Social Media Listening to Understand the Lived Experience of Presbyopia:Systematic Search and Content Analysis Study

BACKGROUND: Presbyopia is defined as the age-related deterioration of near vision over time which is experienced in over 80% of people aged 40 years or older. Individuals with presbyopia have difficulty with tasks that rely on near vision. It is not currently possible to stop or reverse the aging process that causes presbyopia; generally, it is corrected with glasses, contact lenses, surgery, or the use of a magnifying glass. OBJECTIVE: This study aimed to explore how individuals used social media to describe their experience of presbyopia with regard to the symptoms experienced and the impacts of presbyopia on their quality of life. METHODS: Social media sources including Twitter, forums, blogs, and news outlets were searched using a predefined search string relating to symptoms and impacts of presbyopia. The data that were downloaded, based on the keywords, underwent manual review to identify relevant data points. Relevant posts were further manually analyzed through a process of data tagging, categorization, and clustering. Key themes relating to symptoms, impacts, treatment, and lived experiences were identified. RESULTS: A total of 4456 social media posts related to presbyopia were identified between May 2017 and August 2017. Using a random sampling methodology, we selected 2229 (50.0%) posts for manual review, with 1470 (65.9%) of these 2229 posts identified as relevant to the study objectives. Twitter was the most commonly used channel for discussions on presbyopia compared to forums and blogs. The majority of relevant posts originated in Spain (559/1470, 38.0%) and the United States (426/1470, 29.0%). Of the relevant posts, 270/1470 (18.4%) were categorized as posts written by individuals who have presbyopia, of which 37 of the 270 posts (13.7%) discussed symptoms. On social media, individuals with presbyopia most frequently reported experiencing difficulty reading small print (24/37, 64.9%), difficulty focusing on near objects (15/37, 40.5%), eye strain (12/37, 32.4%), headaches (9/37, 24.3%), and blurred vision (8/37, 21.6%). 81 of the 270 posts (30.0%) discussed impacts of presbyopia-emotional burden (57/81, 70.4%), functional or daily living impacts (46/81, 56.8%), such as difficulty reading (46/81, 56.8%) and using electronic devices (21/81, 25.9%), and impacts on work (3/81, 3.7%). CONCLUSIONS: Findings from this social media listening study provided insight into how people with presbyopia discuss their condition online and highlight the impact of presbyopia on individuals' quality of life. The social media listening methodology can be used to generate insights into the lived experience of a condition, but it is recommended that this research be combined with prospective qualitative research for added rigor and for confirmation of the relevance of the findings

Comparison of Literature Review, Social Media Listening, and Qualitative Interview Research Methods in Generating Patient-Reported Symptom and Functional Impact Concepts of Presbyopia

INTRODUCTION: To compare the insights obtained about the experience of individuals with presbyopia (age-related impaired near vision) across three different sources of qualitative data: a structured targeted literature review, a social media listening (SML) review, and qualitative concept elicitation (CE) interviews with individuals with presbyopia and healthcare professionals (HCPs). The number of concepts identified, depth of data, cost and time implications, and value of the patient insights generated were explored and compared for each method. METHODS: Keyword searches in bibliographic databases and review of abstracts identified 120 relevant publications; in-depth targeted literature review of the qualitative studies identified key symptoms/functioning concepts. SML was conducted using publicly accessible social media sources with focus on ophthalmologic diseases using a pre-defined search string. Relevant posts from individuals with presbyopia (n = 270) were analysed and key concepts identified. Semi-structured CE interviews were conducted with individuals with presbyopia (US n = 30, Germany n = 10, France n = 10), and HCPs (US = 3, France n = 2, Germany n = 1, Japan n = 1) who were experienced in treating presbyopia. Verbatim transcripts were coded using thematic analysis. A conceptual model summarised concepts identified across sources RESULTS: Out of the total of 158 concepts identified across the three sources, qualitative CE interviews yielded the highest number of concepts (n = 151/158, 96%), with SML yielding a third of the concepts (n = 51/158, 32%) and the literature review yielding the fewest concepts (n = 33/158, 21%). Qualitative CE interviews provided greater depth of data than SML and literature reviews. SML and literature reviews were less costly and quicker to run than qualitative CE interviews and also were less burdensome for participants. CONCLUSION: Qualitative CE interviews are considered the gold standard in providing greater depth of understanding of the patient experience, and more robust data. However, research requirements, budget, and available time should be considered when choosing the most appropriate research method. More time and cost-effective SML and literature review methods can be used to supplement qualitative CE interview data and provide early identification of measurement concepts. More research and regulatory guidance into less traditional qualitative methods, however, are needed to increase the value of SML and literature review data

