Intraocular pressure fluctuations in professional brass and woodwind musicians during common playing conditions.

BACKGROUND: We investigated the effects on intraocular pressure (IOP) and blood pressure (BP) of playing brass and woodwind instruments by monitoring IOP and BP in a representative group of professional musicians under a variety of common playing conditions. METHODS: IOP and BP measurements were recorded from 37 brass and 15 woodwind instrument players, before and after playing tones of low, middle and high frequency. We also measured IOP and BP before and during playing common exercises of 10 minutes duration, as well as after playing a sustained high-pitched tone, to test for changes in IOP under conditions of maximum effort. RESULTS: Playing tones on brass and woodwind instruments causes a temporary elevation in IOP and BP, depending on the tone frequency: brass instrument players showed a significant elevation after playing high and middle frequency tones (p < 0.0001) whereas woodwind instrument players showed a significant increase only for high frequencies (e.g., oboe, 17 ± 2.9 mm Hg to 21 ± 4.4 mm Hg; p = 0.017). Playing a typical exercise of 10 minutes temporarily increased IOP in both groups of musicians. Finally, playing a sustained tone of high pitch caused a significant elevation in IOP in brass instrument players only (16.6 ± 3.5 mm Hg to 23.3 ± 8.9 mm Hg; p < 0.0001). CONCLUSIONS: The temporary and sometimes dramatic elevations and fluctuations in IOP observed in this study, coupled with daily exposure to instrument play, puts professional wind instrument players at increased risk of developing glaucoma. Consequently, these musicians should be monitored for signs of glaucoma, especially those with co-existing risk factors

A systematic review and evaluation of statistical methods for group variable selection

This review condenses the knowledge on variable selection methods implemented in R and appropriate for datasets with grouped features. The focus is on regularized regressions identified through a systematic review of the literature, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 14 methods are discussed, most of which use penalty terms to perform group variable selection. Depending on how the methods account for the group structure, they can be classified into knowledge and data-driven approaches. The first encompass group-level and bi-level selection methods, while two-step approaches and collinearity-tolerant methods constitute the second category. The identified methods are briefly explained and their performance compared in a simulation study. This comparison demonstrated that group-level selection methods, such as the group minimax concave penalty, are superior to other methods in selecting relevant variable groups but are inferior in identifying important individual variables in scenarios where not all variables in the groups are predictive. This can be better achieved by bi-level selection methods such as group bridge. Two-step and collinearity-tolerant approaches such as elastic net and ordered homogeneity pursuit least absolute shrinkage and selection operator are inferior to knowledge-driven methods but provide results without requiring prior knowledge. Possible applications in proteomics are considered, leading to suggestions on which method to use depending on existing prior knowledge and research question

Shape recognition: convexities, concavities and things in between.

Visual objects are effortlessly recognized from their outlines, largely irrespective of viewpoint. Previous studies have drawn different conclusions regarding the importance to shape recognition of specific shape features such as convexities and concavities. However, most studies employed familiar objects, or shapes without curves, and did not measure shape recognition across changes in scale and position. We present a novel set of random shapes with well-defined convexities, concavities and inflections (intermediate points), segmented to isolate each feature type. Observers matched the segmented reference shapes to one of two subsequently presented whole-contour shapes (target or distractor) that were re-scaled and re-positioned. For very short segment lengths, performance was significantly higher for convexities than for concavities or intermediate points and for convexities remained constant with increasing segment length. For concavities and intermediate points, performance improved with increasing segment length, reaching convexity performance only for long segments. No significant differences between concavities and intermediates were found. These results show for the first time that closed curvilinear shapes are encoded using the positions of convexities, rather than concavities or intermediate regions. A shape-template model with no free parameters gave an excellent account of the data

Isotopomeric polymorphism in a "doubly-polymorphic" multi-component molecular crystal

Isotopomeric polymorphism is observed in complexes of isonicotinamide with oxalic acid, highly unusual here in that each isotopic complex is itself polymorphic, a situation of “double polymorphism”. The four polymorphic forms exhibit different degrees of hydron transfer.</p

Frequency of cataract surgery and its impact on visual function : results from the German Gutenberg Health Study

