bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid onset hydroxychloroquine toxicity
Authors: Jeltsch Brida M. , Sarraf David , Madjdpour Darius , Hanson James V. M. , Pfiffner Fatma K. , Koller Samuel , Berger Wolfgang , Barthelmes Daniel , Al-Sheikh Mayss
Published: March 2023

Purpose:

Hydroxychloroquine (HCQ) can cause irreversible damage to the retina, especially when taken over longer periods. The American Academy of Ophthalmology recommends a regimen for dosing, screening and monitoring of patients treated with HCQ. We present an unusual case of a rapid development of severe HCQ-associated-retinopathy already after 2 years after commencing HCQ treatment.

Methods:

Observational case report. Clinical examination, optical coherence tomography (OCT), fundus autofluorescence imaging (FAF), perimetry, full-field & multifocal electroretinography (ERG) were performed. Ancillary tests included neoplastic and paraneoplastic work-up, vitamin levels and whole exome sequencing, in order to rule out other potential causes of a panretinal degeneration.

Results:

We report on a 58-year-old woman with rheumatoid arthritis, treated initially with 200mg HCQ daily for 1 year (daily dose 3.6mg/kg), then 400mg daily for 1 year (daily dose 7.2mg/kg), and a cumulative dose of 216 g. Her medical history was otherwise unremarkable. No family history for inherited retinal conditions. She was referred due to a rapid and sudden progressive and severe concentric visual field constriction, two years after commencing HCQ treatment.

Conclusion:

This case of a rapid-onset, severe panretinal degeneration shortly after start of HCQ treatment suggests underlying mechanisms and risk factors for HCQ toxicity in addition to those previously reported, and a potential need for supplementary screening tests to prevent HCQ toxicity. AAO dosing guidelines of 5 MG/KG should be strictly adhered to in patients receiving HCQ therapy.
Efficacy and safety of Tuina for chronic nonspecific low back pain: A PRISMA-compliant systematic review and meta-analysis
Authors: Yang Juan , Zhou Xuan , Ma Qingyu , Woods Jeffrey T. , Mohabbat Arya B. , Do Alexander , Brault Jeffrey S. , Jensen Mark A. , Shin Kyung-Min , Shen Longbin , Zhao Canghuan , Cheong Kwok Chee Philip , He Kejie , Guo Yu , Chen Zhuoming , Tang Shujie , Tang Yong , Tan Celia Ia Choo , Chen Jiaxu , Bauer Brent A.
Published: March 2023

Objective:

Chronic nonspecific low back pain (CNLBP) is a serious medical and social problem resulting in functional decline and decreased work ability. Tuina, a form of manual therapy, has been sparsely used to treat patients with CNLBP. To systematically assess the efficacy and safety of Tuina for patients with CNLBP.

Methods:

Multiple English and Chinese literature databases were searched until September 2022 for randomized controlled trials (RCTs) of Tuina in the treatment of CNLBP. The methodological quality was assessed using the Cochrane Collaboration’s tool, and certainty of the evidence was determined with the online Grading of Recommendations, Assessment, Development and Evaluation tool.

Results:

Fifteen RCTs with 1390 patients were included. Tuina demonstrated a significant effect on pain (SMD: −0.82; 95% CI −1.12 to −0.53; P < .001; I
2 = 81%) and physical function (SMD: −0.91; 95% CI −1.55 to −0.27; P = .005; I
2 = 90%) when compared to control. However, Tuina resulted in no significant improvement for quality of life (QoL) (SMD: 0.58; 95% CI −0.04 to 1.21; P = .07; I
2 = 73%;) compared to control. The Grading of Recommendations, Assessment, Development and Evaluation evidence quality was determined to be low level for pain relief, physical function, and QoL measurements. Only six studies reported adverse events; none were serious.

Conclusion:

Tuina might be an effective and safe strategy for treating CNLBP in terms of pain and physical function, but not for QoL. The study results should be interpreted with caution for their low-level evidence. More multicenter, large-scale RCTs with a rigorous design are required to further confirm our findings.
Effect of pre-administration of esketamine intraoperatively on postpartum depression after cesarean section: A randomized, double-blinded controlled trial
Authors: Wang Wei , Ling Bin , Chen Qian , Xu Hua , Lv Jie , Yu Wanyou
Published: March 2023

Background:

To evaluate the effect of pre-administration of esketamine intraoperatively on the occurrence of postpartum depression after cesarean section under combined spinal-epidural anesthesia.

Methods:

A total of 120 women aged 24 to 36 years undergoing cesarean section by spinal-epidural anesthesia with American Society of Anesthesiologists physical status II were enrolled. According to the intraoperative use of esketamine, all participants were randomly divided into 2 groups: test group (group E) and control group (group C). Esketamine was administered intravenously at a dose of 0.2 mg/kg after the infant was delivered in group E and equal volume of normal saline was given in group C. The incidence of postpartum depression was recorded at 1 week and 6 weeks after the operation. The occurrence of adverse reactions such as postpartum bleeding, nausea and vomiting, drowsiness, and nightmares were also recorded at 48 hours after surgery.

Results:

Compared with group C, the incidence of postpartum depression was significantly lower at 1 week and 6 weeks after surgery in group E (P < .01). There was no significant difference of the adverse effects at 48 hours after the operation between the 2 groups.

