bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel Derivatives of Phenylisoxazole‐3/5‐Carbaldehyde Semicarbazone: Synthesis, Characterization, and Computational Studies
Authors: Carrasco Fernando , Hernández Wilfredo , Chupayo Oscar , Pumachagua Rodolfo , Spodine Evgenia , Mosquera Jackeline , Castro Olivio N. , Rodilla Jesus M. , Álvarez Celedonio M. , Dávalos Juan Z.
Published: August 2024

Six novel phenylisoxazole semicarbazone derivatives 1–6 were synthesized by reaction of the corresponding phenylisoxazole‐3/5‐carbaldehyde derivatives with semicarbazide hydrochloride. The synthesized compounds were characterized by ESI‐MS, FT‐IR, and NMR (1H, 13C) spectroscopic techniques. The two‐dimensional 1H‐1H NOESY NMR (in acetone‐d6) data revealed that compound 1 exists in the E isomeric form. The computational study of the energetic, structural, and electronic properties, carried out at B3LYP/6‐311G++(d,p) level of theory, showed that the most stable conformer for the all synthesized compounds, in both gas and liquid (acetone and DMSO) phases, has a cisE geometrical configuration. This evidence found is in good agreement with the spectrometric results. The geometrical parameters, frontier molecular orbital (FMO), molecular electrostatic potential (MEP), Mulliken atomic charges, and natural bonding orbital (NBO) analysis were also performed at the same level of theory. Taking into account the relative enthalpies ΔH computed, we can establish for tautomeric structures of each of the compounds, the following stability order: I (cisE) > II (E′E) > III (cisE). The MEP descriptors indicate that the oxygen atom of the carbonyl group C=O is susceptible to electrophilic attack, while the hydrogen atoms of the amide and hydrazone fragments are sensitive to nucleophilic attack. The calculated HOMO‐LUMO gap energies Eg indicate that 5 (in gas phase) and 6 (in liquid phase) are the most stable and less reactive compounds, while 1 is the less stable and the most reactive compound. From the NBO analysis, it becomes evident that the presence of the hydrazone fragment produces stabilizing effects due to hyperconjugative interactions.
M2BPGi Correlated with Immunological Biomarkers and Further Stratified Recurrence Risk in Patients with Hepatocellular Carcinoma
Authors: Lee I-Cheng , Lei Hao-Jan , Wang Lei-Chi , Yeh Yi-Chen , Chau Gar-Yang , Hsia Cheng-Yuan , Chou Shu-Cheng , Luo Jiing-Chyuan , Hou Ming-Chih , Huang Yi-Hsiang
Published: August 2024

Introduction: Novel biomarkers reflecting liver fibrosis and the immune microenvironment may correlate with the risk of hepatocellular carcinoma (HCC) recurrence. This study aimed to evaluate the prognostic value of serum biomarkers in predicting HCC recurrence. Methods: Serum biomarkers, including M2BPGi, IL-6, IL-10, CCL5, VEGF-A, soluble PD-1, PD-L1, TIM-3, and LAG-3, were measured in 247 patients with HCC undergoing surgical resection. Factors associated with recurrence-free survival (RFS) and overall survival (OS) were evaluated. The ERASL-post model and IMbrave050 criteria were used to define HCC recurrence risk groups. Results: Serum M2BPGi levels significantly correlated with FIB-4 score, aspartate transaminase-to-platelet ratio index, ALBI score, alpha-fetoprotein (AFP), alanine transaminase, aspartate transaminase, IL-10, CCL5, VEGF-A, soluble PD-1, PD-L1, TIM-3, and LAG-3 levels. M2BPGi, VEGF-A, soluble PD-1, and TIM-3 levels significantly correlated with RFS. In multivariate analysis, M2BPGi >1.5 COI (hazard ratio [HR] = 2.100, p < 0.001), tumor size >5 cm (HR = 1.859, p = 0.002), multiple tumors (HR = 2.562, p < 0.001), AFP >20 ng/mL (HR = 2.141, p < 0.001), and microvascular invasion (HR = 1.954, p = 0.004) were independent predictors of RFS. M2BPGi levels significantly stratified the recurrence risk in ERASL-post and IMbrave050 risk groups. An M2BPGi-based model could significantly discriminate RFS in the overall cohort as well as in the IMbrave050 low- and high-risk groups. M2BPGi >1.5 COI was also an independent predictor of OS after resection (HR = 2.707, p < 0.001). Conclusion: Serum M2BPGi levels significantly correlated with surrogate markers of liver fibrosis, liver function, and immunology. M2BPGi is a significant predictor of HCC recurrence and survival after resection and could be incorporated into recurrence-prediction models.
Assessment of Cardiovascular Events Caused by New-Generation Androgen Receptor Pathway Inhibitors Used for Prostate Cancer: A Real-World Study in Japan
Authors: Masuda Rikuto , Noguchi Yoshihiro , Aizawa Haruka , Yoshizawa Shunsuke , Nomura Yuki , Saguchi Mitsuru , Iguchi Kazuhiro , Yoshimura Tomoaki
Published: August 2024

