Fifteen years follow-up of photorefractive keratectomy up to 10 D of myopia: outcomes and analysis of the refractive regression

PURPOSE: To evaluate outcomes of photorefractive keratectomy up to -10.00 D of myopia and -4.50 of astigmatism and to develop a predictive model for the refractive changes in the long term. SETTING: Vissum Corporation and Miguel Hernandez University (Alicante, Spain). DESIGN: Retrospective-prospective observational series of cases. METHODS: This study included 33 eyes of 33 patients aged 46.79±7.04 years (range 40-57) operated with the VISX 20/20 excimer laser with optical zones of 6 mm. No mitomycin C was used in any of these cases. The minimum follow-up was 15 years. The main outcome measures were: uncorrected and corrected distance visual acuity, manifest refraction and corneal topography. Linear regression models were developed from the observed refractive changes over time. RESULTS: Safety and efficacy indexes at 15 years were 1.18 and 0.83, respectively. No statistically significant differences were detected for any keratometric variable during the follow-up (p≥0.103). 15 years after the surgery 54.55% of the eyes were within ±1.00 D of spherical equivalent and 84.85% within ±2.00 D. The uncorrected distance visual acuity at 15 years was 20/25 or better in 60.6% of the eyes and 20/40 or better in 72.73% of the eyes. The correlation between the attempted and the achieved refractions was r=0.948 (p<0.001) at 1 year, and r=0.821 (p<0.001) at 15 years. No corneal ectasia was detected in any case during the follow-up. CONCLUSIONS: Photorefractive keratectomy is a safe refractive procedure in the long term within the range of myopia currently considered suitable for its use, although its efficacy decreases with time, especially, in high myopia. The model developed predicts a myopic regression of 2.00 D at 15 years for an ablation depth of 130 µm

The international EAACI/GA(2)LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria

Publisher Copyright: © 2021 GA²LEN. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.This update and revision of the international guideline for urticaria was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the Global Allergy and Asthma European Network (GA(2)LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), the European Dermatology Forum (EDF; EuroGuiDerm), and the Asia Pacific Association of Allergy, Asthma and Clinical Immunology with the participation of 64 delegates of 50 national and international societies and from 31 countries. The consensus conference was held on 3 December 2020. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease that presents with wheals, angioedema, or both. The lifetime prevalence for acute urticaria is approximately 20%. Chronic spontaneous or inducible urticaria is disabling, impairs quality of life, and affects performance at work and school. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.Peer reviewe

The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria

This update and revision of the international guideline for urticaria was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the Global Allergy and Asthma European Network (GA(2)LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), the European Dermatology Forum (EDF; EuroGuiDerm), and the Asia Pacific Association of Allergy, Asthma and Clinical Immunology with the participation of 64 delegates of 50 national and international societies and from 31 countries. The consensus conference was held on 3 December 2020. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease that presents with wheals, angioedema, or both. The lifetime prevalence for acute urticaria is approximately 20%. Chronic spontaneous or inducible urticaria is disabling, impairs quality of life, and affects performance at work and school. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria

Global Spatial Risk Assessment of Sharks Under the Footprint of Fisheries

Effective ocean management and conservation of highly migratory species depends on resolving overlap between animal movements and distributions and fishing effort. Yet, this information is lacking at a global scale. Here we show, using a big-data approach combining satellite-tracked movements of pelagic sharks and global fishing fleets, that 24% of the mean monthly space used by sharks falls under the footprint of pelagic longline fisheries. Space use hotspots of commercially valuable sharks and of internationally protected species had the highest overlap with longlines (up to 76% and 64%, respectively) and were also associated with significant increases in fishing effort. We conclude that pelagic sharks have limited spatial refuge from current levels of high-seas fishing effort. Results demonstrate an urgent need for conservation and management measures at high-seas shark hotspots and highlight the potential of simultaneous satellite surveillance of megafauna and fishers as a tool for near-real time, dynamic management

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Passiflora incarnata attenuation of neuropathic allodynia and vulvodynia apropos GABA-ergic and opioidergic antinociceptive and behavioural mechanisms

Background: Passiflora incarnata is widely used as an anxiolytic and sedative due to its putative GABAergic properties. Passiflora incarnata L. methanolic extract (PI-ME) was evaluated in an animal model of streptozotocininduced diabetic neuropathic allodynia and vulvodynia in rats along with antinociceptive, anxiolytic and sedative activities in mice in order to examine possible underlying mechanisms. Methods: PI-ME was tested preliminary for qualitative phytochemical analysis and then quantitatively by proximate and GC-MS analysis. The antinociceptive property was evaluated using the abdominal constriction assay and hot plate test. The anxiolytic activity was performed in a stair case model and sedative activity in an open field test. The antagonistic activities were evaluated using naloxone and/or pentylenetetrazole (PTZ). PI-ME was evaluated for prospective anti-allodynic and anti-vulvodynic properties in a rat model of streptozotocin induced neuropathic pain using the static and dynamic testing paradigms of mechanical allodynia and vulvodynia. Results: GC-MS analysis revealed that PI-ME contained predominant quantities of oleamide (9-octadecenamide), palmitic acid (hexadecanoic acid) and 3-hydroxy-dodecanoic acid, among other active constituents. In the abdominal constriction assay and hot plate test, PI-ME produced dose dependant, naloxone and pentylenetetrazole reversible antinociception suggesting an involvement of opioidergic and GABAergic mechanisms. In the stair case test, PI-ME at 200 mg/kg increased the number of steps climbed while at 600 mg/kg a significant decrease was observed. The rearing incidence was diminished by PI-ME at all tested doses and in the open field test, PI-ME decreased locomotor activity to an extent that was analagous to diazepam. The effects of PI-ME were antagonized by PTZ in both the staircase and open field tests implicating GABAergic mechanisms in its anxiolytic and sedative activities. In the streptozotocin-induced neuropathic nociceptive model, PI-ME (200 and 300 mg/kg) exhibited static and dynamic anti-allodynic effects exemplified by an increase in paw withdrawal threshold and paw withdrawal latency. PI-ME relieved only the dynamic component of vulvodynia by increasing flinching response latency. Conclusions: These findings suggest that Passiflora incarnata might be useful for treating neuropathic pain. The antinociceptive and behavioural findings inferring that its activity may stem from underlying opioidergic and GABAergic mechanisms though a potential oleamide-sourced cannabimimetic involvement is also discussed

