Patients with Chronic Spinal Cord Injury and a Long Period of Evolution Exhibit an Altered Cytokine Production by CD4 and CD8 T Cell Populations.

Spinal cord injury (SCI) is a disabling neurological condition coursing with serious multisystem affections and morbidities. Changes in immune cell compartments have been consistently reported in previous works, representing a critical point of study for understanding the pathophysiology and progression of SCI from acute to chronic stages. Some relevant variations in circulating T cells have been noticed in patients with chronic SCI, although the number, distribution, and function of these populations remain to be fully elucidated. Likewise, the characterization of specific T cell subpopulations and their related cytokine production can aid in understanding the immunopathological role of T cells in SCI progression. In this sense, the objective of the present study was to analyze and quantify the total number of different cytokine-producers T cells in the serum of patients with chronic SCI (n = 105) in comparison to healthy controls (n = 38) by polychromatic flow cytometry. Having this goal, we studied CD4 and CD8 lymphocytes as well as naïve, effector, and effector/central memory subpopulations. SCI patients were classified according to the duration of the lesion in chronic SCI with a short period of evolution (SCI-SP) (comprised between 1 and 5 years since initial injury), early chronic phase (SCI-ECP) (between 5 and 15 years since initial injury) and late-chronic phase (SCI-LCP) (>15 years since initial injury). Our results show that patients with chronic SCI exhibited an altered immune profile of cytokine-producer T cells, including CD4/CD8 naïve, effector, and memory subpopulations in comparison to HC. In particular, IL-10 and IL-9 production seems to be importantly altered, especially in patients with SCI-LCP, whereas changes in IL-17, TNF-α, and IFN-γ T cell populations have also been reported in this and other chronic SCI groups. In conclusion, our study demonstrates an altered profile of cytokine-producer T cells in patients with chronic SCI, with marked changes throughout the course of the disease. In more detail, we have observed significant variations in cytokine production by circulating naive, effector, and effector/central memory CD4 and CD8 T cells. Future studies should be directed to explore the possible clinical consequences of these changes or develop additional translational approaches in these groups of patients.

Methrotexate Treatment Inmunomodulates Abnormal Cytokine Expression by T CD4 Lymphocytes Present in DMARD-Naïve Rheumatoid Arthritis Patients.

CD4+T-lymphocytes are relevant in the pathogenesis of rheumatoid arthritis (RA), however, their potential involvement in early RA remains elusive. Methotrexate (MTX) is a commonly used disease-modifying antirheumatic drug (DMARD), but its mechanism has not been fully established. In 47 new-onset DMARD-naïve RA patients, we investigated the pattern of IFNγ, IL-4 and IL-17A expression by naïve (TN), central (TCM), effector memory (TEM) and effector (TE) CD4+ subsets; their STAT-1, STAT-6 and STAT-3 transcription factors phosphorylation, and the circulating levels of IFNγ, IL-4 and IL-17. We also studied the RA patients after 3 and 6 months of MTX treatment and according their clinical response. CD4+T-lymphocyte subsets and cytokine expression were measured using flow cytometry. New-onset DMARD-naïve RA patients showed a significant expansion of IL-17A+, IFNγ+ and IL-17A+IFNγ+ CD4+T-lymphocyte subsets and increased intracellular STAT-1 and STAT-3 phosphorylation. Under basal conditions, nonresponder patients showed increased numbers of circulating IL-17A producing TN and TMC CD4+T-lymphocytes and IFNγ producing TN, TCM, TEM CD4+T-lymphocytes with respect to responders. After 6 months, the numbers of CD4+IL-17A+TN remained significantly increased in nonresponders. In conclusion, CD4+T-lymphocytes in new-onset DMARD-naïve RA patients show IL-17A and IFNγ abnormalities in TN, indicating their relevant role in early disease pathogenesis. Different patterns of CD4+ modulation are identified in MTX responders and nonresponders.

Efficiency and measurements agreement between swept-source OCT and low-coherence interferometry biometry systems.

