bluuebunny/crossref_metadata_2025 huggingface dataset:
O-400 PERCEPTIONS AND EXPERIENCES ON RETURN-TO-WORK INTERVENTIONS FOR PEOPLE WITH BURNOUT: A QUALITATIVE EVIDENCE SYNTHESIS
Authors: Lambreghts Charlotte , Vandenbroeck Sofie , Godderis Lode
Published: July 2024

Introduction

Burnout is a work-related mental health problem and causes long-term work disability. Return-to-work interventions for burned-out employees aim to prevent long-term work disability. Research on the effectiveness of return-to-work interventions for burned-out employees shows inconclusive results due to heterogeneity of study population and intervention type (person-directed, workplace-directed). This study aims 1) to synthesize qualitative research evidence perceptions and experiences regarding return-to-work interventions and 2) to identify hypotheses about why some return-to-work interventions are more effective than others.

Methods

We conducted a systematic search of PubMed, Embase and CINAHL from January 2000 to June 2023. We searched for qualitative or mixed methods studies that included qualitative findings on the experiences and perspectives of people with burnout, care givers, employers or other stakeholders on return-to-work interventions. We identified factors influencing effectiveness of return-to-work interventions using a framework thematic synthesis approach. We assessed the methodological limitations of included studies using the Critical Appraisal Skills Programme (CASP) tool for qualitative research.

Results

We identified 481 articles after removal of all duplicates. Twelve studies met inclusion criteria and we identified 3 key themes: 1) Burned-out people think the support of health professionals and their family promotes the return-to-work process 2) Adaptations in the workplace are considered to be essential by burned-out patients and line managers 3) Communication between all stakeholders is needed to prepare return to work.

Discussion

Stakeholders from different domains need to be involved in the return-to-work process of burned-out people.

Conclusion

An effective return-to-work intervention supports communication between health professionals, the workplace and burned-out people..
P-589 A STUDY OF THE USEFULNESS OF WEARABLE PARTICLE MONITORS (WPM) AND POWERED AIR PURIFYING RESPIRATORS IN PROTECTING WORKERS FROM DUST EXPOSURE ENVIRONMENTS
Authors: Ogami Akira , Ando Hajime , Sekoguchi Shingo , Ikegam Kazunori , Yoshitake Hidetaka , Shirasaka Taiki , Baba Hiroka
Published: July 2024

Introduction

Personal protective equipment is an essential line of defense for minimizing an asbestos risk when elimination is not practicable. It has been reported that wearing such devices may deteriorate physiological indicators such as blood pressure, and some overseas guidelines state that it is required for workers to receive medical suitability tests before wearing them.

Methods and results

On the other hand, there are no such guidelines in Japan, and there has been little research on the effect of respiratory protective devices on physiological indicators. We have investigated and reported on the usefulness of respiratory protective equipment and PAPRs (Powered Air Purifying Respirators), including the effects of wearing them on workers and the exposure reduction effects of wearing them. We have also developed a wearable particle monitor (WPM) with a small PM2.5 sensor to evaluate the exposure status of workers wearing respiratory protective equipment.

Discussion and conclusion

We believe that if these two devices can be used together to monitor individual exposure to dust at the workplace and reduce exposure, they may contribute to the reduction of occupational respiratory illnesses in welding and other dusty work. In this presentation, we will make recommendations for such measures.
P-600 WORKPLACE POLICIES AND PRACTICES FOR THE PREVENTION OF PTSI WORK DISABILITY
Authors: Van Eerd Dwayne , Tompa Emile , Irvin Emma , Gross Doug , Straube Sebastian , Bremault-Phillips Suzette , Varickanickal Joann , Ragunathan Sharmigaa
Published: July 2024

Introduction

First responders (FR) such as police, paramedics, and firefighters are routinely exposed to traumatic situations and may suffer from post-traumatic stress injuries (PTSI) as a result. The scientific evidence on optimal treatment and workplace practices for PTSI is not strong. The objective of this project was to examine first responder workplace policies and practices for the prevention of PTSI work disability.

Methods

The research team worked with a stakeholder advisory committee (police, paramedics, firefighters) to conduct an interview study with FR (workers and manager roles) from Alberta, Canada. A thematic analysis was used for the qualitative interview data.

Results

We gathered data via interviews with 47 FR members from police (16), fire (16), and paramedic (15) services who shared their experience with PTSI and workplace programs. The data reveal three key themes related to workplace PTSI programs and policies: Improving Culture, Programs under development, and Trusted communication. Three additional themes emerged related to recommendations to improve policies and programs in the workplace: stream-lined processes, better resources, and continuing to reduce stigma. The themes and recommendations from participants provide some practical information about how programs can be improved.

Discussion and conclusions

The interview data yielded rich descriptions of current workplace PTSI practices. While participants noted that awareness about PTSI and the culture of first responder workplaces there was still room for improvement. Recommendations regarding improved processes and resources were considered paramount. Future research should examine FR workplace program development as well as implementation.
P-606 THE USABILITY OF A MOTIVATIONAL INTERVIEWING TRAINING TOOLKIT IN WORK REHABILITATION
Authors: Coutu Marie-France , Durand Marie-Jose , Green Rachel , Labreceque Marie-Elise , Pettigrew Sara
Published: July 2024

Introduction

A free web-based training toolkit is available to perform Motivational Interviewing (MI) intervention for work rehabilitation programs.

Objectives

To assess the usability of the toolkit by work rehabilitation professionals.

