bluuebunny/crossref_metadata_2025 huggingface dataset:
The global syndemic of metabolic diseases in the young adult population: a consortium from the Global Burden of Disease 2000-2019
Authors: Chew N , Kannan S , Chong B , Chew J , Lin C X , Goh R , Kong G , Chin Y H , Ng C H , Foo R , Chan M
Published: January 2023

Funding Acknowledgements

Type of funding sources: None.

Background

A large proportion of premature deaths are related to metabolic diseases in the young adult population. We examined the global trends and mortality of metabolic diseases using estimates from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 in individuals aged below 40 years.

Methods

From 2000-2019, global estimates of prevalence, deaths, and disability-adjusted life years (DALYs) were described for metabolic diseases (type 2 diabetes mellitus [T2DM], hypertension, non-alcoholic fatty liver disease [NAFLD]). Global estimates were limited to mortality and DALYs for risk factors (hyperlipidemia and obesity). Subgroup analyses were performed based on sex, geographical regions and Socio-Demographic Index (SDI). Age-standardized prevalence, death, and DALYs were presented per 100,000 population with 95% uncertainty intervals (UI).

Findings

The prevalence for all metabolic diseases increased from 2000-2019, with the most pronounced increase in males and high SDI countries. In 2019, the highest age-standardised death rates were observed in hypertension (133·88 [121·25-155·73]; males, 160·13 [138·91-180·79]; females, 119·66 [102·33-136·86]), followed by obesity (62·59 [39·92-89·13]; males, 66·55 [39·76-97·21]; females, 58·14 [38·53-81·39]), hyperlipidemia (56·51 [41·83-73·62]; males, 67·33 [50·78-86·43]; females, 46·50 [32·70-62·38]), T2DM (18·49 [17·18-19·66]; males, 19·94 [18·50-21·32]; females, 17·30 [15·62-18·70]) and NAFLD (2·09 [1·61-2·60]; males, 2·38 [1·82-3·02]; females, 1·82 [1·41-2·27]). Similarly, obesity (1932·54 [1276·61-2639·74]) had the highest age-standardised DALYs, followed by hypertension (2885·57 [2580·75-3201·05]), hyperlipidemia (1207·15 [975·07-1461·11]), T2DM (801·55 [670·58-954·43]) and NAFLD (53·33 [40·73-68·29]). Mortality rates decreased over time in hyperlipidemia (-60%), hypertension (-47%), NAFLD (-31%) and T2DM (-20%), but not in obesity (107% increase). The highest metabolic-related mortality was observed in the Eastern Mediterranean and low SDI countries.

Conclusion

The growing prevalence of metabolic diseases, increasing obesity-related mortality trends, and the sex-regional-socioeconomic disparities evident in young adulthood, present the concerning global burden of metabolic diseases now and in the years ahead.
Geographic areas of responsibility among PCI-capable hospitals in the Philippines
Authors: Toledano B , Garganera K B , Prado J P , Sabas M L , Gregorio G S
Published: January 2023

Funding Acknowledgements

Type of funding sources: None.

Introduction

The archipelagic nature of the Philippines is unique and the geographic areas of responsibility for ST elevation myocardial infarction patients should be defined.

Methodology

The list of registered PCI capable hospitals and the total members of adult interventional cardiologists per island from the Philippine Society of Cardiac Catheterization Incorporation as of January 2022 was used. Their characteristics were described using frequency and percentage. The web application Map Developers was utilized to locate the exact location of each PCI-capable center and a 120km radius at the center of each PCI-capable hospital was drawn. The 120km radius was based on the average of 60km/hour from the Land Transportation & Traffic code multiplied by 2 hours based on the maximum expected delay from STEMI diagnosis to primary PCI. The map of Philippine provinces was obtained from the Creative Commons Attribution-Share Alike 4.0 international file name Ph administrative map blank. The maps of the geographic area of responsibility and provinces were interposed using MS PowerPoint version 2201 and categorized as covered, partially covered, and not covered.

Results

The analysis included a total of 3 islands with 82 provinces, 244 adult interventional cardiologists (IC) and 54 PCI-capable hospitals. The region registered the highest percentage of IC (85.7%) and PCI-capable hospitals (78.9%) followed by Visayas (8.6%) and (11.5%), and Mindanao (5.7%) and (9.6%) respectively. Most PCI-capable hospitals are privately (79.6%) versus government owned (20.4%). Most percentage of PCI-capable hospitals are in Metro Manila (46.3%), followed by Cebu (9.26%), Laguna and Pampanga (5.57%), Benguet, Davao del Sur, Misamis Oriental, Nueva Ecija and Iloilo (3.7%). Only 46.4% of the provinces are covered, 34.1% are partially covered and 19.5% are not covered.

