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This study illuminates the rich and unique experiences of alumni who successfully completed a Doctor of Education (Ed.D.). During two open-ended interview sessions, eight participants revealed the barriers they encountered and successfully navigated to complete their doctoral programs. Some findings align with previously known barriers from extant literature, such as competing demands and academic integration. Participants' stories also reveal that negative experiences from their habitus and self-sabotaging thoughts created additional factors to their completion. This study describes how these alumni overcame the barriers by using their social capital, relationships with their faculty and chairs, and self-awareness to persist. This study is important because scholarly research has traditionally focused on undergraduate (rather than graduate) persistence, yet, only half of all doctoral students in the United States complete their programs. We discuss implications for graduate student retention research and practice based on eight successful doctoral students.

Abstract Background The term “aura” refers to a well-defined pattern of usually positive, progressive, and reversible neurological symptoms, with spreading depolarization as the underlying mechanism. While commonly associated with migraine, aura can also occur in other neurological disorders (i.e., cerebrovascular disorders). However, current terminology inadequately describes its different underlying clinical etiologies. Main body We propose the following terminology and etiology-based clinical classification for the aura phenomenon: (i) Migrainous Aura (when the etiology is migraine), (ii) Non-migrainous Aura (when there is an alternative etiology), (iii) Aura of uncertain clinical etiology (when etiology is unclear), and (iv) Migrainous Infarction (a typical migrainous aura in a patient with migraine with aura associated with an infarction in a corresponding anatomical brain region). Conclusion This nuanced classification aims to aid in the diagnostic evaluation and phenotyping of aura phenomenon, ultimately improving the diagnosis and management of the different associated neurological conditions. Moreover, it could promote effective communication and translational mechanistic research.

The results of surveys of the innovative youth project U-Report in January – September 2024 are presented in digest: physical activity of young people, mine safety and menstrual hygiene awareness among adolescents, techniques of self-support, attitudes to vaccination, youth meaningfulness index, participation of young people in the processes of recovery of Ukraine, youth policy and reading interests of youth.

Diagnosis of asthma and chronic obstructive pulmonary disease (COPD) remains an actual problem in Russia. The lack of diagnostics and control of these diseases leads to serious consequences for public health and economic damage. Effective initiatives to improve the level of diagnosis and control of asthma and COPD include the organization of educational activities, instrumental methods of examination, the use of mobile offices for outreach work in remote communities and the introduction of medical information systems. The introduction of digital technologies into medical practice will help to improve the quality of medical care, increase the efficiency of medical centers, and ensure timely diagnosis and control of respiratory diseases. The introduction of modern approaches and methods in the diagnosis of asthma and COPD, active use of validated questionnaires and medical information systems will improve the quality of life of patients and reduce the risks of complications and exacerbations of diseases.

Background About 25% of patients with acute ischemic stroke have lacunar infarct on follow‐up imaging. In this secondary analysis from the AcT (Alteplase Compared With Tenecteplase) trial, we assessed if there is variation in safety or efficacy of intravenous thrombolysis by infarct type in patients with no visible occlusion. We also determined if this effect differed between tenecteplase and alteplase. Methods and Results This is a secondary analysis from the AcT trial. Lacunar infarct was defined as single, ≤15 mm, and in regions supplied by perforating arterioles on 24‐hour imaging. Outcomes included symptomatic intracerebral hemorrhage at 24 hours, any hemorrhage on imaging, and 90‐day modified Rankin Scale score. Mixed‐effects regression models adjusted for age, sex, stroke severity, thrombolytic type, and onset‐to‐needle time were used. Of 1577 patients, 456/29.9% had no visible occlusion and interpretable follow‐up imaging (magnetic resonance imaging: 41.2%). Of these 93 (20.4%) (magnetic resonance imaging: 62.3%) had lacunar infarct, 171 (37.5%) (magnetic resonance imaging: 67.4%) had nonlacunar infarct, and 192 (42.1%) (magnetic resonance imaging: 7.3%) had no visible infarct. Four patients (2.3%) in the group with nonlacunar infarct and none in the groups with lacunar infarct and no visible infarct developed symptomatic intracerebral hemorrhage. Any intracranial hemorrhage was highest (21; 12.4%) in the group with nonlacunar infarct. There was no significant interaction between thrombolytic type and treatment outcomes. Conclusions In the AcT trial, safety of intravenous thrombolysis was similar across all infarct types in patients with no visible occlusion but functional outcomes were worst in patients with nonlacunar infarct. Safety and functional outcomes after intravenous thrombolysis were better in the groups with lacunar infarct and no visible infarct as compared with the overall trial population.

