Announcement of Fellowship

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Volumetric comparison of maxillofacial soft tissue morphology: CT in the supine position versus three-dimensional optical scanning in the sitting position

Publication date: Available online 8 January 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Yoshihiro Yamaguchi, Kensuke Yamauchi, Hikari Suzuki, Yuko Sai, Shinnosuke Nogami, Tetsu Takahashi
ObjectiveThree-dimensional (3D) surgical simulation has become popular, but the accuracy of such simulation is difficult to assess. Because maxillofacial soft tissue profiles vary with posture, we compared such profiles obtained in the supine and sitting positions.Study DesignIn total, 28 patients with skeletal class III jaw deformities underwent computed tomography (CT) in the supine position and 3D optical scanning in the sitting position. The two sets of 3D data were superimposed, and linear and volumetric differences were calculated. We evaluated the cheeks, the subauricular and infraorbital regions, the nose, the lips, and the chin. Statistical analyses were performed using paired Student's t-tests. Differences with P < 0.05 were considered to be significant.ResultsPatients were divided into three groups based on body mass index (BMI). The facial profiles of the cheeks and subauricular areas differed significantly between the sitting and supine positions. The extent of variation increased with BMI.ConclusionsWhen a patient moves from a sitting to a supine position, maxillofacial soft tissue migrates from the cheeks to the subauricular regions. Thus, simulations for surgery based on supine CT alone do not accurately model the cheeks and subauricular areas.



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Informed refusal in oral and maxillofacial radiology: does it exist?

Publication date: Available online 8 January 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): James R. Geist




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Bildgebung und Biopsie von Weichteiltumoren

Zusammenfassung

Weichteiltumoren stellen eine ganz besondere Herausforderung in der interdisziplinären Zusammenarbeit dar. Maligne Tumoren benötigen ein multimodales Therapiekonzept, sodass eine Betreuung an einem speziellen Tumorzentrum stets sinnvoll ist. Die Aufgabe des Chirurgen in enger Zusammenarbeit mit dem Radiologen ist die Resektion des Weichteiltumors, wobei das Resektionsverfahren abhängig von der Aggressivität und der Ausdehnung des Tumors ist. Ziel ist es einen Tumor in sano, mit dem benötigten Sicherheitsabstand in Abhängigkeit von der Entität, zu resezieren. Ziel der Diagnostik ist dabei, die primäre Größenausdehnung eines Tumors und eine mögliche Infiltration in benachbarte Kompartimente zu beschreiben. Das wichtigste diagnostische Verfahren stellt hierbei die Magnetresonanztomographie (MRT) dar, wobei speziell T1-gewichtete fettsupprimierte Sequenzen nach i. v. Kontrastmittelgabe diese Fragestellung weitreichend beantworten können. In Zusammenschau mit T2-gewichteten Sequenzen ist eine sichere Differenzierung zwischen Nekrose und vitalem Tumorgewebe möglich, welche die gezielte Biopsie aus vitalen Tumoranteilen ermöglicht. Zur Differenzierung benigner und maligner Weichteiltumoren bzw. zur näheren Abklärung der Liniendifferenzierung hat sich insbesondere in Tumorzentren zunehmend die histologische Abklärung mittels Stanzbiospie, computertomographiegesteuert oder unter sonographischer Kontrolle und zunehmend auch MRT-gesteuert durchgesetzt. Eine repräsentative Biopsie aus vitalem Tumorgewebe führt mit einer sehr hohen Treffsicherheit zur Diagnose.

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Regional Differences in Thrombectomy Rates

Abstract

Background and Purpose

Mechanical thrombectomy, in addition to intravenous (i.v.) thrombolysis is recommended for treatment of acute stroke in patients with large vessel occlusions (LVO) in the anterior circulation up to 6 h after symptom onset. We compared thrombectomy rates of eight university hospitals of the MIRACUM consortium to analyze the implementation of this guideline in clinical routine.

Methods

Anonymized billing data in a standardized format were loaded into a local i2b2 data warehouse by applying already existing extract, transform and load (ETL) routines. A locally executed uniform SQL (structured query language) query delivered aggregated site data for all inpatients with a discharge diagnosis of ischemic stroke (ICD-10 I63) containing counts for type of acute treatment, type of admission and age groups, which were centrally analyzed with R.

Results

From 2014 to 2016, the thrombectomy rate almost doubled from a mean of 4.7% to 9.6%, although significant differences between centers exist (range in 2016: 5.8–17%). The number of drip-and-ship procedures increased in 3 out of 8 centers. There was no evidence for a decrease in thrombectomy rates during weekends/holiday or among patients older than 80 years, but this age group is more likely to receive i.v. recombinant tissue plasminogen activator (rtPA).

Conclusion

The observed increase of thrombectomy rates and drip-and-ship procedures without a significant difference between weekdays and weekends or patients of different ages is substantiating a rapid implementation of stroke guidelines within the analyzed neurovascular centers. The prototype of the MIRACUM Data Integration Center already contributes to health services research in Germany.

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Physiological significance of gravity receptors on larval cephalic cuticle in the silk moth, Antheraea proylei Jolly

Abstract

The lateral aspects of larval cephalic cuticle of oak tasar moth, Antheraea proylei, a hybrid between Antheraea pernyi and Antheraea roylei exhibited the presence of gravity receptors in the form of dorsal campaniform sensilla. The distribution pattern and number of dome shaped dorsal campaniform sensilla were found to vary in different larval stages. In the first and second larval stages, 4-5 sensilla were localized near the apex of the lateral aspects of the cephalic cuticle on either side of the head. From the third larval stage onwards, on the other hand, both the right and left lateral aspects of the cephalic cuticle were covered with innumerable dome shaped dorsal campaniform sensilla. The sensilla were found to be arranged in groups of 3 to 5 on the cephalic cuticle with dome-free cuticular portion of about 50–100 µm in length between two adjacent groups of the sensilla. The individual dome shaped dorsal campaniform sensillum was either smooth surfaced or was covered with smaller domes through out the surface. The significance of differences in the number and distribution pattern of the dorsal campaniform sensilla among different larval stages in relation to gravity reception and preferred feeding posture are discussed in the light of available literature.

