bluuebunny/crossref_metadata_2025 huggingface dataset:
Sequential Customized Therapeutic Keratectomy in Patients With a History of Radial Keratotomy
Authors: Vinciguerra Riccardo , Catania Fiammetta , Rosetta Pietro , Archer Timothy J. , Reinstein Dan Z. , Vinciguerra Paolo
Published: December 2023

Purpose:

To evaluate the outcome of sequential customized therapeutic keratectomy (SCTK) in reducing higher order aberrations (HOAs) and improving quality of vision in highly aberrated corneas consequent to previous radial keratotomy (RK).

Methods:

A retrospective review of patients undergoing SCTK treatment from January 2012 to October 2020 was conducted in the Eye Center, Humanitas Clinical and Research Center (Rozzano, Italy). Indications for treatment in patients who had RK were significantly and/or progressively reduced corrected distance visual acuity (CDVA) combined with visual symptoms critically affecting quality of life. Preoperative and postoperative CDVA, corneal topography and aberrometry, Scheimpflug tomography, and anterior segment optical coherence tomography were registered.

Results:

Thirty-four patients who underwent RK a mean of 26.62 ± 7.10 years before SCTK treatment were included. SCTK induced a significant improvement of CDVA from 0.44 ± 0.82 logMAR preoperatively to 0.15 ± 0.64 logMAR postoperatively (
P
< .001). No patient experienced worsening of CDVA, whereas 8 patients (23,50%) gained one line and 23 patients (67.65%) gained two lines or more. A significant decrease in corneal coma, trefoil, and spherical aberrations was also noted (
P
= .003, .003, and .004, respectively).

Conclusions:

SCTK proved to be a safe and effective option to treat highly aberrated eyes following RK. The authors suggest the use of SCTK as a first-line approach for the treatment of HOAs after RK and avoiding more invasive procedures such as corneal transplantation or intraocular lens implantation.

[
J Refract Surg
. 2023;39(12):808–816.]
Angle Kappa Influence on Multifocal IOL Outcomes
Authors: Wallerstein Avi , Ridgway Chelsea , Gatinel Damien , Debellemanière Guillaume , Mimouni Michael , Albert Darren , Cohen Mark , Lloyd John , Gauvin Mathieu
Published: December 2023

Purpose:

To characterize angle kappa and study the relationship between preoperative angle kappa and postoperative refractive accuracy, visual outcomes, and patient satisfaction in a large population of eyes with multifocal intraocular lens (MIOL) implantation.

Methods:

A comprehensive electronic medical record chart review of 26,470 consecutive eyes that underwent immediate sequential bilateral cataract or refractive lens exchange with MIOLs was conducted. The primary outcome measures were postoperative monocular uncorrected distance visual acuity (UDVA), manifest refraction sphere and cylinder, spherical equivalent (SEQ), defocus equivalent (DEQ), subjective quality of vision at near, intermediate, and distance, and the likelihood of recommending the procedure. Relationships between preoperative angle kappa and postoperative outcomes were assessed with Pearson correlations.

Results:

Angle kappa followed a right-skewed normal distribution (
R
2
= 0.99) with a mean ± standard deviation of 0.64 ± 0.27 mm. No clinically meaningful relationship was found between preoperative angle kappa and postoperative sphere, cylinder, SEQ, and DEQ, all with
R
2
⩽ 0.0005. Similarly, there was no clinically meaningful relationship between preoperative angle kappa and postoperative UDVA (
R
2
= 0.001), postoperative satisfaction for near, intermediate, and distance vision (all
R
2
⩽ 0.0023), or for recommending the MIOL surgery to friends and relatives (
R
2
= 0.0000).

Conclusions:

Preoperative angle kappa does not have a predictive clinical impact on postoperative MIOL visual outcomes, refractive accuracy, or subjective patient satisfaction. Angle kappa as a single variable cannot be used to determine MIOL candidacy.

[
J Refract Surg
. 2023;39(12):840–849.]
Traveling-wave and numerical solutions to nonlinear evolution equations via modern computational techniques
Authors: Alharbi Abdulghani R.
Published: December 2023

In this research, we apply some new mathematical methods to the study of solving couple-breaking soliton equations in two dimensions. Soliton solutions for equations with free parameters like the wave number, phase component, nonlinear coefficient and dispersion coefficient can be obtained analytically by adding trigonometric, rational and hyperbolic functions. We will also look into how two-dimensional diagrams are affected by the wave phenomena, illustrating the answers with a mix of two- and three-dimensional graphs. The proposed system will be transformed into a numerical system by using the finite difference method to simulate Black-Scholes equations numerically. Furthermore, we will evaluate the stability and accuracy of the numerical findings by making analytical and graphical comparisons with precise solutions and we will talk about the error analysis of the numerical scheme. All forms of nonlinear evolutionary systems can benefit from the methods utilized in this work because they are sufficient and acceptable.
Role of the UNC13 family in human diseases: A literature review
Authors: Ansari Ubaid , Chen Vincent , Sedighi Romteen , Syed Burhaan , Muttalib Zohaer , Ansari Khadija , Ansari Fatima , Nadora Denise , Razick Daniel , Lui Forshing
Published: December 2023

