Update on a long-term, prospective study of capsulotomy and retinal detachment rates after cataract surgery

Journal ArticlePURPOSE: To evaluate the retinal detachment risks and neodymium:YAG (Nd:YAG) capsulotomy rates associated with different cataract approaches and intraocular lens (IOL) styles in a long-term,prospective clinical study. SETTING: Clinical practice of 1 ophthalmologist, Fort Collins, Colorado, USA. METHODS: Prospectively studied were surgical approach, date, and complications; IOL type; axial length; patient age and sex; Nd:YAG capsulotomy and date; and retinal detachment and date. RESULTS: Phacoemulsification had a lower risk of retinal detachment than intracapsular cataract extraction (ICCE) (0.4% versus 5.4%; P <.001) and extracapsular cataract extraction (ECCE) (0.4% versus 1.6%; P =. 002). Although retinal detachment was significantly associated with Nd:YAG for ECCE (3.1% versus 1.0%; P =.01), no patient in the phacoemulsification group had a retinal detachment after an Nd:YAG treatment. Retinal detachment was strongly associated with axial length of 24.0 mm and greater (P <.001), age of 60 years or less if axial length was 24.0 mm or greater (for ECCE, P =.001; for phacoemulsification, P =.01) and sex; that is, male (for ECCE, P =. 04; for phacoemulsification, P =.02). Regarding IOL styles the Surgidev B20/20 (P <.001) and AcrySof MA60 (P <.001) had significantly lower Nd:YAG rates, while the Cilco UPB 320 GS had a significantly higher Nd:YAG rate (P <.001). CONCLUSIONS: Cataract surgical approach and IOL style significantly affect Nd:YAG and retinal detachment rates. Being a man, being 60 years or younger, and especially having an axial length of 24.0 mm or greater were associated with detachment. Some Nd:YAG approaches may not put the patient at increased risk for retinal detachment

Comparison of complication risk for open carpal tunnel release: In-office versus operating room settings

BACKGROUND: Performing open carpal tunnel release (oCTR) in an office-based procedure room setting (PR) decreases surgical costs when compared with the operating room (OR). However, it is unclear if the risk of major medical, wound, and iatrogenic complications differ between settings. Our purpose was to compare the risk of major medical complications associated with oCTR between PR and OR settings. METHODS: Utilizing the MarketScan Database, we identified adults undergoing isolated oCTR between 2006 and 2015 performed in PR and OR settings. ICD-9-CM and/or CPT codes were used to identify major medical complications, surgical site complications, and iatrogenic complications within 90 days of oCTR. Multivariable logistic regression was used to compare complication risk between groups. RESULTS: Of the 2134 PR and 76,216 OR cases, the risk of major medical complications was 0.89% (19/2134) and 1.20% (914/76,216), respectively, with no difference observed in the multivariable analysis (adjusted odds ratio [OR] 0.84; 95% CI 0.53–1.33; P=0.45). Risk of surgical site complications was 0.56% (12/2134) and 0.81% (616/76,216) for the PR and OR, respectively, with no difference in the multivariable analysis (OR 0.68; 95% C.I. 0.38–1.22; P=0.19). Iatrogenic complications were rarely observed (PR 1/2134 [0.05%], OR 71/76,216 [0.09%]), which precluded multivariable modeling. CONCLUSION: These results support a similar safety profile for both the PR and OR surgical settings following oCTR with similar pooled major medical complications, pooled wound/surgical site complications, and iatrogenic complications

Empirical evidence for stability of the 405-kiloyear Jupiter-Venus eccentricity cycle over hundreds of millions of years

The Newark–Hartford astrochronostratigraphic polarity timescale (APTS) was developed using a theoretically constant 405-kiloyear eccentricity cycle linked to gravitational interactions with Jupiter–Venus as a tuning target and provides a major timing calibration for about 30 million years of Late Triassic and earliest Jurassic time. While the 405-ky cycle is both unimodal and the most metronomic of the major orbital cycles thought to pace Earth’s climate in numerical solutions, there has been little empirical confirmation of that behavior, especially back before the limits of orbital solutions at about 50 million years before present. Moreover, the APTS is anchored only at its younger end by U–Pb zircon dates at 201.6 million years before present and could even be missing a number of 405-ky cycles. To test the validity of the dangling APTS and orbital periodicities, we recovered a diagnostic magnetic polarity sequence in the volcaniclastic-bearing Chinle Formation in a scientific drill core from Petrified Forest National Park (Arizona) that provides an unambiguous correlation to the APTS. New high precision U–Pb detrital zircon dates from the core are indistinguishable from ages predicted by the APTS back to 215 million years before present. The agreement shows that the APTS is continuous and supports a stable 405-kiloyear cycle well beyond theoretical solutions. The validated Newark–Hartford APTS can be used as a robust framework to help differentiate provinciality from global temporal patterns in the ecological rise of early dinosaurs in the Late Triassic, amongst other problems

