Double-blind placebo-controlled food challenges in children with alleged cow's milk allergy: prevention of unnecessary elimination diets and determination of eliciting doses.

PubMed

Dambacher, Wendy M; de Kort, Ellen H M; Blom, W Marty; Houben, Geert F; de Vries, Esther

2013-02-08

Children with cow's milk allergy (CMA) need a cow's milk protein (CMP) free diet to prevent allergic reactions. For this, reliable allergy-information on the label of food products is essential to avoid products containing the allergen. On the other hand, both overzealous labeling and misdiagnosis that result in unnecessary elimination diets, can lead to potentially hazardous health situations. Our objective was to evaluate if excluding CMA by double-blind placebo-controlled food challenge (DBPCFC) prevents unnecessary elimination diets in the long term. Secondly, to determine the minimum eliciting dose (MED) for an acute allergic reaction to CMP in DBPCFC positive children. All children with suspected CMA under our care (Oct'05-Jun'09) were prospectively enrolled in a DBPCFC. Placebo and verum feedings were administered on two randomly assigned separate days. The MED was determined by noting the 'lowest observed adverse effect level' (LOAEL) in DBPCFC-positive children. Based on the outcomes of the DBPCFC a dietary advice was given. Parents were contacted by phone several months later about the diet of their child. 116 children were available for analysis. In 76 children CMA was rejected. In 60 of them CMP was successfully reintroduced, in 2 the parents refused introduction, in another 3 the parents stopped reintroduction. In 9 children CMA symptoms reappeared. In 40 children CMA was confirmed. Infants aged ≤ 12 months in our study group have a higher cumulative distribution of MED than older children. Excluding CMA by DBPCFC successfully stopped unnecessary elimination diets in the long term in most children. The MEDs form potential useful information for offering dietary advice to patients and their caretakers.

Causes and emerging trends of childhood blindness: findings from schools for the blind in Southeast Nigeria.

PubMed

Aghaji, Ada; Okoye, Obiekwe; Bowman, Richard

2015-06-01

To ascertain the causes severe visual impairment and blindness (SVI/BL) in schools for the blind in southeast Nigeria and to evaluate temporal trends. All children who developed blindness at <15 years of age in all the three schools for the blind in southeast Nigeria were examined. All the data were recorded on a WHO/Prevention of Blindness (WHO/PBL) form entered into a Microsoft Access database and transferred to STATA V.12.1 for analysis. To estimate temporal trends in causes of blindness, older (>15 years) children were compared with younger (≤15 years) children. 124 children were identified with SVI/BL. The most common anatomical site of blindness was the lens (33.9%). Overall, avoidable blindness accounted for 73.4% of all blindness. Exploring trends in SVI/BL between children ≤15 years of age and those >15 years old, this study shows a reduction in avoidable blindness but an increase in cortical visual impairment in the younger age group. The results from this study show a statistically significant decrease in avoidable blindness in children ≤15 years old. Corneal blindness appears to be decreasing but cortical visual impairment seems to be emerging in the younger age group. Appropriate strategies for the prevention of avoidable childhood blindness in Nigeria need to be developed and implemented. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Survey of childhood blindness and visual impairment in Botswana.

PubMed

Nallasamy, Sudha; Anninger, William V; Quinn, Graham E; Kroener, Brian; Zetola, Nicola M; Nkomazana, Oathokwa

2011-10-01

In terms of blind-person years, the worldwide burden of childhood blindness is second only to cataracts. In many developing countries, 30-72% of childhood blindness is avoidable. The authors conducted this study to determine the causes of childhood blindness and visual impairment (VI) in Botswana, a middle-income country with limited access to ophthalmic care. This study was conducted over 4 weeks in eight cities and villages in Botswana. Children were recruited through a radio advertisement and local outreach programmes. Those ≤ 15 years of age with visual acuity <6/18 in either eye were enrolled. The WHO/Prevention of Blindness Eye Examination Record for Children with Blindness and Low Vision was used to record data. The authors enrolled 241 children, 79 with unilateral and 162 with bilateral VI. Of unilateral cases, 89% were avoidable: 23% preventable (83% trauma-related) and 66% treatable (40% refractive error and 31% amblyopia). Of bilateral cases, 63% were avoidable: 5% preventable and 58% treatable (33% refractive error and 31% congenital cataracts). Refractive error, which is easily correctable with glasses, is the most common cause of bilateral VI, with cataracts a close second. A nationwide intervention is currently being planned to reduce the burden of avoidable childhood VI in Botswana.

Enhancing Advocacy for Eye Care at National Levels: What Steps to Take for the Next Decade?

PubMed Central

Rabiu, Muhammad Mansur; Al Rajhi, Abdulaziz; Qureshi, Mohammed Babar; Gersbeck, Jennifer

2012-01-01

The global initiative for the elimination of avoidable blindness by the year 2020-(VISION 2020- The Right to Sight), established in 1999, is a partnership of nongovernmental organizations (NGOs), governments, bilateral organizations, corporate bodies and the World Health Organization. The goal is to eliminate the major causes of avoidable blindness by the year 2020. Significant progress has been made in the last decade. For example, the adoption of three major World Health Assembly resolutions (WHA 56.26, 59.25 and 62.1) requesting governments to increase support and funding for the prevention of blindness and eye care. Additionally, the approval of the VISION 2020 declaration, development of plans and establishment of prevention of blindness committees and a designation of a coordinator by most participating countries represent other major achievements. Furthermore there has been increased political and professional commitment to the prevention of visual impairment and an increase in the provision of high-quality, sustainable eye care. Most of these achievements have been attributed to the advocacy efforts of VISION 2020 at the international level. The full success of this global initiative will likely depend on the extent to which the WHA resolutions are implemented in each country. However, most ratifying countries have not moved forward with implementation of these resolutions. To date, only few countries have shown consistent government support and funding for eye care pursuant to the resolutions. One of the main reasons for this may be inadequate and inappropriate advocacy for eye care at the national level. As such it is believed that the success of VISION 2020 in the next decade will depend on intense advocacy campaigns at national levels. This review identified some of the countries and health programs that have had fruitful advocacy efforts, to determine the factors that dictated success. The review highlights the factors of successful advocacy in two countries (Australia and Pakistan) that secured continued government support. The review further explores the achievements of the HIV/AIDs control network advocacy in securing global and national government support. Common factors for successful advocacy at the national level were identified to include generation of evidence data and effective utilization of the data with an appropriate forum and media to develop a credible relationship with prominent decision makers. Aligning eye care programming to the broad health and development agendas was a useful advocacy effort. Also a broad all-encompassing coalition of all stakeholders provides a solid platform for effective and persistent advocacy for government support of eye care. PMID:22346118

Survey of childhood blindness and visual impairment in Botswana

PubMed Central

Nallasamy, Sudha; Anninger, William V; Quinn, Graham E; Kroener, Brian; Zetola, Nicola M; Nkomazana, Oathokwa

2014-01-01

Background/aims In terms of blind-person years, the worldwide burden of childhood blindness is second only to cataracts. In many developing countries, 30–72% of childhood blindness is avoidable. The authors conducted this study to determine the causes of childhood blindness and visual impairment (VI) in Botswana, a middle-income country with limited access to ophthalmic care. Methods This study was conducted over 4 weeks in eight cities and villages in Botswana. Children were recruited through a radio advertisement and local outreach programmes. Those ≤15 years of age with visual acuity <6/18 in either eye were enrolled. The WHO/Prevention of Blindness Eye Examination Record for Children with Blindness and Low Vision was used to record data. Results The authors enrolled 241 children, 79 with unilateral and 162 with bilateral VI. Of unilateral cases, 89% were avoidable: 23% preventable (83% trauma-related) and 66% treatable (40% refractive error and 31% amblyopia). Of bilateral cases, 63% were avoidable: 5% preventable and 58% treatable (33% refractive error and 31% congenital cataracts). Conclusion Refractive error, which is easily correctable with glasses, is the most common cause of bilateral VI, with cataracts a close second. A nationwide intervention is currently being planned to reduce the burden of avoidable childhood VI in Botswana. PMID:21242581

A survey of visual impairment and blindness in children attending seven schools for the blind in Myanmar.

PubMed

Muecke, James; Hammerton, Michael; Aung, Yee Yee; Warrier, Sunil; Kong, Aimee; Morse, Anna; Holmes, Martin; Yapp, Michael; Hamilton, Carolyn; Selva, Dinesh

2009-01-01

To determine the causes of visual impairment and blindness amongst children in schools for the blind in Myanmar; to identify the avoidable causes of visual impairment and blindness; and to provide spectacles, low vision aids, orientation and mobility training and ophthalmic treatment where indicated. Two hundred and eight children under 16 years of age from all 7 schools for the blind in Myanmar were examined and the data entered into the World Health Organization Prevention of Blindness Examination Record for Childhood Blindness (WHO/PBL ERCB). One hundred and ninety nine children (95.7%) were blind (BL = Visual Acuity [VA] < 3/60 in the better eye) and 3 had severe visual impairment (SVI = VA < 6/60 to 3/60 in the better eye). Most children had corneal abnormalities as the major anatomical site of SVI/BL (100, 49.5%), however the cause of SVI/BL was unknown in the majority (88, 43.6%). Measles keratitis was the commonest identifiable cause (17.4%) and 88 children had avoidable causes of SVI/BL (43.6%). Nearly 16% of children required an optical device and 24.2% required medical attention, with a potential for visual improvement through intervention in 15.8%. Nearly half of the children in schools for the blind in Myanmar had potentially avoidable causes of SVI/BL. With measles being both the commonest identifiable and commonest avoidable cause, the data supports the need for a measles immunization campaign. There is also a need for a dedicated pediatric eye care center with regular ophthalmology visits to the schools, and improved optometric, low vision and orientation and mobility services in Myanmar.

Enhancing Community Knowledge and Health Behaviors to Eliminate Blinding Trachoma in Mali Using Radio Messaging as a Strategy

ERIC Educational Resources Information Center

Bamani, Sanoussi; Toubali, Emily; Diarra, Sadio; Goita, Seydou; Berte, Zana; Coulibaly, Famolo; Sangare, Hama; Tuinsma, Marjon; Zhang, Yaobi; Dembele, Benoit; Melvin, Palesa; MacArthur, Chad

2013-01-01

The National Blindness Prevention Program in Mali has broadcast messages on the radio about trachoma as part of the country's trachoma elimination strategy since 2008. In 2011, a radio impact survey using multi-stage cluster sampling was conducted in the regions of Kayes and Segou to assess radio listening habits, coverage of the broadcasts,…

Avoidable Waste in Ophthalmic Epidemiology: A Review of Blindness Prevalence Surveys in Low and Middle Income Countries 2000-2014.

PubMed

Ramke, Jacqueline; Kuper, Hannah; Limburg, Hans; Kinloch, Jennifer; Zhu, Wenhui; Lansingh, Van C; Congdon, Nathan; Foster, Allen; Gilbert, Clare E

2018-02-01

Sources of avoidable waste in ophthalmic epidemiology include duplication of effort, and survey reports remaining unpublished, gaining publication after a long delay, or being incomplete or of poor quality. The aim of this review was to assess these sources of avoidable waste by examining blindness prevalence surveys undertaken in low and middle income countries (LMICs) between 2000 and 2014. On December 1, 2016 we searched MEDLINE, EMBASE and Web of Science databases for cross-sectional blindness prevalence surveys undertaken in LMICs between 2000 and 2014. All surveys listed on the Rapid Assessment of Avoidable Blindness (RAAB) Repository website ("the Repository") were also considered. For each survey we assessed (1) availability of scientific publication, survey report, summary results tables and/or datasets; (2) time to publication from year of survey completion and journal attributes; (3) extent of blindness information reported; and (4) rigour when information was available from two sources (i.e. whether it matched). Of the 279 included surveys (from 68 countries) 186 (67%) used RAAB methodology; 146 (52%) were published in a scientific journal, 57 (20%) were published in a journal and on the Repository, and 76 (27%) were on the Repository only (8% had tables; 19% had no information available beyond registration). Datasets were available for 50 RAABs (18% of included surveys). Time to publication ranged from <1 to 11 years (mean, standard deviation 2.8 ± 1.8 years). The extent of blindness information reported within studies varied (e.g. presenting and best-corrected, unilateral and bilateral); those with both a published report and Repository tables were most complete. For surveys published and with RAAB tables available, discrepancies were found in reporting of participant numbers (14% of studies) and blindness prevalence (15%). Strategies are needed to improve the availability, consistency, and quality of information reported from blindness prevalence surveys, and hence reduce avoidable waste.

Causes of blindness and career choice among pupils in a blind school; South Western Nigeria.

PubMed

Fadamiro, Christianah Olufunmilayo

2014-01-01

The causes of Blindness vary from place to place with about 80% of it been avoidable. Furthermore Blind people face a lot of challenges in career choice thus limiting their economic potential and full integration into the society. This study aims at identifying the causes of blindness and career choice among pupils in a school for the blind in South -Western Nigeria. This is a descriptive study of causes of blindness and career choice among 38 pupils residing in a school for the blind at Ikere -Ekiti, South Western Nigeria. Thirty eight pupils comprising of 25 males (65.8%) and 13 females (34.2%) with age range from 6-39 years were seen for the study, The commonest cause of blindness was cataract with 14 cases (36.84%) while congenital glaucoma and infection had an equal proportion of 5 cases each (13.16%). Avoidable causes constituted the greatest proportion of the causes 27 (71.05%) while unavoidable causes accounted for 11 (28.9%). The law career was the most desired profession by the pupils 11 (33.3%) followed by Teaching 9 (27.3%), other desired profession includes engineering, journalism and farming. The greatest proportion of causes of blindness identified in this study is avoidable. There is the need to create public awareness on some of the notable causes particularly cataract and motivate the community to utilize available eye care services Furthermore there is need for career talk in schools for the blind to enable them choose career where their potential can be fully maximized.

Looking forward to 20/20: a focus on the epidemiology of eye diseases.

PubMed

West, S K

2000-01-01

The encouraging scenario of international efforts to eliminate preventable and avoidable blindness is the legacy of public health ophthalmology in the 20th century. With active programs currently in place or beginning for the major cause of blindness in childhood and two of the leading infectious causes of blindness, it is natural that research in eye disease will shift even more heavily toward the leading causes of blindness in the older ages. The age-related eye diseases will rapidly become the most common causes of blindness and visual loss and, with the exception of cataract, are the more difficult to identify, diagnose, and treat. The human misery and social cost of blindness, especially in the countries that can ill afford it, are profound. To combat this problem, epidemiologic research in ophthalmology should look toward the following major areas: 1. the identification and testing of better screening modalities to determine early changes possibly amenable to preventive strategies. This includes detection of vitamin A deficiency as well. 2. the creation of uniform definitions for diseases, particularly glaucoma and early AMD, which have relevance for epidemiologic research into risk factors. 3. increased multidisciplinary research, working with investigators skilled in molecular genetics, biologic markers for age-related diseases, and those interested in new imaging and vision-testing techniques. 4. ongoing work in clinical trials of new approaches to prevent or delay the onset of vision loss from eye disease, including future vaccines for chlamydia and onchocerciasis. The major public health issue of blindness prevention will not disappear in the next century but only shift emphasis to different causes if the current programs achieve the success that is hoped. Future epidemiologic research will continue to require a concerted, sustained, and multidisciplinary effort in order to contribute to the vision research agenda in the next century.

Waist-up protection for blind individuals using the EyeCane as a primary and secondary mobility aid.

PubMed

Buchs, Galit; Simon, Noa; Maidenbaum, Shachar; Amedi, Amir

2017-01-01

One of the most stirring statistics in relation to the mobility of blind individuals is the high rate of upper body injuries, even when using the white-cane. We here addressed a rehabilitation- oriented challenge of providing a reliable tool for blind people to avoid waist-up obstacles, namely one of the impediments to their successful mobility using currently available methods (e.g., white-cane). We used the EyeCane, a device we developed which translates distances from several angles to haptic and auditory cues in an intuitive and unobtrusive manner, serving both as a primary and secondary mobility aid. We investigated the rehabilitation potential of such a device in facilitating visionless waist-up body protection. After ∼5 minutes of training with the EyeCane blind participants were able to successfully detect and avoid obstacles waist-high and up. This was significantly higher than their success when using the white-cane alone. As avoidance of obstacles required participants to perform an additional cognitive process after their detection, the avoidance rate was significantly lower than the detection rate. Our work has demonstrated that the EyeCane has the potential to extend the sensory world of blind individuals by expanding their currently accessible inputs, and has offered them a new practical rehabilitation tool.

The Sokoto Blind Beggars: Causes of Blindness and Barriers to Rehabilitation Services

PubMed Central

Balarabe, Aliyu Hamza; Mahmoud, Abdulraheem O.; Ayanniyi, Abdulkabir Ayansiji

2014-01-01

Purpose: To determine the causes of blindness and the barriers to accessing rehabilitation services (RS) among blind street beggars (bsb) in Sokoto, Nigeria. Materials and Methods: A cross-sectional survey of 202 bsb (VA < 3/60) using interviewer administered questionnaire. The causes of blindness were diagnosed by clinical ophthalmic examination. Results: There were 107 (53%) males and 95 (47%) females with a mean age of 49 years (SD 12.2). Most bsb 191 (94.6%) had non-formal education. Of 190 (94.1%) irreversibly bsb, 180/190 (94.7%) had no light perception (NPL) bilaterally. The major causes of blindness were non-trachomatous corneal opacity (60.8%) and trachoma corneal opacity (12.8%). There were 166 (82%) blind from avoidable causes and 190 (94.1%) were irreversibly blind with 76.1% due to avoidable causes. The available sub-standard RS were educational, vocational and financial support. The barriers to RS in the past included non-availability 151 (87.8%), inability to afford 2 (1.2%), unfelt need 4 (2.3%), family refusal 1 (0.6), ignorance 6 (3.5%) and being not linked 8 (4.7%). The barriers to RS during the study period included inability of 72 subjects (35.6%) to access RS and 59 (81.9%) were due to lack of linkage to the existing services. Conclusion: Corneal opacification was the major cause of blindness among bsb. The main challenges to RS include the inadequate services available, societal and users factors. Renewed efforts are warranted toward the prevention of avoidable causes of blindness especially corneal opacities. The quality of life of the blind street beggar should be improved through available, accessible and affordable well-maintained and sustained rehabilitation services. PMID:24791106

Prevalence of blindness and cataract surgical coverage in Narayani Zone, Nepal: a rapid assessment of avoidable blindness (RAAB) study.

PubMed

Pradhan, Sangita; Deshmukh, Avnish; Giri Shrestha, Puspa; Basnet, Prajwal; Kandel, Ram Prasad; Lewallen, Susan; Sapkota, Yuddha Dhoj; Bassett, Ken; Yin, Vivian T

2018-03-01

The 1981 Nepal Blindness Survey first identified the Narayani Zone as one of the regions with the highest prevalence of blindness in the country. Subseuqently, a 2006 survey of the Rautahat District of the Narayani Zone found it to have the country's highest blindness prevalence. This study examines the impact on blind avoidable and treatable eye conditions in this region after significant increase in eye care services in the past decade. The rapid assessment of avoidable blindness (RAAB) methodology was used with mobile data collection using the mRAAB smartphone app. Data analysis was done using the standard RAAB software. Based on the 2011 census, 100 clusters of 50 participants aged 50 years or older were randomly sampled proportional to population size. Of the 5000 participants surveyed, 4771 (95.4%) were examined. The age-adjusted and sex-adjusted prevalence of bilateral blindness, severe visual impairment (SVI) and moderate visual impairment (MVI) were 1.2% (95% CI 0.9% to 1.5%), 2.5% (95% CI 2.0% to -3.0%) and 13.2% (95% CI 11.8% to 14.5%), respectively. Cataract remains the primary cause of blindness and SVI despite cataract surgery coverage (CSC) of 91.5% for VA<3/60. Women still account for two-thirds of blindness. The prevalence of blindness in people over the age of 50 years has decreased from 6.9% in 2006 to 1.2%, a level in keeping with the national average; however, significant gender inequity persists. CSC has improved but continues to favour men. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Sokoto blind beggars: causes of blindness and barriers to rehabilitation services.

PubMed

Balarabe, Aliyu Hamza; Mahmoud, Abdulraheem O; Ayanniyi, Abdulkabir Ayansiji

2014-01-01

To determine the causes of blindness and the barriers to accessing rehabilitation services (RS) among blind street beggars (bsb) in Sokoto, Nigeria. A cross-sectional survey of 202 bsb (VA < 3/60) using interviewer administered questionnaire. The causes of blindness were diagnosed by clinical ophthalmic examination. There were 107 (53%) males and 95 (47%) females with a mean age of 49 years (SD 12.2). Most bsb 191 (94.6%) had non-formal education. Of 190 (94.1%) irreversibly bsb, 180/190 (94.7%) had no light perception (NPL) bilaterally. The major causes of blindness were non-trachomatous corneal opacity (60.8%) and trachoma corneal opacity (12.8%). There were 166 (82%) blind from avoidable causes and 190 (94.1%) were irreversibly blind with 76.1% due to avoidable causes. The available sub-standard RS were educational, vocational and financial support. The barriers to RS in the past included non-availability 151 (87.8%), inability to afford 2 (1.2%), unfelt need 4 (2.3%), family refusal 1 (0.6), ignorance 6 (3.5%) and being not linked 8 (4.7%). The barriers to RS during the study period included inability of 72 subjects (35.6%) to access RS and 59 (81.9%) were due to lack of linkage to the existing services. Corneal opacification was the major cause of blindness among bsb. The main challenges to RS include the inadequate services available, societal and users factors. Renewed efforts are warranted toward the prevention of avoidable causes of blindness especially corneal opacities. The quality of life of the blind street beggar should be improved through available, accessible and affordable well-maintained and sustained rehabilitation services.

The accomplishments of the global initiative VISION 2020: The Right to Sight and the focus for the next 8 years of the campaign

PubMed Central

Ackland, Peter

2012-01-01

In the first 12 years of VISION 2020 sound programmatic approaches have been developed that are capable of delivering equitable eye health services to even the most remote and impoverished communities. A body of evidence around the economic arguments for investment in eye health has been developed that has fuelled successful advocacy work resulting in supportive high level policy statements. More than a 100 national plans to achieve the elimination of avoidable blindness have been developed and some notable contributions made from the corporate and government sectors to resource eye health programs. Good progress has been made to control infectious blinding diseases and at the very least there is anecdotal evidence to suggest that the global increase in the prevalence of blindness and visual impairment has been reversed in recent years, despite the ever increasing and more elderly global population. However if we are to achieve the goal of VISION 2020 we require a considerable scaling up of current efforts–this will depend on our future success in two key areas: i) Successful advocacy and engagement at individual country level to secure significantly enhanced national government commitment to financing their own VISION 2020 plans.ii) A new approach to VISION 2020 thinking that integrates eye health into health system development and develops new partnerships with wider health development initiatives. PMID:22944746

[Survey on avoidable blindness and visual impairment in Panama].

PubMed

López, Maritza; Brea, Ileana; Yee, Rita; Yi, Rodolfo; Carles, Víctor; Broce, Alberto; Limburg, Hans; Silva, Juan Carlos

2014-12-01

Determine prevalence of blindness and visual impairment in adults aged ≥ 50 years in Panama, identify their main causes, and characterize eye health services. Cross-sectional population study using standard Rapid Assessment of Avoidable Blindness methodology. Fifty people aged ≥ 50 years were selected from each of 84 clusters chosen through representative random sampling of the entire country. Visual acuity was assessed using a Snellen chart; lens and posterior pole status were assessed by direct ophthalmoscopy. Cataract surgery coverage was calculated and its quality assessed, along with causes of visual acuity < 20/60 and barriers to access to surgical treatment. A total of 4 125 people were examined (98.2% of the calculated sample). Age- and sex-adjusted prevalence of blindness was 3.0% (95% CI: 2.3-3.6). The main cause of blindness was cataract (66.4%), followed by glaucoma (10.2%). Cataract (69.2%) was the main cause of severe visual impairment and uncorrected refractive errors were the main cause of moderate visual impairment (60.7%). Surgical cataract coverage in individuals was 76.3%. Of all eyes operated for cataract, 58.0% achieved visual acuity ≤ 20/60 with available correction. Prevalence of blindness in Panama is in line with average prevalence found in other countries of the Region. This problem can be reduced, since 76.2% of cases of blindness and 85.0% of cases of severe visual impairment result from avoidable causes.

Waist-up protection for blind individuals using the EyeCane as a primary and secondary mobility aid

PubMed Central

Buchs, Galit; Simon, Noa; Maidenbaum, Shachar; Amedi, Amir

2017-01-01

Background: One of the most stirring statistics in relation to the mobility of blind individuals is the high rate of upper body injuries, even when using the white-cane. Objective: We here addressed a rehabilitation- oriented challenge of providing a reliable tool for blind people to avoid waist-up obstacles, namely one of the impediments to their successful mobility using currently available methods (e.g., white-cane). Methods: We used the EyeCane, a device we developed which translates distances from several angles to haptic and auditory cues in an intuitive and unobtrusive manner, serving both as a primary and secondary mobility aid. We investigated the rehabilitation potential of such a device in facilitating visionless waist-up body protection. Results: After ∼5 minutes of training with the EyeCane blind participants were able to successfully detect and avoid obstacles waist-high and up. This was significantly higher than their success when using the white-cane alone. As avoidance of obstacles required participants to perform an additional cognitive process after their detection, the avoidance rate was significantly lower than the detection rate. Conclusion: Our work has demonstrated that the EyeCane has the potential to extend the sensory world of blind individuals by expanding their currently accessible inputs, and has offered them a new practical rehabilitation tool. PMID:28157111

Relative Luminance and Figure-Background Segmentation Problems: Using AMLA to Avoid Nondiscernible Stimulus Pairs in Common and Color Blind Observers

ERIC Educational Resources Information Center

Jover, Julio Lillo; Moreira, Humberto

2005-01-01

Four experiments evaluated AMLA temporal version accuracy to measure relative luminosity in people with and without color blindness and, consequently, to provide the essential information to avoid poor figure-background combinations in any possible "specific screen-specific observer" pair. Experiment 1 showed that two very different apparatus, a…

Causes of blindness in a special education school.

PubMed

Onakpoya, O H; Adegbehingbe, B O; Omotoye, O J; Adeoye, A O

2011-01-01

Blind children and young adults have to overcome a lifetime of emotional, social and economic difficulties. They employ non-vision dependent methods for education. To assess the causes of blindness in a special school in southwestern Nigeria to aid the development of efficient blindness prevention programmes. A cross-sectional survey of the Ekiti State Special Education School, Nigeria was conducted in May-June 2008 after approval from the Ministry of Education. All students in the blind section were examined for visual acuity, pen-torch eye examination and dilated fundoscopy in addition to taking biodata and history. Thirty blind students with mean age of 18±7.3 years and male: female ratio of 1.7:1 were examined. Blindness resulted commonly from cataract eight (26.7%), glaucoma six (20%) retinitis pigmentosa four (16.7%) and posttraumatic phthysis bulbi two (6.7%). Blindness was avoidable in 18 (61%) of cases. Glaucoma blindness was associated with redness, pain, lacrimation and photophobia in 15 (50%) and hyphaema in 16.7% of students; none of these students were on any medication at the time of study. The causes of blindness in rehabilitation school for the blind are largely avoidable and glaucoma-blind pupils face additional painful eye related morbidity during rehabilitation. While preventive measures and early intervention are needful against childhood cataract and glaucoma, regular ophthalmic consultations and medications are needed especially for glaucoma blind pupils.

A Cross-sectional Study of Prevalence and Etiology of Childhood Visual Impairment in Auckland, New Zealand.

PubMed

Chong, Chee Foong; McGhee, Charles N J; Dai, Shuan

2014-01-01

Childhood visual impairment has significant individual and socioeconomic costs with global differences in etiology and prevalence. This study aimed to determine prevalence, etiology, and avoidable causes of childhood visual impairment in New Zealand. Retrospective data analysis from a national referral center, the Blind and Low Vision Education Network New Zealand, Auckland. The World Health Organization Program for Prevention of Blindness eye examination records for visually impaired children, 16 years or younger, registered with the Auckland Visual Resource Centre, were included. Data analyzed included demographics, etiology, visual acuity, visual fields, educational setting, and rehabilitation plan. Charts of 340 children were examined, of which 267 children (144 blind, 123 low vision) were included in the analysis, whereas the remaining 73 charts of children with no visual impairment were excluded. The calculated prevalence of blindness and low vision was 0.05% and 0.04%, respectively, in the Auckland region. Principal causes of blindness affecting 91 children (63.9%) were cerebral visual impairment in 61 children (42.4%), optic nerve atrophy in 18 children (12.5%), and retinal dystrophy in 13 children (9.0%). The main potentially avoidable causes of blindness in 27 children (19%) were neonatal trauma, asphyxia in 9 children (33%), and nonaccidental injury 6 children (22%). This first report of prevalence for childhood blindness and low vision in New Zealand is similar to data from Established Market Economy countries. The leading causes of blindness are also comparable to other high-income countries; however, proportions of avoidable causes differ significantly.

Increased regional cerebral blood flow but normal distribution of GABAA receptor in the visual cortex of subjects with early-onset blindness.

PubMed

Mishina, Masahiro; Senda, Michio; Kiyosawa, Motohiro; Ishiwata, Kiichi; De Volder, Anne G; Nakano, Hideki; Toyama, Hinako; Oda, Kei-ichi; Kimura, Yuichi; Ishii, Kenji; Sasaki, Touru; Ohyama, Masashi; Komaba, Yuichi; Kobayashi, Shirou; Kitamura, Shin; Katayama, Yasuo

2003-05-01

Before the completion of visual development, visual deprivation impairs synaptic elimination in the visual cortex. The purpose of this study was to determine whether the distribution of central benzodiazepine receptor (BZR) is also altered in the visual cortex in subjects with early-onset blindness. Positron emission tomography was carried out with [(15)O]water and [(11)C]flumazenil on six blind subjects and seven sighted controls at rest. We found that the CBF was significantly higher in the visual cortex for the early-onset blind subjects than for the sighted control subjects. However, there was no significant difference in the BZR distribution in the visual cortex for the subject with early-onset blindness than for the sighted control subjects. These results demonstrated that early visual deprivation does not affect the distribution of GABA(A) receptors in the visual cortex with the sensitivity of our measurements. Synaptic elimination may be independent of visual experience in the GABAergic system of the human visual cortex during visual development.

Progress toward elimination of onchocerciasis in the Americas - 1993-2012.

PubMed

2013-05-24

Onchocerciasis (river blindness) is caused by the parasitic worm Onchocerca volvulus, transmitted to humans by the bite of infected black flies of the genus Simulium, and is characterized by chronic skin disease, severe itching, and eye lesions that can progress to complete blindness. Currently, among approximately 123 million persons at risk for infection in 38 endemic countries, at least 25.7 million are infected, and 1 million are blinded or have severe visual impairment. Periodic, communitywide mass drug administration (MDA) with ivermectin (Mectizan, Merck) prevents eye and skin disease and might interrupt transmission of the infection, depending on the coverage, duration, and frequency of MDA. The Onchocerciasis Elimination Program for the Americas (OEPA) was launched in response to a 1991 resolution of the Pan American Health Organization (PAHO) calling for the elimination of onchocerciasis from the Americas. By the end of 2012, transmission of the infection, judged by surveys following World Health Organization (WHO) guidelines, had been interrupted or eliminated in four of the six endemic countries in the WHO Americas Region. Thus, in 2013, only 4% (23,378) of the 560,911 persons originally at risk in the Americas will be under ivermectin MDA. Active transmission currently is limited to two foci among Yanomami indigenes in adjacent border areas of Venezuela and Brazil.

Rapid assessment of avoidable blindness in Bhutan.

PubMed

Lepcha, Nor Tshering; Chettri, Chandra Kumar; Getshen, Kunzang; Rai, Bhim Bahadur; Ramaswamy, Shamanna Bindiganavale; Saibaba, Saravanan; Nirmalan, Praveen Kumar; Demarchis, Emilia Hansson; Tabin, Geoffrey; Morley, Michael; Morley, Katharine

2013-08-01

To conduct a rapid assessment of avoidable blindness survey in Bhutan to obtain estimates of blindness, visual impairment, and cataract surgical coverage, outcomes and barriers among persons ≥50 years old. A total of 82 clusters of 50 people ≥50 years were selected using probability proportionate to size sampling. Eligible participants were selected from households using compact segment sampling, and underwent ophthalmic examination for visual acuity, followed by penlight and direct ophthalmoscopy. Participants with cataract were interviewed regarding surgical outcomes and barriers to surgery. Overall, 4046 of 4100 persons enumerated (98.7%) underwent ophthalmic examination. Adjusting for age and sex, the prevalence of bilaterally blind persons with available correction was 1.5% (95% confidence interval 1.09-1.89). Most blindness (67.1%) and severe visual impairment (74.1%) resulted from cataract, but 22.1% resulted from posterior segment pathology. Cataract surgical coverage for bilaterally blind persons was 72.7%. Almost 90% of patients reported moderate or good satisfaction, despite poor surgical outcomes in 23.6%. The prevalence of blindness in people aged ≥50 years in Bhutan was relatively low when compared with neighboring countries and World Health Organization sub-region estimates. Areas for improvement include community outreach, surgical outcomes, and posterior segment diseases.

Removal of power line interference of space bearing vibration signal based on the morphological filter and blind source separation

NASA Astrophysics Data System (ADS)

Dong, Shaojiang; Sun, Dihua; Xu, Xiangyang; Tang, Baoping

2017-06-01

Aiming at the problem that it is difficult to extract the feature information from the space bearing vibration signal because of different noise, for example the running trend information, high-frequency noise and especially the existence of lot of power line interference (50Hz) and its octave ingredients of the running space simulated equipment in the ground. This article proposed a combination method to eliminate them. Firstly, the EMD is used to remove the running trend item information of the signal, the running trend that affect the signal processing accuracy is eliminated. Then the morphological filter is used to eliminate high-frequency noise. Finally, the components and characteristics of the power line interference are researched, based on the characteristics of the interference, the revised blind source separation model is used to remove the power line interferences. Through analysis of simulation and practical application, results suggest that the proposed method can effectively eliminate those noise.

The Elimination of a Self-Injurious Avoidance Response through a Forced Running Consequence.

ERIC Educational Resources Information Center

Borreson, Paul M.

1980-01-01

The self-injurious avoidance responses of a 22-year-old severely mentally retarded male were eliminated through a forced running consequence. Side effects, such as reduced noise, increase in smiling, and faster progress toward instructional objectives, were also noted. The results were maintained over a period of two years. (Author/PHR)

A rapid assessment of avoidable blindness in Southern Zambia.

PubMed

Lindfield, Robert; Griffiths, Ulla; Bozzani, Fiammetta; Mumba, Musonda; Munsanje, Joseph

2012-01-01

A rapid assessment of avoidable blindness (RAAB) was conducted in Southern Zambia to establish the prevalence and causes of blindness in order to plan effective services and advocate for support for eye care to achieve the goals of VISION 2020: the right to sight. Cluster randomisation was used to select villages in the survey area. These were further subdivided into segments. One segment was selected randomly and a survey team moved from house to house examining everyone over the age of 50 years. Each individual received a visual acuity assessment and simple ocular examination. Data was recorded on a standard proforma and entered into an established software programme for analysis. 2.29% of people over the age of 50 were found to be blind (VA <3/60 in the better eye with available correction). The major cause of blindness was cataract (47.2%) with posterior segment disease being the next main cause (18.8%). 113 eyes had received cataract surgery with 30.1% having a poor outcome (VA <6/60) following surgery. Cataract surgical coverage showed that men (72%) received more surgery than women (65%). The results from the RAAB survey in Zambia were very similar to the results from a similar survey in Malawi, where the main cause of blindness was cataract but posterior segment disease was also a significant contributor. Blindness in this part of Zambia is mainly avoidable and there is a need for comprehensive eye care services that can address both cataract and posterior segment disease in the population if the aim of VISION 2020 is to be achieved. Services should focus on quality and gender equity of cataract surgery.

[National survey of blindness and avoidable visual impairment in Honduras].

PubMed

Alvarado, Doris; Rivera, Belinda; Lagos, Luis; Ochoa, Mayra; Starkman, Ivette; Castillo, Mariela; Flores, Eduardo; Lansingh, Van C; Limburg, Hans; Silva, Juan Carlos

2014-11-01

To determine the prevalence of blindness and visual impairment in Honduras, its causes and the response by the health services to growing demand. A cross-sectional population study was conducted between June and December 2013 using the standard methodology of the Rapid Assessment of Avoidable Blindness. A random sample survey was done in 63 clusters of 50 individuals aged ≥ 50, representative of the country as a whole. Visual acuity (VA) was assessed using a Snellen eye chart, and the condition of the lens and posterior pole was examined by direct ophthalmoscopy. Cataract surgical coverage was calculated and an assessment made of its quality, the causes of VA < 20/60 and the barriers to accessing surgical treatment. A total of 2 999 people were examined (95.2% of the forecast total). Blindness prevalence was 1.9% (confidence interval of 95%: 1.4-2.4%) and 82.2% of these cases were avoidable. The main causes of blindness were unoperated cataracts (59.2%) and glaucoma (21.1%). Uncorrected refraction error was the main cause of severe (19.7%) and moderate (58.6%) visual impairment. Cataract surgical coverage was 75.2%. 62.5% of the eyes operated for cataracts achieved a VA > 20/60 with available correction. The main barriers against cataract surgery were cost (27.7%) and the lack of availability or difficulty of geographical access to the treatment (24.6%). The prevalence of blindness and visual impairment in Honduras is similar to that of other Latin American countries. 67% of cases of blindness could be resolved by improving the response capacity of the ophthalmological services, especially of cataract surgery, improving optician services and incorporating eye care in primary health care.

[National survey of blindness and avoidable visual impairment in Argentina, 2013].

PubMed

Barrenechea, Rosario; de la Fuente, Inés; Plaza, Roberto Gustavo; Flores, Nadia; Segovia, Lía; Villagómez, Zaida; Camarero, Esteban Elián; Zepeda-Romero, Luz Consuelo; Lansingh, Van C; Limburg, Hans; Silva, Juan Carlos

2015-01-01

Determine the prevalence of blindness and avoidable visual impairment in Argentina, its causes, the coverage of cataract surgery, and the barriers that hinder access to these services. Cross-sectional population study conducted between May and November 2013 using the standard methodology for rapid assessment of avoidable blindness (RAAB), with a random cluster sampling of 50 people aged 50 years or more, -representative of the entire country. Participants' visual acuity (VA) was measured and the lens and posterior pole were examined by direct ophthalmoscopy. An assessment was made of the causes of having VA < 20/60, the coverage and quality of cataract surgery, and the barriers to accessing treatment. 3 770 people were assessed (92.0% of the projected number). The prevalence of blindness was 0.7% (confidence interval of 95%: 0.4-1.0%). Unoperated cataract was the main cause of blindness and severe visual impairment (44.0% and 71.1%, respectively), while the main cause of moderate visual impairment was uncorrected refractive errors (77.8%). Coverage of cataract surgery was of 97.1%, and 82.0% of operated eyes achieved VA ≥ 20/60. The main barriers to receiving this treatment were fear of the surgical procedure or of a poor result (34.9%), the cost (30.2%), and not having access to the treatment (16.3%). There is a low prevalence of blindness in the studied population and cataract is the main cause of blindness and severe visual impairment. Efforts should continue to extend coverage of cataract surgery, enhance preoperative evaluation, improve calculations of the intraocular lenses that patients need, and correct post-operative refractive errors with greater precision.

Reinforcement control of severe dysfunctional behavior of blind, multihandicapped students.

PubMed

Luiselli, J K; Myles, E; Evans, T P; Boyce, D A

1985-11-01

The effectiveness of reinforcement-based programs with blind, multihandicapped students was examined. In Study 1 the aggressive behavior of a deaf/blind adolescent was eliminated through a differential reinforcement of other behavior (DRO) procedure that was combined with a reinforcer cueing technique and brief time-out. In Study 2 DRO was utilized to reduce stereotypic eye-pressing by a young blind child who was also hearing-impaired. Follow-up observations while treatment procedures remained operative revealed maintenance of intervention effects from 1 to 8 months posttreatment.

Suspected ivermectin toxicosis in a miniature mule foal causing blindness.

PubMed

Plummer, Caryn E; Kallberg, Maria E; Ollivier, Franck J; Brooks, Dennis E; Gelatt, Kirk N

2006-01-01

A 9-week-old miniature mule foal presented to the Veterinary Medical Teaching Hospital for acute blindness, ataxia, and depression following an overdose of an over-the-counter ivermectin-based de-worming medication. Ophthalmic examination and electrodiagnostic evaluation eliminated outer retinal abnormalities as the primary cause of the bilateral blindness, implicating instead a central neurologic effect of the drug. With symptomatic and supportive care, the foal recovered fully and regained its vision.

Prevalence and causes of severe visual impairment and blindness among children in the lorestan province of iran, using the key informant method.

PubMed

Razavi, Hessom; Kuper, Hannah; Rezvan, Farhad; Amelie, Khatere; Mahboobi-Pur, Hassan; Oladi, Mohammad Reza; Muhit, Mohammad; Hashemi, Hassan

2010-03-01

To estimate the prevalence and causes of severe visual impairment and blindness among children in Lorestan province of Iran, and to assess the feasibility of the Key Informant Method in this setting. Potential cases were identified using the Key Informant Method, in 3 counties of Lorestan province during June through August 2008, and referred for examination. Causes of severe visual impairment/blindness were determined and categorized using standard World Health Organization methods. Of 123 children referred for examination, 27 children were confirmed to have severe visual impairment/blindness or blindness. The median age was11 years (interquartile range 6-13), and 59% were girls. After adjusting for non-attenders, the estimated prevalence of severe visual impairment/blindness was 0.04% (0.03-0.05). The main site of abnormality was retina (44%), followed by disorders of the whole eye (33%). The majority of causes had a hereditary etiology (70%), which was associated with a family history of blindness (P = 0.002). Potentially avoidable causes of severe visual impairment/blindness were found in 14 children (52%). Almost all children with severe visual impairment/blindness had a history of parental consanguinity (93%). Our findings suggest a moderate prevalence of childhood blindness in the Lorestan province of Iran, a high proportion of which may be avoidable, given improved access to ophthalmic and genetic counselling services in rural areas. The Key Informant Method is feasible in Iran; future research is discussed.

Blindness and low vision in The Netherlands from 2000 to 2020-modeling as a tool for focused intervention.

PubMed

Limburg, Hans; Keunen, Jan E E

2009-01-01

To estimate the magnitude and causes of blindness and low vision in The Netherlands from 2000 to 2020. Recent population-based blindness surveys in established market economies were reviewed. Age and gender specific prevalence and causes of blindness and low vision were extracted and calculated for six population subgroups in The Netherlands. A mathematical model was developed to relate the epidemiologic data with demographic data for each subgroup for each year between 2000 and 2020. In 2008 an estimated 311,000 people are visually impaired in The Netherlands: 77,000 are blind and 234,000 have low vision. With the current intervention the number may increase by 18% to 367,000 in 2020. Visual impairment is most prevalent among residents of nursing homes and care institutions for the elderly, intellectually disabled persons and people aged 50+ living independently. Of all people with visual impairment 31% is male (97,000) and 69% female (214,000). More than half of all visual impairment (56%; 174,000 persons) is avoidable. A variation of around 20% might be applied to the numbers in these estimates. The aim of VISION 2020: The Right to Sight to reduce avoidable visual impairment is also relevant for developed countries like The Netherlands. Vision screening and awareness campaigns focusing on the identified risk groups can reduce avoidable blindness considerably. Regular updates of the model will ensure that the prognoses remain valid and relevant. With appropriate demographic data, the model can also be used in other established market economies.

Rapid assessment of avoidable blindness and diabetic retinopathy in Republic of Moldova.

PubMed

Zatic, Tatiana; Bendelic, Eugen; Paduca, Ala; Rabiu, Mansour; Corduneanu, Angela; Garaba, Angela; Novac, Victoria; Curca, Cristina; Sorbala, Inga; Chiaburu, Andrei; Verega, Florentina; Andronic, Victoria; Guzun, Irina; Căpăţină, Olga; Zamă-Mardari, Iulea

2015-06-01

To evaluate the prevalence and causes of blindness and visual impairment, the prevalence of diabetes mellitus and diabetic retinopathy among people aged ≥50 years in the Republic of Moldova using Rapid Assessment of Avoidable Blindness plus Diabetic Retinopathy ('RAAB+DR') techniques. 111 communities of people aged ≥50 years were randomly selected. In addition to standard RAAB procedures in all people with diabetes (previous history of the disease or with a random blood glucose level >11.1 mm/L (200 mg/dL)), a dilated fundus examination was performed to assess the presence and the degree of diabetic retinopathy using the Scottish DR grading system. 3877 (98%) people out of the 3885 eligible people were examined. The prevalence of blindness was 1.4% (95% CI 1.0% to 1.8%). The major causes of blindness and severe visual impairment were untreated cataract (58.2%), glaucoma (10.9%), and other posterior segment causes (10.9%). The estimated prevalence of diabetes was 11.4%. Among all people with diabetes, 55.9% had some form of retinopathy, and sight threatening diabetic retinopathy affected 14.6%. The RAAB+DR survey in the Republic of Moldova established that untreated cataract is the major cause of avoidable blindness in rural areas. This needs to be tackled by expanding the geographical coverage of cataract surgical services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Ocular morbidity patterns among children in schools for the blind in Chennai.

PubMed

Prakash, M Vs; Sivakumar, S; Dayal, Ashutosh; Chitra, A; Subramaniam, Sudharshini

2017-08-01

To identify the morbidity patterns causing blindness in children attending schools for the blind in Chennai and comparing our data with similar studies done previously. A cross-sectional prevalence study was carried out in two schools for the blind in Chennai. Blind schools were visited by a team of ophthalmologists and optometrists. Students with best-corrected visual acuity (BCVA) worse than 3/60 in the better eye were included and relevant history was noted. Every student underwent anterior segment evaluation and detailed fundus examination. Morbidity of the better eye was taken as cause of blindness. Health records maintained by the school were referred to wherever available. The anatomical causes of blindness include optic nerve disorders in 75 (24.8%) cases, retinal disorders in 55 (18.2%), corneal disorders in 47 (15.6%), lens-related disorders in 39 (12.9%), congenital anomalies in 11 (3.6%), and congenital glaucoma in 20 (6.6%) cases. The whole globe was involved in six cases (1.99%). Among conditions causing blindness, optic atrophy seen in 73 (24.17%) cases was the most common, followed by retinal dystrophy in 44 (14.56%), corneal scarring in 35 (11.59%), cataract in 22 (7.28%), and congenital glaucoma in 20 (6.6%) cases. It was found that avoidable causes of blindness were seen in 31% of cases and incurable causes in 45%. Optic nerve atrophy and retinal dystrophy are the emerging causes of blindness, underlining the need for genetic counseling and low vision rehabilitation centers, along with a targeted approach for avoidable causes of blindness.

