bluuebunny/crossref_metadata_2025 huggingface dataset:
Fabrication and Identification of Characteristics and Biological Evaluation of 2-[(4-hydroxy-phenylimino)-methyl]4-methoxy-phenol (4-MSAP-L) and its First Transition Metal Complexes Derived from 5-methoxysalicylaldehyde and 4-aminophenol
Authors: Joseph Bijoy , Paul Johnpeter M. , Alphonsa Juliet Helina JK. , Paul Raj A.
Published: July 2024

The demand for novel and more effective anti-microbial agents is a continuous occurrence since the microbes has the ability to develop immunity to the existing antibiotics. Combination, characteristics of novel 2-[(4-Hydroxy-phenylimino)-methyl]-4-methoxy-phenol (4-MSAP-L) and its corresponding metal complexes and their biological applications are widely discussed in this paper mixture of 4-MSAP-L from 5-methoxysalicylaldehyde with p-aminophenol is done which has not been earlier on announced. Starting from this 4-MSAP-L, different transition metal complexes were prepared. Here, Mn(II), Ni(II), Co(II), Cu(II) and Zn(II) metal chlorides used in the coordination. With the assistance of analytical as well as physico-chemical arrangements 4-MSAP-L and metal complexes prepared and characterized. Biological studies of the newly synthesized 4-MSAP-L and metal complexes also reported.
Production of Natural Food Colorant with Organic Mordant Solutions and Incorporation into Modern Food Systems
Authors: Subriya S , Maheshwari M , Saranya E , Senthil Nathan M , Sridevi M , Nirmala C
Published: July 2024

Colorants are an important exposure that affects the way we feel and judge foods. The food colorant is normally associated with the flavor, safety and nutritional value of the food product. Colorant are obtained from natural plants and minerals. In today’s world, synthetic oxidative food colors are used. It contains a high chemical composition and is derived from petroleum or crude oil. Sunset yellow, carmine, amaranth and azorubine are examples of common synthetic food colors. It leads to some diseases such as asthma, allergy reactions and cancer. Hence, natural food colors were produced from natural plants. The plants contain several pigments, such as betacyanin, anthocyanin and curcumin. The fruit juice of Opuntia ficus-indica, in particularly it contains betacyanin pigments, which can be used as a natural red-purple food colorant. In order to improve the results, we extracted the juice from Opuntia ficus-indica and banana pseudo-stem. Next, we qualitatively analyzed the juice to find out whether flavonoids, triterpenoids, proteins, alkaloids, carbohydrates, saponin, tannin, and phenol was present. Opuntia ficus-indica has antioxidant properties, as does banana pseudostem sap, which has antioxidant, antithrombotic and anti-haemolytic properties. Then analyzed physical parameters of color strength were measured (using a UV spectrophotometer) at 450 nm to determine color strength and that the results were good with pH, viscosity, smell and taste. And toxicity analyses of aflatoxin and ochratoxin shows good results. This colorant has been used successfully in two food systems: ice cream and milkshakes. which is preserved after one month in the refrigerator.
Dielectric and Mechanical Studies of Cyclohexylammonium Hydrogen Maleate Hemihydrate Single Crystals
Authors: Gomathi R. , Madeswaran S. , Ramki C. , Vedichi N. , Prathab H.
Published: July 2024

CYHMH crystal was grown using solution growth technique The crystal corresponds to monoclinic structural system with C12/C1 space group (centrosymmetric in nature) and The final cell constants values are a = 24.109 (2) Å, b = 5.5157(4) Å, c = 18.6739(14) Å, β = 110.807(2)°, volume = 2321.2(2) Å. Mechanical studies were measured using Vicker’s hardness tester and n was 1.40, therefore the CYHMH crystals comes under hard materials category. The elastic toughness (stiffness) decreased with increases in applied load. Dielectric permittivity of CYHMH and loss factor were calculated as a function of log frequency. While increasing the temperature the dielectric parameters (dielectric constant, loss, AC conductivity) also increased. The energy required to activate the conductivity were also calculated for higher frequency region.
Hysteresis of Northern Hemisphere permafrost to carbon dioxide emissions
Authors: Wei Ting , Chen Yueli , Wang Hui
Published: July 2024

Carbon dioxide removal (CDR) is proposed to limit the level of global warming and minimize the impacts of climate crises. However, how permafrost may respond to negative carbon emissions remains unknown. Here, the response of near-surface permafrost in the Northern Hemisphere is investigated based on idealized carbon dioxide (CO2) ramp-up (284.7–1138.8 ppm) and symmetric ramp-down model experiments. The results demonstrate that the timing of the minimum permafrost area lags the maximum CO2 concentration for decades, which is also observed in soil temperatures at different depths and active layer thicknesses (ALTs). When the CO2 concentration is reversed to the preindustrial level, the permafrost area decreases by ∼12% relative to the initial conditions, together with additional warming in the ground temperature at the top of the permafrost, indicating the hysteresis of permafrost to CO2 removal. The most profound hysteretic responses occur at high latitudes for soil temperatures owing to Arctic amplification and at the southern margins of the permafrost zones for permafrost and ALT that largely linked to the climate state. Moreover, the sensitivity of permafrost and the associated thermodynamic factors to CO2 change is generally lower during the CO2 ramp-down phase than during the ramp-up phase, likely due to the release of stored heat on land. The results reveal the behaviour of permafrost in response to negative carbon emissions, which is informative for the projections of permafrost towards carbon neutral targets. In addition, the results may provide a reference for permafrost-related tipping points (e.g. releasing long-term stored greenhouse gases and destabilising recalcitrant soil carbon) and risk management in the future.
Preoperative imaging of colorectal liver metastases: what the radiologist and the multidisciplinary team need to know
Authors: Dempsey Philip J , Farrelly Cormac , Cronin Carmel G , Fenlon Helen M
Published: July 2024