Стаття присвячена дослідженню теоретичних основ судової експертизи, зокрема судово-еко­логічної. Розглянуто поняття судово-екологічної експертизи та її особливості. Досліджено судо­ву експертизу з точки зору чинного криміналь­но-процесуального законодавства. Проаналізо­вано чинне законодавство в контексті регулю­вання призначення та проведення судово-еко­логічної експертизи в умовах воєнного стану. Зосереджено увагу на меті судово-екологічної експертизи, а саме - встановленні причинно-наслідкового зв’язку між погіршенням здо­ров’я людини та забрудненням довкілля, спри­чиненим антропогенною діяльністю. Ключові законодавчі акти, що регулюють проведення судово-екологічної експертизи, - це Закон України «Про судову експертизу», наказ Міністерства юстиції України «Про затверджен­ня Інструкції про призначення та проведення судових експертиз та експертних досліджень та Науково-методичних рекомендацій з питань підготовки та призначення судових експертиз та експертних досліджень», Кримінальний про­цесуальний кодекс України (далі - КПК Украї­ни). Ці нормативно-правові акти регламентують правові засади проведення судово-екологічної експертизи, визначаючи коло суб’єктів, їхні повноваження та обов’язки, а також порядок здійснення експертних досліджень. Досліджено, які спеціальні знання вико­ристовуються в процесі проведення окремих слідчих дій та призначення судово-екологіч­ної експертизи. Проаналізовано, яким чином ці знання застосовуються для розкриття та розслі­дування злочинів, що завдають шкоди навко­лишньому середовищу. Зроблено висновок, що завдяки проведенню такого виду експертизи, - слідство та суд мають можливість отримати нову інформацію, яка має вирішальне значення для встановлення істини у справі, адже ці дані не можуть бути отримані за допомогою інших про­цесуальних дій. Акцентовано увагу на можливості призна­чення судово-екологічної експертизи на різних стадіях кримінального провадження, що забез­печує всебічне та об’єктивне розслідування еко­логічних злочинів. На основі проведеного дослі­дження були зроблені висновки. Наголошено на тому, що у зв’язку з загостренням екологічної ситуації в Україні, через дію воєнного стану, по­стала необхідність посилити екологічний кон­троль, зокрема ще більше розвивати з різних точок науки, - екологічну судову експертизу.

The research is devoted to the problem of mastering pre-service EFL teachers' specific proficiency in using questions as an effective tool in the EL classroom discourse and university discourse. The purpose of the paper is to submit the teaching scheme of training pre-service EFL teachers' questioning skills, encouraging them to work out their own teaching strategies in the future professional activity. The authors substantiate the possibility of improving MA students and pre-service EFL teachers', questioning skills via suggested teaching scheme actualising interdisciplinary connections between the practical course ("English Communication in Academic Discourse") and theoretical-practical course ("Theory and Practice of Speech Communication") and students' teaching practice that are majors of the Master's degree curriculum. The emphasis is laid on the content level -- EL classroom discourse acquisition. The experiment was conducted involving 90 MA students, pre-service EFL teachers, of South-Ukrainian National Pedagogical University named after K. D. Ushynsky to clarify the efficiency of the suggested teaching scheme. Data were obtained and analysed via pre-experimental assessment stage, experimental teaching (implementation of the suggested teaching scheme), post-experimental assessment stage employing quantitative and qualitative research methods. Data collection procedures included pedagogical observation, analysis of the students' results, self-assessment questionnaire, student's opinion questionnaire, statistical and mathematical processing of obtained data. The findings of the research indicate that the suggested teaching scheme using interdisciplinary approach helps students become more proactive in constructing their knowledge of questions linguodidactic potential, to transform the acquired knowledge to new ways of verbal behaviour, to model successful communication in the EL classroom through appropriate questions, and to modify their teaching styles. The authors come to the conclusion that it is mandatory to include special consecutive training covering initially purely practical courses with a gradual shift to theoretical-practical ones, and finally -- teaching practices as a closing step to improve students' proficiency in using questions effectively in the EL classroom school and university discourse.

