Effects Of Modalities Research Articles

Improving Mental Health Knowledge and Reducing Mental Health Stigma Among Public Safety Personnel: Comparison of Live vs. Online Psychoeducation Training Programs

This study evaluates the effectiveness of a brief psychoeducation training program in reducing mental health stigma, both toward others and oneself, among public safety personnel, while also comparing the relative effectiveness of in-person and online training modalities. In total, 1686 public safety personnel in Florida received psychoeducation on the mental health impacts of public safety work. Participants completed pre- and post-training questionnaires assessing demographics, mental health knowledge, and mental health stigma toward others and themselves. Among the participants, 871 completed the training online, and 44 completed the training in-person. A paired samples t-test assessed changes in knowledge from pre- to post-test, and 2 × 2 repeated measures ANOVAs analyzed stigma-related data. Mental health knowledge increased and mental health stigma toward others decreased post-training, with no differences between training modalities. No changes in mental health self-stigma were found. Police officers reported significantly greater self-stigma than firefighters. Firefighters and dispatchers reported significantly less stigma toward others than police officers. This study found that both in-person and online psychoeducation can similarly improve mental health knowledge and reduce stigma toward others, which may help reduce barriers to seeking care.

Impact of surgical and non-surgical weight loss on echocardiographic and strain parameters in Asian patients

Surgical weight loss (SWL) improves myocardial mechanics as measured by speckle-tracking imaging. However non-surgical versus SWL and the subsequent impact on myocardial function in overweight Asian subjects has not been evaluated. 66 patients underwent a 16-week lifestyle intervention (LSI) programme consisting of dietary interventions and exercise prescription. Echocardiography with speckle tracking was performed at baseline and post-intervention. This group was compared against a group of 12 subjects who had undergone bariatric surgery and a control group of 10 lean Asian subjects. A generalised structural equation model (gSEM) was constructed to ascertain the effect of modality of weight loss on strain parameters, adjusting for BMI. Participants attained significant weight loss after LSI (28.2 ± 2.66 kg/m2 vs. 25.8 ± 2.84 kg/m2, p = 0.001). This was associated with a non-significant trend towards improvement in strain parameters. SWL participants had significant improvement in the left ventricular global longitudinal strain (− 20.52 ± 3.34 vs. − 16.68 ± 4.15, p < 0.01) and left atrium reservoir strain (44.32 ± 14.23 vs. 34.3 ± 19.31, p = 0.02). Lean subjects had significantly higher strain parameters than overweight subjects. The gSEM model demonstrated surgical modality of weight loss as an independent predictor of improvement in strain parameters. Significant improvement in echocardiographic parameters were documented in patients who underwent bariatric surgery.

Effect of different electric stimulation modalities on pain and functionality of patients with pelvic pain: Systematic review with META-analysis.

Pelvic pain is located in the anterior abdominal wall, below the umbilical scar. Its treatment includes pharmacological therapy, which can cause adverse effects and is not always sufficient to control symptoms. Thus, the use of adjunct therapies such as electric stimulation has been suggested. Therefore, this review intends to appraise the literature on the effectiveness of electrostimulation in the treatment of pelvic pain. The search for studies was conducted until April 2024 in PubMed, Cochrane Library, ScienceDirect, SciELO, PEDro, CINAHL, BVS, Web of Science, Scopus, and Google Scholar databases using a combination of Mesh terms "Electric Stimulation" and "Pelvic Pain." Risk of bias assessment and meta-analysis were performed with The Cochrane Collaboration tool (RevMan 5.4). Quality of the evidence was assessed with GRADE tool. From the 3247 studies found, 19 were included. In the qualitative analysis, seven studies showed TENS, electroacupuncture, PTNS, and tDCS reduced pain intensity, one study on PTNS showed increased quality of life, and one on tDCS showed improved functional performance. However, in the meta-analysis, only TENS showed efficacy for the reduction of acute pelvic pain and primary dysmenorrhea. Our results indicate that there is moderate-quality evidence for TENS to reduce pain intensity in primary dysmenorrhea and low-quality evidence for the same outcome in acute pelvic pain. Randomized controlled clinical trials with larger sample size and with better methodological quality are needed to establish the effectiveness of other forms of electrical stimulation in pelvic pain.

