Management of endophthalmitis while preserving the uninvolved crystalline lens

The purpose of this work is to report on the management of endophthalmitis in phakic eyes in which the crystalline lens was preserved. The current study is a noncomparative consecutive case series of patients who developed culture-proven endophthalmitis and were treated between January 1995 and June 2009. The study included only phakic patients whose infection was managed without removal of the crystalline lens. Using a computerized search of Microbiology Department records, patients were identified with phakic lens status and clinically diagnosed endophthalmitis. A total of 12 phakic eyes from 11 patients met the study criteria. The etiology of infection was endogenous (n = 6), postoperative (n = 5), and post-traumatic (n = 1). Pars plana vitrectomy and injection of intravitreal antimicrobials was performed in seven eyes (58%), and vitreous tap and injection of antimicrobials was performed in five eyes (42%). All eyes showed progression of lens opacification after treatment. Overall, nine (75%) achieved visual acuity outcomes ≥20/80, including five of seven (71%) eyes treated with vitrectomy and four of five eyes (80%) treated with injection of antibiotics alone. One of seven eyes (14%) treated with vitrectomy had a poor visual outcome (defined as <20/400) compared with one of five (20%) eyes treated with intravitreal antimicrobials alone. During follow-up, all 12 eyes had progression of lens opacification and five of 12 (42%) eyes underwent cataract surgery with posterior chamber intraocular lens placement. In phakic patients, successful treatment of endophthalmitis can be achieved while preserving the uninvolved crystalline lens. Future cataract surgery with posterior chamber intraocular lens placement can be accomplished in many of these patients

Alumni Voices: Celebrating Global Engagement

This session brought together UD alumni who had a wide array of global experiences while here on campus as students; they spoke on how those experiences impacted their lives and careers.https://ecommons.udayton.edu/global_voices_2/1006/thumbnail.jp

Zhx2 (Zinc Fingers and Homeoboxes 2) Regulates Major Urinary Protein Gene Expression in the Mouse Liver

The mouse major urinary proteins (Mups) are encoded by a large family of highly related genes clustered on chromosome 4. Mups, synthesized primarily and abundantly in the liver and secreted through the kidneys, exhibit male-biased expression. Mups bind a variety of volatile ligands; these ligands, and Mup proteins themselves, influence numerous behavioral traits. Although urinary Mup protein levels vary between inbred mouse strains, this difference is most pronounced in BALB/cJ mice, which have dramatically low urinary Mup levels; this BALB/cJ trait had been mapped to a locus on chromosome 15. We previously identified Zhx2 (zinc fingers and homeoboxes 2) as a regulator of numerous liver-enriched genes. Zhx2 is located on chromosome 15, and a natural hypomorphic mutation in the BALB/cJ Zhx2 allele dramatically reduces Zhx2 expression. Based on these data, we hypothesized that reduced Zhx2 levels are responsible for lower Mup expression in BALB/cJ mice. Using both transgenic and knock-out mice along with in vitro assays, our data show that Zhx2 binds Mup promoters and is required for high levels of Mup expression in the adult liver. In contrast to previously identified Zhx2 targets that appear to be repressed by Zhx2, Mup genes are positively regulated by Zhx2. These data identify Zhx2 as a novel regulator of Mup expression and indicate that Zhx2 activates as well as represses expression of target genes

The first cosmic ray albedo proton map of the Moon

[1] Neutrons emitted from the Moon are produced by the impact of galactic cosmic rays (GCRs) within the regolith. GCRs are high-energy particles capable of smashing atomic nuclei in the lunar regolith and producing a shower of energetic protons, neutrons and other subatomic particles. Secondary particles that are ejected out of the regolith become “albedo” particles. The neutron albedo has been used to study the hydrogen content of the lunar regolith, which motivates our study of albedo protons. In principle, the albedo protons should vary as a function of the input GCR source and possibly as a result of surface composition and properties. During the LRO mission, the total detection rate of albedo protons between 60 MeV and 150 MeV has been declining since 2009 in parallel with the decline in the galactic cosmic ray flux, which validates the concept of an albedo proton source. On the other hand, the average yield of albedo protons has been increasing as the galactic cosmic ray spectrum has been hardening, consistent with a disproportionately stronger modulation of lower energy GCRs as solar activity increases. We construct the first map of the normalized albedo proton emission rate from the lunar surface to look for any albedo variation that correlates with surface features. The map is consistent with a spatially uniform albedo proton yield to within statistical uncertainties

Radiation modeling in the Earth and Mars atmospheres using LRO/CRaTER with the EMMREM Module

