bluuebunny/crossref_metadata_2025 huggingface dataset:
Dispelling Myths Regarding Cisgender Sexual Minority Women and Breast Cancer
Authors: Troy Rachel
Published: June 2023

Lesbian and bisexual cisgender women have higher rates of breast cancer and breast cancer mortality than their heterosexual counterparts (Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities, 2014). There is not much known about why this is the case, although most researchers revert to the common hypotheses that the increased prevalence of obesity, substance abuse, and nulliparity (not having given birth) among lesbian and bisexual women contributes to incidences of breast cancer (Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities, 2014). These hypotheses place individual responsibility on sexual minority women with breast cancer as opposed to identifying complicated, underlying structural problems. This literature review argues that homophobia and bisexual invisibility, in conjunction with fatphobia and inaccurate research methodology, have prevented clinicians and scientists from thoroughly examining the ways in which increased rates alcohol abuse, the physiological effects of stress due to discrimination, and a lower rate of receiving mammograms caused by perceived negative judgment from healthcare providers contribute to the higher prevalence of breast cancer among lesbian and bisexual women.
The Unspoken Plight of HIV Gripping Asian/Pacific Islander Communities in America
Authors: Shaw Sharon E.
Published: June 2023

The HIV pandemic has made a significant impact on various communities and
demographics in the US. Although special attention has been given to African, Latin, Hispanic,
and non-Hispanic white American communities, Asian American and Pacific Islander (A/PI)
communities are often overlooked in HIV prevention efforts. Regardless of how statistically
reassuring HIV diagnoses by ethnicity may seem, HIV poses a threat to the A/PI community.
The “model minority” stereotype, lack of cultural and linguistic accommodations in HIV
education, and cultural barriers may account for the lack of HIV testing and prevention in A/PI
communities. The “model minority” stereotype projected onto A/PI individuals and their health
gives a false sense of security in their current health status. Lack of education leads to
misconceptions around HIV spread and transmission within A/PI communities. Cultural barriers
continue to impact disclosure of HIV status among A/PI individuals and has a role in limiting
HIV prevention efforts in these communities. Personal accounts and studies on HIV-positive
Asian Americans show the lasting impact the “model minority” label, gap in HIV education, and
cultural barriers have on combating HIV in A/PI communities. HIV needs to be addressed in
A/PI communities and public health measures, HIV education, and A/PI HIV support groups
may encourage greater HIV awareness, testing, and prevention in A/PI communities.
L’expérience de pensée dans la science-fiction d’Andreas Eschbach
Authors: Willmann Françoise
Published: June 2023

On peut distinguer deux grandes tendances dans les romans d’A. Eschbach. Les uns, tel Freiheitsgeld, traitent avant tout d’un problème d’actualité, les autres, tel Eines Menschen Flügel relèvent davantage de la tendance classique de la science-fiction, créatrice de nouveaux mondes. Mais à un degré ou à un autre, tous correspondent à une démarche que l’on est tenté de qualifier d’expérience de pensée. Leur schéma plus ou moins apparent correspond à la question : que se passerait-il, si ? Par ex. si des humains s’installaient sur une autre planète pour recommencer l’histoire à zéro, en évitant notamment certains pièges des sciences et des techniques. On peut lire ces romans comme des explorations d’une ou plusieurs thématiques, visant une certaine rigueur, mais réintégrant aussi les perturbations, c’est-à-dire les hasards et les affects indissociables de la vie humaine. Ces constructions n’aboutissent pas à des réponses positives consensuelles, mais à des situations qui posent question, et favorisent un regard critique sur des techniques de plus en plus invasives. Notre thèse sera que sous les dehors d’une littérature facile, la science-fiction d’Eschbach ouvre un espace de réflexion et d’émotions indispensable à une maîtrise collective des technosciences.
An Overview of Corruption in the Context of the Public Sector
Authors: Tinuoye Adekunle Theophilius
Published: June 2023

Corruption is the Hydra that truncated the potentials of Nigerians and stymied the growth of Nigeria. The full embedding and institutionalization of public sector corruption in the Nigerian culture has accentuated widespread poverty, unemployment, inequalities, crime, destitution, and fading transportation, health, housing, and education amenities. Corruption has been fingered as the main cause of Nigeria's socio-economic quagmires. Nigeria is evidently at crossroads and in dire straits due to its inability to decisively tackle public sector corruption, as all the anti-corruption initiatives from 1999 to 2023 didn't attain the desired results. This chapter will examine the definition, elements, and causes of corruption, and also highlight the implications of corruption. Because the public sector is the engine room of government and is central to public service delivery, the chapter will examine the nature and effects of public service corruption before proffering measures to tackle this virus of intractable strain.
Board-Level Diversity Management as a Strategy to Enhance Organizational Performance
Authors: Baporikar Neeta
Published: June 2023

Diversity brings in different perspectives and helps to strengthen the quality of decision-making. Hence, diversity is of importance at all levels of organizations, and more so at the board level as the decisions made therein affect the long-term success of any organization. Hence, adopting a qualitative research approach in combination with a hybrid of exploratory and descriptive research methods the objective of the chapter is to enhance the understanding and deliberate on the significance of board-level diversity as a strategy to enhance organizational performance in the context of the public sector with a focus on Namibia. According to the study findings, there is moderate diversity management at the board level, which needs to be increased so as to aid in better quality decision-making to improve performance. Based on the analysis and findings there are recommendations to the Ministry of Public Enterprises (MPEs) which is the appointing authority.
Variation of inflammatory indexes in patients with chronic abacterial prostatitis treated with an herbal compound/extract
Authors: Cindolo Luca , Fabiani Andrea , Vitelli Daniele , Cianci Filippo , Gatti Lorenzo , Ghidini Nicola , Nyek Ntep Nicolas , Piazza Rosario Calarco , Filosa Alessandra , Ferrari Giovanni
Published: June 2023

