Factors Affecting Intraocular Pressure Measurement and New Methods for Improving Accuracy; What Can IOP Tell Us about Glaucoma? How Can Practitioners Improve IOP Utility and Glaucoma Outcomes?

An increased awareness of how central corneal thickness (CCT) and corneal material properties such as corneal hysteresis has changed both tonometry accuracy and the resultant understanding of glaucoma risk. New research findings and methods of tonometry provide differing information on the diagnosis and treatment of ocular conditions which should be understood to appropriately incorporate this information into individual patient care. Additionally, a useful re-examination of what IOP can tell us about glaucoma empowers practitioners to improve glaucoma outcomes. All clinically utilized tonometry methods are estimates of true IOP, which is only assessed using direct intracameral techniques. Different described tonometry techniques are associated with their own overall bias and interpatient variability, due most typically to tissue biomechanics

The Impact of Multidrug-Resistant Organisms on Outcomes in Patients with Diabetic Foot Infections

Background. Multidrug-resistant organisms (MDROs) are important diabetic foot infection (DFI) pathogens. This study evaluated the impact of DFIs associated with MDRO pathogens (DFI-MDRO) on clinical outcomes. Methods. Adults admitted to Detroit Medical Center from January 2012 to December 2015 with culture-positive DFI were included. Associations between outcomes and DFI-MDRO (evaluated as a single group that included methicillin-resistant Staphylococcus aureus [MRSA], vancomycin-resistant enterococci, Enterobacteriaceae resistant to third-generation cephalosporin [3GCR-EC], Acinetobacter baumannii, and Pseudomonas aeruginosa) were analyzed. Outcomes included above- and below-knee lower extremity amputation (LEA), readmissions, and mortality within a year after DFI. A propensity score predicting the likelihood of having DFI-MDRO was computed by comparing patients with DFI-MDRO with patients with DFI with non-MDRO pathogens (DFI-non-MDRO). Using conditional logistic regression, DFI-MDRO was analyzed as an independent variable after patients in the MDRO and non-MDRO groups were matched by propensity score. Results. Six hundred forty-eight patients were included, with a mean age ± SD of 58.4 ± 13.7. Most patients in the cohort presented with chronic infection (75%). DFI-MDRO occurred in greater than one-half of the cohort (n = 364, 56%), and MRSA was the most common MDRO (n = 224, 62% of the DFI-MDRO group). In propensity-matched analyses, DFI-MDRO was not associated with 1-year LEA or readmissions, but was associated with recurrent DFI episodes (odds ratio, 2.1; 95% confidence interval, 1.38–3.21). Conclusions. DFI-MDRO was associated with a 2-fold increased risk of recurrent DFI compared with patients with DFI-non-MDRO

Epidemiology of Diabetic Foot Infection in the Metro-Detroit Area with a Focus on Independent Predictors for Pathogens Resistant to Recommended Empiric Antimicrobial Therapy

Background. The polymicrobial nature of diabetic foot infection (DFI) and the emergence of antimicrobial resistance have complicated DFI treatment. Current treatment guidelines for deep DFI recommend coverage of methicillin-resistant Staphylococcus aureus (MRSA) and susceptible Enterobacteriaceae. This study aimed to describe the epidemiology of DFI and to identify predictors for DFI associated with multidrug-resistant organisms (MDROs) and pathogens resistant to recommended treatment (PRRT). Methods. Adult patients admitted to Detroit Medical Center from January 2012 to December 2015 with DFI and positive cultures were included. Demographics, comorbidities, microbiological history, sepsis severity, and antimicrobial use within 3 months before DFI were obtained retrospectively. DFI-PRRT was defined as a DFI associated with a pathogen resistant to both vancomycin and ceftriaxone. DFI-MDRO pathogens included MRSA in addition to PRRT. Results. Six-hundred forty-eight unique patients were included, with a mean age of 58.4 ± 13.7 years. DFI-MDRO accounted for 364 (56%) of the cohort, and 194 (30%) patients had DFI-PRRT. Independent predictors for DFI-PRRT included history of PRRT in a diabetic foot ulcer, antimicrobial exposure in the prior 90 days, peripheral vascular disease, and chronic kidney disease. Long-term care facility residence was independently associated with DFI due to ceftriaxone-resistant Enterobacteriaceae, and recent hospitalization was an independent predictor of DFI due to vancomycin-resistant Enterococcus. Conclusions. An unexpectedly high prevalence of DFI-PRRT pathogens was identified. History of the same pathogen in a prior diabetic foot ulcer and recent antimicrobial exposure were independent predictors of DFI-PRRT and should be considered when selecting empiric DFI therapy