Conclusion

In the Philippines, most PCI-capable hospitals are privately owned and centrally located on an island. There may be a need to add PCI-capable hospitals that are government owned, equally distributed, and strategically placed in partially and non-covered provinces. In addition, due to its archipelagic nature, STEMI patients in other provinces that are not covered may benefit from rapid fibrinolysis.
Engineering a fermenting yeast able to produce the fragrant β-ionone apocarotenoid for enhanced aroma properties in wine
Authors: Timmins John , van Wyk Niel , Kroukamp Heinrich , Walker Roy , Fritsch S , Rauhut Doris , Wallbrunn Christian , Pretorius Isak , Paulsen Ian
Published: January 2023

Wine is composed of multitudinous flavour components and volatile organic compounds that provide this beverage with its attractive properties of taste and aroma. The perceived quality of a wine can be attributed to the absolute and relative concentrations of favourable aroma compounds; hence, increasing the detectable levels of an attractive aroma, such as β-ionone with its violet and berry notes, can improve the organoleptic qualities of given wine styles. We here describe the generation of a new grape-must fermenting strain of Saccharomyces cerevisiae that is capable of releasing β-ionone through the heterologous expression of both the enzyme carotenoid cleavage dioxygenase 1 (CCD1) and its substrate, β-carotene. Haploid laboratory strains of S. cerevisiae were constructed with and without integrated carotenogenic genes and transformed with a plasmid containing the genes of CCD1. These strains were then mated with a sporulated diploid wine industry yeast, VIN13, and four resultant crosses—designated MQ01–MQ04–which were capable of fermenting the must to dryness were compared for their ability to release β-ionone. Analyses of their fermentation products showed that the MQ01 strain produced a high level of β-ionone and offers a fermenting hybrid yeast with the potential to enhance the organoleptic qualities of wine.
Rayleigh wave spectral distortions induced by an anticline structure
Authors: El Khoury Christine , Chauris Hervé , Kazantsev Alexandre , Monteiller Vadim
Published: January 2023

Spectral anomalies in the seismic ambient noise are commonly observed above hydrocarbon reservoirs at frequencies of several Hertz. If properly understood, these anomalies could be a potential indicator for hydrocarbon reservoir exploration or monitoring. Under the assumption that ambient noise mainly consists of surface waves, previous studies showed that the geological structure, rather than the hydrocarbon content, could be the major cause of the observed anomalies for purely elastic waves. This work further explores how Rayleigh waves interact with an anticline structure, a typical geological trap for a hydrocarbon reservoir. We propose an approximate semi-analytical surface wave approach for modelling the spectral anomalies. It is based on the contribution of 1-D local solutions from two different models. The results are compared with those obtained via 3-D numerical simulations using the spectral-element approach in the case of a wavefield dominated by Rayleigh waves. Analysis of the anomalies generated by an anticline structure is performed for different source configurations. It shows that the semi-analytical method provides reasonable spectrum predictions for smooth layered models and under some restrictions on the source distribution. Such a tool allows us to run a larger number of simulations to explore the parameter space and finally provide a general law linking the anticline geometrical parameters and the elastic properties of the medium to the anticline-induced spectral anomaly for the case of fundamental mode Rayleigh waves.
Care Work Is Not Conditional: Contingent Labor and “Vocation” in Theological and Religious Studies
Authors: Koh SueJeanne , Capps Franklin Tanner
Published: January 2023

This article is written for people working in the related fields of theological and religious studies, speaking directly to the issue of contingency as a feminist question of care. It acknowledges how cisgendered women in the academy often bear the bulk of caring for others, but goes further, interrogating how care discourses structurally inform the contingent worker’s material realities. Contingency raises the question of the value of the humanities, of which theological and religious studies are a part. Framed as a question of “vocation,” Max Weber argues that the humanities scholar’s work should be oriented to research, rather than moral transformation. A critical and feminist analysis of care, then, unveils contingent labor as a kind of care work that supports masculinist attachments to the tenure track faculty position as the pinnacle of effort and scholarship. The article offers first steps toward constructive recommendations for the issues that we identify.
ISDS and Its Transformations
Authors: Ortino Federico
Published: January 2023

Like the Journal of International Economic Law, which we celebrate with this special 25th Anniversary issue, investor-state dispute settlement (ISDS) came to life in the second half of the 1990s. The aim of this contribution is to ask whether ISDS has gone through any ‘transformation’, that is any ‘complete’ or ‘radical’ change, in the last twenty-five years. The article argues that, while a lot has changed in two and a half decades, in particular, the amount and breadth of criticism against investor-state arbitration, ISDS remains fundamentally the same, at least if one focuses on the practice of ISDS.
Overcoming contractual incompleteness: the role of guiding principles
Authors: Frydlinger David , Hart Oliver
Published: January 2023

Transactions of any complexity between buyers and sellers are supported by long-term contracts and these contracts are inevitably incomplete. We propose an approach for overcoming contractual incompleteness based on the idea that most people are inclined to follow widely accepted social norms, such as being fair-minded and acting with integrity. We suggest that this tendency can be reinforced if these social norms are incorporated into a formal contract in the form of guiding principles. We develop a model in which guiding principles reduce shading behavior and discuss cases where the approach has been successfully applied in practice (JEL D23, D86, K12).
Automatic attention to sexual stimuli: exploring the role of neuroticism and sexual excitation/inhibition through event-related potentials
Authors: Aguiar Sandra , Carvalho Joana , Carrito Mariana L , Santos Isabel M
Published: January 2023

Background

Previous findings have shown that neuroticism is a higher-order vulnerability factor in the development and maintenance of sexual dysfunctions and can have an impact on the attentional processing of sexual stimuli; however, the influence of psychosexual dimensions on the early automatic phases of such cognitive processes has not been established yet.

Aim

To examine the mediating role of sexual inhibition/excitation propensity in the relationship between neuroticism and automatic attention to visual erotica and to identify the neuroelectric correlates of such a process.

Methods

We analyzed the answers provided by 58 individuals on the Neuroticism subscale of the NEO Personality Inventory–Revised and the Sexual Inhibition/Excitation Scales. Event-related potentials (ERPs) were recorded during a modified oddball paradigm containing romantic and sexually explicit pictures. Parallel mediations were performed to simultaneously test the mediating role of sexual inhibition/excitation in the relationship between neuroticism and each ERP.

