The association between gaming disorder and impulsivity: A systematic review / Associação entre transtornos por jogos eletrônicos e impulsividade: uma revisão sistemática

Objective Impulsivity has been robustly linked to various addictions, including behavioral addictions. This systematic review aimed to investigate possible relationships between impulsivity and gaming disorder. Method A total of 1,710 empirical studies, without date or language restrictions, were retrieved from Biblioteca Virtual em Saúde, Cumulative Index to Nursing and Allied Health Literature, PubMed, PsycNET, Scopus, and Web of Science databases. In total, 16 studies met the inclusion criteria and were included for extraction, quantitative analysis, and integrative synthesis. Results Overall, a positive association was observed between gaming disorder and both self-reported measures of impulsivity and behavioral measures of impulsivity. Gaming disorder was associated with the presence of high-risk trends, high sensitivity to rewards, reduced inhibitory control, and low self-control among video game players. Conclusion The present systematic review provides preliminary support for the robust association between impulsivity and gaming disorder. However, given the methodological heterogeneity in assessment instruments and statistical procedures, the identified association should be interpreted cautiously.

Objetivo A impulsividade tem estado fortemente ligada a vários tipos de dependência, incluindo as dependências comportamentais. Esta revisão sistemática visou investigar possíveis relações entre a impulsividade e o transtorno por jogos eletrônicos. Método Um total de 1.710 estudos empíricos, sem restrições de data ou linguagem, foram recuperados das bases de dados Biblioteca Virtual em Saúde, Cumulative Index to Nursing and Allied Health Literature, PubMed, PsycNET, Scopus, e Web of Science. No total, 16 estudos preencheram os critérios de inclusão e foram incluídos para extração, análise quantitativa, e síntese integrativa. Resultados Observou-se uma associação positiva entre o transtorno por jogos eletrônicos e as medidas de impulsividade e de comportamento de impulsividade autorrelatadas. O transtorno por jogos eletrônicos foi associado à presença de tendências de alto risco, alta sensibilidade às recompensas, controle inibitório reduzido, e baixo autocontrole entre os jogadores. Conclusão A presente revisão fornece apoio preliminar para uma associação robusta entre a impulsividade e o transtorno por jogos eletrônicos. Contudo, dada a heterogeneidade metodológica nos instrumentos de avaliação e procedimentos estatísticos, esta associação deve ser interpretada com cautela.

Results of office-based fluid-air exchange for postvitrectomy hemorrhage in diabetic retinopathy

ABSTRACT Purpose: This study aimed to evaluate the efficacy and clinical outcomes of a one-way fluid-air exchange procedure for the treatment of postvitrectomy diabetic vitreous hemorrhage in patients with proliferative diabetic retinopathy. Methods: This retrospective study included 233 patients with proliferative diabetic retinopathy, who underwent vitrectomy. A one-way fluid-air exchange procedure was performed in 24 eyes of 24 (10.30%) patients with persistent vitreous cavity rebleeding after the operation. Preprocedural and postprocedural best-corrected visual acuity values were achieved. Complications occurring during and after the procedure were analyzed. Results: Significant visual improvement was observed 1 month after the one-way fluid-air exchange procedure (2.62 ± 0.60 LogMAR at baseline vs. 0.85 ± 0.94 LogMAR at postprocedure, p<0.0001). Moreover, 19 (79.17%) eyes needed the procedure once, and 5 (20.83%) eyed had the procedure more than twice. In 3 (12.50%) eyes, reoperation was eventually required because of persistent rebleeding despite several fluid-air exchanges. No complication was observed during the follow-up. Conclusions: The one-way fluid-air exchange procedure can be an excellent alternative to re-vitrectomy for patients with proliferative diabetic retinopathy suffering from postvitrectomy diabetic vitreous hemorrhage by removing the hemorrhagic contents directly and achieving fast recovery of visual function without apparent complications.

