Examining COVID-19 pandemic-related economic and household stress and its association with mental health, alcohol, and substance use in a national sample of Latinx sexual minority and heterosexual adults.

OBJECTIVE: Sexual minority adults of Latinx descent faced compounded intersectional stressors during the COVID-19 pandemic across socioeconomic and health domains. Latinx people have experienced some of the highest COVID-19 infection, hospitalization, and mortality rates in the United States in addition to significant economic challenges. Yet, current data have not observed the unique pandemic-related experiences of sexual minority Latinx (SML) adults. We examined sexual identity differences in economic and household stress, social support, mental health symptomatology (depression, anxiety), alcohol, and substance use among sexual minority and nonsexual minority Latinx adults in the United States. METHOD: Primary data were collected via the AmeriSpeak panel, a national probability sample of U.S.-based 2,286 Latinx adults [sexual minority = .34% (n = 465)]. Data were collected from November 2020 to January 2021, during the third wave of the COVID-19 pandemic. RESULTS: SML adults endorsed higher levels of economic and household stress, mental health symptomatology, and alcohol and substance use than nonsexual minority Latinx adults. Economic stress was associated with increased mental health symptomatology, alcohol, and substance use among SML adults. Social support moderated the association between economic stress and mental health symptomatology and substance use, but not alcohol use. CONCLUSION: Findings highlighted unique intersectional considerations among SML adults during the COVID-19 pandemic, including the importance of social support and the negative toll of economic stress on mental health and substance use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Interpersonal and Community-Level Influences Across the PrEP Cascade Among Young Adult Latinx Men who Have Sex with Men Living in a US-Mexico Border Region: A Qualitative Study.

Latinx men who have sex with men (MSM) are an at-risk population for new HIV diagnoses. Pre-exposure prophylaxis (PrEP) is a suite of biomedical approaches to prevent HIV infection. Latinx MSM are less likely to take PrEP compared to non-Latinx White MSM. This qualitative study identified interpersonal- and community-level barriers and facilitators of PrEP among young adult Latinx MSM. Using stratified purposeful sampling, 27 Latinx men, ages 19-29 years and living in a US-Mexico border region, completed self-report demographic surveys and participated in semi-structured in-depth interviews assessing barriers and facilitators to PrEP. Directed content analysis was used to identify both a priori and emerging themes. Most participants reported that other people, including peers, friends, partners, and health care providers were both supportive and discouraging of PrEP use. Participants' intersectional identities as members of both Latinx and LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer) communities both hindered and facilitated PrEP use.

Geographic mobility and its impact on sexual health and ongoing HIV transmission among migrant latinx men who have sex with men.

An understudied social process that may determine variable HIV risk, testing, and linkage to care is geographic mobility, including immigration as well as short-term mobility, especially among sexual minority populations. We aimed to assess how geographic mobility over the lifecourse between Latin America and the U.S., and within the U.S., was linked to sexual risk and health behaviors among Latinx migrant men who have sex with men (MSM) in San Bernardino County, California. Qualitative analysis of 16 semi-structured interviews revealed four major domains of influence on participants' sexual risk behaviors. At the micro level, these included social environment/interpersonal factors (e.g., family and peer support) and geographic factors and pathways (e.g., migration journey to the U.S.). At the macro level data centered on cultural factors (e.g., gender norms in home country) and structural factors (e.g., HIV healthcare). Our results can illuminate and promote effective health policies and HIV reduction efforts for Latinx migrant MSM in metro areas.

Examining Mental Health, Academic, and Economic Stressors During the COVID-19 Pandemic Among Community College and 4-Year University Students.

Objective: The COVID-19 global pandemic has created severe, long-lasting challenges to college students in the United States (US). In the present study, we assessed mental health symptomatology (depression, anxiety, life stress), academic challenges, and economic stress during the first wave of the Coronavirus pandemic. Method: A total sample of 361 college students (Mage = 22.26, SD = 5.56) was gathered from a community college (N = 134) and mid-size public university (N = 227) in Southwest US, both designated as Hispanic Serving Institutions. Results: Pearson and point biserial correlations indicated associations between mental health symptomatology, academic challenges, and economic stress, including expected delays in graduation. Multivariate analysis revealed that community college students had statistically significantly higher scores on anxiety F(1, 312) = 5.27, p = .02, ηp2 = .01 than 4-year university students, as well as key differences with respect to academic challenges. Chi Square analyses revealed that Latinx families experienced greater economic hardships, including job loss or reduced work hours (χ2 (1, N = 361) = 28.56, p = .00) than other ethnic/racial groups. Conclusions/Contributions: Findings revealed that community college students faced disparately negative mental health symptomatology, academic challenges, and economic stress during the first wave of the Coronavirus pandemic. Further, Latinx students' families experienced significant economic hardship that may have impacted students' academic progress and future planning.

