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The TESS space mission provides us with high-precision photometric observations of bright stars over more than 70% of the entire sky, allowing us to revisit and characterise well-known stars. We aim to conduct an asteroseismic analysis of the gamma Doradus star HD112429 using both the available ground-based spectroscopy and TESS photometry, and assess the conditions required to measure the near-core rotation rate and buoyancy travel time. We collect and reduce the available five sectors of short-cadence TESS photometry of this star, as well as 672 legacy observations from six medium- to high-resolution ground-based spectrographs. We determine the stellar pulsation frequencies from both data sets using iterative prewhitening, do asymptotic g mode modelling of the star and investigate the corresponding spectral line profile variations using the pixel-by-pixel method. We validate the pulsation frequencies from the TESS data up to $S/N \geq 5.6$, confirming recent reports in the literature that the classical criterion $S/N \geq 4$ does not suffice for space-based observations. We identify the pulsations as prograde dipole g modes and r-mode pulsations, and measure a near-core rotation rate of $1.536(3) d^{-1}$ and a buoyancy travel time $\Pi_0$ of 4190(50) s. These results are in agreement with the observed spectral line profile variations, which were qualitatively evaluated using a newly developed toy model. We establish a set of conditions that have to be fulfilled for an asymptotic asteroseismic analysis of g-mode pulsators. In the case of HD112429, two TESS sectors of space photometry suffice. Although a detailed asteroseismic modelling analysis is not viable for g-mode pulsators with only short or sparse light curves of space photometry, we find that it is possible to determine global asteroseismic quantities for a subset of these stars. (abbreviated.), Comment: 15 pages, 13 figures, 4 tables. Accepted for publication in Astronomy and Astrophysics

ObjectiveTo determine the molecular basis of a new monogenetic recessive disorder that results in familial autonomic ganglionopathy with diffuse autonomic failure.MethodsTwo adult siblings from one family (I-4 and I-5) and another participant from a second family (II-3) presented with severe neurogenic orthostatic hypotension (nOH), small nonreactive pupils, and constipation. All 3 affected members had low norepinephrine levels and diffuse panautonomic failure.ResultsWhole exome sequencing of DNA from I-4 and I-5 showed compound heterozygosity for c.907_908delCT (p.L303Dfs*115)/c.688 G>A (p.D230N) pathologic variants in the acetylcholine receptor, neuronal nicotinic, α3 subunit gene (CHRNA3). II-3 from the second family was homozygous for the same frameshift (fs) variant (p.L303Dfs*115//p.L303Dfs*115). CHRNA3 encodes a critical subunit of the nicotinic acetylcholine receptors (nAChRs) responsible for fast synaptic transmission in the autonomic ganglia. The fs variant is clearly pathogenic and the p.D230N variant is predicted to be damaging (SIFT)/probably damaging (PolyPhen2). The p.D230N variant lies on the interface between CHRNA3 and other nAChR subunits based on structural modeling and is predicted to destabilize the nAChR pentameric complex.ConclusionsWe report a novel genetic disease that affected 3 individuals from 2 unrelated families who presented with severe nOH, miosis, and constipation. These patients had rare pathologic variants in the CHRNA3 gene that cosegregate with and are predicted to be the likely cause of their diffuse panautonomic failure.

The introduction of the intraocular vitrectomy instrument by Machemer et al. has led to remarkable advancements in vitreoretinal surgery enabling the limitations of human physiologic capabilities to be reached. To overcome the barriers of perception, tremor, and dexterity, robotic technologies have been investigated with current advancements nearing the feasibility for clinical use. There are four categories of robotic systems that have emerged through the research: (1) handheld instruments with intrinsic robotic assistance, (2) hand-on-hand robotic systems, (3) teleoperated robotic systems, and (4) magnetic guidance robots. This review covers the improvements and the remaining needs for safe, cost-effective clinical deployment of robotic systems in vitreoretinal surgery.

Objective Profound and thorough literature search is a vital element of evidence-based medicine. However, increasing number of publications and limited time make it hard to find the best available evidence. The objective of this randomised controlled trial (RCT) was to demonstrate the superiority of the ISGPS Evidence Map of Pancreatic Surgery (via EVIglance on www.evidencemap.surgery) compared to a conventional literature search via PubMed for answering clinically relevant questions in pancreatic surgery. Methods A single-centre, blinded, cross-over RCT including medical students, residents and consultants as participants was performed. Participants conducted literature searches with two predefined PICO (Patient, Intervention, Control, Outcome) questions, one with PubMed and the other with EVIglance. The order of the search tools and the PICO questions were assigned by randomisation. Primary endpoint was time in minutes until a synopsis was made regarding the PICO question. The synopsis was characterised by the direction of the effect and the certainty of evidence. Three times 28 participants were needed to show a minimal difference of 3 minutes at a level of significance of alpha = 1.67%. Furthermore, the correct number of RCTs found by participants that were relevant to answer the PICO question was analysed. Results Each 28 medical students, residents and consultants were randomised and analysed. A synopsis for the PICO question was found with PubMed after 10.8 minutes and with EVIglance after 1.7 minutes (95%-CI for difference: 9.9 to 8.3 minutes; p Conclusion Pancreatic surgeons find best available evidence faster via EVIglance on www.evidencemap.surgery. Furthermore, a synopsis made from EVIglance is more concise regarding direction of effect and certainty of evidence. Given the advantages of EVIglance it may be considered the new gold standard for finding best available evidence in pancreatic surgery.

