Analysis of Choriocapillaris Reperfusion Topography Following Faricimab Treatment for Neovascular Age-Related Macular Degeneration in Therapy-Naïve Patients.

INTRODUCTION: To assess changes in choriocapillaris (CC) vascular density surrounding macular neovascularization (MNV) in treatment-naïve age-related macular degeneration (AMD) after faricimab application using optical coherence tomography angiography (OCTA). METHODS: Twenty-five eyes of 25 treatment-naïve individuals who underwent intravitreal faricimab injections for neovascular AMD (nAMD) with type 1 MNV were included. Spectral-domain optical coherence tomography (SD-OCT) images and en-face swept-source OCTA images were analyzed, and the percentage of CC flow deficit (FD%), FD average area (FDa) and FD number (FDn) in five progressive 20.0-µm-wide concentric rings (R1, R2, R3, R4 and R5) surrounding the dark halo around the MNV were calculated. Image acquisition was carried out prior to the first faricimab injection (T0) and 1 month after the injection (T1). RESULTS: The topographical sub-analysis revealed noteworthy changes in all rings at T1 compared to T0. There was a notable progressive reduction in FD% at T1 compared to T0 values across all rings, indicating a gradual CC reperfusion following anti-VEGF treatment. Additionally, the average size of FD decreased after the loading phase. Although not reaching statistical significance, there was a progressive reduction in the FDa across all rings. CONCLUSION: Our study highlights a CC FD reduction following the administration of three consecutive faricimab injections. This effect was detected in all rings surrounding the dark halo. These observations suggest a partial CC reperfusion surrounding the MNV, potentially serving as an indicator for disease regression.

Analysis of Choriocapillaris Reperfusion Topography following Faricimab Treatment for Neovascular Age-Related Macular Degeneration in Non-Treatment-Naïve Patients.

To assess changes in choriocapillaris (CC) vascular density surrounding macular neovascularization (MNV) in age-related macular degeneration (AMD) when transitioning from various anti-VEGF treatments to faricimab, using optical coherence tomography angiography (OCTA). 25 eyes of 22 individuals who underwent intravitreal faricimab injections for neovascular AMD with type 1 MNV were included. OCTA images were obtained prior to (T0), after one (T1), and after three faricimab injections (T2); Noteworthy changes occurred in the first ring at T2 in comparison to T0. The percentage of CC flow deficit (FD%), FD average area (FDa), and FD number (FDn) in 5 rings (R1-R5) surrounding the dark halo around the MNV were calculated. A reduction in FD% at T2 compared to T0 (50.5 ± 10.2% at T0, 46.4 ± 10.6% at T2; p = 0.020) was seen, indicating CC reperfusion. Additionally, we observed a reduction in the average FDa (140.2 ± 172.1% at T0, 93.7 ± 101.8% at T2; p = 0.029). Our study highlights an FD% after three consecutive faricimab injections. The most pronounced effect was observed in the first ring, directly adjacent to the dark halo, suggesting a partial CC reperfusion surrounding the MNV, potentially indicating disease regression.

Biotite: new tools for a versatile Python bioinformatics library.

BACKGROUND: Biotite is a program library for sequence and structural bioinformatics written for the Python programming language. It implements widely used computational methods into a consistent and accessible package. This allows for easy combination of various data analysis, modeling and simulation methods. RESULTS: This article presents major functionalities introduced into Biotite since its original publication. The fields of application are shown using concrete examples. We show that the computational performance of Biotite for bioinformatics tasks is comparable to individual, special purpose software systems specifically developed for the respective single task. CONCLUSIONS: The results show that Biotite can be used as program library to either answer specific bioinformatics questions and simultaneously allow the user to write entire, self-contained software applications with sufficient performance for general application.

Decrypting the stream periphyton physical habitat of recently deglaciated floodplains.

The rapid recession of glaciers is exposing large zones to the development of embryonic phototrophic ecosystems and eventual ecological succession. Traditionally, succession patterns in glacial forefields have been seen as a response to time since deglaciation, but nowadays forefield exposure is so rapid that this theory may be less applicable. In this succession process, periphyton are potential pioneer organisms because of their role in modifying the local environment (e.g. access to water) to create conditions conducive to plant colonization. In this paper, we aim to decrypt the physical properties of the habitats that define the spatial and temporal assemblage of periphyton during the melt-season of an Alpine temperate glacier in the context of rapid climate change. We show that periphyton develop in glacial floodplains throughout the melt-season and could extend to cover significant surfaces. However, development is only possible when the combined conditions of stability and water accessibility are met. In glacial floodplains, stable zones exist and are typically located on terraces; but they can also be locally found for much shorter periods in the more active, glacial-stream reworked zone. On terraces, water accessibility can be a limit due to well-drained sediments, but when present, often aided by the role that biofilms play in creating an impermeable layer, it provides a stable and clear water source that biofilms could exploit. In the active part of the braid plain, whilst water availability is very high, the water is harsh (low temperature, high turbidity) and erosive. Therein, periphyton can rapidly exploit short windows of opportunity but the habitat conditions rarely remain stable for long enough for continuous periphyton cover to develop. Thus, the role of periphyton in ecosystem succession is strongly conditioned by the spatial extent of the active zone, itself a function of high rates of glacier melt and sediment supply associated with rapid glacier retreat.

