3451
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Corella D, Coltell O, Portolés O, Sotos-Prieto M, Fernández-Carrión R, Ramirez-Sabio JB, Zanón-Moreno V, Mattei J, Sorlí JV, Ordovas JM. A Guide to Applying the Sex-Gender Perspective to Nutritional Genomics. Nutrients 2018; 11:E4. [PMID: 30577445 PMCID: PMC6357147 DOI: 10.3390/nu11010004] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/14/2018] [Accepted: 12/18/2018] [Indexed: 02/07/2023] Open
Abstract
Precision nutrition aims to make dietary recommendations of a more personalized nature possible, to optimize the prevention or delay of a disease and to improve health. Therefore, the characteristics (including sex) of an individual have to be taken into account as well as a series of omics markers. The results of nutritional genomics studies are crucial to generate the evidence needed so that precision nutrition can be applied. Although sex is one of the fundamental variables for making recommendations, at present, the nutritional genomics studies undertaken have not analyzed, systematically and with a gender perspective, the heterogeneity/homogeneity in gene-diet interactions on the different phenotypes studied, thus there is little information available on this issue and needs to be improved. Here we argue for the need to incorporate the gender perspective in nutritional genomics studies, present the general context, analyze the differences between sex and gender, as well as the limitations to measuring them and to detecting specific sex-gene or sex-phenotype associations, both at the specific gene level or in genome-wide-association studies. We analyzed the main sex-specific gene-diet interactions published to date and their main limitations and present guidelines with recommendations to be followed when undertaking new nutritional genomics studies incorporating the gender perspective.
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Affiliation(s)
- Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain.
| | - Oscar Coltell
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Department of Computer Languages and Systems, Universitat Jaume I, 12071 Castellón, Spain.
| | - Olga Portolés
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain.
| | - Mercedes Sotos-Prieto
- School of Applied Health Sciences and Wellness, Ohio University, Athens, OH 45701, USA.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Rebeca Fernández-Carrión
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain.
| | | | - Vicente Zanón-Moreno
- Ophthalmology Research Unit "Santiago Grisolia", Dr. Peset University Hospital, 46017 Valencia, Spain.
- Red Temática de Investigación Cooperativa OftaRed, Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - José V Sorlí
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain.
| | - Jose M Ordovas
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111 USA.
- Department of Cardiovascular Epidemiology and Population Genetics, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain.
- IMDEA Alimentación, 28049 Madrid, Spain.
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3452
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Skenderi Z, Giurgola L, Gatto C, D'Amato Tóthová J, Pruß A, Schroeter J. Increased sensitivity of microbiological testing of cornea organ culture medium by additional resin treatment. BMJ Open Ophthalmol 2018; 3:e000173. [PMID: 30519641 PMCID: PMC6243474 DOI: 10.1136/bmjophth-2018-000173] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/21/2018] [Accepted: 07/23/2018] [Indexed: 11/05/2022] Open
Abstract
Objective This validation study investigates the treatment of cornea organ culture medium (Modified Eagle Medium, Biochrom GmbH, Berlin, Germany) with RESEP, a new medical device for antibiotics removal, before microbiological testing with BACTEC TM blood culture bottles. Methods and analysis 10–100 colony forming units of Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, Bacillus subtillis, Aspergillus brasiliensis, Clostridium sporogenes, Enterobacter cloacae and Staphylococcus epidermidis were inoculated in 9mL of cornea organ culture medium. In group A, the medium was withdrawn with RESEP and treated for 20 min at room temperature, and then inoculated in BACTEC Plus Aerobic/F/Anaerobic/F blood culture bottles. In group B, the medium, spiked by the inoculation of microorganism, was injected directly. For each strain, a growth control was performed, by direct inoculation of the microorganisms in BACTECTMvials (positive control). All samples were incubated in the automated BACTECTMblood culture system at 36°C ±1°C for maximum of 14 days or until a positive reading. The elimination of antibiotics from the medium by RESEP was determined by high-performance liqiud chromatography. Results After 20 min of RESEP treatment, 100% (n=9) of streptomycin, 100% (n=9) of amphotericin B and 99.7% (n=9) of penicillin G were eliminated. In group A, all microorganisms were detected within 3 days of incubation with a sensitivity of 100% (n=99) and showed no significant delay compared with the positive controls. In group B, the overall sensitivity was 67.9% (n=96) with a significant delay until detection of microbial growth for all tested microorganisms except for A. brasiliensis. Conlclusion The use of RESEP to eliminate the antibiotics from cornea organ culture medium increases the sensitivity of the microbiological testing with BACTECTMPlus blood culture bottles significantly and fulfils the requirements of the European Pharmacopoeia method suitability test.
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Affiliation(s)
- Zemra Skenderi
- Institute for Transfusion Medicine, University Tissue Bank, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Laura Giurgola
- Research and Development, Alchilife Srl, Ponte San Nicolo, Italy
| | - Claudio Gatto
- Research and Development, Alchilife Srl, Ponte San Nicolo, Italy
| | | | - Axel Pruß
- Institute for Transfusion Medicine, University Tissue Bank, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Schroeter
- Institute for Transfusion Medicine, University Tissue Bank, Charité - Universitätsmedizin Berlin, Berlin, Germany
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3453
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Frame K, Cheung IM, Wang MT, Turnbull PR, Watters GA, Craig JP. Comparing the in vitro effects of MGO™ Manuka honey and tea tree oil on ocular Demodex viability. Cont Lens Anterior Eye 2018; 41:527-530. [DOI: 10.1016/j.clae.2018.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 06/14/2018] [Accepted: 06/28/2018] [Indexed: 12/27/2022]
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3454
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Gu L, Shan T, Ma YX, Tay FR, Niu L. Novel Biomedical Applications of Crosslinked Collagen. Trends Biotechnol 2018; 37:464-491. [PMID: 30447877 DOI: 10.1016/j.tibtech.2018.10.007] [Citation(s) in RCA: 148] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 10/19/2018] [Accepted: 10/19/2018] [Indexed: 02/08/2023]
Abstract
Collagen is one of the most useful biopolymers because of its low immunogenicity and biocompatibility. The biomedical potential of natural collagen is limited by its poor mechanical strength, thermal stability, and enzyme resistance, but exogenous chemical, physical, or biological crosslinks have been used to modify the molecular structure of collagen to minimize degradation and enhance mechanical stability. Although crosslinked collagen-based materials have been widely used in biomedicine, there is no standard crosslinking protocol that can achieve a perfect balance between stability and functional remodeling of collagen. Understanding the role of crosslinking agents in the modification of collagen performance and their potential biomedical applications are crucial for developing novel collagen-based biopolymers for therapeutic gain.
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Affiliation(s)
- Lisha Gu
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, PR China
| | - Tiantian Shan
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, PR China
| | - Yu-Xuan Ma
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Franklin R Tay
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China; The Dental College of Georgia, Augusta University, Augusta, GA, USA.
| | - Lina Niu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China; The Dental College of Georgia, Augusta University, Augusta, GA, USA.
