Clinical validation of a smartphone-based adapter for optic disc imaging in Kenya

Visualization and interpretation of the optic nerve and retina are essential parts of most physical examinations. To design and validate a smartphone-based retinal adapter enabling image capture and remote grading of the retina. This validation study compared the grading of optic nerves from smartphone images with those of a digital retinal camera. Both image sets were independently graded at Moorfields Eye Hospital Reading Centre. Nested within the 6-year follow-up (January 7, 2013, to March 12, 2014) of the Nakuru Eye Disease Cohort in Kenya, 1460 adults (2920 eyes) 55 years and older were recruited consecutively from the study. A subset of 100 optic disc images from both methods were further used to validate a grading app for the optic nerves. Data analysis was performed April 7 to April 12, 2015. Vertical cup-disc ratio for each testwas compared in terms of agreement (Bland-Altman and weighted κ) and test-retest variability. A total of 2152 optic nerve images were available from both methods (also 371 from the reference camera but not the smartphone, 170 from the smartphone but not the reference camera, and 227 from neither the reference camera nor the smartphone). Bland-Altman analysis revealed a mean difference of 0.02 (95%CI, −0.21 to 0.17) and a weighted κ coefficient of 0.69 (excellent agreement). The grades of an experienced retinal photographer were compared with those of a lay photographer (no health care experience before the study), and no observable difference in image acquisition quality was found. Nonclinical photographers using the low-cost smartphone adapter were able to acquire optic nerve images at a standard that enabled independent remote grading of the images comparable to those acquired using a desktop retinal camera operated by an ophthalmic assistant. The potential for task shifting and the detection of avoidable causes of blindness in the most at-risk communities makes this an attractive public health intervention

Vortex Pinball Under Crossed AC Drives in Superconductors with Periodic Pinning Arrays

Vortices driven with both a transverse and a longitudinal AC drive which are out of phase are shown to exhibit a novel commensuration-incommensuration effect when interacting with periodic substrates. For different AC driving parameters, the motion of the vortices forms commensurate orbits with the periodicity of the pinning array. When the commensurate orbits are present, there is a finite DC critical depinning threshold, while for the incommensurate phases the vortices are delocalized and the DC depinning threshold is absent.Comment: 4 pages, 4 postscript figure

Low-temperature dynamical simulation of spin-boson systems

The dynamics of spin-boson systems at very low temperatures has been studied using a real-time path-integral simulation technique which combines a stochastic Monte Carlo sampling over the quantum fluctuations with an exact treatment of the quasiclassical degrees of freedoms. To a large degree, this special technique circumvents the dynamical sign problem and allows the dynamics to be studied directly up to long real times in a numerically exact manner. This method has been applied to two important problems: (1) crossover from nonadiabatic to adiabatic behavior in electron transfer reactions, (2) the zero-temperature dynamics in the antiferromagnetic Kondo region 1/2<K<1 where K is Kondo's parameter.Comment: Phys. Rev. B (in press), 28 pages, 6 figure

Sinonasal Squamous Cell Carcinoma Survival Outcomes Following Induction Chemotherapy vs Standard of Care Therapy

Objective To compare oncologic outcomes in sinonasal squamous cell carcinoma (SNSCC) treated with standard of care (SOC) definitive therapy, consisting of surgery or chemoradiotherapy, vs induction therapy followed by definitive therapy. Study Design Retrospective review.SettingAcademic tertiary care hospital. Methods The medical records of patients with biopsy-proven SNSCC treated between 2000 and 2020 were reviewed for demographics, tumor characteristics, staging, treatment details, and oncologic outcomes. Patients were matched 1-to-1 by age, sex, and cancer stage according to treatment received. Time-to-event analyses were conducted. Results The analysis included 26 patients with locally advanced SNSCC who received either induction therapy (n = 13) or SOC (n = 13). Baseline demographics, Charlson Comorbidity Index, and median follow-up time were well balanced. Weekly cetuximab, carboplatin, and paclitaxel were the most common induction regimen utilized. Tolerance and safety to induction were excellent. Objective responses were observed in 11 of 13 patients receiving induction. No difference in disease-free survival was found between the induction and SOC groups at 1 or 3 years. However, when compared with SOC, induction therapy resulted in significant improvement in overall survival at 2 years (100% vs 65.3%, P = .043) and 3 years (100% vs 48.4%, P = .016) following completion of definitive therapy. Two patients in the SOC group developed metastatic disease, as compared with none in the induction group. Conclusions Induction therapy was safe and effective. When compared with SOC, induction therapy improved 3-year overall survival

