Ab interno trabecular bypass surgery with Trabectome for open angle glaucoma

BACKGROUND: Glaucoma is the leading cause of irreversible blindness. Minimally invasive surgical techniques, such as ab interno trabecular bypass surgery, have been introduced to prevent glaucoma progressing. OBJECTIVES: The main objective was to assess the results at two years of ab interno trabecular bypass surgery with Trabectome for open angle glaucoma in comparison to conventional medical, laser, or surgical treatment in terms of efficacy and safety. A secondary objective was to examine the effects of Trabectome surgery in people who have concomitant phacoemulsification in comparison to those who do not have concomitant phacoemulsification. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 4), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to May 2016), EMBASE (January 1980 to May 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 12 May 2016. SELECTION CRITERIA: We included only randomised controlled trials (RCTs) of ab interno trabecular bypass surgery with Trabectome. DATA COLLECTION AND ANALYSIS: We planned to have two review authors independently extract data from reports of included studies using a data collection form. MAIN RESULTS: One randomised controlled trial identified from ClinicalTrials.gov, NCT00901108, met the criteria for inclusion. This study has subsequently been terminated. The ClinicalTrials.gov record indicates that the investigators plan to complete 12 months of follow-up and analysis on 19 participants already recruited into the trial. AUTHORS' CONCLUSIONS: There is currently no high-quality evidence for the outcomes of ab interno trabecular bypass surgery with Trabectome for open angle glaucoma. Properly designed RCTs are needed to assess the long-term efficacy and safety of this technique

An algorithm for counting circuits: application to real-world and random graphs

We introduce an algorithm which estimates the number of circuits in a graph as a function of their length. This approach provides analytical results for the typical entropy of circuits in sparse random graphs. When applied to real-world networks, it allows to estimate exponentially large numbers of circuits in polynomial time. We illustrate the method by studying a graph of the Internet structure.Comment: 7 pages, 3 figures, minor corrections, accepted versio

Proximal genomic localization of STAT1 binding and regulated transcriptional activity

BACKGROUND: Signal transducer and activator of transcription (STAT) proteins are key regulators of gene expression in response to the interferon (IFN) family of anti-viral and anti-microbial cytokines. We have examined the genomic relationship between STAT1 binding and regulated transcription using multiple tiling microarray and chromatin immunoprecipitation microarray (ChIP-chip) experiments from public repositories. RESULTS: In response to IFN-γ, STAT1 bound proximally to regions of the genome that exhibit regulated transcriptional activity. This finding was consistent between different tiling microarray platforms, and between different measures of transcriptional activity, including differential binding of RNA polymerase II, and differential mRNA transcription. Re-analysis of tiling microarray data from a recent study of IFN-γ-induced STAT1 ChIP-chip and mRNA expression revealed that STAT1 binding is tightly associated with localized mRNA transcription in response to IFN-γ. Close relationships were also apparent between STAT1 binding, STAT2 binding, and mRNA transcription in response to IFN-α. Furthermore, we found that sites of STAT1 binding within the Encyclopedia of DNA Elements (ENCODE) region are precisely correlated with sites of either enhanced or diminished binding by the RNA polymerase II complex. CONCLUSION: Together, our results indicate that STAT1 binds proximally to regions of the genome that exhibit regulated transcriptional activity. This finding establishes a generalized basis for the positioning of STAT1 binding sites within the genome, and supports a role for STAT1 in the direct recruitment of the RNA polymerase II complex to the promoters of IFN-γ-responsive genes

Sudden emergence of q-regular subgraphs in random graphs

We investigate the computationally hard problem whether a random graph of finite average vertex degree has an extensively large $q$-regular subgraph, i.e., a subgraph with all vertices having degree equal to $q$. We reformulate this problem as a constraint-satisfaction problem, and solve it using the cavity method of statistical physics at zero temperature. For $q=3$, we find that the first large $q$-regular subgraphs appear discontinuously at an average vertex degree c_\reg{3} \simeq 3.3546 and contain immediately about 24% of all vertices in the graph. This transition is extremely close to (but different from) the well-known 3-core percolation point c_\cor{3} \simeq 3.3509. For $q>3$, the $q$-regular subgraph percolation threshold is found to coincide with that of the $q$-core.Comment: 7 pages, 5 figure

