Policy Versus Practice: Facilitators and Barriers of Chronic Care Integration in Dutch General Practice - a Survey Study.

Introduction: Multimorbidity challenges quality and sustainability of healthcare systems. Care groups were introduced in the Netherlands to promote integration of chronic primary care, but it remains unknown to which degree they facilitate this. This study therefore aims to determine whether Dutch general practices perceive themselves to be capable of delivering integrated chronic care and uncover the role of care groups.

Management of the supposed elbow dislocation in newborns.

Background: The newborn transphyseal fracture of the distal humerus is frequently misdiagnosed with an elbow dislocation due to the absence of the lateral condyle ossification node. No consensus has been reported either for the diagnosis or the management of these rare fractures. This study aimed to analyze a series of newborns with transphyseal distal humerus fractures.

Comparison of Refractive Outcomes After Phacoemulsification and Combined 25-Gauge Phacovitrectomy with Implantation of Plate-Haptic Toric Intraocular Lenses.

: To compare intraocular lens (IOL) position and refractive outcomes between eyes that underwent sole phacoemulsification with those that underwent combined 25-gauge phacovitrectomy with a plate-haptic toric IOL implantation. : This retrospective study included 60 eyes of 60 patients. Of these, 30 eyes underwent 25-gauge phacovitrectomy, while the other 30 eyes received phacoemulsification alone.

Dimensionality of instructional quality in physical education. Obtaining students' perceptions using bifactor exploratory structural equation modeling and multilevel confirmatory factor analysis.

Background: In research on instructional quality, the generic model of the three basic dimensions is an established framework, which postulates that the three dimensions of classroom management, student support and cognitive activation represent quality characteristics of instruction that can be generalized across subjects. However, there are hardly any studies that examine if the three basic dimensions model could represent a suitable approach to measure instructional quality in physical education. Based on an extended model of the basic dimensions, a measurement model of instructional quality for physical education is presented, which integrates different theoretical approaches from the fields of educational and psychological research as well as different subfields of sports science in order to test the factorial structure of the corresponding measurement model.

Longitudinal effects of basic psychological need support on the development of intrinsic motivation and perceived competence in physical education. A multilevel study.

Background: Grounded in self-determination theory, this article deals with a multidimensional measurement of the support of the basic psychological needs and the individual and combined effects on the development of intrinsic motivation and perceived competence in physical education. In addition to the supportive teacher behaviors of autonomy support, competence support and relatedness support, peer relatedness support is examined as an additional factor.

Methods: A total of 1,047 students from 72 classes from various German-speaking Swiss cantons took part in the study.

Descemet Membrane Endothelial Keratoplasty for Endothelial Failure in Primary Angle Closure Suspects.

Purpose: To analyze the feasibility and outcome of Descemet membrane endothelial keratoplasty (DMEK) for treatment of endothelial failure in primary angle closure suspect (PACS) eyes.

Methods: Retrospective, single-center case series of eyes treated by DMEK for endothelial failure caused by PACS. Main study parameters were success rate of DMEK, best-corrected visual acuity, anterior chamber depth, central corneal thickness, and endothelial cell density.

Dysregulation of the TCF4 Isoform in Corneal Endothelial Cells of Patients With Fuchs Endothelial Corneal Dystrophy.

Purpose: This study evaluated the dysregulation of TCF4 isoforms and differential exon usage (DEU) in corneal endothelial cells (CECs) of Fuchs endothelial corneal dystrophy (FECD) with or without trinucleotide repeat (TNR) expansion in the intron region of the TCF4 gene.

Methods: Three RNA-Seq datasets of CECs (our own and two other previously published datasets) derived from non-FECD control and FECD subjects were analyzed to identify TCF4 isoforms and DEU events dysregulated in FECD by comparing control subjects to those with FECD with TNR expansion and FECD without TNR expansion.

Results: Our RNA-Seq data demonstrated upregulation of three TCF4 isoforms and downregulation of two isoforms in FECD without TNR expansion compared to the controls.

[The dual competence profile: A support of collaboration between practice and science. A qualitative descriptive study].

The dual competence profile: A support of collaboration between practice and science. A qualitative descriptive study To ensure orientation towards needs existing in the realm of practice, the dual competence profile is mandatory at universities of applied sciences (UAS): in addition to academic qualifications, entrenchment in professional practice is demanded. However, it is unclear how needs, attitudes, and expectation of clinical practice regarding the interface between UAS and practice looks like.

Long-Term Outcomes of Keratoprosthesis With Biological Haptic: A Review of 25 Years of Single-Center Surgeries.

Purpose: To study the outcome of eyes that underwent surgery for keratoprosthesis with a biological haptic, osteo-odonto-keratoprosthesis (OOKP) or tibia keratoprosthesis, by a single surgeon over a time span of more than 25 years.

Methods: One hundred thirty eyes that had received a keratoprosthesis with a biological haptic between 1994 and 2022 by a single surgeon were included in this retrospective analysis. Main outcome parameters were postoperative best corrected visual acuity, postoperative refractive error, postoperative complications, anatomical and functional survival of the prosthesis as well as comparison of subgroups of the 2 different types (OOKP n = 78; tibia keratoprosthesis n = 52) of keratoprostheses, and subgroup analysis of different indications for surgery.

Differences in Guttae Ultramorphology in Relation to Visual Function in Fuchs Endothelial Corneal Dystrophy.

Purpose: The purpose of this study was to investigate the differences in guttae ultramorphology and their relation to visual function in eyes with Fuchs endothelial corneal dystrophy (FECD).

Methods: Thirty FECD eyes without ocular comorbidities were included. Visual functional parameters (best-corrected visual acuity with high-contrast and low-contrast letters and contrast sensitivity/LogCS) and corneal morphology measured with Scheimpflug tomography (Pentacam) were assessed.

