Vision Bus Aotearoa: a platform for strengthening eye health teaching, research and community partnership

CLINICAL RELEVANCE: Vision Bus Aotearoa is a fully equipped mobile eye health clinic designed to provide a novel platform for undergraduate optometry clinical training, community eye health research and deliver services to underserved communities. BACKGROUND: Aotearoa New Zealand has inequitable access to eye health care. Vision Bus Aotearoa aims to work in partnership with communities to provide comprehensive mobile primary eye health care services while training optometry students, and integrating community eye health research. METHODS: A description is provided of the governance model which has been involved throughout the project. RESULTS: The process of vehicle manufacture, clinical set-up, funding models and service delivery are described. The aims of the project are detailed in terms of optometry teaching, clinical services in partnership with communities, and research integration and implementation. CONCLUSION: Vision Bus Aotearoa represents a valuable opportunity to deliver mobile eye health care to historically underserved communities, enhance undergraduate optometry teaching and to provide a unique platform for community eye health research

Early protein intake predicts functional connectivity and neurocognition in preterm born children

© 2021, The Author(s). Nutritional intake can promote early neonatal brain development in very preterm born neonates (\u3c 32 weeks’ gestation). In a group of 7-year-old very preterm born children followed since birth, we examined whether early nutrient intake in the first weeks of life would be associated with long-term brain function and neurocognitive skills at school age. Children underwent resting-state functional MRI (fMRI), intelligence testing (Wechsler Intelligence Scale for Children, 5th Ed) and visual-motor processing (Beery-Buktenica, 5th Ed) at 7 years. Relationships were assessed between neonatal macronutrient intakes, functional connectivity strength between thalamic and default mode networks (DMN), and neuro-cognitive function using multivariable regression. Greater functional connectivity strength between thalamic networks and DMN was associated with greater intake of protein in the first week (β = 0.17; 95% CI 0.11, 0.23, p \u3c 0.001) but lower intakes of fat (β = − 0.06; 95% CI − 0.09, − 0.02, p = 0.001) and carbohydrates (β = − 0.03; 95% CI − 0.04, − 0.01, p = 0.003). Connectivity strength was also associated with protein intake during the first month (β = 0.22; 95% CI 0.06, 0.37, p = 0.006). Importantly, greater thalamic-DMN connectivity strength was associated with higher processing speed indices (β = 26.9; 95% CI 4.21, 49.49, p = 0.02) and visual processing scores (β = 9.03; 95% CI 2.27, 15.79, p = 0.009). Optimizing early protein intake may contribute to promoting long-term brain health in preterm-born children

Feasibility and economic assessment of chromocolonoscopy for detection of proximal serrated neoplasia within a population-based colorectal cancer screening programme (CONSCOP): an open-label, randomised controlled non-inferiority trial

Background Most post-colonoscopy interval colorectal cancers are proximal; serrated polyps are often precursors to these cancers and are considered difficult to detect. We assessed the safety, feasibility, and economic effect of chromocolonoscopy on detection of proximal serrated neoplasia. Methods We did an open-label, multicentre, randomised, controlled non-inferiority trial including patients from Bowel Screening Wales centres. Participants who tested positive for faecal occult blood and who were eligible for and considered fit to have colonoscopy (patients with known cases of polyposis syndromes, Lynch syndrome, and chronic inflammatory disease were excluded) were randomly assigned (1:1; with the use of minimisation, stratified by centre with an 80:20 random element) to either standard white light colonoscopy (standard group) or chromocolonoscopy (indigo carmine dye [0·2%]; chromocolonoscopy group) using a secure, internet-based, computerised, randomisation system that used centralised, dynamic allocation. Participants were followed up for 1 year and data from index colonoscopies and associated clearance procedures were analysed. All proximal polyps were reviewed by an expert pathologist panel. The main outcome on which power was based was time taken to perform the colonoscopy procedure, defined as from the time when the scope was inserted to withdrawal from the anus, assessed in the per-protocol population. The non-inferiority margin was 15 min. This trial is complete and is registered with ClinicalTrials.gov, number NCT01972451. Findings Between Nov 20, 2014, and June 16, 2016, 741 (72%) of 1031 patients screened were eligible and consented: 360 were randomly assigned to white light colonoscopy and 381 to chromocolonoscopy. In the chromocolonoscopy group, the procedure took a mean of 36·8 min (SD 15·0), compared with a mean of 30·6 min (13·7) in the standard group (mean difference 6·3 min [95% CI 4·2–8·4] longer with chromocolonoscopy than in the standard group). The mean difference was within the prespecified non-inferiority margin. Detection rates for proximal serrated lesions were significantly higher in the chromocolonoscopy group than in the control group (45 [12%] of 381 patients vs 23 [6%] of 360 patients; odds ratio 1·96 [95% CI 1·16–3·32]; p=0·012). Serious adverse events (four cases of postpolypectomy bleeding [two in each group], and one case of anxiety and hyperventilation [in the chromocolonoscopy group]), colonoscopy quality measures, comfort scores, and sedation were similar between groups. Interpretation Chromocolonoscopy is feasible within a population-based colorectal cancer screening programme, is safe, and has significantly increased detection of proximal serrated neoplasia and other polyp types compared with standard colonoscopy. Larger randomised trials of chromocolonoscopy, powered for improved detection of significant serrated polyps and for longer-term follow-up to investigate the effect on reduction of interval cancers within screening populations, are warrante