PURPOSE: To compare and evaluate the agreement between the measurements obtained with a swept-source optical coherence tomography (OCT)-based biometer, the IOLMaster® 700 (IOLM), and those obtained by an optical biometer based on optical low-coherence interferometry (OLCI), the Aladdin (ALD); To evaluate the ability to perform biometric measurements in those eyes with transparency alterations. METHODS: Fifty-five eyes of 55 subjects were included in this study. Axial length (AL), corneal power (K, in diopters) and its astigmatism, anterior chamber depth (ACD), central corneal thickness (CCT), and lens thickness (LT) measures were obtained within both biometers, Zeiss IOLMaster 700 and Topcon Aladdin. Results were analyzed and compared using the Student's paired samples t-test, Bland-Altman analysis and intraclass correlation coefficient (ICC). RESULTS: Mean age was 73.12 ± 2.63 (62-89 years). The IOLM mean AL, K, and LT values did not show a statistically significant difference from ALD values and showed excellent agreement and correlation (ICC = 1.000, 0.970, 0.952). IOLM measured a lower mean ACD (-0.036 mm) and higher CCT measurements (9.296 µm). Those results were statistically different (p < 0.001 in both cases) but showed an excellent correlation coefficients (ICC = 0.994, 0.938). IOLM was able to obtain measures from all the eyes examined, while ALD did not measure in two cases with dense nuclear cataract. ALD showed spherical K measures in 7.27% of cases. CONCLUSION: Overall a quite good agreement between IOLM and ALD was found. ALD showed spherical keratometry measures in 7.27% of cases. IOLMaster 700 was more effective in obtaining AL measurements in eyes with dense cataracts.

Abnormal chemokine receptor profile on circulating T lymphocytes from nonallergic asthma patients.

BACKGROUND: T lymphocytes are involved in the pathogenesis of nonallergic asthma. The objective of this study was to characterize the subset distribution and pattern of chemokine receptor expression in circulating T lymphocyte subsets from nonallergic asthma patients. METHODS: Forty stable nonallergic asthma patients and 16 sex- and age-matched healthy donors were studied. Twelve patients did not receive inhaled steroids (untreated patients), 16 received 50-500 µg b.i.d. of inhaled fluticasone propionate (FP) (standard-dose patients), and 12 received over 500 µg b.i.d. of inhaled FP (high-dose patients) for at least 12 months prior to the beginning of this study and were clinically well controlled. Flow cytometry was performed using a panel of monoclonal antibodies (4 colors). RESULTS: Nonallergic asthma patients treated with high doses of inhaled FP showed a significant reduction in the percentages of CD3+ T lymphocytes compared to healthy controls. Untreated patients showed a significant increase in CCR6 expression in CD8+CD25+ and CD8+CD25+bright T cells compared to healthy controls. The results were similar for CXCR3 and CCR5 expression. In patients treated with standard doses of FP, CCR5 expression was significantly increased in CD3+ T lymphocytes relative to healthy controls. CONCLUSIONS: The different groups of clinically stable nonallergic asthmatic patients showed distinct patterns of alterations in subset distribution as well as CCR6, CXCR3, and CCR5 expression on circulating T lymphocytes. .

A serverless computing architecture for Martian aurora detection with the Emirates Mars Mission.

Remote sensing technologies are experiencing a surge in adoption for monitoring Earth's environment, demanding more efficient and scalable methods for image analysis. This paper presents a new approach for the Emirates Mars Mission (Hope probe); A serverless computing architecture designed to analyze images of Martian auroras, a key aspect in understanding the Martian atmosphere. Harnessing the power of OpenCV and machine learning algorithms, our architecture offers image classification, object detection, and segmentation in a swift and cost-effective manner. Leveraging the scalability and elasticity of cloud computing, this innovative system is capable of managing high volumes of image data, adapting to fluctuating workloads. This technology, applied to the study of Martian auroras within the HOPE Mission, not only solves a complex problem but also paves the way for future applications in the broad field of remote sensing.

Pulsed electric field processing as an alternative to sulfites (SO2) for controlling saccharomyces cerevisiae involved in the fermentation of Chardonnay white wine.

