Reliability of Semiautomated Kinetic Perimetry (SKP) and Goldmann Kinetic Perimetry in Children and Adults With Retinal Dystrophies.

PurposeTo investigate the precision of visual fields (VFs) from semiautomated kinetic perimetry (SKP) on Octopus 900 perimeters, for children and adults with inherited retinal degenerations (IRDs). Goldmann manual kinetic perimetry has long been used in the diagnosis and follow-up of these patients, but SKP is becoming increasingly common. Octopus VFs (OVFs) and Goldmann VFs (GVFs) were both mapped on two occasions.MethodsNineteen females and 10 males with IRDs were tested on OVFs and GVFs, with two targets per test (V4e and one smaller target). Tests were performed in the same (randomized) order at two visits about 1 week apart. The VFs were digitized to derive isopter solid angles. Comparisons, within and between visits, were performed with paired t-tests and Bland-Altman plots.ResultsMedian age was 20 years (range, 7-70; 10 participants aged ≤17 years old). There were no significant differences in solid angles between OVFs and GVFs (P ≥ 0.06) or between the two visits' solid angles on either perimeter (P ≥ 0.30). Between-visit test-retest variability for GVFs and OVFs was similar (P ≥ 0.73), with median values of approximately 9% to 13%. Overall variability was lower for children than adults (medians of 7.5% and 12.8%, respectively).ConclusionsOctopus SKP and Goldmann perimetry produced VFs of similar size and variability.Translational relevanceOur study indicates that SKP provides a viable alternative to traditional Goldmann perimetry in clinical trials or care involving both children and adults with IRDs

Evaluating Tisza River Basin Development Plans Using Multiattribute Utility Theory

Selecting a plan to develop the water resources of a region involves the consideration of economic, environmental, social, and technical objectives. Twelve attributes are defined to indicate the degree to which these objectives are achieved in the Tisza River basin of Hungary. A preliminary multiattribute utility function is assessed over these attributes. This is combined with existing information describing the possible consequences of five alternative development plans to yield an overall rating of their desirability. The utility function explicitly indicates the preference tradeoffs among attributes. Discussion indicates further uses of the utility function in the planning and evaluation processes

Inpatient urine cultures are frequently performed without urinalysis or microscopy: Findings from a large academic medical center

OBJECTIVETo describe the frequency of urine cultures performed in inpatients without additional testing for pyuriaDESIGNRetrospective cohort studySETTINGA 1,250-bed academic tertiary referral centerPATIENTSHospitalized adultsMETHODSThis study included urine cultures drawn on 4 medical and 2 surgical wards from 2009 to 2013 and in the medical and surgical intensive care units (ICUs) from 2012 to 2013. Patient and laboratory data were abstracted from the hospital’s medical informatics database. We identified catheter-associated urinary tract infections (CAUTIs) in the ICUs by routine infection prevention surveillance. Cultures without urinalysis or urine microscopy were defined as “isolated.” The primary outcome was the proportion of isolated urine cultures obtained. We used multivariable logistic regression to assess predictors of isolated cultures.RESULTSDuring the study period, 14,743 urine cultures were obtained (63.5 cultures per 1,000 patient days) during 11,820 patient admissions. Of these, 2,973 cultures (20.2%) were isolated cultures. Of the 61 CAUTIs identified, 31 (50.8%) were identified by an isolated culture. Predictors for having an isolated culture included male gender (adjusted odds ratio [aOR], 1.22; 95%; confidence interval [CI], 1.11–1.35], urinary catheterization (aOR, 2.15; 95% CI, 1.89–2.46), ICU admission (medical ICU aOR, 1.72; 95% CI, 1.47–2.00; surgical ICU aOR, 1.82; 95% CI, 1.51–2.19), and obtaining the urine culture ≥1 calendar day after admission (1–7 days aOR, 1.91; 95% CI. 1.71–2.12; &gt;7 days after admission aOR, 2.81; 95% CI, 2.37–3.34).CONCLUSIONSIsolated urine cultures are common in hospitalized patients, particularly in patients with urinary catheters and those in ICUs. Interventions targeting inpatient culturing practices may improve the diagnosis of urinary tract infections.Infect Control Hosp Epidemiol2017;38:455–460</jats:sec

Results from a set of three-dimensional numerical experiments of a hot Jupiter atmosphere

We present highlights from a large set of simulations of a hot Jupiter atmosphere, nominally based on HD 209458b, aimed at exploring both the evolution of the deep atmosphere, and the acceleration of the zonal flow or jet. We find the occurrence of a super-rotating equatorial jet is robust to changes in various parameters, and over long timescales, even in the absence of strong inner or bottom boundary drag. This jet is diminished in one simulation only, where we strongly force the deep atmosphere equator-to-pole temperature gradient over long timescales. Finally, although the eddy momentum fluxes in our atmosphere show similarities with the proposed mechanism for accelerating jets on tidally-locked planets, the picture appears more complex. We present tentative evidence for a jet driven by a combination of eddy momentum transport and mean flow.Comment: 26 pages, 22 Figures. Accepted for publication in Astronomy and Astrophysic

