Study Group Research Articles

Considering management context when investigating behavioral profiles in a group of captive Javan gibbons (Hylobates moloch)

ABSTRACT Effective animal husbandry aims to produce behavioral profiles consistent with those observed in wild counterparts. However, few studies have examined the impacts of management history on sociality. We investigate social dynamics in a group of Javan gibbons (Hylobates moloch) at Perth Zoo using behavioral and proximity data. The group consists of an aging adult female and her two offspring – a maturing sub-adult female and a juvenile male. This composition diverges from commonly observed groupings in the wild. The study group’s social relationships generally align with species-typical behaviors, with the exception of the patterning of play behavior and resting-in-contact. These results indicate an uncharacteristically close bond between the mother and her maturing same sex-offspring, as well as an unexpectedly distant mother-juvenile bond. These relationships are best explained by the group’s management history and resulting atypical group composition including: the absence of an adult male, the mother’s advanced age, and the hand-rearing of the juvenile male. This study gives insight into the effects of a captive setting on social development and provides further evidence of social flexibility in gibbons.

Assassination of Elisabeth, Empress of Austria, Queen of Hungary, on 10September 1898: further additions and minor annotations.

Very recently, acomprehensive re-evaluation of the medical facts and observations surrounding the death of Empress Elisabeth "Sisi" of Austria (1837-1898) was published. The Empress was assassinated in Geneva by the anarchist Luigi Luccheni or Lucheni (1873-1910). In parallel to this recent publication, our study group came across an almost unknown letter from Dr. Golay, who was one of the examining doctors of Empress Elisabeth. In this publication we add relevant additions based on this letter and provide further insights regarding the attempts at resuscitation.

A comprehensive non-targeted approach for the analysis of biomarkers in exhaled breath across different nicotine product categories

In the context of the evolving landscape of nicotine consumption, the assessment of biomarkers plays a crucial role in understanding the health impact of different product categories. Exhaled breath (EB) emerges as a promising, non-invasive matrix for biomarker analysis, complementary to conventional urine and plasma data. This study explores distinctive EB biomarker profiles among users of combustible cigarettes (CC), heated tobacco products (HTP), electronic cigarettes (EC), smokeless/oral tobacco (OT), and oral/dermal nicotine products (NRT). We have successfully developed and validated a non-targeted GC-TOF-MS method for the analysis of EB samples across the aforementioned product categories. A total of 66 compounds were identified, with significantly elevated levels in at least one study group. The study found that CC users had higher levels of established VOCs associated with smoking, which supports the proof-of-concept of the method. Breathomic analysis identified increased levels of p-cymene and α-pinene in EC users, while HTP users showed potential biomarker candidates like γ-butyrolactone. This study underscores the utility of EB biomarkers for a comprehensive evaluation of diverse nicotine products. The unique advantages offered by EB analysis position it as a valuable tool for understanding the relationship between exposure and health outcomes.

471 The use of infrared imaging of piglets to assess ocular surface temperature change before, during and after routine procedures

Abstract Procedures including teeth clipping (TEE), tail docking (TAI), and ear tagging (TAG) are conducted routinely in commercial pig production units during the first days of life in piglets. However, as these procedures are conducted without anesthetics, there is controversy surrounding these procedures due to the pain/stress they may cause. The assessment of vasomotor activity using non-invasive infrared thermography (IRT) is increasingly being promoted as a tool to detect acute stress. The objective of this study was to assess changes in the ocular (OCU) window of piglets before, during and after each of the aforementioned procedures using IRT. This study used crossbred piglets (n = 116; Duroc Danish x Landrace x Large white) from multiparous sows. All thermographic images of piglets were taken between 0900 h and 1600 h using a high-resolution handheld infrared camera FLIR T650sc (640 x 480 pixels; FLIR Systems, Wilsonville, USA) at a uniform distance of 1 m on the left side of the face. To assess TEE, TAI and TAG procedures separately, a recovery period (12 ± 2.5 min) was allowed between procedures. Due to order differences in which procedures were conducted, the following study groups were created (procedures in brackets indicate the procedures performed prior to the focal procedure): TEE, (TEE+) TAI, (TEE+TAI+) TAG, TAI, (TAI+) TEE, (TAI+TEE+) TAG, TAG, (TAG+) TEE, (TAG+TEE+) TAI. Temperature values were recorded from images using FLIR Tools software 6.0 (FLIR Systems). Data were analyzed using a linear mixed model for repeated measures and multiple comparisons were calculated using a post-hoc Tukey test (GraphPad Prism 10.0.2). Table 1 shows the mean and standard deviation (SD) values for IRT recordings in the OCU window. Comparison of evaluation times showed a significant reduction in OCU temperature from before to after the procedure(s) in (TEE+) TAI (-1.21 °C, P < 0.001), (TAI+TEE+) TAG (-0.65 °C, P < 0.001), TAG (-0.58 °C, P < 0.05) and (TAG+TEE+) TAI (-0.3 °C, P < 0.01) groups. These changes in the OCU window of piglets may be in response to the procedures performed, resulting in a sympathetically mediated acute vasomotor response as cutaneous capillary blood flow shifts due to transient peripheral vasoconstriction. In turn, IRT detects this blood flow change as a reduction in surface temperature. Comparison between procedure groups found that mean OCU temperature during the procedure was greater (P = 0.01) in (TAI+) TEE and (TAG+) TEE than the rest of the groups, though the reason for this is unclear and requires further investigation. This work shows that IRT can be used as a non-invasive tool to detect surface temperature changes of piglets.

