Influence of fogging lenses and cycloplegia on open-field automatic refraction

Purpose: To compare refractive values measured without cycloplegia, cycloplegia and fogging lenses using an open-field auto-refractor. Methods: One hundred and forty-two young adults were enrolled from a university population; 96 were female (67.6%) and 46 were male (32.4%), the age range was 18 to 26 years (mean 22.3 ± 3.7 years). The refraction measurement was obtained with autorefractor Grand Seiko Auto Ref/Keratometer WAM-5500 (GS) under three conditions, always in this sequence: 1) without cycloplegia (GS), 2) without cycloplegia but using a +2.00D fogging lens (GS_2D) and 3) with cycloplegia (GS_cycl). Results: When the average values of spherical equivalent were compared both accommodation control strategies were almost equally successful: GS, M= -0.85 ± 2.21 D; GC_2D, M= -0.53 ± 2.10 D and GS_cycl, M= -0.57 ± 2.24 D (Kruskal-Wallis Test, p<0.001). When the results were analyzed separately for different refractive groups, emmetropes and hyperopes show statistically significant differences while myopes did not. When both accommodation strategies were compared there was a trend for more myopic subject to display more negative values under cycloplegia, while low myopes, emmetropes and hyperopes tend to display more negative values with the +2.00 D fogging lenses (less effectiveness of accommodation control). Conclusions: Over-refraction through +2.00 D fogging lenses is useful to achieve additional relaxation of the accommodative response in a similar way than cycloplegia when open-field autorefraction is performed in young adults.Grand Seiko Auto Ref/Keratometer WAM-5500

Dietary cholesterol directly induces acute inflammasome-dependent intestinal inflammation

Prolonged ingestion of a cholesterol- or saturated fatty acid-enriched diet induces chronic, often systemic, auto-inflammatory responses resulting in significant health problems worldwide. In vivo information regarding the local and direct inflammatory effect of these dietary components in the intestine and, in particular, on the intestinal epithelium is lacking. Here we report that both mice and zebrafish exposed to high-fat (HFDs) or high-cholesterol (HCDs) diets develop acute innate inflammatory responses within hours, reflected in the localized interleukin-1β-dependent accumulation of myeloid cells in the intestine. Acute HCD-induced intestinal inflammation is dependent on cholesterol uptake via Niemann-Pick C1-like 1 and inflammasome activation involving apoptosis-associated Speck-like protein containing a caspase recruitment domain, which leads to Caspase-1 activity in intestinal epithelial cells. Extended exposure to HCD results in localized, inflammation-dependent, functional dysregulation as well as systemic pathologies. Our model suggests that dietary cholesterol initiates intestinal inflammation in epithelial cells

The influence of cycloplegic in objective refraction

The purpose of this study was to compare refractions measured with an autorefractor and retinoscopy in cycloplegic and non-cycloplegic eyes. The objective refractions were performed in 199 right eyes from 199 healthy young adults with a mean age of 21.6 ±2.66 years. The measurements were performed first without cycloplegia and repeated 30 minutes later with cycloplegia. Data were analyzed using Fourier decomposition of the power profile. More negative values of component M and J0 were give by non-cycloplegic autorefraction compared to cycloplegic autorefraction (p<0.001). However more positive values were given by non-cycloplegic autorefraciton regarding to the J45 vector, althought this differences were not statistically significant (p=0.233). Regarding retinoscopy, more negative values of component M where obtained with non-cycloplegic retinoscopy (p<0.001); for the cylindrical vectors J0 and J45 the retinoscopy without cycloplegic yields more negative values (p= 0.234; p= 0.112, respectively). Accepting that differences between cycloplegic and non-cycloplegic retinoscopy are only due to accommodative response, present results confirm that when performed by an experienced clinician, retinoscopy is a more reliable method to obtain objective start point for refraction under non-cycloplegic conditions

Does transient increase in axial length during accommodation attenuate with age?

Background: The aim was to profile transient accommodative axial length (AXL) changes from early adulthood to advanced presbyopia and to determine whether any differences exist between the responses of myopic and emmetropic individuals. Methods: Ocular biometry was measured by the LenStar biometer (Haag-Streit, Switzerland) in response to 0.00, 3.00 and 4.50 D accommodative stimuli in 35 emmetropes and 37 myopes, aged 18 to 60 years. All results were corrected to reduce errors arising from the increase in crystalline lens thickness with accommodation. Accommodative responses were measured sequentially by the WAM 5500 Auto Ref/Keratometer (Grand Seiko, Japan). Results: AXL increased significantly with accommodation (p<0.001), with a mean corrected AXL elongation of 2 ± 18 µm and 8 ± 16 µm observed at 3.00 D and 4.50 D, respectively. The magnitude of accommodative AXL change was not dependent on refractive error classification (p=0.959), however a significant reduction in the magnitude and variance of AXL change was evident after 43-44 years of age (p<0.002). Conclusion: The negative association between transient AXL elongation and age, in combination with reduced variance of data after age 43-44 years, is consistent with a significant increase in posterior ocular rigidity, which may be influential in the development of presbyopia

Search for transient optical counterparts to high-energy IceCube neutrinos with Pan-STARRS1

