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AimsTo determine the prevalence and predictors of myopic macular degeneration (MMD) in a consortium of Asian studies.MethodsIndividual-level data from 19 885 participants from four population-based studies, and 1379 highly myopic participants (defined as axial length (AL) >26.0 mm) from three clinic-based/school-based studies of the Asian Eye Epidemiology Consortium were pooled. MMD was graded from fundus photographs following the meta-analysis for pathologic myopia classification and defined as the presence of diffuse choroidal atrophy, patchy chorioretinal atrophy, macular atrophy, with or without ‘plus’ lesion (lacquer crack, choroidal neovascularisation or Fuchs’ spot). Area under the curve (AUC) evaluation for predictors was performed for the population-based studies.ResultsThe prevalence of MMD was 0.4%, 0.5%, 1.5% and 5.2% among Asians in rural India, Beijing, Russia and Singapore, respectively. In the population-based studies, older age (per year; OR=1.13), female (OR=2.0), spherical equivalent (SE; per negative diopter; OR=1.7), longer AL (per mm; OR=3.1) and lower education (OR=1.9) were associated with MMD after multivariable adjustment (all pConclusionIn this pooled analysis of multiple Asian studies, older age, female, lower education, greater myopia severity and longer AL were risk factors of MMD, and myopic SE was the strongest single predictor of MMD.

We postulate that the trends for infective endocarditis (IE) are different for patients admitted for this condition compared with those admitted for a different reason with IE as a secondary diagnosis. Using the Myocardial Infarction Data Acquisition System (MIDAS) database, we analyzed 21,443 records of patients hospitalized with diagnosis of IE from 1994 to 2015. There were 9,191 patients hospitalized with IE as the primary diagnosis, and 12,252 patients with IE as a secondary diagnosis. Piecewise linear models were used to detect changes in trends. A bootstrap method was used to assess the statistical significance of the slopes and break point of each model. Differences in co-morbidities and microbiological patterns were analyzed. Trend analysis showed a significant decrease in IE as the primary diagnosis starting in the year 2004 (p0.01). Hospitalizations with IE as a secondary diagnosis showed a linear increase in incidence (p0.001), without any change points. In primary diagnosis IE, the proportion of streptococci as a causative microorganism was higher compared with staphylococci (p0.001). On the contrary, in secondary diagnosis IE, the proportion of staphylococci was higher than streptococci (p0.001). The proportion of gram-negative and other organism IE was similar in both groups. In conclusion, this study showed 2 divergent temporal trends in hospitalizations for IE as a primary or secondary diagnosis starting in 2004. The profile of the microorganisms reveals a steady higher proportion of staphylococcal infection in secondary diagnosis IE compared with streptococcal infection. Different strategies are needed for the prevention of IE.

Purpose: There has been considerable debate on the extent to which the decline in coronary heart disease (CHD) mortality has been caused by better control of coronary risk factors in the general population or is the result of invasive coronary interventions in symptomatic individuals. Methods Using the Myocardial Infarction Data Acquisition System, a statewide database of all cardiovascular hospital admissions in New Jersey, we examined time trends in incidence of death from CHD in the Years 2000–2014 in persons with a history of hospitalization for CHD in the previous 10 years and those without such a history. Results Over the 10-year study period, there was a marked decline in CHD-related mortality in both persons with a history of CHD and persons without a history of CHD. The decline occurred across all gender, racial, and age groups and was higher in those without a prior history of CHD. Conclusions This adds more evidence that the decline in CHD was not only because of advanced invasive medical and surgical treatments but also equally because of improved lifestyle, pharmacologic treatment of risk factors for CHD, and public health interventions.

Due to increasing power demand in the recent scenario, intensely integrated penetration of distributed generation (DG) has become need of the day. Grid-tied inverter based DG is becoming popular due to its effective controllability. However, voltage unbalance is observed sometime at the Point of Common Coupling (PCC) due to fluctuating demands of injection of active-reactive power by the DG into the Grid. This paper presents realization of two different topologies of grid tied inverter - conventional two-level three-phase four-wire, and three-level T-type Neutral Point Clamped (T-NPC) based DG, both controlled by three-phase damping control strategy. Simulation studies presented indicate effective operational control for DG based on both these topologies of inverter under various operating conditions. The primary function of DG, which is to inject power into the grid and decrease the burden on the conventional generation system is analyzed. Effective behavior of the proposed two-level as-well-as three-level DG without giving rise to voltage unbalance issue is presented in this paper. Detailed analysis of unbalance index and total harmonic distortion (THD) for PCC voltages and currents is presented. Also, performance of both the proposed DGs for fulfilling load requirement during operation in islanding mode are presented. Satisfactory voltage compensation capability of DGs is depicted from the presented results for single-phase asymmetric fault and three-phase symmetric faults. Low voltage ride through capability, reduction in unbalance index, and THD within the standard limits are the main features of the presented DG systems.

Background: There are limited reports of uveal “melanocytic” lesions in patients with oculocutaneous albinism, with no reports from Asia. Objectives: In this study, we report 3 eyes with uveal “melanocytic” lesions in Asian patients with oculocutaneous albinism. Methods: Retrospective small case series. Three eyes of 2 Asian patients with oculocutaneous albinism were included. Case 1 was a 54-year-old female who presented with juxtapapillary choroidal melanoma and underwent enucleation. Case 2 was a 39-year-old male with pigmented choroidal nevus in the right eye and suspicious nevus/choroidal variegation in the left eye. Results: For case 1, metastatic workup including ultrasound of the abdomen, liver function test, and chest X-ray was unremarkable. Magnetic resonance imaging of the cranium ruled out extraocular extension. The left eye was enucleated due to the large tumor size and poor visual potential, and histopathological examination confirmed the diagnosis of choroidal melanoma with mixed cell type. At the last follow-up 6 months after enucleation, there was no evidence of metastasis. Case 2 was observed. Conclusion: Pigmented choroidal nevus and melanoma are rarely observed in patients with oculocutaneous albinism.

There is a gap in knowledge about the clinical course of patients admitted with non-specific chest pain (NSCP) and discharged after finding no evidence of cardiovascular disease. The MIDAS database, a statewide repository for all cardiovascular discharges in New Jersey was used to study 107,692

Background: The incidence of myocardial infarction (MI) has been decreasing for several decades. However, scant data are available on whether this decline has been magnified, diminished, or remained stable over the recent 15 year period. Methods: Using the Myocardial Infarction Data Acquisition