The use of sulfites (SO2) for microbial control in the winemaking process is currently being questioned due to its potential toxicity. Pulsed Electric Fields (PEF) are capable of inactivating microorganisms at low temperatures, thus avoiding the negative effects of heat on food properties. In this study, the capacity of PEF technology for the decontamination of yeasts involved in the fermentation process of Chardonnay wine from a winery was evaluated. PEF treatments at 15 kV/cm of low (65 µs, 35 kJ/kg) and higher intensity (177 µs 97 kJ/kg) were selected for evaluating the microbial stability, physicochemical and volatile composition of wine. Even with the least intense PEF-treatment, Chardonnay wine remained yeast-free during 4 months of storage without sulfites. PEF-treatments did not affect the wine's oenological parameters or its aroma during storage. This study, therefore, reveals the potential of PEF technology as an alternative to sulfites for the microbiological stabilization of wine.

Microbial Decontamination of Red Wine by Pulsed Electric Fields (PEF) after Alcoholic and Malolactic Fermentation: Effect on Saccharomyces cerevisiae, Oenococcus oeni, and Oenological Parameters during Storage.

New techniques are required to replace the use of sulfur dioxide (SO2) or of sterilizing filtration in wineries, due to those methods' drawbacks. Pulsed electric fields (PEF) is a technology capable of inactivating microorganisms at low temperatures in a continuous flow with no detrimental effect on food properties. In the present study, PEF technology was evaluated for purposes of microbial decontamination of red wines after alcoholic and malolactic fermentation, respectively. PEF combined with SO2 was evaluated in terms of microbial stability and physicochemical parameters over a period of four months. Furthermore, the effect of PEF on the sensory properties of red wine was compared with the sterilizing filtration method. Results showed that up to 4.0 Log10 cycles of S. cerevisiae and O. oeni could be eradicated by PEF and sublethal damages and a synergetic effect with SO2 were also observed, respectively. After 4 months, wine treated by PEF after alcoholic fermentation was free of viable yeasts; and less than 100 CFU/mL of O. oeni cells were viable in PEF-treated wine added with 20 ppm of SO2 after malolactic fermentation. No detrimental qualities were found, neither in terms of oenological parameters, nor in the sensory parameters of wines subjected to PEF after storage time.

Sequential extraction of compounds of interest from yeast biomass assisted by pulsed electric fields.

One strategy to reduce cost and improve feasibility of waste-yeast biomass valorization is to obtain a spectrum of marketable products rather than just a single one. This study explores the potential of Pulsed Electric Fields (PEF) for the development of a cascade process designed to obtain several valuable products from Saccharomyces cerevisiae yeast biomass. Yeast biomass was treated by PEF, which affected the viability of 50%, 90%, and over 99% of S. cerevisiae cells, depending on treatment intensity. Electroporation caused by PEF allowed access to the cytoplasm of the yeast cell without causing total breakdown of the cell structure. This outcome was an essential prerequisite to be able to perform a sequential extraction of several value-added biomolecules from yeast cells located in the cytosol and in the cell wall. After incubating yeast biomass previously subjected to a PEF treatment that affected the viability of 90% of cells for 24 h, an extract with 114.91 ± 2.86, 7.08 ± 0.64, and 187.82 ± 3.75 mg/g dry weight of amino acids, glutathione, and protein, respectively, was obtained. In a second step, the extract rich in cytosol components was removed after 24 h of incubation and the remaining cell biomass was re-suspended with the aim of inducing cell wall autolysis processes triggered by the PEF treatment. After 11 days of incubation, a soluble extract containing mannoproteins and pellets rich in ß-glucans were obtained. In conclusion, this study proved that electroporation triggered by PEF permitted the development of a cascade procedure designed to obtain a spectrum of valuable biomolecules from S. cerevisiae yeast biomass while reducing the generation of waste.

Chaotic renormalization group flow and entropy gradients over Haros graphs.