Ocular morbidity patterns among children in schools for the blind in Chennai

PubMed Central

Prakash, MVS; Sivakumar, S; Dayal, Ashutosh; Chitra, A; Subramaniam, Sudharshini

2017-01-01

Purpose: To identify the morbidity patterns causing blindness in children attending schools for the blind in Chennai and comparing our data with similar studies done previously. Methods: A cross-sectional prevalence study was carried out in two schools for the blind in Chennai. Blind schools were visited by a team of ophthalmologists and optometrists. Students with best-corrected visual acuity (BCVA) worse than 3/60 in the better eye were included and relevant history was noted. Every student underwent anterior segment evaluation and detailed fundus examination. Morbidity of the better eye was taken as cause of blindness. Health records maintained by the school were referred to wherever available. Results: The anatomical causes of blindness include optic nerve disorders in 75 (24.8%) cases, retinal disorders in 55 (18.2%), corneal disorders in 47 (15.6%), lens-related disorders in 39 (12.9%), congenital anomalies in 11 (3.6%), and congenital glaucoma in 20 (6.6%) cases. The whole globe was involved in six cases (1.99%). Among conditions causing blindness, optic atrophy seen in 73 (24.17%) cases was the most common, followed by retinal dystrophy in 44 (14.56%), corneal scarring in 35 (11.59%), cataract in 22 (7.28%), and congenital glaucoma in 20 (6.6%) cases. Conclusion: It was found that avoidable causes of blindness were seen in 31% of cases and incurable causes in 45%. Optic nerve atrophy and retinal dystrophy are the emerging causes of blindness, underlining the need for genetic counseling and low vision rehabilitation centers, along with a targeted approach for avoidable causes of blindness. PMID:28820161

Blindness and Visual Impairment Profile and Rapid Assessment of Avoidable Blindness in South East Asia: Analysis of New Data. 2017 APAO Holmes Lecture.

PubMed

Das, Taraprasad

2018-03-13

The International Agency for Prevention of Blindness (IAPB) South East Asia region (SEAR) that consists of 11 countries contains 26% of the world's population (1,761,000,000). In this region 12 million are blind and 78.5 million are visually impaired. This amounts to 30% of global blindness and 32% of global visual impairment. Rapid assessment of avoidable blindness (RAAB) survey analysis. RAAB, either a repeat or a first time survey, was completed in 8 countries in this decade (2010 onwards). These include Bangladesh, Bhutan, India, Indonesia, Maldives, Sri Lanka, Thailand, and Timor Leste. Cataract is the principal cause of blindness and severe visual impairment in all countries. Refractive error is the principal cause of moderate visual impairment in 4 countries: Bangladesh, India, Maldives, and Sri Lanka; cataract continues to be the principal cause of moderate visual impairment in 4 other countries: Bhutan, Indonesia, Thailand, and Timor Leste. Outcome of cataract surgery is suboptimal in the Maldives and Timor Leste. Rigorous focus is necessary to improve cataract surgery outcomes and correction of refractive error without neglecting the quality of care. At the same time allowances must be made for care of the emerging causes of visual impairment and blindness such as glaucoma and posterior segment disorders, particularly diabetic retinopathy. Copyright 2018 Asia-Pacific Academy of Ophthalmology.

Food avoidance in athletes: FODMAP foods on the list.

PubMed

Lis, Dana; Ahuja, Kiran D K; Stellingwerff, Trent; Kitic, Cecilia M; Fell, James

2016-09-01

We surveyed 910 athletes to assess behaviours towards self-selected food/ingredient avoidance to minimize gastrointestinal distress. Fifty-five percent eliminated at least 1 high fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) food/category, with up to 82.6% reporting symptom improvement. In athletes indicating that high FODMAP foods trigger gastrointestinal symptoms, lactose (86.5%) was most frequently eliminated, followed by galactooligosaccharides (23.9%), fructose (23.0%), fructans (6.2%), and polyols (5.4%). Athletes avoid predominantly lactose and to a lesser extent other high FODMAP foods to reduce gastrointestinal distress.

Rapid Assessment of Avoidable Blindness and Diabetic Retinopathy in Gilan Province, Iran.

PubMed

Katibeh, Marzieh; Behboudi, Hassan; Moradian, Siamak; Alizadeh, Yousef; Beiranvand, Ramin; Sabbaghi, Hamideh; Ahmadieh, Hamid

2017-12-01

To conduct an assessment of avoidable blindness and diabetic retinopathy (DR) in Gilan, 2014. A cross-sectional population-based survey was performed on a representative sample of urban and rural individuals aged ≥50 years of the province. Blindness was defined as presenting visual acuity (PVA) <3/60 in the better eye. Moderate visual impairment (MVI) and severe visual impairment (SVI) were defined as 6/60 ≤ PVA <6/18 and 3/60 ≤ PVA <6/60 in the better eye, respectively. Diabetes mellitus (DM) was determined based on random blood sugar (RBS) levels ≥200 mg/dL or a previous diagnosis. We used the Scottish grading system to grade DR. We invited 2975 individuals from 85 clusters. Age- and sex-adjusted prevalence and 95% confidence interval (CI) of blindness, SVI, MVI, and DM in 2587 participants (response rate: 86.9%) were 1.5% (95% CI: 1.1-2.0), 1.5% (95% CI: 0.9-2.0), 11.3% (95% CI: 9.9-12.7) and 21.4% (95% CI: 19.2-23.7), respectively. The leading causes of blindness were cataract (47.1%), age-related macular degeneration (14.7%) and DR (8.8%). Cataract surgery (CS) coverage was 69.3%. The main challenges for CS were cost and unawareness. The outcome of CS was good in 66.9% of operated eyes. Any DR and/or maculopathy were observed in 25.3% (95% CI: 21.0-29.5) of subjects including 12.6% (95% CI: 9.7-15.6) sight-threatening DR. In previously known DM cases, 215 (41.7%) had never undergone an eye examination for DR. The proportion of avoidable blindness and DR is considerable in Gilan Province.

A survey of severe visual impairment and blindness in children attending thirteen schools for the blind in sri lanka.

PubMed

Gao, Zoe; Muecke, James; Edussuriya, Kapila; Dayawansa, Ranasiri; Hammerton, Michael; Kong, Aimee; Sennanayake, Saman; Senaratne, Tissa; Marasinghe, Nirosha; Selva, Dinesh

2011-02-01

To identify the causes of blindness and severe visual impairment (BL/SVI) in children attending schools for the blind in Sri Lanka, and to provide optical devices and ophthalmic treatment where indicated. Two hundred and six children under 16 years from 13 schools for the blind in Sri Lanka were examined by a team of ophthalmologists and optometrists. Data were entered in the World Health Organization Prevention of Blindness Eye Examination Record for Childhood Blindness (WHO/PBL ERCB). Of the 206 children, 83.5% were blind (BL = Visual acuity [VA] <3/60), and 9.2% had severe visual impairment (SVI = VA <6/60 to 3/60 in the better eye). The major anatomical site of BL/SVI was the retina in 35.9% of cases, followed by the whole globe in 22.4% of cases. The major underlying aetiologies of BL/SVI were unknown in 43.8% of cases and hereditary in 37.5%. Avoidable causes of BL/SVI accounted for 34.9% of cases; retinopathy of prematurity made up the largest proportion of this subgroup. One third of the children required an optical device to improve their vision. Just over one third of the children in schools for the blind in Sri Lanka had potentially avoidable causes of BL/SVI. Vision could also be improved in a third of children. The data support the need to develop specialized pediatric ophthalmic services, particularly in the face of advancing neonatal life support in Sri Lanka, and the need for increased provision of optical support.

PREVALENCE OF REFRACTIVE ERRORS IN MADRASSA STUDENTS OF HARIPUR DISTRICT.

PubMed

Atta, Zoia; Arif, Abdus Salam; Ahmed, Iftikhar; Farooq, Umer

2015-01-01

Visual impairment due to refractive errors is one of the most common problems among school-age children and is the second leading cause of treatable blindness. The Right to Sight, a global initiative launched by a coalition of non-government organizations and the World Health Organization (WHO), aims to eliminate avoidable visual impairment and blindness at a global level. In order to achieve this goal it is important to know the prevalence of different refractive errors in a community. Children and teenagers are the most susceptible groups to be affected by refractive errors. So, this population needs to be screened for different types of refractive errors. The study was done with the objective to find the frequency of different types of refractive errors in students of madrassas between the ages of 5-20 years in Haripur. This cross sectional study was done with 300 students between ages of 5-20 years in Madrassas of Haripur. The students were screened for refractive errors and the types of the errors were noted. After screening for refractive errors-the glasses were prescribed to the students. Myopia being 52.6% was the most frequent refractive error in students, followed by hyperopia 28.4% and astigmatism 19%. This study showed that myopia is an important problem in madrassa population. Females and males are almost equally affected. Spectacle correction of refractive errors is the cheapest and easy solution of this problem.

Using Key Informant Method to Determine the Prevalence and Causes of Childhood Blindness in South-Eastern Nigeria.

PubMed

Aghaji, Ada E; Ezegwui, Ifeoma R; Shiweobi, Jude O; Mamah, Cyril C; Okoloagu, Mary N; Onwasigwe, Ernest N

2017-12-01

To determine the prevalence and causes of childhood blindness in an underserved community in south-eastern Nigeria using the key informant method. This was a descriptive cross-sectional study. Key informants (KI) appointed by their respective communities received 1-day training on identification of blind children in their communities. Two weeks later, the research team visited the agreed sites within the community and examined the identified children. The World Health Organization eye examination record for blind children was used for data collection. Data entry and analysis were done with the Statistical Package for Social Sciences (SPSS) version 17.0. Fifteen blind or severely visually impaired children (age range 3 months to 15 years) were identified in this community; nine of these were brought by the KIs. The prevalence of childhood blindness/severe visual impairment (BL/SVI) was 0.12 per 1000 children. By anatomical classification, operable cataract in 6 (40.0%) was the leading cause of BL/SVI in the series; followed by optic nerve lesions (atrophy/hypoplasia) in 3 (20.0%). The etiology of BL/SVI is unknown for the majority of the children (66.7%). It was presumed hereditary in four children (26.7%). Sixty percent of the blindness was judged avoidable. Only three children (20.0%) were enrolled in the Special Education Centre for the Blind. The prevalence of childhood BL/SVI in our study population is low but over half of the blindness is avoidable. There may be a significant backlog of operable childhood cataract in south-eastern Nigeria. The KI method is a practical method for case finding of blind children in rural communities.

Eye health seeking habits and barriers to accessing curative services among blind beggars in an urban community in Northern Nigeria.

PubMed

Balarabe, Aliyu Hamza; Hassan, Ramatu; Fatai, Olatunji O

2014-01-01

The aim of the following study was to determine the types of intervention sought by the blind street beggars and assess the barriers to accessing available eye care services. This cross-sectional study was conducted among consenting blind street beggars in Sokoto, Nigeria between May and June, 2009. A semi-structured interview was conducted to probe issues on historical antecedents of the blindness and the eye heath seeking behavior including the use of traditional eye medications. Assessment of barriers to accessing curative services among the blind persons was explored. Questions were asked and the individual responses were recorded in the questionnaire under the appropriate sections. Two hundred and two of 216 (94.7%) of the examined subjects were found to be blind and included in the analysis. The principal cause of blindness was corneal opacity. Overall 82% of the blindness was due to avoidable causes with majority irreversibly blind. Only 38 subjects (18.8%) sought for intervention in hospitals, others resorted to self-medication (42.1%), medicine store (31.2%) and traditional facility (7.9%). Those that accessed treatment at a hospital did so mainly at a primary health center (50.0%) and General Hospitals (34.2%). The barriers to accessing treatment at the hospital were mainly due to "not taken to any hospital" by the parents/relatives (50.3%) and "services not available" (25.2%). Most respondents resorted to ocular self-medication particularly traditional eye medicines. We advocate for a provision of affordable, accessible and qualitative eye care services with a strong health education component on avoidable causes of blindness.

In blind pursuit of racial equality?

PubMed

Apfelbaum, Evan P; Pauker, Kristin; Sommers, Samuel R; Ambady, Nalini

2010-11-01

Despite receiving little empirical assessment, the color-blind approach to managing diversity has become a leading institutional strategy for promoting racial equality, across domains and scales of practice. We gauged the utility of color blindness as a means to eliminating future racial inequity--its central objective--by assessing its impact on a sample of elementary-school students. Results demonstrated that students exposed to a color-blind mind-set, as opposed to a value-diversity mind-set, were actually less likely both to detect overt instances of racial discrimination and to describe such events in a manner that would prompt intervention by certified teachers. Institutional messages of color blindness may therefore artificially depress formal reporting of racial injustice. Color-blind messages may thus appear to function effectively on the surface even as they allow explicit forms of bias to persist.

Causes of blindness and visual impairment among students in integrated schools for the blind in Nepal.

PubMed

Shrestha, Jyoti Baba; Gnyawali, Subodh; Upadhyay, Madan Prasad

2012-12-01

To identify the causes of blindness and visual impairment among students in integrated schools for the blind in Nepal. A total of 778 students from all 67 integrated schools for the blind in Nepal were examined using the World Health Organization/Prevention of Blindness Eye Examination Record for Children with Blindness and Low Vision during the study period of 3 years. Among 831 students enrolled in the schools, 778 (93.6%) participated in the study. Mean age of students examined was 13.7 years, and the male to female ratio was 1.4:1. Among the students examined, 85.9% were blind, 10% had severe visual impairment and 4.1% were visually impaired. The cornea (22.8%) was the most common anatomical site of visual impairment, its most frequent cause being vitamin A deficiency, followed by the retina (18.4%) and lens (17.6%). Hereditary and childhood factors were responsible for visual loss in 27.9% and 22.0% of students, respectively. Etiology could not be determined in 46% of cases. Overall, 40.9% of students had avoidable causes of visual loss. Vision could be improved to a level better than 6/60 in 3.6% of students refracted. More than one third of students were visually impaired for potentially avoidable reasons, indicating lack of eye health awareness and eye care services in the community. The cause of visual impairment remained unknown in a large number of students, which indicates the need for introduction of modern diagnostic tools.

Epidemiology of blindness in children.

PubMed

Solebo, Ameenat Lola; Teoh, Lucinda; Rahi, Jugnoo

2017-09-01

An estimated 14 million of the world's children are blind. A blind child is more likely to live in socioeconomic deprivation, to be more frequently hospitalised during childhood and to die in childhood than a child not living with blindness. This update of a previous review on childhood visual impairment focuses on emerging therapies for children with severe visual disability (severe visual impairment and blindness or SVI/BL).For children in higher income countries, cerebral visual impairment and optic nerve anomalies remain the most common causes of SVI/BL, while retinopathy of prematurity (ROP) and cataract are now the most common avoidable causes. The constellation of causes of childhood blindness in lower income settings is shifting from infective and nutritional corneal opacities and congenital anomalies to more resemble the patterns seen in higher income settings. Improvements in maternal and neonatal health and investment in and maintenance of national ophthalmic care infrastructure are the key to reducing the burden of avoidable blindness. New therapeutic targets are emerging for childhood visual disorders, although the safety and efficacy of novel therapies for diseases such as ROP or retinal dystrophies are not yet clear. Population-based epidemiological research, particularly on cerebral visual impairment and optic nerve hypoplasia, is needed in order to improve understanding of risk factors and to inform and support the development of novel therapies for disorders currently considered 'untreatable'. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The politics of avoidable blindness in Latin America--surgery, solidarity, and solutions: the case of Misión Milagro.

PubMed

Zakrison, Tanya L; Armada, Francisco; Rai, Nanky; Muntaner, Caries

2012-01-01

Avoidable blindness, especially when caused by cataracts, is a disease primarily of the economically disadvantaged sectors of the population. With a focus on Latin America and the Caribbean, this paper focuses on the program Misión Milagro within its historical, political, and economic contexts. This initiative, led by the governments of Cuba and Venezuela, covers close to 35 countries across Latin America, the Caribbean, Asia, and Africa. It is well-known throughout Latin America as close to 2 million patients have undergone free screening, corrective surgery, and rehabilitation since its inception in 2004. Misión Milagro shows that implementation of a massive initiative to curb avoidable blindness caused by cataracts in a relatively short time is feasible. The program is also built upon a unique model of international cooperation, which stresses social objectives and solidarity rather than hegemonic international initiatives built on commercial relationships. It also provides elements that could be applied to other public health issues of global or national relevance, not only to other low-middle-income countries, but also to high-income countries such as Canada.

Guiding Blind Pedestrians with a Personal Navigation System

NASA Astrophysics Data System (ADS)

Dodson, A. H.; Moon, G. V.; Moore, T.; Jones, D.

With the assistance provided by the white cane or guide dog, most blind pedestrians can find their way to known destinations along familiar routes. Finding new or known destinations along unfamiliar routes is more challenging. Before such a journey is attempted, detailed instructions must be acquired. The difficulty of obtaining and then reliably following such instructions deters many blind pedestrians from travelling alone in unknown areas. This paper demonstrates a technological approach, by way of field trials, that supplements the existing aids and eliminates the need for sighted guides. The approach has the potential to offer greater independence to the blind person. The investigation suggests that the methodology used in personal navigation systems for the sighted is sub-optimal for guiding the blind pedestrian. Suitable extensions are introduced, and the results show the proposed methodology is efficient for guiding the blind individual to unknown destinations in the chosen field trial environment.

Mass drug administration for trachoma: how long is not long enough?

PubMed

Jimenez, Violeta; Gelderblom, Huub C; Mann Flueckiger, Rebecca; Emerson, Paul M; Haddad, Danny

2015-03-01

Blinding trachoma is targeted for elimination by 2020 using the SAFE strategy (Surgery, Antibiotics, Facial cleanliness, and Environmental improvements). Annual mass drug administration (MDA) with azithromycin is a cornerstone of this strategy. If baseline prevalence of clinical signs of trachomatous inflammation - follicular among 1-9 year-olds (TF1-9) is ≥ 10% but <30%, the World Health Organization guidelines are for at least 3 annual MDAs; if ≥ 30%, 5. We assessed the likelihood of achieving the global elimination target of TF1-9 <5% at 3 and 5 year evaluations using program reports. We used the International Trachoma Initiative's prevalence and treatment database. Of 283 cross-sectional survey pairs with baseline and follow-up data, MDA was conducted in 170 districts. Linear and logistic regression modeling was applied to these to investigate the effect of MDA on baseline prevalence. Reduction to <5% was less likely, though not impossible, at higher baseline TF1-9 prevalences. Increased number of annual MDAs, as well as no skipped MDAs, were significant predictors of reduced TF1-9 at follow-up. The probability of achieving the <5% target was <50% for areas with ≥ 30% TF1-9 prevalence at baseline, even with 7 or more continuous annual MDAs. Number of annual MDAs alone appears insufficient to predict program progress; more information on the effects of baseline prevalence, coverage, and underlying environmental and hygienic conditions is needed. Programs should not skip MDAs, and at prevalences >30%, 7 or more annual MDAs may be required to achieve the target. There are five years left before the 2020 deadline to eliminate blinding trachoma. Low endemic settings are poised to succeed in their elimination goals. However, newly-identified high prevalence districts warrant immediate inclusion in the global program. Intensified application of the SAFE strategy is needed in order to guarantee blinding trachoma elimination by 2020.

Mass Drug Administration for Trachoma: How Long Is Not Long Enough?

PubMed Central

Jimenez, Violeta; Gelderblom, Huub C.; Mann Flueckiger, Rebecca; Emerson, Paul M.; Haddad, Danny

2015-01-01

Background Blinding trachoma is targeted for elimination by 2020 using the SAFE strategy (Surgery, Antibiotics, Facial cleanliness, and Environmental improvements). Annual mass drug administration (MDA) with azithromycin is a cornerstone of this strategy. If baseline prevalence of clinical signs of trachomatous inflammation – follicular among 1-9 year-olds (TF1-9) is ≥10% but <30%, the World Health Organization guidelines are for at least 3 annual MDAs; if ≥30%, 5. We assessed the likelihood of achieving the global elimination target of TF1-9 <5% at 3 and 5 year evaluations using program reports. Methodology/Principal Findings We used the International Trachoma Initiative’s prevalence and treatment database. Of 283 cross-sectional survey pairs with baseline and follow-up data, MDA was conducted in 170 districts. Linear and logistic regression modeling was applied to these to investigate the effect of MDA on baseline prevalence. Reduction to <5% was less likely, though not impossible, at higher baseline TF1-9 prevalences. Increased number of annual MDAs, as well as no skipped MDAs, were significant predictors of reduced TF1-9 at follow-up. The probability of achieving the <5% target was <50% for areas with ≥30% TF1-9 prevalence at baseline, even with 7 or more continuous annual MDAs. Conclusions Number of annual MDAs alone appears insufficient to predict program progress; more information on the effects of baseline prevalence, coverage, and underlying environmental and hygienic conditions is needed. Programs should not skip MDAs, and at prevalences >30%, 7 or more annual MDAs may be required to achieve the target. There are five years left before the 2020 deadline to eliminate blinding trachoma. Low endemic settings are poised to succeed in their elimination goals. However, newly-identified high prevalence districts warrant immediate inclusion in the global program. Intensified application of the SAFE strategy is needed in order to guarantee blinding trachoma elimination by 2020. PMID:25799168

The NUC and blind pixel eliminating in the DTDI application

NASA Astrophysics Data System (ADS)

Su, Xiao Feng; Chen, Fan Sheng; Pan, Sheng Da; Gong, Xue Yi; Dong, Yu Cui

2013-12-01

AS infrared CMOS Digital TDI (Time Delay and integrate) has a simple structure, excellent performance and flexible operation, it has been used in more and more applications. Because of the limitation of the Production process level, the plane array of the infrared detector has a large NU (non-uniformity) and a certain blind pixel rate. Both of the two will raise the noise and lead to the TDI works not very well. In this paper, for the impact of the system performance, the most important elements are analyzed, which are the NU of the optical system, the NU of the Plane array and the blind pixel in the Plane array. Here a reasonable algorithm which considers the background removal and the linear response model of the infrared detector is used to do the NUC (Non-uniformity correction) process, when the infrared detector array is used as a Digital TDI. In order to eliminate the impact of the blind pixel, the concept of surplus pixel method is introduced in, through the method, the SNR (signal to noise ratio) can be improved and the spatial and temporal resolution will not be changed. Finally we use a MWIR (Medium Ware Infrared) detector to do the experiment and the result proves the effectiveness of the method.

Causes of severe visual impairment and blindness in children in the Republic of Suriname.

PubMed

Heijthuijsen, Astrid Anna Maria; Beunders, Victoria Apollonia Annemarie; Jiawan, Dinesh; de Mesquita-Voigt, Anne-Marie Bueno; Pawiroredjo, Jerrel; Mourits, Maarten; Tanck, Michael; Verhoeff, Joost; Saeed, Peerooz

2013-07-01

To determine the causes of severe visual impairment and blindness (SVI/BL) in children in Suriname (Dutch Guyana) and to identify preventable and treatable causes. 4643 children under 16 years of age were recruited from two locations: 33 children attending the only school for the blind were examined and 4610 medical records were analysed at an eye clinic. Data have been collected using the WHO Prevention of Blindness Programme eye examination record for children. 65 children were identified with SVI/BL, 58.5% were blind and 41.5% were severely visually impaired (SVI). The major anatomical site of SVI/BL was the retina in 33.8%, lens in 15.4% and normal appearing globe in 15.4%. The major underlying aetiology of SVI/BL was undetermined in 56.9% (mainly cataract and abnormality since birth) and perinatal factors 21.5% (mainly retinopathy of prematurity (ROP)). Avoidable causes of SVI/BL accounted for 40% of cases; 7.7% were preventable and 32.3% were treatable with cataracts and ROP the most common causes (15.4% and 12.3%, respectively). More than a third of the SVI/BL causes are potentially avoidable, with childhood cataract and ROP the leading causes. Corneal scarring from vitamin A deficiency does not seem to be a continuing issue in Suriname.

Improvement of a Quantum Proxy Blind Signature Scheme

NASA Astrophysics Data System (ADS)

Zhang, Jia-Lei; Zhang, Jian-Zhong; Xie, Shu-Cui

2018-02-01

Improvement of a quantum proxy blind signature scheme is proposed in this paper. Six-qubit entangled state functions as quantum channel. In our scheme, a trust party Trent is introduced so as to avoid David's dishonest behavior. The receiver David verifies the signature with the help of Trent in our scheme. The scheme uses the physical characteristics of quantum mechanics to implement message blinding, delegation, signature and verification. Security analysis proves that our scheme has the properties of undeniability, unforgeability, anonymity and can resist some common attacks.

Improvement of a Quantum Proxy Blind Signature Scheme

NASA Astrophysics Data System (ADS)

Zhang, Jia-Lei; Zhang, Jian-Zhong; Xie, Shu-Cui

2018-06-01

Improvement of a quantum proxy blind signature scheme is proposed in this paper. Six-qubit entangled state functions as quantum channel. In our scheme, a trust party Trent is introduced so as to avoid David's dishonest behavior. The receiver David verifies the signature with the help of Trent in our scheme. The scheme uses the physical characteristics of quantum mechanics to implement message blinding, delegation, signature and verification. Security analysis proves that our scheme has the properties of undeniability, unforgeability, anonymity and can resist some common attacks.

Collision avoidance sensor skin

NASA Technical Reports Server (NTRS)

1991-01-01

The objective was to totally eliminate the possibility of a robot (or any mechanism for that matter) inducing a collision in space operations. We were particularly concerned that human beings were safe under all circumstances. This was apparently accomplished, and it is shown that GSFC has a system that is ready for space qualification and flight. However, it soon became apparent that much more could be accomplished with this technology. Payloads could be made invulnerable to collision avoidance and the blind spots behind them eliminated. This could be accomplished by a simple, non-imaging set of 'Capaciflector' sensors on each payload. It also is evident that this system could be used to align and dock the system with a wide margin of safety. Throughout, lighting problems could be ignored, and unexpected events and modeling errors taken in stride. At the same time, computational requirements would be reduced. This can be done in a simple, rugged, reliable manner that will not disturb the form factor of space systems. It will be practical for space applications. The lab experiments indicate we are well on the way to accomplishing this. Still, the research trail goes deeper. It now appears that the sensors can be extended to end effectors to provide precontact information and make robot docking (or any docking connection) very smooth, with minimal loads impacted back into the mating structures. This type of ability would be a major step forward in basic control techniques in space. There are, however, baseline and restructuring issues to be tackled. The payloads must get power and signals to them from the robot or from the astronaut servicing tool. This requires a standard electromechanical interface. Any of several could be used. The GSFC prototype shown in this presentation is a good one. Sensors with their attendant electronics must be added to the payloads, end effectors, and robot arms and integrated into the system.

Do adjusted clinical groups eliminate incentives for HMOs to avoid substance abusers? Evidence from the Maryland Medicaid HealthChoice program.

PubMed

Ettner, Susan L; Johnson, Steven

2003-01-01

The adequacy of risk adjustment to eliminate incentives for managed care organizations (MCOs) to avoid enrolling costly patients had been questioned. This study explored systematic differences in expenditures between beneficiaries with and without substance disorders assigned to the same capitation rate group under the Maryland Medicaid HealthChoice program. The investigators used fiscal year (FY) 1995 to 1997 Medicaid data to assign beneficiaries to rate cells based on FY 1995 diagnoses and compared the distribution of expenditures for beneficiaries with and without substance disorders, defined using FY 1997 and FY 1995 diagnoses. Results showed that differences in FY 1997 expenditures between beneficiaries with and without FY 1995 substance disorders were negligible. However, MCOs could expect greater average losses and lower average profits on beneficiaries with FY 1997 substance disorders. Thus, the adjusted clinical groups methodology used to adjust capitation payments in the HealthChoice program attenuated, but did not eliminate, financial incentives for MCOs to avoid substance abusers.

Prevalence and causes of blindness, low vision and status of cataract in 50 years and older citizen of Qatar-a community based survey.

PubMed

Al Gamra, Hamad; Al Mansouri, Fatima; Khandekar, Rajiv; Elshafei, Maha; Al Qahtani, Omar; Singh, Rajvir; Hashim, Shakeel P; Mujahed, Amjad; Makled, Alaa; Pai, Anant

2010-10-01

Rapid Assessment for the Avoidable Blindness (RAAB) was conducted in Qatar during 2009. We present the prevalence and determinants of visual disabilities and status of cataract among citizens aged 50 years and older. Residents of randomly selected houses and clusters participated in the survey. Opticians noted the presenting and the best corrected vision of participants from 49 clusters. Ophthalmologists examined participants with additional instruments like bio-microscope, digital camera, auto-perimeter and auto-refractor in a mobile van. World Health Organization recommended principal cause of blindness (Visual acuity [VA] < 3/60 in better eye), Severe visual impairment (SVI) (<6/60), low vision (VA < 6/18) and unilateral blindness (VA < 3/60) were designated. Persons with VA < 6/18 and cataract were interviewed to calculate coverage and barriers for cataract surgeries. Age sex adjusted prevalence of visual disabilities and their 95% Confidence Intervals (CI) were estimated. We examined 2,433 (97.3%) participants. The age sex adjusted prevalence of bilateral blindness was 1.28% [95% CI 1.22-1.35], SVI (1.67%), low vision (3.66%) and unilateral blindness (3.61%) in 50 years and older population. Female and older age groups were significant risk factors of visual disabilities. Cataract and glaucoma were the main causes of visual disabilities. The coverage of cataract services was 68.2%. Believing that cataract as an aging process (25) and adequate vision in the fellow eye (15) were the reasons for delay in surgery. To reduce avoidable blindness, un-operated cataract should be addressed. Primary and secondary eye care systems should be strengthened to improve the care of blinding eye diseases in Qatar.

Causes of severe visual impairment and blindness in students in schools for the blind in Northwest Ethiopia.

PubMed

Asferaw, Mulusew; Woodruff, Geoffrey; Gilbert, Clare

2017-01-01

To determine the causes of severe visual impairment and blindness (SVI/BL) among students in schools for the blind in Northwest Ethiopia and to identify preventable and treatable causes. Students attending nine schools for the blind in Northwest Ethiopia were examined and causes assigned using the standard WHO record form for children with blindness and low vision in May and June 2015. 383 students were examined, 357 (93%) of whom were severely visually impaired or blind (<6/60 in their better eye). 253 (70.9%) were aged 16 years or above and 228 (63.9%) were males. 100 students aged <16 years were blind and four were SVI, total 104. The major anatomical site of visual loss among those 0-15 years was cornea/phthisis (47.1%), usually due to measles and vitamin A deficiency, followed by whole globe (22.1%), lens (9.6%) and uvea (8.7%). Among students aged 16 years and above, corneal/phthisis (76.3%) was the major anatomical cause, followed by lens (6.3%), whole globe (4.7%), uvea (3.6%) and optic nerve (3.2%). The leading underlying aetiology among students aged <16 years was childhood factors (39.4%) (13.5% measles, 10.6% vitamin A deficiency), followed by unknown aetiology (54.8%), perinatal (2.9%) and hereditary factors (2.9%). In the older group, childhood factors (72.3%) (25% measles, 15% vitamin A deficiency) were major causes, followed by unknown aetiology (24.1%), perinatal (2.4%) and hereditary factors (0.8%). Over 80% of the causes were avoidable with majority being potentially preventable (65%). Corneal blindness, mainly as the result of measles and vitamin A deficiency, is still a public health problem in Northwest Ethiopia, and this has not changed as observed in other low-income countries. More than three-fourth of causes of SVI/BL in students in schools for the blind are potentially avoidable, with measles/vitamin A deficiency and cataract being the leading causes.

Estimated cases of blindness and visual impairment from neovascular age-related macular degeneration avoided in Australia by ranibizumab treatment.

PubMed

Mitchell, Paul; Bressler, Neil; Doan, Quan V; Dolan, Chantal; Ferreira, Alberto; Osborne, Aaron; Rochtchina, Elena; Danese, Mark; Colman, Shoshana; Wong, Tien Y

2014-01-01

Intravitreal injections of anti-vascular endothelial growth factor agents, such as ranibizumab, have significantly improved the management of neovascular age-related macular degeneration. This study used patient-level simulation modelling to estimate the number of individuals in Australia who would have been likely to avoid legal blindness or visual impairment due to neovascular age-related macular degeneration over a 2-year period as a result of intravitreal ranibizumab injections. The modelling approach used existing data for the incidence of neovascular age-related macular degeneration in Australia and outcomes from ranibizumab trials. Blindness and visual impairment were defined as visual acuity in the better-seeing eye of worse than 6/60 or 6/12, respectively. In 2010, 14,634 individuals in Australia were estimated to develop neovascular age-related macular degeneration who would be eligible for ranibizumab therapy. Without treatment, 2246 individuals would become legally blind over 2 years. Monthly 0.5 mg intravitreal ranibizumab would reduce incident blindness by 72% (95% simulation interval, 70-74%). Ranibizumab given as needed would reduce incident blindness by 68% (64-71%). Without treatment, 4846 individuals would become visually impaired over 2 years; this proportion would be reduced by 37% (34-39%) with monthly intravitreal ranibizumab, and by 28% (23-33%) with ranibizumab given as needed. These data suggest that intravitreal injections of ranibizumab, given either monthly or as needed, can substantially lower the number of cases of blindness and visual impairment over 2 years after the diagnosis of neovascular age-related macular degeneration.

Spectrum of ocular firework injuries in children: A 5-year retrospective study during a festive season in Southern India.

PubMed

John, Deepa; Philip, Swetha Sara; Mittal, Rashmi; John, Sheeja Susan; Paul, Padma

2015-11-01

Ocular trauma is a major cause of acquired monocular blindness in children. Firework injuries account for 20% of ocular trauma. The purpose of our study was to document the profile of ocular firework injuries in children during the festive season of Diwali and to determine the prevalence of unilateral blindness in them. A retrospective chart analysis of ocular firework injury in children during the festival of Diwali from 2009 to 2013, conducted in a tertiary care eye center in Tamil Nadu, Southern India. Children below 18 years of age with ocular firework injuries who presented to the emergency department for 3 consecutive days - the day of Diwali, 1 day before, and 1 day after Diwali - were included in this study. Eighty-four children presented with firework-related ocular injuries during the study period. Male to female ratio was 4:1 with mean age 9.48 ± 4 years. Forty-four percentage required hospitalization. The prevalence of unilateral blindness in children due to fireworks was found to be 8% (95% confidence interval - 2-13%). Vision 2020 gives high priority to avoidable blindness, especially in children. In our study, for every 12 children who presented with firecracker injury, one resulted in unilateral blindness. This is an avoidable cause of blindness. Awareness needs to be created, and changes in policy regarding sales and handling of firecrackers including mandatory use of protective eyewear should be considered.

Spectrum of ocular firework injuries in children: A 5-year retrospective study during a festive season in Southern India

PubMed Central

John, Deepa; Philip, Swetha Sara; Mittal, Rashmi; John, Sheeja Susan; Paul, Padma

2015-01-01

Purpose: Ocular trauma is a major cause of acquired monocular blindness in children. Firework injuries account for 20% of ocular trauma. The purpose of our study was to document the profile of ocular firework injuries in children during the festive season of Diwali and to determine the prevalence of unilateral blindness in them. Materials and Methods: A retrospective chart analysis of ocular firework injury in children during the festival of Diwali from 2009 to 2013, conducted in a tertiary care eye center in Tamil Nadu, Southern India. Children below 18 years of age with ocular firework injuries who presented to the emergency department for 3 consecutive days - the day of Diwali, 1 day before, and 1 day after Diwali - were included in this study. Results: Eighty-four children presented with firework-related ocular injuries during the study period. Male to female ratio was 4:1 with mean age 9.48 ± 4 years. Forty-four percentage required hospitalization. The prevalence of unilateral blindness in children due to fireworks was found to be 8% (95% confidence interval - 2–13%). Conclusion: Vision 2020 gives high priority to avoidable blindness, especially in children. In our study, for every 12 children who presented with firecracker injury, one resulted in unilateral blindness. This is an avoidable cause of blindness. Awareness needs to be created, and changes in policy regarding sales and handling of firecrackers including mandatory use of protective eyewear should be considered. PMID:26669336

Blindness and poverty in India: the way forward.

PubMed

Khanna, Rohit; Raman, Usha; Rao, Gullapalli N

2007-11-01

A few recent studies have shown that poverty is an exacerbating and often determining factor in the incidence of disabling conditions, including visual impairment. Recent estimates from the World Health Organization indicate that 90 per cent of all those affected by visual impairment live in the poorest countries of the world. India is home to one-fifth of the world's visually impaired people and therefore, any strategies to combat avoidable blindness must take into account the socio-economic conditions within which people live. This paper looks at the relationship between poverty and blindness in India and suggests strategies to address blindness prevention in a comprehensive manner.

Prevalence of visual impairment and outcomes of cataract surgery in Chaonan, South China

PubMed Central

Zhang, Xiujuan; Li, Emmy Y.; Leung, Christopher Kai-Shun; Musch, David C.; Tang, Xin; Zheng, Chongren; He, Mingguang; Chang, David F.

2017-01-01

Purpose To estimate the prevalence and causes of blindness and visual impairment (VI), and report the outcomes of cataract surgery in Chaonan Region, Guangdong Province, southern China Design Cross-sectional population-based survey Participants A total of 3484 participants including 1397 men (40.1%) and 2087 women (59.9%) aged ≥50 years were examined (94.2% response rate). Method A two-stage cluster sampling procedure was used to select 3700 participants aged ≥50 years from 74 clusters of Chaonan Region. Participants were examined according to the Rapid Assessment of Avoidable Blindness (RAAB) method. Blindness and visual impairment (VI) were defined by the World Health Organization criteria. Participants with visual acuity (VA) < 6/18 in either eye were examined by ophthalmologists. The primary causes of blindness and VI were reported with reference to the participant’s better eye. Main outcome measures Prevalence and main causes of blindness, severe visual impairment (SVI), VI and the outcomes of cataract surgery Results The standardized prevalence rates of blindness, SVI, and VI were 2.4% (95% confidence interval [CI], 1.9–2.9%), 1.0% (95% CI, 0.7–1.4%), and 6.4% (95% CI, 5.6%– 7.1%), respectively. The principal cause of blindness and SVI was cataract, accounting for 67.1% and 67.6% respectively, and the principal cause of VI was refractive error (46.9%). One hundred and fifty five out of 3484 (4.4%) people (211 eyes) had cataract surgery. Of the 211 eyes that had cataract surgery, 96.7% were pseudophakic. 67.2% of the 211 operated eyes had a presenting visual acuity (PVA) of 6/18 or better. Conclusions The prevalence of blindness, SVI, and VI was high among rural residents in Chaonan. Cataract remained the leading cause of avoidable blindness. Outcomes of cataract surgery performed in rural private clinics were suboptimal. Quality-control initiatives such as hands-on training program should be introduced to improve cataract surgery outcomes. PMID:28797099

Causes of severe visual impairment and blindness in children in the Republic of Suriname

PubMed Central

Heijthuijsen, Astrid Anna Maria; Beunders, Victoria Apollonia Annemarie; Jiawan, Dinesh; de Mesquita-Voigt, Anne-Marie Bueno; Pawiroredjo, Jerrel; Mourits, Maarten; Tanck, Michael; Verhoeff, Joost; Saeed, Peerooz

2013-01-01

Aims To determine the causes of severe visual impairment and blindness (SVI/BL) in children in Suriname (Dutch Guyana) and to identify preventable and treatable causes. Methods 4643 children under 16 years of age were recruited from two locations: 33 children attending the only school for the blind were examined and 4610 medical records were analysed at an eye clinic. Data have been collected using the WHO Prevention of Blindness Programme eye examination record for children. Results 65 children were identified with SVI/BL, 58.5% were blind and 41.5% were severely visually impaired (SVI). The major anatomical site of SVI/BL was the retina in 33.8%, lens in 15.4% and normal appearing globe in 15.4%. The major underlying aetiology of SVI/BL was undetermined in 56.9% (mainly cataract and abnormality since birth) and perinatal factors 21.5% (mainly retinopathy of prematurity (ROP)). Avoidable causes of SVI/BL accounted for 40% of cases; 7.7% were preventable and 32.3% were treatable with cataracts and ROP the most common causes (15.4% and 12.3%, respectively). Conclusions More than a third of the SVI/BL causes are potentially avoidable, with childhood cataract and ROP the leading causes. Corneal scarring from vitamin A deficiency does not seem to be a continuing issue in Suriname. PMID:23603759

Magnitude and Determinants of the Ratio between Prevalence of Low Vision and Blindness in Rapid Assessment of Avoidable Blindness Surveys.

PubMed

Kaphle, Dinesh; Lewallen, Susan

2017-10-01

To determine the magnitude and determinants of the ratio between prevalence of low vision and prevalence of blindness in rapid assessment of avoidable blindness (RAAB) surveys globally. Standard RAAB reports were downloaded from the repository or requested from principal investigators. Potential predictor variables included prevalence of uncorrected refractive error (URE) as well as gross domestic product (GDP) per capita, health expenditure per capita of the country across World Bank regions. Univariate and multivariate linear regression were used to investigate the correlation between potential predictor variables and the ratio. The results of 94 surveys from 43 countries showed that the ratio ranged from 1.35 in Mozambique to 11.03 in India with a median value of 3.90 (Interquartile range 3.06;5.38). Univariate regression analysis showed that prevalence of URE (p = 0.04), logarithm of GDP per capita (p = 0.01) and logarithm of health expenditure per capita (p = 0.03) were significantly associated with the higher ratio. However, only prevalence of URE was found to be significant in multivariate regression analysis (p = 0.03). There is a wide variation in the ratio of the prevalence of low vision to the prevalence of blindness. Eye care service utilization indicators such as the prevalence of URE may explain some of the variation across the regions.

River Blindness: Mathematical Models for Control and Elimination.

PubMed

Basáñez, M G; Walker, M; Turner, H C; Coffeng, L E; de Vlas, S J; Stolk, W A

2016-01-01

Human onchocerciasis (river blindness) is one of the few neglected tropical diseases (NTDs) whose control strategies have been informed by mathematical modelling. With the change in focus from elimination of the disease burden to elimination of Onchocerca volvulus, much remains to be done to refine, calibrate and validate existing models. Under the impetus of the NTD Modelling Consortium, the teams that developed EPIONCHO and ONCHOSIM have joined forces to compare and improve these frameworks to better assist ongoing elimination efforts. We review their current versions and describe how they are being used to address two key questions: (1) where can onchocerciasis be eliminated with current intervention strategies by 2020/2025? and (2) what alternative/complementary strategies could help to accelerate elimination where (1) cannot be achieved? The control and elimination of onchocerciasis from the African continent is at a crucial crossroad. The African Programme for Onchocerciasis Control closed at the end of 2015, and although a new platform for support and integration of NTD control has been launched, the disease will have to compete with a myriad of other national health priorities at a pivotal time in the road to elimination. However, never before had onchocerciasis control a better arsenal of intervention strategies as well as diagnostics. It is, therefore, timely to present two models of different geneses and modelling traditions as they come together to produce robust decision-support tools. We start by describing the structural and parametric assumptions of EPIONCHO and ONCHOSIM; we continue by summarizing the modelling of current treatment strategies with annual (or biannual) mass ivermectin distribution and introduce a number of alternative strategies, including other microfilaricidal therapies (such as moxidectin), macrofilaricidal (anti-wolbachial) treatments, focal vector control and the possibility of an onchocerciasis vaccine. We conclude by discussing challenges, opportunities and future directions. Copyright © 2016 Elsevier Ltd. All rights reserved.

A survey of visual impairment and blindness in children attending four schools for the blind in Cambodia.

PubMed

Sia, David I T; Muecke, James; Hammerton, Michael; Ngy, Meng; Kong, Aimee; Morse, Anna; Holmes, Martin; Piseth, Horm; Hamilton, Carolyn; Selva, Dinesh

2010-08-01

To identify the causes of blindness and severe visual impairment (BL/SVI) in children attending four schools for the blind in Cambodia and to provide spectacles, low vision aids, orientation and mobility training and ophthalmic treatment. Children < 16 years of age were recruited from all 4 schools for the blind in Cambodia. Causes of visual impairment and blindness were determined and categorized using World Health Organization methods. Of the 95 children examined, 54.7% were blind (BL) and 10.5% were severely visually impaired (SVI). The major anatomical site of BL/SVI was the lens in 27.4%, cornea in 25.8%, retina in 21% and whole globe in 17.7%. The major underlying etiologies of BL/SVI were hereditary factors (mainly cataract and retinal dystrophies) in 45.2%, undetermined/unknown (mainly microphthalmia and anterior segment dysgenesis) in 38.7% and childhood factors in 11.3%. Avoidable causes of BL/SVI accounted for 50% of the cases; 12.9% of the total were preventable with measles being the commonest cause (8.1% of the total); 37.1% were treatable with cataracts and glaucoma being the commonest causes (22.6% and 4.8% respectively). More than 35% of children required an optical device and 27.4% had potential for visual improvement with intervention. Half of the BL/SVI causes were potentially avoidable. The data support the need for increased coverage of measles immunization. There is also a need to develop specialized pediatric ophthalmic services for the management of surgically remediable conditions, to provide optometric, low vision and orientation and mobility services. Genetic risk counseling services also may be considered.

Prevalence and causes of blindness in an urban area of Paraguay.

PubMed

Yaacov-Peña, Fernando; Jure, David; Ocampos, José; Samudio, Margarita; Furtado, João Marcello; Carter, Marissa; Lansingh, Van Charles

2012-10-01

To determine the prevalence and causes of blindness in Piribebuy, Paraguay. A population based study was conducted from September to November 2007 in Piribebuy, Paraguay. Based on the city map, seven clusters were randomly selected, containing 22 to 36 squares (423 to 578 houses) each, where all subjects > 40 years old who agreed to participate were included in the study. Presenting vision acuity (VA) was obtained for each eye, with 'E' Snellen charts 6 meters far from the patient with appropriate light. Eyes with VA<20/60 were also tested with the pinhole. Objective and subjective refraction was performed, followed by examination of anterior segment under the slit-lamp, Goldmann applanation tonometry, and pupil dilatation with 0.5% tropicamide plus 0.5% phenylephrine, followed by evaluation of the posterior pole. Best corrected visual acuity was used to classify the patients as follows: blindness was defined as visual acuity of the better eye <20/400, low vision as 20/400

Visual impairment and blindness in Hungary.

PubMed

Szabó, Dorottya; Sándor, Gábor László; Tóth, Gábor; Pék, Anita; Lukács, Regina; Szalai, Irén; Tóth, Georgina Zsófia; Papp, András; Nagy, Zoltán Zsolt; Limburg, Hans; Németh, János

2018-03-01

The aim of this study was to estimate the prevalence and causes of blindness, severe visual impairment (SVI), moderate visual impairment (MVI), and early visual impairment (EVI) and its causes in an established market economy of Europe. A cross-sectional population-based survey. A sample size of 3675 was calculated using the standard Rapid Assessment of Avoidable Blindness (RAAB) software in Hungary. A total of 105 clusters of 35 people aged 50 years or older were randomly selected with probability proportionate to size by the Hungarian Central Statistical Office. Households within the clusters were selected using compact segment sampling. Visual acuity (VA) was assessed with a Snellen tumbling E-chart with or without a pinhole in the households. The adjusted prevalences of bilateral blindness, SVI, MVI and EVI were 0.9% (95% CI: 0.6-1.2), 0.5% (95% CI: 0.2-0.7), 5.1% (95% CI: 4.3-5.9) and 6.9% (95% CI: 5.9-7.9), respectively. The major causes of blindness in Hungary were age-related macular degeneration (AMD; 27.3%) and other posterior segment diseases (27.3%), cataract (21.2%) and glaucoma (12.1%). Cataract was the main cause of SVI, MVI and EVI. Cataract surgical coverage (CSC) was 90.7%. Of all bilateral blindness in Hungary, 45.5% was considered avoidable. This study proved that RAAB methodology can be successfully conducted in industrialized countries, which often lack reliable epidemiologic data. The prevalence of blindness was relatively low, with AMD and other posterior segment diseases being the leading causes, and cataract is still a significant cause of visual impairment. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Causes of blindness in children attending four schools for the blind in Thailand and the Philippines. A comparison between urban and rural blind school populations.