Introduction: Inflammation is a highly prevalent finding in the prostate. Men with inflammation have higher IPSS score and increased prostate size. For men with prostatic inflammation, there is a significantly increased risk of developing acute urinary retention and the need of a surgical approach to the disease. Some laboratory tests (i.e. fibrinogen, C-reactive protein), can play a role in identifying patients at greatest risk of complications and adverse outcomes after surgery. There have been several experiences exploring the role of nutraceutical approach to the prostate inflammation. Aim of our study were to describe the variation in symptoms and inflammatory indexes in men affected by chronic abacterial prostatitis, treated with an herbal extract containing Curcuma Longa 500 mg, Boswellia 300 mg, Urtica dioica 240 mg, Pinus pinaster 200 mg and glycine max 70 mg. Materials and methods: A prospective multicenter study was conducted from February 2021 and March 2022. One hundred patients, with a diagnosis of Chronic Prostatitis were enrolled in a multicentric phase III observational study. They were treated with the herbal extract, one capsule per day, for 60 days. No placebo arm was included. In each patient, inflammatory indexes, PSA, prostate volume, IIEF-5, PUF, uroflowmetry (Qmax), IPSS-QoL, NIH-CPPS were registered and statistically compared at baseline and at the follow up visit. Results: The variation obtained on the inflammation indexes showed a global improvement after treatment, including the PSA reduction. We also recorded a significant improvement on IPSS-QoL, NIH-CPPS, PUF and Qmax scores. Conclusions: The herbal extract considered in our study may represent a promising and safe therapeutic agent leading to a reduction of inflammation markers, and could be used in the treatment of prostatitis and benign prostatic hyperplasia.
The protective effects of sevoflurane on subarachnoid hemorrhage
Authors: Xing Weixin , Zhao Jiashuo , Liu Jiangang , Liu Zhongjie , Chen Gang
Published: June 2023

Sevoflurane has become an important volatile anesthetic in clinic and has been widely studied in recent years. Numerous studies have demonstrated the efficacy of sevoflurane in safeguarding against brain damage across various domains. For example, it has played a neuroprotective role in subarachnoid hemorrhage (SAH), traumatic brain injury, and ischemia/reperfusion injury. The ensuing critique will focus on the significance of sevoflurane in experimental SAH and shed light on the underlying mechanisms. The findings of the current investigation demonstrate that sevoflurane possesses neuroprotective capabilities and clarify that it effectively attenuates secondary damage resulting from SAH through anti-inflammatory and anti-apoptotic pathways. More specifically, sevoflurane is observed to mitigate arterial vasospasm, diminish microvascular thrombosis, and alleviate cerebral edema. In light of these discoveries, we maintain that sevoflurane exhibits significant promise in the management of SAH, and it merits additional investigation to facilitate its prompt clinical implementation. Therefore, a thorough understanding of the neuroprotective properties of sevoflurane is beneficial to exploring novel therapeutic solutions for SAH and providing clinicians with alternative treatment modalities.
Normalizing Arterial Blood Pressure in Patients with Aortic Stenosis Does Not Prevent Grading Discrepancies Between Pre-Cardiopulmonary Bypass Transesophageal Echocardiography and Transthoracic Echocardiography
Authors: Whitener George B. , Wolf Bethany J. , Francis Loren R. , Heinke Tim L. , McKinnon Jared S. , Guldan George J.
Published: June 2023

Background:

Aortic stenosis (AS) grading discrepancies exist between pre-cardiopulmonary (pre-CPB) transesophageal echocardiography (TEE) and preoperative transthoracic echocardiography (TTE). Prior studies have not systematically controlled blood pressure.

Aims:

We hypothesized that normalizing arterial blood pressure during pre-CPB TEE for patients undergoing valve replacement for AS would result in equivalent grading measurements when compared to TTE.

Setting:

Single University Hospital

Design:

Prospective, Interventional

Methods:

Thirty-five adult patients underwent procedures for valvular AS between February 2017 and December 2020 at Medical University of South Carolina. Study participants had a TTE within 90 days of their procedure that documented blood pressure, peak velocity (Vp), mean gradient (PGm), aortic valve area (AVA), and dimensionless index (DI). During pre-CPB TEE, if a patient’s mean arterial pressure (MAP) fell more than 20% below their baseline blood pressure obtained during TTE, measurements were recorded as “out of range.” Phenylephrine was administered to restore MAP to the baseline range and repeat TEE measurements were recorded as “in-range.”

Statistical Analysis:

Differences between imaging modalities and grading parameters were examined using a series of linear mixed models. P values were Bonferroni-adjusted to account for multiple comparisons.

Main Results:

Significant discrepancies between TEE and TTE were observed for Vp, PGm, and DI despite blood pressure normalization across all subjects and for out-of-range measures and corrected measures. There were no statistically significant differences between TEE and TTE for AVA.

