Effects of combined intense pulsed light and cyclosporine 0.05% eyedrops in ocular surface matrix metalloproteinase-9 levels in patients with moderate-to-severe MGD.

To investigate the changes in meibomian gland dysfunction (MGD) and tear matrix metalloproteinase-9 (MMP-9) levels in patients with moderate-to-severe MGD after combined treatment with intense pulsed light (IPL) therapy and cyclosporine 0.05%. Thirty-six patients concurrently treated with IPL and cyclosporine 0.05% ophthalmic drops were retrospectively enrolled. Tear break up time (TBUT), corneal and conjunctival staining scores, Schirmer test, and ocular surface disease index (OSDI) questionnaire responses were recorded. Meibum quality, consistency, and eyelid margin telangiectasia were evaluated. MMP-9 levels were examined by the positivity and signal intensity of red lines (scored 0-4). IPL was performed four times with a vascular filter at 2-week intervals, followed by a 1-month follow-up after treatment cessation. Immediately after each IPL treatment, gentle meibomian gland expression was performed in both the upper and lower eyelids using meibomian gland expressor forceps. TBUT (1.88 ± 1.02 s to 3.12 ± 1.08 s, p < 0.001), corneal and conjunctival staining (6.19 ± 2.11 to 3.12 ± 1.89, p < 0.001), Oxford staining grade (2.66 ± 0.89 to 1.35 ± 0.76, p < 0.001), and OSDI (52.97 ± 21.86 to 36.36 ± 22.45, p < 0.001) scores significantly improved after the combined treatment. Meibum quality, consistency and lid margin telangiectasia showed significant post-treatment improvement in both the upper and lower eyelids. MMP-9 positivity showed a significant decrease (97-69%, p = 0.026) with a reduction in signal intensity (2.72 ± 0.87 to 2.09 ± 0.95, p = 0.011). The combination of IPL therapy and 0.05% cyclosporine eye drops effectively treats moderate-to-severe MGD by reducing symptoms and signs of MGD and by decreasing ocular surface MMP-9-associated inflammation.

Magnetic field control device for transplantation of corneal endothelial tissue with magnetic filaments.

The corneal endothelial transplantation involves the transfer and attachment of a single-layered corneal endothelial tissue to the narrow space between the cornea and iris. Given the high risk of damage to the endothelial tissue and surrounding corneal tissues when using sharp instruments inserted externally to apply force during the process, the development of a device capable of transferring corneal endothelial tissue using a magnetic field became necessary. This study aims to develop a magnetic control device for transferring corneal endothelial tissue with attached magnetic particles to the transplant site, validate its appropriate transfer capabilities, and assess its applicability to corneal endothelial transplantation. For this purpose, a magnetic field-generating manipulation device equipped with four electromagnets controlled by a joystick and microcomputer was developed. Through simulated experiments, the strength of the magnetic field and the attraction force on the tissue were predicted, and the actual magnetic field strength was measured for validation. To measure the magnetic transfer force, experiments were conducted by towing corneal endothelial tissue fixed with 6 mg, 12 mg, and 18 mg plastic weights. Subsequently, the tissue's transfer speed was measured after applying continuous and pulsed magnetic fields. The results confirmed the feasibility of tissue transfer using the magnetic control device, and it was observed that pulsed magnetic fields led to faster transfer speeds and easier control compared to continuous magnetic fields. Exploratory animal experiments using rabbits were conducted to simulate real surgical conditions, confirming the feasibility of corneal endothelial tissue transfer and attachment.

Response-Adapted Ultralow-Dose Radiation Therapy for Orbital Indolent B-Cell Lymphoma: A Phase 2 Nonrandomized Controlled Trial.