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3455
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The Role of Pneumococcal Virulence Factors in Ocular Infectious Diseases. Interdiscip Perspect Infect Dis 2018; 2018:2525173. [PMID: 30538741 PMCID: PMC6257906 DOI: 10.1155/2018/2525173] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 11/07/2018] [Indexed: 12/24/2022] Open
Abstract
Streptococcus pneumoniae is a gram-positive, facultatively anaerobic pathogen that can cause severe infections such as pneumonia, meningitis, septicemia, and middle ear infections. It is also one of the top pathogens contributing to bacterial keratitis and conjunctivitis. Though two pneumococcal vaccines exist for the prevention of nonocular diseases, they do little to fully prevent ocular infections. This pathogen has several virulence factors that wreak havoc on the conjunctiva, cornea, and intraocular system. Polysaccharide capsule aids in the evasion of host complement system. Pneumolysin (PLY) is a cholesterol-dependent cytolysin that acts as pore-forming toxin. Neuraminidases assist in adherence and colonization by exposing cell surface receptors to the pneumococcus. Zinc metalloproteinases contribute to evasion of the immune system and disease severity. The main purpose of this review is to consolidate the multiple studies that have been conducted on several pneumococcal virulence factors and the role each plays in conjunctivitis, keratitis, and endophthalmitis.
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3456
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Minimizing Endothelial Cell Loss Caused by Orientation Stamps on Preloaded Descemet Membrane Endothelial Keratoplasty Grafts. Cornea 2018; 38:233-237. [DOI: 10.1097/ico.0000000000001809] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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3457
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3458
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Short Axial Length and Iris Damage Are Associated With Iris Posterior Synechiae After Descemet Membrane Endothelial Keratoplasty in Asian Eyes. Cornea 2018; 37:1355-1359. [PMID: 30004959 DOI: 10.1097/ico.0000000000001698] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the frequency and severity of iris posterior synechiae after Descemet membrane endothelial keratoplasty (DMEK) and to investigate possible causes of iris posterior synechiae. METHODS Twenty-three eyes were investigated in 20 Asian patients who underwent DMEK 1 month after phacoemulsification and intraocular lens implantation surgery. A preexisting iris damage score was defined by iris damage and classified into 5 grades. Six months after DMEK, the iris posterior synechiae severity score was evaluated based on the extent of posterior synechiae, according to every 45 degrees of the pupillary rim (posterior synechiae score, 0-8). Correlations were analyzed between the posterior synechiae score and preexisting factors (preexisting iris damage score, axial length [AXL], anterior chamber depth, and anterior chamber volume, both before and after cataract surgery). RESULTS Iris posterior synechiae appeared in 20 of 23 eyes (87.0%). Best spectacle-corrected visual acuity significantly improved at 6 months after DMEK (P < 0.001). Endothelial cell density was 1596 ± 530 cells/mm (P < 0.001); loss of cell density was 37.8 ± 19.9% at 6 months. Single regression analysis showed that the onset of iris posterior synechiae was correlated with the preexisting iris damage score (P = 0.006, r = 0.55), AXL (P < 0.001, r = -0.71), anterior chamber depth (P < 0.001, r = -0.70), and anterior chamber volume before cataract surgery (P < 0.001, r = -0.79). CONCLUSIONS Iris posterior synechiae after DMEK frequently appeared in Asian eyes with shorter AXLs or a damaged iris.
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3459
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Use of a Purpose-Built Impression Cytology Device for Gene Expression Quantification at the Ocular Surface Using Quantitative PCR and Droplet Digital PCR. Cornea 2018; 38:127-133. [DOI: 10.1097/ico.0000000000001792] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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3460
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Tian M. Management of recalcitrant epithelial ingrowth after laser in situ keratomileusis: A case report. Medicine (Baltimore) 2018; 97:e13024. [PMID: 30412143 PMCID: PMC6221683 DOI: 10.1097/md.0000000000013024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Surgically lifting and scraping, mitomycin C, fibrin glue, Nd:YAG laser, hydrogel ocular sealant, and amniotic membrane patch are the reported methods for treating epithelial ingrowth after laser in situ keratomileusis (LASIK). Here we report the management of a rare case of recalcitrant epithelial ingrowth using a combined scraping/laser ablation that occurred after LASIK. PATIENT CONCERNS A female patient underwent uncomplicated bilateral LASIK 10 years before incurring trauma to the right eye. Approximately 2.5 years later, she presented with a complaint of blurred vision and a foreign body sensation. DIAGNOSES The patient was diagnosed with epithelial ingrowth because of the presence of corneal melting, wrinkling, and scarring. Approximately 6 months after injury, the patient underwent corneal scraping to remove the epithelial ingrowth. Even after 2 more scraping procedures, the epithelial ingrowth recurred. Corneal densitometry was performed (Oculus Pentacam), which revealed a maximum corneal densitometry value of 87.4 gray scale units (GSUs) in the inferonasal quadrant. This reading highly elevated compared to readings from normal cornea (approximately 20 GSU). INTERVENTIONS We used a combination scraping/laser ablation procedure to correct astigmatism and eliminate any undetected residual corneal epithelial cells. OUTCOMES Two days following the procedure, the patient developed a mild corneal opacity in the area where the epithelial ingrowth had been located. At this time, visual acuity was 20/40, refractive error (manifest refraction) was -0.50 Diopter (D) sph, and the maximum corneal densitometry value was 79.2 GSU. After 2 months, the central cornea remained slightly blurred, but visual acuity was 20/25. No signs of recurrent epithelial ingrowth were present and the maximum corneal densitometry reading had decreased to 55.4 GSU. LESSONS This case demonstrates that epithelial ingrowth should be treated as soon as possible after trauma and that thorough scraping combined with laser ablation is effective for treating recalcitrant epithelial ingrowth. Additionally, corneal densitometry can be used to assess epithelial ingrowth severity and treatment efficacy.