Auditory, Visual, or Both? Comparing Visual and Auditory Representations of Game Elements in a Gamified Image-Tagging Task

In gamification users show increased motivation and engagement towards tasks. So far, this effect has mostly been empirically tested based on the visual depiction of game elements, while research on the use and addition of auditory aspects is sparse. In this work we investigate the effect of different modalities of game elements (auditory, visual, audiovisual) on user experience, perception and performance in a gamified image-tagging task. We approached this via an online validation survey to find suitable sound effects (N=50), a main quantitative study (N=109) and a qualitative semi-structured interview (N=9). Our results show that while visual gamification increases performance, auditory and audiovisual gamification had no effect. However, they were shown to have an influence on the user's flow state. Our qualitative follow-up study shed light on underlying reasons and revealed each modality has its own drawbacks and advantages and that combining both visual and auditory aspects was preferred by participants.

Quantitative analysis of effectiveness and associated factors of exercise on symptoms in osteoarthritis: a pharmacodynamic model-based meta-analysis

ObjectiveThis study aims to evaluate the time point and magnitude of peak effectiveness of exercise and the effects of various exercise modalities for osteoarthritis (OA) symptoms and to identify factors...

Learning novel words for motion by speakers of structurally different languages

Abstract Speakers of different languages follow a three-way split in how they express motion events in speech—with a greater emphasis on manner in satellite-framed languages (English), path in verb-framed languages (Turkish), and comparable expression of manner and path in equipollently-framed languages (Chinese). According to the thinking-for-speaking account, these language-specific patterns can affect speakers’ representation of motion events but only when verbalizing the event. In this study, we asked whether language might influence learning novel words, particularly when the words were accompanied with gestures. We examined effects of language type (equipollent-framed: Chinese, satellite-framed: English, verb-framed: Turkish) and modality (speech-only, gesture+speech) on learning pseudowords for motion (manner, path). Our results showed that speakers of all three languages learned pseudowords for manner and path but with lower accuracy scores and slower rates of learning by Chinese speakers. Regardless of the language they spoke, participants learned manner words more accurately than path words, but with no added benefits of instruction with gesture+speech over speech-only. Taken together, our study extends the lack of language effect on nonverbal representation of events when not speaking to the domain of novel word learning across structurally different languages.

Advances in VNS efficiency and mechanisms of action on cognitive functions.

This systematic review aims to comprehensively analyze the efficacy and underlying mechanisms of vagus nerve stimulation (VNS) in enhancing cognitive functions and its therapeutic potential for various cognitive impairments. The review focuses on the impact of VNS on emotional processing, executive functions, learning, memory, and its clinical applications in conditions such as epilepsy, depression, Alzheimer's disease, and other neurological disorders. A systematic search of electronic databases (PubMed, Scopus, Web of Science) was conducted using the keywords "vagus nerve stimulation," "cognitive enhancement," "emotional processing," "executive function," "learning and memory," "epilepsy," "depression," "Alzheimer's disease," "neurological disorders," "attention-deficit/hyperactivity disorder," "sleep disorders," and "long COVID." The inclusion criteria encompassed controlled trials, longitudinal studies, and meta-analyses published in English between 2000 and July 2024. A comprehensive review of 100 articles highlighted the cognitive effects of Vagus Nerve Stimulation (VNS). Studies show that VNS, especially through transcutaneous auricular VNS (taVNS), enhances emotional recognition, particularly for facial expressions, and improves selective attention under high cognitive demands. Additionally, VNS enhances learning and memory, including associative memory and spatial working memory tasks. In clinical applications, VNS exhibits promising benefits for improving cognitive functions in treatment-resistant epilepsy, depression, and Alzheimer's disease. VNS represents a promising therapeutic approach for enhancing cognitive function across diverse patient populations. The reviewed evidence highlights its efficacy in modulating cognitive domains in healthy individuals and improving cognition in neurological conditions. However, the comparative effectiveness of different VNS modalities and the differential effects of online versus offline VNS on cognitive psychology require further investigation. Future research should focus on optimizing VNS protocols and elucidating specific cognitive domains that benefit most from VNS interventions. This ongoing exploration is essential for maximizing the therapeutic potential of VNS in clinical practice.

