Update and clinical utility of the LenSx femtosecond laser in cataract surgery

� 2016 Roberts et al. The introduction of femtosecond lasers to cataract surgery has been the major disruptive technology introduced into ophthalmic surgery in the last decade. Femtosecond laser cataract surgery (FLACS) integrates high-resolution anterior segment imaging with a femtosecond laser allowing key steps of cataract surgery to be performed with computer-guided laser accuracy, precision, and reproducibility. Since the introduction of FLACS, there have been significant advances in laser software and hardware as well as surgeon experience, with over 250 articles published in the peer-reviewed literature. This review examines the published evidence relating to the LenSx platform and discusses surgical techniques, indications, safety, and clinical results

The six dimensions of personality (HEXACO) and their associations with network layer size and emotional closeness to network members

Previous work has examined how specific personality dimensions are associated with social network characteristics. However, it is unclear how the full range of personality traits relates to the quantity and quality of relationships at different network layers. This study (N = 525) investigates how the six HEXACO personality dimensions relate to the size of support and sympathy groups, and to the level of emotional closeness to network members. Extraversion was positively related to support group size, but did not significantly relate to sympathy group size or emotional closeness. Openness to Experience and Emotionality were positively related to support group size, but not to the size of the sympathy group. Honesty–Humility, but not Agreeableness, was positively related to emotional closeness to members of the sympathy group. Findings suggest that personality effects vary across network layers and highlight the importance of considering both emotional closeness and network size

Visual and refractive outcomes following implantation of a new trifocal intraocular lens.

BACKGROUND: Independence from all optical aids, and freedom from unwanted symptoms, following cataract and lens surgery remains the ultimate goal of both patient and surgeon. The development of trifocal IOL technology provides an ever-increasing range of options. The purpose of our study is to understand the predictability, safety and efficacy of a new trifocal intraocular lens (IOL) following cataract or refractive lens exchange (RLE) surgery. METHODS: This was a retrospective consecutive case series of patients undergoing cataract extraction or RLE followed by implantation of the Alcon IQ Panoptix IOL. Pre and postoperative refractive and visual parameters were recorded and evaluated. As the cohort followed a normal distribution, standard parametric tests were used. Paired t-test was used to compare the difference between target and postoperative refractive errors. The incidence of intraoperative and postoperative complications was also reported. RESULTS: The IOL was implanted in 66 eyes of 33 patients. Mean postoperative spherical equivalent (SE) refraction was -0.08 ± 0.25 dioptres (D). This was not significantly different from the target refraction (p = 0.841). Sixty-five percent of patients were within ± 0.25 D of the target SE refraction with 100% within ± 0.50 D of intended correction. Mean postoperative uncorrected distance visual acuity (UDVA) was 0.01 ± 0.10 LogMAR. All patients achieved an unaided distance acuity of 20/40 or better postoperatively. Binocularly, 100% saw 0.20 LogMAR or better at near without correction and 88.9% achieved this level for uncorrected intermediate visual acuity. No intraoperative complications were noted. Five patients complained of moderate haloes in the early postoperative period. CONCLUSION: The AcrySof IQ Panoptix IOL provides functional uncorrected visual acuity at distance, intermediate and near positions. Our results remain equivalent with existing trifocal IOL outcomes and provide surgeons with a further IOL alternative for the patient motivated to obtain true spectacle independence. Surgeons should consider individual reading and working requirements when counselling patients preoperatively to optimise postoperative patient satisfaction

Ophthalmic surgery teaching

The outcomes of modern ophthalmic surgery, especially cataract surgery, continue to improve and patients now realistically expect an excellent and speedy outcome with good vision and few complications. Social and regulatory demands for greater transparency and accountability in medicine have increased, highlighting a fundamental ethical tension in medical education-balancing the needs of trainees (who have not yet mastered the technique) to gain experience by performing surgery, with patient safety and the needs of the public to be protected from risk. Patient safety and well-being are the paramount considerations in any training program and must be the first consideration in program design. A variety of different educational strategies, each implemented with the aim of improving operative skills assessment and teaching, has recently been described in the literature. Effective use of these educational tools, combined with a structured approach to teaching and providing meaningful feedback, could improve outcomes, decrease complications and improve the quality and efficiency of surgical training in ophthalmology. Supervisors must assess their teaching style and communication, as being a good surgeon does not necessarily make a good trainer. Open disclosure must be given to patients about who will be performing the surgery, and communication during surgery between supervisors and trainees must be clear, respectful and appropriate