Medical decision support system using weakly-labeled lung CT scans.

Purpose: Determination and development of an effective set of models leveraging Artificial Intelligence techniques to generate a system able to support clinical practitioners working with COVID-19 patients. It involves a pipeline including classification, lung and lesion segmentation, as well as lesion quantification of axial lung CT studies. Approach: A deep neural network architecture based on DenseNet is introduced for the classification of weakly-labeled, variable-sized (and possibly sparse) axial lung CT scans. The models are trained and tested on aggregated, publicly available data sets with over 10 categories. To further assess the models, a data set was collected from multiple medical institutions in Colombia, which includes healthy, COVID-19 and patients with other diseases. It is composed of 1,322 CT studies from a diverse set of CT machines and institutions that make over 550,000 slices. Each CT study was labeled based on a clinical test, and no per-slice annotation took place. This enabled a classification into Normal vs. Abnormal patients, and for those that were considered abnormal, an extra classification step into Abnormal (other diseases) vs. COVID-19. Additionally, the pipeline features a methodology to segment and quantify lesions of COVID-19 patients on the complete CT study, enabling easier localization and progress tracking. Moreover, multiple ablation studies were performed to appropriately assess the elements composing the classification pipeline. Results: The best performing lung CT study classification models achieved 0.83 accuracy, 0.79 sensitivity, 0.87 specificity, 0.82 F1 score and 0.85 precision for the Normal vs. Abnormal task. For the Abnormal vs COVID-19 task, the model obtained 0.86 accuracy, 0.81 sensitivity, 0.91 specificity, 0.84 F1 score and 0.88 precision. The ablation studies showed that using the complete CT study in the pipeline resulted in greater classification performance, restating that relevant COVID-19 patterns cannot be ignored towards the top and bottom of the lung volume. Discussion: The lung CT classification architecture introduced has shown that it can handle weakly-labeled, variable-sized and possibly sparse axial lung studies, reducing the need for expert annotations at a per-slice level. Conclusions: This work presents a working methodology that can guide the development of decision support systems for clinical reasoning in future interventionist or prospective studies.

Antianemic activity of quinoa (Chenopodium quinoa Willd) Collana Negra variety and kanihua (Chenopodium pallidicaule Aellen) Ramis variety seed flour in anemic rats.

The Andean grains from the Peruvian Altiplano, quinoa (Chenopodium quinoa Willd) and kanihua (Chenopodium pallidicaule Aellen) have high protein content and an optimal balance of essential amino acids and minerals such as iron (19.8 mg/100 g y 17.6 mg/100 g, respectively). The objective of this research was to evaluate the antianemic activity of extruded flour from quinoa seeds variety Negra Collana and kanihua variety Ramis in anemic Holtzman strain rats. The results of the proximal analysis showed high protein content in quinoa at 22% and kanihua at 16.2%, and the acute toxicity test showed harmlessness up to the dose of 15000 mg/Kg in both flours confirmed with the anatomopathological observation of organs such as liver, stomach, lung, kidneys, and brain. In the evaluation of the antianemic activity, a basal average of 29.3 ± 0.2% of hematocrit was observed in the group of anemic rats treated with quinoa flour, and in twelve weeks, it increased to 53.8 ± 0.3% of hematocrit (p ≤ 0.05). A group of anemic rats treated with kanihua flour had a basal average of 29.5 ± 0.3%, and in twelve weeks, it increased to 51.7 ± 0.3% (p ≤ 0.05). A group of rats without anemia treated with quinoa and kanihua flour showed a basal average of 50.2 ± 0.2% and 49.3 ± 0.3%; in twelve weeks, it increased to 55.2 ± 0.2% and 54.8 ± 0.1%, respectively. It was concluded that oral administration of 360 mg/Kg every 24 h of quinoa flour and kanihua flour increased hematocrit levels by 24.5 ± 0.5% and 22.2 ± 0.3%; weight 65.8 ± 0.3 g and 59.2 ± 0.1 g; height 6.8 ± 0.1 cm and 5.7 ± 0.5 cm, respectively (p ≤ 0.05). In rats without anemia increased hematocrit levels by 5.3 ± 0.0% and 5.5 ± 0.0%; weight 37.7 ± 0.1 g and 21.7 ± 0.05 g; height 4 ± 0.0 cm and 3.9 ± 0.0 cm, respectively (p ≤ 0.05).