[Combined transepithelial PTK and topography-guided PRK for treatment of trauma-related corneal scarring]. / Kombinierte transepitheliale PTK und topografiegesteuerte PRK zur Behandlung von traumatisch bedingten Hornhautnarben.

BACKGROUND: Corneal scars can severely impair visual performance and treatment can be challenging. The study aimed to evaluate a promising minimally invasive option in the treatment of corneal scars using transepithelial topography-guided ablation. METHODS: This retrospective interventional study involved four eyes of four patients who developed corneal scarring and irregular surfaces due to trauma and were treated with topography-guided photorefractive keratectomy (TG-PRK) between 2017 and 2020. The ablation profile was calculated in all four cases using CRS-Master (Zeiss, Jena, Germany). The main outcome measures were uncorrected and best-corrected distance visual acuity, manifest refraction and corneal regularity by topographic images. The mean age was 34.75 ± 15.39 years and the follow-up time was 6 months for all patients. RESULTS: In three cases full subjective refraction was corrected in one session and one patient had a refractive error of +0.5 D. Only corneal surface smoothing without additional refractive correction was performed in this case. All four patients showed improvement in uncorrected (2-3 Snellen lines) and corrected (3 Snellen lines) distance visual acuity. No complications occurred during or after the treatment and there was no reduction of visual acuity in any case. CONCLUSION: The use of TG-PRK in patients with corneal scarring improves visual acuity in selected cases. In myopic patients most of the refractive error can also be corrected in a single session.

Minimally Invasive Lower Leg Fasciotomy for Chronic Exertional Compartment Syndrome-How Safe Is It? A Cadaveric Study.

BACKGROUND: Chronic exertional compartment syndrome (CECS) is a recognized clinical diagnosis in running athletes and military recruits. Minimally invasive fasciotomy techniques have become increasingly popular, but with varied results and small case numbers. Although decompression of the anterior and peroneal compartments has demonstrated a low rate of iatrogenic injury, little is known about the safety of decompressing the deep posterior compartment. PURPOSE: To evaluate the risk of iatrogenic injury when using minimally invasive techniques to decompress the anterior, peroneal, and deep posterior compartments of the lower leg. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 60 lower extremities from 30 adult cadavers were subject to fasciotomy of the anterior, peroneal, and deep posterior compartments using a minimally invasive technique. Two common variations in surgical technique were employed to decompress each compartment. Anatomical dissection was subsequently carried out to identify incomplete division of the fascia, muscle injury, neurovascular injury, and the anatomical relationship of key neurovascular structures to the incisions. RESULTS: Release of the anterior and peroneal compartments was successful in all but 2 specimens. There was no injury to the superficial peroneal nerve or any vessel in any specimen. A transverse incision crossing the anterior intermuscular septum resulted in muscle injury in 20% of the cases. Release of the deep posterior compartment was successful in all but 1 specimen when a longitudinal skin incision was used, without injury to neurovascular structures. Compared with a longitudinal incision, a transverse skin incision resulted in fewer complete releases of the deep posterior compartment and a significantly higher rate of injury to the saphenous nerve (16.7%; P = .052) and long saphenous vein (23.3%; P = .011). CONCLUSION: Minimally invasive fasciotomy of the anterior, peroneal, and deep posterior compartments using longitudinal incisions had a low rate of iatrogenic injury in a cadaveric model. Complete compartment release was achieved in 97% to 100% of specimens when employing this technique. CLINICAL RELEVANCE: Minimally invasive fasciotomy techniques for CECS have become increasingly popular with purported low recurrence rates, improved cosmesis, and faster return to sport. It is important to determine whether this technique is safe, particularly given the variable rates of neurovascular injury reported in the literature.

Relative Body Weight and Standardised Brightness-Mode Ultrasound Measurement of Subcutaneous Fat in Athletes: An International Multicentre Reliability Study, Under the Auspices of the IOC Medical Commission.

