Search

Microvascular inflammation (MVI) is a key diagnostic feature of antibody-mediated rejection (AMR); however, recipients without donor-specific antibodies (DSA) defy etiologic classification using C4d staining of peritubular capillaries (C4dptc) and conventional DSA assignment. We evaluated MVI ≥ 2 (Banff g + ptc ≥ 2) using Banff 2019 AMR (independent of MVI ≥ 2 but including C4dptc) with unconventional endothelial C4d staining of glomerular capillaries (C4dglom) and - arterial endothelium and/or intima (C4dart) using tissue immunoperoxidase, shared-eplet and subthreshold DSA (median fluorescence intensity, [MFI] 100-499), and capillary ultrastructure from 3398 kidney transplant samples for evidence of AMR. MVI ≥ 2 (n = 202 biopsies) from 149 kidneys (12.4% prevalence) correlated with DSA+, C4dptc+, C4dglom+, Banff cg, i, t, ti scores, serum creatinine, proteinuria, and graft failure compared with 202 propensity score matched normal controls. The laboratory reported DSA− MVI ≥ 2 (MFI ≥500) occurred in 34.7%; however, subthreshold (28.6%), eplet-directed (51.4%), and/or misclassified anti-Human leukocyte antigen (HLA) DSA (12.9%) were identified in 67.1% by forensic reanalysis, with vascular C4d+ staining in 67.1%, and endothelial abnormalities in 57.1%, totaling 87.1%. Etiologic analysis attributed 62.9% to AMR (77.8% for MVI with negative reported DSA [DSA− MVI ≥2] with glomerulitis) and pure T cellular rejection in 37.1%. C4dptc−DSA− MVI ≥ 2 was unrecognized AMR in 48.0%. Functional outcomes and graft survival were comparable to normal controls. We concluded that DSA− MVI ≥ 2 frequently signified a mild “borderline” phenotype of AMR which was recognizable using novel serologic and pathological techniques.

The aim of this study was to determine the optimal configuration of silicon carbide-ultrahigh molecular weight polyethylene (SiC-UHMWPE) plates to effectively withstand 0.5 caliber Browning Machine Gun (BMG) projectiles. Six composite plates with varying thicknesses were 3D modeled and assessed for ballistic resistance using finite element analysis in Ansys Explicit Dynamics simulation software. These plates were subjected to high-velocity impacts at 930 m/s using 7.62 mm projectiles. The findings revealed that an 11 mm SiC/80 mm UHMWPE plate provided comparable bullet-stopping performance to a standard 8 mm steel 4340/60 mm UHMWPE plate, but with a significantly lower areal density. The primary mode of failure observed in penetrated samples was petaling, consistent with known behaviors of composite armor under high-impact conditions.

"Through Eyes Bound By Love" is an article from Beautiful Bizarre Magazine that explores the artistry of Fatima Ronquillo. Ronquillo's paintings, influenced by Rococo and Baroque styles, blend mythology and love themes with bold colors and intricate details. Her work reflects a blend of cultural influences and symbolism, with a focus on endangered animals, nature, and themes of love and hope. Ronquillo's art process involves meticulous planning, research, and a deep connection with her paintings, creating intimate and intricate pieces that invite viewers to explore hidden meanings. [Extracted from the article]

AbstractThis study provides the manufacturing process and the main physicochemical characteristics to describe the Guatemalan artisanal beverages Boj and Suchiles. Flow charts were established for the manufacturing processes of these two indigenous fermented beverages of Guatemala. Physicochemical characteristics were analyzed to determine the degree of action of the microorganisms responsible for the alcoholic fermentations. Boj and Suchiles are produced throughout the year using regional ingredients such as sugarcane and pineapple. Boj is especially popular in the northern city of Coban and Suchiles in Guatemala City and Antigua, Guatemala. Although they have cultural relevance, few scientific studies about these beverages exist. The process and raw materials used to elaborate Boj and Suchiles were documented, and samples were taken to conduct the physicochemical characterization of both beverages. Boj and Suchiles showed the following results: pH, 3.3 ± 0.1 and 3.0 ± 0.1 units; alcohol, 6.9 ± 0.9 and 0.79 ± 0.4%(v/v); total soluble solids (TSS), 3.1 ± 0.3 and 15.4 ± 1.2 (g/100 g); reducing sugars 8.6 and 85.2 g/L; lactic acid, 8.7 ± 1.6 and 10.7 ± 3.0 g/L; acetic acid, 2.8 ± 0.6 and 6.9 ± 2.9 g/L. Essential and nonessential amino acids, sugars, protein, organic acids, and B vitamins were analyzed.

