The Association Between Tobacco Retailer Outlet Density and Prevalence of Cigarette Smoking in Virginia.

OBJECTIVE: We examine the association between tobacco retail outlet density and adult smoking prevalence at the county level in Virginia, controlling for spatial autocorrelations. AIMS AND METHODS: Pooling data from 2020 County Health Rankings (compiled data from various sources including, but not limited to, the National Center for Health Statistics-Mortality Files, the Behavioral Risk Factor Surveillance System (BRFSS), and the American Community Survey) and Counter Tools, we conducted regression analyses that accounted for spatial autocorrelation (spatial lag models, LMlag) and adjusted for county-level access to healthcare, demographics, SES, environmental factors, risk conditions or behaviors, and population health measures. RESULTS: Our estimates provide evidence that every increase of one tobacco retail outlet per 1000 persons was associated with 1.16 percentage points (95% CI: 0.80-1.52) higher smoking prevalence at the county level in Virginia after controlling for spatial autocorrelation. The effect of outlet density was largely explained by social determinants of health such as SES, risky conditions or behaviors, and environmental factors. We further noticed that the impact of social determinants of health were closely related and can be explained by indicators of population health (rates of mental distress (ß = 1.49, 95% CI: 1.31-1.67) and physical inactivity (ß = 0.07, 95% CI: 0.04-0.10). CONCLUSIONS: Although higher tobacco outlet density was associated with an increase in county-level smoking prevalence, the impact of outlet density was largely explained by social determinants of health and mental illness. Improving well-being at the community level could be a promising strategy in future tobacco control policies. IMPLICATION: The influence of tobacco outlet density seems to be explained by other social determinants of health and population level of mental or physical health. Thus, efforts to reduce tobacco use and consequent negative health effects should explore the impact of improving regional living standards. However, a sole focus on economic growth may not be sufficient, whereas a focus on such things as promoting work-life balance and improving overall well-being at the community level may be more.

Social Media Data Mining of Antitobacco Campaign Messages: Machine Learning Analysis of Facebook Posts.

BACKGROUND: Social media platforms provide a valuable source of public health information, as one-third of US adults seek specific health information online. Many antitobacco campaigns have recognized such trends among youth and have shifted their advertising time and effort toward digital platforms. Timely evidence is needed to inform the adaptation of antitobacco campaigns to changing social media platforms. OBJECTIVE: In this study, we conducted a content analysis of major antitobacco campaigns on Facebook using machine learning and natural language processing (NLP) methods, as well as a traditional approach, to investigate the factors that may influence effective antismoking information dissemination and user engagement. METHODS: We collected 3515 posts and 28,125 associated comments from 7 large national and local antitobacco campaigns on Facebook between 2018 and 2021, including the Real Cost, Truth, CDC Tobacco Free (formally known as Tips from Former Smokers, where "CDC" refers to the Centers for Disease Control and Prevention), the Tobacco Prevention Toolkit, Behind the Haze VA, the Campaign for Tobacco-Free Kids, and Smoke Free US campaigns. NLP methods were used for content analysis, including parsimonious rule-based models for sentiment analysis and topic modeling. Logistic regression models were fitted to examine the relationship of antismoking message-framing strategies and viewer responses and engagement. RESULTS: We found that large campaigns from government and nonprofit organizations had more user engagements compared to local and smaller campaigns. Facebook users were more likely to engage in negatively framed campaign posts. Negative posts tended to receive more negative comments (odds ratio [OR] 1.40, 95% CI 1.20-1.65). Positively framed posts generated more negative comments (OR 1.41, 95% CI 1.19-1.66) as well as positive comments (OR 1.29, 95% CI 1.13-1.48). Our content analysis and topic modeling uncovered that the most popular campaign posts tended to be informational (ie, providing new information), where the key phrases included talking about harmful chemicals (n=43, 43%) as well as the risk to pets (n=17, 17%). CONCLUSIONS: Facebook users tend to engage more in antitobacco educational campaigns that are framed negatively. The most popular campaign posts are those providing new information, with key phrases and topics discussing harmful chemicals and risks of secondhand smoke for pets. Educational campaign designers can use such insights to increase the reach of antismoking campaigns and promote behavioral changes.

