Ergonomic intervention program for office workers: a case study about its effect in computer vision syndrome and musculoskeletal discomfort.

This study aims to develop and implement an ergonomic intervention program at the workplace of knowledge workers, and to evaluate its impact on the reduction of Computer Vision Syndrome (CVS) and musculoskeletal symptoms. 84 workers were part of the study (mean age 43.2 ± 9.7 years). The intervention included training, delivery of a packaging of artificial tears, and adjustments in workstations. It was conducted intensively along 6 weeks. Data was collected on-site, with questionnaires administered pre-intervention, 2 months after, and 4 months after. Participants exhibited behavioural changes, especially in workplace adjustments and visual rest. By the intervention's end, over 90% had correctly adjusted screens and adopted appropriate postures, while 42.7% adhered to the 20x20x20 rule. CVS severity and prevalence decreased, but not significantly across the three time points. Significant improvements were observed in upper back and neck musculoskeletal symptoms at the end of workdays. Findings suggest that an ergonomic intervention program can benefit employees by reducing visual and musculoskeletal symptoms.

Practitioner summary: This study addresses CVS and MSDs, commonly experienced by individuals working with display screen equipment. It was emphasised the significance of ergonomic interventions in reducing musculoskeletal discomfort. The major finding was the positive behavioural changes, such as improved workplace adjustments and visual rest practices.

Seascape genomics reveals limited dispersal and suggests spatially varying selection among European populations of sea lamprey (Petromyzon marinus).

Sea lamprey Petromyzon marinus is an anadromous and semelparous fish without homing behaviors. Despite being a freshwater, free-living organism for a large part of their life cycle, its adulthood is spent as a parasite of marine vertebrates. In their native European range, while it is well-established that sea lampreys comprise a single nearly-panmictic population, few studies have further explored the evolutionary history of natural populations. Here, we performed the first genome-wide characterization of sea lamprey's genetic diversity in their European natural range. The objectives were to investigate the connectivity among river basins and explore evolutionary processes mediating dispersal during the marine phase, with the sequencing of 186 individuals from 8 locations spanning the North Eastern Atlantic coast and the North Sea with double-digest RAD-sequencing, obtaining a total of 30,910 bi-allelic SNPs. Population genetic analyses reinforced the existence of a single metapopulation encompassing freshwater spawning sites within the North Eastern Atlantic and the North Sea, though the prevalence of private alleles at northern latitudes suggested some limits to the species' dispersal. Seascape genomics suggested a scenario where oxygen concentration and river runoffs impose spatially varying selection across their distribution range. Exploring associations with the abundance of potential hosts further suggested that hake and cod could also impose selective pressures, although the nature of such putative biotic interactions was unresolved. Overall, the identification of adaptive seascapes in a panmictic anadromous species could contribute to conservation practices by providing information for restoration activities to mitigate local extinctions on freshwater sites.

Fibrosis of Peritoneal Membrane, Molecular Indicators of Aging and Frailty Unveil Vulnerable Patients in Long-Term Peritoneal Dialysis.

Peritoneal membrane status, clinical data and aging-related molecules were investigated as predictors of long-term peritoneal dialysis (PD) outcomes. A 5-year prospective study was conducted with the following endpoints: (a) PD failure and time until PD failure, (b) major cardiovascular event (MACE) and time until MACE. A total of 58 incident patients with peritoneal biopsy at study baseline were included. Peritoneal membrane histomorphology and aging-related indicators were assessed before the start of PD and investigated as predictors of study endpoints. Fibrosis of the peritoneal membrane was associated with MACE occurrence and earlier MACE, but not with the patient or membrane survival. Serum α-Klotho bellow 742 pg/mL was related to the submesothelial thickness of the peritoneal membrane. This cutoff stratified the patients according to the risk of MACE and time until MACE. Uremic levels of galectin-3 were associated with PD failure and time until PD failure. This work unveils peritoneal membrane fibrosis as a window to the vulnerability of the cardiovascular system, whose mechanisms and links to biological aging need to be better investigated. Galectin-3 and α-Klotho are putative tools to tailor patient management in this home-based renal replacement therapy.

Real-Time Blink Detection as an Indicator of Computer Vision Syndrome in Real-Life Settings: An Exploratory Study.