This literature review explores the pivotal roles of the Uncoordinated-13 (UNC13) protein family, encompassing UNC13A, UNC13B, UNC13C, and UNC13D, in the pathogenesis of various human diseases. These proteins, which are evolutionarily conserved and crucial for synaptic vesicle priming and exocytosis, have been implicated in a range of disorders, spanning from neurodegenerative diseases like amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) to immune-related conditions such as familial hemophagocytic lymphohistiocytosis (FHL). The involvement of UNC13A in neurotransmitter release and synaptic plasticity is linked to ALS and FTD, with genetic variations affecting disease progression. UNC13B, which is closely related to UNC13A, plays a role in autism spectrum disorders (ASD), epilepsy, and schizophrenia. UNC13C is implicated in oral squamous cell carcinoma (OSCC) and hepatocellular carcinoma (HCC), and has a neuroprotective role in Alzheimer's disease (AD). UNC13D has an essential role in immune cell function, making it a key player in FHL. This review highlights the distinct molecular functions of each UNC13 family member and their implications in disease contexts, shedding light on potential therapeutic strategies and avenues for future research. Understanding these proteins' roles offers new insights into the management and treatment of neurological and immunological disorders.
Izvor pripon -ar, -lj-ar in -n-ar v slovenščini
Authors: Šekli Matej
Published: December 2023

V prispevku je obravnavan izvor pripon -ar (kajžar, gruntar, kočar, bajtar), -lj-ar (kajžljar, kočljar, bajtljar) in -n-ar (gruntnar, kočnar, bajtnar) v narečni in knjižni slovenščini. Pripona -ar je bila namreč v slovenščino podedovana iz praslovanščine in skozi zgodovino slovenščine dodatno prevzemana iz (bavarske) stare, srednje in nove visoke nemščine, zloženi priponi -lj-ar in -n-ar pa sta v (narečno) slovenščino prišli iz (bavarske) visoke nemščine. Nadalje je na osnovi spoznanj germansko-slovanskega nadomestnegaglasoslovja podana natančnejša interpretacija starogermanskega vira praslovanske prevzete pripone *-aŕь.
Denar je/ni vse – iz raziskav jezikovno-kulturne podobe slovencev
Authors: Wacławek Maria , Wtorkowska Maria
Published: December 2023

Denar ni le stvar, ki ima določeno vrednost in nastopa v vlogi plačilnega sredstva. Raziskovalno se zdi zanimiv opis njegovega pomena, ki upošteva antropocentrični način konceptualizacije v primerjalnem slovensko-poljskem okviru. Prispevek predstavlja rezultate anketne raziskave o odnosu do denarja – gre za eno od pomenskih kategorij, ki sta jih avtorici ugotovili pri jezikovno-kulturni stereotipni podobi Slovencev, izoblikovani skozi raziskave. Metodološko sodi predstavljena tematika na področje etnolingvističnih raziskav.
Jezikovna svetovalnica Inštituta za slovenski jezik po desetih letih delovanja (2012–2022)
Authors: Dobrovoljc Helena
Published: December 2023

Prispevek predstavlja Jezikovno svetovalnico za slovenščino s poudarkom na njenem jubilejnem, desetem letu delovanja. Jezikovno svetovanje je bilo vzpostavljeno kot intervencijska spletna svetovalna storitev, danes pa zbirka vprašanj in odgovorov predstavlja za jezikoslovce tudi raziskovalni izziv in samorefleksivni vir za proučevanje jezikovnih zadreg. Vprašanja iz svetovalnice so osnova za problemski pristop k prenovi pravopisnih pravil, ki poteka v okviru Pravopisne komisije pri SAZU in ZRC SAZU.
Photographie, cartes postales et collections : les « compositions » du photographe Gaston Ouvrard
Authors: Bordes François
Published: December 2023

Gaston Ouvrard est certainement l’un des photographes provinciaux les plus originaux de son temps. Né à Agen, il s’installe au début des années 1890 à Biarritz, puis à Bayonne. Portraitiste, il réalise et commercialise également des vues de la côte basque et crée le « Biarritz-Photo-Club ». La naissance et le développement exceptionnel de la carte postale avant 1914 vont lui permettre de montrer l’étendue de son talent créatif. S’inspirant de la grande maison d’édition de cartes postales « fantaisie » Bergeret, de Nancy, Gaston Ouvrard conçoit des séries humoristiques ou poétiques, des « compositions » photographiques, comme il les appelle, dont le but est d’inciter l’acheteur à confectionner autant de collections pour lui ou pour ses correspondants.
Use of Influencers in Different Sectors of the Economy
Authors: Mittal Shikha
Published: December 2023

With the advent of digital technologies, influencer marketing has acquired a key role in the social media approaches adopted by a growing number of companies operating in different sectors. Influencer marketing has grown with a startlingly rapid pace, and it has not just grown, but has helped in better product introduction with increased consumer and influencer communication. In the current scenario, undoubtedly, influencers will rule the digital space, and businesses will constantly come up with new strategies to utilize the influencing powers of these influencers. The author has selected seven different sectors—fashion and lifestyle, technology industry, travel and tourism industry, food and beverage, healthcare, finance sector, and entertainment and gaming—to study the importance of influencers and change they have made. This study examines the use of influencers in chosen sectors of the economy. It also aims to identify factors influencing consumers' behavior to generate revenue.
FORMIGAS (HYMENOPTERA: FORMICIDAE) EM UMA PAISAGEM SUBURBANA NO NOROESTE DO ESTADO DO PARANÁ, BRASIL
Authors: Azevedo Fábio de , Surama Ribeiro Gomes Victória , Lucas Milani Coutinho Rangel , Strieder Philippsen Adriana
Published: December 2023

