Retinal Fractal Dimension Is a Potential Biomarker for Systemic Health-Evidence From a Mixed-Age, Primary-Care Population

PURPOSE: To investigate whether fractal dimension (FD), a retinal trait relating to vascular complexity and a potential "oculomics" biomarker for systemic disease, is applicable to a mixed-age, primary-care population.METHODS: We used cross-sectional data (96 individuals; 183 eyes; ages 18-81 years) from a university-based optometry clinic in Glasgow, Scotland, to study the association between FD and systemic health. We computed FD from color fundus images using Deep Approximation of Retinal Traits (DART), an artificial intelligence-based method designed to be more robust to poor image quality.RESULTS: Despite DART being designed to be more robust, a significant association (P &lt; 0.001) between image quality and FD remained. Consistent with previous literature, age was associated with lower FD (P &lt; 0.001 univariate and when adjusting for image quality). However, FD variance was higher in older patients, and some patients over 60 had FD comparable to those of patients in their 20s. Prevalent systemic conditions were significantly (P = 0.037) associated with lower FD when adjusting for image quality and age.CONCLUSIONS: Our work suggests that FD as a biomarker for systemic health extends to mixed-age, primary-care populations. FD decreases with age but might not substantially decrease in everyone. This should be further investigated using longitudinal data. Finally, image quality was associated with FD, but it is unclear whether this finding is measurement error caused by image quality or confounded by age and health. Future work should investigate this to clarify whether adjusting for image quality is appropriate.TRANSLATIONAL RELEVANCE: FD could potentially be used in regular screening settings, but questions around image quality remain.</p

Predicting spatial-temporal patterns of diet quality and large herbivore performance using satellite time series

Adaptive management of large herbivores requires an understanding of how spatial-temporal fluctuations in forage biomass and quality influence animal performance. Advances in remote sensing have yielded information about the spatial-temporal dynamics of forage biomass, which in turn have informed rangeland management decisions such as stocking rate and paddock selection for free-ranging cattle. However, less is known about the spatial-temporal patterns of diet quality and their influence on large herbivore performance. This is due to infrequent concurrent ground observations of forage conditions with performance (e.g., mass gain), and previously limited satellite data at fine spatial and temporal scales. We combined multi-temporal field observations of diet quality (weekly) and mass gain (monthly) with satellite-derived phenological metrics (pseudo-daily, using data fusion and interpolation) to model daily mass gains of free-ranging yearling cattle in shortgrass steppe. We used this model to predict grazing season (mid-May to October) mass gains, a key management indicator, across 40 different paddocks grazed over a 10-year period (n = 138). We found strong relationships between diet quality and the satellite-derived phenological metrics, especially metrics related to the timing and rate of green-up and senescence. Satellite-derived diet quality estimates were strong predictors of monthly mass gains (R2 = 0.68) across a wide range of aboveground net herbaceous production. Season-long predictions of average daily gain and cattle off-mass had mean absolute errors of 8.9% and 2.9%, respectively. The model performed better temporally (across repeated observations in the same paddock) than spatially (across all paddocks within a given year), highlighting the need for accurate vegetation maps and robust field data collection across both space and time. This study demonstrates that freeranging cattle performance in rangelands is strongly affected by diet quality, which is related to the timing of vegetation green-up and senescence. Senescing vegetation suppressed mass gains, even if adequate forage was available. The satellite-based pseudo-daily approach presented here offers new opportunities for adaptive management of large herbivores, such as identifying withinseason triggers to move livestock among paddocks, predicting wildlife herd health, or timing the grazing season to better match earlier spring green-up caused by climate change and plant species invasion

Multimodal validation of facial expression detection software for real-­time monitoring of affect in patients with suicidal intent

We sought to test the hypothesis that previously validated biomarkers of high risk for suicide, namely EEG event related potentials (ERP), Galvanic skin response (GSR) and heart rate variability (HRV) can be employed in combination with facial affect and pupil dilation measures, in a novel diagnostic battery that will ultimately increase reliability of clinical evaluations of suicidal persons

Cheating the locals: invasive mussels steal and benefit from the cooling effect of indigenous mussels