With the increase in the number of people using digital devices, complaints about eye and vision problems have been increasing, making the problem of computer vision syndrome (CVS) more serious. Accompanying the increase in CVS in occupational settings, new and unobstructive solutions to assess the risk of this syndrome are of paramount importance. This study aims, through an exploratory approach, to determine if blinking data, collected using a computer webcam, can be used as a reliable indicator for predicting CVS on a real-time basis, considering real-life settings. A total of 13 students participated in the data collection. A software that collected and recorded users' physiological data through the computer's camera was installed on the participants' computers. The CVS-Q was applied to determine the subjects with CVS and its severity. The results showed a decrease in the blinking rate to about 9 to 17 per minute, and for each additional blink the CVS score lowered by 1.26. These data suggest that the decrease in blinking rate was directly associated with CVS. These results are important for allowing the development of a CVS real-time detection algorithm and a related recommendation system that provides interventions to promote health, well-being, and improved performance.

Membranous nephropathy after a recent SARS-CoV-2 infection.

SARS-CoV-2 infections can induce kidney injury and glomerulopathy, with the most common pathology findings being acute tubular injury and collapsing glomerulopathy.Here we describe a rare case of membranous nephropathy in a man in his late 70s presented with nephrotic syndrome and rapidly progressive kidney dysfunction 1 month after SARS-CoV-2 infection. Phospholipase A2 receptor antibodies were positive. He was treated with rituximab, with proteinuria control. We review the cases reported in the literature.

Alpha-klotho and peritoneal membrane status: A hypothesis generating study.

BACKGROUND: Long-term success of peritoneal dialysis relies on the integrity of the peritoneal membrane. This proof-of-concept study addressed the hypothesis that fibrosis is already present in the membrane at pre-dialysis and that the membrane status is related to the individual's uraemic fingerprint. METHODS: A clinical-mechanistic, transversal, single-centre study was conducted. Pre-dialysis peritoneal biopsies were scored considering the submesothelial compact zone thickness (STM), vasculopathy and inflammation. We investigated if the membrane status could be inferred from a panel of proteins (α-Klotho, Galectin-3, FGF21, FGF23, Tweak, TNFα and hsPCR) in blood. RESULTS: A total 58 incident patients aged 56 ± 15 years old were included, 31% female, 55% hypertension, 29% diabetic and 24% obese. Person-to-person STM was found to be highly variable and 38% of patients were fibrosis positive. Both α-Klotho (Spearman r = -.7491, p < 0.001) and FGF21 (Spearman r = -.5102, p < 0.001) were negatively associated with STM. α-Klotho, but not FGF21, was able to discriminate fibrosis from nonfibrosis with/without inflammation and vasculopathy. PLS models identified α-Klotho as the protein most relevant for fibrosis. α-Klotho was independently associated with fibrosis of the peritoneal membrane (OR = .991 (.896-.997), p = 0.002). CONCLUSION: Before the start of dialysis in incident patients, some patients already present fibrosis of the peritoneal membrane and other patients do not. Our findings suggest that α-Klotho may be implicated in fibrosis of the peritoneal membrane.

Non-diabetic metabolic nodular glomerulosclerosis.

Nodular glomerulosclerosis is classically associated with diabetes. Nowadays, it is well known that this histologic pattern can be the presentation of different diseases, including dysproteinemias and amyloidosis. Most recently, the previously thought to be idiopathic nodular glomerulosclerosis has been associated with hypertension, smoking, and obesity. We present a clinical case of a non-diabetic 74-year-old man, with hypertension and heavy smoking history, who presented with nephrotic proteinuria and chronic kidney disease. We review the literature and propose a different nomenclature for this pattern of metabolic glomerulopathy.

Pantoea in Peritoneal Dialysis: A Rare Cause of Peritonitis.

Peritonitis is the most common complication of peritoneal dialysis (PD) and an important cause of PD failure. There are numerous etiological agents, mostly bacteria. Pantoea spp is a rare cause of peritonitis. We describe three cases of Pantoea peritonitis in three PD patients. Previous reports have identified risk factors such as close contact with plants and animals. We review the typical clinical presentation and prognosis. It is fulcral to teach patients about the risks regarding proximity to plants and animals to prevent this type of infection.