Conclusions:

Blood pressure normalization during pre-CPB TEE is not sufficient to avoid AS grading discrepancies with preoperative TTE.
Cardiopulmonary Bypass Surgery-Cold Alert!
Authors: Sayed Nazmeen I , Basantwani Shakuntala , Bhalerao Chetana , Nair Usha , Navalkar Priyanka
Published: June 2023

The term “cold agglutinin (CA)” refers to a group of disorders caused by anti-erythrocyte autoantibodies that preferentially bind RBCs at cold temperatures (4°C–18°C). CAs contribute to 10 to 15% of autoimmune hemolytic anemia. We report a case of CAs diagnosed intraoperatively during emergency mitral valve replacement.
Lichenoid Drug Eruption Induced by Teriflunomide
Authors: Agharbi Fatima-Zahra , Aasfara Jehanne , Oqbani Kenza , Slamti Khalqui , Chiheb Soumiya
Published: June 2023

Lichenoid drug eruptions are a type of skin reaction that is caused by medication and mimics idiopathic lichen planus. Various medications have been known to cause lichenoid drug eruptions, such as antibiotics, anti-convulsants, anti-diabetics, anti-malarials, anti-tubercular drugs, anti-hypertensives, psychiatric drugs, chemotherapeutic agents, diuretics, heavy metals, and non-steroidal anti-inflammatory drugs. Various cutaneous side effects have been reported in association with teriflunomide. We present the case of a patient who developed a lichenoid eruption because of teriflunomide. The dermatologists and neurologists should be aware of these skin side effects.
Angelica sinensis Extract Induces Telomere Dysfunction, Cell Cycle Arrest, and Mitochondria-Mediated Apoptosis in Human Glioblastoma Cells
Authors: Ma Tsung-Liang , Chang Kai-Fu , Huang Xiao-Fan , Lai Hung-Chih , Hsiao Chih-Yen , Tsai Nu-Man
Published: June 2023

Glioblastoma (GB) is one of the most aggressive and malignant tumors of the central nervous system. Conventional treatment for GB requires surgical resection followed by radiotherapy combined with temozolomide chemotherapy; however, the median survival time is only 12–15 months. Angelica sinensis Radix (AS) is commonly used as a traditional medicinal herb or a food/dietary supplement in Asia, Europe, and North America. This study aimed to investigate the effect of AS-acetone extract (AS-A) on the progression of GB and the potential mechanisms underlying its effects. The results indicated that AS-A used in this study showed potency in growth inhibition of GB cells and reduction of telomerase activity. In addition, AS-A blocked the cell cycle at the G0/G1 phase by regulating the expression of p53 and p16. Furthermore, apoptotic morphology, such as chromatin condensation, DNA fragmentation, and apoptotic bodies, was observed in AS-A-treated cells, induced by the activation of the mitochondria-mediated pathway. In an animal study, AS-A reduced tumor volume and prolonged lifespans of mice, with no significant changes in body weight or obvious organ toxicity. This study confirmed the anticancer effects of AS-A by inhibiting cell proliferation, reducing telomerase activity, altering cell cycle progression, and inducing apoptosis. These findings suggest that AS-A has great potential for development as a novel agent or dietary supplement against GB.
Efficacy of inferior vena cava collapsibility index and caval aorta index in predicting the incidence of hypotension after spinal anaesthesia- A prospective, blinded, observational study
Authors: Lal Jatin , Jain Mamta , Rahul  , Singh Anish Kumar , Bansal Teena , Vashisth Sumedha
Published: June 2023

Background and Aim:

Spinal anaesthesia-induced hypotension (SAIH) is a frequent side effect of spinal anaesthesia. SAIH is usually observed in patients with hypovolemia. Ultrasonography has evolved as a non-invasive tool for volume status assessment.

Methods:

This prospective, blinded, observational study was conducted on 75 adult patients who required spinal anaesthesia after receiving ethical approval and registering the study. Ultrasonographic evaluation of the aorta and the inferior vena cava (IVC) was done preoperatively, and the IVC collapsibility index (IVCCI) and caval aorta index were calculated. The incidence of SAIH was recorded. The strength of the association between different parameters and SAIH was calculated. To find out the value of the optimal cut-off for the prediction of SAIH, receiver operating characteristic (ROC) analysis for various ultrasound parameters was done. The bidirectional stepwise selection was utilised for multivariate analysis to choose the single best predictor.

Results:

SAIH was observed in 36 patients. Among demographic parameters, age, female gender, and height showed a medium correlation. Among ultrasonographic measurements, minimum IVC internal diameter (IVCmin) and IVCCI showed a strong association with SAIH. The best parameter regarding area under the ROC curve (AUC) and diagnostic accuracy was IVCCI (0.828 and 85%, respectively). On multivariate analysis, age (95% CI [1.01, 1.12], P = 0.024) and IVCCI (95% CI [1.05, 1.18], P < 0.001) were significant independent predictors. At a cut-off point of ≥43.5%, IVCCI accurately predicted SAIH (sensitivity 81% and specificity 90%).

