Evaluation of Epithelial Integrity with Various Transepithelial Corneal Cross-Linking Protocols for Treatment of Keratoconus

Purpose. Corneal collagen cross-linking (CXL) has been demonstrated to stiffen cornea and halt progression of ectasia. The original protocol requires debridement of central corneal epithelium to facilitate diffusion of a riboflavin solution to stroma. Recently, transepithelial CXL has been proposed to reduce risk of complications associated with epithelial removal. Aim of the study is to evaluate the impact of various transepithelial riboflavin delivery protocols on corneal epithelium in regard to pain and epithelial integrity in the early postoperative period. Methods. One hundred and sixty six eyes of 104 subjects affected by progressive keratoconus underwent transepithelial CXL using 6 different riboflavin application protocols. Postoperatively, epithelial integrity was evaluated at slit lamp and patients were queried regarding their ocular pain level. Results. One eye had a corneal infection associated with an epithelial defect. No other adverse event including endothelial decompensation or endothelial damage was observed, except for epithelial damages. Incidence of epithelial defects varied from 0 to 63%. Incidence of reported pain varied from 0 to 83%. Conclusion. Different transepithelial cross-linking protocols have varying impacts on epithelial integrity. At present, it seems impossible to have sufficient riboflavin penetration without any epithelial disruption. A compromise between efficacy and epithelial integrity has to be found

"They have stories to tell”: a symphony exploring BIPOC belongingness, joy, and struggle through improvement science and culturally relevant practices in the community college

Community colleges have a long-standing history of providing higher education to countless individuals who might not otherwise have been offered access. Research demonstrates that faculty members wield an abundance of power in fostering sense of belonging within their classrooms (Byrd, 2016; Carales et al., 2019; Danowitz, 2011; Eagen & Jaeger, 2008; Fong et al., 2021; Hlinka, 2017; Hoffman et al., 2002; Kezar & Maxey, 2012; Ladson-Billings, 2011; Strayhorn, 2019; Wood & Turner, 2010). As such, a focus on the classroom for improving sense of belonging remains compelling. The lack of a culturally relevant campus climate in the community college setting results in students of color continuing to enroll in large numbers while remaining underrepresented in the composition of college faculty and curricula. Such underrepresentation presents a barrier to fostering sense of belonging among students of color while attending college. Lower rates of sense of belonging place students of color at higher risk to not form meaningful relationships on campus or earn a college credential, leading to fewer job prospects, lower wage-earning potential, and less access to quality healthcare and retirement benefits, all of which perpetuate inequity and marginalization. By utilizing an improvement science and phenomenological approach, this disquisition leverages an equity-driven framework for implementing culturally relevant practices within the classroom to explore improving sense of belonging for students of color enrolled at the community college level

The role of river morphodynamic disturbance and groundwater hydrology as driving factors of riparian landscape patterns in mediterranean rivers

Original ResearchFluvial disturbances, especially floods and droughts, are the main drivers of the successional patterns of riparian vegetation. Those disturbances control the riparian landscape dynamics through the direct interaction between flow and vegetation. The main aim of this work is to investigate the specific paths by which fluvial disturbances, distributed by its components of groundwater hydrology (grndh) and morphodynamic disturbance (mrphd), drive riparian landscape patterns as characterized by the location (position in the river corridor) and shape (physical form of the patch) of vegetation patches in Mediterranean rivers. Specifically, this work assesses how the different components of fluvial disturbances affect these features in general and particularly in each succession phase of riparian vegetation. grndh and mrphd were defined by time and intensity weighted indexes calculated, respectively, from the mean annual water table elevations and the annual maximum instantaneous discharge shear stresses of the previous decade. The interactions between riparian landscape features and fluvial disturbances were assessed by confirmatory factor analysis using structural equation modeling. Two hypothetical models for patch location and shape were conceptualized and tested against empirical data collected from 220 patches at four different study sites. Both models were successfully fitted, meaning that they adequately depicted the relationships between the variables. Furthermore, the models achieved a good adjustment for the observed data, based on the evaluation of several approximate fit indexes. The patch location model explained approximately 80% of the patch location variability, demonstrating that the location of the riparian patches is primarily driven by grndh, while the mrphd had very little effect on this feature. In a multigroup analysis regarding the succession phases of riparian vegetation, the fitted model explained more than 68% of the variance of the data, confirming the results of the general model. The patch shape model explained nearly 13% of the patch shape variability, in which the disturbances came to have less influence on driving this feature. However, grndh continues to be the primary driver of riparian vegetation between the two disturbance factors, despite the proportional increase of the mrphd effect to approximately a third of the grndh effectinfo:eu-repo/semantics/publishedVersio

Tales from the chalkface: using narratives to explore agency, resilience and identity of gay teachers

Existing literature is dominated by accounts which position gay teachers as victims. We were concerned that this only presented a partial insight into the experiences of gay teachers. This study researched the personal and professional experiences of four gay teachers in England. It builds on existing research by presenting positive narratives rather than positioning gay teachers as victims. We use the term “chalkface” to illustrate that all were practicing teachers. The purpose of the study was to explore their experiences as gay teachers throughout their careers. The study used the life history method to create narratives of each participant. Semi-structured interviews were used. The study found that the repeal of Section 28 in England in 2003 did not have an immediate effect on the identities, resilience, and agency of the participants. The 2010 Equality Act in England and changes to the school inspection framework had a greater influence in supporting their agency, resilience, and willingness to merge personal and professional identities. All but one participant managed to use their identities as gay teachers to advance inclusion and social justice through the curriculum. Although the narratives that we have presented do illuminate some negative experiences, the accounts are largely positive, in contrast with existing literature which positions gay teachers as victims

Climate-Induced Changes in Spring Snowmelt Impact Ecosystem Metabolism and Carbon Fluxes in an Alpine Stream Network

Although stream ecosystems are recognized as an important component of the global carbon cycle, the impacts of climate-induced hydrological extremes on carbon fluxes in stream networks remain unclear. Using continuous measurements of ecosystem metabolism, we report on the effects of changes in snowmelt hydrology during the anomalously warm winter 2013/2014 on gross primary production (GPP), ecosystem respiration (ER), and net ecosystem production (NEP) in an Alpine stream network. We estimated ecosystem metabolism across 12 study reaches of the 254 km2 subalpine Ybbs River Network (YRN), Austria, for 18 months. During spring snowmelt, GPP peaked in 10 of our 12 study reaches, which appeared to be driven by PAR and catchment area. In contrast, the winter precipitation shift from snow to rain following the low-snow winter in 2013/2014 increased spring ER in upper elevation catchments, causing spring NEP to shift from autotrophy to heterotrophy. Our findings suggest that the YRN transitioned from a transient sink to a source of carbon dioxide (CO2) in spring as snowmelt hydrology differed following the high-snow versus low-snow winter. This shift toward increased heterotrophy during spring snowmelt following a warm winter has potential consequences for annual ecosystem metabolism, as spring GPP contributed on average 33% to annual GPP fluxes compared to spring ER, which averaged 21% of annual ER fluxes. We propose that Alpine headwaters will emit more within-stream respiratory CO2 to the atmosphere while providing less autochthonous organic energy to downstream ecosystems as the climate gets warmer