Study of the Chemical Activities of Carbon Monoxide, Carbon Dioxide, and Oxygen Traces as Critical Inhibitors of Polypropylene Synthesis.

This study outlines the investigation into how the compounds CO2, CO, and O2 interact with the active center of titanium (Ti) on the surface of MgCl2 and how these interactions impact the productivity of the Ziegler-Natta catalyst, ultimately influencing the thermal stability of the produced polypropylene. The calculations revealed that the adsorption energies of Ti-CO2-CO and O2 were -9.6, -12.5, and -2.32 Kcal/mol, respectively. Using the density functional theory in quantum calculations, the impacts of electronic properties and molecular structure on the adsorption of CO, O2, and CO2 on the Ziegler-Natta catalyst were thoroughly explored. Additionally, the Gibbs free energy and enthalpy of adsorption were examined. It was discovered that strong adsorption and a significant energy release (-16.2 kcal/mol) during CO adsorption could explain why this gas caused the most substantial reductions in the ZN catalyst productivity. These findings are supported by experimental tests showing that carbon monoxide has the most significant impact on the ZN catalyst productivity, followed by carbon dioxide, while oxygen exerts a less pronounced inhibitory effect.

Evento cardiovascular en una cohorte de pacientes con artritis reumatoide en Castilla-La Mancha, utilidad de la ecografía carotídea / Cardiovascular event in a cohort of rheumatoid arthritis patients in Castilla-La Mancha: Utility of carotid ultrasound

La artritis reumatoide (AR) presenta una mortalidad de 1,3-3 veces superior a la población general donde destaca la mortalidad de origen cardiovascular con un 40-50%. Actualmente se considera la enfermedad cardiovascular como una manifestación extraarticular de la AR, siendo un factor de riesgo independiente de los tradicionales, con un riesgo elevado de enfermedad cardiovascular (OR: 1,5-4,0). La medición ecográfica del grosor íntimo medial (GIM) de la arteria carótida común y la presencia de placas ateromatosas es un método no invasivo y marcador subrogado de arterioesclerosis subclínica. Objetivo: Establecer si los hallazgos de arterioesclerosis subclínica por ecografía carotídea pueden ser un buen predictor del desarrollo de eventos cardiovasculares (ECV) en una cohorte de pacientes con AR a 10 años. Metodología: Se evaluó una cohorte de pacientes con AR atendidos en consulta externa de Reumatología de una hospital de Castilla-La Mancha durante el año 2013. Se realizó una evaluación para el desarrollo de ECV a los 10 años siguientes de comenzado el estudio y se analizó su correlación con los hallazgos ecográficos previos de GIM y placas ateromatosas. Resultados: Ocho (24%) pacientes presentaron un ECV. Tres (9%), episodio de fallo cardiaco; 3 (9%) accidente cerebrovascular y 2 (6%) episodio de infarto agudo al miocardio. Los pacientes con AR que desarrollaron un ECV habían presentado un GIM mayor (0,97±0,08mm) en comparación con los pacientes con AR que no tuvieron complicaciones cardiovasculares (0,74±0,15mm) (p=0,003). La presencia de un GIM≥0,9mm y placas ateromatosas representó un riesgo relativo de 12,25 (p=0,012) y 18,66 (p=0,003), respectivamente, para el desarrollo de un ECV. Conclusiones: La ecografía carotídea en pacientes con AR nos podría permitir la detección precoz de aterosclerosis subclínica antes del desarrollo de ECV, siendo fundamentalmente el GIM≥0,9mm el hallazgo más asociado a ECV y no influenciado por la edad.(AU)