A fragmentação e homogeneização de habitats decorrentes da urbanização são uma das principais causas de perda de biodiversidade mundiais. Além disso, algumas espécies de formigas invasoras são reportadas como adaptadas e prevalentes nesses ambientes. Porém, alguns estudos registram elevada diversidade de formigas para o Brasil, principalmente quando o ambiente urbano está associado a praças, parques e áreas verdes. No entanto, levantamentos da mirmecofauna no Estado do Paraná são escassos. Neste sentido, investigou-se a diversidade de formigas na Universidade Estadual do Paraná, campus de Paranavaí/PR, cuja amostragem foi do tipo direta, nas partes internas e calçamentos dos blocos prediais e por armadilhas de queda nos gramados e jardins entre os blocos, entre os meses de outubro de 2019 a fevereiro de 2020. A riqueza foi de 63 espécies/morfoespécies e o Boostrap de 68,83. Treze espécies e cinco gêneros são novos registros para o ambiente urbano do Estado do Paraná, seis espécies e seis gêneros, novos registros para o Sul do Brasil e três espécies, novos registros para o ambiente urbano brasileiro, sendo que quatro foram exóticas. O índice de Shannon-Wiener foi de 2,49, o de Simpson (1-D) de 0,84, o de Margalef de 6,87 e a abundância de 8234 indivíduos. Wasmannia auropunctata (Roger, 1863) foi a espécie mais abundante (42,76%), Pheidole Westwood, 1839 e Solenopsis Westwood, 1840 foram os gêneros mais especiosos. O modelo log-série mostrou-se adequado para descrever a estrutura das assembleias. A grande diversidade e heterogeneidade de habitats, provavelmente, sejam as responsáveis pelo padrão de riqueza e abundância observadas.
PROTEIN-CALORIC RESTRICTION DURING LACTATION HAS A TRANSGENERATIONAL EFFECT IN GLUCOSE HOMEOSTASIS OF MALE RATS
Authors: Viana Emanuelle , Pavanello Audrei , Cezar de Freitas Mathias Paulo , Peixoto Martins Isabela
Published: December 2023

Experimental and epidemiological studies demonstrated an important association betweeninsults in sensitive stages of development and metabolic syndrome at adulthood.Developmental Origins of Health and Disease (DOHaD) concept indicates that pregnancy andlactation are windows to metabolic programming, once in these phases, occurs a peak ofneuronal development. There is a gap in the study of the transgenerational effect of insultsperformed in programming windows, especially when it comes to malnutrition. FemaleWistar rats were submitted to a protein-caloric restriction during the first 14 days of lactation(LP, low-protein group) or a normal-caloric diet through the lactation (NP, normal-proteingroup). At 70 days old these females were mated with a control male rat. The offspring (F2generation, NP and LP groups) were fed with normal-caloric diet and were euthanized at 21days old to blood collection and biometric analysis. There were no differences betweengroups in body weight at weaning. Also, retroperitoneal, periepididymal and mesenteric fatpads were similar between NP and LP animals. We showed an 11% (P˂0.05) increase inbrown adipose tissue weight in LP group. Fasting glucose was increased by 99% (P˂0.05) inLP groups, without alteration in fasting insulin levels. We conclude that protein-caloricrestriction during lactation has a transgenerational effect in male rats, altering the glucosehomeostasis.
IDENTIFICATION OF GLUCAGON-LIKE PEPTIDE-1 RECEPTOR LIGANDS AND THEIR IMPACTS IN THE TREATMENT OF TYPE 2 DIABETES
Authors: Gustavo Antunes Pessoa Luiz , Malta Ananda , Cézar de Freitas Mathias Paulo , Dantas dos Santos Wanderley , Augusto Vicente Seixas Flávio
Published: December 2023

Diabetes mellitus is a chronic disease responsible for one of the world's most common publichealth problems. Its prevalence, comorbidities, and medical costs assume a dramatic scale andan efficient response to these projections is the intensified search for new agents andapproaches. Therefore, for the development of potential glucagon-like peptide-1 receptor(GLP-1R) agonists, a virtual screening technique based on molecular docking using thecrystallographic structure of human GLP-1R as a target was employed in two productlibraries natural, Zinc15 and Sigma-Aldrich. The structure of the protein (PDB id 6X1A)bound to Pfizer compound PF-06882961 was modeled by homology. The best-presentedmodel was inserted into a lipid bilayer and subjected to structure minimization, redocking,virtual screening, and molecular dynamics simulations. After simulations, 39 molecules wereselected and analyzed by predicting bioactivity and pharmacokinetics resulting in 4 ligands(Zinc1901002, Zinc1901002m, 336188752 e 336185530). The ligands were inserted into the6X1A crystallographic structure to analyze the conformational changes and the stability ofprotein-ligand interactions through molecular dynamics simulations for 50 ns. We observedthat the ligands coupled to GLP-1R remained stable without conformational changesthroughout the simulation, indicating that the selected ligands can act as potential GLP-1Ragonists.
DA PONTE PRA CÁ: DIVULGANDO A CIÊNCIA COM ESTRATÉGIAS QUE A QUEBRADA ME ENSINOU
Authors: Nascimento Silva Aroldo , Valério Marcelo
Published: December 2023

Divulgação científica não é uma atividade que se realiza apenas a partir da perspectiva acadêmica, que se permita limitada por suas linguagens, discursos e espaços físicos. Quando se permite marcada pelas culturas e públicos das quebradas, territorializada, portanto, a divulgação científica se reinventa em seus fundamentos e práticas. Estas são as premissas da palestra que o biólogo, educador, podcaster e ilustrador, Lucas Andrade apresentou na abertura do VI Simpósio das Licenciaturas em Ciências Exatas e em Computação, da UFPR. Neste texto, dois membros da organização do evento resgatam estes fundamentos em uma entrevista com o ministrante, aproveitando os conhecimentos e a experiência do Lukera, membro fundador podcast Alô, Ciência?, para compartilhar com a comunidade as melhores estratégias para uma divulgação científica que efetivamente constroi pontes! De modo exemplar, cientistas, comunicadores, artistas, público em geral e estudantes podem conhecer e se inspirar com a atuação do entrevistado, com suas parcerias, com a elaboração de sua identidade profissional, com sua trajetória até a Universidade e com a importância da Extensão Universitária para sua permanência na graduação.
O PAPEL DO GESTOR NA CONSTRUÇÃO DE UMA CULTURA ESCOLAR POSITIVA
Authors: Angela Speck Raquel , Monteiro Pacheco Carina
Published: December 2023

