TRENDS IN POPULATION SIZE OF OPHRYS ARGOLICA SUBSP. BISCUTELLA IN THE APPENNINO LUCANO-VAL D’AGRI-LAGONEGRESE NATIONAL PARK (ITALY)

n this study we focused on population monitoring of Ophrys argolica subsp. biscutella, an orchid endemic to the south of the Italian Peninsula belonging to the section Araniferae. The study concerned its main detected population located within the Appennino Lucano-Val d'Agri-Lagonegrese National Park (Basilicata Region, South Italy). Ten permanent plots of 10 × 10 m were annually surveyed from 2010 to 2015 using total counts of flowering plants. The following characters were measured: height of inflorescences, number of flowers, lost plants, fruiting plants and fruit set. Percentage cover of trees, shrubs, herbs and bare rocks were visually estimated in 1 × 1 m subplots and an accurate vegetation map of each plot was drawn. In regards to plant height and reproductive variables, no significant differences between the plots were detected. Similarly, with respect to population variables, no significant correlations with vegetation and environmental features (i.e. slope, aspect) emerged. On the contrary, a strong negative trend in the population size was observed (from 237 individuals in 2010 to 61 in 2015) and the number of plants per plot decreased from 23.7 individuals to 6.1 individuals. Reproductive variables (i.e. number of flowers, fruit set) showed a similar decreasing pattern. As for the lost of individuals we detected a higher incidence in 2011 (average number of lost plants per plot was 16.6) with 75% of lost spikes and fruit set amounting to zero. Although grazing management can heavily influence demographic parameters of Ophrys populations, there was no evidence of any kind of land cover or land use change. No appreciable differences were observed in vegetation cover, grazing type or grazing load. Moreover, no significant disturbance events occurred in this area. Finally, the inspection of meteorological data recorded during the monitoring interval lead to argue that the strong demographic decline of the Ophrys argolica subsp. biscutella population in the Appennino Lucano-Val d'Agri-Lagonegrese National Park must be mainly related to the late frost event that occurred in the spring of 2011

Corneal Endothelial Cell Loss in Glaucoma and Glaucoma Surgery and the Utility of Management with Descemet Membrane Endothelial Keratoplasty (DMEK)

Publisher Copyright: © 2022 Neeru A Vallabh et al.The corneal endothelium has a crucial role in maintaining a clear and healthy cornea. Corneal endothelial cell loss occurs naturally with age; however, a diagnosis of glaucoma and surgical intervention for glaucoma can exacerbate a decline in cell number and impairment in morphology. In glaucoma, the mechanisms for this are not well understood and this accelerated cell loss can result in corneal decompensation. Given the high prevalence of glaucoma worldwide, this review aims to explore the abnormalities observed in the corneal endothelium in differing glaucoma phenotypes and glaucoma therapies (medical or surgical including with new generation microinvasive glaucoma surgeries). Descemet membrane endothelial keratoplasty (DMEK) is increasingly being used to manage corneal endothelial failure for glaucoma patients and we aim to review the recent literature evaluating the use of this technique in this clinical scenario.publishersversionPeer reviewe

Solar retinopathy: a new setting of red, green, and blue channels

Purpose: To introduce a new color imaging technique using improved settings of red, green, and blue channels for improved delineation of retinal damage in patients with solar retinopathy. Method: A retrospective case series of patients with poor vision secondary to solar retinopathy were analyzed. All patients underwent visual acuity, refraction, and dilated fundus examination. A spectral domain–optical coherence tomography of the macula and color fundus imaging using optimized red, green, and blue color setting was performed. Patients were reviewed over a 6-month period. The data were analyzed for statistical significance using an independent t test and a receiver operating characteristic curve. Results: In total, 20 eyes of 10 patients were included between 2009 and 2017. The mean age was 24.9 ± 18.1 years. Best corrected visual acuity at first consultation was 0.78 ± 0.11 and after 6 months was 0.83 ± 0.09. Spectral domain–optical coherence tomography demonstrated retinal abnormalities at the myoid zone, ellipsoid zone, and the outer segment of photoreceptors. Receiver operating characteristic curve analysis showed an improving effect (area under the curve = 0.62; 95% confidence interval = 0.42–0.79). The color channels parameters, which improve visualization of the lesions were found to be 67-0.98-255 for the R-guided setting, 19-0.63-121 for the B-guided setting, and 7-1.00-129 for the G-guided setting. The ideal red, green, and blue setting was in 24-0.82-229. Conclusion: The use of a new setting of red, green, and blue channels could improve the diagnosis and monitoring of solar retinopathy, hence improving patient care

Corneal Endothelial Cell Loss in Glaucoma and Glaucoma Surgery and the Utility of Management with Descemet Membrane Endothelial Keratoplasty (DMEK)

The corneal endothelium has a crucial role in maintaining a clear and healthy cornea. Corneal endothelial cell loss occurs naturally with age; however, a diagnosis of glaucoma and surgical intervention for glaucoma can exacerbate a decline in cell number and impairment in morphology. In glaucoma, the mechanisms for this are not well understood, and this accelerated cell loss can result in corneal decompensation. Given the high prevalence of glaucoma worldwide, this review aims to explore the abnormalities observed in the corneal endothelium in differing glaucoma phenotypes and glaucoma therapies (medical or surgical, including with new generation microinvasive glaucoma surgeries). Descemet membrane endothelial keratoplasty (DMEK) is increasingly being used to manage corneal endothelial failure for glaucoma patients, and we aim to review the recent literature evaluating the use of this technique in this clinical scenario.</jats:p

What is the prevalence of low health literacy in European Union member states? A systematic review and meta-analysis

