A Metascore of Multiple Imaging Methods to Measure Long-Term Glaucoma Structural Progression.

Purpose: To develop a structural metascore (SMS) that combines measurements from different devices and expresses them on a single scale to facilitate their long-term analysis. Methods: Three structural measurements (Heidelberg Retina Tomograph II [HRT] rim area, HD-Cirrus optical coherence tomography [OCT] average retinal nerve fiber layer [RNFL] thickness, Spectralis OCT RNFL global thickness) were normalized on a scale of 0 to 100 and converted to a reference value. The resultant metascores were plotted against time. SMS performance was evaluated to predict future values (internal validation), and correlations between the average grades assigned by three clinicians were compared with the SMS slopes (external validation). Results: The linear regression fit with the variance approach, and adjustment to a Spectralis equivalent was the best-performing approach; this was denominated metascore. Plots were created for 3416 eyes of 1824 patients. The average baseline age (± standard deviation) was 69.8 (±13.9), mean follow-up was 11.6 (±4.7) years, and mean number of structural scans per eye was 10.0 (±4.7). The mean numbers of scans per device were 3.8 (±2.5), 5.0 (±2.9), and 1.3 (±3.0) for HRT, Cirrus, and Spectralis, respectively. The metascore slopes' median was -0.3 (interquartile range 1.1). Correlations between the average grades assigned by the three clinicians and the metascore slopes were -0.51, -0.49, and -0.69 for the first (structural measurement printouts alone), second (metascore plots alone), and third (printouts + metascore plots) series of gradings, respectively. The average absolute predictive ability was 7.63/100 (whereas 100 = entire normalized scale). Conclusions: We report a method that converts Cirrus global RNFL and HRT global rim area normalized measurements to Spectralis global RNFL equivalent values to facilitate long-term structural follow-up. Translational Relevance: Because glaucoma changes usually occur slowly, patients are often examined with different instruments during their follow-up, a method that "unifies" structural measurements provided by different devices, which could assist patients' longitudinal structural follow-up.

Genotype VII.1.1-Based Newcastle Disease Virus Vaccines Afford Better Protection against Field Isolates in Commercial Broiler Chickens.

This study evaluated the efficacy of live and inactivated conventional GII LaSota and recombinant GVII Newcastle disease vaccines in commercial broilers. The experimental groups (G2-G7) were vaccinated on day 7 and day 21 of age with live vaccines from the same vaccine type "GII LaSota, GVII vaccine (A), GVII vaccine (B)" via eye drop; however, G3, G5, and G7 received a single dose from inactivated counterpart vaccines subcutaneously on day 7 of age. Vaccine efficacy was evaluated based on elicited humoral immunity, clinical protection, and reduction in virus shedding after challenge with virulent GVII 1.1. strain. Results demonstrated that live and inactivated recombinant GVII vaccine based on VG/GA strain backbone elicited superior protection parameters (100% protection). Although the conventional GII LaSota live and inactivated vaccination regime protected 93.3% of vaccinated birds, the virus shedding continued until 10 DPC. The post-vaccination serological monitoring was consistent with protection results. The study concludes that conventional GII ND vaccines alone are probably insufficient due to the current epidemiology of the GVII 1.1 NDV strains. Our findings further support that protection induced by recombinant GVII 1.1. ND vaccines are superior. Interestingly, the efficacy of recombinant ND vaccines seemed to be influenced by the backbone virus since the VG/GA backbone-based vaccine provided better protection and reduced virus shedding.

Forecasting the COVID-19 Epidemic by Integrating Symptom Search Behavior Into Predictive Models: Infoveillance Study.

