The normal optic nerve variations in an optometric population:Possible ocular and systemic influences

Early detection of glaucoma relies on a detailed knowledge of how the normal optic nerve (ONH) varies within the population. The purpose of this study focused on two main areas; 1. To explore the optic nerve head appearance in the normal optometric population and compare the south Asian (principally Pakistani) with the European white population, correcting for possible ocular and non-ocular influences in a multiple regression model. The main findings were: • The optic discs of the South Asian (SA) and White European (WE) populations were not statistically different in size. The SA group possessed discs with increased cupping and thinner neuro-retinal rims (NRR) compared with the WE group. The SA group also demonstrated a more vertically oval shape than the WE population. These differences were significant at the p superior> nasal> temporal NRR thickness in the optometric population. The main findings were: • As disc size increased the disc become rounder and less vertically oval in shape. Vertically oval discs had thicker superior and inferior NRRs and thinner nasal and temporal NRRs compared with rounder disc shapes due to cup shape being independent of disc shape. Vertically oval discs were therefore more likely to obey the ISNT rule than larger rounder discs. • The ISNT rule has a low adherence in our sample of normal eyes (5.7%). However, by removing the nasal sector to become the IST rule, 74.5% of normal eyes obeyed. SA eyes and female gender were more likely to obey the ISNT rule due to increased disc ovality. The IST rule is independent of disc shape and therefore more suitable for assessing discs from both ethnic backgrounds. Obeying the ISNT rule or IST rule was not related to disc or cup size

The normal optic nerve variations in an optometric population: Possible ocular and systemic influences

Early detection of glaucoma relies on a detailed knowledge of how the normal optic nerve (ONH) varies within the population. The purpose of this study focused on two main areas; 1. To explore the optic nerve head appearance in the normal optometric population and compare the south Asian (principally Pakistani) with the European white population, correcting for possible ocular and non-ocular influences in a multiple regression model. The main findings were: • The optic discs of the South Asian (SA) and White European (WE) populations were not statistically different in size. The SA group possessed discs with increased cupping and thinner neuro-retinal rims (NRR) compared with the WE group. The SA group also demonstrated a more vertically oval shape than the WE population. These differences were significant at the p<0.01 level. • The upper limits of inter-eye asymmetry were: ≤0.2 for cup to disc area ratio, and 3mmHg for intra-ocular pressure (IOP) for both ethnic groups and this did not increase with age. IOP asymmetry did not vary with gender, ethnicity or a family history of glaucoma and was independent of ONH asymmetry. ONH and IOP asymmetry are therefore independent risk factors when screening for glaucoma for both ethnic groups. 2. To investigate the validity of the ISNT rule: inferior> superior> nasal> temporal NRR thickness in the optometric population. The main findings were: • As disc size increased the disc become rounder and less vertically oval in shape. Vertically oval discs had thicker superior and inferior NRRs and thinner nasal and temporal NRRs compared with rounder disc shapes due to cup shape being independent of disc shape. Vertically oval discs were therefore more likely to obey the ISNT rule than larger rounder discs. • The ISNT rule has a low adherence in our sample of normal eyes (5.7%). However, by removing the nasal sector to become the IST rule, 74.5% of normal eyes obeyed. SA eyes and female gender were more likely to obey the ISNT rule due to increased disc ovality. The IST rule is independent of disc shape and therefore more suitable for assessing discs from both ethnic backgrounds. Obeying the ISNT rule or IST rule was not related to disc or cup siz

Instilling reflective practice – The use of an online portfolio in innovative optometric education Accepted as: e‐poster Paper no. 098

At UCLAN we are breaking the mould and have developed a blended learning MSci optometry programme which is the first blended learning course in optometric education in the UK and the first to use a practice-based online portfolio. Optometry has traditionally been taught as a 3‐year undergraduate programme. Upon successful graduation, students are required to complete a year in practice and meet the General Optical Council's (GOC) “ability to” core competencies. However, a recent study by the GOC found that 76% of students felt unprepared for professional practice with insufficient clinical experience and in response, the GOC is currently undertaking an educational strategic review. To ensure the students receive high-quality clinical experience in the workplace, we have developed an online logbook and portfolio. Students log their experiences, learning points and reflections. The portfolio is closely monitored both by the student's mentor in practice and by academic staff. The content and reflections logged by the students then helps to drive the face to face teaching, small group discussions and clinical experiences provided by the university