Outcomes

Three early attention ERP components (P1, P2, and N2) were assessed.

Results

Findings revealed an indirect effect of neuroticism on automatic attention, via sexual inhibition due to threat of performance failure (SIS1), for romantic and sexually explicit stimuli. This effect was significant only for component N2, which showed increased amplitudes and earlier latencies in participants with high SIS1.

Clinical Implications

Sexual stimuli, due to their emotional valence and arousal potential, might be perceived as virtually threatening by individuals with neuroticism, who may benefit from strategies that decrease hyperarousal and sympathetic activation.

Strengths and Limitations

This was one of the first studies to analyze neuroelectric activity associated with automatic attention toward sexual stimuli in relation to personality and sexual excitation/inhibition propensity. Nevertheless, the limited number of participants demands caution in generalizing the results.

Conclusion

These results provide a better understanding of the relationship between personality and sexual cognition and open new avenues of research in relation to other automatic cognitive phenomena related to human sexual behavior.
Comparing Effectiveness of Hyaluronic Acid-Chitosan Nanoparticles Encapsulation Versus Hyaluronic Acid Monotherapy in Osteoarthritis Rat Model: Microarray Screening for miR-140
Authors: Kamar Samaa Samir , ShamsEldeen Asmaa Mohammed , Hosny Sara Adel , El-Shafei Asmaa Ahmed , Rashid Laila Ahmad , Hassanein Radwa Taha , Hassan Rokia Mohamad
Published: January 2023

Osteoarthritis is a debilitating, progressive joint disease linked to lower quality of life and higher health care costs. This study compared hyaluronic acid-chitosan nanoparticle encapsulation to hyaluronic-acid monotherapy in a rat model of knee osteoarthritis. Four groups of 40 adult male albino rats were designed. Group (Gp) I: control; Gp II (osteoarthritis model): intra-articular injection of monoiodoacetate; Gp III (hyaluronic acid-treated): intra-articular injections of hyaluronic-acid on days 14 and 21 after monoiodoacetate injection; and Gp IV (hyaluronic acid-chitosan nanoparticle-treated): intra-articular injections of hyaluronic acid-chitosan nanoparticle on days 14 and 21 after monoiodoacetate injection. After 28 days, knee joints were examined using H&E, Safranin O, and immunohistochemistry for nuclear factor kappa beta (NF-κB), inducible nitric oxide synthase (iNOS), and matrix metalloproteinase (MMP)-13. Quantification for gene expression of collagen-II, aggrecan, and micro-RNA-140; ELISA for interleukin (IL)-1β and IL-8; and western blotting for IKBα and NF-κB was estimated. Osteoarthritis-knee joints showed a severe cartilage damage and synovial inflammation with increased NF-κB, iNOS, and MMP-13 immunostaining, decreased miR-140, collagen II, and aggrecan levels, and increased inflammatory markers’ gene expressions. The hyaluronic acid-chitosan nanoparticle significantly improved knee joint structure and reduced inflammatory cytokines compared to hyaluronic acid monotherapy. Intra-articular injection of hyaluronic acid-chitosan nanoparticle encapsulation revealed a significant improvement in the knee joint structure compared to hyaluronic-acid in a rat model of osteoarthritis.
Preparation of High-Quality Samples for MEMS-BasedIn-Situ(S)TEM Experiments
Authors: Srot Vesna , Straubinger Rainer , Predel Felicitas , van Aken Peter A
Published: January 2023

A novel focused ion beam (FIB)-based methodology for the preparation of clean and artifact-free specimens on micro-electro-mechanical-system (MEMS)-based chips for in-situ electrical and electro-thermal experiments in a (scanning) transmission electron microscope ((S)TEM) is introduced. Owing to an alternative geometry, the lamellae are attached to a MEMS-based chip directly after the lift-out procedure and afterward further treated or thinned to electron transparency. The quality of produced lamellae on a chip resembles the quality of a classical FIB-prepared sample that is here demonstrated by high-resolution STEM imaging and analytical techniques. Various sample preparation parameters and the performance of in-situ prepared samples have been evaluated through electrical-biasing experiments.
Dynamics of neutron star accretion columns in split-monopole magnetic fields
Authors: Zhang (力中张) Lizhong , Blaes Omer , Jiang (燕飞姜) Yan-Fei
Published: January 2023

We perform 2D axisymmetric radiative relativistic MHD simulations of radiation pressure supported neutron star accretion columns in split-monopole magnetic fields. The accretion columns exhibit quasi-periodic oscillations, which manifest in the luminosity power spectrum as 2–10 kHz peaks, together with broader extensions to somewhat higher frequencies. The peak frequency decreases for wider columns or higher mass accretion rates. In contrast to the case of shorter columns in uniform magnetic fields, pdV work contributes substantially to maintaining the radiation pressure inside the column against sideways radiative cooling. This is in part due to the compression associated with accretion along the converging magnetic field lines towards the stellar surface. Propagating entropy waves which are associated with the slow-diffusion photon bubble instability form in all our simulations. Radial advection of radiation from the oscillation itself as well as the entropy waves is also important in maintaining radiation pressure inside the column. The time-averaged profile of our fiducial simulation accretion is approximately consistent with the classical 1D stationary model provided one incorporates the correct column shape. We also quantify the porosity in all our accretion column simulations so that this may also in principle be used to improve 1D models.
On the follow-up efforts of long-period transiting planet candidates detected with Gaia astrometry
Authors: Sozzetti A , Giacobbe P , Lattanzi M G , Pinamonti M
Published: January 2023