Objective This study tested the Adaptation to Poverty-Related Stress (APRS) model's proposed relationships between poverty-related stress (PRS), ethnic identity affirmation (EI), social support, engagement coping, and depression in a racial/ethnically diverse sample of low-income parents. Method Path analysis was used to test the APRS model in a sample of 602 parents living at or below 200% of the federal poverty line (50% male, mean age = 32.55 years, SD = 8.78, 34.8% White). Multigroup path analysis tested moderation by gender and race/ethnicity. Results Path analysis revealed that PRS was indirectly associated with higher depressive symptoms through less social support and less use of engagement coping operating in parallel and sequentially in a three-path mediated sequence. Conversely, EI was indirectly associated with lower depressive symptoms through greater social support and greater use of engagement coping operating in parallel and sequentially. However, PRS remained a direct predictor of higher depressive symptoms. Moderation by gender and race/ethnicity was not found. Conclusion Overall, the findings provide empirical support for the APRS model. This study suggests that clinical and preventive interventions targeting depression in low-income parents could benefit from focusing on improving low-income parent's use of engagement coping and perceived social support. Ethnic identity is a promising target as it to protects against PRS' negative impact on coping and social support. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Continuum robots (CR) have been recently shown capable of micron-scale motion resolutions. Such motions are achieved through equilibrium modulation using indirect actuation for altering either internal preload forces or changing the cross-sectional stiffness along the length of a continuum robot. Previously reported, but unexplained, turning point behavior is modeled using two approaches. An energy minimization approach is first used to explain the source of this behavior. Subsequently, a kinematic model using internal constraints in multi-backbone CRs is used to replicate this turning point behavior. An approach for modeling the micro-motion differential kinematics is presented using experimental data based on the solution of a system of linear matrix equations. This approach provides a closed-form approximation of the empirical micro-motion kinematics and could be easily used for real-time control. A motivating application of image-based biopsy using 3D optical coherence tomography (OCT) is envisioned and demonstrated in this paper. A system integration for generating OCT volumes by sweeping a custom B-mode OCT probe is presented. Results showing high accuracy in obtaining 3D OCT measurements are shown using a commercial OCT probe. Qualitative results using a miniature probe integrated within the robot are also shown. Finally, closed-loop visual servoing using OCT data is demonstrated for guiding a needle into an agar channel. Results of this paper present what we believe is the first embodiment of a continuum robot capable of micro and macro motion control for 3D OCT imaging. This approach can support the development of new technologies for CRs capable of surgical intervention and micro-motion for ultra-precision tasks.

This proof-of-concept study tests the initial efficacy of the Building a Strong Identity and Coping Skills (BaSICS) intervention, a selective prevention of internalizing problems program for early adolescents exposed to high levels of poverty-related stress. Eighty-four early adolescents (M(age) = 11.36 years) residing in very low-income neighborhoods were randomized to receive the 16-session intervention (n = 44) or to an assessment-only control condition (n = 40). BaSICS teaches coping skills, social identity development, and collective social action to empower youth with the ability to connect with members of their communities and cope with poverty-related stress in positive and collaborative ways. Pretest–posttest analyses showed that intervention adolescents acquired problem-solving and cognitive-restructuring skills and reduced their reliance on avoidant coping. In addition, HPA reactivity was significantly reduced in the intervention youth, but not controls. Finally, intervention youth’s internalizing and somatic symptoms as reported by both youth and their parents, showed significant reductions over time, whereas control youth had no such changes. Results provide strong support for this approach to strength-building and symptom reduction in a population of early adolescents exposed to poverty-related stress.

BACKGROUND AND OBJECTIVE: This paper reports 3-year intraocular pressure (IOP) outcomes of the Prospective Retinal and Optic Nerve Vitrectomy Evaluation (PROVE) study. PATIENTS AND METHODS: The prospective, controlled, observational study included 80 eyes of 40 participants undergoing routine pars plana vitrectomy. Study patients underwent preoperative evaluation and multimodal testing of the study (surgical) and fellow (control) eye. This testing was repeated at 3 months postoperatively and then annually for 3 years. RESULTS: Thirty-two of 40 patients (80%) completed 3-year follow-up. At 3 years postoperatively, there was no difference in IOP measurements in surgical eyes overall from baseline ( P = .36). Subgroup analysis of pseudophakic eyes at baseline showed a significant elevation in IOP from 14.3 mm Hg ± 2.9 mm Hg at baseline to 16.8 mm Hg ± 3.2 mm Hg at 3-year follow-up ( P < .029). Fellow eyes did not experience a significant change from baseline. CONCLUSION: The authors' 3-year results show that IOP is consistently and significantly elevated in pseudophakic eyes compared to baseline following routine vitrectomy. [ Ophthalmic Surg Lasers Imaging Retina . 2019;50:371–376.]

Exfoliation syndrome (XFS) is an age-related systemic disorder characterized by excessive production and progressive accumulation of abnormal extracellular material, with pathognomonic ocular manifestations. It is the most common cause of secondary glaucoma, resulting in widespread global blindness. We performed Transcriptomic Wide Association Studies (TWAS) using PrediXcan models trained in 48 GTEx tissues to identify genetically- determined gene expression changes associated with XFS risk, leveraging on results from a global GWAS that included 123,457 individuals from 24 countries. We observed twenty-eight genes in a three-Megabase chr15q22-25 region that showed statistically significant associations, which were further whittled down to ten genes after additional statistical validations. In experimental analysist of these ten genes, mRNA transcript levels for ARID3B, CD276, LOXL1, NEO1, SCAMP2, and UBL7 were significantly decreased in iris tissues from XFS patients compared to control samples. Genes with genetically determined expression changes in XFS were significantly enriched for genes associated with inflammatory conditions. We further explored the health consequences of high susceptibility to XFS using a large electronic health record and observed a higher incidence of XFS comorbidity with inflammatory and connective tissue diseases. Our results implicate a role for connective tissues and inflammation in the etiology of XFS. Targeting the inflammatory pathway may be a potential therapeutic option to reduce progression in XFS.