Method

A descriptive qualitative study was conducted with professionals in work rehabilitation for musculoskeletal disorders. They had varying levels of experience with MI. They consulted the Internet-based training (4 hours) and applied MI with a standardized patient. A trained expert analyzed the interviews using the Motivational Interviewing Treatment Integrity (MITI 2.0). Professionals were interviewed individually to obtain feedback on the usability of the toolkit based on this experience. Two coders had an agreement of 85%.

Results

A total of 19 professionals participated (mean age =32; mean years of experience in work rehabilitation = 5.2). Prior to training, 6 had no experience with MI, 9 had moderate experience, and 4 self-identified as experienced. Overall, professionals were satisfied with the toolkit. The lowest satisfaction was moderate (n=1). Mean scores for treatment integrity was 3/5 (basic MI proficiency).

Discussion

Professionals found the training useful, clear, and adapted to the context of work rehabilitation. Training videos were highly appreciated. The ease of site navigation and absence of a printable document was less appreciated for a minority of professionals. Experimentation with a standardized patient and expert feedback was suggested as an addition to the toolkit, in a paid supplement.

Conclusion

A training toolkit for the MI is available and is considered usable by the intended users. Testing the perceived MI acceptability of workers will be the next step.
O-401 THE POWER OF WEARABLES IN COMBINATION WITH LOCATION TRACKING IN ERGONOMICS
Authors: Ghoos Thomas , Pollentier Gerrit , Van Hauwermeiren Liesbeth , Verbrugghe Mathieu
Published: July 2024

Introduction

Back pain and upper limb muscle pain are frequently reported by workers. Reducing posture related risks is important to prevent muskuloskeletal disorders. This study aims to (1) develop an easy-to-use system measuring awkward back and shoulders postures, and (2) identify high-risk locations of the working area.

Methods

Four Inertial Measurement Units (IMUs) are used to track workers’ awkward back and shoulders postures during a workday. IMUs are attached to the back (one sensor is attached with a clip on the belt and one integrated in the t-shirt on the upper spine) and upper arms (integrated in both upper arm sleeves). For location tracking, a location tag is attached to the t-shirt. Signals from the tags are captured by multiple anchors and forwarded to the server calculating the real-time location.

Results

Raw IMU position data can be converted to the desired output (e.g. frequency of dynamic movements). The data output of the IMUs is also integrated with the location data. Using different colors, high risk locations can be identified on a heat map. By comparing a work station before and after ergonomic adaptations, the impact of these adaptations on back and shoulder posture could be established.

Discussion

By using IMUs in combination with location tracking, high-risk locations could be detected. Additionally, the effectiveness of ergonomic interventions could be monitored. This information may contribute to the design of new and existing working environments.

Conclusion

IMUs in combination with location tracking can measure awkward back and shoulders postures and identify high-risk locations, before or after ergonomic interventions.
O-404 OBJECTIVE EVALUATION OF ACTIVE INTERACTIONS BETWEEN THE OPERATOR AND DISPLAY SCREEN EQUIPMENT USING AN INNOVATIVE ACQUISITION SYSTEM
Authors: De Palma Giuseppe , Sala Emma , Mattioli Flavia , Ferrari Vittorio
Published: July 2024

Introduction

The evaluation of occupational risk of operators using display screen equipment (DSE) is usually based on activity data collected through questionnaires.

Methods

We evaluated an original and innovative system that can assess operator–DSE interactions by collecting electrical impulses generated by the activation of mouse, keyboard and a camera collecting eye-screen fixation. The main aim of this study was to evaluate the system’s performance on an employee sample involved in active reading and copying at a DSE workstation connected to the system. In the context of mandatory health surveillance at work, we enrolled 38 DSE operators with normal neuropsychological and eye assessments who were required to complete two predefined reading and writing tasks.

Results

The obtained results show that the system is able to collect activity data derived from operator–DSE interactions through screen fixation, keyboard tapping and mouse handling. In the copying task, the session duration as recorded by the system was highly related to the screen fixation time. In the copying task, mouse and keyboard activities were more strongly related to session duration than screen fixation. For the copying task, it was also possible to obtain individual profiles of operator–DSE interactions while performing the same standardized tasks.

Discussion

Collected data can allow an objective evaluation of active time spent by DSE operators at their workstations, thus allowing a more accurate occupational health risk assessment and management.

Conclusion

Prospective analysis of individual operator–DSE interaction profiles can favor the setup of targeted preventive and organizational interventions from an of even wider worker wellbeing perspective.
P-615 EXPLORING WORKLOAD AND ROTATOR CUFF TENDINOPATHY IN ELECTRICIANS: A CROSS-SECTIONAL STUDY UTILIZING QUESTIONNAIRES AND RADIOLOGICAL EXAMINATIONS
Authors: Sellami Imen , Abbes Anwar , Feki Afef , Ghrab Mohamed Anis , Tah Marieme , Masmoudi Mohamed Larbi , Hajjaji Mounira , Hammami Kaouthar Jmal
Published: July 2024

Introduction

Exploring workload and shoulder pain in electricians is crucial due to occupational hazards. Electricians often experience excessive strain on their shoulders, which can result in conditions like rotator cuff tendinopathy (RCT). Our aim was to use imaging to screen for RCT among electricians.

Methods

We conducted a cross-sectional study among electricians using a questionnaire. Socio-professional data and results from radiological examinations of painful shoulders were collected. The raw National Aeronautics and Space Administration Task Load Index (raw NASA-TLX) was employed to assess perceived workload.