The class of transiting cold Jupiters, orbiting at ≳0.5–1.0 au, is to-date underpopulated. Probing their atmospheric composition and physical characteristics is particularly valuable, as it allows for direct comparisons with the Solar system giant planets. We investigate some aspects of the synergy between Gaia astrometry and other ground-based and space-borne programs for detection and characterization of such companions. We carry out numerical simulations of Gaia observations of systems with one cold transiting gas giant, using Jovian planets around a sample of nearby low-mass stars as proxies. Using state-of-the-art orbit fitting tools, we gauge the potential of Gaia astrometry to predict the time of transit centre Tc for the purpose of follow-up observations to verify that the companions are indeed transiting. Typical uncertainties on Tc will be on the order of a few months, reduced to several weeks for high astrometric signal-to-noise ratios and periods shorter than ∼3 yr. We develop a framework for the combined analysis of Gaia astrometry and radial-velocity data from representative ground-based campaigns and show that combined orbital fits would allow to significantly reduce the transit windows to be searched for, down to about ±2 weeks (2–σ level) in the most favourable cases. These results are achievable with a moderate investment of observing time (∼0.5 nights per candidate, ∼50 nights for the top 100 candidates), reinforcing the notion that Gaia astrometric detections of potentially transiting cold giant planets, starting with Data Release 4, will constitute a valuable sample worthy of synergistic follow-up efforts with a variety of techniques.
Employing the policy capacity framework for health system strengthening
Authors: Saddi Fabiana da Cunha , Peckham Stephen , Bloom Gerald , Turnbull Nick , Coelho Vera Schattan , Denis Jean-Louis
Published: January 2023

The policy capacity framework offers relevant analytical ideas that can be mobilized for health system strengthening. However, the employment of this framework in the health field constitutes a relevant interdisciplinary gap in knowledge. This themed issue explores the relationships between the policy capacity framework and health system strengthening, in a multidimensional and interdisciplinary way, in high-income and low–middle-income countries. This introduction unpacks the dynamic interrelationships between the policy capacity framework and health system strengthening, bringing together common and distinct elements from both fields and summarizing possible relationships between them. The analysis shows that both fields together can increase our knowledge on health policies and system’s critical themes and reforms. This challenge could be followed by exploring the convergences between them, as far as concepts/themes (types of capacities and other themes) and levels of analysis are concerned. Although in varied ways, papers in this issue (based on European countries, China, Canada, New Zealand, India, Australia, and Brazil) advance the use of the policy capacity framework for health policy or system strengthening. They give two main interdisciplinary contributions. Critical capacities can be incorporated into the policy capacity framework for the analysis of system strengthening—capacity to adapt, contexts of mixed and complex systems, dynamic view of policy capacity, and policy capacity as a relational power. Policy capacity is contextually interpreted (relative to the problem frame) and dynamic and adaptive (processual and relational), in relation to the properties of a health system, particularly with regard to the existing and developing mixed and complex systems.
Updated constraints on sterile neutrino mixing in the OPERA experiment using a new νe identification method
Authors:   OPERA Collaboration, Agafonova N , Alexandrov A , Anokhina A , Aoki S , Ariga A , Ariga T , Bertolin A , Bozza C , Brugnera R , Buontempo S , Chernyavskiy M , Chukanov A , Consiglio L , D’Ambrosio N , De Lellis G , De Serio M , del Amo Sanchez P , Di Crescenzo A , Di Ferdinando D , Di Marco N , Dmitrievsky S , Dracos M , Duchesneau D , Dusini S , Dzhatdoev T , Ebert J , Ereditato A , Fini R A , Fukuda T , Galati G , Garfagnini A , Gentile V , Goldberg J , Gorbunov S , Gornushkin Y , Grella G , Guler A M , Gustavino C , Hagner C , Hara T , Hayakawa T , Hollnagel A , Ishiguro K , Iuliano A , Jakovčć K , Jollet C , Kamiscioglu C , Kamiscioglu M , Kim S H , Kitagawa N , Kliček B , Kodama K , Komatsu M , Kose U , Kreslo I , Laudisio F , Lauria A , Longhin A , Loverre P , Malgin A , Mandrioli G , Matsuo T , Matveev V , Mauri N , Medinaceli E , Meregaglia A , Mikado S , Miyanishi M , Mizutani F , Monacelli P , Montesi M C , Morishima K , Muciaccia M T , Naganawa N , Naka T , Nakamura M , Nakano T , Niwa K , Ogawa S , Okateva N , Ozaki K , Paoloni A , Paparella L , Park B D , Pasqualini L , Pastore A , Patrizii L , Pessard H , Podgrudkov D , Polukhina N , Pozzato M , Pupilli F , Roda M , Roganova T , Rokujo H , Rosa G , Ryazhskaya O , Sato O , Schembri A , Shakiryanova I , Shchedrina T , Shibayama E , Shibuya H , Shiraishi T , Simone S , Sirignano C , Sirri G , Sotnikov A , Spinetti M , Stanco L , Starkov N , Stellacci S M , Stipčevic M , Strolin P , Takahashi S , Tenti M , Terranova F , Tioukov V , Tufanli S , Vasina S , Vilain P , Voevodina E , Votano L , Vuilleumier J L , Wilquet G , Yoon C S
Published: January 2023