Background: Many studies have shown that low health literacy (HL) is associated with several adverse outcomes. In this study, we systematically reviewed the prevalence of low HL in Europe. Methods: PubMed, Embase, and Scopus were searched. Cross-sectional studies conducted in the European Union (EU), published from 2000, investigating the prevalence of low HL in adults using a reliable tool, were included. Quality was assessed with the Newcastle-Ottawa Scale. Inverse-variance random effects methods were used to produce pooled prevalence estimates. A meta-regression analysis was performed to assess the association between low HL and the characteristics of the studies. Results: The pooled prevalence of low HL ranged from of 27% (95% CI: 18–38%) to 48% (95% CI: 41–55%), depending on the literacy assessment method applied. Southern, Western, and Eastern EU countries had lower HL compared to northern Europe (β: 0.87, 95% CI: 0.40–1.35; β: 0.59, 95% CI: 0.25–0.93; and β: 0.72, 95% CI: 0.06–1.37, respectively). The assessment method significantly influenced the pooled estimate: compared to word recognition items, using self-reported comprehensions items (β: 0.61, 95% CI: 0.15–1.08), reading or numeracy comprehensions items (β: 0.77, 95% CI: 0.24–1.31), or a mixed method (β: 0.66, 95% CI: 0.01–1.33) found higher rates of low HL. Refugees had the lowest HL (β: 1.59, 95% CI: 0.26–2.92). Finally, lower quality studies reported higher rates of low HL (β: 0.56, 95% CI: 0.06–1.07). Discussion: We found that low HL is a public health challenge throughout Europe, where one in every three to almost one in every two Europeans may not be able to understand essential health-related material. Additional research is needed to investigate the underlying causes and to develop remedies

Incidence and management of early postoperative complications in lamellar corneal transplantation.

PurposeTo provide a comprehensive review of the incidence, risk factors, and management of early complications after deep anterior lamellar keratoplasty (DALK), Descemet stripping automated keratoplasty (DSAEK), and Descemet membrane endothelial keratoplasty (DMEK).MethodsA literature review of complications, that can occur from the time of the transplant up to 1 month after the transplant procedure, was conducted. Case reports and case series were included in the review.ResultsComplications in the earliest postoperative days following anterior and posterior lamellar keratoplasty have shown to affect graft survival. These complications include, but are not limited to, double anterior chamber, sclerokeratitis endothelial graft detachment, acute glaucoma, fluid misdirection syndrome, donor-transmitted and recurrent infection, and Uretts-Zavalia syndrome.ConclusionIt is essential for surgeons and clinicians to not only be aware of these complications but also know how to manage them to minimize their impact on long-term transplant survival and visual outcomes

The peopling of the last Green Sahara revealed by high-coverage resequencing of trans-Saharan patrilineages

Little is known about the peopling of the Sahara during the Holocene climatic optimum, when the desert was replaced by a fertile environment

Clinical outcomes of pre-loaded ultra-thin DSAEK and pre-loaded DMEK.

ObjectiveTo compare clinical outcomes and complications between pre-loaded ultra-thin Descemet stripping automated endothelialkeratoplasty (pl-UT-DSAEK) and pre-loaded Descemet membrane endothelial keratoplasty (pl-DMEK).Methods and analysisComparative study in patients with endothelial dysfunction associated with Fuchs endothelial corneal dystrophy and pseudophakic bullous keratopathy who underwent pl-UT-DSAEK or pl-DMEK transplants. For both groups, the tissues were pre-loaded at the Fondazione Banca degli Occhi del Veneto (Venice, Italy) and shipped to The Royal Liverpool University Hospital (Liverpool, UK). Best corrected visual acuity (BCVA) and re-bubbling rates were the main outcome measures.Results56 eyes of 56 patients were included. 31 received pl-UT-DSAEK and 25 received pl-DMEK. At 12 months, BCVA (LogMAR) was significantly better for pl-DMEK (0.17±0.20 LogMAR) compared with pl-UT-DSAEK (0.37±0.37 LogMAR, pConclusionPl-DMEK offers better BCVA than pl-UT-DSAEK. The higher re-bubbling rate associated with pre-loaded DMEK is of concern

Deep Learning Using Preoperative AS-OCT Predicts Graft Detachment in DMEK.

PurposeTo evaluate a novel deep learning algorithm to distinguish between eyes that may or may not have a graft detachment based on pre-Descemet membrane endothelial keratoplasty (DMEK) anterior segment optical coherence tomography (AS-OCT) images.MethodsRetrospective cohort study. A multiple-instance learning artificial intelligence (MIL-AI) model using a ResNet-101 backbone was designed. AS-OCT images were split into training and testing sets. The MIL-AI model was trained and validated on the training set. Model performance and heatmaps were calculated from the testing set. Classification performance metrics included F1 score (harmonic mean of recall and precision), specificity, sensitivity, and area under curve (AUC). Finally, MIL-AI performance was compared to manual classification by an experienced ophthalmologist.ResultsIn total, 9466 images of 74 eyes (128 images per eye) were included in the study. Images from 50 eyes were used to train and validate the MIL-AI system, while the remaining 24 eyes were used as the test set to determine its performance and generate heatmaps for visualization. The performance metrics on the test set (95% confidence interval) were as follows: F1 score, 0.77 (0.57-0.91); precision, 0.67 (0.44-0.88); specificity, 0.45 (0.15-0.75); sensitivity, 0.92 (0.73-1.00); and AUC, 0.63 (0.52-0.86). MIL-AI performance was more sensitive (92% vs. 31%) but less specific (45% vs. 64%) than the ophthalmologist's performance.ConclusionsThe MIL-AI predicts with high sensitivity the eyes that may have post-DMEK graft detachment requiring rebubbling. Larger-scale clinical trials are warranted to validate the model.Translational relevanceMIL-AI models represent an opportunity for implementation in routine DMEK suitability screening