BACKGROUND: Previous studies have suggested associations between trends of web searches and COVID-19 traditional metrics. It remains unclear whether models incorporating trends of digital searches lead to better predictions. OBJECTIVE: The aim of this study is to investigate the relationship between Google Trends searches of symptoms associated with COVID-19 and confirmed COVID-19 cases and deaths. We aim to develop predictive models to forecast the COVID-19 epidemic based on a combination of Google Trends searches of symptoms and conventional COVID-19 metrics. METHODS: An open-access web application was developed to evaluate Google Trends and traditional COVID-19 metrics via an interactive framework based on principal component analysis (PCA) and time series modeling. The application facilitates the analysis of symptom search behavior associated with COVID-19 disease in 188 countries. In this study, we selected the data of nine countries as case studies to represent all continents. PCA was used to perform data dimensionality reduction, and three different time series models (error, trend, seasonality; autoregressive integrated moving average; and feed-forward neural network autoregression) were used to predict COVID-19 metrics in the upcoming 14 days. The models were compared in terms of prediction ability using the root mean square error (RMSE) of the first principal component (PC1). The predictive abilities of models generated with both Google Trends data and conventional COVID-19 metrics were compared with those fitted with conventional COVID-19 metrics only. RESULTS: The degree of correlation and the best time lag varied as a function of the selected country and topic searched; in general, the optimal time lag was within 15 days. Overall, predictions of PC1 based on both search terms and COVID-19 traditional metrics performed better than those not including Google searches (median 1.56, IQR 0.90-2.49 versus median 1.87, IQR 1.09-2.95, respectively), but the improvement in prediction varied as a function of the selected country and time frame. The best model varied as a function of country, time range, and period of time selected. Models based on a 7-day moving average led to considerably smaller RMSE values as opposed to those calculated with raw data (median 0.90, IQR 0.50-1.53 versus median 2.27, IQR 1.62-3.74, respectively). CONCLUSIONS: The inclusion of digital online searches in statistical models may improve the nowcasting and forecasting of the COVID-19 epidemic and could be used as one of the surveillance systems of COVID-19 disease. We provide a free web application operating with nearly real-time data that anyone can use to make predictions of outbreaks, improve estimates of the dynamics of ongoing epidemics, and predict future or rebound waves.

Forecasting the COVID-19 epidemic integrating symptom search behavior: an infodemiology study

BackgroundPrevious studies have suggested associations between trends of web searches and COVID-19 traditional metrics. It remains unclear whether models incorporating trends of digital searches lead to better predictions. MethodsAn open-access web application was developed to evaluate Google Trends and traditional COVID-19 metrics via an interactive framework based on principal components analysis (PCA) and time series modelling. The app facilitates the analysis of symptom search behavior associated with COVID-19 disease in 188 countries. In this study, we selected data of eight countries as case studies to represent all continents. PCA was used to perform data dimensionality reduction, and three different time series models (Error Trend Seasonality, Autoregressive integrated moving average, and feed-forward neural network autoregression) were used to predict COVID-19 metrics in the upcoming 14 days. The models were compared in terms of prediction ability using the root-mean-square error (RMSE) of the first principal component (PC1). Predictive ability of models generated with both Google Trends data and conventional COVID-19 metrics were compared with those fitted with conventional COVID-19 metrics only. FindingsThe degree of correlation and the best time-lag varied as a function of the selected country and topic searched; in general, the optimal time-lag was within 15 days. Overall, predictions of PC1 based on both searched termed and COVID-19 traditional metrics performed better than those not including Google searches (median [IQR]: 1.43 [0.74-2.36] vs. 1.78 [0.95-2.88], respectively), but the improvement in prediction varied as a function of the selected country and timeframe. The best model varied as a function of country, time range, and period of time selected. Models based on a 7-day moving average led to considerably smaller RMSE values as opposed to those calculated with raw data (median [IQR]: 0.74 [0.47-1.22] vs. 2.15 [1.55-3.89], respectively). InterpretationThe inclusion of digital online searches in statistical models may improve the prediction of the COVID-19 epidemic. FundingEOSCsecretariat.eu has received funding from the European Unions Horizon Programme call H2020-INFRAEOSC-05-2018-2019, grant Agreement number 831644.

Thermoluminescence characteristics of lithium borosilicate glass doped with Sm2 O3.

Lithium borosilicate glass composite (SiO2 -Li2 CO3 -H3 BO3 ) doped with various concentrations of Sm2 O3 (0-0.7 mole %) was prepared using the melt quenching method. The investigated thermoluminescence (TL) characteristics of the prepared system revealed that the highest TL response was obtained for this glass composite at 0.05 mol% Sm2 O3 . In this study, the 0.05 mol% Sm2 O3 -doped lithium borosilicate glass composite was subjected to detailed dosimetric investigation in terms of its annealing condition, dose-response, and minimum detectable dose. The reproducibility of the response, thermal characteristics, and optical fading were also studied. The obtained results showed that the prepared glass composite had a linear dose-response over the wide gamma dose range 2Gy to 2 kGy, as well as reasonable thermal fading and excellent reproducibility. These attributes render the composite under investigation promising for utilization in radiation detection.

A BCI System Based on Motor Imagery for Assisting People with Motor Deficiencies in the Limbs.

