bluuebunny/crossref_metadata_2025 huggingface dataset:
Life Space and Activity Space Measurement: Making “Room” for Structural Racism
Authors: Szanton Sarah L , Alexander Kamila A , Kim Boeun , Li Qiwei , Gee Gilbert C , Bandeen-Roche Karen J , Adkins-Jackson Paris B , Hladek Melissa D , Samuel Laura J , Haozous Emily A , Okoye Safiyyah M , Crews Deidra C , Thorpe Roland J
Published: November 2023

As we age, the ability to move is foundational to health. Life space is one measure of a person’s ability to move and engage in activity beyond the home. A separate but related concept is activity space, a measurement of a person’s spatial behaviors and visited locations that include social networks, neighborhoods, and institutions. In this article, we integrate the literature on life space and activity space, discussing how physical function is not only determined by individual capabilities, but also by the surrounding social and environmental factors, which may limit their agency. We show how structural racism contributes to inequities within this paradigm linking related concepts of movement, agency, belonging, and timing. We also explore implications for research and theory for mobility, social connection, and activity.
Pediatric IBD Patients Treated With Infliximab and Proactive Drug Monitoring Benefit From Early Concomitant Immunomodulatory Therapy: A Retrospective Analysis of a 10-Year Real-Life Cohort
Authors: Hoelz Hannes , Bragagna Lena , Litwin Anna , Koletzko Sibylle , Le Thi Thu Giang , Schwerd Tobias
Published: November 2023

Background

Limited approval of second-line treatments in pediatric inflammatory bowel disease (pIBD) necessitates optimized use of infliximab (IFX) with proactive therapeutic drug monitoring (TDM). We investigated whether early combo-therapy with an immunomodulator (IMM) provides additional benefit.

Methods

In the retrospectively reviewed medical records of all children treated with IFX and proactive TDM between 2013 and 2022, IMMearly (IMM ≤3 months since IFX start) was evaluated against IMMother/no (late/short or no IMM) over follow-up of 3 to 60 months. Kaplan-Meier analysis was used to analyze time to loss of response (LOR) with IFX discontinuation or time to antibodies-to-IFX (ATI) development.

Results

Three hundred fifteen patients with pIBD were reviewed; of those, 127 with 2855 visits were included (77 CD, 50 UC/IBD-unclassified). Sixty patients received IMMearly, 20 patients IMMother, and 47 had IFX monotherapy. Median follow-up time was 30 and 26 months for IMMearly and IMMother/no, respectively, with comparable proactive TDM. Infliximab treatment persistence was 68% after 60 months. Loss of response was observed in 7 IMMearly and 15 IMMother/no patients (P = .16). Early combo-therapy significantly delayed LOR with IFX discontinuation (median LOR free interval IMMearly 30 months vs IMMother/no 9 months, P = .01). Patients with IMMother/no were 10-, 3- and 2-times more likely to experience LOR with IFX discontinuation after 1, 3, and 5 years, respectively. There were no significant group differences regarding the presence of any positive (>10 arbitrary units per milliliter [AU/mL]) or high (>100 AU/mL) ATI, median ATI concentrations, and ATI-free interval.

Conclusions

Early IMM combo-therapy in proactively monitored patients with pIBD significantly prolonged the median LOR free interval compared with late/short or no IMM treatment.
Insights on the connectivity, genetic diversity, and population structure of Arctodiaptomus dorsalis (Marsh, 1907) (Copepoda: Calanoida: Diaptomidae) in the Philippines
Authors: Guinto Shea K P , Machida Ryuji J , Papa Rey D S
Published: November 2023

The freshwater calanoid copepod Arctodiaptomus dorsalis (Marsh, 1907) was first recorded from the Philippines in 2001 in Laguna de BayThe copepod gained the status of “invasive species” in 2021 due to its presence in 23 of 32 surveyed Philippine lakes and rivers. Genomic DNA was extracted from 107 individuals of A. dorsalis, representing seven populations on the island of Luzon to gather information on the population structure, genetic connectivity, and range expansion of the species.. A 720-bp fragment of the nuclear ITS1 and ITS2 spacers was used to analyze the genetic structure of the populations. High haplotype diversity (Hd = 0.7951), low nucleotide diversity (π = 0.0024), and low genetic distance between populations indicate high levels of gene flow and low levels of isolation. Six of the 12 haplotypes were unique to particular sites, but the three shared haplotypes suggest panmixia among populations. Tajima’s D (D = 0.4945) and Fu’s F (F = -2.8950) suggest a recent increase in population size following a bottleneck. This may have occurred as the result of the copepod’s suspected initial introduction into the Philippines after 1905 via the trade in ornamental aquarium fish, eventually followed by its expansion into nearby inland waters through one or more aquaculture-mediated introduction events. Laguna de Bay’s role since 1972 as the main source of tilapia fingerlings (Oreochromis niloticus (Linnaeus, 1758)) for release into various Philippine lakes provides circumstantial support for this scenario.
Job demands and temporomandibular disorders: mediating and moderating effects of psychological distress and recovery experiences
Authors: Mori Naana , Miyanaka Daisuke , Tokita Masahito , Kawada Michiko , Sakakibara Keiko , Hamsyah Fuad , Yuheng Lin , Shimazu Akihito
Published: November 2023

Objectives: This study examined the relationship between recovery experience, job demands, psychological distress, and temporomandibular disorders (TMD) in Japanese workers.

