Evaluating Contrast Sensitivity in Early and Intermediate Age-Related Macular Degeneration With the Quick Contrast Sensitivity Function.

Purpose: The purpose of this study was to describe, validate, and compare the contrast sensitivity functions (CSFs) acquired with the novel quick CSF (qCSF) method from patients with early and intermediate age-related macular degeneration (eAMD and iAMD) and healthy controls. Methods: This is a cross-sectional analysis of contrast sensitivity (CS) and visual acuity (VA) baseline data from the prospective Multimodal Functional and Structural Visual System Characterization (MUMOVI) study. The qCSF testing was conducted with the manifold contrast vision meter (Adaptive Sensory Technology, San Diego, CA, USA). CS levels at spatial frequencies from 1 cycle per degree (CPD) to 18 CPD, the area underneath the logarithmic contrast sensitivity function (AULCSF), and contrast acuity (CA) were analyzed. The association of functional metrics with variables of interest was tested with linear models. Results: Ninety-four study eyes from 94 study patients were included in the analysis (13 patients with eAMD, 33 patients with iAMD, and 48 healthy controls). Significant differences between the eAMD and the iAMD model estimates were only found for CS at 1 CPD (t value = -2.9, P value = 0.006) and CS at 1.5 CPD (-2.7, 0.01). A specific association between smoking years and CS at 1 CPD (P = 0.02) and CS at 1.5 CPD (P = 0.03) could be described in patients with AMD. Conclusions: The qCSF testing allows the fast measurement of the whole CSF, enabling the integration into clinical routine. We showed that novel qCSF-derived metrics detect slight functional differences between AMD stages, which testing by Pelli-Robson charts or VA testing would miss. This study, therefore, yields novel qCSF-derived candidate metrics for therapeutic trials in AMD.

Do Race and Ethnicity Affect the Age When Third Molars are Extracted?

PURPOSE: Socioeconomic and racial statuses are barriers to dental and medical healthcare in America leading to poor health outcomes. Delayed management of third molars may increase the risk of complications. There have been no large-scale studies examining the role race and ethnicity have on timing of third molar extraction. The purpose of this study is to explore the associations of race and ethnicity on age of third molar extractions and complications. MATERIALS AND METHODS: This retrospective cohort study composed of patients who underwent third molar extraction at Boston Children's Hospital from April 2011 to March 2021. Patients self-identified race as White, Black/African American, Asian, Native American/Pacific Islander, other, and prefer not to answer. Patients identified ethnicity as Hispanic or non-Hispanic. Subjects with incomplete medical records were excluded. Primary predictor variables were race and ethnicity. The primary outcome variable was the age of third molar extractions and the secondary outcome variable was postoperative complications. Descriptive, univariate, and multivariate statistics were conducted. P < .05 was considered statistically significant. Covariates included gender, insurance type, interpreter requirements, and preoperative symptoms. RESULTS: This study included 3,933 patients after exclusion criteria were applied. The mean age was 18.6 ± 2.49 years. When third molars were removed, White patients were older than the non-White population (18.8 vs 18.2 years, P < .001). Black or African American patients were younger than all other races (18.1 vs 18.7 years, P < .001). Hispanics were younger compared to non-Hispanics (18.1 vs 18.7 years, P < .001). Patients with preoperative symptoms removed their wisdom teeth at an older age compared to those who were asymptomatic (19.0 vs 18.5 years, P < .001). Black patients experienced more preoperative symptoms than other races (46.2% vs 29.2%, P < .001). White patients experienced the most postoperative complications (7.7% vs 5.0%, P = .003), while Black or African American patients experienced less postoperative complications (2.7% vs 7.5%, P < .001). CONCLUSION: This study provides no evidence that patients from historically under-represented racial and ethnic groups had inadequate access for removal of their third molars. Patients from these communities experienced a lower rate of complications after third molar extractions confirming quality of care was not compromised for these patients.

Genetic deletion of mast cell serotonin synthesis prevents the development of obesity and insulin resistance.

