Expansion of patient eligibility for virtual glaucoma clinics: a long-term strategy to increase the capacity of high-quality glaucoma care

AIMS: The virtual glaucoma clinic (VGC) is a well-established diagnostic pathway for delivery of glaucoma care. Current UK national guidance recommends VGCs for patients with ocular hypertension, glaucoma suspects or early glaucoma. This study evaluates whether expanded eligibility criteria, including other glaucoma phenotypes and disease stages, can deliver safe and effective care with a positive patient experience. METHODS: Records of over 8000 patients were reviewed in order to determine suitability for VGC attendance using expanded eligibility criteria. Patients with three prior consecutive visits within the glaucoma service were included. Follow-up interval, clinic type, visual acuity (VA), intraocular pressure (IOP) and visual field performance were recorded. Patient satisfaction was recorded for a sample of 118 patients. RESULTS: 2017 patients over 31 months were included. Two-thirds of eyes had ocular comorbidities, a fifth of eyes had undergone prior cataract surgery and 10% of eyes had undergone a prior laser treatment for glaucoma. After three visits, 32% of patients remained in the VGC, 42% were seen in face-to-face clinics and 25% were discharged. There were no clinically significant changes in VA, IOP and visual field performance during follow-up. 72% of patients expressed a preference to continue their care within VGCs. CONCLUSIONS: This study demonstrates that VGCs with expanded patient eligibility criteria can deliver high-quality glaucoma care that is safe, effective and with high levels of patient satisfaction. This approach provides a long-term solution to adapt delivery of glaucoma care to our expanding and ageing population

Fractionation effects in phase equilibria of polydisperse hard sphere colloids

The equilibrium phase behaviour of hard spheres with size polydispersity is studied theoretically. We solve numerically the exact phase equilibrium equations that result from accurate free energy expressions for the fluid and solid phases, while accounting fully for size fractionation between coexisting phases. Fluids up to the largest polydispersities that we can study (around 14%) can phase separate by splitting off a solid with a much narrower size distribution. This shows that experimentally observed terminal polydispersities above which phase separation no longer occurs must be due to non-equilibrium effects. We find no evidence of re-entrant melting; instead, sufficiently compressed solids phase separate into two or more solid phases. Under appropriate conditions, coexistence of multiple solids with a fluid phase is also predicted. The solids have smaller polydispersities than the parent phase as expected, while the reverse is true for the fluid phase, which contains predominantly smaller particles but also residual amounts of the larger ones. The properties of the coexisting phases are studied in detail; mean diameter, polydispersity and volume fraction of the phases all reveal marked fractionation. We also propose a method for constructing quantities that optimally distinguish between the coexisting phases, using Principal Component Analysis in the space of density distributions. We conclude by comparing our predictions to perturbative theories for near-monodisperse systems and to Monte Carlo simulations at imposed chemical potential distribution, and find excellent agreement.Comment: 21 pages, 23 figures, 2 table

Josephson Traveling Wave Parametric Amplifiers as non-classical light source for Microwave Quantum Illumination

Detection of low-reflectivity objects can be enriched via the so-called quantum illumination procedure. In order that this quantum procedure outperforms classical detection protocols, entangled states of microwave radiation are initially required. In this paper, we discuss the role of Josephson Traveling Wave Parametric Amplifiers (JTWPAs), based on circuit-QED components, as suitable sources of a two-mode squeezed vacuum state, a special signal-idler entangled state. The obtained wide bandwidth makes the JTWPA an ideal candidate for generating quantum radiation in quantum metrology and information processing applications

HPV genotypes detected in the oropharyngeal mucosa of HIV-infected men who have sex with men in Northern Italy

The aim of this study was to investigate the epidemiological profile of HPV oropharyngeal infections in HIV-infected men who have sex with men. A total of 135 subjects were enrolled at the L. Sacco University Hospital (Milan, Italy) to evaluate their HPV oropharyngeal infection status at baseline and at a follow-up visit at least 12 months later. HPV DNA was detected from oropharyngeal swabs using an in-house nested PCR that amplifies a segment of the L1 gene. The PCR products were then sequenced and genotyped. A greater percentage of high-risk genotypes was identified compared to low-risk genotypes (13\ub77% vs. 6\ub79%, P < 0\ub705), and two uncommon alpha-HPV genotypes were detected, i.e. HPV-102 and HPV-114. HPV infection prevalence was 24\ub74% and the cumulative incidence was 24\ub71%. During the follow-up period, one case of HPV infection (HPV-33) persisted, while the overall rate of infection clearance was 58\ub73%. HPV oropharyngeal infection was widespread in the cohort examined, and most of the infections were transient and cleared within 12 months. These results may help to clarify the role of HPV in the oropharynx and may also improve our understanding of the need to implement preventive strategies in at-risk populations

