Primary health eye care: evaluation of the competence of medical students in performing fundoscopy with the direct ophthalmoscope

Background: To evaluate the skill of fifth-year medical students at the University of Cape Town in the performance of fundoscopy at the end of their ophthalmology rotation.Methods: The design was a prospective cohort study. The study was conducted at Groote Schuur Hospital in Cape Town. The ability of fifth-year medical students to perform fundoscopy on mannequin heads fitted with fundus photographs using direct ophthalmoscopes was evaluated. The outcome measures used were ability to see the fundus and ability to recognise fundus pathology.Results: The fundus photographs could be seen in 95% of cases. The correct diagnosis could be made in only 57% of cases.Conclusion: Medical students at the University of Cape Town need more than the current one week of practical ophthalmology training to improve their fundoscopy skills.Keywords: primary health eye care; teaching fundoscopy; essential basic medical skill; medical student trainin

Collaborative International Research in Clinical and Longitudinal Experience Study in NMOSD

Objective To develop a resource of systematically collected, longitudinal clinical data and biospecimens for assisting in the investigation into neuromyelitis optica spectrum disorder (NMOSD) epidemiology, pathogenesis, and treatment. Methods To illustrate its research-enabling purpose, epidemiologic patterns and disease phenotypes were assessed among enrolled subjects, including age at disease onset, annualized relapse rate (ARR), and time between the first and second attacks. Results As of December 2017, the Collaborative International Research in Clinical and Longitudinal Experience Study (CIRCLES) had enrolled more than 1,000 participants, of whom 77.5% of the NMOSD cases and 71.7% of the controls continue in active follow-up. Consanguineous relatives of patients with NMOSD represented 43.6% of the control cohort. Of the 599 active cases with complete data, 84% were female, and 76% were anti-AQP4 seropositive. The majority were white/Caucasian (52.6%), whereas blacks/African Americans accounted for 23.5%, Hispanics/ Latinos 12.4%, and Asians accounted for 9.0%. The median age at disease onset was 38.4 years, with a median ARR of 0.5. Seropositive cases were older at disease onset, more likely to be black/African American or Hispanic/Latino, and more likely to be female. Conclusions Collectively, the CIRCLES experience to date demonstrates this study to be a useful and readily accessible resource to facilitate accelerating solutions for patients with NMOSD

A flexible approach to introductory programming : engaging and motivating students

© 2019 Copyright is held by the owner/author(s). In this paper, we consider an approach to supporting students of Computer Science as they embark upon their university studies. The transition to Computer Science can be challenging for students, and equally challenging for those teaching them. Issues that are unusual – if not unique – to teaching computing at this level include • the wide variety in students background, varying from no prior experience to extensive development practice; • the positives and negatives of dealing with self-taught hobbyists who may developed buggy mental models of the task in hand and are not aware of the problem; • the challenge of getting students to engage with material that includes extensive practical element; • the atypical profile of a computing cohort, with typically 80%+ male students. The variation in background includes the style of prior academic experience, with some students coming from traditional level 3 (i.e. A-levels), some through more vocational routes (e.g. B-Tech, though these have changed in recent years), through to those from experiential (work based) learning. Technical background varies from science, mathematical and computing experience, to no direct advanced technical or scientific experience. A further issue is students’ attainment and progression within higher education, where the success and outcomes in computer science has been identified as particularly problematic. Computer Science has one the worst records for retention (i.e. students leaving with no award, or a lower award than that originally applied for), and the second worst for attainment (i.e. achieving a good degree, that being defined as a first or a 2:1). One way to attempt to improve these outcomes is by identifying effective ways to improve student engagement. This can be through appropriate motivators – though then the balance of extrinsic versus intrinsic motivation becomes critical. In this paper, we consider how to utilize assessment – combining the formative and summative aspects - as a substitute for coarser approaches based on attendance monitoring

A flexible approach to introductory programming : engaging and motivating students

© 2019 Copyright is held by the owner/author(s). In this paper, we consider an approach to supporting students of Computer Science as they embark upon their university studies. The transition to Computer Science can be challenging for students, and equally challenging for those teaching them. Issues that are unusual – if not unique – to teaching computing at this level include • the wide variety in students background, varying from no prior experience to extensive development practice; • the positives and negatives of dealing with self-taught hobbyists who may developed buggy mental models of the task in hand and are not aware of the problem; • the challenge of getting students to engage with material that includes extensive practical element; • the atypical profile of a computing cohort, with typically 80%+ male students. The variation in background includes the style of prior academic experience, with some students coming from traditional level 3 (i.e. A-levels), some through more vocational routes (e.g. B-Tech, though these have changed in recent years), through to those from experiential (work based) learning. Technical background varies from science, mathematical and computing experience, to no direct advanced technical or scientific experience. A further issue is students’ attainment and progression within higher education, where the success and outcomes in computer science has been identified as particularly problematic. Computer Science has one the worst records for retention (i.e. students leaving with no award, or a lower award than that originally applied for), and the second worst for attainment (i.e. achieving a good degree, that being defined as a first or a 2:1). One way to attempt to improve these outcomes is by identifying effective ways to improve student engagement. This can be through appropriate motivators – though then the balance of extrinsic versus intrinsic motivation becomes critical. In this paper, we consider how to utilize assessment – combining the formative and summative aspects - as a substitute for coarser approaches based on attendance monitoring

