Anterior lamellar corneoscleral keratoplasty for the management of corneal thinning following treatment with mitomycin-C and interferon to treat highly suspected ocular surface squamous neoplasia: a case report

ABSTRACT A patient presented with corneoscleral thinning five months after the treatment of suspected ocular squamous surface neoplasia with mitomycin-C and interferon. For tectonic and aesthetic purposes, we decided to perform lamellar corneoscleral transplantation. The approach used established new tectonic support and corneal homeostasis. This technique might be an option in similar cases.

Simultaneous extraction of tocochromanols and flavan-3-ols from the grape seeds: Analytical and industrial aspects.

Grape processing generates large amounts of by-products, including seeds rich in hydrophilic and lipophilic antioxidants. This study demonstrates, for the first time, that subjecting grape seeds to a single ultrasound-assisted extraction (UAE) with aqueous ethanolic solutions yields both flavan-3-ols and tocochromanols in the final extract. Notably, the water content in ethanol significantly influences the extractability of tocochromanols more than flavan-3-ols. Solid-to-solvent ratios of 1:50 to 1:2 were tested for both analytical and industrial applications. A sustainable analytical approach for recovering flavan-3-ols and tocochromanols using 60% and 96.4% ethanol extractions was validated and employed to profile nineteen genotypes of lesser-studied interspecific grape crosses (Vitis spp.). Different genotypes showed a wide range of concentrations of tocopherols (1.6-6.3 mg/100 g), tocotrienols (1.0-17.4 mg/100 g), and flavan-3-ols (861-9994 mg/100 g). This indicated that the genetic background and maturity of the plant material are crucial factors from an industrial perspective due to the initial concentration of bioactive compounds. Finally, the study also discussed the fundamental aspects of hydrophobic antioxidant extractability from the lipid matrix with aqueous ethanol solutions and the limitations of the workflow, such as the non-extractable tocochromanols and their esters and the losses of these lipophilic antioxidants during extraction.

Assessing the therapeutic role of trehalose and hyaluronic acid: implications for patient care.

OBJECTIVE: This Systematic review aims to assess the efficacy of trehalose and hyaluronic acid in enhancing ocular recovery post-cataract surgery, focusing on their impact on tear film stability, ocular surface integrity, and patient-reported outcomes. METHODS: A comprehensive search was conducted across MEDLINE, PubMed, and Cochrane Library databases to identify randomized controlled trials investigating the efficacy of trehalose, hyaluronic acid, or their combination in post-cataract surgery care. The inclusion criteria focused on peer-reviewed studies in English, detailing outcomes relevant to ocular recovery such as tear film stability, ocular surface integrity, patient-reported discomfort, or visual acuity (VA). The quality of the included studies was assessed using the Cochrane Risk of Bias Tool and synthesized the data qualitatively. RESULTS: Four qualitative investigations met the inclusion criteria. The studies collectively assessed the efficacy of a 3% trehalose and 0.15% hyaluronic acid eye drop solution in reducing postoperative eye symptoms compared to various control solutions. Parameters measured included tear break-up time (TBUT), Fluorescein staining, tear production (Schirmer test), and Ocular Surface Disease Index (OSDI) scores. The results indicated significant improvements in tear film stability and ocular surface health for the treatment groups compared to controls, with a notable decrease in patient-reported discomfort. The study showed an improvement of - 18 (± 14.6) in the treatment group compared to - 7 (± 8.0) in the control group for OSDI. For TBUT, the treatment group improved by 3 (± 1.2) s, whereas the control group improved by 0.3 (± 0.71) s. VA, measured on a scale of 0-100, increased to 17 (± 0.7) in the treatment group compared to 15 (± 1.1) in the control group. CONCLUSIONS: Trehalose and hyaluronic acid may be beneficial in the postoperative period by enhancing tear film stability and ocular surface health. While the results are promising, further research is needed to confirm these findings, understand the mechanisms of action, and explore broader applications.