Structural inference of networked dynamical systems with universal differential equations.

Networked dynamical systems are common throughout science in engineering; e.g., biological networks, reaction networks, power systems, and the like. For many such systems, nonlinearity drives populations of identical (or near-identical) units to exhibit a wide range of nontrivial behaviors, such as the emergence of coherent structures (e.g., waves and patterns) or otherwise notable dynamics (e.g., synchrony and chaos). In this work, we seek to infer (i) the intrinsic physics of a base unit of a population, (ii) the underlying graphical structure shared between units, and (iii) the coupling physics of a given networked dynamical system given observations of nodal states. These tasks are formulated around the notion of the Universal Differential Equation, whereby unknown dynamical systems can be approximated with neural networks, mathematical terms known a priori (albeit with unknown parameterizations), or combinations of the two. We demonstrate the value of these inference tasks by investigating not only future state predictions but also the inference of system behavior on varied network topologies. The effectiveness and utility of these methods are shown with their application to canonical networked nonlinear coupled oscillators.

Data-driven modeling of nonlinear traveling waves.

Presented is a data-driven machine learning framework for modeling traveling wave spatiotemporal dynamics. The presented framework is based on the steadily propagating traveling wave ansatz, u(x,t)=U(ξ=x-ct+a). For known evolution equations, this coordinate transformation reduces governing partial differential equations to a set of coupled ordinary differential equations (ODEs) in the traveling wave coordinate ξ. Although traveling waves are readily observed in many physical systems, the underlying governing equations may be unknown. For these instances, the traveling wave dynamical system can be modeled empirically with neural ODEs. Presented are these ideas applied to several physical systems that admit traveling waves. Examples include traveling wave fronts, pulses, and wavetrains restricted to one-way wave propagation in a single spatial dimension. Last, applicability to real-world physical systems is presented with an exploration of data-driven modeling of rotating detonation waves.

Implementation of a triage monitoring program for internal exposure to short-lived radionuclides in Israel-challenges and recommendations.

Monitoring internal exposure to short-lived radionuclides is challenging, due to the frequent measurements required. ISO Standard 16 637 and the Swiss Personal Dosimetry Ordinance describe a screening measurement (triage monitoring) conducted in the workplace to identify workers suspected of internal exposure. Based on a previous study that examined the feasibility of using several commonly found radiation monitors in Israel in a triage monitoring program, we conducted a pilot study towards the implementation of triage monitoring in nuclear medicine facilities in Israel. The pilot study was conducted while considering the current Israeli regulations and local safety culture. We implemented the triage monitoring program in three nuclear medicine facilities in Israel, with a total of 55 monitored workers. The pilot study consisted of two stages: a short-term stage conducted in the largest manufacture of radiopharmaceuticals in Israel and a long-term stage in two nuclear medicine departments in Israel. During the first stage of the study, participants were asked to conduct a daily measurement at the end of the workday and send a urine sample to the national internal dosimetry laboratory. The second stage lasted 5 months in a major hospital and 18 months in a regional hospital. The workers were asked to perform the measurement at the end of the shift and send a urine sample if a defined threshold had been crossed. The mean participation rate in the long-term stage (>70%) indicates that implementation of the triage monitoring program could be successful in Israel. Based on the findings of the study, practical recommendations are listed: suitable monitoring devices, allocating a monitoring location, time of measurement, training of the workers, record keeping and coordination with a certified dosimetry laboratory. The pilot study recommendations were submitted to the Israel Institute for Occupational Safety and Hygiene at the Ministry of Labor, Social Affairs and Social Services.

[Ventilation Patients between Acute Care and Long-term Out-of-Hospital Ventilation - Routine Documentation based Analysis of the Care Situation]. / Beatmungspatienten zwischen Akutversorgung und außerstationärer Langzeitbeatmung.

