A Box Particle Filter for Stochastic and Set-theoretic Measurements with Association Uncertainty

This work develops a novel estimation approach for nonlinear dynamic stochastic systems by combining the sequential Monte Carlo method with interval analysis. Unlike the common pointwise measurements, the proposed solution is for problems with interval measurements with association uncertainty. The optimal theoretical solution can be formulated in the framework of random set theory as the Bernoulli filter for interval measurements. The straightforward particle filter implementation of the Bernoulli filter typically requires a huge number of particles since the posterior probability density function occupies a significant portion of the state space. In order to reduce the number of particles, without necessarily sacrificing estimation accuracy, the paper investigates an implementation based on box particles. A box particle occupies a small and controllable rectangular region of non-zero volume in the target state space. The numerical results demonstrate that the filter performs remarkably well: both target state and target presence are estimated reliably using a very small number of box particles

OCT Angiography Flow Index and Projection Artifacts in Outer Retina

Introduction: Ocular vasculature investigation has always been difficult. Many devices have been invented to measure the hemodynamics of the eye but none of them completely satisfied the requirements because of specific limitations. With optical coherence tomography-angiography (OCTA) it is now possible to assess parameters of ocular hemodynamics non-invasively and quantitatively. Vessel density or density (%) and flow index or flow area (mm2) are quantitative parameters with proven importance in inner retinal diseases like glaucoma. The purpose of this work is to demonstrate quantitative flow area changes in external avascular retina as a result of diseases affect inner retinal layers and vessel density. Material and methods: Our observations are summarized via presentation of several case controls as a representative sample of the total number of participants. We investigated controls and patients with proven inner retinal disease (glaucoma and multiple sclerosis – MS). Non-invasive angio-OCT imaging technique was applied (AngioVue, OptoVue) and Flow Area values were measured in posterior pole around macula in circle area with maximum radius of 1.50 mm. Results: The investigation of Flow area parameter in external retina shows decreasing of the values in inner retinal diseases like glaucoma or neuritis optica associated with MS. It is best demonstrated when asymmetrical process is observed between two eyes. Conclusion: Flow area values vary over a large range in healthy people and a lot of factors may influence the results. Quantitative analysis of Flow area in external retina is a combination between artifacts (projection and dark areas) and real for external retina Flow area values. Flow area changes are indirect reflection of an inner retinal state

Lifetime cost effectiveness of simvastatin in a range of risk groups and age groups derived from a randomised trial of 20,536 people

<i>Objectives</i>: To evaluate the cost effectiveness of 40 mg simvastatin daily continued for life in people of different ages with differing risks of vascular disease. Design A model developed from a randomised trial was used to estimate lifetime risks of vascular events and costs of treatment and hospital admissions in the United Kingdom. <i>Setting</i>: 69 hospitals in the UK. <i>Participants</i>: 20 536 men and women (aged 40-80) with coronary disease, other occlusive arterial disease, or diabetes. <i>Interventions</i>: 40 mg simvastatin daily versus placebo for an average of 5 years. <i>Main</i> <i>outcome</i> <i>measures</i>: Cost effectiveness of 40 mg simvastatin daily expressed as additional cost per life year gained. Major vascular event defined as non-fatal myocardial infarction or death from coronary disease, any stroke, or revascularisation procedure. Results were extrapolated to younger and older age groups at lower risk of vascular disease than were studied directly, as well as to lifetime treatment. <i>Results</i>: At the April 2005 UK price of £4.87 (€7; $9) per 28 day pack of generic 40 mg simvastatin, lifetime treatment was cost saving in most age groups and vascular disease risk groups studied directly. Gains in life expectancy and cost savings decreased with increasing age and with decreasing risk of vascular disease. People aged 40-49 with 5 year risks of major vascular events of 42% and 12% at start of treatment gained 2.49 and 1.67 life years, respectively. Treatment with statins remained cost saving or cost less than £2500 per life year gained in people as young as 35 years or as old as 85 with 5 year risks of a major vascular event as low as 5% at the start of treatment. <i>Conclusions</i>: Treatment with statins is cost effective in a wider population than is routinely treated at present

