Effects of generalization descriptions on risk perception.

The study addresses the effects of generalization descriptions on risk perceptions. In a 1-factorial online experiment, 629 participants were randomly allocated to one of three groups. Group G1 received an excerpt of an original press release from the International Agency for Research on Cancer (IARC) regarding mobile phones and cancer, classifying RF EMF as possibly carcinogenic to humans. Group G2 received an additional explanatory text module, and Group G3 received a rewritten text, with both G2 and G3 highlighting that the possible cancer risk only refers to mobile phones. Risk perceptions regarding cell phones and related personal devices, base stations, and high voltage power lines were used as dependent variables measured before and after text reading. Further, the degree to which participants generalized from cell phone-related to other RF EMF exposures was assessed to determine whether this was predictive of their post-text risk perceptions. Regarding risk perceptions, no differences between the three groups were observed after reading the presented texts. Instead, all three experimental groups indicated increased risk perceptions for all electromagnetic field sources. However, we found significant differences according to the prevailing risk generalization belief. Respondents expressing a strong risk generalization belief showed significantly higher risk perceptions for all tested EMF sources (except mobile phones) than subjects with a weak risk generalization belief.

Eliminating the effects of reporting bias on risk perception.

Taking the public discourse on health risks due to aluminum in antiperspirants as an example, we conducted a randomized controlled study with repeated measurements to research how selective reporting of risk information affects risk perception and trust in risk information. First, the study varied the information scope that the experimental subjects received (selective vs. complete information). Selective information highlighted that a health risk is given. Considering the full range of studies, complete information is indicated the opposite. A second variation referred to the facticity of the hazardous agent mentioned in the risk information (a reference to either an actual or fictitious agent). Moreover, the selectively informed subjects received the complete information after the effects of the selective information were measured. Four risk perceptions constructs were chosen as dependent variables, differing on two dimensions (affective vs. cognitive and personal risk vs. risk for others). In addition, subjects´ trust in the given risk information was measured. The study reveals that presenting selective information amplifies risk perceptions. The effect was observed, irrespective of whether the hazardous agent mentioned in the risk information was actual or fictitious. When subjects who first received the selective information obtained the complete information, indicating no elevated risk, risk perceptions decreased. However, the analysis also indicates that corrective information (indicating no risk) is less trusted than selective information that points to health risks. Furthermore, proper toxicological understanding, i.e., taking into account the dose-response relationship, supports the effect of corrective information on risk perceptions.

Motif lengths of circular codes in coding sequences.

Protein synthesis is a crucial process in any cell. Translation, in which mRNA is translated into proteins, can lead to several errors, notably frame shifts where the ribosome accidentally skips or re-reads one or more nucleotides. So-called circular codes are capable of discovering frame shifts and their codons can be found disproportionately often in coding sequences. Here, we analyzed motifs of circular codes, i.e. sequences only containing codons of circular codes, in biological and artificial sequences. The lengths of these motifs were compared to a statistical model in order to elucidate if coding sequences contain significantly longer motifs than non-coding sequences. Our findings show that coding sequences indeed show on average greater motif lengths than expected by chance. On the other hand, the motifs are too short for a possible frame shift recognition to take place within an entire coding sequence. This suggests that as much as circular codes might have been used in ancient life forms in order to prevent frame shift errors, it remains to be seen whether they are still functional in current organisms.

Effects of selective outcome reporting on risk perception.

The current study aimed to investigate how selective reporting of study results indicating increased health effects will influence its receiver's risk perception. Using the example of the Interphone Study from 2010 on mobile phone usage and cancer, an online experiment was conducted separating respondents into two groups. One group of subjects was informed selectively about a relationship between heavy mobile phone use and an elevated risk of glioma (brain cancer) only. The other group of subjects was informed about the full results of the analyses of glioma risk by cumulative call time, which suggests that other than for the heavy users, there were no statistically significant elevated risks related to mobile phone use. The results showed that selective reporting of risk information increased risk perception when compared to receiving the full information. Additionally, the selectively informed subjects revealed a stronger tendency towards overgeneralization of the 'elevated brain cancer risk' to all mobile phone users, although this did not extend to an overgeneralization to other electromagnetic field sources or differences in the perception of a usage time dependency for possible health risks. These results indicate that reporting of full results is an important factor in effective risk communication.

