DaT-SPECT assessment depicts dopamine depletion among asymptomatic G2019S LRRK2 mutation carriers

Identification of early changes in Dopamine-Transporter (DaT) SPECT imaging expected in the prodromal phase of Parkinson’s disease (PD), are usually overlooked. Carriers of the G2019S LRRK2 mutation are known to be at high risk for developing PD, compared to non-carriers. In this work we aimed to study early changes in Dopamine uptake in non-manifesting PD carriers (NMC) of the G2019S LRRK2 mutation using quantitative DaT-SPECT analysis and to examine the potential for early prediction of PD. Eighty Ashkenazi-Jewish subjects were included in this study: eighteen patients with PD; thirty-one NMC and thirty-one non-manifesting non-carriers (NMNC). All subjects underwent a through clinical assessment including evaluation of motor, olfactory, affective and non-motor symptoms and DaT-SPECT imaging. A population based DaT-SPECT template was created based on the NMNC cohort, and data driven volumes-of-interest (VOIs) were defined. Comparisons between groups were performed based on VOIs and voxel-wise analysis. The striatum area of all three cohorts was segmented into four VOIs, corresponding to the right/left dorsal and ventral striatum. Significant differences in clinical measures were found between patients with PD and non-manifesting subjects with no differences between NMC and NMNC. Significantly lower uptake (p<0.001) was detected in the right and left dorsal striatum in the PD group (2.2±0.3, 2.3±0.4) compared to the NMC (4.2±0.6, 4.3±0.5) and NMNC (4.5±0.6, 4.6±0.6), and significantly (p = 0.05) lower uptake in the right dorsal striatum in the NMC group compared to NMNC. Converging results were obtained using voxel-wise analysis. Two NMC participants, who later phenoconverted into PD, demonstrated reduced uptake mainly in the dorsal striatum. No significant correlations were found between the DaT-SPECT uptake in the different VOIs and clinical and behavioral assessments in the non-manifesting groups. This study shows the clinical value of quantitative assessment of DaT-SPECT imaging and the potential for predicting PD by detection of dopamine depletion, already at the pre-symptomatic stage

A Save Environment of Care: Lessons from COVID-19

Ensuring a safe environment for patients, caregivers, and ancillary staff is job one for hospitals. The unique challenges created by the COVID-19 pandemic required hospitals to create/recreate spaces and processes in the midst of a crisis. How might the lessons-learned inform environments of care in the future? Hosted by: Texas Hospital Association Presentation: 1:01:0

Functional anonymisation: Personal data and the data environment

Anonymisation of personal data has a long history stemming from the expansion of the types of data products routinely provided by National Statistical Institutes. Variants on anonymisation have received serious criticism reinforced by much-publicised apparent failures. We argue that both the operators of such schemes and their critics have become confused by being overly focused on the properties of the data themselves. We claim that, far from being able to determine whether data are anonymous (and therefore non-personal) by looking at the data alone, any anonymisation technique worthy of the name must take account of not only the data but also their environment. This paper proposes an alternative formulation called functional anonymisation that focuses on the relationship between the data and the environment within which the data exist (their data environment). We provide a formulation for describing the relationship between the data and their environment that links the legal notion of personal data with the statistical notion of disclosure control. Anonymisation, properly conceived and effectively conducted, can be a critical part of the toolkit of the privacy-respecting data controller and the wider remit of providing accurate and usable data

Visual acuity improvement in children with albinism beyond the first decade of life.

PurposeTo determine if visual maturation continues beyond the first decade of life in children with albinism and whether this is related to albinism type, presence of nystagmus, eye muscle surgery or refractive errors.DesignCase series based on retrospective study of children with confirmed genetic diagnosis of albinism.MethodsClinical data were obtained from medical files of children examined during school years, including albinism type, visual acuity, eye muscle surgery, nystagmus, and others on different visits (Visit 1: ages 7-9; Visit 2: ages: 10-12; Visit 3: ages 13-16; Visit 4: ages >16).ResultsSeventy-five children with albinism were included in the study. Patients were divided into different groups according to the albinism type including OCA1A: 17; OCA1B: 28; OCA2: 26; HPS: 3; OCA4: 1. Follow-up ranged from 3-13 years. Progressive visual acuity improvement was seen in all three main groups. T-test paired samples showed a statistically significant improvement when comparing vision from Visit 1 and Visit 3 in both OCA1A and OCA2 groups, with a mean vision improvement of 2 lines. There was no correlation between visual improvement and refractive error, eye muscle surgery or nystagmus.ConclusionAn improved visual performance was seen in a large percentage of children with albinism during the second decade of life. The reason for this late improvement in vision is not clear but may be related to late foveal maturation or improvement in nystagmus with time. This information is useful for clinicians of these patients and when counseling parents

Adjustable Augmented Rectus Muscle Transposition Surgery with or Without Ciliary Vessel Sparing for Abduction Deficiencies

