Scheimpflug-based analysis of the reflectivity of the cornea in Marfan Syndrome

Purpose:We sought to investigate corneal reflectivity inMarfan syndrome (MFS) on the basis of Scheimpflug light intensity distribution. Methods: In a retrospective case-control analysis, the left eyes of 40 MFS patients and 40 age- and refraction-matched healthy controls were investigated. Patients with MFS meeting the Ghent II diagnostic criteria and with genetic confirmation of disease were included. Exclusion criteria were the following: Coexisting corneal, conjunctival, or scleral pathology, use of medication known to affect corneal transparency, history of ocular surgery, and insufficient data. Scheimpflug tomography images were exported to analyze corneal transparency in different corneal layers and regions. Each corneal image was automatically segmented, after which the corresponding pixel intensities in the defined regions of interest were statistically modeled using a Weibull probability density function from which parameters a (transparency) and ß (homogeneity) were derived. Results: The cornea in MFS showed significantly higher light reflectivity (overall cornea, a = 71 ± 17 arbitrary units (a.u.)) than in the control group (overall cornea, a = 59 ± 15 a.u.) (t test, P = 0.003). The a parameter was significantly higher in MFS eyes in all examined layers and regions (P 0.05). The difference in a did not correlate with ocular biometric properties (corneal thickness and curvature) or ectopia lentis (P> 0.05). Conclusions: The cornea in MFS shows significantly higher reflectivity than healthy controls with similar levels of homogeneity. Translational Relevance: The proposed methodology detects corneal reflectivity changes in MFS not available from regular slit-lamp examination

A geometric constraint over k-dimensional objects and shapes subject to business rules

This report presents a global constraint that enforces rules written in a language based on arithmetic and first-order logic to hold among a set of objects. In a first step, the rules are rewritten to Quantifier-Free Presburger Arithmetic (QFPA) formulas. Secondly, such formulas are compiled to generators of k-dimensional forbidden sets. Such generators are a generalization of the indexicals of cc(FD). Finally, the forbidden sets generated by such indexicals are aggregated by a sweep-based algorithm and used for filtering. The business rules allow to express a great variety of packing and placement constraints, while admitting efficient and effective filtering of the domain variables of the k-dimensional object, without the need to use spatial data structures. The constraint was used to directly encode the packing knowledge of a major car manufacturer and tested on a set of real packing problems under these rules, as well as on a packing-unpacking problem

Development of type 1 diabetes in a patient treated with anti-TNF-α therapy for active rheumatoid arthritis

Contains fulltext : 80364.pdf (publisher's version ) (Closed access

Pseudocyst of Temporal Bone and Posterior Cranial Fossa Caused by Cholesterol Granuloma

Accurate preoperative diagnosis of temporal bone lesion is critical because the surgical approaches used for this region are different depending upon the specific disease process involved. While CT and MID have improved the accuracy of preoperative diagnosis of temporal bone pathology, these imaging studies are most helpful when used in conjuction with one another. This case showed a pseudocyst of lhe temporal bone and posterior cranial fossa caused by a blockage of aditus ad antrum due to cholesterol granuloma. The patient was a 33-year-old man with a right-sided temporo-occipital headache. Computed tomography revealed a mass involving the temporal bone and posterior cranial fossa with central bony density. On MRI, the mass showed isosignal intensity with respect to the brain on Tl-weighted image, hyperintense signal to the brain on T2-weighted image, peripheral enhancement on gadolinum enhanced image. Histologically, the mass showed a cholesterol cleft, multinucleated giant cells and a fibrotic capsule without endothelial lining. The patient had no postoperative difficulty and was discharged without problems

Direct association between rainfall and non-typhoidal <i>Salmonella</i> bloodstream infections in hospital-admitted children in the Democratic Republic of Congo