Conclusion:

Preoperative ultrasonographic assessment of IVC to evaluate its collapsibility index is a convenient, cost-effective, and reproducible tool for predicting SAIH.
Preoperative lignocaine nebulisation for attenuation of the pressor response of laryngoscopy and tracheal intubation in patients with severe preeclampsia undergoing caesarean section delivery: A randomised double-blind controlled trial
Authors: Nabil Fatma , Gharib Alaa Ahmed , Gadelrab Nawal Abdelaziz , Osman Hany M.
Published: June 2023

Background and Aims:

Following induction of general anaesthesia, direct laryngoscopy and endotracheal intubation usually cause tachycardia and hypertension due to increased sympathetic activity. This response is generally exaggerated in hypertensive patients. This study aimed to evaluate the effectiveness of preoperative lignocaine nebulisation in attenuating the pressor response to laryngoscopy and endotracheal intubation in patients with severe preeclampsia undergoing caesarean delivery.

Methods:

After ethical approval, we conducted this randomised, double-blind study, which included 110 patients with severe preeclampsia who underwent caesarean delivery under general anaesthesia. These patients were randomly allocated into two groups to receive either preoperative nebulisation of lignocaine 2% in a dose of 4.5 mg/kg (not exceeding 400 mg) in the lignocaine group or nebulisation of an equivalent volume of 0.9% NaCl in the saline group. The primary objective was the systolic blood pressure after tracheal intubation. The secondary objectives included heart rate, maternal serum cortisol and blood glucose levels, grade of cough during emergence, postoperative sore throat and hoarseness of voice, neonatal Apgar score and umbilical blood gas.

Results:

The systolic blood pressure was significantly lower in the lignocaine group compared to the saline group at 1, 3 and 5 min after endotracheal intubation and after delivery of the foetus (P = 0.001, 0.003, 0.002 and 0.019, respectively). Similarly, the heart rate was significantly lower in the lignocaine group versus saline group at 1 and 3 min after endotracheal intubation (P = 0.041 and 0.042, respectively).

Conclusion:

Preoperative lignocaine nebulisation in a dose of 4.5 mg/kg effectively attenuated the pressor response to laryngoscopy and endotracheal intubation in patients with severe preeclampsia undergoing caesarean delivery.
Virological and cytological changes in tears and conjunctiva of patients with COVID-19
Authors: Angmo Dewang , Mahalingam Karthikeyan , Kakkar Aanchal , Rathod Aishwarya , Meena Suman Kumari , Kaur Avneet , Choudhary Aashish , Sharma Puneet , Dar Lalit , Samaddar Arpan , Trikha Anjan , Saxena Rohit , Titiyal Jeewan S , Sharma Namrata
Published: June 2023

Purpose:

To analyze the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in tears/conjunctival epithelium and assess the cytomorphological changes in the conjunctival epithelium of coronavirus disease 2019 (COVID-19) patients.

Methods:

In this pilot study, patients with moderate to severe COVID-19 were recruited from the COVID ward/intensive care unit of the institute. Tears and conjunctival swabs were collected from COVID-19 patients and sent to the virology laboratory for reverse transcription polymerase chain reaction (RT-PCR) testing. Conjunctival swabs were used to prepare smears, which underwent cytological evaluation and immunocytochemistry for SARS-CoV-2 nucleocapsid protein.

Results:

Forty-two patients were included. The mean age of participants was 48.61 (range: 5–75) years. Seven (16.6%) patients tested positive for SARS-CoV-2 ribonucleic acid in tears samples, four (9.5%) of which were positive on conjunctival swab by RT-PCR in the first test. Cytomorphological changes were observed significantly more in smears from patients with positive RT-PCR on tear samples, including bi-/multi-nucleation (p = 0.01), chromatin clearing (p = 0.02), and intra-nuclear inclusions (p < 0.001). One case (3.2%) showed immunopositivity for SARS-CoV-2; this patient had severe disease and the lowest Ct values for tear and conjunctival samples among all positive cases.

Conclusion:

Conjunctival smears from patients with COVID-19 revealed cytomorphological alterations, even in the absence of clinically significant ocular infection. However, viral proteins were demonstrated within epithelial cells only rarely, suggesting that although the conjunctival epithelium may serve as a portal for entry, viral replication is possibly rare or short-lived.
Simplifying biometry in oil-filled eyes: A novel formula for axial length calculation in eyes with 1000 cSt silicone oil
Authors: Kapoor Monika , Venkatesh Pradeep , Chawla Rohan , Temkar Shreyas , Aggarwal Esha
Published: June 2023

Purpose:

To derive a formula for accurate axial length (AL) assessment using routine ultrasound in silicone oil-filled eyes, where optical biometry is unavailable or not possible.

Methods:

This was a prospective, consecutive, nonrandomized study of 50 eyes of 50 patients conducted in a tertiary care hospital in North India. AL measurements were taken using both manual A-scan and IOL master, both in silicone oil-filled status and 3 weeks after silicone oil removal. A correction factor of 0.7 was used for AL adjustment in oil-filled eyes. The corrected AL (cAL) was compared with IOL master values in oil-filled eyes. Agreement analysis was carried out using Bland Altman plot. Linear regression analysis was done using uncorrected manual AL to find a new equation. Data was analyzed using Stata 14. A P value <0.05 was taken as significant.

Results:

The study included 40 males and 10 females, with an age range of 6–83 years (mean 41.9 years). The mean AL of the oil-filled eye as measured by manual A-scan was 31.76 mm ± 3.09 and by IOL master was 24.7 mm ± 1.74. Linear regression analysis was performed in randomly selected 35 eyes of the observed data to obtain a new equation: predicted AL (PAL) = 14 + 0.3 × manual AL. The mean difference between PAL and optically measured AL with silicone oil in situ was 0.98 ± 1.67.