Misidentification of epithelial renal tubular cells as decoy cells in the urinary sediment of a kidney transplant recipient: the importance of adequate clinical information.

The examination of the urinary sediment of a kidney transplant recipient, carried out in blind conditions, showed the presence of a moderate number of cells which were identified as decoy cells. Most frequently these cells are a marker of BK polyomavirus reactivation, which can lead to BK virus nephropathy and graft loss. However, the patient's clinical history, the absence of BK viremia, and the renal biopsy findings excluded this condition. The careful examination of the renal biopsy demonstrated a severe tubular damage with cells resembling those identified in the urine as decoy cells. This paper is the first which demonstrates that damaged renal tubular epithelial cells can be misidentified as decoy cells. In addition, it highlights the importance of supplying adequate clinical information for a correct urinary sediment examination.

Thrombotic microangiopathy triggered by podocytopathy.

Thrombotic microangiopathy (TMA) is a rare group of diseases characterized by microangiopathic hemolytic anemia, thrombocytopenia, and target organ damage. It can be divided into primary and secondary TMA. Herein we report a case of TMA associated to a primary glomerular disease. We report the case of a 31-year-old Black male from Cape Verde admitted in March 2018 with nephrotic syndrome and upper gastrointestinal bleeding, the latter due to severe erythematous gastritis. He was discharged after clinical stabilization. The patient came to Portugal 8 months later. On admission, he presented with rapid deterioration of kidney function and hyperkalemia. The etiologic study revealed microangiopathic hemolytic anemia, nephrotic syndrome and microscopic hematuria. Immunologic study and viral serology were negative. ADAMTS13 activity and inhibitor testing were within normal range, genetic complement evaluation showed CFH-H3 in homozygosity, functional complement studies revealed decreased function of alternative pathway. Kidney biopsy was consistent with the diagnosis of TMA, and electron microscopy was compatible with minimal change disease. Patient underwent plasmapheresis with resolution of hemolysis, fluid overload and recovery of renal function. Two months later, he presented with nephrotic syndrome and started prednisolone with remission. Six months later, the nephrotic syndrome relapsed, and it became steroid-, MMF-, and rituximab-resistant. Tacrolimus was initiated, achieving partial remission. Atypical hemolytic uremic syndrome is an uncommon disease and is rarely reported as secondary to glomerular diseases. This case showcases the challenges regarding treatment options in a resistant glomerulopathy and the implications of therapeutic choices and kidney outcomes with the coexisting TMA.

Pattern of Retinal Nerve Fiber Layer Thickness Loss in Fetal Alcohol Syndrome: A Spectral-Domain Optical Coherence Tomography Analysis.

INTRODUCTION: Optic disc hypoplasia is a common feature in fetal alcohol syndrome. Thus, we aimed to evaluate the optic disc morphology changes and the peripapillary retinal nerve fiber layer thickness in these patients. MATERIAL AND METHODS: We performed spectral-domain optical coherence tomography in a cohort of 11 patients (22 eyes) with fetal alcohol syndrome and in an age-matched control group. We evaluated optic nerve head parameters (optic disc area and diameter, rim area, cup/disc horizontal and vertical ratios) and peripapillary retinal nerve fiber layer thickness. RESULTS: Mean optic disc area, rim area and optic disc diameter were, respectively, in fetal alcohol syndrome patients and control subjects: 1.540 ± 0.268 and 1.748 ± 0.326 mm2; 1.205 ± 0.286 and 1.461 ± 0.314 mm2; 1.417 ± 0.124 and 1.501 ± 0.148 mm (p < 0.05). We found no significant differences between groups for cup/disc ratios. Mean retinal nerve fiber layer thickness was significantly lower in fetal alcohol syndrome patients (90.500 ± 9.344 µm) as compared to controls (111.000 ± 7.855 µm) (p < 0.0001). Analysis showed a significant decrease in retinal nerve fiber layer thickness for the superior, inferior and nasal quadrants (p < 0.005). The temporal quadrant showed no significant differences. DISCUSSION: Optic disc area, rim area and optic disc diameters were significantly reduced in fetal alcohol syndrome patients. Although mean peripapillary retinal nerve fiber layer thickness was decreased, the temporal quadrant was spared. CONCLUSION: In addition to a smaller optic disc area/ diameter and rim area, we found a heterogeneous peripapillary retinal nerve fiber layer thickness loss in fetal alcohol syndrome patients with sparing of the temporal quadrant. Spectral-domain optical coherence tomography may be useful to determine the presence of fetal alcohol syndrome status.