Importance: Radiation therapy to doses of 24 to 36 Gy is currently used to treat indolent B-cell lymphoma of the ocular adnexa; however, ocular adverse effects are common. Objective: To determine if a response-adapted radiation therapy strategy will result in excellent disease outcomes while reducing orbital morbidity. Design, Setting, and Participants: This single-institution, phase 2 prospective nonrandomized controlled trial of a response-adapted strategy involved 50 evaluable patients with stage I to IV indolent B-cell lymphoma of the ocular adnexa enrolled between July 2015 and January 2021. This treatment approach was also retrospectively evaluated with a separate 55-patient cohort treated between March 2013 and October 2021. All data were analyzed between November 2021 and December 2023. Interventions: Patients were treated with ultralow-dose radiation therapy to 4 Gy in 2 fractions and assessed for response at 3-month intervals. Patients with persistent orbital lymphoma were offered an additional 20 Gy in 10 fractions to complete the response-adapted treatment. Main Outcome and Measures: The primary end point was 2-year local orbital control within the irradiated field after response-adapted therapy. Secondary end points included overall survival and complete response rate. Results: The 50 prospective patients were a median (range) of 63 (29-88) years old, and 31 (62%) were female. Among the 50 patients, 32 (64%) had mucosa-associated lymphoid tissue lymphoma, 12 (24%) had follicular lymphoma, and 6 (12%) had unclassifiable low-grade B-cell lymphoma. Thirty-one patients (62%) had stage I disease, and 36 (72%) were newly diagnosed. At a median follow-up of 37.4 (95% CI, 33.7-52.5) months, the 2-year local control rate was 89.4% (95% CI, 81.0%-98.7%), and the 2-year overall survival rate was 98.0% (95% CI, 94.1%-100%); 45 patients (90.0%; 95% CI, 78.2%-96.7%) experienced a complete response to response-adapted radiation, including 44 patients with a complete response to ultralow-dose radiation and 1 patient with a complete response after an additional 20 Gy. No local recurrences were observed among patients with a complete response to response-adapted therapy. No grade 3 or higher toxic effects were observed. In a planned subset analysis of 22 patients with newly diagnosed, untreated stage I mucosa-associated lymphoid tissue lymphoma, the 2-year local control rate was 90.7% (95% CI, 79.2%-100%), and the 2-year freedom from distant relapse rate was 95.2% (95% CI, 86.6%-100%). Conclusion and Relevance: In this nonrandomized controlled trial, response-adapted ultralow-dose therapy for indolent orbital B-cell lymphoma resulted in reduced radiation exposure, negligible toxic effects, and excellent disease outcomes. Trial Registration: ClinicalTrials.gov Identifier: NCT02494700.

Response-adapted ultra-low-dose 4 Gy radiation as definitive therapy of gastric MALT lymphoma: a single-centre, pilot trial.

BACKGROUND: Given the favourable prognosis of patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma, treatment-related toxicity should be minimised. We aimed to evaluate the efficacy of 4 Gy radiotherapy given in a response-adapted approach. METHODS: We conducted a single-centre, single-arm, prospective trial at MD Anderson Cancer Center (Houston, TX, USA) of response-adapted ultra-low-dose radiotherapy. Eligible patients were 18 years or older and had newly diagnosed or relapsed Helicobacter pylori-negative gastric MALT lymphoma, with stage I-IV disease. Given the expected low toxicity profile of treatment, performance status was not an exclusion criterion. Patients received external beam photon-based radiotherapy for a total dose of 4 Gy in two fractions. Patients with a complete response to 4 Gy via endoscopy and imaging at 3-4 months were observed; patients with a partial response were re-evaluated in 6-9 months. Residual disease at 9-13 months or stable or progressive disease at any time required additional treatment with 20 Gy. The primary endpoint was gastric complete response at 1 year (second evaluation timepoint) after 4 Gy treatment. All analyses were performed as intention to treat. This trial is registered at ClinicalTrials.gov (NCT03680586) and is complete and closed to enrolment. FINDINGS: Between March 27, 2019, and Oct 12, 2021, we enrolled 24 eligible patients. The median age of participants was 67 years (IQR 58-74; range 40-85); 15 (63%) were female and nine (37%) male; 18 (75%) were White, four (17%) Asian, and two (8%) Hispanic; 20 (83%) had stage I disease, one (4%) stage II, and three (13%) stage IV. Median follow-up time was 36 months (IQR 26-42). 20 patients (83%) had a complete response to 4 Gy (16 at 3-4 months, four at 9-13 months); two patients received 20 Gy for symptomatic stable disease at 3-4 months and two for residual disease at 9-13 months; all had a complete response. The 3-year local control rate was 96% (95% CI 88-100), with one local relapse at 14 months after 4 Gy radiotherapy salvaged successfully with 20 Gy. One patient with stage IV disease had a distant relapse. The most common adverse events were grade 1 nausea (nine [38%] of 24 patients who received 4 Gy and two [50%] of four patients who received 20 Gy) and grade 1 abdominal pain (five [21%] of 24 and zero of four, respectively). No grade 3 or worse adverse events were noted, including no treatment-related deaths. INTERPRETATION: Most patients had a complete response after 4 Gy radiotherapy; all who required an additional 20 Gy had a complete response within 12 months. This response-adapted strategy could be used to select patients who would benefit from additional radiotherapy and spare others potential associated toxicity. FUNDING: National Cancer Institute.

