Visual Outcomes, Spectacle Independence, and Patient-Reported Satisfaction of the Vivity Extended Range of Vision Intraocular Lens in Patients with Early Glaucoma: An Observational Comparative Study.

Purpose: This study aimed to evaluate and compare visual outcomes, spectacle independence, and patient satisfaction on bilaterally implanted Vivity extended depth-of-focus (EDOF) or monofocal intraocular lenses (IOLs) after cataract surgery in patients with early glaucoma. Patients and Methods: In this retrospective, non-randomized, interventional cohort study, patients with early glaucoma undergoing cataract surgery received bilateral implantation of either EDOF (AcrySof IQ Vivity; Alcon) or monofocal (Clareon/SN6ATx/SN60WF; Alcon) IOLs. The primary outcome was monocular uncorrected intermediate visual acuity (UIVA). The secondary outcomes were monocular uncorrected distance (UDVA) and near (UNVA) visual acuity, spectacle independence, patient satisfaction, and photic phenomena. Fifty-eight eyes from 29 patients, including 32 eyes in the EDOF group and 26 eyes in the monofocal group, were included in the study. Results: UIVA (0.06 ± 0.16 versus 0.39 ± 0.10 LogMAR; P < 0.001) and UNVA outcomes (0.29 ± 0.10 versus 0.55 ± 0.18 LogMAR; P < 0.001) were significantly better in the EDOF group than in the monofocal group, respectively. There was no difference in UDVA and corrected distance visual acuity outcomes between the groups (P > 0.05), but both spectacle independence and patient satisfaction scores were significantly higher in the EDOF group (P < 0.001 and P < 0.05, respectively). There was no difference in self-reported photic phenomena. Conclusion: Bilaterally implanted EDOF IOLs provided excellent distance vision and better intermediate and near vision than monofocal IOLs in patients with early glaucoma. Spectacle independence and patient satisfaction were significantly higher in patients who received EDOF IOLs. Photic phenomena were rare and seldom bothersome.

Early morning university classes are associated with impaired sleep and academic performance.

Attending classes and sleeping well are important for students' academic success. Here, we tested whether early morning classes are associated with lower attendance, shorter sleep and poorer academic achievement by analysing university students' digital traces. Wi-Fi connection logs in 23,391 students revealed that lecture attendance was about ten percentage points lower for classes at 08:00 compared with later start times. Diurnal patterns of Learning Management System logins in 39,458 students and actigraphy data in 181 students demonstrated that nocturnal sleep was an hour shorter for early classes because students woke up earlier than usual. Analyses of grades in 33,818 students showed that the number of days per week they had morning classes was negatively correlated with grade point average. These findings suggest concerning associations between early morning classes and learning outcomes.

Primary Needling of the Ab Interno Gelatin Microstent Reduces Postoperative Needling and Follow-up Requirements.

PURPOSE: To evaluate the effect of primary needling at the time of ab interno gelatin microstent insertion on postoperative needling rates. DESIGN: Retrospective, interventional cohort study. PARTICIPANTS: Eighty-six eyes of 74 patients with no prior incisional surgery. METHODS: Consecutive eyes with open-angle glaucoma refractory to medical treatment that underwent ab interno gelatin microstent insertion (XEN; Allergan Inc.) with or without primary needling. MAIN OUTCOME MEASURES: Primary outcome measure was the proportion of eyes requiring postoperative needling. Secondary outcome measures included the mean reduction in intraocular pressure (IOP), topical glaucoma medication use, complications, reoperations, and number of follow-up clinic visits over 12 months. RESULTS: Fifty-one eyes (42 patients, median age 74 years) underwent XEN surgery with primary needling at the time of surgery, and 35 eyes (32 patients, median age 73 years) underwent XEN surgery without routine primary needling. Eyes that received routine primary needling had an 84.8% lower rate of postoperative needling (3.9% vs. 25.7%, P = 0.003) and required fewer postoperative clinic visits (P = 0.043). Median IOP was 18.0 mmHg (interquartile range [IQR], 13.0-23.0) on 3.0 (IQR, 2.0-3.0) classes of topical medications at baseline. At 12 months, the median IOP was 11.0 mmHg (IQR, 9.0-14.0) in the primary needling group and 11 mmHg (IQR, 10.0-14.0) when primary needling was not routinely performed. Both groups demonstrated a high safety profile. In total, 5 eyes required further glaucoma surgery with insertion of a glaucoma drainage device. CONCLUSIONS: Primary needling at the time of XEN gel stent insertion is associated with a significant reduction in the need for postoperative needling and postoperative clinic visits. This modification provides a predictable postoperative course with a significant and sustained reduction in both IOP and glaucoma medication requirements with less intense postoperative management.

Targeting mutant p53-expressing tumours with a T cell receptor-like antibody specific for a wild-type antigen.

Accumulation of mutant p53 proteins is frequently found in a wide range of cancers. While conventional antibodies fail to target intracellular proteins, proteosomal degradation results in the presentation of p53-derived peptides on the tumour cell surface by class I molecules of the major histocompatibility complex (MHC). Elevated levels of such p53-derived peptide-MHCs on tumour cells potentially differentiate them from healthy tissues. Here, we report the engineering of an affinity-matured human antibody, P1C1TM, specific for the unmutated p53125-134 peptide in complex with the HLA-A24 class I MHC molecule. We show that P1C1TM distinguishes between mutant and wild-type p53 expressing HLA-A24+ cells, and mediates antibody dependent cellular cytotoxicity of mutant p53 expressing cells in vitro. Furthermore, we show that cytotoxic PNU-159682-P1C1TM drug conjugates specifically inhibit growth of mutant p53 expressing cells in vitro and in vivo. Hence, p53-associated peptide-MHCs are attractive targets for the immunotherapy against mutant p53 expressing tumours.