Category: Nevin Manimala

J Glaucoma. 2022 Apr 14. doi: 10.1097/IJG.0000000000002037. Online ahead of print.

ABSTRACT

PRCIS: Using an intracanalicular dexamethasone insert or topical prednisolone following iStent and Hydrus surgery provided similar short-term control of post-operative inflammation.

PURPOSE: To compare post-operative inflammation in patients who received an intracanalicular dexamethasone insert or topical prednisolone after iStent or Hydrus surgery.

PATIENTS AND METHODS: Patients receiving a dexamethasone insert after iStent or Hydrus insertion were included and compared to age-matched controls who received topical prednisolone. Pre-operative data were recorded. Post-operative inflammatory cell and the proportion of patients with zero anterior chamber cells was recorded at month 1. Post-operative IOP and rate of cystoid macular edema (CME) were recorded at months 1 and 3.

RESULTS: 40 eyes receiving topical prednisolone were compared to 35 eyes receiving a dexamethasone insert after iStent or Hydrus insertion. Mean post-operative inflammatory cell for the topical group at month 1 was 0.2±0.3, and the dexamethasone group, 0.3±0.5;P=0.816. 70% of patients in the topical group had zero anterior chamber cell at post-operative month 1 compared to 75.8% in the dexamethasone group,P=0.583. Mean pre-operative IOP for the topical group was 18.8±5.5 and the dexamethasone group was 17.1±4.1,P=0.064. Mean post-operative IOP for the topical group at months 1 and 3 was 17.6±6.4 and 15.1±3.1, respectively and the dexamethasone group, 17.5±4.8 and 15.0±3.4, respectively;P=0.772 and 0.884. One patient developed CME in each group.

CONCLUSIONS: There was no statistically significant difference in the proportion of patients who had zero anterior chamber cell at post-operative month 1 between groups.

PMID:35439795 | DOI:10.1097/IJG.0000000000002037

J Contin Educ Health Prof. 2022 Apr 18. doi: 10.1097/CEH.0000000000000428. Online ahead of print.

ABSTRACT

INTRODUCTION: Sickness absence remains a major challenge globally. Primary care physicians often find it challenging to deny patients’ requests for sick leaves, making the gatekeeping role uneasy among doctors.

METHODS: Twenty-one PCPs participated in this non-randomized intervention study. The educational intervention consisted of an interactive presentation, a 20-minute video screening, and 3 text message reminders. The average number for sickness certificates (SCs), sickness absence rate per patient, and causes for sickness absence spells were measured one year before and one year after the intervention.

RESULTS: The average number of SC one year before and after the intervention was 0.44 and 0.47, respectively. The sickness absence rate was 0.63% one year before and 0.75% one year after the intervention with no statistical significance. The mean number of sickness absence days did not significantly change. Causes for sickness absence spells significantly increased for diarrhea and back pain but decreased for upper respiratory infections with no statistical significance.

DISCUSSION: Implementation of a multifaceted intervention to train PCPs on the process of sickness certification did not affect the sickness absence rate. Further research is needed to assess the knowledge and understanding of physicians’ sickness certification process and the underlying factors that govern it to better develop tailored and effective interventions.

PMID:35439792 | DOI:10.1097/CEH.0000000000000428

Cornea. 2022 Apr 14. doi: 10.1097/ICO.0000000000003041. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to report the long-term surgical and visual outcomes of patients with mucopolysaccharidoses (MPS) after big bubble deep anterior lamellar keratoplasty (BB-DALK).

METHODS: This was a retrospective case series of patients with MPS who underwent BB-DALK at a single academic institution. All patients had corneal clouding secondary to MPS limiting visual acuity for which keratoplasty was indicated. Each patient was evaluated and underwent surgery by a single surgeon. Reported data included age at keratoplasty, sex, MPS type, best spectacle-corrected visual acuity, change in pachymetry, ocular comorbidities, surgical complications, and MPS-related medication use.