Re-Esterified Triglyceride ω-3 Fatty Acids in Dry Eye Disease With Meibomian Gland Dysfunction: A Randomized Clinical Trial.

Importance: Taking ω-3 supplements has been associated with a reduction in symptoms of dry eye disease (DED) associated with meibomian gland dysfunction (MGD). However, a recent relatively large clinical trial concluded that treating DED with ω-3 consumption was ineffective, potentially warranting additional investigations. Objectives: To investigate the effect of re-esterified triglyceride (rTG) ω-3 fatty acid supplementation on DED associated with MGD. Design, Setting, and Participants: This double-masked, parallel-group, randomized clinical trial was conducted at 7 institutions from September 2020 to January 2023. Patients with DED associated with MGD were included and randomly assigned to the ω-3 group (received 1680 mg of eicosapentaenoic acid and 560 mg of docosahexaenoic acid), whereas those in the grape-seed group received 3000 mg of grape-seed oil daily. Interventions: rTG ω-3 Fatty acid supplementation vs grape-seed oil. Main Outcome Measures: The primary end point was the Ocular Surface Disease Index (OSDI) from baseline to 6 and 12 weeks. The safety parameters were visual acuity and intraocular pressure change. Results: A total of 132 patients (mean [SD] age, 50.6 [13.8] years; 103 female [78.0%]) were included in this study. The mean (SD) baseline OSDI scores of the ω-3 and grape-seed groups were 43.5 (16.5) and 44.1 (16.6), respectively. A total of 58 patients (87.9%) and 57 patients (86.4%) in the ω-3 and grape-seed groups, respectively, completed 12 weeks of follow-up. There were no differences in compliance with the dietary supplement intake between groups (ω-3, 95.8% and grape-seed, 95.4%). The OSDI (SD) change from baseline to 6 and 12 weeks was -20.5 (16.0) and -22.7 (15.7), respectively, in the ω-3 group and -15.1 (20.2) and -18.8 (21.7), respectively, in the grape-seed control group (difference at 6 weeks = -5.4; 95% CI, -12.15 to 1.33; P = .12 and at 12 weeks = -3.9; 95% CI, -10.90 to 3.13; P = .28). There were no changes in safety parameters or adverse events related to taking the dietary supplement in either group. Conclusions and Relevance: This randomized clinical trial did not show a benefit of the rTG form of ω-3 for ameliorating symptoms of DED associated with MGD, although fewer than 60 participants were evaluated in each group. Any secondary outcomes from this study should be considered for hypothesis generation of future evaluations of the effect of the rTG form of ω-3 on DED associated with MGD. Trial Registration: CRIS Identifier: KCT0004927.

Effect of Exposure to Particulate Matter on the Ocular Surface in an Experimental Allergic Eye Disease Mouse Model.

