Computerised stereoscopic measurement of the human retina

The research described herein is an investigation into the problems of obtaining useful clinical measurements from stereo photographs of the human retina through automation of the stereometric procedure by digital stereo matching and image analysis techniques. Clinical research has indicated a correlation between physical changes to the optic disc topography (the region on the retina where the optic nerve enters the eye) and the advance of eye disease such as hypertension and glaucoma. Stereoscopic photography of the human retina (or fundus, as it is called) and the subsequent measurement of the topography of the optic disc is of great potential clinical value as an aid in observing the pathogenesis of such disease, and to this end, accurate measurements of the various parameters that characterise the changing shape of the optic disc topography must be provided. Following a survey of current clinical methods for stereoscopic measurement of the optic disc, fundus image data acquisition, stereo geometry, limitations of resolution and accuracy, and other relevant physical constraints related to fundus imaging are investigated. A survey of digital stereo matching algorithms is presented and their strengths and weaknesses are explored, specifically as they relate to the suitability of the algorithm for the fundus image data. The selection of an appropriate stereo matching algorithm is discussed, and its application to four test data sets is presented in detail. A mathematical model of two-dimensional image formation is developed together with its corresponding auto-correlation function. In the presense of additive noise, the model is used as a tool for exploring key problems with respect to the stereo matching of fundus images. Specifically, measures for predicting correlation matching error are developed and applied. Such measures are shown to be of use in applications where the results of image correlation cannot be independently verified, and meaningful quantitative error measures are required. The application of these theoretical tools to the fundus image data indicate a systematic way to measure, assess and control cross-correlation error. Conclusions drawn from this research point the way forward for stereo analysis of the optic disc and highlight a number of areas which will require further research. The development of a fully automated system for diagnostic evaluation of the optic disc topography is discussed in the light of the results obtained during this research

Trends in multiplicity of Plasmodium falciparum infections among asymptomatic residents in the middle belt of Ghana.

BACKGROUND: Malaria is the most important cause of mortality and morbidity in children living in the Kintampo districts in the middle part of Ghana. This study has investigated the multiplicity of infection (MOI) within asymptomatic residents of the Kintampo districts, and the influence of age and seasonality on MOI, by studying the distribution of the polymorphic Plasmodium falciparum antigen merozoite surface protein 2 (MSP2). METHODS: DNA was extracted from an asymptomatic cohort of children and adults infected with P. falciparum during the period November 2003 to October 2004. Polymerase chain reaction was carried out and multiplicity of infection (MOI) was determined. RESULTS: Children under 10 years of age had an average MOI of 2.3 while adults 18 years and above had an average MOI of 1.4. Children below five years had high and low average MOIs of 2.8 in the March/April survey and 0.9 in the May/June survey respectively. A similar trend in the monthly distribution of MOI was observed for the entire cohort. IC/3D7 strains outnumbered the FC27 strains throughout the year by a ratio of about 4:1 with the difference between the prevalence of the two strains being least marked in the March/April survey, at the beginning of the rainy season. MOI was not linked to the level of malaria transmission as measured by the entomological inoculation rate. DISCUSSION/CONCLUSION: The impact of interventions, introduced since this baseline study was carried out on the parasite diversity of asymptomatic residents will be the subject of further investigations

PoLAR-FIT: Pliocene Landscapes and Arctic Remains—Frozen in Time

This short summary presents selected results of an ongoing investigation into the feedbacks that contribute to amplified Arctic warming. The consequences of warming for Arctic biodiversity and landscape response to global warmth are currently being interpreted. Arctic North American records of large-scale landscape and paleoenvironmental change during the Pliocene are exquisitely preserved and locked in permafrost, providing an opportunity for paleoenvironmental and faunal reconstruction with unprecedented quality and resolution. During a period of mean global temperatures only ~2.5°C above modern, the Pliocene molecular, isotopic, tree-ring, paleofaunal, and paleofloral records indicate that the high Arctic mean annual temperature was 11°C–19°C above modern values, pointing to a much shallower latitudinal temperature gradient than exists today. It appears that the intense Neogene warming caused thawing and weathering to liberate sediment and create a continuous and thick (>2.5 km in places) clastic wedge from at least Banks Island to Meighen Island to form a coastal plain that provided a highway for camels and other mammals to migrate and evolve in the high Arctic. In this summary we highlight the opportunities that exist for research on these and related topics with the PoLAR-FIT community.RÉSUMÉCe bref résumé présente les résultats choisis d'une enquête en cours sur les déclencheurs qui contribuent à l’amplification du réchauffement de l'Arctique. Les conséquences du réchauffement sur la biodiversité arctique et de la réponse du paysage au réchauffement climatique sont en cours d’être interprété. Des dossiers nord-américains de paysage à grande échelle et le changement paléoenvironnementales durant le Pliocène sont exceptionnellement préservés et scellées dans un état de congélation qui fournissant une occasion pour la reconstruction paléoenvironnementale et faunistique avec une qualité et une résolution sans précédent. Pendent une période de réchauffement global seulement ~2,5°C au-dessus de moderne les dossiers, moléculaire, isotopique, annaux de croissance, paléofaunistique et paléovégétation indiquent que l'Arctique a connu une augmentation de la température annuelle moyenne de 11°C–19°C au-dessus de moderne, en montrant un inferieur gradient de température latitudinal qu'aujourd'hui. Il semble que le réchauffement intense pendent le Néogène a provoqué la décongélation et erosion pour libérer les sédiments et créer une plaine côtière continuel et épaisse (> 2,5 km dans lieux) qui a fourni une route pour les chameaux et autres mammifères pour migrer et évoluer dans l’Haut-Arctique. Dans ce résumé, nous soulignons les opportunités qui existent pour la recherche sur ces sujets et les sujets connexes avec la communauté PoLAR-FIT

Non-malaria fevers in a high malaria endemic area of Ghana.

