Assessing Binocular Interaction in Amblyopia and Its Clinical Feasibility

Purpose To measure binocular interaction in amblyopes using a rapid and patient-friendly computer-based method, and to test the feasibility of the assessment in the clinic. Methods: Binocular interaction was assessed in subjects with strabismic amblyopia (n = 7), anisometropic amblyopia (n = 6), strabismus without amblyopia (n = 15) and normal vision (n = 40). Binocular interaction was measured with a dichoptic phase matching task in which subjects matched the position of a binocular probe to the cyclopean perceived phase of a dichoptic pair of gratings whose contrast ratios were systematically varied. The resulting effective contrast ratio of the weak eye was taken as an indicator of interocular imbalance. Testing was performed in an ophthalmology clinic under 8 mins. We examined the relationships between our binocular interaction measure and standard clinical measures indicating abnormal binocularity such as interocular acuity difference and stereoacuity. The test-retest reliability of the testing method was also evaluated. Results: Compared to normally-sighted controls, amblyopes exhibited significantly reduced effective contrast (∼20%) of the weak eye, suggesting a higher contrast requirement for the amblyopic eye compared to the fellow eye. We found that the effective contrast ratio of the weak eye covaried with standard clincal measures of binocular vision. Our results showed that there was a high correlation between the 1st and 2nd measurements (r = 0.94, p<0.001) but without any significant bias between the two. Conclusions: Our findings demonstrate that abnormal binocular interaction can be reliably captured by measuring the effective contrast ratio of the weak eye and quantitative assessment of binocular interaction is a quick and simple test that can be performed in the clinic. We believe that reliable and timely assessment of deficits in a binocular interaction may improve detection and treatment of amblyopia

Improvement and evaluation of the mesoscale meteorological model MM5 for air-quality applications in Southern California and the San Joaquin Valley: Final Report

The objective of the Penn State University (PSU) part of the study was to investigate the MM5's ability to simulate wintertime fog in the San Joaquin Valley (SJV) and summertime sea breeze flows in the South Coast Air Basin (SoCAB). For the SJV work the MM5 was configured with four nested grid and an advanced turbulence sub-model. Applied to the event of 7-12 December 1995, observed during the IMS-95 program, the model's innermost domain used 40 vertical layers and a 4-km mesh. Several experiments were performed to improve the turbulence sub-model for saturated conditions and to provide more accurate initial conditions for soil temperature and moisture. Results showed the MM5 correctly predicted the type of visibility obscuration (fog, haze, status or clear) in 14 out of the 18 events. For depth was estimated by the MM5 with a mean absolute error of only 92 m and a mean error of -41 m. Mean errors for both the surface temperature and dew point were within +1C, while the mean absolute errors were ~1.5-2.0 C. As a consequence, the mean error for dew-point depression is very small. Thus, the MM5 was shown to simulate fog and haze in the SJV with considerable accuracy. Extensions of the turbulence sub-model to include saturation effects and the specification of accurate soil temperature and moisture were important for simulating fog characteristics in the case. Additionally, MM5 was able to simulate the light and variable winds in the Sacramento and San Joaquin Valleys that prevailed during this event. Moreover, the winds responded quite well to the slowly changing synoptic-scale weather, as well, as confirmed by the observations. the objective for the San Jose State University (SJSU) work included use of SCOS97 data and MM5 simulations to understand meteorological factors in the formation of high ozone concentrations during 4-7 August 1997. Meteorological data for the case study included observations at 110 SCOS97 surface sites and upper air measurements from 12 rawinsonde and 26 RWP/RASS profilers. the MM5 version contained the PSU Marine Boundary Layer Initialization (MBLI) scheme, quadruple nested grids (horizontal resolutions of 135, 45, 15, and 5 km), 30 vertical layers, minimum sigma level of 46 m, USGS global land-use, GDAS global gridded model analyses and SSTs, analysis nudging, observational nudging, force-restore surface temperature, 1.5 order TKE, one-way continuous nesting, and a MAPS statistical evaluation. Analysis showed the ozone episode resulting from a unique combination of large-scale upper level synoptic forcings that included a weak local coastal 700 mb anticyclone. Its movement around SoCAB rotated the upper level synoptic background flow from its normal westerly onshore direction to a less common offshore easterly flow during the nighttime period preceding the episode. The resulting easterly upper level synoptic background winds influenced surface flow direction at inland sites, so that a surface frontal convergence zone resulted where the easterly flow met the westerly onshore sea breeze flow. The maximum inland penetration of the convergence zone was about to the San Gabriel Mountain peaks, the location of daytime maximum ozone-episode concentrations. The current MM5 simulations reproduced the main qualitative features of the evolution of the diurnal sea breeze cycle in the SoCAB with reasonable accuracy. The position of the sea breeze front during its daytime inland penetration and nighttime retreat could be determined from the simulated wind fields. the accuracy of predicted MM5 surface winds and temperatures over SoCAB were improved by the modifications of its deep-soil temperatures, interpolation of predicted temperatures and winds to SCOS97 observational levels, use of updated urban land-use patterns, and use of corrected input values for ocean and urban surface roughness parameter values.Prepared for the California Air Resources Board and California Environmental Protection AgencySJSU Foundation Subcontract no. 22-1505-7384Approved for public release; distribution is unlimited

