objective measurement for assessing unpleasantness.

Methods

Fourteen participants with menopausal symptoms and two age-matched participants who visited our outpatient section were enrolled. Resting-state brain activity was measured using magnetoencephalography. The level of unpleasantness of menopausal symptoms was measured using the Kupperman Kohnenki Shogai Index. The blood level of follicle-stimulating hormone and luteinizing hormone were also measured. Correlation analyses were performed between the oscillatory power of brain activity, index score, and hormone levels.

Results

The level of unpleasantness of menopausal symptoms was positively correlated with high-frequency oscillatory powers in the parietal and bordering cortices (alpha; P = 0.016, beta; P = 0.015, low gamma; P = 0.010). The follicle-stimulating hormone blood level was correlated with high-frequency oscillatory powers in the dorsal part of the cortex (beta; P = 0.008, beta; P = 0.005, low gamma; P = 0.017), whereas luteinizing hormone blood level was not correlated.

Conclusion

Resting-state brain activity can serve as an objective measurement of unpleasantness associated with menopausal symptoms, which aids the selection of appropriate treatment and monitors its outcome.
Barriers and Potential Solutions to Glaucoma Screening in the Developing World: A Review
Authors: Meethal Najiya Sundus K. , Sisodia Vishwendra Pratap Singh , George Ronnie , Khanna Rohit C.
Published: April 2024

Purpose:

Glaucoma is a leading public health concern globally and its detection and management are way more complex and challenging in the developing world. This review article discusses barriers to glaucoma screening in developing countries from the perspective of different key stakeholders and proposes solutions.

Methods/Results:

A literature search was carried out in the electronic catalogs of PubMed, Medline, and Cochrane database of systematic reviews to find studies that focused on barriers and enablers to glaucoma screening. The authors’ interpretations were tabulated as descriptive and qualitative data and presented concisely from the point of view of key stakeholders such as the patients and their relatives, care providers, and system/governing bodies. Key barriers to glaucoma care identified are lack of awareness, poor accessibility to ophthalmic centers, inadequately trained human resources, unsatisfactory infrastructure, and nonavailability of financially viable screening programs. Educating care providers, as well as the public, providing care closer to where people live, and developing cost-effective screening strategies are needed to ensure proper identification of glaucoma patients in developing countries.

Conclusions:

The logistics of glaucoma detection and management are complex. Hence, glaucoma detection programs should be implemented only when facilities for glaucoma management are in place. Understanding the importance of glaucoma screening and its future implications, addressing the various roadblocks, empowering and efficiently implementing the existing strategies, and incorporating novel ones using Artificial Intelligence (AI) and deep learning (DL) will help in establishing a robust glaucoma screening program in developing countries.
Effect of Compression Dressing After Upper Eyelid Blepharoplasty on Edema, Ecchymosis, Pain, and Ocular Surface Irritation
Authors: Schuh Anna , Reischmann Lilian , Hintschich Christoph R.
Published: April 2024

Purpose:

To investigate the effect of a compression dressing (CD) on edema, ecchymosis, aesthetic outcome, pain, and ocular surface irritation after upper eyelid blepharoplasty.

Methods:

We conducted a case–control study. Bilateral blepharoplasty was performed on both upper eyelids at the same time in patients with dermatochalasis. One side was randomized for CD. Edema and ecchymosis were scored at a 4-point rating scale by a blinded observer 1 day (D1), 1 week (D7), and 8 weeks (D56) after surgery; the same for scar formation regarding redness and bulging at D7 and D56. Aesthetic outcome was evaluated by the patient and blinded observer using the global aesthetic improvement score at D1, D7, and D56. Postoperative pain was scored by the patients using a visual analogue scale (0 to 10) at D1. At D1 patients had to state which side they felt more comfortable.

Results:

Edema, scar formation and aesthetic outcome evaluated by the patient and blinded observer did not differ between the 2 sides on any of the survey days (p > 0.05). The median degree of ecchymosis was slightly higher on the lids without CD at D1 (1 [0–2] vs. 1.5 [0–2]; p = 0.495) and D7 (0 [0–2] vs. 0.5 [0–2]; p = 0.183), but not statistically significant. Postoperative pain was similar regardless to the use of CD (p = 0.925). The majority (55%) found the side without CD more comfortable. There was no case of corneal erosion and corneal staining was similar in both groups (p > 0.05).

