Study of Optimal Perimetric Testing In Children (OPTIC): Normative visual field values in children

Purpose: We sought to define normative visual field (VF) values for children using common clinical test protocols for kinetic and static perimetry. Design: Prospective, observational study. Subjects: We recruited 154 children aged 5 to 15 years without any ophthalmic condition that would affect the VF (controls) from pediatric clinics at Moorfields Eye Hospital. Methods: Children performed perimetric assessments in a randomized order using Goldmann and Octopus kinetic perimetry, and Humphrey static perimetry (Swedish Interactive Thresholding Algorithm [SITA] 24-2 FAST), in a single sitting, using standardized clinical protocols, with assessment by a single examiner. Unreliable results (assessed qualitatively) were excluded from the normative data analysis. Linear, piecewise, and quantile mixed-effects regression models were used. We developed a method to display age-specific normative isopters graphically on a VF plot to aid interpretation. Main Outcome Measures: Summary measures and graphical plots describing normative VF data for 3 common perimetric tests. Results: Visual field area increased with age on testing with Goldmann isopters III4e, I4e, and I2e (linear regression; P < 0.001) and for Octopus isopters III4e and I4e (linear regression; P < 0.005). Visual field development occurs predominately in the infero-temporal field. Humphrey mean deviation (MD) showed an increase of 0.3 decibels (dB; 95% CI, 0.21-0.40) MD per year up to 12 years of age, when adult MD values were reached and thereafter maintained. Conclusions: Visual field size and sensitivity increase with age in patterns that are specific to the perimetric approach used. These developmental changes should be accounted for when interpreting perimetric test results in children, particularly when monitoring change over time

Adjuvanted influenza vaccines

In spite of current influenza vaccines being immunogenic, evolution of the influenza virus can reduce efficacy and so influenza remains a major threat to public health. One approach to improve influenza vaccines is to include adjuvants; substances that boost the immune response. Adjuvants are particularly beneficial for influenza vaccines administered during a pandemic when a rapid response is required or for use in patients with impaired immune responses, such as infants and the elderly. This review outlines the current use of adjuvants in human influenza vaccines, including what they are, why they are used and what is known of their mechanism of action. To date, six adjuvants have been used in licensed human vaccines: Alum, MF59, AS03, AF03, virosomes and heat labile enterotoxin (LT). In general these adjuvants are safe and well tolerated, but there have been some rare adverse events when adjuvanted vaccines are used at a population level that may discourage the inclusion of adjuvants in influenza vaccines, for example the association of LT with Bell's Palsy. Improved understanding about the mechanisms of the immune response to vaccination and infection has led to advances in adjuvant technology and we describe the experimental adjuvants that have been tested in clinical trials for influenza but have not yet progressed to licensure. Adjuvants alone are not sufficient to improve influenza vaccine efficacy because they do not address the underlying problem of mismatches between circulating virus and the vaccine. However, they may contribute to improved efficacy of next-generation influenza vaccines and will most likely play a role in the development of effective universal influenza vaccines, though what that role will be remains to be seen

Active surveillance of visual impairment due to adverse drug reactions: findings from a national study in the United Kingdom

As visual impairment (VI) due to adverse drug reactions (ADR) is rare in adults and children, there is an incomplete evidence base to inform guidance for screening and for counseling patients on the potential risks of medications. We report on suspected drugs and the eye conditions found in a national study of incidence of diagnosis of visual impairment due to suspected ADR. Case ascertainment was via the British Ophthalmological Surveillance Unit (BOSU), between March 2010 and February 2012, with follow-up after 6 months

Hydrostatic Chandra X-ray analysis of SPT-selected galaxy clusters - I. Evolution of profiles and core properties

We analyse Chandra X-ray Observatory observations of a set of galaxy clusters selected by the South Pole Telescope using a new publicly available forward-modelling projection code, MBPROJ2, assuming hydrostatic equilibrium. By fitting a power law plus constant entropy model we find no evidence for a central entropy floor in the lowest entropy systems. A model of the underlying central entropy distribution shows a narrow peak close to zero entropy which accounts for 60 per cent of the systems, and a second broader peak around 130keVcm2 . We look for evolution over the 0.28–1.2 redshift range of the sample in density, pressure, entropy and cooling time at 0.015R500 and at 10 kpc radius. By modelling the evolution of the central quantities with a simple model, we find no evidence for a non-zero slope with redshift. In addition, a non-parametric sliding median shows no significant change. The fraction of cool-core clusters with central cooling times below 2 Gyr is consistent above and below z = 0.6 (~30–40 per cent). Both by comparing the median thermodynamic profiles, centrally biased towards cool cores, in two redshift bins, and by modelling the evolution of the unbiased average profile as a function of redshift, we find no significant evolution beyond self-similar scaling in any of our examined quantities. Our average modelled radial density, entropy and cooling-time profiles appear as power laws with breaks around 0.2R500. The dispersion in these quantities rises inwards of this radius to around 0.4 dex, although some of this scatter can be fitted by a bimodal model

Evaluating chemical signatures in a coastal upwelling region to reconstruct water mass associations of settlement-stage rockfishes