Rheumatoid arthritis (RA) has a mortality rate 1.3–3 times higher than the general population, with cardiovascular mortality accounting for 40%–50% of cases. Currently, cardiovascular disease is considered an extra-articular manifestation of RA (OR: 1.5–4.0). Ultrasound measurement of the intima-media thickness (IMT) of the common carotid artery and the presence of atherosclerotic plaques is a non-invasive method and a surrogate marker of subclinical arteriosclerosis. Objective: To determine if subclinical arteriosclerosis findings through carotid ultrasound can serve as a good predictor of cardiovascular events (CVE) development in a cohort of RA patients over a 10-year period. Methodology: A cohort of RA patients seen in the rheumatology outpatient clinic of a hospital in Castilla-La Mancha in 2013 was evaluated. A prospective evaluation for the development of CVE over the following 10 years was conducted, and its correlation with previous ultrasound findings of IMT and atherosclerotic plaques was analyzed. Results: Eight (24%) patients experienced a CVE. Three (9%) had heart failure, three (9%) had a stroke, and two (6%) experienced acute myocardial infarction. RA patients who developed a CVE had a higher IMT (0.97±0.08mm) compared to the RA patients without cardiovascular complications (0.74±0.15mm) (P=.003). The presence of IMT≥0.9mm and atherosclerotic plaques had a relative risk of 12.25 (P=.012) and 18.66 (P=.003), respectively, for the development of a CVE. Conclusions: Carotid ultrasound in RA patients may allow for early detection of subclinical atherosclerosis before the development of CVE, with IMT≥0.9mm being the most closely associated finding with CVE, unaffected by age.(AU)

Cardiovascular event in a cohort of rheumatoid arthritis patients in Castilla-La Mancha: Utility of carotid ultrasound.

Rheumatoid Arthritis (RA) has a mortality rate 1,3 to 3 times higher than the general population, with cardiovascular mortality accounting for 40-50% of cases. Currently, cardiovascular disease is considered an extraarticular manifestation of RA (OR: 1,5-4,0). Ultrasound measurement of the intima-media thickness (IMT) of the common carotid artery and the presence of atherosclerotic plaques (AP) is a non-invasive method and a surrogate marker of subclinical arteriosclerosis. OBJECTIVE: To determine if subclinical arteriosclerosis findings through carotid ultrasound can serve as a good predictor of cardiovascular events (CVE) development in a cohort of RA patients over a 10-year period. METHODOLOGY: A cohort of RA patients seen in the Rheumatology outpatient clinic of a hospital in Castilla La Mancha in 2013 was evaluated. A prospective evaluation for the development of CVE over the following 10 years was conducted, and its correlation with previous ultrasound findings of IMT and AP was analyzed. RESULTS: Eight (24%) patients experienced a CVE. Three (9%) had heart failure, three (9%) had a stroke, and two (6%) experienced acute myocardial infarction. RA patients who developed a CVE had a higher IMT (0,97 +/- 0.08 mm) compared to the RA patients without CV complications (0,74 +/- 0.15 mm) (p = 0,003). The presence of IMT ≥ 0.9 mm and AP had a relative risk of 12,25 (p = 0,012) and 18,66 (p = 0,003), respectively, for the development of a CVE. CONCLUSIONS: Carotid ultrasound in RA patients may allow for early detection of subclinical atherosclerosis before the development of CVE, with IMT ≥ 0.9 mm being the most closely associated finding with CVE, unaffected by age.

Development of films based on chitosan, gelatin and collagen extracted from bocachico scales (Prochilodus magdalenae).

Biodegradable biopolymers from species of the animal kingdom or their byproducts are sustainable as ecological materials due to their abundant supply and compatibility with the environment. The research aims to obtain a biodegradable active material from chitosan, gelatin, and collagen from bocachico scales (Prochilodus magdalenae). Regarding the methodology, films were developed from gelatin, chitosan, and collagen from bocachico scales (Prochilodus magdalenae) at different concentrations using glycerol as a plasticizer and citric acid as a cross-linker. The films were obtained with the hydrated mass processed by compression molding and characterized according to humidity, water solubility, contact angle, mechanical properties, and structural properties. The results of the films showed a hydrophobic characteristic. First, the chitosan-collagen (CS/CO) films showed a yellowish color, while the gelatin-collagen (Gel/CO) films were transparent and less soluble than the gelatin-collagen (Gel/CO) films. Concerning mechanical properties, gelatin films showed higher stiffness and tensile strength than chitosan films. Furthermore, in the morphological analysis, more homogeneous chitosan films were obtained by increasing the concentration of citric acid. In general, chitosan, gelatin, and collagen extracted from the scales of the bocachico (Prochilodus magdalenae) are an alternative in the application of films in the food industry.