BACKGROUND: The number of invasive and non-invasive long-term out-of-hospital ventilations has been increasing rapidly for years. At the same time, there is poor information on the quality of care of out-of-hospital ventilated patients. The present investigation was conducted as part of the OVER-BEAS study. The aim of this study was to describe the care situation of weaning patients from admission to discharge from the weaning center using existing routine documentation. MATERIAL AND METHODS: In our retrospective analysis, we included all patients admitted in 2018 via the weaning ward of the Thorax Center Münnerstadt. Descriptive analysis of routine data collected as part of quality management was performed. Data sources were the WeanNet database, the discharge letter of the weaning center, and the transfer report of the referring hospital. RESULTS: In the studied weaning center, 50.8 % of the patients (n = 31) could be completely weaned from the respirator and extubated or decannulated (category 3aI). If complete weaning was not successful, 75.0 % (n = 21) required the constant presence of specially trained staff or a specialist nurse in the further course. In this case, further care was mostly provided in inpatient care facilities (e. g., ventilator shared living community). CONCLUSION: Based on routine documentation, the care situation of weaning patients can be presented and compared with known data. In this way, the outcome quality of a weaning center can be made comparable.

[Ventilation Patients between Acute Care and Long-term Out-of-Hospital Ventilation - Routine Documentation based Analysis of the Care Situation]. / Beatmungspatienten zwischen Akutversorgung und außerstationärer Langzeitbeatmung.

BACKGROUND: The number of invasive and non-invasive long-term out-of-hospital ventilations has been increasing rapidly for years. At the same time, there is poor information on the quality of care of out-of-hospital ventilated patients. The present investigation was conducted as part of the OVER-BEAS study. The aim of this study was to describe the care situation of weaning patients from admission to discharge from the weaning center using existing routine documentation. MATERIAL AND METHODS: In our retrospective analysis, we included all patients admitted in 2018 via the weaning ward of the Thorax Center Münnerstadt. Descriptive analysis of routine data collected as part of quality management was performed. Data sources were the WeanNet database, the discharge letter of the weaning center, and the transfer report of the referring hospital. RESULTS: In the studied weaning center, 50.8 % of the patients (n = 31) could be completely weaned from the respirator and extubated or decannulated (category 3aI). If complete weaning was not successful, 75.0 % (n = 21) required the constant presence of specially trained staff or a specialist nurse in the further course. In this case, further care was mostly provided in inpatient care facilities (e. g., ventilator shared living community). CONCLUSION: Based on routine documentation, the care situation of weaning patients can be presented and compared with known data. In this way, the outcome quality of a weaning center can be made comparable.

Effects of hydrolyzed fish protein and autolyzed yeast as substitutes of fishmeal in the gilthead sea bream (Sparus aurata) diet, on fish intestinal microbiome.

BACKGROUND: This study evaluated the effects of partial substitution of dietary fishmeal (FM) with either fish protein hydrolysate (FPH) or autolysed dried yeast (HiCell®, Biorigin, Brazil) on intestinal microbiota of gilthead sea bream (Sparus aurata). A total number of 720 fish of 122.18 ± 6.22 g were fed for 92 days with three different diets in triplicate (3 tanks/diet). A diet based on FM/vegetable meal was used as control. The other two diets were formulated by replacing FM with 5% of either FPH or HiCell®. To analyze the gut microbiota associated to autochthonous and allochthonous microbial communities, the Illumina MiSeq platform for sequencing of 16S rRNA gene and QIIME pipeline were used. RESULTS: A total number of 102 OTUs (operational taxonomic units) at 97% identity were identified in fish gut samples collected at the end of feeding trial. Fourteen OTUs constituted the core gut microbiota, i.e. those OTUs found in at least nine out of fifteen samples per group and shared regardless of the diet. Eight OTUs were assigned to Firmicutes represented by Lactobacillus, Staphylococcus, and Bacillus genera, and six to Proteobacteria phylum. Dietary dried yeast autolysate modulated the intestinal microbiota by promoting the growth of some beneficial bacteria. At order level, fish fed yeast showed an enrichment in Bacillales and Clostridiales as compared to the control group, whereas fish fed FPH showed a significantly lower amount of bacteria belonging to Alteromonadales and Enterobacteriales than the other two feeding groups. Although we did not observe any effect of 5% FM replacement with alternative nitrogen sources at phylum level, at lower taxonomical levels, the composition of gut microbiota, in terms of relative abundance of specific taxa, was significantly influenced by the dietary treatment. CONCLUSIONS: The metabarcoding analysis revealed a clearly intestinal microbiota modulation in response to dietary autolyzed yeast. The abundance of some beneficial bacteria, i.e. indigestible carbohydrate degrading- and SCFA producing bacteria, was positively affected. Autolysed dried yeast obtained by the fermentation of a strain of Saccharomyces cerevisiae could be a valid alternative protein source to FM as well as a valid functional ingredient for aquafeed production [corrected].

