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In this Letter we show that pseudoscalar meson leptonic decay data can be used to set stringent limits on the mass m_{W_{R}} of a right-handed vector boson, such as the one that appears in left-right symmetric models. We have shown that for a heavy neutrino with a mass m_{N} in the range 50

Aim: To evaluate the clinical effectiveness and implementation strategies of telecare consultations in post-stroke nurse-led clinics., Background: Telecare consultations could be an alternative to conventional in-person consultations and improve continuity of care for stroke survivors following their discharge from hospital. Previous studies utilizing telecare consultations only focused on testing their clinical effectiveness on stroke survivors; the appropriateness and feasibility of adopting this new delivery modality in a real-world setting were not examined., Design: A Type II hybrid effectiveness-implementation design will be adopted., Methods: Eligible stroke survivor participants will be randomly assigned to the intervention group (telecare consultation) or control group (usual in-person clinic consultation). Both groups will receive the same nursing intervention but delivered through different channels. The Reach, Effectiveness, Adoption, Implementation, Maintenance framework will be used to evaluate the clinical effectiveness and implementation outcomes. The primary outcome is the non-inferiority of the degree of disability between the two groups at 3 months into the intervention and at 3 months post-intervention. The paper complies with the SPIRIT guidelines for study protocols adapted for designing and reporting parallel group randomized trials., Conclusion: The findings of this study will provide key insights into the processes for implementing and adopting telecare consultations into long-term services for post-stroke patients., Impact: This study contributes to the translation of telecare consultations for stroke survivors into real-life settings. If effective, this program may provide guidance for expanding telecare consultations to other post-stroke nurse-led clinics or to patients with other chronic diseases., Trial Registration: This study has been registered at clinicaltrials.gov (identifier: NCT05183672). Registered on 10 January 2022., (© 2023 John Wiley & Sons Ltd.)

Introduction: Tenecteplase is a thrombolytic with higher fibrin affinity and is potentially better in clot lysis. A higher spontaneous recanalisation rate for large vessel occlusion (LVO) strokes had been shown in comparison studies with alteplase. Results of the LVO studies reflect the composite effect of the thrombolytic and thrombectomy, as patients would be treated by thrombectomy had they not been recanalised by intravenous thrombolysis alone. Thrombectomy is not readily available in many parts of the world. Our study aimed to compare the outcomes of suspected LVO patients treated with tenecteplase versus alteplase only, without the confounding effect of thrombectomy., Methods: This is a retrospective review. Data of patients given tenecteplase from May 2020 to August 2023 and those given alteplase 0.9 mg/kg from January 2019 to August 2023 were retrieved. Due to fluctuation in supply of tenecteplase during the COVID pandemic, some LVO patients were given alteplase. Patients with anterior circulation, clinically suspected LVO strokes (defined as National Institutes of Health Stroke Scale (NIHSS) score ≥6, plus cortical signs or hyperdense vessel sign), with thrombolysis given within 4.5 h of stroke onset were analysed. Patients with thrombectomy done were excluded. Safety and efficacy outcomes were compared., Results: There were 245 tenecteplase-treated patients treated between May 1, 2020, and August 31, 2023, and 732 patients were treated with alteplase between January 1, 2019, to August 31, 2023. Out of these, 148 tenecteplase patients and 138 alteplase 0.9 mg/kg patients fulfilled the study criteria. The symptomatic intracerebral haemorrhage rate was non-significantly lower in the tenecteplase group (2.1% vs. 5.8%, p = 0.13). There were no significant differences in the rate of ≥8-point NIHSS improvement (23.6% vs. 23.7%, p = 1) or the ≥4-point improvement (40.5% vs. 40.7%, p = 1) at 24 h. At 3 months, 21.6% of tenecteplase patients had good functional outcome (modified Rankin scale [mRS] 0-2), compared to 26.3% in the alteplase group (p = 0.40)., Conclusion: In this pragmatic study of clinically suspected anterior circulation LVO patients without thrombectomy, outcome solely reflects the effects of tenecteplase. Tenecteplase showed comparable safety and efficacy to alteplase, but the result should be interpreted with caution in view of its small sample size and non-randomised study design., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Background: No large-scale studies have compared associations between body composition and cardiovascular risk factors across multi-ethnic populations., Methods: Population-based surveys included 30,721 Malay, 10,865 Indian and 25,296 Chinese adults from The Malaysian Cohort, and 413,737 White adults from UK Biobank. Sex-specific linear regression models estimated associations of anthropometry and body composition (body mass index [BMI], waist circumference [WC], fat mass, appendicular lean mass) with systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), triglycerides and HbA1c., Results: Compared to Malay and Indian participants, Chinese adults had lower BMI and fat mass while White participants were taller with more appendicular lean mass. For BMI and fat mass, positive associations with SBP and HbA1c were strongest among the Chinese and Malay and weaker in White participants. Associations with triglycerides were considerably weaker in those of Indian ethnicity (eg 0.09 [0.02] mmol/L per 5 kg/m 2 BMI in men, vs 0.38 [0.02] in Chinese). For appendicular lean mass, there were weak associations among men; but stronger positive associations with SBP, triglycerides, and HbA1c, and inverse associations with LDL-C, among Malay and Indian women. Associations between WC and risk factors were generally strongest in Chinese and weakest in Indian ethnicities, although this pattern was reversed for HbA1c., Conclusion: There were distinct patterns of adiposity and body composition and cardiovascular risk factors across ethnic groups. We need to better understand the mechanisms relating body composition with cardiovascular risk to attenuate the increasing global burden of obesity-related disease., (© 2023. The Author(s).)

Background: Globally, nurse-led post-acute stroke clinics have been developed to provide secondary care services to stroke survivors. Although synthesized evidence supports the idea that the secondary prevention services delivered by nurses in these clinics can improve the functional ability of stroke survivors and reduce their readmission rates, long travel and waiting times, high costs, and the pandemic have limited the utilization of such clinics. Telecare consultations are a new modality for expanding public access to healthcare services, although how it can be applied in nurse-led clinics has not been reported., Objective: The aim of this study is to determine the feasibility and effects of telecare consultations in nurse-led post-acute stroke clinics., Methods: The study adopts a quasi-experimental design. The participants will receive three secondary stroke care consultations in 3 months provided via telecare by experienced advanced practice nurses. The outcome measures include feasibility (reasons for refusing to participate and for dropping-out, the attitudes and satisfaction of both the advanced practice nurses and their patients towards the programme), and preliminary effectiveness (degree of disability after stroke, activities of daily living, instrumental activities of daily living, health-related quality of life, depression) outcomes. Data will be collected at pre-(T1) and post-(T2) intervention., Conclusions: The findings of this study may help facilitate the implementation of telecare consultations in a nurse-led post-acute stroke clinic, which may benefit the stroke survivors who are having mobility restrictions from accessing customary healthcare services and may protect them from being exposed to the infectious risk., (© The Author(s) 2023.)