Neste texto são apresentadas reflexões originadas na disciplina de Gestão Escolar, componente do currículo do curso de Licenciatura em Ciências Biológicas da UFPR, no Setor Palotina. Nele, discute-se o papel do gestor escolar na construção de uma cultura escolar positiva. Parte-se do princípio de que uma escola é uma organização social e que, portanto, para além das normas legais, é constituída a partir das interações das pessoas que a integram. Neste espaço coletivo estão presentes valores e crenças, e nele se colocam em práticas rotinas, que se transformam em hábitos e que conformam uma cultura organizacional. O objetivo é discutir a centralidade do papel do diretor na construção de uma cultura escolar que influencia o modo de pensar e agir de seus membros em torno de objetivos comuns, que seja acolhedora das diferenças, que valorize um ambiente saudável e construtivo para alunos, professores e para a comunidade como um todo. A abordagem metodológica utilizada é a da revisão de literatura. Ao final, pontuamos a importância da ação deste profissional na inibição de situações e comportamentos que venham a produzir formas de preconceito e discriminação ou reforçá-las.
UTILIZAÇÃO DE MAPAS MENTAIS NO ENSINO MÉDIO NOTURNO
Authors: Prochnow Igor , Parisoto Mara Fernanda , Do Nascimento William Junior , Rosa Valdir
Published: December 2023

Tornar as aulas de Física que busque manter a atenção dos alunos por mais tempo nas atividades em sala de aula sempre foi um desafio para o professor. Diante do exposto, as metodologias ativas de ensino, como os Mapas Mentais, se apresentam como recurso didático que podem possibilitar maior engajamento e intensificar a aprendizagem quando bem planejadas. Assim, este trabalho consiste em apresentar um relato de experiência sobre o uso de Mapas Mentais em uma turma de Ensino Médio regular noturno. A atividade desenvolvida envolveu a elaboração e confecção, pelos alunos, de mapas mentais sobre conteúdos estudados em sala de aula. A metodologia empregada se mostrou bastante eficaz, embora haja algumas características nos mapas mentais produzidos durante a atividade que se diferem dos modelos indicados na literatura.
RELACIONANDO INFOGRÁFICOS À APRENDIZAGEM SIGNIFICATIVA: UMA PROPOSTA PEDAGÓGICA
Authors: Ferreira da Silva Lucas , Parisoto Mara Fernanda , do Nascimento William Junior
Published: December 2023

A partir de uma pesquisa bibliográfica, este trabalho tem como objetivo fundamentar a utilização de infográficos visando uma aprendizagem significativa, além de apresentar uma proposta pedagógica decorrente. É importante investigar se a utilização de infográficos é relevante e se possibilita uma aprendizagem significativa, pois os alunos já estão acostumados com suas produções, cabendo ao professor articular com a teoria de aprendizagem. A fundamentação teórica deste trabalho está respaldada em Ausubel, Bacich, Moran, Camargo e Daros, de modo que nossas escolhas são intrínsecas aos trabalhos destes autores: Ausubel no que se refere à aprendizagem significativa; Bacich e Moran em relação às metodologias ativas; além de Camargo e Daros na perspectiva de uma sala de aula inovadora. Os resultados obtidos sugerem que a utilização de infográficos pode apresentar indícios de uma aprendizagem significativa a partir da sua construção, com a mesclagem da metodologia ativa aprendizagem baseada em problemas, sendo relevante e válido de acordo com a fundamentação teórica.
TLR9 plus STING Agonist Adjuvant Combination Induces Potent Neopeptide T Cell Immunity and Improves Immune Checkpoint Blockade Efficacy in a Tumor Model
Authors: Castro Eiro Melisa D , Hioki Kou , Li Ling , Wilmsen Merel E P , Kiernan Caoimhe H , Brouwers-Haspels Inge , van Meurs Marjan , Zhao Manzhi , de Wit Harm , Grashof Dwin G B , van de Werken Harmen J G , Mueller Yvonne M , Schliehe Christopher , Temizoz Burcu , Kobiyama Kouji , Ishii Ken J , Katsikis Peter D
Published: December 2023

Immune checkpoint blockade (ICB) immunotherapies have emerged as promising strategies for the treatment of cancer; however, there remains a need to improve their efficacy. Determinants of ICB efficacy are the frequency of tumor mutations, the associated neoantigens, and the T cell response against them. Therefore, it is expected that neoantigen vaccinations that boost the antitumor T cell response would improve ICB therapy efficacy. The aim of this study was to develop a highly immunogenic vaccine using pattern recognition receptor agonists in combination with synthetic long peptides to induce potent neoantigen-specific T cell responses. We determined that the combination of the TLR9 agonist K-type CpG oligodeoxynucleotides (K3 CpG) with the STING agonist c-di-AMP (K3/c-di-AMP combination) significantly increased dendritic cell activation. We found that immunizing mice with 20-mer of either an OVA peptide, low-affinity OVA peptides, or neopeptides identified from mouse melanoma or lung mesothelioma, together with K3/c-di-AMP, induced potent Ag-specific T cell responses. The combined K3/c-di-AMP adjuvant formulation induced 10 times higher T cell responses against neopeptides than the TLR3 agonist polyinosinic:polycytidylic acid, a derivative of which is the leading adjuvant in clinical trials of neoantigen peptide vaccines. Moreover, we demonstrated that our K3/c-di-AMP vaccine formulation with 20-mer OVA peptide was capable of controlling tumor growth and improving survival in B16-F10-OVA tumor-bearing C57BL/6 mice and synergized with anti-PD-1 treatment. Together, our findings demonstrate that the K3/c-di-AMP vaccine formulation induces potent T cell immunity against synthetic long peptides and is a promising candidate to improve neoantigen vaccine platform.
Pre-adjusted Three-Dimensional Plate Employing Printing versus Conventional Plate in the Management of Mandibular Fractures - A Comparative Study
Authors: Kende Prajwalit P. , Sarda Ashish Sunilkumar , Landge Jayant , Wadewale Maroti , Kri Mrimingsi , Ranganath Suleka
Published: December 2023

Introduction:

The aim of this study was to compare the efficacy of pre-adjusted three-dimensional (3D) plating system employing 3D printing with conventional 3D plating in the management of mandibular fractures.