Correction to: Effects of hydrolyzed fish protein and autolyzed yeast as substitutes of fishmeal in the gilthead sea bream (Sparus aurata) diet, on fish intestinal microbiome.

An amendment to this paper has been published and can be accessed via the original article.

Prospective analysis of health-related quality of life after surgery for spinal metastases.

PURPOSE: Most spinal metastases are detected late, and thus, the impact of treatment on the health-related quality of life (HRQOL) is an important consideration. This study investigated the HRQOL following surgery for spinal metastases. METHODS: A prospective study of patients operated for symptomatic spinal metastases, at a single tertiary referral spine centre (2011-2013). Data were collected pre-operatively and up to 2 years following surgery (if alive). The HRQOL assessment was performed using recognised systems including the Frankel score (neurological status), EQ-5D, and the Oswestry Disability Index. RESULTS: A total of 199 patients were studied (median age 65 years, 43% (86) F; 57% (113) M). The Frankel score improved significantly after surgery in 69 patients (35%), worsened in 17 (8%), with 20/39 patients regaining the ability to walk (51%). All the HRQOL scores improved significantly following surgery. The complication rate was 27% and median survival 270 days, and 44 patients (22%) survived at 2 years. CONCLUSIONS: This large prospective study showed that surgical treatment for spinal metastases significantly improved the HRQOL.

Emollient structure and chemical functionality effects on the biomechanical function of human stratum corneum.

OBJECTIVE: Cosmetic emollients are widely used in skincare formulations due to their ability to 'soften' the skin and modulate formulation spreadability. Though emollients are commonly used, little is known about their effects on the biomechanical barrier properties of human stratum corneum (SC), which play a critical role in consumer perception of formulation efficacy. Accordingly, our objective was to provide new insights with a study involving fourteen cosmetic emollient molecules with widely varying structures, molecular weights, SC diffusivities, topological polar surface areas (TPSAs), viscosities and chemical functionalities. METHODS: Mechanical stress in the SC was measured in vitro using a substrate curvature measurement technique. Stress development due to SC drying was measured before and after topical treatment with cosmetic emollients. Emollient diffusivity and alterations to lipid content in SC after treatment were measured via ATR-FTIR spectroscopy. The maximum penetration volume of emollient in SC was characterized to elucidate mechanisms underlying emollient effects on stress. RESULTS: The application of all cosmetic emollients caused a reduction in SC mechanical stress under dehydrating conditions, and a linear correlation was discovered between emollient penetration volume and the degree of stress reduction. These molecules also induced increases in stress equilibration rate, signalling changes to SC transport kinetics. Stress equilibration rate increases linearly correlated with decreasing intensity of the νCH2 band, indicating a previously unknown interaction between cosmetic emollients and SC lipids. Stress and penetration volume results were rationalized in terms of a multi-parameter model including emollient molecular weight, diffusivity, TPSA and viscosity. CONCLUSION: We provide a new rational basis for understanding the effects of cosmetic emollient choice on biomechanical properties affecting SC barrier function and consumer perception. We demonstrate for the first time that emollients very likely reduce SC mechanical stress through their ability to take up volume when penetrating the SC, and how molecular weight, SC diffusivity, TPSA and viscosity are predictive of this ability. As cosmetic formulations continue to evolve to meet the needs of customers, emollient molecules can be selected that not only contribute to formulation texture and/or spreadability but that also leverage this novel connection between emollient penetration and SC biomechanics.