Exotropia associated with syndromes

Въведение: Екзотропията е вид кривогледство, при което очните оси са насочени навън. Среща се много по-рядко от есотропията. Когато е налице още в ранна детска възраст, е наследствена. Най-често срещана е интермитентна екзотропия с ексцес на дивергенция и/или недостатъчност на конвергенцията, която може да компенсира или декомпенсира с времето. Екзотропия може да се наблюдава и при някои синдроми. Цел: Да се демонстрират редки синдромни заболявания, при които една от проявите е екзотропия. Материал и методи: Представени са три синдромни случая на деца с екзотропия от рождение. Използвани са офталмологични и ортоптични методи. Резултати: Първият случай е генетично доказаният синдром на Ангелман. Вторият описан случай представлява хромозомна болест 46,XX,add(17q25), клинично изявен като синдром на Смит-Лемли-Опитц. В третия случай се касае за все още неуточнен синдром на вродени аномалии с предимно засягане на крайниците. Извод: Когато екзотропията е налице в ранна детска възраст и няма данни за дивергентно кривогледство при родителите, вероятно се касае за страбизъм при общи синдромни заболявания, изискващ интердисциплинарен подход.Introduction: Exotropia is strabismus with a deviation of visual axes outwards. It is considerably less frequent than esotropia. When present early in life, it is usually hereditary. Most common form is the intermittent exotropia with excess of divergence or insuf? ciency of convergence, which could either compensate with time or turn into a manifest strabismus. Exotropia is present in some syndromes as well. Aim: To demonstrate rare syndromes in which one of the symptom is exotropia. Material and methods: Three cases with exotropia present at birth are presented. Ophthalmologic and orthoptic methods of examination are used. Results: One of the cases is a genetically proven syndrome of Angelmann, second case is a chromosomal disease 46,XX,add(17q25), clinically manifested as Smith-Lemli-Opitz syndrome and the third case is syndrome with congenital abnormalities of extremities. Conclusion: When exotropia is present very early in life and there is not a family history for exotropia, most probably it is a part of a syndrome and interdisciplinary approach is required

Evaluation of peripapillary and macular retinal nerve fiber layer thickness in anisometropic amblyopic children with spectral-domain optical coherence tomography