Methods: It used cross-sectional data from the fourth survey of a multi-wave longitudinal project, conducted using the registered monitors of an internet research company. Finally, 1278 respondents’ data were analyzed (655 males, 623 females; mean [SD] age = 41.63 [10.31] years). We utilized Sugiaski’s TMD screening question to assess TMD prevalence, Brief Job Stress Questionnaire to assess job demands, Kessler Psychological Distress Scale (K6) to assess psychological distress, and the Japanese version of the Recovery Experience Questionnaire to assess recovery experiences. The moderated mediation analysis was conducted using the Process macro program for SPSS developed by Preacher and Hayes, examining the effect of job demands on TMD through psychological distress, moderated by the recovery experience.

Results: The results showed that 13.1% (n = 168) of the respondents had TMD. Mediation analysis indicated high job demands were associated with an increased TMD prevalence through psychological distress. The moderated mediation analysis revealed that relaxation and control moderated the relationship between job demands and psychological distress.

Conclusions: This cross-sectional study established the relationship between job demands, psychological distress, and TMD among Japanese workers. The findings suggest that increased job demands contribute to high TMD prevalence through the mediation of psychological distress, moderated by relaxation and control.
Penetrative anal intercourse may require high axial loading forces
Authors: Miller Jake A , Loeb Charles A , La Justin , el Khatib Farouk , Yafi Faysal A
Published: November 2023

Background

Despite increases in the lifetime prevalence of anal intercourse, little is known about the safety of inflatable penile prosthesis use during anal intercourse or the forces required for anal penetration.

Aim

We sought to determine the force required for anal penetration.

Methods

A digital force gauge device was secured to a silicone phallus with a length and girth representative of the average male phallus in the United States and inserted into the anal canal of 6 male participants for a total of 5 measurements per participant. The maximum axial forces on insertion were recorded. Participants then completed a survey eliciting demographic information and past experience with receptive anal intercourse.

Outcomes

The outcome measure was the force recorded during insertion of a force gauge device into the anal canal.

Results

The median maximal force recorded on anal penetration was 26.5 N (2.7 kg; range: 16.1-51.7 N or 1.64-5.27 kg). Participants who engaged in receptive anal intercourse more than once per month tended to use lesser median maximal forces (25.7 N or 2.62 kg) than participants who engaged less frequently in receptive anal intercourse (41.6 N or 4.24 kg).

Clinical Implications

Compared with the forces required for vaginal penetration, anal penetration forces may cause additional mechanical stress to the phallus.

Strengths and Limitations

While the study is limited primarily in its small sample size and in the use of a single device for anal penetration with a set size and rigidity, the resulting findings presented here are to our knowledge the first reported data pertaining the force required for anal penetration.

Conclusion

As the forces required for anal penetration exceeded those for vaginal penetration, clinicians may need to carefully counsel patients on the safe use of an inflatable penile prosthesis for anal intercourse.
Navigating Spatial Enclosures: Race, Place, and School Policing
Authors: Allen Terry , Gomez Kimberly
Published: November 2023

Law enforcement’s increased presence in U.S. public schools has significantly affected Black students’ access to opportunities and their overall safety. Limited attention has been paid to the broader context in which school policing operates, extending beyond school buildings and embedded in larger neighborhood dynamics. We develop a theory of “spatial enclosures” to describe how policing manifests across schools, neighborhoods, and school police departments, shaping Black students’ everyday experiences. Drawing on a dataset of 120 interviews with Black high school students in a large urban school district, we find that Black students fear their education being stolen by police officers’ control over their time, school routines, and opportunities to learn. This shared concern is influenced by race and location, affecting how Black students interact with the police and develop strategies to navigate such encounters. Many Black students actively engage in social justice networks to protect their education. Prolonged involvement in these networks equips Black students with culturally sustaining knowledge and strategies to navigate the harms posed by spatial enclosures. These findings have important implications for understanding how school policing not only affects physical spaces but also profoundly influences students’ perceptions and experiences of time and their equal access to educational opportunities.
Recent Advances in Mesenchymal Stem/Stromal Cell-Based Therapy for Alcohol-Associated Liver Disease and Non-alcoholic Fatty Liver Disease
Authors: Korkida Foteini , Stamatopoulou Alexandra , Roubelakis Maria G
Published: November 2023

Alcohol-associated liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD) represent pathological conditions that include many distinct stages, potentially leading to the final stage of cirrhotic liver. To date, liver transplantation is the sole successful treatment with concomitant limitations related to donor organ shortage and the need of life-long immunosuppressive therapy. Recently, cell-based therapies for ALD and NAFLD have been proposed with mesenchymal stem/stromal cells (MSCs) as promising effectors. MSC therapeutic applications offer hepatoprotection, regulation of the inflammatory process and angiogenesis particularly in ALD and NAFLD pre-clinical disease models. Recent studies suggested that hepatospecific MSC-based therapies could benefit liver diseases by restoring liver function and decreasing inflammation and fibrosis. Similarly to solid-organ transplantation, limitations in MSC approaches include donor availability exacerbated by high number of cells and cell trapping into lungs. Herein, based on recent advances, we discuss the use of MSCs as a therapeutic approach for ALD and NAFLD and we provide the available information for the establishment of a framework toward a potential clinical application.
Linnemannia elongata: A Key Species in Chitin-Based Plant Growth Promotion
Authors: De Tender Caroline , Vandecasteele Michiel , Ommeslag Sarah , De Zutter Noémie , Vandenbussche Ellen , Haegeman Annelies , Audenaert Kris , Li Leilei , Vandecasteele Bart , Voorthuijzen Floris , Maenhout Kristof , Beirinckx Stien , Barneveldt Rosita , Goormachtig Sofie , Debode Jane
Published: November 2023