HEXACO Personality Factors and their Associations with Facebook use and Facebook Network Characteristics

Personality factors affect the properties of 'offline' social networks, but how they are associated with the structural properties of online networks is still unclear. We investigated how the six HEXACO personality factors (Honesty-Humility, Emotionality, Extraversion, Agreeableness, Conscientiousness and Openness to Experience) relate to Facebook use and three objectively measured Facebook network characteristics - network size, density, and number of clusters. Participants (n = 107, mean age = 20.6, 66% female) extracted their Facebook networks using the GetNet app, completed the 60-item HEXACO questionnaire and the Facebook Usage Questionnaire. Users high in Openness to Experience spent less time on Facebook. Extraversion was positively associated with network size (number of Facebook Friends). These findings suggest that some personality factors are associated with Facebook use and the size of Facebook networks, and that personality is an important influence on both online and offline sociality

Extraversion is associated with advice network size, but not network density or emotional closeness to network members

Friendship networks are instrumental to a whole range of outcomes including career success and personal wellbeing, and as such it is important to ask how social networks are shaped by personality variables. However, previous research examining how extraversion is associated with social network size and closeness to social network members has produced inconsistent findings. Here, we assessed how extraversion (HEXACO model) was associated with three key features of advice networks (size, density, and emotional closeness to network members) in a sample of 199 participants (17–75 years, M = 25, SD = 11; 146 women). We found that higher levels of extraversion (and its four facets: social self-esteem, social boldness, sociability, and liveliness) corresponded to a significantly larger advice network, but not greater network density, or greater emotional closeness to network members. The social manifestation of extraversion here seems to be operationalised in terms of a greater number of interactive advice partners, but no increased probability of ensuring that contacts are connected to each other, or of developing emotionally deep relationships with contacts. © 2020 Elsevier Lt

No relationships between self-reported Instagram use or type of use and mental well-being: A study using a nationally representative online sample of UK adults

Use of Instagram has grown rapidly in the last decade, but the effects of Instagram use on well-being are still unclear, with many studies based on younger samples with a female bias. The aim of this study was to examine the associations between Instagram use and levels of anxiety, depression, and loneliness in a nationally representative sample of UK adults by age and gender. An online sample of 498 UK adults were recruited using Prolific (Age: M = 49, SD = 15, range 19-82 years old; 52% female, 47% male). Participants stated whether or not they used Instagram, reported their frequency of Broadcast, Interaction and Browsing Instagram use and completed the Revised UCLA Loneliness Scale, and the Hospital Anxiety and Depression Scale. A genetic matching algorithm was used to match Instagram users (n= 372) and non-Instagram users (n = 100) on age, gender, education and nationality. There were no significant differences between users versus non-users of Instagram in levels of anxiety, depression or loneliness. There were also no significant associations between type of Instagram use (Broadcast, Interaction or Browsing) and levels of anxiety, depression or loneliness. The Bayes Factors for these models moderately to strongly supported the null model of no effect for Depression and Loneliness. This research adds to recent findings that suggests that the overall effect of SNSs on well-being may be small to non-existent. Future research should examine how exposure to different types of content on social media are related to well-being

Are we measuring loneliness in the same way in men and women in the general population and in the older population? Two studies of measurement equivalence

Background: High levels of loneliness are associated with negative health outcomes and there are several different types of interventions targeted at reducing feelings of loneliness. It is therefore important to accurately measure loneliness. A key unresolved debate in the conceptualisation and measurement of loneliness is whether it has a unidimensional or multidimensional structure. The aim of this study was to examine the dimensional structure of the widely used UCLA Loneliness Scale and establish whether this factorial structure is equivalent in men and women. Methods and sample: Two online UK-based samples were recruited using Prolific. The participants in Study 1 were 492 adults, selected to be nationally representative by age and gender, whilst the participants in Study 2 were 290 older adults aged over 64. In both studies, participants completed the UCLA Loneliness Scale (Version 3) as part of a larger project. Results: In both studies, the best fitting model was one with three factors corresponding to ‘Isolation,’ ‘Relational Connectedness,’ and ‘Collective Connectedness.’ A unidimensional single factor model was a substantially worse fit in both studies. In both studies, there were no meaningful differences between men and women in any of the three factors, suggesting measurement invariance across genders. Conclusion: These results are consistent with previous research in supporting a multidimensional, three factor structure to the UCLA scale, rather than a unidimensional structure. Further, the measurement invariance across genders suggests that the UCLA scale can be used to compare levels of loneliness across men and women. Overall the results suggest that loneliness has different facets and thus future research should consider treating the UCLA loneliness scale as a multidimensional scale, or using other scales which are designed to measure the different aspects of loneliness