In response to the escalating concern over the effect of environmental factors on ocular health, this study aimed to investigate the impact of air pollution-associated particulate matter (PM) on ocular allergy and inflammation. C57BL/6 mice were sensitized with ovalbumin (OVA) topically and aluminum hydroxide via intraperitoneal injection. Two weeks later, the mice were challenged with OVA and exposed to PM. Three groups-naive, OVA, and OVA-sensitized with PM exposure (OVA + PM) groups-were induced to an Allergic Eye disease (AED) model. Parameters including clinical signs, histological changes, inflammatory cell infiltration, serum OVA-specific immunoglobulins E (IgE) levels, mast cells degranulation, cellular apoptosis and T-cell cytokines were studied. The results demonstrate that exposure with PM significantly exacerbates ocular allergy, evidenced by increased eye-lid edema, mast cell degranulation, inflammatory cytokines (IL-4, IL-5 and TNF-α), cell proliferation (Ki67), and serum IgE, polymorphonuclear leukocytes (PMN), and apoptosis and reduced goblet cells. These findings elucidate the detrimental impact of PM exposure on exacerbating the severity of AED. Noticeably, diminished goblet cells highlight disruptions in ocular surface integrity, while increased PMN infiltration with an elevated production of IgE signifies a systemic allergic response with inflammation. In conclusion, this study not only scientifically substantiates the association between air pollution, specifically PM, and ocular health, but also underscores the urgency for further exploration and targeted interventions to mitigate the detrimental effects of environmental pollutants on ocular surfaces.

Analysis of intraocular lens decentration and tilt after femtosecond laser-assisted cataract surgery using swept-source anterior optical coherence tomography.

Objective: To evaluate and compare the magnitude of intraocular lens (IOL) decentration and tilt following conventional and femtosecond laser-assisted cataract surgery (FLACS) using swept-source anterior optical coherence tomography (SS-OCT). Methods: In this retrospective observational study, we enrolled patients who underwent conventional cataract surgery or FLACS with the implantation of hydrophobic 1-piece monofocal IOL. The magnitude of IOL decentration and tilt were measured using SS-OCT. Visual acuity, intraocular pressure, spherical equivalent, axial length, contrast sensitivity, and satisfaction questionnaire were evaluated before and one-month post-surgery. Additionally, postoperative internal cylinder measurements were obtained using a wavefront aberrometer. Correlation factors between each parameter and IOL decentration or tilt were analyzed. Results: This study included 100 eyes from 100 patients. Mean IOL decentration and tilt were 0.21 ± 0.13 mm and 5.01 ± 1.49°, respectively. Conventional cataract surgery (versus FLACS, P = 0.001) and male sex (versus female, P = 0.047) were significantly correlated with higher postoperative decentration. Preoperative lens diameter (P < 0.001), preoperative lens tilt (P = 0.007), and preoperative intraocular pressure (P = 0.027) were correlated with higher postoperative tilt. Fifty eyes that underwent FLACS demonstrated mean postoperative decentration of 0.21 ± 0.13 mm and tilt of 4.64 ± 1.48°. Compared with the conventional surgery group, the FLACS group significantly differed in postoperative decentration (0.30 ± 0.12 mm, P < 0.001) but not in tilt (5.03 ± 1.35°, P = 0.173). Postoperative visual acuity did not significantly differ between the two groups. Conclusion: Patients who underwent FLACS demonstrated better IOL decentration and tilt than those who underwent conventional cataract surgery one-month post-surgery. However, differences in IOL decentration and tilt did not affect postoperative visual acuity.

Intraocular pressure changes before and after a femtosecond laser procedure for cataract surgery.

This study aimed to evaluate the changes in intraocular pressure (IOP) before and after femtosecond laser capsulorhexis and lens fragmentation for cataract surgery. We measured the IOP before, immediately, 30 min, and 1 h after the laser procedure in 47 eyes of 47 patients who underwent the femtosecond laser procedure. The mean IOP was 17.51 ± 3.28 mmHg, 30.23 ± 6.70 mmHg, 17.96 ± 3.75 mmHg, and 21.77 ± 5.88 mmHg before, immediately after, 30 min after, and 1 h after the laser procedure, respectively. The mean IOP significantly increased immediately (adjusted P < 0.001) and 1 h (adjusted P = 0.001) after the laser procedure compared with the pre-laser IOP. The mean IOP at 30 min after the laser procedure was significantly lower than that immediately after the procedure (adjusted P < 0.001). However, the IOP 1 h after the laser procedure became higher than that 30 min after the laser procedure. Additionally, the IOP 1 h after the laser procedure was positively correlated with the baseline IOP and negatively correlated with the axial length. In conclusion, this study demonstrated that cataract surgery should be commenced within 30 min after the femtosecond laser procedure to ensure a safe cataract surgery that reduces the risk of increased intraocular pressure.