The wettability of complete denture base materials constructed by conventional versus digital techniques: an in-vitro study

BackgroundDecreased salivary flow can make the patients uncomfortable with their complete dentures and affects the retention of the dentures. Milling and 3D printing have become an alternative to conventional denture construction techniques. The goal of this study was to evaluate the effect of conventional and digital techniques of the complete denture construction on the denture surface wettability with distilled water and saliva substitute before and after thermocycling.MethodsA total of 30 specimens were utilized in the present study. Specimens were divided according to the construction techniques into 3 groups (n = 10 each). Group I: Heat-polymerized polymethylmethacrylate (PMMA) group, group II: Milled group, and group III: 3-dimensional (3D)-printed group. All the specimens were subjected to 2000 cycles of thermal aging in a thermocycler. The wettability of all specimens to water and saliva substitute was measured via a contact angle goniometer (Olympus TGHM, Rame-hart Inc, USA) before and after thermocycling. Descriptive statistical analysis, plots, and the Shapiro-Wilk test were used to verify normality for each variable. One-way ANOVA was used to compare the 3 study groups, while paired samples t-test was used to compare the differences within each group (P < .05).ResultsThe smallest contact angle of drop of water to the denture base specimens before and after thermocycling were recorded in the milled group (53.0 ± 4.77 and 50.27 ± 2.30, respectively), followed by the heat polymerized PMMA group (85.65 ± 4.71 and 65.06 ± 2.27, respectively), and the 3D-printed group (91.34 ± 6.74 and 90.86 ± 8.57, respectively). While the smallest contact angle of drop of saliva substitute to denture base specimens was recorded in the milled group (56.82 ± 2.29 and 34.85 ± 7.51, respectively), followed by the 3D-printed group (72.87 ± 4.83 and 58.14 ± 9.58, respectively) and the heat polymerized PMMA group (83.62 ± 4.12 and 67.82 ± 4.93, respectively). There was statistically significant difference between the groups (P < .05). A significant decline in the average contact angle of drop of saliva has been reported in all groups after thermocycling. The contact angle values differed significantly between saliva substitute and distilled water in both 3D-printed and milled groups after thermocycling (P < .001).ConclusionsThe milled denture base material presented the best wettability to water and saliva substitute than the 3D-printed and the heat-polymerized PMMA materials. Saliva substitutes improve the wetting ability of denture base materials manufactured by CAD/CAM compared with water.

Ethnic Differences in the Safety and Efficacy of Tenecteplase Versus Alteplase for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.