У статті йдеться про організацію сакрального простору храму-ікони та храму-міста на прикладі давньоруських пам’яток у контексті візантійської культурно-релігійної традиції. Раніше позитивістська модель опису світу не вбачала в організації сакрального простору предмета дослідження. Проте в багатьох випадках аналіз богословських концептів або візуальних форм є недостатнім, бо деякі явища можуть бути усвідомлені лише на рівні ідеальних образів (ейдосів). Структурний задум сакрального простору постає його ієротопічним проєктом, що охоплює всі зримі та відчутні форми. Як ієротопічні конструкти у статті розглянуто ікони («Трійця» А. Рубльова), храми (Софія Константинопольська, Софія Київська, Успенський собор Києво-Печерського монастиря), міста (Єрусалим, Київ).

Background and Purpose Infarct volume and other imaging markers are increasingly used as surrogate measures for clinical outcome in acute ischemic stroke research, but how improvements in these imaging surrogates translate into better clinical outcomes is currently unclear. We investigated how changes in infarct volume at 24 hours alter the probability of achieving good clinical outcome (modified Rankin Scale [mRS] 0–2). Methods Data are from endovascular thrombectomy patients from the randomized controlled ESCAPE-NA1 (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischaemic Stroke) trial. Infarct volume at 24 hours was manually segmented on non-contrast computed tomography or diffusion-weighted magnetic resonance imaging. Probabilities of achieving good outcome based on infarct volume were obtained from a multivariable logistic regression model. The probability of good outcome was plotted against infarct volume using linear spline regression. Results A total of 1,099 patients were included in the analysis (median final infarct volume 24.9 mL [interquartile range: 6.6–92.2]). The relationship between total infarct volume and good outcome probability was nearly linear for infarct volumes between 0 mL and 250 mL. In this range, a 10% increase in the probability of achieving mRS 0–2 required a decrease in infarct volume of approximately 34.0 mL (95% confidence interval: -32.5 to -35.6). At infarct volumes above 250 mL, the probability of achieving mRS 0–2 probability was near zero. The relationships of tissue-specific infarct volumes and parenchymal hemorrhage volume generally showed similar patterns, although variability was high. Conclusion There seems to be a near-linear association between total infarct volume and probability of achieving good outcome for infarcts up to 250 mL, whereas patients with infarct volumes greater than 250 mL are highly unlikely to have a favorable outcome.

Background and Purpose The safety and efficacy of tenecteplase in patients with ischemic stroke due to medium vessel occlusion (MeVO) are not well studied. We aimed to compare tenecteplase with alteplase in stroke due to MeVO. Methods Patients with baseline M2-middle cerebral artery (MCA), M3/M4-MCA, P2/P3/P4-posterior cerebral artery (PCA), A2/A3/A4-anterior cerebral artery (ACA) occlusions from the Alteplase Compared to Tenecteplase (AcT) trial were included. Primary outcome was the proportion of 90-day modified Rankin Scale (mRS) 0–1. Secondary outcomes were 90-day mRS 0–2, ordinal mRS, mortality, quality of life measures (EuroQol 5-Dimension 5-Level, EuroQol visual analog scale), and symptomatic intracerebral hemorrhage (sICH). Initial and final successful reperfusion were reported in patients undergoing endovascular thrombectomy (EVT). Results Among 1,558 patients with available baseline computed tomography angiography; 455 (29.2%) had MeVO of which 27.5% (125/455) were proximal M2; 16.3% (74/455) were distal M2; 35.2% (160/455) were M3/M4; 7.5% (34/455) were A2/A3/A4; and 13.6% (62/455) were P2/P3/P4 occlusions. EVT was performed in 87/455 (19.1%) patients. mRS 0–1 at 90 days was achieved in 37.9% in the tenecteplase versus 34.7% in the alteplase group (adjusted risk ratio [aRR] 1.07; 95% confidence interval [CI] 0.91–1.25). Rates of 90-day mRS 0–2, sICH, and mortality were similar in both groups. No statistical difference was noted in initial successful reperfusion rates (13.0% vs. 7.5%) among the 87 patients who underwent endovascular thrombectomy. However, final successful reperfusion was higher in the tenecteplase group (71.7% vs. 60.0%, aRR 1.29, 95% CI 1.04–1.61). Conclusion Intravenous tenecteplase had comparable safety, functional outcomes and quality of life compared to intravenous alteplase among patients with MeVO. Among those treated with EVT, tenecteplase was associated with higher successful reperfusion rates than alteplase.

