1,176 research outputs found

    Nutrition and Eye Health

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    Diet is a key lifestyle factor that can have long-term effects on ocular health [...]

    A Critical Appraisal of National and International Clinical Practice Guidelines Reporting Nutritional Recommendations for Age-Related Macular Degeneration: Are Recommendations Evidence-Based?

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    Eye care professionals should have access to high quality clinical practice guidelines that ideally are underpinned by evidence from robust systematic reviews of relevant research. The aim of this study was to identify clinical guidelines with recommendations pertaining to dietary modification and/or nutritional supplementation for age-related macular degeneration (AMD), and to evaluate the overall quality of the guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. We also mapped recommendations to existing systematic review evidence. A comprehensive search was undertaken using bibliographic databases and other electronic resources for eligible guidelines. Quality appraisal was undertaken to generate scores for each of the six AGREE II domains, and mapping of extracted nutritional recommendations was performed for systematic reviews published up to March 2017. We identified 13 national and international guidelines, developed or updated between 2004 and 2019. These varied substantially in quality. The lowest scoring AGREE II domains were for 'Rigour of Development', 'Applicability' (which measures implementation strategies to improve uptake of recommendations), and 'Editorial Independence'. Only four guidelines used evidence from systematic reviews to support their nutritional recommendations. In conclusion, there is significant scope for improving current Clinical Practice Guidelines for AMD, and guideline developers should use evidence from existing high quality systematic reviews to inform clinical recommendations

    Novel, bilateral, two-bellied muscles span the extensor forearm, thenar eminence to insert on the proximal phalanx of the thumb: clinical and embryological significance

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    Muscle and tendon variations in the forearm, wrist and hand are commonly reported in the anatomical and surgical literature. They are frequently the source of inflammatory conditions such as de Quervain’s tenosynovitis or carpal tunnel syndrome. During academic dissection, a cadaver presented with bilateral, additional muscles running parallel to the abductor pollicis longus muscles (APL) in the extensor compartment of the forearm. Both additional muscles had two bellies, one proximal and one distal, with an intervening tendon. The proximal bellies were separate and distinct from the adjacent APLs. The tendons traversed the first dorsal compartments with the tendons of the APLs and the extensor pollicis brevis muscles (EPB). The distal bellies lay adjacent to the abductor pollicis brevis (APB) muscles in the thenar compartments, and inserted onto the volar base of the proximal phalanges of the thumbs. Following a thorough search of the literature, we determined that these additional muscles constitute a previously unreported variation. This report details the variation, compares it with other reported variations, presents the related embryology, and reviews the significance of this variation as it relates to inflammatory conditions and surgical procedures

    Rapid physiological and transcriptomic changes associated with oxygen delivery in larval anemonefish suggest a role in adaptation to life on hypoxic coral reefs

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    Connectivity of coral reef fish populations relies on successful dispersal of a pelagic larval phase. Pelagic larvae must exhibit high swimming abilities to overcome ocean and reef currents, but once settling onto the reef, larvae transition to endure habitats that become hypoxic at night. Therefore, coral reef fish larvae must rapidly and dramatically shift their physiology over a short period of time. Taking an integrative, physiological approach, using swimming respirometry, and examining hypoxia tolerance and transcriptomics, we show that larvae of cinnamon anemonefish (Amphiprion melanopus) rapidly transition between "physiological extremes" at the end of their larval phase. Daily measurements of swimming larval anemonefish over their entire early development show that they initially have very high mass-specific oxygen uptake rates. However, oxygen uptake rates decrease midway through the larval phase. This occurs in conjunction with a switch in haemoglobin gene expression and increased expression of myoglobin, cytoglobin, and neuroglobin, which may all contribute to the observed increase in hypoxia tolerance. Our findings indicate that critical ontogenetic changes in the gene expression of oxygen-binding proteins may underpin the physiological mechanisms needed for successful larval recruitment to reefs

    Structural phase transitions in the kagome lattice based materials Cs2-xRbxSnCu3F12 (x = 0, 0.5, 1.0, 1.5)

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    The solid solution Cs2-xRbxSnCu3F12 (x = 0, 0.5, 1.0, 1.5) has been investigated crystallographically between 100 and 300 K using synchrotron X-ray powder diffraction and, in the case of x = 0, neutron powder diffraction.Comment: 14 pages, 9 figure

    Pointing in a different direction: a case of bilateral absence of extensor indicis

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    Understanding anatomical variations, as well as, normal anatomy of the muscles and tendons of the hand is vital for successful clinical evaluation and surgery. A number of extensor muscle and tendon variations have been reported in the literature including duplication, triplication, and absence. We report a rare anatomical variation that includes bilateral absence of the extensor indicis (EI) muscles and bilateral duplication of the extensor digitorum (ED) tendon to the second digit in the forearm of an 83-year-old male cadaver during routine upper limbs dissection. In the present case, only three muscles were present in the deep compartment: extensor pollicis longus (EPL), extensor pollicis brevis (EPB), and abductor pollicis longus (APL) with bilateral absence of EI. The reported prevalence of bilateral absence of EI muscle and tendon ranges from 0.5 to 3.5%  [1, 26]. The prevalence of an additional index tendon arising bilaterally from the ED muscle belly is 3.2 % of the population [1]. Extension of the index finger is governed by the actions of EI and ED. However, the four tendons of ED are linked to each other by juncturae tendinum (JT), restricting independent extension of the digits in certain postures, e.g. when the hand is fisted. With fisted hand, EI controls extension of the index finger. Clinically, EI tendons are used for tendon reconstruction procedures to restore function to the hand and thumb after trauma or tendon rupture. This report highlights the importance of anticipating anatomical variations and conducting pre-operative evaluations to confirm the presence of EI when planning tendon transfer procedures
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