Chitin has proven to be a valuable alternative to mineral fertilizers in growing media. We recently hypothesized that chitin might work as a biostimulant, attracting plant growth-promoting microbes to the rhizosphere. In particular, Mortierellales species increase in abundance massively with chitin application and might have a profound role in chitin-mediated plant growth promotion. We isolated four strains of this order classified as Linnemannia elongata from chitin-enriched growing medium and the lettuce rhizosphere. The isolates induced a consistent increase in shoot and root fresh weight and increased chlorophyll content of Arabidopsis thaliana in vitro, as measured by multispectral imaging. By studying the isolate's genomes, we postulated that this growth promotion was induced through auxin production, translocation of calcium to the plant, or both. The synergy between chitin and L. elongata was demonstrated by (i) the chitinase activity and chitin degradation potential of all isolates and (ii) the positive effect of chitin and L. elongata seed coating on germination of A. thaliana seeds compared with L. elongata seed coating without chitin. We conclude that chitin-related growth promotion is dependent on activation of the microbial community, with L. elongata as a key species.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
First Report of Mixed Infection of Jasmine Mosaic-Associated Virus (JMaV) and Jasmine Virus H (JaVH) in Jasmine Species in Florida, United States
Authors: Dey Kishore K. , Velez-Climent Maria , Soria Patricia , McVay John , Adkins Scott
Published: November 2023

Over the past 24 years, virus-like symptoms have been observed on Jasminum spp. in Florida. In September 2018, symptomatic Angelwing jasmine leaves from a hedge in Alachua, Florida, were tested for jasmine mosaic-associated virus (JMaV) and jasmine virus H (JaVH). Identification of expected size amplicons was confirmed by sequencing (accession numbers MN245037, MT559755). In December 2018, symptomatic samples from two Gold Coast jasmine plants from St. Lucie County, Florida, were similarly tested. Only JaVH tested positive (accession number MN442626). In July 2019, Angelwing jasmine hedge in Orange County, Florida, exhibiting similar symptoms tested positive only for JaVH (GenBank accession number MN442627). In April 2023, samples from a symptomatic Gold Coast jasmine hedge in Indian River County, Florida, also tested positive only for JaVH. In May 2023, a symptomatic Angelwing jasmine sample from Miami-Dade County tested positive for both JMaV and JaVH. This is the first report of JMaV and JaVH in single or mixed infections in jasmine in Florida, adding to the known virus species infecting jasmine in the state. Because jasmine is propagated vegetatively, it is likely that dissemination of cuttings made from infected plants is responsible for widespread distribution of these viruses.
Real-world relapse-free survival data on adjuvant anti-PD-1 therapy for patients with newly diagnosed and recurrent stage III melanoma
Authors: Stahlie Emma H.A. , Zijlker Lisanne P. , Wouters Michel W.J.M. , Schrage Yvonne M. , van Houdt Winan J. , van Akkooi Alexander C.J.
Published: November 2023

We aimed to compare the relapse-free survival (RFS) in patients treated with adjuvant anti-programmed cell death-1 (anti-PD-1) therapy for a first diagnosis of stage III melanoma to patients treated after resection of the recurrences. Patients treated with adjuvant anti-PD-1 therapy after complete resection of stage III melanoma between September 2018 and January 2021, were included. Depending on when adjuvant anti-PD-1 treatment was initiated, patients were divided over 2 cohorts: for the first diagnosis (cohort A) or for a second or subsequent diagnosis (cohort B) of stage III melanoma. Clinical data and RFS were compared between cohorts. 66 patients were included: 37 in cohort A, 29 in cohort B. Median follow-up time from the start of adjuvant therapy was 21 months and 17 months in cohorts A and B, respectively. Significant differences in ulceration of the primary tumor (P = 0.032), stage according to the 7th AJCC (American Joint Committee on Cancer, P = 0.026) and type of metastatic involvement (P = 0.005) were found between cohorts. In cohorts A and B, 18 (49%) and 8 (28%) patients developed a recurrence and the 1-year RFS was 51% and 72%, respectively. In cohort B, RFS remained longer in the patients of which the interval between first diagnosis of stage III melanoma and start of adjuvant therapy was >48 months compared to ≤48 months (83% vs. 65%, P = 0.253). This study demonstrates that patients with recurrent stage III disease, not previously treated with adjuvant systemic therapy, may derive similar benefit to a first diagnosis of stage III patients if access to adjuvant therapy changes.
The association of urinary incontinence and disability among a diverse sample of midlife Study of Women’s Health Across the Nation women
Authors: Dugan Sheila A. , Crawford Sybil L. , Wente Karla , Waetjen L. Elaine , Karvonen-Gutierrez Carrie , Harlow Siobán D.
Published: November 2023

Objective

The aim of the study is to examine whether urinary incontinence (UI) type, frequency, and amount are associated with self-reported disability in a racially/ethnically diverse cohort of community-dwelling midlife women.

Methods

Data were from longitudinal analyses of questionnaires from the multicenter, prospective cohort Study of Women's Health Across the Nation (SWAN). We used multivariable ordinal logistic regression to examine whether urinary incontinence type, frequency, and amount at the 13th follow-up were associated with the World Health Organization Disability Assessment Schedule at the 15th follow-up controlling for other factors (menopause status, body mass index, lifestyle and psychosocial factors, and disability at follow-up 13).

Results

Urinary incontinence was associated with subsequent reports of disability in participants, particularly in the World Health Organization Disability Assessment Schedule domains of mobility (P < 0.0001), communication (P = 0.0057), and life activities (P = 0.0407). Associations were strongest for mixed UI type compared with stress UI or urgency UI (odds ratio [OR] = 1.66, 95% confidence interval [CI] = 1.26-2.17, P < 0.001), daily frequency of UI compared with monthly or less than weekly frequency of UI (OR = 1.61, 95% CI = 1.04-2.47, P < 0.001), and larger amounts of urine leakage compared with drops of leakage (OR = 2.98, 95% CI = 1.58-5.62, P < 0.0001) for mobility/getting around domain.