Little Things

We present LITTLE THINGS (Local Irregulars That Trace Luminosity Extremes, The HI Nearby Galaxy Survey) that is aimed at determining what drives star formation in dwarf galaxies. This is a multi-wavelength survey of 37 Dwarf Irregular and 4 Blue Compact Dwarf galaxies that is centered around HI-line data obtained with the National Radio Astronomy Observatory (NRAO) Very Large Array (VLA). The HI-line data are characterized by high sensitivity (less than 1.1 mJy/beam per channel), high spectral resolution (less than or equal to 2.6 km/s), and high angular resolution (~6 arcseconds. The LITTLE THINGS sample contains dwarf galaxies that are relatively nearby (less than or equal to 10.3 Mpc; 6 arcseconds is less than or equal to 300 pc), that were known to contain atomic hydrogen, the fuel for star formation, and that cover a large range in dwarf galactic properties. We describe our VLA data acquisition, calibration, and mapping procedures, as well as HI map characteristics, and show channel maps, moment maps, velocity-flux profiles, and surface gas density profiles. In addition to the HI data we have GALEX UV and ground-based UBV and Halpha images for most of the galaxies, and JHK images for some. Spitzer mid-IR images are available for many of the galaxies as well. These data sets are available on-line.Comment: In press in A

Redescription of Lemuricola (Madoxyuris) bauchoti (Nematoda, Oxyuridae) from Lemur catta in Madagascar

Lemuricola (Madoxyuris) bauchoti Chabaud, Brygoo et Petter, 1965 is redescribed from material collected from the ring-tailed lemur, Lemur catta, from the Beza Mahafaly Special Reserve in Madagascar using the scanning electron microscope. This is a new host record and the first oxyurid reported from the ring-tailed lemur. Previously, records of each species of the subgenus Madoxyuris have been restricted to a single host species, but the close relationship between these nematodes and their Strepsirrhini hosts will only be proven when additional records fill in the gaps in their distribution.Centro de Estudios Parasitológicos y de Vectore

Utility of interval kidney biopsy in ANCA-associated vasculitis

OBJECTIVES: ANCA-associated vasculitis (AAV) is a rare autoimmune disorder that commonly involves the kidney. Early identification of kidney involvement, assessing treatment-response and predicting outcome are important clinical challenges. Here, we assessed the potential utility of interval kidney biopsy in AAV. METHODS: In a tertiary referral centre with a dedicated vasculitis service, we identified patients with AAV who had undergone interval kidney biopsy, defined as a repeat kidney biopsy (following an initial biopsy showing active AAV) undertaken to determine the histological response in the kidney following induction immunosuppression. We analysed biochemical, histological and outcome data, including times to kidney failure and death for all patients. RESULTS: We identified 57 patients with AAV who underwent at least one interval kidney biopsy (59 interval biopsies in total; median time to interval biopsy ∼130 days). Of the 59 interval biopsies performed, 24 (41%) patients had clinically suspected active disease at time of biopsy which was confirmed histologically in only 42% of cases; 35 (59%) patients were in clinical disease-remission, and this was correct in 97% of cases. The clinician’s impression was incorrect in one in four patients. Hematuria at interval biopsy did not correlate with histological activity. Interval biopsy showed fewer acute lesions and more chronic damage compared with initial biopsy and led to immunosuppressive treatment-change in 75% (44/59) of patients. Clinical risk prediction tools tended to operate better using interval biopsy data. CONCLUSION: Interval kidney biopsy is useful for determining treatment-response and subsequent disease management in AAV. It may provide better prognostic information than initial kidney biopsy and should be considered for inclusion into future clinical trials and treatment protocols for patients with AAV

Evaluation of bone marrow lesion volume as a knee osteoarthritis biomarker - longitudinal relationships with pain and structural changes: data from the Osteoarthritis Initiative