Introduction: Androgen receptor pathway inhibitors (ARPIs) that significantly improve the prognosis of patients with prostate cancer include abiraterone acetate (androgen synthesis inhibitor) and enzalutamide (androgen receptor inhibitor). A recent analysis of ARPI and cardiovascular events using the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) has been reported; however, the evidence on cardiovascular events for abiraterone acetate and enzalutamide in real-world clinical practice is insufficient. Using a large Japanese database of medical institutions, the Japanese Medical Data Center (JMDC) medical institution database (JMDC Inc., Tokyo, Japan), this study tested the hypothesis that the risk of cardiovascular events with enzalutamide is lower than that with abiraterone acetate. Method: Using the JMDC medical institution database, patients with new use of abiraterone acetate or enzalutamide who had not experienced a major cardiovascular event between October 2014 and February 2022 were included. After adjusting for age, comorbidities, and concomitant medications using propensity score matching, cumulative incidence rates were compared for cardiovascular death and all cardiovascular events as the primary endpoints, and major cardiovascular events, myocardial infarction, heart failure, and stroke as secondary endpoints. Result: A total of 3,033 patients in the enzalutamide group and 2,021 in the abiraterone group met the eligibility criteria. After propensity score matching, the cohort included 1,940 patients in the enzalutamide group and 1,940 patients in the abiraterone group. Enzalutamide was associated with significantly lower cumulative rates of cardiovascular death (hazard ratio [HR]: 0.30, 95% confidence interval [CI]: 0.10–0.93), all cardiovascular events (HR: 0.79, 95% CI: 0.64–0.98), major cardiovascular events (HR: 0.79, 95% CI: 0.64–0.97), and myocardial infarction (HR: 0.62, 95% CI: 0.46–0.84) compared to abiraterone. Conclusion: In a national sample of males with prostate cancer, those newly treated with enzalutamide had a lower risk of adverse cardiovascular events than those treated with abiraterone acetate.
Isolated Respiratory Failure as the Presenting Symptom of Muscle-Specific Kinase Myasthenia Gravis: A Case Report and Literature Review
Authors: Doumiati Hassan , Ezzeddine Ali
Published: August 2024

Introduction: Anti-MuSK antibodies obstruct MuSK binding sites, leading to acetylcholine receptor (AChR) displacement within the postsynaptic membrane. MuSK MG patients often exhibit bulbar involvement and respiratory crises, setting them apart from other MG subtypes. Case Presentation: A case of a 51-year-old male with MuSK MG that presented as isolated respiratory failure was compared to similar cases in the literature. The objectives were to explore the varied clinical presentations, treatment approaches, and outcomes, and to better understand the management of this subgroup of MG. The patient responded well to treatment with pyridostigmine, steroids, and intravenous immunoglobulins and immunosuppressive therapy. Conclusion: A review of the literature revealed varied clinical presentations and treatment approaches among reported cases. Long-term prognosis appears favorable, requiring ongoing immunosuppressive management. Although the reported outcomes of MuSK MG patients with respiratory insufficiency show substantial heterogeneity, long-term prognosis appears favorable.
Invasive freshwater gastropods in South America: Physa acuta and its expansion to Austral Patagonia in Argentina
Authors: Gutiérrez Gregoric Diego Eduardo , Lucía Micaela de , Torres Santiago Hernán , Copa Jorge Luis Esteban , Darrigran Gustavo
Published: August 2024

Physa acuta is a freshwater snail of North American origin that has spread to all continents. In South America it was detected for the first time in 1966 (Brazil) and is currently present in Argentina, Brazil, Peru, Chile, Colombia, Ecuador and Uruguay, occupying 13 of the 52 South American freshwater eco-regions. Its introduction would be related to the import and transportation of aquatic plants. Here we update the distribution of P. acuta in Argentina based on a review of scientific collections, published works and new collections. Our review expands the distribution of the species from 11/23 Argentine provinces (until 2010) to 19/23, and we report the first record for the province of Santa Cruz, this being the southernmost site of the species. This new discovery in the province of Santa Cruz (Austral Patagonia), with an established and reproducing population in an urban area, poses a potential threat to local biodiversity (where there are no records of other non-native mollusks) and to human and animal health. This is due to the finding of populations in southern Argentina that are naturally infested by Fasciola hepatica. The record of P. acuta in aquatic environments of southern Patagonia makes it necessary to generate monitoring and control plans with the objective of identifying the dispersion vectors and preventing the spread of the species in other water bodies in the region.
Effect of Ticagrelor Versus Clopidogrel After Off‐Pump Coronary Artery Bypass Grafting on Postoperative Atrial Fibrillation: A Cohort Study
Authors: Jiang Qin , Huang Keli , Yin Lixue , Kong Hong , Yang Zhenglin , Hu Shengshou
Published: August 2024

Background

This study aimed to explore the effect of a P2Y
12
inhibitor regimen on the occurrence of postoperative atrial fibrillation (POAF) after off‐pump coronary artery bypass graft surgery in carriers with the cytochrome P450 family 2 subfamily C member19 loss‐of‐function allele.