Gravity receptorIn the form of Dorsal Campaniform sensillain lateral aspects of cephalic cuticle in advanced larval stagesgovern vertical feeding posture ensuring proper food consumption

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KIR3DL2 expression in patients with adult T-cell lymphoma/leukemia

Abstract

Adult T-cell lymphoma/leukemia (ATLL) is a hematologic malignancy of mature CD4-positive T-cells associated with chronic infection by human T-lymphotropic virus 1 (HTLV-1). Four different subtypes of ATLL have been described: acute, lymphomatous, chronic and smoldering forms. ATLL prognosis remains poor, with overall survival duration depending on the subtype, because there is no curative treatment of ATLL and patients often suffer from opportunistic infections.

This article is protected by copyright. All rights reserved.

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CD146 positive human dental pulp stem cells promote regeneration of dentin/pulp-like structures

Abstract

CD146 and STRO-1 are endothelial biomarkers that are co-expressed on the cellular membranes of blood vessels within human dental pulp tissue. This study characterized the percentage of dentin-like structures produced by CD146-positive (CD146⁺) human dental pulp stem cells (DPSCs), compared with their CD146-negative (CD146⁻) counterparts. DPSC populations were enriched using magnetic-activated cell sorting (MACS), yielding CD146⁺ and CD146⁻ cells, as well as mixtures composed of 25% CD146⁺ cells and 75% CD146⁻ cells (CD146^+/−). Cell growth assays indicated that CD146⁺ cells exhibit an approximate 3–4 h difference in doubling time, compared with CD146⁻ cells. Cell cycle distributions were determined by flow cytometry analysis. The low percentage of CD146⁺ cells’ DNA content in G₀/G₁ phase were compared with CD146⁻ and non-separated cells. In contrast to CD146⁻ and non-separated cells, prompt mineralization was observed in CD146⁺ cells. Subsequently, qRT-PCR revealed high mRNA expression of CD146 and Alkaline phosphatase in mineralization-induced CD146⁺ cells. CD146⁺ cells were also observed high adipogenic ability by Oil red O staining. Histological examinations revealed an increased area of dentin/pulp-like structures in transplanted CD146⁺ cells, compared with CD146⁻ and CD146^+/− cells. Immunohistochemical studies detected dentin matrix protein-1 (DMP1) and dentin sialophosphoprotein (DSPP), as well as human mitochondria, in transplanted DPSCs. Co-expression of CD146 and GFP indicated that CD146 was expressed in transplanted CD146⁺ cells. CD146⁺ cells may promote mineralization and generate dentin/pulp-like structures, suggesting a role in self-renewal of stem cells and dental pulp regenerative therapy.

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Molecular function of the novel α7β2 nicotinic receptor

Abstract

The α7 nicotinic receptor is a promising drug target for neurological and inflammatory disorders. Although it is the homomeric member of the family, a novel α7β2 heteromeric receptor has been discovered. To decipher the functional contribution of the β2 subunit, we generated heteromeric receptors with fixed stoichiometry by two different approaches comprising concatenated and unlinked subunits. Receptors containing up to three β2 subunits are functional. As the number of β2 subunits increases in the pentameric arrangement, the durations of channel openings and activation episodes increase progressively probably due to decreased desensitization. The prolonged activation episodes conform the kinetic signature of α7β2 and may have an impact on neuronal excitability. For activation of α7β2 receptors, an α7/α7 binding-site interface is required, thus indicating that the three β2 subunits are located consecutively in the pentameric arrangement. α7-positive allosteric modulators (PAMs) are emerging as novel therapeutic drugs. The presence of β2 in the pentamer affects neither type II PAM potentiation nor activation by an allosteric agonist whereas it impairs type I PAM potentiation. This first single-channel study provides fundamental basis required to decipher the role and function of the novel α7β2 receptor and opens doors to develop selective therapeutic drugs.

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The in vitro assessment of dipyridophenazine complexes in H-ras oncogene transformed rat embryo fibroblast 5RP7 cell line

Summary

Purpose The aim of this study is to detect apoptotic and cytotoxic/antiproliferative effects of a ligand substance and its metal derivatives. The substances were investigated by using an h-ras oncogene transformed rat embryo fibroblast cell line (5RP7). Methods The cytotoxic influences of dipyrido[3,2-a:2′,3’c]phenazine ligand, dipyrido[3,2-a:2′,3’c] phenazine-platinum(II) complex ([Pt(dppz)Cl₂]) and dipyrido[3,2-a:2′,3’c] phenazine-gold(III) complex ([Au(dppz)Cl₂]Cl) were determined with MTT (3[4,5-dimetiltiyazol2-yl]-2,5-difeniltetrazolyum bromid) assay on 5RP7 cells. Results Dipyrido[3,2-a:2′,3’c] phenazine, dipyrido[3,2-a:2′,3’c] phenazine-platinum(II) complex ([Pt(dppz)Cl₂]) and dipyrido[3,2-a:2′,3’c] phenazine-gold(III) complexes ([Au(dppz)Cl₂]Cl) caused significant increase in cytotoxicity in a dose and time dependent manner. The effects of dipyridophenazine ligand (dppz) and its metal derivatives on apoptosis were monitorized using cytotoxic dose (10 μM) DAPI fluorescent staining. It was shown that dppz and its compounds induced apoptosis. Conclusions These findings show that dpzz and its complexes can be studied as novel alternative chemotherapeutics in cancer treatment.