Framing effects in risk communication messages - Hazard identification vs. risk assessment.

The way in which risk communication messages are framed can influence recipients' risk perceptions. Despite this, there is a limited understanding of how framing is responsible for influencing risk perception. One particularly important element may be whether a risk communication message is framed as a completed 'risk assessment' (specifying a magnitude of risk to the public as a function of the exposure level), or as a 'hazard identification' (a statement regarding whether an environmental agent could in principle cause detrimental health effects in humans, without addressing whether such effects may occur in practice). The current study aimed to investigate for the first time whether framing a risk communication message regarding 'mobile phones and health' as a hazard identification or as a risk assessment affects the reader's risk perception. Using an online survey, participants were separated into three groups and shown either an original press release from the International Agency for Research on Cancer regarding mobile phones and cancer (Group 1), or the press release with additional text modules intended to frame the press release as either a risk assessment (Group 2) or a hazard identification (Group 3). The experimental manipulation was successful in that framing the message as a hazard identification reduced the number of people that believed the press release was a risk assessment, whereas framing it as a risk assessment was not able to increase the number of people who thought that it was a risk assessment. However, no differences in risk perception were found between the groups. In an attempt to ascertain the reason for this lack of framing effect on the radiofrequency electromagnetic fields risk perception measures, it was found that pre-existing interpretations of risk and hazard strongly predicted risk perception, regardless of experimental group. Participants who believed that the International Agency for Research on Cancer conducted a hazard identification perceived lower risks and were less convinced that radiofrequency electromagnetic field exposure from mobile phones increases cancer risks. The results of the study demonstrate the importance of understanding the distinction between a hazard identification and a risk assessment, and suggest that radiofrequency electromagnetic field risk communication needs to develop means for empowering the public to differentiate between hazards and risks.

[Therapeutic alternatives to surgical treatment of malignant eyelid tumors and their precursors]. / Therapiealternativen zur chirurgischen Versorgung maligner Lidtumoren und deren Vorläuferstufen.

The treatment of choice for malignant eyelid tumors is surgical excision. If this is not feasible or undesirable, a number of alternative treatments are available. Possible systemic preparations are vismodegib and sonidegib for basal cell carcinoma as well as cetuximab and cemiplimab for squamous cell carcinoma. Cryodestruction is possible for superficial tumors. In situ findings can be treated with the local preparations imiquimod or 5­fluorouracil and with photodynamic therapy. An interdisciplinary cooperation with dermatologists is advisable.

[Treatment reality with ranibizumab in clinical routine use for patients with diabetic macular edema : 1­year results of the German POLARIS cohort]. / Behandlungsrealität mit Ranibizumab in der klinischen Routineanwendung bei Patienten mit diabetischem Makulaödem : 1-Jahres-Ergebnisse der deutschen POLARIS-Kohorte.

BACKGROUND: Currently only few data are available on the treatment reality with ranibizumab in patients with diabetic macular edema (DME). MATERIAL AND METHODS: POLARIS is an international observational study which included 983 patients who were treated with ranibizumab due to DME. The primary objective of the study was to investigate the influence of treatment and control intervals as well as resource utilization on the mean change in visual acuity. Secondary endpoints included the collation of disease activity monitoring in the clinical practice. This article describes the results of the German POLARIS population. The study was conducted in 8 European countries from October 2012 to January 2015. RESULTS: In Germany 220 patients were included in the study. Visual acuity improved by 4.3 letters within the first 3 months of treatment. At 12 months, visual acuity increased on average by 4.1 (SD ± 12.4) letters (approximately 1 line) for 168 patients enrolled in the efficacy analysis. Patients received an average of 4.5 (SD ± 1.9) injections, 10.3 (SD ± 6.3) visual acuity tests and 3.3 (SD ± 3.1) optical coherence tomography (OCT) examinations during the first year. Patients with ≤3 injections showed an average improvement in visual acuity by 2.7 letters which was less improvement compared to patients with >3 injections, who achieved an average improvement of 5.4 letters. There was a correlation between the number of injections and the visual acuity achieved. DISCUSSION: For Germany, the results of the POLARIS study indicate that despite a high number of visits, patients with DME are undertreated in clinical routine practice. The injection frequency in Germany was lower than in randomized clinical trials. Almost half of the patients received less than 4 injections in the first year of treatment and thus showed an undertreatment compared to the recommendations of German and international medical societies.