Motor deficiencies constitute a significant problem affecting millions of people worldwide. Such people suffer from a debility in daily functioning, which may lead to decreased and incoherence in daily routines and deteriorate their quality of life (QoL). Thus, there is an essential need for assistive systems to help those people achieve their daily actions and enhance their overall QoL. This study proposes a novel brain-computer interface (BCI) system for assisting people with limb motor disabilities in performing their daily life activities by using their brain signals to control assistive devices. The extraction of useful features is vital for an efficient BCI system. Therefore, the proposed system consists of a hybrid feature set that feeds into three machine-learning (ML) classifiers to classify motor Imagery (MI) tasks. This hybrid feature selection (FS) system is practical, real-time, and an efficient BCI with low computation cost. We investigate different combinations of channels to select the combination that has the highest impact on performance. The results indicate that the highest achieved accuracies using a support vector machine (SVM) classifier are 93.46% and 86.0% for the BCI competition III-IVa dataset and the autocalibration and recurrent adaptation dataset, respectively. These datasets are used to test the performance of the proposed BCI. Also, we verify the effectiveness of the proposed BCI by comparing its performance with recent studies. We show that the proposed system is accurate and efficient. Future work can apply the proposed system to individuals with limb motor disabilities to assist them and test their capability to improve their QoL. Moreover, the forthcoming work can examine the system's performance in controlling assistive devices such as wheelchairs or artificial limbs.

Unusual case of absence of suprascapular notch and foramen

Identification of anatomical variations is essential to understand and perfectly manage the correlated clinical disorders. One of such disorders is shoulder pain that might result from entrapment of suprascapular nerve at the narrow supracondylar foramen. In this article, we report a rare case of absence of such foramen. With absence of the foramen, there is an increasing potentiality of nerve entrapment beneath the superior scapular transverse ligament. Therefore, investigation of such anatomical variation is suggested for proper management of cases of shoulder pain and dysfunction

No disponible

Pointwise Methods to Measure Long-term Visual Field Progression in Glaucoma.

Importance: Rates of visual field (VF) progression vary among patients with glaucoma. Knowing the rate of progression of individual patients would allow appropriately aggressive therapy for patients with high rates of visual loss and protect those with low rates from unnecessary therapy. Objective: To compare 3 pointwise methods of estimating the rate of VF progression in glaucoma. Design, Setting, and Participants: This retrospective, observational cohort study included 729 eyes of 567 consecutive patients with primary open-angle glaucoma who had at least 6 reliable VFs and at least 3 years of follow-up. One hundred seventy-six patients (257 eyes) were treated at a tertiary glaucoma center; in addition, data were collected from 391 participants (472 eyes) in the Advanced Glaucoma Intervention Study. Data were collected from May 1988 to November 2004 and analyzed from October 2018 to February 2019. Exposures: Estimates of VF progression were measured with guided progression analysis (GPA), pointwise linear regression (PLR), and the glaucoma rate index (GRI). A subgroup analysis was performed in a subset of patients with likely VF progression and likely VF stability. Main Outcomes and Measures: Proportion of VF series detected as progressing, estimates of false-positive proportions, time to detect progression, and agreement among measures. Results: Among the 567 patients included in the analysis, mean (SD) age was 65.6 (9.7) years, 300 (52.9%) were female, and 295 (52.0%) were white. The median baseline mean deviation was -6.7 (interquartile range [IQR], -11.6 to -3.5) dB; the median follow-up time, 8.9 (IQR, 7.3-10.4) years. The proportion of eyes labeled as progressing was 27.7% according to the GPA, 33.5% according to the PLR, and 52.9% according to the GRI; pairwise differences for GRI vs PLR were 20% (95% CI, 17%-23%); for GRI vs GPA, 25% (95% CI, 22%-29%); and for PLR vs GPA, 6% (95% CI, 3%-9%; P < .001 for all comparisons, McNemar test). The shortest median time to progression was with the GRI (8.8 [IQR, 2.4-10.5 years), compared with the GPA and PLR (both >16 years). The hazard ratio of VF progression for GRI vs PLR (reference) was 11.3 (95% CI, 9.2-13.7); for GRI vs GPA (reference), 18.1 (95% CI, 14.5-22.6); and for PLR vs GPA (reference), 1.5 (95% CI, 1.3-1.9; P < .001 for all comparisons, Cox proportional hazards regression). These results held in the subgroup with likely progression; the proportions of progressing eyes were 73.7% (115 of 156) for GPA, 81.4% (127 of 156) for PLR, and 92.9% (145 of 156) for GRI. Pairwise difference for GRI vs PLR was 11.5% (95% CI, 7.4%-17.6%; P < .001, McNemar test); for GRI vs GPA, 19.2% (95% CI, 12.6%-26.4%; P < .001, McNemar test); and for PLR vs GPA, 7.7% (95% CI, 0.3%-15.7%; P = .08, McNemar test). Conclusions and Relevance: These results suggest GRI can detect long-term VF progression in glaucoma earlier than PLR or GPA. Validation with prospective designs may strengthen the generalizability and value of this method.

