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Katherine McVeigh,1,3,* Kurt Spiteri Cornish,3 Aravind R Reddy,3 Georgios Vakros2,3,* 1Eye Clinic, Royal United Bath Hospital, Bath, UK; 2Birmingham Midland Eye Centre, Birmingham City Hospital, Birmingham, UK; 3Ophthalmology Department, Aberdeen Royal Infirmary, Aberdeen, United Kingdom *These authors have contributed equally Purpose: To report a case of retained Descemet’s membrane following penetrating keratoplasty in a patient suffering from Fuchs’ endothelial corneal dystrophy. The use of confocal microscopy, histopathological tissue analysis, and treatment options are discussed. Methods: Case report of an 85-year-old man with a past ophthalmic history of atrophic macular degeneration, underwent a penetrating keratoplasty for Fuchs’ endothelial corneal dystrophy. Postoperative review revealed a retained retrocorneal membrane within the anterior chamber. Further surgery was performed to excise the membrane, with a subjective and objective postoperative improvement in visual acuity and without subsequent complications of the corneal graft. Results: Histopathological assessment confirmed the clinical suspicion of a retained Descemet’s membrane, marrying with the initial histology from the corneal button excised during the penetrating keratoplasty, which showed only a very thin Descemet’s layer. Conclusion: Retention of the Descemet’s membrane following penetrating keratoplasty is a rare but potential complication of this surgery, particularly in cases of Fuchs’ endothelial corneal dystrophy due to the thickened and abnormal histological nature of the endothelium and high index of suspicion is required. Keywords: retained Descemet’s membrane, penetrating keratoplasty, Fuch’s endothelial corneal dystrophy, corneal graft

Katherine McVeigh, Georgios VakrosDepartment of Ophthalmology, Raigmore Hospital, Inverness, United KingdomBackground: Lyme disease is a spirochetal disease responsible for a multitude of ocular and systemic manifestations, and patients may present to ophthalmologists and general clinicians with a wide variety of generalized and ocular signs which can result in chronic and disabling sequelae. Here we report two cases of patients suffering with Lyme disease who developed a rare associated papillitis.Methods: A 48-year-old Scottish man presented with diminished visual acuity, painful ocular eye movements, photophobia, and mild ataxia. Fundus examination revealed bilateral disc swelling with associated hemorrhages in the right eye. Following exclusion of raised intracranial pressure as the cause of the findings, enzyme-linked immunosorbent assay and Western blot serology confirmed a positive result for Borrelia burgdorferi which, along with ophthalmic signs and exposure to an endemic area, confirmed the diagnosis of Lyme disease. A 79-year-old gentleman presented with intermittent short-duration “gray film” in his left eye. Fundus examination revealed left optic disc swelling. He was positive for Lyme’s serology and his condition was treated with 2 weeks of intravenous ceftriaxone.Results: The first patient’s inflammation resolved and visual acuity returned to normal following a course of high-dose steroids and intravenous ceftriaxone, followed by oral doxycycline. The second patient’s condition improved with high-dose intravenous ceftriaxone.Conclusion: These patients highlight the fact that Lyme disease should be considered as a differential diagnosis for patients presenting with papillitis. With the incidence of this disease rising and more cases being reported, practitioners in Lyme-endemic areas need to be aware of the various manifestations so that appropriate referrals for treatment can be made.Keywords: Lyme disease, ocular papillitis, Borrelia burgdorferi

The successful management of midface and craniofacial trauma requires a thorough understanding of the anatomy and functional demands of this complex region. To achieve optimal outcomes, it is necessary that these injuries are accurately diagnosed and managed in a multi-disciplinary environment at the appropriate time. This review article discusses an overview of these injuries and highlights some of the key principles of management. [ABSTRACT FROM AUTHOR]