Helicopter tail rotor orthogonal blade vortex interaction

The aerodynamic operating environment of the helicopter is particularly complex and, to some extent, dominated by the vortices trailed from the main and tail rotors. These vortices not only determine the form of the induced flow field but also interact with each other and with elements of the physical structure of the flight vehicle. Such interactions can have implications in terms of structural vibration, noise generation and flight performance. In this paper, the interaction of main rotor vortices with the helicopter tail rotor is considered and, in particular, the limiting case of the orthogonal interaction. The significance of the topic is introduced by highlighting the operational issues for helicopters arising from tail rotor interactions. The basic phenomenon is then described before experimental studies of the interaction are presented. Progress in numerical modelling is then considered and, finally, the prospects for future research in the area are discussed

B(E1) Strengths from Coulomb Excitation of 11Be

The $B$(E1;$1/2^+\to1/2^-$) strength for $^{11}$Be has been extracted from intermediate energy Coulomb excitation measurements, over a range of beam energies using a new reaction model, the extended continuum discretized coupled channels (XCDCC) method. In addition, a measurement of the excitation cross section for $^{11}$Be+$^{208}$Pb at 38.6 MeV/nucleon is reported. The $B$(E1) strength of 0.105(12) e$^2$fm$^2$ derived from this measurement is consistent with those made previously at 60 and 64 MeV/nucleon, i n contrast to an anomalously low result obtained at 43 MeV/nucleon. By coupling a multi-configuration description of the projectile structure with realistic reaction theory, the XCDCC model provides for the first time a fully quantum mechanical description of Coulomb excitation. The XCDCC calculations reveal that the excitation process involves significant contributions from nuclear, continuum, and higher-order effects. An analysis of the present and two earlier intermediate energy measurements yields a combined B(E1) strength of 0.105(7) e$^2$fm$^2$. This value is in good agreement with the value deduced independently from the lifetime of the $1/2^-$ state in $^{11}$Be, and has a comparable p recision.Comment: 5 pages, 2 figures, accepted for publication in Phys. Lett.

Nonanticommutative Deformation of N=4 SYM Theory: The Myers Effect and Vacuum States

We propose a deformation of ${\cal N}=4$ SYM theoery induced by nonanticommutative star product. The deformation introduces new bosonic terms which we identify with the corresponding Myers terms of a stack of D3-branes in the presence of a five-form RR flux. We take this as an indication that the deformed lagrangian describes D3-branes in such a background. The vacuum states of the theory are also examined. In a specific case where the U(1) part of the gauge field is nonvanishing the (anti)holomorphic transverse coordinates of the brane sit on a fuzzy two sphere. For a supersymmetric vacuum the antiholomorphic coordinates must necessarily commute. However, we also encounter non-supersymmetric vacua for which the antiholomorphic coordinates do not commute.Comment: 14 pages, minor changes, refs. adde

On the K^+D Interaction at Low Energies

The Kd reactions are considered in the impulse approximation with NN final-state interactions (NN FSI) taken into account. The realistic parameters for the KN phase shifts are used. The "quasi-elastic" energy region, in which the elementary KN interaction is predominantly elastic, is considered. The theoretical predictions are compared with the data on the K^+d->K^+pn, K^+d->K^0pp, K^+d->K^+d and K^+d total cross sections. The NN FSI effect in the reaction K^+d->K^+pn has been found to be large. The predictions for the Kd cross sections are also given for slow kaons, produced from phi(1020) decays, as the functions of the isoscalar KN scattering length a_0. These predictions can be used to extract the value of a_0 from the data.Comment: 22 pages, 5 figure

Comparative effectiveness of dual vs. single-action antidepressants on HIV clinical outcomes in HIV-infected people with depression

Objective: Depression is highly prevalent among people living with HIV/AIDS (PLWHA) and has deleterious effects on HIV clinical outcomes. We examined changes in depression symptoms, viral suppression, and CD4 + T cells/μl among PLWHA diagnosed with depression who initiated antidepressant treatment during routine care, and compared the effectiveness of dual-action and single-action antidepressants for improving those outcomes. Design: Comparative effectiveness study of new user dual-action or single-action antidepressant treatment episodes occurring from 2004 to 2014 obtained from the Center for AIDS Research Network of Integrated Clinical Systems. Methods: We identified new user treatment episodes with no antidepressant use in the preceding 90 days. We completed intent-to-treat and per protocol evaluations for the main analysis. Primary outcomes, were viral suppression (HIV viral load <200 copies/ml) and CD4 + T cells/μl. In a secondary analysis, we used the Patient Health Questionnaire-9 (PHQ-9) to evaluate changes in depression symptoms and remission (PHQ <5). Generalized estimating equations with inverse probability of treatment weights were fitted to estimate treatment effects. Results: In weighted intent-to-treat analyses, the probability of viral suppression increased 16% after initiating antidepressants [95% confidence interval=(1.12, 1.20)]. We observed an increase of 39 CD4 + T cells/μl after initiating antidepressants (30, 48). Both the frequency of remission from depression and PHQ-9 scores improved after antidepressant initiation. Comparative effectiveness estimates were null in all models. Conclusion: Initiating antidepressant treatment was associated with improvements in depression, viral suppression, and CD4 + T cells/μl, highlighting the health benefits of treating depression in PLWHA. Dual and single-action antidepressants had comparable effectiveness