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To compare rates of vaginal cuff dehiscence (VCD) in transgender patients with cisgender patients after minimally invasive hysterectomy (MIH). We performed a single-surgeon, retrospective cohort analysis comparing the rates of VCD in patients undergoing MIH for gender affirmation with other indications (benign, malignant, prophylactic) with our study surgeon between January, 2015, and December, 2021. Major, urban, academic tertiary care hospital in the United States. 166 patients met inclusion criteria with 49 of those patients undergoing MIH (29.5%) for gender affirmation. Of the remaining 117 patients, 92 (78.6%) underwent MIH for cancer, 15 (12.8%) for prophylaxis, and 10 (8.5%) for benign indications. Not applicable. We assessed included patients for baseline demographics, presence of risk factors for VCD, details of index hysterectomy, and details of cuff dehiscence events. Transgender patients tended to be younger at the time of surgery, but demographics were otherwise similar between both groups. Most transgender patients (n = 36, 73.5%) had both ovaries removed at the time of hysterectomy, 100% were on testosterone therapy pre- and postoperatively, and none used supplementary estrogen. Three of the 49 transgender patients (6.1%) experienced postoperative dehiscence of the vaginal cuff compared with 2 of the 117 cisgender patients (1.7%). This failed to reach statistical significance; however, our descriptive analysis showed that all cases of dehiscence in the cisgender group had identifiable precipitating factors (i.e., trauma). By comparison, all cases of dehiscence in the transgender group were spontaneous with few identifiable risk factors. Transgender patients undergoing MIH may be at increased risk of VCD, although the rarity of this surgical complication precluded determination of statistical significance in our data set. We propose testosterone exposure as a possible risk factor for VCD, although we cannot exclude other factors, such as young age, as drivers of VCD in this population. Future studies of biospecimens are needed to evaluate for cellular differences in these patients. [ABSTRACT FROM AUTHOR]

Poor control of intermittent exotropia may be used as an indication for surgery. However, control fluctuates during the day and from day to day. The standardized triple office control score (mean of three scores on a 6-point ordinal scale) is representative of repeated assessments throughout the day, but lacks validation against an objective measure of eye movements. We report the agreement between the triple office control score measured by the referring eyecare professional and lab-measured vergence instability using an EyeLink video eye tracker. Near and distance triple office control scores were moderately correlated with vergence instability. Near, but not distance, triple office control score was moderately correlated with the percentage of time intermittent exotropia was manifest during EyeLink recording. Larger triple office control scores for intermittent exotropia provide a meaningful description of larger vergence instability, supporting its use in clinical decisions and as a measure in clinical trials.▪ [ABSTRACT FROM AUTHOR]

Contrast-rebalanced dichoptic games and videos have been shown to be an effective treatment for childhood amblyopia. Whether the visual acuity gains achieved with these binocular treatments are long-lasting has not been determined. In this prospective cohort study of 100 consecutive amblyopic children who improved by ≥0.2 logMAR or obtained ≤0.2 logMAR amblyopic eye visual acuity during a binocular treatment clinical trial, risk of recurrence was 24% (95% CI, 16%-35%) at up to 3 years' follow-up according to Kaplan-Meier survival analysis, which accounts for censored, truncated, and missing data. Risk of recurrence was similar among children who required additional treatment for residual amblyopia after 4-8 weeks of dichoptic treatment (n = 62 [19%]; 95% CI, 10%-34%) and those who did not (n = 38 [32%]; 95% CI, 18%-52%; P = 0.12). There was no association between recurrence and age, visual acuity at the end of binocular treatment, stereoacuity, or ocular alignment. In a secondary analysis to compare rates of recurrence with published data, risk of recurrence in the subset of children who had no additional treatment for residual amblyopia (28%) was similar to the reported recurrence after cessation of successful patching and atropine (24%) at 12 months. Children with successful binocular treatment of amblyopia require monitoring for recurrence of amblyopia.▪ [ABSTRACT FROM AUTHOR]