Infectious keratitis is a devastating cause of vision loss worldwide. Cutibacterium acnes(C. acnes), a commensal bacterium of the skin and ocular surface, is an underrecognized but important cause of bacterial keratitis. This review presents the most comprehensive and up-to-date information for clinicians regarding the risk factors, incidence, diagnosis, management, and prognosis of C. acneskeratitis (CAK). Risk factors are similar to those of general bacterial keratitis and include contact lens use, past ocular surgery, and trauma. The incidence of CAK may be approximately 10%, ranging from 5% to 25% in growth-positive cultures. Accurate diagnosis requires anaerobic blood agar and a long incubation period (≥7 days). Typical clinical presentation includes small (<2 mm) ulcerations with deep stromal infiltrate causing an anterior chamber cell reaction. Small, peripheral lesions are usually resolved, and patients recover a high visual acuity. Severe infections causing VA of 20/200 or worse are common and often do not significantly improve even after treatment. Vancomycin is considered the most potent antibiotic against CAK, although other antibiotics such as moxifloxacin and ceftazidime are more commonly used as first-line treatment.

Supplemental Digital Content is Available in the Text.Herpes simplex keratitis resistance to antiviral treatment presents a growing concern. The herpes simplex virus has many different mechanisms of resistance to antiviral treatment, which have been well described. Resistance to acyclovir occurs because of mutations in the viral thymidylate kinase and DNA polymerase that decrease this enzyme's affinity for its substrate. This article discusses factors that explain the prevalence of this resistance, the ability for recurrences in immunocompromised populations, current treatments for acyclovir-resistant herpes simplex keratitis, and novel therapies for this growing concern.

The role of lead exposure or micronutrient deficiencies in children's sleep problems is unknown. Although elevated blood lead concentrations (BPb) are clearly related to behavior problems in children, few researchers have used objective observations. The authors investigated relationships between lead, micronutrient status, sleep, classroom behavior, and activity in Mexican children aged 6-8 years living close to a metal foundry. Mean BPb was 11.5 [+ or -] 6.1 [micro]g/dL; 50% had levels [greater than or equal to] 10 [micro]g/dL. Ten percent of children had hemoglobin < 12.4 g/dL. Parents reported on children's sleep and fatigue (n 550). The authors also observed classroom behavior (n = 157) and measured physical activity (n = 168). BPb [greater than or equal to] 10 [micro]g/dL was associated with later waking time and shorter duration of sleep. Anemia was linked to more off-task behaviors, lower physical activity, earlier bedtime, and shorter sleep onset. Researchers should investigate these relationships further, using more sensitive measures. KEYWORDS: activity, behavior, blood lead, iron deficiency, serum zinc, sleep, Sleep difficulties in children are common. According to parent reports in one Swedish study, almost 6% of children aged 5-7 years had difficulty falling asleep at least 3 days per [...]