Introdução: A hipoplasia do disco ótico é característica comum na síndrome fetal-alcoólica. Assim, propusemo-nos a avaliar as alterações morfológicas do disco ótico e a espessura da camada de fibras nervosas retinianas peripapilares, nunca antes estudada nestes doentes. Material e Métodos: Realizamos tomografia de coerência óptica de domínio espectral num grupo de 11 doentes (22 olhos) com síndrome fetal-alcoólica e num grupo controlo ajustado à idade. Avaliamos alguns parâmetros morfológicos do disco ótico (área e diâmetro do disco ótico, área do anel neurorretiniano, razão escavação/disco horizontal e vertical) e a espessura da camada de fibras nervosas retiniana peripapilares. Resultados: Os valores médios da área do disco ótico, anel neurorretiniano e diâmetro do disco ótico foram, respetivamente, no grupo de doentes e no grupo controlo: 1,540 ± 0,268 e 1,748 ± 0,326 mm2; 1,205 ± 0,286 e 1,461 ± 0,314 mm2; 1,417 ± 0,124 e 1,501 ± 0,148 mm (p < 0,05). Não encontramos diferenças significativas entre as razões escavação/disco. A espessura média da camada de fibras nervosas foi significativamente menor nos pacientes (90,500 ± 9,344 µm) relativamente aos controlos (111,000 ± 7,855 µm) (p < 0,0001). Verificamos uma diminuição significativa nos quadrantes superior, inferior e nasal (p < 0,005). O quadrante temporal não revelou diferenças significativas. Discussão: As áreas do disco ótico e anel neurorretiniano e o diâmetro do disco ótico foram significativamente menores nos pacientes com síndrome fetal-alcoólica. Embora a espessura média da camada de fibras nervosas peripapilares se tenha revelado diminuída, o quadrante temporal parece estar poupado. Conclusão: Para além de uma área/diâmetro do disco ótico e área do anel neurorretiniano menores, descobrimos um padrão heterogéneo de perda da camada de fibras nervosas retinianas peripapilares em pacientes com síndrome fetal-alcoólica, sem atingimento do quadrante temporal. A tomografia de coerência óptica poderá ser útil no estabelecimento do diagnóstico da síndrome fetal-alcoólica.

European Lampreys: New Insights on Postglacial Colonization, Gene Flow and Speciation.

Ice ages are known to be the most dominant palaeoclimatic feature occurring on Earth, producing severe climatic oscillations and consequently shaping the distribution and the population structure of several species. Lampreys constitute excellent models to study the colonization of freshwater systems, as they commonly appear in pairs of closely related species of anadromous versus freshwater resident adults, thus having the ability to colonize new habitats, through the anadromous species, and establish freshwater resident derivates. We used 10 microsatellite loci to investigate the spatial structure, patterns of gene flow and migration routes of Lampetra populations in Europe. We sampled 11 populations including the migratory L. fluviatilis and four resident species, L. planeri, L. alavariensis, L. auremensis and L. lusitanica, the last three endemic to the Iberian Peninsula. In this southern glacial refugium almost all sampled populations represent a distinct genetic cluster, showing high levels of allopatric differentiation, reflecting long periods of isolation. As result of their more recent common ancestor, populations from northern Europe are less divergent among them, they are represented by fewer genetic clusters, and there is evidence of strong recent gene flow among populations. These previously glaciated areas from northern Europe may have been colonized from lampreys expanding out of the Iberian refugia. The pair L. fluviatilis/L. planeri is apparently at different stages of speciation in different locations, showing evidences of high reproductive isolation in the southern refugium, and low differentiation in the north.

A New Approach to Assess Early Progressive Loss Across Multiple Visual Channels In the Natural History of Glaucoma.