This paper describes a new νe identification method specifically designed to improve the low-energy ($\lt {30}\, {\rm GeV}$) νe identification efficiency attained by enlarging the emulsion film scanning volume with the next-generation emulsion readout system. A relative increase of 25–70% in the νe low-energy region is expected, leading to improvements in the OPERA sensitivity to neutrino oscillations in the framework of the 3 + 1 model. The method is applied to a subset of data where the detection efficiency increase is expected to be more relevant, and one additional νe candidate is found. The analysis combined with the ντ appearance results improves the upper limit on sin 22θμe to 0.016 at 90% C.L. in the MiniBooNE allowed region $\Delta m^2_{41} \sim {0.3}\, {\rm eV}^{2}$.
Informing the development of the coaching online and community health (COACH) program: a qualitative study of clubhouse members living with serious mental illness
Authors: O’Neill Kathryn , Hand Rachel , Diop Betty , Weiss Holly , Cruz Pfaeffle Andrea , Maragatham Parameshwari , Rice Kevin , Naslund John A
Published: January 2023

Health and wellness interventions addressing risk factors for early mortality among individuals with serious mental illness have demonstrated success and can be further augmented with digital technology. These programs may be suitable for delivery in psychosocial rehabilitation clubhouses, especially given many services have transitioned to digital platforms during the pandemic. This qualitative study aimed to: (a) explore clubhouse members’ experiences engaging with the virtual clubhouse platform, and their preferences for accessing digital wellness and health promotion content; and, (b) gauge members’ interest in an online peer-driven lifestyle intervention and their suggestions for program design. This study was guided by a community-based participatory action research framework. Ten focus groups were conducted with clubhouse members. Focus groups were coded and analyzed thematically by trained clubhouse members and the research team. Thirty-three members participated in the focus groups. Participants expressed the importance of having technical support from staff; that one-on-one support and consistent communication are important to keep them engaged in health and wellness programming; and described mixed views about use of the virtual platform, but generally were open to engaging in lifestyle intervention programming virtually. Participants who joined the clubhouse during the pandemic expressed feeling overwhelmed by in-person gatherings, and were especially interested in opportunities for remote participation. This study can inform health and wellness programming for delivery on the virtual clubhouse platform for members. The taxonomy of codes, created to generate a framework with recommendations, will inform the design of a virtual health and wellness intervention.
Practice patterns and perspectives regarding treatment for symptoms of menopause: qualitative interviews with US health care providers
Authors: DePree Barbara , Houghton Katherine , DiBenedetti Dana B. , Shiozawa Aki , King Deanna D. , Kim Janet , Mancuso Shayna
Published: January 2023

Objective

To document health care providers' views regarding treatments for symptoms associated with menopause and discussions with patients about symptoms and treatment decisions. Results informed development of a data collection form for a retrospective medical record review (reported separately).

Methods

Registered US gynecologists or primary care providers from all US regions were identified from local association directories and an in-house database and were invited to participate in a qualitative interview if they consulted with three or more patients per week presenting with menopausal symptoms. Participants provided demographic data, information about patients' symptoms, and health care provider and patient views on prescription and nonprescription therapies. Key concepts/themes from interviews were identified.

Results

Participating health care providers (10 gynecologists, 10 primary care providers) agreed there are effective treatment options for menopausal symptoms, particularly vasomotor symptoms and vaginal dryness and/or atrophy. Health care providers reported that treatment was generally dictated by symptoms that interfered with quality of life and/or daily activities, although patients often had symptoms for months before presentation. All health care providers said they prescribe hormone and/or nonhormone therapies for treatment of menopausal symptoms; half stated that they typically inquire about patients' nonprescription therapy use, and 45% recommend specific nonprescription therapies. The most commonly cited barriers to initiation of any therapy for menopausal symptoms were patient concerns about risks and financial considerations (ie, insurance or cost).

Conclusions

US health care providers reported prescribing therapies for menopausal symptoms and noted that these therapies were perceived as generally effective; however, barriers to initiation of prescription therapy exist, and new treatment options are needed.
Loss of muscle mass in women with premature ovarian insufficiency as compared with healthy controls
Authors: Li Saisai , Ma Linjuan , Huang Haiying , Lou Zheng , Qi Tongyun , Huang Yizhou , Zou Yu , Zhou Jianhong
Published: January 2023

Objective

Menopausal transition has been known to be associated with the loss of muscle mass. However, muscle health in women with premature menopause, that is, premature ovarian insufficiency (POI), remains unclear. We aimed to investigate and compare muscle mass parameters and the prevalence of low muscle mass between patients with spontaneous POI and healthy controls.

Methods

In this cross-sectional study, 59 women with spontaneous POI and 57 premenopausal controls with normal ovarian function were enrolled at the Women's Hospital, Zhejiang University School of Medicine (Hangzhou, China) from June 17, 2020, to August 20, 2021. Muscle mass parameters were measured by dual-energy x-ray absorptiometry, and low muscle mass was diagnosed using the Asian Working Group for Sarcopenia criteria. In addition, participants provided their sociodemographic data, menstrual and reproductive history, lifestyle factors, and medical history. Multivariate linear regression analysis was conducted.