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A phase 1 study of PARP-inhibitor ABT-767 in advanced solid tumors with BRCA1/2 mutations and high-grade serous ovarian, fallopian tube, or primary peritoneal cancer

Summary

Purpose This phase 1 study examined safety, pharmacokinetics (PK), and efficacy of the poly(ADP-ribose) polymerase (PARP) inhibitor ABT-767 in patients with advanced solid tumors and BRCA1/2 mutations or with high-grade serous ovarian, fallopian tube, or primary peritoneal cancer. Methods Patients received ABT-767 monotherapy orally until disease progression or unacceptable toxicity. Dose was escalated from 20 mg once daily to 500 mg twice daily (BID). Dose-limiting toxicities, recommended phase 2 dose (RP2D), food effect, objective response rate, and biomarkers predicting response were determined. Results Ninety-three patients were treated with ABT-767; 80 had a primary diagnosis of ovarian cancer. ABT-767 demonstrated dose-proportional PK up to 500 mg BID and half-life of ~2 h. Food had no effect on ABT-767 bioavailability. Most common grade 3/4 treatment-related adverse events were nausea, fatigue, decreased appetite, and anemia. Anemia showed dose-dependent increase. RP2D was 400 mg BID. Objective response rate by RECIST 1.1 was 21% (17/80) in all evaluable patients and 20% (14/71) in evaluable patients with ovarian cancer. Response rate by RECIST 1.1 and/or CA-125 was 30% (24/80) in patients with ovarian cancer. Mutations in BRCA1 or BRCA2, homologous recombination deficiency (HRD), and platinum sensitivity were associated with tumor response. Median progression-free survival was longer for HRD positive (6.7 months) versus HRD negative patients (1.8 months) with ovarian cancer. Conclusions ABT-767 had an acceptable safety profile up to the established RP2D of 400 mg BID and dose-proportional PK. Patients with BRCA1 or BRCA2 mutation, HRD positivity, and platinum sensitivity were more sensitive to ABT-767.

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IJMS, Vol. 19, Pages 186: A Comparative Study on Phytochemical Profiles and Biological Activities of Sclerocarya birrea (A.Rich.) Hochst Leaf and Bark Extracts

IJMS, Vol. 19, Pages 186: A Comparative Study on Phytochemical Profiles and Biological Activities of Sclerocarya birrea (A.Rich.) Hochst Leaf and Bark Extracts

International Journal of Molecular Sciences doi: 10.3390/ijms19010186

Authors: Daniela Russo Rocchina Miglionico Monica Carmosino Faustino Bisaccia Paula Andrade Patrícia Valentão Luigi Milella Maria Armentano

Sclerocarya birrea (A.Rich.) Hochst (Anacardiaceae) is a savannah tree that has long been used in sub-Saharan Africa as a medicinal remedy for numerous ailments. The purpose of this study was to increase the scientific knowledge about this plant by evaluating the total content of polyphenols, flavonoids, and tannins in the methanol extracts of the leaves and bark (MLE and MBE, respectively), as well as the in vitro antioxidant activity and biological activities of these extracts. Reported results show that MLE is rich in flavonoids (132.7 ± 10.4 mg of quercetin equivalents/g), whereas MBE has the highest content of tannins (949.5 ± 29.7 mg of tannic acid equivalents/g). The antioxidant activity was measured using four different in vitro tests: β-carotene bleaching (BCB), 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), O2−•, and nitric oxide (NO•) assays. In all cases, MBE was the most active compared to MLE and the standards used (Trolox and ascorbic acid). Furthermore, MBE and MLE were tested to evaluate their activity in HepG2 and fibroblast cell lines. A higher cytotoxic activity of MBE was evidenced and confirmed by more pronounced alterations in cell morphology. MBE induced cell death, triggering the intrinsic apoptotic pathway by reactive oxygen species (ROS) generation, which led to a loss of mitochondrial membrane potential with subsequent cytochrome c release from the mitochondria into the cytosol. Moreover, MBE showed lower cytotoxicity in normal human dermal fibroblasts, suggesting its potential as a selective anticancer agent.

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Corrigendum to “Association between Virulence Factors and Extended Spectrum Beta-Lactamase Producing Klebsiella pneumoniae Compared to Nonproducing Isolates”

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Percutaneous High Frequency Microwave Ablation of Uterine Fibroids: Systematic Review

Uterine fibroids are the most common benign pelvic tumor of the female genital tract and tend to increase with age; they cause menorrhagia, dysmenorrhea, pelvic pressure symptoms, back pain, and subfertility. Currently, the management is based mainly on medical or surgical approaches. The nonsurgical and minimally invasive therapies are emerging approaches that to the state of the art include uterine artery embolization (UAE), image-guided thermal ablation techniques like magnetic resonance-guided focused ultrasound surgery (MRgFUS) or radiofrequency ablation (RF), and percutaneous microwave ablation (PMWA). The purpose of the present review is to describe feasibility results and safety of PMWA according to largest studies available in current literature. Moreover technical aspects of the procedure were analyzed providing important data on large scale about potential efficacy of PMWA in clinical setting. However larger studies with international registries and randomized, prospective trials are still needed to better demonstrate the expanding benefits of PMWA in the management of uterine fibroids.

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Boundary Control of a Flexible Manipulator Based on a High Order Disturbance Observer with Input Saturation

This paper studies a new boundary control strategy for a flexible manipulator subject to unknown fast time-varying disturbances. The flexible manipulator essentially is an infinite dimensional continuum. Hence, a continuous function of space and time can be employed to describe the position of such a distributed parameter structure, the motion of which can be described by partial differential equations (PDEs). To cope with fast time-varying external disturbances, a high order disturbance observer is adopted. A control strategy based on such a disturbance observer is proposed for the rest-rest maneuvering of the flexible manipulator. Moreover, a smooth hyperbolic function is included in the controller to satisfy the requirement of input saturation. The stability of the boundary control is analyzed using LaSalle’s invariance principle. Finally, the performance of the presented boundary controller is verified through comparison with that of employing a constant disturbance observer via numerical simulations.