The management of patients with colorectal liver metastases (CRLM) has transformed over the past 2 decades. Advances in surgical techniques, systemic therapies, and local treatments have resulted in a paradigm shift. Disease that would once have been considered terminal is now frequently treated aggressively with both a disease-free and overall survival benefit. In line with the expanding range of treatment options, there has been an increase in the volume and complexity of imaging required in the management of these patients to ensure optimal patient selection and outcome. The radiologist plays a pivotal role in interpreting these studies, conveying the relevant information and informing the discussion at multidisciplinary team meetings. The purpose of this review is to provide an update for radiologists on the current surgical management of patients with CRLM highlighting specific imaging information that is required by the multidisciplinary team when assessing resectability and/or the need for additional liver-directed therapies.
The STELLAR trial: a phase II/III randomized trial of high-dose, intermittent sunitinib in patients with recurrent glioblastoma
Authors: Janssen Jorien B E , Brahm Cyrillo G , Driessen Chantal M L , Nuver Janine , Labots Mariette , Kouwenhoven Mathilde C M , Sanchez Aliaga Esther , Enting Roelien H , de Groot Jan Cees , Walenkamp Annemiek M E , van Linde Myra E , Verheul Henk M W
Published: July 2024

Previously, the tyrosine kinase inhibitor sunitinib failed to show clinical benefit in patients with recurrent glioblastoma. Low intratumoural sunitinib accumulation in glioblastoma patients was reported as a possible explanation for the lack of therapeutic benefit. We designed a randomized phase II/III trial to evaluate whether a high-dose intermittent sunitinib schedule, aimed to increase intratumoural drug concentrations, would result in improved clinical benefit compared to standard treatment with lomustine. Patients with recurrent glioblastoma were randomized 1:1 to high-dose intermittent sunitinib 300 mg once weekly (Q1W, part 1) or 700 mg once every two weeks (Q2W, part 2) or lomustine. The primary end-point was progression-free survival. Based on the pre-planned interim analysis, the trial was terminated for futility after including 26 and 29 patients in parts 1 and 2. Median progression-free survival of sunitinib 300 mg Q1W was 1.5 months (95% CI 1.4–1.7) compared to 1.5 months (95% CI 1.4–1.6) in the lomustine arm (P = 0.59). Median progression-free survival of sunitinib 700 mg Q2W was 1.4 months (95% CI 1.2–1.6) versus 1.6 months (95% CI 1.3–1.8) for lomustine (P = 0.70). Adverse events (≥grade 3) were observed in 25%, 21% and 31% of patients treated with sunitinib 300 mg Q1W, sunitinib 700 mg Q2W and lomustine, respectively (P = 0.92). To conclude, high-dose intermittent sunitinib treatment failed to improve the outcome of patients with recurrent glioblastoma when compared to standard lomustine therapy. Since lomustine remains a poor standard treatment strategy for glioblastoma, innovative treatment strategies are urgently needed.
Political Parties and Public Policies. A Review of the Spanish Evidence
Authors: Magre-Pont Jaume , Magontier Pierre , Solé-Ollé Albert
Published: July 2024

To what extent does the incumbent party’s identity shape public policies? We investigate this question by examining national and regional policies in Spain. First, we analyze the evolution of voter preferences, and ofthe platforms of the two mainstream parties (Partido Socialista Obrero Español [PSOE] and Partido Popular [PP]), and the newer challenger parties that emerged post-financial crisis (Ciudadanos, Podemos, and Vox). We focus on three key national-level issue dimensions: economic, social, and centralization. As expected, the right-wing PP adopts a more conservative stance on all dimensions compared to the left-wing PSOE. However, the policy gap between these two parties remains relatively stable until the mid-2000s, with party platforms tracking the evolution of citizen preferences. After this period, platforms start to diverge, especially in the case of new parties, which display radical stances on these dimensions. We also provide descriptive evidence suggesting that these platform differences have translated into enacted policies. Second, to offer causal evidence on the effect of party identity on policy decisions, we examine partisan disparities in regional fiscal policies. Our findings reveal significant differences in tax policy following the granting of tax autonomy to the regions, somewhat moderated by tax competition and fiscal limits.
Moving from Second Sight to Critical Consciousness Building: Using Social Justice Youth Development and Youth Participatory Action Research to Promote Praxis in Out-of-School Time
Authors: Bloomer Rebecka M , Brown Aishia
Published: July 2024

Youth development programs offer flexible environments for healing and positive identity development for youth facing discrimination and oppression. Programs often occur in out-of-school time (OST), a context that is clearly positioned in tandem with the education system to create complex relationships that lead to challenges in OST spaces. Youth development programs occurring in OST settings have the potential for resisting or replicating oppressive practices toward youth occurring in the education system. This article highlights a youth participatory action research (YPAR) project within an OST program using photovoice, field trips, and arts-based strategies. Eleven youth participated in the project over the course of nine months. Thematic content analysis of weekly photovoice and critical consciousness resulted in a primary theme of peeling back the layers. This theme encompassed the evolution of youth understanding the interconnectedness between their individual-level experiences of racism and broader community and systems-level inputs. This article describes critical consciousness development of OST youth participants through intentional engagement in critical dialogue, experiential field trips, and reflective art making.
Genomic analysis of foodborne Staphylococcus aureus obtained from unannounced food inspections between 2012 and 2021 in East China
Authors: Lu Chu , Xiao Wenjie , Yu Haoyun , Song Weiyi , Zhou Zhemin , Dong Ning , Fan Zhihai , Li Heng
Published: July 2024