[Retinal manifestation in hematological diseases]. / Retinabeteiligung bei hämatologischen Erkrankungen.

Hematological diseases can lead to ocular manifestations. Retinal manifestation occurs in patients with anemia, leukemia, lymphoma, myeloproliferative and myelodysplastic syndromes. It is not uncommon for the ocular findings to be the first manifestation of the systemic disease. In these patients the correct diagnosis can be difficult because as a rule the retinal involvement is unspecific. In cases of unexplained retinal changes with hemorrhage and cotton wool spots, an underlying hematological disease should be suspected and the appropriate diagnostics should be recommended.

[Diagnostic Approaches to Suspected Choroidal Melanoma]. / Diagnostisches Vorgehen bei Verdacht auf Aderhautmelanom.

Whenever funduscopy reveals possible choroidal melanoma, all available information must be gathered to either confirm or exclude the diagnosis. Well-defined funduscopic criteria are available, which can already lead to a high degree of diagnostic certainty. Additional technical examinations can be used to exclude possible differential diagnoses. In cases where no clear diagnosis can be established, it is possible to take a biopsy or to watch and wait in order to observe possible growth. Whenever the diagnosis of a choroidal melanoma is established, cancer staging has to be performed in order to search for possible metastases.

[Differential diagnosis of juvenile normal pressure glaucoma]. / Differenzialdiagnose juveniles Normaldruckglaukom.

The case of a 50-year-old female patient with autosomal dominant optic atrophy is described, which was initially misinterpreted and treated as normal pressure glaucoma. Bilateral partial optic atrophy can be diagnosed by chance with mild manifestation of symptoms and can initially be misinterpreted as glaucoma. Taking a detailed medical history and performing a thorough optic nerve head examination can raise the suspicion of hereditary optic atrophy. The reliable detection of autosomal dominant optic atrophy by genetic investigations should be strived for in such cases.

[Bilateral eye injuries by external transversal force]. / Bilaterale Augenverletzung durch transversale Gewalteinwirkung.

A 49-year-old female victim of violent crime with an acute bilateral loss of vision was referred to our hospital. The ophthalmological evaluation showed complete subconjunctival hemorrhage of both eyes, bilateral hemophthalmos and hypotonia of the left eye. These raised the suspicion of an occult scleral rupture. We immediately performed exploratory surgery and found a perforating scleral lesion of the left eye and a penetrating scleral lesion of the right eye. Furthermore, a small, cruciform wound was detected on the left temple. In cooperation with the department of radiology, the extraordinary injury pattern was reconstructed: a horizontal stab wound with perforation of the left eye and penetration of the right eye caused by a screwdriver. Visual rehabilitation necessitated further surgical interventions. Besides the intraoperative approach, immediate primary wound management within 100 h of trauma plays a pivotal role for long-term outcome.

[Proliferative Vitreoretinopathy]. / Die proliferative Vitreoretinopathie.

Proliferative vitreoretinal retinopathy (PVR) is a very severe complication of vitreoretinal surgery. PVR is characterised by a complex cellular reaction. This corresponds to a vitreoretinal wound healing reaction and leads to tractional retinal detachment fixed by membranes. A rational goal of treatment is the removal of active cells and membranes, particularly the whole vitreous body; this can only be achieved surgically.

Anterior Chamber Live Loa loa: Case Report.

We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis.

[Triple Descemet membrane endothelial keratoplasty. Indications, variations and results]. / Triple-Descemet-Membran-Endothel-Keratoplastik. Indikationen, Variationen und Ergebnisse.