Pattern electroretinogram, blue-yellow visual evoked potentials and the risk of developing visual field defects in glaucoma suspects: a longitudinal "survival" analysis with a very long follow-up.

Purpose: Estimating glaucoma suspects' risk for visual field defects helps to avoid under- and over-treatment. In this retrospective, longitudinal cohort study with a very long follow-up, we studied whether pattern electroretinograms (PERG) amplitudes and blue-on-yellow visual evoked potential (BY-VEP) latencies can predict visual field defects.

Methods: Participants of the Erlangen Glaucoma Study were examined with PERG and BY-VEP between 9/1991 and 8/2001.

Type II Diabetes Mellitus Causes Extracellular Matrix Alterations in the Posterior Cornea That Increase Graft Thickness and Rigidity.

Purpose: There is a pressing need to investigate the impact of type II diabetes mellitus on the posterior cornea in donor tissues given its increasing prevalence and potential impact on endothelial keratoplasty surgical outcomes.

Methods: Immortalized human cultured corneal endothelial cells (CECs; HCEC-B4G12) were grown in hyperglycemic media for 2 weeks. Extracellular matrix (ECM) adhesive glycoprotein expression and advanced glycation end products (AGEs) in cultured cells and corneoscleral donor tissues, as well as the elastic modulus for the Descemet membrane (DMs) and CECs of diabetic and nondiabetic donor corneas, were measured.

RNA-Seq-based transcriptome analysis of corneal endothelial cells derived from patients with Fuchs endothelial corneal dystrophy.

Fuchs endothelial corneal dystrophy (FECD) is the most common inherited corneal disease. Fibrillar focal excrescences called guttae and corneal edema due to corneal endothelial cell death result in progressive vision loss. Multiple genetic variants have been reported, but the pathogenesis of FECD is not fully understood.

Posterior Segment Involvement in Infantile Nephropathic Cystinosis - A Review.

Cystinosis is a rare lysosomal storage disease with a prevalence of 1 : 100 000 - 1 : 200 000 cases. It is caused by biallelic mutations in the CTNS gene, which encodes cystinosin, that transport cystine out of the lysosomes. Due to its dysfunction, cystine crystals accumulate in the lysosomes and ultimately cause apoptosis of the cell.

Characterisation of ectasia after penetrating keratoplasty in keratoconus eyes using anterior segment optical coherence tomography.

Background/aims: Ectasia of the cornea can occur decades after penetrating keratoplasty (PK), especially in keratoconus eyes. The purpose of this study was to characterise ectasia after PK by morphological findings in anterior segment optical coherence tomography (AS-OCT).

Methods: In this retrospective, single-centre case series, 50 eyes of 32 patients with a history of PK at an average of 25±10 years earlier were included.

Corneal Manifestation in Patients with Infantile Nephropathic Cystinosis.

Nephropathic cystinosis is a rare autosomal recessive disease caused by mutations in the CTNS gene. This causes dysfunction of cystinosin, a protein that transports cystine out of lysosomes, causing cystine crystals to accumulate in cells in most organ systems. While renal complications predominate in the early forms of cystinosis, corneal crystal accumulation will inevitably manifest in all patients.

Effects of DementiaNet's Community Care Network Approach on Admission Rates and Healthcare Costs: A Longitudinal Cohort Analysis.

Background: People with dementia are increasingly living at home, relying on primary care providers for most healthcare needs. Suboptimal collaboration and communication between providers could cause inefficiencies and worse patient outcomes. Innovative strategies are needed to address this growing disease burden and rising healthcare costs.

Risk factors for ocular hypotony after XEN Gel Stent implantation.

Purpose: To investigate the incidence of postoperative hypotony, and risk factors for the development of hypotony in eyes who had undergone XEN Gel Stent implantation.

Methods: In this retrospective, single-centre case series, medical records of 170 consecutive eyes who had undergone XEN Gel Stent implantation with or without simultaneous phacoemulsification for primary or secondary open angle glaucoma were analysed. Primary outcome parameters were the incidence of postoperative hypotony and potential risk factors for its development, and secondary parameters were pre- and postoperative visual acuity, intraocular pressure (IOP), and number of IOP-lowering eye drops.

Profiling of epigenetic marker regions in murine ILCs under homeostatic and inflammatory conditions.

Epigenetic modifications such as DNA methylation play an essential role in imprinting specific transcriptional patterns in cells. We performed genome-wide DNA methylation profiling of murine lymph node-derived ILCs, which led to the identification of differentially methylated regions (DMRs) and the definition of epigenetic marker regions in ILCs. Marker regions were located in genes with a described function for ILCs, such as Tbx21, Gata3, or Il23r, but also in genes that have not been related to ILC biology.

Acetyl-CoA-Carboxylase 1-mediated de novo fatty acid synthesis sustains Lgr5 intestinal stem cell function.

Basic processes of the fatty acid metabolism have an important impact on the function of intestinal epithelial cells (IEC). However, while the role of cellular fatty acid oxidation is well appreciated, it is not clear how de novo fatty acid synthesis (FAS) influences the biology of IECs. We report here that interfering with de novo FAS by deletion of the enzyme Acetyl-CoA-Carboxylase (ACC)1 in IECs results in the loss of epithelial crypt structures and a specific decline in Lgr5 intestinal epithelial stem cells (ISC).

Long COVID: Association of Functional Autoantibodies against G-Protein-Coupled Receptors with an Impaired Retinal Microcirculation.

Long COVID (LC) describes the clinical phenotype of symptoms after infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Diagnostic and therapeutic options are limited, as the pathomechanism of LC is elusive. As the number of acute SARS-CoV-2 infections was and is large, LC will be a challenge for the healthcare system.