Results

We enrolled 70 male electricians with a mean age of 38.1±10.2 years and an average job tenure of 14.5±11.1 years. Among them, 18.6% experienced right shoulder pain and 14.3% had pain in the left shoulder. Shoulder radiography and ultrasound revealed abnormalities in 48.6% and 67.1% of cases, respectively. Notably, 22.9% and 8.6% of electricians exhibited supraspinatus and subscapular tendinopathies. Electricians with shoulder radiography and ultrasound abnormalities were older and had longer job tenures (p<0.05). Mental and physical demands, performance, effort, frustration, and temporal demand scores were 88.7±14.4, 62.4±22.7, 85.1±13.8, 82.7±14.3, 35.9±28.7, and 59.8±28.9, respectively. Electricians with shoulder radiography abnormalities experienced higher time pressure (p=0.02).

Discussion

This study emphasizes the significance of investigating workload and shoulder pain among electricians due to occupational hazards. Shoulder strain, potentially causing RCT, necessitates screening through imaging.

Conclusion

Electricians are at risk of shoulder issues, notably tendinopathies. Radiological findings and workload indicators highlight the need for ergonomic interventions and preventive measures to ensure their long-term musculoskeletal health.
P-621 STUDY ON CERVICAL MUSCULOSKELETAL DISORDERS AMONG CHINESE DENTISTS BASED ON LOGISTIC REGRESSION AND DECISION TREE MODEL
Authors: Jin Xu , Nazakati Maimaiti , Guo Xiaolong , Peng Yu , He Lihua
Published: July 2024

Introduction

Work-related musculoskeletal disorders (WMSDs) are one of the most common occupational health problems among dentists, with a high prevalence. This study aims to analyze the factors influencing work-related musculoskeletal disorders (WMSDs) in the neck of Chinese dentists.

Methods

Using a convenient sampling method, 509 dentists from nine medical institutions in two cities in the north and the south of China were selected as the study population. Individual information, musculoskeletal health condition, work-related factors was investigated using the Chinese Musculoskeletal Disorders Questionnaire.

Results

Logistic regression analysis showed that female, age 30-40 years, job tenure ≥11 years, keeping your head down for long time and keeping your head twisted sideways for long time at work were negatively associated with having cervical WMSDs in dentist, exercising intermittently at work and use of dental loupes/microscopes were positively associated with having cervical WMSDs in dentists. The results of the decision tree model showed that not using dental loupes/microscopes at work, keeping your head twisted sideways for long time, age > 20 years, and female gender were negatively associated with having cervical WMSDs in dentists.

Discussion

WMSDs in dentists are serious, especially in the neck. Providing appropriate dental loupes/microscopes for dentists and increasing work breaks may be useful for preventing the occurrence of WMSDs.

Conclusion

Job tenure, female, age, and poor posture would increase the risk of having cervical WMSDs in dentists, and using dental loupes/microscopes at work and exercising intermittently are beneficial in reducing the risk of having cervical WMSDs in dentists.
P-623 TRAILBLAZING ERGO PRACTICE FOR DESK BASED WORK
Authors: Bhat Vidya Kiran
Published: July 2024

Introduction

Ergonomics is important to improve our efficiency and productivity anywhere we work also to prevent stress and strain on our body. The ideal ergonomic workstation set ups were in office when pandemic compelled most of the office staff to work from home. For progressive organizations, the concern to provide ideal ergonomic workstation for employees was a great challenge across the globe. Very few organizations supported employees setting agronomical workstation at home during pandemic, continues to support new joiners and existing employees working in hybrid mode.

Objective

To provide the best possible Ergonomic support to the employees in hybrid model of working.

Method

1. To facilitate the right assessment, offer and support to the employees, software based self-learning assessment tool was brought in. 2. Levels of support were reviewed and standardized. New system with 3 level support offers ‘self-resolve’, ‘remote evaluation of work set-up (at home) by expertise’ and ‘curative management by expertise’ in person. 3. While ‘assigned’ eLearning details type of design- purpose - duration, 4. Importance of frequent breaks, stretching are encouraged. 5. with expertise evaluation, required equipment support provided to needy.

Result

Increased Employee satisfaction and trust on the organization was evident in annual Pulse survey. Drastic reduction in % of previously self-assessed high risk for MSD.

Conclusion

Thoughtful proactive support in Health & Wellbeing by organization not only wins the trust but also improves the productivity and satisfaction levels of employees. This drastically reduces the medical issues, sufferings for employee also curative management cost by company directly or via insurance.
First star formation in extremely early epochs
Authors: Ito Mana , Omukai Kazuyuki
Published: July 2024