OBJECTIF: Les émollients cosmétiques sont largement utilisés dans les formulations de soins de la peau en raison de leur capacité à «adoucir¼ la peau et à moduler la capacité d'étalement de la formulation. Bien que les émollients soient couramment utilisés, on en sait peu sur leurs effets sur les propriétés de barrière biomécanique de la couche cornée humaine (SC), qui jouent un rôle essentiel dans la perception par les consommateurs de l'efficacité de la formulation. En conséquence, notre objectif était de fournir de nouvelles perspectives avec une étude impliquant quatorze molécules émollientes cosmétiques avec des structures, des poids moléculaires, des diffusivités SC, des surfaces polaires topologiques (TPSA), des viscosités et des fonctionnalités chimiques très variables. MÉTHODES: La contrainte mécanique dans le SC a été mesurée in vitro en utilisant une technique de mesure de la courbure du substrat. Le développement du stress dû au séchage SC a été mesuré avant et après un traitement topique avec des émollients cosmétiques. La diffusivité émolliente et les altérations de la teneur en lipides dans la SC après le traitement ont été mesurées par spectroscopie ATR-FTIR. Le volume de pénétration maximal de l'émollient dans SC a été caractérisé pour élucider les mécanismes sous-jacents aux effets émollients sur le stress. RÉSULTATS: L'application de tous les émollients cosmétiques a entraîné une réduction de la contrainte mécanique SC dans des conditions de déshydratation, et une corrélation linéaire a été découverte entre le volume de pénétration de l'émollient et le degré de réduction de la contrainte. Ces molécules ont également induit des augmentations du taux d'équilibrage des contraintes, signalant des changements dans la cinétique de transport SC. Le taux d'équilibrage des contraintes augmente linéairement en corrélation avec la diminution de l'intensité de la bande νCH2 , indiquant une interaction jusque-là inconnue entre les émollients cosmétiques et les lipides SC. Les résultats du stress et du volume de pénétration ont été rationalisés en termes d'un modèle multi-paramètres comprenant le poids moléculaire émollient, la diffusivité, le TPSA et la viscosité. CONCLUSION: Nous fournissons une nouvelle base rationnelle pour comprendre les effets du choix des émollients cosmétiques sur les propriétés biomécaniques affectant la fonction de barrière SC et la perception du consommateur. Nous démontrons pour la première fois que les émollients réduisent très probablement la contrainte mécanique SC grâce à leur capacité à prendre du volume lors de la pénétration du SC, et comment le poids moléculaire, la diffusivité SC, le TPSA et la viscosité sont prédictifs de cette capacité. Alors que les formulations cosmétiques continuent d'évoluer pour répondre aux besoins des clients, des molécules émollientes peuvent être sélectionnées qui contribuent non seulement à la texture et / ou à l'étalement de la formulation, mais qui exploitent également cette nouvelle connexion entre la pénétration des émollients et la biomécanique SC.

Fibrinogen concentrate vs. fresh frozen plasma for the management of coagulopathy during thoraco-abdominal aortic aneurysm surgery: a pilot randomised controlled trial.

Major vascular surgery is frequently associated with significant blood loss and coagulopathy. Existing evidence suggests hypofibrinogenaemia develops earlier than other haemostatic deficiencies during major blood loss. The purpose of this study was to assess whether the use of an infusion of fibrinogen concentrate to prevent and treat hypofibrinogenaemia during surgery resulted in satisfactory haemostasis, removing or reducing the need for blood component transfusion. Twenty patients undergoing elective extent-4 thoraco-abdominal aortic aneurysm repair were randomly allocated to receive either fresh frozen plasma or fibrinogen concentrate to treat hypofibrinogenaemia during surgery. Coagulation was assessed during and after surgery by point-of-care and laboratory testing, respectively, and treatment was guided by pre-defined transfusion triggers. Despite blood losses of up to 11,800 ml in the patients who received the fibrinogen concentrate, none required fresh frozen plasma during surgery, and only two required platelet transfusions. The median (IQR [range]) allogeneic blood component administration during surgery and in the first 24 h postoperatively was 22.5 (14-28 [2-41]) units in patients allocated to fresh frozen plasma vs. 4.5 (3-11[0-17]) in patients allocated to fibrinogen concentrate (p = 0.011). All patients in both groups were assessed by the surgeon to have satisfactory haemostasis at the end of surgery. Mean (SD) postoperative fibrinogen concentrations were similar in patients allocated to fresh frozen plasma and fibrinogen concentrate (1.6 (0.3) g.l-1 vs. 1.6 (0.2) g.l-1 ; p = 0.36) but the mean (SD) international normalised ratio and activated partial thromboplastin time ratio were lower in patients allocated to fresh frozen plasma (1.1 (0.1) vs. 1.8 (0.3); p < 0.0001 and 1.1 (0.2) vs. 1.7 (0.5); p = 0.032, respectively). Fibrinogen concentrate may be used as an alternative to fresh frozen plasma in the treatment of coagulopathy during thoraco-abdominal aortic aneurysm repair.