Functional Classification of Intraocular Lenses Based on Defocus Curves: A Scoping Review and Cluster Analysis.

PURPOSE: To explore a potential functional classification of intraocular lenses (IOLs) based on monocular visual acuity defocus curves (VADCs) as a primary end-point. METHODS: A systematic literature search was conducted using PubMed. Two independent reviewers screened the literature for inclusion and data extraction. Inclusion criteria were full-text primary clinical studies of IOLs, published in English from 2010 onward, involving patients undergoing cataract or refractive lens exchange. A cluster analysis was conducted to explore similarities in the range of field (RoF) and increase of visual acuity from intermediate to near (ΔVA). RESULTS: A total of 107 studies were ultimately included from the 436 identified in the systematic search, with an additional 5 studies added through the snowballing technique search. The cluster analysis was conducted using 69 reports that included monocular VADCs. Two main categories were identified based on the achieved RoF for 0.2 and 0.3 logMAR: full (FRoF) and partial (PRoF) RoF IOLs. Three subcategories were identified for FRoF depending on ΔVA: continuous (FRoF-C), smooth (FRoF-Sm), and steep (FRoF-St). On the other hand, PRoF IOLs shared the characteristic of monotonous decrease in visual acuity and were subclassified into two subcategories depending on the achieved RoF: narrowed (PRoF-N) and extended (PRoF-Ex). An additional subcategory was added to PRoF, enhanced (PRoF-En), for 7 reports alternating between PRoF-N and PRoF-Ex depending on the use of 0.2 or 0.3 logMAR as a cut-off for calculating the RoF. CONCLUSIONS: IOLs can be functionally classified into six types depending on the RoF and shape of the monocular VADC. [J Refract Surg. 2024;40(2):e108-e116.].

Analysis of substrate specificity of cytochrome P450 monooxygenases involved in trichothecene toxin biosynthesis.

Trichothecenes are a structurally diverse family of toxic secondary metabolites produced by certain species of multiple fungal genera. All trichothecene analogs share a core 12,13-epoxytrichothec-9-ene (EPT) structure but differ in presence, absence and types of substituents attached to various positions of EPT. Formation of some of the structural diversity begins early in the biosynthetic pathway such that some producing species have few trichothecene biosynthetic intermediates in common. Cytochrome P450 monooxygenases (P450s) play critical roles in formation of trichothecene structural diversity. Within some species, relaxed substrate specificities of P450s allow individual orthologs of the enzymes to modify multiple trichothecene biosynthetic intermediates. It is not clear, however, whether the relaxed specificity extends to biosynthetic intermediates that are not produced by the species in which the orthologs originate. To address this knowledge gap, we used a mutant complementation-heterologous expression analysis to assess whether orthologs of three trichothecene biosynthetic P450s (TRI11, TRI13 and TRI22) from Fusarium sporotrichioides, Trichoderma arundinaceum, and Paramyrothecium roridum can modify trichothecene biosynthetic intermediates that they do not encounter in the organism in which they originated. The results indicate that TRI13 and TRI22 could not modify the intermediates that they do not normally encounter, whereas TRI11 could modify an intermediate that it does not normally encounter. These findings indicate that substrate promiscuity varies among trichothecene biosynthetic P450s. One structural feature that likely impacts the ability of the P450s to use biosynthetic intermediates as substrates is the presence and absence of an oxygen atom attached to carbon atom 3 of EPT.

Screening of positive dysphotopsia before multifocal intraocular lens implantation.

