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The effects of macular ischemia on visual acuity in diabetic retinopathy
PURPOSE: To investigate the impact of diabetic macular ischemia (DMI) on visual acuity (VA), through the analysis of novel fluorescein angiography (FA) parameters.
METHODS: Data were retrospectively collected over a 6-month period. DMI severity was graded using Early Treatment Diabetic Retinopathy Study (ETDRS) protocols. Custom software was used to quantify areas of the foveal avascular zone (FAZ), and of capillary nonperfusion over the papillo-macular nerve fiber layer bundle, and temporal macula, and associations tested with VA.
RESULTS: A total of 488 patients with type 2 diabetes mellitus and FAs of sufficient quality to allow detailed quantitative analyses were included. ETDRS-DMI SEVerity was graded as: none, 39.7%; questionable, 18.4%; mild, 25.2%; moderate, 11.0%; and severe, 5.6%. Median FAZ areas were 0.19 mm(2) (interquartile range [IQR], 0.13-0.25); 0.25 mm(2) (IQR, 0.18-0.32); 0.27 mm(2) (IQR, 0.19-0.38); 0.32 mm(2) (IQR, 0.25-0.54); and 0.78 mm(2) (IQR, 0.60-1.32), respectively, and were significantly different between all grades (P < 0.002), apart from "questionable" versus "mild" grades. Significant association of VA to FAZ area was observed only in the moderate (β = 0.406, SE = 0.101, P = 0.001) and severe (β = 0.299, SE = 0.108, P = 0.006) subgroups, but not in milder ETDRS-DMI grades. A strong association with VA was observed in cases with papillomacular ischemia (β = 1.123, SE = 0.355, P = 0.005), independent of FAZ size or the presence of macular edema.
CONCLUSIONS: Diabetic macular ischemia is associated with reduced VA in eyes with moderate to severe ETDRS-DMI grades of ischemia but preserved in milder grades. In addition, we describe the independent association of papillomacular nerve fiber bundle ischemia with reduced VA
Landbouw
On 18 June 2007 at 1140 hrs (local time), [the Victim] a (Commercial demining group) Deminer, inadvertently caused an item of explosive ordnance (EO), which is considered to be a No. 4A anti-personnel mine, to activate, while conducting the manual mine clearance full excavation procedure. As a result of the explosion [the Victim] was thrown backwards by the blast wave and suffered a traumatic amputation of the right hand, a fractured right humerous and critical head and eye injuries
Errors in chromosome segregation during oogenesis and early embryogenesis
Errors in chromosome segregation occurring during human oogenesis and early embryogenesis are very common. Meiotic chromosome development during oogenesis is subdivided into three distinct phases. The crucial events, including meiotic chromosome pairing and recombination, take place from around 11 weeks until birth. Oogenesis is then arrested until ovulation, when the first meiotic division takes place, with the second meiotic division not completed until after fertilization. It is generally accepted that most aneuploid fetal conditions, such as trisomy 21 Down syndrome, are due to maternal chromosome segregation errors. The underlying reasons are not yet fully understood. It is also clear that superimposed on the maternal meiotic chromosome segregation errors, there are a large number of mitotic errors taking place post-zygotically during the first few cell divisions in the embryo. In this chapter, we summarise current knowledge of errors in chromosome segregation during oogenesis and early embryogenesis, with special reference to the clinical implications for successful assisted reproduction
Cooperation, Norms, and Revolutions: A Unified Game-Theoretical Approach
Cooperation is of utmost importance to society as a whole, but is often
challenged by individual self-interests. While game theory has studied this
problem extensively, there is little work on interactions within and across
groups with different preferences or beliefs. Yet, people from different social
or cultural backgrounds often meet and interact. This can yield conflict, since
behavior that is considered cooperative by one population might be perceived as
non-cooperative from the viewpoint of another.
To understand the dynamics and outcome of the competitive interactions within
and between groups, we study game-dynamical replicator equations for multiple
populations with incompatible interests and different power (be this due to
different population sizes, material resources, social capital, or other
factors). These equations allow us to address various important questions: For
example, can cooperation in the prisoner's dilemma be promoted, when two
interacting groups have different preferences? Under what conditions can costly
punishment, or other mechanisms, foster the evolution of norms? When does
cooperation fail, leading to antagonistic behavior, conflict, or even
revolutions? And what incentives are needed to reach peaceful agreements
between groups with conflicting interests?
Our detailed quantitative analysis reveals a large variety of interesting
results, which are relevant for society, law and economics, and have
implications for the evolution of language and culture as well
HIV-related stigma within communities of gay men: A literature review
While stigma associated with HIV infection is well recognised, there is limited information on the impact of HIV-related stigma between men who have sex with men and within communities of gay men. The consequences of HIV-related stigma can be personal and community-wide, including impacts on mood and emotional well-being, prevention, testing behaviour, and mental and general health. This review of the literature reports a growing division between HIV-positive and HIV-negative gay men, and a fragmentation of gay communities based along lines of perceived or actual HIV status. The literature includes multiple references to HIV stigma and discrimination between gay men, men who have sex with men, and among and between many gay communities. This HIV stigma takes diverse forms and can incorporate aspects of social exclusion, ageism, discrimination based on physical appearance and health status, rejection and violence. By compiling the available information on this understudied form of HIV-related discrimination, we hope to better understand and target research and countermeasures aimed at reducing its impact at multiple levels
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