PubMed

Gilbert, C; Foster, A

1993-08-01

Using WHO definitions of visual loss and a standardised methodology, 256 children were examined in schools for the blind in Thailand (1 school) and the Philippines (3 schools). 244 (95%) were blind (BL) or severely visually impaired (SVI). Causes of SVI and blindness were classified anatomically and aetiologically, and avoidable causes identified. Causes of visual loss in Khon Kaen, Thailand (n = 65) and Manila, Philippines, (n = 113) were similar, with conditions of the whole globe accounting for 27.7 and 27.4% of SVI/BL; retinal disease 29.2 and 23.0%; cataract 16.9 and 16.8%; corneal disease 12.3 and 13.4%; and optic nerve disease and glaucoma 6.2 and 8.8%. Perinatal factors accounted for 20.0 and 23.0% of SVI/BL; hereditary disease 13.8 and 17.7%; and 12.3 and 15.0% was due to events occurring during childhood. The underlying aetiology could not be determined in 50.8 and 41.6% of cases, respectively. In the two schools together twenty six children (15%) were blind from retinopathy of prematurity (ROP) and 16 (9%) from corneal scarring attributed to Vitamin A deficiency. 103 of 178 (58%) children had avoidable causes of visual loss. In the Filipino towns of Baguio and Davao (n = 66), the causes of visual loss were different from those in Khon Kaen and Manila, with 54.8 and 42.9% of SVI/BL being due to corneal disease, and only 3.2 and 8.5% to retinal disease.(ABSTRACT TRUNCATED AT 250 WORDS)

The Value of Grenz-Ray Therapy for Acne Vulgaris

DOE Office of Scientific and Technical Information (OSTI.GOV)

de Groot, W. P.; Prakken, J. R.; Verbeek, Ann M. J. A.

1963-01-01

In view of recent efforts to eliminate the use of radiotherapy for benign conditions or conditions treatable by other means, to avoid the possible detrimental effects of radiation, an evaluation of this treatment of acne was made. In a controlled, double-blind study in 40 patients, one area of skin received 1800 r (in thrice weekly 100-r doses) of 10-kv x irradiation. Comparable areas of skin were shamirradiated with the x-ray apparatus shielded by lead. In no case had the acne cleared up on the irradiated side. ln about half of the cases no difference was seen between the two areas.more » The remaining showed a systematic difference in favor of the treated side 2-6 weeks after treatment. However, in the majority of cases no improvement attributable to grenz-ray irradiation could be ascertained. It is concluded that grenz-ray therapy of acne, at least at the dosage used, is ineffective. At these doses, inhibition of sebaceous gland secretion would not be expected to occur. Severe erythema followed by peeling was not seen in these patients.« less

A MAP blind image deconvolution algorithm with bandwidth over-constrained

NASA Astrophysics Data System (ADS)

Ren, Zhilei; Liu, Jin; Liang, Yonghui; He, Yulong

2018-03-01

We demonstrate a maximum a posteriori (MAP) blind image deconvolution algorithm with bandwidth over-constrained and total variation (TV) regularization to recover a clear image from the AO corrected images. The point spread functions (PSFs) are estimated by bandwidth limited less than the cutoff frequency of the optical system. Our algorithm performs well in avoiding noise magnification. The performance is demonstrated on simulated data.

Definition of blindness under National Programme for Control of Blindness: Do we need to revise it?

PubMed Central

Vashist, Praveen; Senjam, Suraj Singh; Gupta, Vivek; Gupta, Noopur; Kumar, Atul

2017-01-01

A review appropriateness of the current definition of blindness under National Programme for Control of Blindness (NPCB), Government of India. Online search of peer-reviewed scientific published literature and guidelines using PubMed, the World Health Organization (WHO) IRIS, and Google Scholar with keywords, namely blindness and visual impairment, along with offline examination of reports of national and international organizations, as well as their cross-references was done until December 2016, to identify relevant documents on the definition of blindness. The evidence for the historical and currently adopted definition of blindness under the NPCB, the WHO, and other countries was reviewed. Differences in the NPCB and WHO definitions were analyzed to assess the impact on the epidemiological status of blindness and visual impairment in India. The differences in the criteria for blindness under the NPCB and the WHO definitions cause an overestimation of the prevalence of blindness in India. These variations are also associated with an over-representation of refractive errors as a cause of blindness and an under-representation of other causes under the NPCB definition. The targets for achieving elimination of blindness also become much more difficult to achieve under the NPCB definition. Ignoring differences in definitions when comparing the global and Indian prevalence of blindness will cause erroneous interpretations. We recommend that the appropriate modifications should be made in the NPCB definition of blindness to make it consistent with the WHO definition. PMID:28345562

Definition of blindness under National Programme for Control of Blindness: Do we need to revise it?

PubMed

Vashist, Praveen; Senjam, Suraj Singh; Gupta, Vivek; Gupta, Noopur; Kumar, Atul

2017-02-01

A review appropriateness of the current definition of blindness under National Programme for Control of Blindness (NPCB), Government of India. Online search of peer-reviewed scientific published literature and guidelines using PubMed, the World Health Organization (WHO) IRIS, and Google Scholar with keywords, namely blindness and visual impairment, along with offline examination of reports of national and international organizations, as well as their cross-references was done until December 2016, to identify relevant documents on the definition of blindness. The evidence for the historical and currently adopted definition of blindness under the NPCB, the WHO, and other countries was reviewed. Differences in the NPCB and WHO definitions were analyzed to assess the impact on the epidemiological status of blindness and visual impairment in India. The differences in the criteria for blindness under the NPCB and the WHO definitions cause an overestimation of the prevalence of blindness in India. These variations are also associated with an over-representation of refractive errors as a cause of blindness and an under-representation of other causes under the NPCB definition. The targets for achieving elimination of blindness also become much more difficult to achieve under the NPCB definition. Ignoring differences in definitions when comparing the global and Indian prevalence of blindness will cause erroneous interpretations. We recommend that the appropriate modifications should be made in the NPCB definition of blindness to make it consistent with the WHO definition.

Introduction: Why Teach about the Holocaust?

ERIC Educational Resources Information Center

Freedman, Theodore

1978-01-01

Presents a rationale for teaching about the Nazi era in social studies courses. Major objectives are to eliminate prejudice against Jews by rendering it intellectually indefensible and to help students deal with blind obedience to authority. (Author/DB)

The costs (or benefits) associated with attended objects do little to influence inattentional blindness.

PubMed

Stothart, Cary R; Wright, Timothy J; Simons, Daniel J; Boot, Walter R

2017-02-01

We sometimes fail to notice unexpected objects or events when our attention is directed elsewhere, a phenomenon called inattentional blindness. We explored whether unexpected objects that shared the color of consequential objects would be noticed more often. In three pre-registered experiments, participants played a custom video game in which they avoided both low- and high-cost missiles (Experiment 1 and 2) or tried to hit rewarding missiles while avoiding costly ones (Experiment 3). After participants had played the game for about 8min, an unexpected object moved across the screen. Although participants selectively avoided more costly missiles when playing, they were no more likely to notice an unexpected object when its color was associated with greater costs. Apparently, people are no more likely to notice unexpected objects that are associated with negative consequences. Future research should examine whether objects that are themselves consequential are noticed more frequently. Copyright © 2016 Elsevier B.V. All rights reserved.

Retinopathy of prematurity: Past, present and future

PubMed Central

Shah, Parag K; Prabhu, Vishma; Karandikar, Smita S; Ranjan, Ratnesh; Narendran, Venkatapathy; Kalpana, Narendran

2016-01-01

Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina occurring principally in new born preterm infants. It is an avoidable cause of childhood blindness. With the increase in the survival of preterm babies, ROP has become the leading cause of preventable childhood blindness throughout the world. A simple screening test done within a few weeks after birth by an ophthalmologist can avoid this preventable blindness. Although screening guidelines and protocols are strictly followed in the developed nations, it lacks in developing economies like India and China, which have the highest number of preterm deliveries in the world. The burden of this blindness in these countries is set to increase tremendously in the future, if corrective steps are not taken immediately. ROP first emerged in 1940s and 1950s, when it was called retrolental fibroplasia. Several epidemics of this disease were and are still occurring in different regions of the world and since then a lot of research has been done on this disease. However, till date very few comprehensive review articles covering all the aspects of ROP are published. This review highlights the past, present and future strategies in managing this disease. It would help the pediatricians to update their current knowledge on ROP. PMID:26862500

The relationship between fluid intelligence and sustained inattentional blindness in 7-to-14-year-old children.

PubMed

Zhang, Hui; Yan, Congcong; Zhang, Xingli; Shi, Jiannong; Zhu, Beiling

2017-10-01

Previous researches have shown that people with higher fluid intelligence are more likely to detect the unexpected stimuli. The current study systematically explored the relationship between fluid intelligence and sustained inattentional blindness in children. In Experiment 1, we measured one hundred and seventy-nine 7-to-14-year-old children's fluid intelligence and sustained inattentional blindness. The results showed that fluid intelligence was negatively related to sustained inattentional blindness only in 7-to-8-year-old children. In Experiment 2, we explored sustained inattentional blindness in sixty children with high Raven's scores. We found that compared with children who have average Raven's scores aged 11-to-12 years old, children with high Raven's scores were unable to better avoid sustained inattentional blindness. In general, this research implies that the relation between fluid intelligence and sustained inattentional blindness is weak. Fluid intelligence could predict sustained inattentional blindness only when children do not have enough perceptual capacities to complete the primary task. Copyright © 2017 Elsevier Inc. All rights reserved.

Interactions of cognitive and auditory abilities in congenitally blind individuals.

PubMed

Rokem, Ariel; Ahissar, Merav

2009-02-01

Congenitally blind individuals have been found to show superior performance in perceptual and memory tasks. In the present study, we asked whether superior stimulus encoding could account for performance in memory tasks. We characterized the performance of a group of congenitally blind individuals on a series of auditory, memory and executive cognitive tasks and compared their performance to that of sighted controls matched for age, education and musical training. As expected, we found superior verbal spans among congenitally blind individuals. Moreover, we found superior speech perception, measured by resilience to noise, and superior auditory frequency discrimination. However, when memory span was measured under conditions of equivalent speech perception, by adjusting the signal to noise ratio for each individual to the same level of perceptual difficulty (80% correct), the advantage in memory span was completely eliminated. Moreover, blind individuals did not possess any advantage in cognitive executive functions, such as manipulation of items in memory and math abilities. We propose that the short-term memory advantage of blind individuals results from better stimulus encoding, rather than from superiority at subsequent processing stages.

Citings on the Educational Horizon

ERIC Educational Resources Information Center

Mathies, Lorraine

1975-01-01

Article reviewed programs designed to help blind persons take advantage of information not in print form, programs which offer information on careers, programs designed to foster private sponsorship of basic research expeditions, and programs that eliminate social bias in educational materials. (Author/RK)

Optimizing Value and Avoiding Problems in Building Schools.

ERIC Educational Resources Information Center

Brevard County School Board, Cocoa, FL.

This report describes school design and construction delivery processes used by the School Board of Brevard County (Cocoa, Florida) that help optimize value, avoid problems, and eliminate the cost of maintaining a large facility staff. The project phases are examined from project definition through design to construction. Project delivery…

Useful Tips on Avoiding Plagiarism

ERIC Educational Resources Information Center

Hamalainen, Maryellen

2007-01-01

Teachers are generally kind and nurturing people. Students who plagiarize their assignments from these kind and nurturing teachers are often given a second chance when caught and encouraged to do their work over, but it would be better to eliminate their need to plagiarize. The first tip for eliminating plagiarism has not so much to do with what…

Perceptions of racial confrontation: the role of color blindness and comment ambiguity.

PubMed

Zou, Linda X; Dickter, Cheryl L

2013-01-01

Because of its emphasis on diminishing race and avoiding racial discourse, color-blind racial ideology has been suggested to have negative consequences for modern day race relations. The current research examined the influence of color blindness and the ambiguity of a prejudiced remark on perceptions of a racial minority group member who confronts the remark. One hundred thirteen White participants responded to a vignette depicting a White character making a prejudiced comment of variable ambiguity, after which a Black target character confronted the comment. Results demonstrated that the target confronter was perceived more negatively and as responding less appropriately by participants high in color blindness, and that this effect was particularly pronounced when participants responded to the ambiguous comment. Implications for the ways in which color blindness, as an accepted norm that is endorsed across legal and educational settings, can facilitate Whites' complicity in racial inequality are discussed.

Causes of Childhood Vision Impairment in the School for the Blind in Eritrea.

PubMed

Gyawali, Rajendra; Moodley, Vanessa R

2017-12-01

Our study provides the much-needed evidence on causes of childhood blindness in Eritrea. This will assist authorities to plan appropriate strategies and implement preventive, curative, and rehabilitative services to address these causes of vision loss in children in this resource-limited country. This study aims to identify the causes of severe vision impairment and blindness in children attending the only school for the blind in Eritrea. All children enrolled in the school were examined, and the World Health Organization form for the examination of visually impaired children was used to record the data. Examination included visual acuity, refraction, anterior segment, and fundus assessment. Causes of vision loss for children with severe vision impairment (visual acuity <6/60 to 3/60) and blindness (visual acuity <3/60) are reported. Causes were classified by the anatomical site affected and by underlying etiology based on the timing of the insult and causal factor. A total of 92 children were examined, and 71 (77.2%) of them had severe vision impairment and blindness. The major causes of vision loss were corneal scars (16.9%), cataract (12.7%), phthisis bulbi (11.3%), congenital eye deformities (11.3%), optic atrophy (9.3%), and presumed chorioretinal Toxoplasma scars (7.0%). Hereditary factors were the major known etiological category (15.5%) followed by the sequel of eye injuries (12.7%). Blindness due to vitamin A deficiency was not found, whereas infectious causes such as measles and ophthalmia neonatorum were relatively absent (one case each). Potentially avoidable causes of vision impairment were accounted for in 47.9% of children. This study provides the first direct evidence on childhood vision impairment in Eritrea. Despite the limitations, it is clearly shown that nearly half of the vision loss is due to avoidable causes. Thus, preventive public health strategies, specialist pediatric eye care, and rehabilitative services are recommended to address childhood vision impairment in Eritrea.

Visual loss in a school for the blind in Nigeria.

PubMed

Okoye, O I; Aghaji, A E; Ikojo, I N

2009-01-01

There are an estimated 1.4 million blind children worldwide, it has been observed that almost 90% of the so-called blind population (children inclusive) do not have total loss of visual function, but retain a degree of usable residual vision. The study aims to determined the sites and causes of visual loss in the students of a school for the blind in Nigeria, and also the proportion of those students who could benefit from low vision devices. Forty-five students of the school were examined using the standard World Health Organization/Prevention of blindness examination record for childhood blindness. Refraction and assessment for low vision devices were conducted, where necessary. Glaucoma/buphthalmos (22.2%) and corneal lesions (20%) were the major causes of vision loss. Six students (13.3%) benefited from spectacles and/or low vision devices. Glaucoma/buphthalmos is assuming great significance in this study population, though most of the causes of vision loss are avoidable (77.7%). There is need for low vision service in the schools for the blind in South East Nigeria.

Clinical Evaluation of 68Ga-PSMA-II and 68Ga-RM2 PET Images Reconstructed With an Improved Scatter Correction Algorithm.

PubMed

Wangerin, Kristen A; Baratto, Lucia; Khalighi, Mohammad Mehdi; Hope, Thomas A; Gulaka, Praveen K; Deller, Timothy W; Iagaru, Andrei H

2018-06-06

Gallium-68-labeled radiopharmaceuticals pose a challenge for scatter estimation because their targeted nature can produce high contrast in these regions of the kidneys and bladder. Even small errors in the scatter estimate can result in washout artifacts. Administration of diuretics can reduce these artifacts, but they may result in adverse events. Here, we investigated the ability of algorithmic modifications to mitigate washout artifacts and eliminate the need for diuretics or other interventions. The model-based scatter algorithm was modified to account for PET/MRI scanner geometry and challenges of non-FDG tracers. Fifty-three clinical 68 Ga-RM2 and 68 Ga-PSMA-11 whole-body images were reconstructed using the baseline scatter algorithm. For comparison, reconstruction was also processed with modified sampling in the single-scatter estimation and with an offset in the scatter tail-scaling process. None of the patients received furosemide to attempt to decrease the accumulation of radiopharmaceuticals in the bladder. The images were scored independently by three blinded reviewers using the 5-point Likert scale. The scatter algorithm improvements significantly decreased or completely eliminated the washout artifacts. When comparing the baseline and most improved algorithm, the image quality increased and image artifacts were reduced for both 68 Ga-RM2 and for 68 Ga-PSMA-11 in the kidneys and bladder regions. Image reconstruction with the improved scatter correction algorithm mitigated washout artifacts and recovered diagnostic image quality in 68 Ga PET, indicating that the use of diuretics may be avoided.

Visual Impairment and Blindness Avoided with Ranibizumab in Hispanic and Non-Hispanic Whites with Diabetic Macular Edema in the United States.

PubMed

Varma, Rohit; Bressler, Neil M; Doan, Quan V; Danese, Mark; Dolan, Chantal M; Lee, Abraham; Turpcu, Adam

2015-05-01

To estimate visual impairment (VI) and blindness avoided with intravitreal ranibizumab 0.3 mg treatment for central-involved diabetic macular edema (DME) among Hispanic and non-Hispanic white individuals in the United States. Population-based model simulating visual acuity (VA) outcomes over 2 years after diagnosis and treatment of DME. Visual acuity changes with and without ranibizumab were based on data from the RISE, RIDE, and DRCR Network trials. For the better-seeing eye, VA outcomes included VI, defined as worse than 20/40 in the better-seeing eye, and blindness, defined as VA of 20/200 or worse in the better-seeing eye. Incidence of 1 or both eyes with central-involved DME in 2010 were estimated based on the 2010 United States population, prevalence of diabetes mellitus, and 1-year central-involved DME incidence rate. Sixty-one percent of incident individuals had bilateral DME and 39% had unilateral DME, but DME could develop in the fellow eye. Cases of VI and blindness avoided with ranibizumab treatment. Among approximately 102 million Hispanic and non-Hispanic white individuals in the United States 45 years of age and older in 2010, an estimated 37 274 had central-involved DME and VI eligible for ranibizumab treatment. Compared with no ranibizumab treatment, the model predicted that ranibizumab 0.3 mg every 4 weeks would reduce the number of individuals with VI from 11 438 (95% simulation interval [SI], 7249-16 077) to 6304 (95% SI, 3921-8981), a 45% (95% SI, 36%-53%) reduction at 2 years. Ranibizumab would reduce the number of incident eyes with VA worse than 20/40 from 16 910 (95% SI, 10 729-23 577) to 9361 (95% SI, 5839-13 245), a 45% (95% SI, 38%-51%) reduction. Ranibizumab was estimated to reduce the number of individuals with legal blindness by 75% (95% SI, 58%-88%) and the number of incident eyes with VA of 20/200 or worse by 76% (95% SI, 63%-87%). This model suggests that ranibizumab 0.3 mg every 4 weeks substantially reduces prevalence of VI and legal blindness 2 years after initiating treatment among Hispanic and non-Hispanic white individuals in the United States with central-involved DME that has caused vision loss. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Prevalence and causes of blindness and visual impairment and their associated risk factors, in three tribal areas of Andhra Pradesh, India.

PubMed

Singh, Nakul; Eeda, Shiva Shankar; Gudapati, Bala Krishna; Reddy, Srinivasa; Kanade, Pushkar; Shantha, Ghanshyam Palamaner Subash; Rani, Padmaja Kumari; Chakrabarti, Subhabrata; Khanna, Rohit C

2014-01-01

To assess the prevalence of blindness and visual impairment (VI), their associated causes and underlying risk factors in three tribal areas of Andhra Pradesh, India and compare this data in conjunction with data from other countries with low and middle income settings. Using a validated Rapid Assessment of Avoidable Blindness methodology, a two stage sampling survey was performed in these areas involving probability proportionate to size sampling and compact segment sampling methods. Blindness, VI and severe visual impairment (SVI) were defined as per the WHO guidelines and Indian definitions. Based on a prior enumeration, 7281 (97.1%) subjects were enrolled (mean age = 61.0+/-7.9 years). Based on the presenting visual acuity (PVA), the prevalences of VI, SVI and blindness were 16.9% (95% CI: 15.7-18.1), 2.9% (95% CI: 2.5-3.4), and 2.3% (95% CI: 1.9-2.7), respectively. When based on the Pinhole corrected visual acuity (PCVA), the prevalences were lower in VI (6.2%, 95% CI: 5.4-6.9), SVI (1.5%, 95% CI: 1.2-1.9) and blindness (2.1%, 95% CI: 1.7-2.5). Refractive error was the major cause of VI (71.4%), whereas, cataract was the major cause of SVI and blindness (70.3%). Based on the PVA, the odds ratio (OR) of blindness increased in the age groups of 60-69 years (OR = 3.8, 95% CI: 2.8, 5.1), 70-79 years (OR = 10.6, 95% CI: 7.2, 15.5) and 80 years and above (OR = 30.7, 95% CI: 19.2, 49). The ORs were relatively higher in females (OR = 1.3, 95% CI: 1.0, 1.6) and illiterate subjects (OR = 4.3, 95% CI: 2.2, 8.5), but lower in those wearing glasses (OR = 0.2, 95% CI: 0.1, 0.4). This is perhaps the first study to assess the prevalence of blindness and VI in these tribal regions and the majority of the causes of blindness and SVI were avoidable (88.5%). These findings may be useful for planning eye care services in these underserved regions.

Prevalence and Causes of Blindness and Visual Impairment and Their Associated Risk Factors, in Three Tribal Areas of Andhra Pradesh, India

PubMed Central

Singh, Nakul; Eeda, Shiva Shankar; Gudapati, Bala Krishna; Reddy, Srinivasa; Kanade, Pushkar; Shantha, Ghanshyam Palamaner Subash; Rani, Padmaja Kumari; Chakrabarti, Subhabrata; Khanna, Rohit C

2014-01-01

Objective To assess the prevalence of blindness and visual impairment (VI), their associated causes and underlying risk factors in three tribal areas of Andhra Pradesh, India and compare this data in conjunction with data from other countries with low and middle income settings. Methods Using a validated Rapid Assessment of Avoidable Blindness methodology, a two stage sampling survey was performed in these areas involving probability proportionate to size sampling and compact segment sampling methods. Blindness, VI and severe visual impairment (SVI) were defined as per the WHO guidelines and Indian definitions. Results Based on a prior enumeration, 7281 (97.1%) subjects were enrolled (mean age  = 61.0+/−7.9 years). Based on the presenting visual acuity (PVA), the prevalences of VI, SVI and blindness were 16.9% (95% CI: 15.7–18.1), 2.9% (95% CI: 2.5–3.4), and 2.3% (95% CI: 1.9–2.7), respectively. When based on the Pinhole corrected visual acuity (PCVA), the prevalences were lower in VI (6.2%, 95% CI: 5.4–6.9), SVI (1.5%, 95% CI: 1.2–1.9) and blindness (2.1%, 95% CI: 1.7–2.5). Refractive error was the major cause of VI (71.4%), whereas, cataract was the major cause of SVI and blindness (70.3%). Based on the PVA, the odds ratio (OR) of blindness increased in the age groups of 60–69 years (OR = 3.8, 95% CI: 2.8, 5.1), 70–79 years (OR = 10.6, 95% CI: 7.2, 15.5) and 80 years and above (OR = 30.7, 95% CI: 19.2, 49). The ORs were relatively higher in females (OR = 1.3, 95% CI: 1.0, 1.6) and illiterate subjects (OR = 4.3, 95% CI: 2.2, 8.5), but lower in those wearing glasses (OR = 0.2, 95% CI: 0.1, 0.4). Conclusions This is perhaps the first study to assess the prevalence of blindness and VI in these tribal regions and the majority of the causes of blindness and SVI were avoidable (88.5%). These findings may be useful for planning eye care services in these underserved regions. PMID:25007075

Onchocerciasis in the Americas: from arrival to (near) elimination

PubMed Central

2011-01-01

Onchocerciasis (river blindness) is a blinding parasitic disease that threatens the health of approximately 120 million people worldwide. While 99% of the population at-risk for infection from onchocerciasis live in Africa, some 500,000 people in the Americas are also threatened by infection. A relatively recent arrival to the western hemisphere, onchocerciasis was brought to the New World through the slave trade and spread through migration. The centuries since its arrival have seen advances in diagnosing, mapping and treating the disease. Once endemic to six countries in the Americas (Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela), onchocerciasis is on track for interruption of transmission in the Americas by 2012, in line with Pan American Health Organization resolution CD48.R12. The success of this public health program is due to a robust public-private partnership involving national governments, local communities, donor organizations, intergovernmental bodies, academic institutions, non-profit organizations and the pharmaceutical industry. The lessons learned through the efforts in the Americas are in turn informing the program to control and eliminate onchocerciasis in Africa. However, continued support and investment are needed for program implementation and post-treatment surveillance to protect the gains to-date and ensure complete elimination is achieved and treatment can be safely stopped within all 13 regional foci. PMID:22024050

An elevated plus-maze in mixed reality for studying human anxiety-related behavior.

PubMed

Biedermann, Sarah V; Biedermann, Daniel G; Wenzlaff, Frederike; Kurjak, Tim; Nouri, Sawis; Auer, Matthias K; Wiedemann, Klaus; Briken, Peer; Haaker, Jan; Lonsdorf, Tina B; Fuss, Johannes

2017-12-21

A dearth of laboratory tests to study actual human approach-avoidance behavior has complicated translational research on anxiety. The elevated plus-maze (EPM) is the gold standard to assess approach-avoidance behavior in rodents. Here, we translated the EPM to humans using mixed reality through a combination of virtual and real-world elements. In two validation studies, we observed participants' anxiety on a behavioral, physiological, and subjective level. Participants reported higher anxiety on open arms, avoided open arms, and showed an activation of endogenous stress systems. Participants' with high anxiety exhibited higher avoidance. Moreover, open arm avoidance was moderately predicted by participants' acrophobia and sensation seeking, with opposing influences. In a randomized, double blind, placebo controlled experiment, GABAergic stimulation decreased avoidance of open arms while alpha-2-adrenergic antagonism increased avoidance. These findings demonstrate cross-species validity of open arm avoidance as a translational measure of anxiety. We thus introduce the first ecologically valid assay to track actual human approach-avoidance behavior under laboratory conditions.

The international council of ophthalmology: vision for ophthalmic education in an interdependent world.

PubMed

Lee, Andrew G; Golnik, Karl C; Tso, Mark O M; Spivey, Bruce; Miller, Kathleen; Gauthier, Tina-Marie

2012-10-01

To describe the emerging strategic global perspective of the International Council of Ophthalmology (ICO) efforts in ophthalmic education. A global perspective describing how the development of sophisticated educational tools in tandem with information technology can revolutionize ophthalmic education worldwide. Review of ICO educational tools, resources, and programs that are available to ophthalmic educators across the globe. With the explosive growth of the Internet, the ability to access medical information in the most isolated of locations is now possible. Through specific ICO initiatives, including the ICO curricula, the "Teaching the Teachers" program, and the launching of the new ICO Center for Ophthalmic Educators, the ICO is providing ophthalmic educators across the globe with access to standardized but customizable educational programs and tools to better train ophthalmologists and allied eye care professionals throughout the world. Access to educational tools and strengthening of global learning will help providers meet the goals of VISION 2020 and beyond in eliminating avoidable blindness. It is the intent of the ICO that its programs for ophthalmic educators, including conferences, courses, curricula, and online resources, result in better-trained ophthalmologists and eye care professionals worldwide. Copyright © 2012 Elsevier Inc. All rights reserved.

[Effectiveness of Vitex agnus-castus preparations].

PubMed

Gorkow, C; Wuttke, W; März, R W

2002-01-01

The prolactin-inhibiting effect of ACF-preparations, which is due to dopaminergic activities, has been shown in humans too and gives a pharmacological rationale for the clinical effects observed in the different indications (2, 11, 25, 26, 35, 41). Confirmation of efficacy in the treatment of mastalgia has been best endorsed by two recently published double-blind studies conducted according to the principles of GCP (14, 41). One double-blind study, several open and postmarketing surveillance studies have shown that the premenstrual syndrome, or individual symptoms, can be influenced positively (3, 6, 7, 9, 19, 21, 37). Design shortcomings in a second double-blind study should be eliminated in future studies in this indication to improve the body of evidence (18). Hither to there has been one controlled double-blind study of cycle disorders in the case of corpus luteum insufficiency with significant results and a number of non-controlled open studies (1, 4, 15, 16, 20, 24, 26, 27, 32, 35, 36). The high success rates in the open studies indicate therapeutic effects, and it should be possible to reproduce these results under double-blind conditions. The success rates on fertility disorders should be confirmed in controlled double-blind studies (10, 33, 34).

Blind Astronomers

NASA Astrophysics Data System (ADS)

Hockey, Thomas A.

2011-01-01

The phrase "blind astronomer” is used as an allegorical oxymoron. However, there were and are blind astronomers. What of famous blind astronomers? First, it must be stated that these astronomers were not martyrs to their craft. It is a myth that astronomers blind themselves by observing the Sun. As early as France's William of Saint-Cloud (circa 1290) astronomers knew that staring at the Sun was ill-advised and avoided it. Galileo Galilei did not invent the astronomical telescope and then proceed to blind himself with one. Galileo observed the Sun near sunrise and sunset or through projection. More than two decades later he became blind, as many septuagenarians do, unrelated to their profession. Even Isaac Newton temporarily blinded himself, staring at the reflection of the Sun when he was a twentysomething. But permanent Sun-induced blindness? No, it did not happen. For instance, it was a stroke that left Scotland's James Gregory (1638-1675) blind. (You will remember the Gregorian telescope.) However, he died days later. Thus, blindness little interfered with his occupation. English Abbot Richard of Wallingford (circa 1291 - circa 1335) wrote astronomical works and designed astronomical instruments. He was also blind in one eye. Yet as he further suffered from leprosy, his blindness seems the lesser of Richard's maladies. Perhaps the most famous professionally active, blind astronomer (or almost blind astronomer) is Dominique-Francois Arago (1786-1853), director until his death of the powerful nineteenth-century Paris Observatory. I will share other _ some poignant _ examples such as: William Campbell, whose blindness drove him to suicide; Leonhard Euler, astronomy's Beethoven, who did nearly half of his life's work while almost totally blind; and Edwin Frost, who "observed” a total solar eclipse while completely sightless.

Common Sense Design for Safe Schools.

ERIC Educational Resources Information Center

Scanlon, Paul W.; Pillar, Rob M.

2000-01-01

Shows how school design can enhance study safety by facilitating supervision. Design concepts of limiting building access to outsiders, creating good traffic flow, and avoiding blind spots and informal gathering areas that resist monitoring are discussed. (GR)

An update on progress and the changing epidemiology of causes of childhood blindness worldwide.

PubMed

Kong, Lingkun; Fry, Melinda; Al-Samarraie, Mohannad; Gilbert, Clare; Steinkuller, Paul G

2012-12-01

To summarize the available data on pediatric blinding disease worldwide and to present current information on childhood blindness in the United States. A systematic search of world literature published since 1999 was conducted. Data also were solicited from each state school for the blind in the United States. In developing countries, 7% to 31% of childhood blindness and visual impairment is avoidable, 10% to 58% is treatable, and 3% to 28% is preventable. Corneal opacification is the leading cause of blindness in Africa, but the rate has decreased significantly from 56% in 1999 to 28% in 2012. There is no national registry of the blind in the United States, and most schools for the blind do not maintain data regarding the cause of blindness in their students. From those schools that do have such information, the top three causes are cortical visual impairment, optic nerve hypoplasia, and retinopathy of prematurity, which have not changed in past 10 years. There are marked regional differences in the causes of blindness in children, apparently based on socioeconomic factors that limit prevention and treatment schemes. In the United States, the 3 leading causes of childhood blindness appear to be cortical visual impairment, optic nerve hypoplasia, and retinopathy of prematurity; a national registry of the blind would allow accumulation of more complete and reliable data for accurate determination of the prevalence of each. Copyright © 2012 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

Evaluation of camera-based systems to reduce transit bus side collisions : phase II.

DOT National Transportation Integrated Search

2012-12-01

The sideview camera system has been shown to eliminate blind zones by providing a view to the driver in real time. In : order to provide the best integration of these systems, an integrated camera-mirror system (hybrid system) was : developed and tes...

Special Premie Oxygen Targeting (SPOT): a program to decrease the incidence of blindness in infants with retinopathy of prematurity.

PubMed

Coe, Kristi; Butler, Mandy; Reavis, Nicole; Klinepeter, Mary Ellen; Purkey, Connie; Oliver, Tonya; Starbuck, Alisa; Griffin, Jennifer; Wilmoth, Cathy; Block, Steven

2006-01-01

Infants born prematurely have a plethora of medical problems. Some have cerebral palsy, resulting in limited mobility, while others require oxygen, hearing aids, and/or glasses for medical problems. Most of these could have been prevented if preterm birth was avoided, but efforts to curb this have been slow. This article discusses how blindness can be prevented in infants born prematurely by accepting lower oxygen saturations when on oxygen in the intensive care nursery.

A survey of severe visual impairment in children attending schools for the blind in a coastal district of Andhra Pradesh in South India

PubMed Central

Krishnaiah, S; Subba Rao, B; Lakshmi Narasamma, K; Amit, G

2012-01-01

Purpose To identify the major causes of severe childhood visual impairment and blindness among students attending schools for the blind in a coastal district of Andhra Pradesh (AP) in South India. Methods Children ≤16 years of age attending six schools for the blind in the study area were interviewed and examined in the year 2009, and causes were classified according to the World Health Organization Program for Prevention of Blindness (WHO/PBL) childhood blindness proforma. A total of 113 children underwent a detailed eye examination by an experienced ophthalmologist. Results The major causes of blindness were congenital eye anomalies in 46 children (41.4; 95% confidence interval (CI): 32.3–50.6), followed by retinal disorders in 21 children (18.9% 95% CI: 11.6–26.2), cataract in 9 children (9.7% 95% CI: 2.9–12.9), and corneal conditions (scar and Staphyloma) in 8 children (7.1% 95% CI: 2.4–11.8). More than half the children (56.6%) were blind due to conditions that could have been treated or prevented. Discussion Congenital anomalies were found to be the most common cause of blindness. The majority of the cases were due to avoidable causes of blindness. Therefore, robust screening measures may help reduce the burden of visual impairment in children. PMID:22576826

A survey of severe visual impairment in children attending schools for the blind in a coastal district of Andhra Pradesh in South India.

PubMed

Krishnaiah, S; Subba Rao, B; Lakshmi Narasamma, K; Amit, G

2012-08-01

To identify the major causes of severe childhood visual impairment and blindness among students attending schools for the blind in a coastal district of Andhra Pradesh (AP) in South India. Children ≤ 16 years of age attending six schools for the blind in the study area were interviewed and examined in the year 2009, and causes were classified according to the World Health Organization Program for Prevention of Blindness (WHO/PBL) childhood blindness proforma. A total of 113 children underwent a detailed eye examination by an experienced ophthalmologist. The major causes of blindness were congenital eye anomalies in 46 children (41.4; 95% confidence interval (CI): 32.3-50.6), followed by retinal disorders in 21 children (18.9%; 95% CI: 11.6-26.2), cataract in 9 children (9.7%; 95% CI: 2.9-12.9), and corneal conditions (scar and Staphyloma) in 8 children (7.1%; 95% CI: 2.4-11.8). More than half the children (56.6%) were blind due to conditions that could have been treated or prevented. Congenital anomalies were found to be the most common cause of blindness. The majority of the cases were due to avoidable causes of blindness. Therefore, robust screening measures may help reduce the burden of visual impairment in children.

iMAST FY2002 Annual Report

DTIC Science & Technology

2002-01-01

of large precision drive train components such as transmission housings. The approach being pursued, under this program structure, is to eliminate the...an optimum coating and/or coating process will be developed and implemented, and will eliminate /minimize fretting and low-cycle fatigue and the blade...maintaining adequate pollution control efficiency. Benefits: ★ Utilizes MCLB infrastructure ★ Avoids costs associated with existing APCS ★ Biofiltration

An Analysis of Major Recommendations of NAC's On-Site Review Teams.

ERIC Educational Resources Information Center

Nelipovich, Michael

1982-01-01

An analysis of major recommendations of the National Accreditation Council for Agencies Serving the Blind and Visually Handicapped received by 50 state and not-for-profit agencies raised questions about emphasis on administrative standards and low concern about physical facilities. Suggestions, including elimination of duplications, are made. (CL)

Standing crop residues and wind erosion

USDA-ARS?s Scientific Manuscript database

Wind erosion and blinding dust storms in the Central Great Plains region still occasionally erupt. Eliminating all tillage remains the best remedy. However, farmers in the region somehow fail to remember the lessons learned in the “dirty 30’s”. They forget how devastating tillage is in disrupting t...

Causes of blindness in rural Myanmar (Burma): Mount Popa Taung-Kalat Blindness Prevention Project

PubMed Central

Nemet, Arie Y; Nemet, Pinhas; Cohn, Geoff; Sutton, Gina; Sutton, Gerald; Rawson, Richard

2009-01-01

Purpose This study is a review of the major causes of visual impairment (VI) and severe visual impairment/blindness (SVI/BL) in Mount Popa Taung-Kalat, a rural region in Myanmar (Burma). Methods A review of our clinical records of consecutive patients attending clinics was conducted. Participants of all ages (n = 650) of the population of Mount Popa Taung-Kalat and villages in its vicinity underwent ophthalmic interview and a detailed dilated ocular evaluation by trained Australian ophthalmologists and ophthalmic nurses. This evaluation included anterior segment examination with a slit lamp, intraocular pressure recording, and direct or indirect ophthalmoscopy. VI and SVI/BL were defined by the World Health Organization (WHO) criteria. Results Six hundred fifty subjects were screened, with a mean age of 49.0 ± 20.6 years (range, 1–99). One hundred five patients (16.2%) were children (ages 1–18). Five hundred thirty-one eyes of the total 1,300 eyes (39.5%) had VI/SVI/BL, and 40 eyes of the children (38.1%) (average age 15.3 ± 13.3) had VI/SVI/BL. The leading causes of VI/SVI/BL were cataract with 288 cases (54.2%), glaucoma with 84 cases (15.8%), and corneal pathology with 78 cases (14.7%). Of all the VI/SVI/BL cases, 8.4% were preventable, 81.9% were treatable, and total of 90.5% were avoidable. Conclusions In the current study, cataracts were the major cause of blindness and visual impairment, and most of the ophthalmic pathology causing blindness is avoidable. These results highlight the lack of basic ophthalmologist eye care and optician resources in rural regions in Myanmar. PMID:19684864

Prevalence and causes of visual impairment and blindness, cataract surgical coverage and outcomes of cataract surgery in Libya.

PubMed

Rabiu, Muhammad Mansur; Jenf, Mansour; Fituri, Suad; Choudhury, Abdulhanan; Agbabiaka, Idris; Mousa, Ahmed

2013-01-01

To assess the major causes of avoidable blindness, and outcomes and barriers to cataract services in Libya. A stratified multistage cluster random sample study was conducted in the four regions of Libya. Visual acuity and lens assessment were performed on all subjects. Those with presenting visual acuity <6/18 in either or both eyes were further investigated to determine cause(s) of impairment. Barriers to cataract surgery were investigated. Visual outcomes of subjects with surgery performed were assessed. A total of 8538 persons aged ≥50 years were examined across the four regions. The prevalence of blindness was 3.25% (3.15% with best correction), which varied across the regions (2.94-3.80%); after adjustment for age and sex, the prevalence was 2.66%. Major causes of blindness were cataract (29%), glaucoma (24%) and other corneal scars (14%). Causes were similar across all regions except in the south. Avoidable causes were responsible for 60.6% of blindness. Major causes of visual impairment were cataract (31.2%), diabetic retinopathy (16.6%) and posterior segment diseases (15.1%). Cataract surgical coverage among those with visual acuity <3/60 was 95.4%, with no sex differences. About 38% of cataract-operated eyes had poor outcome even after best correction (35%). There was poor outcome in 33% of pseudophakic eyes with best correction. The major barriers to service uptake were "waiting for maturity" (26%), "unaware of treatment" (24%) and "God's will/destiny" (17%). Libya needs to improve the quality of cataract surgery across all the regions. The southern region needs improvement in both quality and coverage of services.

Underwater Acoustic Source Localisation Among Blind and Sighted Scuba Divers: Comparative study.

PubMed

Cambi, Jacopo; Livi, Ludovica; Livi, Walter

2017-05-01

Many blind individuals demonstrate enhanced auditory spatial discrimination or localisation of sound sources in comparison to sighted subjects. However, this hypothesis has not yet been confirmed with regards to underwater spatial localisation. This study therefore aimed to investigate underwater acoustic source localisation among blind and sighted scuba divers. This study took place between February and June 2015 in Elba, Italy, and involved two experimental groups of divers with either acquired (n = 20) or congenital (n = 10) blindness and a control group of 30 sighted divers. Each subject took part in five attempts at an under-water acoustic source localisation task, in which the divers were requested to swim to the source of a sound originating from one of 24 potential locations. The control group had their sight obscured during the task. The congenitally blind divers demonstrated significantly better underwater sound localisation compared to the control group or those with acquired blindness ( P = 0.0007). In addition, there was a significant correlation between years of blindness and underwater sound localisation ( P <0.0001). Congenital blindness was found to positively affect the ability of a diver to recognise the source of a sound in an underwater environment. As the correct localisation of sounds underwater may help individuals to avoid imminent danger, divers should perform sound localisation tests during training sessions.

Physicians' Religious Topic Avoidance during Clinical Interactions.

PubMed

Villagran, Melinda M; MacArthur, Brenda L; Lee, Lauren E; Ledford, Christy J W; Canzona, Mollie R

2017-05-08

Religious and spiritual (R/S) conversations at the end-of-life function to help patients and their families find comfort in difficult circumstances. Physicians who feel uncertain about how to discuss topics related to religious beliefs may seek to avoid R/S conversations with their patients. This study utilized a two-group objective structured clinical examination with a standardized patient to explore differences in physicians' use of R/S topic avoidance tactics during a clinical interaction. Results indicated that physicians used more topic avoidance tactics in response to patients' R/S inquiries than patients' R/S disclosures; however, the use of topic avoidance tactics did not eliminate the need to engage in patient-initiated R/S interactions.

Physicians’ Religious Topic Avoidance during Clinical Interactions

PubMed Central

Villagran, Melinda M.; MacArthur, Brenda L.; Lee, Lauren E.; Ledford, Christy J. W.; Canzona, Mollie R.

2017-01-01

Religious and spiritual (R/S) conversations at the end-of-life function to help patients and their families find comfort in difficult circumstances. Physicians who feel uncertain about how to discuss topics related to religious beliefs may seek to avoid R/S conversations with their patients. This study utilized a two-group objective structured clinical examination with a standardized patient to explore differences in physicians’ use of R/S topic avoidance tactics during a clinical interaction. Results indicated that physicians used more topic avoidance tactics in response to patients’ R/S inquiries than patients’ R/S disclosures; however, the use of topic avoidance tactics did not eliminate the need to engage in patient-initiated R/S interactions. PMID:28481290

[Elderly people with visual impairment in The Netherlands].

PubMed

Limburg, J J; Keunen, J E E; van Rens, G H M B

2009-09-01

To estimate the number of elderly people with visual impairment in The Netherlands, now and in the future. Possibilities for intervention are discussed. Estimates are based on a recent report on behalf of Foundation InZicht, ZonMw, in which prevalence data from population-based studies on blindness and low vision and its causes in The Netherlands, western Europe, The United States and Australia are related to the latest demographic data for The Netherlands. Of the 16.4 million Dutch in 2008 2.4 million (14.7%) are 65 years of age and older. Of this last group 155,000 persons are living in nursing homes or residential homes, the others are living in their own homes. In 2008 an estimated 77,000 persons are blind and 234,000 have low vision. Of them 79% is 65 years of age or older. Of the older people in care institutions 20% is blind (32,000) and 22% has low vision (34,000). In 62% of them the visual impairment is treatable or could have been prevented ('avoidable'). Of the older people living independently 1.2% is blind (27,000) and 6.8% has low vision (154,000). In 57% of them the affliction is avoidable. In 2008 247,000 elderly suffer from a visual impairment that could have been treated or prevented in 143,000 (58%) of them. Screening and treatment of elderly in care institutions seems indicated, as is health education to and goal-oriented screening of elderly who live independently.

Social and monetary incentives counteract fear-driven avoidance: Evidence from approach-avoidance decisions.

PubMed

Pittig, Andre; Hengen, Kristina; Bublatzky, Florian; Alpers, Georg W

2018-04-22

The reduction of avoidance behavior is a central target in the treatment of anxiety disorders, but it has rarely been studied how approach of fear-relevant stimuli may be initiated. In two studies, the impact of hypothetical monetary and symbolic social incentives on approach-avoidance behavior was examined. In Study 1, individuals high or low on fear of spiders (N = 84) could choose to approach a fear-relevant versus a neutral stimulus, which were equally rewarded. In a subsequent micro-intervention, approaching the fear-relevant stimulus was differentially rewarded either by monetary or social incentives. In Study 2 (N = 76), initial incentives for approach were discontinued to investigate the stability of approach. Hypothetical monetary and symbolic social incentives reduced or eliminated initial avoidance, even in highly fearful individuals. Approach resulted in a decrease of self-reported aversiveness towards the fear-relevant stimulus. However, even after successful approach, fearful individuals showed significant avoidance behavior when incentives for approach were discontinued. Future research should investigate the long-term effects of prolonged approach incentives on multiple levels of fear (e.g., self-report, behavioral, physiological). It should also be tested if such an intervention actually improves compliance with exposure based interventions. The present findings highlight that incentives are useful to initiate initial approach towards a feared stimulus. Although incentive-based approach may neither fully eliminate avoidance nor negative feelings towards the feared stimulus, such operant interventions may set the stage for more extensive extinction training. Copyright © 2018 Elsevier Ltd. All rights reserved.

Impact of elimination diets on growth and nutritional status in children with multiple food allergies.