Materials and Methods:

A randomised, clinical trial was conducted where the study sample (n = 20) was divided into two groups. In Group 1, 3D plate and in Group 2, pre-bent 3D plate was fixed to the fracture site. The parameters assessed were number of bends required for adaptation, duration of fixation, pain, occlusal stability, reduction in lingual splaying and post-operative complications.

Results:

Statistically significant difference was seen for the number of bends required (P = 0.000, P < 0.01) and duration of fracture fixation (P = 0.001, P < 0.01). There was statistically significant difference between the values of pain during the adaptation of 3D plate (P = 0.033, P < 0.05).

Discussion:

The application of pre-adjusted 3D plate is superior to conventional 3D plating in terms of reducing number of bends, duration of fixation and pain during adaptation.
Robot-assisted Surgery with Para-aortic Lymphadenectomy for Endometrial Cancer: A Preliminary Report
Authors: Hayashi Shigehiro , Kojima Junya , Sasaki Toru , Yamamoto Akiko , Kato Kazuyoshi , Nishi Hirotaka
Published: December 2023

Objectives:

There are few reported cases of robot-assisted surgery for endometrial cancer with para-aortic lymphadenectomy (PAL) in Japan. Therefore, this study aimed to examine the clinical outcomes of robot-assisted surgery with PAL for endometrial cancer.

Materials and Methods:

This retrospective cohort study was analyzed 13 endometrial cancer patients who underwent robotic surgery with PAL between January 2011 and October 2018 at our hospital. We examined their perioperative complications and oncological outcomes.

Results:

The median follow-up period, median overall survival, and disease-free interval were 80 months, 79 months (61–120), and 79 months (5–120), respectively. There were two (15.3%) cases of perioperative complications of Clavien–Dindo Class II or higher and three (23.0%) cases of recurrence.

Conclusion:

Our results showed that the surgical and oncological outcomes of robot-assisted surgery for endometrial cancer with PAL were comparable with those of other developed countries.
The Current Trend of Fertility Preservation in Patients with Cervical Cancer
Authors: Liu Chih-Ku , Huang Kuan-Gen , Chen Ming-Jer , Lu Chien-Hsing , Hwang Sheau-Feng , Sun Lou , Hsu Shih-Tien
Published: December 2023

Although the incidence of most cancers increases with age, a considerable number of patients receive a diagnosis of cancer during their reproductive years. Young women wishing to get pregnant after cancer treatment should be provided consultation for fertility preservation and possible options. In patients with cervical cancer, hysterectomy is often inevitable because the uterus is located too close to the cervix. For young patients with cervical cancer who desire to get pregnant and whose lesion is confined to the cervix, sparing the uterus and, partially, the cervix should be prioritized as much as possible, while simultaneously ensuring favorable oncologic outcomes. In this review, we explore how to choose an adequate fertility-preserving procedure to achieve a balance between favorable oncologic outcomes and fertility and management during pregnancy after a radical trachelectomy in women with early-stage cervical cancer. For patients who require hysterectomy or radiation, evaluation of the ovarian condition and laparoscopic ovarian transposition followed by the use of artificial reproduction techniques and pregnancy by surrogacy should be discussed as options to achieve a successful pregnancy.
Does Local Infiltration of Anesthesia Reduce Port-site Pain in Gynecological Laparoscopic Surgeries? A Pilot Study
Authors: Malik Roopa , Verma Renu
Published: December 2023

Objectives:

The objectives of this study were to evaluate the visual analog scale (VAS) score in patients receiving port-site bupivacaine infiltration in gynecological laparoscopic surgeries and to compare it with those receiving placebo and to evaluate the additional analgesic requirement in the first 24 h after surgery.

Materials and Methods:

A prospective interventional study was conducted on 60 women scheduled for benign gynecological laparoscopic surgeries. Patients were randomized into two groups using an alternative sequential method of allocation. Approval from the Institute’s Ethics Committee was sought. Informed written consent was taken from all the patients. All laparoscopic surgeries were performed under general anesthesia. Double-blinding was done. A VAS with a 10 cm vertical score ranging from “no pain” to “worst possible pain” was used to assess the postoperative pain when the patient awakened in the operating room (2 h after surgery), then after 6 and 24 h. The primary outcome measured was pain perception by the patient (as VAS scores), and the secondary outcome was the need for additional analgesia.

Results:

Comparison of both groups with the VAS score shows P > 0.001, i.e., nonsignificant in all the groups. Additional analgesics were required in 56% of the patients in the intervention group and 60% of the patients in the control group; however, 44% and 40% of the patients from the intervention and control groups, respectively, do not require any additional analgesic in the postoperative period.