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Free Intraperitoneal Gallstone: An Unusual Case of Small Bowel Obstruction from Extrinsic Compression

Laparoscopic cholecystectomy (LC) is preferred in the treatment of symptomatic cholecystolithiasis. Gallstone spillage is not uncommon, and there have been reports of associated complications. We report a case of a free intraperitoneal gallstone, left inadvertently during LC, which developed an inflammatory phlegmon with abscess containing gallstone, causing extraluminal compression on the distal ileum, resulting in small bowel obstruction. This complication in particular is almost unheard of. The patient underwent laparoscopic drainage of abscess and retrieval of gallstone, which relieved the obstruction. Clinicians, therefore, need to keep an open mind in the workup for bowel obstruction. During LC, gallstone spillage should be prevented and retrieved whenever possible to minimize early and late complications associated with it.

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Mirror Syndrome in Monochorionic Twin Pregnancy with Acardiac Fetus

We report the case of a 20-year-old patient, primigravida, with twin monochorionic pregnancy, with a weight gain of 6 kg in one week and increased blood pressure. During the ultrasound diagnostic investigation, placental edema and hydrops were identified in both fetuses, which, in association with maternal anasarca and pressure control, constitute the triad for mirror syndrome, also known as triple edema. In addition to being hydropic, one of the twins was an acardiac fetus, which is a rare combination of events. Gestation was terminated at 22 weeks and five days because of high maternal risk. The patient progressed with clinical and laboratory improvement. Our study is relevant in that it documents an extremely rare case and discusses relevant aspects of the symptoms and diagnosis of mirror syndrome. It also systematically reviews the condition.

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Proportional Load Sharing and Stability of DC Microgrid with Distributed Architecture Using SM Controller

DC microgrids look attractive in distribution systems due to their high reliability, high efficiency, and easy integration with renewable energy sources. The key objectives of the DC microgrid include proportional load sharing and precise voltage regulation. Droop controllers are based on decentralized control architectures which are not effective in achieving these objectives simultaneously due to the voltage error and load power variation. A centralized controller can achieve these objectives using a high speed communication link. However, it loses reliability due to the single point failure. Additionally, these controllers are realized through proportional integral (PI) controllers which cannot ensure load sharing and stability in all operating conditions. To address limitations, a distributed architecture using sliding mode (SM) controller utilizing low bandwidth communication is proposed for DC microgrids in this paper. The main advantages are high reliability, load power sharing, and precise voltage regulation. Further, the SM controller shows high robustness, fast dynamic response, and good stability for large load variations. To analyze the stability and dynamic performance, a system model is developed and its transversality, reachability, and equivalent control conditions are verified. Furthermore, the dynamic behavior of the modeled system is investigated for underdamped and critically damped responses. Detailed simulations are carried out to show the effectiveness of the proposed controller.

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Multifunctional Amine Mesoporous Silica Spheres Modified with Multiple Amine as Carriers for Drug Release

Mesoporous silica spheres were synthesized by using Stöber theory (MSN-40). Calcination of the mesostructured phase resulted in the starting solid. Organic modification with aminopropyl groups resulted in two MSN-40 materials: named MSN-NH2 and MSN-DQ-40, respectively. These two kinds of samples with different pore sizes (obtained from 3-[2-(2-aminoethylamino)ethylamino]propyl-trimethox-ysilane (NQ-62) and modified NQ-62) showed control of the delivery rate of ibuprofen (IBU) from the siliceous matrix. The obtained sample from modified NQ-62 has an increased loading rate and shows better control of the delivery rate of IBU than the obtained sample from NQ-62. These three solids were characterized using standard solid state procedures. During tests of in vitro drug release, an interesting phenomenon was observed: at high pH (pH 7.45), IBU in all carriers was released slowly; at low pH (pH 4.5), only a part of the IBU was slowly released from this carrier within 25 hours; most IBU was effectively confined in mesoporous material, but the remaining IBU was released rapidly and completely after 25 hours.

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Pre- and Postoperative Body Composition and Metabolic Characteristics in Patients with Acromegaly: A Prospective Study

Objective. To investigate the preoperative body composition, metabolic characteristics, and postoperative changes in patients with active acromegaly and analyze the effects of gender and age. Methods. We included 36 patients with untreated acromegaly and 37 patients with nonfunctional pituitary adenomas. Adipose tissue (AT), the visceral fat index (VFI), sclerotin, protein, skeletal muscle, total body water (TBW), intracellular water (ICW), and extracellular water (ECW) were measured using bioelectrical impedance analysis (BIA). Total energy expenditure (TEE) and basal metabolism (BM) were measured with a cardiopulmonary and metabolic analyzer (CMA). Tricep skinfold thickness (TST), bicep circumference, waistline, hipline, and calf circumference were measured with a skinfold caliper and tape. These indices were measured before surgery and 3 months and 1 year after surgery. Results. Overall, AT, VFI, and TST were lower, whereas sclerotin, protein, skeletal muscle, TBW, ICW, ECW, TEE, and BM were higher in acromegaly patients. Postoperatively, TST rose initially and then decreased, the waistline increased, and sclerotin, skeletal muscle, TEE, and BM decreased. Changes in these indices differed with gender and age in unique patterns. Conclusions. Body composition and metabolism in acromegaly patients changed after surgery, and gender and age influenced these changes.

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Ion Channel Expression and Characterization in Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes

Background. Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are providing new possibilities for the biological study, cell therapies, and drug discovery. However, the ion channel expression and functions as well as regulations in hiPSC-CMs still need to be fully characterized. Methods. Cardiomyocytes were derived from hiPS cells that were generated from two healthy donors. qPCR and patch clamp techniques were used for the study. Results. In addition to the reported ion channels, INa, ICa-L, ICa-T, If, INCX, IK1, Ito, IKr, IKs IKATP, IK-pH, ISK1–3, and ISK4, we detected both the expression and currents of ACh-activated (KACh) and Na+-activated (KNa) K+, volume-regulated and calcium-activated (Cl-Ca) Cl−, and TRPV channels. All the detected ion currents except IK1, IKACh, ISK, IKNa, and TRPV1 currents contribute to AP duration. Isoprenaline increased ICa-L, If, and IKs but reduced INa and INCX, without an effect on Ito, IK1, ISK1–3, IKATP, IKr, ISK4, IKNa, ICl-Ca, and ITRPV1. Carbachol alone showed no effect on the tested ion channel currents. Conclusion. Our data demonstrate that most ion channels, which are present in healthy or diseased cardiomyocytes, exist in hiPSC-CMs. Some of them contribute to action potential performance and are regulated by adrenergic stimulation.