Resonant tunneling through ultrasmall quantum dots: zero-bias anomalies, magnetic field dependence, and boson-assisted transport

We study resonant tunneling through a single-level quantum dot in the presence of strong Coulomb repulsion beyond the perturbative regime. The level is either spin-degenerate or can be split by a magnetic field. We, furthermore, discuss the influence of a bosonic environment. Using a real-time diagrammatic formulation we calculate transition rates, the spectral density and the nonlinear $I-V$ characteristic. The spectral density shows a multiplet of Kondo peaks split by the transport voltage and the boson frequencies, and shifted by the magnetic field. This leads to zero-bias anomalies in the differential conductance, which agree well with recent experimental results for the electron transport through single-charge traps. Furthermore, we predict that the sign of the zero-bias anomaly depends on the level position relative to the Fermi level of the leads.Comment: 27 pages, latex, 21 figures, submitted to Phys. Rev.

Mechanical forces induce an asthma gene signature in healthy airway epithelial cells

Bronchospasm compresses the bronchial epithelium, and this compressive stress has been implicated in asthma pathogenesis. However, the molecular mechanisms by which this compressive stress alters pathways relevant to disease are not well understood. Using air-liquid interface cultures of primary human bronchial epithelial cells derived from non-asthmatic donors and asthmatic donors, we applied a compressive stress and then used a network approach to map resulting changes in the molecular interactome. In cells from non-asthmatic donors, compression by itself was sufficient to induce inflammatory, late repair, and fibrotic pathways. Remarkably, this molecular profile of non-asthmatic cells after compression recapitulated the profile of asthmatic cells before compression. Together, these results show that even in the absence of any inflammatory stimulus, mechanical compression alone is sufficient to induce an asthma-like molecular signature

Comparing proton momentum distributions in A=2A=2 and 3 nuclei via 2^2H 3^3H and 3^3He (e,e′p)(e, e'p) measurements

We report the first measurement of the $(e,e'p)$ reaction cross-section ratios for Helium-3 ($^3$He), Tritium ($^3$H), and Deuterium ($d$). The measurement covered a missing momentum range of $40 \le p_{miss} \le 550$ MeV$/c$, at large momentum transfer ($\langle Q^2 \rangle \approx 1.9$ (GeV$/c$)$^2$) and $x_B>1$, which minimized contributions from non quasi-elastic (QE) reaction mechanisms. The data is compared with plane-wave impulse approximation (PWIA) calculations using realistic spectral functions and momentum distributions. The measured and PWIA-calculated cross-section ratios for $^3$He$/d$ and $^3$H$/d$ extend to just above the typical nucleon Fermi-momentum ($k_F \approx 250$ MeV$/c$) and differ from each other by $\sim 20\%$, while for $^3$He/$^3$H they agree within the measurement accuracy of about 3\%. At momenta above $k_F$, the measured $^3$He/$^3$H ratios differ from the calculation by $20\% - 50\%$. Final state interaction (FSI) calculations using the generalized Eikonal Approximation indicate that FSI should change the $^3$He/$^3$H cross-section ratio for this measurement by less than 5\%. If these calculations are correct, then the differences at large missing momenta between the $^3$He/$^3$H experimental and calculated ratios could be due to the underlying $NN$ interaction, and thus could provide new constraints on the previously loosely-constrained short-distance parts of the $NN$ interaction.Comment: 8 pages, 3 figures (4 panels

The Polygenic and Monogenic Basis of Blood Traits and Diseases

Blood cells play essential roles in human health, underpinning physiological processes such as immunity, oxygen transport, and clotting, which when perturbed cause a significant global health burden. Here we integrate data from UK Biobank and a large-scale international collaborative effort, including data for 563,085 European ancestry participants, and discover 5,106 new genetic variants independently associated with 29 blood cell phenotypes covering a range of variation impacting hematopoiesis. We holistically characterize the genetic architecture of hematopoiesis, assess the relevance of the omnigenic model to blood cell phenotypes, delineate relevant hematopoietic cell states influenced by regulatory genetic variants and gene networks, identify novel splice-altering variants mediating the associations, and assess the polygenic prediction potential for blood traits and clinical disorders at the interface of complex and Mendelian genetics. These results show the power of large-scale blood cell trait GWAS to interrogate clinically meaningful variants across a wide allelic spectrum of human variation. Analysis of blood cell traits in the UK Biobank and other cohorts illuminates the full genetic architecture of hematopoietic phenotypes, with evidence supporting the omnigenic model for complex traits and linking polygenic burden with monogenic blood diseases