Diabetic Retinopathy Environment-Wide Association Study (EWAS) in NHANES 2005–2008

Several circulating biomarkers are reported to be associated with diabetic retinopathy (DR). However, their relative contributions to DR compared to known risk factors, such as hyperglycaemia, hypertension, and hyperlipidaemia, remain unclear. In this data driven study, we used novel models to evaluate the associations of over 400 laboratory parameters with DR compared to the established risk factors. Methods: we performed an environment-wide association study (EWAS) of laboratory parameters available in National Health and Nutrition Examination Survey (NHANES) 2007–2008 in individuals with diabetes with DR as the outcome (test set). We employed independent variable (feature) selection approaches, including parallelised univariate regression modelling, Principal Component Analysis (PCA), penalised regression, and RandomForest™. These models were replicated in NHANES 2005–2006 (replication set). Our test and replication sets consisted of 1025 and 637 individuals with available DR status and laboratory data respectively. Glycohemoglobin (HbA1c) was the strongest risk factor for DR. Our PCA-based approach produced a model that incorporated 18 principal components (PCs) that had an Area under the Curve (AUC) 0.796 (95% CI 0.761–0.832), while penalised regression identified a 9-feature model with 78.51% accuracy and AUC 0.74 (95% CI 0.72–0.77). RandomForest™ identified a 31-feature model with 78.4% accuracy and AUC 0.71 (95% CI 0.65–0.77). On grouping the selected variables in our RandomForest™, hyperglycaemia alone achieved AUC 0.72 (95% CI 0.68–0.76). The AUC increased to 0.84 (95% CI 0.78–0.9) when the model also included hypertension, hypercholesterolemia, haematocrit, renal, and liver function tests

Evaluation of real-world early response of DMO to aflibercept therapy to inform future clinical trial design of novel investigational agents

New clinical trials for diabetic macular oedema (DMO) are being designed to prove superiority over aflibercept when this agent is already very effective in improving visual acuity (VA) and DMO. The aim of this study was to determine the optimal inclusion–exclusion criteria for trials to aim for superiority in visual outcomes with newer agents. As Phase 1 studies are short duration, we aimed to evaluate the early response of aflibercept in a real-world cohort initiated on monthly aflibercept for 3 consecutive injections and observed the effects at 4 months. The sub-optimal responders were pre-defined based on different cut-offs for VA and central sub-field thickness (CST). 200 patients with treatment naïve DMO treated with 3 loading doses of aflibercept were included in the study. We found that those presenting with baseline VA of 35–54 ETDRS letters (n = 43) had higher proportion of sub-optimal responders compared to other categories (p < 0.001). Patients with baseline CST of less than 400 µm (n = 96) responded less well functionally and anatomically to loading dose than eyes with baseline CST of 400 µm or more (n = 104, p = 0.02), indicating that eyes with CST ≥ 400 µm is another inclusion criteria. There was minimal correlation between change in CST and change in VA at 4 months (r = − 0.27), suggesting that both these inclusion criteria are non-exclusive. However, for maximal efficacy, patients that meet both these inclusion criteria are more likely to show benefit from an alternative intervention. New trials should aim to include patients with treatment naïve DMO with VA between 35–54 letters and CST of 400 µm or more when aflibercept is used as the comparator

Reptiles

List of commonly observed reptiles in mangroves are give

Mammals

Mammal

Sea-Anemones

Actiniarians are popularly called ‘sea-anemones’ because of their flower-like appearance of the expanded oral disc. They are very common animals of the sea-shore and muddy intertidal belt of estuary. They belong to the Phylum Cnidaria having solitary, cylindrical body. The body is divided into oral disc, column and base. Different workers like- Annandale (1907&1915), Carlgren (1925), Panikkar (1936), Parulekar (1968), Seshaiya and Cuttres (1971), Misra (1975&1976), Misra and Soota (1981), Bairagi (1998) etc. had worked on sea-anemones in Indian waters. Altogether 20 species under 17 genera belong to 10 families have been recorded from India. Among these only 7 species are reported from West Bengal but Bairagi (1998) had confirmed the occurence of 9 species under 7 genera and 5 families from Hoogly- Matla estuarine area of West Bengal

Molluscs

Molluscs constitute a major group in the animal kingdom. In number of species, the mollusca is the second largest phylum after arthropoda. About 1,00,000 living species of molluscs are reported to be occuring in the world. They occupy almost all possible habitats - marine, brackish water, freshwater, land and also arboreal in some groups. India harbours an approximate total of 3,271 species of molluscs spread over nearly 591 genera and 220 families (Mitra and Dey, 1992). On the other hand, a checklist of molluscs of Indian estuaries includes a total of 245 species (120 gastropods and 125 bivalvs) [Subba Rao and Surya Rao ,1985]. They play a significant role in maintaining the steady state of the mangrove ecosystem and enhance its biological potentiality. Molluscs constitute an important faunal component in the food web of any estuarine-marine coastal environment. Previously several taxonomic and ecological survey of estuarine-marine molluscs of India was conducted by several workers (Banford,1867; Annandale and Kemp, 1916; Annandale and Prasad, 1919; Subba Rao et al., 1983; Subba Rao et al., 1992, Khalua et al., 2003). The present study deals with the taxonomic survey (34 species, 24 genera, 22 families and 9 orders) of intertidal macrobenthic molluscs