Tenecteplase is a thrombolytic agent with pharmacological advantages over alteplase and has been shown to be noninferior to alteplase for acute ischemic stroke in randomized trials. However, evidence pertaining to the safety and efficacy of tenecteplase in patients from different ethnic groups is lacking. The aim of this systematic review and metaanalysis was to investigate ethnicity-specific differences in the safety and efficacy of tenecteplase versus alteplase in patients with acute ischemic stroke. Following an International Prospective Register of Systematic Reviews (PROSPERO)- registered protocol (CRD42023475038), three authors conducted a systematic review of the PubMed/MEDLINE, Embase, Cochrane Library, and CINAHL databases for articles comparing the use of tenecteplase with any thrombolytic agent in patients with acute ischemic stroke up to November 20, 2023. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Two independent authors extracted data onto a standardized data collection sheet. A pairwise meta-analysis was conducted in risk ratios (RR). From 34 studies (59,601 participants), the rate of complete recanalization was significantly higher (P<0.01) in Asian (RR: 1.91, 95% confidence interval [CI]: 1.30 to 2.80) versus Caucasian patients (RR: 0.99, 95% CI: 0.87 to 1.14). However, Asian patients (RR: 1.18, 95% CI: 0.87 to 1.62) had significantly higher (P=0.01) rates of mortality compared with Caucasian patients (RR: 1.10, 95% CI: 1.00 to 1.22). Caucasian patients were also more likely to attain a modified Rankin Scale (mRS) score of 0 to 2 at follow-up (RR: 1.14, 95% CI, 1.10 to 1.19) compared with Asian (RR: 1.00, 95% CI, 0.95 to 1.05) patients. There was no significant difference in the rate of symptomatic intracranial hemorrhage (P=0.20) and any intracranial hemorrhage (P=0.83) between Asian and Caucasian patients. Tenecteplase was associated with significantly higher rates of complete recanalization in Asian patients compared with Caucasian patients. However, tenecteplase was associated with higher rates of mortality and lower rates of mRS 0 to 2 in Asian patients compared with Caucasian patients. It may be beneficial to study the variations in response to tenecteplase among patients of different ethnic groups in large prospective cohort studies.

Polish infection control nurses’ burnout in the context of cooperation of different hospital professionals during COVID-19 pandemic

BackgroundsInfection control nurses’ job are crucial for patient and healthcare workers safety. However, effective infections prevention is based on the interdisciplinary team work, involving almost all hospital employees professionals. Difficulties in cooperation in such a team, especially prolonged ones, as well as crisis situations, may cause burnout. The aim of the study was to determine burnout among infection control nurses working during the COVID-19 pandemic in the context of difficulties in cooperation with different professionals working in hospitals.MethodsThe observational study was conducted between May and September 2021, using an online survey questionnaire consisting of two parts: describing difficulties in ICNs cooperation with different hospital professionals and Maslach Inventory Burnout scale, describing emotional exhaustion (EE), depersonalization (DP) and personal accomplishment rates (PA). Correctly completed online surveys were obtained from 177 participants.ResultsMost of the respondents (176 of 177) were women, working in public hospitals (81.48%). All respondents had considerable experience in work as nurses - the median was 30 years. However, the median experience in the ICNs position was 12 years. Median age of respondents was 51 years. The median level of EE was 31.0, w ith the range 23.0 to 39.0. For DP it was 5.0, with the range 3.0 and 11.5, while for PA – 24.0 (19.0–29.0). The highest values of EE were observed in the context of high level of difficulties with cooperation with management – the median was 36.0. DP was lowest among nurses declaring the lowest difficulties in cooperation with doctors. For PA the lowest level was observed in the group declaring high difficulties in the cooperation with doctors – median 22.0, with range 14.0–29.0.ConclusionsThe surveyed ICNs had higher rates of EE and PA than nurses working with patients, both before and during the pandemic. The level of burnout found in the ICN study group reached a level correlating in other studies with the intention to quit the job. The obtained results indicate the need to include effective training in the skills of working in multidisciplinary teams and the art of communication and achieving goals by ICNs.

A prospective study of Acupuncture Combined With Modified Blood and Vessel Expelling Blood Stasis Tang in Treating Poststroke Facial Paralysis With Insomnia.

This study aimed to assess the clinical efficacy of acupuncture combined with modified Blood and Vessel Expelling Blood Stasis Tang in the treatment of poststroke patients experiencing facial paralysis and insomnia. A total of 120 patients with poststroke facial paralysis and insomnia were selected from the Department of Acupuncture and Moxibustion at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between January 2021 and January 2023. They were randomly assigned to either a control group or a study group, with 60 patients in each group. The control group received conventional treatment, while the study group received acupuncture combined with modified Blood and Vessel Expelling Blood Stasis Tang. The neurological function, facial paralysis, and sleep quality of the patients in both groups were compared. The study group exhibited a significantly higher total effective rate compared with the control group (86.67% versus 66.67%). After treatment, both groups showed a significant reduction in National Institutes of Health Stroke Scale scores, with the study group demonstrating significantly lower scores than the control group. The Functional Disability Index scores for somatic functioning and social life functioning significantly improved in both groups after treatment, with the study group achieving significantly lower scores compared with the control group. The Sleep-Related Symptom Scale and Pittsburgh Sleep Quality Index scores significantly decreased in both groups after treatment, with the study group achieving significantly lower scores than the control group. Acupuncture combined with modified Blood and Vessel Expelling Blood Stasis Tang effectively promotes recovery of neurological function and significantly improves facial paralysis and insomnia in patients with poststroke facial paralysis and insomnia. However, further research is warranted to validate these findings.