Obesity is linked with insulin resistance and is characterized by excessive accumulation of adipose tissue due to chronic energy imbalance. Increasing thermogenic brown and beige adipose tissue futile cycling may be an important strategy to increase energy expenditure in obesity, however, brown adipose tissue metabolic activity is lower with obesity. Herein, we report that the exposure of mice to thermoneutrality promotes the infiltration of white adipose tissue with mast cells that are highly enriched with tryptophan hydroxylase 1 (Tph1), the rate limiting enzyme regulating peripheral serotonin synthesis. Engraftment of mast cell-deficient mice with Tph1-/- mast cells or selective mast cell deletion of Tph1 enhances uncoupling protein 1 (Ucp1) expression in white adipose tissue and protects mice from developing obesity and insulin resistance. These data suggest that therapies aimed at inhibiting mast cell Tph1 may represent a therapeutic approach for the treatment of obesity and type 2 diabetes.

Evaluation of General and Tailor Made Force Fields via X-ray Thermal Diffuse Scattering Using Molecular Dynamics and Monte Carlo Simulations of Crystalline Aspirin.

We have performed a comparison of the experimental thermal diffuse scattering (TDS) from crystalline Aspirin (form I) to that calculated from molecular dynamics (MD) simulations based on a variety of general force fields and a tailor-made force field (TMFF). A comparison is also made with Monte Carlo (MC) simulations which use a "harmonic network" approach to describe the intermolecular interactions. These comparisons were based on the hypothesis that TDS could be a useful experimental data in validation of such simulation parameter sets, especially when calculations of dynamical properties (e.g., thermodynamic free energies) from molecular crystals are concerned. Currently such a validation of force field parameters against experimental data is often limited to calculation of specific physical properties, e.g., absolute lattice energies usually at 0 K or heat capacity measurements. TDS harvested from in-house or synchrotron experiments comprises highly detailed structural information representative of the dynamical motions of the crystal lattice. Thus, TDS is a well-suited experimental data-driven means of cross validating theoretical approaches targeted at understanding dynamical properties of crystals. We found from the results of our investigation that the TMFF and COMPASS (from the commercial software "Materials Studio") parameter sets gave the best agreement with experiment. From our homologous MC simulation analysis we are able to show that force constants associated with the molecular torsion angles are likely to be a strong contributing factor for the apparent reason why these aforementioned force fields performed better.

Sex Offenders in the Digital Age.

With most youths now using the Internet and social networking sites (SNSs), the public has become increasingly concerned about risks posed by online predators. In response, lawmakers have begun to pass laws that ban or limit sex offenders' use of the Internet and SNSs. At the time of this article, 12 states and the federal government have passed legislation attempting to restrict or ban the use of SNSs by registered sex offenders. These laws have been successfully challenged in 4 states. In this article, we discuss examples of case law that illustrate evolving trends regarding Internet and social networking site restrictions on sex offenders on supervised release, as well as those who have already completed their sentences. We also review constitutional questions and empirical evidence concerning Internet and social networking use by sex offenders. To our knowledge, this is the first paper in the psychiatric literature that addresses the evolving legal landscape in reference to sex offenders and their use of the Internet and SNSs. This article is intended to help inform forensic mental health professionals who work with sex offenders on current concerns in this rapidly evolving legal landscape.

Update on cardiorenal Syndrome: a clinical conundrum.

Our understanding of the cardiorenal syndrome continues to progress. Decades of research have led to a better definition of the clinical cardiorenal syndrome and have laid the groundwork for understanding its pathophysiology. Although improvements have been made, there are still knowledge gaps concerning the interactions of these two organ systems. In the present review, we examine those interactions in the setting of acute and chronic cardiac decompensation and the resulting impacts on renal dysfunction. Recognition and prevention of this syndrome may help to better serve a growing patient population.

Cardiorenal Syndrome: The Clinical Cardiologists' Perspective.

The term cardiorenal syndrome has evolved over the years. The understanding of the interactions between these two organ systems has led to better recognition and treatment strategies. As cardiovascular mortality is high in individuals with renal dysfunction, it is imperative to understand the pathophysiology behind the disease process. This knowledge may better serve these patients with this syndrome and improve their outcomes. In this review, we examine the key issues of the cardiorenal syndrome from a cardiologist's perspective.