PubMed

Berry, Melissa J; Adams, Jennifer; Voutilainen, Helena; Feustel, Paul J; Celestin, Jocelyn; Järvinen, Kirsi M

2015-03-01

Impairment of growth has been reported in food-allergic children. It is not known whether this is related to the extent of food allergies. We sought to compare growth, nutritional status, and nutrient intake in children with food allergy either avoiding cow's milk or avoiding cow's milk and wheat, which are staples of the diet in young children. Infants and young children with challenge-proven allergy were recruited to this prospective study. They were strictly avoiding their allergic food triggers, either cow's milk, or cow's milk and wheat. They were counseled by a dietitian specialized in food allergies on food avoidance diets and nutritionally adequate supplementation at regular intervals. A 3-day food diary was kept. Children's height, weight, and laboratory data for nutritional parameters were monitored at 8-month intervals. A total of 18 patients avoiding milk and 28 patients avoiding milk and wheat were evaluated at an average of 12, 21, and 28 months of age. During the follow-up, the markers of nutritional status, nutrient intake or height for age, and weight for height were comparable between the two groups, although the means for anthropometric measures were below the average for age in both groups. The extent of food elimination diet has no impact on growth or nutritional status of food-allergic children, when diet is adequately supplemented. Close physician and dietitian follow-up are essential for food-allergic children when avoiding one or more foods, which are staples of the diet. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

iMAST FY2003 Annual Report

DTIC Science & Technology

2003-01-01

The approach being pursued, under this program structure, is to eliminate the use of physical surfaces on the component as datum. The use of physical...will eliminate /minimize fretting and low-cycle fatigue and the blade-disk interface. This optimum coating and/or coating process will be evaluated both...Utilizes MCLB infrastructure Avoids costs associated with existing APCS Biofiltration produces no secondary emissions Biofiltration is the most

The SAFE strategy for the elimination of trachoma by 2020: will it work?

PubMed Central

Bailey, R.; Lietman, T.

2001-01-01

WHO has recently launched a programme (GET 2020) for the elimination of trachoma, the leading cause of preventable blindness. GET 2020 has adopted the SAFE strategy, a comprehensive set of control measures (Surgery for entropion/trichiasis; Antibiotics for infectious trachoma; Facial cleanliness to reduce transmission; Environmental improvements such as control of disease-spreading flies and access to clean water). The present article reviews the strengths and weaknesses of each component of the strategy. Although significant hurdles remain to be overcome there is every reason to hope that GET 2020 will be successful. PMID:11285668

Prior Corneal Scarification and Injection of Immune Serum are Not Required Before Ocular HSV-1 Infection for UV-B-Induced Virus Reactivation and Recurrent Herpetic Corneal Disease in Latently Infected Mice

PubMed Central

BenMohamed, Lbachir; Osorio, Nelson; Khan, Arif A.; Srivastava, Ruchi; Huang, Lei; Krochmal, John J.; Garcia, Jairo M.; Simpson, Jennifer L.; Wechsler, Steven L.

2017-01-01

Purpose Blinding ocular herpetic disease in humans is due to spontaneous reactivation of herpes simplex virus type 1 (HSV-1) from latency, rather than to primary acute infection. Mice latently infected with HSV-1 undergo little or no in vivo spontaneous reactivation with accompanying virus shedding in tears. HSV-1 reactivation can be induced in latently infected mice by several in vivo procedures, with UV-B-induced reactivation being one commonly used method. In the UV-B model, corneas are scarified (lightly scratched) just prior to ocular infection to increase efficiency of the primary infection and immune serum containing HSV-1 neutralizing antibodies is injected intraperitoneally (i.p.) to increase survival and decrease acute corneal damage. Since scarification can significantly alter host gene transcription in the cornea and in the trigeminal ganglia (TG; the site of HSV-1 latency) and since injection of immune serum likely modulates innate and adaptive herpes immunity, we investigated eliminating both treatments. Material and Methods Mice were infected with HSV-1 with or without corneal scarification and immune serum. HSV-1 reactivation and recurrent disease were induced by UV-B irradiation. Results When corneal scarification and immune serum were both eliminated, UV-B irradiation still induced both HSV-1 reactivation, as measured by shedding of reactivated virus in tears and herpetic eye disease, albeit at reduced levels compared to the original procedure. Conclusion Despite the reduced reactivation and disease, avoidance of both corneal scarification and immune serum should improve the clinical relevance of the UV-B mouse model. PMID:26398722

Perception-action relationships reconsidered in light of spatial display instruments

NASA Technical Reports Server (NTRS)

Shebilske, Wayne L.

1989-01-01

Spatial display instruments convey information about both the identity and the location of objects in order to assist surgeons, astronauts, pilots, blind individuals, and others in identification, remote manipulations, navigation, and obstacle avoidance. Scientists believe that these instruments have not reached their full potential and that progress toward new applications, including the possibility of restoring sight to the blind, will be accelerated by advancing the understanding of perceptual processes. This stimulating challenge to basic researchers was advanced by Paul Bach-Y-Rita (1972) and by the National Academy of Science (1986) report on Electronic Aids for the Blind. Although progress has been made, new applications of spatial display instruments in medicine, space, aviation, and rehabilitation await improved theoretical and empirical foundations.

Triamterene

MedlinePlus

... causes the kidneys to eliminate unneeded water and sodium from the body into the urine, but reduces ... your meals, including advice for a reduced salt (sodium) diet and daily exercise program. Avoid potassium-containing ...

Spironolactone

MedlinePlus

... causes the kidneys to eliminate unneeded water and sodium from the body into the urine but reduces ... your meals, including advice for a reduced-salt (sodium) diet and daily exercise program. Avoid potassium-containing ...

H2O2-Sensitive Isoforms of Drosophila melanogaster TRPA1 Act in Bitter-Sensing Gustatory Neurons to Promote Avoidance of UV During Egg-Laying

PubMed Central

Guntur, Ananya R.; Gou, Bin; Gu, Pengyu; He, Ruo; Stern, Ulrich; Xiang, Yang; Yang, Chung-Hui

2017-01-01

The evolutionarily conserved TRPA1 channel can sense various stimuli including temperatures and chemical irritants. Recent results have suggested that specific isoforms of Drosophila TRPA1 (dTRPA1) are UV-sensitive and that their UV sensitivity is due to H2O2 sensitivity. However, whether such UV sensitivity served any physiological purposes in animal behavior was unclear. Here, we demonstrate that H2O2-sensitive dTRPA1 isoforms promote avoidance of UV when adult Drosophila females are selecting sites for egg-laying. First, we show that blind/visionless females are still capable of sensing and avoiding UV during egg-laying when intensity of UV is high yet within the range of natural sunlight. Second, we show that such vision-independent UV avoidance is mediated by a group of bitter-sensing neurons on the proboscis that express H2O2-sensitive dTRPA1 isoforms. We show that these bitter-sensing neurons exhibit dTRPA1-dependent UV sensitivity. Importantly, inhibiting activities of these bitter-sensing neurons, reducing their dTRPA1 expression, or reducing their H2O2-sensitivity all significantly reduced blind females’ UV avoidance, whereas selectively restoring a H2O2-sensitive isoform of dTRPA1 in these neurons restored UV avoidance. Lastly, we show that specifically expressing the red-shifted channelrhodopsin CsChrimson in these bitter-sensing neurons promotes egg-laying avoidance of red light, an otherwise neutral cue for egg-laying females. Together, these results demonstrate a physiological role of the UV-sensitive dTRPA1 isoforms, reveal that adult Drosophila possess at least two sensory systems for detecting UV, and uncover an unexpected role of bitter-sensing taste neurons in UV sensing. PMID:27932542

H2O2-Sensitive Isoforms of Drosophila melanogaster TRPA1 Act in Bitter-Sensing Gustatory Neurons to Promote Avoidance of UV During Egg-Laying.

PubMed

Guntur, Ananya R; Gou, Bin; Gu, Pengyu; He, Ruo; Stern, Ulrich; Xiang, Yang; Yang, Chung-Hui

2017-02-01

The evolutionarily conserved TRPA1 channel can sense various stimuli including temperatures and chemical irritants. Recent results have suggested that specific isoforms of Drosophila TRPA1 (dTRPA1) are UV-sensitive and that their UV sensitivity is due to H 2 O 2 sensitivity. However, whether such UV sensitivity served any physiological purposes in animal behavior was unclear. Here, we demonstrate that H 2 O 2 -sensitive dTRPA1 isoforms promote avoidance of UV when adult Drosophila females are selecting sites for egg-laying. First, we show that blind/visionless females are still capable of sensing and avoiding UV during egg-laying when intensity of UV is high yet within the range of natural sunlight. Second, we show that such vision-independent UV avoidance is mediated by a group of bitter-sensing neurons on the proboscis that express H 2 O 2 -sensitive dTRPA1 isoforms. We show that these bitter-sensing neurons exhibit dTRPA1-dependent UV sensitivity. Importantly, inhibiting activities of these bitter-sensing neurons, reducing their dTRPA1 expression, or reducing their H 2 O 2 -sensitivity all significantly reduced blind females' UV avoidance, whereas selectively restoring a H 2 O 2 -sensitive isoform of dTRPA1 in these neurons restored UV avoidance. Lastly, we show that specifically expressing the red-shifted channelrhodopsin CsChrimson in these bitter-sensing neurons promotes egg-laying avoidance of red light, an otherwise neutral cue for egg-laying females. Together, these results demonstrate a physiological role of the UV-sensitive dTRPA1 isoforms, reveal that adult Drosophila possess at least two sensory systems for detecting UV, and uncover an unexpected role of bitter-sensing taste neurons in UV sensing. Copyright © 2017 by the Genetics Society of America.

Case Studies of Effects of Artificial Food Colors on Hyperactivity.

ERIC Educational Resources Information Center

Spring, Carl; And Others

1981-01-01

A double blind, double crossover study with six hyperactive boys (8 to 13 years old) tested B. Feingold's hypothesis that synthetic food colors cause hyperactivity in some children. All Ss were on the Feingold diet, eliminating artificial colors and flavors. The authors conclude that evidence for Feingold's hypothesis is weak. (Author)

Creative Problem Solving as Sequential BVSR: Exploration (Total Ignorance) versus Elimination (Informed Guess)

ERIC Educational Resources Information Center

Simonton, Dean Keith

2013-01-01

Although the theory that creativity requires blind variation and selective retention (BVSR) is now more than a half-century old, only recently has BVSR theory undergone appreciable conceptual development, including formal three-parameter definitions of both creativity and sightedness. In this article, these new developments are for the first time…

Genital Warts

MedlinePlus

... transmitted disease (STD) caused by the human papillomavirus (HPV). The warts usually appear as a small bump ... completely eliminate, the risk of catching or spreading HPV. The most reliable way to avoid infection is ...

Underwater Acoustic Source Localisation Among Blind and Sighted Scuba Divers

PubMed Central

Cambi, Jacopo; Livi, Ludovica; Livi, Walter

2017-01-01

Objectives Many blind individuals demonstrate enhanced auditory spatial discrimination or localisation of sound sources in comparison to sighted subjects. However, this hypothesis has not yet been confirmed with regards to underwater spatial localisation. This study therefore aimed to investigate underwater acoustic source localisation among blind and sighted scuba divers. Methods This study took place between February and June 2015 in Elba, Italy, and involved two experimental groups of divers with either acquired (n = 20) or congenital (n = 10) blindness and a control group of 30 sighted divers. Each subject took part in five attempts at an under-water acoustic source localisation task, in which the divers were requested to swim to the source of a sound originating from one of 24 potential locations. The control group had their sight obscured during the task. Results The congenitally blind divers demonstrated significantly better underwater sound localisation compared to the control group or those with acquired blindness (P = 0.0007). In addition, there was a significant correlation between years of blindness and underwater sound localisation (P <0.0001). Conclusion Congenital blindness was found to positively affect the ability of a diver to recognise the source of a sound in an underwater environment. As the correct localisation of sounds underwater may help individuals to avoid imminent danger, divers should perform sound localisation tests during training sessions. PMID:28690888

Making a difference with Vision 2020: The Right to Sight? Lessons from two states of North Western Nigeria.

PubMed

Muhammad, N; Adamu, M D

2014-01-01

Settings and Aim: The World Health Organization launched in 1999 an initiative to eliminate the global avoidable blindness and prevent the projected doubling of avoidable visual impairment between 1990 and 2020 (Vision 2020: The Right to Sight). The World Health Assembly (WHA) adopted resolutions WHA 59.25, WHA 56.26 urging member states to adopt the Vision 2020 principles. More than 90 nongovernmental development organizations, agencies, and institutions, together with a number of major corporations, are now working together in this global partnership. Two neighboring states in North Western Nigeria provide eye care services using different approaches; one state uses the principles of Vision 2020, the other uses a different strategy. The aim of the study was to assess awareness and utilization of eye care services in two Nigerian states. A population-based cross-sectional interview of households was conducted in two neighboring states using a structured questionnaire. Data analysis was performed using SPSS version 21 and a P < 0.05 was considered as significant. Participation rate was 97% in the two states. The population in the Vision 2020-compliant state were significantly more aware about general eye care services (80% vs. 44%, P < 0.0005); had less proportion of households unaware of any eye care service (55% vs. 69%, P < 0.0005); and have a significantly higher felt the need to utilize eye care services (47% vs. 5.9%, P < 0.0005). The service utilization rate was however low in the two states. The principles of Vision 2020: The Right to Sight is adaptable to different cultures/societies and has demonstrated a potential to increase awareness and a felt need for eye care in poor resource settings.

Strengthening the links between mapping, planning and global engagement for disease elimination: lessons learnt from trachoma.

PubMed

Courtright, Paul; Rotondo, Lisa A; MacArthur, Chad; Jones, Iain; Weaver, Angela; Negash, Biruck Kebede; Olobio, Nicholas; Binnawi, Kamal; Bush, Simon; Abdala, Mariamo; Haddad, Danny; Bonfield, Astrid; Emerson, Paul; Sarah, Virginia; Solomon, Anthony W

2018-06-15

Trachoma is the leading infectious cause of blindness. Until recently, reliable data on the global extent of the disease, detailed plans for elimination, and government, donor and partner engagement were all inadequate. The trachoma community undertook a systematic, three-pronged strategy to map trachoma district by district, develop national-level trachoma elimination plans, and create a framework for governments, donors and partners to convene and coordinate in support of trachoma elimination.  RESULT: There has been a frame-shift in internal and external perceptions of the global trachoma programme, from being an effort working towards disease control in focussed geographical areas, to one in the process of achieving worldwide disease elimination. Multiple factors contributed to the successful implementation of mapping, planning, and cross-sectional engagement of governments, partners and donors. Elimination of trachoma is possible if the right combination of factors is in place. Planning for success is a critical first step. Some remaining challenges must still be addressed if the elimination targets are to be successfully attained. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Causes of severe visual impairment and blindness in children in schools for the blind in eastern Africa: changes in the last 14 years.

PubMed

Njuguna, Margaret; Msukwa, Gerald; Shilio, Bernadeth; Tumwesigye, Cillasy; Courtright, Paul; Lewallen, Susan

2009-01-01

To determine the causes of severe visual impairment and blindness in children attending schools for the blind in Kenya, Malawi, Uganda, and Tanzania and to compare the findings with those of a 1994 study. Children attending schools for the blind or annexes in 4 eastern African countries were examined. The major anatomical site of and underlying etiology of severe visual impairment and blindness was recorded using the standardized World Health Organization (WHO) reporting form. A total of 1062 children aged below 16 years were examined of whom 701 (65.2%) had severe visual impairment or blindness. The major anatomical sites of visual loss overall (% and 95% CI) were cornea scar/phthisis bulbi (19%,16.1-21.9), whole globe lesions (15.7%,13.0-18.4), retina (15.4 %, 12.7-18.1), lens related disorders (13.1%, 10.7-15.5), and optic nerve disorders (12.3%, 9.9-14.7). Corneal scar/phthisis was not distributed equally among the countries and was highest in Malawi, similar to findings in 1995. The major etiology of visual loss was childhood factors (29.9%) and an estimated 40% of severe visual impairment and blindness was due to potentially avoidable causes. The major causes of severe visual impairment and blindness overall have not changed appreciably since 1995. There are important differences among countries, however, and using overall estimates for planning may be misleading.

Detecting Signage and Doors for Blind Navigation and Wayfinding

PubMed Central

Wang, Shuihua; Yang, Xiaodong; Tian, Yingli

2013-01-01

Signage plays a very important role to find destinations in applications of navigation and wayfinding. In this paper, we propose a novel framework to detect doors and signage to help blind people accessing unfamiliar indoor environments. In order to eliminate the interference information and improve the accuracy of signage detection, we first extract the attended areas by using a saliency map. Then the signage is detected in the attended areas by using a bipartite graph matching. The proposed method can handle multiple signage detection. Furthermore, in order to provide more information for blind users to access the area associated with the detected signage, we develop a robust method to detect doors based on a geometric door frame model which is independent to door appearances. Experimental results on our collected datasets of indoor signage and doors demonstrate the effectiveness and efficiency of our proposed method. PMID:23914345

Detecting Signage and Doors for Blind Navigation and Wayfinding.

PubMed

Wang, Shuihua; Yang, Xiaodong; Tian, Yingli

2013-07-01

Signage plays a very important role to find destinations in applications of navigation and wayfinding. In this paper, we propose a novel framework to detect doors and signage to help blind people accessing unfamiliar indoor environments. In order to eliminate the interference information and improve the accuracy of signage detection, we first extract the attended areas by using a saliency map. Then the signage is detected in the attended areas by using a bipartite graph matching. The proposed method can handle multiple signage detection. Furthermore, in order to provide more information for blind users to access the area associated with the detected signage, we develop a robust method to detect doors based on a geometric door frame model which is independent to door appearances. Experimental results on our collected datasets of indoor signage and doors demonstrate the effectiveness and efficiency of our proposed method.

Four Practical Steps to Buying Copiers.

ERIC Educational Resources Information Center

Sturgeon, Julie

1999-01-01

Presents practical steps for avoiding overbuying when selecting copiers for university administration. Evaluating copying needs, eliminating excessive features, examining the dealer's capabilities, and being patient for the right price are discussed. (GR)

Iterative algorithm for joint zero diagonalization with application in blind source separation.

PubMed

Zhang, Wei-Tao; Lou, Shun-Tian

2011-07-01

A new iterative algorithm for the nonunitary joint zero diagonalization of a set of matrices is proposed for blind source separation applications. On one hand, since the zero diagonalizer of the proposed algorithm is constructed iteratively by successive multiplications of an invertible matrix, the singular solutions that occur in the existing nonunitary iterative algorithms are naturally avoided. On the other hand, compared to the algebraic method for joint zero diagonalization, the proposed algorithm requires fewer matrices to be zero diagonalized to yield even better performance. The extension of the algorithm to the complex and nonsquare mixing cases is also addressed. Numerical simulations on both synthetic data and blind source separation using time-frequency distributions illustrate the performance of the algorithm and provide a comparison to the leading joint zero diagonalization schemes.

Impact of long-term treatment of onchocerciasis with ivermectin in Ecuador: potential for elimination of infection.

PubMed

Vieira, Juan Carlos; Cooper, Philip J; Lovato, Raquel; Mancero, Tamara; Rivera, Jorge; Proaño, Roberto; López, Andrea A; Guderian, Ronald H; Guzmán, José Rumbea

2007-05-23

Onchocerciasis is a leading cause of blindness worldwide, hence elimination of the infection is an important health priority. Community-based treatment programs with ivermectin form the basis of control programs for the disease in Latin America. The long-term administration of ivermectin could eliminate Onchocerca volvulus infection from endemic areas in Latin America. A strategy of annual to twice-annual treatments with ivermectin has been used for onchocerciasis in endemic communities in Ecuador for up to 14 years. The impact of ivermectin treatment on ocular morbidity, and O. volvulus infection and transmission was monitored in seven sentinel communities. Over the period 1990-2003, high rates of treatment coverage of the eligible population were maintained in endemic communities (mean 85.2% per treatment round). Ivermectin reduced the prevalence of anterior segment disease of the eye to 0% in sentinel communities and had a major impact on the prevalence and transmission of infection, with possible elimination of infection in some foci. The distribution of ivermectin in endemic communities in Ecuador might have eliminated ocular morbidity and significant progress has been made towards elimination of the infection. A strategy of more frequent treatments with ivermectin may be required in communities where the infection persists to achieve the objective of elimination of the infection from Ecuador. The elimination of the infection from an endemic country in Latin America would be a major public health achievement and could stimulate the implementation of elimination strategies in other endemic countries.

[Visual impairment and blindness in children in a Malawian school for the blind].

PubMed

Schulze Schwering, M; Nyrenda, M; Spitzer, M S; Kalua, K

2013-08-01

The aim of this study was to determine the anatomic sites of severe visual impairment and blindness in children in an integrated school for the blind in Malawi, and to compare the results with those of previous Malawian blind school studies. Children attending an integrated school for the blind in Malawi were examined in September 2011 using the standard WHO/PBL eye examination record for children with blindness and low vision. Visual acuity [VA] of the better eye was classified using the standardised WHO reporting form. Fifty-five pupils aged 6 to 19 years were examined, 39 (71 %) males, and 16 (29 %) females. Thirty eight (69%) were blind [BL], 8 (15 %) were severely visually impaired [SVI], 8 (15 %) visually impaired [VI], and 1 (1.8 %) was not visually impaired [NVI]. The major anatomic sites of visual loss were optic nerve (16 %) and retina (16 %), followed by lens/cataract (15 %), cornea (11 %) and lesions of the whole globe (11 %), uveal pathologies (6 %) and cortical blindness (2 %). The exact aetiology of VI or BL could not be determined in most children. Albinism accounted for 13 % (7/55) of the visual impairments. 24 % of the cases were considered to be potentially avoidable: refractive amblyopia among pseudophakic patients and corneal scaring. Optic atrophy, retinal diseases (mostly albinism) and cataracts were the major causes of severe visual impairment and blindness in children in an integrated school for the blind in Malawi. Corneal scarring was now the fourth cause of visual impairment, compared to being the commonest cause 35 years ago. Congenital cataract and its postoperative outcome were the commonest remedial causes of visual impairment. Georg Thieme Verlag KG Stuttgart · New York.

The add-on N-acetylcysteine is more effective than dimethicone alone to eliminate mucus during narrow-band imaging endoscopy: a double-blind, randomized controlled trial.

PubMed

Chen, Ming-Jen; Wang, Horng-Yuan; Chang, Chen-Wang; Hu, Kuang-Chun; Hung, Chien-Yuan; Chen, Chih-Jen; Shih, Shou-Chuan

2013-02-01

Recent studies have shown that pronase can improve mucosal visibility, but this agent is not uniformly available for human use worldwide. This study aimed to assess the efficacy of N-acetylcysteine (NAC), a mucolytic agent, in improving mucus elimination as measured by decreased endoscopic water flushes during narrow-band imaging (NBI) endoscopy. A consecutive series of patients scheduled for upper gastrointestinal endoscopy at outpatient clinics were enrolled in this double-blind, randomized controlled trial. The control group drank a preparation of 100 mg dimethicone (5 ml at 20 mg/ml) plus water up to 100 ml, and the NAC group drank 300 mg NAC plus 100 mg dimethicone and water up to 100 ml. During the endoscopy, the endoscopist used as many flushes of water as deemed necessary to produce a satisfactory NBI view of the entire gastric mucosa. In all, 177 patients with a mean age of 51 years were evaluated in this study. Significantly lesser water was used for flushing during NBI endoscopy for the NAC group than the control group; 40 ml (30-70, 0-120) versus 50 ml (30-100, 0-150) (median (interquartile range, range), p = 0.0095). Considering the safety profile of NAC, decreasing the number of water flushes for optimal vision and unavailability of pronase in some areas, the authors suggest the use of add-on NAC to eliminate mucus during NBI endoscopy.

Avoiding Wildfire Damage: A Checklist for Homeowners

MedlinePlus

... vegetation is fuel for a wildfire, though some trees and shrubs are more flammable than others. To ... you will need to modify or eliminate brush, trees and other vegetation near your home. The greater ...

The National Radon Action Plan - A Strategy for Saving Lives

EPA Pesticide Factsheets

This Plan represents a collaborative effort between eleven organizations dedicated to eliminating avoidable radon-induced lung cancer in the United States. This partnership is led by the American Lung Association.

Striatopallidal neurons control avoidance behavior in exploratory tasks.

PubMed

LeBlanc, Kimberly H; London, Tanisha D; Szczot, Ilona; Bocarsly, Miriam E; Friend, Danielle M; Nguyen, Katrina P; Mengesha, Marda M; Rubinstein, Marcelo; Alvarez, Veronica A; Kravitz, Alexxai V

2018-04-25

The dorsal striatum has been linked to decision-making under conflict, but the mechanism by which striatal neurons contribute to approach-avoidance conflicts remains unclear. We hypothesized that striatopallidal dopamine D2 receptor (D2R)-expressing neurons promote avoidance, and tested this hypothesis in two exploratory approach-avoidance conflict paradigms in mice: the elevated zero maze and open field. Genetic elimination of D2Rs on striatopallidal neurons (iMSNs), but not other neural populations, increased avoidance of the open areas in both tasks, in a manner that was dissociable from global changes in movement. Population calcium activity of dorsomedial iMSNs was disrupted in mice lacking D2Rs on iMSNs, suggesting that disrupted output of iMSNs contributes to heightened avoidance behavior. Consistently, artificial disruption of iMSN output with optogenetic stimulation heightened avoidance of open areas of these tasks, while inhibition of iMSN output reduced avoidance. We conclude that dorsomedial striatal iMSNs control approach-avoidance conflicts in exploratory tasks, and highlight this neural population as a potential target for reducing avoidance in anxiety disorders.

Clinical governance breakdown: Australian cases of wilful blindness and whistleblowing.

PubMed

Cleary, Sonja; Duke, Maxine

2017-01-01

After their attempts to have patient safety concerns addressed internally were ignored by wilfully blind managers, nurses from Bundaberg Base Hospital and Macarthur Health Service felt compelled to 'blow the whistle'. Wilful blindness is the human desire to prefer ignorance to knowledge; the responsibility to be informed is shirked. To provide an account of instances of wilful blindness identified in two high-profile cases of nurse whistleblowing in Australia. Critical case study methodology using Fay's Critical Social Theory to examine, analyse and interpret existing data generated by the Commissions of Inquiry held into Bundaberg Base Hospital and Macarthur Health Service patient safety breaches. All data was publicly available and assessed according to the requirements of unobtrusive research methods and secondary data analysis. Ethical considerations: Data collection for the case studies relied entirely on publicly available documentary sources recounting and detailing past events. Data from both cases reveal managers demonstrating wilful blindness towards patient safety concerns. Concerns were unaddressed; nurses, instead, experienced retaliatory responses leading to a 'social crisis' in the organisation and to whistleblowing. Managers tasked with clinical governance must be aware of mechanisms with the potential to blind them. The human tendency to favour positive news and avoid conflict is powerful. Understanding wilful blindness can assist managers' awareness of the competing emotions occurring in response to ethical challenges, such as whistleblowing.

Causes of childhood blindness in the northeastern states of India.

PubMed

Bhattacharjee, Harsha; Das, Kalyan; Borah, Rishi Raj; Guha, Kamalesh; Gogate, Parikshit; Purukayastha, S; Gilbert, Clare

2008-01-01

The northeastern region (NER) of India is geographically isolated and ethno-culturally different from the rest of the country. There is lacuna regarding the data on causes of blindness and severe visual impairment in children from this region. To determine the causes of severe visual impairment and blindness amongst children from schools for the blind in the four states of NER of India. Survey of children attending special education schools for the blind in the NER. Blind and severely visually impaired children (best corrected visual acuity < 20/200 in the better eye, aged up to 16 years) underwent visual acuity estimation, external ocular examination, retinoscopy and fundoscopy. Refraction and low vision workup was done where indicated. World Health Organization's reporting form was used to code anatomical and etiological causes of visual loss. Microsoft Excel Windows software with SPSS. A total of 376 students were examined of whom 258 fulfilled the eligibility criteria. The major anatomical causes of visual loss amongst the 258 were congenital anomalies (anophthalmos, microphthalmos) 93 (36.1%); corneal conditions (scarring, vitamin A deficiency) 94 (36.7%); cataract or aphakia 28 (10.9%), retinal disorders 15 (5.8%) and optic atrophy 14 (5.3%). Nearly half of the children were blind from conditions which were either preventable or treatable (48.5%). Nearly half the childhood blindness in the NER states of India is avoidable and Vitamin A deficiency forms an important component unlike other Indian states. More research and multisectorial effort is needed to tackle congenital anomalies.

Blinded interpretation of study results can feasibly and effectively diminish interpretation bias.

PubMed

Järvinen, Teppo L N; Sihvonen, Raine; Bhandari, Mohit; Sprague, Sheila; Malmivaara, Antti; Paavola, Mika; Schünemann, Holger J; Guyatt, Gordon H

2014-07-01

Controversial and misleading interpretation of data from randomized trials is common. How to avoid misleading interpretation has received little attention. Herein, we describe two applications of an approach that involves blinded interpretation of the results by study investigators. The approach involves developing two interpretations of the results on the basis of a blinded review of the primary outcome data (experimental treatment A compared with control treatment B). One interpretation assumes that A is the experimental intervention and another assumes that A is the control. After agreeing that there will be no further changes, the investigators record their decisions and sign the resulting document. The randomization code is then broken, the correct interpretation chosen, and the manuscript finalized. Review of the document by an external authority before finalization can provide another safeguard against interpretation bias. We found the blinded preparation of a summary of data interpretation described in this article practical, efficient, and useful. Blinded data interpretation may decrease the frequency of misleading data interpretation. Widespread adoption of blinded data interpretation would be greatly facilitated were it added to the minimum set of recommendations outlining proper conduct of randomized controlled trials (eg, the Consolidated Standards of Reporting Trials statement). Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Microstructure of ceramics fabricated by unidirectional solidification

NASA Technical Reports Server (NTRS)

Kokubo, T.

1984-01-01

The unidirectional solidification methods are zone melting, crystal pulling, Bridgemen, and slow cooling. In order to obtain excellent properties (such as transparency), pores, voids and cracks must be avoided, and elimination of such defects is described.

Poverty and Blindness in Nigeria: Results from the National Survey of Blindness and Visual Impairment.

PubMed

Tafida, A; Kyari, F; Abdull, M M; Sivasubramaniam, S; Murthy, G V S; Kana, I; Gilbert, Clare E

2015-01-01

Poverty can be a cause and consequence of blindness. Some causes only affect the poorest communities (e.g. trachoma), and poor individuals are less likely to access services. In low income countries, cataract blind adults have been shown to be less economically active, indicating that blindness can exacerbate poverty. This study aims to explore associations between poverty and blindness using national survey data from Nigeria. Participants ≥40 years were examined in 305 clusters (2005-2007). Sociodemographic information, including literacy and occupation, was obtained by interview. Presenting visual acuity (PVA) was assessed using a reduced tumbling E LogMAR chart. Full ocular examination was undertaken by experienced ophthalmologists on all with PVA <6/12 in either eye. Causes of vision loss were determined using World Health Organization guidelines. Households were categorized into three levels of poverty based on literacy and occupation at household level. A total of 569/13,591 participants were blind (PVA <3/60, better eye; prevalence 4.2%, 95% confidence interval [CI] 3.8-4.6%). Prevalences of blindness were 8.5% (95% CI 7.7-9.5%), 2.5% (95% CI 2.0-3.1%), and 1.5% (95% CI 1.2-2.0%) in poorest, medium and affluent households, respectively (p = 0.001). Cause-specific prevalences of blindness from cataract, glaucoma, uncorrected aphakia and corneal opacities were significantly higher in poorer households. Cataract surgical coverage was low (37.2%), being lowest in females in poor households (25.3%). Spectacle coverage was 3 times lower in poor than affluent households (2.4% vs. 7.5%). In Nigeria, blindness is associated with poverty, in part reflecting lower access to services. Reducing avoidable causes will not be achieved unless access to services improves, particularly for the poor and women.

Assessment of Allergy to Milk, Egg, Cod, and Wheat in Swedish Schoolchildren: A Population Based Cohort Study.

PubMed

Winberg, Anna; West, Christina E; Strinnholm, Åsa; Nordström, Lisbeth; Hedman, Linnea; Rönmark, Eva

2015-01-01

Knowledge about the prevalence of allergies to foods in childhood and adolescence is incomplete. The purpose of this study was to investigate the prevalence of allergies to milk, egg, cod, and wheat using reported data, clinical examinations, and double-blind placebo-controlled food challenges, and to describe the phenotypes of reported food hypersensitivity in a cohort of Swedish schoolchildren. In a population-based cohort of 12-year-old children, the parents of 2612 (96% of invited) completed a questionnaire. Specific IgE antibodies to foods were analyzed in a random sample (n=695). Children reporting complete avoidance of milk, egg, cod, or wheat due to perceived hypersensitivity and without physician-diagnosed celiac disease were invited to undergo clinical examination that included specific IgE testing, a celiac screening test, and categorization into phenotypes of food hypersensitivity according to preset criteria. Children with possible food allergy were further evaluated with double-blind challenges. In this cohort, the prevalence of reported food allergy to milk, egg, cod, or wheat was 4.8%. Food allergy was diagnosed in 1.4% of the children after clinical evaluation and in 0.6% following double-blind placebo-controlled food challenge. After clinical examination, children who completely avoided one or more essential foods due to perceived food hypersensitivity were categorized with the following phenotypes: allergy (29%), outgrown allergy (19%), lactose intolerance (40%), and unclear (12%). There was a high discrepancy in the prevalence of allergy to milk, egg, cod and wheat as assessed by reported data, clinical evaluation, and double-blind food challenges. Food hypersensitivity phenotyping according to preset criteria was helpful for identifying children with food allergy.

Assessment of Allergy to Milk, Egg, Cod, and Wheat in Swedish Schoolchildren: A Population Based Cohort Study

PubMed Central

Winberg, Anna; West, Christina E; Strinnholm, Åsa; Nordström, Lisbeth; Hedman, Linnea; Rönmark, Eva

2015-01-01

Objectives Knowledge about the prevalence of allergies to foods in childhood and adolescence is incomplete. The purpose of this study was to investigate the prevalence of allergies to milk, egg, cod, and wheat using reported data, clinical examinations, and double-blind placebo-controlled food challenges, and to describe the phenotypes of reported food hypersensitivity in a cohort of Swedish schoolchildren. Methods In a population-based cohort of 12-year-old children, the parents of 2612 (96% of invited) completed a questionnaire. Specific IgE antibodies to foods were analyzed in a random sample (n=695). Children reporting complete avoidance of milk, egg, cod, or wheat due to perceived hypersensitivity and without physician-diagnosed celiac disease were invited to undergo clinical examination that included specific IgE testing, a celiac screening test, and categorization into phenotypes of food hypersensitivity according to preset criteria. Children with possible food allergy were further evaluated with double-blind challenges. Results In this cohort, the prevalence of reported food allergy to milk, egg, cod, or wheat was 4.8%. Food allergy was diagnosed in 1.4% of the children after clinical evaluation and in 0.6% following double-blind placebo-controlled food challenge. After clinical examination, children who completely avoided one or more essential foods due to perceived food hypersensitivity were categorized with the following phenotypes: allergy (29%), outgrown allergy (19%), lactose intolerance (40%), and unclear (12%). Conclusions There was a high discrepancy in the prevalence of allergy to milk, egg, cod and wheat as assessed by reported data, clinical evaluation, and double-blind food challenges. Food hypersensitivity phenotyping according to preset criteria was helpful for identifying children with food allergy. PMID:26134827

Avoiding and Treating Blindness From Fillers: A Review of the World Literature.

PubMed

Beleznay, Katie; Carruthers, Jean D A; Humphrey, Shannon; Jones, Derek

2015-10-01

As the popularity of soft tissue fillers increases, so do the reports of adverse events. The most serious complications are vascular in nature and include blindness. To review the cases of blindness after filler injection, to highlight key aspects of the vascular anatomy, and to discuss prevention and management strategies. A literature review was performed to identify all the cases of vision changes from filler in the world literature. Ninety-eight cases of vision changes from filler were identified. The sites that were high risk for complications were the glabella (38.8%), nasal region (25.5%), nasolabial fold (13.3%), and forehead (12.2%). Autologous fat (47.9%) was the most common filler type to cause this complication, followed by hyaluronic acid (23.5%). The most common symptoms were immediate vision loss and pain. Most cases of vision loss did not recover. Central nervous system complications were seen in 23.5% of the cases. No treatments were found to be consistently successful in treating blindness. Although the risk of blindness from fillers is rare, it is critical for injecting physicians to have a firm knowledge of the vascular anatomy and to understand key prevention and management strategies.

Designing a stable feedback control system for blind image deconvolution.

PubMed

Cheng, Shichao; Liu, Risheng; Fan, Xin; Luo, Zhongxuan

2018-05-01

Blind image deconvolution is one of the main low-level vision problems with wide applications. Many previous works manually design regularization to simultaneously estimate the latent sharp image and the blur kernel under maximum a posterior framework. However, it has been demonstrated that such joint estimation strategies may lead to the undesired trivial solution. In this paper, we present a novel perspective, using a stable feedback control system, to simulate the latent sharp image propagation. The controller of our system consists of regularization and guidance, which decide the sparsity and sharp features of latent image, respectively. Furthermore, the formational model of blind image is introduced into the feedback process to avoid the image restoration deviating from the stable point. The stability analysis of the system indicates the latent image propagation in blind deconvolution task can be efficiently estimated and controlled by cues and priors. Thus the kernel estimation used for image restoration becomes more precision. Experimental results show that our system is effective on image propagation, and can perform favorably against the state-of-the-art blind image deconvolution methods on different benchmark image sets and special blurred images. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cryoablation of focal tachycardia originating from the right atrial free wall during upstream phrenic pacing to avoid phrenic nerve injury.

PubMed

Johnsrude, Christopher

2015-01-01

Recognition of the potential for phrenic nerve injury (PNI) often prompts less aggressive attempts at catheter ablation of multiple forms of tachycardia or abandoning ablation altogether. Some novel techniques to avoid PNI during catheter ablation have been described. Five patients (age: 13-57 years, three females) with ectopic atrial tachycardia originating from the right atrial free wall (RAFW) near the phrenic nerve underwent electrophysiology study with three-dimensional mapping and endocardial cryoablation. Upstream phrenic pacing was performed after cryoadherence was achieved, and cryoablation of ectopic foci was performed during close observation for occurrence of PNI and tachycardia elimination. Cryoablation acutely eliminated five of six atrial tachycardias originating close to the phrenic nerve. Transient PNI during cryothermy occurred in two patients, and resolved within 3 minutes. Patients were observed overnight on telemetry, with no early recurrences of targeted atrial tachycardias and no evidence of PNI. At last follow-up of 1-39 months, four patients were arrhythmia free on no medications. Catheter cryoablation during simultaneous upstream phrenic nerve pacing can lead to safe and effective elimination of focal atrial tachycardias originating from the RAFW close to the phrenic nerve. ©2014 Wiley Periodicals, Inc.

Impact of long-term treatment of onchocerciasis with ivermectin in Ecuador: potential for elimination of infection

PubMed Central

Vieira, Juan Carlos; Cooper, Philip J; Lovato, Raquel; Mancero, Tamara; Rivera, Jorge; Proaño, Roberto; López, Andrea A; Guderian, Ronald H; Guzmán, José Rumbea

2007-01-01

Background Onchocerciasis is a leading cause of blindness worldwide, hence elimination of the infection is an important health priority. Community-based treatment programs with ivermectin form the basis of control programs for the disease in Latin America. The long-term administration of ivermectin could eliminate Onchocerca volvulus infection from endemic areas in Latin America. Methods A strategy of annual to twice-annual treatments with ivermectin has been used for onchocerciasis in endemic communities in Ecuador for up to 14 years. The impact of ivermectin treatment on ocular morbidity, and O. volvulus infection and transmission was monitored in seven sentinel communities. Results Over the period 1990–2003, high rates of treatment coverage of the eligible population were maintained in endemic communities (mean 85.2% per treatment round). Ivermectin reduced the prevalence of anterior segment disease of the eye to 0% in sentinel communities and had a major impact on the prevalence and transmission of infection, with possible elimination of infection in some foci. Conclusion The distribution of ivermectin in endemic communities in Ecuador might have eliminated ocular morbidity and significant progress has been made towards elimination of the infection. A strategy of more frequent treatments with ivermectin may be required in communities where the infection persists to achieve the objective of elimination of the infection from Ecuador. The elimination of the infection from an endemic country in Latin America would be a major public health achievement and could stimulate the implementation of elimination strategies in other endemic countries. PMID:17521449

Mold growth on gypsum wallboard--a summary of three techniques.

PubMed

Menetrez, M Y; Foarde, K K; Webber, T D; Dean, T R; Betancourt, D A

2009-01-01

Reducing occupant exposure to mold growing on damp gypsum wallboard and controlling mold contamination in the indoor environment was studied through 1) delineation of environmental conditions required to promote and avoid mold growth and 2) efficacy testing of antimicrobial products, specifically cleaners and paints, on gypsum wallboard (GWB) surfaces. The effects of moisture and relative humidity (RH) on mold growth and transport are important in avoiding and eliminating problems. These effects have been demonstrated on GWB and are discussed in this article for use as control guidance. The authors discuss the efficacy of antimicrobial cleaners and paints to remove, eliminate, or control mold growth on GWB. Research to control Stachybotrys chartarum growth using 13 separate antimicrobial cleaners and nine varieties of antimicrobial paint on contaminated GWB was performed in laboratory testing. GWB surfaces were subjected to high RH. GWB control measures are summarized and combined, and the antimicrobial product results are explained.

Photodynamic decontamination of blood for transfusion

NASA Astrophysics Data System (ADS)

Ben-Hur, Ehud; Margolis-Nunno, H.; Gottlieb, P.; Lustigman, S.; Horowitz, Bernard

1995-01-01

Currently transfused cellular components of blood are not available in a sterile form and carry a small risk of transmitting viral and parasite diseases. Using phthalocyanines and red light, lipid enveloped viruses, e.g., HIV-1, can be inactivated in red blood cell concentrates (RBCC). Under conditions leading to virus sterilization the blood borne parasites Trypanosoma cruzi (Chagas disease) and Plasmodium falciparum (malaria) could be eliminated to undetectable levels (> 4 log10 kill). RBC damage during treatment could be avoided by increasing the light fluence rate to 80 mW/cm2, and by including the free radical scavenger glutathione and the vitamin E derivative Trolox during light exposure. Similar sterilization of platelet concentrates was achieved with the psoralen derivative AMT and UVA light. Platelet damage due to PUVA treatment was avoided by including the plant flavonoid rutin during irradiation. It is concluded that elimination of the risk of transmitting pathogens during blood transfusion is feasible with photochemical treatments.

Design and evaluation of steering protection for avoiding collisions during a lane change.

PubMed

Itoh, Makoto; Inagaki, Toshiyuki

2014-01-01

This paper discusses the design of a driver assistance system for avoiding collisions with vehicles in blind spots. The following three types of support systems are compared: (1) a warning system that provides the driver with an auditory alert, (2) a 'soft' protection system that makes the steering wheel stiffer to tell the driver that a lane-change manoeuvre is not recommended and (3) a 'hard' protection system that cancels the driver's input and controls the tyre angle autonomously to prevent lane departure. The results of an experiment showed that the hard protection system was more effective for collision avoidance than either the warning or the soft protection system. The warning and soft protection systems were almost the same in terms of collision avoidance. The results suggest that the human-centred automation principle, which requires the human to have the final authority over the automation, can be violated depending on the context.

Optimised quantum hacking of superconducting nanowire single-photon detectors

NASA Astrophysics Data System (ADS)

Tanner, Michael G.; Makarov, Vadim; Hadfield, Robert H.

2014-03-01

We explore bright-light control of superconducting nanowire single-photon detectors (SNSPDs) in the shunted configuration (a practical measure to avoid latching). In an experiment, we simulate an illumination pattern the SNSPD would receive in a typical quantum key distribution system under hacking attack. We show that it effectively blinds and controls the SNSPD. The transient blinding illumination lasts for a fraction of a microsecond and produces several deterministic fake clicks during this time. This attack does not lead to elevated timing jitter in the spoofed output pulse, and hence does not introduce significant errors. Five different SNSPD chip designs were tested. We consider possible countermeasures to this attack.

Optimised quantum hacking of superconducting nanowire single-photon detectors.

PubMed

Tanner, Michael G; Makarov, Vadim; Hadfield, Robert H

2014-03-24

We explore bright-light control of superconducting nanowire single-photon detectors (SNSPDs) in the shunted configuration (a practical measure to avoid latching). In an experiment, we simulate an illumination pattern the SNSPD would receive in a typical quantum key distribution system under hacking attack. We show that it effectively blinds and controls the SNSPD. The transient blinding illumination lasts for a fraction of a microsecond and produces several deterministic fake clicks during this time. This attack does not lead to elevated timing jitter in the spoofed output pulse, and hence does not introduce significant errors. Five different SNSPD chip designs were tested. We consider possible countermeasures to this attack.

Causes of childhood blindness in the northeastern states of India

PubMed Central

Bhattacharjee, Harsha; Das, Kalyan; Borah, Rishi Raj; Guha, Kamalesh; Purukayastha, S; Gilbert, Clare

2008-01-01

Background: The northeastern region (NER) of India is geographically isolated and ethno-culturally different from the rest of the country. There is lacuna regarding the data on causes of blindness and severe visual impairment in children from this region. Aim: To determine the causes of severe visual impairment and blindness amongst children from schools for the blind in the four states of NER of India. Design and Setting: Survey of children attending special education schools for the blind in the NER. Materials and Methods: Blind and severely visually impaired children (best corrected visual acuity <20/200 in the better eye, aged up to 16 years) underwent visual acuity estimation, external ocular examination, retinoscopy and fundoscopy. Refraction and low vision workup was done where indicated. World Health Organization′s reporting form was used to code anatomical and etiological causes of visual loss. Statistical Analysis: Microsoft Excel Windows software with SPSS. Results: A total of 376 students were examined of whom 258 fulfilled the eligibility criteria. The major anatomical causes of visual loss amongst the 258 were congenital anomalies (anophthalmos, microphthalmos) 93 (36.1%); corneal conditions (scarring, vitamin A deficiency) 94 (36.7%); cataract or aphakia 28 (10.9%), retinal disorders 15 (5.8%) and optic atrophy 14 (5.3%). Nearly half of the children were blind from conditions which were either preventable or treatable (48.5%). Conclusion: Nearly half the childhood blindness in the NER states of India is avoidable and Vitamin A deficiency forms an important component unlike other Indian states. More research and multisectorial effort is needed to tackle congenital anomalies. PMID:18974521

Equity and Blindness: Closing Evidence Gaps to Support Universal Eye Health.

PubMed

Ramke, Jacqueline; Zwi, Anthony B; Palagyi, Anna; Blignault, Ilse; Gilbert, Clare E

2015-01-01

The World Health Organization Program for the Prevention of Blindness adopted the principles of universal health coverage (UHC) in its latest plan, Universal Eye Health: A Global Action Plan, 2014-2019. This plan builds on the achievements of Vision 2020, which aimed to reduce the global prevalence of avoidable blindness, and its unequal distribution, by the year 2020. We reviewed the literature on health equity and the generation and use of evidence to promote equity, particularly in eye health. We describe the nature and extent of the equity-focused evidence to support and inform eye health programs on the path to universal eye health, and propose ways to improve the collection and reporting of this evidence. Blindness prevalence decreased in all regions of the world between 1990 and 2010, albeit not at the same rate or to the same extent. In 2010, the prevalence of blindness in West Africa (6.0%) remained 15 times higher than in high-income regions (0.4%); within all regions, women had a higher prevalence of blindness than men. Beyond inter-regional and sex differences, there is little comparable data on the distribution of blindness across social groups within regions and countries, or on whether this distribution has changed over time. Similarly, interventions known to address inequity in blindness are few, and equity-relevant goals, targets and indicators for eye health programs are scarce. Equity aims of eye health programs can benefit from the global momentum towards achieving UHC, and the progress being made on collecting, communicating and using equity-focused evidence.

