Prevalence, Patterns, and Characteristics of Eye Injuries in Professional Mixed Martial Arts.

PURPOSE: To describe the frequency and type of eye injuries in fighters in mixed martial arts (MMA) competition. METHODS: Fight result data were collected from the Nevada Athletic Commission database from 2001 to 2020. Any fighters in a professional mixed martial arts (MMA) contest with an eye injury were included. Main outcome measures included frequency and rate of eye injuries per fight and the types of eye injuries. Secondary outcome measures were gender, laterality, decision type, and length of no-contact recommended. RESULTS: Of the 256 MMA events in the database, 187 events (73.3%) had at least one eye injury. Of a total 2208 fights at these events, there were 363 fighters who sustained 369 eye injuries, with the yearly rate of eye injuries per 100 fighters ranging from 2.56 to 12.22. The most common injuries were eyebrow and eyelid lacerations (n=160, 43%), lacerations around the eye (n=98, 27%), and orbital fractures (n=62, 17%). Most eye injuries were right sided (n=197, 53.3%) and the majority of fighters with eye injuries lost their match (n=228, 62.8%). Fifty-seven fighters were recommended for further ophthalmology clearance after the match. The most common reasons for recommended ophthalmology follow-up was orbital fracture (n=25, 44%) and retinal injury (n=7, 12%). Forty-three fighters received no-contact requirements relating to their injury for an average of 8.9 weeks (range 1-24 weeks). CONCLUSION: Ophthalmic injuries in professional MMA were prevalent, were most often lacerations surrounding the eye, and often accompanied the fighter losing their match.

Long-Term Outcomes After Central Retinal Artery Occlusion Treated Acutely With Hyperbaric Oxygen Therapy: A Case Series.

Purpose: This study assesses the long-term outcomes, including neovascular complications, of central retinal artery occlusion (CRAO) treated acutely with hyperbaric oxygen therapy (HBOT). Methods: Four cases of CRAO treated acutely with HBOT were reviewed. Visual and structural outcomes were reviewed. Ocular complications including neovascularization were assessed and risk factors determined. Results: Two patients with a history of non-insulin dependent diabetes mellitus (NIDDM) developed early-onset ocular neovascularization within 1 month following treatment, with final vision of light perception over 1 year after injury. One patient with NIDDM and 1 patient without NIDDM did not develop ocular neovascularization; both had improvement in final visual acuity to 20/400 and 20/250, respectively. Conclusions: Patients treated acutely with HBOT for CRAO may require more frequent and earlier monitoring for complications, especially in patients with diabetes. Further research is needed to determine the long-term safety and efficacy of HBOT for CRAO, especially in the setting of systemic disease such as diabetes.

Significance of crinoid preservation: Clare Shale Formation (Upper Carboniferous), Fisherstreet Bay, Doolin, County Clare, Ireland.

Some fossils, such as crinoid stems, are not widely appreciated by collectors and researchers, yet can provide unique data regarding taphonomy and palaeoecology. A long crinoid pluricolumnal showing a distinctive pattern of preservation was collected from the Clare Shale Formation (Upper Carboniferous) at Fisherstreet Bay, Doolin, County Clare, western Ireland. The specimen is partly disarticulated and represents the mesistele to mesistele/dististele transition; attachment was by unbranched long, slender radices; pluricolumnal heteromorphic; fragments of pluricolumnal are of multiples of a unit length. This specimen, cladid? sp. indet., slumped to the seafloor after death and started to disarticulate as ligaments rotted. By reference to the broken stick model, the pattern of disarticulation suggests that the noditaxis of the heteromorphic stem was N212.

Posterior Segment Findings in Patients on Extracorporeal Membrane Oxygenation.