Conclusions

Urinary incontinence seems to have a strong association with multiple domains of disability, including mobility and interacting with others, after approximately 3.7 years. Thus, UI may be an important factor limiting social engagement among women. Screening for mixed UI and UI that occurs greater than weekly and in amounts requiring pads may yield better information regarding an individual's future disability risk and may preserve social interaction.
The association between reproductive period and handgrip strength in postmenopausal women: a nationwide cross-sectional study
Authors: Lee Sae Rom , Cho Young Hye , Park Eun Ju , Lee Youngin , In Choi Jung , Kwon Ryuk-Jun , Son Soo Min , Lee Sang Yeoup
Published: November 2023

Objective

Menarche and menopause are associated with muscle loss and strength in women. Handgrip strength (HGS) is a reliable measurement method of muscle strength. However, it is unclear whether the entire reproductive period, which encompasses both menarche and menopause, is associated with HGS in postmenopausal women.

Methods

A total of 2,354 postmenopausal women aged 45-75 years were included for statistical analysis. The reproductive period was divided into tertiles, and HGS was divided into four quartiles. HGS was measured to evaluate muscle strength. Binary logistic regression analysis was used to identify significant predictors with the first quartile HGS, derived from quartile data. Multiple logistic regression analysis was used to assess the relationship between the reproductive period (exposure) and low HGS (outcome).

Results

We found that the more extended the reproductive period, the lower the risk of low absolute HGS. This trend persisted even after controlling for other variables. Specifically, the odds ratio for low absolute HGS was 0.752 (95% confidence interval [CI], 0.563-1.000) for the second tertile reproductive period and 0.683 (95% CI, 0.513-0.900) for the third tertile reproductive period, with the first tertile reproductive period as the reference. The odds ratio for low relative HGS was 0.761 (95% CI, 0.551-1.052) for the second tertile reproductive period and 0.732 (95% CI, 0.533-0.972) for the third tertile reproductive period, using first tertile reproductive period as the reference, after covariate adjustment.

Conclusions

A longer reproductive period is associated with a decreased risk of low HGS in postmenopausal women.
Evaluating Moisture Migration in Schirmer Test Strips: Exploring Brand-Specific Variations and Introducing Calibration and Conversion Methods
Authors: Magone M. Teresa , Schuck Peter
Published: November 2023

Purpose:

Schirmer test results are widely used for ocular surface disease assessment, but Schirmer strips are not standardized. We compare the characteristics and tear volume with millimeter moisture migration in different brands of Schirmer strips and introduce methods for volume-based, brand-independent calibration.

Methods:

Physical parameters of Haag-Streit, EagleVision, TearFlo, Contacare, and MIPL/A6 Schirmer strip brands were compared. Schirmer strip millimeter moisture migration distances were assessed 5 minutes after application of incremental microliter volumes of human tears. Linear regression analysis of data points from each Schirmer strip brand was performed, and the root-mean-square deviation of data points to the best-fit linear regression was calculated. Calibration correction was performed by converting migration distance to the corresponding tear volume. A reference table and calibration method formulas were created.

Results:

Schirmer strips differed in design, shape, and manufacturing precision. Strip width, weight, and length were different between the 5 brands (P < 0.05). A wide range of Schirmer strip moisture migration values for identical tear volumes was observed among brands. Statistical measurement resulted in a root-mean-square deviation of 2.9 mm for all data points from all brands. Millimeter to volume and weight to volume-based calibration correction methods resulted in a 2.2- and 3.1-fold measurement error reduction, respectively.

Conclusions:

Our findings highlight the lack of standardization among different brands of Schirmer strips, raising concerns about potential sources of unintentional measurement errors. We propose volume-based Schirmer strip calibration methods and conversion of millimeter to microliter results to achieve brand-independent results and improve Schirmer test accuracy.
Early Outcomes of an Artificial Endothelial Replacement Membrane Implantation After Failed Repeat Endothelial Keratoplasty
Authors: Fontana Luigi , di Geronimo Natalie , Cennamo Michela , Mencucci Rita , Versura Piera , Moramarco Antonio
Published: November 2023

Purpose:

The purpose of this study was to report the outcomes of a novel artificial endothelial replacement membrane implant for treating corneal edema after failed repeat endothelial keratoplasty (EK).

Design:

This was a retrospective interventional case series.

Methods:

Patients with chronic corneal edema underwent removal of the EK graft and implantation of an artificial endothelial replacement membrane (EndoArt, EyeYon Medical, Israel) several months after 2 or more Descemet stripping endothelial keratoplasty procedures. The implant was secured to the posterior corneal surface using an air–gas bubble. Outcome measures included corrected distance visual acuity (logMAR), central corneal thickness, device-related complications, and ocular discomfort.

Results:

Five eyes of 5 patients underwent EndoArt implantation. Six months after surgery, the synthetic endothelial replacement membrane was well-centered and adherent to the posterior corneal surface, with improvement in central corneal transparency in all patients. Corrected distance visual acuity increased from mean 1.26 ± 0.25 (logMAR) preoperatively to 0.74 ± 0.44 (logMAR) postoperatively (P = 0.06). Central corneal thickness significantly decreased from a mean of 805 ± 135 μm (excluding the EK graft) preoperatively to 588 ± 60 μm (excluding the EndoArt) postoperatively (P = 0.015). No severe device-related complications developed after surgery, although most patients required more than 1 air–gas bubble injection to achieve complete implant adhesion. All patients experienced preoperative reduction in subjective ocular pain.

