Retinal Biomarker Discovery for Dementia in an Elderly Diabetic Population

Dementia is a devastating disease, and has severe implications on affected individuals, their family and wider society. A growing body of literature is studying the association of retinal microvasculature measurement with dementia. We present a pilot study testing the strength of groups of conventional (semantic) and texture-based (non-semantic) measurements extracted from retinal fundus camera images to classify patients with and without dementia. We performed a 500-trial bootstrap analysis with regularized logistic regression on a cohort of 1,742 elderly diabetic individuals (median age 72.2). Age was the strongest predictor for this elderly cohort. Semantic retinal measurements featured in up to 81% of the bootstrap trials, with arterial caliber and optic disk size chosen most often, suggesting that they do complement age when selected together in a classifier. Textural features were able to train classifiers that match the performance of age, suggesting they are potentially a rich source of information for dementia outcome classification

Study protocol: Cost effectiveness of two strategies to implement the NVOG guidelines on hypertension in pregnancy: An innovative strategy including a computerised decision support system compared to a common strategy of professional audit and feedback, a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Hypertensive disease in pregnancy remains the leading cause of maternal mortality in the Netherlands. Seventeen percent of the clinical pregnancies are complicated by hypertension and 2% by preeclampsia. The Dutch Society of Obstetrics and Gynaecology (NVOG) has developed evidence-based guidelines on the management of hypertension in pregnancy and chronic hypertension. Previous studies showed a low adherence rate to other NVOG guidelines and a large variation in usual care in the different hospitals. An explanation is that the NVOG has no general strategy of practical implementation and evaluation of its guidelines. The development of an effective and cost effective implementation strategy to improve adherence to the guidelines on hypertension in pregnancy is needed.</p> <p>Methods/Design</p> <p>The objective of this study is to assess the cost effectiveness of an innovative implementation strategy of the NVOG guidelines on hypertension including a computerised decision support system (BOS) compared to a common strategy of professional audit and feedback. A cluster randomised controlled trial with an economic evaluation alongside will be performed. Both pregnant women who develop severe hypertension or pre-eclampsia and professionals involved in the care for these women will participate. The main outcome measures are a combined rate of major maternal complications and process indicators extracted from the guidelines. A total of 472 patients will be included in both groups. For analysis, descriptive as well as regression techniques will be used. A cost effectiveness and cost utility analysis will be performed according to the intention-to-treat principle and from a societal perspective. Cost effectiveness ratios will be calculated using bootstrapping techniques.</p

The Questionnaire for Psychotic Experiences: An Examination of the Validity and Reliability

Psychotic experiences are prevalent across a wide variety of psychiatric, neurological, and medical conditions. Yet current assessments are often designed for one disorder, or are limited in their examination of phenomenological features; this has hindered transdiagnostic research. This article describes an examination of the validity and reliability of the English version of a new assessment, the Questionnaire for Psychotic Experiences (QPE). This study aimed to use the QPE to examine hallucinations and delusions across a number of different conditions, and to ensure that the QPE had acceptable psychometric properties. An International Consortium on Hallucination Research working group, along with consumer groups, developed the 50-item QPE to assess the presence, severity, and phenomenology of hallucinations and delusions. Participants in the study who reported psychotic experiences included those with schizophrenia, schizoaffective disorder, bipolar affective disorder, and major depressive disorder, and those without a need for care (ie, nonclinical participants). There were 173 participants in total. Convergent and discriminant validity were assessed. Reliability was examined in terms of stability, equivalence, and internal consistency. The data confirmed that the QPE had good psychometric properties and could be put forward as an accepted measure of the transdiagnostic evaluation of psychotic experiences. Further validation is recommended with neurological and medical populations. Given its validity and reliability, comprehensive evaluation of psychotic phenomena, and relatively quick administration time, we propose that the QPE is a valuable instrument for both clinical and research settings

Identification of DNA markers linked to an induced mutated gene conferring resistance to powdery mildew in pea (Pisum sativum L.)

We have recently induced two powdery mildew (Erysiphe pisi Syd) resistant mutants in Pisum sativum L. via ethylnitrosourea (ENU) mutagenesis. Both mutations (er1mut1 and er1mut2) affected the same locus er1 that determines most of the identified natural sources of powdery mildew resistance (PMR) in this crop. The mutated gene er1mut2 was mapped to a linkage group of 16 DNA markers combining three main strategies: near isogenic lines (NILs) analysis, bulked segregant analysis and genetic mapping of randomly identified polymorphic markers, together with three DNA-markers techniques: ISSR, RAPDs and AFLPs. Markers located closer to the PMR locus, OPO06(1100y) (0.5 cM), OPT06(480) (3.3 cM) and AGG/CAA(125) (5.5 cM), were cloned and converted into SCAR markers. Markers AH1R(850) and AHR(920y) were found to be allelic and converted into the co-dominant marker ScAH1 (16.3 cM). Two previously known DNA markers, ScOPE16(1600) and A5(420y,) were mapped at 9.6 and 23.0 cM from the PMR locus, respectively. The novel markers identified in this study are currently being transferred to a new F2 mapping population derived from a cross between the induced PMR mutant line F(er1mut2) and a more genetically distant susceptible line of Pisum sativum var. arvense