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3461
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Modabber M, Talajic JC, Mabon M, Mercier M, Jabbour S, Choremis J. The role of novel DMEK graft shapes in facilitating intraoperative unscrolling. Graefes Arch Clin Exp Ophthalmol 2018; 256:2385-2390. [DOI: 10.1007/s00417-018-4145-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 08/17/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022] Open
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3462
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Wolffsohn JS, Davies LN. Presbyopia: Effectiveness of correction strategies. Prog Retin Eye Res 2018; 68:124-143. [PMID: 30244049 DOI: 10.1016/j.preteyeres.2018.09.004] [Citation(s) in RCA: 148] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 01/04/2023]
Abstract
Presbyopia is a global problem affecting over a billion people worldwide. The prevalence of unmanaged presbyopia is as high as 50% of those over 50 years of age in developing world populations, due to a lack of awareness and accessibility to affordable treatment, and is even as high as 34% in developed countries. Definitions of presbyopia are inconsistent and varied, so we propose a redefinition that states "presbyopia occurs when the physiologically normal age-related reduction in the eye's focusing range reaches a point, when optimally corrected for distance vision, that the clarity of vision at near is insufficient to satisfy an individual's requirements". Strategies for correcting presbyopia include separate optical devices located in front of the visual system (reading glasses) or a change in the direction of gaze to view through optical zones of different optical powers (bifocal, trifocal or progressive addition spectacle lenses), monovision (with contact lenses, intraocular lenses, laser refractive surgery and corneal collagen shrinkage), simultaneous images (with contact lenses, intraocular lenses and corneal inlays), pinhole depth of focus expansion (with intraocular lenses, corneal inlays and pharmaceuticals), crystalline lens softening (with lasers or pharmaceuticals) or restored dynamics (with 'accommodating' intraocular lenses, scleral expansion techniques and ciliary muscle electrostimulation); these strategies may be applied differently to the two eyes to optimise the range of clear focus for an individual's task requirements and minimise adverse visual effects. However, none fully overcome presbyopia in all patients. While the restoration of natural accommodation or an equivalent remains elusive, guidance is given on presbyopic correction evaluation techniques.
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Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK.
| | - Leon N Davies
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK
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3463
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Deguchi H, Kitazawa K, Kayukawa K, Kondoh E, Fukumoto A, Yamasaki T, Kinoshita S, Sotozono C. The trend of resistance to antibiotics for ocular infection of Staphylococcus aureus, coagulase-negative staphylococci, and Corynebacterium compared with 10-years previous: A retrospective observational study. PLoS One 2018; 13:e0203705. [PMID: 30192856 PMCID: PMC6128643 DOI: 10.1371/journal.pone.0203705] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/25/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To retrospectively identify epidemiological trends of infection on the ocular surface and investigate trends of resistance to bacterial antibiotics compared with 10-years previous for Staphylococcus aureus, coagulase-negative staphylococci (CNS), and Corynebacterium in Japan. MATERIALS AND METHODS Bacterial isolate samples were collected from the conjunctival sacs of eyes afflicted with conjunctivitis, keratitis, dacryocystitis, and hordeolum from September 2004 through November 2005 (n = 145 isolates) and September 2014 through November 2015 (n = 195 isolates) at the Baptist Eye Institute, Kyoto, Japan. The prevalence of methicillin-resistant S. aureus (MRSA), methicillin-resistant CNS (MR-CNS), and fluoroquinolone-resistant Corynebacterium were examined, and susceptibility of isolated bacteria to levofloxacin (LVFX), cefmenoxime (CMX), chloramphenicol (CP), erythromycin (EM), vancomycin (VCM), and arbekacin (ABK) were compared between both time periods using the disc susceptibility method. RESULTS Over the 10-year period from initial to final examination, the prevalence of MRSA and MR-CNS significantly decreased from 52% to 22% (P < 0.05) and from 47% to 25% (P < 0.05), respectively, yet there was no change in the prevalence of fluoroquinolone-resistant Corynebacterium (60% and 54%; P = 0.38). Antibiotic-resistance trend analysis revealed that susceptibility to antibiotics in 2014-2015 was similar to that in 2004-2005. MRSA and MR-CNS were susceptible to CP (88%), VCM (100%), and ABK (100%), while fluoroquinolone-resistant Corynebacterium was susceptible to CMX (100%), VCM (100%), and ABK (96%). CONCLUSION The prevalence of MRSA and MR-CNS significantly decreased between the two time periods, yet more than 50% of the Corynebacterium isolates were still resistant to LVFX. Although no increase in bacterial resistance to antibiotics was found, a cautionary use of fluoroquinolone eye drops should be considered.
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Affiliation(s)
| | - Koji Kitazawa
- Baptist Eye Institute, Kyoto, Japan
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
- * E-mail:
| | | | - Eri Kondoh
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Akiko Fukumoto
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Shigeru Kinoshita
- Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto, Prefectural University of Medicine, Kyoto, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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3464
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Hynes NJ, Cufflin MP, Hampson KM, Mallen EAH. Cognitive Demand and Accommodative Microfluctuations. Vision (Basel) 2018; 2:vision2030036. [PMID: 31735899 PMCID: PMC6836075 DOI: 10.3390/vision2030036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/31/2018] [Accepted: 09/04/2018] [Indexed: 12/29/2022] Open
Abstract
Previous studies have shown cognition to have an influence on accommodation. Temporal variation in the accommodative response occurs during the fixation on a stationary target. This constantly shifting response has been called accommodative micro-fluctuations (AMFs). The aim of this study is to determine the effects of increasing task cognitive demand on the ocular accommodation response. AMFs for 12 myopes and 12 emmetropes were measured under three conditions of varying cognitive demand and comprising reading of numbers (Num), simple arithmetic (SA), and complex arithmetic (CA). Fast Fourier transforms were used to analyze the different frequency band components of the AMFs. Other aspects of AMFs including root mean square accommodation values and chaos analysis was applied. A repeated measures ANOVA revealed a significant main effect of cognition in the mean power of the high frequency component (HFC) (F2,44 = 10.03, p < 0.005). Pairwise analyses revealed that these differences exist between SA and CA tasks (p < 0.005) and the Num and CA (p < 0.005) tasks with the HFC power being the highest for the CA condition. It appears that the difficulty of a task does affect active accommodation but to a lesser extent than other factors affecting accommodation.
