Reliability of Semiautomated Kinetic Perimetry (SKP) and Goldmann Kinetic Perimetry in Children and Adults With Retinal Dystrophies.

PurposeTo investigate the precision of visual fields (VFs) from semiautomated kinetic perimetry (SKP) on Octopus 900 perimeters, for children and adults with inherited retinal degenerations (IRDs). Goldmann manual kinetic perimetry has long been used in the diagnosis and follow-up of these patients, but SKP is becoming increasingly common. Octopus VFs (OVFs) and Goldmann VFs (GVFs) were both mapped on two occasions.MethodsNineteen females and 10 males with IRDs were tested on OVFs and GVFs, with two targets per test (V4e and one smaller target). Tests were performed in the same (randomized) order at two visits about 1 week apart. The VFs were digitized to derive isopter solid angles. Comparisons, within and between visits, were performed with paired t-tests and Bland-Altman plots.ResultsMedian age was 20 years (range, 7-70; 10 participants aged ≤17 years old). There were no significant differences in solid angles between OVFs and GVFs (P ≥ 0.06) or between the two visits' solid angles on either perimeter (P ≥ 0.30). Between-visit test-retest variability for GVFs and OVFs was similar (P ≥ 0.73), with median values of approximately 9% to 13%. Overall variability was lower for children than adults (medians of 7.5% and 12.8%, respectively).ConclusionsOctopus SKP and Goldmann perimetry produced VFs of similar size and variability.Translational relevanceOur study indicates that SKP provides a viable alternative to traditional Goldmann perimetry in clinical trials or care involving both children and adults with IRDs

Evidence that implementation intentions reduce drivers' use of mobile phones while driving

Implementation intentions are IF-THEN plans that have the potential to reduce mobile phone use while driving and thus contribute towards the prevention of road traffic crashes. We tested whether an intervention, designed to promote the formation of implementation intentions, could reduce drivers’ use of mobile phones. A randomized controlled design was used. The participants (N = 136) were randomised to an implementation or a control condition. Self-report questionnaires were administered to all participants at both pre- and one-month post-intervention to measure the use of mobile phones while driving, goal intentions and the theoretically derived motivational pre-cursors of goal intentions (attitudes, subjective norm and perceived behavioural control). Immediately following the pre-intervention questionnaire, the participants in the implementation intention condition (n = 67) were given a volitional help sheet, which asked them to form implementation intentions by specifying target driving situations that tempted them the most to use a mobile phone and linking them with goal-directed responses that could be used to resist the temptation. The participants in the control condition (n = 69) were asked to specify target situations that tempted them the most to use a mobile phone while driving and to generally try to avoid using a mobile phone in those situations. One-month post-intervention, the participants in the implementation intention condition reported using a mobile phone less often while driving in their specified target driving situations than did the participants in the control condition. As expected, no differences were found between the conditions in the reported frequency of mobile phone use in unspecified driving situations, goal intentions or any motivational pre-cursor of goal intentions. The implementation intention intervention that was tested in this study is a potentially effective tool for reducing mobile phone use while driving in target driving situations where behaviour-change is most needed

Novel methods for spatial prediction of soil functions within landscapes (SP0531)

Previous studies showed that soil patterns could be predicted in agriculturally managed landscapes by modelling and extrapolating from extensive existing but related integrated datasets. Based on these results we proposed to develop and apply predictive models of the relationships between environmental data and known soil patterns to predict capacity for key soil functions within diverse landscapes for which there is little detailed underpinning soil information available. Objectives were: To develop a high-level framework in which the non-specialist user-community could explore questions. To generate digital soil maps for three selected catchments at a target resolution of 1:50000 to provide the base information for soil function prediction. To use a modelling approach to predict the performance of key soil functions in catchments undergoing change but where only sparse or low resolution soil survey data are available. To use a modelling approach to assess the impact of different management scenarios and/or environmental conditions on the delivery of multiple soil functions within a catchment. To create a detailed outline of the requirements for ground-truthing to test the predicted model outputs at a catchment scale. To contribute to the development of a high-level framework for decision makers

Ammonia decomposition catalysis using lithium–calcium imide

Lithium–calcium imide is explored as a catalyst for the decomposition of ammonia. It shows the highest ammonia decomposition activity yet reported for a pure light metal amide or imide, comparable to lithium imide–amide at high temperature, with superior conversion observed at lower temperatures. Importantly, the post-reaction mass recovery of lithium–calcium imide is almost complete, indicating that it may be easier to contain than the other amide–imide catalysts reported to date. The basis of this improved recovery is that the catalyst is, at least partially, solid across the temperature range studied under ammonia flow. However, lithium–calcium imide itself is only stable at low and high temperatures under ammonia, with in situ powder diffraction showing the decomposition of the catalyst to lithium amide–imide and calcium imide at intermediate temperatures of 200–460 °C.</p