Puberty is often implicated in the onset or exacerbation of psychopathology during adolescence, and pubertal timing and tempo have emerged as important predictors of wellbeing. In the psychosocial literature there is a tendency to view individual differences in the nature (timing and tempo) of pubertal development as either determined by stress experienced in childhood or as a determinant of the development of psychopathology; few studies, however, have examined puberty as both. We propose that pubertal timing and tempo are neither simply antecedents nor consequences with respect to onset or exacerbation of psychopathology, but rather as markers of accumulating risk such as that conceptualized as allostatic load. Further, we propose that integrating coping and self-regulation into models of off-time pubertal maturation presents an opportunity to forge linkages among the processes that precede and follow pubertal development, which may provide malleable intervention targets to offset the costs of early life stress and off-time maturation. The present narrative review synthesizes research from the following literatures: (1) the role of stress in determining the timing and tempo of pubertal development; (2) the role of stress in influencing how pubertal development affects socioemotional and behavioral outcomes during adolescence, and (3) the role of coping and self-regulation in understanding conditional adaptations to stress. Given the conclusions of this synthesis, critical recommendations are made for research and intervention work with adolescents.

To compare the electrophysiological and morphological responses to acute, moderately elevated intraocular pressure (IOP) in Sprague-Dawley (SD), Long-Evans (LE) and Brown Norway (BN) rat eyes. Eleven-week-old SD (n = 5), LE (n = 5) and BN (n = 5) rats were used. Scotopic threshold responses (STRs), Maxwellian flash electroretinograms (ERGs) or ultrahigh-resolution optical coherence tomography (UHR-OCT) images of the rat retinas were collected from both eyes before, during and after IOP elevation of one eye. IOP was raised to ~35 mmHg for 1 h using a vascular loop, while the other eye served as a control. STRs, ERGs and UHR-OCT images were acquired on 3 days separated by 1 day of no experimental manipulation. There were no significant differences between species in baseline electroretinography. However, during IOP elevation, peak positive STR amplitudes in LE (mean ± standard deviation 259 ± 124 µV) and BN (228 ± 96 µV) rats were about fourfold higher than those in SD rats (56 ± 46 µV) rats (p = 0.0002 for both). Similarly, during elevated IOP, ERG b-wave amplitudes were twofold higher in LE and BN rats compared to those of SD rats (947 ± 129 µV and 892 ± 184 µV, vs 427 ± 138 µV; p = 0.0002 for both). UHR-OCT images showed backward bowing in all groups during IOP elevation, with a return to typical form about 30 min after IOP elevation. Differences in the loop-induced responses between the strains are likely due to different inherent retinal morphology and physiology.

Introduction L’hippocratisme digital est un symptome principalement connu comme etant une manifestation precoce de pathologies secondaires neoplasiques, notamment pulmonaires. Le bilan etiologique doit etre complet afin de ne pas meconnaitre une pathologie sous-jacente grave. L’existence du signe de Shamroth permet d’affirmer l’hippocratisme digital. Il s’agit de la perte de l’espace losangique physiologique entre les dernieres phalanges de deux doigts correspondants mis face a face. Observation Nous rapportons le cas d’un patient de 47 ans presentant un hippocratisme digital depuis l’enfance hospitalise pour ileite terminale a Campylobacter jejuni. La persistance des diarrhees apres traitement fait evoquer une maladie inflammatoire chronique de l’intestin, rapportee comme une cause secondaire d’hippocratisme digitale. Les examens endoscopiques et biopsies digestives infirment ce diagnostic. On ne retrouve pas d’arguments en faveur d’un cancer pulmonaire a l’imagerie. Le bilan biologique montre une TSH, un bilan hepatique normal et l’absence de syndrome inflammatoire. Le bilan auto-immun revient negatif, hormis des ANCA positifs sans specificite. Les serologies VIH et syphilis sont negatives. On ne retrouve pas de notion de consanguinite, ni d’antecedents familiaux. Le patient est vu en consultation de medecine interne. Il decrit des arthralgies au niveau de genoux, des coudes et du rachis cervical ; ainsi que des chutes de cheveux et poils. A l’examen clinique, il presente des lesions crouteuses du vertex et frontales du cuir chevelu, ainsi qu’une melanodermie. Les radiographies des os longs realisees retrouvent des appositions periostees au niveau des tibias et fibulas. L’association de cet aspect radiologique et de l’hippocratisme digital fait evoquer, en l’absence de cause secondaire retrouvee, le diagnostic de pachydermoperiostose. Discussion La pachydermoperiostose doit etre connue de l’interniste en tant que diagnostic differentiel des hippocratismes digitaux secondaires. Le diagnostic repose sur l’association d’un hippocratisme digital, d’un epaississement cutane (pachydermie), d’appositions periostees associees a des douleurs, d’une hyperhidrose palmaire, d’une polyarthrite, d’une dermite seborrheique et d’un cutis versitis gyrata. Cette derniere anomalie est une hypertrophie et une hyperlaxite du cuir chevelu qui realise des plis anormalement epais et profonds. Le tableau peut etre complet, incomplet ou fruste. Lorsqu’il n’y a pas de pachydermie, il est dit incomplet, comme dans le cas presente. Lorsqu’il y a une pachydermie sans anomalie osseuse, il est dit fruste. C’est une affection rare, de transmission autosomique recessive ou dominante qui touche 9 hommes pour une femme. Elle commence dans l’enfance ou l’adolescence et evolue pendant 5 a 10 ans avant de se stabiliser. Plusieurs mutations causales ont ete decrites dans les genes HPGD et SLCO2A1. Leur recherche n’est pas disponible en pratique courante en France. Ainsi, le diagnostic est clinique et radiologique. Il n’y a pas de recommandations therapeutiques, au vu de la rarete de cette pathologie. Pour la gestion des douleurs articulaires, un traitement par AINS, colchicine et corticoides en cure courte peuvent etre utilises. Conclusion La pachydermoperiostose est une forme d’hippocratisme digital primaire. Meme si cette pathologie est rare, il faut la connaitre pour eviter une errance diagnostique.