Methods and Results

From May 2019 to November 2023, patients containing the cytochrome P450 family 2 subfamily C member19*2 or *3 allele undergoing elective first‐time off‐pump coronary artery bypass graft surgery including aspirin 100 mg/d and ticagrelor 180 mg/d (AT group; n=95) versus clopidogrel 75 mg/d (aspirin and clopidogrel group; n=95) were prospectively followed. The primary end point was the cumulative incidence of POAF in a week. The secondary end points were POAF burden, platelet aggregability, systemic immune‐inflammation index and heart rate variability. The incidence of POAF was 21.1% in the AT group versus 41.1% in the aspirin and clopidogrel group (hazard ratio, 0.46 [95% CI, 0.27–0.76];
P
=0.003). POAF burden, ADP‐induced platelet aggregation and systemic immune‐inflammation index was notably lower in the AT group than the aspirin and clopidogrel group. Heart rate variability data showed an increase in both high‐frequency and SD of normal‐to‐normal RR intervals in the AT group with a decreased low‐frequency/high‐frequency ratio, suggesting that the sympathetic/parasympathetic activation was balanced.

Conclusions

In patients carrying the cytochrome P450 family 2 subfamily C member19 loss‐of‐function allele, an AT regimen after off‐pump coronary artery bypass grafting was associated with a lower incidence of POAF, paralleled by lower atrial fibrillation burden, ADP‐induced platelet aggregation, lower systemic immune‐inflammation index reaction, and a balanced automatic nerve system compared with an aspirin and clopidogrel regimen. Inhibiting the systemic immune‐inflammation response and sustaining automatic nerve balance may underlie the therapeutic effect of POAF by a potent antiplatelet combination.
Stability of adrenocorticotropic hormone in whole blood samples
Authors: Fettig Julie , Melin Anaïs , Brunel Valéry , Gillibert André , Girot Hélène , Fraissinet François
Published: August 2024

IntroductionAdrenocorticotropic hormone (ACTH) is a peptide secreted by pituitary gland that plays an important role in regulating cortisol secretion. Its determination is difficult because of instability in whole blood. Several factors that influence ACTH stability in blood before analysis have been identified: temperature, hemolysis, time to centrifugation and presence of protease inhibitors. Published results on ACTH whole blood stability seem contradictory.
Materials and methodsWe performed a stability study in 10 healthy volunteers. Three different conditions were tested: ethylenediaminetetraacetic acid (EDTA) at 4 °C, EDTA + aprotinin at 4 °C, EDTA + aprotinin at room temperature. Stability was evaluated for 8 hours. Adrenocorticotropic hormone measurements and hemolysis index were performed respectively on Cobas e602 and c701 (Roche Diagnostics, Mannheim, Germany). We compared percentage deviations with total change limit using a threshold of 7.5%.
ResultsWe showed that ACTH is stable 8 hours with EDTA at 4 °C, 4 hours with EDTA + aprotinin at 4 °C and 2 hours with EDTA + aprotinin at 22 °C.
ConclusionsAprotinin does not appear to give ACTH greater stability but can be used without exceeding 4 hours at 4 °C. Refrigerated pouch transport also seems to be more appropriate for ACTH in whole blood.
Inference on the Macroscopic Dynamics of Spiking Neurons
Authors: Baldy Nina , Breyton Martin , Woodman Marmaduke M. , Jirsa Viktor K. , Hashemi Meysam
Published: August 2024

The process of inference on networks of spiking neurons is essential to decipher the underlying mechanisms of brain computation and function. In this study, we conduct inference on parameters and dynamics of a mean-field approximation, simplifying the interactions of neurons. Estimating parameters of this class of generative model allows one to predict the system’s dynamics and responses under changing inputs and, indeed, changing parameters. We first assume a set of known state-space equations and address the problem of inferring the lumped parameters from observed time series. Crucially, we consider this problem in the setting of bistability, random fluctuations in system dynamics, and partial observations, in which some states are hidden. To identify the most efficient estimation or inversion scheme in this particular system identification, we benchmark against state-of-the-art optimization and Bayesian estimation algorithms, highlighting their strengths and weaknesses. Additionally, we explore how well the statistical relationships between parameters are maintained across different scales. We found that deep neural density estimators outperform other algorithms in the inversion scheme, despite potentially resulting in overestimated uncertainty and correlation between parameters. Nevertheless, this issue can be improved by incorporating time-delay embedding. We then eschew the mean-field approximation and employ deep neural ODEs on spiking neurons, illustrating prediction of system dynamics and vector fields from microscopic states. Overall, this study affords an opportunity to predict brain dynamics and responses to various perturbations or pharmacological interventions using deep neural networks.
Addition to “An updated phylogeny, biogeography, and PhyloCode-based classification of Cornaceae based on three sets of genomic data”
Authors: Du Zhi-Yuan , Xiang Qiu-Yun , Soltis Pamela S. , Soltis Douglas E.
Published: August 2024

Du et al. (2023) produced a phylogeny of Cornus L. using three sets of genomic data, proposed a classification within the clade, and phylogenetically defined 13 clade names following the International Code of Phylogenetic Nomenclature (PhyloCode). However, the clade names were not fully established because no registration numbers were cited in the protologues, as required by the PhyloCode. That omission is remedied here, and expanded protologues are provided for the 13 names defined by Du et al. (2023). Ten of the 13 names are the same as those proposed by Du et al., (2023), while three names proposed by Du et al. (2023) are changed here (viz., Involucry to Involucratae, Bractishowy to Bractipetaloides, and Eurasiancherry to Eurasiamacrocarpium).
Political and cultural changes as an effect of the pestilences and pandemics through the centuries: Case studies
Authors: Cardini Franco
Published: August 2024