Conclusions:

Using a CD after blepharoplasty shows no advantages regarding postoperative edema, ecchymosis, scar formation, or aesthetic results in the early postoperative period. As most patients preferred the noncovered side, CD can be omitted after blepharoplasty without inferiority for the postoperative results.

Clinical trial registry:

NCT06111170.
Composite Histiocytic Sarcoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma of the Ocular Adnexa
Authors: Shi Chenxu , Lytle Andrew , Milman Tatyana , Penne Robert , Bagg Adam
Published: April 2024

Histiocytic sarcoma (HS) is a rare and aggressive hematologic neoplasm characterized by the proliferation of malignant histiocytes. It infrequently presents with periorbital involvement. Here we present the first documented case of ocular adnexal histiocytic sarcoma composite with chronic lymphocytic leukemia/small lymphocytic lymphoma and provide compelling evidence for the transdifferentiation of chronic lymphocytic leukemia/small lymphocytic lymphoma to histiocytic sarcoma in an 80-year-old woman. Comprehending the clinicopathological characteristics of histiocytic sarcoma and various other histiocytic proliferations and neoplasms affecting orbital and ocular structures is imperative for ophthalmic surgeons and pathologists.
Medial Canthal Tendon Reflecting in Lower Eyelid Reconstruction After Palpebral Cancer Surgery: Description of a New Technique
Authors: Arnaiz-Camacho Albert , Alonso Tirso , Oliveres Joan , Pablos-Jiménez Tatiana , García-Hidalgo Sara , Pairó-Salvador Armand , Zapata Miguel-Ángel
Published: April 2024

Purpose:

The aim of this article is to describe a new reconstructive technique of the lower eyelid in the surgery of tumors involving the medial canthal tendon.

Methods:

Our new technique consists of detaching and reflecting the most medial portion of the anterior medial canthal tendon and reinserting it into the posterior lamella. We describe the cases in which our technique can be useful, as well as the results we have obtained.

Results:

The result after a year of follow-up showed no disruption of the angulation of the lower eyelid line and no changes in eyelid position.

Conclusions:

The medial canthal tendon reflection could provide both aesthetic and functional results that may be superior to the usual techniques.
Influencing Physical Therapist's Self-efficacy for Musculoskeletal Ultrasound Through Blended Learning: A Mixed Methods Study
Authors: Umlauf Jon A. , Cervero Ronald , Teng Yating , Battista Alexis
Published: April 2024

Background and Purpose.

With the growing interest for physical therapists to incorporate musculoskeletal (MSK) ultrasound comes a need to understand how to organize training to promote the transfer of training to clinical practice. A common training strategy blends asynchronous learning through online modules and virtual simulations with synchronous practice on live simulated participants. However, few physical therapists who attend MSK ultrasound continuing education courses integrate ultrasound into clinical practice. Self-efficacy is a significant predictor of training transfer effectiveness. This study describes to what degree and how a blended learning strategy influenced participants' self-efficacy for MSK ultrasound and transfer of training to clinical practice.

Subjects.

Twenty-one outpatient physical therapists with no previous MSK ultrasound training.

Methods.

Twenty-one participants assessed their self-efficacy using a 26-item self-efficacy questionnaire at 3 intervals: before asynchronous, before synchronous training, and before returning to clinical practice. Participants were interviewed within 1 week of training using a semi-structured interview guide. Quantitative analysis included descriptive statistics and repeated-measures ANOVA. Thematic analysis was used to examine participants' experiences, and “following the thread” was used to integrate findings.

Results.

Self-efficacy questionnaire mean scores increased significantly across the 3- time points (F [2, 40] = 172.7, P < .001, η2 = 0.896). Thematic analysis indicated that asynchronous activities scaffolded participants' knowledge, enhanced their self-efficacy, and prepared them for synchronous learning; however, it did not replicate the challenges of MSK ultrasound. Synchronous activities further improved self-efficacy and helped participants better calibrate their self-judgments of their abilities and readiness to integrate MSK ultrasound training into clinical practice. Despite individual-level improvements in self-efficacy, interviewees recognized their limitations and a need for longitudinal training in a clinical environment.

Discussion and Conclusion.

