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Dual Role of Clinician Managers in Healthcare - Challenges and Opportunities

Published on: 26th December, 2023

Background: Clinician managers can play a crucial role in healthcare organizations, including hospitals, by combining their clinical expertise with managerial responsibilities. They bring valuable insights and firsthand experience of patient care to managerial positions, contributing to improved patient outcomes and hospital performance. However, they face unique challenges that require careful attention and solutions. Aim: This review aims to critically discuss the role of clinicians as managers, the challenges that they face, and how they exercise their influence in hospital settings. Key findings: The role of clinicians as managers is critical for effective leadership and delivery of high-quality patient care. Described as a two-way window, clinician managers bridge the gap between medicine and management by combining clinical expertise with managerial skills in a hybrid leadership approach. Studies have shown a positive impact on hospital performance, including enhanced quality care, improved patient outcomes, and potentially better financial performance. In addition, they play a vital role in fostering interdisciplinary collaboration and boosting staff engagement. However, challenges such as identity conflicts, and limited formal training, are present, especially for first-time managers. Conclusion: Adapting to the dual role of clinician and manager demands a mindset shift and the development of new skills, necessitating strategic support. This includes leadership education, organizational support, mentoring, and collaborative models to empower clinician managers. Targeted training programs, formal mentoring, and peer support networks equip them with essential skills, while workload management, well-being initiatives, and a culture of balance foster success and growth.
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An Individual Rehabilitation and/or Habilitation Program for Children with Disabilities (IPRH)

Published on: 23rd January, 2024

Introduction: The individual program of rehabilitation and (or) habilitation of children with disabilities (IPRH) is mandatory for execution by the relevant state authorities, local self-government bodies, as well as organizations regardless of organizational-legal forms and forms of ownership.Objective: To conduct a pilot analysis of the implementation of the IPRH contingent of patients of children with disabilities in an urban children’s clinic.Patients and methods: There were 366 reports on the implementation of measures provided for by an IPRH for a disabled person (disabled child) of 222 disabled. The organization of the study was in the nature of a continuous sample. The criterion for the inclusion of patients in it was the passage of an IPRH in a disabled child within a specified time frame. The following techniques were used: grouping, absolute and relative values, average values, detailing, and generalization. The threshold error probability for statistically significant differences was set at a level of 0.05.Results: The structure of the results of the control of the performance of IPRH in 222 disabled children according to the classes of diseases that caused the onset of disability (ICD) was as follows 1) G00-G99 - 35.47 ± 3.13%; 2) Q00-Q99 - 23.50 ± 2.77%; 3) 11.11 ± 2.05%; 4) C00-D48 - 10.25 ± 1.98%; 5) H60-H95 - 7.26 ± 1.67%; 6) M00-M99 - 2.99 ± 1.11%; 7-8) H00-H59 and P00-P96 - 2.14 ± 0.95%; 9-10) K00-K93 and S00-T98 - 1.29 ± 0.74% each; 11-12) I00-I99 and N00-N99 - 0.85 ± 0.60% each; 13-14) J00-J99 and L00-L99 - 0.43 ± 0.42% each.Conclusion: 1. In the structure of IPRH in 222 disabled children, according to the classes of diseases that caused disability (ICD), the following prevailed: 1) VI Diseases of the nervous system G00-G99 – 35.47%; 2) XVII Congenital anomalies, chromosomal disorders Q00-Q99 - 23.50%; 3) IV Diseases of the endocrine system, nutritional disorders, and metabolic disorders E00-E90 – 11.11%; 4) II Neoplasms C00-D48 - 10.25%; 5) VIII Diseases of the ear and mastoid process H60-H95 - 7.26%; 6) XIII Diseases of the musculoskeletal system and connective tissue M00-M99 - 2.99%; 7-8) VIII Diseases of the ear and mastoid process H60-H95 and VII Diseases of the eye and its adnexa H00-H59 - 2.14% each.2. The effectiveness of medical rehabilitation of disabled children was as follows: 1) Improvement - 23.26%; 2) Stabilization - 74.88%; 3) Deterioration - 1.86%. Dynamic observation was carried out on 94.26% of disabled children, drug therapy - 77.32%, non-drug therapy - 66.93%, and other types of medical rehabilitation were received by 14.48% of patients. Reconstructive operations were performed on 11.26% of disabled children.3. Prosthetics and orthotics were performed on 38.74% of disabled children. 32.43% of disabled children in need received sanatorium treatment, and 30.18% are currently in line to receive a voucher. For various reasons, 24.32% refused this type of rehabilitation; 3.60% of patients had contraindications at the time the voucher was provided.4. The obtained research results become the initial everyday statistical tool for objectifying the process of rehabilitation of patients and determining the strength and means of a medical institution to monitor and successfully implement an individual rehabilitation/habilitation program for a disabled person.
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Superior Gluteal Artery Pseudoaneurysm following a Periacetabular Osteotomy