First stars play crucial roles in the development of the Universe, influencing events like cosmic reionization and the chemcal enrichment of the intergalactic medium. While first stars are conventionally thought to form at around $z \sim 20$–30 in the standard $\Lambda$ cold dark matter ($\Lambda$CDM) cosmology, observational constraints on small-scale ($\\lt $Mpc) density fluctuations remain limited, possibly differing significantly from the scale-invariant fluctuations assumed in the $\Lambda $CDM model. Should this be the case, the formation of first stars could occur much earlier than typically predicted. In this study, we investigate the formation process of first stars in the extremely early epochs of $z \gtrsim 100$ in the post-recombination Universe. At such early times, the effects of the warm cosmic microwave background (CMB) become significant. We calculate the collapse of primordial star-forming clouds using a one-zone thermo-chemical model that accounts for CMB influences on radiative heating, Compton cooling, and photodissociation reactions. We found that the impact of the CMB on the evolution is limited at $z \lesssim 100 $, with the temperature evolution closely resembling the conventional model. However, within the range $100 \lesssim z \lesssim 400$, the formation of H$_{2}$ via the H$^{-}$ channel is impeded by H$^{-}$ photo-detachment induced by the CMB, leading to higher temperatures compared to standard thermal evolution. Consequently, first stars with masses exceeding $1000\, {M}_{\odot }$ can emerge at $z \gtrsim 100$. Furthermore, at $z \gtrsim 500$, the temperature evolution becomes nearly isothermal at several thousand Kelvin solely due to atomic cooling, as H$_{2}$ formation is entirely suppressed, including the less-efficient H$_2^{+}$ channel, which is blocked by H$_2^{+}$ photodissociation. In such cases, supermassive stars with masses around $\sim 10^{5}\, {M}_{\odot }$ are expected to form solely via atomic cooling. These findings emphasize the significant variation in the typical mass of the first stars depending on the epoch of formation.
Dynamics of actinotrichia, fibrous collagen structures in zebrafish
fin tissues, unveiled by novel fluorescent probes
Authors: Kuroda Junpei , Hino Hiromu , Kondo Shigeru
Published: July 2024

Collagen fibers provide physical support to animal tissues by orienting in the correct position and at optimal density. Actinotrichia are thick collagen fibers that are present at the tips of fish fins and serve as scaffolds for bone formation. The arrangement and density of actinotrichia must be constantly maintained with a high degree of regularity to form spatial patterns in the fin bones, but the mechanisms of this process are largely unknown. To address this issue, we first identified two fluorescent probes that can stain actinotrichia clearly in vivo. Using these probes and time-lapse observation of actinotrichia synthesized at different growth stages, we revealed the following previously unknown dynamics of actinotrichia. (i) Actinotrichia do not stay stationary at the place where they are produced; instead, they move towards the dorsal area during the notochord bending and (ii) move towards the distal tip during the fin growth. (iii) Actinotrichia elongate asymmetrically as new collagen is added at the proximal side. (iv) Density is maintained by the insertion of new actinotrichia. (v) Actinotrichia are selectively degraded by osteoclasts. These findings suggest that the regular arrangement of actinotrichia is the outcome of multiple dynamic processes.
Defining women’s incomes: household disruptions and gendered resolutions
Authors: Clingan Lauren
Published: July 2024

Women increasingly work for pay, disrupting cultural expectations and relational dynamics tied to men’s breadwinning. Scholars have examined how women’s incomes impact measures of domestic gender inequality, yet there is limited research on the mechanisms underlying that relationship, including how households define and spend women’s wages. Adopting economic sociology’s relational work approach, this study shows how tandem processes, relational accounting of feminine consumption and relational obfuscation of women’s earnings, shape the meaning of women’s work—processes that extend beyond marital dyads to involve siblings, children, and parents. Drawing from interviews with sixty-four Emirati women and men, I show how households leverage contradictory feminine consumption norms to designate women’s wages as communal resources, while at the same time, they conceal women’s financial contributions and disproportionately recognize men’s breadwinning. I call these relational adaptations to the breakdown of patriarchal bargains predicated on men’s provision gendered resolutions, because they illustrate processes through which women’s wages may paradoxically uphold unequal gendered arrangements. This study offers a framework to understand shifting gender relations during periods of economic change.
Allogeneic B cell immunomodulatory therapy in amyotrophic lateral sclerosis
Authors: Sîrbulescu Ruxandra F. , Nicholson Katharine , Kawai Kento , Hilton Orla M. , Sobell Don , Jin Gina , Verrill David E. , Dwyer Liam J. , Xiong Yueyue , Bachanová Petra , Kim Spencer E. , Gallup Shannon , Gelevski Dario , Daley Heather , Hernandez Rodriguez Diego E. , Negre Hélène , Sturtevant Olive , Nikiforow Sarah , Ritz Jerome , Chen Yi‐Bin , Reeves Patrick M. , Sluder Ann E. , Berry James D. , Sadri‐Vakili Ghazaleh , Cudkowicz Merit , Poznansky Mark C.
Published: July 2024

Amyotrophic lateral sclerosis (ALS) is an orphan neurodegenerative disease. Immune system dysregulation plays an essential role in ALS onset and progression. Our preclinical studies have shown that the administration of exogenous allogeneic B cells improves outcomes in murine models of skin and brain injury through a process termed pligodraxis, in which B cells adopt an immunoregulatory and neuroprotective phenotype in an injured environment. Here, we investigated the effects of B‐cell therapy in the SOD1G93A mouse preclinical model of ALS and in a person living with ALS. Purified splenic mature naïve B cells from haploidentical donor mice were administered intravenously in SOD1G93A mice for a total of 10 weekly doses. For the clinical study in a person with advanced ALS, IgA gammopathy of unclear significance, and B lymphopenia, CD19+ B cells were positively selected from a healthy haploidentical donor and infused intravenously twice, at a 60‐day interval. Repeated intravenous B‐cell administration was safe and significantly delayed disease onset, extended survival, reduced cellular apoptosis, and decreased astrogliosis in SOD1G93A mice. Repeated B‐cell infusion in a person with ALS was safe and did not appear to generate a clinically evident inflammatory response. An improvement of 5 points on the ALSFRS‐R scale was observed after the first infusion. Levels of inflammatory markers showed persistent reduction post‐infusion. This represents a first demonstration of the efficacy of haploidentical B‐cell infusion in the SOD1G93A mouse and the safety and feasibility of using purified haploidentical B lymphocytes as a cell‐based therapeutic strategy for a person with ALS.
Comments and illustrations of the European Federation of Societies for Ultrasound in Medicine contrast-enhanced ultrasonography guidelines: multiparametric imaging and EUS-guided sampling in rare pancreatic tumors. Mesenchymal pancreatic tumors of intermediate biological behaviour
Authors: Möller Kathleen , Holz Tamara , Jenssen Christian , Braden Barbara , Hocke Michael , On Wei , Everett Simon M. , Dong Yi , Ge Nan , Sun Siyu , Gerber Michael , Faiss Siegbert , Schlag Christoph , Srivastava David , Dietrich Christoph F.
Published: July 2024