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Affiliation(s)
- Niall J. Hynes
- School of Optometry & Vision Science, University of Bradford, Bradford BD7 1DP, UK
- Correspondence:
| | - Matthew P. Cufflin
- School of Optometry & Vision Science, University of Bradford, Bradford BD7 1DP, UK
| | - Karen M. Hampson
- Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK
| | - Edward A. H. Mallen
- School of Optometry & Vision Science, University of Bradford, Bradford BD7 1DP, UK
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3465
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Vancampfort D, Smith L, Stubbs B, Swinnen N, Firth J, Schuch FB, Koyanagi A. Associations between active travel and physical multi-morbidity in six low- and middle-income countries among community-dwelling older adults: A cross-sectional study. PLoS One 2018; 13:e0203277. [PMID: 30161211 PMCID: PMC6117036 DOI: 10.1371/journal.pone.0203277] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 08/19/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND There is little evidence on the potential health benefits of active travel in low- and middle-income countries (LMICs). The aim of this study was to assess the association between levels of active travel and physical multi-morbidity (i.e., two or more chronic physical conditions) and individual physical conditions among community-dwelling adults aged 65 or older in six LMICs. METHODS Data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health (China, Ghana, India, Mexico, Russia, South Africa). Active travel (minutes / week) was assessed with questions of the Global Physical Activity Questionnaire (GPAQ) and presented in tertiles. Eleven chronic conditions (angina, arthritis, asthma, chronic back pain, chronic lung disease, diabetes, edentulism, hearing problems, hypertension, stroke, visual impairment) were assessed by self-report of diagnosis, symptoms, or blood pressure measurement. Multivariable logistic regression analysis was conducted to assess the association between levels of active travel, physical conditions and physical multi-morbidity. RESULTS The final sample consisted of 14,585 individuals aged ≥65 years (mean age = 72.6±0.1 years; 54.9% female). In the fully adjusted model, compared to the highest tertile, those in the lowest tertile of active travel had a 1.28 (95%CI = 1.06-1.54) times higher odds for physical multi-morbidity. The association between active travel and physical multi-morbidity was significantly mediated by affect (14.4%) and cognition (9.7%). With regard to individual conditions, hearing problems, hypertension, stroke, and visual impairment were particularly strongly associated with less active travel. CONCLUSION The current data suggest that lower levels of active travel are associated with the presence of physical health conditions and physical multi-morbidity. This multi-national study offers potentially valuable insight for a number of hypotheses which may influence this relationship, although testing with longitudinal studies is needed.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- KU Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium
- * E-mail:
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Department of Life Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Nathalie Swinnen
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- KU Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium
| | - Joseph Firth
- NICM Health Research Unit, School of Science and Health, University of Western Sydney, Sydney, Australia
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Felipe B. Schuch
- Universidade La Salle (Unilasalle), Canoas, Brazil
- Escola de Educação Física, Fisioterapia e Dança, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Ai Koyanagi
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Research and Development Unit, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
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3466
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Evaluation of Anterior and Posterior Corneal Irregularity After Descemet Membrane Endothelial Keratoplasty. Cornea 2018; 37:1360-1365. [PMID: 30124590 DOI: 10.1097/ico.0000000000001722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the changes in anterior and posterior corneal irregularity after Descemet membrane endothelial keratoplasty (DMEK). METHODS This retrospective study included 27 eyes of 23 patients who underwent DMEK and 27 eyes of age-matched healthy controls. Corneal irregularity indexes, surface regularity of height (SR_H), and higher-order aberrations were evaluated in 4- and 6-mm diameters of the cornea, preoperatively and postoperatively, using anterior segment optical coherence tomography. RESULTS The best spectacle-corrected visual acuity (logarithm of the minimum angle of resolution) improved from 1.01 ± 0.54 preoperatively to 0.08 ± 0.11 at 6 months postoperatively. Anterior SR_H was significantly lower at 6 months postoperatively [from 1.86 ± 0.73 to 1.20 ± 0.34 (P < 0.01) (4-mm) and from 2.29 ± 0.62 to 1.64 ± 0.42 (P < 0.01) (6-mm)]. Posterior SR_H showed a significant decrease from 6.87 ± 4.19 to 2.18 ± 0.51 (4-mm) and from 5.21 ± 2.60 to 2.44 ± 0.38 (6-mm) at 6 months postoperatively (P < 0.001). The SR_H was positively correlated with best spectacle-corrected visual acuity (anterior 4 mm: R = 0.524; anterior 6 mm: R = 0.477; posterior 4 mm: R = 0.655; posterior 6 mm: R = 0.655, P < 0.001) and with higher-order aberrations for 4-mm and 6-mm diameters (R = 0.511 and R = 0.325, P < 0.001, respectively). CONCLUSIONS The SR_H reflects corneal irregularity and is correlated with the visual outcome after DMEK, which may be very helpful to corneal surgeons as an index indicating the severity before DMEK, and the quality of visual function after DMEK.
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3467
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Yang J, Wang N, Luo X. Intraocular miR-211 exacerbates pressure-induced cell death in retinal ganglion cells via direct repression of FRS2 signaling. Biochem Biophys Res Commun 2018; 503:2984-2992. [PMID: 30131252 DOI: 10.1016/j.bbrc.2018.08.082] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 08/02/2018] [Accepted: 08/09/2018] [Indexed: 12/20/2022]
Abstract
MicroRNAs (miRNAs) are emerging as important regulators of neurodegenerative diseases. However, research into ocular intracellular miRNAs, though possessing great potential to uncover novel and valuable therapeutic targets for glaucoma, is only at an early stage. Here we show that expression levels of miR-211 were significantly induced in aqueous humor (AH) samples from patients with glaucoma when compared to normal AH samples. Notably, oxidative stress-elicited miR-211 potentiated high pressure-induced retinal ganglion cells (RGCs) death by impairing ERK activation but enhancing P38 activation, an effect mediated by direct downregulation of fibroblast growth factor receptor substrate 2 (Frs2) signaling pathway in a sequence complementarity-dependent fashion. In support of the concept of a fundamental connection between miR-211 upregulation and augmented pressure-induced cell death in RGCs, we showed that ectopic expression of the exogenous FRS2 was sufficient to neutralize the miR-211-induced decrease in the cell viability and significantly improved miR-211-inhibited cell survival, in high pressure-challenged RGC-5 cells. Together, our findings show that miR-211 negatively modulates cell survival programs upon high pressure challenge by regulating Frs2 signaling, and they define roles for miR-211/Frs2 cascade in a regulatory feedback loop that mediates the pathogenesis of glaucoma.
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Affiliation(s)
- Jingwen Yang
- Department of Ophthalmology, Baoji Center Hospital, Baoji, 721008, Shaanxi Province, PR China
| | - Na Wang
- Department of Ophthalmology, Baoji Center Hospital, Baoji, 721008, Shaanxi Province, PR China
| | - Xiaoqin Luo
- Department of Ophthalmology, Baoji Center Hospital, Baoji, 721008, Shaanxi Province, PR China.
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3468
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Zandi S, Bodaghi B, Garweg JG. Review for Disease of the Year: Treatment of Viral Anterior Uveitis: A Perspective. Ocul Immunol Inflamm 2018; 26:1135-1142. [PMID: 30096015 DOI: 10.1080/09273948.2018.1498109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To define a clinically tailored therapeutic strategy for the treatment of viral anterior uveitis (VAU). METHODS A PubMed search spanning the past 5 years was conducted using the MesH-terms "viral anterior uveitis" and "therapy." RESULTS The herpes simplex virus (HSV), the varicella zoster virus (VZV), and the cytomegalovirus (CMV) are the predominant pathogens in VAU. Other viruses, including rubella, chikungunya, and zika, have been linked with distinct forms of the disease. Depending on the causative agent and the host immunocompetence, the mainstay treatment for suspected VAU is a combination of topical or systemic antivirals and topical corticosteroids, supplemented with cycloplegics and intraocular-pressure-lowering medication. CONCLUSIONS Oral acyclovir, valacyclovir, and famciclovir are the mainstay of treatment for HSV- and VZV-induced infections. Brivudin serves as an alternative in insufficiently responsive cases. CMV-induced infections respond well to valganciclovir. A 3- to 12-month course of prophylactic treatment against recurrences is worth considering.