Published on: 1st March, 2024

Periacetabular Osteotomy (PAO) is the gold standard for the treatment of hip dysplasia or acetabular retroversion. Due to the proximity of intra-pelvic arteries, there is a risk of iatrogenic vascular injuries, which can present with a delay and should be part of the differential diagnosis of significant pain following a PAO. We present the case of a never-described vascular injury following a periacetabular osteotomy in a 25-year-old woman who presented with gluteal pain 3 weeks after surgery. A delayed diagnosis of a pseudoaneurysm of the superior gluteal artery was made and successfully treated by embolization. The lesion is most probably related to the tip of a screw or to the drilling process.
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Effect of Lower Extremity Training in Diabetic Peripheral Neuropathy

Published on: 12th February, 2024

Background: Diabetic peripheral neuropathy is a symmetrical length-dependent sensorimotor polyneuropathy due to chronic hyperglycemia. The World Health Organization (WHO) identified diabetes as a major global health concern. Diabetic neuropathy is characterized by motor dysfunctions (weakness and atrophy) especially at the distal muscles of lower limbs, and impaired dynamic muscular control in type 2 diabetes patients. Symptoms start in a distal-to proximal pattern in the feet, and ankle and proximally in the hip and knee for both flexors and extensors. Proximal muscle weakness affects postural stability. Dorsiflexor weakness causes increased hip, knee flexion and metatarsophalangeal extension in the initial swing whereas weakness in plantar flexors causes a greater amount of hip and knee flexion during the stance phase.Methodology: 34 subjects with Diabetic Peripheral Neuropathy who fulfilled all the inclusion criteria were recruited for the study. Ethical standards have been maintained and informed consent was taken. Subjects were randomly assigned by lottery method into two groups, intervention, and control with 17 in each. Since it is a single blinded study subjects were blinded about the interventions provided. Pre and post-test scores were taken before and after 4 weeks using Surface Electromyography (sEMG), Kinovea Software, Functional Gait Assessment (FGA) and Short Form -36 (SF-36).Results: The pre and post-score values of the kinematics of gait, Functional Gait Assessment, and Short Form - 36 were analyzed using a Paired t-test and Wilcoxon Signed Rank test within the group analysis, Mann- Whitney U test and Independent t-test for between the group analysis. Both groups displayed notable variations, whereas the intervention group exhibited more significant differences (p < 0.05). Thus, it can be inferred that lower extremity training significantly improves gait kinematics and quality of life in diabetic neuropathy.Conclusion: Lower extremity training is effective in improving the kinematics of gait and quality of life in diabetic neuropathy.
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A Strength-based Approach to Achieving Academic Success for Individuals with Autism Spectrum Disorder (ASD)

Published on: 14th February, 2024

Qualitative research enabled us to explore the personal perceptions and institutional factors that facilitated academic success, as well as challenges, of a sample of 40 academically talented students with autism spectrum disorder (2e/ASD) who were enrolled in highly competitive colleges and universities in the United States. We explored their high school academic and social experiences, their college transition, parental views of their talents and disabilities, as well as college service providers’ opinions about their academic progress and needs. We identified some specific strength-based teaching and instructional strategies and academic experiences that students reported as contributing to their academic success during high school including challenging and advanced classes, use of strengths-based learning strategies (like independent study, and positive relationships with teachers and counselors. We also found that the level of disability support offered by the college was an important consideration for the academic success of this population, as was an understanding of the laws and regulations that apply and don’t apply when students with disabilities attend college. 
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Pets and Pediatrics, Friend and Foe: Companionship Masking Illnesses

