Association of Rhegmatogenous Retinal Detachment Incidence With Myopia Prevalence in the Netherlands

Importance The incidence of rhegmatogenous retinal detachment (RRD) is partly determined by its risk factors, such as age, sex, cataract surgery, and myopia. Changes in the prevalence of these risk factors could change RRD incidence in the population. Objective To determine whether the incidence of RRD in the Netherlands has changed over recent years and whether this change is associated with an altered prevalence of RRD risk factors. Design, Setting, and Participants This cohort study included data from all 14 vitreoretinal clinics in the Netherlands, as well as a large Dutch population-based cohort study. All patients who underwent surgical repair for a primary RRD in the Netherlands from January 1 to December 31, 2009, and January 1 to December 31, 2016, were analyzed, in addition to all participants in the population-based Rotterdam Study who were examined during these years. Analysis began February 2018 and ended November 2019. Exposures RRD risk factors, including age, male sex, cataract extraction, and myopia. Main Outcomes and Measures Age-specific RRD incidence rate in the Dutch population, as well as change in RRD incidence and risk factor prevalence between 2009 and 2016. Results In 2016, 4447 persons (median [range] age, 61 [3-96] years) underwent surgery for a primary RRD within the Netherlands, resulting in an RRD incidence rate of 26.2 per 100 000 person-years (95% CI, 25.4-27.0). The overall RRD incidence rate had increased by 44% compared with similar data from 2009. The increase was observed in both phakic (1994 in 2009 to 2778 in 2016 [increase, 39%]) and pseudophakic eyes (1004 in 2009 to 1666 in 2016 [increase, 66%]), suggesting that cataract extraction could not solely account for the overall rise. Over the same period, the prevalence of mild, moderate, and severe myopia among persons aged 55 to 75 years had increased by 15.6% (881 of 4561 [19.3%] vs 826 of 3698 [22.3%]), 20.3% (440 of 4561 [9.6%] vs 429 of 3698 [11.6%]), and 26.9% (104 of 4561 [2.3%] vs 107 of 3698 [2.9%]), respectively, within the population-based Rotterdam Study. Conclusions and Relevance In this study, an increase was observed in primary RRD incidence in the Netherlands over a 7-year period, which could not be explained by a different age distribution or cataract surgical rate. A simultaneous myopic shift in the Dutch population may be associated, warranting further population-based studies on RRD incidence and myopia prevalence. This cohort study assesses whether the incidence of rhegmatogenous retinal detachment has changed over recent years and whether this change is associated with an altered prevalence of rhegmatogenous retinal detachment risk factors in the Netherlands. Question What is the incidence of primary rhegmatogenous retinal detachment (RRD) in the Netherlands and has it changed over recent years? Findings In this cohort study, 4447 individuals in the Netherlands underwent surgery for RRD in 2016, resulting in an incidence of 26.2 per 100 000 inhabitants, an increase of 44% compared with similar data from 2009. Over the same period, an increase in myopia prevalence in a Dutch population-based cohort study was observed. Meaning In the Netherlands, an increase in RRD incidence may be associated with a simultaneous myopic shift in the population

Properties of generalized univariate hypergeometric functions

Based on Spiridonov's analysis of elliptic generalizations of the Gauss hypergeometric function, we develop a common framework for 7-parameter families of generalized elliptic, hyperbolic and trigonometric univariate hypergeometric functions. In each case we derive the symmetries of the generalized hypergeometric function under the Weyl group of type E_7 (elliptic, hyperbolic) and of type E_6 (trigonometric) using the appropriate versions of the Nassrallah-Rahman beta integral, and we derive contiguous relations using fundamental addition formulas for theta and sine functions. The top level degenerations of the hyperbolic and trigonometric hypergeometric functions are identified with Ruijsenaars' relativistic hypergeometric function and the Askey-Wilson function, respectively. We show that the degeneration process yields various new and known identities for hyperbolic and trigonometric special functions. We also describe an intimate connection between the hyperbolic and trigonometric theory, which yields an expression of the hyperbolic hypergeometric function as an explicit bilinear sum in trigonometric hypergeometric functions.Comment: 46 page

