Single or double? A comparison of evisceration techniques.

PURPOSE: We compared the rates of implant exposure and extrusion after evisceration with single and double scleral closure techniques. METHODS: This retrospective cohort study included all patients who underwent evisceration with an implant insertion over the past 18 years at Tung Wah Eastern Hospital and Pamela Youde Nethersole Eastern Hospital. Clinical documents and operation records were reviewed. RESULTS: A total of 81 ethnic Chinese patients (44 male) who underwent evisceration with primary implant insertion were reviewed. 39 (48%) patients underwent the double scleral closure technique with an implant placed posterior to the posterior sclera, and 42 (52%) patients underwent the single scleral closure technique with an implant inserted in the intra-scleral cavity. The follow-up interval was 70 months. The surgical indications were endophthalmitis (35%), painful blind eye (23%), traumatic disfigured globe (22%) and phthisis bulbi (20%). Silicone was the most used implant material (69%). The patients who underwent double scleral closure had a larger size of the implant (19.7 vs 17.9 mm, p < 0.05). Both implant exposure (26% vs 3%, p < 0.05) and implant extrusion (26% vs 0%, p < 0.05) were more common in patients who underwent single scleral. CONCLUSIONS: Double scleral closure technique allows a larger implant, and it is associated with a lower rate of implant exposure and extrusion. The double scleral closure technique is a superior technique of choice in these patients with primary implant placement.

Tracking the response of industrial fishing fleets to large marine protected areas in the Pacific Ocean.

Large marine protected areas (MPAs) of unprecedented size have recently been established across the global oceans, yet their ability to meet conservation objectives is debated. Key areas of debate include uncertainty over nations' abilities to enforce fishing bans across vast, remote regions and the intensity of human impacts before and after MPA implementation. We used a recently developed vessel tracking data set (produced using Automatic Identification System detections) to quantify the response of industrial fishing fleets to 5 of the largest MPAs established in the Pacific Ocean since 2013. After their implementation, all 5 MPAs successfully kept industrial fishing effort exceptionally low. Detected fishing effort was already low in 4 of the 5 large MPAs prior to MPA implementation, particularly relative to nearby regions that did not receive formal protection. Our results suggest that these large MPAs may present major conservation opportunities in relatively intact ecosystems with low immediate impact to industrial fisheries, but the large MPAs we considered often did not significantly reduce fishing effort because baseline fishing was typically low. It is yet to be determined how large MPAs may shape global ocean conservation in the future if the footprint of human influence continues to expand. Continued improvement in understanding of how large MPAs interact with industrial fisheries is a crucial step toward defining their role in global ocean management.

Seguimiento a la Respuesta de las Flotillas de Pesca Industrial a las Grandes Áreas Marinas Protegidas Extensas Resumen Recientemente se han establecido grandes áreas marinas protegidas (AMPs) de tamaños nunca vistos en todos los océanos del mundo; sin embargo, se sigue debatiendo su habilidad para lograr los objetivos de conservación. El debate se centra en los siguientes temas importantes: la incertidumbre por la capacidad de las naciones para hacer cumplir las vedas de pesca en regiones vastas y remotas y la intensidad del impacto humano antes y después de la implementación de una AMP. Usamos un conjunto de datos de rastreo de navíos recientemente desarrollado (producido usando detecciones mediante el Sistema Automático de Identificación) para cuantificar la respuesta de las flotillas de pesca industrial ante cinco de las AMPs más grandes establecidas en el océano Pacífico desde 2013. Después de su implementación, las cinco AMPs mantuvieron exitosamente los esfuerzos de pesca industrial a niveles excepcionalmente bajos. El esfuerzo de pesca detectado ya se encontraba bajo en cuatro de las cinco grandes AMPs previo a la implementación, particularmente en relación con las regiones próximas que no reciben protección formal. Nuestros resultados sugieren que estas grandes AMPs pueden presentar oportunidades importantes de conservación en ecosistemas relativamente intactos con un impacto inmediato bajo para las pesquerías industriales, pero las grandes AMPs que consideramos con frecuencia no redujeron significativamente el esfuerzo de pesca porque la línea base de la pesca con frecuencia ya era baja. Todavía se debe determinar cómo las grandes AMPs pueden moldear la conservación mundial de los océanos en el futuro si la huella de la influencia humana continúa expandiéndose. La mejoría continua del entendimiento de cómo las grandes AMPs interactúan con las pesquerías industriales es un paso importante hacia la definición de su papel en el manejo mundial de los océanos.