An integrated fast-slow plant and nematode economics spectrum predicts soil organic carbon dynamics during natural restoration.

Aboveground and belowground attributes of terrestrial ecosystems interact to shape carbon (C) cycling. However, plants and soil organisms are usually studied separately, leading to a knowledge gap regarding their coordinated contributions to ecosystem C cycling. We explored whether integrated consideration of plant and nematode traits better explained soil organic C (SOC) dynamics than plant or nematode traits considered separately. Our study system was a space-for-time natural restoration chronosequence following agricultural abandonment in a subtropical region, with pioneer, early, mid and climax stages. We identified an integrated fast-slow trait spectrum encompassing plants and nematodes, demonstrating coordinated shifts from fast strategies in the pioneer stage to slow strategies in the climax stage, corresponding to enhanced SOC dynamics. Joint consideration of plant and nematode traits explained more variation in SOC than by either group alone. Structural equation modeling revealed that the integrated fast-slow trait spectrum influenced SOC through its regulation of microbial traits, including microbial C use efficiency and microbial biomass. Our findings confirm the pivotal role of plant-nematode trait coordination in modulating ecosystem C cycling and highlight the value of incorporating belowground traits into biogeochemical cycling under global change scenarios.

[Volume therapy: which preparation for which situation?] / Volumentherapie ­ welches Präparat in welcher Situation?

The most commonly used fluids for volume therapy are crystalloids and colloids. Crystalloids comprise 0.9% sodium chloride and balanced crystalloids (BC). Colloids can be divided into artificial colloids and human albumin (a natural colloid). Large studies show advantages for BC over 0.9% NaCl with respect to renal endpoints, probably due to the unphysiologically high chloride content of 0.9% NaCl. However, other studies, such as the BaSICS and PLUS trials, showed no significant differences in mortality in a heterogeneous population. Despite this, meta-analyses suggest advantages for BC. Therefore, BC should be preferred, especially in patients at increased risk of acute kidney injury, with acidemia and/or hyperchloremia. Except for specific indications (e.g., in patients with cirrhosis, sepsis resuscitation after initial volume therapy with BC), albumin should not be used. There is clear evidence of harm from hydroxyethyl starch in intensive care patients.

Designing nature to be a solution for climate change in cities: A meta-analysis.

Nature-based solutions (NbS) are designed as a win-win strategy to address societal challenges while providing biodiversity, social, and economic benefits. However, uncertainties and gaps persist, particularly regarding the criteria that define a NbS measure and the specific requirements for a solution to be fully recognized as such, which limit the full potential of these strategies in practice. Another persistent issue is the lack of data on strategy responses across different implementation scales (local, city, regional) and climatic zones (temperate, arid, tropical). This article provides an overview of the potential of NbS to promote climate adaptation in cities. Our meta-analysis, which compiled 7163 records from 89 articles worldwide, indicates that integrating NbS strategies with traditional approaches (gray infrastructure and sustainable technologies) is the most effective response to concurrently address multiple climate-related hazards. Flooding had the highest impact at 35.7 %, followed by increased runoff at 30.5 %. Peak flow and water pollution both had an impact of 10.3 %, while temperature increase accounted for 5.7 %, and decreases in thermal comfort made up 5.0 %. We concluded that all evaluated strategies reduced the impact of climate-related hazards, but this reduction was twice as large when incorporating NbS (18.6 % vs 8.1 %). We also demonstrate that this effect is observed under projected climate scenarios, reinforcing the role of NbS in making cities more resilient and sustainable.

Implementation of an early attention strategy to reduce emergency room overcrowding in an academic institution in Colombia, a pilot study.

