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Visual impairment negatively affects the quality of life of people and it is an important parameter of the outcome of treatment of patients diagnosed with cataracts, glaucoma, strabismus or injuries. The goal of the research was to assess the psychological aspects of the quality of life of patients with the above-mentioned diagnoses.The research included 99 patients of both sexes, who, after surgery at the Clinic for Eye Diseases Tuzla, were monitored on an outpatient basis in the Clinic's Specialist Outpatient Clinic. For the purposes of the research, the Vision Questionnaire (NEI VFQ-25), version 2000, was used.The age of the respondents ranged from 5 to 78 years. The majority of respondents were men 50 (50.50%). The average chronological age of male respondents is 47.50±21.56 years, and female respondents 50.12±20.85. In the total sample, 45.5% of respondents have cataracts, 29.3% glaucoma, 11.1% strabismus and 14.1% have an eye injury. Of these 99 respondents, 47.5% consider their health to be average, 44.4% consider it to be above average, while 8.1% of respondents consider it to be below average. A higher percentage of male respondents have glaucoma (38%) and injuries/trauma (20%) compared to female respondents. A higher percentage of female respondents (55.1%) state that their quality of life is above average, while the percentage of male respondents is 34%. The quality of life is average for 56% of male respondents and 38.8% of female respondents. The results of the chi-square test showed that there is no statistically significant difference in relation to the gender and quality of life of the respondents (χ2= 4.48; df= 2; p= 0.106). The results of the univariate analysis of variance in relation to the cause of visual impairment, and the vision problems experiencedby the subjects showed that there is a statistically significant difference between the subjects in relation to the cause of visual impairment. In relation to the overall results of vision problems, it may be concluded that subjects with cataracts and glaucoma at the statistical significance level of 0.05 state that they have more vision problems compared to subjects with strabismus and injury. Subjects with cataracts at the significance level of 0.05 state that they have more vision problems compared to subjects with glaucoma.Although the self-assessment of the psychological and spiritual components of the quality of life of the subjects gave satisfactory results, it is necessary to provide specific support in order to prevent and eliminate negative reactions to the postoperative condition of operated patients.

Abstract Latent autoimmune diabetes in adults (LADA) is a heterogeneous disease characterized by autoantibodies against insulin producing pancreatic beta cells and initial lack of need for insulin treatment. The aim of the present study was to investigate if individuals with LADA have an altered gut microbiota relative to non-diabetic control subjects, individuals with type 1 diabetes (T1D), and individuals with type 2 diabetes (T2D). Bacterial community profiling was performed with primers targeting the variable region 4 of the 16S rRNA gene and sequenced. Amplicon sequence variants (ASVs) were generated with DADA2 and annotated to the SILVA database. The gut virome was sequenced, using a viral particle enrichment and metagenomics approach, assembled, and quantified to describe the composition of the viral community. Comparison of the bacterial alpha- and beta-diversity measures revealed that the gut bacteriome of individuals with LADA resembled that of individuals with T2D. Yet, specific genera were found to differ in abundance in individuals with LADA compared with T1D and T2D, indicating that LADA has unique taxonomical features. The virome composition reflected the stability of the most dominant order Caudovirales and the families Siphoviridae, Podoviridae, and Inoviridae, and the dominant family Microviridae. Further studies are needed to confirm these findings.

A sensorimotor disorder characterized by a deviation from the parallel position of the eyes is called strabismus, strabismus or strabismus. Strabismus can be non-paralytic, then paralytic (they appear at any age), and concomitant strabismus, the peculiarity of which is that they appear in childhood and are found in 4-6% of the total population. Long-term treatment is required, and it consists of pleoptic methods that include occlusion and exercises for amblyopia, which treat low vision and other sensory complications, and orthoptic methods that refer to: glasses, occlusions, prisms, which establish and maintain the parallelism of the visual axes. After exhaustive conservative treatment, the operative procedure is started. Experience thus far indicates that it is necessary to change and introduce new methods appropriate to the age of a child and the stage to which the treatment has progressed.

ABSTRACTBetween 2019 and 2021, the Autonomous Region of Sardinia and the Eni Enrico Mattei Foundation (FEEM) developed and applied a sustainability assessment model of the investments within the regional operational programmes (ROPs), with specific reference to the United Nations’ 2030 Agenda and its 17 Sustainable Development Goals (SDGs). That same methodology is used here for the assessment of the sustainability of the ROPs co-financed by the European Union with specific reference to Italy’s National Sustainable Development Strategy (NSDS). In particular, the analysis is done by looking at the contribution of the 182 intervention fields to the NSDS’ strategic goals. Throughout the paper the importance of defining implementation strategies of the NSDS’ National strategic goals through the integration of the indicators, goals and choices of the national strategy into local or regional development plans is emphasized. Finally, the work suggests this methodology as a reference point to ensure careful monitoring of the sustainability of the investments of various European Union policies, in consideration of the importance that the strategy assumes for both Italy and the Italian regions.