RESULTS: Outcomes of 12 eyes from 7 patients with MPS type I (Hurler, Scheie, and Hurler-Scheie) are reported using the newest nomenclature. The mean follow-up was 5.58 years (range: 1-10 years). All cases underwent BB-DALK with a type 1 big bubble during the surgery. Two cases (16.6%) required rebubbling because of partial Descemet membrane detachment. One case was complicated by a suture abscess and required a penetrating keratoplasty. No episodes of rejection occurred. Statistically significant improvement in the best spectacle-corrected visual acuity (from a mean 0.85-0.33 logarithm of the minimum angle of resolution, P = logarithm of the minimum angle of resolution 0.0054) and pachymetry (mean reduction of -145.4 μm, P = 0.0018) was observed.

CONCLUSIONS: BB-DALK seems to be an acceptable long-term surgical option in patients with MPS. Our findings suggest that this technique is reproducible and can achieve clear corneal grafts with good visual results on a long-term follow-up.

PMID:35439776 | DOI:10.1097/ICO.0000000000003041

J Glaucoma. 2022 Apr 14. doi: 10.1097/IJG.0000000000002039. Online ahead of print.

ABSTRACT

PRCIS: Pupillary dilation with 0.5% tropicamide and 2.5% phenylephrine resulted in a statistically significant decrease in foveal avascular zone (FAZ) metrics in glaucoma eyes. This observation emphasizes the critical role of pupillary status in interpreting glaucomatous vascular alterations detected by OCTA.

PURPOSE: To evaluate the influence of mydriatic eye drops on optical coherence tomography angiography (OCTA) parameters in patients with primary open-angle glaucoma (POAG).

METHODS: A total of 20 POAG eyes and 20 control eyes were recruited in the study. The imaging area on the fundus was visualized by AngioPlex (Cirrus 5000 HD-OCT; Carl Zeiss Meditec) using en face view of 3×3▒mm and 6×6▒mm preview scans. Images were generated before and after the instillation of topical 0.5% tropicamide and 2.5% phenylephrine. Optic nerve head (ONH) perfusion, ONH flux index, macular perfusion density, macular vessel density, and foveal avascular zone (FAZ) measurements were consecutively obtained for each session. Differences between the pre-and post-dilation measurements were evaluated in POAG patients and controls.

RESULTS: POAG eyes showed a statistically significant decrease in the FAZ area from a mean of 0.29▒mm2to 0.25▒mm2(P=0.037) and FAZ perimeter from a mean of 2.27▒mm to 2.09▒mm (P=0.045) in the OCTA 6×6▒mm scan area after tropicamide/phenylephrine instillation. Pre-and post-dilation measurements of ONH perfusion and ONH flux index were significantly lower in the glaucoma group compared to controls (P<0.05, for all).

CONCLUSION: Topical pupillary dilation with 0.5% tropicamide and 2.5% phenylephrine results in a statistically significant reduction in the FAZ area and FAZ perimeter in POAG eyes. Further OCTA studies are needed for the diagnostic value of vascular changes due to pupil dilation in glaucoma.

PMID:35439783 | DOI:10.1097/IJG.0000000000002039

Bioinspir Biomim. 2022 Apr 19. doi: 10.1088/1748-3190/ac6849. Online ahead of print.