Trauma and latinx sexual- and gender-minority immigrants in the U.S.

Due to their multiple minoritized identities, Latinx sexual- and gender-minority immigrants risk exposure to various forms of traumatic stressors at home and abroad that can result in post-traumatic stress disorder and other comorbid problems like depression. A much-needed review and synthesis of the latest research highlights important factors for practitioners and scholars to consider relevant to this vulnerable and under researched population. A data-driven conceptualization helps identify risk factors across different points in time such as violence and discrimination from communal and institutional sources as well as acculturative and minority stressors. Gender can heighten the risk for victimization. Response factors to consider include social support and coping, trauma-informed interventions, and access to culturally competent integrative care.

Semiactive Knee Orthotic Using a MR Damper and a Smart Insole to Control the Damping Force Sensing the Plantar Pressure.

This work presents the development of semiactive knee orthosis prototype that focus to absorb the forces and impacts in this joint during the human gait. This prototype consists of three subsystems: the first is a wireless and portable system capable of measuring the ground reaction forces in the stance phase of the gait cycle, by means of an instrumented insole with force sensing resistors strategically placed on the sole of the foot, an electronic device allows processing and transmit this information via Bluetooth to the control system. The second is a semiactive actuator, which has inside a magnetorheological fluid, highlighting its ability to modify its damping force depending on the intensity of the magnetic field that circulates through the MR fluid. It is regulated by a Proportional Derivative (PD) controller system according to the values of plantar pressure measured by the insole. The third component is a mechanical structure manufactured by 3D printing, which adapts to the morphology of the human leg. This exoskeleton is designed to support the forces on the knee controlling the action of the magnetorheological actuator by ground reaction forces. The purpose of this assistance system is to reduce the forces applied to the knee during the gait cycle, providing support and stability to this joint. The obtained experimental results indicate that the device fulfills the function by reducing 12 % of the impact forces on the user's knee.

Proximal enamel thickness quantification in orthodontics for interproximal reduction: A systematic review / Cuantificación del espesor del esmalte proximal en ortodoncia para la reducción interproximal: una revisión sistemática

Background: Interproximal enamel reduction is a valuable procedure in orthodontics used in several conditions, however, not knowing the average value of proximal enamel thickness might lead to excess enamel removal and consequently to adverse effects. Objective:The objective of this systematic review is to expose the average proximal enamel thicknesses found in the literature, and the differences that might be found between different ethnicities and age groups. Search Methods: 5 electronic databases were used to perform the search. Representative keywords comprised of "enamel", "thickness", "orthodontics" "proximal thickness" and "quantification"; different combination of these keywords with truncation, and medical subject headings (MESH) were used. Selection Criteria: In vitro and in vivo studies, where the quantification of the proximal enamel thickness of the mesial and distal sides were evaluated independently. Data Collection and Analysis: The PICO model was used to evaluate and select the in vitro and in vivo studies. ROBINS-I tool was used to assess the risk of bias of non-randomized clinical studies and a modification of Cochrane risk of bias tool was implemented for the in vitro studies. The quality of evidence and results were evaluated using The Joanna Briggs Institute (JBI) Critical Appraisal checklist tools for Quasi-Experimental Studies. Results: Literature search identified 3298 records from 5 databases. Ultimately, nine eligible studies were included in the review. Conclusions: The proximal enamel thickness increases as we move distal through the arch and is greater on the distal side compared to the mesial side of each individual tooth. Additionally, there is no difference in the proximal enamel thickness between genders but there is between ethnicities.