In considering pandemics from an historical point of view, we should first have in mind the differences in perception and language which have evolved over the centuries: the numerous sources we are dealing with may refer to the same phenomenon in different ways. Notwithstanding the fact that pestilences belong to human history from the very beginning (the Bible, the Iliad and Thucydides’ The History of the Peloponnesian War are some appropriate witnesses), only between the 1800s and the 1900s did the scientific notions start classifying viruses and related diseases, allowing intervention through scientific medicine to repair all or some of the damage caused by pandemics. The Black Death is in everyone's memory, but other pandemics have killed before and after it. This article goes through the events, giving evidence of the contacts and distances between different pandemics, aware that the effects of those diseases on culture and society are controversial and that the debate is still open.
Book review: M.K. Raghavendra, The Writing of the Nation by Its Elite: The Politics of Anglophone Indian Literature in the Global Age
Authors: Sanyal Devapriya
Published: August 2024

M.K. Raghavendra, The Writing of the Nation by Its Elite: The Politics of Anglophone Indian Literature in the Global Age (London and New York: Routledge, 2022), vii + 221 pp.
Challenging and Enhancing Legitimacy Through Humor: A Comparative Study of Candidates’ Use of Humor on Facebook before the 2019 and 2023 Finnish Parliamentary Elections
Authors: Koivukoski Joonas , Laaksonen Salla-Maaria , Zareff Janne , Knuutila Aleksi
Published: August 2024

A prevalent aspect of contemporary digital campaigning is the use of humor to attract attention, elicit amusement, and mark group boundaries. This study investigates the humor in digital campaigns during two recent Finnish parliamentary elections, focusing on how different styles of humor are used to (de)legitimize political ideas and actors. Our original dataset consists of 125,604 posts by 1262 candidates on Facebook six months before the 2019 and 2023 election days. Using Facebook’s haha reactions and manual coding to annotate humor style, we focused on 729 posts with seemingly intentional humor by candidates. We show how different parties and individual candidates used humor to varying degrees and in different styles. Overall, the proportion of humorous posts was not high, but the populist radical right Finns Party candidates used humor by far the most, and their style was primarily aggressive, aimed at delegitimizing the incumbent government, political opponents, and their reference groups. Candidates from other major parties also used some humor, but overall the tone was more positive. Some of these candidates were profiled as “humor specialists” who produced similar combinations of ridicule and anti-elitism as the Finns Party candidates or, alternatively, focused on disseminating self-deprecating and affiliative humor. Affiliative and self-deprecating humor was used to foster closeness, ordinariness, and spontaneity, thus legitimizing oneself as a relatable candidate. The paper discusses how candidates use humor strategically to stand out in a competition for attention between candidates, and elaborates on the implications of using different humor styles in strategic political communication.
Revisiting the impact of strategic board involvement on organizational performance
Authors: Massicotte Steeve , Henri Jean-François
Published: August 2024

An important stream of research has suggested that there is a significant relationship between the board of directors, through its strategic role, and organizational performance. However, this presumed relationship appears to be more complex, given the conceptual distance between the cause and the effect. This distance is discernible in the omission of intermediate variables explaining the operation of this relationship, that is, (i) a variable reflecting an intermediate-level output, here board effectiveness and (ii) a variable reflecting the mechanisms that enable production of the output, particularly the board’s strategic use of management accounting information (MAI) deriving from the budget or financial and non-financial performance indicators. This study aims to revisit the link conceptually and empirically between strategic board involvement and organizational performance by simultaneously integrating strategic use of MAI and board effectiveness in an integrative model. Using survey data taken from a sample of 185 board of directors, the results suggest that the strategic use of MAI plays a crucial role, particularly in terms of performance indicators, to cement strategic board involvement and improve board effectiveness and organizational performance.
Intervening After Trauma: Child–Parent Psychotherapy Treatment Is Associated With Lower Pediatric Epigenetic Age Acceleration
Authors: Sullivan Alexandra D. W. , Merrill Sarah M. , Konwar Chaini , Coccia Michael , Rivera Luisa , MacIsaac Julia L. , Lieberman Alicia F. , Kobor Michael S. , Bush Nicole R.
Published: August 2024

Early-life adversity increases the risk of health problems. Interventions supporting protective and responsive caregiving offer a promising approach to attenuating adversity-induced changes in stress-sensitive biomarkers. This study tested whether participation in an evidence-based dyadic psychosocial intervention, child–parent psychotherapy (CPP), was related to lower epigenetic age acceleration, a trauma-sensitive biomarker of accelerated biological aging that is associated with later health impairment, in a sample of children with trauma histories. Within this quasi-experimental, repeated-measures study, we examined epigenetic age acceleration at baseline and postintervention in a low-income sample of children receiving CPP treatment ( n = 45; age range = 2–6 years; 76% Latino) compared with a weighted, propensity-matched community-comparison sample ( n = 110; age range = 3–6 years; 40% Latino). Baseline epigenetic age acceleration was equivalent across groups. However, posttreatment, epigenetic age acceleration in the treatment group was lower than in the matched community sample. Findings highlight the potential for a dyadic psychosocial intervention to ameliorate accelerated biological aging in trauma-exposed children.
International Students’ Social Media Use: An Integrative Review of Research Over a Decade
Authors: Zhou Siyu , Yin Jiarui
Published: August 2024

