Ocular higher-order aberrations changes after implantable collamer lens implantation for high myopic astigmatism

Purpose: To investigate the changes in higher-order aberrations (HOAs) induced by the implantation of implantable collamer lenses (ICLs) and Toric ICL (TICL) in eyes with high myopia and high myopic astigmatism. Methods: We investigated 33 eyes of 18 consecutive patients (in a prospective, interventional case series study), with spherical equivalent errors of �6.00 to �21.09 diopters (D) and cylindrical errors of �0.5 to �4.75 D, who underwent ICL and TICL implantation. Before and after 5 days, 2 and 6 months of surgery, the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), defocus and adverse events of the surgery were assessed. Ocular HOAs were also evaluated by Hartmann-Shack aberrometry (Technolas PV, Rochester, New York, USA) before and after 6 months of surgery. Results: At 6.0 months after surgery, the UCVA and BCVA in 40 and 66.7 of eyes were 20/20, respectively. Mean defocus refraction and astigmatism was reduced to �0.66 and 0.65 D from �12.79 and 2.18 at baseline, respectively. For a 6 mm pupil, HOAs were not significantly changed, merely from 0.417 ± 0.162 μ before surgery to 0.393 ± 0.119 μ after surgery (P = 0.45). Spherical aberration (Z400) increased significantly (P = 00.0). Surgical induced astigmatism was lower than 0.25 D, and there were no changes in trefoils and coma aberration. No vision-threatening complications occurred during the observation period. Conclusion: This study shows that the ICL and TICL performed well in correcting high myopic astigmatism without significant changes in HOAs during a 6-month observation period, although the spherical aberration (Z400) increased significantly. © 2017 Iranian Society of Ophthalmolog

Ocular higher-order aberrations changes after implantable collamer lens implantation for high myopic astigmatism

Purpose: To investigate the changes in higher-order aberrations (HOAs) induced by the implantation of implantable collamer lenses (ICLs) and Toric ICL (TICL) in eyes with high myopia and high myopic astigmatism. Methods: We investigated 33 eyes of 18 consecutive patients (in a prospective, interventional case series study), with spherical equivalent errors of �6.00 to �21.09 diopters (D) and cylindrical errors of �0.5 to �4.75 D, who underwent ICL and TICL implantation. Before and after 5 days, 2 and 6 months of surgery, the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), defocus and adverse events of the surgery were assessed. Ocular HOAs were also evaluated by Hartmann-Shack aberrometry (Technolas PV, Rochester, New York, USA) before and after 6 months of surgery. Results: At 6.0 months after surgery, the UCVA and BCVA in 40 and 66.7 of eyes were 20/20, respectively. Mean defocus refraction and astigmatism was reduced to �0.66 and 0.65 D from �12.79 and 2.18 at baseline, respectively. For a 6 mm pupil, HOAs were not significantly changed, merely from 0.417 ± 0.162 μ before surgery to 0.393 ± 0.119 μ after surgery (P = 0.45). Spherical aberration (Z400) increased significantly (P = 00.0). Surgical induced astigmatism was lower than 0.25 D, and there were no changes in trefoils and coma aberration. No vision-threatening complications occurred during the observation period. Conclusion: This study shows that the ICL and TICL performed well in correcting high myopic astigmatism without significant changes in HOAs during a 6-month observation period, although the spherical aberration (Z400) increased significantly. © 2017 Iranian Society of Ophthalmolog

Adjustment formulae to improve the correlation of white-to-white measurement with direct measurement of the ciliary sulcus diameter by ultrasound biomicroscopy

Purpose: This study evaluates the correlation between horizontal white-to-white (WTW) distance using Caliper and Orbscan IIz with the ciliary sulcus diameter measured by high frequency ultrasound biomicroscopy (UBM) and presents an adjustment formula to improve the correlation. Methods: We measured horizontal sulcus-to-sulcus (STS) dimension of 273 right eyes of 273 high myopic patients with 35 MHz UBM and horizontal WTW using Orbscan IIz and Caliper. Mean WTW diameter, differences, and the correlation of measurement methods were evaluated. Results: The mean spherical equivalent was �8.79 ± 4.87 diopters. Mean horizontal STS dimension with UBM was 12.13 ± 0.45 mm (range, 10.81�13.42 mm). Mean WTW diameter in the Caliper method was 11.70 ± 0.40 mm (range, 10.6�12.8 mm) and 11.70 ± 0.40 mm (range, 10.5�13.1 mm) in the Orbscan method. Mean difference of UBM STS and WTW with Caliper was 0.48 ± 0.28 mm (range, �0.19 to 1.37 mm). Mean difference of UBM STS diameter and Orbscan WTW was 0.38 ± 0.31 mm (range, �0.64 to 1.29 mm). The Pearson correlations of WTW diameter measured by Caliper and Orbscan with UBM's STS diameter were 0.778 and 0.773, respectively. This difference diminished after adjustment. The 95 limit of agreement was almost the same in Caliper and Orbscan (�0.07 to 1.03 compared with �0.23 to 0.99). Conclusion: There is a significant difference in measurements between STS diameter using UBM and WTW diameter utilizing Caliper and Orbscan. This difference diminished after our recommended adjustment. © 2017 Iranian Society of Ophthalmolog