Abstract Introduction Bone marrow lesion (BML) size may be an important imaging biomarker for osteoarthritis-related clinical trials and reducing BML size may be an important therapeutic goal. However, data on the interrelationships between BML size, pain, and structural progression are inconsistent and rarely examined in the same cohort. Therefore, we evaluated the cross-sectional and longitudinal associations of BML volume with knee pain and joint space narrowing (JSN). Methods A BML volume assessment was performed on magnetic resonance images of the knee collected at the 24- and 48-month Osteoarthritis Initiative visits from a convenience sample of 404 participants in the progression cohort. During the same visits, knee pain was assessed with WOMAC pain scores and knee radiographs were acquired and scored for JSN. BML volume was summed to generate a total knee volume and an index tibiofemoral compartment volume (compartment with greater baseline JSN). Primary analyses included multiple linear regressions (outcome = pain, predictor = total knee BML volume) and logistic regressions (outcome = JSN, predictor = index tibiofemoral compartment BML volume). Results This sample was 49% female with a mean age of 63 (9.2 standard deviation (SD)) years, and 71% had radiographic osteoarthritis in the study knee. Larger baseline BMLs were associated with greater baseline knee pain (P = 0.01), the presence of JSN at baseline (odds ratio (OR) = 1.50, 95% confidence interval (CI) = 1.23 to 1.83), and JSN progression (OR = 1.27, 95%CI = 1.11 to 1.46). Changes in total knee BML volume had a positive association with changes in knee pain severity (P = 0.004) and this association may be driven by knees that were progressing from no or small baseline BMLs to larger BMLs. In contrast, we found no linear positive relationship between BML volume change and JSN progression. Instead, regression of medial tibiofemoral BML volume was associated with JSN progression compared to knees with no or minimal changes in BML volume (OR = 3.36, 95%CI = 1.55 to 7.28). However, follow-up analyses indicated that the association between JSN progression and BML volume change may primarily be influenced by baseline BML volume. Conclusion Large baseline BMLs are associated with greater baseline knee pain, the presence of JSN at baseline, and disease progression. Additionally, BML regression is associated with decreased knee pain but not a reduced risk of concurrent JSN progression

Impact of Diet and/or Exercise Intervention on Infrapatellar Fat Pad Morphology: Secondary Analysis from the Intensive Diet and Exercise for Arthritis (IDEA) Trial

The infrapatellar fat pad (IPFP) represents intra-articular adipose tissue that may contribute to intra-articular inflammation and pain by secretion of pro-inflammatory cytokines. Here we examined the impact of weight loss by diet and/or exercise interventions on IPFP volume

Use of Coronary Computed Tomographic Angiography to guide management of patients with coronary disease

Background In a prospective, multicenter, randomized controlled trial, 4,146 patients were randomized to receive standard care or standard care plus coronary computed tomography angiography (CCTA). Objectives The purpose of this study was to explore the consequences of CCTA-assisted diagnosis on invasive coronary angiography, preventive treatments, and clinical outcomes. Methods In post hoc analyses, we assessed changes in invasive coronary angiography, preventive treatments, and clinical outcomes using national electronic health records. Results Despite similar overall rates (409 vs. 401; p = 0.451), invasive angiography was less likely to demonstrate normal coronary arteries (20 vs. 56; hazard ratios [HRs]: 0.39 [95% confidence interval (CI): 0.23 to 0.68]; p < 0.001) but more likely to show obstructive coronary artery disease (283 vs. 230; HR: 1.29 [95% CI: 1.08 to 1.55]; p = 0.005) in those allocated to CCTA. More preventive therapies (283 vs. 74; HR: 4.03 [95% CI: 3.12 to 5.20]; p < 0.001) were initiated after CCTA, with each drug commencing at a median of 48 to 52 days after clinic attendance. From the median time for preventive therapy initiation (50 days), fatal and nonfatal myocardial infarction was halved in patients allocated to CCTA compared with those assigned to standard care (17 vs. 34; HR: 0.50 [95% CI: 0.28 to 0.88]; p = 0.020). Cumulative 6-month costs were slightly higher with CCTA: difference $462 (95$303 to $621). Conclusions In patients with suspected angina due to coronary heart disease, CCTA leads to more appropriate use of invasive angiography and alterations in preventive therapies that were associated with a halving of fatal and non-fatal myocardial infarction. (Scottish COmputed Tomography of the HEART Trial [SCOT-HEART]; NCT01149590

Political Leadership and Global Governance: Structural Power Versus Custodial Stewardship

This article examines the role of political leadership within the realm of global governance. Drawing upon relevant theories of political agency, particular attention is given to addressing the relationship between leadership and collective action. A two-level analysis of institution building in relation to maritime security and economic trade and investment reveals both strengths and weaknesses in practice. A review of the Law of the Sea Convention and the Multilateral Investment Agreement provides a salutary reminder that material power does not translate easily into dominating the rules of international conduct. The cases of the Asia Pacific Economic Cooperation Forum and the Trans-Pacific Partnership further highlight the importance of mixed sources of political leadership in responding to economic challenges at the regional level. The policy implication for both the United States and China is that taking the lead in Global Governance, either jointly or multilaterally, will require a renewed focus upon custodial stewardship that aims to realign interests with long-term goals