As advancements in technology rapidly progress and the enrollment of international students continues to increase concurrently, understanding the impact of social media on their experiences has become an area of significant academic interest in the recent decade. This integrative review employs a hybrid review approach, integrating bibliometric analysis with structured review, to provide a comprehensive overview and systematic synthesis of the literature on social media use among international students. One hundred twenty-one studies retrieved from the Web of Science database were analyzed to delineate the evolution of the field and identify the influential journals. The paper further proposes an integrative framework that thematically summarizes the phenomenon, aiming to highlight the potent components in students’ transitions. This review offers insights into the evolving landscape of social media use among international students, identifying potential directions for future study and policymaking.
Equity as a Leadership Competency: A Model for Action
Authors: MacKinnon Kenneth H.
Published: August 2024

In Ontario, Canada, principals’ work is guided by competencies outlined in the Ontario Leadership Framework which reflect the leadership skills and behaviours needed to successfully lead schools, improve student achievement and well-being. The problem is that this document largely ignores equity and anti-oppressive leadership behaviours. The Toronto District School Board (TDSB), created an addendum to this document, introducing the notion of equity as a leadership competency. Other documents of this nature have emerged in multiple systems in Ontario in response to the increasing need to provide guidance to principals about how to engage equity work. The challenge is the gap between the competencies on the page and the actions taken in schools. There is little guidance around how to make these competencies actionable. This paper engages a discourse analysis of the TDSB’s equity as a leadership competency document resulting in the creation of a model for equitable action. A focus on action-oriented language used in each competency revealed three overarching themes: development of self, building, connecting, and creating, and accountability. The model is intended to be used as a decision-making tool to help leaders ask the right questions and guide their thinking towards equitable action and the disruption of the status quo. Critical Race Theory and notions of critical hope inform this work to ensure that the model is well positioned to guide leaders towards actionable and transformative change.
Bicycle disc brake noise analysis and mitigation
Authors: Singh Ajaypal , Vreman Hans , Dressel Andrew E , Moore Jason K
Published: August 2024

This project was designed to understand the causes and mechanisms of bicycle disc brake noise and use that information to formulate and evaluate possible mitigation techniques. Brake noise was generated by a real bicycle running on a treadmill and recorded by microphone and laser vibrometer. Six independent variables, brake force, rotor thickness, front fork stiffness, weather conditions, spoke tension, and friction coefficient, were varied according to a one-quarter fractional factorial design. A finite element model of the rotor, pads, and calliper was also formulated and analysed. The results of these two methods, particularly the disc mode shapes and frequencies, suggest that doublet mode splitting and reconverging plays a role in noise generation and that changing the rotor mass or breaking its symmetry could interfere with such noise generation. Finally, of these mitigations, breaking disc symmetry proved the most fruitful, with noise magnitude reductions from 72% to 99%, depending on frequency.
A Moore-Gibson-Thompson heat conduction problem with second gradient
Authors: Bazarra Noelia , Fernández José R , Quintanilla Ramón
Published: August 2024

In this work, we study, from both analytical and numerical points of view, a heat conduction model which is based on the Moore-Gibson-Thompson equation. The second gradient effects are also included. First, the existence of a unique solution is proved by using the theory of linear semigroups, and the exponential energy decay is also shown when the constitutive tensors are homogeneous. The analyticity of the semigroup is also discussed in the isotropic case, and its spatial behavior is studied. The spatial exponential decay is also proved. Then, we provide the numerical analysis of a fully discrete approximation obtained by using the finite element method and an implicit Euler scheme. A discrete stability property is shown, and some a priori error estimates are derived, from which the linear convergence is concluded under suitable regularity conditions. Finally, some one-dimensional numerical simulations are presented to demonstrate the accuracy of the approximations and the behavior of the discrete energy.
Utilization of apple vision pro in ophthalmic surgery: A pilot study
Authors: Orione M. , Rubegni G. , Tartaro R. , Alberghina A. , Fallico M. , Orione C. , Russo A. , Tosi G. M. , Avitabile T.
Published: August 2024

Purpose

This paper explores the application of Apple Vision Pro in ophthalmic surgery, assessing its potential benefits in providing real-time imaging overlay, surgical guidance, and collaborative opportunities.

Materials and method

The device was worn by 10 ophthalmic surgeons during eyelid malposition surgery. All surgeons performed the entire surgery while wearing the visor. At the end of procedure, all operators had to rate Apple Vision Pro visor according to 10 specific item and system usability scale (SUS) questionnaire.

Results

The surgeons used the Apple Vision Pro during the entire procedure, and the results were positive, with high ratings for practicality, freedom of movement, integration into workflow, and learning. All surgeons rated the Apple Vision Pro above 85/100 in the SUS.

