Effect of Ab interno XEN gel stent implantation on corneal astigmatism

by Pawasoot Supasai, Kanwasee Kanjana, Kannawee Boonchuenchom, Yosanan Yospaiboon

Purpose

To assess surgically induced astigmatism (SIA) after XEN gel stent implantation over 5 visits during a 3-month follow-up. Changes in intraocular pressure (IOP), IOP-lowering medications, and best-corrected visual acuity (BCVA) were also assessed.

Methods

This prospective cohort study recruited 24 eyes from 24 glaucoma patients at KKU Eye Center, Khon Kaen University, Thailand. All eyes underwent XEN implantation, using our specific surgical technique. We evaluated both the magnitude and the axis of SIA at 1, 2 weeks, 1, 2 and 3 months after the procedure. Preoperative and postoperative intraocular pressure (IOP), IOP-lowering medications, and best-corrected visual acuity (BCVA) were also analyzed.

Results

We observed a statistically significant centroid SIA of 0.14 D. at an axis of 105° and median SIA of 0.36 D. at 1 week following XEN (p  Conclusions

Ab Interno XEN gel stent implantation induces a small SIA immediately after the surgery, but no further significant change during 3-month follow-up period. Although SIA has no significant effect on visual acuity, this should be addressed with patients preoperatively. Further studies are needed to investigate how different surgical techniques may affect refractive changes after XEN.

Stay or go? Exploring physician turnover in European Hospitals–Evidence from the METEOR survey

by Laura Maniscalco, Marco Enea, Peter de Winter, Neeltje de Vries, Anke Boone, Olivia Lavreysen, Kamil Baranski, Walter Mazzucco, Adriano Filadelfio Cracò, Malgorzata Kowalska, Szymon Szemik, Lode Godderis, Domenica Matranga

According to the World Health Organization (WHO), in 2022 there was a shortfall of approximately 1.2 million doctors, impacting healthcare system and patient care. Understanding turnover intentions is crucial for managing the healthcare workforce and ensuring continuous, and high-quality patient care. This study investigates the prevalence of physicians planning to leave their hospital or the profession, and risk factors such as job demand, resources, satisfaction, and burnout across four European countries. A cross-sectional multicenter study was conducted in eight hospitals across Belgium, the Netherlands, Poland and Italy, including both academic and non-academic institutions. Data from Poland were excluded due to a low response rate, to preserve respondent anonymity. Multivariable logistic regression analyses were performed, adjusted for country, demographics, and work context, using significant variables from the univariable analysis. The overall intention to leave the hospital was 16.5%, with the highest rates in Belgium (19.6%) and Italy (19%), and the lowest in the Netherlands (9.8%). The intention to leave the profession was 9.1%, with the highest rate in the Netherlands (16.1%), followed by Belgium (6.3%) and Italy (5.7%). Physicians at higher risk of leaving the hospital were younger (adjOR = 0.90, 95%CI = 0.86–0.93), lacked colleague support (adjOR = 3.18, 95%CI = 1.06–9.36), and were dissatisfied with job prospects (adjOR = 2.38, 95%CI = 1.02–5.54) and overall work (adjOR = 2.71, 95%CI = 1.09–6.69). Those more likely to leave the profession were from the Netherlands (adjOR = 4.14, 95%CI = 1.62–11.4), surgeons (adjOR = 2.90, 95%CI = 1.22–6.78), working in non-academic hospitals (adjOR = 2.43, 95%CI = 1.01–5.97), lacked development opportunities (adjOR = 5.97, 95%CI = 1.01–36.2), or were dissatisfied with career prospects (adjOR = 2.77, 95%CI = 1.04–7.27). Health system managers and relevant stakeholders involved in the planning, implementation, or evaluation of health policies and reforms aimed at improving healthcare job retention should take into account the key determinants of the intention to leave identified in this study.

BCG cell wall skeleton augments the immunogenicity of dengue nanoparticle vaccines by promoting dendritic cell activation

by Jitra Limthongkul, Saradee Warit, Panya Sunintaboon, Sukathida Ubol, Tuksin Jearanaiwitayakul

Bacillus Calmette-Guérin cell wall skeleton (BCG-CWS) has been shown to enhance vaccine effectiveness and antitumor immunity. In our previous study, we reported that co-administration of BCG-CWS with the encapsidated dengue antigens, UV-inactivated DENV2 and DENV2 NS1, synergistically induced DENV-specific adaptive immune responses in mice. As dendritic cells (DCs) are key immune players that mediate innate and adaptive immunity, we, here, asked how well the response of DCs to this adjuvant aligns with the immune responses elicited in vivo. The responses of primary monocyte-derived DCs to BCG-CWS-adjuvanted encapsidated dengue immunogens compared with the unadjuvanted vaccine were investigated. DCs stimulated by BCG-CWS and the dengue nanoparticle vaccine exhibited a superior response. This response correlated well with the stronger immune response observed in mice. This was evidenced by the marked elevation in expression levels of DC activation markers, such as CD80, CD83, CD86, and HLA-DR, and various innate immune cytokines. Additionally, this adjuvant markedly elevated the expression levels of miRNAs related to DC function, such as miR-146a, miR-147, miR-223, and miR-155. These immune components could suppress DENV2 multiplication in bystander skin cells. BCG-CWS exerted an adjuvant effect on DC responses by enhancing antigen-processing activity and activating several innate immune cytokines and immune-related miRNAs.