bluuebunny/crossref_metadata_2025 huggingface dataset:
Conflict in the Sahel
Authors: Thurston Alexander
Published: January 2024

The Sahel region of Africa extends, in an ecological sense, from Senegal and Mauritania in the west to Somalia in the east. In a political sense, the region is often more narrowly defined as comprising Mauritania, Mali, Burkina Faso, Niger, and Chad; many accounts, including this article, include Senegal as well. All six of these countries became independent from France in 1960 and, except for Chad, experienced relatively limited armed conflict prior to the 1990s. In 1990 a rebellion in northern Mali touched off cycles of conflict that have continued through the time of writing. Another rebellion in northern Mali in 2012 became the tipping point for the central Sahel (Mali, Burkina Faso, and Niger), as conflict spread from northern Mali into central Mali and then into Burkina Faso and Niger; meanwhile, Niger and Chad also experienced considerable spillover from Nigeria’s Boko Haram conflict, even as Chad continued to grapple with periodic armed rebellions. In the central Sahel, the primary purveyors of conflict since 2012 have been jihadists, ethnic militias, state security forces, external military forces, and, more recently, private security contractors such as the Kremlin-linked Wagner Group. The violence inflicted by each of these actors has tended to elicit reprisals from the other actors, feeding into a matrix of conflict whose causes include both structural factors and self-perpetuating violence. In terms of structural factors that drive conflict, these include the region’s poverty, underdevelopment, state weakness and corruption, demographic pressures, farmer-herder tensions, the politicization and securitization of ethnic and religious identities, and citizens’ lack of trust in judiciaries and politicians. Conflict has further exacerbated these factors, especially in terms of precipitating a collapse of faith in elected officials who are often seen—with some justification—as inept and aloof. In 2012, Mali experienced a military coup amid the northern rebellion of that year, and since 2020 the region has seen multiple coups: in Mali in 2020 and 2021, in Chad in 2021, in Burkina Faso in January 2022 and September 2022, and in Niger in 2023. The political upheavals in the region, combined with the Malian and Burkinabè military regimes’ hostility to France, have intensified geopolitical competition among France, Russia, and the United States for influence in the Sahel. As of 2023, the region’s trajectory remains largely grim, especially with intensifying violence and displacement in much of Mali and Burkina Faso and high levels of continued turmoil in parts of Niger. At the same time, Senegal, Mauritania, and, to a lesser extent, Chad retain a significant level of baseline political stability and internal security.
An Amphibole Perspective on the Recent Magmatic Evolution of Mount St. Helens
Authors: Keller Franziska , Wanke Maren , Kueter Nico , Guillong Marcel , Bachmann Olivier
Published: January 2024

Compositional variations of amphibole stratigraphically recovered from multiple eruptions at a given volcano have a great potential to archive long-term magmatic processes in its crustal plumbing system. Calcic amphibole is a ubiquitous yet chemically and texturally diverse mineral at Mount St. Helens (MSH), where it occurs in dacites and in co-magmatic enclaves throughout the Spirit Lake stage (last ~4000 years of eruptive history). It forms three populations with distinct geochemical trends in key major and trace elements, which are subdivided into a high-Al (11–14.5 wt% Al2O3), a medium-Al (10–12.5 wt% Al2O3), and a low-Al (7.5–10 wt% Al2O3) amphibole population.

The oldest investigated tephra record (Smith Creek period, 3900–3300 years BP) yields a bimodal amphibole distribution in which lower-crustal, high-Al amphibole cores (crystallized dominantly from basaltic andesite to andesite melts) and upper-crustal, low-Al amphibole rims (crystallized from rhyolitic melt) document occasional recharge of a shallow silicic mush by a more mafic melt from a lower-crustal reservoir. The sudden appearance of medium-Al amphiboles enriched in incompatible trace elements in eruptive periods younger than 2900 years BP is associated with a change in reservoir conditions toward hotter and drier magmas, which indicates recharge of the shallow silicic reservoir by basaltic melt enriched in incompatible elements. Deep-crystallizing, high-Al amphibole, however, appears mostly unaffected by such incompatible-element-enriched basaltic recharge, suggesting that these basalts bypass the lower crustal reservoir. This could be the result of the eastward offset position of the lower crustal reservoir relative to the upper crustal storage zone underneath the MSH edifice. Amphibole has proven to be a sensitive geochemical archive for uncovering storage conditions of magmas at MSH. In agreement with geophysical observations, storage and differentiation have occurred in two main zones: an upper crustal and lower crustal reservoir (the lower one being chemically less evolved). The upper crustal silicic reservoir, offset to the west of the lower crustal reservoir, has captured compositionally unusual mafic recharge (drier, hotter, and enriched in incompatible trace elements in comparison to the typical parental magmas in the region), resulting in an increased chemical diversity of amphiboles and their carrier intermediate magmas, in the last ~3000 years of MSH’s volcanic record.
Moderate Exercise Modulates Inflammatory Responses and Improves Survival in a Murine Model of Acute Pneumonia*
Authors: Vermeersch Veronique , Léon Karelle , Caillard Anais , Szczesnowski Amandine , Albacete Gaëlle , Marec Nadege , Tissier Florine , Gilbert Guillaume , Droguet Mickael , Marcorelles Pascale , Giroux-Metges Marie-Agnes , Huet Olivier
Published: January 2024

OBJECTIVES:

An association between physical inactivity and worse outcome during infectious disease has been reported. The effect of moderate exercise preconditioning on the immune response during an acute pneumonia in a murine model was evaluated.

