Assessment of the Impact of a Head-mounted Augmented Reality Low Vision Aid on Vision and Quality of Life in Children and Young People with Visual Impairment

Introduction: Electronic head-mounted low vision aids (LVAs) can help children and young people (CYP) to access schoolwork and leisure activities which they would otherwise struggle to be able to do with traditional optical or hand held LVAs. SightPlus uses a smartphone mounted in a virtual reality headset controlled using a Bluetooth joystick. It offers users 0.7–24.3× magnification alongside enhanced modes to maximise vision. Methods: Eighteen participants aged 8–16 years with reduced vision were given SightPlus to use at home for four weeks. Visual acuity was assessed with and without SightPlus along with reading performance, contrast sensitivity, functional vision and quality of life questionnaires. Results: Clinically significant improvements in distance vision (0.633logMAR SD ± 0.359), near vision (0.411logMAR SD ± 0.368), reading acuity (0.454LlogMAR SD ± 0.406) and critical print size (0.285logMAR ± 0.360) were seen when testing with SightPlus. However, there was a mean decrease in contrast sensitivity and reading speed when using SightPlus. Despite this, nine out of the 14 patients included for analysis indicated a preference to continue to use SightPlus. Of note, younger participants were more likely to show a preference for using SightPlus. All seven CYP aged 10 or under wanted to continue to use SightPlus; in contrast, only two of the seven participants aged 11 or over wanted to continue. Conclusions: Like the results in adult populations, SightPlus has been found to improve CYP visual functions. Older participants were less likely to want to continue to use SightPlus, potentially suggesting they have found other methods for managing sight loss

T cell responses induced by adenoviral vectored vaccines can be adjuvanted by fusion of antigen to the oligomerization domain of C4b-binding protein.

Viral vectored vaccines have been shown to induce both T cell and antibody responses in animals and humans. However, the induction of even higher level T cell responses may be crucial in achieving vaccine efficacy against difficult disease targets, especially in humans. Here we investigate the oligomerization domain of the α-chain of C4b-binding protein (C4 bp) as a candidate T cell "molecular adjuvant" when fused to malaria antigens expressed by human adenovirus serotype 5 (AdHu5) vectored vaccines in BALB/c mice. We demonstrate that i) C-terminal fusion of an oligomerization domain can enhance the quantity of antigen-specific CD4(+) and CD8(+) T cell responses induced in mice after only a single immunization of recombinant AdHu5, and that the T cells maintain similar functional cytokine profiles; ii) an adjuvant effect is observed for AdHu5 vectors expressing either the 42 kDa C-terminal domain of Plasmodium yoelii merozoite surface protein 1 (PyMSP1(42)) or the 83 kDa ectodomain of P. falciparum strain 3D7 apical membrane antigen 1 (PfAMA1), but not a candidate 128kDa P. falciparum MSP1 biallelic fusion antigen; iii) following two homologous immunizations of AdHu5 vaccines, antigen-specific T cell responses are further enhanced, however, in both BALB/c mice and New Zealand White rabbits no enhancement of functional antibody responses is observed; and iv) that the T cell adjuvant activity of C4 bp is not dependent on a functional Fc-receptor γ-chain in the host, but is associated with the oligomerization of small (<80 kDa) antigens expressed by recombinant AdHu5. The oligomerization domain of C4 bp can thus adjuvant T cell responses induced by AdHu5 vectors against selected antigens and its clinical utility as well as mechanism of action warrant further investigation

Snowballs in Euclid and WFIRST Detectors

Snowballs are transient events observed in HgCdTe detectors with a sudden increase of charge in a few pixels. They appear between consecutive reads of the detector, after which the affected pixels return to their normal behavior. The origin of the snowballs is unknown, but it was speculated that they could be the result of alpha decay of naturally radioactive contaminants in the detectors, but a cosmic ray origin cannot be ruled out. Even though previous studies predicted a low rate of occurrence of these events, and consequently, a minimal impact on science, it is interesting to investigate the cause or causes that may generate snowballs and their impact in detectors designed for future missions. We searched for the presence of snowballs in the dark current data in Euclid and Wide Field Infrared Survey Telescope (WFIRST) detectors tested in the Detector Characterization Laboratory at Goddard Space Flight Center. Our investigation shows that for Euclid and WFIRST detectors, there are snowballs that appear only one time, and others that repeat in the same spatial localization. For Euclid detectors, there is a correlation between the snowballs that repeat and bad pixels in the operational masks (pixels that do not fulfill the requirements to pass spectroscopy noise, photometry noise, quantum efficiency, and/or linearity). The rate of occurrence for a snowball event is about 0.9 snowballs/hr. in Euclid detectors (for the ones that do not have associated bad pixels in the mask), and about 0.7 snowballs/hr. in PV3 Full Array Lot WFIRST detectors

Current water quality guidelines across North America and Europe do not protect lakes from salinization

Human-induced salinization caused by the use of road deicing salts, agricultural practices, mining operations, and climate change is a major threat to the biodiversity and functioning of freshwater ecosystems. Yet, it is unclear if freshwater ecosystems are protected from salinization by current water quality guidelines. Leveraging an experimental network of land-based and in-lake mesocosms across North America and Europe, we tested how salinization-indicated as elevated chloride (C-) concentration-will affect lake food webs and if two of the lowest Cl- thresholds found globally are sufficient to protect these food webs. Our results indicated that salinization will cause substantial zooplankton mortality at the lowest Cl- thresholds established in Canada (120 mg Cl-/L) and the United States (230 mg Cl-/L) and throughout Europe where Cl- thresholds are generally higher. For instance, at 73% of our study sites, Cl- concentrations that caused a >= 50% reduction in cladoceran abundance were at or below Cl thresholds in Canada, in the United States, and throughout Europe. Similar trends occurred for copepod and rotifer zooplankton. The loss of zooplankton triggered a cascading effect causing an increase in phytoplankton biomass at 47% of study sites. Such changes in lake food webs could alter nutrient cycling and water clarity and trigger declines in fish production. Current Cl- thresholds across North America and Europe clearly do not adequately protect lake food webs. Water quality guidelines should be developed where they do not exist, and there is an urgent need to reassess existing guidelines to protect lake ecosystems from human-induced salinization.Peer reviewe

Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial

BackgroundAnterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability.MethodsWe did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367.FindingsBetween Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications.InterpretationSurgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management

Agressivité chez les filles adolescentes: pertinence théorique et clinique de l'application du modèle de la mentalisation

Les filles ont le plus souvent été exclues des études scientifiques portant sur l'agressivité à l'adolescence. La préoccupation autour de la "délinquance juvénile" reste importante et on assiste actuellement à une augmentation de l'inquiétude concernant les filles qui seraient impliquées dans ces actes, bien que les statistiques officielles montrent qu'en Suisse (OFS, 2007) les actes délictueux recensés sont restés stables ces dernières années. Les théories explicatives formulées par les politiques publiques et par les recherches scientifiques dans le domaine, font appel à des phénomènes et des contextes socio-économiques particulièrement complexes. Les processus psychologiques en jeu chez les garçons ont classiquement été rattachés aux vécus de maltraitance, aux conditions de socialisation et d'attachement ainsi qu'à la qualité d'empathie. A travers le modèle développemental de la mentalisation (Fonagy, 2003, 2002), ce travail donne sens à ces phénomènes sociaux et psychologiques dans une population de filles, en s'appuyant sur les concepts d'attachement et d'empathie en particulier. L'empathie est la part observable de la fonction symbolique plus large appelée "mentalisation". L'hypothèse principale postule que les filles qui manifestent des conduites agressives ont des prédispositions à risque ainsi qu'une qualité d'attachement insécure qui sont modérées par un défaut d'empathie. Afin de tester cette hypothèse, des entretiens semi-structurés ont été effectués avec 70 adolescentes de 13 à 17 ans, présentant des troubles du comportement pour le groupe clinique, et ne présentant pas ces difficultés pour le groupe contrôle. Les résultats montrent que le faible degré d'attachement et d'empathie influencent de manière significative le degré d'agressivité, en particulier lorsque ces variables sont considérées ensemble. Ainsi, les filles qui n'ont pu développer un attachement suffisamment sécure et qui manifestent de faibles capacités d'empathie, présentent plus d'agressivité que les autres. En conséquence, l'étude relève l'importance de la mentalisation dans l'agressivité et plus largement dans la construction psychique de soi. Ces données viennent appuyer celles rapportées par les théoriciens de la mentalisation vis-à-vis d'autres pathologies et ouvre de nouvelles pistes d'intervention avec des populations de filles adolescentes

Neuropsychological assessment with lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals: Practice, education, and training survey

Objective: We sought to describe the LGBTQ + related education, training, and clinical practice of independently licensed neuropsychologists in the United States and to identify factors that predict affirmative neuropsychological practices. We hypothesized that LGBTQ + identity, female gender, more recent training, and extent of LGBTQ + education/training would predict use of LGBTQ + practice guidelines. Method: A workgroup of clinical psychologists with experience in LGBTQ + psychology and neuropsychology developed a survey to identify personal and professional factors that predict affirmative neuropsychological testing practices. The survey was distributed through professional organizations and listservs between August and September 2021 with 118 responses meeting inclusionary criteria. Results: The majority of participants identified as heterosexual (70.3%) and cisgender (97.5%), and most (48-63%) received LGBTQ + training post-licensure. Between 19% and 32% of participants reported never completing LGBTQ + specific education. Consistent with our hypotheses, factors predicting affirmative clinical practice behaviors were LGBTQ + education/training, and personal background (sexual minority status, female/feminine gender, and years since degree). Other significant factors included prior experience with LGBTQ + patients and primary patient population (child vs. adult). Qualitative responses indicated varying values, attitudes, and knowledge regarding collection of LGBTQ + information and modification of clinical practice. Conclusions: Neuropsychologists underutilize affirming practices as evidenced by low rates of querying pronouns, knowing whether LGBTQ + health information is available at their institutions, and adjusting evaluation and feedback approaches. We provide specific training and education recommendations to increase knowledge and skills and to address beliefs about LGBTQ + health that can serve to promote affirmative neuropsychological practice.</p

Adjuvant activity of IMX108 following immunization with AdHu5-PyMSP1₄₂.

<p>BALB/c mice were immunized i.m. with 1.5×10⁹ or 1.5×10⁷ ifu AdHu5-PyMSP1₄₂±IMX108 (Ad42-IMX108 or Ad42-Nil). Fourteen days post immunization splenocytes were re-stimulated with PyMSP1₃₃ peptides and assessed for frequency of IFN-γ, IL-2, and TNFα positive CD8⁺ (A) and CD4⁺ (B) T cells by ICS. Box and whisker plots show median, IQR and range. The pie charts show the functional composition of the response and represent the proportion of PyMSP1₃₃⁻specific CD8⁺ T cells positive for 1, 2 or all 3 cytokines measured. Fourteen days post-immunization total PyMSP1₁₉-specific IgG responses were measured by ELISA (C). Data points represent individual mice and bars indicate median titer. n = 5 mice per group. **<i>P</i><0.01, *<i>P</i><0.05 compared to AdHu5-PyMSP1₄₂+IMX108 at the same dose by Mann Whitney test. Data are representative of two independent experiments.</p