Conclusion:

Intravenous infusion of 0.2 mg/kg esketamine in women during cesarean section can significantly reduce the incidence of postpartum depression at 1 week and 6 weeks after surgery without increasing related adverse effects.
Development of a home-based cognitive test for cognitive monitoring in subjective cognitive decline with high risk of Alzheimer’s disease
Authors: Hong Yun Jeong , Lee Si Baek , Kim Seong Hoon , Lee Myung Ah , Park Jeong Wook , Yang Dong Won
Published: March 2023

Background and purpose:

Subjective cognitive decline (SCD) indicates a self-perceived persistent cognitive worsening despite of normal performance in standard neuropsychological tests. Owing to its heterogeneity and potential risk of Alzheimer’s disease, baseline biomarkers to predict cognitive decline are important. In the present study, we developed a home-based cognitive test (HCT) to monitor cognitive changes regularly without visiting hospitals. This study aims to compare cognitive and biomarker trajectories during a 48-month period between amyloid positive SCD and amyloid negative SCD subjects.

Methods:

Data will be collected from a prospective observational cohort study conducted in South Korea. Eighty participants with SCD aged ≥ 60 years are eligible for the study. All participants undergo annual neuropsychological tests and neurological examinations, bi-annual brain MRI scans and plasma amyloid markers, and baseline florbetaben Positron Emission Tomography scans. The amyloid burden and regional volumes will be measured. Cognitive and biomarker changes will be compared between the amyloid-positive SCD and amyloid negative SCD groups. Validation would be performed to assess reliability and feasibility of HCT.

Conclusions:

This study would suggest a perspective on SCD in terms of cognitive and biomarker trajectories. Baseline characteristics and biomarker status might affect faster cognitive decline and future biomarker trajectories. In addition, HCT could be an alternative option of in-person neuropsychological tests to track cognitive changes without visiting hospitals.
Reliability and validity of visual analysis of [18F]FE-PE2I PET/CT in early Parkinsonian disease
Authors: af Bjerkén Sara , Axelsson Jan , Larsson Anne , Flygare Carolina , Remes Jussi , Strandberg Sara , Eriksson Linda , Bäckström David , Jakobson Mo Susanna
Published: March 2023

Objective

[18F]FE-PE2I (FE-PE2I) is a new radiotracer for dopamine transporter (DAT) imaging with PET. The aim of this study was to evaluate the visual interpretation of FE-PE2I images for the diagnosis of idiopathic Parkinsonian syndrome (IPS). The inter-rater variability, sensitivity, specificity, and diagnostic accuracy for visual interpretation of striatal FE-PE2I compared to [123I]FP-CIT (FP-CIT) single-photon emission computed tomography (SPECT) was evaluated.

Methods

Thirty patients with newly onset parkinsonism and 32 healthy controls with both an FE-PE2I and FP-CIT were included in the study. Four patients had normal DAT imaging, of which three did not fulfil the IPS criteria at the clinical reassessment after 2 years. Six raters evaluated the DAT images blinded to the clinical diagnosis, interpreting the image as being ‘normal’ or ‘pathological’, and assessed the degree of DAT-reduction in the caudate and putamen. The inter-rater agreement was assessed with intra-class correlation and Cronbach’s
α
. For calculation of sensitivity and specificity, DAT images were defined as correctly classified if categorized as normal or pathological by ≥4/6 raters.

Results

The overall agreement in visual evaluation of the FE-PE2I- and FP-CIT images was high for the IPS patients (
α 
= 0.960 and 0.898, respectively), but lower in healthy controls (FE-PE2I:
α
 = 0.693, FP-CIT:
α
 = 0.657). Visual interpretation gave high sensitivity (both 0.96) but lower specificity (FE-PE2I: 0.86, FP-CIT: 0.63) with an accuracy of 90% for FE-PE2I and 77% for FP-CIT.

Conclusion

Visual evaluation of FE-PE2I PET imaging demonstrates high reliability and diagnostic accuracy for IPS.
Cumulative group metrics: a new and efficient method to measure the scientific impact of research groups
Authors: Moll Uta , Camp Christopher L. , Bedi Asheesh , Khoury Anthony N. , Villinger Sarah M. , Higgins Laurence D. , Wijdicks Coen A.
Published: March 2023

Background:

Various metrics have emerged for assessing scientific impact, most of which are based on complex calculations and, in many cases, are not freely available. Moreover, most of these metrics are not intended for assessing the scientific impact of research groups. Cumulative group metrics are proposed as an efficient and cost-effective strategy for measuring group scientific impact.

Materials and methods:

The authors collected peer-reviewed output in 2020 from two academic orthopedic surgery departments [University of Michigan (UM) and Mayo Clinic Rochester (MC)] and one medical device research department [Arthrex Inc. (AI)]. The sites evaluated the Cumulative Group Number of Publications (CGNP), Cumulative Journal Impact Factor (CJIF), Cumulative CiteScore (CCS), Cumulative SCImago Journal Rank (CSJR), and Cumulative Source Normalized Impact per Paper (CSNIP) for the three institutions.

Results:

In 2020, UM published 159 peer-reviewed studies, MC published 347 peer-reviewed studies, and AI supported 141 publications. The UM publications achieved a CJIF of 513, a CCS of 891, a CSJR of 255, and a CSNIP of 247. The MC publications achieved a CJIF of 956, a CCS of 1568, a CSJR of 485, and a CSNIP of 508. AI-supported publications achieved a CJIF of 314, a CCS of 598, a CSJR of 189, and a CSNIP of 189.