Staphylococcus aureus is a significant cause of foodborne illness in China. Our investigation concentrated on the genetic characterization of foodborne S. aureus identified during unannounced inspections conducted in Suzhou from 2012 to 2021. Dominant clones included clonal complex (CC) 1, CC398, CC188, and CC7, with CC398 notably increasing in 2020–2021. The isolates commonly contained 1–3 plasmids, with rep5a (48.55%) and rep16 (44.51%) predominating. A concerning 24.3% showed multidrug resistance, particularly to penam (blaZ and mecA) and fosfomycin (fosB), with resistance rates rising from 32.7% to 53.3%, potentially linked to the increase in CC types like CC5, CC20, and CC25. Most isolates carried genes for virulence factors such as aureolysin, hemolysin, staphylokinase, and staphylococcal complement inhibitor. A significant increase in virulence genes, especially the enterotoxin gene sea, was observed, possibly associated with shifts in CC1 and CC7 prevalence. This underscores the necessity for ongoing surveillance to understand the genomic traits of S. aureus in ensuring food safety.
Dyadic Ambivalence in Couples Managing Early-Stage Alzheimer’s Disease: Linking Behavioral and Psychological Symptoms of Dementia to Life Satisfaction
Authors: Huo Meng , Gilligan Megan , Kim Kyungmin , Richards Nicole E , Fingerman Karen L , Zarit Steven H
Published: July 2024

Objectives

Caring for a spouse with Alzheimer’s disease (AD) can elicit considerable distress but there are also positive moments. A growing body of work has examined caregivers’ ambivalence in the care relationship and linked it to negative caregiver outcomes such as depression, but dyadic assessments of both parties’ perspectives are missing. We examined ambivalence in both people with AD and their spousal caregivers, seeking to identify the correlates and well-being outcomes of such ambivalence in this unique context.

Methods

Participants included 72 couples managing early-stage AD. People with AD and spousal caregivers independently self-reported positive and negative relationship qualities (used to indirectly calculate their ambivalence) and life satisfaction. Caregivers reported both partners’ demographic characteristics and their spouses’ behavioral and psychological symptoms of dementia (BPSD), focusing on memory-related behaviors and psychological symptoms.

Results

Path analyses revealed that the number and frequency of psychological symptoms in people with AD were positively associated with their own and caregivers’ ambivalence. Caregivers’ distress ratings of memory-related behaviors and psychological symptoms were positively associated with their ambivalence. Greater ambivalence was associated with lower life satisfaction in both spouses. BPSD directly affected both spouses’ life satisfaction but there were also indirect effects via ambivalence.

Discussion

This study utilizes a dyadic approach to assess ambivalence in dementia care. Findings reveal the conflicting emotions that couples experience as they cope with early-stage AD, identify sources of such ambivalence, and shed light on the development of dyadic interventions that can promote positive outcomes in both partners.
Estimating body composition using CT scans of cross-bred lambs fed at 2 feeding levels and 2 stages of maturity to inform predictive growth models
Authors: Keogh Thomas P , McGrath Shawn R , Allworth Maxwell B , Oddy Victor H
Published: July 2024

Livestock producers would benefit from more precise predictions of the growth response from nutrients consumed. Previously published models are often limited by the realities of data collection and are unable to account for alterations to body composition, due in part to the response of visceral organs to an alternate diet. The computerized tomography (CT) scanning of lambs enables the analysis of changes in body composition of individual animals over time, potentially supporting better model development and testing. The aim of this experiment was to develop a repeatable method for the analysis of live lamb body composition using CT scans. A secondary aim was to compare the data collected from CT scanning during a feeding trial to 2 predictive lamb growth models. Cross-bred lambs were fed 2 feeding levels at 2 stages of maturity, with CT scans at the beginning and end of each 8-wk feeding period. The CT scan-derived values for body composition taken at the beginning of feeding periods were used as inputs for 2 existing lamb growth models. Predictions of body composition were compared with CT scan-derived values at the end of feeding periods. The CT scan analysis method used a proportion of images from each lamb to reduce manual image editing. The method was developed by comparing the estimated mass and volume of empty body components using all available CT scans to estimated values using a reduced number of scans from 12 lambs. The CT scan-derived lean tissue mass aligned with model predictions at the end of each feeding period, however, CT scan-derived fat mass was greater than predictions by both models especially for the high feeding level at the later stage of maturity. These results highlight that the analysis of body composition using CT scans requires further validation, particularly for the viscera, and that models likely require refinement to better predict the efficiency of energy utilization by different tissues. The use of live animal CT scans can provide more accurate predictions of the growth of saleable products than measuring liveweight alone and will enable ruminant growth models to better adapt to different genetics and changing diets than comparative slaughter. To replicate the current data using comparative slaughter would require 4 times the animals, as individual lambs were CT scanned 4 times in this study, demonstrating the potential value of CT scanning in live animal research.
A mutation in POLR2A gene associated with body size traits in Dezhou donkeys revealed with GWAS
Authors: Yang Tao , Wang Min , Liu Yu , Li Yuanyuan , Feng Mo , Zhao Chunjiang
Published: July 2024