The role of electronic triplets and high-lying singlet states in the deactivation mechanism of the parent BODIPY: An ADC(2) and CASPT2 study

The potential tunability of the spectroscopic properties of the BODIPY parent dye by suitable functionalization makes it attractive for a number of applications. Unfortunately, its strong fluorescence against minor intersystem crossing to the triplet states prevents its application in photodynamic therapy. With the perspective of designing BODIPY derivatives with enhanced intersystem crossing, the goal of this work is two-fold: (i) investigate the main deactivation channels of the parent BODIPY following irradiation, paying particular attention to the accessibility of the triplet state potential energy surfaces, as well as the non-radiative pathways involving the second brightest more stable singlet electronic state, S2, and (ii) evaluate the performance of the computationally efficient second order algebraic-diagrammatic construction scheme for the polarization propagator, (ADC(2)) against the complete active space second-order perturbation theory (CASPT2) method. Three singlet/triplet crossings were found, all of them with small spin-orbit couplings, being the S1/T2 crossing the most plausible for the observed intersystem crossing yield. Methodologically, it is found that the ADC(2) method qualitatively reproduces the landscape of the potential energy profiles for the photophysical processes investigated; however, it systematically underestimates the energies of the stationary points and crossings of the same and different multiplicity, with the largest discrepancies found at S1/S0 crossing points. Our CASPT2 results provide a comprehensive picture of the landscape of the excited state potential energy surfaces of the parent BODIPY that might serve as a basis for the rational design of photosensitizers with a particular photophysical profileThis work has been supported by the Project CTQ2015-63997- C2 of the Ministerio de Economía y Competitividad of Spain. I.C. gratefully acknowledges the “Ramón y Cajal” program of the Ministerio de Economía y Competitividad of Spain. M.D.V. thanks the Marie Curie Actions, within the Innovative Training Network-European Join Doctorate in Theoretical Chemistry and Computational Modelling TCCM-ITN-EJD-642294, for financial suppor

Prophylactic non-steroidal anti-inflammatory drugs for the prevention of macular oedema after cataract surgery.