Conclusion:

The presented cumulative group metrics are an effective tool to assess the scientific impact of a research group. The cumulative submetrics can further evaluate research groups compared with other departments due to field normalization. Department leadership and funding agencies can utilize these metrics to evaluate research output quantitatively and qualitatively.
The place of prenatal visits in pregnancy care: Should we reconsider the current approach?
Authors: Moise Mbaluku C. , Laurent Kasongo W. N. , Patrick Chirimwami M. , Daniel Safari N. , Peniel Kundo S. , Trésor Okamba A. , Viviane Feza B. , Fernand Manga O.
Published: March 2023

A well-conducted prenatal visit remains of paramount importance because it allows the preservation of mother and child health by reducing the rates of morbidity and mortality for them. However, the quality of prenatal visits remains a serious problem in our environment, and a new approach is urgently needed to improve the quality of prenatal visits in our environment.
Ritonavir-boosted Nirmatrelvir and COVID-19 outcomes in the age of Omicron variant
Authors: Imran Laiba , Zubair Rooja , Mughal Sanila , Shakeel Ramsha
Published: March 2023

Nirmatrelvir boosted with Ritonavir is the recommended and preferred treatment for COVID-19. Because real-world evidence of Nirmatrelvir’s antiviral activity against the Omicron variation is minimal, our study focuses on recent papers suggesting the use of Ritonavir-boosted Nirmatrelvir in the real world against the most frequent SARS coronavirus variant circulating worldwide (Omicron). Despite sparse clinical evidence, we discovered that Ritonavir-boosted Nirmatrelvir reduced COVID-19-related hospitalization and mortality during the onset of the Omicron variant. Furthermore, this study discusses the main limitations and offers recommendations for administering this drug in non-hospitalized COVID-19 patients at high risk for severe infection.
Rare manifestations of alobar holoprosencephaly and the potential causes: a report of two cases
Authors: Nakawa Wael , Alkhalil Sandy , Martini Nafiza , Alawad Ieman
Published: March 2023

Background:

Holoprosencephaly is a rare and possibly fatal neural tube defect represented by complete or partial forebrain noncleavage. It can be classified into four types: alobar, semilobar, lobar, and middle interhemispheric fusion variant. It is usually diagnosed through prenatal ultrasound or after birth by visually observing the morphological abnormalities and/or through neurological screening. Potential causes include maternal diabetes, alcoholism, infections during pregnancy, drugs, and genetic causes.

Case presentation:

Herein, we report two cases of holoprosencephaly’s rarest manifestations, albeit cebocephaly in the first case, and cyclopia with a probocis in the second. Cebocephaly, (hypotelorism with a single nostril and a blind-ended nose) was present in the first case; a Syrian newborn girl for a 41-year-old mother who works in collecting Capparis spinosa, and cyclopia with skull vault absence and posterior encephalocele in the second case; a Syrian newborn girl for a 26-year-old mother, the parents here where second-degree relatives.

Conclusions:

Early diagnosis through ultrasound is preferred in such cases and management options should be assessed and discussed with the parents due to poor prognosis. Adherence to pregnancy follow-up programs is essential to detect malformations and disorders as early as possible, especially when risk factors exist. Also, this paper may suggest a potential correlation between C. spinosa and holoprosencephaly. Therefore, we suggest that more research should be done.
Chronic myelomonocytic leukemia in a 72-year-old male from Nepal: A case report
Authors: Gurung Shekhar , Karki Saurab , Khadka Manoj , Bhatta Bhuwan , Adhikari Ayush , Shrestha Amar N.
Published: March 2023

Introduction:

Chronic myelomonocytic leukemia (CMML) is a rare disease of clonal hematopoietic stem cells with an inherent risk of leukemic transformation, seen in an elderly male.

Case Presentation:

Herein, the authors report a case of CMML in a 72-year-old male who presented with fever and abdominal pain for 2 days with a history of easy fatigability. Examination revealed pallor and palpable supraclavicular nodes. Investigations showed leukocytosis with a monocyte count of 22% of white blood cell count, 17% blast cells in bone marrow aspiration, increased blast/promonocytes, and positive markers in immunophenotyping. The patient is planned for injection of azacitidine, 7 days cycle for a total of six cycles.

Clinical Discussion:

CMML is classified as overlapping myelodysplastic/myeloproliferative neoplasms. It can be diagnosed based on a peripheral blood smear, bone marrow aspiration and biopsy, chromosomal analysis, and genetic tests. The commonly used treatment options are hypomethylating agents like azacitidine and decitabine, allogeneic hematopoietic stem cell transplant, and cytoreductive agents like hydroxyurea.

Conclusion:

Despite various treatment options, the treatment is still unsatisfactory, demanding standard management strategies.
Congenital unilateral absence of right pulmonary artery with VSD and wide aortopulmonary window in an adult patient: a case report
Authors: Mehta Kshitij , Mehta Kajol , Bhattarai Vikash , Mahat Sandeep , Sharma Suraj , Timalsena Birat K. , Neupane Nirmal P.
Published: March 2023

Introduction and background:

Unilateral absence of pulmonary artery (UAPA) is a very rare condition, with an estimated prevalence of 1 in 200,000 population, which is commonly associated with various cardiovascular anomalies or can occur in an isolated manner. Isolated cases survive to adulthood and remain asymptomatic, but they may frequently experience hemoptysis, repeated infections, or symptoms like dyspnea and chest pain. Due to the rarity of the disorder and its ambiguous appearance, diagnosis can be very challenging.

