Predictors for functional and anatomic outcomes in macular edema secondary to non-infectious uveitis

Predictors; Macular edema; Non-infectious uveitisPredictors; Edema macular; Uveïtis no infecciosaPredictores; Edema macular; Uveítis no infecciosaAIMS: We aimed to investigate predictive factors for visual and anatomic outcomes in patients with macular edema secondary to non-infectious uveitis. MATERIAL AND METHODS: We conducted a multicenter, prospective, observational, 12-month follow-up study. Participants included in the study were adults with non-infectious uveitic macular edema (UME), defined as central subfoveal thickness (CST) of >300 μm as measured by spectral domain optical coherence tomography (SD-OCT) and fluid in the macula. Demographic, clinical and tomographic data was recorded at baseline, 1, 3, 6 and 12 months. Foveal-centered SD-OCT exploration was set as the gold-standard determination of UME using a standard Macular Cube 512x128 A-scan, within a 6 x 6 mm2 area, and the Enhanced High Definition Single-Line Raster. To assess favorable prognosis, the main outcomes analyzed were the best-corrected visual acuity (BCVA) and the CST. Favorable prognosis was defined as sustained improvement of BCVA (2 lines of gain of the Snellen scale) and CST (decrease of 20% of the initial value or <300 μm) within a 12 month period. RESULTS: Fifty-six eyes were analyzed. The number of eyes with sustained improvement in the CST was 48 (86.2%), against 23 (41.1%) eyes with sustained improvement in BCVA. Favorable prognosis, as defined above, was observed in 18 (32.1%) eyes. UME prognosis was negatively correlated with baseline foveal thickening, alteration in the vitreo-macular interface and cystoid macular edema. In contrast, bilaterally, systemic disease and the presence of anterior chamber cells were predictive of favorable prognosis. CONCLUSION: Available treatment modalities in UME may avoid chronic UME and improve anatomic outcome. However, the proportion of functional amelioration observed during 12 months of follow-up is lower. Thicker CST, alteration in the vitreo-macular interface and cystoid macular edema may denote less favorable prognosis. Conversely, bilaterally, systemic disease and anterior chamber cells may be associated with favorable prognosis in UME

A stochastic search for intermittent gravitational-wave backgrounds

A likely source of a gravitational-wave background (GWB) in the frequency band of the Advanced LIGO, Virgo and KAGRA detectors is the superposition of signals from the population of unresolvable stellar-mass binary-black-hole (BBH) mergers throughout the Universe. Since the duration of a BBH merger in band ($\sim\!1~{\rm s}$) is much shorter than the expected separation between neighboring mergers ($\sim\!10^3~{\rm s}$), the observed signal will be "popcorn-like" or intermittent with duty cycles of order $10^{-3}$. However, the standard cross-correlation search for stochastic GWBs currently performed by the LIGO-Virgo-KAGRA collaboration is based on a continuous-Gaussian signal model, which does not take into account the intermittent nature of the background. The latter is better described by a Gaussian mixture-model, which includes a duty cycle parameter that quantifies the degree of intermittence. Building on an earlier paper by Drasco and Flanagan, we propose a stochastic-signal-based search for intermittent GWBs. For such signals, this search performs better than the standard continuous cross-correlation search. We present results of our stochastic-signal-based approach for intermittent GWBs applied to simulated data for some simple models, and compare its performance to the other search methods, both in terms of detection and signal characterization. Additional testing on more realistic simulated data sets, e.g., consisting of astrophysically-motivated BBH merger signals injected into colored detector noise containing noise transients, will be needed before this method can be applied with confidence on real gravitational-wave data.Comment: 23 pages, 8 figures, 1 tabl

La aplicación de la sentencia 22-2007 sobre la declaratoria de terroristas a las maras o pandillas en El Salvador: un análisis constitucional-jurisprudencial y la perspectiva actual de la seguridad pública