The indigenous South African mussel Perna perna gapes during periods of aerial exposure to maintain aerobic respiration. This behaviour has no effect on the body temperatures of isolated individuals, but when surrounded by conspecifics, beneficial cooling effects of gaping emerge. It is uncertain, however, whether the presence of the invasive mussel Mytilus galloprovincialis limits the ability of P. perna for collective thermoregulation. We investigated whether varying densities of P. perna and M. galloprovincialis influences the thermal properties of both natural and artificial mussel beds during periods of emersion. Using infrared thermography, body temperatures of P. perna within mixed artificial beds were shown to increase faster and reach higher temperatures than individuals in conspecific beds, indicating that the presence of M. galloprovincialis limits the group cooling effects of gaping. In contrast, body temperatures of M. galloprovincialis within mixed artificial mussel beds increased slower and exhibited lower temperatures than for individuals in beds comprised entirely of M. galloprovincialis. Interestingly, differences in bed temperatures and heating rates were largely dependent on the size of mussels, with beds comprised of larger individuals experiencing less thermal stress irrespective of species composition. The small-scale patterns of thermal stress detected within manipulated beds were not observed within naturally occurring mixed mussel beds. We propose that small-scale differences in topography, size-structure, mussel bed size and the presence of organisms encrusting the mussel shells mask the effects of gaping behaviour within natural mussel beds. Nevertheless, the results from our manipulative experiment indicate that the invasive species M. galloprovincialis steals thermal properties as well as resources from the indigenous mussel P. perna. This may have significant implications for predicting how the co-existence of these two species may change as global temperatures continue to rise

Noncontact surface thermometry for microsystems: LDRD final report.

We describe a Laboratory Directed Research and Development (LDRD) effort to develop and apply laser-based thermometry diagnostics for obtaining spatially resolved temperature maps on working microelectromechanical systems (MEMS). The goal of the effort was to cultivate diagnostic approaches that could adequately resolve the extremely fine MEMS device features, required no modifications to MEMS device design, and which did not perturb the delicate operation of these extremely small devices. Two optical diagnostics were used in this study: microscale Raman spectroscopy and microscale thermoreflectance. Both methods use a low-energy, nonperturbing probe laser beam, whose arbitrary wavelength can be selected for a diffraction-limited focus that meets the need for micron-scale spatial resolution. Raman is exploited most frequently, as this technique provides a simple and unambiguous measure of the absolute device temperature for most any MEMS semiconductor or insulator material under steady state operation. Temperatures are obtained from the spectral position and width of readily isolated peaks in the measured Raman spectra with a maximum uncertainty near {+-}10 K and a spatial resolution of about 1 micron. Application of the Raman technique is demonstrated for V-shaped and flexure-style polycrystalline silicon electrothermal actuators, and for a GaN high-electron-mobility transistor. The potential of the Raman technique for simultaneous measurement of temperature and in-plane stress in silicon MEMS is also demonstrated and future Raman-variant diagnostics for ultra spatio-temporal resolution probing are discussed. Microscale thermoreflectance has been developed as a complement for the primary Raman diagnostic. Thermoreflectance exploits the small-but-measurable temperature dependence of surface optical reflectivity for diagnostic purposes. The temperature-dependent reflectance behavior of bulk silicon, SUMMiT-V polycrystalline silicon films and metal surfaces is presented. The results for bulk silicon are applied to silicon-on-insulator (SOI) fabricated actuators, where measured temperatures with a maximum uncertainty near {+-}9 K, and 0.75-micron inplane spatial resolution, are achieved for the reflectance-based measurements. Reflectance-based temperatures are found to be in good agreement with Raman-measured temperatures from the same device

Route of drug administration in out-of-hospital cardiac arrest: A protocol for a randomised controlled trial (PARAMEDIC-3)

© 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).AIMS: The PARAMEDIC-3 trial evaluates the clinical and cost-effectiveness of an intraosseous first strategy, compared with an intravenous first strategy, for drug administration in adults who have sustained an out-of-hospital cardiac arrest. METHODS: PARAMEDIC-3 is a pragmatic, allocation concealed, open-label, multi-centre, superiority randomised controlled trial. It will recruit 15,000 patients across English and Welsh ambulance services. Adults who have sustained an out-of-hospital cardiac arrest are individually randomised to an intraosseous access first strategy or intravenous access first strategy in a 1:1 ratio through an opaque, sealed envelope system. The randomised allocation determines the route used for the first two attempts at vascular access. Participants are initially enrolled under a deferred consent model.The primary clinical-effectiveness outcome is survival at 30-days. Secondary outcomes include return of spontaneous circulation, neurological functional outcome, and health-related quality of life. Participants are followed-up to six-months following cardiac arrest. The primary health economic outcome is incremental cost per quality-adjusted life year gained. CONCLUSION: The PARAMEDIC-3 trial will provide key information on the clinical and cost-effectiveness of drug route in out-of-hospital cardiac arrest.Trial registration: ISRCTN14223494, registered 16/08/2021, prospectively registered.Peer reviewe