The aim of this research was to examine the development of motor functions in children with visual impairment compared to children without visual impairment. The research included a sample of 70 respondents; 35 with impaired vision and 35 with no visual impairment. The research was conducted in Sarajevo at the Center for Blind and Visually Impaired Children and Youth “Nedzarici”, and in Tuzla at the Elementary School “Centar”. The results of the research have shown that respondents with visual impairment have less developed motor functions compared to respondents without visual impairment. The variables on which the respondents with visual impairment achieved the worst results, which refer to the quality of drawing and the speed of drawing, were especially singled out.

Aims: The safety and efficacy of insulin analogue insulin aspart (IAsp) have been demonstrated in a randomised clinical trial in pregnant women with Type 1 diabetes (T1D), and IAsp is widely used during pregnancy. The aim of this study was to assess glycaemic control and safety of IAsp versus other bolus insulins in Type 1 diabetic pregnancy in a real‐world setting. Methods: This was a post hoc analysis of a prospective cohort study of 1840 pregnant women with T1D, treated with IAsp (n = 1434) or other bolus insulins (n = 406) in the Diabetes Pregnancy Registry. The primary (composite) outcome was the proportion of pregnancies resulting in major congenital malformations or perinatal or neonatal death. Secondary outcomes included all HbA1c values measured immediately before and during pregnancy and major hypoglycaemia, as well as abortion, pre‐eclampsia, pre‐term delivery, large for gestational age at birth, stillbirth and fetal malformations. Results: There were no significant differences found in any of the pregnancy outcomes between treatment with IAsp and other bolus insulins in either the crude or propensity score‐adjusted analyses. However, maternal HbA1c was lower in the IAsp group at the end of the third trimester (adjusted difference, −0.16% point [95% CI −0.28;−0.05]; −1.8 mmol/mol [95% CI −3.1;−0.6]; p = 0.0046). Conclusions: No significant differences in safety or pregnancy outcomes were demonstrated when comparing treatment with IAsp versus other bolus insulins in women with T1D during pregnancy. The observed improvement in HbA1c with IAsp in late pregnancy should be confirmed in other studies. [ABSTRACT FROM AUTHOR]

Background and study aim: Endoscopic submucosal dissection is a minimally invasive endoscopic procedure for the removal of neoplastic benign and early malignant lesions in the gastrointestinal tract. In this study, we analyse the success and safety of rectal ESD at Linz hospitals, focusing on a specific endoscopist. Additionally, we examine whether there is a learning curve regarding success parameters. Methods: This retrospective study included all 102 patients who underwent endoscopic submucosal dissection of the rectum by a defined endoscopist at Ordensklinikum Hospital and Kepler University Hospital between December 2010 and May 2021. With the collected data, a descriptive statistic was carried out and regression analyses were performed. Results: The en bloc resection rate was 78.4% and the rate of lesions removed in healthy tissue was 55.6%. The average procedure time was 179 min and the complication rate was 7.8%. In total, 26.4% of cases showed carcinoma; in 25.9% of these cases, an oncologically curative resection was achieved with ESD. Follow-up data were available for 61.1% of cases, with recurrence being diagnosed in 3.6% of cases. A learning curve was observed regarding the rate of lesions removed in healthy tissue and the procedure time, but not regarding the en bloc resection rate. Conclusions: Endoscopic submucosal dissection is a safe method for the removal of large rectal adenomas and early carcinomas. The en bloc resection rate of the analysed procedures is within the range of comparable European studies. The rate of lesions removed in healthy tissue is below the R0 resection rate of the comparative literature; however, a learning curve could be observed in this parameter. [ABSTRACT FROM AUTHOR]