Abstract We expand upon the efforts of Joyce et al. (2013), who computed the modulation potential at the Moon using measurements from the Cosmic Ray Telescope for the Effects of Radiation (CRaTER) instrument on the Lunar Reconnaissance Orbiter (LRO) spacecraft along with data products from the Earth-Moon-Mars Radiation Environment Module (EMMREM). Using the computed modulation potential, we calculate galactic cosmic ray (GCR) dose and dose equivalent rates in the Earth and Mars atmospheres for various altitudes over the course of the LRO mission. While we cannot validate these predictions by directly comparable measurement, we find that our results conform to expectations and are in good agreement with the nearest available measurements and therefore may be used as reasonable estimates for use in efforts in risk assessment in the planning of future space missions as well as in the study of GCRs. PREDICCS (Predictions of radiation from REleASE, EMMREM, and Data Incorporating the CRaTER, COSTEP, and other solar energetic particles measurements) is an online system designed to provide the scientific community with a comprehensive resource on the radiation environments of the inner heliosphere. The data products shown here will be incorporated into PREDICCS in order to further this effort and daily updates will be made available on the PREDICCS website (http://prediccs.sr.unh.edu). Key Points We model GCR dose and dose equivalent rates in Earth and Mars atmospheres Dose rates are in reasonable agreement with nearby measurements Data products will soon be made available on PREDICCS website

Inequities in the physical activity of disabled young people in Aotearoa New Zealand: A stakeholder SWOT analysis of the physical activity sector

Aims: Disabled people, particularly children and adolescents, tend to participate in less physical activity than their non-disabled peers on average. However, disabled children and youth (i.e., young people [YP]) are typically underrepresented in physical activity (PA) research, with little data available in Aotearoa New Zealand to guide policy makers to alter societal factors that contribute to disability inequities. The purpose of this study was to conduct a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of the PA sector in Aotearoa New Zealand with respect to PA participation and promotion among disabled YP. Methods: Focus group discussions, underpinned by the SWOT framework, were facilitated with stakeholders (n=11) engaged in the Aotearoa New Zealand PA sector. Data were transcribed and analysed using content analysis. Desirable and accessible opportunities were essential enablers of PA in disabled YP. Results: Communication, transport, equipment costs, awareness of activities, and social support were identified as factors that influence PA participation. Schools also have a considerable influence on PA participation among disabled YP, while greater funding for and cohesion/collaboration among PA providers is key to continued growth in PA participation. Conclusions: Communication, accessibility, funding, and collaborative/coordinated multi-level efforts were identified as areas in need of strengthening to provide equitable opportunities for disabled YP in Aotearoa New Zealand to participate in PA

Heterotrophy mitigates the response of the temperate coral

Anthropogenic increases in atmospheric carbon dioxide concentration have caused global average sea surface temperature (SST) to increase by approximately 0.11°C per decade between 1971 and 2010 - a trend that is projected to continue through the 21st century. A multitude of research studies have demonstrated that increased SSTs compromise the coral holobiont (cnidarian host and its symbiotic algae) by reducing both host calcification and symbiont density, among other variables. However, we still do not fully understand the role of heterotrophy in the response of the coral holobiont to elevated temperature, particularly for temperate corals. Here, we conducted a pair of independent experiments to investigate the influence of heterotrophy on the response of the temperate scleractinian coral Oculina arbuscula to thermal stress. Colonies of O. arbuscula from Radio Island, North Carolina, were exposed to four feeding treatments (zero, low, moderate, and high concentrations of newly hatched Artemia sp. nauplii) across two independent temperature experiments (average annual SST (20°C) and average summer temperature (28°C) for the interval 2005-2012) to quantify the effects of heterotrophy on coral skeletal growth and symbiont density. Results suggest that heterotrophy mitigated both reduced skeletal growth and decreased symbiont density observed for unfed corals reared at 28°C. This study highlights the importance of heterotrophy in maintaining coral holobiont fitness under thermal stress and has important implications for the interpretation of coral response to climate change

Radiation environment at the Moon: Comparisons of transport code modeling and measurements from the CRaTER instrument