Characterizing the behavior of larvae prior to settlement is integral to understanding population dynamics because coastal oceanography may facilitate or limit settlement. Otolith microchemistry can be used to determine patterns of fish movement, although there is a limited understanding of how this tool can be applied in coastal marine systems. Our goal in this study was to evaluate the application of otolith microchemistry to characterize water mass associations of settlement-stage marine fish in a coastal upwelling region using a 3-step approach. First, we characterized seawater chemistry of coastal water mass types across multiple years, finding differences in the chemical signatures of strong upwelling, weak upwelling, and relaxation events. Second, we experimentally determined the effect of temperature on the partitioning of trace elements in otoliths for 2 rockfishes (Sebastes spp.) to find that the effect of temperature on otolith partition coefficients was element-and species-specific. Finally, we compared coeval changes in seawater and otolith chemistry of settlement-stage rockfishes that were exposed to naturally variable conditions over an upwelling-relaxation cycle. We subsequently evaluate whether laser ablation inductively coupled plasma mass spectrometry effectively measures otolith chemistry over ecologically relevant time scales. We discovered that elemental concentrations in otoliths respond rapidly to changes in seawater chemistry and reflect equivalent proportional changes. This study provides evidence that elemental signatures are valuable tools for reconstructing larval histories of marine fish in coastal upwelling regions

Rethinking ‘Advanced Search’: A New Approach to Complex Query Formulation

Knowledge workers such as patent agents, recruiters and media monitoring professionals undertake work tasks where search forms a core part of their duties. In these instances, the search task often involves the formulation of complex queries expressed as Boolean strings. However, creating effective Boolean queries remains an ongoing challenge, often compromised by errors and inefficiencies. In this demo paper, we present a new approach to query formulation in which concepts are expressed on a two-dimensional canvas and relationships are articulated using direct manipulation. This has the potential to eliminate many sources of error, makes the query semantics more transparent, and offers new opportunities for query refinement and optimisatio

Telehealth for patients with interstitial lung diseases (ILD): results of an international survey of clinicians

Introduction: Clinicians and policymakers are promoting widespread use of home technology including spirometry to detect disease progression for patients with interstitial lung disease (ILD); the COVID-19 pandemic has accelerated this. Data collating clinicians’ views on the potential utility of telehealth in ILD are limited. Aim: This survey investigated clinicians’ opinions about contemporary methods and practices used to monitor disease progression in patients with ILD using telehealth. Methods: Clinicians were invited to participate in a cross-sectional survey (SurveyMonkey) of 13 questions designed by an expert panel. Telehealth was defined as home monitoring of symptoms and physiological parameters with regular automatic transmission of data from the patient’s home to the clinician. Data are presented as percentages of respondents. Results: A total of 207 clinicians from 23 countries participated in the survey. A minority (81, 39%) reported using telehealth. 50% (n=41) of these respondents completed a further question about the effectiveness of telehealth. A majority of respondents (32, 70%) rated it to be quite or more effective than face-to-face visit. There were a greater number of respondents using telehealth from Europe (94, 45%) than Asia (51, 25%) and America (24%). Clinicians reported the most useful telehealth monitoring technologies as smartphone apps (59%) and wearable sensors (30%). Telehealth was most frequently used for monitoring disease progression (70%), quality of life (63%), medication use (63%) and reducing the need for in-person visits (63%). Clinicians most often monitored symptoms (93%), oxygen saturation (74%) and physical activity (72%). The equipment perceived to be most effective were spirometers (43%) and pulse oximeters (33%). The primary barriers to clinicians’ participation in telehealth were organisational structure (80%), technical challenges (63%) and lack of time and/or workload (63%). Clinicians considered patients’ barriers to participation might include lack of awareness (76%), lack of knowledge using smartphones (60%) and lack of confidence in telehealth (56%). Conclusion: The ILD clinicians completing this survey who used telehealth to monitor patients (n=81) supported its’ clinical utility. Our findings emphasise the need for robust research in telehealth as a mode for the delivery of cost-effective healthcare services in ILD and highlight the need to assess patients’ perspectives to improve telehealth utility in patients with ILD

Do sound waves transport the AGN energy in the Perseus cluster?

The level of random motions in the intracluster gas lying between 20 and 60 kpc radius in the core of the Perseus cluster has been measured by the Hitomi Soft X-ray Spectrometer (SXS) at 164 ± 10 km s$^{−1}$ . The maximum energy density in turbulent motions on that scale is therefore low. If dissipated as heat, the turbulent energy will be radiated away in less than 80 Myr and cannot spread across the core. A higher velocity is needed to prevent a cooling collapse. Gravity waves are shown to travel too slowly in a radial direction. Here we investigate propagation of energy by sound waves. The energy travels at ~1000 km s$^{−1}$ and can cross the core in a cooling time. We show that the displacement velocity amplitude of the gas required to carry the power is consistent with the Hitomi result and that the inferred density and temperature variations are consistent with $\textit{Chandra}$ observations.ACF, CP, CSR and HRR thank the Hitomi collaboration for the opportunity to participate in the analysis of the SXS data. ACF, CP, HRR and SAW acknowledge support from ERC Advanced Grant FEEDBACK, 340442

Draft genome sequences of two unclassified Chitinophagaceae bacteria, IBVUCB1 and IBVUCB2, isolated from environmental samples

We report here the draft genome sequences of two Chitinophagaceae bacteria, IBVUCB1 and IBVUCB2, assembled from metagenomes of surface samples from freshwater lakes. The genomes are >99% complete and may represent new genera within the Chitinophagaceae family, indicating a larger diversity than currently identified

Lower precision for higher accuracy: precision and resolution exploration for shallow water equations

Accurate forecasts of future climate with numerical models of atmosphere and ocean are of vital importance. However, forecast quality is often limited by the available computational power. This paper investigates the acceleration of a C-grid shallow water model through the use of reduced precision targeting FPGA technology. Using a double-gyre scenario, we show that the mantissa length of variables can be reduced to 14 bits without affecting the accuracy beyond the error inherent in the model. Our reduced precision FPGA implementation runs 5.4 times faster than a double precision FPGA implementation, and 12 times faster than a multi-Threaded CPU implementation. Moreover, our reduced precision FPGA implementation uses 39 times less energy than the CPU implementation and can compute a 100×100 grid for the same energy that the CPU implementation would take for a 29×29 grid