Predictors of Long-Term Visual Field Fluctuation in Glaucoma Patients.

PURPOSE: To identify predictive factors for visual field (VF) fluctuation in glaucoma patients. DESIGN: Retrospective cohort study. PARTICIPANTS: A total of 1392 eyes (816 patients) with 6 or more VFs and 3 years or more of follow-up. METHODS: For each eye, the VF mean deviation (MD) and the pointwise sensitivities were regressed against time to model the series trend, and the root mean square error (RMSE) was estimated as a measure of variability. Potential predictors were selected with least absolute shrinkage and selection operator regression and included eye laterality, ethnicity, glaucoma type, intraocular pressure (IOP) fluctuation, baseline best corrected-visual acuity, intervening cataract or glaucoma surgery, length of follow-up, frequency of testing, baseline MD, rates of VF progression, and median false positive (FP) and false negative (FN) responses. MAIN OUTCOME MEASURES: Predictors of global and pointwise VF long-term fluctuation. RESULTS: In the global model, left eye (0.063 dB; P = 0.022), Asian descent (0.265 dB; P = 0.006), larger IOP fluctuation (0.051 dB; P < 0.001), intervening cataract surgery (0.090 dB; P = 0.023), longer follow-up (0.130 dB; P < 0.001), worse baseline MD (-0.145 dB; P < 0.001), faster VF decay rate (-0.090 dB; P < 0.001), and higher FP rate (0.145 dB; P < 0.001) and FN rate (0.220 dB; P < 0.001) were predictors of VF fluctuation. In the pointwise model, larger IOP fluctuation (0.039 dB; P = 0.022), longer follow-up (0.340 dB; P < 0.001), higher VF frequency (0.238 dB; P = 0.002), intervening glaucoma surgery (0.190 dB; P = 0.01), worse baseline MD (-0.535 dB; P < 0.001), faster VF decay rate (-0.340 dB; P < 0.001), and higher FP rate (0.255 dB; P < 0.001) and FN rate (0.395 dB; P < 0.001) were associated with increased fluctuation. The multivariable model explained 57% and 28% of the pointwise and global variances, respectively. CONCLUSIONS: This study identified novel predictors of VF fluctuation, and explains nearly 60% of the pointwise variance. In the presence of factors predictive of high fluctuation, increased frequency of testing and better analytics will help to identify VF progression more accurately.

Quantification of Visual Field Variability in Glaucoma: Implications for Visual Field Prediction and Modeling.

PURPOSE: To quantify visual field (VF) variability as a function of threshold sensitivity and location, and to compare weighted pointwise linear regression (PLR) with unweighted PLR and pointwise exponential regression (PER) for data fit and prediction ability. METHODS: Two datasets were used for this retrospective study. The first was used to characterize and estimate VF variability, and included a total of 4,747 eyes of 3,095 glaucoma patients with six or more VFs and 3 years or more of follow-up. After performing PER for each series, standard deviation of residuals was quantified for each decibel of sensitivity as a measure of variability. A separate dataset was used to test and compare unweighted PLR, weighted PLR, and PER for data fit and prediction, and included 261 eyes of 176 primary open-angle glaucoma patients with 10 or more VFs and 6 years or more of follow-up. RESULTS: The degree of variability changed as a function of threshold sensitivity with a zenith and a nadir at 33 and 11 dB, respectively. Variability decreased with eccentricity and was higher in the central 10° (P < 0.001). Differences among the methods for data fit were negligible. PER was the best model to predict future sensitivity values in the mid term and long term. CONCLUSIONS: VF variability increases with the severity of glaucoma damage and decreases with eccentricity. Weighted linear regression neither improves model fit nor prediction. PER exhibited the best prediction ability, which is likely related to the nonlinear nature of long-term glaucomatous perimetric decay. TRANSLATIONAL RELEVANCE: This study suggests that taking into account heteroscedasticity has no advantage in VF modeling.

Determination of the dynamics of respiratory diseases using thoracic ultrasonographic examination in preweaned dairy calves.