PURPOSE: We aimed to evaluate the ability of new psychophysical discrimination tests, based on readily available hardware, to probe motion, achromatic, and chromatic contrast sensitivity, across the natural history of glaucoma. We assessed the sensitivity of these tests to detect functional damage at ocular hypertension stage, using receiver operating characteristic analysis. We also explored whether eccentricity-related patterns of damage change with disease progression. PATIENTS AND METHODS: We studied a cohort of 43 participants, who were divided between different groups: ocular hypertension (n=16 eyes), glaucoma suspects (n=15), and primary open-angle glaucoma (n=12). These patients were compared with an age-matched control group (n=15 eyes). We tested distinct subsets of retinal ganglion cell populations using 3 novel 2-alternative forced choice psychophysical discrimination tests (independent variables: motion, achromatic, and chromatic L, M, and S-cone contrasts) between 2 separated peripheral, small moving single dots at 4 distinct meridians. Notably these tests were implemented in relatively standard hardware. RESULTS: All tests showed significant correlation with disease progression (mean ρ±SD=0.708±0.075; P<0.0001) and had sufficient power to discriminate glaucoma subgroups. Most tests using this design had large sensitivity (above 90% for 80% specificity) to detect functional damage at the ocular hypertensive stage. Disease-related eccentricity patterns of damage were also found, matching the expected pattern of progression. CONCLUSIONS: Our new psychophysical discrimination tests are capable of probing disease progression and to detect functional damage at ocular hypertension stage. It is therefore possible to customize psychophysical test software to detect early changes and monitor disease progression, including progressive loss of functional reserve, using relatively simple hardware.

Genetically induced impairment of retinal ganglion cells at the axonal level is linked to extrastriate cortical plasticity.

Leber hereditary optic neuropathy (LHON) is a maternally inherited mitochondrial disorder, which leads to initially silent visual loss due to retinal ganglion cell (RGC) degeneration. We aimed to establish a link between features of retinal progressive impairment and putative cortical changes in a cohort of 15 asymptomatic patients harboring the 11778G>A mutation with preserved visual acuity and normal ocular examination. To study plasticity evoked by clinically silent degeneration of RGC we only studied mutation carriers. We phenotyped pre-clinical silent degeneration from the psychophysical, neurophysiological and structural points of view to understand whether retinal measures could be related to cortical reorganization, using pattern electrophysiology, chromatic contrast sensitivity and high-resolution optical coherence tomography to measure macular, RGC nerve fiber layer as well as inner/outer retinal layer thickness. We then performed correlation analysis of these measures with cortical thickness estimates in functionally mapped retinotopic visual cortex. We found that compensatory cortical plasticity occurring in V2/V3 is predicted by the swelling (indicating deficits of axonal transport and intracellular edema) of the macular RGC axonal layer. Increased cortical thickness (CT) in V2 and V3 was observed in peripheral regions, like visual field loss, in these mutation carriers. CT was a very discriminative measure between carriers and controls, as revealed by ROC analysis. Importantly, the substantial cortical reorganization that occurs in the carrier state can be used to provide statistical discrimination between carriers and controls to a level that is similar to measures of retinal dysfunction. We conclude that peripheral cortical compensatory plasticity in early visual areas V2/V3 may be triggered by pathology in peripheral RGC axons in combination with potential developmental changes.

Development and aging of visual hemifield asymmetries in contrast sensitivity.

The relation of development and aging with models of visual anisotropies and their influence on low-level visual processing remain to be established. Our main goal was to explore visual performance asymmetries in development and normal aging using low-level contrast sensitivity behavioral tasks [probing two distinct spatiotemporal frequency channels, (a) intermediate spatial and null temporal frequency (3.5 cycles per degree (cpd) and 0 Hz); and (b) low spatial and high temporal frequency (0.25 cpd undergoing 25 Hz counterphase flicker)]. Different patterns of functional asymmetries were investigated within four (two neurodevelopmental and two adult) age groups (N = 258 participants; 8-65 years). We found a left visual hemifield/right hemisphere advantage for only the intermediate spatial frequency channel that was present early in life and remained stable throughout adulthood. In contrast, inferior/superior visual hemifield asymmetries, with a direct ecological meaning, were found for both spatiotemporal frequency channels. This inferior visual hemifield advantage emerged early in life and persisted throughout aging. These findings show that both right hemispheric and dorsal retinotopic patterns of dominance in low-level vision emerge early in childhood, maintaining during aging.