Background: Surgical site infection (SSI) is associated with inadvertent perioperative hypothermia (IPH). This can be prevented by active patient warming. However, results from comparisons of warming techniques are conflicting. They are based mostly on elective surgery, are from small numbers of patients, and are dominated by the market leader, forced-air warming (FAW). Furthermore, the definition of hypothermia is debatable and systematic reviews of warming systems conclude that a stricter control of temperature is required to study the benefits of warming.Aim: To analyse core temperatures in detail in a large subset of elderly patients who took part in a randomized trial of patient warming following hemiarthroplasty who had received constant zero-flux thermometry to record their temperature.Methods: Regression models with a fixed effect for warming group and covariates related to temperature were compared for 257 participants randomized to FAW or resistant fabric warming (RFW) from a prior clinical trial.Findings: Those in the RFW group were -0.08°C cooler and had a cumulative hypothermia score -1.87 lower than those in the FAW group. There was no difference in the proportion of hypothermic patients at either <36.5°C or <36.0°C.Conclusions: This is the first study to provide accurate temperature measurements in patients undergoing a procedure predominantly under regional rather than general anaesthetic. It shows that RFW is a viable alternative to FAW for preventing IPH during hemiarthroplasty. Further studies are needed to measure the benefits of patient warming in terms of clinically important outcomes. [ABSTRACT FROM AUTHOR]

There is a lack of normative data for children tested with the electronic Early Treatment for Diabetic Retinopathy Study (E-ETDRS) protocol. In the current cross-sectional study, the mean best-corrected normal and 95% lower tolerance limit for E-ETDRS visual acuity by year in children 7-12 years of age was measured. Our objective was to provide a large normative data set for E-ETDRS visual acuity in children for use in clinical management and clinical trials.▪ [ABSTRACT FROM AUTHOR]

• Partner fidelity is essential for establishing and maintaining symbioses. • Exchange of specific signals is one mechanism to ensure partner fidelity. • Signal-structure interfaces evolve to ensure fidelity when using non-specific signals. • Specialized structures for accommodating symbionts are widespread. • Signal-structure interfaces are common and may occur within the human microbiome. Symbiotic microbes are essential to the ecological success and evolutionary diversification of multicellular organisms. The establishment and stability of bipartite symbioses are shaped by mechanisms ensuring partner fidelity between host and symbiont. In this minireview, we demonstrate how the interface of chemical signals and host structures influences fidelity between legume root nodules and rhizobia, Hawaiian bobtail squid light organs and Allivibrio fischeri , and fungus-growing ant crypts and Pseudonocardia. Subsequently, we illustrate the morphological diversity and widespread phylogenetic distribution of specialized structures used by hosts to house microbial symbionts, indicating the importance of signal-structure interfaces across the history of multicellular life. These observations, and the insights garnered from well-studied bipartite associations, demonstrate the need to concentrate on the signal-structure interface in complex and multipartite systems, including the human microbiome. [ABSTRACT FROM AUTHOR]

Abstract We present a topographic processing tool, PriorityFlow, designed to improve the topographic input datasets which are required for physically based hydrologic models. PriorityFlow is available on GitHub, combines multiple processing approaches, and includes several key innovations over previous work: (1) a novel approach for incorporating a-priori stream network information with priority flood routing DEM processing, (2) improved slope calculations that incorporate flow directions, (3) options for incorporating slopes perpendicular to the primary flow direction, (4) more flexible options for defining subbasins and enforcing slopes along stream reaches. Here we document the approach and demonstrate the impact of topographic processing choices on hydrologic simulations. Results demonstrate that the modified priority flood algorithm can better reproduce observed stream networks without relying on traditional stream burning approaches. Additionally, we demonstrate the impact of slope processing options on runoff timing and magnitude. Specifically, we highlight the sensitivity of the hydrograph to slope processing choices along stream reaches. Highlights • Modified priority flood algorithm to prioritize predefined stream networks. • Topographic processing for integrated hydrologic models. • Hydrograph sensitivity to stream segment smoothing and slopes. [ABSTRACT FROM AUTHOR]