SETTING:

Laboratory experiments.

SUBJECTS:

C57BL6/j male mice.

INTERVENTIONS:

Six-week-old C57BL/6J mice were divided in two groups: an exercise group and a control group. In the exercise group, a moderate, progressive, and standardized physical exercise was applied for 8 weeks. It consisted in a daily treadmill training lasting 60 minutes and with an intensity of 65% of the maximal theoretical oxygen uptake. Usual housing recommendation were applied in the control group during the same period. After 8 weeks, pneumonia was induced in both groups by intratracheal instillation of a fixed concentration of a Klebsiella pneumoniae (5 × 103 colony-forming unit) solution.

MEASUREMENTS AND MAIN RESULTS:

Mice preconditioned by physical exercise had a less sever onset of pneumonia as shown by a significant decrease of the Mouse Clinical Assessment Severity Score and had a significantly lower mortality compared with the control group (27% vs. 83%; p = 0.019). In the exercise group, we observed a significantly earlier but transient recruitment of inflammatory immune cells with a significant increase of neutrophils, CD4+ cells and interstitial macrophages counts compared with control group. Lung tumor necrosis factor-α, interleukin (IL)-1β, IL-6, and IL-10 were significantly decreased at 48 hours after pneumonia induction in the exercise group compared with the control group.

CONCLUSIONS:

In our model, preconditioning by moderate physical exercise improves outcome by reducing the severity of acute pneumonia with an increased but transient activation of the innate immune response.
A Systematic Review of Nurses' Perceptions of Electronic Health Record Usability Based on the Human Factor Goals of Satisfaction, Performance, and Safety
Authors: Park Suhyun , Marquard Jenna , Austin Robin R. , Pieczkiewicz David , Jantraporn Ratchada , Delaney Connie White
Published: January 2024

The poor usability of electronic health records contributes to increased nurses' workload, workarounds, and potential threats to patient safety. Understanding nurses' perceptions of electronic health record usability and incorporating human factors engineering principles are essential for improving electronic health records and aligning them with nursing workflows. This review aimed to synthesize studies focused on nurses' perceived electronic health record usability and categorize the findings in alignment with three human factor goals: satisfaction, performance, and safety. This systematic review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Five hundred forty-nine studies were identified from January 2009 to June 2023. Twenty-one studies were included in this review. The majority of the studies utilized reliable and validated questionnaires (n = 15) to capture the viewpoints of hospital-based nurses (n = 20). When categorizing usability-related findings according to the goals of good human factor design, namely, improving satisfaction, performance, and safety, studies used performance-related measures most. Only four studies measured safety-related aspects of electronic health record usability. Electronic health record redesign is necessary to improve nurses' perceptions of electronic health record usability, but future efforts should systematically address all three goals of good human factor design.
Urinary biomarkers of exposure to toxic and essential elements: A comparison of infants fed with human milk or formula
Authors: Pikounis Talia D. , Amann Kassaundra L. , Jackson Brian P. , Punshon Tracy , Gilbert-Diamond Diane , Korrick Susan , Karagas Margaret R. , Cottingham Kathryn L.
Published: January 2024

Background:

Early-life exposure to nonessential (toxic) and essential trace elements can influence child development. Although infant formula powders and the water used to reconstitute them can contain higher concentrations of many elements compared with human milk, the influence of feeding mode on reliable biomarkers of infant exposure has rarely been demonstrated.

Methods:

We evaluated associations between urinary biomarkers and feeding mode (exclusively human milk, exclusively formula, or combination-fed) for four toxic (arsenic, cadmium, nickel, and uranium) and three essential elements (cobalt, molybdenum, and selenium) using general linear models.

Results:

A total of 462 participants from the rural New Hampshire Birth Cohort Study were on average 6 weeks old between July 2012 and March 2019 and had urine samples, 3-day food diaries, and relevant covariate data available. In adjusted models, urinary arsenic was 5.15 (95% confidence interval = 4.04, 6.58), molybdenum was 19.02 (14.13–25.59), and selenium was 1.51 (1.35–1.68) times higher in infants fed exclusively with formula compared with infants fed exclusively with human milk. By contrast, urinary uranium was 0.59 (0.46–0.75) and cobalt was 0.78 (0.65–0.95) times lower with formula feeding than human milk feeding.

Conclusion:

Our findings suggest that infant exposure to several potentially toxic elements varies by feeding mode, as concentrations of reliable urinary biomarkers were higher with formula or human milk, depending on the element. Importantly, exposure to arsenic increased with household tap water arsenic regardless of feeding mode, suggesting that all infants could be at risk in populations with high concentrations of arsenic in drinking water.
The Efficacy of Traditional Chinese Herbal Medicine Across Multiple Cardiovascular Diseases: An Umbrella Review of Systematic Reviews of Randomized Controlled Trials
Authors: Li Xi , Yu Tao , Jiang Qin , Tan Jin , Liu Ke
Published: January 2024