Conclusion:

We propose a new formula for better prediction of the correct AL in silicone oil-filled eyes using ultrasound-based AL measurement.
Next-generation sequencing-based genetic testing and phenotype correlation in retinitis pigmentosa patients from India
Authors: Sen Parveen , Srikrupa Natarajan , Maitra Puja , Srilekha Sundaramurthy , Porkodi Periyasamy , Gnanasekaran Harshavardhini , Bhende Muna , Khetan Vikas , Mathavan Sinnakaruppan , Bhende Pramod , Ratra Dhanashree , Raman Rajiv , Rao Chetan , Sripriya Sarangapani
Published: June 2023

Purpose:

Inherited retinal dystrophies (IRD) are a heterogeneous group of retinal diseases leading to progressive loss of photoreceptors through apoptosis. Retinitis pigmentosa (RP) is considered the most common form of IRD. Panel-based testing in RP has proven effective in identifying the causative genetic mutations in 70% and 80% of the patients. This is a retrospective, observational, single-center study of 107 RP patients who had undergone next-generation sequencing-based targeted gene panel testing for IRD genes. These patients were inspected for common phenotypic features to arrive at meaningful genotype–phenotype correlation.

Methods:

Patients underwent complete ophthalmic examination, and blood was collected from the proband for DNA extraction after documenting the pedigree. Targeted Next Generation Sequencing (NGS) was done by panel-based testing for IRD genes followed by co-segregation analysis wherever applicable.

Results:

Of the 107 patients, 72 patients had pathogenic mutations. The mean age of onset of symptoms was 14 ± 12 years (range: 5–55). Mean (Best Corrected Visual Acuity) BCVA was 6/48 (0.9 logMAR) (range 0.0–3.0). At presentation, over one-third of eyes had BCVA worse than 6/60 (<1 logMAR). Phenotype analysis with the gene defects showed overlapping features, such as peripheral well-defined chorioretinal atrophic patches in patients with CERKL, PROM1, and RPE65 gene mutations and large macular lesions in patients with RDH12 and CRX gene mutations, respectively. Nummular or clump-like pigmentation was noted in CRB1, TTC8, PDE6A, and PDE6B.

Conclusion:

NGS-based genetic testing can help clinicians to diagnose RP more accurately, and phenotypic correlations can also help in better patient counselling with respect to prognosis and guidance regarding ongoing newer gene-based therapies.
Netarsudil monotherapy as the initial treatment for open-angle glaucoma and ocular hypertension in Indian patients: A real-world evaluation of efficacy and safety
Authors: Mathur Manoj Chandra , Ratnam P. Venkat , Saikumar S.J. , John Manuel , Ravishankar Siddharth , Dinesh M.B , Chandil Priya , Pahuja Kishore , Cherlikar Vidya , Wadhwani Sunny , Bendale Pankaj , Hazari Ajit , Mishra Rajesh , Deshmukh Susheel , Achlerkar Rahul Raja , Shah Devang Tilak , Hingorani Chanda , Shah Kaivan , Topiwala Pratik , Jani Sheetal , Rana Viral G. , Majumdar Nilay Kumar , Chakrabarti Debasis , Dey Rituparna , Halder Debabrata , Choudhury Sumit , Kumar Ajeet , Das Sasmita , Nanda Ashok Kumar , Kumar Vidya Bhushan , Dubey Rama , Kamdar Gulam Ali , Pandey Alka , Kishanpuria Sheetal , Srivastava Rajat Mohan , Singh Parul , Verma Sunil Kumar , Sharma Neha , Gupta Rajeev
Published: June 2023

Purpose:

Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40–80. The best way to manage primary open-angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway.

Methods:

An open-label, real-world, multicentric, observation-based 3-month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first-line therapy. Diurnal IOP measurements, best-corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day-1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months).

Results:

Four hundred and sixty-nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once-daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring.

Conclusion:

We found that netarsudil 0.02% w/v solution monotherapy when used as the first-line treatment in primary open-angle glaucoma and ocular hypertension was both safe and effective.
The association between VSX1 exon3 gene variants and keratoconus in Malaysian patients
Authors: Deva Jenny P , Ngeow Yun F , Zin Thaw
Published: June 2023

Purpose:

This case-control study aims to examine possible associations of VSX1 exon3 gene variants with the development of keratoconus (KC) in Malaysian patients.

Methods:

A case-control study was done on 42 keratoconus cases, 127 family member controls, and 96 normal controls.

Results:

Three gene variants, p.A182A, p.P237P, and p.R217H showed significant associations with keratoconus (P < 0.05). While p.A182A and p.P227P were more prevalent than in the family and normal controls (OR 3.14–4.05), the reverse was observed with p.R217H (OR 0.086–1.59). With Haploview analysis, p.A182A and p.P237P were shown to be in linkage disequilibrium (LD) (LOD (logarithm of the odds score) score of 2.0, r2 of 0.957, and 95% confidence interval (CI) of 0.96–1.00).