Vitreopapillary Findings in Non-Arteritic Ischemic Optic Neuropathy versus Healthy Eyes: A Clinical and OCT Comparison

PurposeTo study the vitreopapillary interface in non‐arteritic ischemic optic neuropathy (NAION) for features that may predispose to optic nerve perfusion defects. DesignCase-control study. Participants and ControlsPatients with NAION (Study group) were compared with healthy non‐NAION patients with crowded discs (Control group I) and non-crowded optic discs (Control group II). MethodsThe vitreopapillary interface was studied in 32 eyes with NAION using high-resolution OCT scans. Results were compared with two control groups consisting of age, sex, and refraction‐matched non‐NAION individuals with crowded optic discs (Control Group I: 31 eyes) and non-crowded optic discs (Control Group II: 32 eyes). Main Outcome MeasuresThe incidence of total posterior vitreous detachment (PVD), vitreopapillary and vitreovascular attachments, and epipapillary membranes. ResultsThe rate of PVD over the macula was similar among groups (NAION: 62.5%, Control I: 61.3%, and Control II: 65.6%, p=0.93) while the posterior hyaloid remained attached to the crowded discs at a significantly higher rate (NAION: 81.2%, Control I: 83.9% and Control II: 43.7%, p=0.0005). A higher rate of focal vitreopapillary attachments on crowded discs than on non-crowded discs was noted (NAION: 72.2%, crowded control I: 58.7%, and non-crowded control II: 19.1%, p=0.007). Vitreovascular attachments (NAION: 69%, crowded control I: 3% vs non-crowded control II: 6%, p=0.00001) and dense epipapillary membranes were observed in NAION eyes. ConclusionsCrowded discs may have stronger vitreopapillary attachments. A close relationship of these attachments with optic nerve vessels may lead to the transmission of strong tractional forces by a syneretic vitreous gel, especially after macular PVD. This transduced mechanical force may contort the vessel wall and disrupt the blood flow in NAION.

Lipid-lowering therapy after acute coronary syndromes: a multinational European survey.

Recent guidelines on acute coronary syndromes (ACS) recommend initiating lipid-lowering therapy (LLT) as early as possible to obtain >50% low-density-lipoprotein cholesterol (LDL-c) reduction and an LDL-c < 1.4 mmol/l. A multinational European survey study of ACS patients between 2021-2022 and acquired data on LLT and lipid levels on admission and during 1-year posthospitalization. We compared plasma lipid changes and adherence to post-ACS lipid targets across two in-hospital LLT groups: high-intensity statin (HIS) monotherapy (mono-HIS) and a combination of HIS and ezetimibe (combo-HIS). Of 286 patients, 268 (94%) received in-hospital HIS and were included in the final analysis. Patients (median age: 61.1 years) had a median baseline LDL-c of 3.3 mmol/l. Mono-HIS was the predominant in-hospital LLT (72.4%). In-hospital combo-HIS was administered in 27.6% of the cases. Patients from high-income countries (n = 141) were more likely to receive in-hospital combo-HIS than patients from middle-income countries [n = 127; 38.3% vs. 15.7% patients, P < 0.001). One-year post-ACS, 50 (26.5%) patients from the mono-HIS group received ezetimibe. The target of LDL-c ≤ 55 mg/dl was reached in 85 patients (31.7%), without significant difference between study groups [mono-HIS: 56 (28.9%) and combo-HIS: 29 (39.2%) patients, P = 0.10]. The target of >50% reduction was achieved more frequently among the combo-HIS group than in the mono-HIS group (50.0% vs. 29.9%, respectively, P = 0.002). LDL-c targets were achieved in less than half of the patients post-ACS, regardless of the LLT regimen. Combo-HIS was initiated in-hospital post-ACS in only 28% and was associated with greater LDL-c reduction compared to a staged approach of mono-HIS with up-titration at follow-up.