Overcrowding is a worldwide problem, and long waiting times are associated with increased morbidity and even mortality of patients regardless of triage classification. Although there are many tools published in the literature that contribute to the reduction of overcrowding, for the Colombian population there are not many tools evaluated to reduce the length of stay of patients in the emergency department. This is a retrospective analytical study that compared whether there was a difference in patient definition time and ED length of stay between a group attended under an early care protocol (PAT) versus the usual protocol. Of the total of 969 patients included it was found that the group attended under the PAT protocol had a shorter definition time than the usual protocol, also the Emergency department length of stay (EDLOS) was significantly lower in the PAT group compared to the usual protocol. The implementation of the PAT protocol performed by emergency physicians allows a faster contact with the patient by the physician, and leads to a significant reduction of EDLOS, contributing to the reduction of overcrowding in the emergency department.

Which Intravenous Isotonic Fluid Offers Better Outcomes for Patients with a Brain Injury?

Administering intravenous fluids is a common therapy for critically ill patients. Isotonic crystalloid solutions, such as saline or balanced solutions, are frequently used for intravenous fluid therapy. The choice between saline or a balanced crystalloid has been a significant question in critical care medicine. Recent large randomized controlled trials (RCTs) have investigated whether balanced crystalloids yield better outcomes in general or specific critical care populations, and many of them have confirmed this hypothesis. Although the broad eligibility criteria of these RCTs suggest applicability to neurocritical care patients, it is important to discuss whether using balanced crystalloids, as opposed to saline, would benefit patients who primarily have neurological disorders or diseases. This review considers the relevance of this question, weighs the pros and cons of the two fluid types, examines available data, and anticipates results from ongoing RCTs to guide clinicians in selecting the optimal fluid for patients with brain injury.

Methodological framework for impact evaluation of Building-Integrated Greenery (BIG-impact).

Building-Integrated Greenery systems, i.e., green roofs, walls, and facades, are Nature-based Solutions that make possible the renaturing of cities when there is no room for traditional greenery solutions. These green systems provide several ecosystem services at both the building and city level, such as urban heat island effect mitigation and noise reduction, support for biodiversity, runoff control, thermal and acoustic insulation, etc. However, once implemented in real cases, their impact is almost never evaluated. This fact limits the possibility of carrying out cost-benefit analyses that contribute to justifying their long-term maintenance, thus putting at risk their long-term sustainability and consequently the provision of benefits. Unlike existing approaches, the method presented here offers a comprehensive and practical tool that addresses the gap in BIG systems' impact evaluation, facilitating informed decision-making and promoting the long-term sustainability of BIG systems.•In its design, the current references at European and global level for building-integrated systems impact assessment has been considered.•It is easily replicable in any real project and enables the collaboration of involved stakeholders.•The method is unprecedented and allows a holistic assessment of the impact of BIG in real cases, in terms of ecosystem services provided.

Microplastic retention in green walls for nature-based and decentralized greywater treatment.

In wastewater treatment, two issues have recently received increased attention: nature-based solutions for addressing urban water stress through decentralized treatment and re-use; and emerging pollutants such as microplastics (MPs). At the interface of these, this study investigated living green walls for greywater treatment and their potential for MP removal. A large, pilot-scale green wall was irrigated with greywater (a mix of water collected from laundry, dishwasher, bathroom sinks, and synthetic greywater), and effluent from planted and unplanted sections was compared. MPs >50 µm were analyzed using µRaman spectroscopy and supplementary fluorescence microscopy imaging. The green wall proved efficient for the reduction of chemical oxygen demand (COD) (around 80%), removal of total suspended solids (TSS) (around 90%) and MPs, especially for MPs of the non-polar, hydrophobic polymer type polystyrene and MPs sized 100-500 µm. MP removal was improved in the planted (50-60%) compared to the unplanted section (20%), especially for the size fraction 100-500 µm. Physical filtration by the green wall growing media (a mix of perlite with a grain size of 1-5 mm, and coconut fiber), which was further enhanced by plant roots decreasing the effective pore size, can be considered the most important removal mechanism. Charge-mediated adsorption cannot be expected as MPs and growing media mix were both negatively charged at the prevailing water pH (7-8). Fluorescence imaging for MP analysis, using a merged UV/blue light fluorograph, overestimated MP concentrations in greywater (hundreds of MPs per sample were identified by fluorescence imaging versus tens of MPs by µRaman spectroscopy) and would benefit from further improvement before it can be reliably applied as a cheaper and faster alternative methodology for MP analysis.