Conclusion:

The study results suggest that the p.A182A and p.P237P variants could have contributed to the development of keratoconus in some Malaysians and that these two variants are likely to be co-inherited. In contrast, the p.R217H variant appeared to confer some protection against the development of keratoconus.
Painful-blind eye: A forgotten palliative care
Authors: Parra-Tanoux Daniela , Dussan-Vargas Maria P , Escandon Martha Gonzalez
Published: June 2023

Painful-blind eye (PBE) is a challenging and debilitating condition that greatly affects the quality of life of patients. Although PBE can result from a variety of etiologies, currently there is no guideline or consensus on how to approach therapeutically these patients, and most treatments are experience-based. We summarized the evidence from available studies to investigate the current state of PBE treatment strategies. This review revealed that the information available about therapeutic approaches in patients with PBE is insufficient and outdated, therefore, new experimental and larger studies are needed to reach an agreement about this condition.
The effect of social determinants of health on severity of microbial keratitis presentation at a tertiary eye care hospital in Southern India
Authors: Annadanam Anvesh , Hicks Patrice M , Lu Ming-Chen , Pawar Mercy , Kochar Prabhleen , Selvaraj Suvitha , Kuppuraj Dhanya , Rathod Chetan , Muppala Rekha Sravya , Gaur Smriti , Krishnan Abinaya , Sumithra SR , Woodward Maria A , Prajna N Venkatesh
Published: June 2023

Purpose:

Understanding the association between social determinants of health (SDoHs) and microbial keratitis (MK) can inform underlying risk for patients and identify risk factors associated with worse disease, such as presenting visual acuity (VA) and time to initial presentation.

Methods:

This was a cross-sectional study was conducted with patients presenting with MK to the cornea clinic at a tertiary care hospital in Madurai, India. Patient demographics, SDoH survey responses, geographic pollution, and clinical features at presentation were collected. Descriptive statistics, univariate analysis, multi-variable linear regression models, and Poisson regression models were utilized.

Results:

There were 51 patients evaluated. The mean age was 51.2 years (SD = 13.3); 33.3% were female and 55% did not visit a vision center (VC) prior to presenting to the clinic. The median presenting logarithm of the minimum angle of resolution (logMAR) VA was 1.1 [Snellen 20/240, inter-quartile range (IQR) = 20/80 to 20/4000]. The median time to presentation was 7 days (IQR = 4.5 to 10). The average particulate matter 2.5 (PM2.5) concentration, a measure of air pollution, for the districts from which the patients traveled was 24.3 mg/m3 (SD = 1.6). Age- and sex-adjusted linear regression and Poisson regression results showed that higher levels of PM2.5 were associated with 0.28 worse presenting logMAR VA (Snellen 2.8 lines, P = 0.002). Patients who did not visit a VC had a 100% longer time to presentation compared to those who did (incidence rate ratio = 2.0, 95% confidence interval = 1.3–3.0, P = 0.001).

Conclusion:

Patient SDoH and environmental exposures can impact MK presentation. Understanding SDoH is important for public health and policy implications to mitigate eye health disparities in India.
Cystic Fibrosis: An Updated Comprehensive Review of Literature with Pediatric Dentistry Perspectives
Authors: Khan Mohammad Kamran
Published: June 2023

Cystic fibrosis (CF) is a genetic disorder, inherited in an autosomal recessive manner. It affects the multiple organs or organ systems of human body including mainly respiratory, digestive, and renal systems. CF patients may have various orodental problems either directly by the primary disease of CF or indirectly by comorbidities, its complications and by side effects of pharmacotherapies. The optimization of oral health by meticulous dental care is essential aspect and hence must be an integral part of the multidisciplinary management in such patients with CF. Thus, general and pediatric dentist need to remain updated with the pathophysiology of the disease, its medical treatment, and its adverse effects on oral health in order to manage such CF-affected individuals with best scientific evidence-based approach of dentistry. Therefore, the current article has comprehensively reviewed the existing current literature regarding CF to describe its pathophysiology (etiology), clinical features, screening/diagnostic modalities, and management strategies along with its detailed orodental implications of CF and dental management aspects. Moreover, an overview/outline of dental care of CF patients in age-wise manner has been illustrated in this article. The relevant and recent scientific literature for the comprehensive review has been searched using the suitable keywords or its combinations/Boolean operators in different electronic databases (PubMed-Medline, Web of Science, Scopus, and Google Scholar) and, thus, included the topic-related articles published in English literature till 2022. Furthermore, the articles related to orodental implications and the dental management of the CF with the perspectives of pediatric dentistry was also searched and included for review.
Stress Distribution in Implant-Supported Fixed Dental Prosthesis (Pontic Design) using Two Different Framework Materials: A Finite Element Analysis
Authors: Tahilramani Gunjan , Barapatre Deepali , Mishra Sunil Kumar , Bhasmey Srinivas Rao , Chowdhary Ramesh
Published: June 2023

Aim and Objectives:

The stresses transferred from the implant to the surrounding bone greatly influence the clinical outcome of the implant-supported prosthesis. The role of implant-supported prostheses made from zirconia and polyether ether ketone (PEEK) material in transferring stresses is not much known. The purpose of the finite element analysis study was to evaluate stress distribution in an implant-supported fixed dental prosthesis (FDP) using two different framework materials.