Purpose: Extracorporeal membrane oxygenation (ECMO) is an established treatment modality for critically ill patients with cardiopulmonary failure, yet little is known of the ocular pathology in this population. The aim of this study is to characterize the posterior segment findings of ECMO patients. Methods: This study is a retrospective analysis of 20 ECMO patients evaluated by ophthalmology from September 2012 to May 2019 at a level 1 trauma center. Comprehensive examinations assessed for intraocular pathology. Demographic data, exam findings, and mortality were analyzed. Results: The sample size consisted of 20 patients; a majority were male (75%), and mean age was 37.4 years (interquartile range, 26.75-50 years). All patients received ECMO for care of acute respiratory distress syndrome (ARDS). Average duration of ECMO therapy was 9.6 ± 6.5 days. Eleven (55%) patients had acute retinal pathology, including Purtscher-like retinopathy (20%), intraocular hemorrhage (50%), and septic chorioretinitis (bacterial or fungal, 10%). Location of hemorrhage included the retina (40%), vitreous (30%), and optic disc (15%). Sixty percent (n = 12) of patients were unable to provide a subjective history on initial assessment. Ultimately, 5 out of 20 patients (25%) died of systemic illness during their hospital stay. Conclusion: This study demonstrates high rates of retinal pathology, most commonly vitreous and/or retinal hemorrhage alongside a Purtscher-like retinopathy. This is likely secondary to complications of anticoagulation, microthrombi, septicemia, and hemodynamic instability. We found a mortality rate slightly lower than that of prior ECMO studies. Prospective studies with pre-ECMO and post-ECMO fundus photography is warranted for better understanding of these medically complex patients.

Lewisite Metabolites in Urine by Solid Phase Extraction-Dual Column Reversed-Phase Liquid Chromatography-Isotope Dilution Tandem Mass Spectrometry.

Lewisite (2-chlorovinyldichloroarsine) is a chemical warfare agent developed during World War I. A quantitative method using solid phase extraction (SPE) followed by dual column liquid chromatography (LC)-isotope dilution tandem mass spectrometry (MS-MS) was developed for the determination of (2-chlorovinyl)arsonic acid (CVAOA), a metabolite of Lewisite, in human urine. The sample was treated with hydrogen peroxide to oxidize any (2-chlorovinyl)arsonous acid (CVAA) that remained in the trivalent arsenic oxidation state. There was 1.19% (arsenic purity) of bis-(2-chlorovinyl)arsinic acid (BCVAOA), a minor Lewisite metabolite, in the stock CVAA material. The high-throughput method qualitatively assessed BCVAOA simultaneously utilizing normal-phase silica SPE followed by reversed-phase C18 LC for an orthogonal separation. The chromatographic method results in a 5.8-min cycle time with adequate retention (k' = 2.4) of CVAOA. The mass spectrometer was operated in positive electrospray ionization mode with quantitative m/z 186.9→61.0 and confirmation 186.9→91.0 mass transitions. This selective method demonstrated linearity, accuracy and reproducibility for the clinically relevant calibration range (25-3,200 µg/L as CVAA). The method detection limit was 3.3 µg/L as CVAA from a 10 µL injection. This LC-MS-MS emergency response method has a throughput of >240 samples (2.5 extracted 96-well plates) per day.

A Prejudiced Review of Ancient Parasites and Their Host Echinoderms: CSI Fossil Record or Just an Excuse for Speculation?

Recognizing the presence of a parasite and identifying it is a relatively straightforward task for the twenty-first century parasitologist. Not so the pursuit of ancient parasites in fossil organisms, a much more difficult proposition. Herein, Boucot's seven-tiered scheme of reliability classes is applied as a measure of confidence of the recognition of putative parasitism in two echinoderm classes, Upper Palaeozoic crinoids and a Cretaceous echinoid (high confidence is 1, low confidence 7). Of the five examples, the parasitic(?) organism is preserved in only two of them. A zaphrentoid coral on the camerate crinoid Amphoracrinus may have robbed food from the arms (Category 1 or 2B). A pit in what appears to be a carefully selected site on the disparid crinoid Synbathocrinus is associated with a growth deformity of the cup (Category 4). Multiple pits in an Amphoracrinus theca are also associated with a deformed cup, but it is more difficult to interpret (Category 4 or 7). Some specimens of the camerate crinoid Neoplatycrinites have circular grooves or depressions posteriorly, presumably produced by coprophagic/parasitic platyceratid gastropods (Category 1). Site selectivity of pits in the echinoid Hemipneustes places them preferentially adjacent to respiratory tube feet (Category 4). From these examples it is deduced that sparse infestations of borings or epizoozoic organisms permit a more confident interpretation of organism/organism interactions; dense accumulations, possibly following multiple spatfalls, mask such patterns.