Traditionally, the transesterification reaction for biodiesel production takes place at elevated temperatures, around 60-65°C, for up to two hours of reaction time, entailing a high energy consumption. As the University of the Philippines Los Baños – Interdisciplinary Biofuels Research Studies Center (UPLB-IBRSC) continuously aims to conduct studies on improving process efficiencies in biofuels production, this research investigated the potential of potassium ferrate as a catalyst for fast biodiesel production at room temperature. Particularly, the catalytic activity of potassium ferrate in the transesterification of refined coconut oil and vegetable oil was examined. The effects of the parameters such as methanol-to-oil molar ratio, catalyst loading, and reaction time on biodiesel yield and purity were studied. Thin layer chromatography, with the aid of ImageJ software, was applied to analyze the purity of the biodiesel through the developed spots’ area estimation. Characterization experiments in terms of free fatty acid (FFA) content and acid value were performed to confirm the low FFA content of the feedstocks prior to transesterification. Results of the parametric and optimization study revealed that a biodiesel yield of 87.67% using vegetable oil was experimentally achieved at the optimum conditions of 6.75 wt% catalyst loading, 6:1 methanol-to-oil molar ratio, and 30 minutes reaction time. Using coconut oil, on the other hand, resulted in a higher biodiesel yield of 94.90% at a catalyst loading of 6 wt%, a methanol-to-oil molar ratio of 6:1, and a reaction time of 60 minutes. Generally, findings show that catalyst loading has a positive effect on biodiesel yield and purity only up to a certain optimum amount. Among all the parameters analyzed, the methanol-to-oil molar ratio was found to have the most significant effect as an individual factor. Given the results of this study, it can be concluded that the potassium ferrate-catalyzed transesterification reaction at room temperature can potentially reduce the energy consumption in biodiesel production and the production cost in general.

We demonstrate the preparation of mesoscale semiconductor (II–VI) nanoplatelets (NPLs) for the first time using colloidal seeded growth. These nanoplatelets are quantum-confined and atomically precise but grown to a length scale compatible with conventional optical imaging and microscopic manipulation (even reaching >1 μm2) offering an opportunity to bridge the application space between nanocrystals and two-dimensional (2D) materials. Using CdTe as a model system, we develop a seeded growth procedure, show the parameters that control extension, and apply them to a variety of thicknesses and compositions. In situ spectroscopy demonstrates that addition onto the nanoplatelet seeds is not continuous and likely occurs through ripening. Finally, we use correlative optical and electron microscopy to demonstrate that at large sizes, photoluminescence (PL) mapping of the entire structure can be resolved including spatial inhomogeneities. Overall, these results show that nanoplatelets can be compared to 2D semiconductors while maintaining the advantages of scalable colloidal synthesis, thickness tunability, and solution processability.

Copyright of Albéitar is the property of Grupo Asis Biomedia, S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACTPollutant emissions into the atmosphere are recognized as a significant problem in fossil fuel combustion. The pollution emission measurement in industrial boilers is difficult and expensive but fundamental for monitoring and controlling. Frequently continuous emissions monitoring (CEM) system is out of service or useless due to obsolescence, high maintenance cost, and so on or simply is not installed. When a system for measuring pollutant emissions is not available, an alternative method must be employed to get the pollutant emission value. According to the black-box model approach, this article describes the nonlinear modeling of NOx emissions from a utility boiler. Bayesian-Gaussian (BG), multilayer perceptron (MLP), and Volterra polynomial basis functions (VPBF) neural networks are developed for model benchmarking. Experimental data from a utility boiler was acquired in order to model definition and evaluation. The models process three boiler variables oxygen excess, fuel mass flow and flue gas recirculation gates for NOx emission estimation. Models with BG show better performance than models with MLP and VPBF for NOx prediction.Implications: The technology to control NOx emissions generated by combustion operates under strict regulations. In order to reduce NOx emissions, theoretical models of NOx generation have been studied extensively, including nitrogen chemistry and the dynamic flow of gas particles which is very complex. The new technology trends would require the continuous measurement of high precision NOx emissions to achieve further reductions in NOx emissions. Currently, NOx emissions are measured by a Continuous Emission Monitoring system, which turns out to be extremely expensive and difficult to maintain, so alternative low-cost solutions are desirable. Our contribution shows how algorithms based on different artificial intelligence techniques are viable and quality alternatives for the measurement of continuous NOx emissions. The NOx emissions models based on IA algorithms are viable alternatives that have versatility and self-tuning capacity due to the fact that they are based on boiler operation parameters which have valuable information few explored nowadays.

