The influence of vergence facility on binocular eye movements during reading

Optometrists regularly use binocular measurements in patients with asthenopic complaints when performing close-up work. The focus of this work was therefore on the correlation of optometric parameters and objective fixation disparity (FD) measured by an eye tracker. In our investigation, 20 participants (6 male, 14 female) were subjected to a classical optometric procedure. Subsequently, these subjects read various sentences on a screen and eye movements were registered by using a RED500 eye tracker. The experiment was performed under two reading distance conditions. In order to be comparable with previous work, the present study was conducted under dark illumination conditions (J. A. Kirkby, Blythe, Drieghe, Benson, & Liversedge, 2013). FD values were deduced from objective eye tracking data during reading. Data analysis was done using linear mixed-effects models. FD was found to depend on vergence facility (t=3.3, p=0.004). Subjects with a low vergence facility showed more eso fixation disparity than subjects with a normal vergence facility. If studies of binocular coordination using eye tracking methods are performed under dark illumination conditions, vergence facility is an important parameter and should be accounted for. Neglecting this parameter may mask other important parameters. Vergence facility in context of reading difficulties may be important

CGH-Profiler: Data mining based on genomic aberration profiles

BACKGROUND: CGH-Profiler is a program that supports the analysis of genomic aberrations measured by Comparative Genomic Hybridisation (CGH). Comparative genomic hybridisation (CGH) is a well-established, molecular cytogenetic method that allows the detection of chromosomal imbalances in entire genomes. This technique is widely used in routine molecular diagnostics. Typically, chromosomal imbalances are described in a complex syntax based on the International Standard for Cytogenetic Nomenclature (ISCN). This semantic description of chromosomal imbalances hinders a large-scale statistical analysis across different experiments, e.g. for finding aberration patterns associated with a particular disease type or state. RESULTS: CGH-Profiler circumvents the semantic ISCN description by importing data from different CGH system vendors and by directly transferring the data into a table format that is readily accessible for subsequent statistical analysis. CGH-profiler comes with different consistency checks, calculates various statistics and automatically assigns a median copy number ratio to each chromosomal band. Import of CGH profiles from different CGH system vendors is already supported; its extension to other systems can be readily achieved through Perl scripts. CGH profiler can also be used to analyse comparative expressed sequence hybridisation (CESH) data. CESH reveals gene expression patterns according to chromosomal locations in a similar manner as CGH detects chromosomal imbalances. CONCLUSION: CGH-Profiler is a useful tool for processing of CGH and CESH data

Biphasic decay kinetics suggest progressive slowing in turnover of latently HIV-1 infected cells during antiretroviral therapy

BACKGROUND: Mathematical models based on kinetics of HIV-1 plasma viremia after initiation of combination antiretroviral therapy (cART) inferred HIV-infected cells to decay exponentially with constant rates correlated to their strength of virus production. To further define in vivo decay kinetics of HIV-1 infected cells experimentally, we assessed infected cell-classes of distinct viral transcriptional activity in peripheral blood mononuclear cells (PBMC) of five patients during 1 year after initiation of cART RESULTS: In a novel analytical approach patient-matched PCR for unspliced and multiply spliced viral RNAs was combined with limiting dilution analysis at the single cell level. This revealed that HIV-RNA+ PBMC can be stratified into four distinct viral transcriptional classes. Two overlapping cell-classes of high viral transcriptional activity, suggestive of a virion producing phenotype, rapidly declined to undetectable levels. Two cell classes expressing HIV-RNA at low and intermediate levels, presumably insufficient for virus production and occurring at frequencies exceeding those of productively infected cells matched definitions of HIV-latency. These cells persisted during cART. Nevertheless, during the first four weeks of therapy their kinetics resembled that of productively infected cells. CONCLUSIONS: We have observed biphasic decays of latently HIV-infected cells of low and intermediate viral transcriptional activity with marked decreases in cell numbers shortly after initiation of therapy and complete persistence in later phases. A similar decay pattern was shared by cells with greatly enhanced viral transcriptional activity which showed a certain grade of levelling off before their disappearance. Thus it is conceivable that turnover/decay rates of HIV-infected PBMC may be intrinsically variable. In particular they might be accelerated by HIV-induced activation and reactivation of the viral life cycle and slowed down by the disappearance of such feedback-loops after initiation of cART

Coordinating Role of RXR alpha in Downregulating Hepatic Detoxification during Inflammation Revealed by Fuzzy-Logic Modeling

During various inflammatory processes circulating cytokines including IL-6, IL-1 beta, and TNF alpha elicit a broad and clinically relevant impairment of hepatic detoxification that is based on the simultaneous downregulation of many drug metabolizing enzymes and transporter genes. To address the question whether a common mechanism is involved we treated human primary hepatocytes with IL-6, the major mediator of the acute phase response in liver, and characterized acute phase and detoxification responses in quantitative gene expression and (phospho-)proteomics data sets. Selective inhibitors were used to disentangle the roles of JAK/STAT, MAPK, and PI3K signaling pathways. A prior knowledge-based fuzzy logic model comprising signal transduction and gene regulation was established and trained with perturbation-derived gene expression data from five hepatocyte donors. Our model suggests a greater role of MAPK/PI3K compared to JAK/STAT with the orphan nuclear receptor RXR alpha playing a central role in mediating transcriptional downregulation. Validation experiments revealed a striking similarity of RXRa gene silencing versus IL-6 induced negative gene regulation (r(s) = 0.79;P<0.0001). These results concur with RXRa functioning as obligatory heterodimerization partner for several nuclear receptors that regulate drug and lipid metabolism