A blended learning approach positively affects participants' self-efficacy for MSK ultrasound; however, future training designs should provide learners with additional support during the transition phase.
Do We Make a Difference? The Effect of a Doctor of Physical Therapy Program Curriculum on Student Cultural Competence
Authors: Chesser Brianna T. , Bloomquist Candace D. , Ford Debra J.
Published: April 2024

Introduction.

Doctor of Physical Therapy (DPT) education programs have been charged with developing a culturally competent health care workforce to better meet the needs of diverse communities and reduce health inequities. The purpose of this longitudinal, quasi-experimental educational intervention study was to examine the effects of an integrated DPT program curriculum on student cultural competence at a public, midsize, midwestern university.

Review of Literature.

There is an abundance of research on conceptual models and frameworks for the development of cultural competence within health care education with many studies relying on self-perception to measure outcomes. Using the Model of Interculturalization as a theoretical framework, this study explored the development of cultural competence among DPT students using the Intercultural Development Inventory (IDI).

Subjects.

A purposeful convenience sample of DPT students (n = 177) was used.

Methods.

The IDI was administered to 3 student cohorts. One cohort had data at 4 different time points, including upon entry into the program (baseline) and at the end of the first, second, and third year. Two cohorts had data for 2 time points. IDI Developmental Orientation (DO) and Orientation Gap (OG) scores were used to measure cultural competence and accuracy of self-perception of cultural competence. Data analysis was performed using descriptive statistics, independent and dependent sample t-tests, and analysis of variances.

Results.

There were no differences between the cohorts. There were statistically significant improvements in both cultural competence (DO scores) and accuracy of self-perception of cultural competence (OG scores) for 2 cohorts. However, significant change only occurred during year 1. No other differences across time for any of the cohorts were significant.

Discussion and Conclusion.

Findings can be leveraged and incorporated into recommendations for curricular revision and program reform targeting cultural competence development among DPT students.
The effect of implementing a transanal minimally invasive surgical programme for the local excision of early rectal neoplasia on outcomes in a tertiary referral rectal cancer centre
Authors: Duggan William P. , Lenihan John , Clancy Cillian , McNamara Deborah A. , Burke John P.
Published: April 2024

Transanal minimally invasive surgery (TAMIS) is a surgical alternative to proctectomy in the management of complex rectal polyps and early rectal cancers. In 2016, our institution introduced a TAMIS programme. The purpose of this study was to evaluate changes in practice and outcomes in our institution in the 3 years before and after the implementation of TAMIS. We conducted a retrospective analysis of a prospective database of patients who underwent proctectomy or TAMIS for the management of complex rectal polyps or early rectal cancers at our institution between 2013 and 2018. 96 patients were included in this study (41 proctectomy vs 55 TAMIS). A significant reduction was noted in the number of proctectomies performed in the 3 years after the implementation of TAMIS as compared to the 3 years before (13 vs 28) (P < 0.001); 43% of patients (n = 12) who underwent proctectomy in the period prior to implementation of TAMIS were American Society of Anaesthesiologists grade III, as compared to only 15% (n = 2) of patients during the period following TAMIS implementation (P = 0.02). TAMIS was associated with a significant reduction in length of inpatient stay (P < 0.001). Oncological outcomes were comparable between groups (log rank P = 0.83). Our findings support TAMIS as a safe and effective alternative to radical resection. The availability of TAMIS has resulted in a significant reduction in the number of comorbid patients undergoing proctectomy at our institution. Consequently, we have observed a significant reduction in postoperative complications over this time period.
The role of the fibroblast in Barrett's esophagus and esophageal adenocarcinoma
Authors: Zhu Huili , Jin Ramon U.
Published: April 2024

Purpose of review

Barrett's esophagus (BE) is the number one risk factor for developing esophageal adenocarcinoma (EAC), a deadly cancer with limited treatment options that has been increasing in incidence in the US. In this report, we discuss current studies on the role of mesenchyme and cancer-associated fibroblasts (CAFs) in BE and EAC, and we highlight translational prospects of targeting these cells.