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Affiliation(s)
- Souska Zandi
- a Clinic for Vitreoretinal Diseases , Swiss Eye Institute and Berner Augenklinik am Lindenhofspital , Bern , Switzerland
| | - Bahram Bodaghi
- b DHU ViewRestore, UPMC , Sorbonne Universities, APHP , Paris , France
| | - Justus G Garweg
- a Clinic for Vitreoretinal Diseases , Swiss Eye Institute and Berner Augenklinik am Lindenhofspital , Bern , Switzerland.,c University of Bern , Bern , Switzerland
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3469
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Atalay HT, Dogruman-Al F, Sarzhanov F, Özmen MC, Tefon AB, Arıbaş YK, Bilgihan K. Effect of Riboflavin/Rose Bengal-Mediated PACK-CXL on Acanthamoeba Trophozoites and Cysts in Vitro. Curr Eye Res 2018; 43:1322-1325. [PMID: 30021467 DOI: 10.1080/02713683.2018.1501074] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate the antiamoebic properties of photo-activated chromophore for keratitis (PACK)-corneal cross-linking (CXL) (PACK-CXL), in combination with riboflavin (0.1 and 0.25%) or rose bengal (0.1 and 0.2%), for treatment of Acanthamoeba trophozoites and cysts. MATERIALS AND METHODS Cultures of Acanthamoeba castellanii were grown in a fluid medium at a concentration of 2.7 × 105 cell/ml. PACK-CXL was used on A. castellani cells in combination with either riboflavin (0.1 and 0.25%) or rose bengal (0.1 and 0.2%). Riboflavin-containing wells were irradiated with ultraviolet-A (UVA) light (365-nm wavelength). Rose bengal-containing wells were irradiated with green light (523-nm wavelength). A power density of 9 mW/cm2 for 10 min and total irradiation dose of 5.4 J/cm2 was used for both riboflavin and rose bengal. After UVA and green light irradiation, cell viabilities were evaluated, and percentage of dead cells calculated. RESULTS No significant amoebicidal activity was observed following PACK-CXL/riboflavin at either concentration. PACK-CXL/rose bengal, however, was observed to be highly effective in eradicating Acanthamoeba cells at either concentration, with no significant difference observed between the two concentrations. The percentage of dead cells was 63% following treatment at either rose bengal concentration. CONCLUSION PACK-CXL with rose bengal demonstrated pronounced antiamoebic activity against A.castellanii. Further in vitro and in vivo studies are needed to confirm this finding.
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Affiliation(s)
- Hatice Tuba Atalay
- a Department of Ophthalmology, School of Medicine , Gazi University , Ankara , Turkey
| | - Funda Dogruman-Al
- b Department of Medical Microbiology, School of Medicine , Gazi university , Ankara , Turkey
| | - Fakhriddin Sarzhanov
- b Department of Medical Microbiology, School of Medicine , Gazi university , Ankara , Turkey.,c School of Medicine , Ahmet Yesevi International Kazakh-Turkish University , Turkestan , Kazakhstan
| | - Mehmet Cüneyt Özmen
- a Department of Ophthalmology, School of Medicine , Gazi University , Ankara , Turkey
| | - Atike Burçin Tefon
- a Department of Ophthalmology, School of Medicine , Gazi University , Ankara , Turkey
| | - Yavuz Kemal Arıbaş
- a Department of Ophthalmology, School of Medicine , Gazi University , Ankara , Turkey
| | - Kamil Bilgihan
- a Department of Ophthalmology, School of Medicine , Gazi University , Ankara , Turkey
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3470
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Nurieva O, Diblik P, Kuthan P, Sklenka P, Meliska M, Bydzovsky J, Heissigerova J, Urban P, Kotikova K, Navratil T, Komarc M, Seidl Z, Vaneckova M, Pelclova D, Zakharov S. Progressive Chronic Retinal Axonal Loss Following Acute Methanol-induced Optic Neuropathy: Four-Year Prospective Cohort Study. Am J Ophthalmol 2018; 191:100-115. [PMID: 29709459 DOI: 10.1016/j.ajo.2018.04.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 03/03/2018] [Accepted: 04/19/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE To study the dynamics and clinical determinants of chronic retinal nerve fiber layer thickness (RNFL) loss after methanol-induced optic neuropathy. DESIGN Prospective cohort study. METHODS All patients underwent complete ophthalmic evaluation including spectral-domain optical coherence tomography 3 times during 4 years of observation: 4.9 (±0.6), 25.0 (±0.6), and 49.9 (±0.5) months after discharge. PARTICIPANTS Eighty-four eyes of 42 survivors of methanol poisoning, mean age (standard deviation) of 45.7 (±4.4) years; and 82 eyes of 41 controls, mean age 44.0 (±4.2) years. MAIN OUTCOME MEASURES Global and temporal RNFL loss. RESULTS Abnormal RNFL thickness was registered in 13 of 42 (31%) survivors of methanol poisoning and chronic axonal loss in 10 of 42 (24%) patients. Significant decrease of global/temporal RNFL thickness during the observation period was found in the study population compared to the controls (P < .001). The risk estimate of chronic global RNFL loss for arterial blood pH < 7.3 at admission was 11.65 (95% confidence interval 1.91-71.12) after adjusting for age and sex. The patients with chronic axonal degeneration demonstrated progressive visual loss in 7 of 10 cases. The patients with abnormal RNFL thickness had magnetic resonance signs of brain damage in 10 of 13 vs 8 of 29 cases with normal RNFL thickness (P = .003). Signs of brain hemorrhages were present in 7 of 13 patients with abnormal RNFL thickness vs 5 of 29 cases with normal RNFL thickness (P = .015). CONCLUSIONS Methanol-induced optic neuropathy may lead to chronic retinal axonal loss during the following years. Arterial blood pH on admission is the strongest predictor of chronic RNFL thickness decrease. Chronic retinal neurodegeneration is associated with the progressive loss of visual functions and necrotic brain lesions.
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Affiliation(s)
- Olga Nurieva
- Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Pavel Diblik
- Clinic of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Pavel Kuthan
- Clinic of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Petr Sklenka
- Clinic of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Martin Meliska
- Clinic of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jan Bydzovsky
- Clinic of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jarmila Heissigerova
- Clinic of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Pavel Urban
- Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Katerina Kotikova
- Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Tomas Navratil
- Department of Biomimetic Electrochemistry, J. Heyrovský Institute of Physical Chemistry of the Czech Academy of Sciences, Prague, Czech Republic; Institute of Medical Biochemistry and Laboratory Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Martin Komarc
- Department of Methodology, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Zdenek Seidl
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Manuela Vaneckova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Daniela Pelclova
- Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Sergey Zakharov
- Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
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3471
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Outcomes of Descemet Membrane Endothelial Keratoplasty for Vitrectomized Eyes with Sutured Posterior Chamber Intraocular Lens. J Ophthalmol 2018; 2018:3127126. [PMID: 29850201 PMCID: PMC5925161 DOI: 10.1155/2018/3127126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 03/22/2018] [Indexed: 11/30/2022] Open
Abstract
Purpose To evaluate the clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) for vitrectomized eyes that underwent pars plana vitrectomy (PPV) and transscleral-sutured intraocular lens (IOL) implantation. Methods In this retrospective study, DMEK cases were reviewed from medical records and divided into two groups: the eyes after PPV and transscleral-sutured IOL implantation (vitrectomized group) and the eyes with in-the-bag IOL implantation (control group) prior to DMEK. The main outcome measures included time of graft unfolding during surgery and best spectacle-corrected visual acuity (BSCVA), central corneal thickness (CCT), and endothelial cell density (ECD) at 1, 3, and 6 months after the DMEK. Results Twenty-three eyes (vitrectomized group, n = 8; control group, n = 15) in 23 patients were included in this study. The unfolding time was significantly longer in the vitrectomized group than in the control group (P < 0.001). Postoperative BSCVA was worse in the vitrectomized group (0.16 ± 0.15) than in the control group (−0.06 ± 0.06; P = 0.017). The improvement in BSCVA was negatively correlated with the patients' age and frequency of previous surgeries. Conclusions Despite the longer graft unfolding time and limited visual recovery, DMEK should be applicable to vitrectomized eyes with transscleral-sutured IOL implantation.
