Accuracy and feasibility of an android-based digital assessment tool for post stroke visual disorders - The StrokeVision App

Background: Visual impairment affects up to 70% of stroke survivors. We designed an app (StrokeVision) to facilitate screening for common post stroke visual issues (acuity, visual fields and visual inattention). We sought to describe the test-time, feasibility, acceptability and accuracy of our app based digital visual assessments against a) current methods used for bedside screening, and b) gold standard measures. Methods: Patients were prospectively recruited from acute stroke settings. Index tests were app based assessments of fields and inattention performed by a trained researcher. We compared against usual clinical screening practice of visual fields to confrontation including inattention assessment (simultaneous stimuli). We also compared app to gold standard assessments of formal kinetic perimetry (Goldman or Octopus Visual Field Assessment); and pencil and paper based tests of inattention (Albert’s, Star Cancellation, and Line Bisection). Results of inattention and field tests were adjudicated by a specialist Neuro-Ophthalmologist. All assessors were masked to each other’s results. Participants and assessors graded acceptability using a bespoke scale that ranged from 0 (completely unacceptable) to 10 (perfect acceptability). Results: Of 48 stroke survivors recruited, the complete battery of index and reference tests for fields was successfully completed in 45. Similar acceptability scores were observed for app-based (assessor median score 10 [IQR:9-10]; patient 9 [IQR:8-10]) and traditional bedside testing (assessor 10 [IQR:9-10; patient 10 [IQR:9-10]). Median test time was longer for app-based testing (combined time-to-completion of all digital tests 420 seconds [IQR:390-588]) when compared with conventional bedside testing (70 seconds, [IQR:40-70]) but shorter than gold standard testing (1260 seconds, [IQR:1005-1620]). Compared with gold standard assessments, usual screening practice demonstrated 79% sensitivity and 82% specificity for detection of a stroke-related field defect. This compares with 79% sensitivity and 88% specificity for StrokeVision digital assessment. Conclusion: StrokeVision shows promise as a screening tool for visual complications in the acute phase of stroke. The app is at least as good as usual screening and offers other functionality that may make it attractive for use in acute stroke

Supersymmetric Probes in a Rotating 5D Attractor

Supersymmetric zero-brane and one-brane probes in the squashed $AdS_2\times S^3$ near-horizon geometry of the BMPV black hole are studied. Supersymmetric zero-brane probes stabilized by orbital angular momentum on the $S^3$ are found and shown to saturate a BPS bound. We also find supersymmetric one-brane probes which have momentum and winding around a $U(1)_L\times U(1)_R$ torus in the $S^3$ and in some cases are static.Comment: 13 page

Universal Low-Energy Dynamics for Rotating Black Holes

Fundamental string theory has been used to show that low energy excitations of certain black holes are described by a two dimensional conformal field theory. This picture has been found to be extremely robust. In this paper it is argued that many essential features of the low energy effective theory can be inferred directly from a semiclassical analysis of the general Kerr-Newman solution of supersymmetric four-dimensional Einstein-Maxwell gravity, without using string theory. We consider the absorption and emission of scalars with orbital angular momentum, which provide a sensitive probe of the black hole. We find that the semiclassical emission rates -including superradiant emission and greybody factors - for such scalars agree in striking detail with those computed in the effective conformal field theory, in both four and five dimensions. Also the value of the quantum mass gap to the lowest-lying excitation of a charge-$Q$ black hole, $E_{gap}=1/8Q^3$ in Planck units, can be derived without knowledge of fundamental string theory.Comment: 24 pages, no figures. Typos corrected, some comments adde

The effectiveness of Ultrasound guided Hydrodistension and physiotherapy in the treatment of Frozen shoulder/Adhesive Capsulitis in Primary Care: a single centre service evaluation

Background: Evidence for optimal non-operative treatment of frozen shoulder is lacking. The aim of this study is to evaluate a treatment strategy for stage II-III Frozen shoulder provided by the current primary care Musculoskeletal Service. Methods: GP referrals of shoulder pain to the musculoskeletal service diagnosed with stage II-III frozen shoulder and who opted for a treatment strategy of hydrodistension and guided physiotherapy exercise programme over a 12 month period were evaluated for 6 months. Thirty three patients were diagnosed with stage II-III frozen shoulder by specialist physiotherapists and opted for the treatment strategy. Outcome measures included SPADI and QuickDASH, pain score and range of movement. Data was collected at baseline, 6 weeks, 12 weeks and 6 months. Results: All patients significantly improved in shoulder symptoms on the SPADI and QuickDASH scores (p< 0.001). Pain scores and range of shoulder movement flexion, abduction, external rotation showed significant improvement at all time points (p<0.001). Conclusions: This service evaluation demonstrates that management of frozen shoulder stage II-III, by physiotherapists in a primary care setting utilizing hydrodistension and guided exercise programme is an effective non-operative treatment strategy. Level of evidence: Level III, Service evaluation

Type IIB Solutions with Interpolating Supersymmetries

We study type IIB supergravity solutions with four supersymmetries that interpolate between two types widely considered in the literature: the dual of Becker and Becker's compactifications of M-theory to 3 dimensions and the dual of Strominger's torsion compactifications of heterotic theory to 4 dimensions. We find that for all intermediate solutions the internal manifold is not Calabi-Yau, but has SU(3) holonomy in a connection with a torsion given by the 3-form flux. All 3-form and 5-form fluxes, as well as the dilaton, depend on one function appearing in the supersymmetry spinor, which satisfies a nonlinear differential equation. We check that the fields corresponding to a flat bound state of D3/D5-branes lie in our class of solutions. The relations among supergravity fields that we derive should be useful in studying new gravity duals of gauge theories, as well as possibly compactifications.Comment: 27pp, v2 REVTeX4, typographical fixes and minor clarifications, v3 added ref, modified discussion of RR axion slightl