Expanding Global Surgery Education in Brazil: Perspectives after the 35th Brazilian Surgical Congress / Expandindo o Ensino de Cirurgia Global no Brasil: Perspectivas após o 35º Congresso Brasileiro de Cirurgia

ABSTRACT The 35th Brazilian Congress of Surgery marked a turning point for surgical education in the country. For the first time, the Brazilian College of Surgeons included Global Surgery on the main congressional agenda, providing a unique opportunity to rethink how surgical skills are taught from a public health perspective. This discussion prompts us to consider why and how Global Surgery education should be expanded in Brazil. Although Brazilian researchers and institutions have contributed to the fields expansion since 2015, Global Surgery education initiatives are still incipient in our country. Relying on successful strategies can be a starting point to promote the area among national surgical practitioners. In this editorial, we discuss potential strategies to expand Global Surgery education opportunities and propose a series of recommendations at the national level.

RESUMO O 35º Congresso Brasileiro de Cirurgia foi marcado por discussões inovadoras para a educação cirúrgica no país. Pela primeira vez, o Colégio Brasileiro de Cirurgiões incluiu a Cirurgia Global na pauta principal do congresso, proporcionando uma oportunidade única de repensar como as habilidades cirúrgicas são ensinadas a partir de uma perspectiva de saúde pública. Essa discussão nos leva a considerar por que e como o ensino da Cirurgia Global deve ser expandido no Brasil. Embora pesquisadores e instituições brasileiras tenham contribuído para a expansão do campo desde 2015, as iniciativas de educação em Cirurgia Global ainda são incipientes em nosso país. Basear-se em estratégias bem-sucedidas pode ser um ponto de partida para promover a área entre os profissionais de cirurgia nacionais. Neste editorial, discutimos potenciais estratégias para expandir as oportunidades de educação em Cirurgia Global e propomos uma série de recomendações a nível nacional.

Genomics-driven derivatization of the bioactive fungal sesterterpenoid variecolin: Creation of an unnatural analogue with improved anticancer properties

A biosynthetic gene cluster for the bioactive fungal sesterterpenoids variecolin ( 1) and variecolactone ( 2) was identified in Aspergillus aculeatus ATCC 16872. Heterologous production of 1 and 2 was achieved in Aspergillus oryzae by expressing the sesterterpene synthase VrcA and the cytochrome P450 VrcB. Intriguingly, the replacement of VrcB with homologous P450s from other fungal terpenoid pathways yielded three new variecolin analogues ( 5- 7). Analysis of the compounds' anticancer activity in vitro and in vivo revealed that although 5 and 1 had comparable activities, 5 was associated with significantly reduced toxic side effects in cancer-bearing mice, indicating its potentially broader therapeutic window. Our study describes the first tests of variecolin and its analogues in animals and demonstrates the utility of synthetic biology for creating molecules with improved biological activities.

Adiponectin restores the obesity-induced impaired immunomodulatory function of mesenchymal stromal cells via glycolytic reprogramming

Obesity has been known to negatively modulate the life-span and immunosuppressive potential of mesenchymal stromal cells (MSC). However, it remains unclear what drives the compromised potency of obese MSC. In this study, we examined the involvement of adiponectin, an adipose tissue-derived hormone, in obesity-induced impaired therapeutic function of MSC. Diet-induced obesity leads to a decrease in serum adiponectin, accompanied by impairment of survival and immunomodulatory effects of adipose-derived MSC (ADSC). Interestingly, priming with globular adiponectin (gAcrp) improved the immunomodulatory potential of obese ADSC. Similar effects were also observed in lean ADSC. In addition, gAcrp potentiated the therapeutic effectiveness of ADSC in a mouse model of DSS-induced colitis. Mechanistically, while obesity inhibited the glycolytic capacity of MSC, gAcrp treatment induced a metabolic shift toward glycolysis through activation of adiponectin receptor type 1/p38 MAPK/hypoxia inducible factor-1α axis. These findings suggest that activation of adiponectin signaling is a promising strategy for enhancing the therapeutic efficacy of MSC against immune-mediated disorders.