ß-Adrenergic-stimulated macrophages: Comprehensive localization in the M1-M2 spectrum.

ß-Adrenergic signaling can regulate macrophage involvement in several diseases and often produces anti-inflammatory properties in macrophages, which are similar to M2 properties in a dichotomous M1 vs. M2 macrophage taxonomy. However, it is not clear that ß-adrenergic-stimulated macrophages may be classified strictly as M2. In this in vitro study, we utilized recently published criteria and transcriptome-wide bioinformatics methods to map the relative polarity of murine ß-adrenergic-stimulated macrophages within a wider M1-M2 spectrum. Results show that ß-adrenergic-stimulated macrophages did not fit entirely into any one pre-defined category of the M1-M2 spectrum but did express genes that are representative of some M2 side categories. Moreover, transcript origin analysis of genome-wide transcriptional profiles located ß-adrenergic-stimulated macrophages firmly on the M2 side of the M1-M2 spectrum and found active suppression of M1 side gene transcripts. The signal transduction pathways involved were mapped through blocking experiments and bioinformatics analysis of transcription factor binding motifs. M2-promoting effects were mediated specifically through ß2-adrenergic receptors and were associated with CREB, C/EBPß, and ATF transcription factor pathways but not with established M1-M2 STAT pathways. Thus, ß-adrenergic-signaling induces a macrophage transcriptome that locates on the M2 side of the M1-M2 spectrum but likely accomplishes this effect through a signaling pathway that is atypical for M2-spectrum macrophages.

pHLuc, a Ratiometric Luminescent Reporter for in vivo Monitoring of Tumor Acidosis.

Even under normoxia, cancer cells exhibit increased glucose uptake and glycolysis, an occurrence known as the Warburg effect. This altered metabolism results in increased lactic acid production, leading to extracellular acidosis and contributing to metastasis and chemoresistance. Current pH imaging methods are invasive, costly, or require long acquisition times, and may not be suitable for high-throughput pre-clinical small animal studies. Here, we present a ratiometric pH-sensitive bioluminescence reporter called pHLuc for in vivo monitoring of tumor acidosis. pHLuc consists of a pH-sensitive GFP (superecliptic pHluorin or SEP), a pH-stable OFP (Antares), and Nanoluc luciferase. The resulting reporter produces a pH-responsive green 510nm emission (from SEP) and a pH-insensitive red-orange 580nm emission (from Antares). The ratiometric readout (R580 / 510) is indicative of changes in extracellular pH (pHe). In vivo proof-of-concept experiments with NSG mice model bearing human synovial sarcoma SW982 xenografts that stably express the pHLuc reporter suggest that the level of acidosis varies across the tumor. Altogether, we demonstrate the diagnostic value of pHLuc as a bioluminescent reporter for pH variations across the tumor microenvironment. The pHLuc reporter plasmids constructed in this work are available from Addgene.

Primary Blast Exposure Increases Hippocampal Vulnerability to Subsequent Exposure: Reducing Long-Term Potentiation.

Up to 80% of injuries sustained by U.S. soldiers in Operation Enduring Freedom and Operation Iraqi Freedom were the result of blast exposure from improvised explosive devices. Some soldiers experience multiple blasts while on duty, and it has been suggested that symptoms of repetitive blast are similar to those that follow multiple non-blast concussions, such as sport-related concussion. Despite the interest in the effects of repetitive blast exposure, it remains unknown whether an initial blast renders the brain more vulnerable to subsequent exposure, resulting in a synergistic injury response. To investigate the effect of multiple primary blasts on the brain, organotypic hippocampal slice cultures were exposed to single or repetitive (two or three total) primary blasts of varying intensities. Long-term potentiation was significantly reduced following two Level 2 (92.7 kPa, 1.4 msec, 38.5 kPa·msec) blasts delivered 24 h apart without altering basal evoked response. This deficit persisted when the interval between injuries was increased to 72 h but not when the interval was extended to 144 h. The repeated blast exposure with a 24 h interval increased microglia staining and activation significantly but did not significantly increase cell death or damage axons, dendrites, or principal cell layers. Lack of overt structural damage and change in basal stimulated neuron response suggest that injury from repetitive primary blast exposure may specifically affect long-term potentiation. Our studies suggest repetitive primary blasts can exacerbate injury dependent on the injury severity and interval between exposures.