Traditional Chinese herbal medicine (CHM) has been extensively used in cardiovascular disease (CVD) in modern clinical practice, alone or in combination with conventional treatment. However, its efficacy has not been assessed extensively. From inception until August 2023, we systematically searched 5 public literature databases to conduct the umbrella review. The inclusion criterion is systematic reviews of randomized controlled trials investigating the effect of CHM in the contemporary management of CVDs. The quality of the included systematic reviews, the certainty of the evidence, and the potential risk of bias were assessed. Five hundred and thirty-nine systematic reviews, including 346 studies in Chinese and 193 in English, were selected before the quantitative synthesis. The methodological quality was generally moderate, with a median value of 11. The favorable efficacy of CHM was primarily presented on 5 main conditions: coronary artery disease, hypertension, heart failure, restenosis, and angina pectoris. CHM, with or without conventional treatment, showed a consistent beneficial effect in various CVDs. Nevertheless, the magnitude of the effect requires further investigation as the lack of relevant research and the complexity of the clinical practice of CHM.
Determining Plasma Tacrolimus Concentrations Using High-Performance LC-MS/MS in Renal Transplant Recipients
Authors: Alonge Mirabel , Coller Janet K. , Reuter Stephanie E. , Jesudason Shilpanjali , Sallustio Benedetta C.
Published: January 2024

Background:

Whole-blood therapeutic drug monitoring of tacrolimus is conducted to maintain tacrolimus concentrations within a safe and effective range. Changes in hematocrit cause variability in blood concentrations of tacrolimus because it is highly bound to erythrocytes. Measuring plasma concentrations may eliminate this variability; however, current methods have limitations owing to the use of cross-reactive immunoassays, plasma separation at nonbiological temperatures, and lack of clinical validation. This study aimed to develop and validate a clinically applicable method to measure plasma tacrolimus concentrations in renal transplant recipients and to examine the concentration differences between genotypic CYP3A5 expressors and nonexpressors.

Methods:

Plasma tacrolimus concentrations were measured in 9 stable renal transplant recipients who were genotypic CYP3A5 expressors or nonexpressors. Tacrolimus was extracted from plasma using solid-phase extraction, and liquid chromatography-tandem mass spectrometry was used for detection and quantitation.

Results:

This assay was sensitive, selective, and linear between 100 and 5000 ng/L, with intraassay and interassay imprecision and inaccuracy <10% and <5% respectively. The extraction recovery of tacrolimus and ascomycin was 74%. Matrix ion suppression effects were 31.5% and 35% with overall recovery of 50.6% and 48.3% for tacrolimus and ascomycin, respectively. Whole-blood concentrations accounted for approximately 46% of the variation in plasma concentrations in CYP3A5 expressors and nonexpressors. No difference in dose-adjusted whole-blood and plasma concentrations was observed between CYP3A5 expressors and nonexpressors.

Conclusions:

This assay is clinically applicable with excellent performance and demonstrated that tacrolimus plasma concentrations highly correlated with whole-blood concentrations.
The efficacy of purified pollen extract for reducing vasomotor symptoms in women: a systematic review and meta-analysis
Authors: Acquarulo Erica L. , Hernandez Emily C. , Kodzodziku Fatbardha , Nemec Eric C.
Published: January 2024

Importance

Menopause impacts the quality of life for women, with symptoms varying from hot flashes to night disturbances. When menopausal hormonal therapy is contraindicated or women refuse menopausal hormonal therapy, many consider alternatives such as pollen extract for treating vasomotor symptoms.

Objective

This meta-analysis focuses on the impact of using purified pollen extract as a treatment option to reduce vasomotor symptoms in women, specifically focusing on symptoms such as hot flashes, night disturbances, myalgias, and depression.

Evidence Review

A comprehensive literature search was conducted using the following Boolean search string “women OR females” AND “purified pollen OR pollen extract OR cytoplasmic pollen OR Bonafide OR Femal OR Estroven OR Serelys” AND “menopausal symptoms OR vasomotor symptoms OR hot flashes OR night sweats OR sleep disturbance.” Publications in English from 2003 to the present were included. To assess the risk of bias, authors used the Cochrane Risk-of-Bias 2 for a randomized controlled trial and Risk-of-Bias in Non-Randomized Studies of Interventions (ROBINS-I) for observational studies. Using ReviewManager, a Der Simonian–Laird random-effects model meta-analysis was conducted to determine the standardized mean differences (SMDs) in the outcomes for each study.

Findings

Five articles were retained: one randomized controlled trial and four observational studies (N = 420). An overall decrease in scores from the baseline of studies compared with a 3-month follow-up after purified cytoplasm of pollen (PCP) treatment was recognized when compiling the data. Overall, there was significant improvement across all outcomes at 3 months: hot flashes demonstrated an overall improvement in SMD of −1.66 (P < 0.00001), night disturbance scores were improved with an SMD of −1.10 (P < 0.0001), depression scores were improved with an SMD of −1.31 (P < 0.0001), and myalgia had an improvement in SMD of −0.40 (P < 0.00001). When controlled studies were pooled for meta-analysis, outcomes, however, were no longer statistically significant.

Conclusions and Relevance

Evaluating the risk-to-benefit ratio of alternative therapies, such as PCP extract, is important to care for women who cannot take traditional vasomotor symptom therapies. Pooled data from controlled studies evaluating PCP extract suggest that vasomotor symptom improvements seen in noncontrolled studies may have been due to the placebo effect; however, its use was not associated with significant adverse effects.
Prolactinoma in postmenopausal women: a systematic review
Authors: Carneiro Marcela Souza , de Mira Ticiana Aparecida Alves , Yela Daniela Angerame , Benetti-Pinto Cristina Laguna
Published: January 2024

Importance

Prolactinomas occurring during the reproductive period exhibit a characteristic behavior. There are, however, gaps in the literature regarding the behavior of these tumors after menopause.