Solid-state (15)N CPMAS NMR and computational analysis of ligand hapticity in rhodium(η-diene) poly(pyrazolyl)borate complexes.

Novel [Rh(η-diene)Tp(x)] complexes of sterically encumbered Tp(x) ligands (Tp(x) = Tp(4Bo), diene = cod, 1; nbd, 2; Tp(x) = Tp(4Bo,5Me), diene = cod, 3; nbd, 4; Tp(x) = Tp(a,3Me), diene = cod, 5; nbd, 6; Tp(x) = Tp(a*,3Me), diene = cod, 7; nbd, 8) have been prepared by treatment of [Rh(η-diene)(µ-Cl)](2) with TlTp(x) (Tp(x) in general, in detail: Tp(4Bo) = hydrotris(indazol-1-yl)borate, Tp(4Bo,5Me) = hydrotris(5-methyl-indazol-1-yl)borate, Tp(a,3Me) = hydrotris(3-methyl-2H-benz[g]-4,5-dihydroindazol-2-y1)borate, Tp(a*,3Me) = hydrotris(3-methyl-2H-benz[g]indazol-2-yl)borate), and characterized by analytical and spectral data (IR, (1)H, (11)B, and (13)C NMR solution). The structures adopted by [Rh(nbd)Tp(4Bo)] 2, [Rh(cod)Tp(4Bo,5Me)] 3, [Rh(nbd)Tp(a,3Me)] 6, [Rh(nbd)Tp(a*,3Me)] 8, and [Rh(nbd)Tp(a*,3Me*)] 8* (incorporating a borotropomeric ligand), have been investigated. Low steric hindrance between the ligands in 2 and 3 permits κ(3) coordination of the pyrazolylborate while the high steric encumbrance present in 6, 8, and 8* results in κ(2) ligands. The coordination modes of the ligands to the metal have also been established by (15)N CPMAS studies of selected ligands and their corresponding Rh complexes. These spectroscopic data are in agreement with the (15)N chemical shifts obtained by using quantum-chemical methods to assist reliable assignments of the experimental values, affording new insights into the extraction of structural information concerning the hapticity (κ(2) or κ(3)) of the poly(pyrazolyl)borate ligands to the Rh metal.

Cardiac implantable electronic device infections: presentation, management, and patient outcomes.

BACKGROUND: Indications for cardiac implantable electronic devices (CIEDs) are increasing. Although CIED infections occur infrequently, the impact of this outcome is expected to be substantial. OBJECTIVE: The purpose of this study was to the evaluate the outcome of patients undergoing removal of infected CIEDs. METHODS: A retrospective study was conducted of all patients with proven or suspected infected CIEDs who were referred to the Cleveland Clinic for system removal from January 2002 through March 2007. RESULTS: A total of 412 patients (age 68 +/- 15 years) were included in the study. The majority of patients (241 [59%]) presented with localized infection involving the device pocket. The remaining 171 patients (41%) presented with endovascular infection but no evidence of inflammation of the device pocket. Of the total 414 pathogens isolated, 366 (88%) were aerobic gram-positive organisms, of which 90% were Staphylococcus species, and almost half of these were methicillin resistant. In-hospital mortality was 4.6% (19 patients). Only 2 deaths were extraction related. One-year mortality was 17%. Among the total cohort, 8 (1.9%) patients had relapsing infection within the first year. Among patients who had device replacement during the same hospitalization, 6 (2.6%) had relapsing infections within 1 year of reimplantation; 5 of these patients had systemic symptoms and were bacteremic upon initial presentation. CONCLUSION: CIED infections are most often caused by Staphylococcus species, half of which are methicillin resistant. Percutaneous lead and device removal along with antibiotic therapy are effective as primary interventions. The overall relapse rate is 1.9%, and the relapse rate among patients who had reimplantation during the same hospitalization is 2.6%.

On the polymorphism of benzocaine; a low-temperature structural phase transition for form (II).