Esta investigación tiene como objetivos establecer los parámetros jurídicos aplicables a la declaratoria de terroristas a las maras o pandillas, mediante la sentencia de inconstitucionalidad 22-2007 de la Sala de lo Constitucional. Así como también conocer el contenido de la sentencia emitida por los magistrados de la Sala de lo Constitucional al declarar terroristas a las maras o pandillas. Tipo de Investigación: a partir de una teoría expuesta por especialistas, se explica el fenómeno estudiado y se propone una solución a fin de disminuir o erradicar esta problemática. El tipo de investigación utilizada es la Investigación Descriptiva, debido a que la más reciente sentencia de la Sala de lo Constitucional respecto al tema en cuestión han provocado un cambio trascendente en el ordenamiento jurídico actual, imponiendo líneas y corrientes jurídicas novedosas y creando con ello paradigmas constitucionales erga omnes, especialmente a los diputados, Jueces y miembros de pandillas. El objetivo al investigar de forma descriptiva es conocer las costumbres predominantes de los afectados a través de la descripción de objetos, personas y principalmente, de actividades. Por medio de la investigación descriptiva se tratara de comprobar la veracidad de las hipótesis planteadas. Por último, con la investigación descriptiva se utilizara también la Investigación Analítica, ya que se propone una teoría, la cual, a partir de la descripción del fenómeno, se analiza el mismo para adecuarlo a una teoría que mejor se apegue a la realidad. CONCLUSIONES: para finalizar el contenido de la investigación, en este apartado se establecerán conclusiones en diferentes puntos, tales como: en la doctrina en referencia al fenómenos de las pandillas, relacionado con la decretoria de terroristas emitida por la Sala de lo Constitucional y teoría la teoría de la Seguridad y Defensa Nacional de Jhon Griffiths, en el aspecto, cultural sobre el tipo de cultura que adoptado el país y jurisprudencial el análisis de la sentencia 22- 2007 y en el ámbito jurídico la aplicabilidad de la LECAT . Los grupos terroristas son la más reciente evolución de las maras o pandillas en El Salvador, de ello se dice muy poco por su tan breve aparición en el ordenamiento jurídico como terroristas, pues es hasta el año 2015 que la Sala de lo Constitucional analizando precisamente la Ley Especial Contra Actos de Terrorismo, en un proceso iniciado en 2007, dijo que la Mara MS-13 y la Barrio 18 son grupos terroristas, por su accionar y alta peligrosidad en una serie de eventos que se han venido desarrollando desde entonces y que hasta ahora y con el pasar del tiempo agravan más la situación delincuencial

Peripheral blood metabolic and inflammatory factors as biomarkers to ocular findings in diabetic macular edema.

AIMS: To study the association between peripheral blood metabolic and inflammatory factors and presence of diabetic macular edema (DME) and its related anatomic features in type 2 diabetic mellitus (T2DM) patients. MATERIAL AND METHODS: Observational cross-sectional study on a proof of concept basis. Seventy-six T2DM included patients were divided based on the presence (n = 58) or absence of DME (n = 18) according to optical coherence tomography (OCT). Ultra-widefield fluorescein angiography (UWFA) was performed in DME patients. Fasting peripheral blood sample testing included glycemia, glycated hemoglobin, creatinin and lipid levels among others. Serum levels of a broad panel of cytokines and inflammatory mediators were also analysed. OCT findings included central subfoveal thickness, diffuse retinal thickness (DRT), cystoid macular edema (CME), serous retinal detachment and epirretinal membrane. UWFA items included pattern of DME, presence of peripheral retinal ischemia and enlarged foveal avascular zone (FAZ). RESULTS: Metabolic and inflammatory factors did not statistically differ between groups. However, several inflammatory mediators did associate to certain ocular items of DME cases: IL-6 was significantly higher in patients with DRT (p = 0.044), IL-10 was decreased in patients with CME (p = 0.012), and higher IL-8 (p = 0.031) and VEGF levels (p = 0.031) were observed in patients with enlarged FAZ. CONCLUSION: Inflammatory and metabolic peripheral blood factors in T2DM may not be differentially associated to DME when compared to non-DME cases. However, some OCT and UWFA features of DME such as DRT, CME and enlarged FAZ may be associated to certain systemic inflammatory mediators

Predictors for functional and anatomic outcomes in macular edema secondary to non-infectious uveitis

Aims We aimed to investigate predictive factors for visual and anatomic outcomes in patients with macular edema secondary to non-infectious uveitis. Material and methods We conducted a multicenter, prospective, observational, 12-month follow-up study. Participants included in the study were adults with non-infectious uveitic macular edema (UME), defined as central subfoveal thickness (CST) of > 300 mu m as measured by spectral domain optical coherence tomography (SD-OCT) and fluid in the macula. Demographic, clinical and tomographic data was recorded at baseline, 1, 3, 6 and 12 months. Foveal-centered SD-OCT exploration was set as the gold-standard determination of UME using a standard Macular Cube 512x128 A-scan, within a 6 x 6 mm(2) area, and the Enhanced High Definition Single-Line Raster. To assess favorable prognosis, the main outcomes analyzed were the best-corrected visual acuity (BCVA) and the CST. Favorable prognosis was defined as sustained improvement of BCVA (2 lines of gain of the Snellen scale) and CST (decrease of 20% of the initial value or < 300 mu m) within a 12 month period. Results Fifty-six eyes were analyzed. The number of eyes with sustained improvement in the CST was 48 (86.2%), against 23 (41.1%) eyes with sustained improvement in BCVA. Favorable prognosis, as defined above, was observed in 18 (32.1%) eyes. UME prognosis was negatively correlated with baseline foveal thickening, alteration in the vitreo-macular interface and cystoid macular edema. In contrast, bilaterally, systemic disease and the presence of anterior chamber cells were predictive of favorable prognosis. Conclusion Available treatment modalities in UME may avoid chronic UME and improve anatomic outcome. However, the proportion of functional amelioration observed during 12 months of follow-up is lower. Thicker CST, alteration in the vitreo-macular interface and cystoid macular edema may denote less favorable prognosis. Conversely, bilaterally, systemic disease and anterior chamber cells may be associated with favorable prognosis in UME.This work was supported by grants from: Spanish Ministry of Economy, Industry and Competitivity, Carlos III Health Institute, cofinanced by the European Regional Development Fund, identification number: PI13/02148, Principal Investigator: AA; http://www.eng.isciii.es/ISCIII/es/contenidos/fd-investigacion/financiacion.shtml.The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Endoscopic transorbital resection of the temporal lobe: anatomic qualitative and quantitative study