Transparency of machine-learning in healthcare: the GDPR and European health law

Machine-learning (‘ML’) models are powerful tools which can support personalised clinical judgments, as well as patients’ choices about their healthcare. Concern has been raised, however, as to their ‘black box’ nature, in which calculations are so complex they are difficult to understand and independently verify. In considering the use of ML in healthcare, we divide the question of transparency into three different scenarios: 1) Solely automated decisions. We suggest these will be unusual in healthcare, as Article 22(4) of the General Data Protection Regulation presents a high bar. However, if solely automatic decisions are made (e.g. for inpatient triage), data subjects will have a right to ‘meaningful information’ about the logic involved. 2) Clinical decisions. These are decisions made ultimately by clinicians—such as diagnosis—and the standard of transparency under the GDPR is lower due to this human mediation. 3) Patient decisions. Decisions about treatment are ultimately taken by the patient or their representative, albeit in dialogue with clinicians. Here, the patient will require a personalised level of medical information, depending on the severity of the risk, and how much they wish to know. In the final category of decisions made by patients, we suggest European healthcare law sets a more personalised standard of information requirement than the GDPR. Clinical information must be tailored to the individual patient according to their needs and priorities; there is no monolithic ‘explanation’ of risk under healthcare law. When giving advice based (even partly) on a ML model, clinicians must have a sufficient grasp of the medically-relevant factors involved in the model output to offer patients this personalised level of medical information. We use the UK, Ireland, Denmark, Norway and Sweden as examples of European health law jurisdictions which require this personalised transparency to support patients’ rights to make informed choices. This adds to the argument for post-hoc, rationale explanations of ML to support healthcare decisions in all three scenarios

Présentation du numéro

À la suite de la disparition de Claude Vandeloise en août 2007, la revue CORELA a décidé de rendre hommage à celui qui fut, outre un linguiste qui a apporté une vision originale et passionnante à l’étude des prépositions du français, un des premiers collègues à faire confiance à la toute jeune revue CORELA. Dès le premier numéro de CORELA en 2003, Claude Vandeloise a effectivement été un des premiers relecteurs d’articles, que ces derniers traitent de prépositions ou d’autres domaines de sci..

An Extended TOE Framework for Cybersecurity-adoption Decisions

High-profile cybersecurity incidents, such as the 2019 Capital One data breach and the 2017 Equifax breach, have engendered doubts about firms’ trustworthiness and resulted cybersecurity becoming a critical risk factor firms must address. Breaches can precipitate extreme consequences for affected firms’ managers, shareholders, and customers. Unsurprisingly, data breaches represent IT leaders’ biggest concern. In this paper, we report on a qualitative field study in which we interviewed C-level executives and IT consultants to investigate cybersecurity concerns and factors that influence adoption decisions for cybersecurity. We found that the traditional technology-organization-environment (TOE) framework does not fully capture the range of issues in the cybersecurity context. Thus, we propose a new extended TOE framework that pertains specifically to cybersecurity-adoption decisions. This extended framework includes new dimensions, cyber catalysts, practice standards, and new factors under the traditional technology, organization, and environment dimensions

Enhanced susceptibility of T lymphocytes to oxidative stress in the absence of the cellular prion protein.: PrPC and oxidative stress in T lymphocytes

International audienceThe cellular prion glycoprotein (PrP(C)) is ubiquitously expressed but its physiologic functions remain enigmatic, particularly in the immune system. Here, we demonstrate in vitro and in vivo that PrP(C) is involved in T lymphocytes response to oxidative stress. By monitoring the intracellular level of reduced glutathione, we show that PrP(-/-) thymocytes display a higher susceptibility to H(2)O(2) exposure than PrP(+/+) cells. Furthermore, we find that in mice fed with a restricted diet, a regimen known to increase the intracellular level of ROS, PrP(-/-) thymocytes are more sensitive to oxidative stress. PrP(C) function appears to be specific for oxidative stress, since no significant differences are observed between PrP(-/-) and PrP(+/+) mice exposed to other kinds of stress. We also show a marked evolution of the redox status of T cells throughout differentiation in the thymus. Taken together, our results clearly ascribe to PrP(C) a protective function in thymocytes against oxidative stress