Retinal perfusion 6 months after trabeculectomy as measured by optical coherence tomography angiography.

PURPOSE: To investigate potential changes of vessel density (VD) at the optic nerve head (ONH) and the macula 6 months after trabeculectomy (TE). METHODS: In a prospective monocentric study, 19 eyes with open-angle glaucoma were treated with TE + MMC (mitomycin C). At four different time points multiple morphological papillary parameters were measured by OCT, and the ONH VD in the radial peripapillary capillary layer and the superficial and deep plexuses of the macula was determined by OCTA (optical coherence tomography angiography, RTVue-XR, Optovue). The mean defect was determined by visual field examination (mode 30-2, Humphrey Field Analyzer). The duration of follow-up was 6 months. RESULTS: Nineteen eyes, one each from 19 patients (11 females; 8 males) with a mean age of 66.0 (58.07, 70.94) years and a mean intraocular pressure (IOP) of 21.0 mmHg (17.07, 23.87), were included in the study. All showed a significant reduction in IOP at each follow-up after TE (p < 0.0001). There was no significant change in the peripapillary retinal nerve fiber layer thickness (p = 0.88), the ganglion cell complex (p = 0.97), the cup-disk ratio (p = 0.63), the rim area (p = 0.78), or the mean visual field defect (p = 0.82). With regard to VD, no significant difference could be determined in either the ONH or the macular area. CONCLUSIONS: After significant surgical reduction of IOP by TE, there are no significant detectable morphological changes in the ONH or the ganglion cell complex as measured by OCT, nor does the papillary or macular OCTA-determined VD change significantly. Trial registration 2016-409-f-S Avanti-OCT-A. Registered December 1, 2016.

Harvesting visible light with MoO3 nanorods modified by Fe(iii) nanoclusters for effective photocatalytic degradation of organic pollutants.

The photocatalytic performance of MoO3 is limited due to its weak visible light absorption ability and quick recombination of charge carriers. In the present work, we report the facile synthesis of Fe(iii)-grafted MoO3 nanorods using a hydrothermal method followed by an impregnation technique with the aim of enhancing the light harvesting ability and photocatalytic efficiency of MoO3. The prepared samples were characterized through the standard analytical techniques of XRD, SEM-EDS, TEM, XPS, UV-Vis-DRS, FT-IR, TG-DTA and PL spectrophotometry. XPS and TEM analyses reveal that Fe(iii) ions are successfully grafted onto the surface of the MoO3 nanorod with intimate interfacial contact. The photocatalytic performances of the prepared samples were investigated by studying the degradation of methylene blue (MB), rhodamine B (RhB) and 4-nitrophenol (4-NP) under visible light irradiation. The surface-modified MoO3 with Fe(iii) ions showed excellent photocatalytic activity towards the degradation of the above-mentioned pollutants, where Fe(iii) ions act as effective cocatalytic sites to produce hydroxyl radicals through multi-electron reduction of oxygen molecules. The improved photocatalytic activity could be ascribed to the effective separation of charge carriers and efficient production of hydroxyl radicals via the rapid capture of electrons by Fe(iii) through a well-known photoinduced interfacial charge transfer mechanism. Based on scavenger analysis study, a mechanism for the enhanced photocatalytic activity has been discussed and proposed. The concept of surface grafting onto large bandgap semiconductors with ubiquitous elements opens up a new avenue for the development of visible-light-responsive photocatalysts with excellent photocatalytic activity.

OCTA vessel density changes in the macular zone in glaucomatous eyes.