The focus of the review is on mesenchymal pancreatic tumors with intermediate biological behavior and their imaging appearance. Similar to benign and malignant mesenchymal pancreatic tumors, these tumors are extremely rare. The diagnosis is often confirmed only by postoperative histology. The very limited data on abdominal ultrasound and EUS findings including contrast-enhanced techniques of these pancreatic lesions are summarized here.
Gut microbial metabolites in MASLD: Implications of mitochondrial dysfunction in the pathogenesis and treatment
Authors: Zhang Ruhan , Yan Zhaobo , Zhong Huan , Luo Rong , Liu Weiai , Xiong Shulin , Liu Qianyan , Liu Mi
Published: July 2024

With an increasing prevalence, metabolic dysfunction–associated steatotic liver disease (MASLD) has become a major global health problem. MASLD is well-known as a multifactorial disease. Mitochondrial dysfunction and alterations in the gut bacteria are 2 vital events in MASLD. Recent studies have highlighted the cross-talk between microbiota and mitochondria, and mitochondria are recognized as pivotal targets of the gut microbiota to modulate the host's physiological state. Mitochondrial dysfunction plays a vital role in MASLD and is associated with multiple pathological changes, including hepatocyte steatosis, oxidative stress, inflammation, and fibrosis. Metabolites are crucial mediators of the gut microbiota that influence extraintestinal organs. Additionally, regulation of the composition of gut bacteria may serve as a promising therapeutic strategy for MASLD. This study reviewed the potential roles of several common metabolites in MASLD, emphasizing their impact on mitochondrial function. Finally, we discuss the current treatments for MASLD, including probiotics, prebiotics, antibiotics, and fecal microbiota transplantation. These methods concentrate on restoring the gut microbiota to promote host health.
Liver macrophages revisited: The expanding universe of versatile responses in a spatiotemporal context
Authors: Guillot Adrien , Tacke Frank
Published: July 2024

The liver is a vital organ that continuously adapts to a wide and dynamic diversity of self-antigens and xenobiotics. This involves the active contribution of immune cells, particularly by the liver-resident macrophages, the Kupffer cells (KCs), which exert a variety of central functions in liver homeostasis and disease. As such, KCs interact with their microenvironment to shape the hepatic cellular landscape, control gut-derived signal integration, and modulate metabolism. On injury, the rapid recruitment of bone marrow monocyte-derived macrophages alters this status quo and, when unrestrained, drastically compromises liver homeostasis, immune surveillance, and tissue organization. Several factors determine the functional roles of liver macrophages in these processes, such as their ontogeny, activation/polarization profile and, importantly, spatial distribution within the liver. Loss of tolerance and adaptability of the hepatic immune environment may result in persistent inflammation, hepatic fibrosis, cirrhosis, and a tumorigenic niche promoting liver cancer. In this review, we aim at providing the most recent breakthroughs in our understanding of liver macrophage biology, particularly their diversity and adaptability in the hepatic spatiotemporal context, as well as on potential therapeutic interventions that may hold the key to tackling remaining clinical challenges of varying etiologies in hepatology.
RETINAL STRUCTURAL CHANGES AFTER CESSATION OF PENTOSAN POLYSULFATE SODIUM
Authors: Kalaw Fritz Gerald P. , Most Jesse , Kako Rasha Nabil , Sharma Paripoorna , Arias Juan D. , Chen Jimmy S. , Lin Andrew C. , Walker Evan , Bartsch Dirk-Uwe G. , Baxter Sally L. , Ferreyra Henry , Freeman William R. , Borooah Shyamanga
Published: July 2024

Purpose:

To quantify baseline and longitudinal structural changes post-cessation in patients with pentosan polysulfate sodium retinopathy.

Methods:

This is a retrospective cohort study. Retinal thickness and volume of choroidal and hyperreflective retinal pigment epithelium excrescences were manually segmented from optical coherence tomography volume scans. Baseline measurements were compared against age-matched control subjects. Longitudinal measurements were performed on patients with follow-up data.

Results:

Twenty-four eyes of 13 patients were included. At baseline, the mean total retinal thickness was lower in the pentosan polysulfate sodium retinopathy cohort than in age- and sex-matched control subjects (269.1 µm vs. 290.2 µm, P = 0.006). The median (range) of follow-up was 18.6 (4.1–34.7) months, with the mean last follow-up of 35.2 months after cessation. During the follow-up period, the thickness of the retina decreased significantly by 11.3 µm (CI: 16.8, 5.8) (P < 0.001), with an annual mean decrease of 6.70 µm. However, the mean hyperreflective retinal pigment epithelium excrescence volume did not change significantly (P = 0.140) over the follow-up period.