Patients with autonomic failure developed severe neurogenic orthostatic hypotension (nOH). There are only two reported genetic conditions that cause nOH, dopamine β-hydroxylase deficiency, and CYB561 deficiency; both affect norepinephrine synthesis resulting in an isolated sympathetic failure. Objective: To determine molecular basis of a new Mendelian cause of familial nOH with impaired cardiovagal function, and miosis associated with sympathetic (SNS) and parasympathetic (PNS) failure. Method and Results: The proband developed disabling nOH with poor compensatory increase in heart rate at 39 yrs of age. Plasma norepinephrine levels were abnormally low. His sister had onset of nOH in her late teens. Their parents and brother were healthy. Whole exome sequencing of DNAs from the proband and his affected sister showed that both were compound heterozygotes for c.907_908delCT (p.L303Dfs*115) /c.688G>A (p.D230N) variants in the acetylcholine receptor, neuronal nicotinic, alpha 3 subunit (CHRNA3) gene. CHRNA3 is a subunit of nicotinic acetylcholine receptors (nAChRs) that regulates blood pressure through modulation of synaptic transmission in the autonomic ganglia. The autonomic ganglia regulates both SNS and PNS activity. The frameshift (fs) and missense CHRNA3 variants were inherited from the sibs’ mother and father, respectively, and their non-affected brother was a nl/p.D230N heterozygote. The fs variant is obviously pathogenic and the p.D230N variant is predicted to be damaging (SIFT)/probably damaging (PolyPhen2). Furthermore, we predict from structural modeling that the p.D230N variant lies on the interface between CHRNA3 and other nAChR subunits and that it would destabilize the nAChR pentameric complex. In humans, the presence of acquired nAChR autoantibodies against the alpha 3 subunit is associated with nOH and non-reactive pupils. Conclusions: We report sibs affected with NOH and miosis who are compound heterozygotes forCHRNA3 variants that co-segregate with and have predicted effects on nAChR structure that suggest they likely cause this family’s SNS and PNS failure.

Background. Oculofaciocardiodental (OFCD) syndrome is due to mutations in BCOR (BCL-6 corepressor). OFCD has phenotypic overlaps with PHACE syndrome (Posterior fossa anomalies, Hemangioma, Arterial anomalies, Cardiac defects, Eye anomalies). Infantile hemangiomas are a key diagnostic criterion for PHACE, but not for OFCD. A previous study reported two cases of infantile hemangiomas in OFCD, but the authors could not exclude chance association. Case Presentation. We describe two novel cases of female patients (one initially diagnosed with PHACE syndrome), both of whom had infantile hemangiomas. Ophthalmological findings were consistent with oculofaciocardiodental (OFCD) syndrome. Upon genetic testing, these two females were determined to have X-linked BCOR mutations confirming OFCD syndrome diagnoses. Conclusion. These case reports add support to the hypothesis that infantile hemangiomas may be a feature of OFCD. BCOR may potentially be within a pathway of genes involved in PHACE syndrome and/or in infantile hemangioma formation.

Understanding co-activation patterns of the hypothalamic-pituitary-adrenal axis (HPA) and sympathetic adrenal medullary (SAM) during early adolescence may illuminate risk for development of internalizing and externalizing problems. The present study advances empirical work on the topic by examining SAM-HPA co-activation during both the reactivity and recovery phases of the stress response following acute stress exposure. Fourth and fifth grade boys and girls (N = 149) provided cortisol and alpha-amylase via saliva at seven times throughout a 95-minute assessment in which they were administered the modified Trier Social Stress Test. Parents reported on adolescents’ life stress, pubertal development, medication use, and externalizing problems. Adolescents reported their own internalizing symptoms. Multiple linear regressions tested both direct and interactive effects of SAM and HPA reactivity and recovery on internalizing and externalizing problems. Results from these analyses showed that whereas SAM and HPA reactivity interacted to predict internalizing symptoms, it was their interaction during the recovery phase that predicted externalizing. Concurrent high SAM and HPA reactivity scores predicted high levels of internalizing and concurrently low SAM and HPA recovery scores predicted high levels of externalizing. Implications of the findings for further study and clinical application are discussed.

The Hispanic population is the United States' largest minority and one of the fastest growing as well. In the next 30 to 40 years, the proportion of open-angle glaucoma patients represented by Hispanics is expected to dramatically rise. Here we examine the unique considerations and challenges of glaucoma care in this population, from demographics to risk factors to treatments and outcomes. Currently, access to care and the under-diagnosis of glaucoma in this population are significant issues that look only to grow in significance as the glaucoma burden continues to grow. Additionally, utilization of medical and surgical therapy remains lower in Hispanics than in many other ethnic groups. Understanding and proactively addressing the unique challenges in the screening and treatment of Hispanics will be of utmost importance to providing effective care to this population.

The toxic stress model posits that extended activation of stress response systems in the absence of a supportive relationship with an adult may over time lead to physiological alterations to these same systems, and ultimately to poorer physical and mental health outcomes. However, empirical tests of model hypotheses in adolescence, a critical period of development, are lacking. This study expands the toxic stress model to include more developmentally-appropriate risk and protective factors for adolescents experiencing overwhelming and uncontrollable stressors. Data were collected for a study of early adolescents from urban low-income households (N = 101; 10–12 years old; 59% female). Participants and a caregiver completed questionnaires; youths completed the modified Trier Social Stress Task alone and provided six saliva samples. Using latent profile analysis, three profiles of cortisol reactivity were identified in early adolescents exposed to chronic environmental stress: Elevated and Reactive (11%), Moderate and Non-Reactive (26%), and Blunted and Non-Reactive (63%). In accordance with the toxic stress model, exposure to more community violence and less family support were associated with blunted cortisol reactivity, and Reactive profile membership was associated with fewer trauma symptoms. Overall, the findings provide empirical support for the extension of the toxic stress model in early adolescence through the application of developmentally-sensitive measures and provide implications for future interventions.