This study aimed to explore the dynamics of lung consolidation in preweaned calves and the association between ultrasonographic findings and prognosis (defined as the time until first consolidation occurrence during the preweaning period) and average daily gain. Two dairy herds were visited weekly for 9 weeks. The preweaned dairy heifers were: examined for bovine respiratory disease using thoracic ultrasonography and the calf respiratory scoring criteria, weighed, and had blood samples checked for passive immunity transfer status. A total of 57 preweaned dairy calves were examined. Prevalence of lung consolidation increased from the first week of age (12.5%) and peaked (90%) by 10 weeks of age. In a subgroup of 25 calves monitored from birth, lung consolidation appeared as soon as a few hours after birth (1 cm consolidation depth) and by the 17th day of age (3 cm consolidation depth). Lung consolidation can be detected early by routine thoracic ultrasonography in preweaned dairy calves and is therefore valuable for use in farms with a high risk of pneumonia in preweaned calves.

Détermination de la dynamique des maladies respiratoires par examen échographique thoracique chez des veaux laitiers pré-sevrés. L'étude visait à explorer la dynamique de la consolidation pulmonaire par ultrasons chez les veaux pré-sevrés et l'association entre les résultats de l'échographie et le pronostic (défini comme le délai avant la première consolidation pendant la période de pré-sevrage) et le gain quotidien moyen. Deux troupeaux laitiers ont été visités chaque semaine pendant neuf semaines, toutes les génisses pré-sevrées ont été examinées par échographie thoracique. Les scores cliniques respiratoires à des veaux, et des échantillons de sang ont été prélevés pour vérifier leur statut de transfert d'immunité passive. Un total de 57 veaux laitiers pré-sevrés ont été examinés. La prévalence de la consolidation pulmonaire a augmenté dès la première semaine d'âge (12,5 %) jusqu'à son maximum (90 %) à l'âge de 10 semaines. Dans un sous-groupe de 25 veaux suivis depuis la naissance, la consolidation pulmonaire est apparue quelques heures après la naissance (consolidation DEPTH 1 cm) et au 17ème jour (consolidation DEPTH 3 cm). Une détection précoce des lésions pulmonaires peut être réalisée par échographie thoracique systématique ce qui démontre une application potentielle dans les fermes au risque élevé de pneumonie pré-sevrage.(Traduit par les auteurs).

Risk Factors for Fast Visual Field Progression in Glaucoma.

PURPOSE: To identify baseline and longitudinal risk factors for fast visual field (VF) decay in patients with open-angle glaucoma. DESIGN: Retrospective cohort study. METHODS: Patients with open-angle glaucoma with ≥6 VFs and ≥4 years of follow-up were included. VF decay rates were measured with the following methods: mean deviation (MD) rate, VF index (VFI) rate, and the Glaucoma Rate Index (GRI). The relationship between VF rates and clinical variables were investigated with linear mixed models. Logistic regression analysis was performed to determine which factors were associated with fast progression. RESULTS: A total of 1317 eyes of 745 patients with a mean (± SD) age of 63.3 (±10.9) years and a median (interquartile range) MD -2.4 (-0.7 to -5.6) dB at baseline were analyzed. The median (interquartile range) number of VFs was 12 (9 to 16), and mean follow-up duration was 11.5 (±3.7) years. Older age (P < .001), higher peak intraocular pressure (IOP) (P < .001), and glaucoma surgery during the study period (P < .001) were associated with faster rates of progression regardless of the method used. Worse baseline MD was associated with MD rate (P = .02), but neither with VFI rate (P = .37) nor GRI (P = .31); whereas pseudoexfoliative glaucoma was associated with faster rates of progression with MD (P = .008) and VFI (P = .01) rates, but not with GRI. Higher peak IOPs (P = .005) was a significant predictor for fast progression. CONCLUSION: In this cohort, older age, peak IOP, pseudoexfoliative glaucoma, and baseline MD were associated with the rate of glaucomatous VF worsening. Fast progressors had a higher peak IOP than non-fast progressors. The identification and appropriately aggressive treatment of fast progressors would reduce visual disability from glaucoma.

Cataract Surgery and Rate of Visual Field Progression in Primary Open-Angle Glaucoma.