Dissociable effects of 5-HT2C receptor antagonism and genetic inactivation on perseverance and learned non-reward in an egocentric spatial reversal task

Cognitive flexibility can be assessed in reversal learning tests, which are sensitive to modulation of 5-HT2C receptor (5-HT2CR) function. Successful performance in these tests depends on at least two dissociable cognitive mechanisms which may separately dissipate associations of previous positive and negative valence. The first is opposed by perseverance and the second by learned non-reward. The current experiments explored the effect of reducing function of the 5-HT2CR on the cognitive mechanisms underlying egocentric reversal learning in the mouse. Experiment 1 used the 5-HT2CR antagonist SB242084 (0.5 mg/kg) in a between-groups serial design and Experiment 2 used 5-HT2CR KO mice in a repeated measures design. Animals initially learned to discriminate between two egocentric turning directions, only one of which was food rewarded (denoted CS+, CS−), in a T- or Y-maze configuration. This was followed by three conditions; (1) Full reversal, where contingencies reversed; (2) Perseverance, where the previous CS+ became CS− and the previous CS− was replaced by a novel CS+; (3) Learned non-reward, where the previous CS− became CS+ and the previous CS+ was replaced by a novel CS-. SB242084 reduced perseverance, observed as a decrease in trials and incorrect responses to criterion, but increased learned non-reward, observed as an increase in trials to criterion. In contrast, 5-HT2CR KO mice showed increased perseverance. 5-HT2CR KO mice also showed retarded egocentric discrimination learning. Neither manipulation of 5-HT2CR function affected performance in the full reversal test. These results are unlikely to be accounted for by increased novelty attraction, as SB242084 failed to affect performance in an unrewarded novelty task. In conclusion, acute 5-HT2CR antagonism and constitutive loss of the 5-HT2CR have opposing effects on perseverance in egocentric reversal learning in mice. It is likely that this difference reflects the broader impact of 5HT2CR loss on the development and maintenance of cognitive function

Calcium Homeostasis in Myogenic Differentiation Factor 1 (MyoD)-Transformed, Virally-Transduced, Skin-Derived Equine Myotubes

Dysfunctional skeletal muscle calcium homeostasis plays a central role in the pathophysiology of several human and animal skeletal muscle disorders, in particular, genetic disorders associated with ryanodine receptor 1 (RYR1) mutations, such as malignant hyperthermia, central core disease, multiminicore disease and certain centronuclear myopathies. In addition, aberrant skeletal muscle calcium handling is believed to play a pivotal role in the highly prevalent disorder of Thoroughbred racehorses, known as Recurrent Exertional Rhabdomyolysis. Traditionally, such defects were studied in human and equine subjects by examining the contractile responses of biopsied muscle strips exposed to caffeine, a potent RYR1 agonist. However, this test is not widely available and, due to its invasive nature, is potentially less suitable for valuable animals in training or in the human paediatric setting. Furthermore, increasingly, RYR1 gene polymorphisms (of unknown pathogenicity and significance) are being identified through next generation sequencing projects. Consequently, we have investigated a less invasive test that can be used to study calcium homeostasis in cultured, skin-derived fibroblasts that are converted to the muscle lineage by viral transduction with a MyoD (myogenic differentiation 1) transgene. Similar models have been utilised to examine calcium homeostasis in human patient cells, however, to date, there has been no detailed assessment of the cells’ calcium homeostasis, and in particular, the responses to agonists and antagonists of RYR1. Here we describe experiments conducted to assess calcium handling of the cells and examine responses to treatment with dantrolene, a drug commonly used for prophylaxis of recurrent exertional rhabdomyolysis in horses and malignant hyperthermia in humans