Electroretinographic Mapping of Retinal Function: Evaluation and Clinical Application

The conventional electroretinogram (ERG) is an electrophysiological examination that is used to assess the extent of retinal function within the eye. The test exploits the retina's ability to convert photons of light into electrical impulses. A flash stimulus is employed to evoke an electrical potential within the retinal cells (cones, rods and bipolar cells). These potentials, generated in the retina, are then recorded at the corneal surface of the eye using a contact lens or scleral electrode. The electrical potential generated possesses several distinct components that can be used to locate dysfunction from discrete layers of the retina. Although the ERG is used routinely in the diagnosis and monitoring of a wide range of retinal disorders its application is restricted because the diffuse stimulation of the retina evokes a global response thereby preventing the detection of localised abnormalities. A new technique has recently been developed, the Visual Evoked Response Imaging System (VERIS), which overcomes some of the shortfalls of the conventional electroretinogram. This new method allows functional mapping of the retina by the ERG. The technique enables simultaneous recording from a large number of retinal areas. Each area is independently stimulated in a sequence employing Pseudo Random Binary Sequences (PRBS). The sequences of stimulation are uncorrelated (achieved by temporal modulation of the sequence for each area) therefore the individual responses from different areas of the retina can be extracted. This thesis describes the evaluation of this system with regards to its potential within routine clinical practice. A number of investigations were performed to fulfil this evaluation. Possible factors that may influence the integrity of data obtained from the new technique were investigated and, where possible, minimised. These factors included quantifying the effects of filtering bandwidth, refractive errors, electrode type, response measurement method, luminance, contrast, dilation and the artefacts associated with poor patient shielding (from extraneous electromagnetic interference). The findings from these investigations were used to optimise the recovery of local ERG responses and established a protocol for future investigations. A custom software program was developed for analysis and interpretation of data. A study was undertaken to quantify the repeatability and reproducibility of the technique and to provide normative values. Finally these results were used to assess the techniques ability to objectively detect and quantify several retinal disorders. The investigations indicated that the system was of particular benefit in the assessment of local retinal pathology. However the system suffered a higher exclusion criteria than conventional electrophysiology and was unable, in the clinical setting, to identify retinal pathologies selectively affecting the ganglion cell layer. These factors limited the systems application within clinical practice. Current developments are aimed at improving the technique and establishing a routine clinical test with improved sensitivity and specificity that can be successfully applied to a wider population group

Epigenome-Wide DNA Methylation and Pesticide Use in the Agricultural Lung Health Study

Using family-wise error rate (p<9×10-8) or false-discovery rate (FDR<0.05), we identified 162 differentially methylated CpGs across 8 of 9 currently marketed active ingredients (acetochlor, atrazine, dicamba, glyphosate, malathion, metolachlor, mesotrione, and picloram) and one banned organochlorine (heptachlor). Differentially methylated CpGs were unique to each active ingredient, and a dose-response relationship with lifetime days of use was observed for most. Significant CpGs were enriched for transcription motifs and 28% of CpGs were associated with whole blood cis-gene expression, supporting functional effects of findings. We corroborated a previously reported association between dichlorodiphenyltrichloroethane (banned in the United States in 1972) and epigenetic age acceleration

phot1 inhibition of ABCB19 primes lateral auxin fluxes in the shoot apex required for phototropism

It is well accepted that lateral redistribution of the phytohormone auxin underlies the bending of plant organs towards light. In monocots, photoreception occurs at the shoot tip above the region of differential growth. Despite more than a century of research, it is still unresolved how light regulates auxin distribution and where this occurs in dicots. Here, we establish a system in Arabidopsis thaliana to study hypocotyl phototropism in the absence of developmental events associated with seedling photomorphogenesis. We show that auxin redistribution to the epidermal sites of action occurs at and above the hypocotyl apex, not at the elongation zone. Within this region, we identify the auxin efflux transporter ATP-BINDING CASSETTE B19 (ABCB19) as a substrate target for the photoreceptor kinase PHOTOTROPIN 1 (phot1). Heterologous expression and physiological analyses indicate that phosphorylation of ABCB19 by phot1 inhibits its efflux activity, thereby increasing auxin levels in and above the hypocotyl apex to halt vertical growth and prime lateral fluxes that are subsequently channeled to the elongation zone by PIN-FORMED 3 (PIN3). Together, these results provide new insights into the roles of ABCB19 and PIN3 in establishing phototropic curvatures and demonstrate that the proximity of light perception and differential phototropic growth is conserved in angiosperm