Case presentation:

We present a case of a 28-year-old male who visited our center with the diagnosis of ventricular septal defect with Eisenmenger syndrome elsewhere for further evaluation and was found to have right-sided UAPA with ipsilateral pulmonary hypoplasia and some associated cardiac anomalies.

Clinical discussion:

Discussions are held regarding typical chest radiograph findings, diagnostic methods, and possible therapies.

Conclusion:

Physicians should be aware of UAPA, which might go undiagnosed for several years despite regular medical care and can show up later in life, causing chronic respiratory symptoms along with Eisenmenger syndrome and ventricular septal defect like in our case.
Obesity and incidence of colorectal polyps: a case-controlled study
Authors: Salimian Sina , Habibi Maryam , Sehat Mojtaba , Hajian Abbas
Published: March 2023

Background:

Previous essays have presented possible concordance between obesity and colorectal polyp development. However, neither for the hypothesis nor for the details general consensus exists. This study aimed to evaluate the association between higher BMI rather than the normal and colorectal polyp presentation and characteristics if any.

Methods:

Eligible patients based on study criteria who were candidates for total colonoscopy examination enrolled in this case-controlled trial. Controls had normal colonoscopy reports. A positive colonoscopy for any kind of polyp was followed by a histopathological study. Demographic data also was registered, and patients were categorized according to the calculated BMI. Groups were matched by both gender and status of tobacco abuse. Finally, the outcomes of colonoscopy and histopathological studies were compared between groups.

Results:

A total of 141 and 125 persons investigated, respectively, as patients and controls. Possible effects of gender, tobacco abuse, and cigarette smoking were declined by participants matching. Hence, we found no significant difference between groups regarding the latter variables (P>0.05). Colorectal polyps were found absolutely more in BMI>25 kg/m−2 rather than in lesser values (P<0.001). However, there was no obvious difference in the incidence of colorectal polyps between groups categorized as overweight and obese (P>0.05). Namely, even weighing over could be the risk for colorectal polyp development. Additionally, it was more expected to find neoplastic adenomatous polyp(s) with high-graded dysplasia in BMI>25 kg/m−2 (P<0.001).

Conclusion:

Even little changes in BMI further than the normal values can independently increase the risk of developing dysplastic adenomatous colorectal polyp(s) significantly.
Acute liver failure in a young patient with dengue shock syndrome: a case report
Authors: Achhami Eliz , Adhikari Lukash , Shrestha Shumneva , Shrestha Abhigan Babu
Published: March 2023

Dengue fever is caused by dengue virus, which has four different serotypes and is transmitted by the Aedes mosquitos. This disease is endemic to Southeast Asian countries, including Nepal. Liver involvement in dengue is a crucial feature, and the effect ranges from an asymptomatic rise in liver enzymes to the development of acute liver failure. Acute liver failure often results in multiorgan dysfunction including hemodynamic instability, renal failure, cerebral edema, and even death because of shock. Prompt diagnosis and management are necessary to prevent complications. However, there is no proven proper treatment for this condition, and the only treatment modality is to prevent the symptoms. We presented the case of a young female with dengue fever who developed a life-threatening acute liver failure because of dengue shock syndrome.
An evaluation of the impact of anti-rabies programs in Nigeria
Authors: Adesola Ridwan O. , Akinniyi Hafeez T. , Lucero-Prisno Don E.
Published: March 2023

Background:

Rabies remains a significant public health problem in Africa with outbreaks reported in most countries. In Nigeria, the most populous country in Africa, rabies causes a significant public health burden partly due to uncoordinated efforts and the ineffectiveness of available anti-rabies programs. We aim to address the current efforts, and challenges associated with the available anti-rabies programs in Nigeria and provide recommendations to tackle these challenges.

Results:

The anti-rabies programs available in Nigeria are highlighted. They are sponsored by different bodies such as government parastatals, veterinary teaching hospitals, professional associations, nongovernmental associations, and students. These programs provide support to eradicate rabies but are not devoid of challenges. Recommendations are provided to the Nigerian government, bodies anchoring the anti-rabies programs, and health professionals to tackle the challenges hindering the effective impact of the programs.

Conclusion:

Anti-rabies programs in Nigeria are supported by individual and collaborative bodies. It is pertinent to hold on to these programs and create a comprehensive national program to achieve effective rabies eradication in Nigeria.
Implementation Science for the Practice-Oriented Nurse Leader
Authors: Nelson-Brantley Heather V. , Chipps Esther
Published: March 2023

Senior nurse leaders are accountable for improving patient outcomes efficiently and cost-effectively. Nurse leaders often find heterogeneous patient outcomes across comparable nursing units in the same enterprise, presenting a challenge for nurse leaders tasked with making system-wide quality improvements. Implementation science (IS) offers a promising new approach to guide nurse leaders in understanding why certain implementation efforts meet with success or failure and the barriers faced in making practice changes. Knowledge of IS builds upon evidenced-based practice and quality improvement knowledge, adding to the armamentarium of tools at nurse leaders' disposal for improving nursing and patient outcomes. In this article, we demystify IS, differentiate it from evidence-based practice and quality improvement, describe IS concepts every nurse leader should be familiar with, and outline nurse leaders' role in building IS in their organizations.
Implementation and Evaluation of a Training Curriculum for Experienced Nurses in Care Coordination
Authors: Kelley Lynette , Broadfoot Kirsten , McCreight Marina , Wills Ashlea , Leonard Chelsea , Connelly Brigid , Gilmartin Heather , Burke Robert E.
Published: March 2023

Background:

High-quality transitional care at discharge is essential for improved patient outcomes. Registered nurses (RNs) play integral roles in transitions; however, few receive structured training.

