We assessed whether correction of visual impairment (VI) by cataract surgery was associated with improved long-term survival in an older Australian population.
Population-based cohort study.
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.
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.
All-cause mortality.
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.
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.
Proprietary or commercial disclosure may be found after the references.
Homoarginine is associated with cardio- and cerebrovascular morbidity and mortality. However, the underlying pathomechanisms remain elusive. Here, we evaluated the association of homoarginine with ...adverse events (i.e., death, stroke, and myocardial infarction) and carotid intima-media thickness (cIMT) in stroke patients. In the prospective bioMARKers in STROKE (MARK-STROKE) cohort, patients with acute ischemic stroke or transient ischemic attack (TIA) were enrolled. Plasma homoarginine concentrations were analyzed and associated with clinical phenotypes in cross-sectional (374 patients) and prospective (273 patients) analyses. Adjustments for possible confounders were evaluated. A two-fold increase in homoarginine was inversely associated with the National Institutes of Health Stroke Scale (NIHSS) score at admission, cIMT, and prevalent atrial fibrillation (mean factor -0.68 95% confidence interval (CI): -1.30, -0.07, -0.14 95% CI: -0.22, -0.05; and odds ratio 0.57 95% CI: 0.33, 0.96, respectively). During the follow-up (median 284 25th, 75th percentile: 198, 431 days), individuals with homoarginine levels in the highest tertile had fewer incident events compared with patients in the lowest homoarginine tertile independent of traditional risk factors (hazard ratio 0.22 95% CI: 0.08, 0.63). A lower prevalence of atrial fibrillation and a reduced cIMT pinpointed potential underlying pathomechanisms.
Background
Staphylococcus (S) aureus colonization is known to cause skin barrier disruption in atopic dermatitis (AD) patients. However, it has not been studied how S. aureus induces aberrant ...epidermal lipid composition and skin barrier dysfunction.
Methods
Skin tape strips (STS) and swabs were obtained from 24 children with AD (6.0 ± 4.4 years) and 16 healthy children (7.0 ± 4.5 years). Lipidomic analysis of STS samples was performed by mass spectrometry. Skin levels of methicillin‐sensitive and methicillin‐resistant S. aureus (MSSA and MRSA) were evaluated. The effects of MSSA and MRSA were evaluated in primary human keratinocytes (HEKs) and organotypic skin cultures.
Results
AD and organotypic skin colonized with MRSA significantly increased the proportion of lipid species with nonhydroxy fatty acid sphingosine ceramide with palmitic acid (N‐16:0 NS‐CER, sphingomyelins 16:0–18:0 SM), and lysophosphatidylcholines 16:0–18:0 LPC, but significantly reduced the proportion of corresponding very long‐chain fatty acids (VLCFAs) species (C22–28) compared to the skin without S. aureus colonization. Significantly increased transepidermal water loss (TEWL) was found in MRSA‐colonized AD skin. S. aureus indirectly through interleukin (IL)‐1β, tumor necrosis factor (TNF)‐α, IL‐6, and IL‐33 inhibited expression of fatty acid elongase enzymes (ELOVL3 and ELOVL4) in HEKs. ELOVL inhibition was more pronounced by MRSA and resulted in TEWL increase in organotypic skin.
Conclusion
Aberrant skin lipid profiles and barrier dysfunction are associated with S. aureus colonization in AD patients. These effects are attributed to the inhibition of ELOVLs by S. aureus‐induced IL‐1β, TNF‐α, IL‐6, and IL‐33 seen in keratinocyte models and are more prominent in MRSA than MSSA.
MRSA induces a broad range of cytokines, while MSSA induces IL‐1β and TNF‐α. Staphylococcus aureus‐induced IL‐1β, TNF‐α, and IL‐6 inhibit ELOVL3, resulting in accumulation of lipids with C14‐C18 FAs, while MRSA‐induced IL‐33 inhibits both ELOVL3 and ELOVL4, concomitantly increasing lipids with C14‐C18 FAs and decreasing lipids with FAs ≥ 22. S. aureus‐mediated aberrant lipid profiles cause increased TEWL and skin barrier dysfunction.Abbreviations: 3D skin, organotypic skin; ELOVL, fatty acid elongase; FA, fatty acid; IL, interleukin; MRSA, methicillin‐resistant Staphylococcus aureus; MSSA, methicillin‐sensitive Staphylococcus aureus; SA, Staphylococcus aureus; TEWL, transepidermal water loss; TNF, tissue necrosis factor
Quasi-resonant Theory of Tidal Interactions D'Onghia, Elena; Vogelsberger, Mark; Faucher-Giguere, Claude-Andre ...