Online alcohol interventions, sexual violence and intimate partner violence: A systematic review

Background - Sexual and intimate partner violence (IPV) is a leading cause of disease burden, with alcohol use strongly related to these behaviors. Online interventions have been shown to be effective in reducing both alcohol use and some alcohol-related problems. These programs are widely available especially to university students, a particularly high-risk group for sexual or IPV. Aim - We aimed to systematically review the evidence for the effectiveness of online alcohol interventions in reducing sexual violence or IPV. Methods - We searched electronic databases (PsycInfo, Embase, Global Health, Medline, CINAHI, Pubmed, and ProQuest) and hand searched key reviews. Results - From 569 titles, 23 were assessed in detail: five articles (four studies) fulfilled the inclusion criteria. All these studies were undertaken in the USA, with three recruiting college students (n = 17,332), and one using an emergency department (n = 262) sample of adolescents. We summarized the characteristics of the samples, the interventions and outcomes for alcohol use and sexual violence or IPV. Most interventions were unguided, with only one group receiving a guided intervention. Effect sizes, where they could be calculated, were small (Cohen's d < 0.2) or not significantly different to zero for alcohol, sexual violence or IPV outcomes

A smartphone-based test for the assessment of attention deficits in delirium: A case-control diagnostic test accuracy study in older hospitalised patients.

BACKGROUND: Delirium is a common and serious acute neuropsychiatric syndrome which is often missed in routine clinical care. Inattention is the core cognitive feature. Diagnostic test accuracy (including cut-points) of a smartphone Delirium App (DelApp) for assessing attention deficits was assessed in older hospital inpatients. METHODS: This was a case-control study of hospitalised patients aged ≥65 years with delirium (with or without pre-existing cognitive impairment), who were compared to patients with dementia without delirium, and patients without cognitive impairment. Reference standard delirium assessment, which included a neuropsychological test battery, was based on Diagnostic and Statistical Manual of Mental Disorders-5 criteria. A separate blinded assessor administered the DelApp arousal assessment (score 0-4) and attention task (0-6) yielding an overall score of 0 to 10 (lower scores indicate poorer performance). Analyses included receiver operating characteristic curves and sensitivity and specificity. Optimal cut-points for delirium detection were determined using Youden's index. RESULTS: A total of 187 patients were recruited, mean age 83.8 (range 67-98) years, 152 (81%) women; n = 61 with delirium; n = 61 with dementia without delirium; and n = 65 without cognitive impairment. Patients with delirium performed poorly on the DelApp (median score = 4/10; inter-quartile range 3.0, 5.5) compared to patients with dementia (9.0; 5.5, 10.0) and those without cognitive impairment (10.0; 10.0, 10.0). Area under the curve for detecting delirium was 0.89 (95% Confidence Interval 0.84, 0.94). At an optimal cut-point of ≤8, sensitivity was 91.7% (84.7%, 98.7%) and specificity 74.2% (66.5%, 81.9%) for discriminating delirium from the other groups. Specificity was 68.3% (56.6%, 80.1%) for discriminating delirium from dementia (cut-point ≤6). CONCLUSION: Patients with delirium (with or without pre-existing cognitive impairment) perform poorly on the DelApp compared to patients with dementia and those without cognitive impairment. A cut-point of ≤8/10 is suggested as having optimal sensitivity and specificity. The DelApp is a promising tool for assessment of attention deficits associated with delirium in older hospitalised adults, many of whom have prior cognitive impairment, and should be further validated in representative patient cohorts