Let us introduce ourselves, #WeAreBOSEM

No description supplie

Piezo1 integration of vascular architecture with physiological force

The mechanisms by which physical forces regulate endothelial cells to determine the complexities of vascular structure and function are enigmatic¹⁻⁵. Studies of sensory neurons have suggested Piezo proteins as subunits of Ca²⁺-permeable non-selective cationic channels for detection of noxious mechanical impact⁶⁻⁸. Here we show Piezo1 (Fam38a) channels as sensors of frictional force (shear stress) and determinants of vascular structure in both development and adult physiology. Global or endothelial-specific disruption of mouse Piezo1 profoundly disturbed the developing vasculature and was embryonic lethal within days of the heart beating. Haploinsufficiency was not lethal but endothelial abnormality was detected in mature vessels. The importance of Piezo1 channels as sensors of blood flow was shown by Piezo1 dependence of shear-stress-evoked ionic current and calcium influx in endothelial cells and the ability of exogenous Piezo1 to confer sensitivity to shear stress on otherwise resistant cells. Downstream of this calcium influx there was protease activation and spatial reorganization of endothelial cells to the polarity of the applied force. The data suggest that Piezo1 channels function as pivotal integrators in vascular biology

Renal artery sympathetic denervation:observations from the UK experience

Background: Renal denervation (RDN) may lower blood pressure (BP); however, it is unclear whether medication changes may be confounding results. Furthermore, limited data exist on pattern of ambulatory blood pressure (ABP) response—particularly in those prescribed aldosterone antagonists at the time of RDN. Methods: We examined all patients treated with RDN for treatment-resistant hypertension in 18 UK centres. Results: Results from 253 patients treated with five technologies are shown. Pre-procedural mean office BP (OBP) was 185/102 mmHg (SD 26/19; n = 253) and mean daytime ABP was 170/98 mmHg (SD 22/16; n = 186). Median number of antihypertensive drugs was 5.0: 96 % ACEi/ARB; 86 % thiazide/loop diuretic and 55 % aldosterone antagonist. OBP, available in 90 % at 11 months follow-up, was 163/93 mmHg (reduction of 22/9 mmHg). ABP, available in 70 % at 8.5 months follow-up, was 158/91 mmHg (fall of 12/7 mmHg). Mean drug changes post RDN were: 0.36 drugs added, 0.91 withdrawn. Dose changes appeared neutral. Quartile analysis by starting ABP showed mean reductions in systolic ABP after RDN of: 0.4; 6.5; 14.5 and 22.1 mmHg, respectively (p &lt; 0.001 for trend). Use of aldosterone antagonist did not predict response (p &lt; 0.2). Conclusion: In 253 patients treated with RDN, office BP fell by 22/9 mmHg. Ambulatory BP fell by 12/7 mmHg, though little response was seen in the lowermost quartile of starting blood pressure. Fall in BP was not explained by medication changes and aldosterone antagonist use did not affect response

Projected Loss of a Salamander Diversity Hotspot as a Consequence of Projected Global Climate Change

Background: Significant shifts in climate are considered a threat to plants and animals with significant physiological limitations and limited dispersal abilities. The southern Appalachian Mountains are a global hotspot for plethodontid salamander diversity. Plethodontids are lungless ectotherms, so their ecology is strongly governed by temperature and precipitation. Many plethodontid species in southern Appalachia exist in high elevation habitats that may be at or near their thermal maxima, and may also have limited dispersal abilities across warmer valley bottoms. Methodology/Principal Findings: We used a maximum-entropy approach (program Maxent) to model the suitable climatic habitat of 41 plethodontid salamander species inhabiting the Appalachian Highlands region (33 individual species and eight species included within two species complexes). We evaluated the relative change in suitable climatic habitat for these species in the Appalachian Highlands from the current climate to the years 2020, 2050, and 2080, using both the HADCM3 and the CGCM3 models, each under low and high CO 2 scenarios, and using two-model thresholds levels (relative suitability thresholds for determining suitable/unsuitable range), for a total of 8 scenarios per species. Conclusion/Significance: While models differed slightly, every scenario projected significant declines in suitable habitat within the Appalachian Highlands as early as 2020. Species with more southern ranges and with smaller ranges had larger projected habitat loss. Despite significant differences in projected precipitation changes to the region, projections did no