Abstract Non-typhoidal Salmonella (NTS) ranks first among causes of bloodstream infection in children under five years old in the Democratic Republic of Congo and has a case fatality rate of 15%. Main host-associated risk factors are Plasmodium falciparum malaria, anemia and malnutrition. NTS transmission in sub-Saharan Africa is poorly understood. NTS bloodstream infections mostly occur during the rainy season, which may reflect seasonal variation in either environmental transmission or host susceptibility. We hypothesized that environment- and host-associated factors contribute independently to the seasonal variation in NTS bloodstream infections in children under five years old admitted to Kisantu referral hospital in 2013–2019. We used remotely sensed rainfall and temperature data as proxies for environmental factors and hospital data for host-associated factors. We used principal component analysis to disentangle the interrelated environment- and host-associated factors. With timeseries regression, we demonstrated a direct association between rainfall and NTS variation, independent of host-associated factors. While the latter explained 17.5% of NTS variation, rainfall explained an additional 9%. The direct association with rainfall points to environmental NTS transmission, which should be explored by environmental sampling studies. Environmental and climate change may increase NTS transmission directly or via host susceptibility, which highlights the importance of preventive public health interventions

Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes

BackgroundEstablishing cardiovascular safety of new therapies for type 2 diabetes is important. Safety data are available for the subcutaneous form of the glucagon-like peptide-1 receptor agonist semaglutide but are needed for oral semaglutide.MethodsWe assessed cardiovascular outcomes of once-daily oral semaglutide in an event-driven, randomized, double-blind, placebo-controlled trial involving patients at high cardiovascular risk (age of &gt;= 50 years with established cardiovascular or chronic kidney disease, or age of &gt;= 60 years with cardiovascular risk factors only). The primary outcome in a time-to-event analysis was the first occurrence of a major adverse cardiovascular event (death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke). The trial was designed to rule out 80% excess cardiovascular risk as compared with placebo (noninferiority margin of 1.8 for the upper boundary of the 95% confidence interval for the hazard ratio for the primary outcome).ResultsA total of 3183 patients were randomly assigned to receive oral semaglutide or placebo. The mean age of the patients was 66 years; 2695 patients (84.7%) were 50 years of age or older and had cardiovascular or chronic kidney disease. The median time in the trial was 15.9 months. Major adverse cardiovascular events occurred in 61 of 1591 patients (3.8%) in the oral semaglutide group and 76 of 1592 (4.8%) in the placebo group (hazard ratio, 0.79; 95% confidence interval [CI], 0.57 to 1.11; P&lt;0.001 for noninferiority). Results for components of the primary outcome were as follows: death from cardiovascular causes, 15 of 1591 patients (0.9%) in the oral semaglutide group and 30 of 1592 (1.9%) in the placebo group (hazard ratio, 0.49; 95% CI, 0.27 to 0.92); nonfatal myocardial infarction, 37 of 1591 patients (2.3%) and 31 of 1592 (1.9%), respectively (hazard ratio, 1.18; 95% CI, 0.73 to 1.90); and nonfatal stroke, 12 of 1591 patients (0.8%) and 16 of 1592 (1.0%), respectively (hazard ratio, 0.74; 95% CI, 0.35 to 1.57). Death from any cause occurred in 23 of 1591 patients (1.4%) in the oral semaglutide group and 45 of 1592 (2.8%) in the placebo group (hazard ratio, 0.51; 95% CI, 0.31 to 0.84). Gastrointestinal adverse events leading to discontinuation of oral semaglutide or placebo were more common with oral semaglutide.ConclusionsIn this trial involving patients with type 2 diabetes, the cardiovascular risk profile of oral semaglutide was not inferior to that of placebo

Perturbative Expansion around the Gaussian Effective Potential of the Fermion Field Theory

We have extended the perturbative expansion method around the Gaussian effective action to the fermionic field theory, by taking the 2-dimensional Gross-Neveu model as an example. We have computed both the zero temperature and the finite temperature effective potentials of the Gross-Neveu model up to the first perturbative correction terms, and have found that the critical temperature, at which dynamically broken symmetry is restored, is significantly improved for small value of the flavour number.Comment: 14pages, no figures, other comments Typographical errors are corrected and new references are adde

Physical function improvements and relief from fatigue and pain are associated with increased productivity at work and at home in rheumatoid arthritis patients treated with certolizumab pegol

Objectives. To evaluate the association between improvements in physical function, fatigue and pain and improvements in productivity at work and at home in patients treated with certolizumab pegol (CZP) in combination with MTX