Purpose:

We sought to create, implement, and evaluate an evidence-informed nursing transitional care coordination curriculum, the Transitions Nurse Training Program (TNTP).

Methods:

We conceptualized the curriculum using adult learning theory and evaluated with the New World Kirkpatrick Model. Self-reported engagement, satisfaction, acquired knowledge, and confidence were assessed using surveys. Clinical and communication skills were evaluated by standardized patient assessment and behavior sustainment via observation 6 to 9 months posttraining.

Results:

RNs reported high degrees of engagement, satisfaction, knowledge, and confidence and achieved a mean score of 92% on clinical and communication skills. Posttraining observation revealed skill sustainment (mean score 98%).

Conclusions:

Results suggest TNTP is effective for creating engagement, satisfaction, acquired and sustained knowledge, and confidence for RNs trained in transitional care.
Associations of living in residential care facilities with participation in physical activities among older adults in the United States
Authors: Zhou Weijiao , Larson Janet L.
Published: March 2023

Background:

Physical activity (PA) is important for the healthy aging period, and existing research indicates that older adults in residential care facilities (RCFs) are less physically active compared with community-dwelling, but sociodemographic and health-related characteristics were not controlled. Lower PA levels might be due to older age and worse health conditions of the RCFs residents.

Objective:

This study examined the association between residential status (RCF vs. community-dwelling) and participation in PA, in a sample of 4009 older adults (65 and above) in the National Health and Aging Trends Study (NHATS), adjusting for sociodemographic and health-related characteristics.

Methods:

The current study used Rounds 8 and 9 of the NHATS which was collected in 2018 and 2019. We conducted design-based logistic regression analyses to determine whether residential care status was significantly associated with participation in walking exercises and vigorous activities, and controlled for sociodemographic and health-related characteristics.

Results:

Using multivariable logistic regression models, older adults in RCFs (n=214) were more likely to participate in walking exercises (adjusted odds ratios=1.94, P<0.01) and equally likely to participate in vigorous activities (adjusted odds ratios=1.04, P=0.84) than community-dwelling (n=3795).

Conclusions:

Our finding adds new evidence to the conventional thinking about the potential effect of RCFs on PA. Further research is needed to address the underlying mechanisms.
Interocular Contrast Balancing Partially Improves Stereoacuity in Keratoconus
Authors: Marella Bhagya Lakshmi , Vaddavalli Pravin Krishna , Reddy Jagadesh C. , Conway Miriam L. , Suttle Catherine M. , Bharadwaj Shrikant R.
Published: March 2023

Significance

Partial improvement in stereoacuity may be achieved by balancing the contrast input to the two eyes of patients with bilaterally asymmetric keratoconus.

Purpose

Interocular differences in image quality, characterized by dissimilar contrast loss and phase shifts, is implicated in stereoacuity loss in keratoconus. This study determined whether contrast balancing improves stereoacuity in this disease condition, and, if so, whether it is dependent on the baseline interocular contrast imbalance.

Methods

Interocular contrast imbalance and stereoacuity of 43 subjects (16-33 years) with bilaterally asymmetric keratoconus were tested with spectacle correction as baseline using a binocular rivalry paradigm and random-dot stereograms, respectively. Stereoacuity measurements were repeated in a subset of 33 subjects at their contrast balance point (i.e., contrast level in stronger eye allowing balanced rivalry with 100% contrast in weaker eye) and with contrast levels biased in favor of stronger or weaker eye, all conditions in randomized order.

Results

Contrast imbalance level was significantly correlated with the subject’s stereoacuity at baseline (r = -0.47, P = .002). The median (25th-75th IQR) stereoacuity improved by 34.6% (19.0-65.1%) from baseline [748.8 arc sec (261.3-1257.3 arc sec)] to the contrast balanced condition [419.0 arc sec (86.6-868.9 arc sec)] (P < .001), independent of their baseline stereoacuity or contrast imbalance levels (r < 0.2, P > .26 for both). Contrast bias in favor of weaker eye [881.3 arc sec (239.6 to 1707.6 arc sec)] worsened stereoacuity more than a bias towards stronger eye [502.6 arc sec (181.9 to 1161.4 arc sec)], both relative to the contrast balanced condition (P < .002).