Results

Muscle mass parameters, including appendicular skeletal muscle mass (ASM), ASM/height2, ASM/weight, ASM/body mass index, total skeletal muscle mass (TSM), and TSM/weight, were significantly lower in women with POI as compared with healthy controls (ASM: 14.62 ± 2.08 vs 15.97 ± 1.78, P < 0.001; ASM/height2: 5.71 ± 0.64 vs 6.15 ± 0.62, P < 0.001; ASM/weight: 0.27 [0.25, 0.28] vs 0.28 [0.27, 0.29], P = 0.002; ASM/BMI: 0.68 ± 0.07 vs 0.73 ± 0.06, P = 0.001; TSM: 33.85 ± 4.08 vs 36.43 ± 3.56, P < 0.001; TSM/weight: 0.63 [0.59, 0.65] vs 0.64 [0.61, 0.67], P = 0.02). The prevalence of low muscle mass in POI patients was significantly higher than that in controls (32.20% vs 8.77%, χ
2 = 9.70, P = 0.002). Furthermore, multivariate linear regression analyses demonstrated that POI status was an independent risk factor for ASM (β = −1.13; 95% CI, −1.62 to −0.65), ASM/height2 (−0.35, −0.47 to −0.22), ASM/weight (−0.01, −0.02 to −0.009), ASM/BMI (−0.05, −0.07 to −0.02), TSM (−2.16, −3.14 to −1.17), and TSM/weight (−0.03, −0.04 to −0.02).

Conclusions

Women with POI exhibit significant loss of muscle mass as compared with healthy controls. Early diagnosis and long-term health management in POI patients are important.
Enzymatic Debridement in Severe Burn COVID-19 Patients: A Case Series
Authors: Coletta Francesco , Sala Crescenzo , De Marco Giovanna Paola , Mataro Ilaria , Petroccione Carlo , Bonagura Pietro , Pirolli Rossella , Foreste Giuseppe , Tomasello Antonio , Villani Romolo
Published: January 2023

The presence of a high number of positive SARS-CoV-2 patients is found daily in the emergency room database, finding evidence of infection also in trauma and burns. Surgical debridement remains the gold standard for eschar removal, but it does not come without complications such as bleeding and high heat loss. In recent years, there has been an increase in the use of enzymatic debridement techniques, replacing surgical escharotomy. Early eschar removal is proven to be important; it has been proved that an early and effective burn treatment in COVID-19 patients can reduce other infection. Five clinical cases of patients arrived at our COVID-19 Major Burns Intensive Care Unit. On admission, burns extension and depth were assessed by an expert burn surgeon. We evaluated eschar removal modality, adverse events, and potential side effects. Enzymatic debridement was efficient in all patients treated with complete eschar removal, and no serious adverse events. All patients were treated within 24 hours of arrival at our facility with Nexobrid by specialized personnel in deep sedation and with O2 support using a face mask or nasal goggles. The use of enzymatic debridement in COVID-19–positive burn patients within dedicated pathways through nonsurgical treatment optimizes the treatment time. We believe that the use of enzymatic debridement could be a valid therapeutic option in burn patients, even with SARS-CoV-2 infection, and its use, when indicated, is safe and effective for the patient and optimizes the use of instrumental and human resources in a pandemic emergency.
SYMPTOMATIC EARLY-ONSET X-LINKED RETINOSCHISIS
Authors: Piquin Gwendoline , Abdelmassih Youssef , Martin Gilles , Edelson Catherine , Metge Florence , Caputo Georges , Chapron Thibaut
Published: January 2023

Purpose:

To describe clinical characteristics and outcomes of children with early-onset X-linked retinoschisis.

Methods:

In this retrospective consecutive case series, we included children diagnosed with symptomatic X-linked retinoschisis younger than 2 years. Presenting signs, clinical characteristics, treatments, and outcomes were recorded.

Results:

Seven patients (14 eyes) with a mean age of 17.14 ± 6.28 months were included. Strabismus was the most common presenting symptom (6 of 7 patients, 86%). Clinical signs at the first diagnosis included peripheral retinoschisis in 13 eyes (13/14, 93%), of which 5 (5/13, 38%) were bullous, vitreous hemorrhage in 3 eyes (3/14, 21%), and retinal detachment in 3 eyes (3/14, 21%). The macula was involved in all eyes: It was detached in 2 eyes (2/14, 14%) and involved in the peripheral schisis in 4 eyes (4/14, 29%). In all remaining eyes, optical coherence tomography revealed foveoschisis. Six eyes (6/14, 42%) received surgery. At the last follow-up, visual acuity, when available, ranged from no light perception to 20/40, and no children had persistent retinal detachment.

Conclusion:

Children with early-onset X-linked retinoschisis had severe forms. All children had peripheral retinoschisis which was often bullous and extended to the macula. Diagnosis is often clinical but handheld optical coherence tomography can be helpful in atypical forms. Complications requiring surgical management are frequent.
EPIRETINAL MEMBRANE WITH FOVEAL HERNIATION
Authors: Shah Saumya M. , Eliott Dean , Cox Jacob T. , Yonekawa Yoshihiro , Mahmoudzadeh Raziyeh , Peck Travis J. , Regillo Carl D. , Ho Allen C. , Oellers Patrick , Choudhury Mahin , Arboleda Nathan , Gentile Ronald C. , Sun Vincent , Iezzi Raymond
Published: January 2023

Purpose:

Foveal herniation occurs when neuroretinal tissue protrudes through and above the level of an epiretinal membrane. This study describes the visual symptoms and spectral domain optical coherence tomography findings associated with foveal herniation and evaluates the postoperative visual, anatomical, and surgical outcomes.

Methods:

A multicenter retrospective review of patients diagnosed with epiretinal membrane identified 59 patients with preoperative foveal herniation on spectral domain optical coherence tomography. Data regarding visual symptoms, preoperative and postoperative best-corrected visual acuity (BCVA), central retinal thickness, macular volume, and size of foveal herniation were collected, and statistical analysis was performed.