Population turnover in remote oceania shortly after initial settlement

Ancient DNA from Vanuatu and Tonga dating to about 2,900–2,600 years ago (before present, BP) has revealed that the “First Remote Oceanians” associated with the Lapita archaeological culture were directly descended from the population that, beginning around 5000 BP, spread Austronesian languages from Taiwan to the Philippines, western Melanesia, and eventually Remote Oceania. Thus, ancestors of the First Remote Oceanians must have passed by the Papuan-ancestry populations they encountered in New Guinea, the Bismarck Archipelago, and the Solomon Islands with minimal admixture [1]. However, all present-day populations in Near and Remote Oceania harbor >25% Papuan ancestry, implying that additional eastward migration must have occurred. We generated genome-wide data for 14 ancient individuals from Efate and Epi Islands in Vanuatu from 2900–150 BP, as well as 185 present-day individuals from 18 islands. We find that people of almost entirely Papuan ancestry arrived in Vanuatu by around 2300 BP, most likely reflecting migrations a few hundred years earlier at the end of the Lapita period, when there is also evidence of changes in skeletal morphology and cessation of long-distance trade between Near and Remote Oceania [2, 3]. Papuan ancestry was subsequently diluted through admixture but remains at least 80%–90% in most islands. Through a fine-grained analysis of ancestry profiles, we show that the Papuan ancestry in Vanuatu derives from the Bismarck Archipelago rather than the geographically closer Solomon Islands. However, the Papuan ancestry in Polynesia—the most remote Pacific islands—derives from different sources, documenting a third stream of migration from Near to Remote Oceania

Development of a Hamster Natural Transmission Model of SARS-CoV-2 Infection.

The global pandemic of coronavirus disease (COVID-19) caused by infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to an international thrust to study pathogenesis and evaluate interventions. Experimental infection of hamsters and the resulting respiratory disease is one of the preferred animal models since clinical signs of disease and virus shedding are similar to more severe cases of human COVID-19. The main route of challenge has been direct inoculation of the virus via the intranasal route. To resemble the natural infection, we designed a bespoke natural transmission cage system to assess whether recipient animals housed in physically separate adjacent cages could become infected from a challenged donor animal in a central cage, with equal airflow across the two side cages. To optimise viral shedding in the donor animals, a low and moderate challenge dose were compared after direct intranasal challenge, but similar viral shedding responses were observed and no discernible difference in kinetics. The results from our natural transmission set-up demonstrate that most recipient hamsters are infected within the system developed, with variation in the kinetics and levels of disease between individual animals. Common clinical outputs used for the assessment in directly-challenged hamsters, such as weight loss, are less obvious in hamsters who become infected from naturally acquiring the infection. The results demonstrate the utility of a natural transmission model for further work on assessing the differences between virus strains and evaluating interventions using a challenge system which more closely resembles human infection

The influence of foot geometry on the calcaneal osteotomy angle based on two-dimensional static force analyses

Background: Malalignment of the hindfoot can be corrected with a calcaneal osteotomy (CO). A well-selected osteotomy angle in the sagittal plane will reduce the shear force in the osteotomy plane while walking. The purpose was to determine the presence of a relationship between the foot geometry and loading of the calcaneus, which influences the choice of the preferred CO angle. Methods A static free body force analysis was made of the posterior calcaneal fragment in the second half of the stance phase to determine the main loads: the plantar apeunorosis (PA) and Achilles tendon (AT). The third load is on the osteotomy surface which should be oriented such that the shear component of the force is zero. The force direction of the PA and AT was measured on 58 MRIs of the foot, and the force ratio between both structures was taken from the literature. In addition the PA-to-AT force ratio was estimated for different foot geometries to identify the relationship. Results: Based on the wish to minimize the shear force during walking, a mean CO angle was determined to be 33º (SD8) relative to the foot sole. In pes planus foot geometry, the angle should be higher than the mean. In pes cavus foot geometry, the angle should be smaller. Conclusion: Foot geometry, in particular the relative foot heights is a determinant for the individual angle in performing the sliding calcaneal osteotomy. It is recommended to take into account the foot geometry (arch) when deciding on the CO angle for hindfoot correction.Biomechanical EngineeringMechanical, Maritime and Materials Engineerin