Published on: 8th March, 2024

Animals are companions that have continued to hold importance in the average American household. Traditional animals like dogs and cats are often treated as family members due to the human-animal bond. Although it seems as if there are many benefits to having animals in the home, it comes at a price—pet-borne illnesses. Compared to adults, the pediatric population is at a greater risk for these types of illnesses. Animals are natural reservoirs for many bacteria that may be passed to children, especially those who are immunocompromised. The goal of this article is to educate parents on the risks and symptoms of common pet-borne illnesses that are difficult to prevent from coming into the home.
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Exploring the Prognostic Efficacy of Machine Learning Models in Predicting Adenocarcinoma of the Esophagogastric Junction

Published on: 7th March, 2024

Objective: To investigate the value of machine learning and traditional Cox regression models in predicting postoperative survivorship in patients with adenocarcinoma of the esophagogastric junction (AEG).Methods: This study analyzed clinicopathological data from 203 patients. The Cox proportional risk model and four machine learning models were constructed and internally validated. ROC curves, calibration curves, and clinical decision curves (DCA) were generated. Model performance was assessed using the area under the curve (AUC), while calibration curves determined the fit and clinical significance of the model.Results: The AUC values of the 3-year survival in the validation set for the Cox regression model, extreme gradient boosting, random forest, support vector machine, and multilayer perceptron were 0.870, 0.901, 0.791, 0.832, and 0.725, respectively. The AUC values of 5-year survival in the validation set for each model were 0.915, 0.916, 0.758, 0.905, and 0.737, respectively. The internal validation AUC values for the four machine learning models, extreme gradient boosting, random forest, support vector machine, and multilayer perceptron, were 0.818, 0.772, 0.804, and 0.745, respectively.Conclusion: Compared with Cox regression models, machine learning models do not need to satisfy the assumption of equal proportionality or linear regression models, can include more influencing variables, and have good prediction performance for 3-year and 5-year survival rates of AEG patients, among which, XGBoost models are the most stable and have significantly better prediction performance than other machine learning methods and are practical and reliable.
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Auxin-like and Cytokinin-like Effects of New Synthetic Pyrimidine Derivatives on the Growth and Photosynthesis of Wheat

Published on: 19th March, 2024

The regulatory effect of new synthetic thienopyrimidine derivatives on the growth and photosynthesis of wheat (Triticum aestivum L.) variety Svitlana in the vegetative phase was studied. The regulatory effect of new synthetic thienopyrimidine derivatives was compared with the regulatory effect of auxin IAA (1H-indol-3-yl)acetic acid) or synthetic plant growth regulators Methyur (sodium salt of 6-methyl-2-mercapto-4-hydroxypyrimidine) and Kamethur (potassium salt of 6-methyl-2-mercapto-4-hydroxypyrimidine). After 2 weeks, morphometric parameters (such as average length of shoots and roots (mm), average biomass of 10 plants (g)) and biochemical parameters (such as content of photosynthetic pigments (µg/ml)) of wheat plants grown from seeds treated with synthetic thienopyrimidine derivatives, or auxin IAA, or synthetic plant growth regulators Methyur and Kamethur at a concentration of 10-6M, were measured and compared with similar parameters of control wheat plants grown from seeds treated with distilled water. The regulatory effect of new synthetic thienopyrimidine derivatives on the morphometric and biochemical parameters of wheat plants was similar or higher compared to the regulatory effect of auxin IAA, or synthetic plant growth regulators Methyur and Kamethur. The relationship between the chemical structure of new synthetic thienopyrimidine derivatives and their regulatory effect on the growth and photosynthesis of wheat plants was revealed. The most biologically active thienopyrimidine derivatives are proposed to be used as new synthetic physiological analogues of auxins and cytokinins to improve growth and increase photosynthesis of wheat (Triticum aestivum L.)variety Svitlana in the vegetative phase.
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Endoscopic Endonasal total Removal of a Suprasellar, Preinfundibular Retro Chiasmatic Craniopharyngioma: A Surgical Case Report

Published on: 26th March, 2024

Craniopharyngiomas are benign tumors (WHO Grade I), seen in children and adults. Because of their location, they can require challenging clinical and surgical management. In fact, often, because of the presence of calcifications, of a capsule very strongly adherent to neurovascular structures, of the relationship with hypophysis, pituitary stalk, chiasm, carotids, the circle of Willis, basilar artery, and third ventricle, risk of mortality and morbidity is still mandatory. Various surgical techniques have been proposed: transcranial, transsphenoidal, and supraorbital approaches for surgical resection and treatment of craniopharyngiomas. Still, there is no common consent, but often the endonasal transsphenoidal extended procedures are considered the gold standard in many cases. We present a surgical technique of a case of complete surgical removal of an infundibular and retro chiasmatic craniopharyngioma, via an endoscopic endonasal transphenoidal transplanum approach.
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A Complex Case with a Completely Percutaneous Solution: Treatment of a Severe Calcific Left Main in a Patient with Low-Flow Low-Gradient Aortic Stenosis