Въведение: Въпреки, че промените в анатомията и функцията на зрителната кора и латералното коленчато тяло са добре описани при амблиопия, то ролята на ретината е все още противоречива. Предполага се, че и ретинните ганглийни клетки, неврофибрилерният слой (RNFL) и зрителният нерв също търпят промени в този процес.Цел: Да се направи оценка на дебелината на перипапиларния и макулнияRNFL (pRNFL, mRNFL) при деца с анизаметрапична амблиопия, като дебелината на слоя в амблиопичното око се сравни с контралатералното неамблиопично око и контролна група чрез спектрал-домейн оптична кохерентна томография (SD-OCT).Материал и методи: Анализират се общо 9 RNFL параметри като се използват данните от измерванията с Topcon 3D ОСТ 2000+, програми Circle и Glaucoma Analysis-Macula при общо 90 деца (180 очи) на възраст от 4 до 18 години (средно 8.55±2.65) разпределени в две групи - контролна група (56 деца) и анизаметрапична амблиопия (34 деца) с две подгрупи анизохиперметропична амблиопия - 23 и анизомиопична амблиопия - 11. Получените данни са подложени на статистическа обработка.Резултати: Средната тотална дебелина на pRNFL и mRNFL в контролната група се изчисли съответно 111.72±6.72 μm и 37.18±3.88 μm, в очите с анизохиперметропична амблиопия- 119.96±11.39 μm и 35.09±4.22 μm, a при очите с анизомиопична амблиопия- 102.18±9.64 μm и 36.73±4.05 μm. Дебелината на pRNFL в очи с анизохиперметропична амблиопия е сигнификантно по-голяма, a с анизомиопична амблиопия- сигнификантно по-малка в сравнение с дебелината установена в контролната група. При mRNFL не се установява такава разлика. И при двата RNFL показатели - перипапиларен и макулеи не се намери статистическа разлика между амблиопичното и контралатералното неамблиопично око в двете амблиопични подгрупи.Изводи: Нашите резултати показват изменения в pRNFL, сходни с тези при очи с рефракционна аномалия без амблиопия. Поради установената корелационна зависимост в литературата между предно-задната ос и pRNFL, получените данни не могат да се използват достоверно за отдиференциране на промяна в pRNFL при анизаметрапична амблиопия от тази при рефракционна аномалия. Наши предходни изследвания установяват, че mRNFL не корелира с предно-задната ос на окото, което го прави по-точен от pRNFL показател за установяване на евеюуални промени в ретината, дължащи се на анизаметрапична амблиопия. На базата на стойностите на mRNFL ние не установяваме промени в ретината, дължащи се на анизаметрапична амблиопия. За потвърждаване липсата на промени в ретината при амблиопия е необходимо по нататъшно проучване на поведението на mRNFL при страбизмена и микрострабизмена амблиопия.Ключови думи: анизаметрапична амблиопия, ретинен неврофибрилерен слой, оптична кохерентна томография.AbstractIntroduction: Anatomical and functional changes in visual cortex and lateral geniculate nucleus are well established in amblyopia process, but the part of retina is still controversial. It is supposed that retinal ganglion cells, nerve fiber layer (RNFL) and optic nerve are also involved.Purpose: To evaluate the peripapillary and macular RNFL thickness (pRNFL, mRNFL) in anisometropic amblyopic children with spectral-domain optical coherence tomography (SD-OCT). The RNFL thickness was compared between the amblyopic, the nonamblyopic sound eye and control group of eyes.Material and methods: This was a prospective observational study of 90 children (180 eyes) aged 4-18 years (mean 8.55±2.65) divided into two groups - controls (56 children) and anisometropic amblyopic group (34 children) with two subgroups- anisohyperopic amblyopia- 23 and anisomyopic amblyopia- 11. A Total of 9 RNFL parameters were measured using Topcon 3D OCT 2000+, protocols Circle and Glaucoma AnalysisMacula. The obtained data was statistically analyzed.Results: Mean total values of pRNFL and mRNFL thickness were respectively 111.72±6.72 μm and 37.18±3.88 μm in control group of eyes, 119.96±11.39 μm and 35.09±4.22 μm in anisohyperopic amblyopic eyes, 102.18±9.64 μm and 36.73±4.05 μm in anisomyopic amblyopic eyes. In comparison with control group, statistically significant greater pRNFL thickness was found in anisohyperopic amblyopic eyes, and significantly smaller pRNFL thickness in anisomyopic amblyopic eyes. There was no significant difference in Mrnfl thickness among the three investigated groups. No significant difference in pRNFL and mRNFL thickness was observed between amblyopic and nonamblyopic sound eye in the two subgroups.Conclusion: Our pRNFL thickness results in anisometropic amblyopia show similar changes to that of refraction errors without amblyopia. The well studied relationship between pRNFL thickness and the axial length (AL) prevents the precise interpretation of pRNFL thickness results in amblyopia, because it is not possible to determine whether the pRNFL thickness changes are due to anisometropic amblyopia or refraction error alone. In our previous investigations we did not find a correlation between mRNFL and AL. Therefore mRNFL seems to be a more accurate and reliable parameter than pRNFL for exploring retinal changes due to anisometropic amblyopia. Based on mRNFL results, we did not observe structural retinal changes in anisometropic amblyopia. Further study of mRNFL in strabismic and microstrabismic amblyopia is needed to confirm the statement that no structural changes take place in the retina as a result of amblyopia

The Adhesive Capsulitis Corticosteroid and Dilation (ACCorD) randomized controlled trial.