PURPOSE: To test the hypothesis that cataract surgery slows the apparent rate of visual field (VF) decay in primary open-angle glaucoma patients compared with rates measured during cataract progression. DESIGN: Retrospective cohort study. METHODS: Consecutive open-angle glaucoma patients who underwent cataract surgery and who had ≥4 VFs and ≥3 years of follow-up before and after surgery were retrospectively reviewed. Mean deviation (MD) rate, visual field index (VFI) rate, pointwise linear regression (PLR), pointwise rate of change (PRC), and the Glaucoma Rate Index (GRI) were compared before and after cataract surgery. RESULTS: A total of 134 eyes of 99 patients were included. Median (interquartile range) follow-up was 6.5 (4.7-8.1) and 5.3 (4.0-7.3) years before and after cataract surgery, respectively. All intraocular pressure (IOP) parameters (mean IOP, standard deviation of IOP, and peak IOP) significantly improved (P < .001) after cataract surgery. All VF indices indicated an accelerated VF decay rate after cataract surgery: MD rate (-0.18 ± 0.40 dB/year vs -0.40 ± 0.62 dB/year, P < .001), VFI rate (-0.44% ± 1.09%/year vs -1.19% ± 1.85%/year, P < .001), GRI (-5.5 ± 10.8 vs -13.5 ± 21.5; P < .001), and PRC (-0.62% ± 2.47%/year before and -1.35% ± 3.71%/year after surgery; P < .001) and PLR (-0.20 ± 0.82 dB/year before and -0.42 ± 1.16 dB/year after surgery; P < .001) for all VF locations. Worse baseline MD and postoperative peak IOP were significantly associated with the postoperative VF decay rate and the change in the decay rate after cataract surgery. CONCLUSION: Although all IOP parameters improved after cataract surgery, VFs continued to progress. Cataract surgery does not slow the apparent rate of glaucomatous VF decay as compared to rates measured during the progression of the cataract.

Effectiveness Evaluation of It's Your Game: Keep It Real, a Middle School HIV/Sexually Transmitted Infection/Pregnancy Prevention Program.

PURPOSE: This study assessed the effectiveness of the HIV/sexually transmitted infection/pregnancy prevention program, It's Your Game: Keep It Real (IYG). METHODS: IYG was implemented by classroom teachers in 24 urban middle schools from 2012 to 2015. Using a quasi-experimental design, each year we surveyed ninth-grade students in 10 high schools that were selected based on feeder patterns from project middle schools. We compared two groups of students (n = 4,562): (1) students whose middle school grade cohorts did not receive IYG ("No-IYG"), and (2) students whose middle school grade cohorts received IYG ("IYG"). Multilevel analyses examined differences between the two groups in the initiation of any type of sexual activity (oral, vaginal, or anal sex), presexual behaviors, and psychosocial mediators. RESULTS: Students in the IYG group were less likely to report initiation of sexual activity by ninth grade compared to students in the No-IYG group (odds ratio .77; 95% confidence interval .66-.90). The IYG group was significantly less likely to have engaged in presexual behaviors, including having been on a date, had a boyfriend/girlfriend, and touched or been touched on private body parts. The IYG group had better outcomes on 11 of 19 psychosocial variables, including knowledge; beliefs about abstinence, sex, friends' beliefs, norms, and behaviors; reasons for not having sex; personal limits; exposure to risky situations; self-efficacy; and quality of dating relationships. CONCLUSIONS: The results suggest that IYG, when implemented on a large scale by trained classroom teachers in urban public schools, had positive impacts on students' behaviors, beliefs, and knowledge.

A Method to Measure the Rate of Glaucomatous Visual Field Change.

PURPOSE: To develop a method to measure the rate of glaucomatous visual field (VF) deterioration and to identify fast progressors. METHODS: Retrospective, longitudinal, observational study of 8486 eyes of 4610 glaucomatous patients with ≥6 VFs and ≥3 years of follow-up. A Glaucoma Rate Index (GRI) was calculated. VF locations were partitioned into exponential decay or exponential improvement models. A pointwise rate of change (PRC) was estimated with an exponential fit and expressed as the percent/year change of the age- and location-matched normal perimetric range, presented as a spatially conserved VF map. PRCs were summed and normalized with boundary rates set by simulated decaying and improving VF series on a scale of -100 to +100, respectively. RESULTS: A total of 89,704 VF examinations with 425,039 test location series was used. Median follow-up and number of VFs/eye were 9.7 years and 9 VFs, respectively. Initial and final mean deviations (±SD) were -4.2 (±5.2) and -5.7 (±6.4) dB. The proportions of test locations designated as decayed, improved, and unchanged were 13%, 4%, and 83%, respectively. Mean PRCs for decay, improvement, and no change were -3.7 (±4.7)%/y, 2.5 (±2.6)%/y, and -0.5 (±2.1)%/y, respectively. The number of eyes with negative and positive GRIs was 5802 (68%) and 2390 eyes (28%), respectively. The proportion of eyes defined as fast progressors was 6.8%. CONCLUSIONS: GRI provides a robust measure of glaucomatous VF change, operates without discontinuity over the entire perimetric range, and can be used to identify fast progressors. TRANSLATIONAL RELEVANCE: This study describes a novel method that can help the clinician to determine VF progression.