The Dezhou donkey is a famous local donkey breed in China. The aim of the present study was to identify the genes associated with the body size traits of the Dezhou donkey and facilitate the breeding activities of the donkeys. A total of 349 donkeys from 2 generations (113 individuals in F0 and 236 in F1) were analyzed with restriction-site-associated DNA sequencing. A genome-wide association study revealed that the region between 13.7 and 15.6 Mb of chromosome 13 is significantly associated with body sizes. Candidate genes related to body size development, including POLR2A, CHRNB1, FGF11, and ZBTB4, were identified. The results of GO and KEGG analysis indicated that the genes involved in many GO terms were related to metabolic processes and developmental processes. Additionally, a T>C mutation (Chr13:14312485) was found at intron 10 of the POLR2A gene. The association analysis showed significant differences among genotypes for the size traits. The body size of the individuals with the TT genotype was significantly higher than that with the CC genotype. The results showed that the polymorphism of POLR2A has the potential to be used as a marker in the breeding programs of the Dezhou donkeys.
Benefit assessment of novel systemic therapies for bone and soft tissue sarcomas: a cross-sectional study
Authors: He Qiang , Wang Zhen , Mei Jie , Xie Chengxin , Sun Xin
Published: July 2024

Background

Bone and soft tissue sarcomas are rare malignancies, and their heterogeneity has limited the development of novel drugs. This study aimed to apply two validated tools to evaluate the clinical benefits of novel drug therapies for sarcoma developed over the last decade.

Methods

The PubMed and Embase databases were searched for randomized controlled trials (RCTs) of systemic therapies for sarcomas published between 2013 and 2023. Each trial was scored according to the European Society of Medical Oncology-Magnitude of Clinical Benefit Scale version 1.1 (ESMO-MCBS) and the American Society of Clinical Oncology-Value Framework version 2 (ASCO-VF).

Results

We included 52 RCTs in this study, of which 17 (32.7%) reported positive results that favored the experimental arm. The ESMO-MCBS grades were determined in 14/17 positive trials, and three of them (21.4%) met the threshold for meaningful clinical benefit. Likewise, ASCO-VF scores were calculated for 11/17 positive trials, and three of them (27.3%) met the threshold for meaningful clinical benefit. Weak correlation (r = 0.38, P = 0.277) and agreement (κ = 0.211, P = 0.490) were observed between the two frameworks.

Conclusion

Only a few RCTs with positive results have demonstrated substantial patient benefits for bone and soft tissue sarcomas over the past decade.
Turbulence, thermal pressure, and their dynamical effects on cosmic baryonic fluid
Authors: Wang Yun , He Ping
Published: July 2024

We employ the IllustrisTNG simulation data to investigate the turbulent and thermal motions of the cosmic baryonic fluid. With continuous wavelet transform techniques, we define the pressure spectra, or density-weighted velocity power spectra, as well as the spectral ratios, for both turbulent and thermal motions. We find that the magnitude of the turbulent pressure spectrum grows slightly from $z=4$ to 2 and increases significantly from $z=2$ to 1 at large scales, suggesting progressive turbulence injection into the cosmic fluid, whereas from $z=1$ to 0, the spectrum remains nearly constant, indicating that turbulence may be balanced by energy transfer and dissipation. The magnitude of the turbulent pressure spectra also increases with environmental density, with the highest density regions showing a turbulent pressure up to six times that of thermal pressure. We also explore the dynamical effects of turbulence and thermal motions, discovering that while thermal pressure provides support against structure collapse, turbulent pressure almost counteracts this support, challenging the common belief that turbulent pressure supports gas against overcooling.
Hedge funds and the positive idiosyncratic volatility effect
Authors: G. Bali Turan , Weigert Florian
Published: July 2024

While it is established that idiosyncratic volatility is negatively priced in the cross-section of stock returns, the relation between idiosyncratic volatility and hedge fund returns is largely unexplored. We document that hedge funds with high idiosyncratic volatility earn higher future risk-adjusted returns of 6 percent p.a. than hedge funds with low idiosyncratic volatility. The outperformance arises because hedge funds trade high idiosyncratic volatility stocks wisely. They pick high volatility stocks when they are underpriced and short-sell high volatility stocks when they are overpriced. Our results support the notion that hedge funds’ idiosyncratic volatility is a measure of managerial skill.
Does Spinal Cord-Canal Mismatch Adversely Affect the Clinical Outcomes of Anterior Cervical Discectomy and Fusion for the Treatment of Cervical Myelopathy?
Authors: Park Sehan , Choi Ji Uk , Kim San , Hwang Chang Ju , Cho Jae Hwan , Lee Dong-Ho
Published: July 2024

Study Design.

Retrospective cohort study.

Objective.

To clarify whether clinical outcomes of anterior cervical discectomy and fusion (ACDF), is affected by presence of spinal canal-cord mismatch (SCCM).

Summary of Background Data.

SCCM is considered a factor that would moderately influence surgeons to perform posterior surgery since it could widen the spinal canal, while an anterior approach could only remove degenerative pathologies grown into the spinal canal.

Materials and Methods.

We retrospectively reviewed 186 patients who underwent ACDF and had been followed-up for more than two years. Patients with spinal cord occupation ratio (SCOR) of ≥0.7 were classified into the SCCM group, while those with a SCOR of <0.7 were included in the no-SCCM group. Patient demographics, cervical sagittal parameters, neck pain visual analog scale (VAS), arm pain VAS, and Japanese Orthopedic Association (JOA) score were assessed. JOA score was the primary outcome of the study.

Results.