Treatment outcomes of infertile women with endometrial hyperplasia undergoing their first IVF/ICSI cycle: A matched-pair study

ObjectiveThe aim was to analyze the clinical characteristics, controlled ovarian stimulation status, pregnancy outcomes, and major factors influencing live births in patients with endometrial hyperplasia (EH) undergoing IVF/ICSI for assisted reproduction, so as to identify potential intervention measures. Study designPatients with EH who achieved complete remission (CR) after conservative treatment and who were undergoing their first IVF/ICSI cycle were included in this matched-pair study. Patients with normal endometriums were matched at a 1:2 ratio with the control group for the first cycle of controlled ovarian stimulation. Matching was based on age, and reproductive outcomes were analyzed. ResultsAmong the 263 patients (including 51 cases with atypical endometrial hyperplasia) in the study group, the pregnancy rate after the first controlled ovarian stimulation cycle was 48.67 % (128/263), and the live birth rate was 34.98 % (92/263). Multiple logistic regression analysis revealed that maternal age, body mass index (BMI), and endometrial thickness were significantly associated with live births (P<0.001). Specifically, being aged ≥ 35 years (OR 0.450, 95 % CI 0.223–0.907) and having a BMI≥28 kg/m2 (OR 0.358, 95 % CI 0.161–0.798) were identified as unfavorable factors for a clinical live birth, while an endometrial thickness ≥ 10 mm was found to be a favorable factor. Conclusion(s)ART is effective in patients with EH who have achieved CR after conservative treatment. Avoiding unnecessary intrauterine procedures, controlling body weight appropriately, and choosing suitable ART methods as soon as possible may be beneficial for clinical outcomes.

Evaluation of tocilizumab-induced hypofibrinogenemia in rheumatology practice: a retrospective, real-life, single-center experience.

Tocilizumab (TCZ) which is a humanized interleukin (IL)-6 receptor antibody has been increasingly widespread used in rheumatology practice. TCZ-related hypofibrinogenemia is a not well-described side effect, but awareness seems to be incresing as publications on this topic are also becoming more frequent. Our aim in this study was to determine the frequency, timing, and approach to TCZ-related hypofibrinogenemia in rheumatic diseases. We retrospectively screened our patients who received TCZ for inflammatory rheumatic diseases and studied serum fibrinogen at least once before and/or after drug administration. We recorded and analyzed demographic features (age, gender, diagnosis), comorbidities, laboratory parameters, management, and outcome data. 30 patients who received TCZ due to rheumatological diseases and had at least one fibrinogen level were included in this study. 73.3% were female and median age was found to be 65 (42-82) years, with median disease duration of 148 (36-500) months. 90% of the patients received TCZ for RA and 10% for GCA. We examined the fibrogen levels at an average of 24 months (min 1 max 108) following the start of TCZ treatment. The study group was divided into those with normal fibrinogen levels (normal fibrinogen group) and those with low fibrinogen levels (lowfibrinogen group). In total, hypofibrinogenemia was found in 14 (46.6%) patients. Median serum fibrinogen level in the low fibrinogen group after TCZ was calculated to be 151.5mg/dl (min 92 max 171). Most patients were asymptomatic (71.4%). Ecchymoses were in seen 4 (28,6%) patients. No major bleeding were seen. TCZ was discontinued in 5 out of 14 patients (35.7%), while 9 out of 14 patients (64.3%) were closely followed. Outcomes regarding fibrinogen levels (11 out of 14) were as follows: increase in 4 and not checked in one after cessation of the drug, 3 spontaneous increases under the drug, and 3 persistently low levels on TCZ treatment. We found no difference in terms of gender (p = 0.417), platelets (p = 0.343), ESR (p = 0.448), and CRP (p = 0.660) at the time of TCZ initiation between groups. TCZ-related hypofibrinogenemia is more frequent than expected with occurence in both the early and late stages of treatment. Further research is required to determine whether to regularly measure fibrinogen levels in patients using TCZ and how to treat patients with hypofibrinogenemia.