Introduction Trauma-exposed individuals with and without posttraumatic stress disorder (PTSD) are more likely to smoke and less successful in quit attempts than individuals without psychopathology. Contingency management (CM) techniques (i.e., incentives for abstinence) have demonstrable efficacy for smoking cessation in some populations with psychopathology, but have not been well tested in PTSD. This pilot study examined the feasibility of CM plus brief cognitive behavioral therapy (CBT) in promoting smoking cessation among trauma-exposed individuals with and without PTSD. Methods Fifty trauma-exposed smokers (18 with PTSD) were asked to abstain from tobacco and nicotine replacement therapy for one month. During week one of cessation, CBT was provided daily and increasing CM stipends were paid for each continuous day of biochemically-verified abstinence; CM stipends were withheld in response to smoking lapses and reset to the initial payment level upon abstinence resumption. CBT and fixed payments for study visits were provided during the subsequent three weeks. Results Of the 50 eligible participants who attended at least one pre-quit visit (49% female, 35% current PTSD), 43 (86%) attended the first post-quit study visit, 32 (64%) completed the first week of CM/CBT treatment, and 26 (52%) completed the study. Post-quit seven-day point prevalence abstinence rates for participants with and without PTSD, respectively, were similar: 39% vs. 38% (1 week), 33% vs. 28% (2 weeks), 22% vs. 19% (3 weeks), and 22% vs. 13% (4 weeks). Conclusions Use of CM + CBT to support tobacco abstinence is a promising intervention for trauma-exposed smokers with and without PTSD.

Amplitudes of electroretinograms (ERG) are enhanced during acute, moderate elevation of intraocular pressure (IOP) in rats anaesthetised with isoflurane. As anaesthetics alone are known to affect ERG amplitudes, the present study compares the effects of inhalant isoflurane and injected ketamine:xylazine on the scotopic threshold response (STR) in rats with moderate IOP elevation. Isoflurane-anaesthetised (n = 9) and ketamine:xylazine-anaesthetised (n = 6) rats underwent acute unilateral IOP elevation using a vascular loop anterior to the equator of the right eye. STRs to a luminance series (subthreshold to −3.04 log scotopic cd s/m2) were recorded from each eye of Sprague-Dawley rats before, during, and after IOP elevation. Positive STR (pSTR) amplitudes for all conditions were significantly smaller (p = 0.0001) for isoflurane- than for ketamine:xylazine-anaesthetised rats. In addition, ketamine:xylazine was associated with a progressive increase in pSTR amplitudes over time (p = 0.0028). IOP elevation was associated with an increase in pSTR amplitude (both anaesthetics p

The human brain is made up of functional regions governing movement, sensation, language, and cognition. Unintentional injury during neurosurgery can result in significant neurological deficits and morbidity. The current standard for localizing function to brain tissue during surgery, intraoperative electrical stimulation or recording, significantly increases the risk, time, and cost of the procedure. There is a need for a fast, cost-effective, and high-resolution intraoperative technique that can avoid damage to functional brain regions. We propose that optical coherence tomography (OCT) can fill this niche by imaging differences in the cellular composition and organization of functional brain areas. We hypothesized this would manifest as differences in the attenuation coefficient measured using OCT. Five functional regions (prefrontal, somatosensory, auditory, visual, and cerebellum) were imaged in ex vivo porcine brains (n=3), a model chosen due to a similar white/gray matter ratio as human brains. The attenuation coefficient was calculated using a depth-resolved model and quantitatively validated with Intralipid phantoms across a physiological range of attenuation coefficients (absolute difference < 0.1cm-1). Image analysis was performed on the attenuation coefficient images to derive quantitative endpoints. We observed a statistically significant difference among the median attenuation coefficients of these five regions (one-way ANOVA, p

OBJECTIVES: Substance use may influence study results in human subjects research. This study aims to report the concordance between self‐report and biochemical assessments of substance use and test the effect of methods to reduce false reports of abstinence in trauma‐exposed women participating in a research study. METHODS: In this pilot study, substance use was assessed during telephone prescreening and via self‐report and biochemical verification (i.e., urine toxicology and alcohol breathalyzer tests) at an in‐person evaluation. Due to the high number of participants who tested positive for substances despite self‐reporting abstinence during prescreening, study procedures were modified to disincentivize false self‐reports of substance use two thirds of the way through recruitment. New potential participants were explicitly informed during prescreening and informed consent that a positive drug or alcohol test during screening would result in exclusion from the study and withholding of payment. RESULTS: Prior to modifying study methods, 20% of participants who had reported abstinence during the telephone prescreen had a positive substance use test at the in‐person visit. Modifying study procedures resulted in an 81% decrease in positive substance use assessments. CONCLUSIONS: Adoption of this methodology may decrease inadvertent confounding of clinical research outcomes by undetected and/or misreported substance use.