USGS Blind Sample Project: monitoring and evaluating laboratory analytical quality

USGS Publications Warehouse

Ludtke, Amy S.; Woodworth, Mark T.

1997-01-01

The U.S. Geological Survey (USGS) collects and disseminates information about the Nation's water resources. Surface- and ground-water samples are collected and sent to USGS laboratories for chemical analyses. The laboratories identify and quantify the constituents in the water samples. Random and systematic errors occur during sample handling, chemical analysis, and data processing. Although all errors cannot be eliminated from measurements, the magnitude of their uncertainty can be estimated and tracked over time. Since 1981, the USGS has operated an independent, external, quality-assurance project called the Blind Sample Project (BSP). The purpose of the BSP is to monitor and evaluate the quality of laboratory analytical results through the use of double-blind quality-control (QC) samples. The information provided by the BSP assists the laboratories in detecting and correcting problems in the analytical procedures. The information also can aid laboratory users in estimating the extent that laboratory errors contribute to the overall errors in their environmental data.

Optical needs of students with low vision in integrated schools of Nepal.

PubMed

Gnyawali, Subodh; Shrestha, Jyoti Baba; Bhattarai, Dipesh; Upadhyay, Madan

2012-12-01

To identify the optical needs of students with low vision studying in the integrated schools for the blind in Nepal. A total of 779 blind and vision-impaired students studying in 67 integrated schools for the blind across Nepal were examined using the World Health Organization/Prevention of Blindness Eye Examination Record for Children with Blindness and Low Vision. Glasses and low-vision devices were provided to the students with low vision who showed improvement in visual acuity up to a level that was considered sufficient for classroom learning. Follow-up on the use and maintenance of device provided was done after a year. Almost 78% of students studying in the integrated schools for the blind were not actually blind; they had low vision. Five students were found to be wrongly enrolled. Avoidable causes of blindness were responsible for 41% of all blindness. Among 224 students who had visual acuity 1/60 or better, distance vision could be improved in 18.7% whereas near vision could be improved in 41.1% students. Optical intervention provided improved vision in 48.2% of students who were learning braille. Only 34.8% students were found to be using the devices regularly after assessment 1 year later; the most common causes for nonuse were damage or misplacement of the device. A high proportion of students with low vision in integrated schools could benefit from optical intervention. A system of comprehensive eye examination at the time of school enrollment would allow students with low vision to use their available vision to the fullest, encourage print reading over braille, ensure appropriate placement, and promote timely adoption and proper usage of optical device.

Robust estimation approach for blind denoising.

PubMed

Rabie, Tamer

2005-11-01

This work develops a new robust statistical framework for blind image denoising. Robust statistics addresses the problem of estimation when the idealized assumptions about a system are occasionally violated. The contaminating noise in an image is considered as a violation of the assumption of spatial coherence of the image intensities and is treated as an outlier random variable. A denoised image is estimated by fitting a spatially coherent stationary image model to the available noisy data using a robust estimator-based regression method within an optimal-size adaptive window. The robust formulation aims at eliminating the noise outliers while preserving the edge structures in the restored image. Several examples demonstrating the effectiveness of this robust denoising technique are reported and a comparison with other standard denoising filters is presented.

Modeling Error Distributions of Growth Curve Models through Bayesian Methods

ERIC Educational Resources Information Center

Zhang, Zhiyong

2016-01-01

Growth curve models are widely used in social and behavioral sciences. However, typical growth curve models often assume that the errors are normally distributed although non-normal data may be even more common than normal data. In order to avoid possible statistical inference problems in blindly assuming normality, a general Bayesian framework is…

20 CFR 416.919n - Informing the medical source of examination scheduling, report content, and signature requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determining... examination oversight activities) to ensure that any overscheduling is avoided, as overscheduling may lead to... residual functional capacity (if you are an adult) or your functioning (if you are a child). The report...

20 CFR 416.919n - Informing the medical source of examination scheduling, report content, and signature requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determining... examination oversight activities) to ensure that any overscheduling is avoided, as overscheduling may lead to... residual functional capacity (if you are an adult) or your functioning (if you are a child). The report...

20 CFR 416.919n - Informing the medical source of examination scheduling, report content, and signature requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determining... examination oversight activities) to ensure that any overscheduling is avoided, as overscheduling may lead to... residual functional capacity (if you are an adult) or your functioning (if you are a child). The report...

20 CFR 416.919n - Informing the medical source of examination scheduling, report content, and signature requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determining... examination oversight activities) to ensure that any overscheduling is avoided, as overscheduling may lead to... residual functional capacity (if you are an adult) or your functioning (if you are a child). The report...

Use of the Canterbury Child's Aid in Infancy and Early Childhood: A Case Study.

ERIC Educational Resources Information Center

Harris, Leonard; And Others

1985-01-01

A blind infant used the Canterbury Child's Aid (a binaural spatial sensor) for such purposes as reaching, feeding, and walking. As a preschooler, she used it to explore novel environments and avoid objects in her path. Training increased her responsiveness to and action upon the environment. (CL)

Stereotypes as stumbling-blocks: how coping with stereotype threat affects life outcomes for people with physical disabilities.

PubMed

Silverman, Arielle M; Cohen, Geoffrey L

2014-10-01

Stereotype threat, the concern about being judged in light of negative stereotypes, causes underperformance in evaluative situations. However, less is known about how coping with stereotypes can aggravate underperformance over time. We propose a model in which ongoing stereotype threat experiences threaten a person's sense of self-integrity, which in turn prompts defensive avoidance of stereotype-relevant situations, impeding growth, achievement, and well-being. We test this model in an important but understudied population: the physically disabled. In Study 1, blind adults reporting higher levels of stereotype threat reported lower self-integrity and well-being and were more likely to be unemployed and to report avoiding stereotype-threatening situations. In Study 2's field experiment, blind students in a compensatory skill-training program made more progress if they had completed a values-affirmation, an exercise that bolsters self-integrity. The findings suggest that stereotype threat poses a chronic threat to self-integrity and undermines life outcomes for people with disabilities. © 2014 by the Society for Personality and Social Psychology, Inc.

How the venetian blind percept emerges from the laminar cortical dynamics of 3D vision

PubMed Central

Cao, Yongqiang; Grossberg, Stephen

2014-01-01

The 3D LAMINART model of 3D vision and figure-ground perception is used to explain and simulate a key example of the Venetian blind effect and to show how it is related to other well-known perceptual phenomena such as Panum's limiting case. The model proposes how lateral geniculate nucleus (LGN) and hierarchically organized laminar circuits in cortical areas V1, V2, and V4 interact to control processes of 3D boundary formation and surface filling-in that simulate many properties of 3D vision percepts, notably consciously seen surface percepts, which are predicted to arise when filled-in surface representations are integrated into surface-shroud resonances between visual and parietal cortex. Interactions between layers 4, 3B, and 2/3 in V1 and V2 carry out stereopsis and 3D boundary formation. Both binocular and monocular information combine to form 3D boundary and surface representations. Surface contour surface-to-boundary feedback from V2 thin stripes to V2 pale stripes combines computationally complementary boundary and surface formation properties, leading to a single consistent percept, while also eliminating redundant 3D boundaries, and triggering figure-ground perception. False binocular boundary matches are eliminated by Gestalt grouping properties during boundary formation. In particular, a disparity filter, which helps to solve the Correspondence Problem by eliminating false matches, is predicted to be realized as part of the boundary grouping process in layer 2/3 of cortical area V2. The model has been used to simulate the consciously seen 3D surface percepts in 18 psychophysical experiments. These percepts include the Venetian blind effect, Panum's limiting case, contrast variations of dichoptic masking and the correspondence problem, the effect of interocular contrast differences on stereoacuity, stereopsis with polarity-reversed stereograms, da Vinci stereopsis, and perceptual closure. These model mechanisms have also simulated properties of 3D neon color spreading, binocular rivalry, 3D Necker cube, and many examples of 3D figure-ground separation. PMID:25309467

How the venetian blind percept emerges from the laminar cortical dynamics of 3D vision.

PubMed

Cao, Yongqiang; Grossberg, Stephen

2014-01-01

The 3D LAMINART model of 3D vision and figure-ground perception is used to explain and simulate a key example of the Venetian blind effect and to show how it is related to other well-known perceptual phenomena such as Panum's limiting case. The model proposes how lateral geniculate nucleus (LGN) and hierarchically organized laminar circuits in cortical areas V1, V2, and V4 interact to control processes of 3D boundary formation and surface filling-in that simulate many properties of 3D vision percepts, notably consciously seen surface percepts, which are predicted to arise when filled-in surface representations are integrated into surface-shroud resonances between visual and parietal cortex. Interactions between layers 4, 3B, and 2/3 in V1 and V2 carry out stereopsis and 3D boundary formation. Both binocular and monocular information combine to form 3D boundary and surface representations. Surface contour surface-to-boundary feedback from V2 thin stripes to V2 pale stripes combines computationally complementary boundary and surface formation properties, leading to a single consistent percept, while also eliminating redundant 3D boundaries, and triggering figure-ground perception. False binocular boundary matches are eliminated by Gestalt grouping properties during boundary formation. In particular, a disparity filter, which helps to solve the Correspondence Problem by eliminating false matches, is predicted to be realized as part of the boundary grouping process in layer 2/3 of cortical area V2. The model has been used to simulate the consciously seen 3D surface percepts in 18 psychophysical experiments. These percepts include the Venetian blind effect, Panum's limiting case, contrast variations of dichoptic masking and the correspondence problem, the effect of interocular contrast differences on stereoacuity, stereopsis with polarity-reversed stereograms, da Vinci stereopsis, and perceptual closure. These model mechanisms have also simulated properties of 3D neon color spreading, binocular rivalry, 3D Necker cube, and many examples of 3D figure-ground separation.

Photochemical restoration of visual responses in blind mice

PubMed Central

Polosukhina, Aleksandra; Litt, Jeffrey; Tochitsky, Ivan; Nemargut, Joseph; Sychev, Yivgeny; De Kouchkovsky, Ivan; Huang, Tracy; Borges, Katharine; Trauner, Dirk; Van Gelder, Russell N.; Kramer, Richard H.

2012-01-01

Summary Retinitis pigmentosa (RP) and age-related macular degeneration (AMD) are degenerative blinding diseases caused by the death of rods and cones, leaving the remainder of the visual system intact but largely unable to respond to light. Here we show that, AAQ, a synthetic small molecule photoswitch, can restore light sensitivity to the retina and behavioral responses in vivo in mouse models of RP without exogenous gene delivery. Brief application of AAQ bestows prolonged light sensitivity on multiple types of retinal neurons, resulting in synaptically amplified responses and center-surround antagonism in arrays of retinal ganglion cells (RGCs). Intraocular injection of AAQ restores the pupillary light reflex and locomotory light avoidance responses in mice lacking retinal photoreceptors, indicating reconstitution of light signaling to brain circuits. AAQ and related photoswitch molecules present a new drug strategy for restoring retinal function in degenerative blinding diseases. PMID:22841312

Ophthalmic public health; the way ahead.

PubMed

Heidary, F; Rahimi, A; Gharebaghi, R

2012-01-01

Visual sciences have been progressing quickly in recent decades through globalization phenomenon. An enormous change has taken place in ocular health issues, however, there are various problems facing ophthalmic public health worldwide. In the previous years, the World Health Organization and the International Agency for the Prevention of Blindness in partnership launched the global initiative to eradicate avoidable blindness by the year 2020, VISION 2020 the Right to Sight. It has concentrated on the prevention of blindness disability and recognized a health issue-sight as a human right. In view of challenges ahead of visual sciences, close collaboration between international agencies at the global level to implement new strategies and monitor the progress will be mandatory. In these circumstances non-governmental organizations should not be neglected. World Sight Day 2012 would be a great opportunity to be a focus on importance of visual impairment as an important public health issue and discovering new challenges ahead.

Classical-processing and quantum-processing signal separation methods for qubit uncoupling

NASA Astrophysics Data System (ADS)

Deville, Yannick; Deville, Alain

2012-12-01

The Blind Source Separation problem consists in estimating a set of unknown source signals from their measured combinations. It was only investigated in a non-quantum framework up to now. We propose its first quantum extensions. We thus introduce the Quantum Source Separation field, investigating both its blind and non-blind configurations. More precisely, we show how to retrieve individual quantum bits (qubits) only from the global state resulting from their undesired coupling. We consider cylindrical-symmetry Heisenberg coupling, which e.g. occurs when two electron spins interact through exchange. We first propose several qubit uncoupling methods which typically measure repeatedly the coupled quantum states resulting from individual qubits preparations, and which then statistically process the classical data provided by these measurements. Numerical tests prove the effectiveness of these methods. We then derive a combination of quantum gates for performing qubit uncoupling, thus avoiding repeated qubit preparations and irreversible measurements.

Summary of avoidable cancers in the Nordic countries.

PubMed

Olsen, J H; Andersen, A; Dreyer, L; Pukkala, E; Tryggvadottir, L; Gerhardsson de Verdier, M; Winther, J F

1997-01-01

An overview is given of the most important known causes of cancer in the five Nordic countries and the resulting number of cancers that are potentially avoidable. The main causes include active and passive smoking, alcohol consumption, exposure to asbestos and other occupational carcinogens, solar and ionizing radiation, obesity, human papillomavirus infection in the female genital tract and infection with Helicobacter pylori. The organs most commonly affected are those of the respiratory system, the upper digestive tract and stomach, skin, the lower urinary tract and the uterine cervix. Annually, more than 18,000 cancers in men and 11,000 in women in the Nordic populations could be avoided by eliminating exposure to known carcinogens which is equivalent to 33% and 20% of all cancers arising in men and women, respectively, around the year 2000. Smoking habits account for a little more than half of these avoidable cases. Estimates of avoidable cancers are given for each Nordic country, separately.

An Avoidance Model for Short-Range Order Induced by Soft Repulsions in Systems of Rigid Rods

NASA Astrophysics Data System (ADS)

Han, Jining; Herzfeld, Judith

1996-03-01

The effects of soft repulsions on hard particle systems are calculated using an avoidance model which improves upon the simple mean field approximation. Avoidance reduces, but does not eliminate, the energy due to soft repulsions. On the other hand, it also reduces the configurational entropy. Under suitable conditions, this simple trade-off yields a free energy that is lower than the mean field value. In these cases, the variationally determined avoidance gives an estimate for the short-range positional order induced by soft repulsions. The results indicate little short-range order for isotropically oriented rods. However, for parallel rods, short-range order increases to significant levels as the particle axial ratio increases. The implications for long- range positional ordering are also discussed. In particular, avoidance may explain the smectic ordering of tobacco mosaic virus at volume fractions lower than those necessary for smectic ordering of hard particles.

Prevalence and causes of blindness, visual impairment, and cataract surgery in Timor-Leste

PubMed Central

Correia, Marcelino; Das, Taraprasad; Magno, Julia; Pereira, Bernadette M; Andrade, Valerio; Limburg, Hans; Trevelyan, John; Keeffe, Jill; Verma, Nitin; Sapkota, Yuddha

2017-01-01

Purpose To estimate the prevalence and causes of blindness and visual impairment, cataract surgical coverage (CSC), visual outcome of cataract surgery, and barriers to uptake cataract surgery in Timor-Leste. Method In a nationwide rapid assessment of avoidable blindness (RAAB), the latest population (1,066,409) and household data were used to create a sampling frame which consists of 2,227 population units (study clusters) from all 13 districts, with populations of 450–900 per unit. The sample size of 3,350 was calculated with the assumed prevalence of blindness at 4.5% among people aged ≥50 years with a 20% tolerable error, 95% CI, and a 90% response rate. The team was trained in the survey methodology, and inter-observer variation was measured. Door-to-door visits, led by an ophthalmologist, were made in preselected study clusters, and data were collected in line with the RAAB5 survey protocol. An Android smart phone installed with mRAAB software was used for data collection. Result The age–gender standardized prevalence of blindness, severe visual impairment, and visual impairment were 2.8%, (1.8–3.8), 1.7% (1.7–2.3), and 8.1% (6.6–9.6), respectively. Cataract was the leading cause of blindness (79.4%). Blindness was more prevalent in the older age group and in women. CSC was 41.5% in cataract blind eyes and 48.6% in cataract blind people. Good visual outcome in the cataract-operated eyes was 62% (presenting) and 75.2% (best corrected). Two important barriers to not using available cataract surgical services were accessibility (45.5%) and lack of attendants to accompany (24.8%). Conclusion The prevalence of blindness and visual impairment in Timor-Leste remains high. CSC is unacceptably low; gender inequity in blindness and CSC exists. Lack of access is the prominent barrier to cataract surgery. PMID:29238161

23 CFR 630.1104 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

...-aid highway funding. Exposure Control Measures means traffic management strategies to avoid work zone crashes involving workers and motorized traffic by eliminating or reducing traffic through the work zone... including uniformed law enforcement officers, used to reduce the risk of work zone crashes involving...

23 CFR 630.1104 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

...-aid highway funding. Exposure Control Measures means traffic management strategies to avoid work zone crashes involving workers and motorized traffic by eliminating or reducing traffic through the work zone... including uniformed law enforcement officers, used to reduce the risk of work zone crashes involving...

23 CFR 630.1104 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

...-aid highway funding. Exposure Control Measures means traffic management strategies to avoid work zone crashes involving workers and motorized traffic by eliminating or reducing traffic through the work zone... including uniformed law enforcement officers, used to reduce the risk of work zone crashes involving...

23 CFR 630.1104 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

...-aid highway funding. Exposure Control Measures means traffic management strategies to avoid work zone crashes involving workers and motorized traffic by eliminating or reducing traffic through the work zone... including uniformed law enforcement officers, used to reduce the risk of work zone crashes involving...

23 CFR 630.1104 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

...-aid highway funding. Exposure Control Measures means traffic management strategies to avoid work zone crashes involving workers and motorized traffic by eliminating or reducing traffic through the work zone... including uniformed law enforcement officers, used to reduce the risk of work zone crashes involving...

Beyond Attributable Burden: Estimating the Avoidable Burden of Disease Associated with Household Air Pollution.

PubMed

Kuhn, Randall; Rothman, Dale S; Turner, Sara; Solórzano, José; Hughes, Barry

2016-01-01

The Global Burden of Disease (GBD) studies have transformed global understanding of health risks by producing comprehensive estimates of attributable disease burden, or the current disease that would be eliminated if a risk factor did not exist. Yet many have noted the greater policy significance of avoidable burden, or the future disease that could actually be eliminated if a risk factor were eliminated today. Avoidable risk may be considerably lower than attributable risk if baseline levels of exposure or disease are declining, or if a risk factor carries lagged effects on disease. As global efforts to deliver clean cookstoves accelerate, a temporal estimation of avoidable risk due to household air pollution (HAP) becomes increasingly important, particularly in light of the rapid uptake of modern stoves and ongoing epidemiologic transitions in regions like South and Southeast Asia. We estimate the avoidable burden associated with HAP using International Futures (IFs), an integrated forecasting system that has been used to model future global disease burdens and risk factors. Building on GBD and other estimates, we integrated a detailed HAP exposure estimation and exposure-response model into IFs. We then conducted a counterfactual experiment in which HAP exposure is reduced to theoretical minimum levels in 2015. We evaluated avoidable mortality and DALY reductions for the years 2015 to 2024 relative to a Base Case scenario in which only endogenous changes occurred. We present results by cause and region, looking at impacts on acute lower respiratory infection (ALRI) and four noncommunicable diseases (NCDs). We found that just 2.6% of global DALYs would be averted between 2015 and 2024, compared to 4.5% of global DALYs attributed to HAP in the 2010 GBD study, due in large part to the endogenous tendency towards declining traditional stove usage in the IFs base case forecast. The extent of diminished impact was comparable for ALRI and affected NCDs, though for different reasons. ALRI impacts diminish due to the declining burden of ALRI in the base case forecast, particularly apparent in South Asia and Southeast Asia. Although NCD burdens are rising in regions affected by HAP, the avoidable risk of NCD nonetheless diminishes due to lagged effects. Because the stove transition and the decline of ALRI are proceeding more slowly in Sub-Saharan Africa, avoidable impacts would also be more persistent (3.9% of total DALY due to HAP) compared to South Asia (3.6%) or Southeast Asia (2.5%). Our results illustrate how a temporal dynamic calculation of avoidable risk may yield different estimates, compared to a static attributable risk estimate, of the global and regional burden of disease. Our results suggest a window of rising and falling opportunity for HAP interventions that may have already closed in Southeast Asia and may be closing quickly in South Asia, but may remain open longer in Sub-Saharan Africa. A proper accounting of global health priorities should apply an avoidable risk framework that considers the role of ongoing social, economic and health transitions in constantly altering the disease and risk factor landscape.

Trachoma in Indigenous Settlements in Brazil, 2000-2008.

PubMed

Freitas, Helen Selma de Abreu; Medina, Norma Helen; Lopes, Maria de Fátima Costa; Soares, Oscar Espellete; Teodoro, Marco Túlio Costa; Ramalho, Karen Ruth Brock; Caligaris, Ligia Santos Abreu; Mörschbächer, Ricardo; de Menezes, Maria Nazaré Correia; Luna, Expedito José de Albuquerque

2016-12-01

Trachoma, caused by the bacterium Chlamydia trachomatis, is a chronic, recurrent inflammatory disease that affects the cornea and conjunctiva. Trachoma is the leading infectious cause of avoidable blindness worldwide. Its prevalence is higher among individuals of low socioeconomic status, and trachoma is common in indigenous communities. The present study presents aspects of the epidemiological profile of trachoma in indigenous communities in Brazil. We analyzed data from two databases collected during trachoma screening activities among the population of indigenous settlements in Brazil between 2000 and 2008. Trachoma cases were detected by ocular examination in accordance with the World Health Organization simplified trachoma grading system. According to the surveillance database, a total of 9582 individuals in six different states were examined. Among children aged 1-9 years, the prevalence of follicular trachomatous inflammation (TF) was 35.2%. In individuals aged ≥15 years, the prevalence of trachomatous trichiasis (TT) was 1.2% in individuals and the sex-specific prevalence was 0.8% in males and 1.6% in females (p = 0.02). In a survey of two states, 2301 indigenous schoolchildren were examined. In the age bracket 5-9 years, the prevalence of TF was 4.9 (95% confidence interval 3.8-6.0%). In Brazil, trachoma appears to be a serious public health problem in indigenous settlements, which should therefore be given priority in programs aimed at the elimination of trachoma in the country.

Human cooperation by lethal group competition.

PubMed

Egas, Martijn; Kats, Ralph; van der Sar, Xander; Reuben, Ernesto; Sabelis, Maurice W

2013-01-01

Why humans are prone to cooperate puzzles biologists, psychologists and economists alike. Between-group conflict has been hypothesized to drive within-group cooperation. However, such conflicts did not have lasting effects in laboratory experiments, because they were about luxury goods, not needed for survival ("looting"). Here, we find within-group cooperation to last when between-group conflict is implemented as "all-out war" (eliminating the weakest groups). Human subjects invested in helping group members to avoid having the lowest collective pay-off, whereas they failed to cooperate in control treatments with random group elimination or with no subdivision in groups. When the game was repeated, experience was found to promote helping. Thus, not within-group interactions alone, not random group elimination, but pay-off-dependent group elimination was found to drive within-group cooperation in our experiment. We suggest that some forms of human cooperation are maintained by multi-level selection: reciprocity within groups and lethal competition among groups acting together.

Childhood blindness and severe visual impairment in Malaysia: a nationwide study

PubMed Central

Patel, D K; Tajunisah, I; Gilbert, C; Subrayan, V

2011-01-01

Aim To determine the causes of childhood blindness and severe visual impairment (BL/SVI) in schools for the blind in Malaysia. Methods All children ≤15years attending 24 schools for the blind throughout the country were examined using the WHO Prevention of Blindness Programme (WHO/PBL) eye examination record for children, and visual loss was classified according to the International Classification of Disease (ICD). Results In all, 469 children were examined, of whom 448 (95.6%) had BL/SVI. The major causes of visual loss were retinal disorders (n=148, 33% mainly retinopathy of prematurity (n=78, 17.4%)), cataract/pseudophakia/aphakia (n=77, 17.2%), and anomalies affecting the whole globe. (n=86, 19.2%). The major underlying etiology was undetermined (n=193, 43.1%), followed by hereditary factors, 21.7% (mainly retinal dystrophies), and perinatal factors, 20.5%. More than 34 (7.6%) cases were considered potentially preventable and 192 (42.9%) potentially treatable. Conclusion Diseases of the retina are the major cause of visual impairment, with retinopathy of prematurity being an important avoidable cause. This reflects expansion of neonatal services in Malaysia, and improved survival of very low birth weight and preterm babies. Lens-related causes of visual impairment reflect the need to further improve pediatric ophthalmology services in Malaysia. PMID:21350565

Improved toughness of refractory compounds. [with elimination of the grain boundary phase

NASA Technical Reports Server (NTRS)

Wright, T. R.; Niesz, D. E.

1974-01-01

The concept of grain-boundary-engineering through elimination of the grain-boundary silicate phase in silicon nitride was developed. The process involved removal of the silica from the nitride powder via a thermal treatment coupled with the use of nitride additives to compensate the remaining oxygen. Magnesium and aluminum nitrides are found to be the most effective additive for use as oxygen compensators. Strength decreases at elevated temperatures are not observed in the alumina containing material. The creep rate of a dual additive sialon composition was two orders of magnitude lower at 1400 C than commercial silicon nitride. A cursory analysis of the creep mechanism indicate that grain-boundary sliding is avoided through elimination of the grain-boundary silicate phase.

Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments.

PubMed

Sonuga-Barke, Edmund J S; Brandeis, Daniel; Cortese, Samuele; Daley, David; Ferrin, Maite; Holtmann, Martin; Stevenson, Jim; Danckaerts, Marina; van der Oord, Saskia; Döpfner, Manfred; Dittmann, Ralf W; Simonoff, Emily; Zuddas, Alessandro; Banaschewski, Tobias; Buitelaar, Jan; Coghill, David; Hollis, Chris; Konofal, Eric; Lecendreux, Michel; Wong, Ian C K; Sergeant, Joseph

2013-03-01

Nonpharmacological treatments are available for attention deficit hyperactivity disorder (ADHD), although their efficacy remains uncertain. The authors undertook meta-analyses of the efficacy of dietary (restricted elimination diets, artificial food color exclusions, and free fatty acid supplementation) and psychological (cognitive training, neurofeedback, and behavioral interventions) ADHD treatments. Using a common systematic search and a rigorous coding and data extraction strategy across domains, the authors searched electronic databases to identify published randomized controlled trials that involved individuals who were diagnosed with ADHD (or who met a validated cutoff on a recognized rating scale) and that included an ADHD outcome. Fifty-four of the 2,904 nonduplicate screened records were included in the analyses. Two different analyses were performed. When the outcome measure was based on ADHD assessments by raters closest to the therapeutic setting, all dietary (standardized mean differences=0.21-0.48) and psychological (standardized mean differences=0.40-0.64) treatments produced statistically significant effects. However, when the best probably blinded assessment was employed, effects remained significant for free fatty acid supplementation (standardized mean difference=0.16) and artificial food color exclusion (standardized mean difference=0.42) but were substantially attenuated to nonsignificant levels for other treatments. Free fatty acid supplementation produced small but significant reductions in ADHD symptoms even with probably blinded assessments, although the clinical significance of these effects remains to be determined. Artificial food color exclusion produced larger effects but often in individuals selected for food sensitivities. Better evidence for efficacy from blinded assessments is required for behavioral interventions, neurofeedback, cognitive training, and restricted elimination diets before they can be supported as treatments for core ADHD symptoms.

Eliminating sun glare disturbance at signalized intersections by a vehicle to infrastructure wireless communication : final report.

DOT National Transportation Integrated Search

2016-05-01

Due to sun glare disturbances, drivers may encounter fatal threats on roadways, particularly at signalized intersections. Many studies have attempted to develop applicable solutions, such as avoiding sun positions, road geometric redirections, and we...

Evaluation of trench and slotted drain maintenance and cleaning : Phase 1 : final report.

DOT National Transportation Integrated Search

2017-03-01

Trench and slotted drains are increasingly being used by ODOT to remove storm water from the roadways. These drains have to be properly cleaned and maintained to prevent vehicles from hydroplaning, eliminate flooding and avoid premature roadway failu...

Augmenting Outpatient Alcohol Treatment as Usual With Online Alcohol Avoidance Training: Protocol for a Double-Blind Randomized Controlled Trial

PubMed Central

Bratti-van der Werf, Marleen KJ; Postel, Marloes G; Pieterse, Marcel E; Ben Allouch, Somaya; Wiers, Reinout W; Bohlmeijer, Ernst T; Salemink, Elske

2018-01-01

Background Recent theoretical models emphasize the role of impulsive processes in alcohol addiction, which can be retrained with computerized Cognitive Bias Modification (CBM) training. In this study, the focus is on action tendencies that are activated relatively automatically. Objective The aim of the study is to examine the effectiveness of online CBM Alcohol Avoidance Training using an adapted Approach-Avoidance Task as a supplement to treatment as usual (TAU) in an outpatient treatment setting. Methods The effectiveness of 8 online sessions of CBM Alcohol Avoidance Training added to TAU is tested in a double-blind, randomized controlled trial with pre- and postassessments, plus follow-up assessments after 3 and 6 months. Participants are adult patients (age 18 years or over) currently following Web-based or face-to-face TAU to reduce or stop drinking. These patients are randomly assigned to a CBM Alcohol Avoidance or a placebo training. The primary outcome measure is a reduction in alcohol consumption. We hypothesize that TAU + CBM will result in up to a 13-percentage point incremental effect in the number of patients reaching the safe drinking guidelines compared to TAU + placebo CBM. Secondary outcome measures include an improvement in health status and a decrease in depression, anxiety, stress, and possible mediation by the change in approach bias. Finally, patients’ adherence, acceptability, and credibility will be examined. Results The trial was funded in 2014 and is currently in the active participant recruitment phase (since May 2015). Enrolment will be completed in 2019. First results are expected to be submitted for publication in 2020. Conclusions The main purpose of this study is to increase our knowledge about the added value of online Alcohol Avoidance Training as a supplement to TAU in an outpatient treatment setting. If the added effectiveness of the training is proven, the next step could be to incorporate the intervention into current treatment. Trial Registration Netherlands Trial Register NTR5087; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5087 (Archived at WebCite http://www.webcitation.org/6wuS4i1tH) PMID:29496657

Enhancing community knowledge and health behaviors to eliminate blinding trachoma in Mali using radio messaging as a strategy.

PubMed

Bamani, Sanoussi; Toubali, Emily; Diarra, Sadio; Goita, Seydou; Berté, Zana; Coulibaly, Famolo; Sangaré, Hama; Tuinsma, Marjon; Zhang, Yaobi; Dembelé, Benoit; Melvin, Palesa; MacArthur, Chad

2013-04-01

The National Blindness Prevention Program in Mali has broadcast messages on the radio about trachoma as part of the country's trachoma elimination strategy since 2008. In 2011, a radio impact survey using multi-stage cluster sampling was conducted in the regions of Kayes and Segou to assess radio listening habits, coverage of the broadcasts, community knowledge and behavior specific to trachoma and facial cleanliness of children. Radio access and listening were high, with 60% of respondents having heard a message on the radio about trachoma. The majority of respondents knew about trachoma, its root causes, its impact on health and prevention measures. Additionally, 66% reported washing their children's faces more than or equal to twice/day and 94% reported latrine disposal of feces. A high percentage of persons who gave a positive response to knowledge and behavior questions reported hearing the trachoma messages on the radio with 60% reporting that the radio is where they learned about trachoma. There was no significant difference in facial cleanliness when comparing children whose primary caregiver had/had not heard the trachoma messages. Next steps include revising the current messages to include more focused behavior change messaging and to engage in a more robust use of community radios.

Pain hypersensitivity in congenital blindness is associated with faster central processing of C-fibre input.

PubMed

Slimani, H; Plaghki, L; Ptito, M; Kupers, R

2016-10-01

We have recently shown that visual deprivation from birth exacerbates responses to painful thermal stimuli. However, the mechanisms underlying pain hypersensitivity in congenital blindness are unclear. To study the contribution of Aδ- and C-fibres in pain perception, we measured thresholds and response times to selective C- and Aδ-fibre activation in congenitally blind, late blind and normally sighted participants. Ultrafast constant-temperature heat pulses were delivered to the hand with a CO2 laser using an interleaved adaptive double staircase procedure. Participants were instructed to respond as quickly as possible when detecting a laser-induced sensation. We used a 650 ms cut-off criterion to distinguish fast Aδ- from slow C-fibre-mediated sensations. Congenitally blind participants showed significantly faster reaction times to C- but not to Aδ-fibre-mediated sensations. In contrast, thresholds for Aδ- and C-fibre stimulation did not differ between groups. Late blind individuals did not differ from sighted controls in any aspect. A follow-up experiment using only suprathreshold stimuli for Aδ- and C-fibre activation confirmed these findings and further showed that congenitally blind individuals detected significantly more C-fibre-mediated stimuli than sighted controls. A decomposition analysis of the reaction times indicated that the faster response times in the congenitally blind are due to more efficient central processing of C-fibre-mediated sensations. The increased sensitivity to painful thermal stimulation in congenital blindness may be due to more efficient central processing of C-fibre-mediated input, which may help to avoid impending dangerous encounters with stimuli that threaten the bodily integrity. WHAT DOES THIS STUDY ADD?: Hypersensitivity to heat pain in congenital blindness is associated with faster responses to C-fibre activation, likely caused by more efficient central processing of C-fibre-mediated input. © 2016 European Pain Federation - EFIC®

Avoidance of urinary catheterization to minimize in-hospital complications after transcatheter aortic valve implantation: An observational study.

PubMed

Lauck, Sandra B; Kwon, Jae-Yung; Wood, David A; Baumbusch, Jennifer; Norekvål, Tone M; Htun, Nay; Stephenson, Leo; Webb, John G

2018-01-01

Contemporary transcatheter aortic valve implantation (TAVI) devices and approach present opportunities to review historical practices initially informed by early treatment development and cardiac surgery. The avoidance of urinary catheterization in the older TAVI population is a strategy to minimize in-hospital complications. The purpose of the study was to explore elimination-related complications following the phased implementation of a default strategy of avoiding urinary catheterization in patients undergoing transfemoral (TF) TAVI. We conducted an observational study using a retrospective chart review of patients treated between 2011 and 2013 to identify patient characteristics, peri-procedure details, in-hospital outcomes and elimination-related complications in patients who did or did not receive a peri-procedure indwelling catheter. Descriptive analyses were used to report differences between the groups; we conducted a regression analysis to explore the relationship between the practice of urinary catheterization and total procedure time. Of the 408 patients who underwent TF TAVR, 188 (46.1%) received a peri-procedure indwelling urinary catheter and 220 (53.9%) did not. There was no difference in in-hospital mortality (2.2%), disabling stroke (0.5%), or other major cardiac adverse events. The avoidance of a urinary catheter resulted in significantly lower rates of urinary tract infection requiring a new antibiotic regimen (1.4% versus 6.1%, p = 0.014), haematuria documented by medicine or nursing (3.7% versus 17.6%, p = 0.001), and the need for continuous bladder irrigation (2.7% versus 0%, p = 0.027). The avoidance of a urinary catheter may contribute to improved outcomes in patients undergoing TAVI. The intervention should be further evaluated within the broader study of minimalist TAVI.

The effects of the non-contingent presentation of safety signals on the elimination of safety behaviors: An experimental comparison between individuals with low and high obsessive-compulsive profiles.

PubMed

Angelakis, Ioannis; Austin, Jennifer L

2018-06-01

Safety behaviors, defined as engagement in avoidance within safe environments, are a key symptom of obsessive-compulsive and related disorders. They may interfere with daily functioning and as such their emission should be reduced. The purpose of the current study is to investigate the effects of the non-contingent presentation of safety signals (cues produced by safety behaviors) on reducing safety behaviors in participants self-reporting low and high OCD profiles. In total, 32 participants were asked to play a game to gain points and avoid their loss. After having developed avoidance behavior, evidenced by maintaining all of their earned points, they were exposed to safe environments where no point loss was programmed. In Test 1, safety cues (blue bar) were produced contingent on performing safety behaviors. In Test 2, safety cues were presented continuously without any response requirement. Findings demonstrated that high OCD group displayed higher rates of safety behaviors than low OCD group. However, exposure to the non-contingent presentation of safety signals eliminated their emission in both groups. Future studies need to evaluate the effects of different non-contingent schedules on the suppression of safety behaviors. These findings contribute to the literature by demonstrating that non-contingent introduction of safety signals eliminated safety behaviors completely, even in high OCD participants, who performed safety behavior at higher rates. Such a treatment protocol may ameliorate exposure therapy in which response prevention constitutes a key element and is generally associated with increased drop-out rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prevalence of blindness and cataract surgical outcomes in Takeo Province, Cambodia.

PubMed

Mörchen, Manfred; Langdon, Toby; Ormsby, Gail M; Meng, Ngy; Seiha, Do; Piseth, Kong; Keeffe, Jill E

2015-01-01

To estimate the prevalence of blindness and cataract surgical outcomes in persons 50 years or older above in Takeo Province, Cambodia. A population based survey. A total of 93 villages were selected through probability proportionate to size using the Rapid Assessment of Avoidable Blindness methodology. Households from 93 villages were selected using compact segment sampling. Visual acuity (VA) of 4650 people 50 years or older was tested and lens status and cause of visual impairment were assessed. The response rate was 96.2%. The age- and sex-adjusted prevalence of bilateral blindness [presenting visual acuity (PVA) <3/60 in the better eye] was 3.4% (95% confidence interval, 2.8%-4.0%), resulting in an estimated 4187 people blind in Takeo Province. The age- and sex-adjusted prevalence of low vision (PVA <6/18 to 3/60) was 21.1%, an estimated 25,900 people. Cataract surgical coverage in the bilaterally blind was 64.7% (female 59.5%, male 78.1%). Cataract surgical outcome was poor (best-corrected visual acuity <6/60) in only 7.7% and good in 88.7% (best-corrected visual acuity ≥6/18) of eyes operated in the last 5 years before the survey. The cataract surgical coverage for women is less than that for men. The increased life expectancy in Cambodia and the fact that women constitute 60.6% of the population (aged ≥50 years) at Takeo Province could have had an impact on cataract workload and high prevalence of blindness. A repeated survey using the same methodology after 8-12 years might be helpful in proving genuine change over time.

Cerebral venous hypertension and blindness: a reversible complication.

PubMed

Cuadra, Salvador A; Padberg, Frank T; Turbin, Roger E; Farkas, Jeffrey; Frohman, Larry P

2005-10-01

A 57-year-old woman developed blindness during treatment for sarcoidosis-induced end-stage renal disease. An initial renal transplantation failed, and hemoaccess was maintained with multiple central catheters and upper extremity prosthetic arteriovenous grafts. A successful second transplantation eliminated her need for hemodialysis, but a right brachial to internal jugular graft remained patent. Progressive visual loss 2 years after transplantation prompted ophthalmic evaluation which initially revealed unilateral left optic nerve edema and visual loss, ultimately worsening over several months to no light perception in the left eye, 20/60 vision in the right eye, and bilateral papilledema. Arteriography demonstrated cerebral venous hypertension attributed to the functioning hemoaccess graft. Permanent graft occlusion normalized the papilledema, and visual field defects in the right eye and visual acuity returned to 20/20 in the right eye.

Radar-based collision avoidance for unmanned surface vehicles

NASA Astrophysics Data System (ADS)

Zhuang, Jia-yuan; Zhang, Lei; Zhao, Shi-qi; Cao, Jian; Wang, Bo; Sun, Han-bing

2016-12-01

Unmanned surface vehicles (USVs) have become a focus of research because of their extensive applications. To ensure safety and reliability and to perform complex tasks autonomously, USVs are required to possess accurate perception of the environment and effective collision avoidance capabilities. To achieve these, investigation into realtime marine radar target detection and autonomous collision avoidance technologies is required, aiming at solving the problems of noise jamming, uneven brightness, target loss, and blind areas in marine radar images. These technologies should also satisfy the requirements of real-time and reliability related to high navigation speeds of USVs. Therefore, this study developed an embedded collision avoidance system based on the marine radar, investigated a highly real-time target detection method which contains adaptive smoothing algorithm and robust segmentation algorithm, developed a stable and reliable dynamic local environment model to ensure the safety of USV navigation, and constructed a collision avoidance algorithm based on velocity obstacle (V-obstacle) which adjusts the USV's heading and speed in real-time. Sea trials results in multi-obstacle avoidance firstly demonstrate the effectiveness and efficiency of the proposed avoidance system, and then verify its great adaptability and relative stability when a USV sailing in a real and complex marine environment. The obtained results will improve the intelligent level of USV and guarantee the safety of USV independent sailing.

32 CFR 634.31 - Parking.

Code of Federal Regulations, 2013 CFR

2013-07-01

... be avoided. (c) Illegal parking contributes to congestion and slows traffic flow on an installation... INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.31 Parking. (a) The most efficient use... eliminates conditions causing traffic accidents. (d) The “Denver boot” device is authorized for use as a...

32 CFR 634.31 - Parking.

Code of Federal Regulations, 2011 CFR

2011-07-01

... be avoided. (c) Illegal parking contributes to congestion and slows traffic flow on an installation... INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.31 Parking. (a) The most efficient use... eliminates conditions causing traffic accidents. (d) The “Denver boot” device is authorized for use as a...

32 CFR 634.31 - Parking.

Code of Federal Regulations, 2014 CFR

2014-07-01

... be avoided. (c) Illegal parking contributes to congestion and slows traffic flow on an installation... INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.31 Parking. (a) The most efficient use... eliminates conditions causing traffic accidents. (d) The “Denver boot” device is authorized for use as a...

32 CFR 634.31 - Parking.

Code of Federal Regulations, 2012 CFR

2012-07-01

... be avoided. (c) Illegal parking contributes to congestion and slows traffic flow on an installation... INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.31 Parking. (a) The most efficient use... eliminates conditions causing traffic accidents. (d) The “Denver boot” device is authorized for use as a...

32 CFR 634.31 - Parking.

Code of Federal Regulations, 2010 CFR

2010-07-01

... eliminates conditions causing traffic accidents. (d) The “Denver boot” device is authorized for use as a... INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.31 Parking. (a) The most efficient use... be avoided. (c) Illegal parking contributes to congestion and slows traffic flow on an installation...

A Drosophila Gustatory Receptor Required for Strychnine Sensation

PubMed Central

Lee, Youngseok; Moon, Seok Jun; Wang, Yijin

2015-01-01

Strychnine is a potent, naturally occurring neurotoxin that effectively protects plants from animal pests by deterring feeding behavior. In insects, such as the fruit fly, Drosophila melanogaster, bitter-tasting aversive compounds are detected primarily through a family of gustatory receptors (GRs), which are expressed in gustatory receptor neurons. We previously described multiple GRs that eliminate the behavioral avoidance to all bitter compounds tested, with the exception of strychnine. Here, we report the identity of a strychnine receptor, referred to as GR47a. We generated a mutation in Gr47a and found that it eliminated strychnine repulsion and strychnine-induced action potentials. GR47a was narrowly tuned, as the responses to other avoidance compounds were unaffected in the mutant animals. This analysis supports an emerging model that Drosophila GRs fall broadly into two specificity classes—one class is comprised of core receptors that are broadly required, whereas the other class, which includes GR47a, consists of narrowly tuned receptors that define chemical specificity. PMID:26187906

Kernel Recursive Least-Squares Temporal Difference Algorithms with Sparsification and Regularization

PubMed Central

Zhu, Qingxin; Niu, Xinzheng

2016-01-01

By combining with sparse kernel methods, least-squares temporal difference (LSTD) algorithms can construct the feature dictionary automatically and obtain a better generalization ability. However, the previous kernel-based LSTD algorithms do not consider regularization and their sparsification processes are batch or offline, which hinder their widespread applications in online learning problems. In this paper, we combine the following five techniques and propose two novel kernel recursive LSTD algorithms: (i) online sparsification, which can cope with unknown state regions and be used for online learning, (ii) L 2 and L 1 regularization, which can avoid overfitting and eliminate the influence of noise, (iii) recursive least squares, which can eliminate matrix-inversion operations and reduce computational complexity, (iv) a sliding-window approach, which can avoid caching all history samples and reduce the computational cost, and (v) the fixed-point subiteration and online pruning, which can make L 1 regularization easy to implement. Finally, simulation results on two 50-state chain problems demonstrate the effectiveness of our algorithms. PMID:27436996

Kernel Recursive Least-Squares Temporal Difference Algorithms with Sparsification and Regularization.

PubMed

Zhang, Chunyuan; Zhu, Qingxin; Niu, Xinzheng

2016-01-01

By combining with sparse kernel methods, least-squares temporal difference (LSTD) algorithms can construct the feature dictionary automatically and obtain a better generalization ability. However, the previous kernel-based LSTD algorithms do not consider regularization and their sparsification processes are batch or offline, which hinder their widespread applications in online learning problems. In this paper, we combine the following five techniques and propose two novel kernel recursive LSTD algorithms: (i) online sparsification, which can cope with unknown state regions and be used for online learning, (ii) L 2 and L 1 regularization, which can avoid overfitting and eliminate the influence of noise, (iii) recursive least squares, which can eliminate matrix-inversion operations and reduce computational complexity, (iv) a sliding-window approach, which can avoid caching all history samples and reduce the computational cost, and (v) the fixed-point subiteration and online pruning, which can make L 1 regularization easy to implement. Finally, simulation results on two 50-state chain problems demonstrate the effectiveness of our algorithms.

Oxytocin attenuates social and non-social avoidance: Re-thinking the social specificity of Oxytocin.

PubMed

Harari-Dahan, Osnat; Bernstein, Amit

2017-07-01

Re-examining decades of the social construal of Oxytocin, the General Approach-Avoidance Hypothesis of Oxytocin (GAAO) predicts that Oxytocin will modulate responding to emotionally-evocative and personally-relevant social and non-social stimuli due to its action on the neural substrate of approach and avoidance motivation. We report the first critical experimental test of GAAO predictions by means of a double-blind intra-nasal administration of Oxytocin vs. placebo in 90 healthy adults (N=90, 50% women). As predicted, we found that among men and women for whom negative emotion (anxious arousal) is motivationally-relevant, intra-nasal administration of Oxytocin reduced behavioral avoidance of emotionally-evocative negatively-valenced social and non-social stimuli, but not closely matched emotionally-neutral stimuli. Findings cannot be explained by extant social theories of Oxytocin. We discuss the implications of the present findings for basic and translational clinical Oxytocin research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prevalence and causes of blindness and diabetic retinopathy in Southern Saudi Arabia.