In order to identify the sources of the observed diffuse high-energy neutrino flux, it is crucial to discover their electromagnetic counterparts. IceCube began releasing alerts for single high-energy ($E > 60$ TeV) neutrino detections with sky localisation regions of order 1 deg radius in 2016. We used Pan-STARRS1 to follow-up five of these alerts during 2016-2017 to search for any optical transients that may be related to the neutrinos. Typically 10-20 faint ($m < 22.5$ mag) extragalactic transients are found within the Pan-STARRS1 footprints and are generally consistent with being unrelated field supernovae (SNe) and AGN. We looked for unusual properties of the detected transients, such as temporal coincidence of explosion epoch with the IceCube timestamp. We found only one transient that had properties worthy of a specific follow-up. In the Pan-STARRS1 imaging for IceCube-160427A (probability to be of astrophysical origin of $\sim$50 %), we found a SN PS16cgx, located at 10.0' from the nominal IceCube direction. Spectroscopic observations of PS16cgx showed that it was an H-poor SN at z = 0.2895. The spectra and light curve resemble some high-energy Type Ic SNe, raising the possibility of a jet driven SN with an explosion epoch temporally coincident with the neutrino detection. However, distinguishing Type Ia and Type Ic SNe at this redshift is notoriously difficult. Based on all available data we conclude that the transient is more likely to be a Type Ia with relatively weak SiII absorption and a fairly normal rest-frame r-band light curve. If, as predicted, there is no high-energy neutrino emission from Type Ia SNe, then PS16cgx must be a random coincidence, and unrelated to the IceCube-160427A. We find no other plausible optical transient for any of the five IceCube events observed down to a 5$\sigma$ limiting magnitude of $m \sim 22$ mag, between 1 day and 25 days after detection.Comment: 20 pages, 6 figures, accepted to A&

Impact of cholinesterase inhibitors or memantine on survival in adults with Down syndrome and dementia: clinical cohort study

Background: There is little evidence to guide pharmacological treatment in adults with Down syndrome and Alzheimer's disease. / Aims: To investigate the effect of cholinesterase inhibitors or memantine on survival and function in adults with Down syndrome and Alzheimer's disease. / Method: This was a naturalistic longitudinal follow-up of a clinical cohort of 310 people with Down syndrome diagnosed with Alzheimer's disease collected from specialist community services in England. / Results: Median survival time (5.59 years, 95% CI 4.67–6.67) for those on medication (n = 145, mainly cholinesterase inhibitors) was significantly greater than for those not prescribed medication (n = 165) (3.45 years, 95% CI 2.91–4.13, log-rank test P<0.001). Sequential assessments demonstrated an early effect in maintaining cognitive function. / Conclusions: Cholinesterase inhibitors appear to offer benefit for people with Down syndrome and Alzheimer's disease that is comparable with sporadic Alzheimer's disease; a trial to test the effect of earlier treatment (prodromal Alzheimer's disease) in Down syndrome may be indicated. / Declaration of interest: A.S. has undertaken consulting for Ono Pharmaceuticals, outside the submitted work. Z.W. has received a consultancy fee and grant from GE Healthcare, outside the submitted work

Preoperative cardiac risk assessment in geriatric patients with hip fractures: an orthopedic surgeons’ perspective

Hip fracture is one of the most common orthopedic conditions and is associated with significant morbidity and mortality. With a progressively aging population, the annual incidence of hip fracture is expected to increase substantially. Emerging evidence suggests that early surgery (<24 h) minimizes complications secondary to immobilization, including orthostatic pneumonia and venous thromboembolism. Delayed surgical repair (>48 h) has been consistently demonstrated to be associated with an increased risk of 30-day and 1-year mortality. Nonetheless, early surgery necessitates a shorter time for preoperative medical preparation, in particular cardiac assessment. Patients who undergo emergent orthopedic surgery are therefore at greater risk of perioperative cardiac events than those who undergo elective surgery. In addition, the prompt triage system for preoperative cardiac assessment not only identifies patients at high risk of perioperative cardiac complications but also reduces unnecessary cardiac consultations for low-risk patients. We review the current recommendations for preoperative cardiac assessment adapted for patients with hip fracture and describe our current triage system for preoperative cardiac consultation

Transglutaminases (TGs) in Ocular and Periocular Tissues: Effect of Muscarinic Agents on TGs in Scleral Fibroblasts

10.1371/journal.pone.0018326PLoS ONE64

Genomic attributes of airway commensal bacteria and mucosa

Microbial communities at the airway mucosal barrier are conserved and highly ordered, in likelihood reflecting co-evolution with human host factors. Freed of selection to digest nutrients, the airway microbiome underpins cognate management of mucosal immunity and pathogen resistance. We show here the initial results of systematic culture and whole-genome sequencing of the thoracic airway bacteria, identifying 52 novel species amongst 126 organisms that constitute 75% of commensals typically present in heathy individuals. Clinically relevant genes encode antimicrobial synthesis, adhesion and biofilm formation, immune modulation, iron utilisation, nitrous oxide (NO) metabolism and sphingolipid signalling. Using whole-genome content we identify dysbiotic features that may influence asthma and chronic obstructive pulmonary disease. We match isolate gene content to transcripts and metabolites expressed late in airway epithelial differentiation, identifying pathways to sustain host interactions with microbiota. Our results provide a systematic basis for decrypting interactions between commensals, pathogens, and mucosa in lung diseases of global significance