ABOUT THE TEST REPORT AND USE OF THE DATA The test data contained in this report are a tabulation of the results of a series of tests. Due to the restricted format of these pages, only a limited amount of data and not all of the tractor specifications are included. The full OECD report contains usually about 30 pages of data and specifications. The test data were obtained for each tractor under similar conditions and therefore, provide a means of comparison of performance based on a limited set of reported data. EXPLANATION OF THE TEST PROCEDURES Purpose The purpose of the tests in this booklet, and available test reports is to provide users with data for comparisons of performance among tractor models. General Tractors are tested at the University of Nebraska according to test procedures of the OECD (Organization of Economic Cooperation and Development), the SAE (Society of Automotive Engineers) International and the ASABE (American Society of Agricultural and Biological Engineers). The three codes are technically equivalent, but do differ slightly. For the past 10 years, the majority of tests have been performed according to the OECD codes. The manufacturer selects the tractor to be tested from its production line, provides the specifications, and certifies that the tractor is a stock model. Each tractor is equipped with the common energy consuming accessories (power steering, PTO, implement lifts, etc.). Any power consuming accessory may be disconnected when the means for doing so can be reached from the operator position. A manufacturer\u27s representative is present during the tests to as certain that the tractor gives its optimum performance. Weight can be added to the tractor to improve drawbar performance in certain tests. Static tire loads and inflation pressures must conform to the specifications of the Tire and Rim Association or to weight limits set by the manufacturer. Specifications All manufacturers provide the Laboratory with detailed specifications which are required for the tests. The Nebraska Tractor Test report provides only a limited amount of data due to space constraints. Preparation for Test The tractor is required to have been limbered up by the manufacturer for a sufficient number of hours; if this was not done, this limber- up is performed at the Tractor Test Lab. Adjustments are permitted during this period. After the start of the official test, no adjustments can be made. Any adjustments. repairs, alterations or replacements are mentioned in the final Nebraska Tractor Test report. At this time, instrumentation for measuring engine rpm, fan speed, temperatures and pressures is installed on the tractor. The tractor is also provided with connections to the Lab\u27s fuel supply. PTO Performance The tractor PTO is connected to a dynamometer, which is a device for putting a load on the tractor and measuring the power generated by the tractor. During the preliminary runs, the manufacturer is allowed to make some adjustments to optimize the performance. These adjustments, which include the injection pump volume and timing and the high idle set within the specified range, will remain during the whole test program and must be settings guaranteed by the manufacturer. The tests are performed while maintaining an ambient temperature of 75°F (24°C) and at a barometer reading above 28.5 inches Hg (96.6 kPa). Data are taken at intervals after the tractor performance has stabilized. Inlet fuel temperatures are also maintained at a predetermined level. The throttle being set for maximum no-load rpm (High Idle), an increasing load is applied to the PTO by the dynamometer along the operating curve of the engine. The full test report will show the torque, rpm, power and fuel consumption data obtained at Rated Engine speed, Standard PTO speed (either 1000 or 540 rpm), the maximum power on the curve and the torque rise. Drawbar Performance Tests are performed in all gears between one gear below the one at Which 15% slip occurs and a maximum speed of 10 mph (16.1 km/h). In each gear, the throttle is set for maximum speed (High Idle) and the drawbar load increased until maximum drawbar power is obtained. The drawbar load is created by towing load units behind the test-and- measurement vehicle which, itself, is hitched to the tested tractor\u27s drawbar. For each load, measurements and calculations are made to determine drawbar pull, speed, drawbar power, slip and fuel consumption. All measurements are recorded at intervals after the tractor\u27s condition is stabilized. No operational limits set by the manufacturer can be exceeded. A second test series investigates the part loads at 75% and 50% of the drawbar load at Rated Engine Speed in a gear close to 4.6 mph (7.5 km/h) and in the gear where maximum drawbar power was obtained. Sound Measurement Sound measurement is made on the test track in two locations-at the driver\u27s ear and in a location representing bystander noise. The tests at the driver\u27s ear are performed in several gears and under a number of conditions, but only the maximum level is reported. The bystander sound test is performed with the microphone located at 25 ft (7.5 m) from the centerline of the tractor which is accelerating from a lower speed to full speed in its top gear. The OECD procedure differs. The SAE/ASABE procedures and only the numbers for the same gears and same load conditions can be compared. The SAE/ASABE procedure measures sound in only one gear under different load conditions, whereas the GECD procedure measures sound in different gears between High Idle and Rated Engine speed. For tractors with Mechanical Front Wheel Drive, operator- ear measurements are made with the front-wheel drive engaged and disengaged. Hydraulic Lift Capacity and Flow Hydraulic lift capacity is measured in a special test stand. A frame is fitted to the three-point hitch lift links. Measurements of lift capacity are taken at the hitch points and at a point 24 (610 mm) behind the hitch points when the lower links are horizontal. The load is applied with a hydraulic cylinder and the arms move stepwise through the lift range. The number which is reported is 90% of the load which can be carried throughout the lift range. The booklet reports the lift capacity at 24 (610 mm) behind the hitch points. A second test determines the pressure/flow relationship and performance of the hydraulic system for supplying power to external hydraulic cylinders or hydraulic motors. The Nebraska report provides data on delivery rate, pressure and available powe