Aims: Combining insulin with a glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) to treat type 2 diabetes (T2D) is common. While many studies have investigated concomitant therapy with basal insulin+GLP‐1RA, few have reported on premixed insulin+GLP‐1RA. We aimed to address this gap using data from the Clinical Practice Research Datalink Aurum database in England. Methods: This retrospective cohort study with propensity score matching assessed glycaemic levels and other clinical outcomes in people with T2D, comparing biphasic insulin aspart 30/70 (BIAsp 30) + GLP‐1RA with basal insulin (insulin detemir/glargine U100) + GLP‐1RA (from 2006 to 2021). Results: In total, 4770 eligible people were identified; 1511 had a BIAsp 30 + GLP‐1RA regimen and were propensity score‐matched to an equal number receiving basal+GLP‐1RA. There was no significant difference in glycated haemoglobin (HbA1c) reduction between cohorts at 6 months (p = 0.15), with a decrease of −1.07 (95% CI: −1.16; −0.98) %‐points (−11.7 mmol/mol [95% CI: −12.7; –10.7]) in the BIAsp 30 + GLP‐1RA cohort, versus −0.97 (95% CI: −1.07; −0.88) %‐points (−10.6 mmol/mol [95% CI: −11.7; –9.6]) in the basal+GLP‐1RA cohort. Body mass index (BMI) decreased by −0.35 kg/m2 (95% CI: −0.52;−0.18) at 6 months with BIAsp 30 + GLP‐1RA, versus −0.72 kg/m2 (95% CI: −0.90;−0.54) with basal+GLP‐1RA (p = 0.003). BMI was influenced by the initiation sequence of GLP‐1RA in relation to insulin (p < 0.0001). Hypoglycaemia rates were low and not significantly different between cohorts. Conclusions: Combining BIAsp 30 + GLP‐1RA provides glycaemic control with no significant difference to that of propensity score‐matched people receiving basal insulin+GLP‐1RA, with no increase in hypoglycaemia risk or weight gain. [ABSTRACT FROM AUTHOR]

Background: Circumferential pulmonary vein isolation (PVI) using radiofrequency ablation (RFA) is a standard of care intervention for patients with symptomatic atrial fibrillation (AF). During follow-up, a substantial number of patients need a redo procedure due to reconnections on the basis of insufficient non-transmural ablation lesions. High-power short-duration ablation (HPSD) is expected to create efficient lesions while causing fewer complications than in conventional RFA settings. The aim of this study was to compare one-year outcome data of very HPSD (90 Watt, 4 s) to a strategy using 50 Watt HPSD ablation guided by the CLOSE protocol using the Ablation Index (AI), an arbitrary unit composed of power, contact force and ablation time. Methods: We retrospectively analyzed short and long-term (median follow-up 23.2 ± 9.9 months) outcome data from 52 patients that were scheduled for first-do-symptomatic PVI. A very HPSD ablation protocol with 90 Watt and a 4 s duration cut-off was compared to an HPSD CLOSE approach (50 Watts; AI 550 at the anterior LA wall; AI 400 at the posterior LA wall, the roof and the floor) in terms of freedom from AF recurrence in a long-term electrocardiogram (ECG) over a five days surveillance period. To gain an impression of the subjective sense of wellbeing, the Atrial Fibrillation Effects on QualiTy-of-Life (AFEQT) score was recorded. Results: Overall freedom from AF was found in 81% (90 W 4 s) vs. 87.5% (50 W), (p = 0.52). There were 3 AF recurrences during the blanking period (90 W 4 s) vs. 1 (50 W). Within each population, one patient was scheduled for a redo-PVI-procedure. The AFEQT score was in favor of the 90 Watt 4 s approach (86.1 vs. 77.5; p = 0.37). Conclusion: Within our relatively small studied population, we found hints that in addition to shortening ablation times and radiation exposure without significantly increasing the rate of relevant intraprocedural complications, very high power short-duration ablation (90 W 4 s) provides comparable efficacy rates after one year.