Haros graphs have been recently introduced as a set of graphs bijectively related to real numbers in the unit interval. Here we consider the iterated dynamics of a graph operator R over the set of Haros graphs. This operator was previously defined in the realm of graph-theoretical characterization of low-dimensional nonlinear dynamics and has a renormalization group (RG) structure. We find that the dynamics of R over Haros graphs is complex and includes unstable periodic orbits of arbitrary period and nonmixing aperiodic orbits, overall portraiting a chaotic RG flow. We identify a single RG stable fixed point whose basin of attraction is associated with the set of rational numbers, and find periodic RG orbits that relate to (pure) quadratic irrationals and aperiodic RG orbits, related with (nonmixing) families of nonquadratic algebraic irrationals and transcendental numbers. Finally, we show that the graph entropy of Haros graphs is globally decreasing as the RG flows towards its stable fixed point, albeit in a strictly nonmonotonic way, and that such graph entropy remains constant inside the periodic RG orbit associated to a subset of irrationals, the so-called metallic ratios. We discuss the possible physical interpretation of such chaotic RG flow and put results regarding entropy gradients along RG flow in the context of c-theorems.

Abnormal Characterization and Distribution of Circulating Regulatory T Cells in Patients with Chronic Spinal Cord Injury According to the Period of Evolution.

Spinal cord injury (SCI) is a progressive and complex neurological disorder accompanied by multiple systemic challenges. Peripheral immune dysfunction is a major event occurring after SCI, especially in its chronic phase. Previous works have demonstrated significant changes in different circulating immune compartments, including in T cells. However, the precise characterization of these cells remains to be fully unraveled, particularly when considering important variants such as the time since the initial injury. In the present work, we aimed to study the level of circulating regulatory T cells (Tregs) in SCI patients depending on the duration of evolution. For this purpose, we studied and characterized peripheral Tregs from 105 patients with chronic SCI using flow cytometry, with patients classified into three major groups depending on the time since initial injury: short period chronic (SCI-SP, <5 years since initial injury); early chronic (SCI-ECP, from 5-15 years post-injury) and late chronic SCI (SCI-LCP, more than 15 years post-injury. Our results show that both the SCI-ECP and SCI-LCP groups appeared to present increased proportions of CD4+ CD25+/low Foxp3+ Tregs in comparison to healthy subjects, whereas a decreased number of these cells expressing CCR5 was observed in SCI-SP, SCI-ECP, and SCI-LCP patients. Furthermore, an increased number of CD4+ CD25+/high/low Foxp3 with negative expression of CD45RA and CCR7 was observed in SCI-LCP patients when compared to the SCI-ECP group. Taken together, these results deepen our understanding of the immune dysfunction reported in chronic SCI patients and how the time since initial injury may drive this dysregulation.

Prognostic Value of Malondialdehyde (MDA) in the Temporal Progression of Chronic Spinal Cord Injury.

BACKGROUND: Oxidative stress is a major signature of spinal cord injury (SCI). The altered levels of various oxidative stress markers have been demonstrated in acute and chronic SCI. However, the variation of these markers in patients with chronic SCI depending on the time since the initial injury has not been explored yet. OBJECTIVE: Our aim was to measure plasma levels of malondialdehyde (MDA), a marker of lipid peroxidation in patients with SCI stratified in different periods of suffering the injury (0-5 years, 5-10 years, and more than 10 years). PATIENTS AND METHODS: This cross-sectional study enrolled patients with SCI (N = 105) from different periods of the lesion and healthy control (HC) subjects (N = 38): short period (SCI SP, N = 31, time of evolution less than 5 years); early chronic (SCI ECP, N = 32, time of evolution 5-15 years); and late chronic (SCI LCP, N = 42, time of evolution more than 15 years). The plasma levels of MDA were measured using a commercially available colorimetric assay. RESULTS: Patients with SCI had significantly higher plasma levels of MDA than HC subjects. Receiver operating characteristic (ROC) curve analysis for plasma MDA levels in patients with SCI demonstrated areas under the curve (AUC) of 1 (HC vs. SCI-SP); 0.998 (HC vs. SCI-ECP); and 0.964 (HC vs. SCI-LCP). Additionally, three ROC curves were used to compare the different concentrations of MDA between the subgroups of patients with SCI, and the resulting AUCs were: 0.896 (SCI-SP vs. SCI-ECP); 0.840 (SCI-ECP vs. SCI-LCP); and 0.979 (SCI-SP vs. SCI-LCP). CONCLUSION: Plasma concentration of MDA can be considered as an oxidative stress biomarker to assess the prognosis of SCI in chronic stages.