Materials and Methods:

Two three-dimensional models of implant-supported FDPs were designed using ANSYS software, with implants in right maxillary central incisor and canine regions supporting a three-unit fixed partial denture. Model 1 was made using zirconia as a framework material and model 2 using PEEK as a framework material. A static load of 100 N was applied in two directions, i.e., vertically and obliquely at an angle of 30° along the long axis of the implant. The von Mises stress analysis was done to find stresses generated in implants and the prosthesis, and the maximum and minimum principal stress analyses were used to find the stress generated in the bone.

Results:

Under both the loading conditions, maximum stress concentration was observed in the connector region of model 1 (zirconia group) compared to model 2 (PEEK group); 6.28 MPa versus 2.17 MPa in vertical loading and 8.85 MPa versus 2.69 MPa in oblique loading, respectively. The stresses generated in bone were nearly similar in both models.

Conclusion:

The framework material does affect the load-bearing capacity of the prosthesis. Stresses observed with PEEK as framework material were lesser compared to zirconia. Therefore, PEEK can be considered a suitable framework material for implant-supported FDPs.
Consciousness, Perspective, and Implementation of Selective Grinding in Complete Dentures among Prosthodontic Postgraduates in India
Authors: Krishankumar  , Agarkar Anand Vinod , Gade Jaykumar
Published: June 2023

Background and Objectives:

Success of prosthodontic treatment in edentulous patients depends on acceptable function and esthetics of complete dentures. Complete denture occlusion plays a role in providing uniform distribution of masticatory forces, better retention, and stabilization of denture bases. In our study, the consciousness, perspective, and implementation of selective grinding in prosthodontic postgraduates (PGs) in India were assessed.

Materials and Methods:

A pretested, self-administered, and closed-ended questionnaire comprising different sections formed the survey instrument. A structured questionnaire containing 14 questions was framed. A specially created web-designed survey in Google Forms was circulated among prosthodontic PG students and the responses were recorded.

Results:

The questionnaire consisted of 11 nondemographic questions. About 67.5% of the responses were correct. The outcome of the study can be considered fair.

Conclusion:

A good occlusal philosophy combined with esthetics is paramount in the patient acceptance of a complete denture prosthesis. Its knowledge and implementation are paramount toward the success of treatment.
Impact on COVID-19 Pandemic in Children’s Mental Health and Current Emergency Care – A Narrative Review
Authors: Das Somadatta , Anjeela Abhipsa , Padhy Rabindra Nath , Pradhan Bibhuti Bhusan
Published: June 2023

Coronavirus disease-2019 (COVID-19) has quickly spread worldwide, suffering countless people from its severe acute respiratory syndrome and lowering the economic status of almost every nation. A pivotal factor in determining the severity of the current pandemic situation in society was the emergence of the current pandemic, the risk factors associated with the mental state of children with COVID-19 infection, and the immunology and behavior of the children. The treatment of hypoxic children (oxygen saturation below 92%) and the elderly involves oxygen therapy; with the availability of facilities such as continuous positive airway pressure therapy, a nasal cannula with a high flow rate, or a ventilatory tube may be necessary for children and the adult population. Multisystem inflammatory syndrome in children, a newly identified COVID-19-related condition/disease, has also been identified and is now termed omicron.
Patient-Reported Outcome Measures in Physiotherapy: An Overview
Authors: Naqvi Waqar M. , Sahu Arti , Arora Sakshi P.
Published: June 2023

High-quality patient-centered health care involves incorporating patient choice in the treatment plan. Patient engagement corresponds with the quality of life (QoL) and satisfaction, which can be achieved by including patient-reported outcome measures (PROMs) in physiotherapy practice. PROMs are instruments to evaluate health outcomes from the perspective of the patient and to determine whether the management plan enhances their QoL. PROMs in regular practice offer a structured way for clinicians to track patient symptoms, determine clinical outcomes, and facilitate collaborative decision-making. During the patient assessment, it aids in establishing a consistent framework, confirming the clinical results, and ascertaining the validity of the evaluation to the desired treatment. PROM data can be collected in several ways, including in-person interviews, questionnaires, and diaries. The use of PROMs in research increases both the research process as well as the validity of its findings. Integrating PROMs into physiotherapy management is an opportunity to rightly understand the patient’s QoL trajectory and broaden the range of PROMs estimated in shared decision-making. Although PROM administration by clinicians helps for tracking patients, for guiding treatment considerations, and for providing a more central viewpoint for patients, its usage remains unclear by including patients in shared decision-making. However, establishing a patient-centered, comprehensive prototype of treatment requires the regular application of authorized PROMs. Incorporation of PROMs in physiotherapy practice can facilitate a multidimensional and patient-centered evaluation of the disease, identify unfulfilled needs, direct physiotherapist attention to these needs, and better inform policymakers in the light of identifying patient goals.
Utilization of Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy to Evaluate Cystic Brain Lesions
Authors: Pavanan Asish , Kashikar Shivali , Parihar Pratapsingh Hanumansingh , Pandey Shivesh
Published: June 2023

Background:

Cystic brain lesions may be exceedingly challenging to diagnose for both the radiologist and the neurologist. A biopsy or surgical approach followed by a histopathology study can pinpoint the exact final diagnosis in uncertain situations.

Aims and Objectives:

In the current study, magnetic resonance spectroscopy (MRS) and diffusion-weighted imaging (DWI) are being investigated as diagnostic modalities.

Materials and Method:

Cystic brain lesions from 78 participants were assessed by magnetic resonance imaging (MRI) and MRS. TI-weighted image (T1WI), T2-weighted image (T2WI), DWI, apparent diffusion coefficient (ADC), C+, and MRS imaging sequences are the parameters examined.

