Amblyopia and quality of life: a systematic review

Background/Aims Amblyopia is a common condition which can affect up to 5% of the general population. The health-related quality of life (HRQoL) implications of amblyopia and/or its treatment have been explored in the literature. Methods A systematic literature search was undertaken (16th-30th January 2007) to identify the HRQoL implications of amblyopia and/or its treatment. Results A total of 25 papers were included in the literature review. The HRQoL implications of amblyopia related specifically to amblyopia treatment, rather than the condition itself. These included the impact upon family life; social interactions; difficulties undertaking daily activities; and feelings and behaviour. The identified studies adopted a number of methodologies. The study populations included; children with the condition; parents of children with amblyopia; and adults who had undertaken amblyopia treatment as a child. Some studies developed their own measures of HRQoL, and others determined HRQoL through proxy measures. Conclusions The reported findings of the HRQoL implications are of importance when considering the management of cases of amblyopia. Further research is required to assess the immediate and long-term effects of amblyopia and/or its treatment upon HRQoL using a more standardised approach

Estimating relative risk of within-lake aquatic plant invasion using combined measures of recreational boater movement and habitat suitability

Effective monitoring, prevention and impact mitigation of nonindigenous aquatic species relies upon the ability to predict dispersal pathways and receiving habitats with the greatest risk of establishment. To examine mechanisms affecting species establishment within a large lake, we combined observations of recreational boater movements with empirical measurements of habitat suitability represented by nearshore wave energy to assess the relative risk of Eurasian watermilfoil (Myriophyllum spicatum) establishment. The model was evaluated using information from a 17 year (1995–2012) sequence of M. spicatum presence and absence monitoring. M. spicatum presence was not specifically correlated with recreational boater movements; however its establishment appears to be limited by wave action in Lake Tahoe. Of the sites in the “High” establishment risk category (n = 37), 54% had current or historical infestations, which included 8 of the 10 sites with the highest relative risk. Of the 11 sites in the “Medium” establishment risk category, 5 had current or historical M. spicatum populations. Most (76%) of the sites in the “Low” establishment risk category were observed in locations with higher wave action. Four sites that received zero boater visits from infested locations were occupied by M. spicatum. This suggests that the boater survey either represents incomplete coverage of boater movement, or other processes, such as the movement of propagules by surface currents or introductions from external sources are important to the establishment of this species. This study showed the combination of habitat specific and dispersal data in a relative risk framework can potentially reduce uncertainty in estimates of invasion risk

Inter-individual variability in load carriage economy and comparisons between different load conditions.

Equivocal findings exist for the economy associated with load carried close to the body's centre of mass. Individual variation could explain some of the equivocal findings. This research aimed to examine the extent of individual variation in loaded walking economy. Eighteen females carried load on the back, head and split between the front and back. Individual variation in relative load carriage economy (ELI) was primarily assessed using standard deviation, coefficients of variation (CV) and intraclass correlation coefficients (ICC). There was large inter-individual variation in ELI values with highest mean CV's of 16%, 12% and 10% for head-, back- and combined front and back-loading. Mean ELI values were not significantly different between methods. The large amount of individual variation found here suggests future load carriage research should account for individual variation, particularly when considering sample size and when making inferences on the economy associated with different types of load carriage using group mean data

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Active recharge biphasic stimulation for the intraoperative monopolar review in deep brain stimulation

IntroductionCharge balancing is used in deep brain stimulation (DBS) to avoid net charge accumulation at the tissue-electrode interface that can result in neural damage. Charge balancing paradigms include passive recharge and active recharge. In passive recharge, each cathodic pulse is accompanied by a waiting period before the next stimulation, whereas active recharge uses energy to deliver symmetric anodic and cathodic stimulation pulses sequentially, producing a net zero charge. We sought to determine differences in stimulation induced side effect thresholds between active vs. passive recharge during the intraoperative monopolar review.MethodsSixty-five consecutive patients undergoing DBS from 2021 to 2022 were retrospectively reviewed. Intraoperative monopolar review was performed with both active recharge and passive recharge for all included patients to determine side effect stimulation thresholds. Sixteen patients with 64 total DBS contacts met inclusion criteria for further analysis. Intraoperative monopolar review results were compared with the monopolar review from the first DBS programming visit.ResultsThe mean intraoperative active recharge stimulation threshold was 4.1 mA, while the mean intraoperative passive recharge stimulation threshold was 3.9 mA, though this difference was not statistically significant on t-test (p = 0.442). Mean stimulation threshold at clinic follow-up was 3.2 mA. In Pearson correlation, intraoperative passive recharge thresholds had stronger correlation with follow-up stimulation thresholds (Pearson r = 0.5281, p < 0.001) than intraoperative active recharge (Pearson r = 0.340, p = 0.018), however the difference between these correlations was not statistically significant on Fisher Z correlation test (p = 0.294). The mean difference between intraoperative passive recharge stimulation threshold and follow-up stimulation threshold was 0.8 mA, while the mean difference between intraoperative active recharge threshold and follow-up threshold was 1.2 mA. This difference was not statistically significant on a t-test (p = 0.134).ConclusionsBoth intraoperative active recharge and passive recharge stimulation were well-correlated with the monopolar review at the first programming visit. No statistically significant differences were observed suggesting that either passive or active recharge may be utilized intraoperatively

Starting the invasion pathway: the interaction between source populations and human transport vectors

Human transport hubs, such as shipping ports, airports and mail centers are important foci for the spread of non-indigenous species. High relative abundance in a transport hub has been proposed as a correlate of invasion success, since abundant species are thought more likely to colonize vectors and to be transported more frequently. We here evaluate the relative importance of vector characteristics and local source assemblages in determining the pool of species that is transported by hull fouling on recreational boats. We compared the resident fouling communities of three recreational boat harbors in Australia with the assemblages on the hulls of boats that travel between them. We used data on the recent travel and maintenance history of the boats to evaluate correlates of transport probability and the potential for intra-coastal spread of fouling organisms. Invertebrate assemblages on heavily fouled vessels reflected the composition of biotic assemblages within the marina in which they were moored, but by itself, relative abundance in the source port was not a reliable predictor of transport probability. More important was the age of the antifouling paint on the vessels’ hulls, which acted selectively on some groups of organisms. Movements of vessels were characterized by “fidelity” (vessels remaining close to homeport) interspersed with “promiscuity” (vessels traveling to a diverse pool of destinations). In an infested harbor, measures taken to increase the resistance of vectors to colonization by the invader should be effective in slowing the rate of spread to other locations, by decreasing the overall frequency of transport