Conclusions:

Synthetic endothelial replacement membrane implantation improves central corneal transparency and visual acuity in patients with failed EK and guarded prognosis for repeat keratoplasty. No significant implant-related adverse events occurred after surgery.
Outcomes of Flap Amputation After Laser In Situ Keratomileusis
Authors: Castillejo Becerra Clara M. , Maguire Leo J. , Salomao Diva R. , Patel Sanjay V.
Published: November 2023

Purpose:

The aim of this study was to describe the indications and outcomes of flap amputation after laser in situ keratomileusis (LASIK) at a referral-based institution.

Methods:

In this retrospective consecutive case series, medical records of patients who underwent LASIK flap amputation at Mayo Clinic, Rochester, MN, between January 1, 1998, and January 31, 2023, were reviewed.

Results:

Fifteen eyes (15 patients) underwent flap amputation during the study period. The median age was 45 years (range, 25–71 years), and 8 patients (53%) were men. The median uncorrected visual acuity before flap amputation was 20/200 (range 20/40-hand motions). Indications for flap amputation included epithelial ingrowth (n = 6, 40%), infectious keratitis (n = 6, 40%), diffuse lamellar keratitis (n = 1, 7%), vegetative foreign body (n = 1, 7%), and astigmatism from fixed flap striae (n = 1, 7%). The median duration of follow-up was 8 months (range 1–234 months). Subsequent corneal interventions included chelation of calcific band keratopathy (n = 1, 7%), lamellar keratoplasty (n = 1, 7%), penetrating keratoplasty (n = 2, 18%), keratoprosthesis (n = 1, 7%), and rigid contact lens wear (n = 4, 27%). The final median best visual acuity was 20/25 (range 20/20–20/200). Compared with noninfectious indications for flap amputation, eyes with infectious indications had worse baseline median uncorrected visual acuity (hand motions vs. 20/63, P < 0.001), were more likely to undergo major corneal surgical intervention (50% vs. 11%), and had worse final median best visual acuity (20/50 vs. 20/20, P = 0.018).

Conclusions:

LASIK flap amputation is sometimes necessary to control threatening corneal diseases. Excellent visual outcomes were achieved in most cases, albeit with additional intervention or rigid contact lens wear.
Deformable Biomechanics of DMEK Tissue Scrolls Traveling Through Narrow Lumens: The Inverse Relationships Between Fluid Velocity, Scroll Width, and Wall Contact and Their Clinical Implications for Preloading
Authors: Kigin Matthew , Revis Benjamin , Vigmostad Sarah , Sales Christopher
Published: November 2023

Purpose:

The aim of this study was to evaluate Descemet membrane endothelial keratoplasty (DMEK) scroll width and length in relation to variable velocities as the tissue transits through wide and narrow lumen glass tubes.

Methods:

Sets of DMEK tissue were processed using the Iowa Lions Eye Bank standard DMEK protocol and were passed through 2 glass tube widths at variable speeds. Two hourglass-shaped glass tubes were created, one “wide” and one “narrow.” A syringe pump, valve, and pressure gauge were used to modulate tissue speed through each tube. For both tube sizes, DMEK tissue was passed through their lumens with incrementally increasing velocity and visualized with a high-speed camera at frame rates from 1000 to 8000 fps. Scroll width and length were measured using IDT Motion Studio software and digital calipers.

Results:

There was a significant, indirect correlation between scroll velocity and width in both the wide (R2 = −0.98, P < 0.001) and narrow (R2 = −0.84, P < 0.001) tubes. There was a significant, direct correlation between scroll velocity and length in both the wide (R2 = 0.84, P < 0.001) and narrow (R2 = 0.83, P < 0.001) tubes. The resting widths of the scrolls were 105% and 207% wider than the wide and narrow tubes, respectively. All transits recorded scroll widths that were equal to or smaller than their respective tube's internal diameter.

Conclusions:

There is a significant, inverse correlation between DMEK scroll velocity and width as well as a direct correlation between scroll velocity and length, allowing DMEK scrolls to transit through a tube that is narrower than its resting width without sustained lumen wall contact.
Corneal Superficial Plaque Formation After Recombinant Human Nerve Growth Factor Use in a Patient With Neurotrophic Keratopathy and Limbal Stem Cell Deficiency From Mucous Membrane Pemphigoid
Authors: Surico Pier Luigi , Kaufman Aaron R. , Lin Julie , Dehghani Shima , Dana Reza
Published: November 2023

Purpose:

The aim of this study was to report a rare observation of corneal superficial plaque formation after topical recombinant human nerve growth factor (rhNGF) treatment for a nonhealing epithelial defect in a patient with advanced mucous membrane pemphigoid, limbal stem cell deficiency, and neurotrophic keratopathy.

Methods:

This study was a case report.

Results:

A 72-year-old man with a complex course of mucous membrane pemphigoid, leading to cicatrizing keratoconjunctivits, limbal stem cell deficiency, and neurotrophic keratopathy presented with a recurrent persistent epithelial defect in the right eye. After a long course of unsuccessful epithelial healing, despite various treatment modalities, he was administered topical rhNGF (cenegermin 0.002%; Oxervate, Dompé US Inc., Boston, MA) which successfully resolved the epithelial defect. However, on day 22 posttreatment, an unusual white, thick, adherent corneal superficial plaque formed. rhNGF was stopped and the plaque was carefully removed. Subsequently, there was no recurrence, and the patient's epithelial healing remained stable.