BACKGROUND: The importance of fevers not due to malaria [non-malaria fevers, NMFs] in children in sub-Saharan Africa is increasingly being recognised. We have investigated the influence of exposure-related factors and placental malaria on the risk of non-malaria fevers among children in Kintampo, an area of Ghana with high malaria transmission. METHODS: Between 2008 and 2011, a cohort of 1855 newborns was enrolled and followed for at least 12 months. Episodes of illness were detected by passive case detection. The primary analysis covered the period from birth up to 12 months of age, with an exploratory analysis of a sub-group of children followed for up to 24 months. RESULTS: The incidence of all episodes of NMF in the first year of life (first and subsequent) was 1.60 per child-year (95 % CI 1.54, 1.66). The incidence of NMF was higher among infants with low birth weight [adjusted hazard ratio (aHR) 1.22 (95 % CI 1.04-1.42) p = 0.012], infants from households of poor socio-economic status [aHR 1.22 (95 % CI 1.02-1.46) p = 0.027] and infants living furthest from a health facility [aHR 1.20 (95 % CI 1.01-1.43) p = 0.037]. The incidence of all episodes of NMF was similar among infants born to mothers with or without placental malaria [aHR 0.97 (0.87, 1.08; p = 0.584)]. CONCLUSION: The incidence of NMF in infancy is high in the study area. The incidence of NMF is associated with low birth weight and poor socioeconomic status but not with placental malaria

Seasonality and outbreak of a predominant Streptococcus pneumoniae serotype 1 clone from The Gambia: Expansion of ST217 hypervirulent clonal complex in West Africa

BACKGROUND: Streptococcus pneumoniae serotype 1 causes > 20% of invasive disease, among all age groups combined, in The Gambia. In contrast, it is rarely detected in carriage studies. This study compares the molecular epidemiology of S. pneumoniae serotype 1 causing invasive disease in The Gambia between 1996 and 2005 to those carried in the nasopharynx between 2004 and 2006. RESULTS: A total of 127 invasive and 36 nasopharyngeal carriage serotype 1 isolates were recovered from individuals of all age groups and were analyzed by serotyping, antibiotic susceptibility testing and MLST. MLST analysis revealed 23 different sequence types (STs), 18 of which were novel. The most prevalent clone among the 163 isolates was ST618 (70.5%), followed by ST3575 (7.4%), ST2084 (2.5%) and ST612 (2.5%). A single ST (ST618), previously shown to belong to the ST217 hypervirulent clonal complex, was frequent among carriage (61.1%) and invasive (72.7%) serotype 1 isolates. ST618 causing both paediatric and adult disease peaked annually in the hot dry season and caused outbreak in 1997 and 2002. CONCLUSION: For over a decade, isolates of ST618 have been the dominant lineage among serotype 1 carriage and disease isolates circulating in the Gambia. This lineage shows similar epidemiological features to those of the meningococcus in the African meningitis belt being able to cause outbreaks of disease

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Evaluation of the Safety and Immunogenicity of the RTS,S/AS01E Malaria Candidate Vaccine When Integrated in the Expanded Program of Immunization

Background. The RTS,S/AS01E malaria candidate vaccine is being developed for immunization of African infants through the Expanded Program of Immunization (EPI). Methods. This phase 2, randomized, open, controlled trial conducted in Ghana, Tanzania, and Gabon evaluated the safety and immunogenicity of RTS,S/AS01E when coadministered with EPI vaccines. Five hundred eleven infants were randomized to receive RTS,S/AS01E at 0, 1, and 2 months (in 3 doses with diphtheria, tetanus, and wholecell pertussis conjugate [DTPw]; hepatitis B [HepB]; Haemophilus influenzae type b [Hib]; and oral polio vaccine [OPV]), RTS,S/AS01E at 0, 1, and 7 months (2 doses with DTPwHepB/Hib+OPV and 1 dose with measles and yellow fever), or EPI vaccines only. Results. The occurrences of serious adverse events were balanced across groups; none were vaccine-related. One child from the control group died. Mild to moderate fever and diaper dermatitis occurred more frequently in the RTS,S/AS01E coadministration groups. RTS,S/AS01E generated high anti-circumsporozoite protein and anti- hepatitis B surface antigen antibody levels. Regarding EPI vaccine responses upon coadministration when considering both immunization schedules, despite a tendency toward lower geometric mean titers to some EPI antigens, predefined noninferiority criteria were met for all EPI antigens except for polio 3 when EPI vaccines were given with RTS,S/AS01E at 0, 1, and 2 months. However, when antibody levels at screening were taken into account, the rates of response to polio 3 antigens were comparable between groups. Conclusion. RTS,S/AS01E integrated in the EPI showed a favorable safety and immunogenicity evaluation. Trial registration. ClinicalTrials.gov identifier: NCT00436007. GlaxoSmithKline study ID number: 106369 (Malaria-050