Improving Access to Mental Health Care and Psychosocial Support within a Fragile Context: A Case Study from Afghanistan

As one article in a series on Global Mental Health Practice, Peter Ventevogel and colleagues provide a case study of their efforts to integrate brief, practice-oriented mental health training into the Afghanistan health care system at a time when the system was being rebuilt from scratch

Retention of basic laparoscopic skills after a structured training program

The purpose of this study was to test the retention of basic laparoscopic skills on a box trainer 1 year after a short training program. For a prior study, eight medical students without prior experience (novices) underwent baseline testing, followed by five weekly training sessions and a final test. During each of seven sessions, they performed five tasks on an inanimate box trainer. Scores were calculated by adding up the time to completion of the task with penalty points, consequently rewarding speed and precision. The sum score was the sum of the five scores. One year later, seven of them underwent retention testing for the current study. The final test results were compared with retention test results as a measure of durability of acquired skills. Novices’ scores did not worsen significantly for four out of five tasks (i.e., placing a pipe cleaner p = 0.46, placing beads p = 0.24, cutting a circle p = 0.31, and knot tying p = 0.13). However, deterioration was observed in the performance on stretching a rubber band (p < 0.05), as well as in the sum score (p < 0.05). Nevertheless, all retention scores remained better than the baseline results. In conclusion, basic laparoscopic skills acquired during a short training program merely sustain over time. However, ongoing practice is advisable, especially to preserve tissue-handling skills, since these may be the first to deteriorate

Prevalences of hyperhomocysteinemia, unfavorable cholesterol profile and hypertension in European populations

Item does not contain fulltextBACKGROUND: Hyperhomocysteinemia (HHCY) is a risk factor for cardiovascular diseases (CVD). HHCY may interact with hypertension (HTEN) and an unfavorable cholesterol profile (UNFAVCHOL) to alter the risk of CVD. OBJECTIVES: To estimate the prevalences of HHCY (1) isolated and (2) in combination with UNFAVCHOL and/or HTEN in different age categories. To provide information that may improve the screening and treatment of subjects at risk of CVD. DESIGN: Cross-sectional data on 12,541 men and 12,948 women aged 20 + y were used from nine European studies. RESULTS: The prevalence of isolated HHCY was 8.5% in subjects aged 20-40 y, 4.7% in subjects aged 40-60 y and 5.9% in subjects aged over 60 y. When combining all age groups, 5.3% had isolated HHCY and an additional 5.6% had HHCY in combination with HTEN and/or UNFAVCHOL. The combinations of risk factors increased with age and, except for HHCY&UNFAVCHOL, were more prevalent than predicted by chance. Of the young subjects (20-40 y), 24% suffered from one or more of the investigated CVD risk factors. This figure was 75.1% in the old subjects (60+ years). CONCLUSIONS: A substantial number of subjects in selected European populations have HHCY (10.9%). In half of these cases, subjects suffer also from other CVD risk factors like UNFAVCHOL and HTEN. Older people in particular tend to have more than one risk factor. Healthcare professionals should be aware of this when screening and treating older people not only for the conventional CVD risk factors like UNFAVCHOL and HTEN but also HHCY, as this can easily be reduced through increased intake of folic acid via supplement or foods fortified with folic acid

Ergodicity criteria for non-expanding transformations of 2-adic spheres

In the paper, we obtain necessary and sufficient conditions for ergodicity (with respect to the normalized Haar measure) of discrete dynamical systems $$ on 2-adic spheres $\mathbf S_{2^{-r}}(a)$ of radius $2^{-r}$, $r\ge 1$, centered at some point $a$ from the ultrametric space of 2-adic integers $\mathbb Z_2$. The map $f\colon\mathbb Z_2\to\mathbb Z_2$ is assumed to be non-expanding and measure-preserving; that is, $f$ satisfies a Lipschitz condition with a constant 1 with respect to the 2-adic metric, and $f$ preserves a natural probability measure on $\mathbb Z_2$, the Haar measure $\mu_2$ on $\mathbb Z_2$ which is normalized so that $\mu_2(\mathbb Z_2)=1$