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Comparison of Glycomacropeptide with Phenylalanine Free-Synthetic Amino Acids in Test Meals to PKU Patients: No Significant Differences in Biomarkers, Including Plasma Phe Levels

Introduction. Management of phenylketonuria (PKU) is achieved through low-phenylalanine (Phe) diet, supplemented with low-protein food and mixture of free-synthetic (FS) amino acid (AA). Casein glycomacropeptide (CGMP) is a natural peptide released in whey during cheese-making and does not contain Phe. Lacprodan® CGMP-20 used in this study contained a small amount of Phe due to minor presence of other proteins/peptides. Objective. The purpose of this study was to compare absorption of CGMP-20 to FSAA with the aim of evaluating short-term effects on plasma AAs as well as biomarkers related to food intake. Methods. This study included 8 patients, who had four visits and tested four drink mixtures (DM1–4), consisting of CGMP, FSAA, or a combination. Plasma blood samples were collected at baseline, 15, 30, 60, 120, and 240 minutes (min) after the meal. AA profiles and ghrelin were determined 6 times, while surrogate biomarkers were determined at baseline and 240 min. A visual analogue scale (VAS) was used for evaluation of taste and satiety. Results. The surrogate biomarker concentrations and VAS scores for satiety and taste were nonsignificant between the four DMs, and there were only few significant results for AA profiles (not Phe). Conclusion. CGMP and FSAA had the overall same nonsignificant short-term effect on biomarkers, including Phe. This combination of FSAA and CGMP is a suitable supplement for PKU patients.

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Evidence-Based Cutoff Threshold Values from Receiver Operating Characteristic Curve Analysis for Knee Osteoarthritis in the 50-Year-Old Korean Population: Analysis of Big Data from the National Health Insurance Sharing Service

We aimed to investigate the characteristics of patients with osteoarthritis (OA), using the data of all Koreans registered in the National Health Insurance Sharing Service Database (NHISS DB), and to provide ideal alternative cutoff thresholds for alleviating OA symptoms. Patients with OA (codes M17 and M17.1–M17.9 in the Korean Standard Classification of Disease and Causes of Death) were analyzed using SAS software. Optimal cutoff thresholds were determined using receiver operating characteristic curve analysis. The 50-year age group was the most OA pathogenic group (among 40~70 years, ). All exercise types affected the change of body mass index () and the sex difference in blood pressure (BP) (). All types of exercise positively affected the loss of waist circumference and the balance test (standing time on one leg in seconds) (). The cutoff threshold for the time in seconds from standing up from a chair to walking 3 m and returning to the same chair was 8.25 (80% sensitivity and 100% specificity). By using the exercise modalities, categorized multiple variables, and the cutoff threshold, an optimal alternative exercise program can be designed for alleviating OA symptoms in the 50-year age group.

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Effect of Tofogliflozin on Body Composition and Glycemic Control in Japanese Subjects with Type 2 Diabetes Mellitus

Sodium-glucose cotransporter 2 inhibitor tofogliflozin is a new type of antidiabetic drug for individuals with type 2 diabetes mellitus (T2DM). The aim of this study was to examine in which type of individuals and/or under which conditions tofogliflozin could exert more beneficial effects on body composition and/or glycemic control in Japanese individuals with T2DM. We retrospectively evaluated the effects of tofogliflozin on body composition and/or glycemic control in individuals with T2DM who newly started taking tofogliflozin. After tofogliflozin treatment, body weight was significantly reduced and HbA1c levels were significantly decreased. Body fat mass, skeletal muscle mass, and skeletal muscle index, a marker for sarcopenia, were also reduced after the treatment. In univariate analyses, there was a statistically significant association between the decrease of HbA1c level after tofogliflozin treatment (Δ HbA1c) and the following parameters such as HbA1c levels at baseline, visceral fat area (VFA) at baseline, and reduction of VFA after the treatment (Δ VFA). Furthermore, in multivariate analyses, HbA1c levels at baseline and duration of diabetes were independently associated with Δ HbA1c. These results suggest that tofogliflozin would be more suitable for relatively obese individuals whose duration of diabetes is relatively short.

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Magnitude of Anemia in Geriatric Population Visiting Outpatient Department at the University of Gondar Referral Hospital, Northwest Ethiopia: Implication for Community-Based Screening

Objective. This study is aimed at assessing the magnitude and its associated factors of anemia in geriatric population visiting outpatient department at the University of Gondar referral hospital, northwest Ethiopia. Method. A cross-sectional study was conducted among elder patients in Gondar town, North Gondar District, in May 2013. A total of 200 randomly selected geriatric population participated in the study. Summary statistics were computed and presented in tables and figure. Both bivariate and multivariable binary logistic regression were fitted to identify associated factors. A value

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Innovative Design and Performance Evaluation of Bionic Imprinting Toothed Wheel

A highly efficient soil-burrowing dung beetle possesses an intricate outer contour curve on its foreleg end-tooth. This study was carried out based on evidence that this special outer contour curve has the potential of reducing soil penetration resistance and could enhance soil-burrowing efficiency. A toothed wheel is a typical agricultural implement for soil imprinting, to increase its working efficiency; the approach of the bionic geometrical structure was utilized to optimize the innovative shape of imprinting toothed wheel. Characteristics in the dung beetle’s foreleg end-tooth were extracted and studied by the edge detection technique. Then, this special outer contour curve was modeled by a nine-order polynomial function and used for the innovative design of imprinting the tooth’s cutting edge. Both the conventional and bionic teeth were manufactured, and traction tests in a soil bin were conducted. Taking required draft force and volume of imprinted microbasin as the evaluating indexes, operating efficiency and quality of different toothed wheels were compared and investigated. Results indicate that compared with the conventional toothed wheel, a bionic toothed wheel possesses a better forward resistance reduction property against soil and, meanwhile, can enhance the quality of soil imprinting by increasing the volume of the created micro-basin.