The photolytic activity of poly-arginine cell penetrating peptides conjugated to carboxy-tetramethylrhodamine is modulated by arginine residue content and fluorophore conjugation site.

Upon light irradiation, Fluorophore-cell-penetrating peptide (Fl-CPP) conjugates can disrupt the integrity of biological membranes. This activity can in turn be used to photoinduce the disruption of endocytic organelles and promote the delivery of entrapped macromolecules such as proteins or RNAs into live cells. Recent mechanistic studies have shown that ROS production by the fluorophore and a latent lytic ability of CPPs act in synergy to elicit photolysis. However, how the structure of fluorophore-CPP conjugates impacts this synergistic activity remains unclear. Herein, using red blood cells (RBCs) as a model of biological membranes, we show that the number of arginine residues in a CPP as well as the position of fluorophore with respect to the CPP dramatically affect the photolytic activity of a fluorophore-CPP conjugate. These factors should therefore be considered for the development of effective photoinducible delivery agents.

The "younger-sibling-at-risk design": a pilot study of adolescents with ADHD and an older sibling with substance use disorder.

INTRODUCTION: This article introduces a ?younger at-risk sibling? design to study progression from other psychopathologies to their substance use disorder (SUD) complications. The design selects not-yet-SUD adolescents with high-risk-for-SUD psychopathology only if an older sibling has SUD. This "proof of concept' pilot study examines the design?s feasibility if the younger sibling has attention deficit hyperactivity disorder (ADHD). METHOD: Subjects were recruited from families at substance abuse treatment centers that had a non-SUD younger child with ADHD, from families at behavior disorder clinics that had a younger child with ADHD and SUD older child, and through general advertisements. Subjects were seen weekly for at least 3 months and monthly thereafter for 3 months. All were treated with open-label lisdexamfetamine dimesylate 30-70 mg per day. Outcomes explored were recruitment, compliance, diversion, ADHD improvement, and substance use interest. RESULTS: 25 families were screened, 13 evaluated, and 8 began medication. ADHD Rating Scale-IV scores obtained by parent?adolescent consensus improved as expected with a stimulant. Rating forms could quantify substance use interest in subjects with some drug culture exposure but encountered a floor effect in those without. The design's complexity and implicit commentary on family dynamics complicated recruitment but may have facilitated retention. CONCLUSION: Sibling pairs in which the older sibling has substance use and the younger sibling has ADHD exist. Such younger siblings can be recruited into a treatment study. The design may shed light on the pathogenesis and prevention of SUD complications from ADHD and theoretically other SUD comorbidities.

Automated potentiometric titrations in KCl/water-saturated octanol: method for quantifying factors influencing ion-pair partitioning.

The knowledge base of factors influencing ion pair partitioning is very sparse, primarily because of the difficulty in determining accurate log P(I) values of desirable low molecular weight (MW) reference compounds. We have developed a potentiometric titration procedure in KCl/water-saturated octanol that provides a link to log P(I) through the thermodynamic cycle of ionization and partitioning. These titrations have the advantage of being independent of the magnitude of log P, while maintaining a reproducibility of a few hundredths of a log P in the calculated difference between log P neutral and log P ion pair (diff (log P(N - I))). Simple model compounds can be used. The titration procedure is described in detail, along with a program for calculating pK(a)'' values incorporating the ionization of water in octanol. Hydrogen bonding and steric factors have a greater influence on ion pairs than they do on neutral species, yet these factors are missing from current programs used to calculate log P(I) and log D. In contrast to the common assumption that diff (log P(N - I)) is the same for all amines, they can actually vary more than 3 log units, as in our examples. A major factor affecting log P(I) is the ability of water and the counterion to approach the charge center. Bulky substituents near the charge center have a negative influence on log P(I). On the other hand, hydrogen bonding groups near the charge center have the opposite effect by lowering the free energy of the ion pair. The use of this titration method to determine substituent ion pair stabilization values (IPS) should bring about more accurate log D calculations and encourage species-specific QSAR involving log D(N) and log D(I). This work also brings attention to the fascinating world of nature's highly stabilized ion pairs.