PURPOSE To determine the frequency of cataract surgery in Germany and to evaluate its impact on visual function in an adult population. METHODS The population-based Gutenberg Health Study was conducted in Germany with its baseline examination between 2007 and 2012 and a 5-year follow-up examiantion. An ophthalmological examination including slit-lamp examination, ocular biometry, and Scheimpflug imaging was carried out. Overall and age-specific frequencies of unilateral and bilateral cataract surgery within 5 years were computed including the 95% confidential intervals [95%-CI]. Association analyses were conducted to determine social and ocular associated factors using multivariable logistic regression analysis. Vision-related quality of life was assessed using NEI VFQ-25. RESULTS A total of 10,544 people aged 35 to 74 years were bilateral phakic at baseline and had information on lens status at the 5-year examination. Of these, 168 had unilateral cataract surgery (1.6% [1.4–1.9%]), and 448 had bilateral cataract surgery (4.2% [3.9–4.7%]) in the following 5 years. The frequency of cataract surgery increased with age: 45–54-year-old subjects had twice as often cataract surgery (in at least on eye: OR = 2.32) than at age 35–44 years. The frequency further strongly increases with age (55–64 years: OR = 10.5; 65–74 years: OR = 43.8, p < 0.001). Subjects with glaucoma were more likely to have cataract surgery (OR = 2.52, p < 0.001). Visual function increased when undergoing bilateral cataract surgery. CONCLUSIONS The frequency of cataract surgery is low at younger ages and increases up to 26% at age 70–74 years. Persons with glaucoma are more likely to undergo cataract surgery at population-based level in Germany

Distribution of estimated glomerular filtration rate and determinants of its age dependent loss in a German population-based study

Glomerular filtration rate (GFR) declines with age by approx. 1 ml/min/m2 per year beginning in the third decade of life. At 70 years of age > 40 ml/min/m2 of GFR will be lost. Thus, factors affecting loss of GFR have significant public health implications. Furthermore, the definition of chronic kidney disease based on GFR may not be appropriate for the elderly. We analyzed factors affecting absolute and relative change of eGFR over a 5 year period in 12,381 participants of the Gutenberg Health Study. We estimated GFR at baseline and after 5 years of follow-up by two different equations. Association with the decline of estimated GFR (eGFR) was assessed by multivariable regression analysis. We confirmed a median loss of eGFR per year of approx. 1 ml/min/m2. Aside from albuminuria systolic blood pressure was most strongly associated with faster decline of eGFR followed by echocardiographic evidence of left ventricular diastolic dysfunction and reduced ejection fraction. White blood cell count showed a moderate association with eGFR loss. Diastolic blood pressure, serum uric acid and serum albumin were associated with slower GFR decline in multivariable analysis. Sensitivity analysis with exclusion of individuals taking diuretics, antihypertensive, antidiabetic, or lipid lowering drugs confirmed these associations

Midregional pro atrial natriuretic peptide : a novel important biomarker for noise annoyance-induced cardiovascular morbidity and mortality?

BACKGROUND Environmental noise exposure has been associated with increased cardiovascular morbidity and mortality. Recently, noise annoyance was shown to induce atrial fibrillation, which was accompanied by significantly increased levels of midregional pro atrial natriuretic peptide (MR-proANP). Therefore, the aim of the present study was to analyze the association between noise annoyance, MR-proANP, incident cardiovascular events, and all-cause mortality. METHODS Levels of MR-proANP were measured in the first 5000 participants of the population-based Gutenberg Health Study. Annoyance was assessed separately for aircraft, road traffic, railway, neighborhood, and industrial/construction noise during the day and sleep. RESULTS In cross-sectional analyses, aircraft noise annoyance during day and sleep, industrial/construction noise annoyance during day, and railway noise annoyance during sleep were independently associated with increased levels of MR-proANP after multivariable adjustment. After a 5-year follow-up period, there were 43 cases of incident atrial fibrillation and 103 of incident cardiovascular disease (comprising atrial fibrillation, coronary artery disease, myocardial infarction, heart failure, or stroke). Moreover, there were 301 deaths after a mean follow-up of 7.42 ± 1.66 years. An odds ratio (OR) of 2.82 ([95% confidence interval (CI) 1.86; 4.35], p < 0.0001) for incident atrial fibrillation and an OR of 1.49 ([95% CI 1.13; 1.96], p = 0.0046) for incident cardiovascular disease per 1-standard deviation (SD) increase in MR-proANP levels were found. A 36% (hazard ratio: 1.36 [95% CI 1.19; 1.55], p < 0.0001) higher risk of death was found per 1-SD increase in MR-proANP levels. CONCLUSIONS Noise annoyance may contribute to cardiovascular morbidity and mortality and is characterized by increased levels of MR-proANP

Protective behavior and SARS-CoV-2 infection risk in the population : results from the Gutenberg COVID-19 study