Biological Medicines Prepared Using Vibration Processing Are Able to Influence Their Targets Without Direct Contact With Them.

Recently, there has been a radical change in understanding of the nature of drugs based on highly diluted solutions. It has been established that their activity does not depend on the content of the original substance in dilutions, but is a consequence of the technological processing (TP) of dilutions with vibration, which accompanies each dilution during the preparation of solutions and, among others, leads to the formation of nanoparticles with certain properties. Repeated vibration treatment leads to the appearance of modifying activity that is absent in the original substance, and these effects of TP solutions can be exerted without direct contact with their targets, which clearly indicates the physical nature of the TP solution's activity. In the framework of this article, a statistically significant effect of TP antibodies to the insulin receptor on glucose consumption by CHO cells both with and without contact exposure, as compared with control (P < 0.05) was shown in the vast majority of the experiments. The obtained results shed light on a possible source of activity of drugs based on TP antibodies, which should be associated with the applied vibration effect and can manifest itself both with contact exposure and without it.

A besyian regularisation neural network approach for hepatitis B virus spread prediction and immune system therapy model.

The primary aim of the article is to analyze the response of the human immune system when it encounters the hepatitis B virus. This is done using a mathematical system of differential equations. The differential equation system has six components, likely representing various aspects of the immune response or virus dynamics. A Bayesian regularization neural network has been presented in the process of training. These networks are employed to find solutions for different categories or scenarios related to hepatitis B infection. The Adams method is used to generate reference data sets. The back-propagated artificial neural network, based on Bayesian regularization, is trained and validated using the generated data. The data is divided into three sets: 90% for training and 5% each for testing and validation. The correctness and effectiveness of the proposed neural network model have been assessed using various evaluation metrics. The metrics have been used in this study are Mean Square Error (MSE), histogram errors, and regression plots. These measures provide support to the neural network to approximate the immune response to the hepatitis B virus.

Data-driven solutions and parameter estimations of a family of higher-order KdV equations based on physics informed neural networks.

Physics informed neural network (PINN) demonstrates powerful capabilities in solving forward and inverse problems of nonlinear partial differential equations (NLPDEs) through combining data-driven and physical constraints. In this paper, two PINN methods that adopt tanh and sine as activation functions, respectively, are used to study data-driven solutions and parameter estimations of a family of high order KdV equations. Compared to the standard PINN with the tanh activation function, the PINN framework using the sine activation function can effectively learn the single soliton solution, double soliton solution, periodic traveling wave solution, and kink solution of the proposed equations with higher precision. The PINN framework using the sine activation function shows better performance in parameter estimation. In addition, the experiments show that the complexity of the equation influences the accuracy and efficiency of the PINN method. The outcomes of this study are poised to enhance the application of deep learning techniques in solving solutions and modeling of higher-order NLPDEs.

A roadmap for the nursing scientific workforce to eliminate health and healthcare inequities.

BACKGROUND: The National Academies of Sciences, Engineering, and Medicine's Ending Unequal Treatment report emphasizes immediate actions to eliminate health inequities (i.e., solutions-oriented health inequity research), versus incrementally advancing health equity. Nurse scientists are uniquely positioned to lead national efforts to eliminate health inequities. PURPOSE: To outline nursing science's contributions to solutions-oriented health inequity research, highlight opportunities and challenges for nursing leadership, and key competencies for which workforce support infrastructure is needed. METHODS: We draw on the landmark 2024 Ending Unequal Treatment report, supplemented by a review of the literature on scientific nursing-specific workforce challenges. DISCUSSION: We identify strategies for sustaining and advancing nursing science's leadership in solutions-oriented health inequity research, including objectives, competencies, and programmatic elements needed to support current and future nurse investigators. CONCLUSION: Bolstering the nursing scientific workforce in solutions-oriented health inequity will elevate the critical role of nursing science in eliminating health inequities and improving population health.