Conclusions:

Although the successful resolution of the persistent epithelial defect with rhNGF administration was notable, the development of the unusual epithelial overgrowth emphasizes the importance of vigilant monitoring and evaluation when using rhNGF in complex ocular conditions. Making informed decisions on the timing of discontinuing rhNGF can lead to desirable effects of the drug while mitigating additional side effects when managing such challenging cases.
Comparison of long-term outcomes of simultaneous accelerated corneal crosslinking combined with intracorneal ring segment or topography-guided PRK
Authors: Cohen Eyal , Ong Tone Stephan , Mimouni Michael , Stein Raymond , Chan Clara C. , Chew Hall F. , Rabinovitch Theodore , Rootman David S. , Slomovic Allan R. , Hatch Wendy V. , Singal Neera
Published: November 2023

Purpose:

To compare long-term outcomes of simultaneous accelerated corneal crosslinking (CXL) with intrastromal corneal ring segments (CXL-ICRS) with simultaneous accelerated CXL with topography-guided photorefractive keratectomy (CXL-TG-PRK) in progressive keratoconus (KC).

Setting:

Kensington Eye Institute and Bochner Eye Institute, Toronto, Canada.

Design:

Prospective nonrandomized interventional study.

Methods:

The change in visual and topographical outcomes of CXL-ICRS and CXL-TG-PRK 4 to 5 years postoperatively were compared using linear regression models adjusted for preoperative corrected distance visual acuity (CDVA) and maximum keratometry (Kmax).

Results:

57 eyes of 43 patients with progressive KC who underwent simultaneous accelerated (9 mW/cm2, 10 minutes) CXL-ICRS (n = 32) and CXL-TG-PRK (n = 25) were included. Mean follow-up duration was 51.28 (9.58) and 54.57 (5.81) months for the CXL-ICRS and CXL-TG-PRK groups, respectively. Initial mean Kmax was higher in the CXL-ICRS group compared with the CXL-TG-PRK group (60.68 ± 6.81 diopters [D] vs 57.15 ± 4.19 D, P = .02). At the last follow-up, change (improvement) in logMAR uncorrected distance visual acuity (UDVA) compared with that preoperatively was significant with CXL-ICRS (−0.31 ± 0.27, P < .001, which is equivalent to approximately 3 lines) and not significant with CXL-TG-PRK (−0.06 ± 0.42, P = .43). The logMAR CDVA improved significantly with CXL-ICRS (−0.22 ± 0.20, P < .001), but not with CXL-TG-PRK (−0.05 ± 0.22, P = .25). Adjusting for baseline Kmax and CDVA, the improvement in UDVA was significantly greater with CXL-ICRS than with CXL-TG-PRK (−0.27, 95% CI, 0.06-0.47, P = .01). Improvement in CDVA was not significantly different.

Conclusions:

In this cohort of progressive KC with long-term follow-up, UDVA showed more improvement with accelerated CXL-ICRS than with CXL-TG-PRK.
Safety and efficacy of kidney transplantation in patients with aortoiliac stenosis: a retrospective cohort study
Authors: Fang Yitian , Hamm Julie J.M. , den Hartog Floris P.J. , Kimenai Hendrikus J.A.N. , de Bruin Ron W.F. , Minnee Robert C.
Published: November 2023

Background:

The impact of aortoiliac occlusive disease on kidney transplantation remains unclear. This study aims to investigate the clinical outcomes of kidney transplant patients with aortoiliac atherosclerotic stenosis.

Methods:

Retrospective data from our transplant center were used to identify patients undergoing kidney transplantation between January 2010 and December 2020. Aortoiliac atherosclerotic stenosis was screened and stratified by the Trans-Atlantic Inter-Society Consensus (TASC) II classification. The primary outcome was patient survival. Secondary outcomes were 90-day mortality, death-censored graft survival, graft function and arterial complications. Propensity score matching was used to match all patients in the stenosis group with patients without stenosis sharing similar characteristics.

Results:

The analysis included 655 patients, 524 without stenosis, and 131 with aortoiliac stenosis (95 with TASC A/B stenosis, 36 with TASC C/D stenosis). Recipient age (median [IQR], 66 [60-70] vs. 66 [59-71] years; P=0.47), gender (male: 87 [66%] vs. 355 [68%], P=0.85), and comorbidities were comparable between the stenosis and no-stenosis groups. Forty-six (35%) patients with stenosis were symptomatic. Patient survival was significantly lower in the stenosis group compared to the no-stenosis group (TASC A/B: 30.6% vs. no-stenosis: 44.1%, P=0.013; TASC C/D: 11.4% vs. no-stenosis: 44.1%, P<0.001). The incidence rates of artery dissection, lower extremity ischemia and acute thrombosis were significantly higher in the stenosis group (P<0.001). However, death-censored graft survival (TASC A/B: 73.6% vs. no-stenosis: 72.9%, P=0.62; TASC C/D: 58.1% vs. no-stenosis: 72.9%, P=0.16) and graft function were comparable between the groups.

Conclusions:

Aortoiliac atherosclerotic stenosis significantly impacts patient survival but not graft survival. Our analyses suggest that patients with TASC A/B stenosis have prolonged survival and enhanced quality of life through kidney transplantation. However, for patients with TASC C/D stenosis, kidney transplantation improves quality of life without bringing survival benefits.
Intraoperative blood pressure and cardiac complications after aneurysmal subarachnoid hemorrhage: a retrospective cohort study
Authors: Wang Juan , Lin Fa , Zeng Min , Liu Minying , Zheng Maoyao , Ren Yue , Li Shu , Yang Xiaodong , Chen Yiqiang , Chen Xiaolin , Sessler Daniel I. , Peng Yuming
Published: November 2023

Background:

Previous studies report that intraoperative hypotension worsens outcomes after aneurysmal subarachnoid hemorrhage (aSAH). However, the hypotensive harm threshold for major adverse cardiovascular events remains unclear.