Antecedentes:La reducción del esmalte interproximal es un procedimiento valioso en ortodoncia utilizado en varias condiciones, sin embargo, no conocer el valor promedio del espesor del esmalte proximal puede conducir a una eliminación excesiva del esmalte y, en consecuencia, a efectos adversos. Objetivo:El objetivo de esta revisión sistemática es exponer los espesores promedio de esmalte proximal encontrados en la literatura y las diferencias que se pueden encontrar entre diferentes etnias y grupos de edad. Materiales y métodos:se utilizaron 5 bases de datos electrónicas para realizar la búsqueda. Palabras clave representativas compuestas por "esmalte", "grosor", "ortodoncia", "grosor proximal" y "cuantificación"; Se utilizaron diferentes combinaciones de estas palabras clave con truncamiento y encabezados de temas médicos (MESH). Criterios de Selección: Estudios in vitro e in vivo, donde se evaluó de forma independiente la cuantificación del espesor del esmalte proximal de los lados mesial y distal. Recopilación y análisis de datos:se utilizó el modelo PICO para evaluar y seleccionar los estudios in vitro e in vivo. Se utilizó la herramienta ROBINS-I para evaluar el riesgo de sesgo de los estudios clínicos no aleatorizados y se implementó una modificación de la herramienta Cochrane de riesgo de sesgo para los estudios in vitro. La calidad de la evidencia y los resultados se evaluaron utilizando las herramientas de lista de verificación de evaluación crítica del Instituto Joanna Briggs (JBI) para estudios cuasi-experimentales. Resultados:La búsqueda bibliográfica identificó 3298 registros de 5 bases de datos. Finalmente, se incluyeron nueve estudios elegibles en la revisión. Conclusiones:El grosor del esmalte proximal aumenta a medida que avanzamos distalmente a travésdel arco y es mayor en el lado distal en comparación con el lado mesial de cada diente individual. Además, no hay diferencia en el grosor del esmalte proximal entre géneros, pero sí entre etnias

Pilot randomised controlled trial of a patient navigation intervention to enhance engagement in the PrEP continuum among young Latino MSM: a protocol paper.

INTRODUCTION: Men who have sex with men (MSM) are one of the most at-risk group for contracting HIV in the USA. However, the HIV epidemic impacts some groups of MSM disproportionately. Latino MSM comprise 25.1% of new HIV infections among MSM between the ages of 13 and 29 years. The daily medication tenofovir/emtricitabine was approved by the Food and Drug Administration for pre-exposure prophylaxis (PrEP) in 2012 and has demonstrated strong efficacy in reducing HIV acquisition. METHODS AND ANALYSIS: Through extensive formative research, this study uses a pilot randomised controlled trial design and will examine the feasibility and acceptability of a patient navigation intervention designed to address multiple barriers to improve engagement in the PrEP continuum among 60 Latino MSM between the ages of 18 and 29 years. The patient navigation intervention will be compared with usual care plus written information to evaluate the feasibility and acceptability of the intervention and study methods and the intervention's potential in improving PrEP continuum behaviours. The results will be reviewed for preparation for a future full-scale efficacy trial. ETHICS AND DISSEMINATION: This study was approved by the institutional review board at San Diego State University and is registered at ClinicalTrials.gov. The intervention development process, plan and the results of this study will be shared through peer-reviewed journal publications, conference presentations and healthcare system and community presentations. REGISTRATION DETAILS: Registered under the National Institutes of Health's ClinicalTrials.gov (NCT04048382) on 7 August 2019 and approved by the San Diego State University (HS-2017-0187) institutional review board. This study began on 5 August 2019 and is estimated to continue through 31 March 2021. The clinical trial is in the pre-results stage.

Traditional Machismo, Caballerismo, and the Pre-Exposure Prophylaxis (PrEP) Cascade Among a Sample of Latino Sexual Minority Men.

Between 2010 and 2017, HIV diagnoses increased 17% among Latino sexual minority men (SMM) while decreasing 19% among White SMM and stabilizing among African American SMM. Traditional machismo is characterized by aggressiveness/power; caballerismo consists of family values/chivalry. Latino SMM high in traditional machismo may avoid seeking Pre-Exposure Prophylaxis (PrEP) to prevent being stigmatized as effeminate. Latino SMM high in caballerismo may be more likely to use PrEP to remain healthy for their family and/or partners. The current study explored the association between traditional machismo and caballerismo with four steps of the PrEP cascade. Participants were 151 HIV-negative/unknown Latino SMM living in San Diego, California (M = 24.18 years old) who completed an online study. Traditional machismo was associated with low odds of PrEP awareness, willingness, and adherence and high odds of PrEP use. Caballerismo was associated with greater odds of PrEP awareness, willingness, use, and adherence. High levels of traditional machismo among Latino SMM may be a barrier to PrEP. Caballerismo may be a facilitator of PrEP awareness, willingness, use, and adherence. Programs which serve to move Latino SMM through the PrEP cascade may benefit from discussing culturally-relevant masculinity given the potential for their differential associations with PrEP variables.