Dietary methyl donors, methyl metabolizing enzymes, and epigenetic regulators: diet–gene interactions and promoter CpG island hypermethylation in colorectal cancer

Dietary methyl donors might influence DNA methylation during carcinogenesis of colorectal cancer (CRC). Among 609 CRC cases and 1,663 subcohort members of the Netherlands Cohort Study on diet and cancer (n = 120,852), we estimated CRC risk according to methyl donor intake across genotypes of folate metabolizing enzymes and methyltransferases

Detection of unsafety in families with parental and/or child developmental problems at the start of family support

Background Risk assessment is crucial in preventing child maltreatment as it can identify high-risk cases in need of child protection intervention. Despite this importance, there have been no validated risk assessment instruments available in the Netherlands for assessing the risk of child maltreatment. Therefore, the predictive validity of the California Family Risk Assessment (CFRA) was examined in Dutch families who received family support. In addition, the added value of a number of experimental items was examined. Finally, it was examined whether the predictive value of the instrument could be improved by modifying the scoring procedure. Methods Dutch families who experienced parenting and/or child developmental problems and were referred by the Centres for Youth and Family for family support between July 2009 and March 2011 were included. This led to a sample of 491 families. The predictive validity of the CFRA and the added value of the experimental items were examined by calculating AUC values. A CHAID analysis was performed to examine whether the scoring procedure could be improved. Results About half of the individual CFRA items were not related to future reports of child maltreatment. The predictive validity of the CFRA in predicting future reports of child maltreatment was found to be modest (AUC = .693). The addition of some of the experimental items and the modification of the scoring procedure by including only items that were significantly associated with future maltreatment reports resulted in a ‘high’ predictive validity (AUC = .795). Conclusions This new set of items might be a valuable instrument that also saves time because only variables that uniquely contribute to the prediction of future reports of child maltreatment are included. Furthermore, items that are perceived as difficult to assess by professionals, such as parental mental health problems or parents’ history of abuse/neglect, could be omitted without compromising predictive validity. However, it is important to examine the psychometric properties of this new set of items in a new dataset

Modified Chrispin-Norman chest radiography score for cystic fibrosis: observer agreement and correlation with lung function

Contains fulltext : 96114.pdf ( ) (Closed access)OBJECTIVE: To test observer agreement and two strategies for possible improvement (consensus meeting and reference images) for the modified Chrispin-Norman score for children with cystic fibrosis (CF). METHODS: Before and after a consensus meeting and after developing reference images three observers scored sets of 25 chest radiographs from children with CF. Observer agreement was tested for line, ring, mottled and large soft shadows, for overinflation and for the composite modified Chrispin-Norman score. Correlation with lung function was assessed. RESULTS: Before the consensus meeting agreement between observers 1 and 2 was moderate-good, but with observer 3 agreement was poor-fair. Scores correlated significantly with spirometry for observers 1 and 2 (-0.72<R<-0.42, P < 0.05), but not for observer 3. Agreement with observer 3 improved after the consensus meeting. Reference images improved agreement for overinflation and mottled and large shadows and correlation with lung function, but agreement for the modified Chrispin-Norman score did not improve further. CONCLUSION: Consensus meetings and reference images improve among-observer agreement for the modified Chrispin-Norman score, but good agreement was not achieved among all observers for the modified Chrispin-Norman score and for bronchial line and ring shadows

A Meta-analysis of Attachment to Parents and Delinquency

To investigate the link between attachment to parents and delinquency, and the potential moderating effects of age and sex, 74 published and unpublished manuscripts (N = 55,537 participants) were subjected to a multilevel meta-analysis. A mean small to moderate effect size was found (r = 0.18). Poor attachment to parents was significantly linked to delinquency in boys and girls. Stronger effect sizes were found for attachment to mothers than attachment to fathers. In addition, stronger effect sizes were found if the child and the parent had the same sex compared to cross-sex pairs of children and parents. Age of the participants moderated the link between attachment and delinquency: larger effect sizes were found in younger than in older participants. It can be concluded that attachment is associated with juvenile delinquency. Attachment could therefore be a target for intervention to reduce or prevent future delinquent behavior in juveniles