Tube-assisted Minimally Invasive versus Open Posterior Decompression for Multilevel Degenerative Cervical Myelopathy: A Prospective Comparative Study

Objective There have been several reports of minimally invasive decompression for cervical canal stenosis and degenerative myelopathy. Most of these reports are for less than 4 levels and there have not been any comparative studies between Open and MIS cervical decompression for multilevel (≥4) degenerative cervical myelopathy. Methods Twenty consecutive patients were allotted to undergo either ‘Open’ cervical laminectomy (n=10) or MIS posterior cervical decompression (n=10). All patients were evaluated for 1. Clinical, (JOA, MDI, NDI, Nurick grade, Blood loss, Duration of surgery); 2. Radiological (CSA of dural sac and Spinal cord, Muscle edema on post-op T2W MRI); 3. Laboratory (TLC, CRP, ESR, CPK) and 4. Physical (Isometric neck extensor muscle strength). Differences between Open and MIS groups were calculated with respect to above parameters. Results The mean number of levels decompressed was 4.4 (range, 4–6). MIS group had significantly longer duration of surgery and lesser blood loss as compared to open group. The patients in open group were more disabled than MIS group pre-operatively, as evidenced by higher MDI and NDI. However, proportionate improvements were seen in both groups post-operatively in terms of all clinical parameters. Postoperative increase in CSA of spinal cord was also identical in both groups. Elevations in CRP and ESR were significantly higher in Open group post-operatively as compared to MIS group. Post-operative extensor neck muscle strength improved to a higher extent in MIS group as compared to open group though this was not statistically significant. No patient had any major post-operative complications. Conclusion MIS posterior cervical decompression is safe and effective, can achieve similar extent of decompression and degree of clinical improvement as compared to open surgery. MIS has definite advantages of lesser blood loss, reduced tissue injury and better improvement in post-operative neck muscle strength as compared to open surgery

Crystal structures of the NO sensor NsrR reveal how its iron-sulfur cluster modulates DNA binding

NsrR from Streptomyces coelicolor (Sc) regulates the expression of three genes through the progressive degradation of its [4Fe–4S] cluster on nitric oxide (NO) exposure. We report the 1.95 Å resolution crystal structure of dimeric holo-ScNsrR and show that the cluster is coordinated by the three invariant Cys residues from one monomer and, unexpectedly, Asp8 from the other. A cavity map suggests that NO displaces Asp8 as a cluster ligand and, while D8A and D8C variants remain NO sensitive, DNA binding is affected. A structural comparison of holo-ScNsrR with an apo-IscR-DNA complex shows that the [4Fe–4S] cluster stabilizes a turn between ScNsrR Cys93 and Cys99 properly oriented to interact with the DNA backbone. In addition, an apo ScNsrR structure suggests that Asn97 from this turn, along with Arg12, which forms a salt-bridge with Asp8, are instrumental in modulating the position of the DNA recognition helix region relative to its major groove

Genetic Variability, Genotype × Environment Interaction, Correlation, and GGE Biplot Analysis for Grain Iron and Zinc Concentration and Other Agronomic Traits in RIL Population of Sorghum (Sorghum bicolor L. Moench)