Cardiovascular vulnerability in COVID-19 elderly patients: getting into the biological mechanisms / Vulnerabilidad cardiovascular en adultos mayores con COVID-19: conociendo los mecanismos biológicos

The COVID-19 pandemic has had an important impact on older adults, conferring a worse prognosis. Older adults may have atypical presentations, which can delay the diagnosis of the disease, making its evolution more unfavorable. In addition to the cardiovascular damage mechanisms conferred by SARS-CoV-2 infection, the changes inherent in the aging cardiovascular and immune system favor the appearance of cardiovascular complications in a more relevant way in this population. The objective of this article will be to summarize the knowledge about cardiovascular involvement in older adults and explain its pathophysiological mechanisms, to alert about the early recognition and timely treatment of these complications.

La pandemia por COVID-19 ha impactado de forma importante en los adultos mayores, confiriéndoles un peor pronóstico. Los adultos mayores pueden tener presentaciones atípicas, las cuales pueden retrasar el diagnóstico de la enfermedad, haciendo su evolución más desfavorable. Además de los mecanismos de daño cardiovascular conferidos por la infección por SARS-CoV-2, los cambios inherentes al sistema cardiovascular e inmune ya envejecido, favorecen la aparición de complicaciones cardiovasculares de forma más relevante en esta población. El objetivo de este artículo será resumir los conocimientos sobre el involucro cardiovascular en adultos mayores y explicar los mecanismos fisiopatológicos de este, para alertar sobre el reconocimiento temprano y tratamiento oportuno de estas complicaciones.

Reemplazo de hombro ambulatorio: Presentación de protocolo perioperatorio y resultados iniciales / Same-day discharge shoulder arthroplasty: Perioperative protocol and initial results

Introducción El reemplazo de hombro es efectivo para mejorar el dolor y la funcionalidad en patologías crónicas del hombro. Considerando los riesgos y costos asociados a la estancia hospitalaria, realizar este procedimiento de forma ambulatoria surge como una opción para optimizar esta estrategia terapéutica. Materiales & Métodos Estudio observacional descriptivo prospective de pacientes operados por un mismo cirujano con artroplastia de hombro ambulatoria (RHA) utilizando analgesia regional con bomba de infusión elastomérica. Se registraron las escalas de ASES y SANE, el dolor, la satisfacción del paciente, las complicaciones y reingresos a 90 días. Resultados Se intervinieron 10 pacientes de un promedio de edad de 59.6 (±3.9) años, siendo el 40% prótesis anatómicas, 50% reversas y 10% hemiartroplastia. Al cuarto día postoperatorio el dolor por EVA fue 1,3 (±0,62) y al décimo día 2,7 (±1,1). La puntuación SANE antes del procedimiento fue de 31 (±9,7), y 90 días después fue de 76,1 (±6,8). Todos los pacientes refirieron una alta satisfacción. Un paciente al 3er día presentó un episodio de broncoespasmo leve, tratado de forma ambulatoria. Un paciente presentó una infección superficial que mejoró completamente con el antibiótico oral. No se presentaron reingresos o consultas a urgencias a 90 días. Discusión Se presentan los desenlaces a corto plazo de la primera serie de casos en nuestro medio de RH ambulatorio. Este procedimiento puede ser realizado de forma segura, siguiendo un protocolo estandarizado y realizando una juiciosa selección de los pacientes.