Background: The history of gunshot wound treatment dates back several centuries. However, every new war or protracted armed conflict makes surgeons return to this issue. In recent years the nature of wounds changed: injuries become more severe, with a larger amount of damaged tissue. Among the wounded persons, blast and fragment injuries prevail over gunshot injuries. Gunshot wounds, as a rule, differ from wounds inflicted by old-style weapons in the scale, depth, and severity of anatomical destruction of soft tissue and bones. Modern physical methods of wound management and preparation of wounds for plastic closure, such as low-frequency ultrasound, enable to debride the wound surface with minimal damage to viable tissues and perform plastic closure of soft tissue defects as radically and as early as could be.Objective: To improve methods of primary surgical debridement in patients with combat surgical trauma using low-frequency ultrasound.Materials and methods: We studied treatment results in 176 wounded and injured people hospitalized in the burn unit and the division of plastic surgery and cell transplantation at the V.K. Gusak Institute of Emergency and Reconstructive Surgery (Donetsk, Russian Federation) between 2015 and 2023. All the patients were divided into 2 groups. Group 1 (main) included 86 patients who underwent surgical wound debridement with ultrasonic cavitation. Group 2 consisted of 90 patients who were operated on without ultrasonic wound debridement. The groups of patients were comparable.Results: After surgical wound debridement, segmented neutrophils (78%-68%) were the main type of blood cells. After ultrasonic wound debridement, the amount of detritus decreased by 3.75 times. In the main group, the number of fibroblasts was 1.88 times higher than that in the comparison group. On day 4, the specific area of the granulation tissue was 1.7 times higher in the main group compared with that in the comparison group. Results of the morphometric control revealed that on day 4 the number of capillaries in the granulation tissue was 31.3 ± 2.5 units in the main group and 20.0 ± 1.12 units in the comparison group. Ultrasonic cavitation of wounds helps suppress wound infection by day 4-5 of treatment: in 82.2 ± 5.7% of the patients, the number of microorganisms per gram of tissue decreased below the “critical number”, whereas in the comparison group it was achieved in 28.9 ± 6.7% of the patients. According to laser Doppler flowmetry findings, we obtained a statistically significant increase in the mean blood flow value (M index) by 1.22 times 24-48 hours after surgical treatment. In the main group, 11.6 ± 3.4% of complications were reported, whereas in the comparison group it was 24.5 ± 4.4%, P < .05. The mean number of operations per person was 1.6 ± 0.4 in the main group and 2.8 ± 0.5 in the comparison group, P < .05. The mean duration of inpatient treatment was 13.5 ± 3.4 days in the main group and 24.3 ± 2.5 days in the comparison group, P < .01.Conclusions: We can conclude that ultrasonic cavitation is advantageous in routine surgical debridement of gunshot wounds followed by primary or delayed primary closure.