PURPOSE: To assess the photic phenomena (PP) and positive dysphotopsia in candidates for presbyopia or cataract surgery and to evaluate their relationship with cataract grading systems. DESIGN: Retrospective observational. METHODS: Monocular data for 82 subjects measured during the preoperative screening were retrospectively retrieved from our database. The evaluated variables consisted of two methods for PP measurement: light distortion index (LDI) and parameters obtained from a simulator, both of which were combined with subjective bother related to PP. The cutoff for LDI that better predicted patients passing from slightly to moderately bothersome was estimated. The relationships between LDI and the following objective cataract grading methods were also assessed: objective scatter index (OSI), dysfunctional lens index (DLI), and Pentacam Nucleus Staging (PNS). RESULTS: LDI was the best method for measuring PP, which showed a significant correlation with the bothersome question (rho = 0.34, P = 0.002) and also with OSI (rho = 0.67, P < 0.0005), DLI (rho = -0.29, P = 0.007), and PNS (rho = 0.48, P < 0.0005). The number/percentage of patients who found it bothersome was as follows: "Not at all" (18/22%), "Slightly" (41/50%), "Moderately" (15/18.3%), and "Very" (8/9.7%). The cutoff value that predicted the transition from slightly to moderately bothersome was ≥15.20% according to LDI, which could be estimated with the following values for grading: ≥2.8 for OSI, ≤7.6 for DLI, and ≥2 for PNS. CONCLUSIONS: Patients reporting moderately or higher bothersome levels in the preoperative period and with LDI <15.20%, <2.8 for OSI, >7.6 for DLI, and <2 for PNS might deserve special attention in the multifocal intraocular lens selection.

Simulations of Multifocal Vision in Patients With Previous Monofocal Intraocular Lens Implantation.

PURPOSE: To evaluate the effectiveness and patient acceptance of multifocal vision simulation in patients with previous monofocal intraocular lens (IOL) implantation, and to explore their willingness-to-pay (WTP) and willingness-to-accept (WTA) based on the perceived advantages and disadvantages of multifocal vision. METHODS: Seventeen patients with previous monofocal IOL implantation participated in this cross-sectional study. The SimVis Gekko device (2EyesVision SL) was used to simulate monofocal (Evaluation B) and multifocal (Evaluation C) visual experiences, compared to their existing vision (Evaluation A). Visual acuity at three distances and defocus curves were measured. Patients responded to inquiries about visual quality in each evaluation, bothersomeness of photic phenomena, probability to select the visual experience, and the monetary value they associated with enhanced WTP or diminished WTA visual quality. RESULTS: The simulations underestimated the visual acuity reported for the IOL in existing literature by one or two lines, depending on the testing distance. This underestimation was more pronounced in defocus curves. However, 70.6% of patients were likely or very likely to opt for multifocal vision, indicating they perceived the benefits of multifocality. The WTP for multifocal vision was twice that of monofocal vision, and the WTP/WTA ratio exceeded 1, suggesting the perceived vision benefits outweighed potential drawbacks. CONCLUSIONS: Despite underestimating the expected postoperative visual performance, the multifocal simulation enabled patients to perceive the benefits of multifocal vision to some extent. This system could be beneficial in avoiding potential postoperative complaints, but the possible rise in false-positive results should be considered and evaluated in future research. [J Refract Surg. 2023;39(12):831-839.].

Descemet membrane endothelial keratoplasty combined with presbyopia-correcting and toric intraocular lenses - a narrative review.

Fuchs endothelial corneal dystrophy (FECD) is the leading indication for EK and may coexist with cataract and presbyopia. Notably, the outcomes of phacoemulsification in FECD patients are not as favorable as those in eyes without this condition. Historically, only monofocal intraocular lenses (IOLs) were recommended for these patients. However, recent reports have described the implantation of Premium-IOLs (such as Multifocal IOLs, Enhanced Depth of Focus IOLs, and Toric IOLs) in FECD eyes undergoing cataract surgery and Descemet membrane endothelial keratoplasty (DMEK). While the results are encouraging, they are not as optimal as those from unoperated eyes, especially when comparing simultaneous procedures to sequential ones. It's advised to perform the DMEK first to improve the accuracy of IOL calculations. Still, even successfully operated eyes may experience secondary graft failure or graft rejection after DMEK. The success rate of a secondary DMEK is typically lower than that of the initial procedure. Furthermore, if the postoperative thickness after DMEK is less than anticipated, laser enhancements might not be an option. There's a pressing need for more controlled and randomized clinical trials to ascertain the safety and effectiveness of Premium-IOLs for FECD eyes. This narrative review aims to collate evidence on the use of Premium IOL technologies in eyes receiving EK and to underscore key points for surgeons performing EK combined with cataract surgery.