ObjectiveStarting from an anatomic study describing the possibility of reaching the temporal region through an endoscopic transorbital approach, many clinical reports have now demonstrated the applicability of this strategy when dealing with intra-axial lesions. The study aimed to provide both a qualitative anatomic description of the temporal region, as seen through a transorbital perspective, and a quantitative analysis of the amount of temporal lobe resection achievable via this route.Material and methodsA total of four cadaveric heads (eight sides) were dissected at the Laboratory of Surgical Neuroanatomy (LSNA) of the University of Barcelona, Spain. A stepwise description of the resection of the temporal lobe through a transorbital perspective is provided. Qualitative anatomical descriptions and quantitative analysis of the amount of the resection were evaluated by means of pre- and post-dissection CT and MRI scans, and three-dimensional reconstructions were made by means of BrainLab®Software.ResultsThe transorbital route gives easy access to the temporal region, without the need for extensive bone removal. The resection of the temporal lobe proceeded in a subpial fashion, mimicking what happens in a surgical scenario. According to our quantitative analysis, the mean volume removed was 51.26%, with the most superior and lateral portion of the temporal lobe being the most difficult to reach.ConclusionThis anatomic study provides qualitative and quantitative details about the resection of the temporal lobe via an endoscopic transorbital approach. Our results showed that the resection of more than half of the temporal lobe is possible through this surgical corridor. While the anterior, inferior, and mesial portions of the temporal lobe were easily accessible, the most superior and lateral segment was more difficult to reach and resect. Our study serves as an integration to the current anatomic knowledge and clinical practice knowledge highlighting and also as a starting point for further anatomic studies addressing more selected segments of the temporal lobe, i.e., the mesial temporal region

pygwb: Python-based library for gravitational-wave background searches

The collection of gravitational waves (GWs) that are either too weak or too numerous to be individually resolved is commonly referred to as the gravitational-wave background (GWB). A confident detection and model-driven characterization of such a signal will provide invaluable information about the evolution of the Universe and the population of GW sources within it. We present a new, user-friendly Python--based package for gravitational-wave data analysis to search for an isotropic GWB in ground--based interferometer data. We employ cross-correlation spectra of GW detector pairs to construct an optimal estimator of the Gaussian and isotropic GWB, and Bayesian parameter estimation to constrain GWB models. The modularity and clarity of the code allow for both a shallow learning curve and flexibility in adjusting the analysis to one's own needs. We describe the individual modules which make up {\tt pygwb}, following the traditional steps of stochastic analyses carried out within the LIGO, Virgo, and KAGRA Collaboration. We then describe the built-in pipeline which combines the different modules and validate it with both mock data and real GW data from the O3 Advanced LIGO and Virgo observing run. We successfully recover all mock data injections and reproduce published results.Comment: 32 pages, 14 figure

The impact of donor and recipient common clinical and genetic variation on estimated glomerular filtration rate in a European renal transplant population

Genetic variation across the HLA is known to influence renal‐transplant outcome. However, the impact of genetic variation beyond the HLA is less clear. We tested the association of common genetic variation and clinical characteristics, from both the donor and recipient, with post‐transplant eGFR at different time‐points, out to 5‐years post‐transplantation. We conducted GWAS meta‐analyses across 10,844 donors and recipients from five European ancestry cohorts. We also analysed the impact of polygenic risk scores (PRS), calculated using genetic variants associated with non‐transplant eGFR, on post‐transplant eGFR. PRS calculated using the recipient genotype alone, as well as combined donor and recipient genotypes were significantly associated with eGFR at 1‐year post‐transplant. 32% of the variability in eGFR at 1‐year post‐transplant was explained by our model containing clinical covariates (including weights for death/graft‐failure), principal components and combined donor‐recipient PRS, with 0.3% contributed by the PRS. No individual genetic variant was significantly associated with eGFR post‐transplant in the GWAS. This is the first study to examine PRS, composed of variants that impact kidney function in the general population, in a post‐transplant context. Despite PRS being a significant predictor of eGFR post‐transplant, the effect size of common genetic factors is limited compared to clinical variables

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London