Conclusions

Interocular contrast balancing partially improves stereoacuity in bilaterally asymmetric keratoconus, independent of their baseline contrast imbalance level. Cyclopean viewing may be inherently biased towards the input from the stronger eye in keratoconus.
Factors associated with persistent postsurgical pain after total knee or hip joint replacement: a systematic review and meta-analysis
Authors: Ghoshal Arunangshu , Bhanvadia Shivam , Singh Som , Yaeger Lauren , Haroutounian Simon
Published: March 2023

Studies have identified demographic, clinical, psychosocial, and perioperative variables associated with persistent pain after a variety of surgeries. This study aimed to perform a systematic review and meta-analysis of factors associated with persistent pain after total knee replacement (TKR) and total hip replacement (THR) surgeries. To meet the inclusion criteria, studies were required to assess variables before or at the time of surgery, include a persistent postsurgical pain (PPSP) outcome measure at least 2 months after a TKR or THR surgery, and include a statistical analysis of the effect of the risk factor(s) on the outcome measure. Outcomes from studies implementing univariate and multivariable statistical models were analyzed separately. Where possible, data from univariate analyses on the same factors were combined in a meta-analysis. Eighty-one studies involving 171,354 patients were included in the review. Because of the heterogeneity of assessment methods, only 44% of the studies allowed meaningful meta-analysis. In meta-analyses, state anxiety (but not trait anxiety) scores and higher depression scores on the Beck Depression Inventory were associated with an increased risk of PPSP after TKR. In the qualitative summary of multivariable analyses, higher preoperative pain scores were associated with PPSP after TKR or THR. This review systematically assessed factors associated with an increased risk of PPSP after TKR and THR and highlights current knowledge gaps that can be addressed by future research.
Diagnostic Yield of Transabdominal Ultrasound-Guided Core Needle Method in Biopsies of Pancreatic Lesions
Authors: Turgut Bekir , Bakdik Süleyman , Öncü Fatih , Küçükosmanoğlu İlknur , Eren Karanis Meryem İlkay , Kerimoğlu Ramazan Saygin , Saraçoğlu Mustafa
Published: March 2023

In this study, it was aimed to contribute to the selection of the method to perform pancreatic lesion biopsies.

Data of patients, who had undergone a percutaneous biopsy because of pancreatic masses in our institution in the period between January 2015 and November 2019, were evaluated retrospectively. The percutaneous biopsy method, the type of needle used in the procedure, and periprocedural complications were listed. Pathology and cytology reports in the archive were reviewed, and biopsy results were divided into 3 groups as benign, malignant, and inadequate. Of 308 patients included in the study, the diagnostic accuracy was verified in 124 patients through the assessment of surgical outcomes, results of biopsies from metastatic lesions, or follow-up findings. The verified results were classified as true-positives and true-negatives.

Of a total of 308 patients included in the study, 23 underwent a fine-needle aspiration biopsy (FNAB) and 285 underwent a core needle biopsy (CNB). No statistical differences were observed in sample acquisition success and complications between the groups.

Of the lesions with a confirmed pathological diagnosis, 67.74% were malignant and 32.26% were benign. The diagnosis was correct in 107 of 112 CNB patients (95.54%) and 9 of 12 FNAB patients (75.00%). When the success of the 2 methods was compared, it was found that outcomes of CNB were statistically more successful compared with those of FNAB.

A transabdominal ultrasound-guided percutaneous CNB is a safe method with a high diagnostic yield to perform a biopsy of the pancreas.
Biomechanical Comparison of Titanium and Poly-L-Lactic Acid Trapezoidal Plates Applied in a Subcondylar Fracture Model
Authors: Keskin Yalcin Basak
Published: March 2023

Background/Aim:

Different types of plates are used in clinical practice for the management of subcondylar fractures. This study aimed to compare the performance of poly-L-lactic acid (PLLA) and titanium trapezoidal plates in the fixation of subcondylar mandibular fractures using finite element analysis.

Methods:

Titanium and PLLA trapezoidal plates and screws were placed on the virtual model obtained from computed tomography images of a patient with a subcondylar fracture to perform finite element analysis. The analysis included maximum tension distribution, maximum principal strain, displacement, and deformation of the bone, plates, and screws.

Results:

The maximum tension distribution and maximum principal stress were found to be significantly higher on the titanium plate than on the PLLA plate and screws. Almost no difference was found between the trapezoidal and PLLA plates regarding the displacement of the fracture fragments at the fracture line. No difference was recorded regarding the displacement of the PLLA and titanium screws. The values of maximal principal strain between the PLLA and titanium materials showed no significant difference.

Conclusions:

The trapezoidal PLLA plates can be an alternative to trapezoidal titanium plates due to their functional stability and rigidity.
Extreme acidity in a cynipid gall: a potential new defensive strategy against natural enemies
Authors: Guiguet Antoine , McCartney Nathaniel B. , Gilbert Kadeem J. , Tooker John F. , Deans Andrew R. , Ali Jared G. , Hines Heather M.
Published: March 2023

The morphology of insect-induced galls contributes to defences of the gall-inducing insect species against its natural enemies. In terms of gall chemistry, the only defensive compounds thus far identified in galls are tannins that accumulate in many galls, preventing damage by herbivores. Intrigued by the fruit-like appearance of the translucent oak gall (TOG;
Amphibolips nubilipennis
, Cynipidae, Hymenoptera) induced on red oak (
Quercus rubra
), we hypothesized that its chemical composition may deviate from other galls. We found that the pH of the gall is between 2 and 3, making it among the lowest pH levels found in plant tissues. We examined the organic acid content of TOG and compared it to fruits and other galls using high-performance liquid chromatography and gas chromatography–mass spectrometry. Malic acid, an acid with particularly high abundance in apples, represents 66% of the organic acid detected in TOGs. The concentration of malic acid was two times higher than in other galls and in apples. Gall histology showed that the acid-containing cells were enlarged and vacuolized just like fruits mesocarp cells. Accumulation of organic acid in gall tissues is convergent with fruit morphology and may constitute a new defensive strategy against predators and parasitoids.
The earliest pollen-loaded insects from the Lower Permian of Russia
Authors: Khramov Alexander V. , Foraponova Tatiana , Węgierek Piotr
Published: March 2023