Evaluation of the Reactivity of Methanol and Hydrogen Sulfide Residues with the Ziegler-Natta Catalyst during Polypropylene Synthesis and Its Effects on Polymer Properties.

The study focused on the evaluation of the influence of inhibitory compounds such as hydrogen sulfide (H2S) and methanol (CH3OH) on the catalytic productivity and properties of the polymers in the polymerization process with the Ziegler-Natta catalyst. The investigation involved experimental measurements, computational calculations using DFT, and analysis of various parameters, such as molecular weight, melt flow index, xylene solubility, and reactivity descriptors. The results revealed a clear correlation between the concentration of H2S and methanol and the parameters evaluated. Increasing the H2S concentrations, on average by 0.5 and 1.0 ppm, resulted in a drastic decrease in the polymer's molecular weight. A directly proportional relationship was observed between the flow rate and the H2S concentration. In the case of methanol, the change occurred from 60 ppm, causing a sharp decrease in the molecular weight of the polymer, which translates into an increase in the fluidity index and a decrease in solubility in xylene. The presence of these inhibitors also affected the catalytic activity, causing a reduction in the productivity of the Ziegler-Natta catalyst. Computational calculations provided a deeper understanding of the molecular behavior and reactivity of the studied compounds. The computational calculations yielded significantly lower results compared to other studies, with values of -69.0 and -43.9 kcal/mol for the Ti-CH3OH and H2S interactions, respectively. These results indicate remarkable stability in the studied interactions and suggest that both adsorptions are highly favorable.

Parts per Million of Propanol and Arsine as Responsible for the Poisoning of the Propylene Polymerization Reaction.

Polypropylene synthesis is a critical process in the plastics industry, where control of catalytic activity is essential to ensure the quality and performance of the final product. In this study, the effect of two inhibitors, propanol and arsine, on the properties of synthesized polypropylene was investigated. Experiments were conducted using a conventional catalyst to polymerize propylene, and different concentrations of propanol and arsine were incorporated into the process. The results revealed that the addition of propanol led to a significant decrease in the Melt Flow Index (MFI) of the resulting polypropylene. The reduction in the MFI was most notable at a concentration of 62.33 ppm propanol, suggesting that propanol acts as an effective inhibitor by slowing down the polymerization rate and thus reducing the fluidity of the molten polypropylene. On the other hand, introducing arsine as an inhibitor increased the MFI of polypropylene. The maximum increase in the MFI was observed at a concentration of 0.035 ppm arsine. This suggests that small amounts of arsine affect the MFI and Mw of the produced PP. Regarding the catalyst productivity, it was found that as the concentration of propanol in the sample increased (approximately seven ppm), there was a decrease in productivity from 45 TM/kg to 44 TM/kg. Starting from 10 ppm, productivity continued to decline, reaching its lowest point at 52 ppm, with only 35 MT/kg. In the case of arsine, changes in catalyst productivity were observed at lower concentrations than with propanol. Starting from about 0.006 ppm, productivity decreased, reaching 39 MT/kg at a concentration of 0.024 ppm and further decreasing to 36 TM/kg with 0.0036 ppm. Computational analysis supported the experimental findings, indicating that arsine adsorbs more stably to the catalyst with an energy of -60.8 Kcal/mol, compared to propanol (-46.17 Kcal/mol) and isobutyl (-33.13 Kcal/mol). Analyses of HOMO and LUMO orbitals, as well as reactivity descriptors, such as electronegativity, chemical potential, and nucleophilicity, shed light on the potential interactions and chemical reactions involving inhibitors. Generated maps of molecular electrostatic potential (MEP) illustrated the charge distribution within the studied molecules, further contributing to the understanding of their reactivity. The computational results supported the experimental findings and provided additional information on the molecular interactions between the inhibitors and the catalyst, shedding light on the possible modes of inhibition. Solubles in xylene values indicate that both propanol and arsine affect the polymer's morphology, which may have significant implications for its properties and final applications.

Dimethylformamide Impurities as Propylene Polymerization Inhibitor.