Thygeson superficial punctate keratitis (TSPK) is clinically characterized by exacerbations and remissions of gray–white opacities within the corneal epithelium, most often bilateral but may be asymmetric. Symptoms typically include photophobia, tearing, blurring, and eye irritation. Although disease progression and prognosis are well described, the exact cause is unknown. Hypotheses exist implicating virus-mediated immunity as the cause of TSPK following cases of viral keratitis; however, several polymerase chain reaction studies refute the infectious process concurrently with symptomatic TSPK. This is further supported by the consistent lack of response to antiviral and antibacterial treatment. A subset of dendritic cells known as Langerhans cells (LC) found within the corneal epithelium has been positively correlated with exacerbations of TSPK. Langerhans cells proliferate to protect and mitigate the cornea's inflammatory response, but the inflammatory triggers and relapses associated with TSPK are not well understood. Several topical drugs exist to treat inflammation related to TSPK; however, drug delivery is a major barrier to treatment because of the tear film and epithelial barrier. Drug-eluting contact lenses that target intermediates of inflammation could serve as a more effective treatment modality because of the increased bioavailability of the drugs. This review is an in-depth survey of the literature regarding the relationship between the origin and pathophysiology of LC and TSPK at the immunologic level. We also discuss potential pharmacotherapeutic interventions for TSPK prevention and treatment.

Population databases could help patients with cancer and providers better understand current pharmacogenomic prescribing and testing practices. This retrospective observational study analysed patients with cancer, drugs with pharmacogenomic evidence and related genetic testing in the National Institutes of Health All of Usdatabase. Most patients with cancer (19 633 (88.3%) vs 2590 (11.7%)) received ≥1 drug and 36 (0.2%) received genetic testing, with a significant association between receiving ≥1 drug and age group (p<0.001), but not sex (p=0.612), race (p=0.232) or ethnicity (p=0.971). Drugs with pharmacogenomic evidence—but not genetic testing—were common for patients with cancer, reflecting key gaps preventing precision medicine from becoming standard of care.

Explorar las necesidades, motivos y limitaciones hacia la alimentación saludable y hacia material digital desarrollado, así como identificar pautas para su diseño como estrategia dirigida a familias mexicanas.

AbstractThe objective of this study was to evaluate nutrient digestibility, nitrogen balance, and purine derivative excretion from growing sheep fed on ryegrass silage (S) or ryegrass hay (H) cut at two maturity stages (21 and 35 d). In an in vivotrial, 32 Suffolk × Merino growing sheep (22 ± 2 kg) were used in a completely randomised design with eighth replications in a 2 × 2 factorial arrangement. Four diets were used containing 75% forage (S at 21 or 35 d and H at 21 or 35 d) and 25% concentrate. In an in vitrotrial, a completely randomised design was used for gas production parameters. Contents of N and NDF were higher in H (30 and 674 g/kg DM) than in S (26 and 411 g/kg DM). Animals fed on S had higher digestibility (P < .008) of DM and OM (661 and 715 g/kg) than H at 35 d (557 and 596 g/kg). In vitrogas production was lower (P < .04) in H at 35 d. In vitroDM disappearance at 96 h was lower (P < .03) for H at 35 d. Excretion of allantoin (mmol/day) in urine was higher (P < .001) in S (7.91 and 3.95) than H (5.01 and 3.03) at 21 and 35 d respectively. Overall, compared to ryegrass hay, ryegrass silage cut at 21 d can be an advantageous feeding strategy for growing sheep without negative effects in nutrient intake, N-balance, and purine derivatives.HighlightsContents of N and NDF were higher in hay than in silage form ryegrass.Animals fed on silage had higher digestibility of DM and OM.In vitrogas production was lower in hay cut at 35 days.