Global Connectivity of Southern Ocean Ecosystems

Southern Ocean ecosystems are globally important. Processes in the Antarctic atmosphere, cryosphere, and the Southern Ocean directly influence global atmospheric and oceanic systems. Southern Ocean biogeochemistry has also been shown to have global importance. In contrast, ocean ecological processes are often seen as largely separate from the rest of the global system. In this paper, we consider the degree of ecological connectivity at different trophic levels, linking Southern Ocean ecosystems with the global ocean, and their importance not only for the regional ecosystem but also the wider Earth system. We also consider the human system connections, including the role of Southern Ocean ecosystems in supporting society, culture, and economy in many nations, influencing public and political views and hence policy. Rather than Southern Ocean ecosystems being defined by barriers at particular oceanic fronts, ecological changes are gradual due to cross-front exchanges involving oceanographic processes and organism movement. Millions of seabirds and hundreds of thousands of cetaceans move north out of polar waters in the austral autumn interacting in food webs across the Southern Hemisphere, and a few species cross the equator. A number of species migrate into the east and west ocean-basin boundary current and continental shelf regions of the major southern continents. Human travel in and out of the Southern Ocean region includes fisheries, tourism, and scientific vessels in all ocean sectors. These operations arise from many nations, particularly in the Northern Hemisphere, and are important in local communities as well as national economic, scientific, and political activities. As a result of the extensive connectivity, future changes in Southern Ocean ecosystems will have consequences throughout the Earth system, affecting ecosystem services with socio-economic impacts throughout the world. The high level of connectivity also means that changes and policy decisions in marine ecosystems outside the Southern Ocean have consequences for ecosystems south of the Antarctic Polar Front. Knowledge of Southern Ocean ecosystems and their global connectivity is critical for interpreting current change, projecting future change impacts, and identifying integrated strategies for conserving and managing both the Southern Ocean and the broader Earth system

Chromatin dynamics during interphase and cell division:similarities and differences between model and crop plants

Genetic information in the cell nucleus controls organismal development, responses to the environment and finally ensures own transmission to the next generations. To achieve so many different tasks, the genetic information is associated with structural and regulatory proteins, which orchestrate nuclear functions in time and space. Furthermore, plant life strategies require chromatin plasticity to allow a rapid adaptation to abiotic and biotic stresses. Here, we summarize current knowledge on the organisation of plant chromatin and dynamics of chromosomes during interphase and mitotic and meiotic cell divisions for model and crop plants differing as to the genome size, ploidy and amount of genomic resources available. The existing data indicate that chromatin changes accompany most (if not all) cellular processes and that there are both shared and unique themes in the chromatin structure and global chromosome dynamics among species. Ongoing efforts to understand the molecular mechanisms involved in chromatin organisation and remodeling have, together with the latest genome editing tools, potential to unlock crop genomes for innovative breeding strategies and improvements of various traits

Water vapour and ozone profiles in the midlatitude upper troposphere

International audienceWe present an investigation of upper tropospheric humidity profiles measured with a standard radiosonde, the Vaisala RS80-A, and a commercial frost-point hygrometer, the Snow White. Modifications to the Snow White, to enable the mirror reflectivity and Peltier cooling current to be monitored during flight, were found to be necessary to determine when the instrument was functioning correctly; a further modification to prevent hydrometeors entering the inlet was also implemented. From 23 combined flights of an ozonesonde, radiosonde and Snow White between September 2001 and July 2002, clear agreement was found between the two humidity sensors, with a mean difference of <2% in relative humidity from 2 to 10km, and 2.2% between 10 and 13km. This agreement required a correction to the radiosonde humidity, as described by Miloshevich et al. (2001). Using this result, the dataset of 324 ozonesonde/RS80-A profiles measured from Aberystwyth between 1991 and 2002 was examined to derive statistics for the distribution of water vapour and ozone. Supersaturation with respect to ice was frequently seen at the higher levels - 24% of the time in winter between 8 and 10km. The fairly uniform distribution of relative humidity persisted to 120% in winter, but decreased rapidly above 100% in summer

Intraocular pressure fluctuation during resistance exercise

Objective To evaluate the effect of weightlifting (leg press) on intraocular pressure (IOP).Design Prospective cohort study.Subjects A total of 24 participants met the inclusion criteria and completed the study procedures. Participants had an average age of 22.7±2.7 years and included nine women. The mean baseline IOP was 13.9 mm Hg (SD=2.4) with an average body mass index of 24.5 (SD= 3.1).Methods The maximum load for a single lift was found for each participant. Participants then performed three leg press regimens: one repetition using 95% of maximal load (1RM), six repetitions using 75% of maximal load (6RM) and isometric push against a weight much heavier than maximal load (ISO).Main outcome measure IOP was measured pre-exercise, during and immediately following the exercise using an iCare TA01i rebound tonometer. Blood pressure and HR were being monitored continuously during the lift. Optical coherence tomography images were obtained pre and postexercise session.Results The average maximum weight lifted by our participants was 331.9 Kg (SD=97.3). Transient increased IOP was observed across the 1RM, 6RM and ISO exercises with an average increase in 26.4 mm Hg (23.7 mm Hg to 28.7 mm Hg) to reach an average max IOP of 40.7 mm Hg (27.8 mm Hg to 54.2 mm Hg), with an absolute maximum of 70 mm Hg in one participant.Conclusions There is a transient and dramatic fluctuation in IOP with resistance training. This coupled with regular exposure to resistance training is potentially a significant risk factor for glaucoma. It should be noted that this study has been carried out in a healthy young population, and, thus, the external validity of these results in glaucoma participants requires further investigation