Non-coding RNAs and Exosomes: Their Role in the Pathogenesis of Sepsis

Non-coding RNAs and exosomes present an opportunity for early diagnosis as well as an ability to interact with key points of the biological mechanisms, suggesting that measurement of non-coding RNAs and exosomes are a promising approach for intensive care patients. © 2020 The Author(s) Sepsis is characterized as an uncontrolled host response to infection, and it represents a serious health challenge, causing excess mortality and morbidity worldwide. The discovery of sepsis-related epigenetic and molecular mechanisms could result in improved diagnostic and therapeutic approaches, leading to a reduced overall risk for affected patients. Accumulating data show that microRNAs, non-coding RNAs, and exosomes could all be considered as novel diagnostic markers for sepsis patients. These biomarkers have been demonstrated to be involved in regulation of sepsis pathophysiology. However, epigenetic modifications have not yet been widely reported in actual clinical settings, and further investigation is required to determine their importance in intensive care patients. Further studies should be carried out to explore tissue-specific or organ-specific epigenetic RNA-based biomarkers and their therapeutic potential in sepsis patients. © 2020 The Author(s

Continues renal replacement therapy (CRRT) with disposable hemoperfusion cartridge: A promising option for severe COVID-19

Cytokine release syndrome is prevalent in severe cases of COVID-19. In this syndrome, an uncontrolled response of immune system occurs. Extracorporeal blood purification has been proven to effectively remove the released inflammatory cytokines. Here, we reported a successful case to represent our experience of extracorporeal blood purification in a patient with severe COVID-19. © 2020 The Author

Death in hospital following ICU discharge : insights from the LUNG SAFE study

Background: To determine the frequency of, and factors associated with, death in hospital following ICU discharge to the ward. Methods: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE study was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted across 459 ICUs from 50 countries globally. This study aimed to understand the frequency and factors associated with death in hospital in patients who survived their ICU stay. We examined outcomes in the subpopulation discharged with no limitations of life sustaining treatments (‘treatment limitations’), and the subpopulations with treatment limitations. Results: 2186 (94%) patients with no treatment limitations discharged from ICU survived, while 142 (6%) died in hospital. 118 (61%) of patients with treatment limitations survived while 77 (39%) patients died in hospital. Patients without treatment limitations that died in hospital after ICU discharge were older, more likely to have COPD, immunocompromise or chronic renal failure, less likely to have trauma as a risk factor for ARDS. Patients that died post ICU discharge were less likely to receive neuromuscular blockade, or to receive any adjunctive measure, and had a higher pre- ICU discharge non-pulmonary SOFA score. A similar pattern was seen in patients with treatment limitations that died in hospital following ICU discharge. Conclusions: A significant proportion of patients die in hospital following discharge from ICU, with higher mortality in patients with limitations of life-sustaining treatments in place. Non-survivors had higher systemic illness severity scores at ICU discharge than survivors. Trial Registration: ClinicalTrials.gov NCT02010073

Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure : an analysis of the LUNG SAFE database

Background: Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). Methods: An ancillary analysis of a global, multi-centre prospective observational study (LUNG SAFE) was undertaken. LUNG SAFE evaluated all patients admitted to an intensive care unit (ICU) over a 4-week period, that required mechanical ventilation and met AHRF criteria. Patients who had their AHRF fully explained by cardiac failure were excluded. Important clinical characteristics were included in a stepwise selection approach (forward and backward selection combined with a significance level of 0.05) to identify a set of independent variables associated with having ARDS at any time, developing ARDS (defined as ARDS occurring after day 2 from meeting AHRF criteria) and with hospital mortality. Furthermore, propensity score analysis was undertaken to account for the differences in baseline characteristics between patients with and without diabetes mellitus, and the association between diabetes mellitus and outcomes of interest was assessed on matched samples. Results: Of the 4107 patients with AHRF included in this study, 3022 (73.6%) patients fulfilled ARDS criteria at admission or developed ARDS during their ICU stay. Diabetes mellitus was a pre-existing co-morbidity in 913 patients (22.2% of patients with AHRF). In multivariable analysis, there was no association between diabetes mellitus and having ARDS (OR 0.93 (0.78-1.11); p = 0.39), developing ARDS late (OR 0.79 (0.54-1.15); p = 0.22), or hospital mortality in patients with ARDS (1.15 (0.93-1.42); p = 0.19). In a matched sample of patients, there was no association between diabetes mellitus and outcomes of interest. Conclusions: In a large, global observational study of patients with AHRF, no association was found between diabetes mellitus and having ARDS, developing ARDS, or outcomes from ARDS. Trial registration: NCT02010073. Registered on 12 December 2013