Published on: 2nd April, 2024

Background: This case study explores an integrated approach to managing a complex cardiac condition, presenting a comprehensive single-session intervention. This includes balloon valvuloplasty using a Nucleus 18 mm balloon, complex angioplasty with rotational atherectomy (rotablator) targeting calcified lesions in the left main and left anterior descending artery, and Transcatheter Aortic Valve Implantation (TAVI) with a 23 mm Sapien 3 valve, all performed on an 81-year-old woman. Furthermore, this report underscores the strategic left atrial appendage closure conducted three months post-procedure due to the patient’s elevated hemorrhagic risk.Case presentation: Facing critical coronary and valvular pathologies, the patient underwent a meticulously planned, single-session intervention. The process began with a balloon valvuloplasty using a Nucleus 18 mm balloon to address the aortic stenosis. This was followed by a high-risk angioplasty, during which the Impella CP device provided hemodynamic support and rotational atherectomy was employed to address the calcified coronary artery disease effectively. The same session saw the successful execution of TAVI using a 23 mm Sapien 3 valve. The comprehensive approach notably diminished procedural complications, illustrating the benefits of an integrated treatment pathway in managing high-risk patients. Three months later, the patient underwent a left atrial appendage closure, a critical move considering her high risk of hemorrhage. This procedure also provided an opportunity to assess the favorable outcomes of the previous angioplasty.Conclusion: This case validates the feasibility and efficacy of performing multiple advanced percutaneous interventions in a single session for high-risk cardiac patients. It underscores the crucial role of innovative and personalized treatment strategies in improving patient outcomes, particularly in complex clinical scenarios. Moreover, the case exemplifies the essential relationship between immediate, comprehensive intervention and subsequent follow-up procedures in ensuring optimal long-term patient care.
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Causal Mediation Analysis for Childhood Cancer Survival Disparity in Texas, 2005 to 2014

Published on: 29th March, 2024

This study aimed to examine the disparities of childhood cancer survival among different racial and ethnic groups in Texas. The analysis was mediated by socioeconomic status (SES) and spatial accessibility to Children Oncology Group (COG) hospitals. The relationship between race-ethnicity and overall survival was measured using the Cox proportional hazards model with a robust variance estimator. The counterfactual model measures the total effect of race-ethnicity on survival through all mediating pathways while adjusting for baseline confounders (age, sex, and stage at diagnosis), which are then decomposed into natural direct and indirect effects. Considering all cancer site groups, African Americans showed a statistically significant higher hazard ratio in death (HR = 3.63; 95% CI = 1.87 - 6.62) compared with non-Hispanic White children. At the same time, the mortality hazard ratio among Hispanic children is not significant (HR = 1.23; 95% CI = 0.80 - 1.93) when compared with non-Hispanic White children. Analysis results also suggested that both mediators significantly contribute to racial-ethnic survival disparities for specific cancer site groups such as Leukemia for African American children. This study builds knowledge and understanding about underlying factors (mediators) responsible for the disparities in the outcomes among childhood cancer patients.
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Approaching Mental Health Through a Preventive Data Analysis Platform

Published on: 3rd April, 2024

The rising prevalence of chronic diseases and the aging population globally are diminishing the overall quality of life, especially for those with demanding daily routines. As medical advancements extend lifespans, the proportion of individuals over 60 is set to double by 2050, necessitating societal shifts toward health-responsible citizenship. Despite longer lifespans, evidence suggests that older age often accompanies mental health challenges such as anxiety, depression, and substance misuse. Social isolation and loneliness further compound these issues, affecting both physical and mental well-being. Digital wellness empowers individuals to take charge of their health, promoting proactive care and literacy to foster health-conscious citizenship. This paper explores the intersection of mental health, aging populations, preventive wellness initiatives, and health literacy, emphasizing their significance within the Health 5.0 framework, especially for older adults. Traditionally, health regulators offer static workflows for adopting standard procedures in health and well-being, reflecting a reactive approach. However, the evolving landscape of wearable and mobile devices connecting to healthcare IT systems through secure online networks necessitates a shift. Technology now facilitates remote patient monitoring and telemedicine service subscriptions and empowers individuals to manage their health proactively.The BE4YOU project, conducted in Portugal, serves as a case study, facilitating individual maintenance of health and well-being through intelligent and dynamic workflows, which are defined based on analytical models considering each person’s risk profile. By facilitating data sharing, promoting healthy lifestyles, and enabling early detection of mental health issues, the project leverages technology to support personalized monitoring and enhance overall health outcomes. Through technology-driven empowerment, individuals and healthcare professionals are better equipped to assess risks and ensure ongoing wellness monitoring, underscoring the role of technology in fostering personal health and supporting healthcare effectiveness.
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Statistical Mathematical Analysis of COVID-19 at World Level