Objective

This study aimed to review and characterize the influence of menopause on prolactinoma behavior.

Evidence review

A systematic review of observational prospective or retrospective studies and clinical trials on prolactinomas was conducted in two situations: tumors diagnosed in the reproductive period (before menopause), with follow-up in the postmenopausal period, or prolactinomas diagnosed in the postmenopausal period, without language or date restrictions. Data extracted from the articles included patient and tumor characteristics (prolactinoma type, previous treatment, symptoms, and serum prolactin [PRL] levels).

Findings

This study included five studies comprising 180 participants. Prolactinomas diagnosed in women of reproductive age are treated with dopaminergic agonists (DAs), with indications of treatment withdrawal after menopause, exhibited stable tumor behavior and PRL levels. Considering the diagnosis during the postmenopausal period, macroprolactinomas were more prevalent and showed tumor shrinkage when DAs were used. Cabergoline, the most commonly used drug, lowers PRL levels and reduces symptoms associated with adenoma.

Conclusions and Relevance

Microadenomas diagnosed before menopause can be followed up without treatment. Prolactinomas diagnosed after menopause are typically macroadenomas. Cabergoline remains the treatment of choice in the presence of clinical or compressive symptoms. We recommend at least one annual follow-up for such patients.
Pelvic abscess treatment: A novel experience with UNICO drainage
Authors: Fazzotta Salvatore , Locurto Paolo , Airò Farulla Marco , Lazzaro Luigi Antonio , D’Ippolito Giovanni , Amico Maria , Fodale Pietro , Termini Pietro , Ciaccio Giovanni
Published: January 2024

Pelvic abscess can be a life-threatening condition due to infected fluid collection. Usually, pelvic abscess occurs as a complication of surgical procedures or pelvic organ tumors, inflammatory pelvic conditions, infectious gastrointestinal tract and gynecological diseases. Drainage is the standard treatment of pelvic abscess especially after failure of the antibiotic therapy. UNICO drainage is an innovative catheter for minimal invasive centesis and miscellaneous drainage procedures. In this report, it was used on three patients with pelvic abscess of different etiology: Pelvic inflammatory disease, Crohn disease, and endometriosis. In all cases, UNICO drainage was applied transrectally under loco-regional anesthesia. The procedure was well tolerated with rapid improvement of clinical conditions in all cases. The procedure was easy and rapid and there were no complications in any of the three cases reported. UNICO drainage is a simple and effective drainage tool and it can be a valid alternative for pelvic abscess drainage.
Combined application of B-scan ultrasonography and eye-steering ultrawide field imaging to improve the detection of retinal tears before cataract surgery
Authors: Meng Jiaqi , Cheng Kaiwen , Huang Zhiqian , He Wenwen , Zhang Keke , Lu Yi , Zhu Xiangjia
Published: January 2024

Purpose:

To investigate the efficacy of combined application of B-scan ultrasonography (US) and ultrawide field imaging (UWFI) in detecting retinal tears before cataract surgery.

Methods:

2552 eyes of 1277 cataract patients were enrolled and received both B-scan US and UWFI examinations preoperatively. Three types of combination were applied: type 1 (union, B-scan US or centered UWFI), type 2 (intersection, B-scan US and centered UWFI), and type 3 (B-scan US and eye-steering UWFI). Sensitivity and specificity of detecting retinal tears by different methods were assessed.

Results:

Totally 4.55% (116/2552) of eyes were presented with retinal tears. The sensitivity of B-scan US and UWFI was 87.93% and 84.48%, and specificity was 95.16% and 99.79%, respectively. By applying type 1 and 2 combination, the sensitivity was 98.28% and 74.14%, and specificity was 95.03% and 99.92%, respectively. By type 3 combination, the sensitivity increased to 95.69% and specificity to 99.88%, both of which were comparable to indirect ophthalmoscopy regardless of the number, type and location of tears (P>0.05). In eyes with any cataract type or axial length, type 3 combination also gained comparable performance to indirect ophthalmoscopy.

Conclusion:

Combined application of B-scan US and eye-steering UWFI presented satisfactory performance in detecting retinal tears before cataract surgery.
Ab Interno Ahmed Glaucoma Valve Plugs In An Eye With Persistent Hypotony
Authors: Me Rao , LeRose Jennifer , Alfaro Cesar , Lee Patrick S.Y. , Lin Xihui
Published: January 2024

Purpose:

This case report aims to describe a new method for increasing intraocular pressure (IOP) in patients with acute hypotony resulting from uveitis flare-ups and preexisting glaucoma drainage devices. The temporary glaucoma tube plug method described is effective and safe.

Methods:

This case report presents a 47-year-old female patient with a history of chronic panuveitis and secondary glaucoma, who had 2 previously implanted Ahmed glaucoma valves. The patient developed panuveitis flare-up and persistent hypotony. A novel method of ab interno plugging of the glaucoma tubes using 2-0 prolene suture plugs was performed. Following treatment, the IOP increased successfully and remained within the normal range.