During the pandemic healthcare professionals and political leaders routinely used traditional and new media outlets to publicly respond to COVID-19 myths and inaccuracies. We examine how variations in the sources and messaging strategies of these public statements affect respondents' beliefs about the safety of COVID-19 vaccines. We analyzed the results of an experiment embedded within a multi-wave survey deployed to US and UK respondents in January–February 2022 to examine these effects. We employ a test-retest between-subjects experimental protocol with a control group. Respondents were randomly assigned to one of four experimental conditions reflecting discrete pairings of message source (political authorities vs. healthcare professionals) and messaging strategy (debunking misinformation vs. discrediting mis-informants) or a control condition. We use linear regression to compare the effects of exposure to treatment conditions on changes in respondent beliefs about the potential risks associated with COVID-19 vaccination. In the UK sample, we observe a statistically significant decrease in beliefs about the risks of COVID-19 vaccines among respondents exposed to debunking messages by healthcare professionals. We observe a similar relationship in the US sample, but the effect was weaker and not significant. Identical messages from political authorities had no effect on respondents' beliefs about vaccine risks in either sample. Discrediting messages critical of mis-informants likewise had no influence on respondent beliefs, regardless of the actor to which they were attributed. Political ideology moderated the influence of debunking statements by healthcare professionals on respondent vaccine attitudes in the US sample, such that the treatment was more effective among liberals and moderates than among conservatives. Brief exposure to public statements refuting anti-vaccine misinformation can help promote vaccine confidence among some populations. The results underscore the joint importance of message source and messaging strategy in determining the effectiveness of responses to misinformation. • The source and content of corrective messages jointly influence their effectiveness. • Corrective messages by healthcare professionals reduce concerns about COVID-19 vaccine risk. • Identical messages by political authorities are ineffective. • Critical discrediting messages are ineffective (but not counterproductive), regardless of source. • Political ideology moderates the effectiveness of corrective statements by healthcare authorities. [ABSTRACT FROM AUTHOR]

Seepage into tunnels bored through fractured rock is a common occurrence that can cause significant problems for the construction process, tunnel longevity, and regional hydrogeology. Predictions of seepage using analytical solutions and numerical models are often inaccurate due to the inherent assumptions, volumetric averaging of fractures, and lack of important hydrogeological features. This study seeks to better understand tunnel infiltration processes through the application of a high-resolution, integrated hydrologic model. First, a conceptual model is developed for this research using the factors shown by previous studies to control net infiltration and seepage. A stochastic fracture continuum is generated for bedrock using FRACK, which maps discrete fracture networks to a finite difference grid with heterogeneous, anisotropic permeability fields. An integrated hydrologic model, ParFlow is then used to investigate the control exhibited by factors such as climatic forcing; vegetation; soil type and depth; bedrock type; fracture spacing; and tunnel depth on the timing and magnitude of seepage into tunnels. Simulations are run using hourly meteorological forcing. Surface and subsurface properties are adjusted individually to investigate the change in seepage response for varying hydrogeology and land cover. Results show that fracture spacing and connectivity, bedrock type, and overburden are particularly important pieces in obtaining reliable seepage estimates. Higher fracture spacing causes higher total seepage at a more constant rate than a lesser spacing, which exhibits a much larger range of fluctuation in seepage volumes. More permeable and porous bedrock increases lag times while reducing seepage volumes that remain relatively constant over time. Thicker and less conductive soils both increase lag times and reduce seepage magnitude. Tunnels, precipitation, infiltration, seepage, fractured rock. [ABSTRACT FROM AUTHOR]

Study Objectives: Few studies have prospectively compared multiple cardiac risk prediction scores. We compared the rate of missed acute myocardial infarction (AMI) in chest pain patients prospectively categorized as low risk by unstructured clinical impression, and by HEART, TIMI, GRACE, and EDACS scores, in combination with two negative contemporary cardiac troponins (cTn) available in the U.S.Methods: We enrolled 434 patients with chest pain presenting to one of seven emergency departments (ED). Risk scores were prospectively calculated and included the first two cTn. Low risk was defined for each score as HEART≤3, TIMI≤0, GRACE≤50, and EDACS≤15. AMI incidence was calculated for low risk patients and compared across scores using Χ2 tests and C statistics.Results: The patients' median age was 57, 58% were male, 60% white, and 80 (18%) had AMI. The missed AMI rate in low risk patients for each of the scores when combined with 2 cTn were HEART 3.6%, TIMI 0%, GRACE 6.3%, EDACS 0.9%, and unstructured clinical impression 0%. The C-statistic was greatest for the EDACS score, 0.94 (95% CI, 0.92-0.97).Conclusions: Using their recommended cutpoints and non high sensitivity cTn, TIMI and unstructured clinical impression were the only scores with no missed cases of AMI. Using lower cutpoints (GRACE≤48, TIMI=0, EDACS≤11, HEART≤2) missed no case of AMI, but classified less patients as low-risk. [ABSTRACT FROM AUTHOR]