Self-assembled micro-patterns in uphill-diffusion solution system.

In this work we present self-organized regular patterns in a solution system through uphill-diffusion. Organic semiconductor solution is sandwiched between a substrate and cover plate with micrometer distance. Self-assembled regular patterns can be observed on the substrate after solvent evaporation. Different micro-patterns and pattern defects were displayed and analyzed. Mechanisms of pattern and defect formation, competitive mode selection process, and pattern sedimentation onto substrate from solution were proposed. Organic thin film transistors were fabricated with the assembled line patterns which demonstrate a promising way to produce patterned micro/nano materials. .

Fluidoterapia reflexiva: desde la fisiología a la práctica clínica / Reflexive fluid therapy: From physiology to clinical practice

Introducción. La fluidoterapia es una intervención ampliamente usada en la práctica clínica. No obstante, su aplicación no está exenta de riesgos y demanda una evaluación cuidadosa de la tolerancia del paciente y su respuesta al volumen. La práctica empírica de la reanimación con líquidos puede ser potencialmente letal. El propósito de esta revisión fue proporcionar una visión general de los principios fisiológicos y terapéuticos para la administración de líquidos intravenosos en pacientes críticamente enfermos, abordando poblaciones especiales, como los pacientes quirúrgicos, sépticos y politraumatizados. Métodos. Se hizo una revisión narrativa a partir de artículos publicados en PUBMED, ScienceDirect y LILACS, entre 2001 y 2023. Para la búsqueda se emplearon los términos MESH fluid therapy, crystalloid solutions y colloids. Resultados. Se encontraron 371 artículos, de los cuales se seleccionaron los estudios clínicos aleatorizados, las revisiones narrativas, las revisiones sistemáticas y los metaanálisis que analizaron el rol de los cristaloides y coloides. Se incluyeron manuscritos publicados en fechas por fuera del rango de búsqueda, que se consideraron relevantes para la descripción de la fisiopatología y los fundamentos del uso de líquidos endovenosos. Conclusión. La reanimación reflexiva se fundamenta en un entendimiento holístico de la fisiología y la individualización de la fluidoterapia. El uso liberal de líquidos endovenosos tiene potenciales efectos nocivos y las estrategias de reanimación deben ser guiadas por medidas dinámicas y estáticas individuales, que proporcionan un panorama seguro para el manejo de los líquidos.

Introduction. Fluid therapy is an intervention widely used in clinical practice. However, its application is not without risks and requires a careful evaluation of patient's tolerance and response to volume. The empirical practice of fluid resuscitation can be potentially lethal. The purpose of this review was to provide an overview of the physiological and therapeutic principles for the administration of intravenous fluids in critically ill patients, addressing special populations, such as surgical, septic, and trauma patients. Methods. A narrative review was carried out based on articles published in PUBMED, ScienceDirect, and LILACS between 2001 and 2023. MESH terms fluid therapy, crystalloid solutions, and colloids were employed. Results. A total of 371 articles were found, of which randomized clinical trials studies, narrative reviews, systematic reviews, and meta-analyses that analyzed the role of crystalloids and colloids were selected. Manuscripts published on dates outside the search range, which were considered relevant for the description of the pathophysiology and the rationale for the use of intravenous fluids, were included. Conclusion. Reflective resuscitation is based on a holistic understanding of physiology and individualization of fluid therapy. The liberal use of intravenous fluids has potential harmful effects and resuscitation strategies should be guided by individual dynamic and static measures, which provide a safe framework for fluid management

Nature-based solutions for improving food security: A systematic global review.