Conclusion:

After pentosan polysulfate sodium discontinuation, although retinal pigment epithelium excrescence volume do not change significantly, there continues to be a progressive long-term thinning of the retina, which continues at a rate greater than that associated with normal aging. Consequently, long-term follow-up is suggested to monitor patients with pentosan polysulfate sodium retinopathy.
FIVE-YEAR CHANGES IN METAMORPHOPSIA AND THE ASSOCIATION OF OUTER RETINAL LAYERS AFTER VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT INVOLVING THE MACULA
Authors: Okuda Tetsuhiko , Higashide Tomomi , Sugiyama Kazuhisa
Published: July 2024

Purpose:

To evaluate the 5-year changes in metamorphopsia and outer retinal morphology after vitrectomy for macula-off rhegmatogenous retinal detachment.

Methods:

The authors included 21 eyes from 21 patients with macula-off rhegmatogenous retinal detachment who underwent pars plana vitrectomy. Metamorphopsia was quantified using M-CHARTS. Using spectral-domain optical coherence tomography, the authors assessed the risk factors for metamorphopsia severity 5 years after surgery.

Results:

Metamorphopsia scores substantially improved from 1 month to 5 years postoperatively; however, they remained unchanged from 1 year to 5 years postoperatively. Overall, 11 patients (52.4%) had metamorphopsia 5 years postoperatively. The metamorphopsia scores in eyes with a continuous interdigitation zone and ellipsoid zone at 5 years were considerably lower than those in eyes with a disrupted interdigitation zone. Multiple regression analysis revealed that the metamorphopsia score at 5 years was markedly associated with the score at 1 month and continuous interdigitation zone.

Conclusion:

No statistically significant change was observed in metamorphopsia scores after 1 year postoperatively, and >50% of the patients had metamorphopsia at 5 years postoperatively. The improvement was associated with lower metamorphopsia scores at 1 month and continuous interdigitation zone at 5 years. Moreover, the study revealed that early metamorphopsia was a poor prognostic marker for long-term functional deficits.
SUPPLEMENTAL DEXTROSE IN THE INFUSION FLUID DURING DIABETIC VITRECTOMY
Authors: Schildroth Kathleen R. , Peterson Kyle D. , Altaweel Michael M. , Channa Roomasa , Chang Jonathan S. , Gottlieb Justin L. , Ip Michael S. , Nork T. Michael
Published: July 2024

Purpose:

Historically, supplemental dextrose to infusion fluid has been used to reduce the need for intraoperative lensectomies to maintain visualization during diabetic vitrectomy. Valved, small-gauge vitrectomy has reduced surgical time and decreased intraoperative fluid flow. Assessment of supplemental dextrose in modern vitrectomy is presented in this study.

Methods:

A retrospective cohort study of diabetic patients undergoing vitrectomy was conducted. The dextrose group received supplemental dextrose in the infusion fluid, while the nondextrose group used a standard balanced salt solution (BSS Plus). Group assignment was per surgeons' typical practice patterns. Eyes with tractional retinal detachments were also evaluated as a subgroup.

Results:

Three hundred thirty phakic eyes were included. Supplemental dextrose was used in 199 eyes (60.3%). One unplanned lensectomy was performed in this series, in the nondextrose group, not statistically different from the dextrose group, with zero lensectomies (P = 0.4). Cataract survival curves overlapped for all eyes and for the tractional retinal detachment subgroup.

Conclusion:

In modern vitrectomy, unplanned lensectomy is rare. No difference was observed in the rate of intraoperative lensectomies or overall postoperative cataract course with or without dextrose supplementation to the infusion fluid. Standard solutions appear to be adequate for infusion, even for diabetics.
OPTICAL COHERENCE TOMOGRAPHY FEATURES ASSOCIATED WITH VITREOMACULAR TRACTION RELEASE AND MACULAR HOLE SIZE PROGRESSION FOLLOWING TREATMENT WITH OCRIPLASMIN
Authors: Johannigmann-Malek Navid , Iannetta Danilo , Zheng Yalin , Kaye Stephen B. , Groselli Sofia , Kirchmair Katharina , Dervenis Nikolaos , Issa Peter Charbel , Baumann Carmen
Published: July 2024

Purpose:

To evaluate OCT features for vitreomacular traction (VMT) release and change in macular hole (MH) size after treatment with ocriplasmin.

Methods:

Patients who had undergone treatment with ocriplasmin for VMT with or without MH ≤400 µm were included. The main outcomes were VMT release and changes in minimum linear diameter MH size at 4 weeks in MHs that persisted. OCT features evaluated were central retinal thickness, vitreomacular adhesion length, posterior vitreous cortex (PVC) insertion angles 500 µm from the insertion points, and minimum linear diameter size.