Conclusion:

The temporary ab interno glaucoma tube plug method effectively increased IOP in a patient with 2 preimplanted Ahmed glaucoma valves with persistent low IOP due to uveitis.
Effect of “365 Breathing Technique” on Intraocular Pressure and Autonomic Functions in Patients With Glaucoma: A Randomized Controlled Trial
Authors: Dada Tanuj , Gwal Rajat S. , Mahalingam Karthikeyan , Chandran Dinu Santha , Angmo Dewang , Gupta Shikha , Velpandian Thirumurthy , Deepak Kishore K.
Published: January 2024

Précis:

Patients with primary open angle glaucoma were advised to follow the “365 breathing technique” for 6 weeks in addition to their pharmacological glaucoma treatment. It helped to reduce intraocular pressure (IOP), stress biomarker—cortisol, and improve autonomic dysfunction.

Objective:

To study the effect of the “365 breathing technique” on IOP, autonomic functions, and stress biomarkers in patients with primary open angle glaucoma.

Methods:

In this randomized, controlled, interventional trial, after randomization, 40 patients in the intervention group followed “365 breathing” (three times a day, breathing rate: 6 cycles/min for 5 min) in addition to their pharmacological glaucoma treatment and 40 patients in the control group continued only with their pharmacological glaucoma treatment. IOP, serum cortisol, heart rate variability (HRV), and heart rate response to deep breathing test (DBT) were recorded at preintervention and 6 weeks postintervention.

Results:

The mean IOP, serum cortisol, parameters of the HRV test, and DBT were comparable between the two groups at baseline. At the 6-week follow-up, in the intervention group, mean IOP was significantly lower (16.09 ± 2.24 vs 18.38 ± 1.58 mm Hg, P = 0.03) and serum cortisol were significantly lower (13.20 ± 3.11 vs 14.95 ± 2.60 mcg/dL, P = 0.038) compared with the control group. In the HRV test, time domain analysis showed a significant difference in the root mean square of the successive difference between RR interval values between both groups at 6 weeks (P = 0.015) pointing towards higher postintervention parasympathetic activation in the intervention group. In frequency domain analysis (HRV test), the ratio of the low-frequency component to the high-frequency component was significantly lower in the intervention group at 6 weeks (1.65 vs 1.79, P = 0.019) indicating a shift in sympathovagal balance towards greater vagal modulation.

There was a significant increase in delta heart rate (P = 0.019) and expiratory:inspiratory ratio (P = 0.011) in the intervention group at 6 weeks when compared with baseline values, indicating improved parasympathetic reactivity to DBT.

Conclusion:

“365 breathing” technique can reduce IOP and serum cortisol, and improve autonomic dysfunction in patients with glaucoma.
One-Year Outcomes of the PAUL Glaucoma Implant Compared With the Ahmed Glaucoma Valve for the Treatment of Silicone Oil Glaucoma
Authors: Karapapak Murat , Olgun Ali
Published: January 2024

Précis:

Longer-term studies with a larger sample size are needed to demonstrate the superiority or equivalence of these procedures.

Objective:

To evaluate the outcomes of the PAUL glaucoma implant (PGI) and Ahmed glaucoma valve (AGV) in patients with secondary glaucoma caused due to silicone oil emulsification.

Patients and Methods:

A retrospective examination was conducted using the medical records of 36 patients who developed secondary glaucoma due to silicone oil emulsification after vitreoretinal surgery and then underwent PGI and AGV implantation surgery. The main outcome measures in the PGI and AGV groups were intraocular pressure (IOP) and its change, the number of antiglaucoma medications, and postoperative complications during the 12-month follow-up period. IOP of <6 mm Hg is used to define hypotonia.

Results:

There was no statistically significant difference among the patients who underwent PGI and AGV surgeries in terms of IOP averages, both preoperatively and postoperatively on day 1, week 1, month 1, month 3, month 6, and month 12 (P > 0.05). Before PGI and AGV implantation, the mean IOP was 40 ± 13 mm Hg and 39.3 ± 10 mm Hg, and the mean number of medications was 3.8 ± 0.4 and 4 ± 0, respectively. At the end of the 12-month follow-up period, the mean IOP was 13.5 ± 2.2 (P < 0.001) mm Hg and 14.9 ± 4.2 (P < 0.001) mm Hg, whereas the mean number of glaucoma medications decreased to 1.7 ± 1.3 (P < 0.001) and 1.9 ± 1.8 (P < 0.001) in the PGI and AGV groups, respectively. Surgical success was achieved in 17 of 18 eyes (94%) in the PGI group and 16 of 18 eyes (89%) in the AGV group.

Conclusions:

Although the outcomes were similar in both the PGI and AGV groups, complications requiring medical and surgical intervention were less common in the PGI group. Longer-term studies with a larger sample size are needed to demonstrate the superiority or equivalence of these procedures.
Biomechanical and Vascular Metrics Between Eyes of Patients With Asymmetric Glaucoma and Symmetric Glaucoma
Authors: Harvey Devon H. , Roberts Cynthia J. , Mahmoud Ashraf M. , Nuñez Fernando M. , Ma Yanhui , Fleming Gloria P.
Published: January 2024

Précis:

Corneal hysteresis (CH) and pulsatile ocular blood volume (POBV) were significantly lower in the eye with greater damage in asymmetric glaucoma, without a difference in intraocular pressure (IOP) or central corneal thickness (CCT), and no difference in elastic parameters.

Objective:

To compare biomechanical and vascular metrics between the eyes of patients with asymmetric glaucoma (ASYMM) and those with symmetric glaucoma (SYMM).