A regulatory focus theory perspective on the dynamics between action and power.

Building on the strong consensus that the experience of power motivates individuals to take action, prior research postulates a positively reinforcing cycle wherein taking action leads to power, which in turn leads to subsequent actions. Applying regulatory focus theory, we differentiate between promotion-oriented and prevention-oriented actions to develop a within-person theory of when and why promotion-oriented and prevention-oriented actions should relate to power, and vice-versa. Across two studies, we find that when employees engaged in promotive voice behaviors, they were more likely to experience a sense of power; this effect was amplified for employees with trait promotion focus. When employees engaged in prohibitive voice behaviors, employees with trait prevention focus were less likely to experience a sense of power. The experience of power subsequently motivated employees to engage in promotive voice behaviors, but not prohibitive voice behaviors. By elucidating the differences between promotion and prevention pathways of action and power, our research challenges the notion that action and power positively reinforce each other. We discuss the theoretical and practical implications of our findings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Discrepancies in Splenic Size Measurement: A Comparative Analysis of Ultrasound and Computed Tomography.

The accurate measurement of splenic size is essential for the diagnosis and management of various gastrointestinal and hematological conditions. While ultrasound (US) and computed tomography (CT) are widely used imaging modalities for assessing splenic size, discrepancies between their measurements have been observed in clinical practice. This study aimed to analyze the measurement differences between US and CT and identify factors influencing these differences. A retrospective analysis of 598 asymptomatic patients who underwent both abdominal US and CT was conducted. Measurements of splenic size obtained from US, axial CT, and coronal CT scans were compared, and various factors such as patient demographics, operator experience, and imaging parameters were evaluated to elucidate their impact on the measurement discrepancies. The results revealed that US consistently underestimated splenic size compared to CT. The magnitude of the discrepancy was influenced by factors such as patient age, body mass index (BMI), depth of the spleen from skin on US and that on CT, visibility of the splenic hilum on US, sonic window quality, and operator experience. This study underscores the importance of considering these factors when interpreting splenic measurements obtained from different imaging modalities in clinical practice.

Effect of Topical Programmed Death-Ligand1 on Corneal Epithelium in Dry Eye Mouse.

Dry eye disease (DED) is a growing health concern that impacts millions of individuals every year, and is associated with corneal injury, excessive oxidative stress and inflammation. Current therapeutic strategies, including artificial tears and anti-inflammatory agents, are unable to achieve a permanent clinical cure due to their temporary nature or adverse side effects. Therefore, here, we investigated the effectiveness of the topical administration of programmed death-ligand 1 (PD-L1) in the mouse model of DED. The model was generated in C57BL/6 mice by excising the extra orbital lacrimal gland and causing desiccation stress with scopolamine injections. Subsequently, either phosphate-buffered saline (3 µL/eye) or PD-L1 (0.5 µg/mL) was topically administered for 10 days. Tear volume was evaluated with phenol red thread, and corneal fluorescein staining was observed to quantify the corneal epithelial defect. Corneas were collected for histological analysis, and the expression levels of inflammatory signaling proteins such as CD4, CD3e, IL-17, IL-1ß, pIkB-α, pNF-kB and pERK1/2 were assessed through immunofluorescence and Western blot techniques. Our results demonstrate that desiccating stress-induced corneal epithelial defect and tear secretion were significantly improved by topical PD-L1 and could reduce corneal CD4+ T cell infiltration, inflammation and apoptosis in a DED mouse model by downregulating IL-17 production and ERK1/2-NFkB pathways.