BACKGROUND: Macular oedema (MO) is the accumulation of extracellular fluid in the central retina (the macula). It may occur after cataract surgery and may give rise to poor visual outcome, with reduced visual acuity and distortion of the central vision. MO is often self-limiting with spontaneous resolution, but a small proportion of people with chronic persistent MO may be difficult to treat. Chronic oedema may lead to the formation of cystic spaces in the retina termed 'cystoid macular oedema' (CMO). Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in cataract surgery and may reduce the chances of developing MO. OBJECTIVES: The aim of this review is to answer the question: is there evidence to support the prophylactic use of topical NSAIDs either in addition to, or instead of, topical steroids postoperatively to reduce the incidence of macular oedema (MO) and associated visual morbidity. SEARCH METHODS: We searched a number of electronic databases including CENTRAL, MEDLINE and Embase. Date last searched 2 September 2016. SELECTION CRITERIA: We included randomised controlled trials (RCTs) in which adult participants had undergone surgery for age-related cataract. We included participants irrespective of their baseline risk of MO, in particular we included people with diabetes and uveitis. We included trials of preoperative and/or postoperative topical NSAIDs in conjunction with postoperative topical steroids. The comparator was postoperative topical steroids alone. A secondary comparison was preoperative and/or postoperative topical NSAIDs alone versus postoperative topical steroids alone. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies for inclusion, assessed risk of bias and extracted data using standard methods expected by Cochrane. We pooled data using a random-effects model. We graded the certainty of the evidence using GRADE and considered the following: risk of bias of included studies, precision of the effect estimate, consistency of effects between studies, directness of the outcome measure and publication bias. MAIN RESULTS: We identified 34 studies that were conducted in the Americas, Europe, the Eastern Mediterranean region and South-East Asia. Over 5000 people were randomised in these trials. The majority of studies enrolled one eye per participant; a small subset (4 trials) enrolled a proportion of people with bilateral surgery. Twenty-eight studies compared NSAIDs plus steroids with steroids alone. Six studies compared NSAIDs with steroids. A variety of NSAIDs were used, including ketorolac, diclofenac, nepafenac, indomethacin, bromfenac, flurbiprofen and pranopfen. Follow-up ranged from one to 12 months. In general, the studies were poorly reported. We did not judge any of the studies at low risk of bias in all domains. Six studies were funded by industry, seven studies were funded from non-industry sources, and the rest of the studies did not report the source of funding.There was low-certainty evidence that people receiving topical NSAIDs in combination with steroids may have a lower risk of poor vision due to MO at three months after cataract surgery compared with people receiving steroids alone (risk ratio (RR) 0.41, 95% confidence interval (CI) 0.23 to 0.76; eyes = 1360; studies = 5; I2 = 5%). We judged this to be low-certainty evidence because of risk of bias in the included studies and indirectness, as the extent of visual loss was not always clear. Only one study reported poor vision due to MO at 12 months and we judged this to be very low-certainty evidence as there were only two events. Quality of life was only reported in one of the 34 studies comparing NSAIDs plus steroids versus steroids alone, and it was not fully reported, other than to comment on lack of differences between groups. There was evidence of a reduced risk of MO with NSAIDs at three months after surgery, but we judged this to be low-certainty due to risk of bias and publication bias (RR 0.40, 95% CI 0.32 to 0.49; eyes = 3638; studies = 21). There was inconsistent evidence on central retinal thickness at three months (I2 = 87%). Results ranged from -30.9 µm in favour of NSAIDs plus steroids to 7.44 µm in favour of steroids alone. Similarly, data on best corrected visual acuity (BCVA) were inconsistent, but nine out of 10 trials reporting this outcome found between-group differences in visual acuity of less than 0.1 logMAR.None of the six studies comparing NSAIDs alone with steroids reported on poor vision due to MO at three or 12 months. There was low-certainty evidence that central retinal thickness was lower in the NSAIDs group at three months (mean difference (MD) -22.64 µm, 95% CI -38.86 to -6.43; eyes = 121; studies = 2). Five studies reported on MO and showed a reduced risk with NSAIDs, but we judged this evidence to be of low-certainty (RR 0.27, 95% CI 0.18 to 0.41; eyes = 520). Three studies reported BCVA at three months and the results of these trials were inconsistent, but all three studies found differences of less than 0.1 logMAR between groups.We did not note any major adverse events - the main consistent observation was burning or stinging sensation with the use of NSAIDs. AUTHORS' CONCLUSIONS: Using topical NSAIDs may reduce the risk of developing macular oedema after cataract surgery, although it is possible that current estimates as to the size of this reduction are exaggerated. It is unclear the extent to which this reduction has an impact on the visual function and quality of life of patients. There is little evidence to suggest any important effect on vision after surgery. The value of adding topical NSAIDs to steroids, or using them as an alternative to topical steroids, with a view to reducing the risk of poor visual outcome after cataract surgery is therefore uncertain. Future trials should address the remaining clinical uncertainty of whether prophylactic topical NSAIDs are of benefit, particularly with respect to longer-term follow-up (at least to 12 months), and should be large enough to detect reduction in the risk of the outcome of most interest to patients, which is chronic macular oedema leading to visual loss

Statistical Mechanics of maximal independent sets

The graph theoretic concept of maximal independent set arises in several practical problems in computer science as well as in game theory. A maximal independent set is defined by the set of occupied nodes that satisfy some packing and covering constraints. It is known that finding minimum and maximum-density maximal independent sets are hard optimization problems. In this paper, we use cavity method of statistical physics and Monte Carlo simulations to study the corresponding constraint satisfaction problem on random graphs. We obtain the entropy of maximal independent sets within the replica symmetric and one-step replica symmetry breaking frameworks, shedding light on the metric structure of the landscape of solutions and suggesting a class of possible algorithms. This is of particular relevance for the application to the study of strategic interactions in social and economic networks, where maximal independent sets correspond to pure Nash equilibria of a graphical game of public goods allocation

Efficacy of Repeat Selective Laser Trabeculoplasty in Medication-Naïve Open Angle Glaucoma and Ocular Hypertension during the LiGHT Trial