Results:

Pediatric group made up 29.5% of the entire population. The majority of the subjects (47.4%) had arachnoid cysts. About 79.5% of the individuals had hypointense T1WI, 100% had hyperintense T2WI, 82.1% had hypointense DWI, and 82.1% had high ADC. Arachnoid cysts contained lactate in 16.2% of the participants.Lipid was detected only in tumor lesions. Lactate with amino acid was observed in the abscess.

Conclusion:

Due to their noninvasive nature and low cost, DWI and MRS can be used as an adjunct to MRI, to improve the diagnosis of brain lesions.
Predictors of Clinical Deterioration of Hospitalized Adult Medical Patients
Authors: Deeb Ahmad M. , Maddigan Joy
Published: June 2023

Clinical deterioration of hospitalized medical patients negatively affects patient outcomes and hospital capacity. Failure to recognize and respond promptly to an individual's worsening health status can lead to complications with far-reaching impacts on the patient and family. The ability to identify patient cues that can predict clinical deterioration is an essential role for frontline health-care providers to avert an avoidable health crisis. This protocol is designed to describe an integrative literature review plan that aims to identify, analyze, and synthesize the predictors and associated factors underlying the clinical deterioration of hospitalized medical ward patients. This planned review will follow the methodology of Whittemore and Knafl (2005), which comprises five stages: problem identification, literature search, data evaluation, data analysis, and presentation. CINAHL Plus, Embase, and PubMed databases will be used in the literature search. Primary research studies focusing on the predictors or the associated factors of clinical deterioration among medical ward patients will be eligible for the review. The quality of selected articles will be critically appraised using the Joanna Briggs Institute tools. The process of findings synthesis will be conducted according to Miles and Huberman (1994), which consists of data reduction, data display, data comparison, conclusion drawing, and verification. The findings will be presented as major themes that are supported by the appropriate primary studies.
A variational approach to hyperbolic evolutions and fluid-structure interactions
Authors: Benešová Barbora , Kampschulte Malte , Schwarzacher Sebastian
Published: June 2023

We show the existence of a weak solution for a system of partial differential equations describing the motion of a flexible solid inside a fluid: A nonlinear, viscoelastic,

n

-dimensional bulk solid governed by a PDE including inertia is interacting with an incompressible fluid governed by the (

n

-dimensional) Navier–Stokes equation for

n\geq 2

. The result is the first allowing for large bulk deformations in the regime of long time existence for fluid-structure interactions. The existence is achieved by introducing a novel variational scheme involving two time-scales that allows us to extend the method of minimizing movements to hyperbolic problems involving nonconvex and degenerate energies.
Tolerances Copper and Copper Alloy Wire
Authors:   AMS D Nonferrous Alloys Committee
Published: June 2023

This specification covers established inch/pound manufacturing tolerances applicable to copper and copper alloy wire ordered to inch/pound dimensions. These tolerances apply to all conditions, unless otherwise noted.
Aluminum Alloy, Sheet and Plate 2.5Mg - 0.25Cr (5052-O) Annealed
Authors:   AMS D Nonferrous Alloys Committee
Published: June 2023

This specification covers an aluminum alloy in the form of sheet and plate 0.006 to 3.000 inches (0.15 to 76.20 mm), inclusive, in nominal thickness (see 8.5).
Steel, Corrosion-Resistant, Bars and Wire 18Cr - 9.0Ni (302) Solution Heat Treated and Cold Drawn 100 ksi (689 MPa) Tensile Strength
Authors:   AMS F Corrosion and Heat Resistant Alloys Committee
Published: June 2023

This specification covers a corrosion-resistant steel in the form of bars and wire 0.75 inch (19 mm) and under in nominal diameter or distance between parallel sides (thickness).
Aluminum-Beryllium Alloy, Extrusions 38Al - 62Be Annealed
Authors:   AMS G Titanium and Refractory Metals Committee
Published: June 2023

This specification covers an aluminum-beryllium alloy in the form of bars, rods, tubing, and shapes consolidated from powder by extrusion.
Instrument and Cockpit Illumination for General Aviation Aircraft
Authors:   A-20A Crew Station Lighting
Published: June 2023

This document establishes acceptable design criteria for instrument and cockpit illumination for general aviation aircraft.
Decarbonized Fuel Options for Civil Aviation
Authors: Muelaner Jody E.
Published: June 2023

Drop-in replacement biofuels and electrofuels can provide net-zero CO2 emissions
with dramatic reductions in contrail formation. Biofuels must transition to
second-generation cellulosic feedstocks while improving land and soil
management. Electrofuels, or "e-fuels,” require aggressive cost reduction in
hydrogen production, carbon capture, and fuel synthesis. Hydrogen has great
potential for energy efficiency, cost reduction, and emissions reduction;
however, its low density (even in liquid form) combined with it’s extremely low
boiling temperature mean that bulky spherical tanks will consume considerable
fuselage volume. Still, emerging direct-kerosene fuel cells may ultimately
provide a superior zero-emission, energy-dense solution.

Decarbonized Power Options for Civil Aviation discusses the current
challenges with these power options and explores the economic incentives and
levers vital to decarbonization. Until common and enforceable global carbon
pricing arrives, targeted national measures (e.g., mandates, price support, and
finance) will be required.

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