Multimodal imaging systems that combine scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT) have demonstrated the utility of concurrent en face and volumetric imaging for aiming, eye tracking, bulk motion compensation, mosaicking, and contrast enhancement. However, this additional functionality trades off with increased system complexity and cost because both SLO and OCT generally require dedicated light sources, galvanometer scanners, relay and imaging optics, detectors, and control and digitization electronics. We previously demonstrated multimodal ophthalmic imaging using swept-source spectrally encoded SLO and OCT (SS-SESLO-OCT). Here, we present system enhancements and a new optical design that increase our SS-SESLO-OCT data throughput by >7x and field-of-view (FOV) by >4x. A 200 kHz 1060 nm Axsun swept-source was optically buffered to 400 kHz sweep-rate, and SESLO and OCT were simultaneously digitized on dual input channels of a 4 GS/s digitizer at 1.2 GS/s per channel using a custom k-clock. We show in vivo human imaging of the anterior segment out to the limbus and retinal fundus over a >40° FOV. In addition, nine overlapping volumetric SS-SESLO-OCT volumes were acquired under video-rate SESLO preview and guidance. In post-processing, all nine SESLO images and en face projections of the corresponding OCT volumes were mosaicked to show widefield multimodal fundus imaging with a >80° FOV. Concurrent multimodal SS-SESLO-OCT may have applications in clinical diagnostic imaging by enabling aiming, image registration, and multi-field mosaicking and benefit intraoperative imaging by allowing for real-time surgical feedback, instrument tracking, and overlays of computationally extracted image-based surrogate biomarkers of disease.

Surgical interventions for ocular diseases involve manipulations of semi-transparent structures in the eye, but limited visualization of these tissue layers remains a critical barrier to developing novel surgical techniques and improving clinical outcomes. We addressed limitations in image-guided ophthalmic microsurgery by using microscope-integrated multimodal intraoperative swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography (iSS-SESLO-OCT). We previously demonstrated in vivo human ophthalmic imaging using SS-SESLO-OCT, which enabled simultaneous acquisition of en face SESLO images with every OCT cross-section. Here, we integrated our new 400 kHz iSS-SESLO-OCT, which used a buffered Axsun 1060 nm swept-source, with a surgical microscope and TrueVision stereoscopic viewing system to provide image-based feedback. In vivo human imaging performance was demonstrated on a healthy volunteer, and simulated surgical maneuvers were performed in ex vivo porcine eyes. Denselysampled static volumes and volumes subsampled at 10 volumes-per-second were used to visualize tissue deformations and surgical dynamics during corneal sweeps, compressions, and dissections, and retinal sweeps, compressions, and elevations. En face SESLO images enabled orientation and co-registration with the widefield surgical microscope view while OCT imaging enabled depth-resolved visualization of surgical instrument positions relative to anatomic structures-of-interest. TrueVision heads-up display allowed for side-by-side viewing of the surgical field with SESLO and OCT previews for real-time feedback, and we demonstrated novel integrated segmentation overlays for augmented-reality surgical guidance. Integration of these complementary imaging modalities may benefit surgical outcomes by enabling real-time intraoperative visualization of surgical plans, instrument positions, tissue deformations, and image-based surrogate biomarkers correlated with completion of surgical goals.

Ophthalmic diagnostic imaging using optical coherence tomography (OCT) is limited by bulk eye motions and a fundamental trade-off between field-of-view (FOV) and sampling density. Here, we introduced a novel multi-volumetric registration and mosaicking method using our previously described multimodal swept-source spectrally encoded scanning laser ophthalmoscopy and OCT (SS-SESLO-OCT) system. Our SS-SESLO-OCT acquires an entire en face fundus SESLO image simultaneously with every OCT cross-section at 200 frames-per-second. In vivo human retinal imaging was performed in a healthy volunteer, and three volumetric datasets were acquired with the volunteer moving freely and refixating between each acquisition. In post-processing, SESLO frames were used to estimate en face rotational and translational motions by registering every frame in all three volumetric datasets to the first frame in the first volume. OCT cross-sections were contrast-normalized and registered axially and rotationally across all volumes. Rotational and translational motions calculated from SESLO frames were applied to corresponding OCT B-scans to compensate for interand intra-B-scan bulk motions, and the three registered volumes were combined into a single interpolated multi-volumetric mosaic. Using complementary information from SESLO and OCT over serially acquired volumes, we demonstrated multivolumetric registration and mosaicking to recover regions of missing data resulting from blinks, saccades, and ocular drifts. We believe our registration method can be directly applied for multi-volumetric motion compensation, averaging, widefield mosaicking, and vascular mapping with potential applications in ophthalmic clinical diagnostics, handheld imaging, and intraoperative guidance.

Fire blight causes enormous losses in pome fruit production worldwide. Due to the lack of resistance against its causative agent Erwinia amylovora, fruit growers appear defenseless against this bacteriosis. Since the usage of antibiotics in food production is undesirable and there is no approved substance with the same efficiency as streptomycin available, phytosanitary measures were tested for effectiveness against fire blight in apple orchards in Switzerland. Pathogen abundance was monitored by taking samples from different tissue followed by real-time PCR-based quantification throughout the years 2008 to 2011. Examinations were conducted in orchards which applied or did not apply phytosanitary control measures. Conclusions from these examinations could be used to modify recommendations for good cultural practices and, as consequence, to help reducing the pathogen load in the orchards without using antibiotics or other control agents.

