Microscopic Inner Retinal Hyper-reflective Phenotypes in Retinal and Neurologic Disease

Purpose. We surveyed inner retinal microscopic features in retinal and neurologic disease using a reflectance confocal adaptive optics scanning light ophthalmoscope (AOSLO). Methods. Inner retinal images from 101 subjects affected by one of 38 retinal or neurologic conditions and 11 subjects with no known eye disease were examined for the presence of hyper-reflective features other than vasculature, retinal nerve fiber layer, and foveal pit reflex. The hyper-reflective features in the AOSLO images were grouped based on size, location, and subjective texture. Clinical imaging, including optical coherence tomography (OCT), scanning laser ophthalmoscopy, and fundus photography was analyzed for comparison. Results. Seven categories of hyper-reflective inner retinal structures were identified, namely punctate reflectivity, nummular (disc-shaped) reflectivity, granular membrane, waxy membrane, vessel-associated membrane, microcysts, and striate reflectivity. Punctate and nummular reflectivity also was found commonly in normal volunteers, but the features in the remaining five categories were found only in subjects with retinal or neurologic disease. Some of the features were found to change substantially between follow up imaging months apart. Conclusions. Confocal reflectance AOSLO imaging revealed a diverse spectrum of normal and pathologic hyper-reflective inner and epiretinal features, some of which were previously unreported. Notably, these features were not disease-specific, suggesting that they might correspond to common mechanisms of degeneration or repair in pathologic states. Although prospective studies with larger and better characterized populations, along with imaging of more extensive retinal areas are needed, the hyper-reflective structures reported here could be used as disease biomarkers, provided their specificity is studied further

Is surgical antibiotic prophylaxis necessary for pediatric orchiopexy?

Introduction Surgeons frequently use surgical antibiotic prophylaxis (SAP), despite limited evidence to support its efficacy. Potential adverse events associated with antibiotic use include allergic reaction (including anaphylaxis), Clostridium difficile infection, and selecting for resistant bacteria. Surgical site infections (SSI) are very rare in patients undergoing clean pediatric urologic procedures. Current guidelines are unclear about the efficacy of surgical antibiotic prophylaxis for prevention of SSI in the pediatric population. Objective It was hypothesized that children who received SAP prior to orchiopexy would have no reduction in surgical site infection (SSI) risk but an increased risk of antibiotic-associated adverse events. Methods A retrospective cohort study was conducted of all males aged between 30 days and 18 years who underwent an orchiopexy (ICD-9 CM 62.5) in an ambulatory or observation setting from 2004 to 2015 using the Pediatric Health Information System database. Inpatients and those with concomitant procedures were excluded. Chi-squared or Fisher's exact tests were used to determine the association between SAP and allergic reaction (defined as a charge for epinephrine or ICD-9 diagnosis code for allergic reaction on the date of surgery) and any of the following within 30 days: SSI, hospital readmission or any repeat hospital encounter. Mixed effects logistic regression was performed, controlling for age, race, and insurance, and clustering of similar practice patterns by hospital. Results A total of 71,767 patients were included: median age was 4.6 years, 61.4% were white, and 49.3% had public insurance; 33.5% received SAP. Of these participants, 996/71,767 (1.4%) had a perioperative allergic reaction and <0.1% were diagnosed with an SSI. On mixed effects logistic regression, those who received SAP had 1.2 times the odds of a perioperative allergic reaction compared with those who did not receive SAP ( P = 0.005). Surgical antibiotic prophylaxis was not associated with decreased rates of SSI, lower hospital readmission, nor a lower chance of a repeat encounter within 30 days. Conclusions In patients undergoing orchiopexy, it was found that SAP did not reduce the risk of postoperative SSI, readmissions, or hospital visits. Patients who received SAP had significantly increased odds of perioperative allergic reaction. This demonstrated that the risks of SAP outweigh the benefits in children undergoing orchiopexy

Dynamical Lorentz simmetry breaking from 3+1 Axion-Wess-Zumino model

We study the renormalizable abelian vector-field models in the presence of the Wess-Zumino interaction with the pseudoscalar matter. The renormalizability is achieved by supplementing the standard kinetic term of vector fields with higher derivatives. The appearance of fourth power of momentum in the vector-field propagator leads to the super-renormalizable theory in which the $\beta$-function, the vector-field renormalization constant and the anomalous mass dimension are calculated exactly. It is shown that this model has the infrared stable fixed point and its low-energy limit is non-trivial. The modified effective potential for the pseudoscalar matter leads to the possible occurrence of dynamical breaking of the Lorentz symmetry. This phenomenon is related to the modification of Electrodynamics by means of the Chern-Simons (CS) interaction polarized along a constant CS vector. Its presence makes the vacuum optically active that has been recently estimated from astrophysical data. We examine two possibilities for the CS vector to be time-like or space-like, under the assumption that it originates from v.e.v. of some pseudoscalar matter and show that only the latter one is consistent in the framework of the AWZ model, because a time-like CS vector makes the vacuum unstable under pairs creation of tachyonic photon modes with the finite vacuum decay rate.Comment: 33 pages, no Figures, Plain TeX, submitted to Phys. Rev.