Results:

A total of 58 of the 59 patients with foveal herniation underwent surgical epiretinal membrane peeling, with foveal contour restored in 53.5% of patients after surgery. Average BCVA improved from 20/80 to 20/40 Snellen equivalent at most-recent postoperative visit (P < 0.0001). The average central retinal thickness decreased from 632 µm to 432 µm (P < 0.0001) and the average macular volume decreased from 11.3 mm3 to 9.5 mm3 (P < 0.0001) at 3 months postoperatively. Preoperatively, greater herniation height was associated with worse BCVA (P = 0.008), greater central retinal thickness (P = 0.01), retinoschisis, cystoid macular edema, foveolar detachment, ellipsoid zone abnormality, and external limiting membrane abnormalities (P < 0.05). Postoperatively, there was a decrease in retinoschisis, cystoid macular edema, foveolar detachment, ellipsoid zone, and external limiting membrane abnormality (P < 0.05) on spectral domain optical coherence tomography.

Conclusion:

Patients with larger foveal herniation height had greater preoperative central retinal thickness, worse preoperative and postoperative BCVA, and more intraretinal abnormalities on spectral domain optical coherence tomography. Surgical epiretinal membrane peeling in patients with foveal herniation resulted in a significant improvement in patients' BCVA and microstructural abnormalities.
Current Trends in Scleral Lens Prescription, Management, and Evaluation
Authors: Schornack Muriel M. , Nau Cherie B. , Harthan Jennifer , Shorter Ellen , Nau Amy , Fogt Jenny
Published: January 2023

Objectives:

To report current trends in scleral contact lens prescription and management, including lens designs prescribed, care products recommended, and procedures performed during routine scleral lens (SL) evaluation.

Methods:

An online survey was designed by the Scleral Lenses in Current Ophthalmic Practice Evaluation study team and administered to eye care practitioners attending a specialty contact lens meeting. The survey was available from November 8, 2019, through March 31, 2020. Participants' demographic data were collected, along with information on lens diameters, landing zone (LZ) designs, recommended care products, and components of routine SL evaluation.

Results:

In total, 715 participants responded to at least one of the survey items of interest. Most lenses prescribed (63%) were 16 mm or more in diameter. Lenses with toric LZs were the most frequently prescribed (48%), followed by spherical (40%), quadrant-specific (8%), and impression-based or image-based designs (3%). Most participants (61%) recommended hydrogen peroxide products for lens care. Nonpreserved saline in a single-use vial was most frequently recommended to fill the bowl of the lens before application. Intraocular pressure was measured during SL evaluation by 45% of participants; 38% of participants routinely measured corneal thickness.

Conclusions:

Practitioners increasingly are prescribing SLs with advanced LZ designs. Most practitioners recommend hydrogen peroxide–based disinfection systems and single-use vials of nonpreserved saline for lens care and application. Because differences in components of routine SL evaluations were reported, clinicians may benefit from reaching a consensus on essential components of SL evaluation.
Higher-Order Aberrations and Visual Performance in Myopic Children Treated With Aspheric Base Curve-Designed Orthokeratology
Authors: Chen Changxu , Ma Wei , Wang Jianglan , Yang Bi , Liu Tong , Liu Longqian
Published: January 2023

Objectives:

To investigate the impact of aspheric base curve (BC)-designed orthokeratology (ortho-k) (AOK) lenses on higher-order aberrations (HOA) at different pupil diameters and visual performance.

Methods:

This prospective clinical study included subjects randomized to wear spherical BC-designed ortho-k (SOK) or AOK lenses. The Pediatric Refractive Error Profile (PREP) questionnaire was completed before and after 3 months of lens wear. The Strehl ratio (SR) and root mean square of ocular higher-order aberrations (HOAs), spherical aberration (SA), coma, and trefoil were measured under 4-mm, 5-mm, and 6-mm pupil diameters at baseline and 3-month visits. Corneal topography, uncorrected low-contrast (LC) visual acuity (VA), and high-contrast (HC) VA were measured at baseline and at 1 day, 1 week, 1 month, and 3 month follow-ups.

Results:

Sixty-five participants completed the study. After 3 months with the ortho-k lens, there were no significant differences in ocular HOA, SA, coma, or trefoil between the SOK group and AOK group at 4-mm, 5-mm, and 6-mm pupil diameters (all P>0.05), except for a significant increase in SA in the AOK group (P=0.01). Stratified analyses showed that the AOK group exhibited greater HOA and SA at 5-mm and 6-mm pupil diameters in the lower myopia subgroup and greater SA at 6 mm in the higher myopia subgroup (all P<0.05). There were no significant differences between the groups in SR, HC VA, LC VA, or PREP scores (all P>0.05).

Conclusion:

Aspheric BC-designed ortho-k lenses produced a significantly greater SA than SOK lenses, with more significance at lower diopters, without sacrificing subjective visual performance.
Cost-Effectiveness of Screening for Open Angle Glaucoma Compared With Opportunistic Case Finding
Authors: Anton Alfonso , Serrano David , Nolivos Karen , Fatti Gianluca , Zmuc Natasa , Crespo Carlos , Monleon-Getino Toni , Sotelo Katia , Morilla Antonio , García Virginia , Comas Merce , Castells Xavier
Published: January 2023

Précis:

The manuscript evaluates cost-effectiveness of glaucoma screening with imaging devices and telemedicine based on a screening campaign performed in Spain. The screening strategy implemented in our analysis was cost-effective compared with opportunistic case finding.

Introduction:

Open angle glaucoma is an asymptomatic ocular disease that represents one of the first causes of blindness. Diagnosis is currently made by opportunistic case finding, usually by community optometrists or general ophthalmologists. The aim of this study was to assess the cost-effectiveness of a screening strategy based on optical coherence tomography and fundus photographs in glaucoma detection.