Recent findings

New insights through studies using single-cell RNA sequencing (sc-RNA seq) have revealed an important emerging role of the mesenchyme in developmental signaling and cancer initiation. BE and EAC share similar stromal gene expression, as functional classifications of nonepithelial cells in BE show a remarkable similarity to EAC CAFs. Several recent sc-RNA seq studies and novel organoid fibroblast co-culture systems have characterized the subgroups of fibroblasts in BE and EAC, and have shown that these cells can directly influence the epithelium to induce BE development and cancer progression. Targeting the CAFs in EAC with may be a promising novel therapeutic strategy.

The fibroblasts in the surrounding mesenchyme may have a direct role in influencing altered epithelial plasticity during BE development and progression to EAC.
A systematic review and meta-analysis of extra-intestinal manifestation of inflammatory bowel disease in the Eastern Mediterranean Region (EMRO) countries
Authors: Momayez Sanat Zahra , Vahedi Homayoon , Malekzadeh Reza , Fanni Zeinab
Published: April 2024

Background:

Inflammatory bowel disease which is subgrouped mainly to ulcerative colitis and Crohn’s disease is thought to be a multi-organ disease. Most organs can be involved in the disease course in addition to gastrointestinal tract involvement. In this systematic review we aimed to assess the prevalence of these manifestations in Eastern Mediterranean Regional Office (EMRO) countries.

Method:

The present systematic review and meta-analysis study was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guideline. Joanna Briggs Institute (JBI) Critical Appraisal Checklist was admired for the quality evaluation of the included studies. For determining the heterogeneity, we used Cochran test and I2 statistics.

Result:

Finally, 12 studies were included in our study. Based on the results of our study the prevalence of arthritis in ulcerative colitis and Crohn’s disease patients was 7.1% (95% CI: 2.6–18.2%) and 13.5% (95% CI: 2.6–47.3%), respectively. Prevalence of arthralgia in ulcerative colitis patients was 18.4% (95% CI: 14.3–23.3%). skin involvement prevalence was 9.9% (95% CI 4.7–19.6%) in inflammatory bowel disease (IBD) patients. ocular involvement prevalence was 7.2% (95% CI 17–25.8%) in IBD patients. PSC prevalence in ulcerative colitis and Crohn’s disease patients was 3.5% (95% CI: 1.7–7.3%) and 2.7% (95% CI: 1.3–5.5%), respectively.

Conclusion:

Based on the results of this study arthralgia and arthritis were the most common extra-intestinal manifestation of IBD followed by dermatologic and ocular involvements. This extra-intestinal manifestation can challenge the patients’ management and identifying their pattern is important during the disease course.
Systemic sclerosis (positive anti-Ro 52 and anti-centromere antibodies) in a patient after COVID-19 infection: a rare case report
Authors: Oli Paras , Poudel Prabhat , KC Shradha , KC Aastha , Sah Anil Kumar , Yadav Pankaj
Published: April 2024

Introduction and importance:

The SARS-CoV-2 is the source of COVID-19, a respiratory disease. It typically manifests as restricted pulmonary symptoms, but autoimmune dysfunction might occasionally show up. A COVID-19 infection may cause a multi-system connective tissue disease known as systemic sclerosis (SSc). In patients who recovered from COVID-19, autoimmunity may have multiple underlying causes.

Case presentation:

The authors report the case of a 68-year-old female who, 1 month after contracting COVID-19, complained of dyspnoea and muscle exhaustion. The patient was treated for post-COVID syndrome. She developed symptoms of chronic dyspnoea, pale fingers, pursed lips, trouble chewing and swallowing, and muscle weakness after 7 weeks. A chest high-resolution computerised tomography (HRCT) scan suggested interstitial lung disease. Clinical characteristics and an autoantibody profile containing anti-Ro 52 and anti-centromere antibodies pointed towards SSc. She was treated with azathioprine and prednisolone at a reduced dosage, and she is now stable with monthly follow-ups.

Clinical discussion:

COVID-19 might induce cytokine storms and immunological dysregulation, ultimately culminating in autoimmune manifestations. Several autoantibodies are observed in autoimmune illnesses in post-COVID-19 infection patients. Our situation is distinct because SSc following a COVID-19 infection is not commonly seen as an autoimmune illness.

Conclusion:

The number of patients with rare autoimmune diseases, like SSc, following COVID-19 has been rising. Therefore, we should consider the possibility of autoimmune disease when looking into a patient who presents strangely or has developed new symptoms after COVID and should contact the patient’s management immediately.