Patients and Methods:

Forty-five patients were prospectively recruited and divided into ASYMM, defined as cup-to-disc (C/D) ratio difference >0.1 between eyes and SYMM, with C/D difference ≤0.1. For ASYMM, the smaller C/D was defined as the best eye (“best”) and the fellow eye was defined as the worst eye (“worse”). All metrics were subtracted as “worse” minus “best,” including the viscoelastic parameter CH, and elastic parameters from the Corvis ST, including stiffness parameter at first applanation, stiffness parameter at highest concavity, integrated inverse radius, deformation amplitude ratio, IOP, CCT, mean deviation (MD), ganglion cell complex (GCC), and POBV were included. Paired t tests were performed between eyes in both groups. Statistical analyses were performed with SAS using a significance threshold of P <0.05.

Results:

For ASYMM (16 patients), “worse” showed significantly lower CH (−0.76 ± 1.22), POBV (−0.38 ± 0.305), MD (−3.66 ± 6.55), and GCC (−7.9 ± 12.2) compared with “best.” No other parameters were significantly different. For SYMM (29 patients), there were no significantly different metrics between eyes.

Conclusions:

Lower CH, POBV, GCC, and worse MD were associated with greater glaucomatous damage in asymmetric glaucoma without a difference in IOP or CCT. Lower CH and GCC are consistent with previous studies. POBV, a new clinical parameter that may indicate reduced blood flow, is also associated with greater damage.
Endothelial cell loss post–implantable collamer lens V4c: meta-analysis
Authors: Kisiel Filip Blazej , Gurumurthy Gerard Jonathan
Published: January 2024

Endothelial cell density (ECD) loss is a noted effect of implantable collamer lens (ICL) V4c surgery. Current literature provides a wide range of values for ECD loss postsurgery, which may not be helpful in advising patients and clinicians. A meta-analysis exploring ECD loss in ICL V4c for myopia correction was undertaken. 18 studies were included in this meta-analysis with 2 subgroup analyses to account for the variability in follow-up lengths. The average ECD loss 3 months, 12 months, and 21.25 (mean) months postsurgery were 1.32% ± 1.28% (P < .001, 95% CI, −75.158 to −1.19), 1.75% ± 2.17% (P < .001, 95% CI, −134.09 to 14.52), and 3.84% ± 1.78% (P < .001, 95% CI, −156.04 to −54.26), respectively. ECD loss is most pronounced 3 months postsurgery, suggesting that acute surgical trauma was the primary contributor rather than long-term lens implantation. Overall, ICL V4c is for myopia correction exhibits similar ECD loss as seen in other ICL models, thereby affirming its safety.
Surgical approach to and morphology of visually significant persistent pupillary membranes
Authors: Chen Wan , Chen Kexin , Chen Hui , Wang Qiwei , Lin Duoru , Qin Tingfeng , Bai Bingyu , Lin Zhuoling , Li Jing , Li Xiaoyan , Lin Xiaoshan , Zhong Qiuping , Chen Weirong
Published: January 2024

Purpose:

To characterize the morphology of persistent pupillary membranes (PPMs) in pediatric patients and explore the corresponding surgical approaches.

Setting:

Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

Design:

Prospective observational study.

Methods:

Consecutive pediatric patients with PPMs who underwent surgery from April 2020 to July 2022 were included. PPM morphology was assessed and categorized according to its anatomic relationship with crystalline lens and distribution of iris strands. The surgical approaches for different morphologies of PPMs were described in detail. The visual outcome and operation-related complications were recorded.

Results:

31 eyes from 19 patients were included with the mean age of 7.2 years. 3 morphological variants of PPMs were observed: type I (51.6%, 16/31), a spider-like appearance and no adhesion to the anterior lens capsule (ALC); type II (38.7%, 12/31), a loose central adherence to the ALC and partially thick iris strands attached to the iris collarette; type III (9.7%, 3/31), a tight central adherence to the ALC and only silk-like iris strands. Surgeries were performed with a natural pupil size in type I, while dilated pupil in the other types. The adhesions between PPM and the ALC were separated by viscoelastic injection in type II and by discission needles in type III. The corrected distance visual acuity was significantly improved from 0.34 ± 0.18 logMAR preoperatively to 0.17 ± 0.09 logMAR postoperatively (P < .001). No operation-related complications were observed during 9.5-month follow-up.

Conclusions:

PPMs were categorized into 3 types according to their different morphologies, which helped to determine the best surgical strategy.
Time-varying phase synchronization of resting-state functional magnetic resonance imaging reveals a shift toward self-referential processes during sustained pain
Authors: Lou Wutao , Li Xiaoyun , Jin Richu , Peng Weiwei
Published: January 2024

Growing evidence has suggested that time-varying functional connectivity between different brain regions might underlie the dynamic experience of pain. This study used a novel, data-driven framework to characterize the dynamic interactions of large-scale brain networks during sustained pain by estimating recurrent patterns of phase-synchronization. Resting-state functional magnetic resonance imaging signals were collected from 50 healthy participants before (once) and after (twice) the onset of sustained pain that was induced by topical application of capsaicin cream. We first decoded the instantaneous phase of neural activity and then applied leading eigenvector dynamic analysis on the time-varying phase-synchronization. We identified 3 recurrent brain states that show distinctive phase-synchronization. The presence of state 1, characterized by phase-synchronization between the default mode network and auditory, visual, and sensorimotor networks, together with transitions towards this brain state, increased during sustained pain. These changes can account for the perceived pain intensity and reported unpleasantness induced by capsaicin application. In contrast, state 3, characterized by phase-synchronization between the cognitive control network and sensory networks, decreased after the onset of sustained pain. These results are indicative of a shift toward internally directed self-referential processes (state 1) and away from externally directed cognitive control processes (state 3) during sustained pain.
Validation of the ANDON KD-595 automated upper-arm blood pressure monitor according to the universal standard
Authors: Liu Kui , Wu Dan , Bing Sen , Li Lin-Yi
Published: January 2024

Objective

To validate the ANDON KD-595 automated upper-arm blood pressure monitor for clinical use and self-measurement blood pressure measurement according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard.