While adolescents and underage emerging adults typically obtain alcohol from social sources (e.g., parents, friends, parties), taking alcohol from the home without permission is not well understood. The current study investigated plausible individual characteristics associated with taking alcohol from one's parents' home without permission and associations between taking alcohol and drinking, alcohol consequences, and marijuana use. Two cohorts of alcohol-experienced underage emerging adults (N = 562) completed a web-based survey pre-college matriculation. Participants reported sources of alcohol (friend, mother, father, party, took it from home); drinking; consequences; marijuana use (ever and past 30 days); age of alcohol initiation; symptoms of depression, anxiety, and stress; parental modeling of drinking; and demographic information. Results revealed that taking alcohol was significantly associated with several of the measures examined here (e.g., having obtained alcohol from friends, parents, and parties; earlier age of alcohol initiation; parental modeling of alcohol). Having taken alcohol from the home without permission and obtained it from friends were uniquely associated with increased odds of typical weekly drinking, consequences, and marijuana use in the past 30 days when controlling for all other variables assessed in this study (including drinking, in the consequences and marijuana models). Parent-based interventions targeting adolescents and emerging adults should inform parents of the risks associated with taking alcohol from the home and obtaining it from friends. Further, parents should also be informed that supplying their adolescent with alcohol or modeling drinking may increase the likelihood that they take alcohol from their home. [ABSTRACT FROM AUTHOR]

To determine whether deficits in manual dexterity in children with amblyopia improve after binocular amblyopia treatment and whether improvements are related to age at treatment, baseline sensory status, or amount of improvement in sensory status with treatment. Manual dexterity (Movement Assessment Battery for Children–2), visual acuity, fusion, suppression, and stereoacuity were measured at baseline and after 4-8 weeks of binocular amblyopia in 134 children with amblyopia, including 75 children in the "younger group" (aged 3 to <7 years) and 59 in the "older group" (aged 7-10 years), and in 40 age-similar control children. Baseline manual dexterity standard scores of amblyopic children were significantly below those of controls in both the younger (8.81 ± 0.33 vs 11.80 ± 0.60 [ P < 0.0001]) and older groups (7.19 ± 0.34 vs 9.75 ± 0.57 [ P = 0.00013]). After 4-8 weeks of binocular amblyopia treatment, the younger group standard score improved to 9.85 ± 0.35 and the older group improved to 8.08 ± 0.39, but both groups remained significantly lower than controls (P = 0.03 and P = 0.01, resp.). Improvement in manual dexterity standard score was not associated with any baseline factors but was weakly correlated with the amount of visual acuity improvement (r s = 0.26; 95% CI, 0.09-0.41) Manual dexterity impairments are common among children with amblyopia. In our study cohort, binocular amblyopia treatment improved visual acuity and manual dexterity.▪ [ABSTRACT FROM AUTHOR]

Previous research has shown a reliable association between social media (SM) use and drinking among college students. However, most studies have investigated SM behaviors (e.g., time spent on a platform, posting frequency) in isolation and on a single site. While some have studied multiple SM behaviors across platforms using person-centered approaches (e.g., latent profile analysis [LPA]), these studies have failed to take alcohol-related SM behaviors into account. This longitudinal study addressed this gap in the literature by using LPA to identify subpopulations of SM users during the college transition (N = 319; 62.1% female) using general (frequency of checking, time spent on, and frequency of posting to Instagram/Facebook/Snapchat; Finstagram ownership) and alcohol-related SM behaviors (posting alcohol, partying, and marijuana content). LPA results revealed three SM user profiles at baseline: low general use with low alcohol-related posting (LGU + LAP), high general use with low alcohol-related posting (HGU + LAP), and high general use with high alcohol-related posting (HGU + HAP). Prospective analyses revealed that HGU + HAP membership was associated with greater descriptive peer drinking norms, alcohol use, and consequences relative to HGU + LAP and LGU + LAP membership. Results suggest that there are distinct patterns of general and alcohol-related SM use during the college transition associated with risky drinking that can inform interventions combating SM-related alcohol risks. These findings illustrate the importance of investigating SM use holistically and suggests studying alcohol-related SM behaviors may reveal differences in individuals' alcohol risk that general SM behaviors might not capture. [ABSTRACT FROM AUTHOR]