Objective: The ongoing pandemic has accentuated the use of telecare services; however, only limited progress has been made in understanding the barriers and facilitators to using these services. In order to move towards sustaining such essential services, the present study aimed to ascertain the experiences of stroke survivors and healthcare providers regarding the utilization of a post-stroke telecare service in Hong Kong., Methods: Interpretive description was employed for this study. Semi-structured discussions and interviews were undertaken with nine stroke survivors and four stroke nurses who delivered the telecare services. The principles of thematic analysis were inductively followed to analyse the data. The Standards for Reporting Qualitative Research checklist was used to guide the reporting of the data., Results: Three themes emerged: (a) pre-existing post-discharge service pathways; (b) push factors/facilitators for telecare usage; and (c) barriers to telecare usage. Overall, the telecare service was considered a significant alternative and one that complements conventional face-to-face follow-ups. Stroke survivors were motivated to use the service because it was convenient and flexible. However, significant barriers exist, including technical issues and a lack of guidelines and training opportunities for healthcare providers., Conclusions: Although telecare is still evolving, several factors drive stroke survivors to use the service. Attention needs to be paid to the emerging barriers to improve long-term usage of the service. Clear guidelines are needed to underpin the development and implementation of telecare services., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

The stakeholders' perceptions on the impacts of Urban Heat Island (UHI) are critical for reducing exposure and influencing their response to interventions that are aimed at encouraging a behaviour change. A proper understanding of the UHI impacts on the society, economy and environment is deemed an essential motivating factor for the stakeholders to work towards UHI mitigations in the local context. This study adopted an inductive qualitative approach using Stakeholder Dialogue Sessions (SDSs) to assess the perceived impacts of UHI among various stakeholders, comprising policy makers, academicians, developers and Non-Governmental Organizations (NGO), in a tropical metropolitan city. The results revealed five themes such as deterioration of public health, acceleration of urban migration patterns and spending time in cooler areas, reduction of workers' productivity, increased energy consumption by the households and deterioration of environmental quality and natural resources that were categorized into social, economic and environmental impacts. Although most of the stakeholders were quite unfamiliar with the term UHI, they still display a good understanding of the potential impacts of UHI due to their posteriori knowledge and ability to rationalize the physical condition of the environment in which they live. The findings provide useful insights and valuable information to the local authorities to tailor necessary actions and educational campaigns to increase UHI awareness among the stakeholders. Being among the earlier studies to use a qualitative approach to attain the aforementioned objective, the findings are crucial to determine the level of understanding of the stakeholders on the impact of UHI. Through this study, the authors have highlighted the gaps and needs for knowledge improvements aimed at behaviour change among the stakeholders., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Due to the changing climate, more frequent and prolonged heatwaves are expected to have a catastrophic consequence on urban human settlement. In tropical cities such as Kuala Lumpur (KL), the quality of the urban environment is made worse by urban heat island (UHI) phenomena due to poor urban planning practices. The prolonged exposure to urban heat is hypothesized to influence human health and well-being, especially in tropical urban areas with high population density. Therefore, a study was conducted to understand the association of urban heat stress with physical, psychosomatic and psychological (PPP) health symptoms within a tropical urban setting. Continuous urban microclimate monitoring is conducted using an automated weather station to define the level of heat stress in the study area expressed as Physiological Equivalent Temperature (PET). A cross-sectional approach is used to identify heat-related health symptoms experienced by the urban population. Through exploratory factor analysis, a total of 38 PPP health symptoms are reduced into 8 heat-related health clusters which are sensory organ pain, heat-related illnesses, cardiopulmonary, pain, fatigue, anxiety, somatization, and depression-related symptoms. Heat stress was found to significantly affect psychosomatic pain (p = 0.016) as well as psychological anxiety (p = 0.022) and somatization (p = 0.041) related symptoms. Other health clusters were not significantly associated with heat stress. More studies are needed to unravel the influence of confounding factors and the long-term impact of urban heat on the health and well-being of the urban population in a tropical city., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Rivers in Malaysia are classified based on water quality index (WQI) that comprises of six parameters, namely, ammoniacal nitrogen (AN), biochemical oxygen demand (BOD), chemical oxygen demand (COD), dissolved oxygen (DO), pH, and suspended solids (SS). Due to its tropical climate, the impact of seasonal monsoons on river quality is significant, with the increased occurrence of extreme precipitation events; however, there has been little discussion on the application of artificial intelligence models for monsoonal river classification. In light of these, this study had applied artificial neural network (ANN) and support vector machine (SVM) models for monsoonal (dry and wet seasons) river classification using three of the water quality parameters to minimise the cost of river monitoring and associated errors in WQI computation. A structured trial-and-error approach was applied on input parameter selection and hyperparameter optimisation for both models. Accuracy, sensitivity, and precision were selected as the performance criteria. For dry season, BOD-DO-pH was selected as the optimum input combination by both ANN and SVM models, with testing accuracy of 88.7% and 82.1%, respectively. As for wet season, the optimum input combinations of ANN and SVM models were BOD-pH-SS and BOD-DO-pH with testing accuracy of 89.5% and 88.0%, respectively. As a result, both optimised ANN and SVM models have proven their prediction capacities for river classification, which may be deployed as effective and reliable tools in tropical regions. Notably, better learning and higher capacity of the ANN model for dataset characteristics extraction generated better predictability and generalisability than SVM model under imbalanced dataset.

After 9/11, threat of nuclear attack on American urban centers prompted government agencies to develop medical radiation countermeasures to mitigate hematopoietic acute radiation syndrome (H-ARS) and higher-dose gastrointestinal acute radiation syndrome (GI-ARS) lethality. While repurposing leukemia drugs that enhance bone marrow repopulation successfully treats H-ARS in preclinical models, no mitigator potentially deliverable under mass casualty conditions preserves GI tract. Here, we report generation of an anti-ceramide 6B5 single-chain variable fragment (scFv) and show that s.c. 6B5 scFv delivery at 24 hours after a 90% lethal GI-ARS dose of 15 Gy mitigated mouse lethality, despite administration after DNA repair was complete. We defined an alternate target to DNA repair, an evolving pattern of ceramide-mediated endothelial apoptosis after radiation, which when disrupted by 6B5 scFv, initiates a durable program of tissue repair, permitting crypt, organ, and mouse survival. We posit that successful preclinical development will render anti-ceramide 6B5 scFv a candidate for inclusion in the Strategic National Stockpile for distribution after a radiation catastrophe.