Background During the SARS-CoV-2 pandemic, preventive measures like physical distancing, wearing face masks, and hand hygiene have been widely applied to mitigate viral transmission. Beyond increasing vaccination coverage, preventive measures remain urgently needed. The aim of the present project was to assess the effect of protective behavior on SARS-CoV-2 infection risk in the population. Methods Data of the Gutenberg COVID-19 Study (GCS), a prospective cohort study with a representative population-based sample, were analyzed. SARS-CoV-2 infections were identified by sequential sampling of biomaterial, which was analyzed by RT-qPCR and two antibody immunoassays. Self-reported COVID-19 test results were additionally considered. Information on protective behavior including physical distancing, wearing face masks, and hand hygiene was collected via serial questionnaire-based assessments. To estimate adjusted prevalence ratios and hazard ratios, robust Poisson regression and Cox regression were applied. Results In total, 10,250 participants were enrolled (median age 56.9 [43.3/68.6] years, 50.8% females). Adherence to preventive measures was moderate for physical distancing (48.3%), while the use of face masks (91.5%) and the frequency of handwashing (75.0%) were high. Physical distancing appeared to be a protective factor with respect to SARS-CoV-2 infection risk independent of sociodemographic characteristics and individual pandemic-related behavior (prevalence ratio [PR] = 0.77, 95% confidence interval [CI] 0.62–0.96). A protective association between wearing face masks and SARS-CoV-2 transmission was identified (PR = 0.73, 95% CI 0.55–0.96). However, the protective effect declined after controlling for potential confounding factors (PR = 0.96, 95% CI 0.68–1.36). For handwashing, this investigation did not find a beneficial impact. The adherence to protective behavior was not affected by previous SARS-CoV-2 infection or immunization against COVID-19. Conclusion The present study suggests primarily a preventive impact of physical distancing of 1.5 m, but also of wearing face masks on SARS-CoV-2 infections, supporting their widespread implementation. The proper fit and use of face masks are crucial for effectively mitigating the spread of SARS-CoV-2 in the population

Peripheral corneal thickness and associated factors : results from the population-based German Gutenberg Health Study

Purpose Changes in peripheral corneal thickness are described in various corneal diseases such as corneal ectasia. However, few data exist describing the increase in corneal thickness from central to peripheral and reporting the normal distribution of corneal thickness in rings around the corneal centre. The aim of this study was to report these cornea characteristics and investigate associated factors in a population-based setting. Methods The Gutenberg Health Study is a prospective, population-based study examining participants in a 5-year follow-up (age range 40–80 years) using Scheimpflug imaging. Corneal thickness was assessed in each participant at the apex, as well as in the corneal centre (thinnest corneal thickness) and in rings with 2, 4, 6, 8 and 10 mm diameter around the corneal centre, and the increase in corneal thickness towards the periphery. The relationship between corneal thickness at these locations and possible associated factors was determined using linear regression models. For this purpose, general and ocular parameters were included. Results A total of 9729 participants were included in the present analysis (4874 women, age 59.2 ± 10.8 years). Multivariable analysis showed a correlation between the increase in corneal thickness in the circles from 0 to 10 mm (diameter) and the following parameters: age (B = −0.24 µm per year, p < 0.001); body height (B = −0.04 µm, p = 0.005); smoking (B = −0.72 µm, p < 0.001); spherical equivalent (B = −0.70 µm per dioptre, p < 0.001); white-to-white distance (B = −0.75 µm/mm, p < 0.001); mean corneal radius (B = −3.61 µm/mm, p < 0.001); intraocular pressure (B = −0.12 µm/mmHg, p < 0.001); glaucoma (B = −1.94 µm, p < 0.001); and pseudophakia (B = 0.89 µm, p < 0.001). Conclusion The results of the present study suggest that several general and ocular parameters are associated with peripheral corneal thickness. In the context of diagnosing glaucoma, a smaller increase in corneal thickness towards the periphery might be a new additional marker

Peripapillary retinal nerve fiber layer profile in relation to refractive error and axial length : results from the Gutenberg Health Study

Purpose: To investigate the retinal nerve fiber layer profile measured by optical coherence tomography and its relation to refractive error and axial length. Methods: The Gutenberg Health Study is a population-based study in Mainz, Germany. At the five-year follow-up examination, participants underwent optical coherence tomography, objective refraction and biometry. Peripapillary retinal nerve fiber layer (pRNFL) was segmented using proprietary software. The pRNFL profiles were compared between different refraction groups and the angle between the maxima, i.e., the peaks of pRNFL thickness in the upper and lower hemisphere (angle between the maxima of pRNFL thickness [AMR]) was computed. Multivariable linear regression analysis was carried out to determine associations of pRNFL profile (AMR) including age, sex, optic disc size, and axial length in model 1 and spherical equivalent in model 2. Results: A total of 5387 participants were included. AMR was 145.3° ± 23.4° in right eyes and 151.8° ± 26.7° in left eyes and the pRNFL profile was significant different in the upper hemisphere. The AMR decreased with increasing axial length by −5.86°/mm (95% confidence interval [CI]: [−6.44; −5.29], P < 0.001), female sex (−7.61°; 95% CI: [−8.71; −6.51], P < 0.001) and increased with higher age (0.08°/year; 95% CI: [0.03; 0.14], P = 0.002) and larger optic disc size (2.29°/mm2; 95% CI: [1.18; 3.41], P < 0.001). In phakic eyes, AMR increased with hyperopic refractive error by 2.60°/diopters (dpt) (95% CI: [2.33; 2.88], P < 0.001). Conclusions: The pRNFL profiles are related to individual ocular and systemic parameters. Translational Relevance: Biometric parameters should be considered when pRNFL profiles are interpreted in diagnostics, i.e., in glaucoma