Coping strategies to achieve food security among households with children in an urban poor community in Quezon City during COVID-19

Background@#In the Philippines, the prevalence of food insecurity increased during the COVID-19 pandemic, affecting the nutritional status of communities nationwide. Urban areas in particular are vulnerable to the harmful effects of food insecurity, and the effects are extended and magnified when it comes to children.@*Objectives@#This study aims to evaluate the coping strategies of households with children aged 0-10 years old in an urban poor community in Quezon City. In particular, the study will determine Coping Strategies Index (CSI) scores and the frequency of specific coping strategies used.@*Methods@#A descriptive cross-sectional study was conducted to assess the coping strategies of 405 households with children in the community during the pandemic. Mothers or caregivers were given a survey inquiring about the sociodemographic data and CSI.@*Results@#Sociodemographic profiling showed that the households generally belonged to class D and E (PhP 15,000 and below) income households (73.8%). The majority of the household heads (52.6%) have their highest educational attainment at the high school level. The majority (77.5%) of the households were categorized as having low CSI classification (90%CI: 73.9, 80.8). This could indicate that relief operations conducted in the community may have helped ease their food insecurity. Coping strategies that were most frequently employed by the households were depending on less preferred or more affordable food (74.8%), rationing money for prepared food (69.1%), and purchasing food on credit (58.5%).@*Conclusion@#Low CSI classification was noted, which may be due to increased adaptation to persistent food insecurity and the utilization of coping strategies not indicated in the questionnaire. Common coping strategies used by households include reliance on less favored or less costly food items, rationing resources for prepared food, and food on credit. It is recommended that the results collected be used to target food availability and accessibility interventions in the community.

Effects of a Free Electronic Book on Systemic Anatomy with Schematics on Student Learning / Efectos de un Libro Electrónico Gratuito sobre Anatomía Sistémica con Esquemas sobre el Aprendizaje de los Estudiantes

SUMMARY: For students in schools of nursing, health sciences, and premed, a systemic anatomy textbook with minimized contents, schematics, and mnemonics may be helpful for learning an otherwise often unappealing subject. In this study, we assess the educational effect of such a textbook. Schematic drawings, anatomy comics, and easily readable text were generated for the chapters of the book (e.g., skeletal system, articular system). The book was presented without charge via a webpage (anatomy.co.kr). Nursing students who were exposed to the book and those who were not exposed were compared; a survey was administered to those who were exposed. The students who read the presented textbook were more knowledgeable than those who used other textbooks. Hours spent reading the presented textbook and scores of fill-in-the-blank questions were positively correlated. In general, the students replied that the presented textbook was helpful for learning systemic anatomy. The systemic anatomy textbook accompanies preexisting textbooks in regional anatomy, neuroanatomy, and the histology, all of which are written by the same authors. We suggest anatomy instructors generate their own books with unique style to enrich the student learning process.

Para los estudiantes de las escuelas de enfermería, ciencias de la salud y premedicina, un libro de texto de anatomía sistémica con contenidos, esquemas y mnemónicos minimizados puede ser útil para aprender un tema que de otro modo sería poco atractivo. En este estudio, evaluamos el efecto educativo de dicho libro de texto. Se generaron dibujos esquemáticos, cómics de anatomía y texto de fácil lectura para los capítulos del libro (por ejemplo, sistema esquelético, sistema articular). El libro se presentó sin costo a través de una página web (anatomy.co.kr). Se compararon los estudiantes de enfermería que estuvieron expuestos al libro y los que no estuvieron expuestos. Se administró una encuesta a quienes estuvieron expuestos. Los estudiantes que leyeron el libro de texto presentado tenían más conocimientos que aquellos que usaron otros libros de texto. Las horas dedicadas a leer el libro de texto presentado y las decenas de preguntas para completar espacios en blanco se correlacionaron positivamente. En general, los estudiantes respondieron que el libro de texto presentado fue útil para aprender anatomía sistémica. El libro de texto de anatomía sistémica acompaña a los libros de texto preexistentes de anatomía regional, neuroanatomía e histología, todos escritos por los mismos autores. Sugerimos que los instructores de anatomía generen sus propios libros con un estilo único para enriquecer el proceso de aprendizaje de los estudiantes.

