Inferior altitudinal visual loss and mask-wearing practices: A case series

Face mask-wearing practices and their impact on the visual field bear particular importance in the coronavirus disease 2019 (COVID-19) pandemic era. This case series examines 10 participants with no history of ocular impairment or visual field defects who underwent age-corrected visual field testing in both eyes with different types of face masks. Wearing duckbill N95 masks was consistently associated with increased accuracy errors in the inferior altitudinal visual field when compared to wearing surgical masks or no masks. These findings support public health guidance that has previously attributed the risks of falls and accidents to face mask wearing.

Addressing problems in accident management in a shopping complex through action research

Introduction@#Accidents are unpredictable and sometimes unavoidable. Businesses such as shopping complexes need to follow safety protocols to ensure that nobody is hurt. The shopping complex should have preventive measures and an accident management team to offer efficient and timely treatment for these accident victims.@*Objective@#This paper aims to identify problems experienced by the accident management team in dealing with accidents in a shopping complex. The report will also propose and implement solutions to all issues identified.@*Methods@#Two action research cycles were conducted for this paper, with the results of the first action research flowing into the second action research cycle. Reeves et al.’s interprofessional teamwork framework addressed concerns related to teamwork. The data used in this action research came from journal entries, informal and formal one-on-one discussions, and discussions with each department.@*Results@#The workflow for the current post-accident management activities was evaluated. The problems identified were grouped into 5: roles and responsibilities, procedures, knowledge transfer, logistics, and skills. The issues concerning the roles and responsibilities of each team member were addressed by realigning these with their current skills, training, and job description. The remaining and new problems were addressed by developing an accident management policy. Inclusions in the policy are protocols on transporting patients, communication and transportation procedures, letter of authorization (LOA) approval procedures, post-accident evaluation procedures, pre-accident recommendations, policy revision procedures to address organizational changes, changes in the job description or government regulatory mandates, and the evaluation of current skills in case training is needed.@*Conclusion@#Accident management requires a coordinated effort amongst all the team members, with members from different social and health specialties. Using Reeves et al.’s interprofessional teamwork framework, the team identified the problems and implemented solutions by realigning the roles and responsibilities of each team member and implementing an accident management policy that can improve preventive measures and improve post-accident responses.

Outcome predictors for severely brain-injured patients directly admitted or transferred from emergency departments to a trauma center / 世界急诊医学杂志（英文）

@#Dear editor, After sustaining severe traumatic brain injury (TBI), patients frequently require invasive mechanical ventilation (MV). However, up to 26% of patients require tracheostomy due to failure to wean from the ventilator.[1] The decision of when to perform tracheostomy is important as it balances the risk between avoiding prolonged MV and avoiding risk of tracheostomy. Early predictors for tracheostomy, i.e., clinical factors when patients first present to an Emergency Department after trauma or when patient first arrive at a regional trauma center, can help clinicians’ medical decision-making process.

Ureteropelvic junction obstruction caused by metastatic cholangiocarcinoma

ABSTRACT We describe the rare case of a 61-year-old female with right ureteropelvic junction (UPJ) obstruction caused by metastatic cholangiocarcinoma. Her past medical history was notable for cholangiocarcinoma treated with neoadjuvant chemoradiation and two orthotopic liver transplants six years earlier. Urology was consulted when she presented with flank pain and urinary tract infection. Diagnostic workup demonstrated right UPJ obstruction. She was managed acutely with percutaneous nephrostomy. She subsequently underwent robotic pyeloplasty and intrinsic obstruction of the UPJ was discovered. Histological examination revealed adenocarcinoma, consistent with systemic recurrence of the patient's known cholangiocarcinoma.

Designing the new generation of intelligent biocompatible carriers for protein and peptide delivery

Therapeutic proteins and peptides have revolutionized treatment for a number of diseases, and the expected increase in macromolecule-based therapies brings a new set of challenges for the pharmaceutics field. Due to their poor stability, large molecular weight, and poor transport properties, therapeutic proteins and peptides are predominantly limited to parenteral administration. The short serum half-lives typically require frequent injections to maintain an effective dose, and patient compliance is a growing issue as therapeutic protein treatments become more widely available. A number of studies have underscored the relationship of subcutaneous injections with patient non-adherence, estimating that over half of insulin-dependent adults intentionally skip injections. The development of oral formulations has the potential to address some issues associated with non-adherence including the interference with daily activities, embarrassment, and injection pain. Oral delivery can also help to eliminate the adverse effects and scar tissue buildup associated with repeated injections. However, there are several major challenges associated with oral delivery of proteins and peptides, such as the instability in the gastrointestinal (GI) tract, low permeability, and a narrow absorption window in the intestine. This review provides a detailed overview of the oral delivery route and associated challenges. Recent advances in formulation and drug delivery technologies to enhance bioavailability are discussed, including the co-administration of compounds to alter conditions in the GI tract, the modification of the macromolecule physicochemical properties, and the use of improved targeted and controlled release carriers.