ABSTRACT

Individual insects flying in crowded assemblies perform complex aerial maneuvers by sensing and feeding back neighbor measurements to small changes in their wing motions. To understand the individual feedback rules that permit these fast, adaptive behaviors in group flight, both experimental preparations inducing crowded flight and high-speed tracking systems capable of tracking both body motions and more subtle wing motion changes for multiple insects in simultaneous flight are needed. This measurement capability extends tracking beyond the previous focus on individual insects to multiple insects. This paper describes an experimental preparation that induces crowded insect flight in more naturalistic conditions (a laboratory-outdoor transition tunnel) and directly compares the resulting flight performance to traditional flight enclosures. Measurements are made possible via the introduction of a multi-agent high speed insect tracker called Hi-VISTA, which provides a capability to track wing and body motions of multiple insects using high speed cameras (9000-12,500 fps). Processing steps consist of automatic background identification, data association, hull reconstruction, segmentation, and feature measurement. To improve the biological relevance of laboratory experiments and develop a platform for interaction studies, this paper applies the Hi-VISTA measurement system toApis melliferaforagers habituated to transit flights through the transparent transition environment. Binary statistical analysis (Welch’s t-test, Cohen’s d effect size) of 95 flight trajectories is presented, quantifying the differences between flights in an unobstructed environment and in a confined tunnel volume. The results indicate that body pitch angle, heading rate, flapping frequency, and vertical speed (heave) are each affected by confinement, and other flight variables show minor or statistically insignificant changes. These results form a baseline as swarm tracking and analysis begins to isolate the effects of neighbors from environmental enclosures, and improve the connection of high speed insect laboratory experiments to outdoor field experiments.

PMID:35439741 | DOI:10.1088/1748-3190/ac6849

J Electromyogr Kinesiol. 2022 Apr 12;64:102658. doi: 10.1016/j.jelekin.2022.102658. Online ahead of print.

ABSTRACT

Gait disorders are one of the cardinal features of Parkinson’s Disease (PD) and might be affected by a modified pattern of motor unit activation. This work explores how PD affects the lower limb muscle control and how muscle activity contributes to gait impairment. Using clinical gait analysis data, the onset and the offset of the surface electromyographic (sEMG) signal of four lower limb muscles were determined in 18 people with PD and compared with 10 heathy controls. Different motor patterns were identified in both the populations through a statistical detector algorithm and described in terms of linear envelope, local maxima activation magnitude and occurrence, co-contractions, and bursts duration. Statistical analysis was performed using statistical parametric mapping for the sEMG envelope and linear mixed effects models for the sEMG parameters. An equivalent number of sEMG patterns was detected in PD with respect to controls. Significant differences were highlighted between the two cohorts within the same activation modality. Plantarflexors muscles activation was delayed on time and had different durations and activations peaks, while Biceps Femoris revealed a higher local maximum. These results suggested that functional tibiotarsus joint reeducation coupled with postural rehabilitation might be beneficial for people with PD.

PMID:35439716 | DOI:10.1016/j.jelekin.2022.102658

Oral Oncol. 2022 Apr 16;128:105866. doi: 10.1016/j.oraloncology.2022.105866. Online ahead of print.

ABSTRACT

INTRODUCTION: Neoplasms of the tongue base are rare, but they range from benign neoplasms to congenital diseases and malignant neoplasms. The purpose of this study is to analyze the clinical features and recurrence factors of benign tumors of the tongue base.

METHODS: The study included 27 cases of benign neoplasms of the tongue base from January 2010 to February 2022.

RESULTS: Of these 27 patients, 19 were male and 8 were female. Most cases were found incidentally without any specific symptoms, and squamous papilloma was the most common tumor. We performed microscopic or endoscopic transoral resection of benign neoplasms of the tongue base under general anesthesia in all patients without any complications. The recurrence rate was 14.8%, and we found that the younger the patient, the higher the recurrence rate (p < 0.001).

CONCLUSION: We performed transoral resection of benign neoplasms of the tongue base in all patients without any complications. The recurrence of benign neoplasms of the tongue base was statistically significant only in terms of age.

PMID:35439708 | DOI:10.1016/j.oraloncology.2022.105866

J Clin Virol. 2022 Apr 12;150-151:105161. doi: 10.1016/j.jcv.2022.105161. Online ahead of print.

ABSTRACT

BACKGROUND: Booster doses for COVID-19 vaccinations are currently recommended and approved in many countries. However, we need more evidence on the immune response of individuals to booster doses of inactivated vaccines and the neutralizing effect against the variants of concerns of SARS-CoV-2.

OBJECTIVE: To compare the fold reduction in antibody titers against the variants of concerns of SARS-CoV-2 between the primary doses and booster dose vaccine cohorts of inactivated BBIBP-CorV vaccine.