Background Shoulder arthoplasty is an effective procedure to improve pain and function in chronic shoulder pathologies. Considering the risks and costs associated with hospital stay, performing joint replacements on an outpatient setting emerges as an option to optimize this therapeutic strategy. Methods A prospective analysis was performed in 10 patients undergoing same-day discharge total shoulder arthroplasty with anatomic and reverse prostheses. Pain was managed with a continuous peripheral interscalene block using an elastomeric infusion pump. ASES and SANE scores, pain, patient satisfaction, complications, and readmissions after 90 days were recorded. Results 10 patients (average age 59.6 (±3.9) years) underwent outpatient shoulder arthroplasty (50% reverse shoulder arthroplasty, 40% total shoulder arthroplasty and 10% hemiarthroplasty). On post-operative day 4, mean visual analogue scale (VAS) for pain assessment was 1.3 (±0.62) and day 10, 2.7 (±1.1). Pre-operative SANE score was 31 (±9.7), and 90 days after the procedure was 76.1 (±6.8). All patients were satisfied with the procedure. One patient had a mild bronchospasm on day 3 that resolved with bronchodilators on an outpatient basis. One patient had a superficial surgical site infection that resolved completely with oral antibiotics administration. There were no re-admissions or major complications.

Transcriptome Changes in Colorectal Cancer Cells upon Treatment with Avicequinone B.

Purpose: Naphtho[2,3-b]furan-4,9-dione (Avicequinone B), a natural naphthoquinone isolated from the mangrove tree Avicennia alba , is recognized as a valuable synthetic precursor with anti-proliferative effect. However, the molecular mechanism involved in its bioactivity has not been investigated. This study aimed to determine the selectivity of avicequinone B against cancer cells and the transcriptomic changes induced in colorectal cancer (CRC). Methods: The cytotoxic effect against adenocarcinoma-derived cells or fibroblasts was evaluated using MTT assay. In addition, CRC cells were treated with avicequinone B in different settings to evaluate colony-forming ability, cell cycle progression, apoptosis/necrosis induction, and transcriptome response by RNA-seq. Results: Avicequinone B effectively reduced the viability of breast, colorectal, and lung adenocarcinoma cells with IC50 lower than 10 µM, while fibroblasts were less affected. The induction of G2/M arrest and necrosis-like cell death were observed in avicequinone B-treated HT-29 cells. Furthermore, RNA-seq revealed 490 differentially expressed genes, highlighting the reduction of interferon stimulated genes and proliferative signaling pathways (JAK-STAT, MAPK, and PI3K-AKT), as well as the induction of ferroptosis and miR-21 expression. Conclusion: In short, these results demonstrated the therapeutic potential of avicequinone B and paved the foundation for elucidating its mechanisms in the context of CRC.

Telemedicine as an instrument for cardiological consultation during the COVID-19 pandemic.

Telemedicine is an underused instrument along our healthcare systems. It´s a technological tool that optimizes resources, save money, expands our capacities, decongests our traditional medical services and is an invaluable help for teaching and research. The COVID-19 pandemic is forcing us to expand its use and it gives us the opportunity to design an appropriate implementation.

La telemedicina es una herramienta subutilizada en nuestros sistemas de atención sanitaria. Se trata de un recurso tecnológico que optimiza los servicios de salud, ahorra recursos, expande la capacidad de atención especializada a lugares remotos, descongestiona servicios médicos tradicionales y es un instrumento invaluable de enseñanza e investigación. La pandemia por COVID-19 nos obliga a extender su uso y supone una oportunidad para diseñar una adecuada implementación.

Medical Mistrust and the PrEP Cascade Among Latino Sexual Minority Men.

Latino sexual minority men (SMM) have high HIV incidence rates but report low pre-exposure prophylaxis (PrEP) use. Medical mistrust predicts lower medical care use and could contribute to decreased PrEP engagement. This study examines how medical mistrust relates to the PrEP cascade among 151 Latino SMM aged 18-29. Logistic regressions were employed with medical mistrust predicting PrEP awareness, willingness, current use, and adherence. Greater medical mistrust was associated with decreased odds of all outcomes and may represent a barrier to PrEP engagement for Latino SMM. Further research should explore whether reducing medical mistrust among Latino SMM could increase PrEP engagement.

Refractive Outcomes for Cataract Surgery With Toric Intraocular Lenses at a Veterans Affairs Medical Center.