B - 91 Characterizing Memory Profiles of Movement Disorders: the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Recognition Subtests

Abstract Objective This study explores the utility of novel recognition memory composites integrating recently developed recognition subtests from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS; Duff et al., 2021) in characterizing memory profiles across Mild Cognitive Impairment (MCI) and Normal Cognitive Study (NCS) groups in patients with movement disorders. Methods Twenty patients with movement disorders (M = 69.4 years, SD = 6.3) were administered the RBANS including additional Story and Figure Recognition subtests as part of a comprehensive neuropsychological evaluation at an academic medical center. Samples were stratified by MCI (n = 15) and NCS (n = 5) groups based on clinician diagnoses. Z-score based composites were created for individual recognition measures (total, hits, false positives, and discriminability indices, d’) and “Total Delayed Recall” memory composites across list, story, and figure subtests. Results Mann–Whitney U test analyses revealed significant differences between MCI and NCS groups on Story recognition d’ performance, U = 9.50, p = &amp;lt;0.05. Within the MCI group, a paired samples t-test revealed significantly worse performance on recognition d’ compared to “Total Delayed Recall” (M = 1.63, SD = 2.22); t(14) = 2.84, p = &amp;lt;0.05. Conclusions Greater impairment in recognition discriminability compared to delayed recall suggests the involvement of memory processes that extend beyond retrieval deficits typically observed in movement disorders characterized by subcortical/frontosubcortical profiles. Further investigations are warranted in establishing implications of recognition memory composites in differentiating among MCI subtypes and neurodegenerative disease progression within movement disorder populations, as findings may have been influenced by unequal variances between groups.

The effect of interdisciplinary teaching approach on the creative and critical thinking skills of gifted pupils

The aim of this study is to develop "Teaching Practices to Improve Thinking Skills Based on an Interdisciplinary Approach (PTSIA)" and to examine its effect on creative thinking and critical thinking skills of gifted fifth-grade students. This study used explanatory sequential design, which is a mixed research method that combines quantitative and qualitative research techniques. The study group of the research consisted of 62 gifted fifth grade students. For the students in the experimental group, the activities in accordance with the results prepared for the PTSIA for the students in the experimental group were carried out for a total of 45 h, 3 h per week during the extracurricular hours. The study used both quantitative and qualitative data analysis techniques. Quantitative data were analysed using the independent samples t-test, which is one of the relational statistics based on the comparison of two variables, experimental and control groups, and Cohen d values were calculated to determine the effect size. Qualitative data were analysed using descriptive and content analysis. It was concluded that the PTSIA prepared with the research were effective in developing creative and critical thinking skills, which are among the high-level thinking skills of gifted students. The applications were found to be beautiful, interesting, intriguing, and exciting by the students. It was concluded that teachers had positive opinions about the practices. Based on the results obtained from this study, the use of an interdisciplinary approach in teaching practices aimed at developing students' thinking skills will facilitate the acquisition of cognitive thinking abilities and their application to daily life. This approach will enable students to more clearly perceive the relationships between events, facts, and ideas, and learn to establish deeper connections between them by integrating various disciplines and perspectives.

Association of Quality of Life and Visual Function in Glaucoma with Tests of Structure and Function.

In addition to standard automated perimetry tests, contrast sensitivity testing and macular analyses may predict changes in the quality of life in patients at different stages of glaucoma. To examine the relationship between functional and structural tests of visual function and the 25-item National Eye Institute-Visual Function Questionnaire (NEI-VFQ-25) and the 36-item Short Form Health Survey (SF-36) in patients with different stages of glaucoma. Standard automated perimetry tests, optical coherence tomography scans, and contrast sensitivity (CS) testing were prospectively performed in 160 patients with glaucoma. The Hoddap-Parrish-Anderson staging system was used for glaucoma staging. Health-related quality of life questionnaires (NEI-VFQ-25, SF-36) were also administered to all patients. The study group comprised 29 patients with suspected glaucoma, 104 with mild glaucoma, 15 with moderate glaucoma, and 12 with severe glaucoma. The mean total score of the NEI-VFQ-25 was 88.8±8.2. The SF-36 did not show a significant correlation with the data on functional and structural tests of visual function, whereas the NEI-VFQ-25 showed a low to moderate correlation (r=0.212--0.492). Vision parameters can explain up to 18.6% of the total score of the NEI-VFQ-25. CS was the only function significantly correlated with glaucoma suspects, while in the early stages, VA was the strongest correlated function with the NEI-VFQ-25 total score (P=0.003 and r=0.551; P=0.001 and r=0.343, respectively). The impact of the visual field on vision-related quality of life increased in the advanced stages (P=0.013, r=0.688). The macular retinal ganglion cell plus inner plexiform layer thickness remained associated with NEI-VFQ-25 at all stages of glaucoma (r=0.335-0.802). The NEI-VFQ-25 total score and most of the subscales were correlated with the physical and mental component summary scores of the SF-36 (r=0.159-0.587). VA correlated the most with quality of life in glaucoma patients, as measured with the NEI-VFQ-25 to assess quality of life in glaucoma. The impact of visual functions on quality of life varies at different stages of glaucoma.