Modal identification as a tool to increase the accuracy of acoustic absorption measurements in reverberation rooms

Measuring the acoustic properties of materials may be very challenging. At low frequencies, the sample may interfere with the room's modal behavior. When it occurs, the longest modal decays are influenced. Differences in reverberation time - empty Vs with-specimen conditions - are often emphasized by these modal effects, and, as a matter of fact, the absorption coefficient may be overestimated. The present work aims to increase the accuracy through data augmentation at low frequencies. Modal identification was performed on measured impulse responses of porous specimens, allowing the determination of modal-decay times within the third-octave bands of 80-160 Hz. A statistical analysis of natural modes highlights the modes whose decay exceeds the density function as outliers. This preliminary study ultimately provides some statistical considerations on the modal distribution of decay times and their relationship with the reverberation time measured through the Schroeder integral.

Elasticity and modal effects on the optimal performance of micro-perforated multi-layered absorbers

Multi-layered wall-treatments with thin lightweight micro-perforated panels offer a potential solution to achieve broadband noise absorption while complying with mass saving and compactness. This study examines how vibrational effects, often neglected, may impede the wideband acoustical performance of such partitions, made up of a distribution of either periodic or graded micro-perforated membranes or panels. The impedance translation method and a scattering matrix analysis have been implemented. It is found that the elasticity behavior of thin micro-perforated membranes has a beneficial effect on the acoustical efficiency of the partitions. The contributions of the individual acoustical resonances tend to merge if the elasticity effects are accounted for. If the partition is optimized, near-constant high absorption and low transmission values are obtained over a wide frequency range. A more robust design involves partitions made up of micro-perforated panels. It was observed that the first volumetric volumetric mode of the panels modifies the absorption properties of the partition. It cross-couples with the acoustical resonances and redistributes their spectral locations. This structural resonance sets an upper frequency bound, below which the partition achieves a high broadband performance. It should be accounted for when setting the frequency limits of the total dissipation to be optimized.

Fish behavior recognition based on an audio-visual multimodal interactive fusion network

In light of the challenges imposed by fish behavior recognition, which arise from environmental noise and dim lighting in aquaculture environments and adversely affect the effectiveness of unimodal recognition methods based on either sound or visual cues, this paper proposes a fish behavior recognition model, Mul-SEResNet50, based on the fusion of audio and visual information. To address issues such as image blurring and indistinct sounds in aquaculture environments, which hinder the effectiveness of multimodal fusion and complementary modalities, a multimodal interaction fusion (MIF) module is introduced. This module integrates audio-visual modalities at multiple stages to achieve a more comprehensive joint feature representation. To enhance complementarity during the fusion process, we designed a U-shaped bilinear fusion structure to fully utilize multimodal information, capture cross-modal associations, and extract high-level features. Furthermore, to address the potential loss of key features, a temporal aggregation and pooling (TAP) layer is introduced to preserve more fine-grained features by extracting both the maximum and average values within pooling regions. To validate the effectiveness of the proposed model, both ablation experiments and comparative experiments are conducted. The results demonstrate that Mul-SEResNet50 achieves a 5.04 % accuracy improvement over SEResNet50 without sacrificing detection speed. Compared to the state-of-the-art U-FusionNet-ResNet50 +SENet model, Mul-SEResNet50 achieves accuracy and F1 score improvements of 0.47 % and 1.32 %, respectively. These findings confirm the efficacy of the proposed model in terms of accurately recognizing fish behavior, facilitating the precise monitoring of fish behavior.