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Ruta chalepensis L. Essential Oil: A New Antisprouting Agent for Potatoes Bioconservation

The main concern of this work was to find a new biological antisprouting product for potatoes during storage. Ruta chalepensis L. essential oil (RCEO) was for the first time used as a potential sprouting inhibitor for potatoes. To confirm RCEO antisprouting effect, evolution of sprout length and weight loss of potato tubers was determined during a storage period of six weeks under three RCEO different treatments (2%, 4%, and 6%). Sprout final weight was also computed. Then, a screening of RCEO chemical composition was performed. An outstanding antisprouting effect of 6% emulsions concentrations was observed as compared to 2% and 4% emulsions concentrations. Final sprout weight (SW) of untreated samples was 4.66%, while 6% treated samples scored 0.98%. These results were endorsed by high Pearson correlation coefficients (>0.9). Indeed, increasing treatment concentration enhanced the sprout growth inhibition. Identification of RCEO major components showed that 2-undecanone represented 87.18% of total identified components suggesting that this component is the possible active agent of RCEO against potatoes sprouting.

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Deep Eutectic Solvent-Based Microwave-Assisted Extraction of Baicalin from Scutellaria baicalensis Georgi

Deep eutectic solvents (DESs) have attracted significant attention as green media for the extraction and separation of natural compounds from Chinese medicine. In this study, a hydrophobic DESs-based microwave-assisted extraction (MAE) was successfully used to efficiently extract baicalin from Scutellaria baicalensis Georgi. Firstly, DecA: N4444-Cl (DES-1 , molar ratio 1 : 2) was screened and selected as the most appropriate DES by comparing the extraction yield in different hydrophobic DESs. Based on the extraction yield of baicalin, response surface methodology (RSM) was employed to model and optimize the parameters (extraction temperature, liquid-solid ratio, and extraction time). Furthermore, the maximum yield of 106.96 mg·g−1 was achieved under optimum conditions in DES-containing aqueous solutions (33 vol% water content), which reached a similar level that was conducted using the pharmacopoeia procedure (104.94 mg·g−1). These results indicated that the proposed method is an excellent alternative for the extraction of baicalin.

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Noncaloric Sweeteners in Children: A Controversial Theme

Noncaloric sweeteners (NCS) are food additives used to provide sweetness without adding calories. Their consumption has become more widespread around the world in all age groups, including children. The aim of this study is to show the state of the art about the intake of noncaloric sweeteners in children, as well as their benefits and consumption risk. Scientific searchers were used (PUBMED, Scopus, and Scielo) to analyze articles that included keywords (noncaloric sweeteners/saccharin/cyclamate/acesulfame potassium/aspartame/sucralose/stevia/children) in English, Spanish, and Portuguese. Authors conclude that it is imperative that health professionals judiciously and individually evaluate the overall benefits and risks of NCS use in consumers before recommending their use. Different subgroups of the population incorporate products containing NCS in their diet with different objectives, which should be considered when recommending a diet plan for the consumer. In childhood, in earlier age groups, this type of additives should be used as a dietary alternative when other forms of prevention in obesity are not sufficient.

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Self-Powered Wireless Sensor Network for Automated Corrosion Prediction of Steel Reinforcement

Corrosion is one of the key issues that affect the service life and hinders wide application of steel reinforcement. Moreover, corrosion is a long-term process and not visible for embedded reinforcement. Thus, this research aims at developing a self-powered smart sensor system with integrated innovative prediction module for forecasting corrosion process of embedded steel reinforcement. Vibration-based energy harvester is used to harvest energy for continuous corrosion data collection. Spatial interpolation module was developed to interpolate corrosion data at unmonitored locations. Dynamic prediction module is used to predict the long-term corrosion based on collected data. Utilizing this new sensor network, the corrosion process can be automated predicted and appropriate mitigation actions will be recommended accordingly.

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Formononetin Administration Ameliorates Dextran Sulfate Sodium-Induced Acute Colitis by Inhibiting NLRP3 Inflammasome Signaling Pathway

Formononetin is a kind of isoflavone compound and has been reported to possess anti-inflammatory properties. In this present study, we aimed to explore the protective effects of formononetin on dextran sulfate sodium- (DSS-) induced acute colitis. By intraperitoneal injection of formononetin in mice, the disease severity of colitis was attenuated in a dose-dependent manner, mainly manifesting as relieved clinical symptoms of colitis, mitigated colonic epithelial cell injury, and upregulations of colonic tight junction proteins levels (ZO-1, claudin-1, and occludin). Meanwhile, our study found that formononetin significantly prevented acute injury of colonic cells induced by TNF-α in vitro, specifically manifesting as the increased expressions of colonic tight junction proteins (ZO-1, claudin-1, and occludin). In addition, the result showed that formononetin could reduce the NLRP3 pathway protein levels (NLRP3, ASC, IL-1β) in vivo and vitro, and MCC950, the NLRP3 specific inhibitor, could alleviate the DSS-induced mice acute colitis. Furthermore, in the foundation of administrating MCC950 to inhibit activation of NLRP3 inflammasome, we failed to observe the protective effects of formononetin on acute colitis in mice. Collectively, our study for the first time confirmed the protective effects of formononetin on DSS-induced acute colitis via inhibiting the NLRP3 inflammasome pathway activation.