The Astrophysical journal,
12/2010, Letnik:
725, Številka:
1
Journal Article
Recenzirano
Odprti dostop
When a spinning system experiences a transient gravitational encounter with an external perturber, a quasi-resonance occurs if the spin frequency of the victim roughly matches the peak angular speed ...of the perturber. Such encounters are responsible for the formation of long tails and bridges during galaxy collisions. For high-speed encounters, the resulting velocity perturbations can be described by the impulse approximation. The traditional impulse approximation, however, does not distinguish between prograde and retrograde encounters, and therefore completely misses the resonant response. Here, we modify the impulse approximation to include the effects of quasi-resonant phenomena on stars orbiting within a disk. Explicit expressions are derived for the velocity and energy changes to the stars induced by tidal forces from an external gravitational perturber passing either on a straight line or a parabolic orbit. Comparisons with numerical-restricted three-body calculations illustrate the applicability of our analysis.
Although triple negative breast cancers (TNBC) are the most aggressive subtype of breast cancer, they currently lack targeted therapies. Because this classification still includes a heterogeneous ...collection of tumors, new tools to classify TNBCs are urgently required in order to improve our prognostic capability for high risk patients and predict response to therapy. We previously defined a gene expression signature, RKIP Pathway Metastasis Signature (RPMS), based upon a metastasis-suppressive signaling pathway initiated by Raf Kinase Inhibitory Protein (RKIP). We have now generated a new BACH1 Pathway Metastasis gene signature (BPMS) that utilizes targets of the metastasis regulator BACH1. Specifically, we substituted experimentally validated target genes to generate a new BACH1 metagene, developed an approach to optimize patient tumor stratification, and reduced the number of signature genes to 30. The BPMS significantly and selectively stratified metastasis-free survival in basal-like and, in particular, TNBC patients. In addition, the BPMS further stratified patients identified as having a good or poor prognosis by other signatures including the Mammaprint® and Oncotype® clinical tests. The BPMS is thus complementary to existing signatures and is a prognostic tool for high risk ER-HER2- patients. We also demonstrate the potential clinical applicability of the BPMS as a single sample predictor. Together, these results reveal the potential of this pathway-based BPMS gene signature to identify high risk TNBC patients that can respond effectively to targeted therapy, and highlight BPMS genes as novel drug targets for therapeutic development.
Cryopreservation provides a secure long-term conservation option for rare and endangered plant species with non-orthodox or limitedly available seeds. Wide application of cryopreservation to biobank ...wild flora is hampered by the need to re-optimize nearly all protocol steps for every new species. We applied a systematic approach to simplify optimization of a multi-stage droplet-vitrification method for the endangered wetland Korean species,
. This approach consisted of a standard procedure pre-selected based on material type and size, which was complemented with 11 additional treatments to reveal the most impactful conditions. Effect of ammonium nitrate at various protocol steps was also tested. The highest shoot tip survival (92%) and plant regeneration (90%) after cryopreservation were achieved using preculture with 10% sucrose followed by 40 min osmoprotection and 60 min treatment with vitrification solution A3-80% (33.3% glycerol + 13.3% dimethyl sulfoxide + 13.3% ethylene glycol + 20.1% sucrose) on ice. A three-step regrowth procedure starting with ammonium-free medium with 1 mg/L GA
and 1 mg/L BA followed by ammonium-containing medium with and without growth regulators was essential for the development of healthy plants from cryopreserved shoot tips. This approach enables fast optimization of the cryopreservation procedure for new osmotic stress-sensitive plant species.
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.
El objetivo principal de los juegos educativos, es, como su propia descripción nos indica educar a los más pequeños, proporcionar un aprendizaje más dinámico y divertido a través del juego de una ...determinada materia proporcionando al alumno diferentes beneficios. A parte de los niños, los juegos educativos, pueden utilizarse como método de aprendizaje en personas con deficiencias psíquicas, puesto que de igual forma, para ellos también es una manera más fácil de adquirir nuevos conocimientos. Los juegos de ordenador, móvil o consola pueden producir muchos beneficios en el desarrollo de un niño, sin embargo, el niño no debe pasar todo su tiempo delante del ordenador. El ejercicio y principalmente jugar e interactuar con los demás niños es muy importantes en el desarrollo de un niño. De esta forma, este proyecto tiene un objetivo principal: * Desarrollar un juego educativo para móviles que facilite el conocimiento acerca de los riesgos cotidianos que le pueden surgir a un niño en el entorno de su hogar y como actuar ante ellos.
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.
PDF