Graviton-induced Bremsstrahlung

We discuss photon Bremsstrahlung induced by virtual graviton exchange in proton-proton interactions at hadronic colliders, resulting from the exchange of Kaluza-Klein excitations of the graviton. The relevant subprocesses, gg to G to e^+e^-gamma and q barq to e^+e^-gamma are discussed in both the ADD and the RS scenarios. Although two-body final states (or real graviton emission) would presumably be the main discovery channels, a search for three-body final states could be worthwhile since such events have characteristic features that could provide additional confirmation. In particular, the k_perp-distribution of the photon is in both scenarios harder than that of the Standard-model background.Comment: 24 pages, including figures. v2: Including initial-state Bremsstrahlung and photon k_perp spectra. Version to appear in PR

Magnetochronology of the Entire Chinle Formation (Norian Age) in a Scientific Drill Core From Petrified Forest National Park (Arizona, USA) and Implications for Regional and Global Correlations in the Late Triassic

Building on an earlier study that confirmed the stability of the 405‐kyr eccentricity climate cycle and the timing of the Newark‐Hartford astrochronostratigraphic polarity time scale back to 215 Ma, we extend the magnetochronology of the Late Triassic Chinle Formation to its basal unconformity in scientific drill core PFNP‐1A from Petrified Forest National Park (Arizona, USA). The 335‐m‐thick Chinle section is imprinted with paleomagnetic polarity zones PF1r to PF10n, which we correlate to chrons E17r to E9n (~209 to 224 Ma) of the Newark‐Hartford astrochronostratigraphic polarity time scale. A sediment accumulation rate of ~34 m/Myr can be extended down to ~270 m, close to the base of the Sonsela Member and the base of magnetozone PF5n, which we correlate to chron E14n that onsets at 216.16 Ma. Magnetozones PF5r to PF10n in the underlying 65‐m‐thick section of the mudstone‐dominated Blue Mesa and Mesa Redondo members plausibly correlate to chrons E13r to E9n, indicating a sediment accumulation rate of only ~10 m/Myr. Published high‐precision U‐Pb detrital zircon dates from the lower Chinle tend to be several million years older than the magnetochronological age model. The source of this discrepancy is unclear but may be due to sporadic introduction of juvenile zircons that get recycled. The new magnetochronological constraint on the base of the Sonsela Member brings the apparent timing of the included Adamanian‐ Revueltian land vertebrate faunal zone boundary and the Zone II to Zone III palynofloral transition closer to the temporal range of the ~215 Ma Manicouagan impact structure in Canada

Genome sequence analysis of emm89 Streptococcus pyogenes strains causing infections in Scotland, 2010-2016.

PurposeStrains of type emm89 Streptococcus pyogenes have recently increased in frequency as a cause of human infections in several countries in Europe and North America. This increase has been molecular epidemiologically linked with the emergence of a new genetically distinct clone, designated clade 3. We sought to extend our understanding of this epidemic behavior by the genetic characterization of type emm89 strains responsible in recent years for an increased frequency of infections in Scotland.MethodologyWe sequenced the genomes of a retrospective cohort of 122 emm89 strains recovered from patients with invasive and noninvasive infections throughout Scotland during 2010 to 2016.ResultsAll but one of the 122 emm89 infection isolates are of the recently emerged epidemic clade 3 clonal lineage. The Scotland isolates are closely related to and not genetically distinct from recent emm89 strains from England, they constitute a single genetic population.ConclusionsThe clade 3 clone causes virtually all-contemporary emm89 infections in Scotland. These findings add Scotland to a growing list of countries of Europe and North America where, by whole genome sequencing, emm89 clade 3 strains have been demonstrated to be the cause of an ongoing epidemic of invasive infections and to be genetically related due to descent from a recent common progenitor

Multiple spillovers from humans and onward transmission of SARS-CoV-2 in white-tailed deer.