Verbal abilities as predictors of retention among adolescents in a therapeutic community.

The relationship between verbal skills and retention among adolescents in substance abuse treatment is understudied. In order to assess verbal predictors of retention, twenty-eight 16-19 year old adolescents in a therapeutic community for substance abuse were evaluated between 30 and 90 days after admission. These adolescents were then followed prospectively for 1 year. Verbal and non-verbal cognitive screens, audio taped narrative responses, and self-reports of socio-emotional function and psychiatric symptoms were completed. Verbal scores were associated with self-restraint and counselor reports of therapeutic engagement and comprehension. General verbal scores predicted attrition, while therapeutic expressiveness (verbal expressiveness in a therapeutic context) predicted retention. Remediation of verbal communication skills may be an overlooked aspect of the therapeutic process in treating adolescent substance abusers.

Pharmacotherapy for marijuana dependence: a double-blind, placebo-controlled pilot study of divalproex sodium.

There is a noticeable lack of targeted treatment options for marijuana dependence, in particular pharmacologic approaches. This is the first study evaluating a targeted pharmacologic approach for marijuana dependence. The goals of the study were to determine if such patients would seek pharmacologic treatment, whether these patients could be retained in treatment using a design previously developed for cocaine-dependent patients, and especially whether divalproex sodium showed promise as a treatment agent for marijuana dependence. We found that marijuana-dependent patients will seek treatment, and such patients can be adequately maintained in a pharmacologic trial. Regardless of treatment group, patients reported a significant reduction in their frequency and amount of marijuana use as well as a reduction in irritability. Given the lack of proven effective treatments for marijuana dependence, pharmacotherapies should be sought. The design of a preliminary clinical trial should include a psychosocial/behavioral intervention emphasizing motivation and medication compliance and a placebo control group.

"Outer-directed irritability": a distinct mood syndrome in explosive youth with a disruptive behavior disorder?

OBJECTIVE: To examine whether "outer-directed irritability," a mood construct from the adult literature, characterizes a subgroup of disruptive behavior disordered children and adolescents previously shown to improve on divalproex, a mood stabilizer. METHOD: A sample (N = 20) of disruptive youth (aged 10-18 years) entering a divalproex treatment study of temper and irritable mood swings was compared to normal controls (N = 18) on measures of aggression/irritability directed against others (externalizing symptoms) and on aggression/ irritability against self, anxiety, and depression (internalizing symptoms). All patients met DSM-IV criteria for a disruptive behavior disorder (oppositional defiant disorder of conduct disorder) in addition to research criteria. RESULTS: "Outer-directed irritability" most clearly distinguished patients from controls (effect size 4.1) and did not correlate with other mood measures. Patients and controls showed no to minimal differences on internalizing symptoms. CONCLUSION: Disruptive behavior disordered children and adolescents characterized by outer-directed irritability exist, can be identified, and should be further investigated, especially since they are potentially treatable.

Un significado global para el científico biomédico o bioanalista / A signification global for the biomedical scientist

El rol tradicional del Científico Biomédico o del Bioanalista en el estudio de las patologías ha tomado una definición más amplia esta es generada, al menos en parte, por una demarcacación entre las profesiones no muy clara entre: Los Científicos Biomédicos o Bioanalistas, los Científicos Clínicos o Médicos y los Oficiales Médicos e Investigadores Académicos o Universitarios. Resulta apropiado examinar nuevamente estas definiciones con la finalidad de apreciar completamente el rol fundamental jugado por el Científico Biomédico o Bioanalista en el tratamiento de la enfermedad y en el avance del conocimiento científico. El rol del Científico Biomédico o Bioanalista, el cual está en expanción, en el estudio de la patología, particularmente en Europa, ha continuado aumentando la contribución de este importante grupo profesional, como proveedores de los servicios esenciales en patología y como directores en la investigación de nuevas y más eficientes técnicas para el diagnóstico y tratamiento de las enfermedades humanas. Sin embargo, es también importante reconocer que dentro de la nueva definición del Científico Biomédico o Bioanalista hay que incluir la contribución significativa que estos profesionales han hecho en el campo de la investigación académica pura. Ciertamente, la vertiginosa carrera para secuenciar y finalmente interpretar el genoma humano esta conduciendo la demanda de investigadores en ciertas áreas clave de las ciencias de la vida y aquí yace al menos uno de los nichos importantes para el Científico Biomédico o Bioanalista. Es importante explorar también el rol del Científico Biomédico o Bioanalista en áreas de la Farmacia, Farmacología, Biología Molecular y Biofísica y más recientemente en el área de la Bioinformática y de la Información Tecnológica, cuyos temas todos apuntan hacia la Ciencia de la Salud en el sentido más amplio. La diversidad en la experiencia requerida por el Científico Biomédico o Bioanálisis a los cambios en el manejo de los servicios de patología, esto particularmente en el Reino Unido, ha demandado que los educadores re-evaluen tanto el contenido como el modo de impartir sus programas de estudios para poder alcanzar las expectativas de los futuros graduandos y que estos profesionales sean apropiados para los requerimientos que hace la comunidad científica. No hay duda de que la enseñanza de la Ciencia Biomédica o del Bioanálisis siempre ha logrado satisfacer las demandas de un ambiente profesional cambiante