Purpose To report 1-year outcomes of the Prospective Retinal and Optic Nerve Vitrectomy Evaluation study. Design Prospective, controlled, observational study. Participants Eighty eyes of 40 participants undergoing pars plana vitrectomy for epiretinal membrane (ERM), macular hole (MH), or vitreous opacities. Methods Enrolled participants underwent baseline evaluation of the study (surgical) and fellow (control) eyes by a masked fellowship-trained glaucoma specialist; evaluation included intraocular pressure (IOP; Goldmann applanation and Tono-Pen), central corneal thickness, gonioscopy, and cup-to-disc ratio measurement. Baseline testing included bilateral color fundus and optic disc photography, fundus autofluorescence, automated perimetry, and optical coherence tomography (OCT) of the macula and optic nerve. Evaluations were repeated at 3 months and 1 year after surgery. Main Outcome Measures The primary outcome measure was changes in peripapillary retinal nerve fiber layer (pRNFL) thickness. Secondary outcomes included changes in macular thickness and IOP. Results Thirty-eight of 40 patients completed 1 year of follow-up. Mean visual acuity (VA) improved in study eyes from baseline ( P = 0.003) but remained worse than fellow eyes ( P P = 0.004). Mean IOP difference between study eyes and fellow eyes increased from baseline to 1 year. At 1 year, MH study eyes had higher mean IOP (16.0±3.7 mmHg) compared with fellow eyes (14.8±3.4 mmHg; P = 0.08). Mean IOP for pseudophakic study eyes increased from 14.5±3.2 mmHg at baseline to 16.0±2.8 mmHg at 1 year ( P = 0.04). Central subfield thickness (CST) and cube volume decreased in study eyes at 1 year but remained greater than that of fellow eyes ( P P P = 0.02) but remained worse than fellow eyes (−1.2; P = 0.002). Conclusions One year after vitrectomy, VA, CST, and MD improved in study eyes but not to the level of fellow eyes. Inferior pRNFL thickness decreased in study eyes. Reduction in CST from baseline correlated with degree of VA improvement. Pseudophakic study eyes demonstrated increased IOP when compared with baseline.

Lowe syndrome is a rare X-linked congenital disease that presents with congenital cataracts and glaucoma, as well as renal and cerebral dysfunction. OCRL, an inositol polyphosphate 5-phosphatase, is mutated in Lowe syndrome. We previously showed that OCRL is involved in vesicular trafficking to the primary cilium. Primary cilia are sensory organelles on the surface of eukaryotic cells that mediate mechanotransduction in the kidney, brain, and bone. However, their potential role in the trabecular meshwork (TM) in the eye, which regulates intraocular pressure, is unknown. Here, we show that TM cells, which are defective in glaucoma, have primary cilia that are critical for response to pressure changes. Primary cilia in TM cells shorten in response to fluid flow and elevated hydrostatic pressure, and promote increased transcription of TNF-α, TGF-β, and GLI1 genes. Furthermore, OCRL is found to be required for primary cilia to respond to pressure stimulation. The interaction of OCRL with transient receptor potential vanilloid 4 (TRPV4), a ciliary mechanosensory channel, suggests that OCRL may act through regulation of this channel. A novel disease-causing OCRL allele prevents TRPV4-mediated calcium signaling. In addition, TRPV4 agonist GSK 1016790A treatment reduced intraocular pressure in mice; TRPV4 knockout animals exhibited elevated intraocular pressure and shortened cilia. Thus, mechanotransduction by primary cilia in TM cells is implicated in how the eye senses pressure changes and highlights OCRL and TRPV4 as attractive therapeutic targets for the treatment of glaucoma. Implications of OCRL and TRPV4 in primary cilia function may also shed light on mechanosensation in other organ systems.

Background and Objective Investigations have shown that pulsed lasers tuned to 6.1 µm in wavelength are capable of ablating ocular and neural tissue with minimal collateral damage. This study investigated whether a miniature B-scan forward-imaging optical coherence tomography (OCT) probe can be combined with the laser to provide real-time visual feedback during laser incisions. Study Design/Methods and Materials A miniature 25-gauge B-scan forward-imaging OCT probe was developed and combined with a 250 µm hollow-glass waveguide to permit delivery of 6.1 µm laser energy. A gelatin mixture and both porcine corneal and retinal tissues were simultaneously imaged and lased (6.1 µm, 10 Hz, 0.4–0.7 mJ) through air. The ablation studies were observed and recorded in real time. The crater dimensions were measured using OCT imaging software (Bioptigen, Durham, NC). Histological analysis was performed on the ocular tissues. Results The combined miniature forward-imaging OCT and mid-infrared laser-delivery probe successfully imaged real-time tissue ablation in gelatin, corneal tissue, and retinal tissue. Application of a constant number of 60 pulses at 0.5 mJ/pulse to the gelatin resulted in a mean crater depth of 123 ± 15 µm. For the corneal tissue, there was a significant correlation between the number of pulses used and depth of the lased hole (Pearson correlation coefficient = 0.82; P = 0.0002). Histological analysis of the cornea and retina tissues showed discrete holes with minimal thermal damage. Conclusions A combined miniature OCT and laser-delivery probe can monitor real-time tissue laser ablation. With additional testing and improvements, this novel instrument has the future possibility of effectively guiding surgeries by simultaneously imaging and ablating tissue. Lasers Surg. Med. 46:216–223, 2014. © 2014 Wiley Periodicals, Inc.

Towards the end of LHC Run1, gas leaks were observed in some parts of the Transition Radiation Tracker (TRT) of ATLAS. Due to these leaks, primary Xenon based gas mixture was replaced with Argon based mixture in various parts. Test-beam studies with a dedicated Transition Radiation Detector (TRD) prototype were carried out in 2015 in order to understand transition radiation performance with mixtures based on Argon and Krypton. We present and discuss the results of these test-beam studies with different active gas compositions., 5 pages,12 figures, The 2nd International Conference on Particle Physics and Astrophysics (ICPPA-2016); Acknowledgments section corrected