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Non-invasive measurement of reepithelialization and microvascularity of suction-blister wounds with benchmarking to histology

ABSTRACT

We explored use of the suction-blister wound model in the assessment of not only epidermal regeneration but also pain, the microvascular response and bacteriology. The effects of topical zinc sulfate were studied to articulate the methodologies in this double-blind trial. One epidermal suction blister (10 mm) was induced on each buttock in 30 healthy volunteers (15 females:15 males) and de-roofed on day 0. The wounds were randomized to daily treatment with 1.4% zinc sulfate shower gel (n = 20), placebo (n = 20) or control (n = 20). Digital photography coupled with planimetry, transepidermal water loss (TEWL) measurement and optical coherence tomography (OCT) was benchmarked to the gold standard of histology of 60 full-thickness wound biopsies on day 4. Pain increased after application of the shower gels. Vessel density, determined from OCT images, increased from day 0 to day 2 in the three groups but increased more with the placebo than with the zinc shower gel (p = 0.003) or the control treatment (p = 0.002) and correlated (r_S = 0.313, p = 0.015) with the inflammatory response on day 4, as determined by histology. Coagulase-negative staphylococci were more common in wounds compared with skin (p = 0.002) and was reduced (p = 0.030) with zinc sulfate treatment. Planimetric analysis of digital wound images was not biased (p = 0.234) compared with histology, and TEWL measurements showed no correlation (r_S = 0.052, p = 0.691) with epithelialization. Neoepidermal formation, determined by histology, did not differ (p = 0.290) among the groups. Zinc sulfate reduced (p = 0.031) the release of lactate dehydrogenase from cultured keratinocytes isolated from the blister roofs. Therefore, combination of the standardized suction-blister wound model with non-invasive planimetry and OCT is a useful tool for assessing wound therapies. Zinc sulfate transiently dampened inflammation and reduced bacterial growth. This article is protected by copyright. All rights reserved.

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Probiotics or Pro-healers the Role of Beneficial Bacteria in Tissue Repair

Abstract

Probiotics are beneficial microorganisms, known to exert numerous positive effects on human health, primarily in the battle against pathogens. Probiotics have been associated with improved healing of intestinal ulcers, and healing of infected cutaneous wounds. This manuscript reviews the latest findings on probiotics related to their pro-healing properties on gut epithelium and skin. Proven mechanisms by which probiotic bacteria exert their beneficial effects include direct killing of pathogens, competitive displacement of pathogenic bacteria, reinforcement of epithelial barrier, induction of fibroblasts and epithelial cells' migration and function. Beneficial immunomodulatory effects of probiotics relate to modulation and activation of intraepithelial lymphocytes, natural killer cells and macrophages through induced production of cytokines. Systemic effects of beneficial bacteria and link between gut microbiota, immune system, and cutaneous health through gut-brain-skin axes are discussed as well. In light of growing antibiotic resistance of pathogens, antibiotic use is becoming less effective in treating cutaneous and systemic infections. This review points to a new perspective and therapeutic potential of beneficial probiotic species as a safe alternative approach for treatment of patients affected by wound healing disorders and cutaneous infections. This article is protected by copyright. All rights reserved.

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Inhibition of IRE1 Results in Decreased Scar Formation

ABSTRACT

Wound healing is characterized by the production of large amounts of protein necessary to replace lost cellular mass and extracellular matrix. The unfolded protein response (UPR) is an important adaptive cellular response to increased protein synthesis. One of the main components of the UPR is IRE1, an ER transmembrane protein with endonuclease activity that produces the activated form of the transcription factor XBP1. Using luciferase reporter mice for Xbp1 splicing, we showed that IRE1 was up-regulated during excisional wound healing at the time in wound healing consistent with that of the proliferative phase, when the majority of protein synthesis for cellular proliferation and matrix deposition occurs. Furthermore, using a small molecule inhibitor of IRE1 we demonstrated that inhibition of IRE1 led to decreased scar formation in treated mice. Results were re-capitulated in a hypertrophic scar mouse model. These data help provide a cellular pathway to target in the treatment of hypertrophic scarring and keloid disorders. This article is protected by copyright. All rights reserved.

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The efficacy of basic fibroblast growth factor-loaded poly(lactic-co-glycolic acid) nanosheet for mouse wound healing

Abstract

Although human recombinant basic fibroblast growth factor (bFGF) is widely used for wound healing, daily treatment with bFGF is required because of its short half-life. An effective controlled-release system of bFGF is therefore desired in clinical settings. To investigate the efficacy of a bFGF-loaded nanosheet for wound healing, focusing on the controlled-release of bFGF, bFGF-loaded poly lactic-co-glycolic acid (PGLA) nanosheets were developed, and their in vitro release profile of bFGF and their in vivo efficacy for wound healing were examined. A polyion complex of positively charged human recombinant bFGF and negatively charged alginate was sandwiched between PLGA nanosheets (70 nm thick). The resulting bFGF-loaded nanosheet robustly adhered to silicon skin by observation using a micro-scratch test. bFGF was gradually and continuously released over three days in an in vitro incubation study. Treatment with the bFGF-loaded nanosheets (every 3 days for 15 days) as well as with a conventional bFGF spray effectively promoted wound healing of mouse dorsal skin defects with accelerated tissue granulation and angiogenesis, although the dose of bFGF used in the treatment with the bFGF nanosheets was approximately 1/20 of the sprayed bFGF. In conclusion, we developed a bFGF-loaded nanosheet that sustained a continuous release of bFGF over three days and effectively promoted wound healing in mice. This article is protected by copyright. All rights reserved.

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Novice’s Sojourn to Parotid Surgery

Abstract

Salivary gland tumors are rare, comprising less than 3% of all neoplasia of head and neck region. Pleomorphic adenoma is the most common salivary gland tumor, accounting for 60–80% of benign tumors of salivary glands, which predominantly affect the superficial lobe of the parotid gland. The “pleomorphic” nature of the tumor can be explained on the basis of its epithelial and connective tissue origin. Usually they are found as solitary unilateral, firm and mobile, painless, slow growing mass. The tumor has a female predilection between 30 and 50 years of age. Utmost care is to be taken to preserve the facial nerve while performing superficial or total parotidectomy. We present 10 cases of pleomorphic adenoma of parotid gland over period of 2 years, highlighting the prognosis following surgical management.

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Considerations in computer-aided design for inlay cranioplasty: technical note

Abstract

Context

Cranioplasty is a frequently performed procedure that uses a variety of reconstruction materials and techniques. In this technical note, we present refinements of computer-aided design–computer-aided manufacturing inlay cranioplasty.