This study quantitatively investigated the scientific progress of walkability research landscape and its future prospects using bibliometric indicators to highlight the research hotspots. The results accentuated multifaceted nature of walkability research landscape with a strong association towards public health disciplines. Keyword co-occurrence analysis emphasized that majority of the walkability studies centred on the interactions between walking and other three main factors such as built environment attributes, transportation and obesity. Based on the identified research hotspots, a brief state-of-the-art review of walkability studies was presented. Future prospects based on the unexplored research gaps within the hotspots were also discussed. High correlation (r = 0.99, p < 0.05) between annual publications and citation counts demonstrated the significance of walkability studies to the contemporary scientific community. Being one of the comprehensive studies to evaluate the historic trajectory of walkability research landscape, the findings were expected to accelerate a comprehensive understanding of the walkability research domain that will assist future research direction.

Recognizing and mainstreaming pertinent walkability elements into the university campus planning is crucial to materialise green mandates of the campus, while enhancing social and economic sustainability. In one of such attempts, this transverse study investigated the walking motivations, built environment factors associated with campus walkability and the relative importance of the studied built environment factors in reference to the sociodemographic attributes from the viewpoint of the campus community in a tropical university campus in Kuala Lumpur, Malaysia. An online survey using a structured questionnaire was conducted between May and September 2019. The built environment factors associated with campus walkability were expressed and ranked as adjusted scores (AS). Meanwhile, multivariable logistic regression was deployed to examine the relative importance of the studied built environment factors in reference to the sociodemographic attributes of the campus community. Among 504 total responses acquired, proximity between complementary land uses (90.7%) was reported as the main motivation for walking. On the other hand, street connectivity and accessibility (AS: 97.62%) was described as the most opted built environment factor, followed by land use (AS: 96.76%), pedestrian infrastructure (AS: 94.25%), walking experience (AS: 87.07%), traffic safety (AS: 85.28%) and campus neighbourhood (AS: 59.62%), respectively. Among the sociodemographic attributes, no regular monthly income (OR = 3.162; 95% CI = 1.165-8.379; p < 0.05) and willingness to walk more than 60 min inside the campus per day (OR = 0.418; 95% CI = 0.243-0.720; p < 0.05) were significantly associated with the expression of higher importance towards the reported built environment factors in the multivariate analysis. In brief, the findings of this study were envisaged to elicit valuable empirical evidence for informed interventions and strengthening campus sustainable mobility policies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Temperature-sensitive (ts) mutants provide powerful tools for investigation of cellular functions of essential genes. We report here asimple procedure to generate ts mutations using error-prone PCR within pcp1 that encodes aspindle pole body (SPB) component in Schizosaccharomyces pombe . This manipulation is not restricted to pcp1 , and can be suited to any essential genes involved in other processes.

Centriole-to-centrosome conversion (CCC) safeguards centriole homeostasis by coupling centriole duplication with segregation, and is essential for stabilization of mature vertebrate centrioles naturally devoid of the geometric scaffold or the cartwheel. Here we identified PPP1R35, a putative regulator of the protein phosphatase PP1, as a novel centriolar protein required for CCC. We found that PPP1R35 is enriched at newborn daughter centrioles in S or G2 phase. In the absence of PPP1R35, centriole assembly initiates normally in S phase, but none of the nascent centrioles can form active centrosomes or recruit CEP295, an essential factor for CCC. Instead, all PPP1R35-null centrioles, although stable during their birth in interphase, become disintegrated after mitosis upon cartwheel removal. Surprisingly, we found that neither the centriolar localization nor the function of PPP1R35 in CCC requires the putative PP1-interacting motif. PPP1R35 is thus acting upstream of CEP295 to induce CCC for proper centriole maintenance.

Seasonal haze episodes and the associated inimical health impacts have become a regular crisis among the ASEAN countries. Even though many emerging experimental and epidemiological studies have documented the plausible health effects of the predominating toxic pollutants of haze, the consistency among the reported findings by these studies is poorly understood. By addressing such gap, this review aimed to critically highlight the evidence of physical and psychological health impacts of haze from the available literature in ASEAN countries. Systematic literature survey from six electronic databases across the environmental and medical disciplines was performed, and 20 peer-reviewed studies out of 384 retrieved articles were selected. The evidence pertaining to the health impacts of haze based on field survey, laboratory tests, modelling and time-series analysis were extracted for expert judgement. In specific, no generalization can be made on the reported physical symptoms as no specific symptoms recorded in all the reviewed studies except for throat discomfort. Consistent evidence was found for the increase in respiratory morbidity, especially for asthma, whilst the children and the elderly are deemed to be the vulnerable groups of the haze-induced respiratory ailments. A consensual conclusion on the association between the cardiovascular morbidity and haze is unfeasible as the available studies are scanty and geographically limited albeit of some reported increased cases. A number of modelling and simulation studies demonstrated elevating respiratory mortality rates due to seasonal haze exposures over the years. Besides, evidence on cancer risk is inconsistent where industrial and vehicular emissions are also expected to play more notable roles than mere haze exposure. There are insufficient regional studies to examine the association between the mental health and haze. Limited toxicological studies in ASEAN countries often impede a comprehensive understanding of the biological mechanism of haze-induced toxic pollutants on human physiology. Therefore, the lack of consistent evidence among the reported haze-induced health effects as highlighted in this review calls for more intensive longitudinal and toxicological studies with greater statistical power to disseminate more reliable and congruent findings to empower the institutional health planning among the ASEAN countries.

Mitosis occurs efficiently, but when it is disturbed or delayed, p53-dependent cell death or senescence is often triggered after mitotic exit. To characterize this process, we conducted CRISPR-mediated loss-of-function screens using a cell-based assay in which mitosis is consistently disturbed by centrosome loss. We identified 53BP1 and USP28 as essential components acting upstream of p53, evoking p21-dependent cell cycle arrest in response not only to centrosome loss, but also to other distinct defects causing prolonged mitosis. Intriguingly, 53BP1 mediates p53 activation independently of its DNA repair activity, but requiring its interacting protein USP28 that can directly deubiquitinate p53 in vitro and ectopically stabilize p53 in vivo. Moreover, 53BP1 can transduce prolonged mitosis to cell cycle arrest independently of the spindle assembly checkpoint (SAC), suggesting that while SAC protects mitotic accuracy by slowing down mitosis, 53BP1 and USP28 function in parallel to select against disturbed or delayed mitosis, promoting mitotic efficiency.

Polo-like kinase 4 is known to drive centriole duplication, but the relevant substrate remains elusive. A new study shows that PLK4 phosphorylates a key centriolar component, Ana2/STIL, to initiate centriole assembly., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The conserved TACC protein family localises to the centrosome (the spindle pole body, SPB in fungi) and mitotic spindles, thereby playing a crucial role in bipolar spindle assembly. However, it remains elusive how TACC proteins are recruited to the centrosome/SPB. Here, using fission yeast Alp7/TACC, we have determined clustered five amino acid residues within the TACC domain required for SPB localisation. Critically, these sequences are essential for the functions of Alp7, including proper spindle formation and mitotic progression. Moreover, we have identified pericentrin-like Pcp1 as a loading factor to the mitotic SPB, although Pcp1 is not a sole platform., (Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.)