PubMed

Hajar, Saad; Al Hazmi, Ali; Wasli, Mustafa; Mousa, Ahmed; Rabiu, Mansour

2015-04-01

To determine the prevalence and causes of blindness and diabetic retinopathy (DR) in Jazan district, Southern Saudi Arabia. Using the standardized Rapid Assessment for Avoidable Blindness (RAAB) and DR cross-sectional methodology, 3800 subjects were randomly selected from the population of ≥50 years of age in Jazan, Saudi Arabia between November 2011 and January 2012. Participants underwent screening comprised of interview, random blood glucose test, and ophthalmic assessment including visual acuity (VA) and fundus examination. Among participants with VA less than 6/18 in either eye, the cause(s) of visual impairment was determined. Participants were classified as diabetic if they had previous diagnoses of diabetes, or random blood glucose more than 200 mg/dl. Diabetic participants were assessed for DR using dilated fundus examination. All data were recorded using the RAAB + DR standardized forms. The prevalence of bilateral blindness less than 3/60 was 3.3% (95% confidence interval [CI]: 2.74 - 3.90). Cataract was the leading cause of blindness (58.6%); followed by posterior segment diseases (20%), which included DR (7; 3.3%). The prevalence of diabetes mellitus (DM) was 22.4%, (95% CI: 21.09 - 23.79]), among them; 27.8% had DR. The prevalence of sight-threatening DR was 5.7%. The prevalence of DM and the corresponding proportion of DR in this region is lower than that reported in other regions of Saudi Arabia. However, the prevalence of blindness not related to DR is relatively higher than the other studies.

Prevalence and causes of blindness and diabetic retinopathy in Southern Saudi Arabia

PubMed Central

Hajar, Saad; Hazmi, Ali Al; Wasli, Mustafa; Mousa, Ahmed; Rabiu, Mansour

2015-01-01

Objectives: To determine the prevalence and causes of blindness and diabetic retinopathy (DR) in Jazan district, Southern Saudi Arabia. Methods: Using the standardized Rapid Assessment for Avoidable Blindness (RAAB) and DR cross-sectional methodology, 3800 subjects were randomly selected from the population of ≥50 years of age in Jazan, Saudi Arabia between November 2011 and January 2012. Participants underwent screening comprised of interview, random blood glucose test, and ophthalmic assessment including visual acuity (VA) and fundus examination. Among participants with VA <6/18 in either eye, the cause(s) of visual impairment was determined. Participants were classified as diabetic if they had previous diagnoses of diabetes, or random blood glucose >200 mg/dl. Diabetic participants were assessed for DR using dilated fundus examination. All data were recorded using the RAAB + DR standardized forms. Results: The prevalence of bilateral blindness <3/60 was 3.3% (95% confidence interval [CI]: 2.74 - 3.90). Cataract was the leading cause of blindness (58.6%); followed by posterior segment diseases (20%), which included DR (7; 3.3%). The prevalence of diabetes mellitus (DM) was 22.4%, (95% CI: 21.09 - 23.79), among them; 27.8% had DR. The prevalence of sight-threatening DR was 5.7%. Conclusion: The prevalence of DM and the corresponding proportion of DR in this region is lower than that reported in other regions of Saudi Arabia. However, the prevalence of blindness not related to DR is relatively higher than the other studies. PMID:25828282

Development and Validation of the Self-Acceptance Scale for Persons with Early Blindness: The SAS-EB

PubMed Central

Morgado, Fabiane Frota da Rocha; Campana, Angela Nogueira Neves Betanho; Tavares, Maria da Consolação Gomes Cunha Fernandes

2014-01-01

Investigations of self-acceptance are critical to understanding the development and maintenance of psychological health. However, valid and reliable instruments for measuring self-acceptance in persons with early blindness have yet to be developed. The current research describes three studies designed to develop and validate the Self-acceptance Scale for Persons with Early Blindness (SAS-EB). In Study 1, we developed the initial item pool. Thirty-three items were generated, based on data from specialized literature and from 2 focus groups. Items were organized in a three-factor structure, theoretically predicted for SAS-EB - (1) body acceptance, (2) self-protection from social stigmas, and (3) feeling and believing in one's capacities. In Study 2, information obtained from a panel of 9 experts and 22 persons with early blindness representing the target population was used to refine the initial item pool, generating a new pool of 27 items. In Study 3, 318 persons with early blindness (141 women and 177 men), between 18 and 60 years of age (M = 37.74 years, SD = 12.37) answered the new pool of 27 items. After the elimination of 9 items using confirmatory factor analysis, we confirmed the theoretical three-factor structure of the SAS-EB. Study 3 also provided support for the scale's internal consistency and construct validity. Finally, the psychometric properties of the SAS-EB, its utility, and its limitations are discussed along with considerations for future research. PMID:25268633

Norm-Referenced Tests and Race-Blind Admissions: The Case for Eliminating the SAT and ACT at the University of California. Research & Occasional Paper Series: CSHE.15.17

ERIC Educational Resources Information Center

Geiser, Saul

2017-01-01

Of all college admission criteria, scores on nationally normed tests like the SAT and ACT are most affected by the socioeconomic background of the student. The effect of socioeconomic background on test scores has grown substantially at University of California over the past two decades, and tests have become more of a barrier to admission of…

Effect of Education Sessions of a Structured School Eye Screening Programme on Indian Schoolteachers' Knowledge and Responsibility for Children's Eye Health

ERIC Educational Resources Information Center

Thummalapalli, Rohit; Williams, Jachin D.; Khoshnood, Kaveh; Salchow, Daniel J.; Forster, Susan H.

2013-01-01

Objective: To evaluate the effect of education sessions on Indian schoolteacher awareness of childhood eye health issues, responsibility for children's eye health, and successful participation in a teacher-led eye screening health intervention programme in primary schools aimed at addressing avoidable childhood blindness in India. Design:…

Non-Lethal Weapons (NLW) Reference Book

DTIC Science & Technology

2012-01-01

Array (DSLA) 7 Navy Anti- Swimmer Grenade 7 CP DEVELOPMENTAL NLW Improved Flash Bang Grenade (IFBG) 8 Airburst Non-Lethal Munitions (ANLM) 8...to take all feasible precautions to avoid the incidence of permanent blindness to unenhanced vision training . Frequently Asked Questions iv v...deliver an electro-muscular disruption charge out to 35 feet to disable resistant individuals. This device enhances force protection and mission

Supersampling multiframe blind deconvolution resolution enhancement of adaptive-optics-compensated imagery of LEO satellites

NASA Astrophysics Data System (ADS)

Gerwe, David R.; Lee, David J.; Barchers, Jeffrey D.

2000-10-01

A post-processing methodology for reconstructing undersampled image sequences with randomly varying blur is described which can provide image enhancement beyond the sampling resolution of the sensor. This method is demonstrated on simulated imagery and on adaptive optics compensated imagery taken by the Starfire Optical Range 3.5 meter telescope that has been artificially undersampled. Also shown are the results of multiframe blind deconvolution of some of the highest quality optical imagery of low earth orbit satellites collected with a ground based telescope to date. The algorithm used is a generalization of multiframe blind deconvolution techniques which includes a representation of spatial sampling by the focal plane array elements in the forward stochastic model of the imaging system. This generalization enables the random shifts and shape of the adaptive compensated PSF to be used to partially eliminate the aliasing effects associated with sub- Nyquist sampling of the image by the focal plane array. The method could be used to reduce resolution loss which occurs when imaging in wide FOV modes.

Supersampling multiframe blind deconvolution resolution enhancement of adaptive optics compensated imagery of low earth orbit satellites

NASA Astrophysics Data System (ADS)

Gerwe, David R.; Lee, David J.; Barchers, Jeffrey D.

2002-09-01

We describe a postprocessing methodology for reconstructing undersampled image sequences with randomly varying blur that can provide image enhancement beyond the sampling resolution of the sensor. This method is demonstrated on simulated imagery and on adaptive-optics-(AO)-compensated imagery taken by the Starfire Optical Range 3.5-m telescope that has been artificially undersampled. Also shown are the results of multiframe blind deconvolution of some of the highest quality optical imagery of low earth orbit satellites collected with a ground-based telescope to date. The algorithm used is a generalization of multiframe blind deconvolution techniques that include a representation of spatial sampling by the focal plane array elements based on a forward stochastic model. This generalization enables the random shifts and shape of the AO- compensated point spread function (PSF) to be used to partially eliminate the aliasing effects associated with sub-Nyquist sampling of the image by the focal plane array. The method could be used to reduce resolution loss that occurs when imaging in wide- field-of-view (FOV) modes.

Eliminating Unpredictable Variation through Iterated Learning

ERIC Educational Resources Information Center

Smith, Kenny; Wonnacott, Elizabeth

2010-01-01

Human languages may be shaped not only by the (individual psychological) processes of language acquisition, but also by population-level processes arising from repeated language learning and use. One prevalent feature of natural languages is that they avoid unpredictable variation. The current work explores whether linguistic predictability might…

Superelastic Ball Bearings: Materials and Design to Avoid Mounting and Dismounting Brinell Damage in an Inaccessible Press-Fit Application-. I ; Design Approach

NASA Technical Reports Server (NTRS)

Dellacorte, Christopher; Howard, S. Adam

2015-01-01

Ball bearings require proper fit and installation into machinery structures (onto shafts and into bearing housings) to ensure optimal performance. For some applications, both the inner and outer race must be mounted with an interference fit and care must be taken during assembly and disassembly to avoid placing heavy static loads between the balls and races otherwise Brinell dent type damage can occur. In this paper, a highly dent resistant superelastic alloy, 60NiTi, is considered for rolling element bearing applications that encounter excessive static axial loading during assembly or disassembly. A small (R8) ball bearing is designed for an application in which access to the bearing races to apply disassembly tools is precluded. First Principles analyses show that by careful selection of materials, raceway curvature and land geometry, a bearing can be designed that allows blind assembly and disassembly without incurring raceway damage due to ball denting. Though such blind assembly applications are uncommon, the availability of bearings with unusually high static load capability may enable more such applications with additional benefits, especially for miniature bearings.

Managing symptoms and health through self-prescribed restrictive diets: What can general practitioners learn from the phenomenon of wheat avoidance?

PubMed

Golley, Sinéad; Corsini, Nadia; Mohr, Philip

2017-01-01

Seven per cent of Australian adults report avoiding wheat products for the relief of symptoms. The objective of this study was to explore the experiences, symptoms, influences and beliefs that may explain the tendency for this behaviour to occur pre-dominantly in the absence of a reported medical diagnosis or expert dietary supervision. Data were collected through preliminary questionnaires and semi-structured interviews with 35 self-identified symptomatic individuals who avoid consumption of wheat-based products without a diagnosis of coeliac disease or wheat allergy. Like other contested health phenomena, symptomatic wheat avoidance is characterised by broad symptomatology, perceived benefits, absence of clear biological markers, dissatisfaction with conventional medicine following previous negative test results, and the fact that presumed treatment - elimination of a dietary factor - requires no medical intervention. Self-prescribed food avoidance represents a diagnostic and therapeutic challenge for practitioners, central to which is a tension between patient expectations and biomedical standards of evidence in the diagnostic relationship.

The Diabetic Retinopathy Screening Workflow

PubMed Central

Bolster, Nigel M.; Giardini, Mario E.; Bastawrous, Andrew

2015-01-01

Complications of diabetes mellitus, namely diabetic retinopathy and diabetic maculopathy, are the leading cause of blindness in working aged people. Sufferers can avoid blindness if identified early via retinal imaging. Systematic screening of the diabetic population has been shown to greatly reduce the prevalence and incidence of blindness within the population. Many national screening programs have digital fundus photography as their basis. In the past 5 years several techniques and adapters have been developed that allow digital fundus photography to be performed using smartphones. We review recent progress in smartphone-based fundus imaging and discuss its potential for integration into national systematic diabetic retinopathy screening programs. Some systems have produced promising initial results with respect to their agreement with reference standards. However further multisite trialling of such systems’ use within implementable screening workflows is required if an evidence base strong enough to affect policy change is to be established. If this were to occur national diabetic retinopathy screening would, for the first time, become possible in low- and middle-income settings where cost and availability of trained eye care personnel are currently key barriers to implementation. As diabetes prevalence and incidence is increasing sharply in these settings, the impact on global blindness could be profound. PMID:26596630

Causes of blindness and visual impairment in Pakistan. The Pakistan national blindness and visual impairment survey

PubMed Central

Dineen, B; Bourne, R R A; Jadoon, Z; Shah, S P; Khan, M A; Foster, A; Gilbert, C E; Khan, M D

2007-01-01

Objective To determine the causes of blindness and visual impairment in adults (⩾30 years old) in Pakistan, and to explore socio‐demographic variations in cause. Methods A multi‐stage, stratified, cluster random sampling survey was used to select a nationally representative sample of adults. Each subject was interviewed, had their visual acuity measured and underwent autorefraction and fundus/optic disc examination. Those with a visual acuity of <6/12 in either eye underwent a more detailed ophthalmic examination. Causes of visual impairment were classified according to the accepted World Health Organization (WHO) methodology. An exploration of demographic variables was conducted using regression modeling. Results A sample of 16 507 adults (95.5% of those enumerated) was examined. Cataract was the most common cause of blindness (51.5%; defined as <3/60 in the better eye on presentation) followed by corneal opacity (11.8%), uncorrected aphakia (8.6%) and glaucoma (7.1%). Posterior capsular opacification accounted for 3.6% of blindness. Among the moderately visually impaired (<6/18 to ⩾6/60), refractive error was the most common cause (43%), followed by cataract (42%). Refractive error as a cause of severe visual impairment/blindness was significantly higher in rural dwellers than in urban dwellers (odds ratio (OR) 3.5, 95% CI 1.1 to 11.7). Significant provincial differences were also identified. Overall we estimate that 85.5% of causes were avoidable and that 904 000 adults in Pakistan have cataract (<6/60) requiring surgical intervention. Conclusions This comprehensive survey provides reliable estimates of the causes of blindness and visual impairment in Pakistan. Despite expanded surgical services, cataract still accounts for over half of the cases of blindness in Pakistan. One in eight blind adults has visual loss from sequelae of cataract surgery. Services for refractive errors need to be further expanded and integrated into eye care services, particularly those serving rural populations. PMID:17229806

Thick section aluminum weldments for SRB structures

NASA Technical Reports Server (NTRS)

Bayless, E.; Sexton, J.

1978-01-01

The Space Shuttle Solid Rocket Booster (SRB) forward and aft skirts were designed with fracture control considerations used in the design data. Fracture control is based on reliance upon nondestructive evaluation (NDE) techniques to detect potentially critical flaws. In the aerospace industry, welds on aluminum in the thicknesses (0.500 to 1.375 in.) such as those encountered on the SRB skirts are normally welded from both sides to minimize distortion. This presents a problem with the potential presence of undefined areas of incomplete fusion and the inability to detect these potential flaws by NDE techniques. To eliminate the possibility of an undetectable defect, weld joint design was revised to eliminate blind root penetrations. Weld parameters and mechanical property data were developed to verify the adequacy of the new joint design.

Bilateral blindness following anterior nasal packing in a case of nasopharyngeal angiofibroma.

PubMed

Sahoo, A K; Preetam, C; Kumar, R; Samal, D K

2016-11-01

Epistaxis is the most common ENT emergency encountered in the Emergency Department. Most cases can be managed by simple anterior nasal packing. This is usually a safe and very effective option in an emergency situation, requiring minimal expertise and infrastructure. This paper describes a rare instance of a serious complication following anterior nasal packing in a case of nasopharyngeal angiofibroma. A 27-year-old man diagnosed with nasopharyngeal angiofibroma presented to the Emergency Department with bilateral epistaxis. The patient was stabilised and anterior nasal packing was performed, which controlled the bleeding. Three hours later, the patient developed complete blindness in both eyes. Aggressive medical management was initiated immediately, but failed to restore the patient's vision. Anterior nasal packing is a simple and minimally invasive procedure practised regularly in an Emergency Department setting. However, it can occasionally lead to serious complications such as blindness. Thus, obtaining informed consent is essential to avoid medico-legal consequences in high-risk cases.

Disease-avoidance processes and stigmatization: cues of substandard health arouse heightened discomfort with physical contact.

PubMed

Park, Justin H; van Leeuwen, Florian; Chochorelou, Ypapanti

2013-01-01

An evolutionary approach to stigmatization suggests that disease-avoidance processes contribute to some instances of social exclusion. Disease-avoidance processes are over-inclusive, targeting even non-threatening individuals who display cues of substandard health. We investigated whether such cues motivate avoidance of physical contact in particular. In Studies 1 and 2, targets with disease (e.g., leprosy) or atypical morphologies (e.g., amputated leg, obesity) were found to arouse differentially heightened discomfort with physical (versus nonphysical) contact, whereas a criminal target (stigmatized for disease-irrelevant reasons) was found to arouse elevated discomfort for both types of contact. Study 3 used a between-subjects design that eliminated the influence of extraneous factors. A diseased target was found to arouse differentially heightened discomfort with physical (versus nonphysical) contact, and to do so more strongly than any other type of target.

Method of making quasi-grain boundary-free polycrystalline solar cell structure and solar cell structure obtained thereby

DOEpatents

Gonzalez, Franklin N.; Neugroschel, Arnost

1984-02-14

A new solar cell structure is provided which will increase the efficiency of polycrystalline solar cells by suppressing or completely eliminating the recombination losses due to the presence of grain boundaries. This is achieved by avoiding the formation of the p-n junction (or other types of junctions) in the grain boundaries and by eliminating the grain boundaries from the active area of the cell. This basic concept can be applied to any polycrystalline material; however, it will be most beneficial for cost-effective materials having small grains, including thin film materials.

Blindness and visual impairment in the Americas and the Caribbean

PubMed Central

Muñoz, B; West, S K

2002-01-01

Aim: To summarise available data on the prevalence and causes of visual impairment and blindness in the Americas and the Caribbean. Methods: The published literature was searched in Medline and LILACS using the following key words: blindness, visual impairment, prevalence. Articles were reviewed, and the references of the articles were also searched for relevant articles, which were also reviewed. Results: Using the mortality in children under the age of 5 as an indicator, the overall prevalence of childhood blindness (in the under age 15 group) for the region was estimated at 0.45/1000, with the majority (67%) living in countries with mortality of children under age 5 above 30/1000 live births. Corneal opacities were more common in countries where the under 5 year mortality are above 30/1000 live births and retinopathy of prematurity (ROP) was an important cause in countries with intermediate death rates. For adults, overall blindness rates were not estimated because of the social, economic, and ethnic diversity in the region. The primary causes of visual loss in adults in the Americas were age related eye diseases, notably cataract and glaucoma in the African-American and Hispanic populations, and age related macular degeneration in the white population. Uncorrected refractive error was a significant cause of decreased vision across ages, ethnic groups, and countries. Conclusion: More data are needed on the magnitude and causes of visual loss for the Caribbean and Latin American countries. Rates of blindness and visual loss from available data within these countries are widely disparate. Prevention and control of avoidable blindness needs to be an ongoing focus in this region. PMID:11973241

Infrared optical manufacturing trends

NASA Astrophysics Data System (ADS)

Myers, Jennifer L.; Alexay, Christopher C.

2005-10-01

This paper attempts to inform and educate readers to some of the more recent changes in infrared material pricing and availability along with the impact of optical manufacturing trends and the means by which optical designers, manufacturers and product end-users are using to avoid or eliminate the pitfalls these changes may create.

A Nitrogen Balance Experiment Using Simulated Urine Samples

ERIC Educational Resources Information Center

Sadighi, Mehri; Reichman, Nurit; Wilson, Kaye; Carne, Alan; Thompson, Mary P.

2006-01-01

We describe an undergraduate laboratory experiment that combines the advantages of problem-based learning with the need for biochemistry students to become proficient in practical laboratory skills. It also avoids the need to obtain ethical approval for recruiting volunteers and eliminates any possible biosafety issues with the handling and…

Gender-Based Linguistic Reform in International Organisations

ERIC Educational Resources Information Center

Teso, Elena; Crolley, Liz

2013-01-01

This paper analyses the policies proposed by three international organisations to eliminate the use of sexist language. This research compares the main guidelines and recommendations presented at supranational level by the United Nations, the Council of Europe and the European Union to avoid the use of sexist language. It then evaluates the…

Teaching Linear Algebra: Proceeding More Efficiently by Staying Comfortably within Z

ERIC Educational Resources Information Center

Beaver, Scott

2015-01-01

For efficiency in a linear algebra course the instructor may wish to avoid the undue arithmetical distractions of rational arithmetic. In this paper we explore how to write fraction-free problems of various types including elimination, matrix inverses, orthogonality, and the (non-normalizing) Gram-Schmidt process.

Liquid methane gelled with methanol and water reduces rate of nitrogen absorption

NASA Technical Reports Server (NTRS)

Vanderwall, E. M.

1972-01-01

Dilution of gelant vapor with inert carrier gas accomplishes gelation. Mixture is injected through heated tube and orifice into liquid methane for immediate condensation within bulk of liquid. Direct dispersion of particles in liquid avoids condensation on walls of vessel and eliminates additional mixing.

77 FR 16434 - Revocation of Multiple Domestic, Alaskan, and Hawaiian Compulsory Reporting Points

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-21

... previously removed from service and taken out of the FAA aeronautical database. The FAA is removing these... FAA's aeronautical database. This will avoid confusion and eliminate safety issues with existing fixes... and not contained in the FAA's aeronautical database as reporting points. The reporting points...

Grafting Technique to Eliminate Rootstock Suckering of Grafted Tomatoes

USDA-ARS?s Scientific Manuscript database

Vegetable grafting has been proposed as a technique for avoiding disease problems in tomatoes in open field production. In this study we investigated the current use of grafting in an open field scenario and found a serious problem with the grafting techniques. In the Fall of 2007, commercially pr...

Schools Get Smart about Energy

ERIC Educational Resources Information Center

Hoff, Randy

2011-01-01

Regardless of size or community served, school districts across California and the nation face one common challenge--a reduction in funding. Becoming more efficient in managing precious taxpayer dollars has become the highest priority for districts in order to minimize or avoid staff reductions or the elimination of student programs. Dozens of…

36 CFR 28.14 - Emergency action.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Emergency action. 28.14... Emergency action. If allowable by local law and if immediate action is essential to avoid or eliminate an... for undertaking the emergency action no longer exist, the agency or person shall cease an emergency...

Human cooperation by lethal group competition

PubMed Central

Egas, Martijn; Kats, Ralph; van der Sar, Xander; Reuben, Ernesto; Sabelis, Maurice W.

2013-01-01

Why humans are prone to cooperate puzzles biologists, psychologists and economists alike. Between-group conflict has been hypothesized to drive within-group cooperation. However, such conflicts did not have lasting effects in laboratory experiments, because they were about luxury goods, not needed for survival (“looting”). Here, we find within-group cooperation to last when between-group conflict is implemented as “all-out war” (eliminating the weakest groups). Human subjects invested in helping group members to avoid having the lowest collective pay-off, whereas they failed to cooperate in control treatments with random group elimination or with no subdivision in groups. When the game was repeated, experience was found to promote helping. Thus, not within-group interactions alone, not random group elimination, but pay-off-dependent group elimination was found to drive within-group cooperation in our experiment. We suggest that some forms of human cooperation are maintained by multi-level selection: reciprocity within groups and lethal competition among groups acting together. PMID:23459158

Diabetes Care and Treatment Project: A Diabetes Institute of the Walter Reed Health Care System and Joslin (and University of Hawaii) Telemedicine Initiative

DTIC Science & Technology

2010-04-01

project are the establishment of a telemedicine system for comprehensive diabetes management and the assessment of diabetic retinopathy that...virtually eliminate diabetic retinopathy as a cause of severe vision loss. Nevertheless, diabetes remains the leading cause of new blindness in working...Eye care module DESCRIPTION: The primary questions are: What are the costs associated with diabetic retinopathy evaluations performed by an

The Labouring Sleepwalker: Evocation and Expression as Modes of Qualitative Educational Research

ERIC Educational Resources Information Center

Smeyers, Paul

2005-01-01

This paper deals with the highly personal way an individual makes sense of the world in a way that avoids the pitfalls of the so-called private language. For Wittgenstein following a rule can never mean just following another rule, though we do follow rules blindly. His idea of the "form of life" elicits that "what we do" refers to what we have…

Is It Happening? How to Avoid the Deleterious Effects of Plagiarism and Cheating in Your Courses

ERIC Educational Resources Information Center

Hall, Susan E.

2011-01-01

Plagiarism can be "plaguing" if it is not discussed, understood, and enforced by the professor right at the beginning of the course and throughout the semester. Students usually don't "have" to cheat or plagiarize; they do so mainly because "they can." Professors who turn a deaf ear or a blind eye to students who plagiarize create deleterious…

A rationale for continuing mass antibiotic distributions for trachoma

PubMed Central

Ray, Kathryn J; Porco, Travis C; Hong, Kevin C; Lee, David C; Alemayehu, Wondu; Melese, Muluken; Lakew, Takele; Yi, Elizabeth; House, Jenafir; Chidambaram, Jaya D; Whitcher, John P; Gaynor, Bruce D; Lietman, Thomas M

2007-01-01

Background The World Health Organization recommends periodic mass antibiotic distributions to reduce the ocular strains of chlamydia that cause trachoma, the world's leading cause of infectious blindness. Their stated goal is to control infection, not to completely eliminate it. A single mass distribution can dramatically reduce the prevalence of infection. However, if infection is not eliminated in every individual in the community, it may gradually return back into the community, so often repeated treatments are necessary. Since public health groups are reluctant to distribute antibiotics indefinitely, we are still in need of a proven long-term rationale. Here we use mathematical models to demonstrate that repeated antibiotic distributions can eliminate infection in a reasonable time period. Methods We fit parameters of a stochastic epidemiological transmission model to data collected before and 6 months after a mass antibiotic distribution in a region of Ethiopia that is one of the most severely affected areas in the world. We validate the model by comparing our predicted results to Ethiopian data which was collected biannually for two years past the initial mass antibiotic distribution. We use the model to simulate the effect of different treatment programs in terms of local elimination of infection. Results Simulations show that the average prevalence of infection across all villages progressively decreases after each treatment, as long as the frequency and coverage of antibiotics are high enough. Infection can be eliminated in more villages with each round of treatment. However, in the communities where infection is not eliminated, it returns to the same average level, forming the same stationary distribution. This phenomenon is also seen in subsequent epidemiological data from Ethiopia. Simulations suggest that a biannual treatment plan implemented for 5 years will lead to elimination in 95% of all villages. Conclusion Local elimination from a community is theoretically possible, even in the most severely infected communities. However, elimination from larger areas may require repeated biannual treatments and prevention of re-introduction from outside to treated areas. PMID:17683646

A rationale for continuing mass antibiotic distributions for trachoma.

PubMed

Ray, Kathryn J; Porco, Travis C; Hong, Kevin C; Lee, David C; Alemayehu, Wondu; Melese, Muluken; Lakew, Takele; Yi, Elizabeth; House, Jenafir; Chidambaram, Jaya D; Whitcher, John P; Gaynor, Bruce D; Lietman, Thomas M

2007-08-07

The World Health Organization recommends periodic mass antibiotic distributions to reduce the ocular strains of chlamydia that cause trachoma, the world's leading cause of infectious blindness. Their stated goal is to control infection, not to completely eliminate it. A single mass distribution can dramatically reduce the prevalence of infection. However, if infection is not eliminated in every individual in the community, it may gradually return back into the community, so often repeated treatments are necessary. Since public health groups are reluctant to distribute antibiotics indefinitely, we are still in need of a proven long-term rationale. Here we use mathematical models to demonstrate that repeated antibiotic distributions can eliminate infection in a reasonable time period. We fit parameters of a stochastic epidemiological transmission model to data collected before and 6 months after a mass antibiotic distribution in a region of Ethiopia that is one of the most severely affected areas in the world. We validate the model by comparing our predicted results to Ethiopian data which was collected biannually for two years past the initial mass antibiotic distribution. We use the model to simulate the effect of different treatment programs in terms of local elimination of infection. Simulations show that the average prevalence of infection across all villages progressively decreases after each treatment, as long as the frequency and coverage of antibiotics are high enough. Infection can be eliminated in more villages with each round of treatment. However, in the communities where infection is not eliminated, it returns to the same average level, forming the same stationary distribution. This phenomenon is also seen in subsequent epidemiological data from Ethiopia. Simulations suggest that a biannual treatment plan implemented for 5 years will lead to elimination in 95% of all villages. Local elimination from a community is theoretically possible, even in the most severely infected communities. However, elimination from larger areas may require repeated biannual treatments and prevention of re-introduction from outside to treated areas.

Health system dynamics analysis of eyecare services in Trinidad and Tobago and progress towards Vision 2020 Goals.

PubMed

Braithwaite, Tasanee; Winford, Blaine; Bailey, Henry; Bridgemohan, Petra; Bartholomew, Debra; Singh, Deo; Sharma, Subash; Sharma, Rishi; Silva, Juan Carlos; Gray, Alastair; Ramsewak, Samuel S; Bourne, Rupert R A

2018-01-01

Avoidable blindness is an important global public health concern. This study aimed to assess Trinidad and Tobago's progress towards achieving the Pan American Health Organization, 'Strategic Framework for Vision 2020: The Right to Sight-Caribbean Region,' indicators through comprehensive review of the eyecare system, in order to facilitate health system priority setting. We administered structured surveys to six stakeholder groups, including eyecare providers, patients and older adult participants in the National Eye Survey of Trinidad and Tobago. We reviewed reports, registers and policy documents, and used a health system dynamics framework to synthesize data. In 2014, the population of 1.3 million were served by a pluralistic eyecare system, which had achieved 14 out of 27 Strategic Framework indicators. The Government provided free primary, secondary and emergency eyecare services, through 108 health centres and 5 hospitals (0.26 ophthalmologists and 1.32 ophthalmologists-in-training per 50 000 population). Private sector optometrists (4.37 per 50 000 population), and ophthalmologists (0.93 per 50 000 population) provided 80% of all eyecare. Only 19.3% of the adult population had private health insurance, revealing significant out-of-pocket expenditure. We identified potential weaknesses in the eyecare system where investment might reduce avoidable blindness. These included a need for more ophthalmic equipment and maintenance in the public sector, national screening programmes for diabetic retinopathy, retinopathy of prematurity and neonatal eye defects, and pathways to ensure timely and equitable access to subspecialized surgery. Eyecare for older adults was responsible for an estimated 9.5% (US$22.6 million) of annual health expenditure. This study used the health system dynamics framework and new data to identify priorities for eyecare system strengthening. We recommend this approach for exploring potential health system barriers to addressing avoidable blindness, and other important public health problems. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Ecology and vegetarian considerations: does environmental responsibility demand the elimination of livestock?

PubMed

Gussow, J D

1994-05-01

Although the recommendation to avoid animal flesh for environmental reasons has been increasingly advanced, especially in the highly industrialized countries, the ecological implications of such avoidance are seldom carefully examined. If sustainable food systems are to be modeled after natural systems that maintain fertility, both plants and animals would be involved. This paper examines the history of the idea that environmental responsibility is linked to vegetarianism and the destructive effects of present methods of animal raising on farmers, animal welfare, and the environment. Finally, it explores the question of whether vegetarianism is the appropriate response to these problems.

Environmental controls and avoidance measures.

PubMed

Krouse, Helene J

2014-09-01

Environmental control measures refer to using 1 or more interventions aimed at avoiding, reducing, or eliminating allergens and irritants in the environment to improve symptoms of allergic rhinitis. Although avoiding known allergens is highly effective, completely eliminating an allergen from one's environment is often impractical or even impossible. The purpose of this work is to review evidence on the efficacy of various environmental control measures aimed at preventing the development of new sensitizations, reducing the progression of allergic rhinitis, and improving its symptoms and quality of life. Current literature examining the protective effects of specific measures such as breastfeeding and early pet exposure against the development of allergic diseases including allergic rhinitis has been inconclusive. Environmental measures such as frequently washing cats and dogs, encasing bedding within impermeable covers, air filtration, and chemicals can effectively reduce levels of allergens in the home. Although environmental control measures reduce allergen exposure levels, significant alleviation in symptoms or improvement in quality of life in patients with allergic rhinitis have not been shown. An evidence-based approach can assist health providers in educating patients and helping them to make informed decisions in selecting the most appropriate and cost-effective environmental control strategies to manage their disease. The greatest benefits can be achieved from using a multifaceted environmental approach aimed at routinely and systematically reducing exposure to allergens over time. © 2014 ARS-AAOA, LLC.

Advanced experimental techniques for transonic wind tunnels - Final lecture

NASA Technical Reports Server (NTRS)

Kilgore, Robert A.

1987-01-01

A philosophy of experimental techniques is presented, suggesting that in order to be successful, one should like what one does, have the right tools, stick to the job, avoid diversions, work hard, interact with people, be informed, keep it simple, be self sufficient, and strive for perfection. Sources of information, such as bibliographies, newsletters, technical reports, and technical contacts and meetings are recommended. It is pointed out that adaptive-wall test sections eliminate or reduce wall interference effects, and magnetic suspension and balance systems eliminate support-interference effects, while the problem of flow quality remains with all wind tunnels. It is predicted that in the future it will be possible to obtain wind tunnel results at the proper Reynolds number, and the effects of flow unsteadiness, wall interference, and support interference will be eliminated or greatly reduced.

Real-time obstacle avoidance using harmonic potential functions

NASA Technical Reports Server (NTRS)

Kim, Jin-Oh; Khosla, Pradeep K.

1992-01-01

This paper presents a new formulation of the artificial potential approach to the obstacle avoidance problem for a mobile robot or a manipulator in a known environment. Previous formulations of artificial potentials for obstacle avoidance have exhibited local minima in a cluttered environment. To build an artificial potential field, harmonic functions that completely eliminate local minima even for a cluttered environment are used. The panel method is employed to represent arbitrarily shaped obstacles and to derive the potential over the whole space. Based on this potential function, an elegant control strategy is proposed for the real-time control of a robot. The harmonic potential, the panel method, and the control strategy are tested with a bar-shaped mobile robot and a three-degree-of-freedom planar redundant manipulator.

Experiences of model year 2011 Dodge and Jeep owners with collision avoidance and related technologies.

PubMed

Cicchino, Jessica B; McCartt, Anne T

2015-01-01

Crash avoidance technologies have the potential to prevent or mitigate many crashes, but their effectiveness depends on drivers' acceptance and proper use. Owners of 2011 Dodge Charger, Dodge Durango, and Jeep Grand Cherokee vehicles were interviewed about their experiences with their vehicles' technologies. Interviews were conducted in April 2013 with 215 owners of Dodge and Jeep vehicles with adaptive cruise control and forward collision warning and 215 owners with blind spot monitoring and rear cross-path detection. Most owners said that they always keep each collision avoidance technology turned on, and more than 90% of owners with each system would want the technology again on their next vehicle. The majority believed that the systems had helped prevent a collision; this ranged from 54% of drivers with forward collision warning to more than three-quarters with blind spot monitoring and rear cross-path detection. Some owners reported behavioral changes with the systems, but over-reliance on them is not prevalent. Reported use of the systems varied by the age and gender of the driver and duration of vehicle ownership to a greater degree than in previous surveys of luxury Volvo and Infiniti vehicles with collision avoidance technologies. Notably, drivers aged 40 and younger were most likely to report that forward collision warning had alerted them multiple times and that it had prevented a collision and that they follow the vehicle ahead less closely with adaptive cruise control. Reports of waiting for the alert from forward collision warning before braking were infrequent but increased with duration of ownership. However, these reports could reflect confusion of the system with adaptive cruise control, which alerts drivers when braking is necessary to maintain a preset speed or following distance but a crash is not imminent. Consistent with previous surveys of luxury vehicle owners with collision avoidance technologies, acceptance and use remains high among owners of more mainstream vehicles. Varying experiences with the technologies by driver age and gender suggest that safety benefits are not uniform for all drivers, and differential benefits may become increasingly apparent as collision avoidance technologies become available to a more heterogeneous population of drivers. The potential for over-reliance on the technologies should continue to be monitored, especially as drivers gain more experience with them.

Augmenting Outpatient Alcohol Treatment as Usual With Online Alcohol Avoidance Training: Protocol for a Double-Blind Randomized Controlled Trial.

PubMed

Bratti-van der Werf, Marleen Kj; Laurens, Melissa C; Postel, Marloes G; Pieterse, Marcel E; Ben Allouch, Somaya; Wiers, Reinout W; Bohlmeijer, Ernst T; Salemink, Elske

2018-03-01

Recent theoretical models emphasize the role of impulsive processes in alcohol addiction, which can be retrained with computerized Cognitive Bias Modification (CBM) training. In this study, the focus is on action tendencies that are activated relatively automatically. The aim of the study is to examine the effectiveness of online CBM Alcohol Avoidance Training using an adapted Approach-Avoidance Task as a supplement to treatment as usual (TAU) in an outpatient treatment setting. The effectiveness of 8 online sessions of CBM Alcohol Avoidance Training added to TAU is tested in a double-blind, randomized controlled trial with pre- and postassessments, plus follow-up assessments after 3 and 6 months. Participants are adult patients (age 18 years or over) currently following Web-based or face-to-face TAU to reduce or stop drinking. These patients are randomly assigned to a CBM Alcohol Avoidance or a placebo training. The primary outcome measure is a reduction in alcohol consumption. We hypothesize that TAU + CBM will result in up to a 13-percentage point incremental effect in the number of patients reaching the safe drinking guidelines compared to TAU + placebo CBM. Secondary outcome measures include an improvement in health status and a decrease in depression, anxiety, stress, and possible mediation by the change in approach bias. Finally, patients' adherence, acceptability, and credibility will be examined. The trial was funded in 2014 and is currently in the active participant recruitment phase (since May 2015). Enrolment will be completed in 2019. First results are expected to be submitted for publication in 2020. The main purpose of this study is to increase our knowledge about the added value of online Alcohol Avoidance Training as a supplement to TAU in an outpatient treatment setting. If the added effectiveness of the training is proven, the next step could be to incorporate the intervention into current treatment. Netherlands Trial Register NTR5087; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5087 (Archived at WebCite http://www.webcitation.org/6wuS4i1tH). ©Marleen KJ Bratti-van der Werf, Melissa C Laurens, Marloes G Postel, Marcel E Pieterse, Somaya Ben Allouch, Reinout W Wiers, Ernst T Bohlmeijer, Elske Salemink. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 01.03.2018.

Key considerations for the experimental training and evaluation of cancer odour detection dogs: lessons learnt from a double-blind, controlled trial of prostate cancer detection

PubMed Central

2014-01-01

Background Cancer detection using sniffer dogs is a potential technology for clinical use and research. Our study sought to determine whether dogs could be trained to discriminate the odour of urine from men with prostate cancer from controls, using rigorous testing procedures and well-defined samples from a major research hospital. Methods We attempted to train ten dogs by initially rewarding them for finding and indicating individual prostate cancer urine samples (Stage 1). If dogs were successful in Stage 1, we then attempted to train them to discriminate prostate cancer samples from controls (Stage 2). The number of samples used to train each dog varied depending on their individual progress. Overall, 50 unique prostate cancer and 67 controls were collected and used during training. Dogs that passed Stage 2 were tested for their ability to discriminate 15 (Test 1) or 16 (Tests 2 and 3) unfamiliar prostate cancer samples from 45 (Test 1) or 48 (Tests 2 and 3) unfamiliar controls under double-blind conditions. Results Three dogs reached training Stage 2 and two of these learnt to discriminate potentially familiar prostate cancer samples from controls. However, during double-blind tests using new samples the two dogs did not indicate prostate cancer samples more frequently than expected by chance (Dog A sensitivity 0.13, specificity 0.71, Dog B sensitivity 0.25, specificity 0.75). The other dogs did not progress past Stage 1 as they did not have optimal temperaments for the sensitive odour discrimination training. Conclusions Although two dogs appeared to have learnt to select prostate cancer samples during training, they did not generalise on a prostate cancer odour during robust double-blind tests involving new samples. Our study illustrates that these rigorous tests are vital to avoid drawing misleading conclusions about the abilities of dogs to indicate certain odours. Dogs may memorise the individual odours of large numbers of training samples rather than generalise on a common odour. The results do not exclude the possibility that dogs could be trained to detect prostate cancer. We recommend that canine olfactory memory is carefully considered in all future studies and rigorous double-blind methods used to avoid confounding effects. PMID:24575737

Evaluation of a novel technique for wound closure using a barbed suture.

PubMed

Murtha, Amy P; Kaplan, Andrew L; Paglia, Michael J; Mills, Benjie B; Feldstein, Michael L; Ruff, Gregory L

2006-05-01

Suture knots present several disadvantages in wound closure, because they are tedious to tie and place ischemic demands on tissue. Bulky knots may be a nidus for infection, and they may extrude through skin weeks after surgery. Needle manipulations during knot-tying predispose the surgeon to glove perforation. A barbed suture was developed that is self-anchoring, requiring no knots or slack management for wound closure. The elimination of knot tying may have advantages over conventional wound closure methods. This prospective, randomized, controlled trial was designed to show that the use of barbed suture in dermal closure of the Pfannenstiel incision during nonemergent cesarean delivery surgery produces scar cosmesis at 5 weeks that is no worse than that observed with conventional closure using 3-0 polydioxanone suture. Cosmesis was assessed by review of postoperative photographs by a blinded, independent plastic surgeon using the modified Hollander cosmesis score. Secondary endpoints included infection, dehiscence, pain, closure time, and other adverse events. The study enrolled 195 patients, of whom 188 were eligible for analysis. Cosmesis scores did not significantly differ between the barbed suture group and the control group. Rates of infection, dehiscence, and other adverse events did not significantly differ between the two groups. Closure time and pain scores were comparable between the groups. The barbed suture represents an innovative option for wound closure. With a cosmesis and safety profile that is similar to that of conventional suture technique, it avoids the drawbacks inherent to suture knots.

Health systems analysis of eye care services in Zambia: evaluating progress towards VISION 2020 goals.

PubMed

Bozzani, Fiammetta Maria; Griffiths, Ulla Kou; Blanchet, Karl; Schmidt, Elena

2014-02-28

VISION 2020 is a global initiative launched in 1999 to eliminate avoidable blindness by 2020. The objective of this study was to undertake a situation analysis of the Zambian eye health system and assess VISION 2020 process indicators on human resources, equipment and infrastructure. All eye health care providers were surveyed to determine location, financing sources, human resources and equipment. Key informants were interviewed regarding levels of service provision, management and leadership in the sector. Policy papers were reviewed. A health system dynamics framework was used to analyse findings. During 2011, 74 facilities provided eye care in Zambia; 39% were public, 37% private for-profit and 24% owned by Non-Governmental Organizations. Private facilities were solely located in major cities. A total of 191 people worked in eye care; 18 of these were ophthalmologists and eight cataract surgeons, equivalent to 0.34 and 0.15 per 250,000 population, respectively. VISION 2020 targets for inpatient beds and surgical theatres were met in six out of nine provinces, but human resources and spectacles manufacturing workshops were below target in every province. Inequalities in service provision between urban and rural areas were substantial. Shortage and maldistribution of human resources, lack of routine monitoring and inadequate financing mechanisms are the root causes of underperformance in the Zambian eye health system, which hinder the ability to achieve the VISION 2020 goals. We recommend that all VISION 2020 process indicators are evaluated simultaneously as these are not individually useful for monitoring progress.

Drawing enhances cross-modal memory plasticity in the human brain: a case study in a totally blind adult

PubMed Central

Likova, Lora T.

2012-01-01

In a memory-guided drawing task under blindfolded conditions, we have recently used functional Magnetic Resonance Imaging (fMRI) to demonstrate that the primary visual cortex (V1) may operate as the visuo-spatial buffer, or “sketchpad,” for working memory. The results implied, however, a modality-independent or amodal form of its operation. In the present study, to validate the role of V1 in non-visual memory, we eliminated not only the visual input but all levels of visual processing by replicating the paradigm in a congenitally blind individual. Our novel Cognitive-Kinesthetic method was used to train this totally blind subject to draw complex images guided solely by tactile memory. Control tasks of tactile exploration and memorization of the image to be drawn, and memory-free scribbling were also included. FMRI was run before training and after training. Remarkably, V1 of this congenitally blind individual, which before training exhibited noisy, immature, and non-specific responses, after training produced full-fledged response time-courses specific to the tactile-memory drawing task. The results reveal the operation of a rapid training-based plasticity mechanism that recruits the resources of V1 in the process of learning to draw. The learning paradigm allowed us to investigate for the first time the evolution of plastic re-assignment in V1 in a congenitally blind subject. These findings are consistent with a non-visual memory involvement of V1, and specifically imply that the observed cortical reorganization can be empowered by the process of learning to draw. PMID:22593738

Drawing enhances cross-modal memory plasticity in the human brain: a case study in a totally blind adult.

PubMed

Likova, Lora T

2012-01-01

In a memory-guided drawing task under blindfolded conditions, we have recently used functional Magnetic Resonance Imaging (fMRI) to demonstrate that the primary visual cortex (V1) may operate as the visuo-spatial buffer, or "sketchpad," for working memory. The results implied, however, a modality-independent or amodal form of its operation. In the present study, to validate the role of V1 in non-visual memory, we eliminated not only the visual input but all levels of visual processing by replicating the paradigm in a congenitally blind individual. Our novel Cognitive-Kinesthetic method was used to train this totally blind subject to draw complex images guided solely by tactile memory. Control tasks of tactile exploration and memorization of the image to be drawn, and memory-free scribbling were also included. FMRI was run before training and after training. Remarkably, V1 of this congenitally blind individual, which before training exhibited noisy, immature, and non-specific responses, after training produced full-fledged response time-courses specific to the tactile-memory drawing task. The results reveal the operation of a rapid training-based plasticity mechanism that recruits the resources of V1 in the process of learning to draw. The learning paradigm allowed us to investigate for the first time the evolution of plastic re-assignment in V1 in a congenitally blind subject. These findings are consistent with a non-visual memory involvement of V1, and specifically imply that the observed cortical reorganization can be empowered by the process of learning to draw.

[The road to elimination: an overview of neglected infectious diseases in Latin America and the Caribbean].

PubMed

Ault, Steven Kenyon; Catalá Pascual, Laura; Grados-Zavala, Maria Elena; Gonzálvez García, Guillermo; Castellanos, Luis Gerardo

2014-04-01

Neglected infectious diseases (NID) affect mainly isolated populations living in isolation and in poor socioeconomic conditions. These diseases, by their chronic and silent nature, often affect communities with a weak political voice. This translates into very little attention or political priority; which is reflected in minimal and insufficient preventive measures, monitoring and control. However, there is evidence this situation is changing favorably in some countries of the Americas. In recent years, several resolutions (official agreement of the member countries of the Pan American Health Organization / World Health Organization-PAHO / WHO), regional and global agreements on public health; with a greater commitment from the pharmaceutical industry, and other donors and international partners in combination with the development and use of integrated action plans have allowed countries to intensify public interventions to control these diseases and thus achieve target elimination of NID. Onchocerciasis, lymphatic filariasis, Chagas disease, leprosy and trachoma blindness, among others, have been eliminated in several countries and endemic areas, regardless of the level of development of the country or geographical area where they are located. The political decision reflected in adequate financial resources in the next decade will be crucial to achieving the goals of elimination of NID (regional and national).