Formation and psychometric evaluation of a health-related quality of life instrument for children living with HIV in India.

In-depth interviews and focus group discussions were conducted to inform the development of an instrument to measure the health-related quality of life of children living with HIV. The QOL-CHAI instrument consists of four generic core scales of the "Pediatric Quality of Life Inventory" and two HIV-targeted scales-"symptoms" and "discrimination." A piloting exercise involving groups of children living with HIV and HIV-negative children born to HIV-infected parents provided evidence for the acceptable psychometric properties and usability of the instrument. It is expected that the QOL-CHAI can serve well as a brief, standardized, and culturally appropriate instrument for assessing health-related quality of life of Indian children living with HIV.

The surface chemistry of sapphire-c: A literature review and a study on various factors influencing its IEP.

A wide range of isoelectric points (IEPs) has been reported in the literature for sapphire-c (α-alumina), also referred to as basal plane, (001) or (0001), single crystals. Interestingly, the available data suggest that the variation of IEPs is comparable to the range of IEPs encountered for particles, although single crystals should be much better defined in terms of surface structure. One explanation for the range of IEPs might be the obvious danger of contaminating the small surface areas of single crystal samples while exposing them to comparatively large solution reservoirs. Literature suggests that factors like origin of the sample, sample treatment or the method of investigation all have an influence on the surfaces and it is difficult to clearly separate the respective, individual effects. In the present study, we investigate cause-effect relationships to better understand the individual effects. The reference IEP of our samples is between 4 and 4.5. High temperature treatment tends to decrease the IEP of sapphire-c as does UV treatment. Increasing the initial miscut (i.e. the divergence from the expected orientation of the crystal) tends to increase the IEP as does plasma cleaning, which can be understood assuming that the surfaces have become less hydrophobic due to the presence of more and/or larger steps with increasing miscut or due to amorphisation of the surface caused by plasma cleaning. Pre-treatment at very high pH caused an increase in the IEP. Surface treatments that led to IEPs different from the stable value of reference samples typically resulted in surfaces that were strongly affected by subsequent exposure to water. The streaming potential data appear to relax to the reference sample behavior after a period of time of water exposure. Combination of the zeta-potential measurements with AFM investigations support the idea that atomically smooth surfaces exhibit lower IEPs, while rougher surfaces (roughness on the order of nanometers) result in higher IEPs compared to reference samples. Two supplementary investigations resulted in either surprising or ambiguous results. On very rough surfaces (roughness on the order of micrometers) the IEP lowered compared to the reference sample with nanometer-scale roughness and transient behavior of the rough surfaces was observed. Furthermore, differences in the IEP as obtained from streaming potential and static colloid adhesion measurements may suggest that hydrodynamics play a role in streaming potential experiments. We finally relate surface diffraction data from previous studies to possible interpretations of our electrokinetic data to corroborate the presence of a water film that can explain the low IEP. Calculations show that the surface diffraction data are in line with the presence of a water film, however, they do not allow to unambiguously resolve critical features of this film which might explain the observed surface chemical characteristics like the dangling OH-bond reported in sum frequency generation studies. A broad literature review on properties of related surfaces shows that the presence of such water films could in many cases affect the interfacial properties. Persistence or not of the water film can be crucial. The presence of the water film can in principle affect important processes like ice-nucleation, wetting behavior, electric charging, etc.

Vertical Macular Asymmetry Measures Derived From SD-OCT for Detection of Early Glaucoma.