This research study examined how the use of dimethylformamide (DMF) as an inhibitor affects the propylene polymerization process when using a Ziegler-Natta catalyst. Several experiments were carried out using TiCl4/MgCl2 as a catalyst, aluminum trialkyl as a cocatalyst, and different amounts of DMF. Then, we analyzed how DMF influences other aspects of the process, such as catalyst activity, molecular weight, and the number of branches in the polymer chains obtained, using experimental and computational methods. The results revealed that as the DMF/Ti ratio increases, the catalyst activity decreases. From a concentration of 5.11 ppm of DMF, a decrease in catalyst activity was observed, ranging from 45 TM/Kg to 44 TM/Kg. When the DMF concentration was increased to 40.23 ppm, the catalyst activity decreased to 43 TM/Kg, and with 75.32 ppm, it dropped even further to 39 TM/Kg. The highest concentration of DMF evaluated, 89.92 ppm, resulted in a catalyst productivity of 36.5 TM/Kg and lost productivity of 22%. In addition, significant changes in the polymer's melt flow index (MFI) were noted as the DMF concentration increased. When 89.92 ppm of DMF was added, the MFI loss was 75%, indicating a higher flowability of the polymer. In this study, it was found that dimethylformamide (DMF) exhibits a strong affinity for the titanium center of a Ziegler-Natta (ZN) catalyst, with an adsorption energy (Ead) of approximately -46.157 kcal/mol, indicating a robust interaction. This affinity is significantly higher compared to propylene, which has an Ead of approximately -5.2 kcal/mol. The study also revealed that the energy gap between the highest occupied molecular orbital (HOMO) of DMF and the lowest unoccupied molecular orbital (SOMO) of the Ziegler-Natta (ZN) catalyst is energetically favorable, with a value of approximately 0.311 eV.

Experimental-Density Functional Theory (DFT) Study of the Inhibitory Effect of Furan Residues in the Ziegler-Natta Catalyst during Polypropylene Synthesis.

In this experimental-theoretical study, the effect of furan on Ziegler-Natta catalyst productivity, melt flow index (MFI), and mechanical properties of polypropylene were investigated. Through the analysis of the global and local reactivity of the reagents, it was determined that the furan acts as an electron donor. In contrast, the titanium of the ZN catalyst acts as an electron acceptor. It is postulated that this difference in reactivity could lead to forming a furan-titanium complex, which blocks the catalyst's active sites and reduces its efficiency for propylene polymerization. Theoretical results showed a high adsorption affinity of furan to the active site of the Ti catalyst, indicating that furan tends to bind strongly to the catalyst, thus blocking the active sites and decreasing the availability for propylene polymerization. The experimental data revealed that the presence of furan significantly reduced the productivity of the ZN catalyst by 10, 20, and 41% for concentrations of 6, 12.23, and 25.03 ppm furan, respectively. In addition, a proportional relationship was observed between the furan concentration and the MFI melt index of the polymer, where the higher the furan concentration, the higher the MFI. Likewise, the presence of furan negatively affected the mechanical properties of polypropylene, especially the impact Izod value, with percentage decreases of 9, 18, and 22% for concentrations of 6, 12.23, and 25.03 ppm furan, respectively.

Refraction and defocus curves in eyes with monofocal and multifocal intraocular lenses

Several clinical techniques have been described to evaluate visual performance and optical quality with intraocular lenses (IOL). However, subjective refraction remains one of the most important methods for assessing post-surgery results, taking decisions about retreatments, advanced spectacle prescription and the refinement of the constant for the formula used in the IOL power calculation. Beyond clinical refraction, defocus curve measurement has been described as a complementary tool for assessing visual performance and taking clinical decisions. However, to date, there are no clinical guidelines or evidence-based protocols published in the scientific literature recommended for pseudophakic patients implanted with either monofocal or multifocal IOLs. This narrative review highlights the importance of clinical refraction in pseudophakic eyes, its utility in the decision of different types of IOL implantation, and describes a clinical refraction protocol for eyes implanted with monofocal and multifocal IOLs. (AU)

Identifying, Quantifying, and Recovering a Sorbitol-Type Petrochemical Additive in Industrial Wastewater and Its Subsequent Application in a Polymeric Matrix as a Nucleating Agent.