Two-Step PEF Processing for Enhancing the Polyphenol Concentration and Decontaminating a Red Grape Juice.

This study's aim is to evaluate Pulsed Electric Fields (PEF) technology as an alternative method for the processing of red grape juice. For this purpose, two PEF treatments were applied: first to grapes for polyphenol enrichment of the juice, and subsequently for microbial decontamination of the obtained juice. Juice obtained from PEF-treated grapes (5 kV/cm, 63.4 kJ/kg) had the polyphenol content 1.5-fold higher and colour intensity two times higher of control juices by spectrophotometric measurement (p ≤ 0.05). A subsequent decontamination treatment by PEF (17.5 kV/cm and 173.6 kJ/kg) achieved inactivation of the present microbiota (yeasts, moulds, and vegetative mesophilic bacteria) below detection level (<30 CFU/mL). Furthermore, PEF-treated juices were microbiologically stable up to 45 days, even at abusive refrigeration storage temperatures (10 °C). PEF juice quality and sensory characteristics were similar to a fresh juice; they were neither affected by the PEF decontamination treatment, nor by storage time and temperature. Results obtained in this study demonstrate the considerable potential of PEF for the production of a polyphenol-enriched and microbially stabilized red grape juice as a unique and sustainable alternative for the juice industry, while avoiding enzymatic and heat treatments.

Agreement between the biometric measurements used to calculate the size of the implantable collamer lenses measured with four different technologies.

Purpose: To evaluate the agreement between the biometric measurements used to calculate the size of the implantable collamer lenses (ICL) with different technologies: swept-source optical coherence tomography, spectral domain optical coherence tomography, and Scheimpflug tomography. Methods: This retrospective observational study included subjects undergoing refractive surgery with posterior chamber phakic IOL implantation to correct their myopia. The anterior chamber depth (ACD) and the horizontal white to white (WTW) or the angle to angle (ATA) distance were measured with the following four devices: the IOLMaster 700 biometer (Carl Zeiss Meditec, Jena, Germany), based on swept-source optical coherence tomography; the Cirrus and Visante optical coherence tomographs (Carl Zeiss Meditec) based on low-coherence interferometry; and the Pentacam rotating Scheimpflug camera (Oculus, Wetzlar, Germany). Results: In the horizontal corneal diameter measurements, there were statistically significant differences between Pentacam-IOLMaster 700 pair (P < 0.001) and Pentacam-Visante pair (P < 0.001). WTW from CIRRUS showed the lowest correlation when paired with Pentacam and IOLMaster 700 (R2 = 0.452 and 0.385 for Visante and R2 = 0.494 and 0.426 for Cirrus). Regarding the linear correlation of the ACD measurements, all pairs of devices were statistically significant and all of them showed a very good correlation index. Conclusion: There is a good agreement between the different devices under evaluation for ACD measurements. As for WTW, the values measured with the different devices showed large discrepancies with low correlation levels, especially when comparing the tomographs with the other devices under evaluation.

Co-Management Reduces Mortality in Post-Sternotomy Mediastinitis.