A-188 Modal Failure and Effects Analysis, FMEA methodology, as a strategy to increase patient safety

Abstract Background Patient safety during the clinical care process is considered a priority in healthcare. Failure Mode and Effects Analysis (FMEA) is a proactive and systematic method of process evaluation and is used to identifying where and how each phase of the analytical process could fail allowing the detection of the causes and the effects they produce on the quality of the results that are issued. A regular use of this tool makes possible to identify the most critical steps, propose improvement strategies and evaluate their impact. The aim of the study is to evaluate applicability of the FMEA tool to identify errors in the pre analytical, analytical, and post analytical phase of a clinical laboratory as well as the main causes and effects, to reduce them by proposing improvement strategies Methods For each phase into which the laboratory activity is divided, the frequency and type of errors that are made and their final consequences on the patient are evaluated. A risk index (NPR=OxDxS) is calculated for each error considering the frequency with which it occurs (O), the ease with which it is detected (D) and the severity of the consequences on the patient (S). Values goes from 1 (rarely) to 10 (often). Improvement actions are proposed for all errors with a risk index greater than 100 and this index is re-evaluated after the implementation of that improvement measures. This same analysis is performed for three times over the last 10 years (in 2014, 2019 and 2023). Results In FMEA analysis carried out in 2014, a total of 40 errors were identified in the pre-analytical phase (63.5% of the total), 12 in the analytical phase and 11 in the post-analytical phase. 50% of the total errors detected required improvement strategies because they had an NPR≥100 value. In the 2023 evaluation, a total of 27 errors were identified in the pre-analytical phase, 10 in the analytical phase, and 5 in the post-analytical phase but only 6 required improvement strategies, which represents an 80% reduction in the most critical errors for patient safety. However, the pre-analytical phase continues to be the most critical, as it continues to account for 64% of the total errors identified, including the lack of identification of the patient or sample and the inadequate prior preparation of the patient. In analytical and post-analytical phases, the NPR values obtained in 2023 decrease significantly over analysis carried out in 2014 and its not needed to apply improvement strategies. Automation and the IT tools significantly reduce the number of errors with high NPR values, but it is undoubtedly the involvement of service professionals that makes the difference over the years. Conclusions The use of the FMEA methodological tool allows the design of appropriate indicators to detect and reduce errors in the clinical laboratory. Its application as part of a good quality control allows a continuous improvement in the laboratory process and consequently a guarantee of quality for the patient

The Determinants of Maximal Speed Adaptation During Preseason in Subelite Female Australian Rules Footballers.

Maximal speed is an important physical-fitness attribute for female Australian footballers. The effects of sprint training, maximal strength, and technical training have been reported in laboratory studies. However, no study has determined the combined effect and relative contribution of these training modalities on maximal speed adaptation in situ. Therefore, the aim of this study was to determine the training factors affecting maximal speed adaptation during a preseason in subelite female Australian Rules footballers. Maximal speed during field training, predicted 1-repetition maximum (1RM) for box squat and hip thrust, and sprint biomechanics were assessed during early and late preseason (∼9wk apart) in 15 female subelite Australian Rules Football players (age 20 [3]y). On-field training volume and intensity (total distance, high-speed running, very-high-speed running, and maximal speed) were determined using a Global Positioning System. A multivariate regression model was used to determine the factors associated with changes in maximal speed across the preseason. The preseason training program had a small effect on maximal speed and large to very large effects on strength and sprint biomechanics. The multivariate regression with the greatest fit (P < .001, R2 = .939) included change in estimated 1RM box squat (β = -0.63), total distance per week (β = -0.55), and change in hip projection (β = 0.16) as factors. Multivariate regression of biomechanical factors (P = .044, R2 = .717) and maximal strength factors (P = .003, R2 = .676) were also significant. The development of maximal speed across a preseason is dependent on (1)total distance per week, (2)maximal strength adaptation, and (3)sprint technique adaptation in female subelite Australian rules football players.