Methods

Same left-arm blood pressure was sequentially measured in 90 qualified adult participants and compared with a standard mercury sphygmomanometer. A total of 270 comparison pairs were obtained and analyzed according to the universal standard.

Results

For the validation Criterion 1 of the universal standard, the mean ± SD of the differences between the test device and reference blood pressure readings was 0.96 ± 5.35 and 0.82 ± 5.08 mmHg for SBP and DBP, respectively. For Criterion 2, the SDs of the averaged blood pressure differences between the test device and reference blood pressure per subject were 4.84 and 4.64 mmHg (with maximum allowed SDs of 6.87 and 6.89 mmHg) for SBP and DBP, respectively.

Conclusion

The ANDON KD-595 automated upper-arm blood pressure monitor passed all the validation requirements according to the AAMI/ESH/ISO Universal Standard and can be recommended for clinical use and self-measurement blood pressure measurement in the general population.
A case report: Infection-related glomerulonephritis and mantle cell lymphoma due to mycobacterium avium complex infection
Authors: Huang Yiqi , Xia Li , Shen Weigang , Fu Tianxiao
Published: January 2024

Rationale:

Mycobacterium avium complex (MAC) infection is common in lung, liver and skin. However, MAC presenting with peritonitis is uncommon and is particularly rare in immunocompetent patients. We report a case of infection-associated glomerulonephritis and mantle cell lymphoma caused by peritonitis due to MAC.

Patient concerns:

We report a case of a 73-year-old elderly man with fever and abdominal pain for 2 days and gradually developed anuria, ascites, and abdominal lymphadenopathy.

Diagnoses:

The initial diagnosis was peritonitis and acute renal failure. There was no significant relief of symptoms after empirical anti-infective therapy and hemodialysis. infection-associated glomerulonephritis, mantle cell lymphoma, and peritonitis due to MAC were diagnosed by renal biopsy, abdominal lymph node biopsy, and metagenomics next-generation sequencing.

Interventions:

The patient received empirical antibiotic therapy, hemodialysis, and anti-MAC therapy.

Outcomes:

Unfortunately, the patient eventually died of septic shock after the 21st day of admissiom.

Lessons:

Early diagnosis of MAC infection is essential. When the cause of fever is unknown, metagenomics next-generation sequencing can be considered.
An effective treatment and suspicious adverse reaction to Ibrutinib in a patient diagnosed with splenic B-cell lymphoma/leukaemia with prominent nucleoli: A first case report
Authors: Shen Mei-Xiao , Li Fu-Ling , Luo Xian-Sheng , Wang Zhi-Ming
Published: January 2024

Rationale:

Splenic B-cell lymphoma/leukemia with prominent nucleoli (SBLPN) is a new classification, which is so rare that it lacks clinical data.

Patient concerns:

An increased proportion of prolymphocytes (84%) in the bone marrow smear. Whole exon sequence analysis revealed a TP53 mutation.

Diagnoses:

Combining the clinical features with laboratory test results led to a diagnosis of SBLPN which was made according to the 5th edition of the WHO classification of hematolymphoid tumors, although the patient was diagnosed with B-PLL when guided by the 4th edition of the WHO classification.

Interventions:

The use of Ibrutinib as an effective treatment.

Outcomes:

The patient was in complete remission after 5 months of Ibrutinib and then died of sudden aortic dissection.

Lessons:

Ibrutinib was an effective regimen for SBLPN. Aortic dissection might be considered as a suspicious adverse reaction to Ibrutinib.
Homonymous hemianopia due to cerebral venous thrombosis: A case report
Authors: Choi Woo Seok , Yoon Sook Hyun , Lee Donghun
Published: January 2024

Rationale:

Diagnosing cerebral venous thrombosis (CVT) can be difficult because of nonspecific symptoms, such as headache and homonymous hemianopia (HH). Herein, we present a case of delayed CVT diagnosis due to nonspecific neurological symptoms and nonprominent lesions in a patient with HH.

Patient concern:

A 65-year-old woman presented with a sudden onset headache accompanied by right HH that lasted for 1 day. Brain computed tomography and magnetic resonance imaging were initially performed due to suspicion of ischemic lesions or hemorrhage in the left postchiasmal visual pathway; however, no remarkable acute brain lesions were detected. Ophthalmological examinations revealed no notable findings, except for a definite field defect in the Humphrey visual field test. The headaches then waxed and waned but recurred 3 days after the initial symptom.

A repeat brain magnetic resonance imaging was performed, which revealed left sectoral gyral swelling and vascular enhancement in the occipital lobe. To further evaluate venous drainage, additional 3-dimensional cerebral computed tomography angiography and 4-vessel angiography were conducted, revealing a partial filling defect in the left transverse sinus and superior venous drainage impairment. These findings suggested the presence of venous thrombosis in the left transverse sinus.

Diagnosis:

The patient was diagnosed with thrombosis of the left transverse sinus, which subsequently caused the right HH.

