Femtosecond Laser-Assisted In Situ Keratomileusis Treatment of Residual Refractive Error following Femtosecond Laser-Enabled Keratoplasty.

Purpose:To evaluate the safety and effectiveness of femtosecond laser-assisted in situ keratomileusis (LASIK) in the treatment of residual myopia and astigmatism following femtosecond laser-enabled keratoplasty (FLEK). Design:Retrospective case review. Methods:Chart review of all patients with prior FLEK who subsequently underwent femto-LASIK surgery after full suture removal was performed at the Gavin Herbert Eye Institute at the University of California, Irvine. A total of 14 eyes in 13 patients met this criterion, and their comprehensive examinations performed at standard intervals were reviewed. Main outcome measures include uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) expressed as the logarithm of the minimum angle of resolution (logMAR), manifest refractive astigmatism, and spherical equivalent. Results:From the preoperative visit to the 3 month visit, all 14 eyes significantly improved in UDVA (logMAR, 0.93 ± 0.23 to 0.44 ± 0.32, P = 0.002) with no loss of CDVA (logMAR, 0.26 ± 0.19 to 0.18 ± 0.23, P = 0.50). All 14 eyes showed significant improvement in manifest refractive astigmatism (4.71 ± 1.77 to 2.18 ± 1.45 diopters (D), P = 0.003) and spherical equivalent (-2.57 ± 2.45 to -0.48 ± 0.83 D, P = 0.0007). There were no flap or graft complications as a result of femto-LASIK. Conclusions:Our findings suggest that femto-LASIK on eyes with prior FLEK is safe and effective in improving visual acuity and reducing residual astigmatism

Computational fluid dynamic analysis of bioprinted self-supporting perfused tissue models

Natural tissues are incorporated with vasculature, which is further integrated with a cardiovascular system responsible for driving perfusion of nutrient‐rich oxygenated blood through the vasculature to support cell metabolism within most cell‐dense tissues. Since scaffold‐free biofabricated tissues being developed into clinical implants, research models, and pharmaceutical testing platforms should similarly exhibit perfused tissue‐like structures, we generated a generalizable biofabrication method resulting in self‐supporting perfused (SSuPer) tissue constructs incorporated with perfusible microchannels and integrated with the modular FABRICA perfusion bioreactor. As proof of concept, we perfused an MLO‐A5 osteoblast‐based SSuPer tissue in the FABRICA. Although our resulting SSuPer tissue replicated vascularization and perfusion observed in situ, supported its own weight, and stained positively for mineral using Von Kossa staining, our in vitro results indicated that computational fluid dynamics (CFD) should be used to drive future construct design and flow application before further tissue biofabrication and perfusion. We built a CFD model of the SSuPer tissue integrated in the FABRICA and analyzed flow characteristics (net force, pressure distribution, shear stress, and oxygen distribution) through five SSuPer tissue microchannel patterns in two flow directions and at increasing flow rates. Important flow parameters include flow direction, fully developed flow, and tissue microchannel diameters matched and aligned with bioreactor flow channels. We observed that the SSuPer tissue platform is capable of providing direct perfusion to tissue constructs and proper culture conditions (oxygenation, with controllable shear and flow rates), indicating that our approach can be used to biofabricate tissue representing primary tissues and that we can model the system in silico

END(S) of vaping: A search query review of e-cigarettes

Background: As of December 2019, 52 electronic nicotine delivery system (ENDS) related deaths and over 2,400 related cases of lung damage have been confirmed in the US; the CDC refers to this pathology as EVALI—e-cigarette, or vaping, product use associated lung injury. The primary endpoint of this investigation is to provide insight into the public consciousness and to shape future studies and policies on this rapidly evolving topic by updating a 2015 study by John W. Ayers, Ph.D. et al.Methods: Internet search query data were located using Google Trends (https://trends.google.com/trends). We compared the terms "vape," "vaping," "e cig," and "e cigarette," as well as searches for alternative tobacco options such as "snus," "Chantix," and "nicotine-replacement therapies." Variations in state search rates were explored by comparing ENDS searches according to 10 state specific traits: the longitude of each state, tobacco excise tax rates, cigarette smoking rate, population density, lung cancer incidence rate, national tobacco control program funding and the percentage of available funding used by the state, smoke-free air grades from the American Lung Association, crude ENDS prevalence, and the anti-smoking norms as reported by Ayers et al. All analyses were conducted using Stata 15.1 (STATA Corp., College Station, TX).Results: Total ENDS searches increased 88% over the past 5 years. We found that ENDS was searched with greater frequency than other popular smoking alternatives. Significant geographic findings for 2019 include a lower annual relative search rate for all ENDS on either coast of the United States with a higher relative search rate in the center of the country. Trends from 2015 - 2019 for different ENDS search phrases meant to represent different intentions (buying, health, and cessation) behind ENDS searches were compared and the phrase buy vape was searched the most out of this set. Over the last 5 years, both YouTube and Google Shopping saw total ENDS searches rise from 2015 to 2018 only for both to fall in 2019.Conclusion: Total ENDS searches in the United States increased dramatically over the last 5 years compared to the decade prior, peaking the week of September 8, 2019. Earlier that week, a warning was sent by the CDC of the potential link between ENDS and severe lung illnesses after more than 25 states had reported possible cases of lung illnesses associated with use of ENDS products. ENDS searches by state have become more concentrated in the last 5 years, reversing the trend of the early 2010's observed by Ayers et al. This trend could be, in part, due to states passing laws to curb the use of ENDS. The public definitively prefers using vaping terms over e-cigarette terms in a phenomenon similar to that of high fructose corn syrup versus sugar. It would be wise to frame policy discussions and public education campaigns using vaping terms as well as e-cigarette terms, and encourage states to enact policies associated with lower ENDS usage