Investigating preoperative myoglobin level as predictive factor for acute kidney injury following cardiac surgery with cardiopulmonary bypass: a retrospective observational study

Abstract Background: Early identification of patients at risk of AKI after cardiac surgery is of critical importance for optimizing perioperative management and improving outcomes. This study aimed to identify the association between preoperative myoglobin levels and postoperative acute kidney injury (AKI) in patients undergoing valve surgery or coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass. Methods: This retrospective study included 293 patients aged over 17 years who underwent valve surgery or CABG with cardiopulmonary bypass. We excluded 87 patients as they met the exclusion criteria. Therefore, 206 patients were included in the final analysis. The patients' demographics as well as intraoperative and postoperative data were collected from electronic medical records. AKI was defined according to the Acute Kidney Injury Network classification system. Results: Of the 206 patients included in this study, 77 developed AKI. The patients who developed AKI were older, had a history of hypertension, underwent valve surgery with concomitant CABG, had lower preoperative hemoglobin levels, and experienced prolonged extracorporeal circulation (ECC) times. Multivariate logistic regression analysis revealed that preoperative myoglobin levels and ECC time were correlated with the development of AKI. A higher preoperative myoglobin level was an independent risk factor for the development of cardiac surgery-associated AKI. Conclusions: Higher preoperative myoglobin levels may enable physicians to identify patients at risk of developing AKI and optimize management accordingly.

The Digastric Muscle: Its Anatomy and Functions Revisited / El Músculo Digástrico: Revisión de su Anatomía y Funciones

SUMMARY: As one of the suprahyoid muscles, the digastric muscle is characterized by two separate bellies of different embryologic origins. The origin of the anterior belly is the digastric fossa, while the origin of the posterior belly is the mastoid notch. They share a common insertion: the intermediate tendon. When the digastric muscle contracts, the hyoid bone is raised. Opening of the jaw and swallowing of food boli are associated with digastric muscle activity. This review discusses the general anatomic features of the digastric muscle and its variation, primary functions, and clinical implications focused on surgical reconstruction and rejuvenation.

Como uno de los músculos suprahioideos, el músculo digástrico se caracteriza por dos vientres separados, de diferentes orígenes embriológicos. El origen del vientre anterior es la fosa digástrica, mientras que el origen del vientre posterior es la incisura mastoidea. Comparten una inserción común, El tendón intermedio. Cuando el músculo digástrico se contrae, el hueso hioides se eleva. La apertura de la mandíbula y la deglución del bolo alimenticio se asocian con la actividad del músculo digástrico. Esta revisión analiza las características anatómicas generales del músculo digástrico y su variación, funciones primarias e implicaciones clínicas centradas en la reconstrucción y el rejuvenecimiento quirúrgico.

Different approaches for bladder neck dissection during robot-assisted radical prostatectomy: the Aalst technique

ABSTRACT Introduction: Bladder neck dissection is one of the most delicate surgical steps of robotic-assisted radical prostatectomy (RARP) [1, 2], and it may affect surgical margins rate and functional outcomes [3, 4]. Given the relationship between outcomes and surgical experience [5-7], it is crucial to implement a step-by-step approach for each surgical step of the procedure, especially in the most challenging part of the intervention. In this video compilation, we described the techniques for bladder neck dissection utilized at OLV Hospital (Aalst, Belgium). Surgical Technique: We illustrated five different techniques for bladder neck dissection during RARP. The anterior technique tackles the bladder neck from above until the urethral catheter is visualized, and then the dissection is completed posteriorly. The lateral and postero-lateral approaches involve the identification of a weakness point at the prostate-vesical junction and aim to develop the posterior plane - virtually until the seminal vesicles - prior to the opening of the urethra anteriorly. Finally, we described our techniques for bladder neck dissection in more challenging cases such as in patients with bulky middle lobes and prior surgery for benign prostatic hyperplasia. All approaches follow anatomic landmarks to minimize positive surgical margins and aim to preserve the bladder neck in order to promote optimal functional recovery. All procedures were performed with DaVinci robotic platforms using a 3-instruments configuration (scissors, fenestrated bipolar, and needle driver). As standard protocol at our Institution, urinary catheter was removed on postoperative day two [8]. Conclusions: Five different approaches for bladder neck dissection during RARP were described in this video compilation. We believe that the technical details provided here might be of help for clinicians who are starting their practice with this surgical intervention.