Conclusion:

The local infiltration of bupivacaine does not significantly reduce the port-site postoperative pain in gynecological laparoscopic surgeries.
Vaginal Vault Closure Following Total Laparoscopic Hysterectomy: Laparoscopic versus Conventional Technique – A Comparative Study
Authors: Agarwal Mukta , Sinha Shivangni , Singh Smita , Haripriya H. , Simran S
Published: December 2023

Objectives:

Vault closure is the final step to hysterectomy, protecting the abdominal cavity from the exterior environment. Thus, closure becomes crucial in preventing ascend of infection to the peritoneal cavity. Our study aims to compare vault closure between laparoscopic and vaginal routes, their operating time, and postoperative complications.

Materials and Methods:

The ambispective comparative study was done in a tertiary care teaching center from June 2016 to December 2022. Three hundred and forty-four patients were included in the study that underwent a total laparoscopic hysterectomy. Interventions – Patients who had laparoscopic vault closure were in Group 1 (N = 198) and those who had vaginal closure were in Group 2 (N = 146). The results were compared. It included age, body mass index of the patient, the indication of surgery, intraoperative blood loss, size of the uterus, time taken during vault closure, and postoperative complications.

Results:

The time taken by laparoscopic vault repair was significantly less than vaginal repair (19.7 ± 13.3 min vs. 30.1 ± 6.6 min, P < 0.001). There was postoperative vault infection (2.7%), vault hematoma (1.3%), and no vault prolapse seen in vaginal repair. The organisms isolated were mainly Pseudomonas aeruginosa, Escherichia coli, and Klebsiella.

Conclusion:

Laparoscopic vault closure has shown significantly improved results compared to vaginal route repair.
Robot-Assisted Versus Laparoscopic Surgery for Pelvic Lymph Node Dissection in Patients with Gynecologic Malignancies
Authors: Aiko Kiyoshi , Kanno Kiyoshi , Yanai Shiori , Sawada Mari , Sakate Shintaro , Andou Masaaki
Published: December 2023

Objectives:

The objective of this study was to compare the surgical outcomes for pelvic lymph node dissection (PLND) performed through conventional laparoscopic surgery (CLS) versus robot-assisted surgery (RAS) in patients with gynecologic malignancies.

Materials and Methods:

Perioperative data, including operative time, estimated blood loss, and complications, were retrospectively analyzed in 731 patients with gynecologic malignancies who underwent transperitoneal PLND, including 460 and 271 in the CLS and RAS groups, respectively. Data were statistically analyzed using the Chi-square test or Student’s t-test as appropriate. P < 0.05 was considered statistically significant.

Results:

The mean age was 50 ± 14 years and 53 ± 13 years in the RAS and CLS groups (P < 0.01), respectively. The mean body mass index was 23.4 ± 4.8 kg/m2 and 22.4 ± 3.6 kg/m2 in the RAS group and CLS groups (P < 0.01), respectively. The operative time, blood loss, and number of resected lymph nodes were 52 ± 15 min, 110 ± 88 mL, and 45 ± 17, respectively, in the RAS group and 46 ± 15 min, 89 ± 78 mL, and 38 ± 16, respectively, in the CLS group (all P < 0.01). The rate of Clavien-Dindo Grade ≥ III complications was 6.3% and 8.7% in the RAS and CLS groups, respectively (P = 0.17).

Conclusion:

Shorter operative time and lower blood loss are achieved when PLND for gynecologic malignancies is performed through CLS rather than RAS. However, RAS results in the resection of a greater number of pelvic lymph nodes.
Bipolar affective disorder in India: A multi-site population-based cross-sectional study
Authors: Vajawat Bhavika , Suhas Satish , Moirangthem Sydney , Kumar Channaveerachari Naveen , Varghese Mathew , Gururaj Gopalkrishna , Benegal Vivek , Rao Girish N. ,   NMHS National Collaborators Group
Published: December 2023

Introduction:

Bipolar Affective Disorder (BPAD) merits careful consideration within the medical and healthcare communities, researchers, and policymakers. This is due to its substantial disability burden, elevated prevalence of co-morbidities, heightened lifetime risk of suicidality, and a significant treatment gap. This article focuses on the lifetime and current prevalence, correlates, co-morbidities, associated disabilities, socio-economic impact, and treatment gap for BPAD in the adult population of the National Mental Health Survey (NMHS) 2016.

Materials and Methods:

The NMHS 2016 was a nationally representative study conducted across 12 Indian states between 2014 and 2016. A multi-stage, stratified, random cluster sampling technique based on probability proportionate to size at each stage was used. The diagnosis of BPAD was based on Mini-International Neuropsychiatric Interview 6.0.0. Sheehan's Disability Scale was used to assess the disability.

Results:

A total of 34,802 adults were interviewed. The overall weighted prevalence of BPAD was 0.3% [95% confidence interval (CI): 0.29–0.31] for current and 0.5% (95% CI: 0.49–0.51) for lifetime diagnosis. Male gender [odds ratio (OR) 1.56] and residence in urban metropolitans (OR 2.43) had a significantly higher risk of a lifetime diagnosis of BPAD. Substantial cross-sectional co-morbidities were noted as per MINI 6.0.0 with the diagnosis of current BPAD such as tobacco use disorder (33.3%), other substance use disorders (14.6%), and anxiety disorders (10.4%). Two-thirds of persons with current BPAD reported disability of varying severity at work (63%), social (59.3%), and family life (63%). The treatment gap for current BPAD was 70.4%.