Centrioles are 9-fold symmetric structures duplicating once per cell cycle. Duplication involves self-oligomerization of the centriolar protein SAS-6, but how the 9-fold symmetry is invariantly established remains unclear. Here, we found that SAS-6 assembly can be shaped by preexisting (or mother) centrioles. During S phase, SAS-6 molecules are first recruited to the proximal lumen of the mother centriole, adopting a cartwheel-like organization through interactions with the luminal wall, rather than via their self-oligomerization activity. The removal or release of luminal SAS-6 requires Plk4 and the cartwheel protein STIL. Abolishing either the recruitment or the removal of luminal SAS-6 hinders SAS-6 (or centriole) assembly at the outside wall of mother centrioles. After duplication, the lumen of engaged mother centrioles becomes inaccessible to SAS-6, correlating with a block for reduplication. These results lead to a proposed model that centrioles may duplicate via a template-based process to preserve their geometry and copy number., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Purpose: This study aimed to assess self-reported satisfaction following cataract surgery, and the sustainability of improved visual function and health-related quality of life in a cataract surgical cohort over 3 years post-phacoemulsification surgery., Design: A clinic-based cohort study., Methods: Cataract surgical patients were recruited and followed up annually after surgery. Logarithm of the minimum angle of resolution (LogMAR) visual acuity, visual function (using the VF-14 questionnaire), and health-related quality of life (using the Short-Form Health Survey [SF-36] questionnaire) were assessed preoperatively and at 1, 2, and 3 years postoperatively., Results: Of the 2029 patients recruited, 1924 (94.8%) had at least 1 postoperative visit, and 1229 (63.9%) had the 3-year follow-up examination performed. The mean age was 75.1 ± 6 years, and 54.1% were female. Of the 1229, 439 (35.7%) and 286 (23.3%) had completed the VF-14 and SF-36 questionnaires, respectively, at all 3 follow-up visits. The majority (92.1%) of patients reported being satisfied with the outcome of the surgery 6 months postoperatively. The overall VF-14 scores were significantly improved at the 12-month postoperative visits compared with preoperative scores (P < 0.01), independent of age and sex. The improved VF-14 mean scores were sustained for up to 3 years postoperatively. Health-related quality of life (SF-36 scores) showed no significant changes between preoperative and 1-, 2-, and 3-year postoperative examinations., Conclusions: We documented the sustainability of improvement in visual function-related quality of life associated with cataract surgery over 3 postoperative years. Cataract surgery was not associated with improvement in health-related quality-of-life scores.

Purpose: To assess 3-year incidence and associated factors of posterior capsule opacification (PCO) after phacoemulsification surgery., Design: Cohort study., Methods: A total of 1934 consecutive patients aged ≥64 years undergoing phacoemulsification surgery at Westmead Hospital were recruited, of whom 1495 (77.3%) had retroillumination anterior segment images taken of the surgical eyes after 1 month and at a further postoperative visit within 3 years. Severe PCO was defined if the view of the optic disc was obscured, or neodymium-yttrium-aluminum-garnet capsulotomy was performed. Cumulative incidence of PCO was estimated using Kaplan-Meier methods. Associations of PCO with surgeon groups and different types of implanted intraocular lenses (IOLs) were assessed, adjusting for age, sex, diabetes, and ethnicity., Results: Three-year cumulative incidence of PCO was 38.5% (95% confidence interval [CI] 36.1%-40.9%) among the 1495 patients, including 4.7% (95% CI 3.5%-5.8%) with severe PCO. PCO incidence was higher in: (1) eyes operated on by junior trainees (49%) compared to those by senior ophthalmologist surgeons (36%) (adjusted odds ratio [OR] 1.6, 95% CI 1.2-2.0); and (2) eyes with hydrophobic, 3-piece (either square-edged [51%, OR 2.3, 95% CI 1.4-3.6] or partial-round-edged [39%, OR 1.5, 95% CI 1.1-2.1]), or hydrophilic IOLs (64%, OR 2.9, 95% CI 1.9-4.4) compared to those with single-piece, square-edged, hydrophobic IOLs (34%), after additional adjustment for surgeon group., Conclusions: Predominantly mild PCO occurred in one-third of eyes after phacoemulsification surgery. Possible predisposing factors associated with PCO development include surgery performed by ophthalmologic trainees and the use of hydrophilic or other hydrophobic IOLs apart from the single-piece, square-edged one., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Purpose: To compare mortality risk between cataract surgical patients with corrected and persistent visual impairment., Design: Cohort study., Methods: A total of 1864 consecutive patients, aged ≥64 years, undergoing phacoemulsification surgery at Westmead Hospital were followed annually for 5 years postoperatively. Visual impairment status in the surgical eye was categorized as none (presenting visual acuity [VA], ≥20/40), mild (VA <20/40-20/60), or moderate-severe (VA <20/60). All-cause mortality was obtained from the Australian National Death Index., Results: Of 901 patients with moderate-severe visual impairment before surgery, 60.4% (n = 544), 15.5% (n = 140), and 24.1% (n = 217) had no, mild, or moderate-severe visual impairment in the surgical eye, respectively, 1 month postoperatively. Age-standardized 5-year mortality rates were nonsignificantly lower in patients with either mild (24.7%, 95% confidence interval [CI] 16.5%-32.9%) or no visual impairment (24.1%, 95% CI 19.9%-28.4%) post surgery compared to that in patients whose moderate-severe visual impairment persisted (30.6%, 95% CI 23.3%-37.9%). After adjusting for age, sex, smoking, body mass index, and individual comorbid conditions, such as