Published on: 5th April, 2024

Worldwide, statistical data of people infected by COVID-19 has been taken until March 29, 2023, which, when correlated, showed a predictive logistic  model. The purpose was to determine the predictive model, which was acceptable, in such a way that the proportionality constant and the correlation and determination coefficients are of great importance to estimating epidemiological and pandemic data; coinciding with what was reported by other authors. Bearing in mind that a mathematical model is a mathematical description through a function or equation of a phenomenon in the real world; whose purpose is to understand infections and make predictions for the future. The stages were: to model the number of people infected as a function of time, formulate, and choose the logistic model, determine the model and obtain mathematical conclusions, and make predictions (estimates) about the number of people infected by COVID-19 worldwide. The logistic model was derived to predict the speed of people infected by COVID-19 and the critical time (tc = 733 days) for which the speed was maximum (1694,7209 infected/day). The Pearson correlation coefficient for the time elapsed (t) and the number of people infected (N) worldwide, based on 32 cases, was r = -0.88; the relationship between time and those infected is real, there is a “very strong correlation” between the time elapsed (t) and the number of people infected (N) and 77.03% of the variance in N is explained by t. 
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Designing a Community Health Worker (CHW) Certificate Training that Centers Marginalized Youth’s Health and Wellness

Published on: 23rd April, 2024

The genesis of the youth Community Health Worker (CHW) and Citizen/Community Science (CS) training is rooted in interdisciplinary research and the lived experiences of families in Chicago and Urbana-Champaign. Dr. Mendenhall and colleagues’ (Drs. Robinson, Roberts and Rodriquez-Zas) South Chicago’s Black Mothers’ Resiliency Project provide dinsights into Black women’s experiences with genomics, trauma, and community science. Black women’s testimonies highlighted the health impacts of living in neighborhoods with high levels of gun violence and the resilience strategies they employ. This led to the development of a youth-centered CHW and CS training program, aimed at addressing health disparities. The program trained high school students and young adults (up to age 24) as CHWs and CSs, focusing on the objectives of (1) embedding culturally competent health workers in marginalized communities; (2) amplifying community voices; (3) collecting, analyzing, and quantifying observational data to inform policy decision-making; (4) amplifying community voices in healthcare discussions and (5) creating community health care worker training certification for youth. Over three years, the program trained over 50 participants, incorporating elements of wellness, art, and entrepreneurship.Based on ethnographic notes participants reported increases in wellness such as reduced anxiety and increased empowerment. The program’s long-term goals include creating employment opportunities for graduates and contributing to improved community health outcomes. This initiative represents a step towards addressing racial trauma and promoting community healing through youth-led innovation and empowerment.
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Advancing Oral Health and Craniofacial Science through Microchip Implants

Published on: 25th April, 2024

Microchip implants have emerged as transformative tools in the realm of oral health and craniofacial science, offering novel solutions to longstanding challenges. This paper aims to explore the diverse applications of microchip technology in dentistry and craniofacial medicine, envisioning a future where these implants play a pivotal role in diagnostics, treatment modalities, and ongoing patient care. The integration of microchips enables real-time monitoring of oral conditions, facilitating early detection of dental issues and providing personalized treatment strategies. Additionally, these implants open avenues for smart prosthetics and orthodontic devices, optimizing patient comfort and treatment outcomes. However, ethical considerations, patient perceptions, and the societal impact of such technology should also be addressed. By examining the multifaceted implications and applications of microchip implants in oral health and craniofacial science, this research overview seeks to contribute valuable insights to the intersection of technology and healthcare in the dental domain.
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Relationship between Particle Size, Anti-Microbial Activity and Leachability of Copper Particles in Liquid Suspension and Compounded in Polypropylene