Results:

Sixty patients were included: 37 had isolated VMT and 23 VMT with a MH. Four weeks after ocriplasmin injection, the overall VMT release rate was 66.7% (40/60); 64.9% (24/37) in eyes with isolated VMT and 69.6% (16/23) in eyes with MH. VMT release was associated with younger age (P = 0.02). Macular hole closure was achieved in 26.1% (6/23) and was associated with a smaller ratio of the temporal to the nasal PVC angle (P < 0.01). Of the 17 persistent MHs, 76.5% (13/17) increased in minimum linear diameter size from baseline 186 (±78) to 358 (±133) µm (P < 0.001). Progression in minimum linear diameter size showed a negative linear association with the size of the nasal PVC angle (R2 = 0.39, P = 0.002) and a positive linear association with the ratio of the temporal to nasal PVC angle (R2 = 0.39, P = 0.002).

Conclusion:

In patients with VMT-associated MHs, the risk of MH enlargement following ocriplasmin is negatively correlated with the nasal PVC angle size and is increased if the ratio of the temporal to nasal angle is >1.
Mpox Keratitis: A Case Report and Review
Authors: Croasdale Christopher R. , Weinlander Eric , Boyce Thomas G.
Published: July 2024

Purpose:

Mpox is a rare infectious disease. Lack of knowledge among eye care professionals regarding mpox keratitis greatly reduces the likelihood of diagnosis and effective management. This report and review seek to increase the knowledge of mpox keratitis among eye care professionals.

Methods:

We report a patient with mpox keratitis who underwent successful penetrating keratoplasty, with 20 years of follow-up. A systematic literature search and review of cases of mpox keratitis from 1970 to 2024 was performed.

Results:

A total of 24 articles and 2 abstracts reporting 35 cases of mpox keratitis were identified. A frequency of 0.5% to 1.0% may be the lower range of mpox keratitis among symptomatic patients with a confirmed mpox diagnosis. Mpox keratitis occurred with and without systemic mpox. Initial misdiagnoses were common (40%). Polymerase chain reaction results aided clinical diagnosis. Corneal disease ranged from mild epitheliopathy to fulminant ulcerative keratitis. Outcomes ranged from 20/20 acuity to no light perception. In the absence of fulminant systemic disease, tecovirimat was associated with clinical improvement of mpox keratitis in almost all cases. Our case is the only known report of successful penetrating keratoplasty for mpox keratitis and the only case whereby monkeypox virus was cultured from the corneal surface.

Conclusions:

Mpox keratitis is rare but can result in severe vision loss and blindness. Systemic tecovirimat seems to be effective in treating mpox keratitis, although the low frequency of keratitis precludes clinical trials. Topical steroids may extend virus survival in the cornea. Polymerase chain reaction may help confirm mpox corneal involvement.
Modified Reverse Hatchet Flap for Ablepharon-Macrostomia Syndrome
Authors: Vaishnav Yash J. , Mawn Louise A.
Published: July 2024

Ablepharon-macrostomia syndrome is a rare disorder characterized by TWIST2 mutations and anterior lamellar dysgenesis. Timely intervention is critical to prevent exposure keratopathy, corneal ulceration, and permanent vision loss. We report a novel approach to multiplanar eyelid reconstruction in ablepharon-macrostomia syndrome involving use of a modified reverse hatchet flap in 1 lower eyelid along with division at the eyelid margin, recession of the eyelid retractors in conjunction with preputial skin grafting for anterior lamellar restoration in the other 3 eyelids.
A systematic literature review on patient-reported outcome domains and measures in nonsurgical efficacy trials related to chronic pain associated with endometriosis: an urgent call to action
Authors: Rosenberger Daniela Constanze , Mennicken Emilia , Schmieg Iris , Medkour Terkia , Pechard Marie , Sachau Juliane , Fuchtmann Fabian , Birch Judy , Schnabel Kathrin , Vincent Katy , Baron Ralf , Bouhassira Didier , Pogatzki-Zahn Esther Miriam
Published: July 2024

Endometriosis, a common cause for chronic pelvic pain, significantly affects quality of life, fertility, and overall productivity of those affected. Therapeutic options remain limited, and collating evidence on treatment efficacy is complicated. One reason could be the heterogeneity of assessed outcomes in nonsurgical clinical trials, impeding meaningful result comparisons. This systematic literature review examines outcome domains and patient-reported outcome measures (PROMs) used in clinical trials. Through comprehensive search of Embase, MEDLINE, and CENTRAL up until July 2022, we screened 1286 records, of which 191 were included in our analyses. Methodological quality (GRADE criteria), information about publication, patient population, and intervention were assessed, and domains as well as PROMs were extracted and analyzed. In accordance with IMMPACT domain framework, the domain pain was assessed in almost all studies (98.4%), followed by adverse events (73.8%). By contrast, assessment of physical functioning (29.8%), improvement and satisfaction (14.1%), and emotional functioning (6.8%) occurred less frequently. Studies of a better methodological quality tended to use more different domains. Nevertheless, combinations of more than 2 domains were rare, failing to comprehensively capture the bio–psycho–social aspects of endometriosis-associated pain. The PROMs used showed an even broader heterogeneity across all studies. Our findings underscore the large heterogeneity of assessed domains and PROMs in clinical pain-related endometriosis trials. This highlights the urgent need for a standardized approach to both, assessed domains and high-quality PROMs ideally realized through development and implementation of a core outcome set, encompassing the most pivotal domains and PROMs for both, stakeholders and patients.
Stem cell therapy for COVID-19 treatment: an umbrella review
Authors: Tang Chaozhi , Dziedzic Arkadiusz , Khatib Mahalaqua Nazli , Alhumaid Saad , Thangavelu Lakshmi , Parameswari RP , Satapathy Prakasini , Zahiruddin Quazi Syed , Rustagi Sarvesh , Alanazi Maha Afri , Al-Thaqafy Majid S. , Hazazi Ali , Alotaibi Jawaher , Al Faraj Nehad J. , Al-Zaki Nisreen A. , Al Marshood Mona J. , Al Saffar Thuria Y. , Alsultan Khadija A. , Al-Ahmed Shamsah H. , Rabaan Ali A.
Published: July 2024

Background:

COVID-19 has presented significant obstacles to healthcare. Stem cell therapy, particularly mesenchymal stem cells, has emerged as a potential treatment modality due to its immunomodulatory and regenerative properties. This umbrella review aims to synthesize current evidence from systematic reviews on the safety and efficacy of stem cell therapy in COVID-19 treatment.