Exploring the feasibility of preoperative tumor-bed boost, oncoplastic surgery, and adjuvant radiotherapy schedule in early-stage breast cancer: A phase II clinical trial.

Oncoplastic breast-conserving surgery (OBCS) improves satisfaction in patients who would fare otherwise sub-optimal cosmetic outcome, while brings challenge in tumor-bed identification during adjuvant radiotherapy. The ultra-hypofractionated breast radiotherapy further shortens treatment sessions from moderately hypofractionated regimens. To circumscribe the difficulty in tumor-bed contouring and the additional toxicity from larger boost volumes, we propose to move forward the boost session preoperatively from the adjuvant radiation part. Thus, the present study aims to evaluate the feasibility of a new treatment paradigm of preoperative primary-tumor boost before breast-conserving surgery (BCS) or OBCS followed by adjuvant ultra-hypofractionated whole-breast irradiation (u-WBRT) for patients with early-stage breast cancer. There was a phase II study. Patients younger than 55 years old, with a biopsy confirmed mono-centric breast cancer, without lymph node involvement were enrolled. Preoperative primary-tumor boost was given by a single 10Gy in 1 fraction, and BCS or OBCS was conducted within two weeks afterwards. Adjuvant u-WBRT (26Gy/5.2Gy/5f) was given in 6 weeks postoperatively without any boost, after the full recovery from surgery. Surgical complications and patient-reported outcomes, as assessed via Breast-Q questionnaires, were documented. A propensity score matching approach was employed to identify a control group at a 1:1 ratio for BREAST-Q outcomes comparison. From May 2022 to September 2023, 36 patients were prospectively enrolled. Surgical complications were observed in 7 cases (19.4%), including 3 cases with Clavien-Dindo (CD) grade 1-2 and 4 cases with CD grade 3 complications. All but four patients (11.1%) started the planned u-WBRT within one week after the pre-defined due dates postoperatively (≤49d). Four patients (11.1%) developed grade 2 radiodermatitis after chemotherapy initiation. Compared to the study group, the control patients reported higher scores in chest physical well-being (P=0.045) and in their attitudes towards arm swelling (P=0.01). No significant difference was detected in the other of domains (Satisfaction with Breasts, Sexual and Psychosocial Well-Being, and Adverse Effects of Radiation). With a median follow-up period of 9.8 months (2.4-18.9mo), none had any sign of relapse. This Phase II clinical trial confirmed the technical and safety feasibility of novel radiation schedule in patients undergoing BCS or OBCS. According to the BREAST-Q questionnaire, patients who underwent novel radiation schedules reported lower satisfaction in chest physical well-being. A randomized controlled trial is necessary to further investigate these findings. Additionally, long-term follow-up is required to assess oncological outcomes.

Vaccinations at home: a new strategy to contain vaccine hesitancy? The experience of ASL Napoli 1 Centro, Italy.

Vaccination coverage are generally geographically variable, even within large cities; furthermore, across target population are embedded difficult-to-reach clusters. To address this issue and improve coverage of mandatory vaccinations, a study group explored bringing vaccination at home as an interventional strategy. In a pilot experience, parents of unvaccinated and under vaccinated children of the 2020 birth cohort living in Naples, Italy were contacted by telephone to offer home administration of vaccinations. A specifically trained team arranged vaccinations visits at home. Coverage rates were evaluated at baseline and one month after the intervention strategy. A significant positive increase in hexavalent vaccine (+1.43%) and measles-mumps-rubella (+1.85%) coverage was registered despite the short duration of the pilot program. Home vaccination turned out to be a medical resource consuming but feasible and successful strategy to increase mandatory vaccinations coverage among the most difficult-to-reach and fragile segments of the pediatric population.

The intratesticular artery resistive index as a predictor of spermatogenesis: A prospective study.