Shapes, contact angles, and line tensions of droplets on cylinders

Using an interface displacement model we calculate the shapes of nanometer-size liquid droplets on homogeneous cylindrical surfaces. We determine effective contact angles and line tensions, the latter defined as excess free energies per unit length associated with the two contact lines at the ends of the droplet. The dependences of these quantities on the cylinder radius and on the volume of the droplets are analyzed.Comment: 26 pages, RevTeX, 10 Figure

A New Finite-lattice study of the Massive Schwinger Model

A new finite lattice calculation of the low lying bound state energies in the massive Schwinger model is presented, using a Hamiltonian lattice formulation. The results are compared with recent analytic series calculations in the low mass limit, and with a new higher order non-relativistic series which we calculate for the high mass limit. The results are generally in good agreement with these series predictions, and also with recent calculations by light cone and related techniques

Assessing Retinal Structure In Complete Congenital Stationary Night Blindness and Oguchi Disease

Purpose To examine retinal structure and changes in photoreceptor intensity after dark adaptation in patients with complete congenital stationary night blindness and Oguchi disease. Design Prospective, observational case series. Methods We recruited 3 patients with complete congenital stationary night blindness caused by mutations in GRM6, 2 brothers with Oguchi disease caused by mutations in GRK1, and 1 normal control. Retinal thickness was measured from optical coherence tomography images. Integrity of the rod and cone mosaic was assessed using adaptive optics scanning light ophthalmoscopy. We imaged 5 of the patients after a period of dark adaptation and examined layer reflectivity on optical coherence tomography in a patient with Oguchi disease under light- and dark-adapted conditions. Results Retinal thickness was reduced in the parafoveal region in patients with GRM6 mutations as a result of decreased thickness of the inner retinal layers. All patients had normal photoreceptor density at all locations analyzed. On removal from dark adaptation, the intensity of the rods (but not cones) in the patients with Oguchi disease gradually and significantly increased. In 1 Oguchi disease patient, the outer segment layer contrast on optical coherence tomography was 4-fold higher under dark-adapted versus light-adapted conditions. Conclusions The selective thinning of the inner retinal layers in patients with GRM6 mutations suggests either reduced bipolar or ganglion cell numbers or altered synaptic structure in the inner retina. Our finding that rods, but not cones, change intensity after dark adaptation suggests that fundus changes in Oguchi disease are the result of changes within the rods as opposed to changes at a different retinal locus

VUV/EUV ionising radiation and atoms and ions: dual laser plasma investigations

The interaction of ionising radiation with atoms and ions is a key fundamental process. This report concentrates on studies of photoexcitation/photoionisation using laser-produced plasmas as continuum sources and synchronised laser plasma plumes to provide the absorbing atom or ion species. Examples from studies of the interaction of ionising radiation with atoms and ions ranging from few-electron atomic and ionic systems to the many-electron high atomic number actinides are reviewed and illustrate the advantages and limitations of the Dual Laser Plasma technique

Series Expansions for the Massive Schwinger Model in Hamiltonian lattice theory

It is shown that detailed and accurate information about the mass spectrum of the massive Schwinger model can be obtained using the technique of strong-coupling series expansions. Extended strong-coupling series for the energy eigenvalues are calculated, and extrapolated to the continuum limit by means of integrated differential approximants, which are matched onto a weak-coupling expansion. The numerical estimates are compared with exact results, and with finite-lattice results calculated for an equivalent lattice spin model with long-range interactions. Both the heavy fermion and the light fermion limits of the model are explored in some detail.Comment: RevTeX, 10 figures, add one more referenc

On the consistency of Lorentz invariance violation in QED induced by fermions in constant axial-vector background

We show for the first time that the induced parity--even Lorentz invariance violation can be unambiguously calculated in the physically justified and minimally broken dimensional regularization scheme, suitably tailored for a spontaneous Lorentz symmetry breaking in a field theory model. The quantization of the Lorentz invariance violating quantum electrodynamics is critically examined and shown to be consistent either for a light--like cosmic anisotropy axial--vector or for a time--like one, when in the presence of a bare photon mass.Comment: 10 pages, revised for publication in Phys.Lett.