Devising, Implementing, and Evaluating Interventions to Eliminate Health Care Disparities in Minority Children

PubMed Central

Flores, Glenn

2010-01-01

Despite an accumulating body of literature addressing racial/ethnic disparities in children’s health and health care, there have been few published studies of interventions that have been successful in eliminating these disparities. The objectives of this article, therefore, are to (1) describe 3 interventions that have been successful in eliminating racial/ethnic disparities in children’s health and health care, (2) high-light tips and pitfalls regarding devising, implementing, and evaluating pediatric disparities interventions, and (3) propose a research agenda for pediatric disparities interventions. Key characteristics of the 3 successful interventions include rigorous study designs; large sample sizes; appropriate comparison groups; community-based interventions that are culturally and linguistically sensitive and involve collaboration with participants; research staff from the same community as the participants; appropriate blinding of outcomes assessors; and statistical adjustment of outcomes for relevant covariates. On the basis of these characteristics, I propose tips, pitfalls, an approach, and a research agenda for devising, implementing, and evaluating successful pediatric disparities interventions. Examination of 3 successful interventions indicates that pediatric health care disparities can be eliminated. Achievement of this goal requires an intervention that is rigorous, evidence-based, and culturally and linguistically appropriate. The intervention must also include community collaboration, minimize attrition, adjust for potential confounders, and incorporate mechanisms for sustainability. PMID:19861473

Devising, implementing, and evaluating interventions to eliminate health care disparities in minority children.

PubMed

Flores, Glenn

2009-11-01

Despite an accumulating body of literature addressing racial/ethnic disparities in children's health and health care, there have been few published studies of interventions that have been successful in eliminating these disparities. The objectives of this article, therefore, are to (1) describe 3 interventions that have been successful in eliminating racial/ethnic disparities in children's health and health care, (2) highlight tips and pitfalls regarding devising, implementing, and evaluating pediatric disparities interventions, and (3) propose a research agenda for pediatric disparities interventions. Key characteristics of the 3 successful interventions include rigorous study designs; large sample sizes; appropriate comparison groups; community-based interventions that are culturally and linguistically sensitive and involve collaboration with participants; research staff from the same community as the participants; appropriate blinding of outcomes assessors; and statistical adjustment of outcomes for relevant covariates. On the basis of these characteristics, I propose tips, pitfalls, an approach, and a research agenda for devising, implementing, and evaluating successful pediatric disparities interventions. Examination of 3 successful interventions indicates that pediatric health care disparities can be eliminated. Achievement of this goal requires an intervention that is rigorous, evidence-based, and culturally and linguistically appropriate. The intervention must also include community collaboration, minimize attrition, adjust for potential confounders, and incorporate mechanisms for sustainability.

Conditioned food aversion for control of poisoning by Ipomoea carnea subsp. fistulosa

USDA-ARS?s Scientific Manuscript database

Conditioned food aversion is a technique that can be used to train livestock to avoid ingestion of poisonous plants. This study tested the efficacy and durability of conditioned food aversion to eliminate goat’s consumption of Ipomoea carnea subsp. fistulosa. We used 14 young Moxotó goats, which wer...

Avoid Workplace Injury through Ergonomics | Poster

Cancer.gov

Ergonomics is “the scientific study of people at work,” with the goal of reducing stress and eliminating injuries associated with overused muscles, bad posture, and repeated tasks, according to the Centers for Disease Control and Prevention (CDC). The Occupational Safety and Health Administration (OSHA) states that working ergonomically reduces muscle fatigue, increases

Considering Layoffs? Tips for Avoiding Legal Problems

ERIC Educational Resources Information Center

Kelderman, Eric

2009-01-01

The fiscal year that begins on July 1 for most colleges is expected to bring a wave of layoffs, as institutions grapple with declining state contributions, a falloff in donations, and other budget pressures. Eliminating jobs can create a number of legal pitfalls, including potential lawsuits for breach of contract or discrimination. If handled…

76 FR 68512 - Carolina Power & Light Company; H. B. Robinson Steam Electric Plant, Unit 2; Exemption

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-04

... (~1 percent). The elimination of tin has resulted in superior corrosion resistance and reduced irradiation-induced growth relative to both standard zircaloy (1.7 percent tin) and low-tin zircaloy (1.2 percent tin). The addition of niobium increases ductility, which is desirable to avoid brittle failures...

43 CFR 3809.5 - How does BLM define certain terms used in this subpart?

Code of Federal Regulations, 2011 CFR

2011-10-01

... (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINING CLAIMS... may determine that it is practical to avoid or eliminate particular impacts. Mining claim means any unpatented mining claim, millsite, or tunnel site located under the mining laws. The term also applies to...

43 CFR 3809.5 - How does BLM define certain terms used in this subpart?

Code of Federal Regulations, 2012 CFR

2012-10-01

... (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINING CLAIMS... may determine that it is practical to avoid or eliminate particular impacts. Mining claim means any unpatented mining claim, millsite, or tunnel site located under the mining laws. The term also applies to...

43 CFR 3809.5 - How does BLM define certain terms used in this subpart?

Code of Federal Regulations, 2013 CFR

2013-10-01

... (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINING CLAIMS... may determine that it is practical to avoid or eliminate particular impacts. Mining claim means any unpatented mining claim, millsite, or tunnel site located under the mining laws. The term also applies to...

43 CFR 3809.5 - How does BLM define certain terms used in this subpart?

Code of Federal Regulations, 2014 CFR

2014-10-01

... (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINING CLAIMS... may determine that it is practical to avoid or eliminate particular impacts. Mining claim means any unpatented mining claim, millsite, or tunnel site located under the mining laws. The term also applies to...

Revolving Classroom Door: Management Strategies To Eliminate the Quick Spin.

ERIC Educational Resources Information Center

Rancifer, Jesse L.

This paper presents classroom management practices that can be used to avoid the "revolving classroom door." In the revolving classroom door, misbehaving students are sent to the principal, and eventually returned to the classroom with no gains in student behavior or opportunity for learning. The paper begins by discussing the meaning of classroom…

A Drosophila Gustatory Receptor Required for Strychnine Sensation.

PubMed

Lee, Youngseok; Moon, Seok Jun; Wang, Yijin; Montell, Craig

2015-09-01

Strychnine is a potent, naturally occurring neurotoxin that effectively protects plants from animal pests by deterring feeding behavior. In insects, such as the fruit fly, Drosophila melanogaster, bitter-tasting aversive compounds are detected primarily through a family of gustatory receptors (GRs), which are expressed in gustatory receptor neurons. We previously described multiple GRs that eliminate the behavioral avoidance to all bitter compounds tested, with the exception of strychnine. Here, we report the identity of a strychnine receptor, referred to as GR47a. We generated a mutation in Gr47a and found that it eliminated strychnine repulsion and strychnine-induced action potentials. GR47a was narrowly tuned, as the responses to other avoidance compounds were unaffected in the mutant animals. This analysis supports an emerging model that Drosophila GRs fall broadly into two specificity classes-one class is comprised of core receptors that are broadly required, whereas the other class, which includes GR47a, consists of narrowly tuned receptors that define chemical specificity. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Adaptive color demosaicing and false color removal

NASA Astrophysics Data System (ADS)

Guarnera, Mirko; Messina, Giuseppe; Tomaselli, Valeria

2010-04-01

Color interpolation solutions drastically influence the quality of the whole image generation pipeline, so they must guarantee the rendering of high quality pictures by avoiding typical artifacts such as blurring, zipper effects, and false colors. Moreover, demosaicing should avoid emphasizing typical artifacts of real sensors data, such as noise and green imbalance effect, which would be further accentuated by the subsequent steps of the processing pipeline. We propose a new adaptive algorithm that decides the interpolation technique to apply to each pixel, according to its neighborhood analysis. Edges are effectively interpolated through a directional filtering approach that interpolates the missing colors, selecting the suitable filter depending on edge orientation. Regions close to edges are interpolated through a simpler demosaicing approach. Thus flat regions are identified and low-pass filtered to eliminate some residual noise and to minimize the annoying green imbalance effect. Finally, an effective false color removal algorithm is used as a postprocessing step to eliminate residual color errors. The experimental results show how sharp edges are preserved, whereas undesired zipper effects are reduced, improving the edge resolution itself and obtaining superior image quality.

Distributed capillary adiabatic tissue homogeneity model in parametric multi-channel blind AIF estimation using DCE-MRI.

PubMed

Kratochvíla, Jiří; Jiřík, Radovan; Bartoš, Michal; Standara, Michal; Starčuk, Zenon; Taxt, Torfinn

2016-03-01

One of the main challenges in quantitative dynamic contrast-enhanced (DCE) MRI is estimation of the arterial input function (AIF). Usually, the signal from a single artery (ignoring contrast dispersion, partial volume effects and flow artifacts) or a population average of such signals (also ignoring variability between patients) is used. Multi-channel blind deconvolution is an alternative approach avoiding most of these problems. The AIF is estimated directly from the measured tracer concentration curves in several tissues. This contribution extends the published methods of multi-channel blind deconvolution by applying a more realistic model of the impulse residue function, the distributed capillary adiabatic tissue homogeneity model (DCATH). In addition, an alternative AIF model is used and several AIF-scaling methods are tested. The proposed method is evaluated on synthetic data with respect to the number of tissue regions and to the signal-to-noise ratio. Evaluation on clinical data (renal cell carcinoma patients before and after the beginning of the treatment) gave consistent results. An initial evaluation on clinical data indicates more reliable and less noise sensitive perfusion parameter estimates. Blind multi-channel deconvolution using the DCATH model might be a method of choice for AIF estimation in a clinical setup. © 2015 Wiley Periodicals, Inc.

The Diabetic Retinopathy Screening Workflow: Potential for Smartphone Imaging.

PubMed

Bolster, Nigel M; Giardini, Mario E; Bastawrous, Andrew

2015-11-23

Complications of diabetes mellitus, namely diabetic retinopathy and diabetic maculopathy, are the leading cause of blindness in working aged people. Sufferers can avoid blindness if identified early via retinal imaging. Systematic screening of the diabetic population has been shown to greatly reduce the prevalence and incidence of blindness within the population. Many national screening programs have digital fundus photography as their basis. In the past 5 years several techniques and adapters have been developed that allow digital fundus photography to be performed using smartphones. We review recent progress in smartphone-based fundus imaging and discuss its potential for integration into national systematic diabetic retinopathy screening programs. Some systems have produced promising initial results with respect to their agreement with reference standards. However further multisite trialling of such systems' use within implementable screening workflows is required if an evidence base strong enough to affect policy change is to be established. If this were to occur national diabetic retinopathy screening would, for the first time, become possible in low- and middle-income settings where cost and availability of trained eye care personnel are currently key barriers to implementation. As diabetes prevalence and incidence is increasing sharply in these settings, the impact on global blindness could be profound. © 2015 Diabetes Technology Society.

A Clinical Picture of the Visual Outcome in Adamantiades-Behçet's Disease

PubMed Central

Figus, Michele; Albert, Timothy G.; Talarico, Rosaria; Nardi, Marco

2015-01-01

Adamantiades-Behçet's disease is a multisystemic vasculitis with multiorgan involvement. Ocular disorders occur often in this syndrome typically in the form of a relapsing-remitting panuveitis and vasculitis and can lead to blindness as one of its most disabling complications if left untreated. There are known risk factors related with the worst visual prognosis, which require early and intensive treatment in order to obtain a rapid suppression of inflammation and to prevent future relapses. The management strategy to avoid vision loss and blindness currently involves the use of local and systemic drugs including steroids and immunosuppressive and biologic agents. This review aims to demonstrate how the introduction and the use of biologic agents improves the visual outcome of patients with Adamantiades-Behçet's disease. PMID:26558256

Preventing medication errors in cancer chemotherapy.

PubMed

Cohen, M R; Anderson, R W; Attilio, R M; Green, L; Muller, R J; Pruemer, J M

1996-04-01

Recommendations for preventing medication errors in cancer chemotherapy are made. Before a health care provider is granted privileges to prescribe, dispense, or administer antineoplastic agents, he or she should undergo a tailored educational program and possibly testing or certification. Appropriate reference materials should be developed. Each institution should develop a dose-verification process with as many independent checks as possible. A detailed checklist covering prescribing, transcribing, dispensing, and administration should be used. Oral orders are not acceptable. All doses should be calculated independently by the physician, the pharmacist, and the nurse. Dosage limits should be established and a review process set up for doses that exceed the limits. These limits should be entered into pharmacy computer systems, listed on preprinted order forms, stated on the product packaging, placed in strategic locations in the institution, and communicated to employees. The prescribing vocabulary must be standardized. Acronyms, abbreviations, and brand names must be avoided and steps taken to avoid other sources of confusion in the written orders, such as trailing zeros. Preprinted antineoplastic drug order forms containing checklists can help avoid errors. Manufacturers should be encouraged to avoid or eliminate ambiguities in drug names and dosing information. Patients must be educated about all aspects of their cancer chemotherapy, as patients represent a last line of defense against errors. An interdisciplinary team at each practice site should review every medication error reported. Pharmacists should be involved at all sites where antineoplastic agents are dispensed. Although it may not be possible to eliminate all medication errors in cancer chemotherapy, the risk can be minimized through specific steps. Because of their training and experience, pharmacists should take the lead in this effort.

Blind system identification of two-thermocouple sensor based on cross-relation method.

PubMed

Li, Yanfeng; Zhang, Zhijie; Hao, Xiaojian

2018-03-01

In dynamic temperature measurement, the dynamic characteristics of the sensor affect the accuracy of the measurement results. Thermocouples are widely used for temperature measurement in harsh conditions due to their low cost, robustness, and reliability, but because of the presence of the thermal inertia, there is a dynamic error in the dynamic temperature measurement. In order to eliminate the dynamic error, two-thermocouple sensor was used to measure dynamic gas temperature in constant velocity flow environments in this paper. Blind system identification of two-thermocouple sensor based on a cross-relation method was carried out. Particle swarm optimization algorithm was used to estimate time constants of two thermocouples and compared with the grid based search method. The method was validated on the experimental equipment built by using high temperature furnace, and the input dynamic temperature was reconstructed by using the output data of the thermocouple with small time constant.

Repetition blindness has a perceptual locus: evidence from online processing of targets in RSVP streams

NASA Technical Reports Server (NTRS)

Johnston, James C.; Hochhaus, Larry; Ruthruff, Eric

2002-01-01

Four experiments tested whether repetition blindness (RB; reduced accuracy reporting repetitions of briefly displayed items) is a perceptual or a memory-recall phenomenon. RB was measured in rapid serial visual presentation (RSVP) streams, with the task altered to reduce memory demands. In Experiment 1 only the number of targets (1 vs. 2) was reported, eliminating the need to remember target identities. Experiment 2 segregated repeated and nonrepeated targets into separate blocks to reduce bias against repeated targets. Experiments 3 and 4 required immediate "online" buttonpress responses to targets as they occurred. All 4 experiments showed very strong RB. Furthermore, the online response data showed clearly that the 2nd of the repeated targets is the one missed. The present results show that in the RSVP paradigm, RB occurs online during initial stimulus encoding and decision making. The authors argue that RB is indeed a perceptual phenomenon.

Does granisetron eliminate the gag reflex? A crossover, double-blind, placebo-controlled pilot study.

PubMed

Barenboim, Silvina Friedlander; Dvoyris, Vladislav; Kaufman, Eliezer

2009-01-01

Although gagging is a frequent problem that, when severe, can jeopardize the dental procedure, no single protocol is used to alleviate this phenomenon. Selective 5-HT3 antagonists, such as granisetron, may attenuate gagging. In this study, granisetron and placebo were administered intravenously, in a crossover, double-blind manner, to 25 healthy volunteers in 2 different sessions. Gagging levels were recorded before and after administration, as were BP, pulse, and O2 saturation. Recorded results were analyzed with the use of tests for nonparametric values (P = .05). A significant increase in the depth of swab insertion was noted after administration of both placebo and drug. The increase in drug effectiveness correlated with decreased body weight. The true efficacy of granisetron in gagger patients with this treatment protocol has yet to be fully established, although it has been theorized that an increased dosage of granisetron may have a better effect.

Does Granisetron Eliminate the Gag Reflex? A Crossover, Double-Blind, Placebo-Controlled Pilot Study

PubMed Central

Friedlander Barenboim, Silvina; Dvoyris, Vladislav; Kaufman, Eliezer

2009-01-01

Although gagging is a frequent problem that, when severe, can jeopardize the dental procedure, no single protocol is used to alleviate this phenomenon. Selective 5-HT3 antagonists, such as granisetron, may attenuate gagging. In this study, granisetron and placebo were administered intravenously, in a crossover, double-blind manner, to 25 healthy volunteers in 2 different sessions. Gagging levels were recorded before and after administration, as were BP, pulse, and O2 saturation. Recorded results were analyzed with the use of tests for nonparametric values (P = .05). A significant increase in the depth of swab insertion was noted after administration of both placebo and drug. The increase in drug effectiveness correlated with decreased body weight. The true efficacy of granisetron in gagger patients with this treatment protocol has yet to be fully established, although it has been theorized that an increased dosage of granisetron may have a better effect. PMID:19562886

Forward and inverse solutions for three-element Risley prism beam scanners.

PubMed

Li, Anhu; Liu, Xingsheng; Sun, Wansong

2017-04-03

Scan blind zone and control singularity are two adverse issues for the beam scanning performance in double-prism Risley systems. In this paper, a theoretical model which introduces a third prism is developed. The critical condition for a fully eliminated scan blind zone is determined through a geometric derivation, providing several useful formulae for three-Risley-prism system design. Moreover, inverse solutions for a three-prism system are established, based on the damped least-squares iterative refinement by a forward ray tracing method. It is shown that the efficiency of this iterative calculation of the inverse solutions can be greatly enhanced by a numerical differentiation method. In order to overcome the control singularity problem, the motion law of any one prism in a three-prism system needs to be conditioned, resulting in continuous and steady motion profiles for the other two prisms.

Blind system identification of two-thermocouple sensor based on cross-relation method

NASA Astrophysics Data System (ADS)

Li, Yanfeng; Zhang, Zhijie; Hao, Xiaojian

2018-03-01

In dynamic temperature measurement, the dynamic characteristics of the sensor affect the accuracy of the measurement results. Thermocouples are widely used for temperature measurement in harsh conditions due to their low cost, robustness, and reliability, but because of the presence of the thermal inertia, there is a dynamic error in the dynamic temperature measurement. In order to eliminate the dynamic error, two-thermocouple sensor was used to measure dynamic gas temperature in constant velocity flow environments in this paper. Blind system identification of two-thermocouple sensor based on a cross-relation method was carried out. Particle swarm optimization algorithm was used to estimate time constants of two thermocouples and compared with the grid based search method. The method was validated on the experimental equipment built by using high temperature furnace, and the input dynamic temperature was reconstructed by using the output data of the thermocouple with small time constant.

Unidirectional waveguide grating antennas with uniform emission for optical phased arrays.

PubMed

Raval, Manan; Poulton, Christopher V; Watts, Michael R

2017-07-01

We demonstrate millimeter-scale optical waveguide grating antennas with unidirectional emission for integrated optical phased arrays. Unidirectional emission eliminates the fundamental problem of blind spots in the element factor of a phased array caused by reflections of antenna radiation within the substrate. Over 90% directionality is demonstrated using a design consisting of two silicon nitride layers. Furthermore, the perturbation strength along the antenna is apodized to achieve uniform emission for the first time, to the best of our knowledge, on a millimeter scale. This allows for a high effective aperture and receiving efficiency. The emission profile of the measured 3 mm long antenna has a standard deviation of 8.65% of the mean. These antennas are state of the art and will allow for integrated optical phased arrays with blind-spot-free high transmission output power and high receiving efficiency for LIDAR and free-space communication systems.

A lab-on-chip for malaria diagnosis and surveillance

PubMed Central

2014-01-01

Background Access to timely and accurate diagnostic tests has a significant impact in the management of diseases of global concern such as malaria. While molecular diagnostics satisfy this need effectively in developed countries, barriers in technology, reagent storage, cost and expertise have hampered the introduction of these methods in developing countries. In this study a simple, lab-on-chip PCR diagnostic was created for malaria that overcomes these challenges. Methods The platform consists of a disposable plastic chip and a low-cost, portable, real-time PCR machine. The chip contains a desiccated hydrogel with reagents needed for Plasmodium specific PCR. Chips can be stored at room temperature and used on demand by rehydrating the gel with unprocessed blood, avoiding the need for sample preparation. These chips were run on a custom-built instrument containing a Peltier element for thermal cycling and a laser/camera setup for amplicon detection. Results This diagnostic was capable of detecting all Plasmodium species with a limit of detection for Plasmodium falciparum of 2 parasites/μL of blood. This exceeds the sensitivity of microscopy, the current standard for diagnosis in the field, by ten to fifty-fold. In a blind panel of 188 patient samples from a hyper-endemic region of malaria transmission in Uganda, the diagnostic had high sensitivity (97.4%) and specificity (93.8%) versus conventional real-time PCR. The test also distinguished the two most prevalent malaria species in mixed infections, P. falciparum and Plasmodium vivax. A second blind panel of 38 patient samples was tested on a streamlined instrument with LED-based excitation, achieving a sensitivity of 96.7% and a specificity of 100%. Conclusions These results describe the development of a lab-on-chip PCR diagnostic from initial concept to ready-for-manufacture design. This platform will be useful in front-line malaria diagnosis, elimination programmes, and clinical trials. Furthermore, test chips can be adapted to detect other pathogens for a differential diagnosis in the field. The flexibility, reliability, and robustness of this technology hold much promise for its use as a novel molecular diagnostic platform in developing countries. PMID:24885206

Virtual reality-based navigation task to reveal obstacle avoidance performance in individuals with visuospatial neglect.

PubMed

Aravind, Gayatri; Darekar, Anuja; Fung, Joyce; Lamontagne, Anouk

2015-03-01

Persons with post-stroke visuospatial neglect (VSN) often collide with moving obstacles while walking. It is not well understood whether the collisions occur as a result of attentional-perceptual deficits caused by VSN or due to post-stroke locomotor deficits. We assessed individuals with VSN on a seated, joystick-driven obstacle avoidance task, thus eliminating the influence of locomotion. Twelve participants with VSN were tested on obstacle detection and obstacle avoidance tasks in a virtual environment that included three obstacles approaching head-on or 30 (°) contralesionally/ipsilesionally. Our results indicate that in the detection task, the contralesional and head-on obstacles were detected at closer proximities compared to the ipsilesional obstacle. For the avoidance task collisions were observed only for the contralesional and head-on obstacle approaches. For the contralesional obstacle approach, participants initiated their avoidance strategies at smaller distances from the obstacle and maintained smaller minimum distances from the obstacles. The distance at detection showed a negative association with the distance at the onset of avoidance strategy for all three obstacle approaches. We conclusion the observation of collisions with contralesional and head-on obstacles, in the absence of locomotor burden, provides evidence that attentional-perceptual deficits due to VSN, independent of post-stroke locomotor deficits, alter obstacle avoidance abilities.

Toward Adversarial Online Learning and the Science of Deceptive Machines

DTIC Science & Technology

2015-11-14

noise . Adver- saries can take advantage of this inherent blind spot to avoid detection (mimicry). Adversarial label noise is the intentional switching...of classification labels leading to de- terministic noise , error that the model cannot capture due to its generalization bias. An experiment in user...potentially infinite and with imperfect information. We will combine Monte-Carlo tree search ( MCTS ) with rein- forcement learning because the manipulation

Modafinil alters decision making based on feedback history - a randomized placebo-controlled double blind study in humans.

PubMed

Bellebaum, Christian; Kuchinke, Lars; Roser, Patrik

2017-02-01

Modafinil is becoming increasingly popular as a cognitive enhancer. Research on the effects of modafinil on cognitive function have yielded mixed results, with negative findings for simple memory and attention tasks and enhancing effects for more complex tasks. In the present study we examined whether modafinil, due to its known effect on the dopamine level in the striatum, alters feedback-related choice behaviour. We applied a task that separately tests the choice of previously rewarded behaviours (approach) and avoidance of previously punished behaviours. 18 participants received a single dose of 200 mg modafinil. Their performance was compared to a group of 22 participants who received placebo in a double-blind design. Modafinil but not placebo induced a significant bias towards approach behaviour as compared to the frequency of avoidance behaviour. General attention, overall feedback-based acquisition of choice behaviour and reaction times in high vs low conflict choices were not significantly affected by modafinil. This finding suggests that modafinil has a specific effect on dopamine-mediated choice behaviour based on the history of feedback, while a contribution of noradrenaline is also conceivable. The described change in decision making cannot be considered as cognitive enhancement, but might rather have detrimental effects on decisions in everyday life.

Editing Wikipedia content by screen reader: easier interaction with the Accessible Rich Internet Applications suite.

PubMed

Buzzi, Marina; Leporini, Barbara

2009-07-01

This study aims to improve Wikipedia usability for the blind and promote the application of standards relating to Web accessibility and usability. First, accessibility and usability of Wikipedia home, search result and edit pages are analysed using the JAWS screen reader; next, suggestions for improving interaction are proposed and a new Wikipedia editing interface built. Most of the improvements were obtained using the Accessible Rich Internet Applications (WAI-ARIA) suite, developed by the World Wide Web Consortium (W3C) within the framework of the Web Accessibility Initiative (WAI). Last, a scenario of use compares interaction of blind people with the original and the modified interfaces. Our study highlights that although all contents are accessible via screen reader, usability issues exist due to the user's difficulties when interacting with the interface. The scenario of use shows how building an editing interface with the W3C WAI-ARIA suite eliminates many obstacles that can prevent blind users from actively contributing to Wikipedia. The modified Wikipedia editing page is simpler to use via a screen reader than the original one because ARIA ensures a page overview, rapid navigation, and total control of what is happening in the interface.

Blind motion image deblurring using nonconvex higher-order total variation model

NASA Astrophysics Data System (ADS)

Li, Weihong; Chen, Rui; Xu, Shangwen; Gong, Weiguo

2016-09-01

We propose a nonconvex higher-order total variation (TV) method for blind motion image deblurring. First, we introduce a nonconvex higher-order TV differential operator to define a new model of the blind motion image deblurring, which can effectively eliminate the staircase effect of the deblurred image; meanwhile, we employ an image sparse prior to improve the edge recovery quality. Second, to improve the accuracy of the estimated motion blur kernel, we use L1 norm and H1 norm as the blur kernel regularization term, considering the sparsity and smoothing of the motion blur kernel. Third, because it is difficult to solve the numerically computational complexity problem of the proposed model owing to the intrinsic nonconvexity, we propose a binary iterative strategy, which incorporates a reweighted minimization approximating scheme in the outer iteration, and a split Bregman algorithm in the inner iteration. And we also discuss the convergence of the proposed binary iterative strategy. Last, we conduct extensive experiments on both synthetic and real-world degraded images. The results demonstrate that the proposed method outperforms the previous representative methods in both quality of visual perception and quantitative measurement.

Eye health promotion and the prevention of blindness in developing countries: critical issues.

PubMed

Hubley, J; Gilbert, C

2006-03-01

This review explores the role of health promotion in the prevention of avoidable blindness in developing countries. Using examples from eye health and other health topics from developing countries, the review demonstrates that effective eye health promotion involves a combination of three components: health education directed at behaviour change to increase adoption of prevention behaviours and uptake of services; improvements in health services such as the strengthening of patient education and increased accessibility and acceptability; and advocacy for improved political support for blindness prevention policies. Current eye health promotion activities can benefit by drawing on experiences gained by health promotion activities in other health topics especially on the use of social research and behavioural models to understand factors determining health decision making and the appropriate choice of methods and settings. The challenge ahead is to put into practice what we know does work. An expansion of advocacy-the third and most undeveloped component of health promotion-is essential to convince governments to channel increased resources to eye health promotion and the goals of Vision 2020.

India is on the way forward to maternal and neonatal tetanus elimination!

PubMed Central

Bairwa, Mohan; S.K., Shashikantha; Rajput, Meena; Khanna, Pardeep; Malik, Jagbir Singh; Nagar, Mukesh

2012-01-01

Tetanus is an acute, potentially fatal disease, caused by a bacterium, Clostridium tetani. The disease usually occurs in newborns through infection of the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument. NT contributes to 5–7% of neonatal mortality worldwide. Several thousand mothers are also estimated to die annually of maternal tetanus. MNT elimination relies on promotion of maternal tetanus immunization along with safe delivery and avoidance of unsafe abortion and umbilical cord care practices. The Government of India (1983) introduced at least two doses of tetanus toxoid vaccine (TT) to all pregnant women during each pregnancy as a part of its nationwide immunization policy. To date, a total of 15 States including union territories of the India have achieved NT elimination. The remaining Indian States need to strengthen TT coverage to save the lives of neonates as well as mothers from tetanus. PMID:22854674

Prostatic Tissue Elimination After Prostatic Artery Embolization (PAE): A Report of Three Cases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leite, Leandro Cardarelli; Assis, Andre Moreira de; Moreira, Airton Mota

PurposeWe report three cases of spontaneous prostatic tissue elimination through the urethra while voiding following technically successful prostatic artery embolization (PAE) as a treatment for lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH).MethodsAll patients were embolized with 100- to 300-μm microspheres alone or in combination with 300- to 500-μm microspheres.ResultsDuring follow-up prior to eliminating the tissue fragments, the three patients all presented with intermittent periods of LUTS improvement and aggravation. After expelling the prostatic tissue between 1 and 5 months of follow-up, significant improvements in LUTS and urodynamic parameters were observed in all patients.ConclusionsUrethral obstruction after PAEmore » caused by sloughing prostate tissue is a potential complication of the procedure and should be considered in patients with recurrent LUTS in order to avoid inappropriate management.« less

India is on the way forward to maternal and neonatal tetanus elimination!

PubMed

Bairwa, Mohan; Sk, Shashikantha; Rajput, Meena; Khanna, Pardeep; Malik, Jagbir Singh; Nagar, Mukesh

2012-08-01

Tetanus is an acute, potentially fatal disease, caused by a bacterium, Clostridium tetani. The disease usually occurs in newborns through infection of the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument. NT contributes to 5-7% of neonatal mortality worldwide. Several thousand mothers are also estimated to die annually of maternal tetanus. MNT elimination relies on promotion of maternal tetanus immunization along with safe delivery and avoidance of unsafe abortion and umbilical cord care practices. The Government of India (1983) introduced at least two doses of tetanus toxoid vaccine (TT) to all pregnant women during each pregnancy as a part of its nationwide immunization policy. To date, a total of 15 States including union territories of the India have achieved NT elimination. The remaining Indian States need to strengthen TT coverage to save the lives of neonates as well as mothers from tetanus.

78 FR 21380 - Agency Information Collection Activities: Submission to OMB for Review and Approval; Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-10

... associations plan events and report the details of their events to BCRS so that they can be added to the state-by-state map of events. In order to avoid duplication of effort, eliminate confusion regarding... Collection Request Title: Corps Community Day Event Form (OMB No. 0915-xxxx)--[NEW] Abstract: Corps Community...

Some remarks on the design of transonic tunnels with low levels of flow unsteadiness

NASA Technical Reports Server (NTRS)

Mabey, D. G.

1976-01-01

The principal sources of flow unsteadiness in the circuit of a transonic wind tunnel are presented. Care must be taken to avoid flow separations, acoustic resonances and large scale turbulence. Some problems discussed are the elimination of diffuser separations, the aerodynamic design of coolers and the unsteadiness generated in ventilated working sections.

The Elements of Nonsexist Usage: A Guide to Inclusive Spoken and Written English.

ERIC Educational Resources Information Center

Dumond, Val

This handbook is intended for students, teachers, journalists, executives, and court and government workers who want to eliminate sexism from their English. It offers sound advice on gender-inclusive or gender-neutral language. Among its topics of interest are: the reasons to avoid sexist language; sensible alternatives to offensive terminology;…

"The Things They" [All] "Carried": Discovering Theme through Imagined Stories of Votive Offerings

ERIC Educational Resources Information Center

Krajeck, Amy J.

2009-01-01

Imaginations are the best tools people have to avoid future conflicts and unpopular wars. People may never find the panacea to eliminate all violence, but perhaps if students develop their imaginations today, America as a nation can begin to solve more problems with creativity than with fists. Imaginations allow for better decision-making.…

Black Leadership and Outside Allies in Virginia Freedom Schools

ERIC Educational Resources Information Center

Bonastia, Christopher

2016-01-01

In July 1963, students from Queens College (QC) and a group of New York City teachers traveled to Prince Edward County (PEC), Virginia, to teach local black youth in Freedom Schools. The county had eliminated public education four years earlier to avoid a desegregation order. PEC Freedom Schools represented the first major effort to recruit an…

["Long-branch Attraction" artifact in phylogenetic reconstruction].

PubMed

Li, Yi-Wei; Yu, Li; Zhang, Ya-Ping

2007-06-01

Phylogenetic reconstruction among various organisms not only helps understand their evolutionary history but also reveal several fundamental evolutionary questions. Understanding of the evolutionary relationships among organisms establishes the foundation for the investigations of other biological disciplines. However, almost all the widely used phylogenetic methods have limitations which fail to eliminate systematic errors effectively, preventing the reconstruction of true organismal relationships. "Long-branch Attraction" (LBA) artifact is one of the most disturbing factors in phylogenetic reconstruction. In this review, the conception and analytic method as well as the avoidance strategy of LBA were summarized. In addition, several typical examples were provided. The approach to avoid and resolve LBA artifact has been discussed.

Blind, olfactory bulbectomized female rats do not have daily luteinizing hormone surges.

PubMed

Pieper, D R; Mortiere, M R

1985-03-15

Previous studies from other laboratories have shown that female hamsters on short photoperiod become acyclic and have daily LH surges. These effects are eliminated if the animals are pinealectomized (PX) before being placed on the short photoperiod. Reiter and colleagues have shown that pre-pubertally blinded (BL) and olfactory bulbectomized (BX) female rats also have irregular estrous cycles, and this effect is also eliminated by PX [Endocr. Rev., 1 (1983) 109]. The main question addressed by the present study was whether the BL + BX rats also have daily LH surges. Twenty-five-day-old female Sprague-Dawley rats were divided into 5 groups: LD 14:10 sham (control); BL + BX; BL + BX + PX; LD 6:18 sham; and LD 6:18 BX. Ten weeks following surgery, all animals were sampled (0.5 ml) every 5 h for 2 days from an indwelling atrial catheter. Daily vaginal smears indicated that the BL + BX group were in estrus much less frequently than controls (15.8 +/- 1.8 vs 27.3 +/- 1.5% of days cornified cells, 10 rats/group smeared for more than 23 days each) and in general had longer, irregular cycles. The other 3 groups all had smear patterns similar to controls. All 5 groups had LH surges on the day of proestrus (greater than 200 ng/ml maximum value), but no group had LH surges on 2 sequential days or an LH surge on any other day of the cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

Hyperactivity: is candy causal?

PubMed

Krummel, D A; Seligson, F H; Guthrie, H A

1996-01-01

Adverse behavioral responses to ingestion of any kind of candy have been reported repeatedly in the lay press. Parents and teachers alike attribute excessive motor activity and other disruptive behaviors to candy consumption. However, anecdotal observations of this kind need to be tested scientifically before conclusions can be drawn, and criteria for interpreting diet behavior studies must be rigorous. Ingredients in nonchocolate candy (sugar, artificial food colors), components in chocolate candy (sugar, artificial food colors in coatings, caffeine), and chocolate itself have been investigated for any adverse effects on behavior. Feingold theorized that food additives (artificial colors and flavors) and natural salicylates caused hyperactivity in children and elimination of these components would result in dramatic improvement in behavior. Numerous double-blind studies of the Feingold hypothesis have led to the rejection of the idea that this elimination diet has any benefit beyond the normal placebo effect. Although sugar is widely believed by the public to cause hyperactive behavior, this has not been scientifically substantiated. Twelve double-blind, placebo-controlled studies of sugar challenges failed to provide any evidence that sugar ingestion leads to untoward behavior in children with Attention-Deficit Hyperactivity Disorder or in normal children. Likewise, none of the studies testing candy or chocolate found any negative effect of these foods on behavior. For children with behavioral problems, diet-oriented treatment does not appear to be appropriate. Rather, clinicians treating these children recommend a multidisciplinary approach. The goal of diet treatment is to ensure a balanced diet with adequate energy and nutrients for optimal growth.

An effective dose of ketamine for eliminating pain during injection of propofol: a dose response study.

PubMed

Wang, M; Wang, Q; Yu, Y Y; Wang, W S

2013-09-01

Ketamine can completely eliminate pain associated with propofol injection. However, the effective dose of ketamine to eliminate propofol injection pain has not been determined. The purpose of this study was to determine the effective dose of ketamine needed to eliminate pain in 50% and 95% of patients (ED50 and ED95, respectively) during propofol injections. This study was conducted in a double-blinded fashion and included 50 patients scheduled for elective gynecological laparoscopy under general anesthesia. The initial dose of ketamine used in the first patient was 0.25mg/kg. The dosing modifications were in increments or decrements of 0.025 mg/kg. Ketamine was administered 15 seconds before injecting propofol (2.5mg/kg), which was injected at a rate of 1mL/s. Patients were asked to rate their pain during propofol injection every 5s econds using a 0-3 pain scale. The highest pain score was recorded. The ED50, ED95 and 95% confidence intervals (CI) were determined by probit analyses. The dose of ketamine ranged from 0.175 to 0.275 mg/kg. The ED50 and ED95 of ketamine for eliminating pain during propofol injection were 0.227 mg/kg and 0.283 mg/kg, respectively (95%CI: 0.211-0.243 mg/kg and 0.26-0.364 mg/kg, respectively). Ketamine at an approximate dose of 0.3mg/kg was effective in eliminating pain during propofol injection. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

Stress management versus lifestyle modification on systolic hypertension and medication elimination: a randomized trial.

PubMed

Dusek, Jeffery A; Hibberd, Patricia L; Buczynski, Beverly; Chang, Bei-Hung; Dusek, Kathryn C; Johnston, Jennifer M; Wohlhueter, Ann L; Benson, Herbert; Zusman, Randall M

2008-03-01

Isolated systolic hypertension is common in the elderly, but decreasing systolic blood pressure (SBP) without lowering diastolic blood pressure (DBP) remains a therapeutic challenge. Although stress management training, in particular eliciting the relaxation response, reduces essential hypertension its efficacy in treating isolated systolic hypertension has not been evaluated. We conducted a double-blind, randomized trial comparing 8 weeks of stress management, specifically relaxation response training (61 patients), versus lifestyle modification (control, 61 patients). Inclusion criteria were >or=55 years, SBP 140-159 mm Hg, DBP <90 mm Hg, and at least two antihypertensive medications. The primary outcome measure was change in SBP after 8 weeks. Patients who achieved SBP <140 mm Hg and >or=5 mm Hg reduction in SBP were eligible for 8 additional weeks of training with supervised medication elimination. SBP decreased 9.4 (standard deviation [SD] 11.4) and 8.8 (SD 13.0) mm Hg in relaxation response and control groups, respectively (both ps <0.0001) without group difference (p=0.75). DBP decreased 1.5 (SD 6.2) and 2.4 (SD 6.9) mm Hg (p=0.05 and 0.01, respectively) without group difference (p=0.48). Forty-four (44) in the relaxation response group and 36 in the control group were eligible for supervised antihypertensive medication elimination. After controlling for differences in characteristics at the start of medication elimination, patients in the relaxation response group were more likely to successfully eliminate an antihypertensive medication (odds ratio 4.3, 95% confidence interval 1.2-15.9, p=0.03). Although both groups had similar reductions in SBP, significantly more participants in the relaxation response group eliminated an antihypertensive medication while maintaining adequate blood pressure control.

Antigravity treadmill training during the early rehabilitation phase following unicompartmental knee arthroplasty: A case series.

PubMed

Huang, Chun-Hao; Schroeder, E Todd; Powers, Christopher

2018-02-26

Patients who have undergone unicompartmental knee arthroplasty (UKA) have been reported to exhibit altered gait 19-25 months post-surgery. The most common gait impairment in this population is inadequate knee flexion and a corresponding decrease in the knee extensor moment during loading response (i.e., quadriceps avoidance). The purpose of this case series was to determine whether incorporation of antigravity treadmill training into a standard physical therapy program can eliminate quadriceps avoidance gait during the early rehabilitation phase following UKA. Four females who underwent UKA were recruited for this study. Participants completed antigravity treadmill training three times per week for 12 weeks in addition to their standard physical therapy program. Instrumented gait analysis was performed at baseline (pre-intervention), week 6 (mid-intervention), and week 12 (post-intervention). We found that peak knee flexion and the peak knee extensor moment during the weight acceptance phase of gait increased to normal values following the 12-week intervention period (14.1 ± 6.5° to 20.6 ± 1.5° and 0.4 ± 0.3 to 0.7 ± 0.2 Nm/kg respectively). The findings of this case series suggest that a standard physical therapy program that incorporates early gait training using an antigravity treadmill may be beneficial in eliminating "quadriceps avoidance" during the early rehabilitation phase following UKA.

Assessing outcomes of tinnitus intervention.

PubMed

Newman, Craig W; Sandridge, Sharon A; Jacobson, Gary P

2014-01-01

It has been estimated that as many as 50 million Americans do experience or have experienced tinnitus. For approximately 12 million of these individuals, tinnitus makes it impossible for them to carry out normal everyday activities without limitation. These are the patients that present to audiology clinics for assessment and management. The tinnitus evaluation includes the measurement of acoustical characteristics of tinnitus and the impact that this impairment has on health-related quality of life (HRQoL). Tinnitus is a disorder that often occurs as a result of auditory system impairment. The impairment for some can impart an activity limitation and a participation restriction (i.e., tinnitus-related disability or handicap, respectively). The goal of tinnitus management is to reduce, or eliminate, activity limitations and participation restrictions by reducing or eliminating a patient's perception of tinnitus or their reaction to tinnitus. Implicit in this statement is the assumption that there exist standardized measures for quantifying the patient's tinnitus perception and their reaction to it. If there existed stable and responsive standardized tinnitus measures, then it would be possible to compare a patient's tinnitus experience at different time points (e.g., before and after treatment) to assess, for example, treatment efficacy. The purposes of the current review are to (1) describe psychometric standards used to select outcome measurement tools; (2) discuss available measurement techniques and their application to tinnitus evaluation and treatment-related assessment within the domains established by the World Health Organization's International Classification of Functioning, Disability and Health; (3) list and briefly describe self-report tinnitus questionnaires; (4) describe how valuation of tinnitus treatment can be assessed using economic models of treatment effectiveness; and (5) provide future directions including the development of a tinnitus outcomes test battery and treatment-related study designs. Retrospective literature review Although psychometrically robust measures of tinnitus HRQoL do exist, there is no unanimity in, for example, what tests should be included in the tinnitus assessment, and how studies of HRQoL should be conducted. The current authors suggest that future studies employ more rigorous designs and contain (minimally) the following characteristics: (1) utilization of randomized control groups and blinding; (2) appropriate statistical testing including "dropouts" that should be used in an "intention to treat" analysis rather than elimination from the final data set; (3) long-term follow-up assessment to evaluate responsiveness; (4) appropriate inclusion criteria to avoid "ceiling" and "floor" effects; and (5) suitable sample sizes based on the application of power analyses. American Academy of Audiology.

The Nakuru posterior segment eye disease study: methods and prevalence of blindness and visual impairment in Nakuru, Kenya.

PubMed

Mathenge, Wanjiku; Bastawrous, Andrew; Foster, Allen; Kuper, Hannah

2012-10-01

To estimate the prevalence of blindness and visual impairment (VI) in adults aged ≥50 years in the Nakuru district of Kenya and to identify sociodemographic risk factors for these conditions. We also sought to validate the Rapid Assessment of Avoidable Blindness (RAAB) methodology. There were 5010 subjects enumerated for this study. Of these, 4414 participants underwent examination, for a response rate of 88.1%. Cross-sectional, population-based survey. Cluster random samplings with probability proportionate to size procedures were used to select a representative cross-sectional sample of adults aged ≥50 years. Each participant was interviewed, had distance visual acuity (VA) measured with reduced logarithm of the minimal angle of resolution tumbling-E chart, underwent autorefraction, and thereby had measurements of presenting, uncorrected, and best-corrected VA. All participants, regardless of vision, underwent detailed ophthalmic examinations including slit-lamp assessment and dilated retinal photographs. Visual acuity of <6/12. A representative sample of 4414 adults were enumerated (response rate, 88.1%). The prevalence of blindness (VA < 3/60 in better eye) was 1.6% (95% confidence interval [CI], 1.2-2.1%) and of VI, 0.4% (95% CI, 0.3-0.7%); 8.1% (95% CI, 7.2-9.2%); and 5.1% (95% CI, 4.3-6.1%) were severely (<6/60-3/60), moderately (<6/18-6/60), or mildly (<6/12-6/18) visually impaired, respectively. Being male, having less education, having Kalenjin tribal origin, and being ≥80 years old were associated with increased blindness prevalence. Prevalence estimates were comparable to a RAAB performed in the same area 2 years earlier. This survey provides reliable estimates of blindness and VI prevalence in Nakuru. Older age and tribal origin were identified as predictors of these conditions. This survey validates the use of RAAB as a method of estimating blindness and VI prevalence. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Prevalence of blindness and diabetic retinopathy in northern Jordan.

PubMed

Rabiu, Mansur M; Al Bdour, Muawyah D; Abu Ameerh, Mohammed A; Jadoon, Muhammed Z

2015-01-01

To estimate the prevalence of blindness, visual impairment, diabetes, and diabetic retinopathy in north Jordan (Irbid) using the rapid assessment of avoidable blindness and diabetic retinopathy methodology. A multistage cluster random sampling technique was used to select participants for this survey. A total of 108 clusters were selected using probability proportional to size method while subjects within the clusters were selected using compact segment method. Survey teams moved from house to house in selected segments examining residents 50 years and older until 35 participants were recruited. All eligible people underwent a standardized examination protocol, which included ophthalmic examination and random blood sugar test using digital glucometers (Accu-Chek) in their homes. Diabetic retinopathy among diabetic patients was assessed through dilated fundus examination. A total of 3638 out of the 3780 eligible participants were examined. Age- and sex-adjusted prevalence of blindness, severe visual impairment, and visual impairment with available correction were 1.33% (95% confidence interval [CI] 0.87-1.73), 1.82% (95% CI 1.35-2.25), and 9.49% (95% CI 8.26-10.74), respectively, all higher in women. Untreated cataract and diabetic retinopathy were the major causes of blindness, accounting for 46.7% and 33.2% of total blindness cases, respectively. Glaucoma was the third major cause, accounting for 8.9% of cases. The prevalence of diabetes mellitus was 28.6% (95% CI 26.9-30.3) among the study population and higher in women. The prevalence of any retinopathy among diabetic patients was 48.4%. Cataract and diabetic retinopathy are the 2 major causes of blindness and visual impairment in northern Jordan. For both conditions, women are primarily affected, suggesting possible limitations to access to services. A diabetic retinopathy screening program needs to proactively create sex-sensitive awareness and provide easily accessible screening services with prompt treatment.

Perception and Attitude of a Rural Community Regarding Adult Blindness in North Central Nigeria.