With the objective to assess the correlation between the resistive index of intratesticular artery as predictor of spermatogenesis this case control study was conducted. A Prospective study conducted during period April 2021 to March 2023. Total 50 patients, with oligoasthenozoospermia taken as cases and other 50 men with normal sperm count taken as controls. History taken & clinical examination, Semen analysis, hormonal evaluation & Color Doppler ultrasonography of scrotum done. Resistive Index of testicular arteries was obtained. Cases and controls were compared. The age of the study group ranged between 21 and 40 years. Among the cases maximum patients 23 out of 50 and among controls with maximum number 21 out of 50 patients were belonged to age group 26-30 years.The mean semen volume for the cases & controls was 2.76 ± 0.44 ml and 3.32 ± 0.54 ml respectively. The Mean sperm concentration in the cases & controls was 14.33 million/ml & 84.8 million/ml. Mean Type A sperm motility was 20.82% ± 7.86 in cases and 54.96% ± 5.41 in controls. The mean testicular volume in cases was 18.36 ± 0.75 & in controls was 18.39 ± 0.62 ml. Hormonal evaluation done in both cases and controls and mean value of FSH in cases and controls was 7.57 ± 2.34 and 6.27 ± 3.55 respectively (p-value = 0.036). Mean value of Resistive Index (PSV - EDV)/PSV) in cases and controls were found 0.63 ± 0.32 and 0.53 ± 0.37 respectively (p-value = 0.001). The intratesticular artery resistive index can be utilized as valuable predictive marker to indicate spermatogenesis.

Retention of implant retained obturator using two implant placement configurations for maxillectomy cases: in-vitro study

BackgroundImplant-retained obturators for maxillectomy cases have several advantages over traditional obturators but prosthetic design for specific conditions after maxillary resection has several challenges and the appropriate implant placement configuration is essential for improving retention and the stability of the implant-retained obturator.ObjectivesThe present study aimed to assess the retention force of using linear and nonlinear implant placement configurations using ball and socket attachment in implant-retained obturators at the initial retention and after simulation of six months of use.Materials and methodsTwo identical epoxy resin maxillary models of a completely edentulous unilateral maxillary defect (Brown’s class IIb) were used for implant placement, in the first model three implants were arranged with linear placement configuration, and in the second model three implants were arranged in nonlinear placement configuration. For proper sample sizing, 26 models and obturator were used. Two equal groups of obturators (13 for each group) were constructed, each with a different implant placement configuration. Both groups used the same attachment design (a non-splinted ball attachment). Using a cyclic loading machine that served as a dental insertion and removal simulator, each study group was subjected to 500 tension-compression cycles simulating 6 months of use. Using the universal testing machine, each obturator was removed at a speed of 50 mm/min for the crosshead. peak load to dislodgement was measured at the initial retention and after the simulations of six months of use. Data were analyzed using independent and paired t-tests while percent change was analyzed using the Mann Whitney U test.ResultsThere were a statistically significant differences in retention between the nonlinear implant placement configuration for Brown’s class IIb maxillectomy and the linear implant placement configuration at initial retention evaluation with p-value of < 0.0001 and after simulation of six months of usage with p-value of < 0.0001 Also, after simulation of 6 months of use group I lose − 24.87 (10.16) % of its retention while group II lose − 17.49 (7.78) %.ConclusionsNon-linear implant placement is more retentive at the initial retention and after simulation of six months of use than linear and loses less retention after usage.

Roma Children’s Access to Education: Barriers and Supports

ABSTRACT This study aims to identify the barriers encountered in the access of Roma children to education and to offer solutions according to the school administrators’ and teachers’ views. It is conducted with a phenomenological research design. The study group is composed of 24 participants, including 7 school administrators and 17 teachers. Data collected employing semi-structured interviews are analyzed with inductive content analysis. According to the findings, within the framework of Bourdieu’s cultural capital theory, the barriers to Roma children’s access to education are revealed as the structure of the education system, cultural characteristics, and perspective on education. Participants have stated that low expectations from Roma children within the current education system and the formation of Roma Schools are significant barriers to accessing education. These barriers to Roma children’s access to education are seen as a product of deficiencies caused by the family and the student himself. Additionally, neighborhood culture and social learning also prevent Roma children from accessing education. To overcome these barriers, participants suggest that schools should be turned into centers of attraction, flexible education programs should be implemented, and Roma children should be educated in mixed schools. The findings suggest that these barriers are regarded as a product of deficiencies caused by Roma children.