hypertension, diabetes, angina, myocardial infarction, stroke, transient ischemic attack, and kidney disease, patients with no visual impairment 1 month postoperatively had a lower mortality risk (HR 0.73, 95% CI 0.52-1.01) compared to those with persistent moderate-severe visual impairment after surgery. This finding was significant (HR 0.71, 95% CI 0.51-0.99) after additional adjustment for number of medications taken (continuous variable) and number (≥3 vs <3) of comorbid conditions., Conclusion: Correcting moderate-severe visual impairment in older patients with phacoemulsification surgery was associated with a lower mortality risk, compared to surgical patients whose visual impairment persisted postoperatively., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Purpose: To describe the change in visual acuity (VA) and incidence of visual impairment (VI) in an older population over a 15-year period., Design: Population-based cohort., Participants: Of the 3654 participants of the Blue Mountains Eye Study (BMES) baseline examination from 1992 through 1994, 1149 were re-examined during the 15-year follow-up between 2007 and 2010., Methods: Best-corrected VA by means of subjective refraction was measured with a logarithm of the minimum angle of resolution chart using Early Treatment Diabetic Retinopathy Study methods at each examination., Main Outcome Measures: Unilateral VI was defined as VA worse than 20/40 and blindness was defined as VA worse than 20/200 in the worse eye. Incident bilateral VI and blindness were determined according to VA in the better eye at the 15-year visit. Doubling of the visual angle was defined as a loss of 15 letters or more from baseline to the 15-year visit. Halving of the visual angle was defined as a VA improvement of 15 letters or more over the same period. Causes of VI were determined at examination, by photographic grading, and from medical records., Results: Cumulative 15-year incidence of unilateral and bilateral VI was 12.3% (95% confidence interval [CI], 11.0-13.6) and 5.2% (95% CI, 4.3-6.1), respectively, and for unilateral and bilateral blindness, the cumulative incidence was 3.7% (95% CI, 3.0-4.4) and 0.9% (95% CI, 0.5-1.3), respectively. These incidence rates increased significantly with increasing age (P<0.01 for trend). Doubling and halving of the visual angle occurred in 6.9% (95% CI, 5.9-7.9) and 1.6% (95% CI, 1.0-2.2) of participants, respectively. Cataract accounted for 48.5% of unilateral and bilateral incident VI, followed by age-related macular degeneration (26.9%). Age-related macular degeneration accounted for 56.9% of unilateral and bilateral incident blindness cases, followed by cataract (20.7%)., Conclusions: These data provide population-based estimates of long-term incidence of visual impairment among older persons. Our estimate for cumulative incidence of blindness, accounting for competing risk of death, was similar to that of the Beaver Dam Eye Study (BDES) after age standardization. However, our estimate for cumulative incidence of VI was lower compared with that observed in the BDES population. This difference may be explained in part by a higher mortality rate among our population., Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article., (Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Objective: We assessed whether correction of visual impairment (VI) by cataract surgery was associated with improved long-term survival in an older Australian population., Design: Population-based cohort study., Participants: In the Blue Mountains Eye Study, 354 participants, aged ≥ 49 years, had both cataract and VI or had undergone cataract surgery before baseline examinations. They were subsequently examined after 5- and 10-year follow-ups., Methods: Associations between the mortality risk and the surgical correction of VI (visual acuity [VA] <20/40, attributable to cataract) were assessed in Cox proportional hazard regression models, after multivariate adjustment, using time-dependent variables for the study factor., Main Outcome Measures: All-cause mortality., Results: The 15-year crude mortality of participants who had undergone cataract surgery at baseline with no subsequent VI (71.8%) was relatively similar to that in participants with cataract-related VI who had not yet undergone surgery (79.4%). However, after adjusting for age and sex, participants who underwent cataract surgery before baseline or during follow-up and no longer had VI had significantly lower long-term mortality risk (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.46-0.77) than participants with VI due to cataract who had not undergone cataract surgery. This lower mortality risk in the group with surgically corrected VI (HR, 0.54; 95% CI, 0.41-0.73) persisted after further adjustment for smoking, body mass index, home ownership, qualifications, poor self-rated health, the presence of poor mobility, hypertension, diabetes, self-reported history of angina, myocardial infarction, stroke, cancer, asthma, and arthritis. This finding remained significant (HR, 0.55; 95% CI, 0.41-0.73) after additional adjustment for the number of medications taken (continuous variable) and the number (≥ 5 vs. <5) of comorbid conditions (poor mobility, hypertension, diabetes, angina, myocardial infarction, stroke, cancer, asthma, or arthritis) as indicators of frailty., Conclusions: Surgical correction of VI due to cataract was associated with significantly better long-term survival of older persons after accounting for known cataract and mortality risk factors, and indicators of general health. Whether some uncontrolled factors (frailty or general health) could have influenced decisions not to perform cataract surgery in some participants is unknown. However, this finding strongly supports many previous reports linking VI with poor survival., Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references., (Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