Recent fossil discoveries suggest that the coevolution of insect pollinators and gymnosperms started long before the appearance of flowering plants. One of the keys to understanding the origins of pollination relationships is fossil insects with gymnosperm pollen attached to the body surface. Such fossils are exceedingly rare to find, especially from the Palaeozoic, a time when ambers with insect inclusions were absent. Here, we report compression fossils of Early Permian tillyardembiid insects (Polyneoptera) preserved with pollen on their heads, thoraces, legs and abdomens. This is the earliest finding of pollen-bearing insects, predating the previous oldest record from the Middle Jurassic by
ca
120 Ma. Judging by the pollen composition, tillyardembiids visited a narrow range of host plants, including Rufloriaceae (Cordaitales). While it is impossible to say for certain whether tillyardembiids as pollen consumers contributed to pollination, a trophic specialization of this kind could be considered an evolutionary precursor of pollination mutualism.
Beetle elytra: evolution, modifications and biological functions
Authors: Goczał Jakub , Beutel Rolf G.
Published: March 2023

Conversion of forewings into hardened covers, elytra, was a ground-breaking morphological adaptation that has contributed to the extraordinary evolutionary success of beetles. Nevertheless, the knowledge of the functional aspects of these structures is still fragmentary and scattered across a large number of studies. Here, we have synthesized the presently available information on the evolution, development, modifications and biological functions of this crucial evolutionary novelty. The formation of elytra took place in the earliest evolution of Coleoptera, very likely already in the Carboniferous, and was achieved through the gradual process of progressive forewing sclerotization and the formation of inward directed epipleura and a secluded sub-elytral space. In many lineages of modern beetles, the elytra have been distinctly modified. This includes multiple surface modifications, a rigid connection or fusion of the elytra, or partial or complete reduction. Beetle elytra can be involved in a very broad spectrum of functions: mechanical protection of hind wings and body, anti-predator strategies, thermoregulation and water saving, water harvesting, flight, hind wing folding, diving and swimming, self-cleaning and burrow cleaning, phoresy of symbiotic organisms, mating and courtship, and acoustic communication. We postulate that the potential of the elytra to take over multiple tasks has enormously contributed to the unparalleled diversification of beetles.
Shifting effects of host physiological condition following pathogen establishment
Authors: Langwig Kate E. , Kilpatrick A. Marm , Kailing Macy J. , Laggan Nichole A. , White J. Paul , Kaarakka Heather M. , Redell Jennifer A. , DePue John E. , Parise Katy L. , Foster Jeffrey T. , Hoyt Joseph R.
Published: March 2023

Understanding host persistence with emerging pathogens is essential for conserving populations. Hosts may initially survive pathogen invasions through pre-adaptive mechanisms. However, whether pre-adaptive traits are directionally selected to increase in frequency depends on the heritability and environmental dependence of the trait and the costs of trait maintenance. Body condition is likely an important pre-adaptive mechanism aiding in host survival, although can be seasonally variable in wildlife hosts. We used data collected over 7 years on bat body mass, infection and survival to determine the role of host body condition during the invasion and establishment of the emerging disease, white-nose syndrome. We found that when the pathogen first invaded, bats with higher body mass were more likely to survive, but this effect dissipated following the initial epizootic. We also found that heavier bats lost more weight overwinter, but fat loss depended on infection severity. Lastly, we found mixed support that bat mass increased in the population after pathogen arrival; high annual plasticity in individual bat masses may have reduced the potential for directional selection. Overall, our results suggest that some factors that contribute to host survival during pathogen invasion may diminish over time and are potentially replaced by other host adaptations.
Analysis of diffuse scattering in electron diffraction data for the crystal structure determination of Pigment Orange 13, C32H24Cl2N8O2
Authors: Gorelik Tatiana E. , Bekő Sàndor L. , Teteruk Jaroslav , Heyse Winfried , Schmidt Martin U.
Published: March 2023

The crystallographic study of two polymorphs of the industrial pyrazolone Pigment Orange 13 (P.O.13) is reported. The crystal structure of the β phase was determined using single-crystal X-ray analysis of a tiny needle. The α phase was investigated using three-dimensional electron diffraction. The electron diffraction data contain sharp Bragg reflections and strong diffuse streaks, associated with severe stacking disorder. The structure was solved by careful analysis of the diffuse scattering, and similarities of the unit-cell parameters with the β phase. The structure solution is described in detail and this provides a didactic example of solving molecular crystal structures in the presence of diffuse scattering. Several structural models were constructed and optimized by lattice-energy minimization with dispersion-corrected DFT. A four-layer model was found, which matches the electron diffraction data, including the diffuse scattering, and agrees with X-ray powder data. Additionally, five further phases of P.O.13 are described.
Dashed expectations in service experiences. Effects of robots human-likeness on customers’ responses
Authors: Grazzini Laura , Viglia Giampaolo , Nunan Daniel
Published: March 2023

Purpose

There is growing interest in the use of human-like social robots, able to undertake complex tasks whilst building consumer engagement. However, further exploration is needed on the optimal level of humanoid appearance for service robots. In particular, the literature is limited with respect to mitigating disconfirmed expectations for robots high in human-likeness. This paper aims to address this gap by testing the effect of robot appearance, disconfirmed expectations and warmth (vs competence) on customers’ responses.