INTRODUCTION: Fat is a metabolic fuel, but excess body fat is ballast mass, and therefore, many elite athletes reduce body fat to dangerously low levels. Uncompressed subcutaneous adipose tissue (SAT) thickness measured by brightness-mode ultrasound (US) provides an estimate of body fat content. METHODS: The accuracy for determining tissue borders is about 0.1-0.2 mm and reliability (experienced measurers) was within ± 1.4 mm (95% limit of agreement, LOA). We present here inter- and intra-measurer scores of three experienced US measurers from each of the centres C1 and C2, and of three novice measurers from each of the centres C3-C5. Each of the five centres measured 16 competitive adult athletes of national or international level, except for one centre where the number was 12. The following sports were included: artistic gymnastics, judo, pentathlon, power lifting, rowing, kayak, soccer, tennis, rugby, basketball, field hockey, water polo, volleyball, American football, triathlon, swimming, cycling, long-distance running, mid-distance running, hurdles, cross-country skiing, snowboarding, and ice hockey. SAT contour was detected semi-automatically: typically, 100 thicknesses of SAT at a given site (i.e., in a given image), with and without fibrous structures, were measured. RESULTS: At SAT thickness sums DI (of eight standardised sites) between 6.0 and 70.0 mm, the LOA of experienced measurers was 1.2 mm, and the intra-class correlation coefficient ICC was 0.998; novice measurers: 3.1 mm and 0.988. Intra-measurer differences were similar. The median DI value of all 39 female participants was 51 mm (11% fibrous structures) compared to 17 mm (18%) in the 37 male participants. DISCUSSION: DI measurement accuracy and precision enables detection of fat mass changes of approximately 0.2 kg. Such reliability has not been reached with any other method. Although females' median body mass index and mass index were lower than those of males, females' median DI was three times higher, and their percentage of fibrous structures was lower. The standardised US method provides a highly accurate and reliable tool for measuring SAT and thus changes in body fat, but training of measurers is important.

The Effects of 3 Weeks of Uphill and Downhill Walking on Blood Lipids and Glucose Metabolism in Pre-Diabetic Men: A Pilot Study.

The prevention of type 2 diabetes in persons at risk for diabetes is of utmost importance. Physical activity in general and even exercises at moderate intensities such as walking significantly reduce the risk of the development of type 2 diabetes. However, it is still a matter of debate whether lipids and glucose metabolism are differently affected by regular concentric (e.g., uphill walking) and eccentric (e.g., downhill walking) endurance exercise. The aim of this study was to investigate the effects of short-term (3 weeks) uphill and downhill walking on glucose metabolism and blood lipids in pre-diabetic middle-aged men in a real world setting. The study was designed as an investigator-initiated 2 group random selection pre-test post-test trial. Sixteen pre-diabetic men (age: 56.9 ± 5.1 years; BMI: 28.1 ± 2.3 kg·m-2) performed 9 uphill (n = 8) or 9 downhill (n = 8) walking sessions within 3 weeks. The primary outcomes were the markers of glucose metabolism and blood lipids measured before and after the training period. After uphill walking glucose tolerance (area under the curve of the oral glucose tolerance test: -43.25 ± 53.12 mg·dl-1; p = 0.05; effect size: 0.81), triglycerides (-48.75 ± 54.49 mg·dl-1; p = 0.036; effect size: 0.89), HDL-C (+7.86 ± 9.54 mg·dl-1; p = 0.05; effect size: 0.82) and total cholesterol/HDL-C ratio (-0.58 ± 0.41; p = 0.012; effect size: 1.39) had significantly improved. No significant metabolic adaptations were found after downhill walking. However, when adjusted for estimated energy expenditure, uphill and downhill walking had equal effects on almost all metabolic parameters. Moreover, the magnitude of the baseline impairments of glucose tolerance was significantly related to the extent of change in both groups. Depending on the fitness level and individual preferences both types of exercise may be useful for the prevention of type 2 diabetes and disorders in lipid metabolism.

Climbing-specific finger flexor performance and forearm muscle oxygenation in elite male and female sport climbers.

Climbing performance relies to a great extent on the performance of the finger flexor muscles. Only a few studies investigated this performance in top class climbers and only one study compared gender-specific differences. This study investigated the climbing-specific finger flexor strength and endurance and related muscular oxygenation in 12 elite female and male climbers and 12 non-climbers. After the assessment of maximum voluntary finger flexor contraction (MVC), two isometric finger flexor endurance tests were performed at 40% MVC until exhaustion. A continuous isometric test was followed by an intermittent isometric test (10 s contraction, 3 s rest). Changes in oxygenation of finger flexor muscles were recorded using near infrared spectroscopy. MVC and strength-to-weight ratio were greater in climbers than non-climbers (P = 0.003; P < 0.001) and greater in men than women (P < 0.001; P = 0.002). Time to task failure for the intermittent test and the force-time integrals for the continuous and the intermittent test were also significantly greater in climbers (P = 0.030; P = 0.027; P = 0.005). During the intermittent test, re-oxygenation of the working muscles was faster in climbers (P < 0.05) without gender-specific differences. Close correlations were demonstrated between the best on-sight climbing performance and strength-to-weight ratio (r (2) = 0.946, P < 0.001) only in female climbers. The superior intermittent finger flexor endurance of climbers over non-climbers may be explained by the faster re-oxygenation of the finger flexor muscles during the short rest phases.