Background: Post-sternotomy mediastinitis (PSM) is one of the most feared complications of cardiac surgery. The impact of a multidisciplinary management approach on this pathology is yet unknown. Patients and Methods: A multidisciplinary approach based on a co-management model (CMM) of care was initiated in January 2018 because of the incorporation of a hospitalist unit on a cardiac surgery department. An observational retrospective cohort study was designed to evaluate the impact of the CMM of care compared to the standard model (SM) of care in patients diagnosed with PSM. Our primary and secondary outcomes were survival time and treatment failure rate (two or more surgical procedures needed to solve PSM or PSM-related death), respectively. Data related to patient death date were collected from the Spanish National Death Index. A multivariable Cox regression model was created using those variables believed to be clinically relevant. Results: Ninety-one patients developed PSM from January 2010 to June 2020. Regarding the pre-operative clinical status, surgical procedure, and PSM severity, both groups had similar baseline characteristics. Patients were followed for a mean of 27.54 ± 30.5 months. A total of 60.3% of the SM group and 11.1% of the CMM group (p < 0.001) died. Treatment failure occurred in 53 patients (72.6%) in the SM group versus 7 (38.6%) in the CMM group (p = 0.007). The CMM independently reduced overall mortality (hazard ratio [HR], 0.11; 95% confidence interval [CI]. 0.01-0.83) and treatment failure rate (HR, 0.01; 95% CI, 0.001-0.183). Gram-positive bacterial infection (HR, 3.73; 95% CI, .6-8.3), and complete osteosynthesis material removal (HR, 0.47; 95% CI, 0.24-0.91) also influenced mortality in our model. Conclusions: A co-management care model reduced overall mortality in patients diagnosed with post-sternotomy mediastinitis.

Risk predictors in a Spanish cohort with cardiac laminopathies. The REDLAMINA registry.

INTRODUCTION AND OBJECTIVES: According to sudden cardiac death guidelines, an implantable cardioverter-defibrillator (ICD) should be considered in patients with LMNA-related dilated cardiomyopathy (DCM) and ≥ 2 risk factors: male sex, left ventricular ejection fraction (LVEF) <45%, nonsustained ventricular tachycardia (NSVT), and nonmissense genetic variants. In this study we aimed to describe the clinical characteristics of carriers of LMNA genetic variants among individuals from a Spanish cardiac-laminopathies cohort (REDLAMINA registry) and to assess previously reported risk criteria. METHODS: The relationship between risk factors and cardiovascular events was evaluated in a cohort of 140 carriers (age ≥ 16 years) of pathogenic LMNA variants (54 probands, 86 relatives). We considered: a) major arrhythmic events (MAE) if there was appropriate ICD discharge or sudden cardiac death; b) heart failure death if there was heart transplant or death due to heart failure. RESULTS: We identified 11 novel and 21 previously reported LMNA-related DCM variants. LVEF <45% (P=.001) and NSVT (P <.001) were related to MAE, but not sex or type of genetic variant. The only factor independently related to heart failure death was LVEF <45% (P <.001). CONCLUSIONS: In the REDLAMINA registry cohort, the only predictors independently associated with MAE were NSVT and LVEF <45%. Therefore, female carriers of missense variants with either NSVT or LVEF <45% should not be considered a low-risk group. It is important to individualize risk stratification in carriers of LMNA missense variants, because not all have the same prognosis.

Blue light emission spectra of popular mobile devices: The extent of user protection against melatonin suppression by built-in screen technology and light filtering software systems.

Blue light, with wavelengths shorter than 440-450 nm, is the most energetic radiation of the visible spectrum for the human eye, and its possible multiple effects on the human nervous and other systems have become a line of research by many investigators. The use of mobile devices whose screens emit various amounts of blue light is common nowadays. This study evaluated the efficiency of the blue light screen and control software technologies of eight different mobile devices. Emitted screen spectra of the different mobile devices according to different conditions of blue light emission software control were obtained using a spectrograph, and the derived spectra were compared with the melatonin suppression action spectrum. The amount of blue light emission and predicted melatonin suppression varied according to the unique software control and screen technology of each device. AMOLED screen technology, compared with other screen technologies, achieved better control of blue light emission. The effect of blue light filters depends on the screen technology; however, the melatonin suppression index of mobile devices is not reduced sufficiently by the use of blue light-attenuating software.

Characterization of optical performance with defocusing curve: Analysis of two refractive intraocular lens models with high and medium addition.