This article proposes the Poetics of Mosaic Narrative as a tool for telling dramatically compelling interactive new media stories. In doing so it validates the crucial elements of cinematic storytelling in the digital medium, which due to its fragmentary, variable and re-combinatory nature, affords the opportunity for audience interaction. In particular it focuses on the theory and practice of the prominent new media theorist, Lev Manovich, as a means of investigating and creating a practical poetics. The key element of the Poetics of Mosaic Narrative is the expansion of the previously forgotten and undeveloped Russian formalist concept of cinematurgy. This concept, as originally proposed but not elaborated by Kazansky, encompasses the notion of the creation of cinematic new media narrative as a mosaic-integrally driven by the narrative systems of plot, as well as the cinematic systems of visual style created by the techniques of cinema-montage, cinematography and mise-en-scene. [ABSTRACT FROM AUTHOR]

The murine Na[sup +] /myo-inositol cotransporter (SLC5A3) gene (Slc5a3) was cloned, the restriction sites mapped, and the coding region sequenced. Similar to other mammalian counterparts, including human, the gene has a single coding exon, with an open reading frame of 2.2 kb. The predicted protein of 718 amino acids is also highly conserved, compared to other mammalian homologs. Using fluorescence in situ hybridization, Slc5a3 was localized to the telomeric region of mouse chromosome 16, which is syntenic to human chromosome 21q22. An increased Slc5a3 copy number may explain the increased levels of myo-inositol in the brains of trisomy 16 mice and the increased rate of transport of myo-inositol into cultured neurons derived from trisomy 16 mice. Copyright © 2000 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Katherine Anne McVeigh,1 Georgios Vakros21Department of Ophthalmology, Royal United Hospital, Combe Park, Bath, UK; 2Department of Ophthalmology, Queen’s Hospital, Romford, Essex, UKAim: In order to improve patient education, compliance, and administration of eye drops prescribed for patients suffering with glaucoma within a UK ophthalmology department, an eye drop chart (EDC) was designed, developed, and piloted with patients attending the glaucoma clinic over 1 month.Methods: A cross-sectional prospective pilot study of 25 patients using an administration aid and a self-reported questionnaire. Chi-square tests were used to compare responses pre- and postintervention.Results: Results demonstrated an impressive improvement in nine of eleven categories assessed regarding drop administration and compliance. Patients stating that they always wash their hands increased significantly from 64% (13 participants) to 92% (23 participants) (P=0.029), and those who always shake the bottle improved from 40% (10) to 84% (21) (P=0.001). Punctal occlusion techniques improved from 44% (11) to 72% (18) (P=0.015). Finally, patients who always discarded the bottle after 28 days of use rose from 68% to 92%, though the difference was not significant (P=0.09). Only the number of drops being administered to the eye and the length of time left between the application of drops remained relatively unchanged. Sixty-four percent reported finding EDC helpful or useful, 52% had positive responses when asked if they would continue using EDC, and 88% would recommend it to a friend.Conclusion: Although there are limitations to the data as they are subjective, descriptive, and limited to sample size of 25, the results of this pilot study have shown promise. The EDC appears to be a cost-effective way at improving patients’ use of topical ocular medications.Keywords: glaucoma, administration, compliance, aid, drop chart

People place value on emotion categories that inform which emotions to cultivate and which to regulate in life. Here, we examined how people's beliefs about emotion categories varied along three valence-related dimensions: evaluation (good, bad), hedonic feeling (pleasure, displeasure), and desirability (want to feel, do not want to feel). In Studies 1A and 1B, we found that evaluative (good/bad) and hedonic (pleasant/unpleasant) ratings were distinct for certain emotions including lust, anger, shame, fear, and guilt. In Study 2, we found that emotion valuation depended on cultural background in a sample of Asian Americans and Caucasian Americans. Overall, Asian American participants evaluated certain emotions (including, but not limited to, anger, sadness, guilt, and shame) more positively than Caucasian American participants, and this difference was more pronounced on the evaluative rating dimension. Finally, in Study 3, we examined how evaluative and hedonic dimensions further relate with the desire to experience certain emotions and the emotions that people believe they feel in everyday life. Our findings support a model in which evaluative and hedonic dimensions of emotion valuation predict desired emotional states, which in turn predicts beliefs about the reported frequency of emotions experienced in everyday life. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background/Objectives : The need for surgical reconstruction of scalp defects following the excision of cutaneous skin cancers is an increasingly common procedure. Particular challenges arise when considering options for reconstruction of large defects not amenable to local skin flap coverage. The use of skin grafts poses the risk of donor site morbidity. This paper investigates the emerging use of Integra ® , a synthetic acellular dermal regeneration template, as an alternative or adjunct to skin grafting in scalp reconstruction. Methods : The study presents a retrospective analysis of 101 patients who underwent Integra ® -based reconstruction of scalp defects. Demographics, procedure details, complications, need for further surgery, and time to healing were evaluated. Results : The overall success rate of the one-stage Integra ® -only procedure was 95%, with a minor complication rate of 30.7%. Anticoagulation medication was identified as an independent risk factor for post-operative infection, while previous head and neck radiotherapy and increased defect depth were associated with the requirement for a second-stage skin graft. Conclusions : These findings support the consideration of Integra ® as a safe and viable alternative for both partial and full thickness scalp defects in a select cohort of complex highly co-morbid patients, reducing complications and the need for additional procedures.