A promising approach to the standard model flavor puzzle is based on the idea that the SU(3)3 quark-flavor symmetry is spontaneously broken by vacuum expectation values of "Yukawa fields" which minimize the symmetry invariant scalar potential at configurations corresponding to the observed quark masses and mixing angles. We show that this approach provides a simple and elegant explanation for CP conservation in strong interactions.

Purpose: To assess the impact of visual impairment and blindness on the incident use of community support services in the Blue Mountains Eye Study., Design: Population-based cohort., Methods: Of 3654 baseline participants (1992-1994), 2334, 1952, and 1149 were re-examined after 5, 10, and 15 years, respectively. Incident visual impairment was defined as subsequent development of visual impairment (visual acuity <20/40) in the better eye of subjects with best-corrected visual acuity ≥20/40 at baseline. Community support service use included regular use of Meals on Wheels, Home Care, or community nurse services. Informal support included assistance from family or friends. Discrete logistic regression models with time-dependent study and outcome variables were used to assess associations between visual impairment and subsequent use of support, adjusted for potential confounders., Results: Among participants with bilateral visual impairment at baseline, incident use of community services over 5-15 years was 41.7% compared to 19.4% in those without visual impairment at baseline (odds ratio, 1.39; 95% confidence interval, 0.54-3.60). Persons with incident bilateral visual impairment were more likely to subsequently need community support (odds ratio, 3.32; confidence interval 1.96-5.59) in 5 years, compared to persons without visual impairment during the entire follow-up period. Baseline older age, walking disability, receiving pension, and having 2+ hospital admissions within 12 months were also significantly associated with incident use of support services., Conclusions: Development of bilateral visual impairment in this cohort was associated with greater likelihood of subsequent use of community or informal support services in 5 years, independent of physical comorbidities., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Purpose: To assess eye-specific epiretinal membrane (ERM) incidence 3 years after phacoemulsification surgery, and ERM detection bias attributable to cataract., Design: Cohort study., Methods: We recruited 1932 cataract surgical patients aged ≥64 years at Westmead Hospital (2004-2007). The surgical eye of each patient was assessed for presence of cellophane reflex or preretinal fibrosis at preoperative and 1-month-postoperative visits, and annually thereafter, using retinal image grading. Agreement on ERM detection between preoperative and 1-month-postoperative visits was assessed using kappa statistics. Cumulative incidence of ERM from 1 month to 3 years postoperatively was estimated using Kaplan-Meier methods and compared to the 5-year incidence of idiopathic ERM in right eyes of age-matched Blue Mountains Eye Study (BMES) participants., Results: ERM prevalence was 13.9% among 1394 participants with retinal photographs taken 1 month postoperatively. Of 1040 participants with retinal photographs from both preoperative and 1-month-postoperative visits, ERM was detected in 3.1% and 14.8%, respectively, with low diagnostic agreement (kappa = 0.17). Of 1119 subjects without ERM 1 month post surgery, the 3-year cumulative incidence of ERM was 11.2% (95% confidence interval [CI], 9.4%-13.4%; cellophane reflex 6.6%; preretinal fibrosis 4.2%). The age-standardized 3-year incidence of ERM in the surgical cohort (12.1%, 95% CI 8.6%-16.9%) was higher than the 5-year incidence of the BMES subsample (4.4%, 95% CI 3.0%-6.0%)., Conclusions: A substantial under-detection of ERM in eyes before cataract surgery could incorrectly contribute to ERM incidence after surgery. Over 3 years, ERM developed in >10%, including preretinal fibrosis in 4%, of surgical eyes free of ERM 1 month post surgery., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objective: To clarify possible associations between cataract surgery and progression of age-related macular degeneration (AMD)., Design: Clinic-based cohort., Participants: We followed cataract surgical patients aged 65+ years in the Australian Cataract Surgery and Age-related Macular Degeneration (CSAMD) study. Patients who remained unilaterally phakic for at least 24 months after recruitment were included., Methods: We performed annual examinations with retinal photography. We assessed AMD using side-by-side grading of images from all visits. Paired comparisons between operated and nonoperated fellow eyes (defined as nonoperated or operated <12 months previously) were made using generalized estimating equation models., Main Outcome Measures: Incident early AMD was defined as the new appearance of soft indistinct/reticular drusen or coexisting retinal pigmentary abnormality and soft distinct drusen in eyes at risk of early AMD. Incident late AMD was defined as the new appearance of neovascular AMD or geographic atrophy (GA) in eyes at risk of late AMD., Results: Among 2029 recruited, eligible participants, 1851 had cataract surgery performed at Westmead Hospital, Sydney, and 1244 (70.7%) had 36-month postoperative visits. Of these participants, 1178 had gradable photographs at baseline and at least 1 follow-up visit. Of 308 unilaterally operated participants at risk of late AMD, this developed in 4 (1.3%) operated and 7 (2.3%) nonoperated fellow eyes (odds ratio [OR], 0.74; 95% confidence interval [CI], 0.23-2.36) after adjusting for the presence of early AMD at baseline. Of 217 unilaterally operated participants at risk of early AMD, this developed in 23 (10.6%) operated and 21 (9.7%) nonoperated fellow eyes (OR, 1.07; 95% CI, 0.74-1.65). Incident retinal pigment abnormalities were more frequent in operated than nonoperated fellow eyes (15.3% vs. 9.9%; OR, 1.64; 95% CI, 1.07-2.52). There was no difference in the 3-year incidence of large soft indistinct or reticular drusen between the 2 eyes (8.8% vs. 7.9%; OR, 1.12; 95% CI, 0.79-1.60)., Conclusions: Prospective follow-up data and paired eye comparisons of this older surgical cohort showed no increased risk of developing late AMD, early AMD, or soft/reticular drusen over 3 years. There was a 60% increased detection of retinal pigmentary changes in surgical eyes., (Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Background:   It is unclear whether differences exist in surgical complication rates and long-term visual acuity outcomes between patients whose phacoemulsification cataract surgery was performed by ophthalmological trainees and those performed by consultants., Design:   Prospective clinical cohort study., Participants:   1851 participants of the Cataract Surgery and Age-related Macular Degeneration study, aged ≥64 years, had cataract surgery performed at Westmead Hospital, Sydney., Methods:   Surgical complication rates and visual acuity at 24-month postoperative visits were compared between patients who were operated on by trainees and those operated on by consultants., Main Outcome Measures:   Surgical outcomes included operative complications recorded in surgical audit forms and 24-month postoperative visual acuity., Results:   Of 1851 patients, 1274 (68.8%) were reviewed 24 months after surgery. Of these, 976 had data on the type of surgeon who performed the operation. After excluding 152 challenging cases and three cases operated on by first-year trainees at the beginning of their training, 821 patients were included in this study, of those, 498 were operated on by trainees and 323 by consultants. Habitual visual acuity ≥6/12 was achieved in 77.3% (n = 385/498) and 74.3% (n = 240/323), respectively, of the two groups of patients 24 months postoperatively. Of 514 patients who had surgical audit data, the major complication rate was numerically greater, but not significantly different for the 330 trainee-operated (6.1%) patients, compared with the 184 consultant-operated patients (2.7%, P = 0.091)., Conclusions:   We found relatively comparable complication rates and visual outcomes after 2 years between patients operated on by ophthalmological trainees and those by consultants, in a cataract surgical cohort at Westmead Hospital., (© 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.)

Polarized cortical cues are known to guide spindle movements to dictate division axis and cleavage site during asymmetric cell division. In a recent issue of Nature Cell Biology, Kiyomitsu and Cheeseman (2012) report two novel spindle-intrinsic signals that regulate spindle orientation and position in symmetrically dividing human cells., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Purpose: To assess cataract surgery visual outcomes 12 months postoperatively in patients with diabetes, with or without diabetic retinopathy (DR), compared to patients without diabetes., Methods: We followed 1192 cataract surgical patients aged ≥65 for 12 months postoperatively. Standardised pre- and postoperative pinhole LogMAR visual acuity (VA) measurements were taken. Mean VA improvement was determined by comparing VA after 12 months to preoperative VA., Results: Of 1192 surgical patients, 324 (27.2%) had diabetes, of whom, 136 (42.0%) had DR. After adjusting for age, gender, diabetes duration and preoperative pinhole VA, the average VA gained 12 months after surgery was 10.8 letters among 868 patients without diabetes, 10.6 letters among 188 patients with diabetes but no DR, 10.0 letters among 95 patients with DR but no past laser treatment, and no letters among 41 patients with DR plus past laser treatment (p < 0.0001, compared to the other three groups). Diabetes duration ≥20 years was associated with mean VA gain of 3 fewer letters than duration <10 years (7 versus 10 letters, p = 0.023), after adjusting for age, gender, DR and preoperative pinhole VA., Conclusion: Cataract surgery improved VA by an average two lines for patients both with and without diabetes, or with DR but no past laser treatment. No significant VA improvement was evident for patients who had preoperative DR and laser therapy., (© 2010 The Authors. Acta Ophthalmologica © 2010 Acta Ophthalmologica Scandinavica Foundation.)

Purpose: To assess whether improved visual acuity (VA) is sustained 2 years after the cataract surgery., Methods: The Cataract Surgery and Age-Related Macular Degeneration (CSAMD) study followed 1936 patients aged ≥ 65 years undergoing phacoemulsification cataract surgery at Westmead Hospital (Sydney, Australia) between 2004 and 2007. Presenting and pinhole VA were assessed and retinal photography was performed annually. VA improvement or reduction was defined if VA differed by ≥ 2 lines between 1 and 24 months., Results: VA data were available for 1809 patients at 1 month and 1294 at both postoperative visits (71.5% of 1809). At the 2-year visit, 930 patients (71.9%) maintained the same pinhole VA levels that they had at 1 month postoperatively, 199 (15.4%) had an improvement and 165 (12.7%) a reduction in pinhole VA. After adjusting for age and gender, pre-existing macular conditions (early AMD, macular hole or previous laser treatment) were associated with pinhole VA reduction (p=0.02). At the 24-month visit, 58.1% of those with presenting VA improvement wore distance spectacles., Conclusions: One in eight cataract surgical patients lost at least two lines in pinhole VA over the 2-year postoperative period. Regular eye examinations of patients after cataract surgery may help to maximise the surgical benefits over the long term.