Many animal species are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and could act as reservoirs; however, transmission in free-living animals has not been documented. White-tailed deer, the predominant cervid in North America, are susceptible to SARS-CoV-2 infection, and experimentally infected fawns can transmit the virus. To test the hypothesis that SARS-CoV-2 is circulating in deer, 283 retropharyngeal lymph node (RPLN) samples collected from 151 free-living and 132 captive deer in Iowa from April 2020 through January of 2021 were assayed for the presence of SARS-CoV-2 RNA. Ninety-four of the 283 (33.2%) deer samples were positive for SARS-CoV-2 RNA as assessed by RT-PCR. Notably, following the November 2020 peak of human cases in Iowa, and coinciding with the onset of winter and the peak deer hunting season, SARS-CoV-2 RNA was detected in 80 of 97 (82.5%) RPLN samples collected over a 7-wk period. Whole genome sequencing of all 94 positive RPLN samples identified 12 SARS-CoV-2 lineages, with B.1.2 (n = 51; 54.5%) and B.1.311 (n = 19; 20%) accounting for ∼75% of all samples. The geographic distribution and nesting of clusters of deer and human lineages strongly suggest multiple human-to-deer transmission events followed by subsequent deer-to-deer spread. These discoveries have important implications for the long-term persistence of the SARS-CoV-2 pandemic. Our findings highlight an urgent need for a robust and proactive "One Health" approach to obtain enhanced understanding of the ecology, molecular evolution, and dissemination of SARS-CoV-2

New Pathogenesis Mechanisms and Translational Leads Identified by Multidimensional Analysis of Necrotizing Myositis in Primates

A fundamental goal of contemporary biomedical research is to understand the molecular basis of disease pathogenesis and exploit this information to develop targeted and more-effective therapies. Necrotizing myositis caused by the bacterial pathogen Streptococcus pyogenes is a devastating human infection with a high mortality rate and few successful therapeutic options. We used dual transcrip-tome sequencing (RNA-seq) to analyze the transcriptomes of S. pyogenes and host skeletal muscle recovered contemporaneously from infected nonhuman primates. The in vivo bacterial transcriptome was strikingly remodeled compared to organisms grown in vitro, with significant upregulation of genes contributing to virulence and altered regulation of metabolic genes. The transcriptome of muscle tissue from infected nonhuman primates (NHPs) differed significantly from that of mock-infected animals, due in part to substantial changes in genes contributing to inflammation and host defense processes. We discovered significant positive correlations between group A streptococcus (GAS) virulence factor transcripts and genes involved in the host immune response and inflammation. We also discovered significant correlations between the magnitude of bacterial virulence gene expression in vivo and pathogen fitness, as assessed by previously conducted genome-wide transposon-directed insertion site sequencing (TraDIS). By integrating the bacterial RNA-seq data with the fitness data generated by TraDIS, we discovered five new pathogen genes, namely, S. pyogenes 0281 (Spy0281 [dahA]), ihk-irr, slr, isp, and ciaH, that contribute to necrotizing myositis and confirmed these findings using isogenic deletion-mutant strains. Taken together, our study results provide rich new information about the molecular events occurring in severe invasive infection of primate skeletal muscle that has extensive translational research implications. IMPORTANCE Necrotizing myositis caused by Streptococcus pyogenes has high morbidity and mortality rates and relatively few successful therapeutic options. In addition, there is no licensed human S. pyogenes vaccine. To gain enhanced understanding of the molecular basis of this infection, we employed a multidimensional analysis strategy that included dual RNA-seq and other data derived from experimental infection of nonhuman primates. The data were used to target five streptococcal genes for pathogenesis research, resulting in the unambiguous demonstration that these genes contribute to pathogen-host molecular interactions in necrotizing infections. We exploited fitness data derived from a recently conducted genome-wide transposon mutagenesis study to discover significant correlation between the magnitude of bacterial virulence gene expression in vivo and pathogen fitness. Collectively, our findings have significant implications for translational research, potentially including vaccine efforts.Peer reviewe

Increase in invasive Streptococcus pyogenes M1 infections with close evolutionary genetic relationship, Iceland and Scotland, 2022 to 2023

Group A Streptococcus isolates of the recently described M1UK clade have emerged to cause human infections in several European countries and elsewhere. Full-genome sequence analysis of M1 isolates discovered a close genomic relationship between some isolates from Scotland and the majority of isolates from Iceland causing serious infections in 2022 and 2023. Phylogenetic analysis strongly suggests that an isolate from or related to Scotland was the precursor to an M1UK variant responsible for almost all recent M1 infections in Iceland