AbstractThe objective of the present study was to determine the dietary effect of different growth stages of rapeseed (Brassica rapaL.) on nutrient intake and digestibility, nitrogen balance, and rumen fermentation kinetics in sheep. Four dietary treatments were utilised. A basal control diet based on alfalfa hay, oat hay, soybean meal and corn grain. Then alfalfa hay was replaced with 300 g/kg DM of rapeseed forage harvested at three different growth stages: Vegetative, Flowering and Pod. In vitrogas production was determined using three rumen cannulated Suffolk sheep in a completely randomised design, and nutrients intake and digestibility of each diet were determined using four Suffolk sheep in a 4 × 4 Latin square design with 21 d periods consisting of 14 d for diet adaptation and 7 d for sample collection. Feed intake and excretion of faeces and urine were recorded. Dry matter intake was higher for control and Pod compared to Vegetative and Flowering. The digestibility of dry matter, organic matter, neutral detergent fibre and acid detergent fibre were similar among treatments. Nitrogen intake was higher for control and Pod and lower for Vegetative and Flowering. In vitrogas production was similar among treatments (P > .05). In vitrogas yield at 24 h was higher (P < .05) for control than the rest of the treatments. Overall, inclusion of 300 g/kg DM of rapeseed forage harvested at pod stage as a substitute for alfalfa hay is an alternative source of protein without affecting nutrient intake and digestibility.HighlightsEffect of different growth stages of rapeseed on nutrient intake and digestibility was determinedNutrient digestibility was similar between growth stages of rapeseedIn vitrogas production was similar between growth stages of rapeseed

El primer caso de COVID-19 se detectó en México el 27 de febrero de 2020. El 30 de abril, 64 días después de este primer diagnóstico, el número de pacientes aumentó exponencialmente, alcanzando un total de 19.224 casos confirmados y 1.859 (9,67%) fallecidos. En respuesta a este brote global, resumimos el estado actual del conocimiento sobre COVID-19 en México.

Adenoid cystic carcinoma (ACC) of the eyelid is a very rare tumor, and only 11 cases have been previously reported in the literature. Here the authors report the 12th case of eyelid ACC that was initially diagnosed as adenoid basal cell carcinoma. This is the first report of local recurrence after wide local excision using the Mohs technique. Additionally, this is the first report that demonstrates that ACC can present clinically and histologically similar to basal cell carcinoma. The authors summarize the previous reports of eyelid ACC to compile a reference for this growing body of literature. It is important for oculoplastic surgeons and dermatopathologists to keep ACC in the differential diagnosis of eyelid tumors and carefully examine histology specimens with this differential in mind.This is a case report of adenoid cystic carcinoma originating from the eyelid and mimicking a basal cell carcinoma and first report of local recurrence after Mohs resection.

Background:Differences in gut microbiota composition have been associated with obesity and metabolic alterations in children. The aim of this study was to analyze the abundance of the main bacterial families of the gut among children according to their body composition and metabolic markers.Methods:A cross-sectional study was conducted with 93 school-aged children (8.4 ± 1.6 years old). Anthropometric and body composition variables were measured and a blood sample was collected to determine glucose, insulin, lipid profile, C-reactive protein, leptin, and cytokines [interleukin 6, interleukin 10 (IL-10), tumor necrosis factor α (TNFα)]. DNA was extracted from stool samples and the abundance of bacterial families (Bacteroidaceae–Porphyromonadaceae–Prevotellaceae, Lactobacillaceae, Enterococcaceae, and Lachnospiraceae–Ruminococcaceae) was determined by qPCR assays.Results:Children with obesity and high waist/height ratio had lower Bacteroidaceae–Porphyromonadaceae–Prevotellaceaeand higher abundance of Lactobacillaceaewhen compared with normal-weight children. TNFα was negatively associated and IL-10 was positively associated with Bacteroidaceae–Porphyromonadaceae–Prevotellaceae.Triglycerides showed a positive relationship with Lachnospiraceae–Ruminococcaceaewhereas high-density lipoprotein-cholesterol was negatively associated with Lactobacillaceae.Conclusion:In rural Mexican school-aged children, a low abundance of Bacteroidaceae–Porphyromonadaceae–Prevotellaceaeand a high abundance of Lactobacillaceaeare associated with obesity and metabolic disturbances.