Is there a universal mapping of physiology to emotion, or do these mappings vary substantially by person or situation? Psychologists, philosophers, and neuroscientists have debated this question for decades. Most previous studies have focused on differentiating emotions on the basis of accompanying autonomic responses using analytical approaches that often assume within-category homogeneity. In the present study, we took an alternative approach to this question. We determined the extent to which the relationship between subjective experience and autonomic reactivity generalizes across, or depends upon, the individual and situation for instances of a single emotion category, specifically, fear. Electrodermal activity and cardiac activity-two autonomic measures that are often assumed to show robust relationships with instances of fear-were recorded while participants reported fear experience in response to dozens of fear-evoking videos related to three distinct situations: spiders, heights, and social encounters. We formally translated assumptions from diverse theoretical models into a common framework for model comparison analyses. Results exceedingly favored a model that assumed situation-dependency in the relationship between fear experience and autonomic reactivity, with subject variance also significant but constrained by situation. Models that assumed generalization across situations and/or individuals performed much worse by comparison. These results call into question the assumption of generalizability of autonomic-subjective mappings across instances of fear, as required in translational research from nonhuman animals to humans, and advance a situated approach to understanding the autonomic correlates of fear experience. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This study evaluated a practice redesign to improve access into a specialty practice. The secondary goal was to improve financial performance, while avoiding an increase in physician burnout. Historical demand was utilized to calculate capacity. Next, data-driven schedules were developed for this practice. We also transitioned schedules from five 8-hour to four 10-hour workdays. Access was improved for news (100% increase), consultations (16% increase), and procedures (70% increase). Gross revenue increased by 10.62% and physician burnout reduced by 25%. This project offers insights into improving the efficiency of a resource-constrained practice, while improving financial performance and reducing burnout., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background Prevention of unplanned hospital readmissions remains a priority in the US healthcare sector. Patient functional status has evolved as an important factor in identifying patients at risk for unplanned readmissions and poor predischarge functional performance has been shown to be predictive of increased readmission risk. Yet, patient functional status appears to be underutilized in readmission prediction models. Methods To examine the impact of inpatient functional status (mobility and activity performance) on unplanned 30-day hospital readmissions at two tertiary care hospitals, retrospective cohort analysis was performed on electronic health record data from adult inpatients (N = 26,298) having undergone completed functional assessments during their index hospitalization. Primary outcomes were functional assessment scores and unplanned all-cause patient readmission within 30 days following hospital discharge. Secondary analysis stratified the assessment by discharge destination. Functional assessment scores from the Activity Measure for Post-Acute Care (AM-PAC) "6-Clicks" Basic Mobility Short Form or Daily Activity Short Form were extracted along with patient demographics, admission diagnoses, comorbid conditions, and hospital readmission risk score.  Results Adjusting for age, sex, and comorbidity, lower AM-PAC "6-Clicks" Basic Mobility and Daily Activity scores resulted in higher readmission rates when each score was considered separately. When both scores were considered, only Daily Activity scores were significant.  Conclusion Patients with lower Basic Mobility and Daily Activity scores are at a higher risk for readmission. The relative importance of AM-PAC "6-Click" scores on short-term readmission depends on discharge destination. Timely identification of patient mobility and activity performance may lead to earlier intervention strategies to reduce readmissions., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Arnold et al.)