Aim To assess whether the proportion of patients aged 70 and over with ER+ operable breast cancer in England who are treated with surgery has changed since 2002, and to determine whether age and individual level factors including tumour characteristics and co-morbidity influence treatment choice. Methods A retrospective cohort analysis of routinely collected cancer registration data from two English regions (West Midlands, Northern & Yorkshire) was carried out (n = 17,129). Trends in surgical use over time for different age groups were assessed graphically and with linear regression. Uni- and multivariable logistic regressions were used to assess the effects of age, comorbidity, deprivation and disease characteristics on treatment choice. Missing data was handled using multiple imputation. Results There is no evidence of a change in the proportion of patients treated surgically over time. The multivariable model shows that age remains an important predictor of whether or not a woman with ER+ operable breast cancer receives surgery after covariate adjustment (Odds ratio of surgery vs no surgery, 0.82 (per year over 70)). Co-morbidity, deprivation, symptomatic presentation, later stage at diagnosis and low grade are also associated with increased probability of non-surgical treatment. Conclusion Contrary to current NICE guidance in England, age appears to be an important factor in the decision to treat operable ER+ breast cancer non-surgically. Further research is needed to assess the role of other age-related factors on treatment choice, and the effect that current practice has on survival and mortality from breast cancer for older women. [ABSTRACT FROM AUTHOR]

Purpose To determine the specificity of the Pediatric Vision Scanner, a binocular retinal birefringence scanner, in its intended setting, a pediatric primary care office. Methods A total of 102 preschool children (age 2-6 years) were screened during a well-child pediatric visit using the Pediatric Vision Scanner and the SureSight Autorefractor and completed a masked comprehensive pediatric ophthalmic examination (gold standard examination). Results Based on the gold standard examination, one child had anisometropic amblyopia, and the remaining 101 had no amblyopia or strabismus. Specificity of the Pediatric Vision Scanner was 90% (95% CI, 82%-95%) while specificity of the SureSight was 87% (95%CI, 79-93%). Combining these results with the sensitivity of the devices determined in our previous study conducted in a pediatric ophthalmology office setting, the positive likelihood ratio for the Pediatric Vision Scanner was 10.2; for the SureSight, 5.0. The negative likelihood ratio for the Pediatric Vision Scanner was 0.03; for the SureSight, 0.42, a significant difference. Conclusions The Pediatric Vision Scanner had high specificity (90%) in screening for amblyopia and strabismus as part of a pediatric well-child visit. Likelihood ratio analysis suggests that affected children have a high probability of being correctly identified by the Pediatric Vision Scanner. The high level of confidence conferred by Pediatric Vision Scanner screening may remove an important barrier to vision screening in pediatric primary care. [ABSTRACT FROM AUTHOR]

Background Recent evidence suggests that amblyopia results in fixation instability and atypical saccades. Reading is a vision-reliant ability that requires sequential eye movements, including forward and regressive saccades. This study investigated reading and associated eye movements in school-age amblyopic children. Methods Amblyopic children with strabismus and/or anisometropia (n = 29) were compared to nonamblyopic children treated for strabismus (n = 23) and normal control children (n = 21). While fitted with the ReadAlyzer, an eye movement recording system, children silently read a grade-level paragraph of text during binocular viewing. Reading rate, number of forward and regressive saccades per 100 words, and fixation duration were determined. Comprehension was evaluated with a 10-item quiz; only data from children with at least 80% correct responses were included. Results Amblyopic children read more slowly and had more saccades compared with nonamblyopic children with treated strabismus and normal controls. Fixation duration did not differ significantly for amblyopic children versus normal controls. Treated strabismic children without amblyopia did not differ significantly from normal controls on any reading measure. Amblyopic eye visual acuity was not correlated with any reading measure. Conclusions Amblyopia was associated with slower reading speed in school-age children. Treatment for monocular amblyopia visual acuity impairment could improve reading speed and efficiency. [ABSTRACT FROM AUTHOR]