The Cosmic Ray Telescope for the Effects of Radiation (CRaTER), an instrument carried on the Lunar Reconnaissance Orbiter spacecraft, directly measures the energy depositions by solar and galactic cosmic radiations in its silicon wafer detectors. These energy depositions are converted to linear energy transfer (LET) spectra. High LET particles, which are mainly high‐energy heavy ions found in the incident cosmic ray spectrum, or target fragments and recoils produced by protons and heavier ions, are of particular importance because of their potential to cause significant damage to human tissue and electronic components. Aside from providing LET data useful for space radiation risk analyses for lunar missions, the observed LET spectra can also be used to help validate space radiation transport codes, used for shielding design and risk assessment applications, which is a major thrust of this work. In this work the Monte Carlo transport code HETC‐HEDS (High‐Energy Transport Code‐Human Exploration and Development in Space) is used to estimate LET contributions from the incident primary ions and their charged secondaries produced by nuclear collisions as they pass through the three pairs of silicon detectors. Also in this work, the contributions to the LET of the primary ions and their charged secondaries are analyzed and compared with estimates obtained using the deterministic space radiation code HZETRN 2010, developed at NASA Langley Research Center. LET estimates obtained from the two transport codes are compared with measurements of LET from the CRaTER instrument during the mission. Overall, a comparison of the LET predictions of the HETC‐HEDS code to the predictions of the HZETRN code displays good agreement. The code predictions are also in good agreement with the CRaTER LET measurements above 15 keV/µm but differ from the measurements for smaller values of LET. A possible reason for this disagreement between measured and calculated spectra below 15 keV/µm is an inadequate representation of the light ion spectra in HETC‐HEDS and HZETRN code calculations. It is also clear from the results of this work that Vavilov distributions need to be incorporated into the HETC‐HJEDS code before it will be able to recreate the observed LET spectra measured by the CRaTER instrument. Key Points Vavilov corrections should be incorporated into simulated results The predictions of the transport codes reasonably agree with the CRaTER LET The observed LET can be used to help validate space radiation transport codesPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108081/1/swe20145.pd

Does the worsening galactic cosmic radiation environment observed by CRaTER preclude future manned deep space exploration?

Abstract The Sun and its solar wind are currently exhibiting extremely low densities and magnetic field strengths, representing states that have never been observed during the space age. The highly abnormal solar activity between cycles 23 and 24 has caused the longest solar minimum in over 80 years and continues into the unusually small solar maximum of cycle 24. As a result of the remarkably weak solar activity, we have also observed the highest fluxes of galactic cosmic rays in the space age and relatively small solar energetic particle events. We use observations from the Cosmic Ray Telescope for the Effects of Radiation (CRaTER) on the Lunar Reconnaissance Orbiter to examine the implications of these highly unusual solar conditions for human space exploration. We show that while these conditions are not a show stopper for long-duration missions (e.g., to the Moon, an asteroid, or Mars), galactic cosmic ray radiation remains a significant and worsening factor that limits mission durations. While solar energetic particle events in cycle 24 present some hazard, the accumulated doses for astronauts behind 10 g/cm2 shielding are well below current dose limits. Galactic cosmic radiation presents a more significant challenge: the time to 3% risk of exposure-induced death (REID) in interplanetary space was less than 400 days for a 30 year old male and less than 300 days for a 30 year old female in the last cycle 23–24 minimum. The time to 3% REID is estimated to be ∼20% lower in the coming cycle 24–25 minimum. If the heliospheric magnetic field continues to weaken over time, as is likely, then allowable mission durations will decrease correspondingly. Thus, we estimate exposures in extreme solar minimum conditions and the corresponding effects on allowable durations

Larger Perioperative Opioid Prescriptions Lead to Prolonged Opioid Use After Hand and Upper Extremity Surgery: A Multicenter Analysis

Introduction: The opioid epidemic remains an ongoing public health crisis. The purpose of this study was to investigate whether surgeons\u27 prescribing patterns of the initial postoperative opioid prescription predispose patients to prolonged opioid use after upper extremity surgery. Methods: This multicenter retrospective study was done at three academic institutions. Patients who underwent carpal tunnel release, basal joint arthroplasty, and distal radius fracture open reduction and internal fixation over a 1.5-year period were included. Opioid prescription data were obtained from the Pennsylvania Prescription Drug Monitoring Program website. Results: Postoperatively, 30.1% of the patients (191/634) filled ≥1 additional opioid prescription, and 14.0% (89/634) experienced prolonged opioid use 3 to 6 months postoperatively. Patients who filled an additional prescription postoperatively were initially prescribed significantly more pills (P = 0.001), a significantly longer duration prescription (P = 0.009), and a significantly larger prescription in total milligram morphine equivalents (P = 0.002) than patients who did not fill additional prescriptions. Patients who had prolonged opioid use were prescribed a significantly longer duration prescription (P = 0.026) than those without prolonged use. Conclusion: Larger and longer duration of initial opioid prescriptions predisposed patients to continued postoperative opioid use. These findings emphasize the importance of safe and evidence-based prescribing practices to prevent the detrimental effects of opioid use after orthopaedic surgery