Conclusion

The incorporation of Apple Vision Pro in oculoplastic surgery offers several advantages, including improved visualization, enhanced precision, and streamlined communication among surgical teams. According to our preliminary results Apple Vision Pro could represents a valuable tool in ophthalmic surgery, with implications for enhancing surgical techniques and advancing XR research in the surgical field.
Dexamethasone intravitreal implant in the treatment of macular edema secondary to necrotizing retinitis
Authors: Copete Sergio , García-García Jose Gregorio , Júdez Enrique
Published: August 2024

Purpose

To describe our experience with the use of a sustained-release dexamethasone implant in three patients with recalcitrant macular edema that developed after necrotizing retinitis in the context of the previously treated virus.

Case description

Two immunocompetent patients presented with unilateral acute retinal necrosis (ARN) due to Varicella-Zoster (VZV). The other, an immunocompromised patient, presented with unilateral cytomegalovirus (CMV) necrotizing retinitis. The diagnoses were confirmed by anterior chamber polymerase chain reaction (PCR) and all were treated with oral valganciclovir and intravitreal ganciclovir (2 mg/0.1 ml). Infection was controlled but two of them required pars plana vitrectomy. Between 2 and 4 months after the resolution of signs of infection, resistant macular edema (RME) developed, and an intravitreal dexamethasone device was implanted after anterior chamber PCR had been negative. Functional and anatomical improvement was achieved, with the resolution of the edema accompanied by improvement in visual acuity in all patients. There was no evidence of reactivation at two years. No cataract or ocular hypertension was observed. One patient required two additional dexamethasone implants.

Conclusion

Dexamethasone intravitreal implant could be considered as an option for the treatment of macular edema developed after ARN. Care should be taken to avoid reactivation and patients need to be properly informed.
Pro Re Nata brolucizumab for early onset and treatment-naïve diabetic macular edema: A prospective study
Authors: Bilgic Alper , Kodjikian Laurent , Sudhalkar Aditya , Gonzalez-Cortes Jesus Hernan , de Ribot Francesc March , Deshpande Riddhima , Spitzer Martin S , Mathis Thibaud
Published: August 2024

Objectives

To determine the efficacy and safety of brolucizumab therapy administered on a pro re nata (PRN) basis without loading dose in treatment naïve patients with diabetic macular edema (DME) for 1 year follow-up.

Methods

Patients with recent DME (<6 months) received a mandatory brolucizumab injection at inclusion and other injections could be given on a PRN basis with an 8-week interval (between injections) at minimum. Rescue therapy with other anti-VEGF was possible in case of incomplete DME resolution after the second brolucizumab with a minimum of 1-month treatment free interval between 2 injections. The primary outcome measure was the change in (BCVA) at 12 months. Secondary outcome measures included the change in central subfield thickness (CST), the change in hard exudate surface area and microaneurysms at 1 year.

Results

A total of 53 patients were included. At 12 months, the mean (SD) number of injections was 2.6 (0.8) in addition to the first mandatory injection. The mean (SD) interval between 2 consecutive injections was 3.2 (1.4) months. The mean (SD) BCVA improved from 0.62 (0.1) logMAR to 0.40 (0.16) logMAR (p = 0.012). The mean CST reduced from 397.0 (47.2) µm to 224.5 (28.1) µm (p = 0.013). The hard exudate surface area decreased significantly (p = 0.012) as did microaneurysms (p = 0.02). Seven patients required at least 1 rescue therapy. No patients experienced intra-ocular inflammatory adverse events.

Conclusion

Brolucizumab therapy for DME is a safe and effective modality for the treatment of recent DME and has the potential to reduce the number of injections.
EXPRESS: Prosopagnosia is highly comorbid in individuals with probable developmental coordination disorder (DCD).
Authors: Maw Katherine Jane , Burns Edwin , Beattie Geoffrey
Published: August 2024

Developmental co-ordination disorder (DCD) is characterised by difficulties in motor control and coordination from early childhood. While problems processing facial identity are often associated with neurodevelopmental conditions, such issues have never been directly tested in adults with DCD. We tested this possibility through a range of tasks, and assessed the prevalence of developmental prosopagnosia (i.e., lifelong difficulties with faces), in a group comprising individuals who self-reported a diagnosis of, or suspected that they had, DCD. Strikingly, we found 53% of this probable DCD group met recently recommended criteria for a diagnosis of prosopagnosia, with 22% acquiring a diagnosis using traditional cognitive task-based methods. Moreover, their problems with faces were apparent on both unfamiliar and familiar face memory tests, as well as on a facial perception task (i.e., could they tell faces apart). Positive correlations were found between self-report measures assessing movement and coordination problems, and objective difficulties on experimental face identity processing tasks, suggesting widespread neurocognitive disruption in DCD. Importantly, issues in identity processing in our probable DCD group remained even after excluding participants with comorbid conditions traditionally associated with difficulties in face recognition, i.e., autism and dyslexia. We recommend that any diagnostic test for DCD should include an assessment for prosopagnosia. Given the high prevalence of prosopagnosia in our probable DCD group, and the positive correlations between DCD and prosopagnosia symptoms, there may be a stronger link between movement and facial identity abilities than previously thought.
Ortho-digital dynamics: Exploration of advancing digital health technologies in musculoskeletal disease management
Authors: Maimaiti Zulipikaer , Li Zhuo , Li Zhiyuan , Fu Jun , Xu Chi , Chen Jiying , Chai Wei , Liu Liang
Published: August 2024