Background Contrast-balanced dichoptic experience with perceptual-learning tasks or simple games has been shown to improve visual acuity significantly in amblyopia. However, these tasks are intensive and repetitive, and up to 40% of unsupervised patients are noncompliant. We investigated the efficacy of a potentially more engaging movie method to provide contrast-balanced binocular experience via complementary dichoptic stimulation. Methods Eight amblyopic children 4-10 years of age were enrolled in a prospective cohort study to watch 3 dichoptic movies per week for 2 weeks on a passive 3D display. Dichoptic versions of 18 popular animated feature films were created. A patterned image mask of irregularly shaped blobs was multiplied with the movie images seen by the amblyopic eye and an inverse mask was multiplied with the images seen by the fellow eye. Fellow-eye contrast was initially set at a reduced level that allowed binocular vision and was then incremented by 10% at each visit. Best-corrected visual acuity, random dot stereoacuity, and interocular suppression were measured at baseline and 2 weeks. Results Mean amblyopic eye visual acuity (with standard error of the mean) improved from a logarithm of minimum angle of resolution of 0.72 ± 0.08 at baseline to 0.52 ± 0.09 ( P = 0.003); that is, 2.0 lines of improvement at the 2-week outcome visit. No significant change in interocular suppression or stereoacuity was found. Conclusions Passive viewing of dichoptic feature films is feasible and could be a promising new treatment for childhood amblyopia. The maximum improvement that may be achieved by watching dichoptic movies remains to be determined. No known side effects are associated with this new treatment. [ABSTRACT FROM AUTHOR]

Water age is a fundamental descriptor of the source, storage, and mixing of water in watersheds. The Lagrangian, particle tracking, approach is a powerful tool for physically-based modeling of water age distributions, but its application has been hampered because it is computationally demanding. Here, we present a parallel approach for particle tracking simulations. This approach uses a multi-GPU with MPI parallelism based on domain decomposition. An inherent challenge of the distributed parallelization of Lagrangian approaches is the disparity in computational work or load imbalance (LIB) among different processing elements (PEs). In this study, load balancing (LB) schemes were proposed to dynamically balance the distribution of particles across PEs during runtime. In the followed hillslope simulations, LIB was observed in all LB-disabled runs, e.g., with a load ratio of 4.3 by using 2-GPU in the test case. LB schemes then accurately balanced the load distribution and improved the parallel scaling. Additionally, the parallel approach showed an excellent overall speedup: a 25-fold improvement using 4-GPU relative to 128 OpenMP threads. A regional-scale application further demonstrated the LB performance. The wall-clock time used by 8-GPU without LB was reduced by 31.33% after the LB was activated. Increasing 8-GPU with LB to 16-GPU with LB showed parallel scalability by reducing the wall-clock time by ∼50%. This work shows how massively parallel computing can be applied to particle tracking in water age simulations. It also demonstrates the practical importance of load balancing in this context, which enables large-scale simulations with the increased complexity of flow paths. • Massively parallel computing of Lagrangian water-age simulations is realized. • Mechanisms of load imbalance are identified, and LB schemes are proposed. • Parallel performance of the approach is demonstrated at the regional scale. [ABSTRACT FROM AUTHOR]

While recent studies suggest that interleukin (IL)-1β production is modulated by macroautophagy or sensors of endoplasmic reticulum (ER) stress upon pro-inflammatory insult, autophagy and IL-1β production during viral infection has not been fully investigated. This was addressed using respiratory syncytial virus (RSV), which is associated with lung immunopathology, IL-1, and IL-17a secretion in severely infected patients. Mice deficient in the autophagy-associated protein Map1-LC3b (LC3b−/−) developed increased IL-17a-dependent lung pathology upon infection. RSV-infected LC3b−/− dendritic cells (DCs) fail to upregulate autophagosome formation, secrete IL-1β and IL-6, and elicit IL-17a production from CD4+ T cells. Bone marrow chimeras revealed that both structural and hematopoietic LC3b deficiency contribute to the development of IL-17a-dependent lung pathology in vivo. Further investigation revealed airway epithelium as the primary source of IL-1β during infection, whereas inhibition of the ER-stress sensor inositol-requiring protein-1 in primary airway epithelial cells reduced IL-1β production identifying a primary ER stress pathway. Finally, blockade of IL-1 receptor signaling in RSV-infected LC3b−/− mice abolished IL-17a-dependent lung pathology. These findings provide novel mechanistic insight into the contribution of autophagy- and ER stress-dependent cytokine production that initiate and maintain aberrant Th17 responses, while identifying IL-1 as a potential therapeutic target in the treatment of severe respiratory viral infections. [ABSTRACT FROM AUTHOR]