Pharmacokinetic, neurochemical, stereological and neuropathological studies on the potential effects of paraquat in the substantia nigra pars compacta and striatum of male C57BL/6J mice

AbstractThe pharmacokinetics and neurotoxicity of paraquat dichloride (PQ) were assessed following once weekly administration to C57BL/6J male mice by intraperitoneal injection for 1, 2 or 3 weeks at doses of 10, 15 or 25mg/kg/week. Approximately 0.3% of the administered dose was taken up by the brain and was slowly eliminated, with a half-life of approximately 3 weeks. PQ did not alter the concentration of dopamine (DA), homovanillic acid (HVA) or 3,4-dihydroxyphenylacetic acid (DOPAC), or increase dopamine turnover in the striatum. There was inconsistent stereological evidence of a loss of DA neurons, as identified by chromogenic or fluorescent-tagged antibodies to tyrosine hydroxylase in the substantia nigra pars compacta (SNpc). There was no evidence that PQ induced neuronal degeneration in the SNpc or degenerating neuronal processes in the striatum, as indicated by the absence of uptake of silver stain or reduced immunolabeling of tyrosine-hydroxylase-positive (TH+) neurons. There was no evidence of apoptotic cell death, which was evaluated using TUNEL or caspase 3 assays. Microglia (IBA-1 immunoreactivity) and astrocytes (GFAP immunoreactivity) were not activated in PQ-treated mice 4, 8, 16, 24, 48, 96 or 168h after 1, 2 or 3 doses of PQ.In contrast, mice dosed with the positive control substance, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP; 10mg/kg/dose×4 doses, 2h apart), displayed significantly reduced DA and DOPAC concentrations and increased DA turnover in the striatum 7 days after dosing. The number of TH+ neurons in the SNpc was reduced, and there were increased numbers of degenerating neurons and neuronal processes in the SNpc and striatum. MPTP-mediated cell death was not attributed to apoptosis. MPTP activated microglia and astrocytes within 4h of the last dose, reaching a peak within 48h. The microglial response ended by 96h in the SNpc, but the astrocytic response continued through 168h in the striatum.These results bring into question previous published stereological studies that report loss of TH+ neurons in the SNpc of PQ-treated mice. This study also suggests that even if the reduction in TH+ neurons reported by others occurs in PQ-treated mice, this apparent phenotypic change is unaccompanied by neuronal cell death or by modification of dopamine levels in the striatum

Microscopic Realization of the Kerr/CFT Correspondence

Supersymmetric M/string compactifications to five dimensions contain BPS black string solutions with magnetic graviphoton charge P and near-horizon geometries which are quotients of AdS_3 x S^2. The holographic duals are typically known 2D CFTs with central charges c_L=c_R=6P^3 for large P. These same 5D compactifications also contain non-BPS but extreme Kerr-Newman black hole solutions with SU(2)_L spin J_L and electric graviphoton charge Q obeying Q^3 \leq J_L^2. It is shown that in the maximally charged limit Q^3 -> J_L^2, the near-horizon geometry coincides precisely with the right-moving temperature T_R=0 limit of the black string with magnetic charge P=J_L^{1/3}. The known dual of the latter is identified as the c_L=c_R=6J_L CFT predicted by the Kerr/CFT correspondence. Moreover, at linear order away from maximality, one finds a T_R \neq 0 quotient of the AdS_3 factor of the black string solution and the associated thermal CFT entropy reproduces the linearly sub-maximal Kerr-Newman entropy. Beyond linear order, for general Q^3<J_L^2, one has a finite-temperature quotient of a warped deformation of the magnetic string geometry. The corresponding dual deformation of the magnetic string CFT potentially supplies, for the general case, the c_L=c_R=6J_L CFT predicted by Kerr/CFT.Comment: 18 pages, no figure

Improving Interpretation of Cardiac Phenotypes and Enhancing Discovery With Expanded Knowledge in the Gene Ontology.

BACKGROUND: A systems biology approach to cardiac physiology requires a comprehensive representation of how coordinated processes operate in the heart, as well as the ability to interpret relevant transcriptomic and proteomic experiments. The Gene Ontology (GO) Consortium provides structured, controlled vocabularies of biological terms that can be used to summarize and analyze functional knowledge for gene products. METHODS AND RESULTS: In this study, we created a computational resource to facilitate genetic studies of cardiac physiology by integrating literature curation with attention to an improved and expanded ontological representation of heart processes in the Gene Ontology. As a result, the Gene Ontology now contains terms that comprehensively describe the roles of proteins in cardiac muscle cell action potential, electrical coupling, and the transmission of the electrical impulse from the sinoatrial node to the ventricles. Evaluating the effectiveness of this approach to inform data analysis demonstrated that Gene Ontology annotations, analyzed within an expanded ontological context of heart processes, can help to identify candidate genes associated with arrhythmic disease risk loci. CONCLUSIONS: We determined that a combination of curation and ontology development for heart-specific genes and processes supports the identification and downstream analysis of genes responsible for the spread of the cardiac action potential through the heart. Annotating these genes and processes in a structured format facilitates data analysis and supports effective retrieval of gene-centric information about cardiac defects. Circ Genom Precis Med 2018 Feb; 11(2):e001813