Cultural Considerations: Pharmacological and Nonpharmacological Means for Improving Blood Pressure Control among Hispanic Patients

Cardiovascular disease is a leading cause of morbidity and mortality in the United States, and its prevention and treatment remain a priority for the medical community. Ethnic variations account for some differences in the prevalence of hypertension and blood pressure (BP) control rates among Hispanics, indicating the need for culturally appropriate management models. Aggressive treatment strategies are key to achieving optimal BP control in high-risk Hispanic patients. Hypertension in this ethnic group continues to be a major health concern. Of note, when provided access to comprehensive care, Hispanics demonstrate similar response rates to treatment as the majority of non-Hispanic whites. This highlights the importance of effective, culturally responsive hypertension management among high-risk Hispanic patients for achieving observable, positive health outcomes

Description of the cloud layer experiment (CLEX), field phase, surface data archive

December 1996.Includes bibliographical references.Sponsored by the DOD Center for Geosciences, Phase II grant DAAHO4-94-G-0420

CometChip: A High-throughput 96-Well Platform for Measuring DNA Damage in Microarrayed Human Cells

DNA damaging agents can promote aging, disease and cancer and they are ubiquitous in the environment and produced within human cells as normal cellular metabolites. Ironically, at high doses DNA damaging agents are also used to treat cancer. The ability to quantify DNA damage responses is thus critical in the public health, pharmaceutical and clinical domains. Here, we describe a novel platform that exploits microfabrication techniques to pattern cells in a fixed microarray The ‘CometChip’ is based upon the well-established single cell gel electrophoresis assay (a.k.a. the comet assay), which estimates the level of DNA damage by evaluating the extent of DNA migration through a matrix in an electrical field. The type of damage measured by this assay includes abasic sites, crosslinks, and strand breaks. Instead of being randomly dispersed in agarose in the traditional assay, cells are captured into an agarose microwell array by gravity. The platform also expands from the size of a standard microscope slide to a 96-well format, enabling parallel processing. Here we describe the protocols of using the chip to evaluate DNA damage caused by known genotoxic agents and the cellular repair response followed after exposure. Through the integration of biological and engineering principles, this method potentiates robust and sensitive measurements of DNA damage in human cells and provides the necessary throughput for genotoxicity testing, drug development, epidemiological studies and clinical assays.National Institute of Environmental Health Sciences (Training Grant in Environmental Toxicology T32-ES007020)Massachusetts Institute of Technology. Center for Environmental Health Sciences (P30-ES002109)National Institute of Environmental Health Sciences (5-UO1-ES016045)National Institute of Environmental Health Sciences (1-R21-ES019498)National Institute of Environmental Health Sciences (R44-ES021116

Improving the LSST dithering pattern and cadence for dark energy studies

The Large Synoptic Survey Telescope (LSST) will explore the entire southern sky over 10 years starting in 2022 with unprecedented depth and time sampling in six filters, $ugrizy$. Artificial power on the scale of the 3.5 deg LSST field-of-view will contaminate measurements of baryonic acoustic oscillations (BAO), which fall at the same angular scale at redshift $z \sim 1$. Using the HEALPix framework, we demonstrate the impact of an "un-dithered" survey, in which $17\%$ of each LSST field-of-view is overlapped by neighboring observations, generating a honeycomb pattern of strongly varying survey depth and significant artificial power on BAO angular scales. We find that adopting large dithers (i.e., telescope pointing offsets) of amplitude close to the LSST field-of-view radius reduces artificial structure in the galaxy distribution by a factor of $\sim$10. We propose an observing strategy utilizing large dithers within the main survey and minimal dithers for the LSST Deep Drilling Fields. We show that applying various magnitude cutoffs can further increase survey uniformity. We find that a magnitude cut of $r < 27.3$ removes significant spurious power from the angular power spectrum with a minimal reduction in the total number of observed galaxies over the ten-year LSST run. We also determine the effectiveness of the observing strategy for Type Ia SNe and predict that the main survey will contribute $\sim$100,000 Type Ia SNe. We propose a concentrated survey where LSST observes one-third of its main survey area each year, increasing the number of main survey Type Ia SNe by a factor of $\sim$1.5, while still enabling the successful pursuit of other science drivers.Comment: 9 pages, 6 figures, published in SPIE proceedings; corrected typo in equation

Open surgical partial nephrectomy for upper tract urothelial carcinoma

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106973/1/iju12301.pd