PURPOSE: To determine the efficacy of repeat selective laser trabeculoplasty (SLT) in medication-naïve open angle glaucoma (OAG) and ocular hypertensive (OHT) patients requiring repeat treatment for early to medium-term failure during the Laser in Glaucoma and Ocular Hypertension (LiGHT) trial. // DESIGN: Post-hoc analysis of SLT treatment arm of a multicentre prospective randomised-controlled-trial. // PARTICIPANTS: Treatment-naïve OAG or OHT requiring repeat 360-degree SLT within 18 months. Re-treatment was triggered by pre-defined IOP and disease-progression criteria (using objective individualised target IOPs) // METHODS: After SLT at baseline, patients were followed for a minimum of 18 months after second (‘repeat’) SLT. A mixed model analysis was performed with the eye as the unit of analysis, with crossed random-effects to adjust for correlation between fellow eyes and repeated measures within eyes. Kaplan-Meier curves plot the duration of effect. // OUTCOME MEASURES: Initial (‘early’) IOP lowering at 2-months and duration of effect following initial and Repeat SLT. // RESULTS: 115 eyes of 90 patients received Repeat SLT during first 18 months of the trial. Pre-treatment IOP prior to Initial SLT was significantly higher than that prior to pre-retreatment IOP of Repeat SLT (mean difference: 3.4, 95% confidence interval (CI) 2.6 to 4.3, mmHg; p<0.001). Absolute IOP reduction at 2-months was greater following Initial, compared to Repeat, SLT (mean difference: 1.0, 95% CI 0.2 to 1.8, mmHg; p=0.02). Adjusted absolute IOP reduction at 2-months (adjusting for IOP prior to initial or repeat laser) was greater following Repeat SLT (adjusted mean difference: -1.1, 95% CI -1.7 to -0.5, mmHg; p=0.001). 34 eyes were ‘early failures’ (retreated 2-months after Initial SLT) vs 81 ‘later failures’ (retreatment beyond 2-months following Initial SLT). No significant difference in early absolute IOP reduction at 2-months following Repeat SLT was noted between ‘early’ vs ‘later’ failures’ (mean difference: 0.3, 95% CI, -1.1 to 1.8,mmHg; p=0.655). Repeat SLT maintained drop-free IOP control in 67% of 115 eyes at 18 months, with no clinically-relevant adverse events. // CONCLUSION: These exploratory analyses demonstrate Repeat SLT can maintain IOP at or below Target IOP in medication-naive OAG and OHT eyes requiring retreatment with atleast an equivalent duration of effect to initial laser

On large deviation properties of Erdos-Renyi random graphs

We show that large deviation properties of Erd\"os-R\'enyi random graphs can be derived from the free energy of the $q$-state Potts model of statistical mechanics. More precisely the Legendre transform of the Potts free energy with respect to $\ln q$ is related to the component generating function of the graph ensemble. This generalizes the well-known mapping between typical properties of random graphs and the $q\to 1$ limit of the Potts free energy. For exponentially rare graphs we explicitly calculate the number of components, the size of the giant component, the degree distributions inside and outside the giant component, and the distribution of small component sizes. We also perform numerical simulations which are in very good agreement with our analytical work. Finally we demonstrate how the same results can be derived by studying the evolution of random graphs under the insertion of new vertices and edges, without recourse to the thermodynamics of the Potts model.Comment: 38 pages, 9 figures, Latex2e, corrected and extended version including numerical simulation result

Spectra of complex networks

We propose a general approach to the description of spectra of complex networks. For the spectra of networks with uncorrelated vertices (and a local tree-like structure), exact equations are derived. These equations are generalized to the case of networks with correlations between neighboring vertices. The tail of the density of eigenvalues $\rho(\lambda)$ at large $|\lambda|$ is related to the behavior of the vertex degree distribution $P(k)$ at large $k$. In particular, as $P(k) \sim k^{-\gamma}$, $\rho(\lambda) \sim |\lambda|^{1-2\gamma}$. We propose a simple approximation, which enables us to calculate spectra of various graphs analytically. We analyse spectra of various complex networks and discuss the role of vertices of low degree. We show that spectra of locally tree-like random graphs may serve as a starting point in the analysis of spectral properties of real-world networks, e.g., of the Internet.Comment: 10 pages, 4 figure