Fibrin glues carry many advantages over traditional suture as a tissue adhesive and have been increasingly used in a variety of ophthalmic procedures over the past 15 years. Several fibrin sealants are commercially available worldwide, each of which differs slightly in its composition and mechanism of delivery. The focus of our review is to briefly discuss the reported uses of fibrin in ophthalmic surgery and provide a broad overview of the properties associated with each commercially available fibrin sealant.

Determinar el control de la presión arterial sistólica (PAS) de forma retrospectiva según las recomendaciones de la guía ESC/ESH-2018 y su probable asociación con la mortalidad en pacientes octogenarios con demencia.

•A total of 48% of pregnant or breastfeeding respondents were unvaccinated.•For unvaccinated persons, friends/family and health providers hold similar sway in vaccine choices.•A proportion of unvaccinated respondents were willing to get vaccinated eventually.

The objective was to evaluate the effect of feed inoculation with effective microorganisms (EM®) (mainly containing Lactobacillus spp.,Rhodopseudomona palustrisand Saccharomyces cerevisiae) on rumen fermentation using in vitrogas production technique. We hypothesized that increasing doses and allowing exposure of EM® for up to 48 hours, would improve digestibility and rumen fermentation. The experimental design was a 4×4 completely randomized block design including 4 EM® levels [(0(EM0), 0.5(EM0.5), 1.0 (EM1) and 1.5 (EM1.5) mL EM® / kg DM] and 4 preincubation times [0 (T0), 12(T12), 24(T24), 48 (T48) h], with four repetitions per treatment. Treatments were evaluated using 100ml glass bottles with 0.5g of the diet (20% corn stover, 20% oat hay, 48.8% ground corn, 7% molasses, 1.2% urea, 1% soybean meal, 0.9% mineral premix,1.1% salt, dry matter basis) incubated with sheep ruminal fluid in 3 different occasions. Data were analyzed with PROC MIXED of SAS and orthogonal contrasts to determine the linear and quadratic effects of EM dose and exposure time. Interaction (P < 0.05) of EM x T was observed for in vitrodry matter digestibility (IVDMD), maximum gas volume (Vmax), total volatile fatty acids (VFA), acetate (ACE), propionate (PROP), butyrate (BUT) and ammonia-nitrogen (NH3), IVDMD was higher (P < 0.01, 4.8 and 3.72%) for T48EM1.5 than T12EM0 and T0EM0, PROP was higher (P < 0.05) for T48EM0, T48EM1 and 1.5 than T12EM0. The ACE:PROP ratio was higher (P < 0.05, 17.2%) for T12EM0 than T48EM1.5. IVDMD, PROP and NH3 linearly increased (P < 0.01) with increasing exposure time. EM levels have a quadratic effect (P < 0.01) with maximum response at EM0.5. It was concluded that the addition of 0.5 to 1.5 mL/kg DM of EM® to a sheep diet and increasing preincubation time, up to 48h, improve feed fermentation and digestibility.Project was supported by UNAM, DGAPA, PAPIIT (IT202120).

ObjectiveTo assess how the baby food market in the UK has changed between 2013 and 2019.SettingUnited Kingdom.DesignA cross-sectional survey of all infant food products available to buy in the UK online and in-store collected in 2019. Nutritional content and product descriptions were recorded and compared with an existing 2013 database.Main outcome measuresChange in the proportion of products marketed to infants aged 4 months, proportion classified as sweet versus savoury, spoonable versus dry (snacks) average sugar content.ResultsFewer products were described as suitable for infants aged 4 months in 2019 (201, 23%) compared with 2013 (178, 43%; p<0.001), while the proportion for children in the 6–7-month age range increased (2013: 135, 33%; 2019: 369, 43%; p=0.001). The proportion of sweet and savoury products was unchanged; sweet spoonable products showed a small but significant decrease in sugar content (6%) between 2013 and 2019, but savoury spoonable products showed a 16% increase. Sweet snacks remained very sweet (~20 g/100 g median sugar at both time points). In the 2019 dataset, concentrated juice was added to 29% (n=253) of products and 18% (n=80) ‘savoury’ products comprised more than 50% sweet vegetables or fruit. The number and proportion of snacks increased markedly in 2019 (185, 21%) compared with 2013 (42, 10%; p=0.001) while the proportion of wet spoonable foods decreased (2013: 326, 79%; 2019: 611, 71%; p=0.001).ConclusionsFewer foods are now marketed to infants aged 4 months, but there has been no overall reduction in the sweetness of products and the increase in snack foods and the sweetness of savoury foods is a concern.