Methods:

A thorough literature search was performed across Embase, PubMed, Cochrane, and Web of Science from December 2019 to February 2024. Systematic reviews focusing on the use of stem cell therapy for COVID-19 were included. Evidence was synthesized by meta-analysis using R software (V 4.3) for each outcome. The certainty of evidence was assessed using the GRADE approach.

Results:

A total of 24 systematic reviews were included. Stem cell therapy was associated with reduced mortality [risk ratio (RR) 0.72, 95% CI: 0.60–0.86]; shorter hospital stays (mean difference −4.00 days, 95% CI: −4.68 to −3.32), and decreased need for invasive ventilation (RR 0.521, 95% CI: 0.320–0.847). Symptom remission rates improved (RR 1.151, 95% CI: 0.998–1.330), and a reduction in C-reactive protein levels was noted (standardized mean difference −1.198, 95% CI: −2.591 to 0.195), albeit with high heterogeneity. For adverse events, no significant differences were found between stem cell therapy and standard care (RR 0.87, 95% CI: 0.607–1.265). The certainty of evidence ranged from low to moderate.

Conclusion:

Stem cell therapy demonstrates a potential benefit in treating COVID-19, particularly in reducing mortality and hospital stay duration. Despite these promising findings, the evidence is varied, and future large-scale randomized trials are essential to confirm the efficacy and optimize the therapeutic protocols for stem cell therapy in the management of the disease. The safety profile is encouraging, with no significant increase in adverse events, suggesting a viable avenue for treatment expansion.
Ex-situ machine perfusion in clinical liver transplantation: Current practices and future directions
Authors: Nguyen Michelle C. , Li Xingjie , Linares Natalia , Jadlowiec Caroline , Moss Adyr , Reddy Kunam S. , Mathur Amit K.
Published: July 2024

Ex-situ machine perfusion of the liver has surmounted traditional limitations associated with static cold storage in the context of organ preservation. This innovative technology has changed the landscape of liver transplantation by mitigating ischemia perfusion injury, offering a platform for continuous assessment of organ quality, and providing an avenue for optimizing the use of traditionally marginal allografts. This review summarizes the contemporary clinical applications of machine perfusion devices and discusses potential future strategies for real-time viability assessment, therapeutic interventions, and modulation of organ function after recovery.
Comparative efficacy and safety of olanzapine and risperidone in the treatment of psychiatric and behavioral symptoms of Alzheimer’s disease: Systematic review and meta-analysis
Authors: Zhang Zhihua , Zhang Xijuan , Xu Lingyan
Published: July 2024

Objectives:

Olanzapine and risperidone have emerged as the most widely used drugs as short-term prescription in the treatment of behavioral disturbances in dementia. The present systematic review and meta-analysis was hence performed to investigate the effectiveness and safety profile of olanzapine and risperidone in the treatment of behavioral and psychological symptoms of dementia (BPSD), aiming to provide updated suggestion for clinical physicians and caregivers.

Design:

Prospective controlled clinical studies were included, of which available data was extracted. Outcomes of BEHAVE-AD scores with the variation of grades, specific behaviors variables, as well as safety signals were pooled for the analysis by odds rates and weighted mean differences, respectively.

Data sources:

Medline, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WanFang.

Eligibility criteria:

Prospective, controlled clinical studies, conducted to compare the effectiveness and safety profile of olanzapine and risperidone in the treatment of BPSD.

Data extraction and synthesis:

Interested data including baseline characteristics and necessary outcomes from the included studies were extracted independently by 2 investigators. BEHAVE-AD scale was adopted to assess the efficacy in the present study. All behaviors were evaluated at the time of the initiation of the treatment, as well as the completion of drugs courses. Adverse events were assessed with the criteria of Treatment Emergent Symptom Scale, or Coding Symbols for a Thesaurus of Adverse Reaction Terms dictionary. Weighted mean difference was used for the pooled analysis.

Results:

A total of 2427 participants were included in the present meta-analysis. Comparative OR on response rate, and remarkable response rate between olanzapine and risperidone was 0.65 (95% CI: 0.51–0.84; P = .0008), and 0.62 (95% CI: 0.50–0.78; P < .0001), respectively. There were statistical differences observed by olanzapine on the improvement of variables including delusions (WMD, −1.83, 95% CI, −3.20, −0.47), and nighttime behavior disturbances (WMD, −1.99, 95% CI, −3.60, −0.38) when compared to risperidone.

Conclusion:

Our results suggested that olanzapine might be statistically superior to risperidone on the reduction of BPSD of Alzheimer’s disease, especially in the relief of delusions and nighttime behavior disturbances. In addition, olanzapine was shown statistically lower risks of agitation, sleep disturbance, and extrapyramidal signs.