Improved methods for the synthesis of nicotine are of great importance due to the wide range of applications of synthetic nicotine, which is free from contamination with nitrosamines. Herein, we present a four-step chemical synthesis of (S)-nicotine, involving the reduction in myosmine, enantiomeric separation of nornicotine, and subsequent methylation of the appropriate enantiomer of nornicotine obtained. The reduction in myosmine was investigated using both electrochemical and chemical approaches, achieving up to 90% yields of pure nornicotine. To achieve the enantioseparation of nornicotine, its diastereomeric salts with chiral acids, specifically, N-lauroyl-(R)-alanine, were obtained in a mixture of methyl tert-butyl ether (MTBE) and chloroform, which led to the isolation of (S)-nornicotine with 92% ee. The structures of the obtained salts were determined by the X-ray diffraction (XRD) technique, which helped to explain the origin of enantiodiscrimination during the crystallization. The described methodology allows efficient regeneration of the reagents and solvents used, leading to cost-effective production of (S)-nicotine suitable for industrial-scale applications.

Recent advancements in polymer science and manufacturing technologies triggered new developments of porous materials used for mitigating heat losses, such as thermal insulating polymeric foams. The major bottleneck in the optimization of these products, however, remains the absence of analytical methods able to scrutinize their large design space reasonably quickly and cost-effectively. This manuscript targets the paucity of data for polymeric foams by illustrating, at a proof-of-principle level, that several well-established analytical methods including optical microscopy, pycnometry, dielectric spectroscopy, thermogravimetric analysis, and nuclear magnetic resonance can be exploited for an extensive, yet logistically efficient, characterization of these materials. The purpose of this study is thus introducing an experimental platform for the characterization of market foam products and for the development of new polymeric foams with pore sizes that are particularly relevant for industrial and residential thermal insulation. Since this work introduces several new methodologies, it may be used as a guide for both laboratory users and specialists in the field, who may further improve the herein proposed experimental concepts.

The study explores justice, forensic examination and mediation from the time of their genesis to the present day. The article analyzes historical examples of the application of forensic examination within the mediation process from the Ancient East and Antiquity to the 20th century, as well as the processes of establishing the legitimization of forensic examination (from the end of the 19th century) and mediation (from the end of the 20th century) in Ukraine and abroad. Attention is paid to the prototypes of forensic examination in the times of Kievan Rus, the Principality of Galicia-Volhynia, the Grand Duchy of Lithuania, the Cossack State and the entry of Ukrainian lands into the Austro-Hungarian and Russian empires, as well as the emergence of forensic examination before the First World War and during the Ukrainian Revolution and the expansion of the Bolsheviks and the establishment of Soviet power. The formation of regional offices (1923) and later institutes of scientific and forensic expertise (1925) in Kyiv, Odesa and Kharkiv is studied. The article reveals the peculiarities of the development of forensic examination within the establishment and legitimization of the mediation procedure in independent Ukraine. The provisions of the current legislation on forensic examination and mediation are analyzed. The authors substantiate the prospects of using the results of forensic expert activity for the application of mediation procedures in the settlement of disputes through negotiations between the parties using the conclusions of forensic experts. The authors identify the most promising types of forensic expertise for the mediation procedure (economic, commodity, construction, intellectual property, etc.). The authors determine the prospects for mediators to use expert opinions not only in family, labor, civil, commercial and administrative disputes, but also in criminal cases during martial law and post-war revival of Ukraine.

In 2022, Russia’s war against Ukraine shook the world and kickstarted an active humanitarian operation to save war-affected Ukrainians. All the neighbouring countries of Ukraine were forced to react actively. However, the subsequent refugee crisis affected Poland the most. Currently, Poland is playing the most important role among the countries receiving war refugees from Ukraine, which raises obvious questions about future developments and possible future challenges in relations between Ukraine and Poland and, above all, migration policy itself. The objective of this paper is to conduct a comprehensive analysis of Poland’s policy in the fi eld of accepting refugees and to examine the relevant legislation and procedures related to Ukrainian refugees, thereby shedding light on the assistance and support mechanisms put in place by the Polish authorities. Furthermore, this study seeks to draw insightful conclusions regarding the impact of Ukrainian refugees on Poland’s economic and social spheres, in addition to exploring the refugees’ integration into various aspects of daily life. A critical aspect of this research involves a comparative analysis to ascertain whether Poland’s policy towards Ukrainian refugees has undergone any significant changes since the beginning of the full-scale invasion on February 24th, 2022. This timeline provides a crucial backdrop for understanding how evolving geopolitical dynamics may have influenced Poland’s approach. This research employs a multidisciplinary approach, utilising a combination of data collection, policy analysis, and an extensive review of relevant literature to provide a comprehensive and nuanced understanding of the complex issue at hand.