PURPOSE:To compare U.S. Food and Drug Administration (FDA)–reported visual and refractive outcomes following surgical correction of myopia and myopic astigmatism using the Visian Toric Implantable Collamer Lens (STAAR Surgical, Monrovia, CA) (Toric ICL), small incision lenticule extraction (SMILE), and topography-guided laser in situ keratomileusis (TG-LASIK).METHODS:FDA summary of safety and effectiveness data (SSED) were analyzed for each of the three platforms. Primary outcomes measured were efficacy, safety, stability, and accuracy of refractive correction. Stratified mean refractive spherical equivalent (MRSE) data were assessed.RESULTS:One hundred twenty-four Toric ICL patients (210 eyes), 357 SMILE patients (357 eyes), and 212 TG-LASIK patients (249 eyes) were included. SMILE eyes had a significant improvement in postoperative uncorrected distance visual acuity with respect to preoperative corrected distance visual acuity from 3 to 12 months (One hundred twenty-four Toric ICL patients (210 eyes), 357 SMILE patients (357 eyes), and 212 TG-LASIK patients (249 eyes) were included. SMILE eyes had a significant improvement in postoperative uncorrected distance visual acuity with respect to preoperative corrected distance visual acuity from 3 to 12 months (P< .001), whereas TG-LASIK had no further improvement from 3 to 12 months (P= .79). For preoperative MRSE greater than 10.00 diopters (D), there was a significant difference in the percentage of eyes achieving postoperative MSRE within ±0.50 D between Toric ICL (66%) and SMILE (100%) (P< .001). SMILE was consistently more accurate than Toric ICL for cylinder within ±0.25 D (P< .001), ±0.50 D (P< .001), and ±1.00 D (P= .0014).CONCLUSIONS:All three platforms analyzed in this study had excellent efficacy, safety, stability, and accuracy. Stratified analysis revealed that SMILE may be comparable to Toric ICL for patients with high myopia or myopic astigmatism, and SMILE may have a longer visual recovery compared to TG-LASIK than previously indicated.[[J Refract Surg. 2019;35(11):699–706.]

The purpose of this project was to develop a multidimensional understanding of synergistic connections between food-related and emotional health in the lives of Latina immigrants using a community-engaged approach with women who participate in a social isolation support group. The domains of interest included the intersection of social isolation, depression, diabetes, and food insecurity. We tested an innovative “structured dialogue” (SD) approach to integrating the domains of interest into the group dynamic. We documented key positive impacts of participation in the group on women’s everyday experiences and emotional wellbeing. We demonstrated the extent to which this approach increases women’s knowledge of food and food resources, and their self-efficacy for dealing with diabetes and food insecurity.

PURPOSE:To describe a case of light adjustable lens implantation after radial keratotomy.METHODS:A patient with a 30-year history of radial keratotomy subsequently underwent phacoemulsification with implantation of intraocular light adjustable lenses. Serial refractions were performed at varying hours of the day postoperatively and were repeated for 3 months. The light adjustable lenses were adjusted twice, and the refractive power of the implant was eventually locked.RESULTS:The patient was able to achieve uncorrected distance visual acuity of 20/25 in both eyes, improving from 20/125 in the right eye and 20/80 in the left eye, with no surgical complications.CONCLUSIONS:The authors report the first case of light adjustable lens implantation after radial keratotomy, which has yielded promising results for mitigating intraocular lens miscalculations after radial keratotomy.[[J Refract Surg. 2020;36(12):852–854.]