One hundred and forty-seven patients (79.0%) were included into the no-SCCM group, while 39 patients (21.0%) were classified into the SCCM group. Postoperative radiographic parameters including C2–C7 lordosis, C2–C7 sagittal vertical axis, and range of motion did not significantly differ between the two groups. Neck pain VAS, arm pain VAS, and JOA score (no-SCCM group, from 13.7±2.5 to 14.6±2.3, P<0.001; SCCM group, from 13.8±1.6 to 15.0±2.0, P<0.001) significantly improved after the operation in both groups, and results were not significantly different between the two groups. Furthermore, SCOR was not significantly associated with JOA recovery rate at two years postoperatively in linear regression analysis.

Conclusion.

Clinical and radiographic outcomes of ACDF were not affected by the presence of SCCM. Furthermore, SCOR was not significantly associated with neurological recovery at two years of follow-up. Therefore, ACDF can be safely and effectively applied for treating cervical myelopathy, regardless of the presence of SCCM, when other factors favor the anterior approach.

Level of evidence.

Level III.
Dynamically Normalized Pupillometry for Detecting Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage
Authors: Klug Julian , Martins Joana , De Trizio Ignazio , Carrera Emmanuel , Filipovic Miodrag , Hostettler Isabel Charlotte , Pietsch Urs
Published: July 2024

OBJECTIVES:

Delayed cerebral ischemia (DCI) is a major driver of morbidity after aneurysmal subarachnoid hemorrhage (aSAH). Quantitative pupillometry has been shown to be of prognostic value after acute neurological injury. However, the evidence for the use of pupillometric features for the detection of DCI has been conflicting. The aim of this study was to investigate the prognostic value of frequent pupillometric monitoring for DCI detection.

DESIGN:

Observational cohort study from a prospective aSAH registry.

SETTING:

Tertiary referral center.

PATIENTS:

Adult patients with confirmed aSAH admitted to the ICU between March 2019 and December 2023.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

One hundred fourteen patients were included, of which 31 (27.2%) suffered from DCI. All patients underwent frequent pupillometry (every 3 hr). We determined the absolute value of the neurological pupil index (NPi) and constriction velocity (CV), and their value normalized to the maximal recorded value between the admission and the pupillometry measure to account for personalized baselines. The association between pupillometry values and the occurrence of DCI within 6–24 hours was investigated. Normalized CV had the best discriminative performance to identify DCI within 8 hours, with an area under the receiver operating characteristic curve of 0.82 (95% CI, 0.69–0.91). NPi, as well as non-normalized metrics, were not significantly associated with DCI.

CONCLUSIONS:

Normalized CV has a clinically and statistically significant association with the occurrence of DCI after aSAH. Frequent quantitative pupillometry could improve the multimodal monitoring of patients after aSAH with the goal of improving the identification of patients likely to benefit from therapeutic interventions.
Estrogen deficiency in the menopause and the role of hormone therapy: integrating the findings of basic science research with clinical trials
Authors: Yang Jane L. , Hodara Emmanuelle , Sriprasert Intira , Shoupe Donna , Stanczyk Frank Z.
Published: July 2024

Menopause, defined by the cessation of menstrual cycles after 12 months of amenorrhea not due to other causes, is associated with significant hormonal changes, primarily a decrease in estrogen, androgen, and progesterone levels. This review delves into the effects of estrogen deficiency during the perimenopausal transition and postmenopause, integrating the findings of basic science with clinical trials. Here, we first outline the variation in endogenous estrogens before and after menopause, exploring both genomic and nongenomic actions of estrogen and its estrogen receptors throughout the body. Next, we detail the spectrum of menopausal symptoms, from acute vasomotor, urogenital, and psychological issues during perimenopause to chronic reproductive, cardiovascular, neurological, skeletal, dermatologic, immune, and digestive changes postmenopause. Finally, we evaluate the role of hormone therapy in alleviating these symptoms, weighing its benefits against known risks. Publicizing these findings and an accurate representation of the risks and benefits of estrogen replacement to our aging patients is fundamental to improving their care, quality, and even quantity of life.
Effects of herbal medicine on ovulation in premature ovarian insufficiency patients during in vitro fertilization
Authors: Kim Dong In
Published: July 2024

Introduction:

Premature ovarian insufficiency (POI) is a condition in which menopause occurs before the age of 40 and is known to be a relatively common disease that occurs in 1% of all women. The only way for patients diagnosed with POI to become pregnant is through oocyte donation, in which fertilized ovums are transplanted by receiving oocytes from donors.4 Can POI patients increase their chances of normal ovulation? POI patients were more likely to observe and collect follicles larger than the average 15 mm diameter when herbal medicine was administered.

Methods:

This study is a retrospective cohort study conducted on POI patients undergoing in vitro fertilization (IVF) who visited our hospital from 2020 to 2022. We would like to report the response rate to gonadotropin-releasing hormone (GnRH) during IVF in the hyperovulation induction low response group after herbal medicine treatment. Statistical analysis was performed using IBM’s SPSS Statistics to verify significance with a P-value<0.05.

Results:

In recovering ovarian POI patient's ovarian function, herbal medicine treatment increased the response rate to GnRH (the number of oocytes collected) during IVF, follicle-stimulating hormone (FSH) and cortisol levels decreased, and estradiol (E2) and luteinizing hormone (LH) levels increased.