Secuelas cognitivas en encefalitis inmunomediadas: cohorte de pacientes en Argentina / Cognitive sequelae in immunomediated encephalitis: cohort of patients in Argentina

Resumen Introducción: Las encefalitis inmunomediadas son un desorden neurológico de origen autoinmune. Actual mente es escasa la descripción de las secuelas cognitivas crónicas. El objetivo del presente trabajo fue caracterizar la secuela cognitiva de diferentes tipos de encefalitis inmunomediadas en una cohorte de un centro único de Argentina. Métodos: Estudio prospectivo, observacional, trans versal, de pacientes en seguimiento en un hospital de la Ciudad de Buenos Aires, con diagnóstico de encefalitis inmunomediada probable y definitiva. Se evaluaron variables epidemiológicas, clínicas, paraclínicas y tra tamiento. Se determinó la secuela cognitiva a través de una evaluación neurocognitiva realizada a partir del año de la presentación clínica. Resultados: Fueron incluidos 15 pacientes, todos con resultado disminuido en al menos un test. La memoria fue el dominio más afectado. Aquellos que se encon traban bajo tratamiento inmunosupresor al momento de evaluarse presentaron menores resultados en el aprendizaje seriado (media -2.94; desvío estándar 1.54) versus los que se encontraban sin tratamiento (media -1.18; desvío estándar 1.40; p = 0.05) y en la prueba de reconocimiento (media -10.34; desvío estándar 8.02) ver sus sin tratamiento (media -1.39; desvío estándar 2.21; p = 0.003). Los pacientes con estatus epiléptico tuvieron resultados deficitarios en la prueba de reconocimiento (media -7.2; desvío estándar 7.91) en comparación a los que no lo tenían (media -1.47; desvío estándar 2.34; p = 0.05). Conclusión: Nuestros resultados demuestran que, a pesar del curso monofásico de la enfermedad, todos los pacientes presentan daño cognitivo persistente más allá del año del inicio del cuadro. Estudios prospectivos de mayor envergadura serían necesarios para confirmar nuestros hallazgos.

Abstract Introduction: Autoimmune encephalitis represents a group of immune-mediated neurological disorders. At present, the description of the chronic cognitive sequela is scarce. The objective of this study was to characterize the cognitive after effects of different types of autoimmune encephalitis in a cohort from a single center in Argentina. Methods: Prospective, observational, cross-sectional study of patients under follow-up at a hospital in Buenos Aires city, with a diagnosis of probable and definitive immune-mediated encephalitis. Epidemiological, clini cal, paraclinical and treatment related variables were evaluated. Cognitive sequela was determined through a neurocognitive evaluation performed at least a year after the clinical presentation. Results: Fifteen patients were included. All had di minished results in at least one test. Memory was the most affected domain. Patients who were under im munosuppressive treatment at the time of evaluation presented lower results in serial learning (mean -2.94; standard deviation 1.54) versus those who weren't under treatment (mean -1.18; standard deviation 1.40; p = 0.05). The same pattern was observed on the recognition test of treatment group (mean -10.34; standard deviation 8.02) versus treatment-free group (mean -1.39; standard deviation 2.21; p =0.003). Patients with status epilepticus had poorer results in the recognition test (mean -7.2; standard deviation 7.91) compared to those without it (mean -1.47; standard deviation 2.34; p = 0.05). Conclusion: Our results show that, despite the mo nophasic course of this disease, all patients had persis tent cognitive damage beyond the year of onset. Larger prospective studies are required to confirm our findings.