Review on the use of dexamethasone and its impact on fertility and pregnancy

Purpose: Although benefit/risk analysis is usually undertaken prior to starting a treatment, some conditions will inevitably require the use of drugs with known side effects even during pregnancy. This is the case with dexamethasone use in ante natal care. The purpose of this review was to provide an overview of the uses of dexamethasone and its impacts on pregnancy and fertility in humans. Data source: The review is based on literature searches using PubMed and MeSH and authors' personal manuscript/abstract files and citations of known references. Study selection: The selection of articles reflects the authors' opinion as to originality and importance in the context of the review. The review included human and some aspects of animal study.Data extraction: The electronic searches were scrutinized and full manuscripts of all quotes considered relevant to the study were obtained. All the articles whose abstracts were not available were excluded.Results: Dexamethasone use has evolved over the years to include fertility treatment in both males and females in addition to its use in pregnancy to prevent respiratory distress syndrome in neonates despite its side effects due to the fact that its benefits outweigh the risks. Conclusions: Dexamethasone use has evolved over the years to include fertility treatment in addition to use in the prevention of respiratory distress syndrome. Low doses have no major adverse effects; however, repeated doses and long-term therapy are associated with more serious sequelae. It is recommended that dexamethasone therapy be incorporated into maternal and neonatal health care services

Do omnivorous shrimp influence mayfly nymph life history traits in a tropical island stream?

Interspecific interactions can play an important role in determining habitat selection and resource use between competing species. We examined interactions between an omnivorous shrimp and a grazing mayfly, two co-dominant taxa found in Puerto Rican headwater streams, to assess how predator presence may influence mayfly resource use and instantaneous growth in a tropical rainforest ecosystem. We conducted a series of behavioral and growth experiments to determine the effects of the freshwater shrimp, Xiphocaris elongata, on the growth rate and resource selection of mayfly nymphs in the family Leptophlebiidae. For resource choice assessments, we conducted a series of five day laboratory experiments where mayflies were given access to two resource substrate choices (cobble vs. leaves) in the presence or absence of shrimp. To assess for the effects of shrimp on mayfly fitness, we measured mayfly growth in laboratory aquaria after five days using four treatments (cobble, leaves, cobble + leaves, no resource) in the presence or absence of shrimp. In resource choice experiments, mayflies showed preference for cobble over leaf substrata (p<0.05) regardless of the presence of shrimps, however, the preference for cobble was significantly greater when shrimp were present in the leaf habitat. In growth experiments, there were no statistical differences in mayfly growth in the presence or absence of shrimp (p=0.07). However, we measured increased mayfly nymph growth in the absence of predators and when both cobble and leaves were available. Our results suggest that interspecific interactions between these taxa could potentially influence organic matter resource dynamics (e.g., leaf litter processing and export) in Puerto Rican streams. Rev. Biol. Trop. 62 (Suppl. 2): 41-51. Epub 2014 April 01.

Las relaciones interespecíficas pueden jugar un papel importante en la determinación del uso de recursos y selección de hábitat entre especies que compiten. Hemos examinado las interacciones entre un camarón omnívoro y un efemeróptero que se alimenta de vegetación , dos taxones codominantes en las partes altas de arroyos de Puerto Rico, para evaluar el efecto de los depredadores en el uso de recursos del efemeróptero y el crecimiento instantáneo en un ecosistema de selva tropical. Examinamos experimentalmente el efecto del camarón Xiphocaris elongata sobre la tasa de crecimiento y selección de recursos en ninfas efemerópteras (Leptophlebiidae). Hicimos experimentos de laboratorio de 5 días, dando a los efemerópteros acceso a dos opciones de sustrato (piedrecillas u hojas) en presencia o ausencia del camarón. Para evaluar los efectos sobre el crecimiento probamos cuatro tratamientos (piedrecillas, hojas , piedrecillas + hojas, sin ambas), en presencia o ausencia del camarón. Los efemerópteros prefirieron las piedrecillas a las hojas ( p < 0,05 ) independientemente de la presencia de los camarones. Esta preferencia fue mayor cuando junto a las hojas había camarones. Los camarones no afectaron el crecimiento de los efemerópteros (p = 0,07). Las ninfas efemerópteras crecieron mejor sin camarones y en acuarios con piedrecillas y hojas. Nuestros resultados sugieren que las interacciones interespecíficas entre estos animales podrían influir en la dinámica de la materia orgánica (por ejemplo, procesamiento de la hojarasca y su exportación) en los arroyos puertoriqueños.

The foliar trichomes of Hypoestes aristata (Vahl) Sol. ex Roem. & Schult var aristata (Acanthaceae) a widespread medicinal plant species in tropical sub-Saharan Africa: with comments on its possible phylogenetic significance

The micromorphology of foliar trichomes of Hypoestes aristata var. aristata was studied using stereo, light and scanning microscopy (SEM). This genus belongs to the advanced angiosperm family Acanthaceae, for which few micromorphological leaf studies exist. Results revealed both glandular and non-glandular trichomes, the latter being more abundant on leaf veins, particularly on the abaxial surface of very young leaves. With leaf maturity, the density of non-glandular trichomes decreased. Glandular trichomes were rare and of two types: long-stalked capitate and globose-like peltate trichomes. Capitate trichomes were observed only on the abaxial leaf surface, while peltate trichomes were distributed on both adaxial and abaxial leaf surfaces.

Sacroilitis in male systemic lupus erythematosus

Cincuenta porciento de nuestros pacientes varones con lupus sistémico eritematoso y enfermedad mixta del tejido conectivo presentaron evidencia radiológica de sacroileitis. Esto fue más común en miembros de la raza caucásica donde notamos una relación entre envolvimiento bilateral articular y necrosis osea aséptica en otros lugares. Aunque la predisposición genética es muy probable por uno de dos mecanismos; 1) antígenos comunes en el sistema de histocompatibilidad, 2) desequilibrio en enlaus cercanos; la necrosis aséptica osea de estas articulaciones es otra posibilidad