Decoherence and wave function collapse

The possibility of consistency between the basic quantum principles of quantum mechanics and wave function collapse is reexamined. A specific interpretation of environment is proposed for this aim and applied to decoherence. When the organization of a measuring apparatus is taken into account, this approach leads also to an interpretation of wave function collapse, which would result in principle from the same interactions with environment as decoherence. This proposal is shown consistent with the non-separable character of quantum mechanics

Ipsilateral reexpansion pulmonary edema after drainage of a spontaneous pneumothorax: a case report

We report a case of ipsilateral reexpansion pulmonary edema occurring after the insertion of a chest tube in a patient with spontaneous pneumothorax. The patient received supplemental oxygen via a non-rebreather face mask to compensate for hypoxemia. 24 hours after the acute event, the patient recovered completely without residual hypoxemia. Reexpansion pulmonary edema after the insertion of a thoracic drainage for pneumothorax or pleural effusion is a rare complication with a high mortality rate up to 20%. It should be considered in case of hypoxemia following the insertion of a chest tube. The exact pathophysiology leading to this complication is not known. Risk factors for reexpansion pulmonary edema should be evaluated and considered prior to the insertion of chest tubes. Treatment is supportive

Improving cooperation between general practitioners and dermatologists via telemedicine: study protocol of the cluster-randomized controlled TeleDerm study

Background: Internationally, teledermatology has proven to be a viable alternative to conventional physical referrals. Travel cost and referral times are reduced while patient safety is preserved. Especially patients from rural areas benefit from this healthcare innovation. Despite these established facts and positive experiences from EU neighboring countries like the Netherlands or the United Kingdom, Germany has not yet implemented store-and-forward teledermatology in routine care. Methods: The TeleDerm study will implement and evaluate store-and-forward teledermatology in 50 general practitioner (GP) practices as an alternative to conventional referrals. TeleDerm aims to confirm that the possibility of store-and-forward teledermatology in GP practices is going to lead to a 15% (n=260) reduction in referrals in the intervention arm. The study uses a cluster-randomized controlled trial design. Randomization is planned for the cluster county. The main observational unit is the GP practice. Poisson distribution of referrals is assumed. The evaluation of secondary outcomes like acceptance, enablers and barriers uses a mixed-methods design with questionnaires and interviews.Discussion: Due to the heterogeneity of GP practice organization, patient management software, information technology service providers, GP personal technical affinity and training, we expect several challenges in implementing teledermatology in German GP routine care. Therefore, we plan to recruit 30% more GPs than required by the power calculation. The implementation design and accompanying evaluation is expected to deliver vital insights into the specifics of implementing telemedicine in German routine care.Trial registration: German Clinical Trials Register, DRKS00012944. Registered prospectively on 31 August 2017

‘Better see a doctor?’ status quo of symptom checker apps in Germany : a cross-sectional survey with a mixed-methods design (CHECK.APP)

Background: Symptom checker apps (SCAs) offer symptom classification and low-threshold self-triage for laypeople. They are already in use despite their poor accuracy and concerns that they may negatively affect primary care. This study assesses the extent to which SCAs are used by medical laypeople in Germany and which software is most popular. We examined associations between satisfaction with the general practitioner (GP) and SCA use as well as the number of GP visits and SCA use. Furthermore, we assessed the reasons for intentional non-use. Methods: We conducted a survey comprising standardised and open-ended questions. Quantitative data were weighted, and open-ended responses were examined using thematic analysis. Results: This study included 850 participants. The SCA usage rate was 8%, and approximately 50% of SCA non-users were uninterested in trying SCAs. The most commonly used SCAs were NetDoktor and Ada. Surprisingly, SCAs were most frequently used in the age group of 51–55 years. No significant associations were found between SCA usage and satisfaction with the GP or the number of GP visits and SCA usage. Thematic analysis revealed skepticism regarding the results and recommendations of SCAs and discrepancies between users’ requirements and the features of apps. Conclusion: SCAs are still widely unknown in the German population and have been sparsely used so far. Many participants were not interested in trying SCAs, and we found no positive or negative associations of SCAs and primary care.German Federal Ministry of Education and ResearchEmployers' Association of the Metal and Electric Industry Baden-Württemberg (Südwestmetall

Decoherence, irreversibility and the selection by decoherence of quantum states with definite probabilities

The problem investigated in this paper is einselection, i. e. the selection of mutually exclusive quantum states with definite probabilities through decoherence. Its study is based on a theory of decoherence resulting from the projection method in the quantum theory of irreversible processes, which is general enough for giving reliable predictions. This approach leads to a definition (or redefinition) of the coupling with the environment involving only fluctuations. The range of application of perturbation calculus is then wide, resulting in a rather general master equation. Two distinct cases of decoherence are then found: (i) A ``degenerate'' case (already encountered with solvable models) where decoherence amounts essentially to approximate diagonalization; (ii) A general case where the einselected states are essentially classical. They are mixed states. Their density operators are proportional to microlocal projection operators (or ``quasi projectors'') which were previously introduced in the quantum expression of classical properties. It is found at various places that the main limitation in our understanding of decoherence is the lack of a systematic method for constructing collective observables.Comment: 54 page