Materials and Methods:

A cost-effectiveness analysis was carried out to compare 2 alternative strategies: opportunistic finding versus screening. A Markov tree model was carried out with 10 health states according to disease progression. Quality-adjusted life years (QALYs) were used as a measure of effectiveness. We included short-term and long-term direct health costs and a discount rate of 3%. We performed a probabilistic sensitivity analysis and several 1-way sensitivity analyses.

Results:

The cohort in the screening program entailed an increase in 0.097 QALYs and additional costs of €1187 versus opportunistic finding, with an incremental cost-effectiveness ratio of about €12.214/QALY. The 1-way sensitivity analysis showed that inputs related to age and screening program (cost and detection rate) were those most strongly influencing the results of the analysis. Probabilistic sensitivity analyses showed that the model was robust to significant changes in the main variables of the analysis.

Conclusions:

The screening strategy implemented in our analysis was cost-effective compared with opportunistic finding in patients with glaucoma in this Spanish setting.
Early Lensectomy in Patients With Pseudoexfoliation: Long-Term Effectiveness and Safety Outcomes
Authors: Rodríguez-Una Ignacio , Fernández-Vega Cueto Andrés , Rodríguez-Calvo Pedro P. , García Montserrat , Fernández-Vega Cueto Luis , Cobián-Tovar Ramón , Merayo-Lloves Jesús , Alfonso José F.
Published: January 2023

Précis:

Early lensectomy in patients presenting pseudoexfoliation (PXF) in an asymmetric clinical stage resulted in effective, safe, and predictable long-term results. Good intraocular pressure (IOP) was found, thus it might be considered as a possible surgical approach in these patients.

Purpose:

The purpose of this study is to assess the long-term effectiveness, predictability, and safety of cataract surgery performed in patients with capsular PXF at an early stage of the disease.

Materials and Methods:

This retrospective, comparative study included PXF patients who underwent phacoemulsification with hydrophobic acrylic intraocular lens implantation in both eyes with a postoperative follow-up ≥5 years. Patients were classified in 2 groups: symmetric PXF (n=102) and asymmetric PXF (n=59). Preoperative and postoperative uncorrected and corrected distance visual acuity, manifest refraction, IOP, number of hypotensive drugs, visual field mean deviation, and the incidence of complications were registered.

Results:

The mean follow-up time was 8.5±2.8 years. Six months after cataract surgery, monocular uncorrected and corrected distance visual acuity were 0.3±0.4 and 0.1±0.3 logMAR, respectively, for the symmetric PXF, and 0.2±0.2 and 0.1±0.2 logMAR, respectively, for the asymmetric group. Total 95% and 96% of eyes were within ±1.00D in symmetric and asymmetric groups, respectively. At the final follow-up, IOP decreased only in the asymmetric group (P=0.004), with a reduction in the number of medications in both eyes (P<0.001). Mean deviation changed from −8.8 to −11.6 dB in the symmetric group (P<0.001), and from −5.0±6.2 to −7.9±10.6 dB (P=0.42) in the asymmetric group. Intraoperative complications were only registered in the symmetric group: 7 (3.4%; P=0.04). Ten cases (4.9%) of late intraocular lens dislocation were found, all from the symmetric group (P=0.03).

Conclusions:

Early lensectomy in patients with PXF before its symmetric presentation resulted in effective, safe, and predictable long-term results.
Evolving Landscape of Practice Patterns in the Management of Localized Low-Risk Prostate Cancer: A NCDB Study
Authors: Mao Shifeng , Samiei Arash , Yin Yue , Schorr Rebecca , Wegner Rodney E. , Fuhrer Russell , Lyne John , Sanguino Angela , Miller Ralph , Cohen Jeffrey
Published: January 2023

Introduction:

Most patients with low-risk prostate cancer (LRPC) are candidates for active surveillance (AS) or definitive local treatment, including radical prostatectomy (RP), external beam radiotherapy (EBRT), or prostate seed implant (PSI). In this study, we analyzed the treatment pattern of patients with LRPC using a large patient population provided by the National Cancer Database (NCDB).

Methods:

Patients with LRPC, as defined by the National Comprehensive Cancer Network criteria, between 2004 and 2015 from the NCDB were analyzed. Patients, with no or minimal comorbidity, were categorized according to treatment modalities, including RP, EBRT, PSI, and no local therapy (NLT). Chi-square tests were used to analyze the association among demographic variables and treatments. Multivariate logistic regression analyses were conducted to determine the likelihood of choosing NLT.

Results:

In total, 195,452 patients diagnosed with LRPC between 2004 and 2015 were identified. There was a significant change in practice patterns with increased utilization of NLT over time, from 11.3% in 2004 to 53.5% in 2015, with a turning point in 2009. RP utilization peaked at 41.6% in 2008, EBRT peaked at 24.3% in 2006, and PSI peaked at 35.3% in 2004. However, it dropped to 17.6%, 18.1%, and 10.8%, respectively, in 2015. Academic/research programs (A/RP), older age, lower income, poorer education, lack of insurance, African Americans, and other races were associated with increased NLT use. The difference between White and African American, and older and younger patients in odds ratios were less after 2010.

Conclusions:

There was a significant shift in treatment patterns between 2004 and 2015. AS, as represented by the NLT in this study, has become the dominant treatment of choice for patients with LRPC. A/RPs were leading this trend, particularly in younger patients. Socioeconomic factors played roles in choosing NLT, but the racial difference became less apparent after 2010.