Development of air therapy as a novel therapeutic branch in the field of rehabilitation.

Developing technology in the field of rehabilitation is vital to accelerate recovery and decrease the side effects of current modalities. Rehabilitation is a challenging science in which the main challenge is not just treating the patient but also to shorten the rehabilitation time and avoid harmful effects. Thus, this review demonstrates the possible design and effects of air therapy as a novel treatment branch besides hydrotherapy, electrotherapy, and manual therapy in the field of rehabilitation. The search was conducted over clinical trials, literature reviews, and systematic reviews on the possible effects of treatments that may have similar effects to the newly developed air therapy. This search was conducted in the Web of Science, Scopus, EBSCO, and Medline databases. Air therapy could be used to improve the function of mechanoreceptors, improve circulation and microcirculation, decrease pain, the release of trigger points, regain the elasticity of soft tissues, treat acute and chronic inflammations, decrease muscle cramps and spasticity, strengthen muscle, and decrease muscle fatigue and Decreasing muscle fatigue and delayed muscle soreness. Air therapy is a novel treatment modality that can be used effectively in the field of rehabilitation. Air therapy could be a valuable and safe treatment in rehabilitation.

The Opioid Crisis, Preventing and Managing Substance Abuse in India: A Systematic Review.

The opioid crisis has emerged as a significant public health concern globally, with India facing unique challenges in preventing and managing substance abuse. This systematic review aims to analyze the current state of the opioid crisis in India, evaluate existing prevention and management strategies, and propose evidence-based recommendations for addressing this complex issue. A comprehensive literature search was conducted across multiple databases, resulting in the inclusion of 30 studies meeting the predefined criteria. The review highlights the multifaceted nature of the opioid crisis in India, influenced by factors such as socioeconomic conditions, cultural norms, and healthcare accessibility. Key findings include the need for comprehensive prevention programs, improved access to evidence-based treatments, and integration of harm reduction strategies. The review also emphasizes the importance of addressing co-occurring mental health disorders and the potential of community-based interventions in managing substance abuse. Challenges identified include stigma, limited access to treatment, inadequate healthcare infrastructure, regulatory barriers, and lack of comprehensive policies. Recommendations for future directions include developing culturally appropriate prevention programs, assessing the long-term effectiveness of treatment modalities, exploring innovative approaches to reduce stigma, and investigating the role of technology in improving access to care. By implementing a multifaceted approach that considers the unique sociocultural context of India (including factors such as family structures, religious beliefs, economic disparities, and regional variations in drug use patterns), there is potential to significantly reduce the burden of opioid abuse and improve outcomes for affected individuals and communities.

AGING GRACEFULLY IN OSTEOARTHRITIS: IMPACT OF COMORBIDITIES

Background: Osteoarthritis (OA) is a prevalent musculoskeletal disorder, often complicated by comorbid conditions such as cardiovascular diseases, metabolic syndromes, and mental health issues. These comorbidities significantly impact the progression of OA and the effectiveness of its management, posing challenges for comprehensive patient care. Objectives: This review examines the relationship between OA and its common comorbidities, focusing on cardiovascular diseases, metabolic conditions, and mood disorders. We also explore the impact of pharmacological and non-pharmacological treatments in these patients, emphasizing the importance of integrated care strategies. Methods: Data from multiple studies were analyzed to assess the association between OA and comorbid conditions. The studies examined mortality risk, cardiovascular incidents, metabolic syndrome, diabetes, obesity, and mood disorders, while considering the effects of various OA treatment modalities, particularly non-steroidal anti-inflammatory drugs (NSAIDs). Results: Cardiovascular comorbidities, including coronary heart disease, are significantly linked to OA, with functional limitations such as impaired mobility being major contributors to increased cardiovascular risks and mortality. NSAIDs, commonly prescribed for OA, present substantial cardiovascular and renal risks, complicating their use in patients with pre-existing cardiovascular conditions. Metabolic comorbidities, particularly obesity and diabetes, are highly prevalent in OA patients and are associated with reduced quality of life and exacerbation of OA symptoms. Furthermore, mood disorders like depression and anxiety are common among OA patients, leading to a vicious cycle of pain and psychological distress that worsens functional outcomes. Conclusions: OA is closely related to various comorbidities, necessitating a holistic, multimodal approach to treatment. Beyond pharmacologic interventions, lifestyle changes, psychosocial support, and careful management of comorbid conditions are essential for improving outcomes in OA patients.