Published on: 29th May, 2024

Testing the antimicrobial efficiency of plastics with good precision and repeatability remains a challenge in the plastic industry, as commonly used standards can provide unreliable data. In this paper, we show that the “Bacterial Liquid Suspension Test” is a reliable method that allows for the measurement of antimicrobial activity of poor to very potent biocides. We used this technique to discriminate the performance of two Cu-based biocides, either in nanoparticle (NP) or macroparticle (MP) size, at three different loadings (0.02, 0.2 and 2 wt.%) in PP. With this technique, we also tested the antibacterial performance of PP as powders, pellets, and injection molded disks. As anticipated, the technique shows that both the increased loading and the smaller particle size showed higher antimicrobial activity than the larger particle size due to their increased surface area. Also, PP powders showed greater bacterial reduction than pellets and disks. While the PP with 2 wt.% Cu NPs showed the best antimicrobial performance, the detection of Cu at the surface (using SEM-EDX) and in the water leachate (using ICP-MS) were below the LODs, indicating their ability to kill bacteria.
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Effects of Physiotherapy Care in the Postoperative of Total Hip Arthroplasty: An Integrative Review

Published on: 11th June, 2024

Introduction: Total hip arthroplasty is a procedure widely performed in orthopedics, as it is capable of restoring function in the hips, severely affected by orthopedic diseases, such as osteoarthritis and consequently reducing pain and restoring function. Objective: To identify the effects of physical therapy in the postoperative period of total hip arthroplasty. Method: This is an integrative review, of an exploratory and descriptive nature, carried out between January and May 2024 and guided by the recommendations of the Joanna Brigs Institute. The Pubmed, LILACS, and SciELO databases were used. The following descriptors were used for the search procedure: “Physiotherapy and hip arthroplasty”. For the operationalization of the search, the Boolean descriptor “AND” was used to cross the descriptors. Articles were included in randomized clinical trials, published in full, without restriction of language and/or year of publication, which dealt with the theme addressed and that responded to the objective of the study. On the other hand, editorial letters, any type of literature review, articles unavailable at the time of search, abstracts and/or full articles published in annals of scientific events, preprints, and articles without abstracts were excluded. Results: After searches in the databases, 108 articles were identified on the platforms, subsequently, all had their titles and abstracts read, then 58 articles were excluded for not meeting the eligibility criteria, leaving 50 articles carefully read in full, after complete reading, only 7 articles composed the final sample. Final considerations: based on the reading and analysis of the articles that were previously selected, it was observed that there is no pre-established protocol among the authors for the postoperative period of hip arthroplasty, but that physical therapy techniques associated with therapist support and an early start are responsible for improving functionality, quality of life, pain reduction and increased muscle strength.
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An Interesting Case of COPD Exacerbation Presenting with Mixed Features of Intracranial Hypertension and Hypercapnic Encephalopathy

Published on: 2nd July, 2024

Background: Idiopathic intracranial hypertension (IIH or pseudotumor cerebri) has two major morbidities: papilledema with visual loss and disabling headache. Intracranial Venous Hypertension (IVH) is a fundamental mechanism of IIH. Although traditionally considered limiting to the central nervous system, evidence suggests IIH as a systemic disease associated with cardiorespiratory disorders, which has been far less comprehended. Case Report: A 60-year-old female with Chronic Obstructive Pulmonary Disease (COPD) was admitted for dyspnea and developed a coma with a pH of 7.01 and pCO2 of 158 mmHg. She was intubated and had persistent nuchal rigidity, a brief myoclonus episode with a negative electroencephalogram, and negative CT head studies. A Lumbar Puncture (LP) revealed elevated opening pressure (35 cmH2O) with normal Cerebral Spinal Fluid (CSF) studies. Her nuchal rigidity improved after the removal of 40 mL CSF. The ophthalmology examination the next day after her the large volume LP didn’t show visual loss or papilledema. The patient improved clinically and was extubated two days later. Her echocardiogram showed a dilated right ventricle with pulmonary hypertension. The patient was discharged home.Discussion: IIH is different from hypercapnic encephalopathy and characterized by increased intracranial pressure with papilledema, vision loss, and debilitating headache. Hypercapnia-induced increased intracranial venous flow and pulmonary hypertension-caused elevated central venous pressure with consequent outflow resistance lead to IVH. In hypercapnic encephalopathy, the presentation is mostly cognitive changes. In this case, nuchal rigidity with a negative CT head scan triggered the investigation of IIH. Conclusion: A deep understanding of the relationship between COPD and IIH is vital. There is insufficient evidence to recommend routine eye examinations in COPD patients for papilledema and to conduct a pulmonary function test for a newly diagnosed IIH patient. However, we highly suggest a timely ophthalmology exam prior to performing an LP in COPD patients with suspecting IIH to avoid unnecessary procedures and meanwhile improve clinical outcomes.
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The Influence of Gravity on the Frequency of Processes in Various Geospheres of the Earth. Biogenic and Abiogenic Pathways of Formation of HC Accumulations