Performances of 4H-SiC Schottky diodes as neutron detectors

Abstract Large area 4H-SiC Schottky diodes equipped with a 6LiF converter were tested as neutron detectors in the epithermal column realized for Boron Neutron Capture Therapy (BNCT) applications at the fast reactor TAPIRO (ENEA Casaccia Roma). The neutron spectra were assessed using the Monte Carlo code MCNP-4C. The performances of SiC detectors were evaluated with neutron fluences in the range of 109–1013 cm−2 which is typical for BNCT. Spectra of alpha and tritium particles generated by 6Li(n,α)3H reaction were collected at various neutron fluences and spectra obtained by interposing polyethylene moderators of different thickness. Only weak damaging effects primarily due to the alpha particles were observed; at neutron fluence of 1013 cm−2 the count rate decreased b

Equilibrium phase behavior of polydisperse hard spheres

We calculate the phase behavior of hard spheres with size polydispersity, using accurate free energy expressions for the fluid and solid phases. Cloud and shadow curves, which determine the onset of phase coexistence, are found exactly by the moment free energy method, but we also compute the complete phase diagram, taking full account of fractionation effects. In contrast to earlier, simplified treatments we find no point of equal concentration between fluid and solid or re-entrant melting at higher densities. Rather, the fluid cloud curve continues to the largest polydispersity that we study (14%); from the equilibrium phase behavior a terminal polydispersity can thus only be defined for the solid, where we find it to be around 7%. At sufficiently large polydispersity, fractionation into several solid phases can occur, consistent with previous approximate calculations; we find in addition that coexistence of several solids with a fluid phase is also possible

Quiescent neuronal progenitors are activated in the juvenile guinea pig lateral striatum and give rise to transient neurons

In the adult brain, active stem cells are a subset of astrocytes residing in the subventricular zone (SVZ) and the dentate gyrus (DG) of the hippocampus. Whether quiescent neuronal progenitors occur in other brain regions is unclear. Here, we describe a novel neurogenic system in the external capsule and lateral striatum (EC-LS) of the juvenile guinea pig that is quiescent at birth but becomes active around weaning. Activation of neurogenesis in this region was accompanied by the emergence of a neurogenic-like niche in the ventral EC characterized by chains of neuroblasts, intermediate-like progenitors and glial cells expressing markers of immature astrocytes. Like neurogenic astrocytes of the SVZ and DG, these latter cells showed a slow rate of proliferation and retained BrdU labeling for up to 65 days, suggesting that they are the primary progenitors of the EC-LS neurogenic system. Injections of GFPtagged lentiviral vectors into the SVZ and the EC-LS of newborn animals confirmed that new LS neuroblasts originate from the activation of local progenitors and further supported their astroglial nature. Newborn EC-LS neurons existed transiently and did not contribute to neuronal addition or replacement. Nevertheless, they expressed Sp8 and showed strong tropism for white matter tracts, wherein they acquired complex morphologies. For these reasons, we propose that EC-LS neuroblasts represent a novel striatal cell type, possibly related to those populations of transient interneurons that regulate the development of fiber tracts during embryonic life

Levantamento semidetalhado de solos para atualização de legenda na reserva florestal Embrapa/Epagri de Caçador-SC.

Resumo

An objective based classification of aggregation techniques for wireless sensor networks

Wireless Sensor Networks have gained immense popularity in recent years due to their ever increasing capabilities and wide range of critical applications. A huge body of research efforts has been dedicated to find ways to utilize limited resources of these sensor nodes in an efficient manner. One of the common ways to minimize energy consumption has been aggregation of input data. We note that every aggregation technique has an improvement objective to achieve with respect to the output it produces. Each technique is designed to achieve some target e.g. reduce data size, minimize transmission energy, enhance accuracy etc. This paper presents a comprehensive survey of aggregation techniques that can be used in distributed manner to improve lifetime and energy conservation of wireless sensor networks. Main contribution of this work is proposal of a novel classification of such techniques based on the type of improvement they offer when applied to WSNs. Due to the existence of a myriad of definitions of aggregation, we first review the meaning of term aggregation that can be applied to WSN. The concept is then associated with the proposed classes. Each class of techniques is divided into a number of subclasses and a brief literature review of related work in WSN for each of these is also presented