Safety and efficacy of ibrutinib in combination with rituximab and lenalidomide in previously untreated follicular and marginal zone lymphoma: An open label, phase 2 study.

BACKGROUND: Follicular lymphoma (FL) and marginal zone lymphoma (MZL) are indolent non-Hodgkin lymphomas (iNHL). Median survival for iNHL is approximately 20 years. Because standard treatments are not curative, patients often receive multiple lines of therapy with associated toxicity-rationally designed, combination therapies with curative potential are needed. The immunomodulatory drug lenalidomide was evaluated in combination with rituximab for the frontline treatment of FL in the phase 3 RELEVANCE study. Ibrutinib, an oral Bruton tyrosine kinase inhibitor, is active in NHL and was evaluated in combination with lenalidomide, rituximab, and ibrutinib (IRR) in a phase 1 study. METHODS: The authors conducted an open-label, phase 2 clinical trial of IRR for previously untreated FL and MZL. The primary end point was progression-free survival (PFS) at 24 months. RESULTS: This study included 48 participants with previously untreated FL grade 1-3a (N = 38), or MZL (N = 10). Participants received 12, 28-day cycles of lenalidomide (15 mg, days 1-21 cycle 1; 20 mg, cycles 2-12), rituximab (375 mg/m2 weekly in cycle 1; day 1 cycles 2-12), and ibrutinib 560 mg daily. With a median follow-up of 65.3 months, the estimated PFS at 24 months was 78.8% (95% confidence interval [CI], 68.0%-91.4%) and 60-month PFS was 59.7% (95% CI, 46.6%-76.4%). One death occurred unrelated to disease progression. Grade 3-4 adverse events were observed in 64.6%, including 50% with grade 3-4 rash. CONCLUSIONS: IRR is highly active as frontline therapy for FL and MZL. Compared to historical results with lenalidomide and rituximab, PFS is similar with higher grade 3-4 toxicity, particularly rash. The study was registered with ClinicalTrials.gov (NCT02532257).

Distances and directions: An emotional journey into the recovery process.

Positive emotions stemming from leisure activities are often promoted as a way to achieve a state of recovery, in particular by counteracting negative emotions experienced throughout the workday. Yet the recovery literature frequently takes an undifferentiated view of both the positive emotions employees experience as well as the negative emotions employees are recovering from. This implicitly assumes that all positive emotions are equally effective in facilitating recovery from all negative emotions. Drawing from theory treating emotional movements as a metaphorical journey, we develop a framework for understanding recovery that highlights the importance of the distance and direction that individuals "travel" when moving from negative emotions to positive emotions during the recovery process. We argue that the negative emotions that people start with from work-that is, their emotional origin-as well as the positive emotions that people end with following leisure activities-that is, their emotional destination-jointly influence the state of being recovered. Across two studies using experience-sampling methodologies, we find that "shorter" journeys consisting of emotional destinations that match the activation level of emotional origins (e.g., experiencing high activation positive emotion [HAP] to counter high activation negative emotion) are effective in promoting recovery, while "longer" journeys consisting of mismatches (e.g., experiencing HAP to counter low activation negative emotion) are ineffective for recovery. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Refractive Predictability between Standard and Total Keratometry during the Femtosecond Laser-Assisted Cataract Surgery with Monofocal Intraocular Lens with Enhanced Intermediate Function.

PURPOSE: We aimed to compare the accuracy of the intraocular lens (IOL) calculation formula using the standard keratometry (K) and total K (TK) during the femtosecond laser-assisted cataract surgery (FLACS) with a monofocal IOL with enhanced intermediate function using currently used formulas. METHODS: A retrospective review of 125 eyes from 125 patients who had undergone FLACS with implantation of monofocal IOL with enhanced intermediate function was conducted. The predicted refractive power was calculated using an optical biometer (IOLmaster 700) according to the K and TK in the Barrett Universal II, SRK/T, Haigis, and Holladay 2 formulas. Absolute prediction error (APE) obtained from the actual postoperative refractive outcomes and the refractive error predicted in each formula was compared one month after surgery. RESULTS: Mean APE ranged between 0.29 and 0.39 diopters (D) regardless of the calculation formula and the method of measuring corneal curvature. Significant differences were observed in the APE from the four formulas and the two keratometric measurements (p = 0.014). In a total of 125 eyes from 125 patients, the mean APE was lowest with the Barrett Universal II formula. Across all formulas, both the mean APE and the median APE tended to be lower for K than for TK, although there was no significant difference. Approximately 70% to 80% of the patients were included within 0.5 D of the refractive error across all formulas. The percentage of eyes within 0.5 D of APE outcomes was not statistically different between the K and TK data when using each formula. CONCLUSIONS: Keratometric measurements considering the poster corneal curvature did not show any additional advantages when implanting the monofocal IOL with enhanced intermediate function during the FLACS.