PURPOSE: To evaluate whether macular optical coherence tomography angiography (OCTA) can detect altered vessel density (VD) in the superficial and deep vascular plexus in glaucomatous eyes and to compare the diagnostic utility of the individual VD parameters. METHODS: The macular VD of 135 eyes, comprising 85 eyes diagnosed with glaucoma and 50 healthy control eyes, was examined using two OCTA devices (AngioPlex-Zeiss Meditec, Inc., Dublin, CA, USA, and AngioVue-OptoVue, Inc., Fremont, CA, USA). All study participants had neither vascular pathology, diabetes, nor vasoactive medication. The macular VD was measured at two different levels of segmentation (superficial [SL] and deep [DL] retinal vascular plexus) with a 6 × 6-mm macula scan, and VD was correlated with various structural and functional measurements. In order to test the accuracy of differentiation between eyes with and without glaucoma, we calculated the receiver operating characteristic (ROC) curve and the area under the curve (AUC). RESULTS: Macular VD was significantly lower in both SL and DL in glaucomatous eyes than in healthy eyes (p = SL < 0.0001; DL = 0.009). There was no significant difference in VD between the SL and the DL (p = 6.60 · 10-18). The greatest reduction of VD in glaucomatous eyes was found in the inferior macular sector. There was no correlation of VD with age or refractive error but moderate to high correlation with intraocular pressure, time of initial diagnosis, mean deviation, ganglion cell complex, peripapillary retinal nerve fiber layer thickness, cup to disc ratio, and rim area. Among the 14 individual features of macular VD, whole VD in the SL had the best diagnostic accuracy (77.6%) as measured by the area under the ROC. CONCLUSION: OCTA detects glaucomatous damage by measuring the macular vessel density in the superficial and deep retinal vascular plexus. It can be an additional diagnostic tool to detect glaucoma independently of the optic nerve.

Openness to adopting evidence-based practice in public substance use treatment in South Africa using task shifting: Caseload size matters.

BACKGROUND: In response to the lack of coverage for substance use treatment in the Western Cape province of South Africa, the local government expanded funding for evidence-based practices (EBPs) for treating substance use. Yet, little is known about provider and staff attitudes towards adopting EBPs in this setting, which is particularly relevant in this context where task shifting clinical care increases demands on paraprofessional providers. This study aimed to (1) assess attitudes towards adopting EBPs among a range of staff working in substance use treatment in Cape Town using a task shifting model; and (2) evaluate factors associated with openness towards adopting EBPs in this setting. METHODS: Staff (n = 87) were recruited from 11 substance use treatment clinics. Demographics and job-related characteristics were assessed. Staff perceptions of organizational factors were assessed using the TCU Organizational Readiness for Change (ORC) scale. The dependent variable, attitudes towards adopting EBPs, was assessed using the Evidence-Based Practice Attitude Scale (EBPAS). RESULTS: This study is one of the first to administer the EBPAS in South Africa and found good internal consistency (total score: α = .82). In a multivariable model adjusting for site and factors associated with EBPAS total score at the bivariate level, only smaller caseload size was associated with greater openness to adopting EBPs (B = 1.61, SE = .73; t = 2.21; p<.05). CONCLUSIONS: As pressure to scale up implementation of EBPs in South African substance use treatment services intensifies, additional efforts are needed to understand barriers to adopt EBPs in this setting. Supporting staff adoption of EBPs in resource-limited settings may require additional resources to limit staff caseloads in the context of task shifting.

[OCT Angiography of the Glaucoma Optic Nerve]. / OCT-Angiografie der Glaukompapille.

BACKGROUND: Glaucoma is a major cause of blindness worldwide. One possible pathophysiological cause may be vascular dysregulation. Our aim was to investigate whether OCT angiography (OCTA) can detect modified flow density in glaucoma patients in the area of the optic disc. METHODS: A total of 68 eyes were examined by the OCTA system AngioVue™, including 34 eyes diagnosed with glaucoma and 34 healthy control eyes. Total peripapillary flow density was measured at two different levels of segmentation and also in each optic disc sector. RESULTS: At both segmentation levels, it was demonstrated that peripapillar total flow density was significantly different in glaucoma eyes from healthy eyes. Disease progression was determined from the thickness of the ganglion cell complex and retinal nerve fibre layer. Flow density was reduced with disease progression. There was no significant difference between the optic disc sectors. CONCLUSION: The new technology of OCT angiography enables non-invasive quantification of flow density, which is significantly reduced in glaucomatous eyes. OCTA expands the diagnostic spectrum for the detection and monitoring of glaucoma patients.

