The Controversy of Myopia as a Risk Factor for Glaucoma: a Mathematical Approach

poster abstractPurpose: to quantify how individual variations in anatomical parameters often associated with myopia (e.g. longer ocular axial length (OAL), reduced scleral thickness (ST), lamina cribrosa diameter (LCD) and thickness (LCT)) affect retinal blood flow (RBF) and its sensitivity to ocular perfusion pressure (OPP). Methods: A mathematical model is used to calculate RBF through central retinal artery (CRA), arterioles, capillaries, venules, and central retinal vein (CRV). The flow is time-dependent, driven by systemic pressure and regulated by variable resistances to account for nonlinear effects due to (1) autoregulation (AR), and (2) lamina cribrosa effect on CRA and CRV. The latter is a nonlinear function of intraocular pressure (IOP), cerebrospinal fluid pressure (CSF) and OAL, ST, LCD, and LCT. RBF is computed as the solution of a system of five non-linear ordinary differential equations. The system is solved for different OPP values, obtained by varying independently IOP and mean arterial pressure (MAP), with and without AR. Results: Four representative eyes are compared: Eye 1 (OAL=24mm, ST=1mm, LCD=3mm, LCT=0.4mm), Eye 2 (OAL=28mm, ST=1mm, LCD=3mm, LCT=0.4mm), Eye 3 (OAL=24mm, ST=0.7mm, LCD=2mm, LCT=0.2mm), Eye 4 (OAL=28mm, ST=0.7mm, LCD=2mm, LCT=0.2mm). The model predicts that the cardiac cycle RBF average (RBFav) for eyes with smaller LCD and LCT is notably less than in normal eyes when IOP is elevated and without AR (c). Without AR and reduced MAP, the four eyes show similar RBFav reductions (d). With AR, anatomical changes do not induce notable changes in RBFav, (a) and (b). Conclusions: Reduced LCD and LCT, often associated with myopia, seem to affect RBFav more than elevated OAL. RBFav reductions magnify when AR is impaired, and this might reduce IOP safe levels for eyes with reduced LCD and LCT. These findings suggest that a combination of anatomical and vascular factors might cause certain myopic eyes to be at higher risk for glaucomatous damage than others

The Expanded Evidence-Centered Design (e-ECD) for Learning and Assessment Systems: A Framework for Incorporating Learning Goals and Processes Within Assessment Design

Evidence-centered design (ECD) is a framework for the design and development of assessments that ensures consideration and collection of validity evidence from the onset of the test design. Blending learning and assessment requires integrating aspects of learning at the same level of rigor as aspects of testing. In this paper, we describe an expansion to the ECD framework (termed e-ECD) such that it includes the specifications of the relevant aspects of learning at each of the three core models in the ECD, as well as making room for specifying the relationship between learning and assessment within the system. The framework proposed here does not assume a specific learning theory or particular learning goals, rather it allows for their inclusion within an assessment framework, such that they can be articulated by researchers or assessment developers that wish to focus on learning

Challenges of tuberculosis management in high and low prevalence countries in a mobile world

This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.In this issue of the PCRJ, Bishara et al. 1 present a case report about the treatment of a pregnant woman with tuberculosis (TB). She had emigrated from a country with a high prevalence of TB to one with a lower prevalence. This presented a challenge to her physicians who were faced with identifying and treating close contacts who were also infected. This Perspective article explores in more depth some of the questions raised by this case report. It discusses the role of primary care physicians in low prevalence countries who can implement evidence-based screening programmes, it discusses effective strategies for the diagnosis and treatment of TB in countries with high TB prevalence, and it presents insights from medical anthropology that can help practitioners overcome the barriers to TB diagnosis, treatment and screening described in the case report

Adherence to Southern European Atlantic Diet and physical fitness on the atherogenic index of plasma in adolescents

We sought (i) to evaluate the associations of cardiorespiratory fitness (CRF), muscular fitness (MF) and Southern European Atlantic Diet (SEADiet) with atherogenic index of plasma (AIP) and (ii) to investigate de combined association of MF, CRF and SEADiet on AIP in adolescents. A cross-sectional school-based study was conducted on 493 adolescents (285 girls and 208 boys) aged 15-18 years, from the Portuguese Azorean Archipelago. CRF was measured by shuttle run test and MF by curl up and push up tests. Adherence to SEADiet was assessed with a semi-quantitative food frequency questionnaire (FFQ). The AIP was estimated as log (TG/HDL-C). Measures of pubertal stage and socioeconomic status were assessed. Linear regression showed a significant inverse association between MF (standardized β = -0.165; p \u3c 0.001), CRF (standardized β = -0.081; p \u3c 0.030) and SEADiet (standardized β = -0.081; p \u3c 0.045) with AIP, after adjustments for age, sex, pubertal stage and parental education. Furthermore, participants classified with an optimal as well as those with low adherence to a SEADiet but with LowMF/LowCRF had on average the highest AIP (F(7.482) = 3.270; p = 0.002). Moreover, optimal SEADiet with HighMF/HighCRF group showed the lowest AIP when compared with those with low adherence to a SEADiet with HighMF/HighCRF group (p = 0.03). AIP is inversely associated with MF, CRF and SEADiet. The low MF combined with a low CRF levels seems to overcome the potential healthy effect of having an optimal adherence to the SEADiet on AIP. However, an optimal adherence to SEADiet seems to improve the AIP in those adolescents with high fitness levels

Weak pairwise correlations imply strongly correlated network states in a neural population

Biological networks have so many possible states that exhaustive sampling is impossible. Successful analysis thus depends on simplifying hypotheses, but experiments on many systems hint that complicated, higher order interactions among large groups of elements play an important role. In the vertebrate retina, we show that weak correlations between pairs of neurons coexist with strongly collective behavior in the responses of ten or more neurons. Surprisingly, we find that this collective behavior is described quantitatively by models that capture the observed pairwise correlations but assume no higher order interactions. These maximum entropy models are equivalent to Ising models, and predict that larger networks are completely dominated by correlation effects. This suggests that the neural code has associative or error-correcting properties, and we provide preliminary evidence for such behavior. As a first test for the generality of these ideas, we show that similar results are obtained from networks of cultured cortical neurons.Comment: Full account of work presented at the conference on Computational and Systems Neuroscience (COSYNE), 17-20 March 2005, in Salt Lake City, Utah (http://cosyne.org

Neural Network Mechanisms Underlying Stimulus Driven Variability Reduction

It is well established that the variability of the neural activity across trials, as measured by the Fano factor, is elevated. This fact poses limits on information encoding by the neural activity. However, a series of recent neurophysiological experiments have changed this traditional view. Single cell recordings across a variety of species, brain areas, brain states and stimulus conditions demonstrate a remarkable reduction of the neural variability when an external stimulation is applied and when attention is allocated towards a stimulus within a neuron's receptive field, suggesting an enhancement of information encoding. Using an heterogeneously connected neural network model whose dynamics exhibits multiple attractors, we demonstrate here how this variability reduction can arise from a network effect. In the spontaneous state, we show that the high degree of neural variability is mainly due to fluctuation-driven excursions from attractor to attractor. This occurs when, in the parameter space, the network working point is around the bifurcation allowing multistable attractors. The application of an external excitatory drive by stimulation or attention stabilizes one specific attractor, eliminating in this way the transitions between the different attractors and resulting in a net decrease in neural variability over trials. Importantly, non-responsive neurons also exhibit a reduction of variability. Finally, this reduced variability is found to arise from an increased regularity of the neural spike trains. In conclusion, these results suggest that the variability reduction under stimulation and attention is a property of neural circuits