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The lowering effect of physical exercise on intraocular pressure (IOP) has been reported both in healthy people and those with glaucoma, but a comparison of the lowering effect of isometric and isokinetic exercises on IOP has not been conducted in any study. Our aims were to investigate the relationship between intensity of exercise and IOP, and whether a significant difference in IOP lowering effect existed between isometric and isokinetic exercises. Sixty-seven patients with an age range of 23–40 who had no ocular disease were randomly divided into two groups. While 31 patients in the first group, group A, performed isokinetic exercise with the Cybex 6000 dynamometer, 32 patients in the second group, group B, had isometric exercises with the same machine. IOP was measured in the right eye of patients with Shiøtz tonometer just before and 10 min following exercise. Exercise intensity and total energy consumption were determined by the machine for each patient. While IOP values measured before exercise, the degree of exercise applied, and total energy consumption did not differ significantly between groups, both isometric and isotonic exercises lowered IOP significantly. As a result, isometric and isokinetic exercises lowered IOP in ophthalmologically normal subjects with direct relationship to exercise intensity and total energy consumption. Since the pressure lowering effect of isokinetic exercise was more significant, it might prove useful to glaucomatous patients.

Niemann Pick disease type C (NPC) is a neurovisceral disorder due to mutations in NPC1 or NPC2. This review focuses on poorly characterized clinical and molecular features of early infantile form of NPC (EIF) and identified 89 cases caused by NPC1 (NPC1) and 16 by NPC2 (NPC2) mutations. Extra-neuronal features were common; visceromegaly reported in 80/89 NPC1 and in 15/16 NPC2, prolonged jaundice in 30/89 NPC1 and 7/16 NPC2. Early lung involvement was present in 12/16 NPC2 cases. Median age of neurological onset was 12 (0–24) and 7.5 (0–24) months in NPC1 and NPC2 groups, respectively. Developmental delay and hypotonia were the commonest first detected neurological symptoms reported in 39/89 and 18/89 NPC1, and in 8/16 and 10/16 NPC2, respectively. Additional neurological symptoms included vertical supranuclear gaze palsy, dysarthria, cataplexy, dysphagia, seizures, dystonia, and spasticity. The following mutations in homozygous state conferred EIF: deletion of exon 1+promoter, c.3578_3591 + 9del, c.385delT, p.C63fsX75, IVS21-2delATGC, c. 2740T>A (p.C914S), c.3584G>T (p.G1195V), c.3478-6T>A, c.960_961dup (p.A321Gfs*16) in NPC1 and c.434T>A (p.V145E), c.199T>C (p.S67P), c.133C>T (p.Q45X), c.141C>A (p.C47X) in NPC2. This comprehensive analysis of the EIF type of NPC will benefit clinical patient management, genetic counselling, and assist design of novel therapy trials.

Background— It is well established that cardiorespiratory fitness (CRF) is inversely associated with cardiovascular and all-cause mortality. However, little is known regarding the association between CRF and incidence of heart failure (HF). Methods and Results— Between 1987 and 2014, we assessed CRF in 21 080 HF-free subjects (58.3±11 years) at the Veterans Affairs Medical Centers in Washington, DC, and Palo Alto, CA. Subjects were classified by age-specific quintiles of CRF. Multivariable Cox models were used to determine the association between HF incidence and clinical and exercise test variables. Reclassification characteristics of fitness relative to standard clinical risk factors were determined using the category-free net reclassification improvement and integrated discrimination improvement indices. During the follow-up (mean 12.3±7.4 years), 1902 subjects developed HF (9.0%; average annual incidence rate, 7.4 events per 1000 person-years). When CRF was considered as a binary variable (unfit/fit), low fitness was the strongest predictor of risk for HF among clinical and exercise test variables (hazard ratio, 1.91; 95% confidence interval, 1.74–2.09; P <0.001). In a fully adjusted model with the least-fit group as the reference, there was a graded and progressive reduction in risk for HF as fitness level was higher. Risks for developing HF were 36%, 41%, 67%, and 76% lower among increasing quintiles of fitness compared with the least-fit subjects ( P <0.001). Adding CRF to standard risk factors resulted in a net reclassification improvement of 0.37 ( P <0.001). Conclusions— CRF is strongly, inversely, and independently associated with the incidence of HF in veterans referred for exercise testing.

Mucopolysaccharidosis type III (MPS III) or Sanfilippo disease is an orphan inherited lysosomal storage disease and one of the most common MPS subtypes. The classical presentation is an infantile‐onset neurodegenerative disease characterised by intellectual regression, behavioural and sleep disturbances, loss of ambulation, and early death. Unlike other MPS, no disease‐modifying therapy has yet been approved. Here, we review the numerous approaches of curative therapy developed for MPS III from historical ineffective haematopoietic stem cell transplantation and substrate reduction therapy to the promising ongoing clinical trials based on enzyme replacement therapy or adeno‐associated or lentiviral vectors mediated gene therapy. Preclinical studies are presented alongside the most recent translational first‐in‐man trials. In addition, we present experimental research with preclinical mRNA and gene editing strategies. Lessons from animal studies and clinical trials have highlighted the importance of an early therapy before extensive neuronal loss. A disease‐modifying therapy for MPS III will undoubtedly mandate development of new strategies for early diagnosis.

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Clinical psychological science is a field committed to reducing the negative impact of psychiatric illness through innovative research and psychological treatments. Unfortunately, the impact of racial injustices that pervade American society and permeate our academic institutions is felt not only by the individuals who work in our departments as faculty, staff, and students, but also by those who seek our services as mental health providers. Representing the collective work of numerous graduate students and postdoctoral trainees from multiple institutions, this call to action instantiates the need for prompt and consistent efforts towards dismantling institutionalized racism and inequity in clinical science. Specifically, we articulate the multiple roles our field plays in perpetuating racial oppression and outline concrete demands and recommendations for structural reform in the following key areas: (1) the mental health needs of Black, Indigenous, and People of Color (BIPOC) students, (2) clinical training and supervision, (3) curriculum and pedagogical approaches, (4) research and methods, and (5) the recruitment, retention, and success of graduate students and faculty.

W. Murcott scion, budded onto two rootstocks, was evaluated under high pH conditions supplied with different Fe levels. Plant dry weight, leaf area, iron chlorosis symptom scale, leaf chlorophyll concentration, net photosynthetic rate, and ferric-chelate reductase (FCR) activity variables were investigated under high pH conditions. Control plants (T1) produced the most leaf area, whereas plants grown without Fe (T2) produced the least. Dry weight was highest in 'Volkameriana' T1 (control) plants and lowest in 'Swingle citrumelo' T3 (10 µM Fe and 7.8 pH) and T2 (0 µM Fe and 7.8 pH) treatments. Significant differences in SPAD and iron chlorosis scale reading were found between rootstocks and treatments. Treatments significantly affected the net photosynthetic rate of the W. Murcott mandarin. Moreover, it was found that tolerant rootstock had higher FCR activity in application T2 than in applications T3 and T4 (100 µM Fe and 7.8 pH). The data of the present study suggested that scion budded onto Volkameriana rootstock showed a higher tolerance to iron deficiency than those budded onto Swingle citrumelo under high pH conditions.