Overlapping Agencies: The Collision of Cancer, Consumers, and Corporations in Richard Powers’s Gain

Richard Powers\u27s 1998 novel Gain establishes a complicated relationship between its two main characters, a corporation called Clare International and suburban mom named Laura Bodey. Readers, assuming the malignity of such corporations, mistake the hints Laura encounters that Clare is responsible for her ovarian cancer for facts. Such readings overlook the science of ovarian cancer as well as how Powers depicts Laura\u27s relation to her disease. I analyze Laura\u27s understudied half of the novel, framing it as a cancer narrative that reworks conventions of that genre. In placing her cancer in broad social and environmental contexts, Powers eschews the individualist strain that characterizes many illness narratives. In so doing, the novel demands engagement with consumer agency and bodily frailty in the face of corporate dominance

CSF Tau phosphorylation at Thr205 is associated with loss of white matter integrity in autosomal dominant Alzheimer disease

BACKGROUND: Hyperphosphorylation of tau leads to conformational changes that destabilize microtubules and hinder axonal transport in Alzheimer\u27s disease (AD). However, it remains unknown whether white matter (WM) decline due to AD is associated with specific Tau phosphorylation site(s). METHODS: In autosomal dominant AD (ADAD) mutation carriers (MC) and non-carriers (NC) we compared cerebrospinal fluid (CSF) phosphorylation at tau sites (pT217, pT181, pS202, and pT205) and total tau with WM measures, as derived from diffusion tensor imaging (DTI), and cognition. A WM composite metric, derived from a principal component analysis, was used to identify spatial decline seen in ADAD. RESULTS: The WM composite explained over 70% of the variance in MC. WM regions that strongly contributed to the spatial topography were located in callosal and cingulate regions. Loss of integrity within the WM composite was strongly associated with AD progression in MC as defined by the estimated years to onset (EYO) and cognitive decline. A linear regression demonstrated that amyloid, gray matter atrophy and phosphorylation at CSF tau site pT205 each uniquely explained a reduction in the WM composite within MC that was independent of vascular changes (white matter hyperintensities), and age. Hyperphosphorylation of CSF tau at other sites and total tau did not significantly predict WM composite loss. CONCLUSIONS: We identified a site-specific relationship between CSF phosphorylated tau and WM decline within MC. The presence of both amyloid deposition and Tau phosphorylation at pT205 were associated with WM composite loss. These findings highlight a primary AD-specific mechanism for WM dysfunction that is tightly coupled to symptom manifestation and cognitive decline

Forest Regeneration Following Emerald Ash Borer (Agrilus planipennis Fairemaire) Enhances Mesophication in Eastern Hardwood Forests

Emerald ash borer (EAB, Agrilus planipennis Fairemaire) is a phloem-feeding beetle that was introduced into North America in the late 20th century and is causing widespread mortality of native ash (Fraxinus) species. The loss of an entire genus from the forest flora is a substantial disturbance, but effects vary because of differences in Fraxinus dominance and remaining vegetation. At three sites near the center of the North American EAB range, we investigated the impacts of Fraxinus mortality on recruitment of woody and non-native vegetation in 14 permanent plots from 2012 to 2017. We used the change in relative Fraxinus basal area to determine the impact of EAB on density of woody species and non-native vegetation less than 2.5 cm diameter at breast height (dbh). Changes in canopy cover were not correlated with loss of Fraxinus from the overstory, and only the density of shade-tolerant shrubs and saplings increased with Fraxinus mortality. Both native and non-native shrub species increased in density at sites where they were present before EAB, but no new invasions were detected following Fraxinus mortality. These shifts in understory vegetation indicate that Fraxinus mortality enhances the rate of succession to shade-tolerant species