More spoken or more translated?

Abstract This article explores the features of simultaneous interpreting (SI) from a multidimensional (MD) analysis perspective (Biber 1988), drawing on a newly built comparable intermodal corpus, the LegCo+ corpus. The corpus incorporates Cantonese speeches that are both interpreted and translated into English, as SI and written translation (WT), respectively. Additionally, a third English corpus consisting of English native speeches (NS), without mediation, serves as a benchmark comparison. We aim to examine the extent of similarities and differences between SI, NS and WT in terms of the linguistic patterns they display. Our findings show that: (1) SI is a hybrid language mode, exhibiting features that lie between those of non-mediated spoken language and mediated written language; (2) in terms of its spoken nature, SI resembles NS in certain dimensions where typical features are associated with orality, suggesting a strong modality effect; and (3) in terms of its mediated status, SI demonstrates similarities with WT, despite their perceptibly distinct modalities, pointing to a potential mediation-specific effect. These empirical findings emphasize the necessity of understanding the multidimensionality inherent in interpreted language.

The Potential of Intra-Articular Therapies in Managing Knee Osteoarthritis: A Systematic Review.

Knee osteoarthritis (KOA) is a common degenerative and progressive joint disorder that negatively influences patients' quality of life. Intra-articular therapies, such as hyaluronic acid (HA) and platelet-rich plasma (PRP), have garnered attention for their potential to manage osteoarthritis OA symptoms effectively. This systematic review aims to identify the effectiveness and safety of HA and PRP treatment modalities in treating KOA. A literature search was conducted across MEDLINE (PubMed), Web of Science Core Collection, and Science Direct Collection Elsevier. Twenty-three randomized controlled trials, cohort studies, and observational studies were included in the review. The selection criteria focused on studies published in English within the last 10 years, involving subjects with KOA treated with intra-articular injections of HA or PRP and reporting on pain, function, or overall treatment efficacy outcomes. The analysis showed that both HA and PRP significantly improve functionality and reduce pain in KOA patients. High molecular weight HA consistently reduced pain and improved joint mobility in various studies. PRP had better long-term outcomes when combined with HA, leading to greater pain reduction and functional improvement. Both therapies had generally favorable safety profiles, with only minor adverse events reported. However, there were potential biases identified across the studies, such as selection, performance, detection, and reporting biases, which impacted the reliability of the results. Intra-articular treatments with HA and PRP show promise in managing knee osteoarthritis, with personalized treatment plans and further research needed to confirm these findings.

Effects of long-term Tai Chi vs. aerobic exercise on antioxidant activity and cognitive function in individuals with Parkinson’s disease