Additional external electromagnetic fields for laser microprocessing of metals.

Ultra-short pulsed laser processing is a potent tool for microstructuring of a lot of materials. At certain laser parameters, particular periodical and/or quasi-periodical µm-size surface structures evolve apparently during processing. With extended plasmonics theory, it is possible to predict the structure formation, and a systematic technology can be derived to alter the surface for laser processing. In this work, we have demonstrated the modification of the laser processing with applying tailored dynamic surface electro-magnetic fields. Possible improvement in applications is seen in the fields of process efficiency of laser ablation and a superior control of the surface topography.

Safety and efficacy of pharmacological cardioversion of recent-onset atrial fibrillation: a single-center experience.

BACKGROUND AND AIM: The management of patients with recent-onset atrial fibrillation (AF) presenting at emergency departments (EDs) varies widely. Our aim was to describe the management of patients with recent-onset (<48 hours) AF, to determine safety and efficacy of pharmacological cardioversion at the ED, and to evaluate the incidence of thromboembolism or death at 30 days. METHODS: In a prospective, observational, single-center study, 236 subjects with recent-onset AF were consecutively enrolled from January 2011 until January 2013. Follow-up information was obtained by reviewing all available clinical records. RESULTS: As first-line therapy, 45.3% (n = 107) received ibutilide, 28.8% (n = 68) vernakalant, 25% (n = 59) flecainide, and 0.8% (n = 2) amiodarone, respectively. Successful cardioversion was achieved in 72.5% (n = 171) of patients after first-line therapy. There was no significant difference between treatment groups. In univariable logistic regression analysis, age (odds ratio [OR] = 1.027; 95% confidence interval [CI], 1.003-1.052; P= .03), duration of symptoms (OR = 0.968; 95% CI, 0.938-0.999; P= .045), as well as the CHA2DS2-VASc score (1 point for Congestive heart failure, Hypertension, Age between 65 and 74 years, Diabetes, Vascular disease, Sex category if female and 2 points for previous TIA/Stroke and Age ≥ 75 years) (OR = 1.237; 95% CI, 1.01-1.515; P= .04) were associated with success of pharmacological cardioversion. Within 30 days, 1 patient suffered from fatal ischemic stroke. CONCLUSION: Pharmacological cardioversion followed by discharge after a short observation period is safe. There was no significant difference between the agents used in terms of short-term safety and efficacy. Importantly, the coherence of the ED to recent guidelines regarding first-line therapy is high.

Clinical onset and course, response to treatment and outcome in 24 patients with the cblE or cblG remethylation defect complemented by genetic and in vitro enzyme study data.

BACKGROUND: The cobalamin E (cblE) (MTRR, methionine synthase reductase) and cobalamin G (cblG) (MTR, methionine synthase) defects are rare inborn errors of cobalamin metabolism leading to impairment of the remethylation of homocysteine to methionine. METHODS: Information on clinical and laboratory data at initial full assessment and during the course of the disease, treatment, outcome and quality of life was obtained in a survey-based, retrospective study from physicians caring for patients with the CblE or CblG defect. In addition, data on enzyme studies in cultured skin fibroblasts and mutations in the MTRR and MTR gene were analysed. RESULTS: In 11 cblE and 13 cblG patients, failure to thrive, feeding problems, delayed milestones, muscular hypotonia, cognitive impairment and macrocytic anaemia were the most frequent symptoms. Delay in diagnosis depended on age at first symptom and clinical pattern at presentation and correlated significantly with impaired communication abilities at follow-up. Eighteen/22 patients presented with brain atrophy or white matter disease. Biochemical response to treatment with variable combinations of betaine, cobalamin, folate was significant. The overall course was considered improving (n = 8) or stable (n = 15) in 96% of patients, however the average number of CNS symptoms per patient increased significantly over time and 16 of 23 patients were classified as developmentally delayed or severely handicapped. In vitro enzyme analysis data showed no correlation with outcome. Predominantly private mutations were detected and no genotype- phenotype correlations evident. CONCLUSIONS: The majority of patients with the cblE and cblG defect show limited clinical response to treatment and have neurocognitive impairment.