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3472
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Double-Bubble Technique in Descemet Membrane Endothelial Keratoplasty for Vitrectomized Eyes: A Case Series. Cornea 2018; 37:1185-1188. [DOI: 10.1097/ico.0000000000001606] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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3473
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Verbakel SK, van Huet RAC, Boon CJF, den Hollander AI, Collin RWJ, Klaver CCW, Hoyng CB, Roepman R, Klevering BJ. Non-syndromic retinitis pigmentosa. Prog Retin Eye Res 2018; 66:157-186. [PMID: 29597005 DOI: 10.1016/j.preteyeres.2018.03.005] [Citation(s) in RCA: 492] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/20/2018] [Accepted: 03/22/2018] [Indexed: 12/23/2022]
Abstract
Retinitis pigmentosa (RP) encompasses a group of inherited retinal dystrophies characterized by the primary degeneration of rod and cone photoreceptors. RP is a leading cause of visual disability, with a worldwide prevalence of 1:4000. Although the majority of RP cases are non-syndromic, 20-30% of patients with RP also have an associated non-ocular condition. RP typically manifests with night blindness in adolescence, followed by concentric visual field loss, reflecting the principal dysfunction of rod photoreceptors; central vision loss occurs later in life due to cone dysfunction. Photoreceptor function measured with an electroretinogram is markedly reduced or even absent. Optical coherence tomography (OCT) and fundus autofluorescence (FAF) imaging show a progressive loss of outer retinal layers and altered lipofuscin distribution in a characteristic pattern. Over the past three decades, a vast number of disease-causing variants in more than 80 genes have been associated with non-syndromic RP. The wide heterogeneity of RP makes it challenging to describe the clinical findings and pathogenesis. In this review, we provide a comprehensive overview of the clinical characteristics of RP specific to genetically defined patient subsets. We supply a unique atlas with color fundus photographs of most RP subtypes, and we discuss the relevant considerations with respect to differential diagnoses. In addition, we discuss the genes involved in the pathogenesis of RP, as well as the retinal processes that are affected by pathogenic mutations in these genes. Finally, we review management strategies for patients with RP, including counseling, visual rehabilitation, and current and emerging therapeutic options.
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Affiliation(s)
- Sanne K Verbakel
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ramon A C van Huet
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands; Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Anneke I den Hollander
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rob W J Collin
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Caroline C W Klaver
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Carel B Hoyng
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ronald Roepman
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B Jeroen Klevering
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.
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3474
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Dietrich M, Helling N, Hilla A, Heskamp A, Issberner A, Hildebrandt T, Kohne Z, Küry P, Berndt C, Aktas O, Fischer D, Hartung HP, Albrecht P. Early alpha-lipoic acid therapy protects from degeneration of the inner retinal layers and vision loss in an experimental autoimmune encephalomyelitis-optic neuritis model. J Neuroinflammation 2018. [PMID: 29514678 PMCID: PMC5840773 DOI: 10.1186/s12974-018-1111-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background In multiple sclerosis (MS), neurodegeneration is the main reason for chronic disability. Alpha-lipoic acid (LA) is a naturally occurring antioxidant which has recently been demonstrated to reduce the rate of brain atrophy in progressive MS. However, it remains uncertain if it is also beneficial in the early, more inflammatory-driven phases. As clinical studies are costly and time consuming, optic neuritis (ON) is often used for investigating neuroprotective or regenerative therapeutics. We aimed to investigate the prospect for success of a clinical ON trial using an experimental autoimmune encephalomyelitis-optic neuritis (EAE-ON) model with visual system readouts adaptable to a clinical ON trial. Methods Using an in vitro cell culture model for endogenous oxidative stress, we compared the neuroprotective capacity of racemic LA with the R/S-enantiomers and its reduced form. In vivo, we analyzed retinal neurodegeneration using optical coherence tomography (OCT) and the visual function by optokinetic response (OKR) in MOG35–55-induced EAE-ON in C57BL/6J mice. Ganglion cell counts, inflammation, and demyelination were assessed by immunohistological staining of retinae and optic nerves. Results All forms of LA provided equal neuroprotective capacities in vitro. In EAE-ON, prophylactic LA therapy attenuated the clinical EAE score and prevented the thinning of the inner retinal layer while therapeutic treatment was not protective on visual outcomes. Conclusions A prophylactic LA treatment is necessary to protect from visual loss and retinal thinning in EAE-ON, suggesting that a clinical ON trial starting therapy after the onset of symptoms may not be successful. Electronic supplementary material The online version of this article (10.1186/s12974-018-1111-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michael Dietrich
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Niklas Helling
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Alexander Hilla
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Annemarie Heskamp
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Andrea Issberner
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Thomas Hildebrandt
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Zippora Kohne
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Patrick Küry
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Carsten Berndt
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Orhan Aktas
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Dietmar Fischer
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Philipp Albrecht
- Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
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3475
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Prediction of pupil size under binocular open-view settings using the new CASIA2 device. Int Ophthalmol 2018; 39:791-796. [DOI: 10.1007/s10792-018-0879-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 02/21/2018] [Indexed: 10/17/2022]
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3476
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MOSHIRFAR M, SHAH TJ, MASUD M, FANNING T, LINN SH, RONQUILLO Y, HOOPES PCSR. A Modified Small-Incision Lenticule Intrastromal Keratoplasty (sLIKE) for the Correction of High Hyperopia: A Description of a New Surgical Technique and Comparison to Lenticule Intrastromal Keratoplasty (LIKE). MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2018; 7:48-56. [PMID: 30250852 PMCID: PMC6146242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Patients with high hyperopia are generally confined to either spectacle wear or contact lenses as a primary means of refractive correction. For this patient population, the surgical corrective methods, such as hyperopic laser assisted in-situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) are imperfect options due to induction of higher-order aberrations, optical regression, and loss of best corrected distance visual acuity. Recently, there has been growing interest in lenticule implantation underneath a flap via lenticule intrastromal keratoplasty (LIKE) for high hyperopia correction (+3 diopters to +10 diopters). We instead propose a modified surgical technique (small-incision lenticule intrastromal keratoplasty, sLIKE), in which the lenticule is implanted inside an intrastromal pocket thereby causing less injury to the subbasal nerve plexus injury, less postoperative dry eye symptoms, less reduction in biomechanical strength, and lower chances for epithelial ingrowth. We provide an overview of these novel surgical techniques to treat high hyperopia, and compare the associated advantages and disadvantages. In addition, we will discuss the enhancement options and methods of optimization for both surgical techniques.