The low grain iron and zinc densities are well documented problems in food crops, affecting crop nutritional quality especially in cereals. Sorghum is a major source of energy and micronutrients for majority of population in Africa and central India. Understanding genetic variation, genotype × environment interaction and association between these traits is critical for development of improved cultivars with high iron and zinc. A total of 336 sorghum RILs (Recombinant Inbred Lines) were evaluated for grain iron and zinc concentration along with other agronomic traits for 2 years at three locations. The results showed that large variability exists in RIL population for both micronutrients (Iron = 10.8 to 76.4 mg kg−1 and Zinc = 10.2 to 58.7 mg kg−1, across environments) and agronomic traits. Genotype × environment interaction for both micronutrients (iron and zinc) was highly significant. GGE biplots comparison for grain iron and zinc showed greater variation across environments. The results also showed that G × E was substantial for grain iron and zinc, hence wider testing needed for taking care of G × E interaction to breed micronutrient rich sorghum lines. Iron and zinc concentration showed high significant positive correlation (across environment = 0.79; p 0.60, in individual environments) for Fe and Zn and other traits studied indicating its suitability to map QTL for iron and zinc

Rapid evolution of microbe-mediated protection against pathogens in a worm host.

Microbes can defend their host against virulent infections, but direct evidence for the adaptive origin of microbe-mediated protection is lacking. Using experimental evolution of a novel, tripartite interaction, we demonstrate that mildly pathogenic bacteria (Enterococcus faecalis) living in worms (Caenorhabditis elegans) rapidly evolved to defend their animal hosts against infection by a more virulent pathogen (Staphylococcus aureus), crossing the parasitism-mutualism continuum. Host protection evolved in all six, independently selected populations in response to within-host bacterial interactions and without direct selection for host health. Microbe-mediated protection was also effective against a broad spectrum of pathogenic S. aureus isolates. Genomic analysis implied that the mechanistic basis for E. faecalis-mediated protection was through increased production of antimicrobial superoxide, which was confirmed by biochemical assays. Our results indicate that microbes living within a host may make the evolutionary transition to mutualism in response to pathogen attack, and that microbiome evolution warrants consideration as a driver of infection outcome

Akustisk Beamforming för hörapparater Använda Multi mikrofoner genom att utforma grafiska användargränssnitt

Hearing impaired persons lose their ability to distinguish speech signal in ambient noise. Human hearing system is sensitive to interfering noise. Interfering noise decreases the quality and intelligibility of the speech signal which in turn makes speech communication default. To make the speech signal effective and useful for hearing impaired, they need to be enhanced from noisy speech signal. Speech enhancement is one of the most emerging and useful branch in signal processing, to reduce the noise and improves the perceptual quality and intelligibility of the speech signal. Several signal processing techniques has been widely used in hearing aids to enhance the speech signal from the noisy environment. Microphone array is one of the signal processing technique implemented in hearing aids to provide a better solution to the problem encountered by the hearing impaired person when listening to speech in the presence of background noise. Generalized Sidelobe Canceller (GSC) is a powerful technique to enhance the signal of interest which suppressing the interference signal and noise at the output of the array microphones. The main focus of the thesis is to implement a GSC using microphone array, the blocking matrix in the GSC is replaced with Elko’s algorithm. Elko’s algorithm is used to track and attenuate interference or background noise located in the back half plane of the array of microphones. The proposed system is implemented successfully and validated effectively. Clean speech signal is corrupted by various background noises respectively multi-talker babble noise, wind noise, car interior noise, destroyer engine room noise, tank noise, interference male and female voices at five different Signal-to-Noise Ratio (SNR) levels 0db, 5db, 10db, 15db and 20db. Different types of objective tests, such as SNR, Signal-to-Noise Ratio Improvement (SNRI), Perceptual Evaluation of Speech Quality (PESQ), Speech Distortion (SD) and Noise Distortion (ND) are performed on the test set. The platform is made in Matlab Graphical User Interface (GUI) and all the results have been shown by plots produced from Matlab code.S S V Sumanth Kotta Mobile No. 00919703575170 Bulli Koteswararao Kommineni 0046-(0)-73675176