The results of surveys of the innovative youth project U-Report for October are shown – December 2023: gender stereotypes and violence against women, culture of charity, attitude to same-sex partnership.

Environmental exposures are ubiquitous and play a significant, and sometimes understated, role in public health as they can lead to the development of various chronic and infectious diseases. In an ideal world, there would be sufficient experimental data to determine the health effects of exposure to priority environmental contaminants. However, this is not the case, as emerging chemicals are continuously added to this list, furthering the data gaps. Recently, simulation science has evolved and can provide appropriate solutions using a multitude of computational methods and tools. In its quest to protect communities across the country from environmental health threats, ATSDR employs a variety of simulation science tools such as Physiologically Based Pharmacokinetic (PBPK) modeling, Quantitative Structure–Activity Relationship (QSAR) modeling, and benchmark dose (BMD) modeling, among others. ATSDR’s use of such tools has enabled the agency to evaluate exposures in a timely, efficient, and effective manner. ATSDR’s work in simulation science has also had a notable impact beyond the agency, as evidenced by external researchers’ widespread appraisal and adaptation of the agency’s methodology. ATSDR continues to advance simulation science tools and their applications by collaborating with researchers within and outside the agency, including other federal/state agencies, NGOs, the private sector, and academia.

The research concerns the problem of mastering English voice production skills in oral interpretation of the authentic belles-lettres texts. The purpose of the paper is to present the teaching algorithm of training future English language and literature teachers' skills in decoding and orally interpreting verbalised English voice prosodic characteristics. The authors argue the necessity of training future English teachers in mastering their voices on the basis of the mechanism of English voice perception in order to make them sound English. The research represents the results of experimental teaching English voice production skills to the 4th year BA students at South-Ukrainian National Pedagogical University named after K. D. Ushynsky. The participants were 60 students -- future English language and literature teachers -- who agreed to take part in the research. Data analysis tools comprise pedagogical observation, questionnaires, testing for skills level assessment, expert assessment of testing results, statistical and mathematical processing of obtained data. The experimental teaching included three stages: diagnostic (entry testing), empirical training (teaching algorithm implementation) and checkout (final testing). The obtained results prove that the suggested four-stepped teaching algorithm in "Oral interpretation of the text" successfully starts in students the mechanism of the English voice perception, develops their ability to decode verbalised English voice prosodic characteristics and their functions in the process of philological reading, and forms future English language and literature teachers' specific skills in English voice modulation in oral interpretation.

Purpose. Scientific substantiation of theoretical foundations and provision of practical recommendations for improving the system of crisis monitoring, assessment of its actual and predicted state; deterioration of living conditions. Methods. Based on the use of general scientific and special methods of cognition. The hypothetical and deductive method was used to reveal the content and essence of the concept of "crisis monitoring". The method of structural and functional analysis is used to identify current trends in the preparation, planning and implementation of measures related to the improvement of crisis monitoring. The method of generalisation and comparison is used to assess the current state of the crisis monitoring system, to evaluate its actual and forecasted state; deterioration of people's living conditions. Results. The article shows that emergency and crisis situations are an integral part of the social system. The author analyses the scientific heritage and legislation, which makes it possible to conclude that a crisis situation, critical situation, crisis, emergency situation are the defining properties of these systems and are the result of the action of factors. The author establishes that emergency and crisis situations develop in time and space and allow identifying certain stages at which crisis situations may arise. Conclusions. The consequences of emergency and crisis situations are always negative, but there is a direct and inverse relationship between crisis and emergency situations.