Background

Musculoskeletal (MSK) disorders, affecting billions of people worldwide, pose significant challenges to the healthcare system and require effective management models. The rapid development of digital healthcare technologies (DHTs) has revolutionized the healthcare industry. DHT-based interventions have shown promising clinical benefits in managing MSK disorders, alleviating pain, and improving functional impairment. There is, however, no bibliometric analysis of the overall trends on this topic.

Methods

We extracted all relevant publications from the Web of Science Core Collection (WoSCC) database until April 30, 2023. We performed bibliometric analysis and visualization using CiteSpace, VOSviewer, and R software. Annual trends of publications, countries/regions distributions, funding agencies, institutions, co-cited journals, author contributions, references, core journals, and keywords and research hotspots were analyzed.

Results

A total of 6810 papers were enrolled in this study. Publications have increased drastically from 16 in 1995 to 1198 in 2022, with 4067 articles published in the last five years. In all, 53 countries contributed with publications to this research area. The United States, the United Kingdom, and China were the most productive countries. Harvard University was the most contributing institution. Regarding keywords, research focuses include artificial intelligence, deep learning, machine learning, telemedicine, rehabilitation, and robotics.

Conclusion

The COVID-19 pandemic has further accelerated the adoption of DHTs, highlighting the need for remote care options. The analysis reveals the positive impact of DHTs on improving physician productivity, enhancing patient care and quality of life, reducing healthcare expenditures, and predicting outcomes. DHTs are a hot topic of research not only in the clinical field but also in the multidisciplinary intersection of rehabilitation, nursing, education, social and economic fields. The analysis identifies four promising hotspots in the integration of DHTs in MSK pain management, biomechanics assessment, MSK diagnosis and prediction, and robotics and tele-rehabilitation in arthroplasty care.
A hybrid approach for automatic segmentation and classification to detect tuberculosis
Authors: Khan Muzammil , Zaman Abnash , Khan Sarwar Shah , Arshad Muhammad
Published: August 2024

Objective

Tuberculosis (TB) remains a significant global infectious disease, posing a considerable health threat, particularly in resource-constrained regions. Due to diverse datasets, radiologists face challenges in accurately diagnosing TB using X-ray images. This study aims to propose an innovative approach leveraging image processing techniques to enhance TB diagnostic accuracy within the automatic segmentation and classification (AuSC) framework for healthcare.

Methods

The AuSC of detection of TB (AuSC-DTB) framework comprises several steps: image preprocessing involving resizing and median filtering, segmentation using the random walker algorithm, and feature extraction utilizing local binary pattern and histogram of gradient descriptors. The extracted features are then classified using the support vector machine classifier to distinguish between healthy and infected chest X-ray images. The effectiveness of the proposed technique was evaluated using four distinct datasets, such as Japanese Society of Radiological Technology (JSRT), Montgomery, National Library of Medicine (NLM), and Shenzhen.

Results

Experimental results demonstrate promising outcomes, with accuracy rates of 94%, 95%, 95%, and 93% achieved for JSRT, Montgomery, NLM, and Shenzhen datasets, respectively. Comparative analysis against recent studies indicates superior performance of the proposed hybrid approach.

Conclusions

The presented hybrid approach within the AuSC framework showcases improved diagnostic accuracy for TB detection from diverse X-ray image datasets. Furthermore, this methodology holds promise for generalizing other diseases diagnosed through X-ray imaging. It can be adapted with computed tomography scans and magnetic resonance imaging images, extending its applicability in healthcare diagnostics.
Through our eyes: Understanding how autistic children co-author a sense of self and relate to the world. An interpretative, observational thematic analysis
Authors: Wood Philippa
Published: August 2024

Identity development is often viewed as co-constructed within social contexts. Much research focuses on older childhood, despite early childhood being considered critical in the formation of ‘self’. Creative methodologies (i.e., those that might utilise creative mediums and the senses such as audio-visual stimuli or play), drawing upon attachment, narrative and systemic theory, and interpretative, observational thematic analysis were utilised to explore child meaning-making in the context of autism. Participant understanding of self often related to a sense of ‘difference’ and desire for belonging and acceptance. Development of creative, sensitive, applied methods has advanced methodological approaches for working with vulnerable populations. This study demonstrates that experiences of parental perspectives and interactions are connected to children contextualising their experiences of self, other, and the world around them in some capacity. As such, it is important to provide parents with the tools, knowledge, and understanding to aid the development of positive narratives to provide the best support for their children
Facilitators and Barriers to the Implementation of a Digital Pain Assessment Tool in Pediatric Oncology Practice: A Qualitative Evaluation of a Quality Improvement Project
Authors: Hamilton Rachel , Nguyen Cynthia , Mills Denise , Stinson Jennifer N. , Jibb Lindsey A.
Published: August 2024