Effect of Narrow Spectrum Versus Selective Kinase Inhibitors on the Intestinal Proinflammatory Immune Response in Ulcerative Colitis

Background: Kinases are key mediators of inflammation, highlighting the potential of kinase inhibitors as treatments for inflammatory disorders. Selective kinase inhibitors, however, have proved disappointing, particularly in the treatment of rheumatoid arthritis and inflammatory bowel disease. Consequently, to improve efficacy, attention has turned to multikinase inhibition. Methods: The activity of a narrow spectrum kinase inhibitor, TOP1210, has been compared with selective kinase inhibitors (BIRB-796, dasatinib and BAY-61-3606) in a range of kinase assays, inflammatory cell assays, and in inflamed biopsies from patients with ulcerative colitis (UC). Effects on recombinant P38α, Src, and Syk kinase activities were assessed using Z-lyte assays (Invitrogen, Paisley, United Kingdom). Anti-inflammatory effects were assessed by measurement of proinflammatory cytokine release from peripheral blood mononuclear cells, primary macrophages, HT29 cells, inflamed colonic UC biopsies, and myofibroblasts isolated from inflamed colonic UC mucosa. Results: TOP1210 potently inhibits P38α, Src, and Syk kinase activities. Similarly, TOP1210 demonstrates potent inhibitory activity against proinflammatory cytokine release in each of the cellular assays and the inflamed colonic UC biopsies and myofibroblasts isolated from inflamed colonic UC mucosa. Generally, the selective kinase inhibitors showed limited and weaker activity in the cellular assays compared with the broad inhibitory profile of TOP1210. However, combination of the selective inhibitors led to improved efficacy and potency in both cellular and UC biopsy assays. Conclusions: Targeted, multikinase inhibition with TOP1210 leads to a broad efficacy profile in both the innate and adaptive immune responses, with significant advantages over existing selective kinase approaches, and potentially offers a much improved therapeutic benefit in inflammatory bowel disease

Improved estimate of the policy-relevant background ozone in the United States using the GEOS-Chem global model with 1/2° × 2/3° horizontal resolution over North America

The policy-relevant background (PRB) ozone is defined by the US Environmental Protection Agency (EPA) as the surface ozone concentration that would be present over the US in the absence of North American anthropogenic emissions. It is intended to provide a baseline for risk and exposure assessments used in setting the National Ambient Air Quality Standard (NAAQS). We present here three-year statistics (2006–2008) of PRB ozone over the US calculated using the GEOS-Chem global 3-D model of atmospheric composition with 1/2° × 2/3° horizontal resolution over North America and adjacent oceans (2° × 2.5° for the rest of the world). We also provide estimates of the US background (no anthropogenic US emissions) and natural background (no anthropogenic emissions worldwide and pre-industrial methane). Our work improves on previous GEOS-Chem PRB estimates through the use of higher model resolution, 3-year statistics, better representation of stratospheric influence, and updated emissions. PRB is particularly high in the intermountain West due to high elevation, arid terrain, and large-scale subsidence. We present for this region a detailed model evaluation showing that the model is successful in reproducing ozone exceedances up to 70 ppbv. However, the model cannot reproduce PRB-relevant exceptional events associated with wildfires or stratospheric intrusions. The mean PRB estimates for spring–summer are 27 ± 8 ppbv at low-altitude sites and 40 ± 7 ppbv at high-altitude sites. Differences between the PRB simulation and the natural simulation indicate a mean enhancement from intercontinental pollution and anthropogenic methane of 9 ppbv at low-altitude sites and 13 ppbv at high-altitude sites. The PRB is higher than average when ozone exceeds 60 ppbv, particularly in the intermountain West. Our PRB estimates are on average 4 ppbv higher than previous GEOS-Chem studies and we attribute this to higher lighting, increasing Asian emissions, and improved model resolution. Whereas previous studies found no occurrences of PRB exceeding 60 ppbv, we find here some occurrences in the intermountain West. The annual 4th-highest PRB values in the intermountain West are typically 50–60 ppbv, as compared to 35–45 ppbv in the East or on the West Coast. Such high PRB values in the intermountain West suggest that special consideration of this region may be needed if the ozone NAAQS is decreased to a value in the 60–70 ppbv range.Earth and Planetary SciencesEngineering and Applied Science

Ethnicity and differences between clinic and ambulatory blood pressure measurements.