A low-temperature structural phase transition has been observed for form (II) of benzocaine (BZC). Lowering the temperature doubles the b-axis repeat and changes the space group from P2(1)2(1)2(1) to P112(1) with gamma now 99.37 degrees. The structure is twinned, the twin rule corresponding to a 2(1) screw rotation parallel to a. The phase transition is associated with a sequential displacement parallel to a of zigzag bi-layers of ribbons perpendicular to b*. No similar phase transition was observed for form (I) and this was attributed to the different packing symmetries of the two room-temperature polymorphic forms.

What can we expect from omega-3 fatty acids?

Omega-3 fatty acids are abundant in fish oil. A high dietary intake of omega-3 fatty acids has been strongly linked to lower rates of cardiovascular disease in epidemiologic studies. Fish oil supplements lower triglyceride levels and may have other benefits such as preventing arrhythmias, reducing inflammation (although they have minimal impact on C-reactive protein), inhibiting platelet aggregation, and lowering blood pressure, all of which should reduce cardiovascular risk.

Tris(ethanol-κO)tris-(picrato-κO,O)lanthanum(III) tri-2-pyridylamine solvate.

The title compound, [La(C(6)H(2)N(3)O(7))(3)(C(2)H(6)O)(3)]·C(15)H(12)N(4), has two mol-ecular building blocks, namely the neutral mononuclear adduct of lanthanum picrate with ethanol [i.e. La(pic)(3):EtOH (1:3); La(pic)(3) = lanthanum picrate and EtOH = ethanol] and the oligodentate aromatic nitro-gen base tri-2-pyridylamine (tpa). The asymmetric unit contains two formula units. The compound was prepared during an investigation of the stereochemistry of lanthanoid picrate complexes with O-donor ligands. The metal-ligand adduct adopts a nine-coordinate tricapped trigonal-prismatic metal atom environment. The stereochemical arrangement of the ligands about the metal core is typical of a fac-isomer with stoichiometry M(bidentate)(3)(monodentate)(3). Face-to-face hydrogen bonds are found between the tpa mol-ecule and the ethanol ligands. One ethanol ligand is disordered over two positions, with site occupancy factors of ca 0.7 and 0.3. The oxygen atoms of a nitro group are also disordered over two positions; the site occupancy factors are ca 0.6 and 0.4.

Areneruthenium(II) 4-acyl-5-pyrazolonate derivatives: coordination chemistry, redox properties, and reactivity.

Areneruthenium(II) molecular complexes of the formula [Ru(arene)(Q)Cl], containing diverse 4-acyl-5-pyrazolonate ligands Q with arene = cymene or benzene, have been synthesized by the interaction of HQ and [Ru(arene)Cl(micro-Cl)]2 dimers in methanol in the presence of sodium methoxide. The dinuclear compound [{Ru(cymene)Cl}2Q4Q] (H2Q4Q = bis(4-(1-phenyl-3-methyl-5-pyrazolone)dioxohexane), existing in the RRuSRu (meso form), has been prepared similarly. [Ru(cymene)(Q)Cl] reacts with sodium azide in acetone, affording [Ru(cymene)(Q)N3] derivatives, where Cl- has been replaced by N3-. The reactivity of [Ru(cymene)(Q)Cl] has also been explored toward monodentate donor ligands L (L = triphenylphosphine, 1-methylimidazole, or 1-methyl-2-mercaptoimidazole) and exo-bidentate ditopic donor ligands L-L (L-L = 4,4'-bipyridine or bis(diphenylphosphino)propane) in the presence of silver salts AgX (X = SO3CF3 or ClO4), new ionic mononuclear complexes of the formula [Ru(cymene)(Q)L]X, and ionic dinuclear complexes of the formula [{Ru(cymene)(Q)}2L-L]X2 being obtained. The solid-state structures of a number of complexes were confirmed by X-ray crystallographic studies. Their redox properties have been investigated by cyclic voltammetry and controlled potential electrolysis, which, on the basis of their measured RuII/III reversible oxidation potentials, have allowed the ordering of the bidentate acylpyrazolonate ligands according to their electron-donor character and are indicative of a small dependence of the HOMO energy upon the change of the monodentate ligand. This is accounted for by DFT calculations, which show a relevant contribution of acylpyrazolonate ligand orbitals to the HOMOs, whereas that from the monodentate ligand is minor.