Wee1 is a protein kinase that negatively regulates mitotic entry in G2 phase by suppressing cyclin B-Cdc2 activity, but its spatiotemporal regulations remain to be elucidated. We observe the dynamic behavior of Wee1 in Schizosaccharomyces pombe cells and manipulate its localization and kinase activity to study its function. At late G2, nuclear Wee1 efficiently suppresses cyclin B-Cdc2 around the spindle pole body (SPB). During the G2/M transition when cyclin B-Cdc2 is highly enriched at the SPB, Wee1 temporally accumulates at the nuclear face of the SPB in a cyclin B-Cdc2-dependent manner and locally suppresses both cyclin B-Cdc2 activity and spindle assembly to counteract a Polo kinase-dependent positive feedback loop. Then Wee1 disappears from the SPB during spindle assembly. We propose that regulation of Wee1 localization around the SPB during the G2/M transition is important for proper mitotic entry and progression.

Background: Influence of folate/homocysteine conversion is considered to be important in the pathogenesis of Parkinson's disease (PD). However, association of the folate metabolic pathway gene polymorphisms with PD susceptibility remains unclear., Methods: To test this possibility in PD, we conducted a hospital-based case-control study constituting 211 patients and 218 age- and sex-matched controls of ethnic Chinese in Taiwan. Genotyping assay was performed to screen for polymorphisms of the methylenetetrahydrofolate reductase (MTHFR C677T), methyltetrahydrofolate-homocysteine methyltransferase (MTR A2756G), and 5-methyltetrahydrofolate-homocysteine methyltransferase reductase (MTRR A1049G and C1783T) genes and assess the association between these genotype polymorphisms and PD risk using logistic regression analysis., Results: Of these four non-synonymous polymorphisms, the MTRR 1049GG variant was significantly associated with PD susceptibility (OR=3.17, 95%CI=1.08-9.35). Furthermore, we stratified our patients based on the MTHFR 677TT genotype in different strata, a significant association between the joint effect of polymorphisms and PD risk was observed in those patients whose genotypes were MTRR A1049G/MTR A2756G or MTRR C1783T/MTR A2756G (P<0.05)., Conclusion: Our findings provide support for the synergistic effects of polymorphisms in the folate metabolic pathway genes in PD susceptibility; the increased PD risk would be more significant in carriers with the polymorphisms of MTHFR, MTR, and MTRR genes., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Background: Gamma-glutamyl carboxylation, a reaction essential for the biosynthesis of vitamin K-dependent coagulation factors, requires the participation of the gamma-glutamyl carboxylase (GGCX), vitamin K epoxide reductase (VKORC1), and NAD(P)H:quinone oxidoreductase (NQO1). We evaluated the role of these genotype polymorphisms in patients with large-artery atherosclerotic stroke., Methods: In this hospital-based case-control study, 117 patients who were categorized as having large-artery atherosclerotic stroke and 115 age- and gender-matched controls were recruited. Genotyping determination for the GGCX1 (Gln325Arg), NQO1 (Pro187Ser), and VKORC1 (rs9923231) polymorphisms was performed. The associations of genotype with ischemic stroke (IS) risk were examined., Results: A higher genotypic frequency of NQO1 C609T was found in the controls than in the patients, manifesting a 0.47-fold risk reduction in IS (95% CI=0.25-0.87). A tendency toward a reduced IS risk was statistically significant in those subjects who carried a greater number of the NQO1, GGCX, and VKORC1 polymorphisms (aOR=0.58, P(trend)=0.005). The synergistic effect of multiple genes on risk reduction was more significant in a subset of patients who were not alcoholics and who were non-smokers (P<0.05)., Conclusions: Compartmentation of coagulation factor metabolism may account for the preferential role of NQO1, GGCX, and VKORC1 polymorphisms to lower the risk for large-artery atherosclerotic stroke., (Copyright 2010 Elsevier B.V. All rights reserved.)

The centrosomal pericentrin-related proteins play pivotal roles in various aspects of cell division; however their underlying mechanisms remain largely elusive. Here we show that fission-yeast pericentrin-like Pcp1 regulates multiple functions of the spindle pole body (SPB) through recruiting two critical factors, the gamma-tubulin complex (gamma-TuC) and polo kinase (Plo1). We isolated two pcp1 mutants (pcp1-15 and pcp1-18) that display similar abnormal spindles, but with remarkably different molecular defects. Both mutants exhibit defective monopolar spindle microtubules that emanate from the mother SPB. However, while pcp1-15 fails to localise the gamma-TuC to the mitotic SPB, pcp1-18 is specifically defective in recruiting Plo1. Consistently Pcp1 forms a complex with both gamma-TuC and Plo1 in the cell. pcp1-18 is further defective in the mitotic-specific reorganisation of the nuclear envelope (NE), leading to impairment of SPB insertion into the NE. Moreover pcp1-18, but not pcp1-15, is rescued by overproducing nuclear pore components or advancing mitotic onset. The central role for Pcp1 in orchestrating these processes provides mechanistic insight into how the centrosome regulates multiple cellular pathways.

Purpose: To assess changes in the pattern of eye care utilization among older Australians with correctable visual impairment, identified in an eye survey., Methods: The Blue Mountains Eye Study (BMES) examined 3654 Australians aged >or= 49 years at baseline (BMES-I). Five-year follow-up examinations were attended by 2334 participants, 75.0% of survivors (BMES-II). Interviewers collected data on eye care utilization at each visit. Habitual (presenting) and best-corrected visual acuity were assessed using a LogMAR chart. Survey reports, including visual acuity and recommendations were sent to participants after each visit. Those with under-corrected refractive error were informed that they could benefit from a new distance prescription. Eye care utilization was compared before and after the BMES-I survey., Results: Of 2152 participants with data from both examinations, 26 had non-correctable and 115 had correctable visual impairment at BMES-I. The proportion of the 115 participants with correctable visual impairment who reported seeing an eye care provider during the previous 2 years increased from 55% at BMES-I to 64% at BMES-II. Comparing the data collected at BMES-II with that at BMES-I, a higher proportion of reported optometric visits in the previous 5 years was evident for all participants regardless of their correctable visual impairment status. Among those with correctable visual impairment at BMES-I, 58% improved to no visual impairment at BMES-II, and the proportion who subsequently wore distance correction increased from 57% to 71%., Conclusions: We observed modest increases in eye care utilization by older persons after an eye survey, particularly those with correctable visual impairment.

