Associations with photoreceptor thickness measures in the UK Biobank.

Spectral-domain OCT (SD-OCT) provides high resolution images enabling identification of individual retinal layers. We included 32,923 participants aged 40-69 years old from UK Biobank. Questionnaires, physical examination, and eye examination including SD-OCT imaging were performed. SD OCT measured photoreceptor layer thickness includes photoreceptor layer thickness: inner nuclear layer-retinal pigment epithelium (INL-RPE) and the specific sublayers of the photoreceptor: inner nuclear layer-external limiting membrane (INL-ELM); external limiting membrane-inner segment outer segment (ELM-ISOS); and inner segment outer segment-retinal pigment epithelium (ISOS-RPE). In multivariate regression models, the total average INL-RPE was observed to be thinner in older aged, females, Black ethnicity, smokers, participants with higher systolic blood pressure, more negative refractive error, lower IOPcc and lower corneal hysteresis. The overall INL-ELM, ELM-ISOS and ISOS-RPE thickness was significantly associated with sex and race. Total average of INL-ELM thickness was additionally associated with age and refractive error, while ELM-ISOS was additionally associated with age, smoking status, SBP and refractive error; and ISOS-RPE was additionally associated with smoking status, IOPcc and corneal hysteresis. Hence, we found novel associations of ethnicity, smoking, systolic blood pressure, refraction, IOPcc and corneal hysteresis with photoreceptor thickness

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Pensacola in 1770

The article describes the tension between the British and the Spanish governments in the Americas, especially related to West Florida when British troops were headquartered in Pensacola.  The document here presented is from Jonathan Ogden to Robert Morris and is one of the large collection of original manuscripts in the Robert Morris Papers in the Rutgers University Library. The recipient of the letter was the natural son of Robert Hunter Morris, Chief Justice of the New Jersey Supreme Court before the Revolution

The application of sanctions in the Italo-Ethiopian conflict

This study was undertaken with the idea of arriving at some conclusion as to the effectiveness of economic sanctions. No study of the diplomacy of the conflict, other than that directly connected with the application of sanctions was made, nor was any study made of the actual war itself. The effectiveness of sanctions was well-demonstrated in one way; that is, in the curtailment of trade, Sanctions as a weapon for international peace, however, is another matter. In a world torn by armed conflict at the present time in China and Spain, in a world apparently dominated by the desire of many nations to become strong military empires, those who desire peace should be making every effort to arrive at some plan to insure world peace. Italy, since the Ethiopian conquest, has continued to increase her arms, until at the present time she has nine million men under arms, according to Winston Churchhill. Germany has annexed Austria and is endeavoring to interfere in Czechoslovakian affairs with the intention of annexing her also. Russia and Japan, as a result of recent border incidents, are threatening war. The situation between the United States and Mexico over the confiscation of lands, while in no way carrying a threat of war in the immediate future, could grow into a serious situation. For the anti-militaristic Anglo-Saxon people of the world the situation is alarming, and as a result they are casting about for some means of promoting international peace. The writer seriously hopes that those who read the succeeding pages will carefully study the various questions arising and will try to reach some definite conclusion that will help fight for world peace

Francisco I. Madero, revolutionary

The violence of the Mexican Revolution in the years between 1914 and 1920 was shocking and disconcerting to those who had become accustomed to the peace and security of the Diaz administration. Numerous investigations into the causes and the nature of the Revolution, with its broad social and economic implications, have been made by qualified scholars, but the period between 1910 and 1913 has generally been neglected. The purpose of this study has been to clarify to some extent the forces operative during these crucial years, and to analyze the character of the events preceding the bloody shambles from which the new Mexico emerged. Francisco I. Madero, the man responsible for the overthrow of the Diaz government and as such responsible for the Revolution, has been the subject of much discussion, but little attempt has been made to view his administration in the proper perspective and to give it a studied evaluation. Few men in the history of Mexico have been so roundly and viciously condemned, and few so highly praised. Madero was either the whitest of saints or the blackest of sinners, but the black has outweighed the white. American historians, in general, have been sympathetic to the intentions and ideals of Madero, but since serious studies of his regime are lacking, the tendency has been to dismiss him as a visionary idealist of negligible importance. But any serious student of Mexican history will realize that under the conditions of 1910 the Revolution could not have sprung fullblown into existence. That unrest existed is patent, but the Revolution was a true revolution in the broadest sense of the term. The real importance of the Mexican Revolution has not been in the apparent victory of democratic principles or of the principle of rotation in office; it has been in the magnitude of the social and economic changes which have come to the Mexican nation. Even though the factors resulting in those changes were rooted in the Diaz regime, a crystallization of the ideas and demands was necessary before the basic structure of Mexico's society could be altered. A revolution of that scope cannot develop from a vacuum. In an effort to trace that crystallization, the present study has been undertakenHistor