Intervention:

Anticoagulation therapy with parenteral heparin was started as soon as the diagnosis of CVT was confirmed. Eventually, the patient was solely managed with oral warfarin administration.

Outcomes:

Following 3 days of treatment, her headache resolved, and a subsequent visual field testing conducted 2 weeks later revealed a definite improvement in the field defect.

Lessons:

Despite its favorable prognosis, CVT can be challenging to diagnose. CVT should be considered as a differential diagnosis when diagnosing patients who present with headaches accompanied by HH without prominent brain lesions.
Using ultrasound guided needle biopsy in conjunction with GeneXpert MTB/RIF to diagnose epididymal tuberculosis
Authors: Cui Jia , Li Xiuju , Yu Yong , Xue Feng , Tian Jiakai , Yan Qinghu
Published: January 2024

This study aimed to investigate the diagnostic utility of percutaneous ultrasound-guided needle biopsy conjunction with GeneXpert MTB/RIF for epididymal tuberculosis. A retrospective analysis was conducted on the pathological and laboratory examinations of 20 patients with epididymal lesions undergoing ultrasound guided biopsy at Shandong Public Health Clinical Center. Laboratory examination included acid-fast staining, Mycobacterium tuberculosis culture by BACTEC MGIT 960, and GeneXpert MTB/RIF test. Diagnosis and complications were comprehensively analyzed. Among the 20 patients, 15 had epididymal tuberculosis and 5 had non-epididymal tuberculosis. Ten patients had granulomatous inflammation and necrotic tissues. The sensitivity and specificity of acid-fast staining, Mycobacterium tuberculosis culture, and GeneXpert MTB/RIF for the diagnosis of epididymis tuberculosis were 26.67% and 100.00%, 33.33% and 100.00%, and 86.67% and 100.00%, respectively. The diagnostic value analysis of the 3 detection techniques indicated that the GeneXpert MTB/RIF technique (Kappa = 0.765, Area under the curve (AUC) = 0.933) was superior to Mycobacterium tuberculosis culture (Kappa = 0.200, AUC = 0.667) and acid-fast staining (Kappa = 0.154, AUC = 0.633). Ultrasound-guided percutaneous biopsy is a safe procedure. The GeneXpert MTB/RIF test has high sensitivity, specificity, and superior AUC value, which are of great value in the diagnosis of epididymal tuberculosis and rifampicin resistance detection.
Effect of functional electrical stimulation-based mirror therapy using gesture recognition biofeedback on upper extremity function in patients with chronic stroke: A randomized controlled trial
Authors: Kim Young-Soung , Song Jun-Young , Park Sam-Ho , Lee Myung-Mo
Published: January 2024

Background:

Mirror therapy (MT) is an intervention used for upper extremity rehabilitation in stroke patients and has been studied in various fields. Recently, effective MT methods have been introduced in combination with neuromuscular electrical stimulation or with electromyography (EMG)-triggered biofeedback. The purpose of this study was to investigate the effects of functional electrical stimulation (FES)-based MT incorporating a motion recognition biofeedback device on upper extremity motor recovery to chronic stroke patients.

Methods:

Twenty-six chronic stroke patients with onset of more than 6 months were randomly assigned into experimental group (n = 13) and control group (n = 13). Both groups participated in conventional rehabilitation program, while the control group received conventional MT intervention and the experimental group received FES-based MT with motion recognition biofeedback device. All interventions were conducted for 30 min/d, 5 d/wk, for 4 weeks. Upper limb motor recovery, upper limb function, active-range of motion (ROM), and activities of daily living independence were measured before and after the intervention and compared between the 2 groups.

Results:

The Fugl-Meyer assessment (FMA), manual function test (MFT), K-MBI, and active-ROM (excluding deviation) were significantly improved in both groups (P < .05). Only the experimental group showed significant improvement in upper extremity recovery, ulnar and radial deviation (P < .05). There was a significant difference of change in Brunstrom’s recovery level, FMA, MFT, and active-ROM in the experimental group compared to the control group (P < .05).

Conclusion:

FES-based MT using gesture recognition biofeedback is an effective intervention method for improving upper extremity motor recovery and function, active-ROM in patients with chronic stroke. This study suggests that incorporating gesture-recognition biofeedback into FES-based MT can provide additional benefits to patients with chronic stroke.
KRAS modulates immune infiltration levels and survival outcomes in patients with lung adenocarcinoma
Authors: Li Na , Tian Yue , Liu Xin , Pan Ciming , Xue Jian
Published: January 2024

The murine sarcoma virus oncogene (KRAS) is a key gene associated with tumorigenesis and chemotherapy resistance. However, little is known about the molecular mechanisms and immune infiltration of RASs in lung adenocarcinoma. Gene Expression Profiling Interaction Analysis was used for RASs expression analysis, and Kaplan–Meier analysis was used to analyze the potential of RASs in clinical prognosis. The effect of KRAS on immune infiltration was analyzed by TIMER. In addition, the correlation between KRAS expression and molecular mechanisms was investigated by TIMER and Cancer Single-cell State Atlas (Cancer SEA). KRAS expression levels were associated with good prognosis and tumor progression. Furthermore, KRAS expression correlates with several immune cell markers and regulates tumorigenesis. KRAS expression is involved in the regulation of multiple oncogenes and tumorigenesis, especially in the prognosis and immune infiltration of lung adenocarcinoma.