Neurological complications due to the uremic state or hemodialysis, contribute to the important cause of mortality in patients with uremia. Despite continuous advances in uremic treatment, many neurological complications of uremia, like uremic encephalopathy, peripheral neuropathy and myopathy fail to fully respond to hemodialysis. Moreover, hemodialysis or kidney transplantation may even induce neurological complications. Hemodialysis can directly or indirectly be associated with Wernicke's encephalopathy, dialytic dementia, dysequilibrium syndrome, cerebrovascular accidents, osmotic myelinolysis and mononeuropathy. Renal transplantation can give rise to rejection encephalopathy and acute femoral neuropathy. The use of immunosuppressive drugs after renal transplantation can cause reversible posterior leukoencephalopathy encephalopathy. The clinical, pathophysiological and therapeutical aspects of central nervous system, peripheral nervous system and myopathy complications in uremia are reviewed.

Cells treated with low doses of linoleic acid hydroperoxide (LoaOOH) exhibit a cell-cycle delay that may provide a mechanism to overcome oxidative stress. Strains sensitive to LoaOOH from the genome-wide deletion collection were screened to identify deletants in which the cell-cycle delay phenotype was reduced. Forty-seven deletants were identified that were unable to mount the normal delay response, implicating the product of the deleted gene in the oxidant-mediated cell-cycle delay of the wild-type. Of these genes, SWI6 was of particular interest due to its role in cell-cycle progression through Start. The swi6 deletant strain was delayed on entry into the cell cycle in the absence of an oxidant, and oxidant addition caused no further delay. Transforming the swi6 deletant with SWI6 on a plasmid restored the G1 arrest in response to LoaOOH, indicating that Swi6p is involved in oxidant sensing leading to cell division delay. Micro-array studies identified genes whose expression in response to LoaOOH depended on SWI6. The screening identified 77 genes that were upregulated in the wild-type strain and concurrently downregulated in the swi6 deletant treated with LoaOOH. These data show that functions such as heat shock response, and glucose transport are involved in the response.

Objective: To identify the midlife risk factors for subtypes of dementia newly developed later in life., Methods: A nested case-control study was conducted on 157 demented cases and 628 comparison cases selected from 40,636 men and women who were enrolled from 1982 to 1992. Four comparison cases were frequency-matched on age, time at enrollment (within 6 months), gender, and residential township. Midlife risk factors included vascular risk factors (body mass index [BMI], total cholesterol, total triglycerides, blood glucose, cerebrovascular accident [CVA] history, diabetes mellitus history, and hypertension history), cigarette smoking, and alcohol consumption. Dementia assessments were ascertained through the computerized data linkage from National Health Insurance Database from 2000 to 2002 and clinically confirmed by neurologists or psychiatrists. Conditional logistic regression analysis was used to estimate the matched odds ratio (OR) and its 95% confidence intervals (CI) for each risk factor., Results: A J-shaped relationship was observed between BMI (kg/m(2)) and dementia. The multivariate-adjusted ORs (95% CI) of developing dementia were 1.84 (1.02-3.33), 1.87 (1.08-3.23) and 2.44 (1.39-4.28), respectively, for BMIs of <20.5, 23.0-25.4, >or=25.5 compared with a BMI of 20.5-22.9 as the referent group (OR = 1.0). Similar findings were observed for Alzheimer disease (AD) and vascular dementia (VaD). The association between obesity (BMI >or=25.5) and both AD and VaD was statistically significant among cigarette smokers but not among nonsmokers. Additionally, history of CVA was a significant risk factor for VaD, but not for AD., Conclusion: Being underweight, being overweight, and a cerebrovascular accident in midlife may increase the risk of dementia in late life.

The history of refractive eye surgery is recent, but has seen rapid advancement. Older technologies, such as radial keratectomy, had the problem of overcorrection and epithelial complications. Newer technologies, such as photorefractive keratectomy, laser-assisted in-situ keratomileusis (LASIK) and laser-assisted subepithelial keratomileusis (LASEK), which require the use of laser, has revolutionised eye surgery. However, there are complications, such as corneal hazing, postoperative pain, regression, and poorer correction for high myopes. If not contraindicated, wavefront analysis and femtosecond laser are useful adjuncts to laser photoablation for better visual results. Wavefront analysis improves the precision of laser photoablation by measuring the individual's wavefront aberrations, while femtosecond laser offers an instrument-free means of creating the corneal hinge. Lastly, implantation of intraocular lenses, with or without extraction of the crystalline lens, provides an alternative to laser photoablation for the treatment of high myopia. Clear lens exchange offers refractive correction to presbyopes and people with cataracts. However, complications, such as endothelial cell loss, cataract formation and retinal detachment, exist. In conclusion, refractive eye surgery provides an alternative to wearing spectacles or contact lenses. However, potential patients must be warned of the complications and long-term effects on the eyes.

Background: Hypothetic mechanism of the individual vulnerability to oxidative stress through metabolism of environmental xenobiotics and genotypic polymorphisms has been considered to promote the development of Parkinson's disease (PD). In this case-control study, we determined the role of manganese-containing superoxide dismutase (MnSOD) and NAD(P)H: quinone oxidoreductase 1 (NQO1) genes in PD risk in a population with high prevalence of pesticide exposure., Methods: From southwestern region of Taiwan, we enrolled 153 patients with idiopathic PD and 155 healthy control subjects matched for age, sex and origin. Detailed questionnaires of face-to-face interviews among these subjects were collected. PCR-based restriction fragment length polymorphism (RFLP) assays were used to determine the genotypes of MnSOD (-9 T>C) and NQO1 (609 C>T) genes., Results: Exposure to pesticides associated with PD was significant among patients with an increased odds ratio (OR) of 1.69 (95%CI, 1.07-2.65), and this association remained significant after adjustment for age, sex, and cigarette smoking (aOR=1.68, 95%CI, 1.03-2.76, P=0.023). Considering genetic factors, there were no significant differences in frequencies of both genotypes of MnSOD and NQO1 polymorphisms between PD patients and the control subjects (P>0.05). However, this difference in genotype distribution was significant among subjects who had been exposed to pesticide, with aOR of 2.49 (95%CI, 1.18-5.26, P=0.0072) for MnSOD C allele and aOR of 2.42 (95%CI, 1.16-4.76, P=0.0089) for NQO1 T allele, respectively. Moreover, among subjects exposed to pesticide, the combined MnSOD/NQO1 variant genotype was significantly associated with a 4.09-fold increased risk of PD (95%CI, 1.34-10.64, P=0.0052)., Conclusion: Susceptible variants of MnSOD and NQO1 genes may interact with occupational pesticide exposure to increase PD risk in southwestern Taiwanese.

Hypertensive encephalopathy rarely presented with widespread edema in the cerebral white matters, deep structures and whole brainstem. A 80-year-old woman manifested as high arterial blood pressure, visual disturbance, severe headache, nausea, and vomiting. T2-weighted and fluid-attenuated inversion recovery magnetic resonance imaging showed high signal-intensity lesions in the cerebral white matter, cerebellum, basal ganglia, thalamus, and brainstem. Diffusion-weighted brain MRI did not show hyperintense signals in these lesions. These findings suggested the pathological basis of vasogenic edema. After control of hypertension, clinical symptoms and these edematous lesions on MRI gradually reduced.