BACKGROUND: This study investigated the relationship of ethnicity to the differences between blood pressure (BP) measured in a clinic setting and by ambulatory blood pressure monitoring (ABPM) in individuals with a previous diagnosis of hypertension (HT) and without a previous diagnosis of hypertension (NHT). METHODS: A cross-sectional comparison of BP measurement was performed in 770 participants (white British (WB, 39%), South Asian (SA, 31%), and African Caribbean (AC, 30%)) in 28 primary care clinics in West Midlands, United Kingdom. Mean differences between daytime ABPM, standardized clinic (mean of 3 occasions), casual clinic (first reading on first occasion), and last routine BP taken at the general practitioner practice were compared in HT and NHT individuals. RESULTS: Daytime systolic and diastolic ABPM readings were similar to standardized clinic BP (systolic: 128 (SE 0.9) vs. 125 (SE 0.9) mm Hg (NHT) and 132 (SE 0.7) vs. 131 (SE 0.7) mm Hg (HT)) and were not associated with ethnicity to a clinically important extent. When BP was taken less carefully, differences emerged: casual clinic readings were higher than ABPM, particularly in the HT group where the systolic differences approached clinical relevance (131 (SE 1.2) vs. 129 (SE 1.0) mm Hg (NHT) and 139 (SE 0.9) vs. 133 (SE 0.7) mm Hg (HT)) and were larger in SA and AC hypertensive individuals (136 (SE 1.5) vs. 133 (SE 1.2) mm Hg (WB), 141 (SE 1.7) vs. 133 (SE 1.4) mm Hg (SA), and 142 (SE 1.6) vs. 134 (SE 1.3) mm Hg (AC); mean differences: 3 (0-7), P = 0.03 and 4 (1-7), P = 0.01, respectively). Differences were also observed for the last practice reading in SA and ACs. CONCLUSIONS: BP differences between ethnic groups where BP is carefully measured on multiple occasions are small and unlikely to alter clinical management. When BP is measured casually on a single occasion or in routine care, differences appear that could approach clinical relevance.This report presents independent research funded by the National Institute for Health Research (NIHR).The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of HealthThis is a pre-copyedited, author-produced PDF of an article accepted for publication in American Journal of Hypertension following peer review. The version of record, Am J Hypertens (2014) doi: 10.1093/ajh/hpu211, is available online at: http://ajh.oxfordjournals.org/content/early/2014/11/18/ajh.hpu211.long

Patient preferences for different methods of blood pressure measurement: is ethnicity relevant?

This is the author accepted manuscript. It is currently under an indefinite embargo pending publication by the Royal College of General Practitioners.$\textit{Background:}$ Ambulatory and/or home monitoring are recommended in the UK and North America for the diagnosis of hypertension but little is known about acceptability. $\textit{Aim:}$ To determine the acceptability of different methods of measuring blood pressure to people from different ethnic minority groups. $\textit{Design and setting:}$ Cross sectional study with focus groups in primary care. $\textit{Methods:}$ People with and without hypertension of different ethnicities were assessed for acceptability of clinic, home and ambulatory blood pressure measurement using completion rate, questionnaire and focus groups. $\textit{Results:}$ 770 participants were included comprising white British (n=300), South Asian (n=241) and African Caribbean (n=229). White British participants had significantly higher successful completion rates across all monitoring modalities compared to the other ethnic groups, especially for ambulatory monitoring: white British (277 completed, 92%[89-95%]) vs South Asian (171, 71%[65-76%], p<0.001 and African Caribbean (188, 82%[77-87%], p<0.001) respectively. There were significantly lower acceptability scores for minority ethnic participants across all monitoring methods compared to white British. Focus group results highlighted self-monitoring as most acceptable and ambulatory monitoring least without consistent differences by ethnicity. Clinic monitoring was seen as inconvenient and anxiety provoking but with the advantage of immediate professional input. $\textit{Conclusions:}$ Reduced acceptability and completion rates amongst minority ethnic groups raise important questions for the implementation and interpretation of blood pressure monitoring in general and ambulatory monitoring in particular. Selection of method for blood pressure monitoring should take into account clinical need and patient preference as well as consideration of potential cultural barriers to monitoring.National Institute for Health Research (Grant ID: PB-PG-1207-15042