Paper demonstrated the results of surveys of the innovative youth project U-Report for July – September 2023: domestic tourism, radiation and nuclear safety, financial literacy.

Purpose: To examine the features of the bulbar conjunctiva in patients who developed dry-eye disease (DED) after drug treatment for primary open-angle glaucoma (POAG). Methods: Impression cytology was performed by applying twice a strip of cellulose acetate filter to the ocular surface to remove the superficial epithelial layers of the temporal bulbar conjunctiva. The strips were removed with a peeling motion in a few seconds, and the samples were immediately fixed in 95% ethyl alcohol, stained with hematoxylin and eosin, mounted on glass slides and coverslipped for light microscopy. Squamous metaplasia was graded according to Nelson’s grading system on the basis of cell morphology, staining and integrity as well as the nucleus-to-cytoplasm ratio. This study included a case group of 80 patients (mean age, 63.8 ± 6.7 years) with POAG-associated DED, with the group being divided into four subgroups. Subgroups 1 and 2 were composed of 40 patients each, with glaucoma duration of less or more than 5 years, respectively. Subgroups a and b were composed of 40 patients each, with a number of topical ocular hypotensive drugs used equal to one or at least two, respectively. The control group was composed of 20 apparently healthy volunteers (mean age, 67.9 ± 8.9 years). All patients underwent a routine eye examination. Results: All patients with glaucoma had symptoms of DED with Ocular Surface Disease Index (OSDI) scores of at least 15. In subgroup 1, 60% had Nelson’s grade 1 and 40%, Nelson’s grade 2 squamous metaplasia. In subgroup 2, 10% had Nelson’s grade 1; 60%, Nelson’s grade 2 and 30%, Nelson’s grade 3 squamous metaplasia. In subgroup a, 20% had Nelson’s grade 1; 60%, Nelson’s grade 2 and 30%, Nelson’s grade 3 squamous metaplasia. In subgroup b, 10% had Nelson’s grade 1; 60%, Nelson’s grade 2 and 30%, Nelson’s grade 3 squamous metaplasia. Conclusion: Changes in the bulbar conjunctival epithelium corresponded to Nelson’s grade 2 or 3 squamous metaplasia in 80% of patients who developed DED after drug treatment for POAG. The severity of squamous metaplasia correlated with the duration of glaucoma and, consequently, longer use of hypotensive eye drops (r1 = 0.15, p1 = 0.02, p2 = 0.01). Findings of the current study and international guidelines argue for the use of the medications containing no preservatives or potentially toxic components in long-term therapy against glaucoma.

Abstract Background and purpose The ANNEXA‐4 trial measured hemostatic efficacy of andexanet alfa in patients with major bleeding taking factor Xa inhibitors. A proportion of this was traumatic and nontraumatic intracranial bleeding. Different measurements were applied in the trial including volumetrics to assess for intracranial bleeding depending on the compartment involved. We aimed to determine the most reliable way to measure intracranial hemorrhage (ICrH) volume by comparing individual brain compartment and total ICrH volume. Methods Thirty patients were randomly selected from the ANNEXA‐4 database to assess measurement of ICrH volume by compartment and in total. Total and compartmental hemorrhage volumes were measured by five readers using Quantomo software. Each reader measured baseline hemorrhage volumes twice separated by 1 week. Twenty‐eight different ANNEXA‐4 subjects were also randomly selected to assess intra‐rater reliability of total ICrH volume measurement change at baseline and 12‐h follow up, performed by three readers twice to assess hemostatic efficacy categories used in ANNEXA‐4. Results Compartmental minimal detectable change percentages (MDC%) ranged between 9.72 and 224.13, with the greatest measurement error occurring in patients with a subdural hemorrhage. Total ICrH volume measurements had the lowest MDC%, which ranged between 6.57 and 33.52 depending on the reader. Conclusion Measurement of total ICrH volumes is more accurate than volume by compartment with less measurement error. Determination of hemostatic efficacy was consistent across readers, and within the same reader, as well as when compared to consensus read. Volumetric analysis of intracranial hemostatic efficacy is feasible and reliable when using total ICrH volumes.