AIMS: Is it feasible to conduct a definitive multicentre trial in community settings of corticosteroid injections (CSI) and hydrodilation (HD) compared to CSI for patients with frozen shoulder? An adequately powered definitive randomized controlled trial (RCT) delivered in primary care will inform clinicians and the public whether hydrodilation is a clinically and cost-effective intervention. In this study, prior to a full RCT, we propose a feasibility trial to evaluate recruitment and retention by patient and clinician willingness of randomization; rates of withdrawal, crossover and attrition; and feasibility of outcome data collection from routine primary and secondary care data. METHODS: In the UK, the National Institute for Health and Care Excellence (NICE) advises that prompt early management of frozen shoulder is initiated in primary care settings with analgesia, physiotherapy, and joint injections; most people can be managed without an operation. Currently, there is variation in the type of joint injection: 1) CSI, thought to reduce the inflammation of the capsule reducing pain; and 2) HD, where a small volume of fluid is injected into the shoulder joint along with the steroid, aiming to stretch the capsule of the shoulder to improve pain, but also allowing greater movement. The creation of musculoskeletal hubs nationwide provides infrastructure for the early and effective management of frozen shoulder. This potentially reduces costs to individuals and the wider NHS perhaps negating the need for a secondary care referral. RESULTS: We will conduct a multicentre RCT comparing CSI and HD in combination with CSI alone. Patients aged 18 years and over with a clinical diagnosis of frozen shoulder will be randomized and blinded to receive either CSI and HD in combination, or CSI alone. Feasibility outcomes include the rate of randomization as a proportion of eligible patients and the ability to use routinely collected data for outcome evaluation. This study has involved patients and the public in the trial design, dissemination methods, and how to include groups who are underserved by research. CONCLUSION: We will disseminate findings among musculoskeletal clinicians via the British Orthopaedic Association, the Chartered Society of Physiotherapy, the Royal College of Radiologists, and the Royal College of General Practitioners. To ensure wide reach we will communicate findings through our established network of charities and organizations, in addition to preparing dissemination findings in Bangla and Urdu (commonly spoken languages in northeast London). If a full trial is shown to be feasible, we will seek additional National Institute for Health and Care Research funding for a definitive RCT. This definitive study will inform NICE guidelines for the management of frozen shoulder

Patterns of Inheritance of Acylsugar Acyl Groups in Selected Interspecific Hybrids of Genus \u3cem\u3eNicotiana\u3c/em\u3e

Glandular trichomes on the surface of Solanaceae species produce acyl sugars that are species-, and cultivar-specific. Acyl sugars are known to possess insecticidal, antibiotic, and hormone-like properties, and as such have great potential as a class of naturally occurring pesticides and antibiotics. The objective of this work was to analyze the acyl composition of acyl sugars in the leaf trichome exudate from selected Nicotiana species and to follow the inheritance of acyl content in their hybrids. Trichome exudates were collected, and the acyl profiles of acyl sugars were identified via GC–MS. The variations in acyl group inheritance in the hybrids (a single parent resemblance, missing, complementary, and novel groups) matched the patterns described in the literature for a variety of secondary metabolites. However, we did not find a complementation of major parental acyl groups. Instead, in some hybrids we observed a dynamic change in the proportions of acyl groups, distinguishing the acyl group profiles as novel. We observed paternal (i.e. N. tabacum cv. Turkish Samsun × N. benthamiana hybrids) and maternal (i.e. N. tabacum cv. Samsun-nn × N. otophora) inheritance patterns, novel acyl profiles (N. excelsior hybrids), and missing acyl groups (N. excelsiana). Selective inheritance of some acyl groups in the hybrids of N. benthamiana (4- and 5-methylheptanoic isomers) or N. alata (octanoate) was found. Suggestions are given to explain certain patterns of inheritance. The data presented here contribute to the body of knowledge about the effect of interspecific hybridization on the secondary metabolites by including acylsugar acyl groups that have not been studied previously