An imbalance between the generation of reactive oxygen species and the body’s antioxidant defense mechanisms is closely related to the development and progression of Parkinson’s disease (PD). Considering that physical exercise is a potential therapeutic intervention for modulating oxidative stress markers and cognitive function in PD, the primary purpose of this study was to compare the effects of different long-term exercise modalities on antioxidants and cognitive performance in patients with PD. In addition, the secondary purpose was to explore whether changes in the levels of these biochemical markers are associated with alterations in cognitive performance pre- and post-intervention. In all, 61 participants were randomly divided into the aerobic exercise (AE, n=20), Tai Chi exercise (TCE, n=21), or control (n=20) group. Blood samples were collected before and after a 12-week intervention period for the analysis of antioxidant markers [leukocyte 8-hydroxydeoxyguanosine (8-OHdG), catalase (CAT), glutathione (GSH), glutathione peroxidase (GSH-Px), oxidized glutathione (GSSG), superoxide dismutase (SOD), and uric acid (UA)]. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE). Although no significant changes were observed in the activity of 8-OhdG, GSH-Px, GSSG, GSH:GSSG ratio, SOD, and cognitive performance in the AE and TCE groups, the 12-week AE intervention led to a significant increase in CAT and GSH levels, along with a significantly decrease in UA levels among individuals with PD. Conversely, the TCE intervention resulted in a significant increase in GSH levels. However, SOD activity and MMSE scores were significantly decreased after 12 weeks in the control group. The correlations between changes in MMSE scores and changes in the levels of GSH and UA prior to and after the intervention reached significance in the AE group. Thus, long-term AE and TCE might serve as effective strategies for reducing oxidative damage and preserving cognitive function in PD, with AE exhibiting greater benefits compared with TCE. These findings hold potential clinical relevance as complementary measures to standard medical treatments and alternative therapies, such as antioxidant supplements and dietary adjustments, particularly for individuals in the early stages of PD.

AYURVEDIC PROPRIETARY INTERVENTION IN LEUCODERMA (SHVITRA): A CASE STUDY

Ayurveda mentions all types of skin disorders under one common term i.e., Kushtha Roga. Shvitra is explained in the classics as a type of Kushtha. The disease is said to be result of impairment of Tridosha and Dhatu such as Rakta, Mamsa and Meda. Signs and symptoms of Shvitra and vitiligo resemble closely, hence the two diseases are co-related as well. The cause of vitiligo is yet unclear and is believed to be an auto-immune disease. Modern science has limited treatment options to address this concern. Whereas, in Ayurveda, although the disease is termed as Kricchasadhya (difficult to treat) or Asaadhya, yet many treatment options are advised. This case report elucidates the therapeutic effect of Ayurveda treatment modality in a patient having progressive leucoderma. A 21-year-old female patient with complaints of whitish-lesions over forehead, neck and back having moderate itching and pre-diagnosed with leucoderma visited our OPD. After the treatment for 11 months, significant changes were observed in the shape and size of lesions.

Bim Expression Influences Choroidal Endothelial Cell Characteristics and Their Response to Therapeutic Intervention.

In the aging population, choroidal vessels grow through the Bruch's membrane, resulting in a loss of central vision due to choroidal neovascularization (CNV). During active neovascularization, CNV is associated with inappropriate levels of apoptosis in multiple cell types, including choroidal endothelial cells (ChECs). Bim is a pro-apoptotic member of the Bcl-2 family. It is essential for cell apoptosis due to exposure to drugs such as dexamethasone or decreased pro-survival factors, including vascular endothelial growth factor (VEGF). To better elucidate the cell autonomous contribution of Bim expression in the integrity and neovascularization of the choroidal vasculature, we isolated ChECs from wild-type and Bim-deficient (Bim-/-) mice. ChECs lacking Bim expression demonstrated increased expression of VEGF, osteopontin, and the inflammatory cytokines Rantes/Ccl5 and IL6. Bim-/- ChECs were more proliferative and demonstrated an increased capacity to undergo capillary morphogenesis. Anti-VEGF had a diminished capacity to disrupt capillary morphogenesis in Bim-/- ChECs. In vivo, utilizing the mouse laser photocoagulation model, anti-VEGF treatment mitigated CNV in wild-type but not Bim-/- mice. We also tested other modalities that are thought to not require the intrinsic death pathway for their function and showed that propranolol, anti-CTGF, and the TSP1-mimetic peptide ABT898 mitigated CNV in mice lacking Bim expression to varying degrees. Thus, in ChECs, Bim expression could impact the effectiveness of treatment modalities that require the intrinsic death pathway to mitigate CNV.