Method for measuring the logarithm of the octanol-water partition coefficient by using short octadecyl-poly(vinyl alcohol) high-performance liquid chromatography columns.

A simple, quick, versatile and inexpensive HPLC method to estimate the logarithm of the octanol-water partition coefficient (log Pow) employing a methanol-water gradient and a short octadecyl-poly(vinyl alcohol) (ODP) column is described. This method is different from published HPLC-based log Pow methods because it uses retention times from a rapid methanol-water gradient to directly generate log Pow estimates, rather than from a series of isocratic mixtures extrapolated to 100% water. These HPLC log Pow values have good precision and correlate well with traditional shake-flask log Pow values. If necessary, the log Pow determination (including replications) can easily be carried out using only a milligram of sample. By suppressing ionization of acids and bases by the use of a buffer in the aqueous phase, the method can measure the log Pow of neutral organic molecules at any pH between 2 and 13. The method can be used with impure material and is rapid, 7 min per run and 4 min equilibration; it lends itself to and has been utilized for high-throughput hydrophobicity determinations (we have now carried out thousands of HPLC log Pow measurements by this method).

Increased glucocorticoid receptor expression in human skeletal muscle cells may contribute to the pathogenesis of the metabolic syndrome.

Altered glucocorticoid hormone action may contribute to the etiology of the metabolic syndrome, but the molecular mechanisms are poorly defined. Tissue sensitivity to glucocorticoid is regulated by expression of the glucocorticoid receptor (GR)-alpha and 11beta-hydroxysteroid dehydrogenase type I (11beta-HSD1)-mediated intracellular synthesis of active cortisol from inactive cortisone. We have analyzed GRalpha and 11beta-HSD1 expression in skeletal myoblasts from men (n = 14) with contrasting levels of insulin sensitivity (euglycemic clamp measurements of insulin-dependent glucose disposal rate), blood pressure, and adiposity. Positive associations were evident between myoblast expression of GRalpha under basal conditions and levels of insulin resistance (r(2) = 0.34, P < 0.05), BMI (r(2) = 0.49, P < 0.01), percent body fat (r(2) = 0.34, P < 0.02), and blood pressure (r(2) = 0.86, P < 0.001). Similar associations were evident when myoblasts were incubated with physiological levels of cortisol (P < 0.01 for all). Importantly, GRalpha expression was unaffected by variations in in vivo concentrations of insulin, IGF-1, or glucose concentrations. In common with the GR, 11beta-HSD1 expression in myoblasts incubated with physiological concentrations of cortisol in vitro was positively associated with levels of insulin resistance (r(2) = 0.68, P < 0.001), BMI (r(2) = 0.63, P < 0.005), and blood pressure (r(2) = 0.27, P < 0.05). Regulation of GRalpha and 11beta-HSD1 by cortisol was abolished by the GR antagonist RU38486. In summary, our data suggest that raised skeletal muscle cell expression of GRalpha and 11beta -HSD1-mediated regulation of intracellular cortisol may play a fundamental role in mechanisms contributing to the pathogenesis of the metabolic syndrome.