Purpose: To test the hypothesis that vertical asymmetry in macular ganglion cell/inner plexiform layer (GCIPL) thickness can improve detection of early glaucoma. Methods: Sixty-nine normal eyes and 101 glaucoma eyes had macular imaging with spectral-domain optical coherence tomography (OCT; 200 × 200 cube). The resulting GCIPL thickness matrix was grouped into a 20 × 20 superpixel array and superior superpixels were compared to their inferior counterparts. A global asymmetry index (AI) was defined as the grand mean of the asymmetry ratios. To measure local asymmetry, the corresponding thickness measurements of three rows above and below the horizontal raphe were compared individually and in combinations. Global and local AIs were compared to the best-performing GCIPL thickness parameters with area under the receiver operating curves (AUC) and sensitivity/specificities. Results: Age or axial length did not influence AIs in normal subjects (P ≥ 0.08). Global and local AIs were significantly higher in the glaucoma group compared to normal eyes. Minimum (AUC = 0.962, 95% confidence interval [CI]: 0.936-0.989) and inferotemporal thickness (AUC = 0.944, 95% CI: 0.910-0.977; P = 0.122) performed best for detection of early glaucoma. The AUC for global AI was 0.851 (95% CI: 0.792-0.909) compared to 0.916 (95% CI: 0.874-0.958) for the best local AI. Combining minimum or inferotemporal GCIPL thickness and the best local AI led to higher partial AUCs (0.088 and 0.085, 90% specificity, P = 0.120 and 0.130, respectively) than GCIPL thickness measures. Conclusions: Macular vertical thickness asymmetry measures did not perform better than sectoral or minimum GCIPL thickness for detection of early glaucoma. Combining local asymmetry parameters with the best sectoral GCIPL thickness measures enhanced this task.

Health-related quality of life (HRQoL) and its correlates among community-recruited children living with HIV and uninfected children born to HIV-infected parents in West Bengal, India.

PURPOSE: Helping children living with HIV (CLH) to attain an optimum quality of life is an important goal for HIV programs around the world. Our principal objectives were to determine the association of HIV infection with different domains of health-related quality of life (HRQoL) among 8- to 15-year-old CLH in India and to compare the HRQoL parameters between CLH and HIV-negative children born to HIV-infected parents ("HIV-affected"). We also assessed whether antiretroviral therapy (ART) and CD4 lymphocyte counts were associated with HRQoL among CLH. METHODS: Using the "Quality of Life (health-related) of Children Living with HIV/AIDS in India" instrument, we interviewed 199 CLH and 194 HIV-affected children from three districts of West Bengal, India. Participants were asked to quantify the difficulties faced by them in six HRQoL domains: physical, emotional, social, school functioning, symptoms, and discrimination. RESULTS: The mean age of the participants was 11.6 (SD ± 2.5) years. CLH, compared to HIV-affected children, had poorer scores on all HRQoL domains except 'discrimination.' Among CLH, there were no significant differences in HRQoL domain scores (except in the 'discrimination' domain) between ART-treated and -untreated groups. CD4 lymphocyte count was found to be a significant positive predictor of the 'symptom' scale score. CONCLUSIONS: In India, interventions for CLH mostly focus on biological disease. However, the current study revealed that HRQoL among CLH was much poorer than that of a socio-demographically comparable group. Culturally and developmentally appropriate psychosocial support measures for Indian CLH are urgently needed.

The relationship between central visual field sensitivity and macular ganglion cell/inner plexiform layer thickness in glaucoma.

AIMS: To explore the correlation of local macular ganglion cell/inner plexiform layer (GC/IPL) thickness measurements with sensitivity at individual test locations on the central 10-2 visual fields (VFs) in patients with glaucoma. METHODS: One hundred thirty-seven eyes of 125 patients with spectral domain optical coherence tomography (OCT) and 10-2 VFs were included. The exported thickness matrices (200×200) of GC/IPL measurements were centred on the fovea. Total deviation values at each test location were correlated with the 20 000 GC/IPL thickness measurements in the corresponding inferior or superior hemiretina, and areas of highest correlation were plotted. Macular structure-function relationships were also examined between six wedge-shaped GC/IPL sectors and the corresponding VF clusters. A multivariate model was built to identify the 10-2 VF test locations associated with each GC/IPL sector thickness. RESULTS: Average mean deviation on 10-2 VFs was -9.2±6.1 dB. The 10-2 VF test points demonstrated correlations with GC/IPL thickness in localised arcuate patterns mostly limited within the central 4.8×4.0 mm measurement ellipse (ρ=0.43-0.74, p<0.05 for all). Twenty-one test points of the 10-2 VF were the best predictors of sectoral GC/IPL thickness. Sectoral VF-OCT correlations were high (ρ=0.53-0.66, p<0.001) and did not significantly change after adjusting for retinal GC displacement (p>0.05). CONCLUSIONS: Macular OCT/VF relationships have localised arcuate characteristics in the central region of the macula. Given the overlapping nature of structure-function relationships, a smaller number of VF test locations may be used to summarise macular functional damage. TRIAL REGISTRATION NUMBER: NCT01742819.