Currently, polypropylene (PP) is highlighted using sorbitol-based clarifying agents since these agents are high quality, low cost, and work as a barrier against moisture, which makes PP ideal for packaging food, beverages, and medical products, among others. The use of analytical methods capable of recovering these additives in wastewater streams and then reusing them in the PP clarification stage represents an innovative methodology that makes a substantial contribution to the circular economy of the PP production industry. In this study, a method of extraction and recovery of the Millad NX 8000 was developed. The additive was recovered using GC-MS and extracted with an activated carbon column plus glass fiber, using an injection molded sample, obtaining a recovery rate greater than 96%. TGA, DSC, and FTIR were used to evaluate the recovered additive's glass transitions and purity. The thermal degradation of the recovered additive was found to be between 340 and 420 °C, with a melting temperature of 246 °C, adopting the same behavior as the pure additive. In FTIR, the characteristic absorption peak of Millad NX 8000 was observed at 1073 cm-1, which indicates the purity of the extracted compound. Therefore, this work develops a new additive recovery methodology with high purity to regulate the crystallization behavior and of PP.

One-year follow-up of a multifocal intraocular lens with optimized elevated phase shift.

PURPOSE: To evaluate the standard outcomes of a multifocal intraocular lens (mIOL) with optimized elevated phase shift (EPS). SETTING: Qvision, Ophthalmology Department, VITHAS Almería, Spain. DESIGN: Retrospective observational. METHODS: 41 patients, consecutively operated on cataracts or refractive lens exchange with the implantation of the Liberty 640PM (EPS 2.0) and followed during 12 months, were included in the analysis. Retrieved variables were visual acuities at far, intermediate, and near distances; defocus curves (VADC); and prediction error of 4 formulas optimized for IOLMaster 500 and Pentacam AXL Wave. Patient-reported outcomes were also obtained for assessing spectacle independence, satisfaction, bothersome to dysphotopsia, difficulties in daily life tasks, and decision to be operated with the same mIOL. RESULTS: The median monocular efficacy with best distance correction was 0, 0.1, and 0.1 logMAR at far, intermediate, and near distances, respectively, with patients achieving binocularly a median of 0 logMAR at the 3 distances. VADC showed a depth of field of 3 diopters (D) above 0.2 logMAR with a median increase of 0.07 logMAR from -1.5 to -2.5 D. Complete spectacle independence was achieved at far distance, whereas 97.6% and 85.4% was achieved at intermediate and near distances, respectively. 7.3% of patients were bothered by dysphotopsia, and 92.6% of patients were likely to be operated again. CONCLUSIONS: EPS 2.0 restored patients' vision in the full range of the depth of field with a nearly monotone decrease of visual performance from far to near, achieving high rates of spectacle independence at all distances and with low positive dysphotopsia rates ( ClinicalTrials.gov Identifier: NCT05735990).

Efficacy of Presbyopia-Correcting Contact Lenses: A Systematic Review.

PURPOSE: To analyze critically the clinical trials on presbyopia correction with contact lenses (CLs) to investigate the quality of the research performed. METHODS: A search was performed in PubMed database on clinical trials evaluating the efficacy of the presbyopia correction with different CLs, including multifocal or simultaneous vision contact lenses (MCLs). After a comprehensive analysis of the relevant publications found, quality assessment of such publications was performed by means of Critical Appraisal Skills Programme checklist tool according to the five types of evaluations: MCL versus spectacles, MCL versus pinhole CLs, MCL versus monovision, comparison between MCL designs, and MCL versus extended depth of focus CLs. RESULTS: A total of 16 clinical trials were selected for evaluation. All evaluated studies addressed a clearly focused research question and were randomized, with a crossover design in most of the cases. Blinding was not possible in all cases due to the physical appearance of some of the CLs evaluated (pinhole or hybrid designs). Most of studies analyzed reported outcomes with complete data, providing the statistical tests used and the P -values, but some of the authors did not provide the statistical power associated to the sample size evaluated. The small sample size in some trials as well as the scarce information about the effect of addition on visual performance was the main limitations found in the peer-reviewed literature revised. CONCLUSIONS: There is a high-quality scientific evidence supporting the use of presbyopia-correcting CLs, with several randomized controlled clinical trials conducted to this date.