Impact of moderate-to-late preterm birth on neurodevelopmental outcomes in young children: Results from retrospective longitudinal follow-up with nationally representative data.

This study investigated the relationship between moderate-to-late preterm (MLPT) birth and the risk of neurodevelopmental impairments (NIs) in young children compared with the risks associated with very preterm (VPT) and full-term (FT) birth based on nationally representative large-scale population data. Retrospective follow-up was conducted over 71 months for 738,733 children who were born and participated in the Korean National Health Screening Program for Infants and Children (NHSPIC) between 2011 and 2013. Using a data linkage between the NHSPIC and Korean healthcare claim information, data on birth year, sex, delivery type, birth weight, growth abnormality, gestational age, breastfeeding history, maternal age, NIs, multiple gestation, preterm labor, premature rupture of membranes (PROM), gestational diabetes, gestational hypertension, smoking during pregnancy, and socioeconomic status were collected and included in the final analysis. Cox proportional hazards models were applied to identify the impact of gestational age on NI risk, with all variables adjusted as appropriate. Overall, 0.9% and 3.8% rates of VPT and MLPT births were identified, respectively. NI incidence was highest among VPT children (34.7%), followed by MLPT (23.9%) and FT (18.2%) children. Both VPT (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.03 to 2.05) and MLPT (HR, 1.21; 95% CI, 1.04 to 1.41) births were associated with increased NI risk. Low birth weight, PROM, and smoking during pregnancy were also associated with increased NI risk, while longer breastfeeding and higher socioeconomic status were associated with decreased risk. Special attention must be given to NIs for both VPT and MLPT children.

Biocompatibility and Transplantation Efficacy of the C-Clear Artificial Cornea in a Rabbit Chemical Burn Model.

We investigated the bioavailability and stability of a C-Clear artificial cornea in a rabbit chemical burn model. Thirty-six rabbits were divided into a control group (n = 16) and a chemical burn group that used NaOH solution (n = 20). After lamellar dissection, the central posterior lamella was excised using a 3 mm diameter trephine, and an artificial cornea was transplanted into the lamellar pocket. After 2 weeks, the central anterior lamella was excised using a 3 mm diameter trephine to secure a clean visual axis. We examined the anterior segment of the eyes weekly for 12 weeks after transplantation. Successful subjects whose artificial corneas were maintained stably for 12 weeks were euthanized and underwent histologic examinations. Artificial corneas remained stable for up to 12 weeks in 62.5 and 50% of rabbits in the control and chemical burn groups, respectively. Two rabbits in the chemical burn group showed the formation of a retroprosthetic membrane, and one rabbit with visual axis blockage underwent membrane removal using a Nd:YAG laser. In histologic examinations, adhesion between artificial cornea and peripheral corneal stoma was observed. In conclusion, we confirmed structural stability and biocompatibility of the C-Clear artificial cornea for up to 12 weeks after implantation in control and chemical burn groups.

Short-term clinical outcomes after implantation of monofocal intraocular lens with enhanced intermediate function in eyes with epiretinal membrane.