STUDY DESIGN: In this observational study Plaque Reduction Neutralization Test (PRNT) assay was done on pooled serum samples of the recipients of primary two doses of inactivated BBIBP-CorV and on the pooled serum samples of recipients of a booster dose of inactive BBIBP-CorV. The neutralizing antibody titers against the wild (Wuhan) strain and the variants of concern (alpha, beta and delta) were compared.

RESULTS: The serum sample pool from the booster cohort had high neutralizing antibody titers against the SARS-CoV-2 variants compared to the pooled serum samples of the recipients of primary two doses of inactivated BBIBP-CorV and the difference was statistically significant. The observed fold reduction in antibody titers from the serum pool of recipients of two doses of BBIBP-CorV vaccine were 3.7-fold, 14.6-fold and 10.4-fold compared to 1.8 -fold, 6.5-fold and 3.8-fold reduction against the alpha, beta and delta lineages respectively in the serum pool of recipient of a booster dose (three doses of BBIBP-CorV).

CONCLUSION: Booster doses of inactive BBIBP-CORV offered better protection against the variants of concern of SARS-CoV-2.

PMID:35439702 | DOI:10.1016/j.jcv.2022.105161

Complement Ther Clin Pract. 2022 Apr 12;48:101590. doi: 10.1016/j.ctcp.2022.101590. Online ahead of print.

ABSTRACT

The objective of this study was to investigate the day-to-day experiences of positive and negative emotions among partners of veterans assigned service dogs for posttraumatic stress disorder (PTSD). As part of a larger clinical trial, a total of N = 87 partners of post-9/11 veterans with PTSD were recruited from a nonprofit service dog provider and participated in an ecological momentary assessment (EMA) protocol. The sample included partners of veterans who received a PTSD service dog after baseline (n = 48, treatment group) and partners of veterans on the waitlist for a service dog (n = 39, control group). Data were collected twice daily for two weeks at baseline and again at follow-up three months later, for approximately 56 assessments per participant (28 at baseline, 28 at follow up). Participants completed an average of 84% of questionnaires at baseline (n = 23.6) and 86% (n = 24.1) at follow-up. A total of 3780 EMA questionnaires were collected among partners for this analysis. Data were analyzed using a generalized linear mixed model. Three months following baseline, partners of veterans with service dogs reported statistically significant higher levels of positive emotions than the control partners (p = .01, d = 0.39) with small-to-medium effect sizes for each individual positive emotion. No statistically significant differences were reported for negative emotions (p = .77, d = 0.21). This study quantitatively identifies higher levels of positive emotion in partners who are cohabitating with a PTSD service dog compared to those partners who remained on the waitlist. Given the influence that positive emotions have on well-being and coping, findings suggest that the influence of service dogs may go beyond veterans to influence their cohabitating partners.

PMID:35439705 | DOI:10.1016/j.ctcp.2022.101590

J Magn Reson. 2022 Apr 9;339:107218. doi: 10.1016/j.jmr.2022.107218. Online ahead of print.

ABSTRACT

Dipolar electron paramagnetic resonance (EPR) experiments, such as double electron-electron resonance (DEER), measure distributions of nanometer-scale distances between paramagnetic centers, which are valuable for structural characterization of proteins and other macromolecular systems. One challenge in the least-squares fitting analysis of dipolar EPR data is the separation of the inter-molecular contribution (background) and the intra-molecular contribution. For noisy experimental traces of insufficient length, this separation is not unique, leading to identifiability problems for the background model parameters and the long-distance region of the intra-molecular distance distribution. Here, we introduce a regularization approach that mitigates this by including an additional penalty term in the objective function that is proportional to the variance of the distance distribution and thereby penalizes non-compact distributions. We examine the reliability of this approach statistically on a large set of synthetic data and illustrate it with an experimental example. The results show that the introduction of compactness can improve identifiability.

PMID:35439683 | DOI:10.1016/j.jmr.2022.107218