Methods:

We included aSAH patients who had general anaesthesia for aneurysmal clipping/coiling. Major adverse cardiovascular events (MACE) were defined by a composite of acute myocardial injury, acute myocardial infarction, and other cardiovascular complications identified by electrocardiogram and echocardiography. We initially used logistic regression and change-point analysis based on the second derivative to identify mean arterial pressure (MAP) of 75 mmHg as the best threshold. Thereafter, our major exposure was MAP below 75 mmHg characterized by area, duration, and time-weighted average. The area below 75 mmHg represents the severity and duration of exposure and was defined as the sum of all areas below a specified threshold using the trapezoid rule. Time-weighted average MAP was derived by dividing area below the threshold by the duration of anaesthesia. All analyses were adjusted for baseline risk factors including age >70 years, female sex, severity of intracerebral haemorrhage, history of cardiovascular disease, and preoperative elevated myocardial enzymes.

Results:

Among 1029 patients enrolled, 254 (25%) developed postoperative MACE. Patients who experienced MACE were slightly older (59±11 vs. 54±11 y), were slightly more often women (69% vs. 58%), and had a higher prevalence of cardiovascular history (65% vs. 47%). Adjusted cardiovascular risk increased nearly linearly over the entire range of observed MAP. However, there was a slight inflexion at MAP of 75 mmHg. MACE was significantly associated with area (adjusted odds ratios [aOR] 1.004 per 10 mmHg.min, 95% confidence interval [CI]: 1.001-1.007, P=0.002), duration (aOR 1.031 per 10 min, 95%CI: 1.009-1.054, P=0.006), and time-weighted average (aOR 3.516 per 10 mmHg, 95%CI: 1.818-6.804, P<0.001) of MAP <75 mmHg.

Conclusions:

Lower blood pressures were associated with cardiovascular complications over the entire observed range, but worsened when MAP was <75 mmHg. Pending trial data to establish causality, it may be prudent to keep MAP above 75 mmHg in patients having surgical aSAH repairs to reduce the risk of major adverse cardiovascular events.
Investigating Deferral Rates in Cochlear Implantation: How Often Do Candidates Defer and Why?
Authors: Kaul Vivian F. , Dzubara Bryce P.G. , Munjal Vikas , Katta Juhi , Adunka Oliver F. , Ren Yin
Published: November 2023

Objective

Evaluate the rate at which cochlear implant (CI) candidates decline surgery and identify associated factors.

Study Design

Retrospective cohort study.

Setting

Tertiary referral center.

Patients

Four hundred ninety-three CI candidates from July 1989 to December 2020 with complete demographic and socioeconomic data.

Interventions

Diagnostic.

Main Outcome Measures

Age, sex, race, marital and employment status, median household income percentile, distance-to-CI-center, and residence in a medically underserved county.

Results

Of the 493 CI candidates included, 80 patients (16.2%) declined surgery. Based on chart checking, the most common reason patients did not receive the implant was due to loss of follow-up (38%). African American patients were 73% less likely to undergo implantation compared with White patients (odds ratio [OR], 0.27 [0.11–0.68];p= 0.005). Asian patients were 95% less likely to undergo implantation (OR, 0.05 [0.009–0.25];p= 0.0003) compared with White patients. For every 1-year age increase, patients were 4% less likely to undergo implantation (OR, 0.96 [0.94–0.98];p< 0.0001) and for every 10-year age increase, the patients were 33% less likely. Compared with their single counterparts, married patients were more likely to undergo implantation (OR, 1.87 [1.12–3.15];p= 0.02). No differences were observed when comparing implanted and nonimplanted CI candidates in sex, employment status, distance-to-CI-center, or median family income percentile. Aχ2test of independence showed no association between receiving CIs and living in medically underserved counties (χ2= 2; N = 493; 0.3891;p= 0.53).

Conclusions

Not infrequently, CI candidates decline surgery. Although demographic factors (race, age, and marital status) were associated with the cochlear implantation decision, socioeconomic factors (median family income and residence in a medically underserved community) were not. Perhaps cultural components of a patient's race have a larger impact on whether or not the patients get implanted.
Characterization of Vestibular Perception in Patients with Persistent Postural-Perceptual Dizziness
Authors: Kobel Megan J. , Wagner Andrew R. , Oas John G. , Merfeld Daniel M.
Published: November 2023

Objective

To assess vestibular (i.e., passive self-motion) perception in patients diagnosed with persistent postural-perceptual dizziness (PPPD).

Study Design

Case-controlled, cross-sectional, observational investigation.

Setting

Single-center laboratory-based study.

Patients

Thirteen patients with PPPD, 13 age-matched healthy control volunteers. Of those with PPPD, eight had co-occurring vestibular migraine (VM).

Interventions

All participants completed a vestibular threshold test battery reflecting perception with predominant inputs from (a) the otoliths (1-Hz interaural y-axis translation, 1-Hz superior-inferior z-axis translation), (b) the semicircular canals (2-Hz yaw rotation, 2-Hz tilts in the planes of the vertical canal pairs), and (c) and canal-otolith integration (0.5-Hz roll tilt).

Main Outcome Measures

Direction-recognition thresholds for each vestibular threshold test condition.

Results

Across all patients with PPPD, higher thresholds for superior-inferior z-translations thresholds in comparison to age-matched healthy control participants were identified (p < 0.001). Those patients with co-occurring VM and PPPD (PPPD/+VM) displayed significantly higher z-translation thresholds (p = 0.006), whereas patients with PPPD without VM (PPPD/−VM) displayed significantly higher roll tilt thresholds (p = 0.029).