Comparative proteomics of proliferative diabetic retinopathy in people with Type 2 diabetes highlights the role of inflammation, visual transduction, and extracellular matrix pathways

Purpose: To explore the vitreous humor proteome from type 2 diabetes subjects with proliferative diabetic retinopathy (PDR) in the Indian population. Methods: We performed mass spectrometry?based label?free quantitative analysis of vitreous proteome of PDR (n = 13) and idiopathic macular hole (IMH; control) subjects (n = 14). Nine samples of PDR and 10 samples of IMH were pooled as case and control, respectively, and compared. Four samples each of PDR and IMH were analyzed individually without pooling to validate the results of the pooled analysis. Comparative quantification was performed using Scaffold software which calculated the fold changes of differential expression. Bioinformatics analysis was performed using DAVID and STRING software. Results: We identified 469 proteins in PDR and 517 proteins in IMH vitreous, with an overlap of 172 proteins. Also, 297 unique proteins were identified in PDR and 345 in IMH. In PDR vitreous, 37 proteins were upregulated (P < 0.05) and 19 proteins were downregulated compared to IMH. Protein distribution analysis clearly demonstrated a separation of protein expression in PDR and IMH. Significantly upregulated proteins included fibrinogen gamma chain, fibrinogen beta chain, and carbonic anhydrase 1 and downregulated proteins included alpha?1?antitrypsin, retinol?binding protein 3, neuroserpin, cystatin C, carboxypeptidase E and cathepsin?D. Conclusion: Diabetic retinopathy pathogenesis involves proteins which belong to inflammation, visual transduction, and extracellular matrix pathways. Validation?based experiments using enzyme?linked immunosorbent assay (ELISA) or western blotting are needed to establish cause and effect relationships of these proteins to the disease state, to develop them as biomarkers or drug molecules

A Simple and Consistent Rule for Easy Learning of Neuroanatomy: Three Neurons of Afferent Nerves / Una Regla Simple y Consistente para Facilitar el Aprendizaje de la Neuroanatomía: Tres Neuronas de los Nervios Aferentes

SUMMARY: Many students regard neuroanatomy as a terrifying subject due to the complicated neuronal connections. Purpose of this research was to promote the easy and logical learning of neuroanatomy by systematizing a rule "three neurons of afferent nerves." The rule, in which the second neuron decussates and reaches the thalamus, was applied to as many structures as possible. The three neurons are drawn in a constant pattern to intuitively demonstrate the rule. The rule could be applied not only to the spinothalamic tract, medial lemniscus pathway, sensory cranial nerves (visual pathway, trigeminothalamic tract, taste pathway, and auditory pathway) and ascending reticular activating system, but also to the pontocerebellum (afferent to cerebrum), basal nuclei (direct pathway), and limbic system (medial limbic circuit). Exceptionally, some afferent nerves do not exactly follow the suggested rule. This simple rule, which corresponds to many pathways of the neuroanatomy, is expected to make the learning by novice students easier.

Muchos estudiantes consideran la neuroanatomía como un tema aterrador debido a las complicadas conexiones neuronales. El propósito de esta investigación fue promover el aprendizaje fácil y lógico de la neuroanatomía mediante la sistematización de una regla "tres neuronas de los nervios aferentes". La regla, en la que la segunda neurona se decusa y llega al tálamo, se aplicó a todas las estructuras cuando esto fue posible. Las tres neuronas se dibujan en un patrón constante para demostrar la regla intuitivamente. La regla podría aplicarse no solo al tracto espinotalámico, la vía del lemnisco medial, los nervios craneales sensoriales (vía visual, tracto trigeminotalámico, vía gustativa y vía auditiva) y el sistema de activación reticular ascendente, sino también al pontocerebelo (aferente al cerebro), núcleos basales (vía directa) y sistema límbico (circuito límbico medial). Excepcionalmente, algunos nervios aferentes no siguen exactamente la regla sugerida. Se espera que esta simple regla, que corresponde a muchas vías de la neuroanatomía, facilite el aprendizaje de los estudiantes principiantes.

Frontal osteomyelitis post-COVID-19 associated mucormycosis

Rhino-orbito-cerebral mucormycosis (ROCM) is the most commonly noted form of mucormycosis, which is the most common secondary fungal infection following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Osteomyelitis is one of the rare sequelae of ROCM, frontal osteomyelitis being the rarest. We present four patients of coronavirus disease 2019 (COVID-19)-associated mucormycosis, who presented with frontal bone osteomyelitis after being treated for ROCM surgically and medically. This is the first case series highlighting this complication in post–COVID-19 mucormycosis patients and needs utmost attention as it can be life-threatening and can cause extreme facial disfiguration. All four patients are alive with salvage of the affected globe and vision being preserved in one patient. If identified early, disfiguration of face and intracranial extension can be avoided.