Conclusion:

Most individuals with current BPAD reported moderate–severe disability. There were substantial co-morbidities and a large treatment gap. These warrant concentrated efforts from policymakers in devising effective strategies.
Ocular manifestations in a case of herpes zoster ophthalmicus with human immunodeficiency virus
Authors: Bindiya Chalattil , Veluri Haritha , Singh Manmeet
Published: December 2023

This is a case report of human immunodeficiency virus infection whose primary presentation was with herpes zoster ophthalmicus with sterile corneal perforation which is unusual. A 48-year-old female patient presented with redness and painful decrease in vision in the right eye for the past two weeks. Examination revealed skin lesions in right side of face, with complete ptosis in right eye with restricted ocular movements suggestive of third nerve palsy. Slit lamp examination revealed sterile perforated peripheral corneal ulcer in right eye. Screening of viral markers revealed that patient was positive for human immunodeficiency virus. The case was treated conservatively with oral antivirals, topical antibiotics, and lubricants. The patient was started on highly active antiretroviral therapy from nearby antiretroviral therapy centre. We planned to do a corneal patch graft for the patient but the patient was not willing for any surgical intervention.
Tear cytokines and their relevance as biomarkers in ocular surface inflammatory diseases
Authors: Gurumurthy Srividya , Bhambhani Varsha , Agarwal Shweta , Srinivasan Bhaskar , Iyer Geetha
Published: December 2023

Ocular surface disorders (OSDs) are complex, multifactorial diseases, often coexisting and with overlapping symptoms leading to discomfort and visual compromise. OSD is driven by chronic inflammation and its pathogenesis involves multiple ocular surface structures such as the cornea, conjunctiva, lacrimal glands, and meibomian glands.

Diagnosing and monitoring disease progression based on clinical features is crucial for effective treatment implementation. However, achieving a differential diagnosis solely through clinical features can be challenging. The evaluation of biomarkers can facilitate disease diagnosis, aid in classification, and offer insights into disease progression and treatment effectiveness. There remains an unmet clinical need for biological tools to manage ocular surface diseases (OSDs).

Tear fluid serves as a readily accessible source of biological material that has undergone extensive analysis in the quest for biomarkers related to OSD. Numerous studies have contributed to the extensive catalog of biomarkers found in tear fluid for OSD. The objective of this review is to provide a comprehensive and up-to-date overview of the most pertinent biomarkers for various OSDs, with a specific focus on quantitative analyses and their correlations with clinical parameters.

To achieve this objective, we conducted a review of the PubMed database from January 2013 to June 2023, including original articles that investigated tear cytokines in various OSD pathologies. These studies unveiled a dysregulated interplay of pro- and anti-inflammatory cytokines within these disease pathologies. Pro-inflammatory interleukins (IL-1β, IL-2, IL-8, and IL-17), tumor necrotic factor (TNF-α), interferon-gamma (IFN-γ), as well as IL-4, IL-5, and IL-13 (Th2 pathway), and chemokines such as CCL5, IP-10 (CXCL10), and CX3CL, appear to represent similar inflammatory mechanisms in OSD pathologies.

The cytokines identified through tear fluid analysis can aid in categorizing the disease as either pro-inflammatory or pro-fibrotic based on its severity, or they may serve as potential targets for intervention. This, in turn, can facilitate the planning of appropriate management strategies. The integration of biomarker testing into clinical settings holds the potential to advance personalized medicine and represents the next significant step in managing OSD.
Coronavirus Disease Outbreak: Assessing the Level of Preparedness for Containment in Healthcare Facilities in Nigeria: Qualitative Research Findings
Authors: Ayowole Damilola , Abdul-Azeez Muhammed , Uvere Ezinne O. , Adebayo Oladimeji , Okunade Praise T. , Oghenechodja Josephine
Published: December 2023

Background:

The COVID-19 pandemic has raised serious public health concerns globally. Cases keep increasing across countries: exposing the emergency-containing capability, level of preparedness, emergency disease prevention, and risk management alertness of various healthcare facilities in managing the crisis.

Aim:

to assess the level of preparedness for the containment of the COVID-19 disease outbreak across health-care facilities in Nigeria.

Materials and Methods:

Participants were the stakeholders within selected healthcare facilities. Data were collected via in-depth interviews using a list of 37 structured questions to assess the level of preparedness of the Nigerian health-care facilities in containing the COVID-19 pandemic. The findings were manually and thematically analysed using the constructivist variant of the grounded theory methodology.

Results:

Overall, the level of preparedness across the selected health facilities was estimated as average, as several facilities were fairly prepared while a few others were relatively unprepared for the COVID-19 pandemic containment.

Conclusion:

The COVID-19 virus disease outbreak can be said to be fairly contained by the Nigerian health system from the standpoint of the available mortality and incidence indices. Meanwhile, there are still loopholes around financial, structural, and material provisions which are essential needs for better and sustainable pandemic containment.
Incidence and Predictive Factors of Lower Extremity Deep-vein Thrombosis in Patients with Neurological Diseases in a Sub-Saharan Tertiary Hospital
Authors: Campbell Francis Chukwuebuka , Ajare Enyereibe Chuks , Ndukuba Kelechi Onyenekeya , Okwunodulu Okwuoma , Hart Idawarifagha , Nnama Sunday Samuel , Azaatse Terngu Titus , Ndubuisi Chika Anele , Ohaegbulam Samuel
Published: December 2023

Background:

Deep-vein thrombosis (DVT) is a major cause of morbidity among patients with neurological disease and is implicated in 50%–90% of pulmonary embolisms (PE).

Aim:

This study aims to identify the incidence and predictive factors of lower extremity (LE) DVT in high-risk neurological patients.

Materials and Methods:

All patients with neurological diseases who were confined to bed for three days or more, or had elevated D-dimer over a 22 months were included in the study. They all had routine mechanical and chemical prophylaxis. Serial color duplex ultrasonography of the LE was performed for all the patients, and the results were used to stratify them into two groups: DVT positive and DVT negative, and their clinical parameters were recorded and utilised for statistical analysis. Multivariate logistic regression analysis was used to determine the predictive risk factors.