Background Recent experimental evidence supports a role for binocular visual experience in the treatment of amblyopia. The purpose of this study was to determine whether repeated binocular visual experience with dichoptic iPad games could effectively treat amblyopia in preschool children. Methods A total of 50 consecutive amblyopic preschool children 3-6.9 years of age were assigned to play sham iPad games (first 5 children) or binocular iPad games (n = 45) for at least 4 hours per week for 4 weeks. Thirty (67%) children in the binocular iPad group and 4 (80%) in the sham iPad group were also treated with patching at a different time of day. Visual acuity and stereoacuity were assessed at baseline, at 4 weeks, and at 3 months after the cessation of game play. Results The sham iPad group had no significant improvement in visual acuity ( t 4 = 0.34, P = 0.75). In the binocular iPad group, mean visual acuity (plus or minus standard error) improved from 0.43 ± 0.03 at baseline to 0.34 ± 0.03 logMAR at 4 weeks (n = 45; paired t 44 = 4.93; P < 0.0001). Stereoacuity did not significantly improve ( t 44 = 1.35, P = 0.18). Children who played the binocular iPad games for ≥8 hours (≥50% compliance) had significantly more visual acuity improvement than children who played 0-4 hours ( t 43 = 4.21, P = 0.0001). Conclusions Repeated binocular experience, provided by dichoptic iPad game play, was more effective than sham iPad game play as a treatment for amblyopia in preschool children. [ABSTRACT FROM AUTHOR]

Aquifer heterogeneity is known to affect solute characteristics such as spatial spreading, mixing, and residence time, and is often modeled geostatistically to address aquifer uncertainties. While parameter uncertainty is often considered, the model uncertainty of the heterogeneity structure is frequently ignored. In this high-resolution heterogeneity model comparison, we perform a stochastic analysis utilizing spatial moment and breakthrough curve (BTC) metrics on Gaussian ( G ), truncated Gaussian ( TG ), and non-Gaussian, or “facies” ( F ) heterogeneous domains. Three-dimensional plume behavior is rigorously assessed with meter (horizontal) and cm (vertical) scale discretization over a ten-kilometer aquifer. Model differences are quantified as a function of statistical anisotropy, ε , by varying the x -direction integral scale of hydraulic conductivity, K , from 15 to 960 (m). We demonstrate that the model is important only for certain metrics within a range of ε . For example, spreading is insensitive to the model selection at low ε , but not at high ε . In contrast, center of mass is sensitive to the model selection at low ε , and not at high ε . A conceptual model to explain these trends is proposed and validated with BTC metrics. Simulations show that G model effective K , and 1st and 2nd spatial moments are much greater than that of TG and F models. A comparison of G and TG models (which only differ in K -distribution tails) reveal drastically different behavior, exemplifying how accurate characterization of the K -distribution may be important in modeling efforts, especially in aquifers where extreme K values are often not measured, or inadvertently overlooked. [ABSTRACT FROM AUTHOR]

To evaluate a newly developed, web-based system for at-home pediatric visual acuity testing and to compare results with standard in-office visual acuity test results. Children aged 3-12 years with and without visual deficits were enrolled (N = 65; 130 eyes). Monocular visual acuity was tested in-office using the ATS-HOTV (ages 3-6) or E-ETDRS (ages 7-12) protocol. Each child's family was emailed a link to a web-based version of the same visual acuity test for at-home testing. Equivalence was evaluated by using a linear mixed model to estimate the mean difference between in-office and at-home visual acuity test results and the corresponding two-sided 95% confidence interval. For children tested with the ATS-HOTV protocol, the mean difference between in-office and at-home visual acuity test results was 0.01 log MAR (95% CI, −0.06 to 0.09). For children tested with the E-ETDRS protocol, the mean difference was 0.04 log MAR (95% CI, −0.06 to 0.14). At-home, web-based ATS-HOTV and E-ETDRS visual acuity test results had excellent concordance with in-office visual acuity testing. If the burden of travel is significant, at-home testing of children's visual acuity may provide the information needed to continue care when it might otherwise be discontinued or delayed.▪ [ABSTRACT FROM AUTHOR]

Highlights: [•] Age distributions can be estimated from pairs of radiometric tracers. [•] A superposition of streamtubes is used to approximate flow and transport. [•] Simple models can provide approximations of complex age distributions. [ABSTRACT FROM AUTHOR]