Investigating population structure of Sea Lamprey (Petromyzon marinus, L.) in Western Iberian Peninsula using morphological characters and heart fatty acid signature analyses.

This study hypothesizes the existence of three groups of sea lamprey Petromyzon marinus L. in Portugal (North/Central group, Tagus group, and Guadiana group), possibly promoted by seabed topography isolation during the oceanic phase of the life cycle. Within this context, our purpose was to analyze the existence of a stock structure on sea lamprey populations sampled in the major Portuguese river basins using both morphological characters and heart tissue fatty acid signature. In both cases, the multiple discriminant analysis revealed statistically significant differences among groups, and the overall corrected classification rate estimated from cross-validation procedure was particularly high for the cardiac muscle fatty acid profiles (i.e. 83.8%). Morphometric characters were much more useful than meristic ones to discriminate stocks, and the most important variables for group differentiation were eye length, second dorsal fin length and branchial length. Fatty acid analysis showed that all lampreys from the southern Guadiana group were correctly classified and not mixing with individuals from any other group, reflecting a typical heart fatty acid signature. Our results revealed that 89.5% and 72.2% of the individuals from the Tagus and North/Central groups, respectively, were also correctly classified, despite some degree of overlap between individuals from these groups. The fatty acids that contributed to the observed segregation were C16:0; C17:0; C18:1ω9; C20:3ω6 and C22:2ω6. Detected differences are probably related with environmental variables to which lampreys may have been exposed, which leaded to different patterns of gene expression. These results suggest the existence of three different sea lamprey stocks in Portugal, with implication in terms of management and conservation.

Neuroretinal dysfunction with intact blood-retinal barrier and absent vasculopathy in type 1 diabetes.

It is unknown whether independent neural damage may occur in the pre-/absent vascular diabetic retinopathy (DR). To exclude vasculopathy, it is important to measure the integrity of the blood-retinal barrier (BRB). This cross-sectional study addressed this problem in type 1 diabetic patients with normal ocular fundus and absent breakdown of the BRB (confirmed with vitreous fluorometry). These were compared with a group with disrupted BRB (with normal fundus or initial DR) and normal controls. Multifocal electroretinography and chromatic/achromatic contrast sensitivity were measured in these 42 patients with preserved visual acuity. Amplitudes of neurophysiological responses (multifocal electroretinogram) were decreased in all eccentricity rings in both clinical groups, when compared with controls, with sensitivity >78% for a specificity level of 90%. Implicit time changes were also found in the absence of initial DR. Impaired contrast sensitivity along chromatic axes was also observed, and achromatic thresholds were also different between controls and both clinical groups. The pattern of changes in the group without baseline BRB permeability alterations, as probed by psychophysical and electrophysiological measurements, does thereby confirm independent damage mechanisms. We conclude that retinal neuronal changes can be diagnosed in type 1 diabetes, independently of the breakdown of the BRB and onset of vasculopathy.

Strong genome-wide divergence between sympatric European river and brook lampreys.

Lampreys, together with hagfishes, are the only extant representatives of jawless vertebrates and thus of prime interest for the study of vertebrate evolution [1]. Most lamprey genera occur in two forms with divergent life histories: a parasitic, anadromous and a non-parasitic, freshwater resident form [2-8]. The taxonomic status of such 'paired species' is disputed, however. While indistinguishable at larval stages, but clearly distinct as adults, they cannot be differentiated with available genetic data [6,7], which has fuelled speculations that the two forms may in fact represent products of phenotypic plasticity within a single species. Here, we use restriction site-associated DNA sequencing (RADseq) to examine the genetic population structure of sympatric European river (Lampetra fluviatilis L., 1758) and brook (Lampetra planeri Bloch, 1784) lampreys. We find strong genetic differentiation and identify numerous fixed and diagnostic single nucleotide polymorphisms (SNPs) between the two species, 12 of which can be unequivocally assigned to specific genes.