Objective, design, and setting

In an attempt to decrease complications related to polyether-ether-ketone (PEEK) cranioplasty, we gradually made changes to implant design and cranioplasty techniques. These changes include under-contouring of the implant and the use of segmented plates for large defects, microplate fixation for small temporal defects, temporal shell implants to reconstruct the temporalis muscle, and perforations to facilitate the drainage of blood and cerebrospinal fluid and serve as fixation points.

Results

From June 2016 to June 2017, 18 patients underwent cranioplasty, and a total of 31 PEEK and titanium implants were inserted. All implants were successful.

Conclusions

These changes to implant design and cranioplasty techniques facilitate the insertion and fixation of patient-specific cranial implants and improve esthetic outcomes.

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IJERPH, Vol. 15, Pages 91: Climate Change Risk Perception in Taiwan: Correlation with Individual and Societal Factors

IJERPH, Vol. 15, Pages 91: Climate Change Risk Perception in Taiwan: Correlation with Individual and Societal Factors

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15010091

Authors: Yingying Sun Ziqiang Han

This study differentiates the risk perception and influencing factors of climate change along the dimensions of global severity and personal threat. Using the 2013 Taiwan Social Change Survey (TSGS) data (N = 2001) as a representative sample of adults from Taiwan, we investigated the influencing factors of the risk perceptions of climate change in these two dimensions (global severity and personal threat). Logistic regression models were used to examine the correlations of individual factors (gender, age, education, climate-related disaster experience and risk awareness, marital status, employment status, household income, and perceived social status) and societal factors (religion, organizational embeddedness, and political affiliations) with the above two dimensions. The results demonstrate that climate-related disaster experience has no significant impact on either the perception of global severity or the perception of personal impact. However, climate-related risk awareness (regarding typhoons, in particular) is positively associated with both dimensions of the perceived risks of climate change. With higher education, individuals are more concerned about global severity than personal threat. Regarding societal factors, the supporters of political parties have higher risk perceptions of climate change than people who have no party affiliation. Religious believers have higher risk perceptions of personal threat than non-religious people. This paper ends with a discussion about the effectiveness of efforts to enhance risk perception of climate change with regard to global severity and personal threat.

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IJERPH, Vol. 15, Pages 89: Annual Direct Medical Costs of Diabetic Foot Disease in Brazil: A Cost of Illness Study

IJERPH, Vol. 15, Pages 89: Annual Direct Medical Costs of Diabetic Foot Disease in Brazil: A Cost of Illness Study

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15010089

Authors: Cristiana Toscano Tatiana Sugita Michelle Rosa Hermelinda Pedrosa Roger Rosa Luciana Bahia

The aim of this study was to estimate the annual costs for the treatment of diabetic foot disease (DFD) in Brazil. We conducted a cost-of-illness study of DFD in 2014, while considering the Brazilian Public Healthcare System (SUS) perspective. Direct medical costs of outpatient management and inpatient care were considered. For outpatient costs, a panel of experts was convened from which utilization of healthcare services for the management of DFD was obtained. When considering the range of syndromes included in the DFD spectrum, we developed four well-defined hypothetical DFD cases: (1) peripheral neuropathy without ulcer, (2) non-infected foot ulcer, (3) infected foot ulcer, and (4) clinical management of amputated patients. Quantities of each healthcare service was then multiplied by their respective unit costs obtained from national price listings. We then developed a decision analytic tree to estimate nationwide costs of DFD in Brazil, while taking into the account the estimated cost per case and considering epidemiologic parameters obtained from a national survey, secondary data, and the literature. For inpatient care, ICD10 codes related to DFD were identified and costs of hospitalizations due to osteomyelitis, amputations, and other selected DFD related conditions were obtained from a nationwide hospitalization database. Direct medical costs of DFD in Brazil was estimated considering the 2014 purchasing power parity (PPP) (1 Int$ = 1.748 BRL). We estimated that the annual direct medical costs of DFD in 2014 was Int$ 361 million, which denotes 0.31% of public health expenses for this period. Of the total, Int$ 27.7 million (13%) was for inpatient, and Int$ 333.5 million (87%) for outpatient care. Despite using different methodologies to estimate outpatient and inpatient costs related to DFD, this is the first study to assess the overall economic burden of DFD in Brazil, while considering all of its syndromes and both outpatients and inpatients. Although we have various reasons to believe that the hospital costs are underestimated, the estimated DFD burden is significant. As such, public health preventive strategies to reduce DFD related morbidity and mortality and costs are of utmost importance.

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IJERPH, Vol. 15, Pages 90: Characteristics of Refractive Errors in a Population of Adults in the Central Region of Poland

IJERPH, Vol. 15, Pages 90: Characteristics of Refractive Errors in a Population of Adults in the Central Region of Poland

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15010090

Authors: Michal Nowak Piotr Jurowski Andrzej Grzybowski Janusz Smigielski

Background: To investigate the distribution of refractive errors and their characteristics in older adults from a Polish population. Methods: The study design was a cross-sectional study. A total of 1107 men and women were interviewed and underwent detailed ophthalmic examinations, 998 subjects underwent refraction. Myopia was defined as spherical equivalent (SER) refraction ≤−0.5 dioptres (D) and hyperopia was defined as SER ≥+0.5 dioptres (D). Results: Among those who were refracted the distribution of myopia and hyperopia was 24.1% (95% CI 21.4–26.7) and 37.5% (95% CI 34.5–40.5), respectively. Myopia decreased from 28.7% in subjects aged 35–59 years to 19.3% in those aged 60 years or older and hyperopia increased from 21.8% at 35–59 years of age to 53.3% in subjects aged ≥60 years. Multiple regression analysis showed decreasing age (OR 0.98, 95% CI 0.96–1.00), female gender (OR 1.87, 95% CI 1.18–2.95) and presence of cataract (OR 2.40, 95% CI 1.24–4.63) were independent risk factors associated with myopia. Conclusions: The distribution of refractive errors found in our study is similar to those reported in other Caucasian populations and differs from Asian populations. Myopia was positively associated with younger age, female gender and presence of cataract.

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