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Affiliation(s)
- Majid MOSHIRFAR
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Utah, United States
- Utah Lions Eye Bank, Murray, UT, United States
- HDR Research Center, Hoopes Vision, 11820 S. State Street Suite #200, Draper, UT 84020, United States
| | - Tirth J. SHAH
- Department of Ophthalmology, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, United States
| | - Maliha MASUD
- University of Utah, Salt Lake City, Utah, United States
| | - Trey FANNING
- HDR Research Center, Hoopes Vision, 11820 S. State Street Suite #200, Draper, UT 84020, United States
| | - Steven H. LINN
- HDR Research Center, Hoopes Vision, 11820 S. State Street Suite #200, Draper, UT 84020, United States
| | - Yasmyne RONQUILLO
- HDR Research Center, Hoopes Vision, 11820 S. State Street Suite #200, Draper, UT 84020, United States
| | - Phillip C. SR HOOPES
- HDR Research Center, Hoopes Vision, 11820 S. State Street Suite #200, Draper, UT 84020, United States
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3477
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3478
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Blondeau JM. Targeted drug delivery and drug resistant pathogens. Expert Rev Respir Med 2017; 12:161-164. [PMID: 29265893 DOI: 10.1080/17476348.2018.1420479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Joseph M Blondeau
- a Division of Clinical Microbiology, Royal University Hospital and the Saskatoon Health Region and Departments of Microbiology and Immunology, Pathology and Ophthalmology , University of Saskatchewan , Saskatoon , Canada
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3479
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Kalogerou M, Kolovos P, Prokopiou E, Papagregoriou G, Deltas C, Malas S, Georgiou T. Omega-3 fatty acids protect retinal neurons in the DBA/2J hereditary glaucoma mouse model. Exp Eye Res 2017; 167:128-139. [PMID: 29258748 DOI: 10.1016/j.exer.2017.12.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 11/15/2017] [Accepted: 12/11/2017] [Indexed: 12/31/2022]
Abstract
The purpose of this study was to evaluate the neuroprotective effects of omega-3 polyunsaturated fatty acid (ω3-PUFA) supplementation, alone or in combination with timolol eye drops, in a mouse model of hereditary glaucoma. DBA/2J mice (8.5-month-old) were assigned to an ω3-PUFAs + timolol, ω3-PUFAs only, timolol only, or an untreated group. Treated mice received a daily gavage administration of eicosapentaenoic acid (EPA) and docosahexaenoic acid and/or topical instillation of timolol (0.5%) once a day for 3 months. Blood was analysed regularly to determine ω3-PUFA levels and retinas were histologically analysed. Real-time PCR and Western blot were performed for retinal pro-inflammatory cytokines and macrophages. Blood arachidonic acid/EPA ratio gradually decreased and reached the desired therapeutic range (1-1.5) after 4 weeks of daily gavage with ω3-PUFAs in the ω3-PUFAs + timolol and ω3-PUFAs only groups. Retinal ganglion cell densities were significantly higher in the ω3-PUFAs + timolol (1303.77 ± 139.62/mm2), ω3-PUFAs only (768.40 ± 52.44/mm2) and timolol only (910.57 ± 57.28/mm2) groups than in the untreated group (323.39 ± 95.18/mm2). ω3-PUFA supplementation alone or timolol alone, significantly increased protein expression levels of M1 macrophage-secreted inducible nitric oxide synthase and M2 macrophage-secreted arginase-1 in the retina, which led to significant decreases in the expression levels of tumour necrosis factor-α (TNF-α). ω3-PUFA supplementation alone also resulted in significantly reduced expression of interleukin-18 (IL-18). ω3-PUFA + timolol treatment had no effect on the expression level of any of the aforementioned mediators in the retina. Supplementation with ω3-PUFAs has neuroprotective effect in the retinas of DBA/2J mice that is enhanced when combined with timolol eye drops. The continued inflammation following ω3-PUFAs + timolol treatment suggests that downregulation of IL-18 and TNF-α may not be the only factors involved in ω3-PUFA-mediated neuroprotection in the retina.
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MESH Headings
- Administration, Ophthalmic
- Adrenergic beta-Antagonists/therapeutic use
- Animals
- Arachidonic Acid/blood
- Arginase/metabolism
- Blotting, Western
- Cell Survival
- Disease Models, Animal
- Drug Combinations
- Eicosapentaenoic Acid/blood
- Fatty Acids, Omega-3/administration & dosage
- Female
- Glaucoma, Open-Angle/genetics
- Glaucoma, Open-Angle/metabolism
- Glaucoma, Open-Angle/prevention & control
- Interleukin-18/metabolism
- Intraocular Pressure/drug effects
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Inbred DBA
- Nitric Oxide Synthase Type II/metabolism
- Ophthalmic Solutions
- Optic Nerve Diseases/genetics
- Optic Nerve Diseases/metabolism
- Optic Nerve Diseases/prevention & control
- Real-Time Polymerase Chain Reaction
- Retinal Ganglion Cells/drug effects
- Timolol/therapeutic use
- Tonometry, Ocular
- Tumor Necrosis Factor-alpha/metabolism
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Affiliation(s)
- Maria Kalogerou
- Ophthalmos Research and Educational Institute, Morfou 48, Egkomi, 2417 Nicosia, Cyprus.
| | - Panagiotis Kolovos
- Ophthalmos Research and Educational Institute, Morfou 48, Egkomi, 2417 Nicosia, Cyprus.
| | - Ekatherine Prokopiou
- Ophthalmos Research and Educational Institute, Morfou 48, Egkomi, 2417 Nicosia, Cyprus.
| | - Gregory Papagregoriou
- Molecular Medicine Research Centre and Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Kallipoleos 75, 1678 Nicosia, Cyprus.
| | - Constantinos Deltas
- Molecular Medicine Research Centre and Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Kallipoleos 75, 1678 Nicosia, Cyprus.
| | - Stavros Malas
- Developmental and Functional Genetics Group, The Cyprus Institute of Neurology and Genetics, 1683 Nicosia, Cyprus.
| | - Tassos Georgiou
- Ophthalmos Research and Educational Institute, Morfou 48, Egkomi, 2417 Nicosia, Cyprus.