Conclusions

Patients with PPPD did not display a global worsening of passive self-motion perception as quantified by vestibular perceptual thresholds. Instead, patients with PPPD displayed elevated thresholds for only roll tilt and z-translation thresholds, with the relative change in each threshold impacted by the co-occurrence of VM. Because both z-translation and roll tilt motions are reliant on accurate gravity perception, our data suggest that patients with PPPD may exhibit impaired processing of graviceptive cues.
Comparison of Speech Recognition and Hearing Preservation Outcomes Between the Mid-Scala and Lateral Wall Electrode Arrays
Authors: Patro Ankita , Lindquist Nathan R. , Schauwecker Natalie , Holder Jourdan T. , Perkins Elizabeth L. , Haynes David S. , Tawfik Kareem O.
Published: November 2023

Objective

To assess speech recognition and hearing preservation (HP) outcomes with the Advanced Bionics Mid-Scala and SlimJ electrodes.

Study Design

Retrospective cohort.

Setting

Tertiary referral center.

Patients

A total of 237 adult patients implanted between 2013 and 2020 (Mid-Scala, n = 136; SlimJ, n = 101).

Main Outcome Measures

Consonant-nucleus-consonant (CNC) and AzBio (Arizona Biomedical) scores at 6 and 12 months; postoperative HP, defined as low-frequency pure-tone average ≤ 80 dB HL; scalar position.

Results

Mean CNC scores did not significantly differ between Mid-Scala and SlimJ recipients at 6 (45.8% versus 46.0%,p= 0.962) and 12 (51.9% versus 48.8%,p= 0.363) months. Similarly, mean AzBio in quiet scores were equivalent for both groups at 6 (55.1% versus 59.2%,p= 0.334) and 12 (60.6% versus 62.3%,p= 0.684) months. HP rates were significantly higher with the SlimJ (48.4%) than the Mid-Scala (30.8%;p= 0.033). Scalar translocations were 34.8 and 16.1% for the Mid-Scala and SlimJ groups, respectively (p= 0.019). Ears with postoperative HP had significantly fewer scalar translocations (16.7% versus 37.2%,p= 0.048), and postoperative HP was associated with higher AzBio in noise scores at the most recent follow-up interval (38.7% versus 25.1%,p= 0.042). CNC, AzBio in quiet and noise, low-frequency pure-tone average shifts, and PTA at 6 and 12 months were not significantly different between patients with scala tympani insertions of the SlimJ versus the Mid-Scala (p> 0.05).

Conclusions

Compared with the Mid-Scala, the lateral wall electrode has superior HP rates and fewer scalar translocations, whereas speech recognition scores are equivalent between both electrode arrays. These findings can help providers with electrode selection and patient counseling.
Globalization and Glocalization in the History of Chinese Medicine
Authors: ZHANG Yong-an , Armus Diego
Published: November 2023

The globalization of Chinese medicine, forged through successive waves of migration, cultural exchanges, and economic imperatives, constitutes a nuanced and intricate process with historical roots extending over millennia. It stands as the culmination of interconnected historical events that reverberated beyond the confines of China, emerging as a phenomenon characterized by the adjustment of Chinese medical theories, clinical practices, and materia medica to indigenous customs and healthcare traditions prevalent in both proximate and distant regions. In theseglocalizedprocesses, the global and the local intersect and mix. The frameworks of globalization andglocalizationallow a critical interpretation of the many hybridizations that have shaped overseas Chinese medicine’s history and present.
Cystic encapsulated papillary carcinoma with ductal carcinoma in situ in the male breast: a clinicopathologic feature with a diagnostic challenge: A case report and review of literature
Authors: Wang Bo , Wang Li , Zhao Zhenya , Xu Xin
Published: November 2023

Rationale:

Encapsulated papillary carcinoma (EPC) is a rare subset of breast carcinoma accounting for 0.5% to 2.0% of all patients with breast cancer and occuring mostly in postmenopausal women. It is even rarer in male breast cancer, and male EPC has only been reported in few cases. EPC has a distinctive histological pattern and a better prognosis compared with other types of breast carcinoma. Compared to the previously reported EPC cases, the lesion was unusually cystic made the diagnosis challenging. Accordingly, herein, we describe a rare case of EPC was unusually cystic in an elder male breast, associated with ductal carcinoma in situ (DCIS), along with an indepth literature discussion, and then to improve our understanding more about this uncommon tumor and further to provide more experience to treat this disease.

Patient concerns:

A 73-year-old man noticed a slowly enlarging mass in the right breast 1 year ago and sought medical attention. The patient presented with a right breast mass of 1-year duration and bloody nipple discharge in the first couple of days. The medical history was unremarkable.

Diagnoses:

Physical examination, an elastic hard, smooth and movable 4-cm lesion was palpated below the right papilla. On the sonography, a well-defined predominantly cystic-solid tumor of 3.6 × 2.3 cm was confirmed. Postoperative pathological and immunohistochemical examinations of the surgical specimens revealed a final diagnosis of breast EPC with DCIS.

Interventions:

The patient underwent surgery. A diagnosis of “a little papillary neoplasm of the breast with epithelial atypia and hypertrophy in the fibrous cystic wall” was made by the frozen section. Further, total mastectomy was performed.

Outcomes:

The operation was successful. Then the male patient recovered completely, did not require any additional treatment and continued to do well on postsurgical mammary surgical clinic visits. The patient had been followed-up regularly for 2 years after surgery; he did not experience any complications and remained disease-free.