Expanding R through accessible interactivity: The development of tidy psychological statistics modules

The "Psychological Statistics You Can Handle" (PSYCH) module addresses the replication crisis in psychology by integrating open science principles into statistical education. Utilizing R's open-source platform, PSYCH offers a hands-on learning experience with pre-processed data from psychology research, simplifying data setup for educators and engaging students with real research scenarios. The module reduces student anxiety through immediate feedback, encouraging learning through practice. Built within the "swirl" package, PSYCH focuses on code readability, employing the tidyverse 'pipe' syntax for clearer code structure. Despite excluding advanced statistical techniques, PSYCH provides essential analysis tools for psychology students, with adaptable content for instructors via GitHub. This educational tool bridges the gap between statistical theory and practical application, preparing students for data analysis in psychological research

Soil Type Affects <i>Pinus ponderosa</i> var. <i>scopulorum</i> (Pinaceae) Seedling Growth in Simulated Drought Experiments

Premise of the study: Effects of drought stress and media type interactions on growth of Pinus ponderosa var. scopulorum germinants were investigated. Methods and Results: Soil properties and growth responses under drought were compared across four growth media types: two native soils (dolomitic limestone and granite), a soil-less industry standard conifer medium, and a custom-mixed conifer medium. After 35 d of growth, the seedlings under drought stress (reduced watering) produced less shoot and root biomass than watered control seedlings. Organic media led to decreased root biomass, but increased root length and shoot biomass relative to the mineral soils. Conclusions: Media type affected root-to-shoot biomass partitioning of P. ponderosa var. scopulorum, which may influence net photosynthetic rates, growth, and long-term seedling survival. Further work should examine how specific soil properties like bulk density and organic matter influence biomass allocation in greenhouse studies

Climate-Growth Relationships for Native and Nonnative Pinaceae in Northern Michigan's Pine Barrens

Secondary growth responses of native and nonnative trees exposed to the same climatic conditions can elucidate sensitivities and thus adaptability to a particular region. A long-term mixed-species planting in the pine barrens of northern lower Michigan presented an opportunity to discriminate responses from species commonly planted in this region. Mean ring-width chronologies from living native Pinus resinosa Ait. and P. strobus L. and nonnative P. sylvestris L. and Picea abies (L.) Karst. at this plantation were generated, standardized, and analyzed by correlation analysis against mean monthly climatic variables. The native pine chronologies had the highest mean ring widths and signal-to-noise ratios (SNR), were highly correlated to each other, and exhibited positive responses to years with above-normal April temperatures but no significant relationships to variations in precipitation. The P. sylvestris chronology was highly correlated to the other two pine chronologies and responded similarly to April temperatures but exhibited negative correlations to January and April precipitation and positive correlations to September precipitation. The P. abies chronology had the highest mean sensitivity and was correlated with the P. strobus chronology but only responded positively to precipitation from the previous December. The low SNR (P. sylvestris, P. abies), high mean sensitivity (P. abies), and larger number of significant correlations to variations in monthly climatic variables (P. sylvestris) suggest that these nonnative species are more sensitive to this local climate. These results provide insights to the adaptability, establishment, and geographic distribution of the nonnative Pinaceae.This item is part of the Tree-Ring Research (formerly Tree-Ring Bulletin) archive. It was digitized from a physical copy provided by the Laboratory of Tree-Ring Research at The University of Arizona. For more information about this peer-reviewed scholarly journal, please email the Editor of Tree-Ring Research at [email protected]