Serialization of Behavior During Car Following in Older Drivers

Age-related declines in cognitive functioning can push older adults to adopt strategies that may or may not improve their driving safety. Previous research suggests one strategy involves performing complex driving tasks (e.g., right turn negotiation) in discrete steps (“serialization”) rather than fluidly. The current study used simulator scenarios developed to test possible age-related serialization of behavior during complex car following. In all scenarios, participants closely monitored a lead vehicle using sustained attention. During multi-tasking scenarios, drivers performed an additional localization task designed to increase the demands on attention. The results demonstrate that older adults showed general impairments in multi-tasking and vehicle control during car following. Importantly, ageassociated changes in task execution were observed, demonstrating older adults also serialize car following behavior under certain conditions. As a result, older drivers withdrew attention from the lead vehicle for several seconds. This pattern of behavior identifies a remediable situation where age-associated impairments may increase crash risk

Identifying acne treatment uncertainties via a James Lind Alliance Priority Setting Partnership

Objectives: The Acne Priority Setting Partnership (PSP) was set up to identify and rank treatment uncertainties by bringing together people with acne, and professionals providing care within and beyond the National Health Service (NHS). Setting: The UK with international participation. Participants: Teenagers and adults with acne, parents, partners, nurses, clinicians, pharmacists, private practitioners. Methods: Treatment uncertainties were collected via separate online harvesting surveys, embedded within the PSP website, for patients and professionals. A wide variety of approaches were used to promote the surveys to stakeholder groups with a particular emphasis on teenagers and young adults. Survey submissions were collated using keywords and verified as uncertainties by appraising existing evidence. The 30 most popular themes were ranked via weighted scores from an online vote. At a priority setting workshop, patients and professionals discussed the 18 highest-scoring questions from the vote, and reached consensus on the top 10. Results: In the harvesting survey, 2310 people, including 652 professionals and 1456 patients (58% aged 24 y or younger), made submissions containing at least one research question. After checking for relevance and rephrasing, a total of 6255 questions were collated into themes. Valid votes ranking the 30 most common themes were obtained from 2807 participants. The top 10 uncertainties prioritised at the workshop were largely focused on management strategies, optimum use of common prescription medications and the role of nondrug based interventions. More female than male patients took part in the harvesting surveys and vote. A wider range of uncertainties were provided by patients compared to professionals. Conclusions: Engaging teenagers and young adults in priority setting is achievable using a variety of promotional methods. The top 10 uncertainties reveal an extensive knowledge gap about widely used interventions and the relative merits of drug versus non-drug based treatments in acne management

Reforming Test Standards to Expand Student Opportunities

A poster presented by Riley Ground, Katie Lester, Ali Owen, Matthew Maines, Noah Thacker and Rico Walker for the class Design of Everyday Things.https://scholarworks.moreheadstate.edu/gsp_projects_2019/1014/thumbnail.jp

Granulocytes as models for human protein marker identification following nicotine exposure

Nicotinic acetylcholine receptors (nAChRs) are pentameric cation channels expressed in the mammalian CNS, in the peripheral nervous system, and in skeletal muscle. Neuronal-type nAChRs are also found in several non-neuronal cell types, including leukocytes. Granulocytes are a subtype of leukocytes that include basophils, eosinophils, and neutrophils. Granulocytes, also known as polymorphonuclear leukocytes, are characterized by their ability to produce, store, and release compounds from intracellular granules. Granulocytes are the most abundant type of leukocyte circulating in the peripheral blood. Granulocyte abundance, nAChR expression, and nAChR upregulation following chronic nicotine administration makes granulocytes interesting models for identifying protein markers of nicotine exposure. Nicotinic receptor subunits and several non-nAChR proteins have been identified as protein markers of granulocyte nicotine exposure. We review methods to isolate granulocytes from human tissue, summarize present data about the expression of nAChRs in the three granulocyte cell types (basophils, eosinophils, and neutrophils), describe current knowledge of the effects of nicotine exposure on human granulocyte protein expression, and highlight areas of interest for future investigation