Background: Most children and adolescents with cancer experience acute pain, and many experience longer-lasting chronic pain, negatively impacting health-related quality of life and resulting in long-term morbidity. Digital apps can aid in enhancing pain assessment and management by offering children and adolescents with cancer an accessible tool to describe their pain as a multifaceted biopsychosocial construct. Pain Squad is a useable, acceptable, and psychometrically sound multidimensional cancer pain assessment app for children and adolescents with cancer. This project aimed to evaluate the capacity to implement Pain Squad into routine pediatric oncology practice. Method: Nurse champions were asked to prescribe the Pain Squad app to patients over a 6-month implementation period. After the implementation period, we conducted audiorecorded, semistructured interviews with nurse champions to investigate the facilitators and barriers related to nurses’ experiences with implementing Pain Squad. Results: The facilitators and barriers to Pain Squad implementation were organized into four overarching Consolidated Framework for Implementation Research (CFIR)-related themes: (a) characteristics of the Pain Squad app; (b) clinic setting and its context; (c) nurse implementation champions; and (d) the process of implementing Pain Squad into clinical practice. Conclusions: Interviewed nurses believed Pain Squad had the potential to improve child cancer pain care, but barriers to everyday use were evident, described in relation to the internal setting, especially the lack of compatibility between app prescription and current nurse workflows. The use of CFIR to map identified implementation facilitators and barriers can formally support the recognition of factors that may boost the chances of successful uptake.
Retrospective Evaluation of Inpatient Warfarin Management Practices in Patients Immediately Following Left Ventricular Assist Device Implantation
Authors: Feih Joel , Weierstahl Kaytie , Juul Janelle , Brazauskas Ruta , Held-Godgluck Bethanne , Rinka Joseph
Published: August 2024

Background: The International Society for Heart and Lung Transplantation recommends patients receive warfarin and aspirin following left ventricular assist device (LVAD) placement. Optimal warfarin management in this population has not been well established. Objectives: The objectives of this study were to evaluate warfarin practices in patients immediately post-LVAD implantation. Methods: This single-center, retrospective cohort study included patients 18 years and older following LVAD placement from August 1, 2012 to April 1, 2020. The primary outcome was to assess patient-specific risk factors affecting time to therapeutic range. Secondary outcomes included bleeding events, thrombotic events, and warfarin dosing patterns. Results: Of 104 included patients, 91% reached the therapeutic range at a median of 8 days. A higher proportion of patients started on 3.5 mg or higher reached therapeutic international normalized ratio (INR) and faster (96% vs 90%; 8 vs 5 days) compared to lower doses. Univariate analysis of associations with reaching therapeutic INR range included initial warfarin dose, cumulative warfarin, and warfarin dosing changes, whereas HAS-BLED and CHA2DS2VAC were associated with slower time to therapeutic INR. Overall, 44% of patients met Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) bleeding criteria. There were a total of 12 thrombotic events and no pump thrombotic events. Total weekly warfarin dosing was significantly lower post-LVAD (24.3 mg vs 35 mg, P = 0.0009). In addition, warfarin requirements were statistically higher after the first week of therapy (4.0 mg vs 2.89 mg, P < 0.0001). Conclusion: Based on the results, consider warfarin starting dose between 2.5 and 4 mg for patients on LVAD therapy, while balancing patient-specific risks for bleeding.
Medication adherence to CFTR modulators in patients with cystic fibrosis: a systematic review
Authors: Hansen Carina M.E. , Breukelman Anna J. , van den Bemt Patricia M.L.A. , Zwitserloot Annelies M. , van Dijk Liset , van Boven Job F.M.
Published: August 2024

Background

In the last decade, a fundamental shift in the treatment of cystic fibrosis (CF) took place due to the introduction of CF transmembrane conductance regulator (CFTR) modulators. Adequate medication adherence is a prerequisite for their effectiveness, but little is known about adherence to CFTR modulators. We aimed to assess the extent of medication adherence to CFTR modulators in patients with CF and assess which characteristics are associated with adherence.

Methods

A systematic review following PRISMA guidelines was performed. Studies needed to report adherence to CFTR modulators. Main outcomes were: 1) level of medication adherence and 2) associations of demographic and/or clinical characteristics with adherence.

Results

In total, 4082 articles were screened and 21 full-text papers were assessed for eligibility. Ultimately, seven studies were included. Most studies were retrospective and focused on adherence to ivacaftor or lumacaftor–ivacaftor with only one focusing on elexacaftor–tezacaftor–ivacaftor. The majority used pharmacy refill data with adherence determined with the proportion of days covered (PDC) or the medication possession ratio (MPR). One study additionally used electronic monitoring and patient self-reported adherence. Adherence was 0.62–0.99 based on pharmacy data (PDC or MPR), 61%viaelectronic monitoring and 100%viaself-report. Age <18 years appeared to be associated with good adherence, as was a higher lung function.

Conclusions

Despite the wide variety of adherence methods used, adherence to CFTR modulators is suboptimal, based on objective measures such as pharmacy refill data or electronic monitoring. CFTR modulator adherence measurement and definitions requires more standardisation with a preference for objective and granular methods.