Limnologic study Sabalan run off Dam for aquaculture fish cold water

Limnological study of Sabalan run off Damfor aquaculture cold water fish was conducted in sixtimesat four stations from July to December 2009. Average minimum and maximum parameters measured in different stations were included water temperature, dissolved Oxygen, total hardness, electrical conductivity, pH, BOD5, COD, TDS, NH4, NO2, NO3, PO4, TN, TP, SiO2, respectively (10/3±9/5-14±8/7°C), (9±1/2-11/4±2/1 mg/liter), (367±19/8-381±17/8mg/liter), (0/95±0/07-1/05±0/07 mz/cm), (8/3±0/1-8/4±0/1), (3/3±1/14-3/88 ± 0/71mg/ liter), (15/5 ± 3/1-16/3 ± 3 mg/liter), (0/48 ± 0/04-0/54 ± 0/06mg/ liter), (0/08 ± 0/02-0/13 ± 0/07 mg/liter), (0/004 ± 0/003- 0/05 ± 0/1 mg/ liter), (0/6 ± 0/2-0/64 ± 0/29 mg/ liter), (0/19 ± 0/07-0/22 ± 0/07 mg/ liter), (10/48 ± 0/6-10/98 ± 0/54mg/liter), (0/39 ± 0/11-0/44 ± 0/18 mg/liter), and(9/9 ±0/6-11/1 ± 1/4 mg/liter). Average minimum and maximum of water heavy metalswas included of Cd, Pb, Zn, Fe, Cuand Ni respectively was measured as ND(No Deliver), ND, ND- 0/242, ND- 1/075, ND- 0/018 and ND-0/014inmg/ liter. Also among the 16 organochlorinecom pounds measured the highest amount of was belonged totoxin Hexachlorine Benzene (1/5 mg/ liter). The results of the analysis of water quality parameters showed that parameters except ofCOD, TDS, PO4, TP, Zn, Fe and water temperature, other parameters do not haveany restrictions foraquaculturecold water fish in therunoffDam. Based on data results it was noticed that there was temperature restriction up to November at downstream and station 2 showed less temperature fluctuation and more suitable condition compared to other stations. BOD5 value was within the allowable range for growing trout, in which station 2 somewhat with lower volatility of value had the most suitable BOD5 condition. In the present study, the amount of TDS in the study area was somewhat higher than the limitation and since TDS values increased with distance from the dam, therefore station 2 had somewhat better conditions for fish farming. In addition the amount of EC in the study area, indicating the inappropriateness of it for various activities in the fisheries. Although none of the stations in terms of the amount of phosphorus didn't show favorable conditions for rainbow trout fish propagation, it appears between the researches stations, station 2 had the most favorable terms. The results of this study (regardless of the unseen), it seems that in August and September; Zn had overestimated value for cold fish propagation. Recent study showed that among heavy metals, Fe in water, sediments and fish was over limitation value. Also, Fe value was measured of 1.08 at station 4, which showed over normal value for cold fish propagation. Therefore, station 2 at downstream seemed to have suitable cold fish propagation due to lower Fe value. On the based on the recent study, planktonic biological index did not endorse water quality for fish propagation. In this study, aquatic plant such as Potamogeton pectinatus and Pheragmitie saustralis was found at water of higher and somehow polluted organic matter. Probably, based on the results it was noticed that downstream water of dam was polluted to organic matter. At the recent study, resisted maroinvertebrates to organic matter (Chironomidae) was consisted noticeable frequency compared to other sensitive invertebrates to organic matter (EPT).Statistically, it can be expressed that probably organic pollution resulted to increase of resistance invertebrates and decreased of sensitive groups. In recent study, EPT/CHIR index was measured 0.6 in station 2 and 1.74 in station 4. This ration was less to many other mountain rivers. As ETP sensitive invertebrates has higher sensitive to other groups with the regards of environmental condition and pollution, unpredicted increase of Chironomidae compare to sensitive groups resulted of EPT/CHIR value which showed environmental stress. In this study, HFBI index was measured as 7.49 at station 2 and 7 in station 4. Based on HFBI index, station 2 was classified as a high organic pollution and station 4 with noticeable organic pollution. At the recent study, station 2 was catch more fish to station4. For instance, Squaliuscephalus and Alburnoides pinctatus were catch in station 2 and were not found in station 4. As a whole, Biological indicators whichwas included Plankton Bioindicator, EPT / CHIR. ,Hilsenh off Biological Indicator, diversity and distribution ofaquatic plants and fish, showed water situation in run off Damrich inorganic matter. Finally, the study area was approved for fish farm about 50 tons and needs management arrangements with the increased production rate

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.Peer reviewe