Background: Refractive outcomes for cataract surgery with toric intraocular lenses (IOLs) are not well described in a teaching hospital setting. This study investigated the refractive outcomes of cataract surgery with toric IOLs at an academic-affiliated Veterans Affairs Medical Center (VAMC) and compared the accuracy of 2 biometric formulae for toric IOL power calculation. Methods: A retrospective chart review of patients who received cataract surgery with toric IOLs from November 2013 to May 2018 was conducted. The Holladay 2 and Barrett toric IOL formulae were used to predict the postoperative refraction for each cataract surgery. The main outcome measures were best-corrected visual acuity (BCVA) and the difference in cylinder between the preoperative and postoperative manifest refractions. The accuracy of each biometric formula was also assessed using 2-tailed t tests of the mean absolute error, and subgroup analyses were conducted for short, medium, and long eyes. Results: Of 325 charts reviewed, 283 patients met the inclusion criteria; 87% (248/283) of these surgeries were performed by resident surgeons. The median postoperative BCVA was 20/20, and 92% of patients had a postoperative BCVA of 20/25 or better. There was no statistically significant difference in mean absolute error between the 2 formulae for the entire axial length range (P = .21), as well as the short (P = .94), medium (P = .49), and long axial length (P = .08) groups. Conclusions: To our knowledge, this is the largest study that compared the performance of the Barrett toric and Holladay 2 formulae and the first that made the comparison in a teaching hospital setting. This study suggests that the 2 formulae have similar refractive outcomes across all axial lengths.

Physalis angulata Calyces Modulate Macrophage Polarization and Alleviate Chemically Induced Intestinal Inflammation in Mice.

As part of the search for new bioactive plants from the Colombian Caribbean, the dichloromethane fraction of the calyces of Physalis angulata L. (PADF) was selected for its anti-inflammatory activity. In this work, we investigated the immunomodulatory effect of PADF in activated macrophages and during dextran sulfate sodium (DSS)-induced colitis. PADF displayed a low content of withanolides or phenolic compounds, and a higher content of sucrose esters, representative anti-inflammatory metabolites of the Physalis genus. The PADF fraction at 12.5 µg/mL prevented the induction of interleukin (IL)-1ß, tumor necrosis factor (TNF-α), IL-6, IL-12, cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS) by lipopolysaccharide (LPS), while increased the levels of arginase (ARG1), IL-10, and mannose receptor C (MRC1). The polarization towards an anti-inflammatory profile was also observed in resting macrophages, without promoting the typical gene profile induced by IL-4, suggesting that PADF promotes a shift to a regulatory status rather than to an alternative one. In vivo, the administration of PADF to mice with chronic DSS-colitis reduced disease signs (i.e., body weight loss and colon shortening), and improved the histology score by diminishing the levels of pro-inflammatory cytokines and increasing the production of IL-10. Overall, results suggest that the regulatory effect on PADF towards macrophages might contribute to the therapeutic activity observed in the murine model of inflammatory bowel disease.

Accuracy of biometric formulae for intraocular lens power calculation in a teaching hospital.

AIM: To evaluate the accuracy of three commonly used biometric formulae across different axial lengths (ALs) at one United States Veterans Affairs teaching hospital. METHODS: A retrospective chart review was conducted from November 2013 to May 2018. One eye of each patient who underwent cataract surgery with a monofocal intraocular lens (IOL) was included. The range of postoperative follow-up period was from 3wk to 4mo. The Holladay 2, Barrett Universal II, and Hill-Radial Basis Function (Hill-RBF) formulae were used to predict the postoperative refraction for all cataract surgeries. For each formula, we calculated the prediction errors [including mean absolute prediction error (MAE)] and the percentage of eyes within ±0.25 diopter (D) and ±0.5 D of predicted refraction. We performed subgroup analyses for short (AL<22.0 mm), medium (AL 22.0-25.0 mm), and long eyes (AL>25.0 mm). RESULTS: A total of 1131 patients were screened, and 909 met the inclusion criteria. Resident ophthalmologists were the primary surgeons in 710 (78.1%) cases. We found no statistically significant difference in predictive accuracy among the three formulae over the entire AL range or in the short, medium, and long eye subgroups. Across the entire AL range, the Hill-RBF formula resulted in the lowest MAE (0.384 D) and the highest percentage of eyes with postoperative refraction within ±0.25 D (42.7%) and ±0.5 D (75.5%) of predicted. All three formulae had the highest MAEs (>0.5 D) and lowest percentage within ±0.5 D of predicted refraction (<55%) in short eyes. CONCLUSION: In cataract surgery patients at our teaching hospital, three commonly used biometric formulae demonstrate similar refractive accuracy across all ALs. Short eyes pose the greatest challenge to predicting postoperative refractive error.