The Seasonal Dynamics of Organic and Inorganic Carbon along the Tropical Usumacinta River Basin (Mexico)

Rivers are important sites for carbon (C) transport and critical components of the global C cycle that is currently not well constrained. However, little is known about C species’ longitudinal and temporal changes in large tropical rivers. The Usumacinta River is Mexico’s main lotic system and the tenth largest in North America. Being a tropical river, it has a strong climatic seasonality. This study aims to evaluate how organic (DOC and POC) and inorganic (DIC and PIC) carbon change spatially and seasonally along the Usumacinta River (medium and lower basin) in rainy (RS-2017) and dry (DS-2018) seasons and to estimate C fluxes into the southern Gulf of Mexico. Concentrations of DOC, POC, DIC, and PIC ranged from 0.88 to 7.11 mg L−1, 0.21 to 3.78 mg L−1, 15.59 to 48.27 mg L−1 and 0.05 to 1.51 mg L−1, respectively. DOC was the dominant organic species (DOC/POC > 1). It was ~doubled in RS and showed a longitudinal increase, probably through exchange with wetlands and floodplains. Particulate carbon showed a positive relationship with the total suspended solids, suggesting that in RS, it derived from surface erosion and runoff in the watershed. DIC is reported for the first time as the highest concentration measured in tropical rivers in America. It was higher in the dry season without a longitudinal trend. The C mass inflow–outflow balance in the RS suggested net retention (DOC and POC sink) in floodplains. In contrast, in the DS, the balance suggested that floodplains supply (C source) autochthonous DOC and POC. The lower Usumacinta River basin is a sink for DIC in both seasons. Finally, the estimated annual C export for the Usumacinta-Grijalva River was 2.88 (2.65 to 3.14) Tg yr−1, of which DIC was the largest transported fraction (85%), followed by DOC (10%), POC (4%), and PIC (<1%). This investigation is the first to present the C loads in a Mexican river.This research was funded by the FORDECYT-CONACYT Project 273646 “Fortalecimiento de las capacidades científicas y tecnológicas para la gestión territorial sustentable de la Cuenca del Río Usumacinta y su Zona Marina de Influencia (CRUZMI), así como su adaptación ante el cambio climático”, the UNAM-PAPIIT Project IN216818 “Flujos de carbono, nutrientes y sedimentos en un sistema lótico tropical”, the Programa de Investigación en Cambio Climático, UNAM, Projects PINCC 2020 & PINCC 2021 “Cuerpos acuáticos epicontinentales: papel en la dinámica del carbono y emisiones de gases de efecto invernadero en México”, and the Ministerio de Ciencia e Innovación, Consejo Superior de Investigaciones Científicas de España Project COOPA20433 “Contribución del neotrópico acuático continental a las emisiones de gases de efecto invernadero” and COOPA20472 “Los grandes ríos del neotrópico y su contribución al ciclo de carbono global”.Peer reviewe

Particulate Organic Carbon in the Tropical Usumacinta River, Southeast Mexico: Concentration, Flux, and Sources

Particulate organic carbon (POC) derived from inland water plays an important role in the global carbon (C) cycle; however, the POC dynamic in tropical rivers is poorly known. We assessed the POC concentration, flux, and sources in the Usumacinta, the largest tropical river in North America, to determine the controls on POC export to the Gulf of Mexico. We examined the Mexican middle and lower Usumacinta Basin during the 2017 dry (DS) and rainy (RS) seasons. The POC concentration ranged from 0.48 to 4.7 mg L1 and was higher in the RS, though only in the middle basin, while remaining similar in both seasons in the lower basin. The POC was predominantly allochthonous (54.7 to 99.6%). However, autochthonous POC (phytoplankton) increased in the DS (from 5.1 to 17.7%) in both basins. The POC mass inflow–outflow balance suggested that floodplains supply (C source) autochthonous POC during the DS while retaining (C sink) allochthonous POC in the RS. Ranging between 109.1 (DS) and 926.1 t POC d1 (RS), the Usumacinta River POC export to the Gulf of Mexico was similar to that of other tropical rivers with a comparable water discharge. The extensive floodplains and the “Pantanos de Centla” wetlands in the lowlands largely influenced the POC dynamics and export to the southern Gulf of Mexico.This research was financially supported by the FORDECYT-CONACYT project 273646 “Fortalecimiento de las capacidades científicas y tecnológicas para la gestión territorial sustentable de la Cuenca del Río Usumacinta y su Zona Marina de Influencia (CRUZMI), así como su adaptación ante el cambio climático” and UNAM-PAPIIT project IN216818 “Flujos de carbono, nutrientes y sedimentos en un sistema lótico tropical.” This research was also financially supported by the Programa de Investigación en Cambio Climático (PINCC 2020-2021) through project “Cuerpos acuáticos epicontinentales: papel en la dinámica del carbono y emisiones de gases de efecto invernadero en México.”Peer reviewe