AbstractThis meta-analysis aims to identify if there are differences between the weight of lamb carcases and their main characteristics according to the production systems and type of feeding around the word. Lambs finished on feeding supplement (with or without supplement) and production system (feed-lot or free-range) were analysed. Data from 21 controlled studies were used, the variables of interest in the meta-analysis include: initial body weight (IBW, kg), final body weight (FBW, kg), hot carcase weight (HCW, kg), cold carcase weight (CCW, kg), area of longissimus dorsi(ALd, cm2), subcutaneous dorsal fat thickness (SFT, mm) and slaughter weight (kg). The high heterogeneity (>98%) found in this study may be due to many factors (breed, climate, age and management). Furthermore, the number of animals allocated for each treatment and the lack of repetitions make it difficult to correctly understand the effect of feeding and production system on the lamb meat. Lambs finished in a feedlot or with supplementation under extensive systems exhibit faster growth rates, achieve target weights quicker, and produce heavier carcase weights when compared to grazing lambs.HighlightsLambs finished in a feedlot or with supplementation under extensive systems exhibit faster growth rates compared to grazing lambs.Lambs finished in a feedlot or with supplementation under extensive systems achieve target weights quicker compared to grazing lambs.Finishing lambs on high-quality pasture can produce satisfactory growth rates without compromising characteristics of carcase.

IMPORTANCE: The apparent genetic penetrance of macular telangiectasia type 2 (MacTel) is important for gene discovery studies and for clinical risk assessment of affected individuals’ family members. OBJECTIVE: To determine the genetic penetrance of MacTel. DESIGN, SETTING, AND PARTICIPANTS: Descriptive cross-sectional study of patients with MacTel at a tertiary referral eye center. From 2008 to 2016, consecutive patients with MacTel were independently identified, and all of their available siblings and parents were recruited. Seventeen probands with MacTel were included in the study who satisfied the requirement of having at least 1 parent or sibling willing and able to participate. Data from these 17 families were included for the analysis of apparent genetic penetrance. MAIN OUTCOMES AND MEASURES: Determination of MacTel genetic penetrance in probands’ parents and siblings. RESULTS: Of 80 study participants, 50 (62.5%) were women. The mean (SD) age of study participants with MacTel was 61.2 (14.0) years (range, 23-81 years) and without MacTel was 60.7 (16.4) years (range, 24-92 years). There were 17 MacTel probands, and there was a high rate of enrollment of living siblings and parents: 52 of 71 living siblings (73%) and 11 of 12 parents (92%). Of 52 enrolled siblings, 9 (17%) were affected. Of 11 enrolled parents, 3 (27%) had MacTel. Apparent genetic penetrance was calculated to be 0.35 (95% CI, 0.14-0.6) by sibling analysis and 0.55 (95% CI, 0.02-1.00) by parent analysis. Combining the sibling and parent analyses, the apparent penetrance was calculated to be 0.38 (95% CI, 0.19-0.57). CONCLUSIONS AND RELEVANCE: The genetic penetrance of MacTel in rigorously phenotyped multiple large families is described. Families such as these could be critical for successful identification of MacTel genes.

Primary synovial chondromatosis is a rare, benign disorder due to metaplastic proliferation of the synovium, leading to the formation of cartilaginous loose bodies. Typically monoarticular and intra-articular, its occurrence in the shoulder is uncommon, and concomitant extra-articular involvement is very rare. Removal of the loose bodies with synovectomy is usually the only standard form of treatment. This is the case of a 23-year-old male patient from Myanmar who presented with a 2-year history of right shoulder pain with progressive limitation of motion. Radiographic and magnetic resonance imaging findings were consistent with chondromatosis, showing multiple loose bodies within the glenohumeral joint, extending to the subcoracoid area and along the extra-articular biceps tendon. Arthroscopic synovectomy, debridement, and removal of loose bodies was performed, with subsequent conversion to open removal of loose bodies. A capsular shift was also performed due to an enlarged inferior pouch and a loosened anterior capsule. This paper presents a rare case of synovial chondromatosis of the shoulder with both intra-articular and extra-articular involvement. The standard of care addresses loose body removal. However, associated problems should be established when dealing with similar problems. In this case, careful preoperative and perioperative evaluation identified other areas affected and dealt with the potential complication of shoulder instability.