Introduction La prise en charge des infections osteo-articulaires sur prothese (IOAp) peut necessiter une approche medico-chirurgicale palliative dont les donnees sont limitees. L’objectif etait ici de decrire l’utilisation de la fistulisation comme alternative de traitement palliatif chez les patients avec une IOAp complexe. Materiels et methodes Etude retrospective descriptive multicentrique incluant les patients avec une IOAp traitee par fistule spontanee ou dirigee de janvier 2013 a decembre 2018. Les criteres de jugement etaient la survenue d’un evenement (hospitalisation ou deces lie a l’IOAp) et la gravite des sequelles. Resultats Sur 3 centres, 48 patients ont ete inclus d’âge median 78 ans (48–95) avec un sex-ratio 0,92. Le score ASA median etait de 3 (1–4) et 34 patients (71 %) avaient au moins une comorbidite severe. Une fistule spontanee depuis au moins 1 an etait deja presente chez 29 patients (60 %) lorsque la decision de traitement a ete prise en RCP. Ces IOAp touchaient la hanche (n = 26 ; 54 %), le genou (n = 17 ; 35 %), l’epaule (n = 4 ; 9 %) et le coude (n = 1 ; 2 %). Elles etaient precoces pour 9 patients (18 %), tardives pour 17 (36 %) et retardees pour 21 (46 %). Une documentation bacteriologique etait obtenue pour 37 patients, plurimicrobiens dans 7 cas. Les germes isoles etaient : Staphylococcus aureus (13 ; 25 %) dont 3 resistants a la methicilline, autres staphylocoques (4 ; 8 %), enterobacteries (9 ; 17,5 %), enterocoques (9 ; 17,5 %), streptocoques (7 ; 14 %), pseudomonas (4 ; 8 %), corynebacterium (2 ; 4 %), cutibacterium (1 ; 2 %), autres anaerobies (2 ; 4 %). Huit patients (18 %) ont recu une antibiotherapie suppressive (ATS). Dix-huit patients (40 %) ont ete hospitalises pour des complications de l’IOAp, 2 (4 %) sont decedes en lien avec l’IOAp, 3 patients ont ete perdus de vue et 25 (56 %) n’ont eu aucun evenement. Dans 19 cas (42 %), aucune sequelle fonctionnelle n’a ete notee, 14 patients (31 %) avaient des sequelles non graves (gene a la fonction articulaire) et 12 (27 %) des sequelles graves (perte de la fonction articulaire). Il n’y avait pas de difference significative entre le groupe avec ou sans ATS concernant le risque d’hospitalisation, de deces (p = 0,62), ou sur de sequelle (p = 0,38). Conclusion Le traitement palliatif des IOAp par fistulisation semble donner un bon taux d’efficacite et un maintien de la fonction articulaire et pourrait constituer une option raisonnable pour les patients avec des comorbidites et un score ASA 3. L’interet de l’association fistule et ATS reste a demontrer.

Rahul K Reddy,1 Maziar Lalezary,1 Stephen J Kim,1 Jeffrey A Kammer,1 Rachel W Kuchtey,1 Edward F Cherney,1 Franco M Recchia,2 Karen M Joos,1 Anita Agarwal,1 Janice C Law11Department of Ophthalmology, Vanderbilt University School of Medicine, Nashville, TN, USA; 2Tennessee Retina, PC, Nashville, TN, USABackground: The purpose of this paper is to report the 3-month findings of the Prospective Retinal and Optic Nerve Vitrectomy Evaluation (PROVE) study.Methods: Eighty eyes of 40 participants undergoing vitrectomy were enrolled. Participants underwent baseline evaluation of the study (surgical) and fellow (control) eye that included: intraocular pressure, central corneal thickness, gonioscopy, cup-to-disc ratio measurement, color fundus and optic disc photography, automated perimetry, and optical coherence tomography of the macula and optic nerve. Evaluation was repeated at 3 months. Main outcome measures were changes in macula and retinal nerve fiber layer (RNFL) thickness and intraocular pressure.Results: All participants completed follow-up. Mean cup-to-disc ratio of study and fellow eyes at baseline was 0.43 ± 0.2 and 0.46 ± 0.2, respectively, and 13% of participants had undiagnosed narrow angles. There was no significant change in intraocular pressure, cup-to-disc ratio, or pattern standard deviation in study eyes compared with baseline or fellow eyes at 3 months. Vision improved in all study eyes at 3 months compared with baseline (P = 0.013), but remained significantly worse than fellow eyes (P < 0.001). Central subfield and temporal peripapillary RNFL thickness were significantly greater in eyes with epiretinal membrane (P < 0.05), and resolution after surgery correlated with visual improvement (P < 0.05).Conclusion: The 3-month results do not indicate any increased risk for open-angle glaucoma but suggest that a relatively high percentage of eyes may be at risk of angle closure glaucoma. Temporal RNFL thickness and central subfield were increased in eyes with epiretinal membrane, and resolution correlated with degree of visual recovery.Keywords: vitrectomy, open-angle glaucoma, intraocular pressure, epiretinal membrane, macular hole

Scanning laser ophthalmoscopy (SLO) benefits diagnostic imaging and therapeutic guidance by allowing for high-speed en face imaging of retinal structures. When combined with optical coherence tomography (OCT), SLO enables real-time aiming and retinal tracking and provides complementary information for post-acquisition volumetric co-registration, bulk motion compensation, and averaging. However, multimodality SLO-OCT systems generally require dedicated light sources, scanners, relay optics, detectors, and additional digitization and synchronization electronics, which increase system complexity. Here, we present a multimodal ophthalmic imaging system using swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography (SS-SESLO-OCT) for in vivo human retinal imaging. SESLO reduces the complexity of en face imaging systems by multiplexing spatial positions as a function of wavelength. SESLO image quality benefited from single-mode illumination and multimode collection through a prototype double-clad fiber coupler, which optimized scattered light throughput and reduce speckle contrast while maintaining lateral resolution. Using a shared 1060 nm swept-source, shared scanner and imaging optics, and a shared dual-channel high-speed digitizer, we acquired inherently co-registered en face retinal images and OCT cross-sections simultaneously at 200 frames-per-second.