Exploratory Study on Visual Acuity and Patient-Perceived Visual Function in Patients with Subretinal Drusenoid Deposits

Purpose: To investigate the value of visual acuity and patient-perceived visual function test when subretinal drusenoid deposits (SDD) are incorporated into the classification of age-related macular degeneration (AMD). A total of 50 participants were recruited into the study in these groups: healthy ageing (n = 11), intermediate AMD (iAMD) with no SDD (n = 17), iAMD with SDD (n = 11) and non-foveal atrophic AMD (n = 11) confirmed by two retinal imaging modalities. Best-corrected visual acuity (BCVA) and low luminance visual acuity (LLVA) were measured and low luminance deficit (LLD) was calculated. Participants were also interviewed with the low luminance questionnaire (LLQ). Linear regression was used to assess function–function relations. Compared with healthy participants, BCVA and LLVA scores were significantly reduced in the atrophic AMD group (p < 0.0001 and p = 0.00016, respectively) and in patients with SDD (p = 0.028 and p = 0.045, respectively). Participants with atrophy also had reduced BCVA (p = 0.001) and LLVA (p = 0.009) compared with the iAMD no SDD group. However, there were no differences in visual function tests between healthy aging and iAMD without SDD and between iAMD with SDD and atrophic AMD groups. The LLD score did not differ between groups. BCVA and LLVA correlated well. The LLQ did not correlate with visual function tests. This study shows that LLD is not a marker of disease severity as assessed clinically. Although LLQ is a good marker for disease severity using the current AMD classification, it does not differentiate between eyes with and without SDD. Eyes with non-macular geographic atrophy and SDD had lower function than eyes with no SDD and healthy controls

Avian Fauna

Avian Faun

Crustacea (Crab)

Brachyuran crabs, a bioenergetically significant group constitute one of the most dominant macrobenthic faunal components in all the mangrove ecosystems of the world. Several species of commercially important crabs like - Scylla serrata occur in mangroves. Brachyuran crabs play significant role to maintain the steady state condition of mangrove ecosystems several ways. The feedig activities of detritivore crabs such as - Uca, Macrophthalmus, Dotilla, Sesarma etc. help in the degradation of organic matter, especially mangrove litters and decaying woods. They also influence the functioning of mangrove ecosystems as burrowers since their repeated burrowing and reburrowing activities enhance the soil aeration, mixing of different soil profiles, nutrient cycling, maintaining of fluidity etc. (Montague, 1980, 1982 ; Bertness, 1985). Furthermore, crabs create a wide variety of bioturbation structures which are very significant for trapping sediments and mangrove seeds (Choudhury and Choudhury, 1994). In India several taxonomic works on estuarine and mangrove brachyuran crabs have been done (Chakraborty et al.,1986; Mandal and Nandi, 1989; Chakraborty and Choudhury, 1992; Dev Roy and Das, 2000 etc.). A total of 55 species of brachyuran crabs under 31 genera have been reported earlier from the mangrove habitats of India (Dev Roy and Das, 2000). Eighteen species of brachyuran crabs under 9 genera and 4 families were identified from Sundarbans Mangrove Ecosystems (Chakraborty and Choudhury, 1992)

Survival analysis following enucleation for uveal melanoma

OBJECTIVES: To determine survival outcomes following enucleation for uveal melanoma. To compare these outcomes with the 8th edition AJCC classification and determine the influence of cytogenetics, using Fluorescent in situ Hybridisation (FISH), on survival. To determine whether failure to gain sufficient sample for cytogenetics using Fine Needle Aspiration Biopsy (FNAB) correlates with survival. SUBJECTS/METHODS: All patients undergoing primary enucleation for uveal melanoma at Moorfields Eye Hospital between 2012 and 2015 were included. Clinical, pathological, cytological and survival data were analysed for all patients. RESULTS: In total, 155 subjects were included. Mean age at enucleation was 65.9 years (SD 14.13). 88 (56.8%) patients died at a mean of three (SD 1.9) years following enucleation. Of these, 52 (33.5%) died from metastatic melanoma, 16 (10.3%) from other causes and 20 (12.9%) causes of death were unknown. Cumulative incidence analysis demonstrated AJCC grade, chromosome 8q gain and monosomy three all predict metastatic mortality. The greatest 5-year mortality rate (62%, SD10.1%) was in those with both chromosome abnormalities and AJCC stage III (Stage IV patients excluded due to low numbers). Largest basal diameter and chromosome status, both independently (p = 0.02 and p < 0.001) predicted metastatic mortality on multivariable regression analysis. Those who had an insufficient sample of cells gained during FNAB (n = 16) had no different prognosis. CONCLUSIONS: This study confirms, in this population, the poor survival of patients enucleated for uveal melanomas. It confirms the prognostic utility of adding AJCC grade to cytogenetic information. It demonstrates that the lack of sample in patients undergoing FNAB is not related to prognosis