Design/methodology/approach

The study adopts a mixed-method design by presenting a focus group (Study 1) that guides two laboratory experiments (Studies 2 and 3). Studies 2 and 3 test for the moderating effect of warmth (vs competence) and the mediating roles of perceived eeriness and disconfirmed expectations.

Findings

The findings show that a robot high (vs low) in human-likeness leads to higher negative customers’ responses, which is explained by disconfirmed expectations rather than perceived eeriness. However, when customers interact with a warm (vs competent) robot high in human-likeness, this negative effect vanishes.

Research limitations/implications

The paper investigates boundary conditions and underlying mechanisms that affect customers’ experiences. Although the study adopts high realistic experiments, a limitation lies in not measuring customers’ actual behaviours in the field.

Practical implications

This study provides new insights on how the appearance and characteristics of social robots influence the consumers’ experience. By doing so, this study offers managers actionable insights (i.e. enhancing warmth) to lessen the risk of disconfirmed expectations.

Originality/value

The paper offers new explanations as to why human-like robots can generate negative responses from customers. Moving beyond the “uncanny valley” hypothesis, this study shows the key role of disconfirmed expectations in explaining consumers’ negative responses towards humanoid robots. Moreover, it sheds light on the moderating role of warmth (vs competence), which can mitigate such negative effects.
In search of a suitable way to deploy Triple-A capabilities through assessment of AAA models' competitive advantage predictive capacity
Authors: Marin-Garcia Juan A. , Machuca Jose A.D. , Alfalla-Luque Rafaela
Published: March 2023

Purpose

To determine how to best deploy the Triple-A supply chain (SC) capabilities (AAA-agility, adaptability and alignment) to improve competitive advantage (CA) by identifying the Triple-A SC model with the highest CA predictive capability.

Design/methodology/approach

Assessment of in-sample and out-of-sample predictive capacity of Triple-A-CA models (considering AAA as individual constructs) to find which has the highest CA predictive capacity. BIC, BIC-Akaike weights and PLSpredict are used in a multi-country, multi-informant, multi-sector 304 plant sample.

Findings

Greater direct relationship model (DRM) in-sample and out-of-sample CA predictive capacity suggests DRM's greater likelihood of achieving a higher CA predictive capacity than mediated relationship model (MRM). So, DRM can be considered a benchmark for research/practice and the Triple-A SC capabilities as independent levers of performance/CA.

Research limitations/implications

DRM emerges as a reference for analysing how to trigger the three Triple-A SC levers for better performance/CA predictive capacity. Therefore, MRM proposals should be compared to DRM to determine whether their performance is significantly better considering the study's aim.

Practical implications

Results with our sample justify how managers can suitably deploy the Triple-A SC capabilities to improve CA by implementing AAA as independent levers. Single capability deployment does not require levels to be reached in others.

Originality/value

First research considering Triple-A SC capability deployment to better improve performance/CA focusing on model's predictive capability (essential for decision-making), further highlighting the lack of theory and contrasted models for Lee's Triple-A framework.
Pro-gender policies and the empowerment of women in the DRC
Authors: Joshi Christian Lukineyo , Maisonnave Helene , Baroki Robert Luanda , Mariam Anastasie Bulumba
Published: March 2023

Purpose

The purpose of this study was to show how pro-gender public policies in the agricultural sectors can contribute to the reduction of gender inequalities in the labour market and the diversification of the Congolese economy.

Design/methodology/approach

Computable general equilibrium model that has been adapted to the Congolese economy from the Democratic Republic of the Congo (DRC)'s SAM.

Findings

The results reveal that policies of increasing women's land allocation and government cash transfers to rural female households contribute to the reduction of inequalities in the labour market. However, only the policy of increasing women’s land allocation improves economic diversification.

Research limitations/implications

The implementation of the policy of government cash transfers to rural women's households comes at a cost to the government. Future studies to look at the most effective mode of financing for this policy. Moreover, the policy of increasing women's land allocation is feasible in the DRC as there is a lot of unused arable land available.

Social implications

In Pillar 1 of the National Strategic Development Plan (PNSD) on Economic Diversification and Transformation, the policy of increasing land allocation to women could be added to the objectives related to strengthening the contribution of agriculture to economic growth and employment creation. In Pillar 3 of the PNSD on Social Development and Human Resource Development, the policy of increasing land allocation to women as well as the policy of increasing government transfers to female rural households could be added to the objectives related to the promotion of employment of youth, women and vulnerable groups.

Originality/value

To the best of the authors’ knowledge, this is the first study of its kind for the DRC, which highlights the impact of pro-gender policies on women's employment, particularly in the agricultural sectors and in the diversification of the Congolese economy. This study contributes to policy orientation in DRC. The two policies (increasing land allocation to women and cash transfers to rural women) analysed in this study were chosen in light of the DRC's National Strategic Plan, the first phase of which focuses on promoting employment for vulnerable groups and economic diversification through the development of agricultural sectors.