When Descemet membrane endothelial keratoplasty (DMEK) is indicated in patients with phakic eyes, a combination with phacoemulsification and intraocular lens implantation in one sitting should be considered as a triple DMEK. The best possible preoperative deswelling of the cornea should be strived for in order to allow sufficient viewing conditions for the individual stages of cataract surgery. Furthermore, technical details, e.g. regulation of pupillary width also must be considered. The power of the intraocular lens has to be adjusted in order to compensate for the shift of refraction towards hyperopic values induced by DMEK surgery. A rapid and clear improvement in visual acuity can normally be achieved after a triple DMEK. There seem to be no disadvantages compared with a two-stage procedure for DMEK and cataract surgery.

[Refractive changes in triple Descemet membrane endothelial keratoplasty]. / Refraktive Veränderungen bei Triple-Descemet-Membran-Endothel-Keratoplastik.

BACKGROUND: A hyperopic shift, i.e. a shift of refraction in the direction of plus values, in Descemet membrane endothelial keratoplasty (DMEK) is a well-known phenomenon. Because of the need to select an appropriate intraocular lens power this becomes particularly relevant in triple DMEK, which is a combination of DMEK and cataract surgery. OBJECTIVES: In this study the refractive changes induced by triple DMEK were evaluated. The underlying mechanisms were classified based on corneal topographical data. MATERIAL AND METHODS: The study involved a retrospective evaluation of 29 eyes from 26 patients who underwent triple DMEK. The preoperative and postoperative refractions were compared with the initially desired target refraction. Calculations concerning refractive power were performed using corneal topographical data and the Gullstrand formula. RESULTS: On average a hyperopic shift was observed. The operation led to steepening of the posterior corneal surface and flattening of the anterior corneal surface. Both resulted in a reduction of corneal refractive power but changes of the posterior corneal surface were identified as the most important factor. Those patients in whom both eyes had been operated on, showed very similar postoperative topography for both eyes, irrespective of the preoperative values. CONCLUSION: The observed hyperopic shift was a mean value. A prediction of refraction in the individual cases by means of the available parameters was not possible. In general, the selection of an intraocular lens with a stronger myopic target refraction than that for standard cataract surgery is recommended.

[Unilateral Ranibizumab Treatment and Reduction of Macular Edema in the Contralateral Eye. Medication Effect or Natural Course?]. / Rückgang von Makulaödemen unter Ranibizumab-Therapie des Partnerauges - Kollateraleffekte oder natürlicher Verlauf?

BACKGROUND: During unilateral treatment with ranibizumab, a reduction in the retinal thickness in the non-treated eye is occasionally observed. This may be due to the natural progression of the condition. It could also be the consequence of systemic absorption of intravitreal injections, leading to effects in the contralateral eye. PATIENTS: We describe 40 patients with either exsudative age-related macular degeneration (AMD) or diabetic macular oedema (DME). During treatment with ranibizumab, a reduction in retinal thickness in the contralateral eye was observed in this group (observation group). Another 40 AMD or diabetes patients under treatment with ranibizumab were selected as control group. These patients showed retinal swelling in the contralateral eye, which remained stable or increased. RESULTS: In the observation group, 58 % of the patients had a DME and 42 % had an AMD; in the control group, 25 % of the patients had a DME and 75 % of the patients had an AMD (p = 0.003). Retinal thickness before injection was 519 ± 126 µm in the observation group and 432 ± 87 µm in the control group (p = 0.003). Retinal thickness in the contralateral eye was then 511 ± 162 µm in the observation group and 436 ± 149 µm in the control group (p = 0.036). The reduction in retinal thickness in the injected eye was 214 ± 144 µm in the observation group and 150 ± 89 µm in the control group (p = 0.06). CONCLUSION: In the group of patients that showed reduction in retinal thickness under ranibizumab in the contralateral eye, there were more diabetes patients than in the comparable control group. Even before injection, these patients showed higher retinal thickness in both eyes than did those in the control group. Further prospective studies would be required to confirm a possible causal connection between ranibizumab injection and reduction in DME in the contralateral eye.