PURPOSE: To characterize the optical performance of two models of refractive bifocal intraocular lenses, with medium and high addition, using defocus curves. METHODS: 20 eyes from 20 subjects were included in this study. 10 eyes underwent caratact surgery with an implant of a medium addition refractive bifocal intraocular lens (IOL) (Lentis LS-313 MF20) and the other 10 eyes underwent cataract surgery with an implant of a high addition refractive bifocal IOL (Lentis LS-313 MF30). Six weeks after surgery, subjective refraction and defocus curve were made. RESULTS: Mean final residual refraction in spherical equivalent was +0.10±0.07D in the LS-313MF30 group and +0.12±0.10D in the LS-313MF20 group. Defocus curve showed a different optical performance in intermediate/near distance depending on the IOL model. The medium addition IOL provided good visual acuity (VA) at far and intermediate distance up to 50cms, and the high addition IOL provided better VA in near distance up to 25cms. CONCLUSIONS: The high addition intraocular lens provides better visual acuity in the spatial range from infinity to the point close to 25cm. The medium addition intraocular lens provides excellent visual acuity in far and intermediate vision. The defocus curve seems to be a valid and reproducible tool for evaluating the optical behavior of multifocal sector refractive lenses.

Clinical application of bicylindric intraocular lens power calculation method.

Purpose: To analyze the reliability of the refractive results prediction obtained in intraocular lens (IOL) calculation using bicylindric power calculation method, with the use of steep and flat keratometry readings compared with the classical mean keratometry calculation method. Methods: Fifty-seven eyes of 57 subjects who underwent cataract surgery were included in this prospective study. Optical biometry was performed with IOLMaster 700 and IOL power calculation was performed using both keratometry readings and the surgically induced astigmatism. Four weeks after surgery, subjective refraction was done. Finally, results obtained with both IOL calculation methods were compared. Results: Mean spherical equivalent using bicylindric IOL power calculation method was -0.082 ± 0.296D, and achieved mean spherical equivalent using classical IOL power method with Haigis formula was -0.088 ± 0.405D. Achieved mean spherical equivalent obtained in subjective refraction after surgery was -0.101 ± 0.265D. Linear correlation between bicylindric method spherical equivalent calculation and achieved spherical equivalent was statistically significant (r = 0.761, P < 0.001), also correlation between Haigis spherical equivalent calculation and achieved spherical equivalent was statistically significant (r = 0.339, P = 0.010). Emmetropia was achieved in 49 of 57 (85.86%) subjects and bicylindric method calculated that 49 of 57 (85.86%) of subjects would get emmetropia (P = 1.000). Classical IOL power calculation estimated that 38/57 subjects would get emmetropia (66.67%) (P = 0.026). Conclusion: The IOL power calculation including both keratometry readings and surgically induced astigmatism seems to be more accurate and provides more precision in refractive prediction than classical calculation method.

"Can patients learn how to reduce their shoulder dislocation?" A one-year follow-up of the randomized clinical trial between the Boss-Holzach-Matter self-assisted technique and the Spaso method.

OBJECTIVE: The aim of this study was to assess the effectiveness and reproducibility of self-assisted Boss-Holzach-Matter (BHM) technique compared with the Spaso (Sp) method for shoulder dislocation. METHODS: We conducted a follow-up at 1 year from the randomization of 60 patients with shoulder dislocation enrolled in the study "Teaching patients to reduce a shoulder dislocation." Half of these patients had been taught the self-assisted technique, whereas the other half had been treated by a physician's manipulative maneuver for reduction. We surveyed all the enrolled patients to describe recurrence rates and reproducibility for both the techniques without supervision as well as the number of emergency visits. RESULTS: In total, 52 patients (age range: 18-44 years) answered the survey from the 60 patients enrolled in the study. The total rate of recurrence was 38.5% (20 patients). For the Sp group, 4 of the 30 patients were lost. There were 9 recurrent patients (30%), and 7 were treated in the emergency department (ED). For the BHM group, 4 of the 30 patients were lost. There were 11 recurrent patients (37%), and 2 were treated in the ED. The difference in self-reduction rates and ED visits for both the groups was statistically significant (p=0.025). CONCLUSION: Teaching the BHM technique to the patients is effective and reproducible without direct supervision. It can decrease the number of visits to the ED and is a valid option to teach the patients at risk of recurrence when not being able to get immediate help. LEVEL OF EVIDENCE: Level I, Therapeutic study.