Nature-based solutions (NBS) have been promoted as a holistic way to solve a variety of societal issues while benefiting biodiversity at the same time. To date, applications of NBS approaches that help ensure food security have yet been systematically reviewed. In this paper, we critically review the specific NBS for food security, highlighting their limitations, to provide recommendations that promote their applications for improving global food security. We accessed and evaluated publications on four different scholastic databases, and our systematic review of relevant materials indicated that many NBS approaches can be applied to enhance food security dimensions individually or together. However, there is a strong bias towards food availability, and not enough research has been done to link NBS with improvements in food access and utilization. Over 80 % of the reviewed papers were of short-term studies or without specific timeframes, and 25 % offered no information on the economic effectiveness of NBS. Environmental benefits of NBS were explicitly described in about 60 % of these papers, and biodiversity enhancement was measured in only about 10 %. We, therefore, recommend future applications of NBS to safeguard food security be shifted to food access and utilization with careful consultation with local communities to address their specific context, using indicators that are easily measured and managed. Systematic monitoring regimes and robust and diversified financial support systems are also equally important in efforts to successfully implement NBS. Moreover, environmental and societal benefits, especially water productivity and biodiversity, must be incorporated into the planning and design of NBS.

Indium-iron oxide nanosized solid solutions as photocatalysts for the degradation of pollutants under visible radiation.

A series of solid solutions of indium and iron oxides with different In/Fe ratios (InxFeyO3, with x + y = 2) were synthesized in the form of nanoparticles with the purpose of generating semiconductors with an intermediate band gap width compared to those of In2O3 and Fe2O3. XRD analysis proved the formation of the desired InxFeyO3 solid solutions for Fe content in the range 5-25% mol. UV-Vis absorption analysis showed that the substitution of In with Fe in the crystalline structure led to the anticipated gradual decrease of the band gaps energy values compared to In2O3. The obtained materials were tested as photocatalysts for the degradation of model organic pollutants (phenol and methylene blue) in water. Among the InxFeyO3 solid solutions, In1.7Fe0.3O3 displayed the highest photocatalytic activity in the degradation of the selected probe molecules under UV and visible radiation. Remarkably, In1.7Fe0.3O3 showed a significantly enhanced activity under visible light compared to monometallic indium oxide and iron oxide. This demonstrates that our strategy consisting in engineering the band gap by tuning the composition of InxFeyO3 solid solutions was successful in improving the photocatalytic performance under visible light. Additionally, In1.7Fe0.3O3 fully retained its photocatalytic activity upon reuse in four consecutive cycles.

An approximate solution of the SLIP model under the regime of linear angular dynamics during stance and the stability of symmetric periodic running gaits.

Terrestrial locomotion is a complex phenomenon that is often linked to the survival of an individual and of an animal species. Mathematical models seek to express in quantitative terms how animals move, but this is challenging because the ways in which the nervous and musculoskeletal systems interact to produce body movement is not completely understood. Models with many variables tend to lack biological interpretability and describe the motion of an animal with too many independent degrees of freedom. Instead, reductionist models aim to describe the essential features of a gait with the smallest number of variables, often concentrating on the center of mass dynamics. In particular, spring-mass models have been successful in extracting and describing important characteristics of running. In this paper, we consider the spring loaded inverted pendulum model under the regime of constant angular velocity, small compression, and small angle swept during stance. We provide conditions for the asymptotic stability of periodic trajectories for the full range of parameters. The hypothesis of linear angular dynamics during stance is successfully tested on publicly available human data of individuals running on a treadmill at different velocities. Our analysis highlights a novel bifurcation phenomenon for varying Froude number: there are periodic trajectories of the spring loaded inverted pendulum model that are stable only in a restricted range of Froude numbers, while they become unstable for smaller or larger Froude numbers.