Conclusions:

It was confirmed that herbal medicine treatment can increase the probability of normal ovulation in patients with idiopathic POI with high cortisol levels. Until now, it has been known that ovarian function cannot be recovered once irreversibly decreased, but by increasing the probability of ovulation through herbal medicine treatment, it is significant that it may be possible to suppress ovarian aging or preserve fertility.
Comparative Analysis of Combined Topography-Guided Photorefractive Keratectomy and Corneal Crosslinking in Progressive Versus Stable Keratoconus
Authors: Gil Pedro , Gil João Quadrado , Dias Margarida , Cunha Bruna , Alves Nuno , Rosa Andreia , Murta Joaquim
Published: July 2024

Purpose:

To perform a comparative analysis of visual, refractive, and tomographic outcomes of combined topography-guided photorefractive keratectomy (TG-PRK) and corneal crosslinking (CXL) in patients with progressive versus stable keratoconus.

Methods:

Longitudinal retrospective case–control study. Patients with keratoconus submitted to simultaneous TG-PRK and CXL were included, with a minimum follow-up of 12 months up to 3 years. According to predefined disease progression criteria, patients were considered as progressive or stable.

Results:

A total of 101 eyes from 93 patients were included, 62 considered progressive and 39 stable keratoconus. All baseline characteristics were similar between groups, except for age at surgery (progressive: 23.40 ± 4.22 years; stable: 35.97 ± 9.09; P < 0.001). Logarithm of the minimum angle of resolution CDVA improved significantly in progressive (baseline: 0.48 ± 0.24; 12 months: 0.33 ± 0.29; P < 0.001) and stable (baseline: 0.51 ± 0.24; 12 months: 0.28 ± 0.21; P < 0.001) patients, with no differences between groups. Maximum keratometry decreased significantly in progressive (baseline: 59.18 ± 5.63 diopters; 12 months: 54.73 ± 5.95; P < 0.001) and stable (baseline: 57.77 ± 5.02; 12 months: 53.59 ± 4.20; P < 0.001) patients, with no differences between groups. Index of surface variance significantly improved in progressive (baseline: 109.18 ± 31.74 diopters; 12 months: 94.11 ± 34.11; P < 0.001) and stable (baseline: 102.87 ± 29.52; 12 months: 86.95 ± 27.21; P < 0.001) patients, with no differences between groups. Other tomographic outcomes were also similar between groups. Pachymetry significantly decreased after surgery but remained stable throughout the follow-up.

Conclusions:

Combined TG-PRK and CXL is a safe and effective procedure for improving CDVA and regularizing the cornea, with comparable visual, refractive, and tomographic outcomes in both progressive and stable keratoconus. Combined TG-PRK and CXL may be added to the armamentarium of therapeutic tools for visual rehabilitation in patients with stable keratoconus.
Minimally invasive, maximally impactful: minimally invasive glaucoma surgery and the changing glaucoma landscape
Authors: Sharma Arjun , Tijerina Jonathan D. , Bitrian Elena
Published: July 2024

Purpose of review

The advent of minimally invasive glaucoma surgery (MIGS) procedures has ushered in a new era of interventional glaucoma. MIGS has expanded the treatment options for surgeons necessitating a rethinking of the optimal management strategy for patients with glaucoma.

Recent findings

There are several new MIGS devices and procedures available to glaucoma surgeons. With several options available, patient selection is crucial to maximize the utility of MIGS in the context of traditional glaucoma surgery.

A management algorithm is presented based on our practice pattern to help guide decision-making for glaucoma surgeons. Although we encourage surgeons to continue to broaden their toolkit, we emphasize the continued importance of teaching the next-generation traditional glaucoma surgery in the MIGS era. Future prospective studies are warranted to elucidate the optimal treatment strategy for patients with glaucoma.
Combined Phacoemulsification and Hydrus Microstent Implantation in Asian Eyes With Moderate-to-Severe Normal Tension Glaucoma—12-Month Outcomes
Authors: Ang Bryan Chin Hou , Chen Elizabeth Jiahui , Chee Wai Kitt , Betzler Bjorn Kaijun , Chua Chun Hau , Yip Vivien Cherng Hui , Yip Leonard Wei Leon
Published: July 2024

Précis:

This study reports 12-month outcomes of combined phacoemulsification and Hydrus Microstent implantation in Asian eyes with moderate-to-severe normal tension glaucoma (NTG), demonstrating a significant reduction in glaucoma medications with an excellent intra and postoperative safety profile.

Objective:

To evaluate the 12-month safety and efficacy outcomes of combined phacoemulsification and Hydrus Microstent (Ivantis Inc.) implantation in Asian eyes with moderate to severe NTG.

Methods:

Retrospective study of consecutive surgeries performed from August 2019 to August 2021 in a single tertiary eye centre in Singapore. Outcome measures included a reduction in intraocular pressure (IOP), number of glaucoma medications, and intra and postoperative complications.

Results:

Data from 21 eyes of 21 subjects were analyzed. All subjects were ethnic Chinese, and the majority were males (14, 66.7%). At baseline, the mean IOP was 13.3 (2.3) mm Hg, all eyes had a Humphrey visual field mean deviation of ≥−6 dB [mean: −13.9 (4.3) dB], and all eyes were on at least one glaucoma medication. There was no statistically significant reduction in IOP at all time points compared with baseline (all P > 0.05). However, the median number of medications was reduced from 2 to 0 at all time points, up to postoperative month (POM) 12 (all P < 0.001). There were no intraoperative complications. No eyes underwent secondary glaucoma procedures nor lost any Snellen line of visual acuity by POM12. One (4.8%) eye experienced numerical hypotony at postoperative day 1, which resolved conservatively. Two (9.5%) eyes underwent laser iridoplasty for stent occlusion by iris. There was no deterioration in Humphrey visual field mean deviation at POM12 compared with baseline (n = 20, P > 0.05).