Results:

A total of 611 patients were admitted, and 107 met the inclusion criteria. The mean age was 57 ± 17 years, with a male-to-female ratio of 1.7:1. Forty-four (41.4%) patients had DVT (overall incidence was 7.2%). Primary intracranial tumours and craniocerebral trauma accounted for 27.2% and 20.5% of aetiology, respectively. The comparative DVT-positive versus DVT-negative group D-dimer levels were 7.9 versus 4.9 mg/L (P = 0.0065), duration of immobility 65.0 versus 35.3 days (P = 0.0001), and length of hospital (LOH) stay 32.5 versus 18.2 days (P = 0.0001). The proximal LE vessels were involved in 64.2%. The PE risk was 0.98%, with three mortalities. The predictive factors on multivariate logistic regression were elevated D-dimers (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.1–4.45 P = 0.030) and preoperative immobility >seven days ([OR] 2.38, 95% [CL] 1.28–4.39 P = 0.042). Gender, C-reactive protein, Glasgow Coma Scale, comorbidities, LOH, and chronic steroid use were not predictive.

Conclusion:

The overall incidence of DVT and mortality from PE were low among patients with neurological diseases. Most thrombi involved proximal LE veins. Elevated D-dimers and preoperative immobility >seven days were predictive factors for LE DVT.
Clinical Presentation and Management of Peripheral-induced Oromandibular Dystonia in Nigeria: A Case Report and Literature Update
Authors: Onyia Nonso Emmanuel , Okoh Mercy , Igwilo Obinna Francis , Ukpebor Izegboya Vivian , Nwauzor Eze Stephen
Published: December 2023

Oromandibular dystonia (OMD) is a rare focal neurological disorder associated with impaired masticatory function, dysphagia, dysphonia, and involuntary abnormal movements of the mandible of varying severity. The peripheral-induced variant among other factors is a common aetiological factor of secondary dystonias, associated with constellations of clinical features and presents with differing responses to various treatment therapies. To report a case of oromandibular dystonia and to add to the body of literature. The case report is of a 33-year-old male who presented with complaints pain on speaking and from the temporomandibular joint area for 8 months which adversely affected patient’s work, social life and psychological well-being. Examination revealed retraction and repetitive but uncoordinated pattern of labial, cheek and masticatory muscular movement on mouth opening and closing. Diagnosis of oromandibular dystonia was made on clinical grounds. Patient was managed with a combination of medications by the oral physician, and physical therapy, which led to a significant improvement in the control of muscle contractions within 5 weeks. OMD though a rare neuromuscular condition can present to the dentist, and effective assessment, diagnosis and collaboration with relevant specialities are key to improved outcome.
Hybridity in Theatre Translation
Authors: Mikolič Južnič Tamara , Pisanski Peterlin Agnes
Published: December 2023

In Slovenia, surtitles are increasingly used to facilitate access to the textual content of a play when it is performed for an international audience. The process of creating a translation in the format of surtitles is characterized by complexity and hybridity, as a translation of a theatre text, even when available, needs to be adapted for a different medium. This paper examines how English surtitles for the Slovenian play Pavla nad prepadom / Pavla above the Precipice were created by comparing four versions of the text of the performance.
Witchcraft or Otherness
Authors: Onič Tomaž
Published: December 2023

Tituba, a supporting character in Arthur Miller’s 1953 play The Crucible, can be associated with the concept of otherness in several respects. For one, she is not free like the rest of the population of Salem, Massachusetts, where the play is set, but was brought to the community from the island of Barbados by Reverend Parris as an enslaved woman. Being of Caribbean origin, she is also not an English Protestant like the rest of the village, and despite having accepted her master’s church, as was common for the enslaved throughout the British colonial period, Protestantism is not her first religion. Finally, the two most evident and immediately perceivable characteristics placing her in the category of the Other are her skin colour and her language, which also seem to be the main reasons that she was the first person to be accused of witchcraft in Salem. This paper focuses on Tituba’s speech, particularly from the point of view of the possibilities as well as difficulties of translating her utterances into Slovene. The contrastive analysis includes Miller’s original play, its two Slovene translations, Lov na čarovnice, the published one (1964) and the unpublished theatre translation (1997/2019), as well as a brief insight into two theatre productions of the play at the Maribor National Theatre.
“Who the Hell Are You?”
Authors: Erdem Ayyıldız Nilay
Published: December 2023

Tom Stoppard is an outstanding playwright, embellishing his plays with scientific and philosophical approaches and presenting complicated, mysterious plots to the reader. He bases the plot of his postmodern play, Hapgood (1988), on quantum theory and draws an analogy between Werner Heisenberg’s principle of indeterminism, termed “The Uncertainty Principle”, and international espionage. Thus, he constructs the complicated relationship between the particle and the whole throughout the play to depict the relativistic and deceptive relationship between sex and gender. Focusing on the title character of the play, the present study proposes that the play represents the fluid and indeterminate nature of gender and identity within the context of espionage and indeterminism. Hapgood, who is a mother, a lover and a successful master agent in a man-dominated British secret service, navigates between “masculinity” and “femininity” during a day. Moreover, she metamorphoses into her twin, who is entirely different from her, except for their identical faces, to entrap the mole in the office. The study consults Judith Butler’s theory of gender performativity and fluidity to indicate the unpredictable and uncertain nature of ‘gender identity’, which formulates itself through performances in social relations and trespasses the heterosexual matrix. It juxtaposes the Butlerian approach with the Uncertainty Principle in quantum theory pertaining to the confusing relationship between gender, the body and identity. The Butlerian analysis of the play reveals that particularly the modern way of life makes women transgress the Cartesian dichotomies of sex/gender, masculine/feminine and man/woman through the fluidity of their roles even during a single day and makes it difficult to find out who is really who.