Aim: To evaluate long‐term outcomes and prognostic factors of non‐reconstructive surgical treatment of peri‐implantitis. Materials and Methods: One hundred forty‐nine patients (267 implants) were surgically treated for peri‐implantitis and followed for an average of 7.0 (SD: 3.6) years. The primary outcome was implant loss. Additional bone loss and surgical retreatment were secondary outcomes. Patient/implant characteristics, as well as clinical and radiographic parameters collected prior to initial surgery, were evaluated as potential predictors of implant loss. Flexible parametric survival models using restricted cubic spline functions were used; 5‐ and 10‐year predicted rates of implant loss were calculated according to different scenarios. Results: Fifty‐three implants (19.9%) in 35 patients (23.5%) were lost during the observation period. Implant loss occurred after a mean period of 4.4 (SD: 3.0) years and was predicted by implant surface characteristics (modified surface; HR 4.5), implant length (HR 0.8 by mm), suppuration at baseline (HR 2.7) and disease severity (baseline bone loss: HR 1.2 by mm). Estimates of 5‐ and 10‐year implant loss ranged from 1% (best prognostic scenario; initial bone loss <40% of implant length, turned implant surface and absence of suppuration on probing (SoP)) to 63% (worst prognostic scenario; initial bone loss ≥60% of implant length, modified implant surface and SoP) and from 3% to 89%, respectively. Surgical retreatment was performed at 65 implants (24.3%) in 36 patients (24.2%) after a mean time period of 4.5 (3.1) years. In all, 59.5% of implants showed additional bone loss, were surgically retreated or lost. Conclusions: Recurrence of disease is common following surgical treatment of peri‐implantitis. The strongest predictor for implant loss was implant surface characteristics. Implant length as well as suppuration and disease severity at baseline were also relevant factors. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare the risk of fetal overgrowth and preterm delivery in pregnant women with type 1 diabetes (T1D) treated with insulin pumps versus multiple daily injections (MDI) and examine whether possible differences were mediated through improved glycemic control or gestational weight gain during pregnancy. RESEARCH DESIGN AND METHODS: The risk of pregnancy and perinatal outcomes were evaluated in a cohort of 2,003 pregnant women with T1D enrolled from 17 countries in a real-world setting during 2013–2018. RESULTS: In total, 723 women were treated with pumps and 1,280 with MDI. At inclusion (median gestational weeks 8.6 [interquartile range 7–10]), pump users had lower mean HbA1c (mean ± SD 50.6 ± 9.8 mmol/mol [6.8 ± 0.9%] vs. 53.6 ± 13.8 mmol/mol [7.1 ± 1.3%], P < 0.001), longer diabetes duration (18.4 ± 7.8 vs. 14.4 ± 8.2 years, P < 0.001), and higher prevalence of retinopathy (35.3% vs. 24.4%, P < 0.001). Proportions of large for gestational age (LGA) offspring and preterm delivery were 59.0% vs. 52.2% (adjusted odds ratio [OR] 1.36 [95% CI 1.09; 1.70], P = 0.007) and 39.6% vs. 32.1% (adjusted OR 1.46 (95% CI 1.17; 1.82), P < 0.001), respectively. The results did not change after adjustment for HbA1c or gestational weight gain. CONCLUSIONS: Insulin pump treatment in pregnant women with T1D, prior to the widespread use of continuous glucose monitoring or automated insulin delivery, was associated with a higher risk of LGA offspring and preterm delivery compared with MDI in crude and adjusted analyses. This association did not appear to be mediated by differences in glycemic control as represented by HbA1c or by gestational weight gain. [ABSTRACT FROM AUTHOR]

Between 2019 and 2021, the Autonomous Region of Sardinia and the Eni Enrico Mattei Foundation (FEEM) developed and applied a sustainability assessment model of the investments within the regional operational programmes (ROPs), with specific reference to the United Nations’ 2030 Agenda and its 17 Sustainable Development Goals (SDGs). That same methodology is used here for the assessment of the sustainability of the ROPs co-financed by the European Union with specific reference to Italy’s National Sustainable Development Strategy (NSDS). In particular, the analysis is done by looking at the contribution of the 182 intervention fields to the NSDS’ strategic goals. Throughout the paper the importance of defining implementation strategies of the NSDS’ National strategic goals through the integration of the indicators, goals and choices of the national strategy into local or regional development plans is emphasized. Finally, the work suggests this methodology as a reference point to ensure careful monitoring of the sustainability of the investments of various European Union policies, in consideration of the importance that the strategy assumes for both Italy and the Italian regions. [ABSTRACT FROM AUTHOR]

Constitutive activation of the PI3K/AKT/mTOR‐pathway plays an important role in the pathogenesis of mantle cell lymphoma (MCL), leading to approval of the mTOR inhibitor temsirolimus for relapsed or refractory MCL. Yet, despite favorable initial response rates, early relapses under treatment have been observed. Therefore, understanding the underlying mechanisms of temsirolimus resistance and developing strategies to overcome it is highly warranted. Here, we established a new temsirolimus‐resistant MCL cell line to evaluate the molecular background of resistance to this drug. Transcriptome profiling and gene set enrichment analysis comparing temsirolimus‐sensitive and ‐resistant cell lines showed significant upregulation of PI3K/AKT/mTor‐, RAS signaling‐ and the RTK‐dependent PDGFR‐, FGFR‐, Met‐ and ALK‐signaling‐pathways in the resistant cells. Furthermore, MET, known as important proto‐oncogene and mediator of drug resistance, was among the most upregulated genes in the resistant cells. Importantly, Met protein was overexpressed in both, MCL cells with acquired as well as intrinsic temsirolimus resistance, but could not be detected in any of the temsirolimus sensitive ones. Combined pharmacological inhibition of mTOR and Met signaling with temsirolimus and the RTK inhibitor crizotinib significantly restored sensitivity to temsirolimus. Furthermore, this combined treatment proved to be synergistic in all MCL cell lines investigated and was also active in primary MCL cells. In summary, we showed for the first time that overexpression of MET plays an important role for mediating temsirolimus resistance in MCL and combined treatment with temsirolimus and crizotinib is a very promising therapeutic approach for MCL and an effective strategy to overcome temsirolimus resistance. [ABSTRACT FROM AUTHOR]