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3480
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Ocular bioanalysis: challenges and advancements in recent years for these rare matrices. Bioanalysis 2017; 9:1997-2014. [DOI: 10.4155/bio-2017-0175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
There are many ocular diseases still presenting unmet medical needs. Therefore, new ophthalmologic drugs are being developed. Bioanalysis of eye compartments (along with plasma and other tissues) is important to determine exposure of the target organ to the drug and to help interpret local pharmacological or toxic effects. This review article identifies several challenges that occur within ocular bioanalysis. They include sample collection and preparation, analytical issues, sourcing control matrix, data interpretation and regulatory requirements. It summarizes how these challenges have been recently addressed, how research has advanced and which questions remain unanswered. Recommendations are made based on the literature and our practical experience within ocular bioanalysis and future perspectives are discussed.
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3481
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Austin A, Lietman T, Rose-Nussbaumer J. Update on the Management of Infectious Keratitis. Ophthalmology 2017; 124:1678-1689. [PMID: 28942073 PMCID: PMC5710829 DOI: 10.1016/j.ophtha.2017.05.012] [Citation(s) in RCA: 303] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 05/12/2017] [Accepted: 05/15/2017] [Indexed: 11/29/2022] Open
Abstract
Infectious keratitis is a major global cause of visual impairment and blindness, often affecting marginalized populations. Proper diagnosis of the causative organism is critical, and although culture remains the prevailing diagnostic tool, newer techniques such as in vivo confocal microscopy are helpful for diagnosing fungus and Acanthamoeba. Next-generation sequencing holds the potential for early and accurate diagnosis even for organisms that are difficult to culture by conventional methods. Topical antibiotics remain the best treatment for bacterial keratitis, and a recent review found all commonly prescribed topical antibiotics to be equally effective. However, outcomes remain poor secondary to corneal melting, scarring, and perforation. Adjuvant therapies aimed at reducing the immune response associated with keratitis include topical corticosteroids. The large, randomized, controlled Steroids for Corneal Ulcers Trial found that although steroids provided no significant improvement overall, they did seem beneficial for ulcers that were central, deep or large, non-Nocardia, or classically invasive Pseudomonas aeruginosa; for patients with low baseline vision; and when started early after the initiation of antibiotics. Fungal ulcers often have worse clinical outcomes than bacterial ulcers, with no new treatments since the 1960s when topical natamycin was introduced. The randomized controlled Mycotic Ulcer Treatment Trial (MUTT) I showed a benefit of topical natamycin over topical voriconazole for fungal ulcers, particularly among those caused by Fusarium. MUTT II showed that oral voriconazole did not improve outcomes overall, although there may have been some effect among Fusarium ulcers. Given an increase in nonserious adverse events, the authors concluded that they could not recommend oral voriconazole. Viral keratitis differs from bacterial and fungal cases in that it is often recurrent and is common in developed countries. The Herpetic Eye Disease Study (HEDS) I showed a significant benefit of topical corticosteroids and oral acyclovir for stromal keratitis. HEDS II showed that oral acyclovir decreased the recurrence of any type of herpes simplex virus keratitis by approximately half. Future strategies to reduce the morbidity associated with infectious keratitis are likely to be multidimensional, with adjuvant therapies aimed at modifying the immune response to infection holding the greatest potential to improve clinical outcomes.
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MESH Headings
- Anti-Bacterial Agents/therapeutic use
- Antifungal Agents/therapeutic use
- Antiviral Agents/therapeutic use
- Corneal Ulcer/diagnosis
- Corneal Ulcer/drug therapy
- Corneal Ulcer/microbiology
- Diagnostic Techniques, Ophthalmological
- Eye Infections, Bacterial/diagnosis
- Eye Infections, Bacterial/drug therapy
- Eye Infections, Bacterial/microbiology
- Eye Infections, Fungal/diagnosis
- Eye Infections, Fungal/drug therapy
- Eye Infections, Fungal/microbiology
- Female
- Glucocorticoids/therapeutic use
- Humans
- Keratitis, Herpetic/diagnosis
- Keratitis, Herpetic/drug therapy
- Keratitis, Herpetic/virology
- Male
- Randomized Controlled Trials as Topic
- Visual Acuity/physiology
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Affiliation(s)
- Ariana Austin
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Tom Lietman
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Jennifer Rose-Nussbaumer
- Francis I. Proctor Foundation, University of California, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, California.
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3482
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Craig JP, Wang MTM, Ganesalingam K, Rupenthal ID, Swift S, Loh CS, Te Weehi L, Cheung IMY, Watters GA. Randomised masked trial of the clinical safety and tolerability of MGO Manuka Honey eye cream for the management of blepharitis. BMJ Open Ophthalmol 2017; 1:e000066. [PMID: 29354710 PMCID: PMC5721638 DOI: 10.1136/bmjophth-2016-000066] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 04/10/2017] [Accepted: 04/27/2017] [Indexed: 12/28/2022] Open
Abstract
Objective To assess the clinical safety and tolerability of a novel MGO Manuka Honey microemulsion (MHME) eye cream for the management of blepharitis in human subjects. Methods and analysis Twenty-five healthy subjects were enrolled in a prospective, randomised, paired-eye, investigator-masked trial. The MHME eye cream (Manuka Health New Zealand) was applied to the closed eyelids of one eye (randomised) overnight for 2 weeks. LogMAR visual acuity, eyelid irritation symptoms, ocular surface characteristics and tear film parameters were assessed at baseline, day 7 and day 14. Expression of markers of ocular surface inflammation (matrix metalloproteinase-9 and interleukin-6) and goblet cell function (MUC5AC) were quantified using impression cytology at baseline and day 14. Results There were no significant changes in visual acuity, eyelid irritation symptoms, ocular surface characteristics, tear film parameters and inflammatory marker expression during the 2-week treatment period in treated and control eyes (all p>0.05), and measurements did not differ significantly between eyes (all p>0.05). No major adverse events were reported. Two subjects experienced transient ocular stinging, presumably due to migration of the product into the eye, which resolved following aqueous irrigation. Conclusion The MHME eye cream application was found to be well tolerated in healthy human subjects and was not associated with changes in visual acuity, ocular surface characteristics, tear film parameters, expression of markers of inflammation or goblet cell function. The findings support future clinical efficacy trials in patients with blepharitis. Trial registration number ACTRN12616000540415.
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Affiliation(s)
- Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Michael T M Wang
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Kalaivarny Ganesalingam
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Ilva D Rupenthal
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Simon Swift
- Department of Molecular Medicine and Pathology, The University of Auckland, Auckland, New Zealand
| | - Chee Seang Loh
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Leah Te Weehi
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Isabella M Y Cheung
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Grant A Watters
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
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3483
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Jones L, Downie LE, Korb D, Benitez-del-Castillo JM, Dana R, Deng SX, Dong PN, Geerling G, Hida RY, Liu Y, Seo KY, Tauber J, Wakamatsu TH, Xu J, Wolffsohn JS, Craig JP. TFOS DEWS II Management and Therapy Report. Ocul Surf 2017; 15:575-628. [DOI: 10.1016/j.jtos.2017.05.006] [Citation(s) in RCA: 578] [Impact Index Per Article: 82.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 02/06/2023]
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3484
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