Published on: 9th July, 2024

Based on the results obtained in the study of the interaction of geological and biosphere processes, we found out that there is a close relationship between them. It was also found that the gravity of the bodies of the solar system on the Earth plays a significant role in the above relationship. The effect of gravity was demonstrated on the movement of lithosphere plates, on the processes in the atmosphere and hydrosphere, on related climatic cycles, and the biosphere processes, including "living" organisms' evolution and their mass extinctions. The periodicity of these processes due to gravity is shown. It is expressed in the alternation of short-term orogenic periods of the beginning of the processes with long-term geosynclinal periods of their development and completion. Both periods constitute the repetitive orogenic cycles. The relationship of the cycles with the evolution of photosynthesis, as well as with related Organic Matter (OM) accumulation in sediments after mass extinction of organisms, including OM transformation leading to the formation of Hydrocarbon (HC) accumulations, is shown. Biogenic processes accounting for the accumulation and transformation of organic matter in sediments constitute the biogenic pathway of the formation of hydrocarbon accumulations. It is shown that the influence of gravity extends to the processes in the inner geospheres, including the movement of magma in the asthenosphere under the lithosphere shell, to the movement of hydrogen gas coming from the Earth's core, combining with volatile compounds of elements present in magma, as well as to the rifting process. It is shown that rifting processes lead to the formation of gaseous HC accumulations and constitute a pathway called abiogenic. The obtained results shed light on the peculiarities of the formation of HC accumulations by biogenic and abiogenic pathways, allowing prediction of their chemical characteristics. This is essential when searching for oil and gas and planning exploration works.
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Causal Inference for Scoliosis and Strabismus: A 2-sample Mendelian Randomization Study

Published on: 24th July, 2024

Background: Some studies have shown an association between spinal curvature and strabismus, but the genetic association has not been clarified. Therefore, the present study is proposed to be a Mendelian randomization study aiming to investigate the genetic causal association between spinal curvature and strabismus.Purpose: Genetic causal associations between strabismus, convergent concomitant strabismus (Ccs), Divergent concomitant strabismus (Dcs), Other specified and unspecified strabismus (Osus), Other strabismus (Os) and spinal curvature were investigated by a bidirectionalMendelian randomization study to provide a basis for the prevention and treatment of spinal curvature.Methods: Significant and independent Single Nucleotide Polymorphisms (SNPs) in genome-wide association studies were selected as Instrumental Variables (IVs) for Mendelian Randomization (MR) analysis. Inverse Variance Weighted (IVW), MR-Egger regression, Weighted Median (WME), Simple Mode (SM), and weighted mode (WM) were used to analyze causal association; Heterogeneity and multiplicity tests were also performed and analyzed using the leave-one-out method to assess the stability of the results.Results: MR and reverse MR were utilized to assess the impact of scoliosis on strabismus, revealing that the 95% confidence intervals of all instrumental variables’ OR values spanned 1 and the p values were all above 0.05. These results indicate a lack of evidence supporting a causal relationship between scoliosis and strabismus. Conclusion: There is currently no conclusive evidence of a genetic causal relationship between scoliosis and strabismus, including their subtypes. Further laboratory studies are needed to confirm these findings, and future research with larger sample sizes is necessary to provide more robust support.
Cite this ArticleCrossMarkPublonsHarvard Library HOLLISGrowKudosResearchGateBase SearchOAI PMHAcademic MicrosoftScilitSemantic ScholarUniversite de ParisUW LibrariesSJSU King LibrarySJSU King LibraryNUS LibraryMcGillDET KGL BIBLiOTEKJCU DiscoveryUniversidad De LimaWorldCatVU on WorldCat

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