Mapping prognostic factors for globe survival in panophthalmitis using logistic regression and Cox proportional hazard models: A retrospective study

Purpose: The aim of this study was to report the outcomes of panophthalmitis and to identify factors significantly affecting globe survival in the disease. Methods: This was a retrospective study on patients with panophthalmitis in a tertiary hospital between January 1, 2017, and December 31, 2019. The demographics, treatment details, culture results, and final outcomes were recorded. Logistic regression and Cox proportional hazards (CPH) were calculated to identify variables associated with globe loss. A P < 0.05 was considered significant. Results: Eighty?five eyes of 85 patients (31 culture positive) were eligible for review. The mean age of the participants was 55.21 ± 20.17 years with a male?to?female ratio of 2.04:1. Corneal ulcer (38.82%; n = 33) and open globe injuries (OGIs) (38.82%; n = 33) were the most common etiologies. Pseudomonas aeruginosa (n = 10; 11.76%) was the most common isolate. The mean duration of hospital stay was 7.58 ± 2.32 days. Overall, 44 (51.76%) globes could be salvaged. The need for evisceration (P = 0.901) and hospital stays (P = 0.095) were similar for culture?positive and ?negative cohorts. The unadjusted logistic regression and CPH models showed that culture sterility did not affect globe survival [OR = 1.210 (0.501– 2.950), P = 0.668; HR = 1.176 (0.617–2.243), P = 0.623]. The adjusted logistic regression and the CPH models showed that corneal ulcers [OR = 10.900 (2.460–48.200), P = 0.002; HR = 5.393 (1.603–18.140), P = 0.006] and OGI [OR = 7.360 (1.650–32.700), P = 0.009; HR = 4.548 (1.321–15.660), P = 0.016] were significantly associated with globe loss. Conclusion: Corneal ulcer or OGI as the primary etiology is detrimental to globe survival in panophthalmitis.

Transformed Time Series Analysis of First Wave COVID-19: Universal Similarities Found in The Group of Twenty (G20) Countries

As of April 30, 2020, cumulative confirmed coronavirus disease 2019 (COVID-19) cases exceeded 3 million worldwide and 1 million in the US, with an estimated fatality rate of more than 7 percent. Because the occurrence patterns of new confirmed cases and deaths over time are complex and seemingly country-specific, estimating the long-term pandemic spread is challenging. I developed a simple transformation algorithm to investigate the characteristics of the case and death time series per nation and described the universal similarities observed in the transformed time series of 19 nations in the Group of Twenty (G20). A transformation algorithm of the time series data sets was developed with open-source software programs to investigate the universal similarities among the cumulative profiles of confirmed cases and deaths of 19 individual nations in the G20. The algorithm extracted and analyzed statistical information from daily updated COVID-19 pandemic data sets from the European Centre for Disease Prevention and Control (ECDC). Two new parameters for each nation were suggested as factors for time-shifting and time-scaling to define reduced time, which was used to quantify the degree of universal similarities among nations. After the cumulative confirmed case and death profiles of a nation were transformed by using reduced time, most of the 19 nations, with few exceptions, had transformed profiles that closely converged to those of Italy after the onset of cases and deaths. The initial profiles of the cumulative confirmed cases per nation universally showed 3 to 4-week latency periods, during which the total number of cases remained at approximately ten. The latency period of the cumulative number of deaths was approximately half the latency number of cumulative cases, and subsequent uncontrollable increases in human deaths seemed unavoidable because the coronavirus had already widely spread. Immediate governmental actions, including responsive public-health policymaking and enforcement, are observed to be critical to minimize (and possibly stop) further infections and subsequent deaths. In the pandemic spread of infectious viral diseases, such as COVID-19, studied in this work, different nations show dissimilar and seemingly uncorrelated time series profiles of infected cases and deaths. After these statistical phenomena were viewed as identical events occurring at a distinct rate in each country, the reported algorithm of the data transformation using the reduced time revealed a nation-independent, universal profile (especially initial periods of the pandemic spread) from which a nation-specific, predictive estimation could be made and used to assist in immediate public-health policymaking.