Conclusion:

Combined phacoemulsification and Hydrus Microstent implantation were effective in reducing medication burden in Asian eyes with moderate to severe NTG, up to 12 months postoperatively.
Patient Experience and Barriers to the Visual Field Test for Glaucoma
Authors: Lu Siyuan J. , Girgis Shenouda , Shah Peter , Lee Graham A.
Published: July 2024

Précis:

There are significant mental, physical, and perceptual challenges in patients undergoing visual field testing, particularly in the elderly population with glaucoma.

Purpose:

To quantitatively and qualitatively investigate patient experiences of undergoing visual field testing.

Methods:

This cross-sectional, mixed-methods study involves adult patients attending a private outpatient ophthalmology clinic in Brisbane, Australia. Participant experiences of visual field testing were assessed using a 100 mm visual analog scale (VAS), followed by face-to-face semi-structured interviews. Outcome data comprised of VAS scores (1–100) and thematically analyzed verbatim notes.

Results:

Of the 152 participants [M:F 79 (52.0%):73 (48.0%)], the age group with the highest proportion of participants was 71–80 years [n=56 (36.8%)], and most had a primary ocular diagnosis of glaucoma [n=107 (70.4%)]. The mean VAS score for visual field testing experience was 60.45 (SD=30.38). The mean VAS score of participants with glaucoma was significantly lower than that of participants without glaucoma [55.34 (31.13) vs. 72.67 (25.04); P<0.05]. Prevalent themes regarding participant experiences of visual field testing consisted of concentration difficulties, intra-test and peri-test anxiety, skepticism in the testing process, and physical discomfort. Age, sex, and mean visual field index did not influence participant experiences of visual field testing.

Conclusions:

Mental and physical barriers to visual field testing tolerability were identified in a predominantly elderly population with glaucoma. Our findings highlight the importance of addressing patient concerns and apprehensions regarding visual field testing and emphasize the value of patient-initiated breaks, particularly for individuals experiencing concentration difficulties and physical discomfort.
Can Prostate Cancer Patients be Prescribed Chinese Herbal Medicine? A Review of its Potential Modulatory Effects on the Androgen Receptor
Authors: Wu Yu-Lin , Xian Yan-Fang , Zhang Juan , Guo Jun , Lin Zhi-Xiu
Published: July 2024

Prostate cancer (PCa) is a common disease among men worldwide, and conventional treatments for PCa typically involve surgery, chemotherapy, and radiation therapy. However, Chinese medicine (CM) has gained increasing attention as a complementary therapy for PCa treatment in recent decades. Chinese herbal medicine (CHM), a form of CM, has been shown to have good potential in PCa treatment, particularly by targeting the androgen receptor (AR), which plays a critical role in the development and progression of PCa. CHM interventions have been shown to inhibit AR activity, thereby delaying the disease’s progression. Moreover, most PCa patients at a later stage usually develop castration-resistant disease and drug resistance, posing a daunting challenge to clinical treatment. CHM offers several advantages, including improvement of patients’ quality of life, amelioration of clinical symptoms, and prolongation of survival; therefore, it offers a new direction for PCa treatment. This review aims to examine the current literatures on CM interventions targeting AR in PCa treatment. The review provides valuable insights into the potential benefits of CM as a complementary therapy for PCa treatment.
Iris defect management in the context of presbyopia-correcting intraocular lenses
Authors: Fram Nicole R. , Safran Steven G. , Pratte Eli , Sheybani Arsham , Agarwal Ashvin , Houser Kourtney , Garg Sumit , Schoen Marisa
Published: July 2024

A 65-year-old man had uneventful cataract surgery in the right eye with a toric diffractive intraocular lens (IOL) placed fully within the capsule bag. On postoperative day 1 and week 1, the IOL was well positioned and his eye was healing normally. The plan was to proceed with cataract surgery in the left eye in the near future. One month postoperatively, he presented with blurred vision, glare, and halos and was noted to have iris prolapse out of the temporal clear corneal main incision. Of interest, the patient reported some itching and eye rubbing in the early postoperative period. He was taken back to surgery by the referring doctor, and despite 2 heroic attempts to reposit and save the iris tissue, there was significant iris loss causing transillumination defects and debilitating glare and halos.

Ocular examination revealed an uncorrected distance visual acuity (UDVA) of 20/40 − 2 J3 and binocular corrected distance visual acuity (CDVA) 20/30 J1 in the right eye and UDVA of 20/60 J3 and binocular CDVA of 20/25 J1 in the left eye. Manifest refraction was −0.25 −1.25 × 155 in the right eye and plano −2.25 × 090 in the left eye. Fortunately, there was no relative afferent pupillary defect, and intraocular pressures were normal off all drops.

On slitlamp examination of the right eye, pertinent findings revealed a protective ptosis, trace conjunctival injection with 1 large subconjunctival polypropylene flange at 8:30 o'clock 1.5 mm from the limbus and 1 exposed irregular polypropylene flange eroded through the conjunctiva at 10 o'clock 0.5 mm from the limbus (Figures 1 and 2

JOURNAL/jcrs/04.03/02158034-202408000-00019/figure1/v/2024-07-30T221851Z/r/image-tiff

JOURNAL/jcrs/04.03/02158034-202408000-00019/figure2/v/2024-07-30T221851Z/r/image-tiff

). There was a localized area of erythema and scleral thinning surrounding the exposed flange. The cornea was edematous over the main incision. The iris was disinserted with atrophic changes and a residual iridodialysis extending from 8:30 to 10 o'clock. The trifocal IOL was fully in the capsule bag with trace fibrosis of the capsule and rotated approximately 7 degrees off the capsulotomy tab, designating the intended axis of 1 degree. The anterior chamber was deep and quiet, and the posterior segment was unremarkable with a 0.45 cup-to-disc ratio. Pertinent examination findings in the left eye included a 2 + NS cataract and a 0.45 cup-to-disc ratio. The remainder of the examination was otherwise unremarkable.