Our study evaluated the clinical outcomes after implantation of a monofocal intraocular lens (IOL) with enhanced intermediate function in eyes with epiretinal membrane (ERM). Patients with preexisting ERM who underwent cataract surgery with implantation of monofocal IOL with enhanced intermediate function were included retrospectively. According to the ERM grade and central subfield thickness (CST) obtained from preoperative optical coherence tomography, patients were divided into non-fovea-involving and fovea-involving ERM groups. At 1 month after surgery, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), contrast sensitivity, defocus curve, and satisfaction questionnaire were evaluated. Postoperative clinical findings were compared with age-matched controls without ERM. A total of 50 patients' eyes (28 and 22 in the non-fovea-involving and fovea-involving ERM groups, respectively) were compared with 42 control eyes. One month post-surgery, significant differences in UDVA, CDVA, and CST (corrected P was < 0.001, = 0.001, and < 0.001, respectively) were observed between the fovea-involving ERM and control group; however, no significant differences in UIVA and UNVA were observed between the two groups. Contrast sensitivity showed inferior results in the fovea-involving group without significance. Photic phenomena were reported less in the fovea-involving group than in the non-fovea-involving group. More than 70% of patients in both ERM groups were satisfied. Implantation of monofocal IOL with enhanced intermediate function could be a good option for patients with ERM that need intermediate vision.

Effects of psychological symptoms on life adjustment among survivors of humidifier disinfectants.

OBJECTIVES: The humidifier disinfectant catastrophe in South Korea was a social disaster caused by toxic chemical substances. The present study aimed to examine the relationships between psychological symptoms and adaptive life functioning in survivors of humidifier disinfectants. This study examined the differential effects of psychological symptoms on life adjustment between survivors of humidifier disinfectant and the general population. MATERIAL AND METHODS: A total of 452 individuals (228 general and 224 survivor groups) participated in this research. This study utilized the Adult Self-Report, one of the most widely used comprehensive mental health scales for measuring both psychological symptoms (e.g., anxiety/depression) and life adjustment functioning (e.g., interpersonal relationship). For the data analysis, multi-group structural equation modeling analysis was conducted using AMOS 21.0 program. RESULTS: The results of this study indicated that attention problems out of 8 psychological symptoms was the only significant factor related to life adjustment in both general and survivor groups. In addition, there was a significant 2-way interaction effect of group status and somatic complaints on life adjustment. CONCLUSIONS: When the somatic complaint symptom was higher, participants in the survivor group were less likely to adjust in life than the general group. Taken together, the somatic complaints of the survivors more strongly influence the life adjustment than the general population. Finally, the authors discuss practical implications for survivors of humidifier disinfectants for designing suitable intervention strategies.Int J Occup Med Environ Health. 2023;36(5):596-605.

Impact of cumulative dose of brentuximab vedotin on outcomes of frontline therapy for advanced-stage Hodgkin lymphoma.

In the pivotal study ECHELON-1, brentuximab vedotin (BV), doxorubicin, vinblastine, and dacarbazine (A + AVD) demonstrated superior efficacy compared with bleomycin + AVD for the treatment of advanced-stage classic Hodgkin lymphoma (cHL). However, there are minimal available data regarding the frequency of dose reductions or omission of BV during curative therapy and the potential impact on patient outcomes. In a real-world analysis, we retrospectively reviewed the characteristics and outcomes of 179 patients with stage III or IV cHL treated with frontline A + AVD from January 2010 to April 2022. Treatment consisted of up to 1.2 mg/kg of BV and standard dose AVD IV on days 1 and 15 of each 28-day cycle for up to 6 cycles. At the time of treatment, the median patient age was 37 years, and a high-risk International Prognostic Score was observed in 46% of patients. Overall, 91% of patients received 6 cycles of AVD; 55% of patients did not receive the intended cumulative dose of BV (CDB); 28% of patients received two-thirds or less than the planned CDB. At a median follow-up time of 27.4 months (95% confidence interval [CI], 24.8-29), the median progression-free survival (PFS) was not reached, and the 12-month PFS was 90.3% (95% CI, 85.9-95.0). The impact of CDB on PFS was not significant (P = .15), nor was high CDB significantly associated with increased adverse events. In real-world experience, A + AVD is a highly effective treatment for patients with advanced-stage cHL, including for patients with prominent dose reductions of BV.

Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample.

OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS: The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.