A study establishing sensitivity and accuracy of smartphone photography in ophthalmologic community outreach programs: Review of a smart eye camera

Purpose: Diseases affecting the cornea are a major cause of corneal blindness globally. The pressing issue we are facing today is the lack of diagnostic devices in rural areas to diagnose these conditions. The aim of the study is to establish sensitivity and accuracy of smartphone photography using a smart eye camera (SEC) in ophthalmologic community outreach programs. Methods: In this pilot study, a prospective non?randomized comparative analysis of inter?observer variability of anterior segment imaging recorded using an SEC was performed. Consecutive 100 patients with corneal pathologies, who visited the cornea specialty outpatient clinic, were enrolled. They were examined with a conventional non?portable slit lamp by a cornea consultant, and the diagnoses were recorded. This was compared with the diagnoses made by two other consultants based on SEC videos of the anterior segment of the same 100 patients. The accuracy of SEC was accessed using sensitivity, specificity, PPV, and NPV. Kappa statistics was used to find the agreement between two consultants by using STATA 17.0 (Texas, USA). Results: There was agreement between the two consultants to diagnosing by using SEC. Above 90% agreements were found in all the diagnoses, which were statistically significant (P?value < 0.001). More than 90% sensitivity and a negative predictive value were found. Conclusion: SEC can be used successfully in the community outreach programs like field visits, eye camps, teleophthalmology, and community centers, where either a clinical setup is lacking or ophthalmologists are not available.

Analysis of Watson for oncology and clinicians� treatment recommendations for patients with breast cancer in Korea: A single center experience

Background: Various clinical applications have been attempted using artificial intelligence (AI) clinical decision support system (CDSS), and it has become a starting point for personalized cancer treatment. We aimed to identify the degree of agreement between the AI?CDSS, Watson for Oncology (WFO), and the clinician in treatment recommendations for Korean breast cancer patients and to provide guidelines for future improvement. Methods: One hundred and eighty?three breast cancer patients who underwent treatment at the Pusan National University Hospital between January 1, 2016 and May 31, 2017 were enrolled in this study. The concordance between WFO抯 and clinicians� treatment recommendations were examined according to various factors. Results: WFO gave the same treatment option recommendations as clinicians in 74 (40.4%) of the cases. According to the logistic regression, the difference in recommendation concordance between stage I and stage III was statistically significant (P = 0.004), and there was no difference among other factors. Conclusion: The concordance of treatment recommendations was low overall. However, this is largely attributable to the differences of medical insurance system and healthcare environment between the United States and Korea. In the future, region?specific features should be considered or reflected during the development of AI?CDSS.

Geniohyoid Muscle: Anatomy and Clinical Implications in Dentistry / Músculo Geniohioideo: Anatomía e Implicaciones Clínicas en Odontología

SUMMARY: The geniohyoid muscle is one of the suprahyoid muslces, and arises from the inferior mental spine and inserts into the hyoid bone. The muscle is a narrow paired one and its main action is pulling the hyoid upward and forward. Its function is very important in deglutition as well as respiration. Therefore, this muscle has been extensively researched, especially in the context of dysphagia and sleep apnea. This review deals with the general anatomic features, main functions, and abnormal states of the geniohyoid muscle, and the clinical implications of these.

El músculo geniohioideo es uno de los músculos suprahioideos que surge de la espina mental inferior y se inserta en el hueso hioides. Son un par de músculo delgados y su acción principal es elevar y estirar el hueso hioides hacia arriba y hacia adelante. Su función es importante tanto en la deglución como en la respiración. Por lo tanto, este músculo ha sido ampliamente investigado, especialmente en el contexto de la disfagia y la apnea del sueño. Esta revisión trata de las características anatómicas generales, funciones principales y estados anormales del músculo geniohioideo, y las implicaciones clínicas de estos.