What testing and surgical plan would you offer this patient? How would you counsel regarding postoperative expectations?
Heartmate 3 Left Ventricular Assist Device Bend Relief Disconnection Causing Laceration of the Outflow Graft
Authors: Donato Britton B. , Seadler Benjamin D. , Mohammed Buruj W. , Zdanovec Amber , Ubert H. Adam , Durham Lucian A.
Published: July 2024

As technology in mechanical circulatory support continues to advance, so does the utilization of durable left ventricular assist devices (LVADs). We present the first reported case of HeartMate 3 (HM3) LVAD bend relief disconnection causing laceration of the outflow graft. Our patient is a 34 year old male with end-stage heart failure status post-HM3 implantation with recent debridement of a driveline infection who presented with weakness and sanguineous drainage 5 days after an episode of heavy lifting associated with a palpable substernal pop. During the initial evaluation, he experienced sudden massive decompression of a left chest hematoma through a thoracotomy incision with exsanguinating hemorrhage and an abrupt drop in LVAD flow. An emergent anterolateral thoracotomy was performed where it was discovered that the bend relief was disconnected and had lacerated the outflow graft. The graft was repaired and the ring was removed using a diamond blade rotary saw. He was discharged home and made a full recovery. Mechanical device malfunction has been documented in several prior versions of durable LVADS. Although there have been reported cases in the Heartmate 2, this is the first reported case of a HM3 bend relief disconnection and resultant laceration of the outflow graft.
Identification of HLA alleles involved in immune thrombotic thrombocytopenic purpura patients from Turkey
Authors: Kikili Cevat İlteriş , Kivanç Demet , Ortaboz Damla , Şentürk Çiftçi Hayriye , Özbalak Mustafa Murat , Yenerel Mustafa Nuri , Nalçaci Meliha , Ar Muhlis Cem , Oğuz Fatma Savran , Beşişik Sevgi Kalayoğlu
Published: July 2024

Thrombotic thrombocytopenic purpura (TTP) is one of the rare group disorders classified as thrombotic microangiopathies (TMAs). Approximately 90% of TTP developed immune-mediation by the formation of antibodies against the enzyme ADAMTS-13. The exact cause is unknown. To establish an association between human leukocyte antigen (HLA) and autoimmune basis, as susceptibility or protection against the disease, we contributed a study aiming to evaluate the role of HLA in immune-mediated TTP (iTTP). Considering epidemiological factors such as age, sex, ethnicity, and geographical origins, we contributed the study in our country, Turkey, which consist of a very heterogeneous population. Patients’ data collection was retrospectively from electronic database on two University hospitals having big therapeutic apheresis service. Control arm was healthy people registered as stem cell donors matched in terms of age and sex. The frequency of HLA-DRB1 and HLA-DQB1 alleles between acquired TTP and the control group was compared using the chi-square method. Yates correction and logistic regression were performed on these results. A total of 75 iTTP patients and 150 healthy individuals enrolled to the study. HLA-DRB1∗11, HLA-DQB1∗03, HLA-DRB1∗11:01, HLA-DRB1∗14:01, HLA-DRB1∗13:05, HLA-DRB1∗11 + HLA-DQB1∗03 allele pair and HLA-DRB1∗15 + HLA- DQB1∗06 were proved to be susceptibility allele pairs for iTTP. HLA-DRB1∗15, HLA-DRB1∗01:01, HLA-DRB1∗07:01, HLA-DRB1∗13:01, HLA-DRB1∗14:54, HLA-DQB1∗05:01, HLA-DQB1∗02:02 and HLA-DRB1∗07 + HLA-DQB1∗02 allele pair were found to be protective against iTTP. Our findings support an association with iTTP across very heterogenous populations in Turkey.
TSHR-IGF-IR complex drives orbital fibroblast misbehavior in thyroid eye disease
Authors: Smith Terry J.
Published: July 2024

Purpose of review

Evolving understanding of thyroid eye disease (TED) has led to rapidly advancing therapeutic options. Most new treatments under development or recently available to patients are predicated on insights into disease mechanism.

Recent findings

TED, a disfiguring process, involves inflammation and remodeling of the connective tissues around the eye. TED most frequently presents as a component of Graves’ disease. Advances in our understanding of cells involved in TED and their molecular interactions have led to novel therapeutic targets. Among these cell types are orbital fibroblasts and a subset comprising monocyte progenitor cells, known as CD34+CXCR4+ fibrocytes. Among the attributes of fibrocytes is their expression of several autoantigens associated with Graves’ disease, including TSHR, thyroglobulin and thyroperoxidase. Fibrocytes also express high levels of the insulin-like growth factor-I (IGF-I) receptor, thought to mediate fibroblast activation. Therapeutically targeting the TSHR/IGF-IR receptor complex using an IGF-I receptor antagonist, teprotumumab, has resulted in substantial clinical benefit for patients with TED. The neural axon repellent, Slit2, and its cognate receptor, ROBO1, appear to modulate the inflammatory phenotype of these orbit-infiltrating fibrocytes.

More detailed understanding of orbital fibroblasts and the distinctions between cell subsets comprising them should lead to more effective therapies with fewer side effects.