PubMed

Olatunji, Victoria A; Adepoju, Feyi G; Owoeye, Joshua F A

2015-01-01

To determine the perception and attitudes of a rural community regarding the etiology, prevention, and treatment of blindness in adults. A cross-sectional, descriptive study was performed in a rural community in Kwara State, Nigeria using semi-structured questionnaire. All adults aged 40 years or older who were residents for a minimum of 6 months in the community were included. Data were collected on patient demographics, knowledge, attitude, perception, and use of the eye care facility. A total of 290 participants were interviewed. The male-to-female ratio was 1:2. Consumption of certain types of food was an important cause of blindness as perceived by 57.9% of the respondents, followed by supernatural forces (41.7%) and aging (19%). Sixty percent of respondents thought blindness could be prevented. Age (P = 0.04) and level of education (P =0.003) significantly affected the beliefs on the prevention of blindness. Most respondents (79.3%) preferred orthodox eye care, but only 65% would accept surgical intervention if required. The level of education significantly affected the acceptance of surgery (P = 0.04). Reasons for refusing surgery were, fear (64%), previous poor outcomes in acquaintances (31%), belief that surgery is not required (3%), and cost (2%). About 65% used one form of traditional eye medication or the other. Over half (56.6%) believed that spectacles could cure all causes of blindness. Of those who had ocular complaints, 57.1% used orthodox care without combining with either traditional or spiritual remedies. This rural Nigerian community had some beliefs that were consistent with modern knowledge. However, the overall knowledge, attitude, and perceptions of this community need to be redirected to favor the eradication of avoidable blindness. Although an eye care facility was available, use by the community was suboptimal. Age and the level of education affected their overall perception and attitudes.

International Vision Care: Issues and Approaches.

PubMed

Khanna, Rohit C; Marmamula, Srinivas; Rao, Gullapalli N

2017-09-15

Globally, 32.4 million individuals are blind and 191 million have moderate or severe visual impairment (MSVI); 80% of cases of blindness and MSVI are avoidable. However, great efforts are needed to tackle blindness and MSVI, as eye care in most places is delivered in isolation from and without significant integration with general health sectors. Success stories, including control of vitamin A deficiency, onchocerciasis, and trachoma, showed that global partnerships, multisectoral collaboration, public-private partnerships, corporate philanthropy, support from nongovernmental organizations-both local and international-and governments are responsible for the success of these programs. Hence, the World Health Organization's universal eye health global action plan for 2014-2019 has a goal of reducing the public health problem of blindness and ensuring access to comprehensive eye care; the plan aims to integrate eye health into health systems, thus providing universal eye health coverage (UEHC). This article discusses the challenges faced by low- and middle-income countries in strengthening the six building blocks of the health system. It discusses how the health systems in these countries need to be geared toward tackling the issues of emerging noncommunicable eye diseases, existing infectious diseases, and the common causes of blindness and visual impairment, such as cataract and refractive error. It also discusses how some of the comprehensive eye care models in the developing world have addressed these challenges. Moving ahead, if we are to achieve UEHC, we need to develop robust, sustainable, good-quality, comprehensive eye care programs throughout the world, focusing on the areas of greatest need. We also need to develop public health approaches for more complex problems such as diabetic retinopathy, glaucoma, childhood blindness, corneal blindness, and low vision. There is also a great need to train high-level human resources of all cadres in adequate numbers and quality. In addition to this, we need to exploit the benefits of modern technological innovations in information, communications, biomedical technology, and other domains to enhance quality of, access to, and equity in eye care.

Causes of vision impairment and assessment of need for low vision services for students of blind schools in Nepal.

PubMed

Kansakar, I; Thapa, H B; Salma, K C; Ganguly, S; Kandel, R P; Rajasekaran, S

The present study is first of its kind to evaluate causes of visual impairment of blind students in Nepal and assess their need for low vision rehabilitation services. To evaluate causes of vision impairment of students enrolled in blind schools in Nepal and assess the need for low vision rehabilitation services in these students. A survey was conducted in 12 blind schools in Nepal, which were registered with Nepal Association for Welfare of Blindness (NAWB).It was conducted by a team of an ophthalmologist and an optometrist, by using standard eye examination protocols of the World Health Organization Prevention of Blindness Program (WHO/PBL). Of the 345 students enrolled in 12 schools, 285 students were examined (response rate of 82.61%). The students were in the 5 - 29 years age group. Nearly three-fourth of the children had become blind within one year of age and 52.3% visually impaired at birth and 20.7% developed vision impairment within one year of age. After refraction, 26 students (9.12%) had mild visual impairment, 21 students (7.37%) had severe visual impairment and 238 students (83.51%) were blind. The main cause of vision impairment was found to be corneal 35.79% and retina diseases, mainly dystrophy, 20.35% followed by problems with the whole globe, lens and optic nerve, accounting for 13.33%, 12.63% and 12.98% respectively. The major etiological factors were those of childhood such as Vitamin A deficiency, measles and similar causes (42.11%) followed by hereditary causes (25.26%). Of the total students examined, 48.07% were visually impaired due to preventable causes and 16.14% treatable aggregating to 64.21% of avoidable blindness. Fifty seven (28.22%) students could read smaller than 2 M print size after low vision assessment for near and 33(15.78%) students benefited with telescopic trial for distance low vision. In Nepal, renewed focus on providing best possible quality of life for visually impaired children by proper low vision assessment and eye health education focusing on, general public and community health workers, with governmental and institutional support is required to achieve Vision 2020 objectives to decrease childhood blindness.

An Avoidance-Based Rodent Model of Exposure With Response Prevention Therapy for Obsessive-Compulsive Disorder.

PubMed

Rodriguez-Romaguera, Jose; Greenberg, Benjamin D; Rasmussen, Steven A; Quirk, Gregory J

2016-10-01

Obsessive-compulsive disorder is treated with exposure with response prevention (ERP) therapy, in which patients are repeatedly exposed to compulsive triggers but prevented from expressing their compulsions. Many compulsions are an attempt to avoid perceived dangers, and the intent of ERP is to extinguish compulsions. Patients failing ERP therapy are candidates for deep brain stimulation (DBS) of the ventral capsule/ventral striatum, which facilitates patients' response to ERP therapy. An animal model of ERP would be useful for understanding the neural mechanisms of extinction in obsessive-compulsive disorder. Using a platform-mediated signaled avoidance task, we developed a rodent model of ERP called extinction with response prevention (Ext-RP), in which avoidance-conditioned rats are given extinction trials while blocking access to the avoidance platform. Following 3 days of Ext-RP, rats were tested with the platform unblocked to evaluate persistent avoidance. We then assessed if pharmacologic inactivation of lateral orbitofrontal cortex (lOFC) or DBS of the ventral striatum reduced persistent avoidance. Following Ext-RP training, most rats showed reduced avoidance at test (Ext-RP success), but a subset persisted in their avoidance (Ext-RP failure). Pharmacologic inactivation of lOFC eliminated persistent avoidance, as did DBS applied to the ventral striatum during Ext-RP. DBS of ventral striatum has been previously shown to inhibit lOFC activity. Thus, activity in lOFC, which is known to be hyperactive in obsessive-compulsive disorder, may be responsible for impairing patients' response to ERP therapy. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Measured daylighting potential of a static optical louver system under real sun and sky conditions

DOE PAGES

Konis, Kyle; Lee, Eleanor S.

2015-05-04

Side-by-side comparisons were made over solstice-to-solstice changes in sun and sky conditions between an optical louver system (OLS) and a conventional Venetian blind set at a horizontal slat angle and located inboard of a south-facing, small-area, clerestory window in a full-scale office testbed. Daylight autonomy (DA), window luminance, and ceiling luminance uniformity were used to assess performance. The performance of both systems was found to have significant seasonal variation, where performance under clear sky conditions improved as maximum solar altitude angles transitioned from solstice to equinox. Although the OLS produced fewer hours per day of DA on average than themore » Venetian blind, the OLS never exceeded the designated 2000 cd/m2 threshold for window glare. In contrast, the Venetian blind was found to exceed the visual discomfort threshold over a large fraction of the day during equinox conditions. Notably, these peak periods of visual discomfort occurred during the best periods of daylighting performance. Luminance uniformity was analyzed using calibrated high dynamic range luminance images. Under clear sky conditions, the OLS was found to increase the luminance of the ceiling as well as produce a more uniform distribution. Furthermore, compared to conventional venetian blinds, the static optical sunlight redirecting system studied has the potential to significantly reduce the annual electrical lighting energy demand of a daylit space and improve the quality from the perspective of building occupants by consistently transmitting useful daylight while eliminating window glare.« less

Potential for Hospital Based Corneal Retreival in Hassan District Hospital

PubMed Central

Melsakkare, Suresh Ramappa; Manipur, Sahana R.; Acharya, Pavana; Ramamurthy, Lakshmi Bomalapura

2015-01-01

Context In developing countries, corneal diseases are the second leading cause of blindness. This corneal blindness can be treated through corneal transplantation. Though the present infrastructure is strong enough to increase keratoplasty numbers at a required rate, India has largest corneal blind population in the world. So a constant supply of high quality donor corneal tissue is the key factor for reduction of prevalence of corneal blindness. Considering the magnitude of corneal blindness and shortage of donor cornea, there is a huge gap in the demand and supply. Aim To study the potential for hospital based retrieval of donor corneal tissue in Hassan district hospital after analysing the indicated and contraindicated causes of deaths, so that hospital corneal retrieval program in Hassan district hospital can be planned. Materials and Methods The cross-sectional, retrospective and record-based study included all hospital deaths with age group more than two years occurred during one year period (January 2014 to December 2014). Data regarding demographic profile, cause of death, treatment given and presence of any systemic diseases were collected. The causes of deaths which are contraindicated for the retrieval of corneas were analysed and noted. The contraindications were based on the NPCB guidelines for standard of eye banking in India 2009. Results Out of 855 deaths, number of deaths in males (565) was greater than females (290). Numbers of deaths were highest between 41-60 years age group (343). Deaths due to HIV, septicaemia, meningitis, encephalitis, disseminated malignancies were contraindicated for corneal retrieval. Corneas could be retrieved from 736 deaths out of 855. Potential for corneal retrieval in a period of one year in Hassan District hospital was 86%. Conclusion Hospital corneal retrieval program has got a great potential to bridge the gap between the need for the cornea and actually collected corneas which will contribute enormously in eliminating corneal blindness. In present study there was 86% potential for corneal retrieval among the hospital deaths. PMID:26435976

Symmetrically private information retrieval based on blind quantum computing

NASA Astrophysics Data System (ADS)

Sun, Zhiwei; Yu, Jianping; Wang, Ping; Xu, Lingling

2015-05-01

Universal blind quantum computation (UBQC) is a new secure quantum computing protocol which allows a user Alice who does not have any sophisticated quantum technology to delegate her computing to a server Bob without leaking any privacy. Using the features of UBQC, we propose a protocol to achieve symmetrically private information retrieval, which allows a quantum limited Alice to query an item from Bob with a fully fledged quantum computer; meanwhile, the privacy of both parties is preserved. The security of our protocol is based on the assumption that malicious Alice has no quantum computer, which avoids the impossibility proof of Lo. For the honest Alice, she is almost classical and only requires minimal quantum resources to carry out the proposed protocol. Therefore, she does not need any expensive laboratory which can maintain the coherence of complicated quantum experimental setups.

A mobile phone system to find crosswalks for visually impaired pedestrians

PubMed Central

Shen, Huiying; Chan, Kee-Yip; Coughlan, James; Brabyn, John

2010-01-01

Urban intersections are the most dangerous parts of a blind or visually impaired pedestrian’s travel. A prerequisite for safely crossing an intersection is entering the crosswalk in the right direction and avoiding the danger of straying outside the crosswalk. This paper presents a proof of concept system that seeks to provide such alignment information. The system consists of a standard mobile phone with built-in camera that uses computer vision algorithms to detect any crosswalk visible in the camera’s field of view; audio feedback from the phone then helps the user align him/herself to it. Our prototype implementation on a Nokia mobile phone runs in about one second per image, and is intended for eventual use in a mobile phone system that will aid blind and visually impaired pedestrians in navigating traffic intersections. PMID:20411035

A conceptual design of shock-eliminating clover combustor for large scale scramjet engine

NASA Astrophysics Data System (ADS)

Sun, Ming-bo; Zhao, Yu-xin; Zhao, Guo-yan; Liu, Yuan

2017-01-01

A new concept of shock-eliminating clover combustor is proposed for large scale scramjet engine to fulfill the requirements of fuel penetration, total pressure recovery and cooling. To generate the circular-to-clover transition shape of the combustor, the streamline tracing technique is used based on an axisymmetric expansion parent flowfield calculated using the method of characteristics. The combustor is examined using inviscid and viscous numerical simulations and a pure circular shape is calculated for comparison. The results showed that the combustor avoids the shock wave generation and produces low total pressure losses in a wide range of flight condition with various Mach number. The flameholding device for this combustor is briefly discussed.

Advanced use of tissue adhesive in hair transplantation.

PubMed

Elliott, R M; Thomas, R A; True, R H

1993-09-01

Cobblestoning is an unsightly result of graft elevation in the recipient site after hair transplantation. To describe the use of tissue adhesives for the avoidance of cobblestoning. The long-term cosmetic appearance of hair transplants may be improved through the use of cyanoacrylate adhesives is the virtual elimination of the common problem of graft elevation or cobblestoning, which produces an unsightly bumpiness in the recipient area. The choice of type of adhesive and the method of application are central to successful use of this technique. The indirect benefits of elimination of the need for postoperative bandages and restrictions in activities couple with the cosmetic results to produce a high degree of patient satisfaction.

Is adding a new class of cones to the retina sufficient to cure color-blindness?

PubMed

Cornelissen, Frans W; Brenner, Eli

2015-01-01

New genetic methods have made it possible to substitute cone pigments in the retinas of adult nonhuman primates. Doing so influences the animals' visual abilities, demonstrating that the gene therapy was effective. However, we argue that no studies conducted so far have unambiguously demonstrated that the experimental animals have also acquired the ability to make new color distinctions. Simply put, it has been shown that animals that underwent the gene treatment can now-in addition to finding a red ball on a grayish background-find a green ball on a grayish background. However, it has not been shown that the animals can distinguish a red ball from a green one. For most people, that essential ability would be the primary reason for wanting to undergo a treatment for color-blindness in the first place, for instance, because their color-blindness currently prevents them from pursuing a career as a pilot or firefighter. It is important to point out such possible limitations of gene therapy for color-blindness to avoid unwarranted expectations in both clinicians and patients. To explain the origin of our concerns, we simulate how replacing the pigment of some cones is expected to influence the outcomes on the behavioral test used so far. The simulations show that this test does not provide conclusive evidence that the animals acquired the ability to make new chromatic distinctions. In our view, it is therefore premature to claim that human color-blindness can be cured through gene therapy. We propose a test that would provide more conclusive evidence of fundamentally altered color vision after gene therapy.

Restoration of visual function by expression of a light-gated mammalian ion channel in retinal ganglion cells or ON-bipolar cells

PubMed Central

Gaub, Benjamin M.; Berry, Michael H.; Holt, Amy E.; Reiner, Andreas; Kienzler, Michael A.; Dolgova, Natalia; Nikonov, Sergei; Aguirre, Gustavo D.; Beltran, William A.; Flannery, John G.; Isacoff, Ehud Y.

2014-01-01

Most inherited forms of blindness are caused by mutations that lead to photoreceptor cell death but spare second- and third-order retinal neurons. Expression of the light-gated excitatory mammalian ion channel light-gated ionotropic glutamate receptor (LiGluR) in retinal ganglion cells (RGCs) of the retina degeneration (rd1) mouse model of blindness was previously shown to restore some visual functions when stimulated by UV light. Here, we report restored retinal function in visible light in rodent and canine models of blindness through the use of a second-generation photoswitch for LiGluR, maleimide-azobenzene-glutamate 0 with peak efficiency at 460 nm (MAG0460). In the blind rd1 mouse, multielectrode array recordings of retinal explants revealed robust and uniform light-evoked firing when LiGluR-MAG0460 was targeted to RGCs and robust but diverse activity patterns in RGCs when LiGluR-MAG0460 was targeted to ON-bipolar cells (ON-BCs). LiGluR-MAG0460 in either RGCs or ON-BCs of the rd1 mouse reinstated innate light-avoidance behavior and enabled mice to distinguish between different temporal patterns of light in an associative learning task. In the rod-cone dystrophy dog model of blindness, LiGluR-MAG0460 in RGCs restored robust light responses to retinal explants and intravitreal delivery of LiGluR and MAG0460 was well tolerated in vivo. The results in both large and small animal models of photoreceptor degeneration provide a path to clinical translation. PMID:25489083

Intraocular straylight screening in medical testing centres for driver licence holders in Spain

PubMed Central

Michael, Ralph; Barraquer, Rafael I.; Rodríguez, Judith; Tuñi i Picado, Josep; Jubal, Joan Serra; González Luque, Juan Carlos; van den Berg, Tom

2010-01-01

Purpose To test the performance of the C-quant straylight meter during the daily routine work in medical testing centres for driver license applicants and driver license holders in Spain. Methods Altogether 914 subjects, of which 376 younger than 35 years, 428 between 35 and 60 years and 110 over 60 years were measured with the C-quant in three medical testing centres (Barcelona, Zaragoza and Palma de Mallorca) in 2006. Technicians were instructed once and the measurements were done during the daily routine work. We recorded: age, BCVA, self-reported subjective blinding at night; and from the C-quant: straylight parameter (log s), measurement quality parameters (ESD, Q) and test duration. Results Total C-quant test duration increases slightly with age from a mean of 7 min (< 35 years) to a mean of 9 min (> 60). At first attempt, 82 % of all subjects produced reliable results (ESD < 0.12). The straylight parameter for this group was independent of ESD and ESD was independent of total test duration. The known age dependence of the straylight parameter and the weak correlation with BCVA was confirmed. The distribution of subjective blinding at night was very different between test centres. Subjects with “very strong” subjective blinding had significantly higher straylight values than subjects with “no” subjective blinding. Subjects avoiding night driving had significant higher straylight values than subjects driving at night. Conclusion The C-quant measure is reasonable fast. Good subject instruction is important to get first attempt reliable results. Self-reported subjective blinding results depend strongly on the interviewer.

Driving With Hemianopia: III. Detection of Stationary and Approaching Pedestrians in a Simulator

PubMed Central

Alberti, Concetta F.; Peli, Eli; Bowers, Alex R.

2014-01-01

Purpose. To compare blind-side detection performance of drivers with homonymous hemianopia (HH) for stationary and approaching pedestrians, initially appearing at small (4°) or large (14°) eccentricities in a driving simulator. While the stationary pedestrians did not represent an imminent threat, as their eccentricity increased rapidly as the vehicle advanced, the approaching pedestrians maintained a collision course with approximately constant eccentricity, walking or running, toward the travel lane as if to cross. Methods. Twelve participants with complete HH and without spatial neglect pressed the horn whenever they detected a pedestrian while driving along predetermined routes in two driving simulator sessions. Miss rates and reaction times were analyzed for 52 stationary and 52 approaching pedestrians. Results. Miss rates were higher and reaction times longer on the blind than the seeing side (P < 0.01). On the blind side, miss rates were lower for approaching than stationary pedestrians (16% vs. 29%, P = 0.01), especially at larger eccentricities (20% vs. 54%, P = 0.005), but reaction times for approaching pedestrians were longer (1.72 vs. 1.41 seconds; P = 0.03). Overall, the proportion of potential blind-side collisions (missed and late responses) was not different for the two paradigms (41% vs. 35%, P = 0.48), and significantly higher than for the seeing side (3%, P = 0.002). Conclusions. In a realistic pedestrian detection task, drivers with HH exhibited significant blind-side detection deficits. Even when approaching pedestrians were detected, responses were often too late to avoid a potential collision. PMID:24346175

The societal burden of blindness secondary to retinopathy of prematurity in Lima, Peru.

PubMed

Dave, Hreem B; Gordillo, Luz; Yang, Zhou; Zhang, Monica S; Hubbard, G Baker; Olsen, Timothy W

2012-10-01

To determine the cost-effectiveness of laser treatment for retinopathy of prematurity (ROP) in Lima, Peru. A cost-of-illness study (in US dollars) to determine the direct cost of treatment, the indirect lifetime cost of blindness, and the quality-adjusted life years. The direct cost of ROP-related treatment was determined by reviewing data retrospectively from a social security sector hospital. The indirect cost was determined using national economic data of Peru published by the Central Information Agency (CIA), including the per capita gross domestic product, the sex-adjusted income distribution, and years spent in the work force. Indirect costs per child that were avoided by treatment were calculated using the known natural history of ROP vs evidence-based treatment. For ROP-related neonatal blindness in Peru, we estimate the total indirect cost saving at $197,753 per child and the direct cost of laser treatment at $2496 per child. The societal lifetime cost saving per child is estimated at $195,257. The mean annual income per educated adult in Peru is $8000 and treating 1 child is equivalent to employing 24 educated Peruvians per year. The generational cost savings for society is approximately $516 million, or the equivalent of 64,500 educated Peruvian work years. The societal burden of blindness far exceeds the costs of treatment per child. Proper screening and treatment of ROP prevents blindness and leads to substantial cost savings for society. Public health policy in Peru and other middle-income countries should consider financial impact when allocating healthcare resources. Copyright © 2012 Elsevier Inc. All rights reserved.

The meninges contribute to the conditioned taste avoidance induced by neural cooling in male rats.

PubMed

Wang, Yuan; Chambers, Kathleen C

2002-08-21

After consumption of a novel sucrose solution, temporary cooling of neural areas that mediate conditioned taste avoidance can itself induce conditioned avoidance to the sucrose. It has been suggested that this effect is either a result of inactivation of neurons in these areas or of cooling the meninges. In a series of studies, we demonstrated that cooling the outer layer of the meninges, the dura mater, does not contribute to the conditioned taste avoidance induced by cooling any of these areas. The present experiments were designed to determine whether the inner layers of the meninges are involved. If they are involved, then one would expect that cooling locations in the brain that do not mediate conditioned taste avoidance, such as the caudate putamen (CP), would induce conditioned taste avoidance as long as the meninges were cooled as well. One also would expect that cooling neural tissue without cooling the meninges would reduce the strength of the conditioned taste avoidance. Experiment 1 established that the temperature of the neural tissue and meninges around the cold probes implanted in the CP were cooled to temperatures that have been shown to block synaptic transmission. Experiment 2 demonstrated that cooling the caudate putamen and overlying cortex and meninges induced conditioned taste avoidance. In experiment 3, a circle of meninges was cut away so that the caudate putamen and overlying cortex could be cooled without cooling the meninges. The strength of the conditioned taste avoidance was substantially reduced, but it was not entirely eliminated. These data support the hypothesis that cooling the meninges contributes to the conditioned taste avoidance induced by neural cooling. They also allow the possibility that neural inactivation produces physiological changes that can induce conditioned taste avoidance. Copyright 2002 Elsevier Science B.V.

Military Hybrid Vehicle Survey

DTIC Science & Technology

2011-08-03

III Composite 4.3% Integrated starter generator for engine shut down, regenerative braking and avoidance of inefficient engine operation [28]. FMTV...eliminating the inefficiencies associated with idling, vehicle braking and low engine speed part load efficiency, many improvements can be realized...literature. They can be divided into the following two categories : (1) Time dependent speed profiles, shown in Figure 4, usually defined by the federal

Current State of Military Hybrid Vehicle Development

DTIC Science & Technology

2011-08-31

Integrated starter generator for engine shut down, regenerative braking and avoidance of inefficient engine operation [28]. FMTV VI Composite 6-9% Fuel...and eliminating the inefficiencies associated with idling, vehicle braking and low engine speed part load efficiency, many improvements could be...different drive cycles were being used to evaluate vehicle performance. These cycles can be divided into the following two categories : (1) Time

Cancer, culture, and health disparities: time to chart a new course?

PubMed

Kagawa-Singer, Marjorie; Dadia, Annalyn Valdez; Yu, Mimi C; Surbone, Antonella

2010-01-01

Little progress has been made over the last 40 years to eliminate the racial/ethnic differences in incidence, morbidity, avoidable suffering, and mortality from cancer that result from factors beyond genetic differences. More effective strategies to promote equity in access and quality care are urgently needed because the changing demographics of the United States portend that this disparity will not only persist but significantly increase. Such suffering is avoidable. The authors posit that culture is a prime factor in the persistence of health disparities. However, this concept of culture is still poorly understood, inconsistently defined, and ineffectively used in practice and research. The role of culture in the causal pathway of disparities and the potential impact of culturally competent cancer care on improving cancer outcomes in ethnic minorities has, thus, been underestimated. In this article, the authors provide a comprehensive definition of culture and demonstrate how it can be used at each stage of the cancer care continuum to help reduce the unequal burden of cancer. The authors conclude with suggestions for clinical practice to eliminate the disconnection between evidence-based, quality, cancer care and its delivery to diverse population groups.

Elimination des constantes arbitraires dans la theorie relativiste des quanta [85

NASA Astrophysics Data System (ADS)

This article shows how the influence of the undetermined constants in the integral theory of collisions1)2)3)4) can be avoided. A rule is given by which the probability amplitudes (5[F]-matrix) may be calculated in terms of a given local action. The procedure of the integral method differs essentially from the differential method employed by Tomonaga6), Schwikger5), FÅÕímaí7) and Dyson8) in that the two sorts of diverging terms occuring in the formal solution of a Schroedinqer equation are avoided. These two divergencies are: 1) the well known «.self energy» divergencies which have been since corrected by methods of regularization (Rivikr1), Pattli and Villaks9)); 2) the more serious boundary divergencies (Stueckelberg4)) due to the sharp spatio-temporal limitation of the space-time region of evolution V in which the collisions occur. The convergent parts (anomalous g-factor of the electron and the Lamb-Rethekford shift) obtained by Schwinger are, in the present theory, the boundary independent amplitudes in fourth approximation. Üp to this approximation the rule eliminates the arbitrary constants from all conservative processes.

Visual feedback training improves postural adjustments associated with moving obstacle avoidance in elderly women.

PubMed

Hatzitaki, V; Voudouris, D; Nikodelis, T; Amiridis, I G

2009-02-01

The study examined the impact of visually guided weight shifting (WS) practice on the postural adjustments evoked by elderly women when avoiding collision with a moving obstacle while standing. Fifty-six healthy elderly women (70.9+/-5.7 years, 87.5+/-9.6 kg) were randomly assigned into one of three groups: a group that completed 12 sessions (25 min, 3s/week) of WS practice in the Anterior/Posterior direction (A/P group, n=20), a group that performed the same practice in the medio/lateral direction (M/L group, n=20) and a control group (n=16). Pre- and post-training, participants were tested in a moving obstacle avoidance task. As a result of practice, postural response onset shifted closer to the time of collision with the obstacle. Side-to-side WS resulted in a reduction of the M/L sway amplitude and an increase of the trunk's velocity during avoidance. It is concluded that visually guided WS practice enhances elderly's ability for on-line visuo-motor processing when avoiding collision eliminating reliance on anticipatory scaling. Specifying the direction of WS seems to be critical for optimizing the transfer of training adaptations.

Enhancement Of Water-Jet Stripping Of Foam

NASA Technical Reports Server (NTRS)

Cosby, Steven A.; Shockney, Charles H.; Bates, Keith E.; Shalala, John P.; Daniels, Larry S.

1995-01-01

Improved robotic high-pressure-water-jet system strips foam insulation from parts without removing adjacent coating materials like paints, primers, and sealants. Even injects water into crevices and blind holes to clean out foam, without harming adjacent areas. Eliminates both cost of full stripping and recoating and problem of disposing of toxic solutions used in preparation for coating. Developed for postflight refurbishing of aft skirts of booster rockets. System includes six-axis robot provided with special end effector and specially written control software, called Aftfoam. Adaptable to cleaning and stripping in other industrial settings.

Cardiovascular responses to glucagon - Physiologic measurement by external recordings.

NASA Technical Reports Server (NTRS)

Byrne, M. J.; Pigott, V.; Spodick, D. H.

1972-01-01

Assessment by noninvasive polygraphic techniques of the cardiovascular responses of normal subjects to intravenous injections of glucagon and glucagon diluent. A blinding procedure which eliminated observer bias was used during the reading of tracings. Analysis of group results showed that glucagon provoked uniformly significant changes, including increase in heart rate, blood pressure, pressure-rate product, and ejection time index, and decrease in prejection period, mechanical and electromechanical systole, left ventricular ejection time, and the ratio PEP/LVET. The principal results correlated well with those of previous studies of the hemodynamic effects of glucagon.

Comparative Pharmacodynamics and Plasma Concentrations of D-Threo-Methylphenidate Hydrochloride after Single Doses of D-Threo-Methylphenidate Hydrochloride and D,l-Threo-Methylphenidate Hydrochloride in a Double-Blind, Placebo-Controlled, Crossover Laboratory School Study in Children with Attention-Deficit/hyperactivity Disorder

ERIC Educational Resources Information Center

Quinn, Declan; Wigal, Sharon; Swanson, James; Hirsch, Sharon; Ottolini, Yvonne; Dariani, Maghsoud; Roffman, Mark; Zeldis, Jerome; Cooper, Thomas

2004-01-01

Objective: Methylphenidate has four optical isomers due to two asymmetries (erythro-threo and dextro-levo). The initial commercial formulation eliminated the erythro isomer, but the dextro-levo asymmetry was racemic, with equal amounts of d and l-threo isomers (d,l-MPH). Previous work has suggested that the d-threo isomer methylphenidate (d-MPH)…

Large-Format AlGaN PIN Photodiode Arrays for UV Images

NASA Technical Reports Server (NTRS)

Aslam, Shahid; Franz, David

2010-01-01

A large-format hybridized AlGaN photodiode array with an adjustable bandwidth features stray-light control, ultralow dark-current noise to reduce cooling requirements, and much higher radiation tolerance than previous technologies. This technology reduces the size, mass, power, and cost of future ultraviolet (UV) detection instruments by using lightweight, low-voltage AlGaN detectors in a hybrid detector/multiplexer configuration. The solar-blind feature eliminates the need for additional visible light rejection and reduces the sensitivity of the system to stray light that can contaminate observations.

Ensuring Universal Access to Eye Health in Urban Slums in the Global South: The Case of Bhopal (India).

PubMed

Pregel, Andrea; Vaughan Gough, Tracy; Jolley, Emma; Buttan, Sandeep; Bhambal, Archana

2016-01-01

Sightsavers is an international organisation working with partners in over 30 countries to eliminate avoidable blindness and help people with disabilities participate more fully in society. In the context of its Urban Eye Health Programme in Bhopal (India), the organisation launched a pilot approach aimed at developing an Inclusive Eye Health (IEH) model and IEH Minimum Standards. Accessibility audits were conducted in a tertiary eye hospital and four primary vision centres located within urban slums, addressing the accessibility of physical infrastructures, communication and service provision. The collection and analysis of disaggregated data inform the inclusion strategy and provide a baseline to measure the impact of service provision. Trainings of eye health staff and sensitisation of decision makers on accessibility, Universal Design, disability and gender inclusion are organised on a regular basis. A referral network is being built to ensure participation of women, people with disabilities and other marginalised groups, explore barriers at demand level, and guarantee wider access to eye care in the community. Finally, advocacy interventions will be developed to raise awareness in the community and mainstream disability and gender inclusion within the public health sector. Founded on principles of Universal Design, accessibility and participation, and in line with international human rights treaties, Agenda 2030 and the Sustainable Development Goals (SDGs), Sightsavers' IEH model ultimately aims to develop a sustainable, scalable and universally accessible system-strengthening approach, capable of ensuring more inclusive services to people with disabilities, women and other marginalised groups, and designed to more effectively meet the health needs of the entire population.

The role of food allergy in atopic dermatitis.

PubMed

Greenhawt, Matthew

2010-01-01

Atopic dermatitis (AD) affects ∼10% of children. Food allergy is a known provoking cause of AD in a subset of affected children. A literature search of PubMed and Medline was conducted to review the epidemiology and pathophysiology of AD, with special focus on the role of food allergy in the development of AD, its management, and its long-term preventive strategies. A literature search of PubMed and Medline was conducted. Food allergens readily provoke AD in ∼35% of patients, as proven through double-blind placebo-controlled food challenge studies. Milk, egg, wheat, soy, and peanut account for 75% of the cases of food-induced AD. However, the positive predictive values of the parental history, skin-prick tests, or serum tests for detecting food-specific IgE are low, making these unsuitable for use as single diagnostic modalities. Therefore, the use of a food challenge test is very helpful in objectively confirming the history or positive tests. Elimination diets are often helpful in challenge-proven cases, but care must be taken to evaluate the nutritional status of the child. There are few effective long-term strategies to prevent the development of food allergen-induced AD. Early onset of AD has been shown to be a risk factor for the development of other allergic diseases, including other food allergy/sensitization, as part of the atopic march. Treatment of other causes of AD, such as barrier dysfunction and cutaneous infection, are of equal importance to food allergen avoidance. Food allergy is an important provoking cause of AD, but it is only relevant in ∼35% of affected individuals.

Health systems analysis of eye care services in Zambia: evaluating progress towards VISION 2020 goals

PubMed Central

2014-01-01

Background VISION 2020 is a global initiative launched in 1999 to eliminate avoidable blindness by 2020. The objective of this study was to undertake a situation analysis of the Zambian eye health system and assess VISION 2020 process indicators on human resources, equipment and infrastructure. Methods All eye health care providers were surveyed to determine location, financing sources, human resources and equipment. Key informants were interviewed regarding levels of service provision, management and leadership in the sector. Policy papers were reviewed. A health system dynamics framework was used to analyse findings. Results During 2011, 74 facilities provided eye care in Zambia; 39% were public, 37% private for-profit and 24% owned by Non-Governmental Organizations. Private facilities were solely located in major cities. A total of 191 people worked in eye care; 18 of these were ophthalmologists and eight cataract surgeons, equivalent to 0.34 and 0.15 per 250,000 population, respectively. VISION 2020 targets for inpatient beds and surgical theatres were met in six out of nine provinces, but human resources and spectacles manufacturing workshops were below target in every province. Inequalities in service provision between urban and rural areas were substantial. Conclusion Shortage and maldistribution of human resources, lack of routine monitoring and inadequate financing mechanisms are the root causes of underperformance in the Zambian eye health system, which hinder the ability to achieve the VISION 2020 goals. We recommend that all VISION 2020 process indicators are evaluated simultaneously as these are not individually useful for monitoring progress. PMID:24575919

Elimination of leprosy as a public health problem by 2000 AD: an epidemiological perspective.

PubMed

Nsagha, Dickson Shey; Bamgboye, Elijah Afolabi; Assob, Jules Clement Nguedia; Njunda, Anna Longdoh; Kamga, Henri Lucien Foumou; Zoung-Kanyi Bissek, Anne-Cécile; Tabah, Earnest Nji; Oyediran, Alain Bankole O O; Njamnshi, Alfred Kongnyu

2011-01-01

Leprosy is caused by Mycobacterium leprae and manifests as damage to the skin and peripheral nerves. The disease is dreaded because it causes deformities, blindness and disfigurement. Worldwide, 2 million people are estimated to be disabled by leprosy. Multidrug therapy is highly effective in curing leprosy, but treating the nerve damage is much more difficult. The World Health Assembly targeted to eliminate leprosy as a public health problem from the world by 2000. The objective of the review was to assess the successes of the leprosy elimination strategy, elimination hurdles and the way forward for leprosy eradication. A structured search was used to identify publications on the elimination strategy. The keywords used were leprosy, elimination and 2000. To identify potential publications, we included papers on leprosy elimination monitoring, special action projects for the elimination of leprosy, modified leprosy elimination campaigns, and the Global Alliance to eliminate leprosy from the following principal data bases: Cochrane data base of systematic reviews, PubMed, Medline, EMBASE, and the Leprosy data base. We also scanned reference lists for important citations. Key leprosy journals including WHO publications were also reviewed. The search identified 63 journal publications on leprosy-related terms that included a form of elimination of which 19 comprehensively tackled the keywords including a book on leprosy elimination. In 1991, the 44th World Health Assembly called for the elimination of leprosy as a public health problem in the world by 2000. Elimination was defined as less than one case of leprosy per 10000-population. Elimination has been made possible by a confluence of several orders of opportunities: the scientific (the natural history of leprosy at the present state of knowledge), technological (multi-drug therapy and the blister pack); political (commitment of governments) and financial (support from NGOs for example the Nippon Foundation that supplies free multi-drug therapy) opportunities. Elimination created the unrealistic expectation that the leprosy problem could be solved by 2000. First, the elimination goal was not feasible in several areas which had high incidence of leprosy. Even if elimination was to be attained, significant numbers of new cases of leprosy would continue to occur and many people with physical imperfections, severe psychological, economic and social problems caused by leprosy would need continuous assistance. Extra-human reservoirs of Mycobacterium leprae, the relationship between leprosy and poverty, prevention of disabilities, lack of a reliable laboratory test to detect subclinical infection and a vaccine are also challenging issues. The evidence base available to inform on leprosy elimination is highly positive with the availability of multi-drug therapy blister packs. There are concerns that leprosy was not the right disease to be targeted for elimination as there are no reliable diagnostic tests to detect subclinical infection including the lack of a vaccine, extra-human reservoirs (monkeys and armadillos), increase in the burden of child cases, no good epidemiological indicator as prevalence instead of incidence is used to measure elimination. Multi-drug therapy treats leprosy very well but there is no proof that it concurrently interrupts transmission. The high social stigma, prevention of disabilities, and the relationship between leprosy and poverty are still major concerns.

Role of maternal elimination diets and human milk IgA in development of cow’s milk allergy in the infants

PubMed Central

Järvinen, Kirsi M.; Westfall, Jennifer E.; Seppo, Max S.; James, Aisha K.; Tsuang, Angela J.; Feustel, Paul J.; Sampson, Hugh A.; Berin, Cecilia

2014-01-01

Background The role of maternal avoidance diets in the prevention of food allergies is currently under debate. Little is known regarding the effects of such diets on human milk (HM) composition or induction of infant humoral responses. Objective To assess the association of maternal cow’s milk (CM) avoidance during breastfeeding with specific IgA levels in HM and development of cow’s milk allergy (CMA) in infants. Methods We utilized HM and infant serum samples from a prospective birth cohort of 145 dyads. Maternal serum and HM samples were assessed for casein and beta-lactoglobulin (BLG)-specific IgA and IgG by ELISA; 21 mothers prophylactically initiated a strict maternal CM avoidance diet due to a sibling’s history of food allergy and 16 due to atopic eczema or regurgitation/vomiting seen in their infants within the first 3 months of life. Infants’ sera were assessed for casein and BLG-specific IgG, IgA and IgE; CMA was confirmed by an oral food challenge. The impact of HM on BLG uptake was assessed in transcytosis assays utilizing Caco-2 intestinal epithelial cell line. Results Mothers avoiding CM had lower casein- and BLG-specific IgA in HM than mothers with no CM restriction (p=0.019 and p=0.047). Their infants had lower serum casein- and BLG-specific IgG1 (p=0.025 and p<0.001) and BLG-specific IgG4 levels (p=0.037) and their casein- and BLG-specific IgA levels were less often detectable than those with no CM elimination diet (p=0.003 and p=0.007). Lower CM-specific IgG4 and IgA levels in turn were associated with infant CMA. Transcytosis of BLG was impaired by HM with high, but not low levels of specific IgA. Conclusions Maternal CM avoidance was associated with lower levels of mucosal specific IgA levels and development of CMA in infants. Clinical relevance HM IgA may play a role in preventing excessive, uncontrolled food antigen uptake in the gut lumen and thereby in the prevention of CMA. PMID:24164317

Role of maternal elimination diets and human milk IgA in the development of cow's milk allergy in the infants.

PubMed

Järvinen, K M; Westfall, J E; Seppo, M S; James, A K; Tsuang, A J; Feustel, P J; Sampson, H A; Berin, C

2014-01-01

The role of maternal avoidance diets in the prevention of food allergies is currently under debate. Little is known regarding the effects of such diets on human milk (HM) composition or induction of infant humoral responses. To assess the association of maternal cow's milk (CM) avoidance during breastfeeding with specific IgA levels in HM and development of cow's milk allergy (CMA) in infants. We utilized HM and infant serum samples from a prospective birth cohort of 145 dyads. Maternal serum and HM samples were assessed for casein and beta-lactoglobulin (BLG)-specific IgA and IgG by ELISA; 21 mothers prophylactically initiated a strict maternal CM avoidance diet due to a sibling's history of food allergy and 16 due to atopic eczema or regurgitation/vomiting seen in their infants within the first 3 months of life. Infants' sera were assessed for casein and BLG-specific IgG, IgA and IgE; CMA was confirmed by an oral food challenge. The impact of HM on BLG uptake was assessed in transcytosis assays utilizing Caco-2 intestinal epithelial cell line. Mothers avoiding CM had lower casein- and BLG-specific IgA in HM than mothers with no CM restriction (P = 0.019 and P = 0.047). Their infants had lower serum casein- and BLG-specific IgG(1) (P = 0.025 and P < 0.001) and BLG-specific IgG(4) levels (P = 0.037), and their casein- and BLG-specific IgA levels were less often detectable than those with no CM elimination diet (P = 0.003 and P = 0.007). Lower CM-specific IgG4 and IgA levels in turn were associated with infant CMA. Transcytosis of BLG was impaired by HM with high, but not low levels of specific IgA. Maternal CM avoidance was associated with lower levels of mucosal-specific IgA levels and the development of CMA in infants. HM IgA may play a role in preventing excessive, uncontrolled food antigen uptake in the gut lumen and thereby in the prevention of CMA. © 2013 John Wiley & Sons Ltd.

A Systematic Review of Carrion Eaters' Adaptations to Avoid Sickness.

PubMed

Blumstein, Daniel T; Rangchi, Tiana N; Briggs, Tiandra; De Andrade, Fabrine Souza; Natterson-Horowitz, Barbara

2017-07-01

Species that scavenge on dead animals are exposed to enhanced disease risks. Eight hypotheses have been suggested to explain how scavengers avoid becoming sick from their diet. We conducted a systematic review of the literature and found correlative support for four of the eight hypotheses but limited evidence of systematic studies of the hypotheses. We found no support that using urine to sterilize carcasses, having bald heads, eating rapidly, or food-washing behavior reduced disease risk in carrion eaters. With the exception of food washing, none of these hypotheses have been properly evaluated as an adaptation to avoid sickness from carrion. There is some support for having a specialized microbiome, having enhanced immunologic defenses, avoiding rotten food, and maintaining a low gastric pH to eliminate pathogens. Specialized immunologic defenses and having a low pH have the most support, but the diversity of mechanisms suggests that there is a great opportunity for even more detailed study. Increased knowledge in these mechanisms may provide biomimetic insights to help combat foodborne illnesses and enhance health.

The risk of unblinding was infrequently and incompletely reported in 300 randomized clinical trial publications.

PubMed

Bello, Segun; Moustgaard, Helene; Hróbjartsson, Asbjørn

2014-10-01

To assess the proportion of clinical trials explicitly reporting the risk of unblinding, to evaluate the completeness of reporting on unblinding risk, and to describe the reported procedures involved in assessing unblinding. We sampled at random 300 blinded randomized clinical trials indexed in PubMed in 2010. Two authors read the trial publications and extracted data independently. Twenty-four trial publications, or 8% (95% confidence interval [CI], 5, 12%), explicitly reported the risk of unblinding, of which 16 publications, or 5% (95% CI, 3, 8%), reported compromised blinding; and 8 publications, or 3% (95% CI, 1, 5%), intact blinding. The reporting on risk of unblinding in the 24 trial publications was generally incomplete. The median proportion of assessments per trial affected by unblinding was 3% (range 1-30%). The most common mechanism for unblinding was perceptible physical properties of the treatments, for example, a difference in the taste and odor of a typhoid vaccine compared with its placebo. Published articles on randomized clinical trials infrequently reported risk of unblinding. This may reflect a tendency for avoiding reporting actual or suspected unblinding or a genuine low risk of unblinding. Copyright © 2014 Elsevier Inc. All rights reserved.

Viagra, surgery and anesthesia: a dangerous cocktail with a risk of blindness.

PubMed

Fodale, V; Di Pietro, R; Santamaria, S

2007-01-01

Since the launch in 1998 of the anti-impotence drug sildenafil (viagra), the American food and drug administration has identified 50 cases of drug-related blindness, the so-called nonarteritic anterior ischemic optic neuropathy. This, very serious, side effect frequently leads to sudden, mostly irreversible loss of vision, and there is no proven effective treatment to cure patients or to prevent recurrence. The mechanism of ischemic optic neuropathy is not clear, but it could be related to the fact that the ophthalmic and central retinal arteries have an autoregulation of their own blood flow without any autonomic nerve supply; vasoreactivity could be lower albeit efficient, and therefore more vulnerable to systemic modifications of the circulation. But decreased visual acuity and loss of visual ability also are, although uncommon, anesthesiological and surgical complications. These data are consistent with the hypothesis that sildenafil, surgery and anesthesia, taken together, could be a potentially dangerous cocktail of risk factors for sudden irreversible loss of vision. To reduce the risk, sildenafil use should be avoided at least one week before surgical operations, since the reported cases of blindness developed 36h after drug ingestion.

Inattentional blindness reflects limitations on perception, not memory: Evidence from repeated failures of awareness.

PubMed

Ward, Emily J; Scholl, Brian J

2015-06-01

Perhaps the most striking phenomenon of visual awareness is inattentional blindness (IB), in which a surprisingly salient event right in front of you may go completely unseen when unattended. Does IB reflect a failure of perception, or only of subsequent memory? Previous work has been unable to answer this question, due to a seemingly intractable dilemma: ruling out memory requires immediate perceptual reports, but soliciting such reports fuels an expectation that eliminates IB. Here we introduce a way of evoking repeated IB in the same subjects and the same session: we show that observers fail to report seeing salient events' not only when they have no expectation, but also when they have the wrong expectations about the events nature. This occurs when observers must immediately report seeing anything unexpected, even mid-event. Repeated IB thus demonstrates that IB is aptly named: it reflects a genuine deficit in moment-by-moment conscious perception, rather than a form of inattentional amnesia.

Joint channel estimation and multi-user detection for multipath fading channels in DS-CDMA systems

NASA Astrophysics Data System (ADS)

Wu, Sau-Hsuan; Kuo, C.-C. Jay

2002-11-01

The technique of joint blind channel estimation and multiple access interference (MAI) suppression for an asynchronous code-division multiple-access (CDMA) system is investigated in this research. To identify and track dispersive time-varying fading channels and to avoid the phase ambiguity that come with the second-order statistic approaches, a sliding-window scheme using the expectation maximization (EM) algorithm is proposed. The complexity of joint channel equalization and symbol detection for all users increases exponentially with system loading and the channel memory. The situation is exacerbated if strong inter-symbol interference (ISI) exists. To reduce the complexity and the number of samples required for channel estimation, a blind multiuser detector is developed. Together with multi-stage interference cancellation using soft outputs provided by this detector, our algorithm can track fading channels with no phase ambiguity even when channel gains attenuate close to zero.

Effect of maternal dietary exclusion on breast fed infants with eczema: two controlled studies.

PubMed Central

Cant, A J; Bailes, J A; Marsden, R A; Hewitt, D

1986-01-01

Thirty seven breast fed infants with eczema were studied to see whether changes in their mothers' diets affected their skin condition. Nineteen mothers and babies took part in a double blind crossover trial of exclusion of egg and cows' milk, and 18 took part in open exclusion of 11 foods followed by double blind challenge to those mothers whose infants seemed to respond. Babies were examined at the beginning and end of each dietary period, and the extent and severity of the rash were given a numerical score. The eczema improved in six infants when their mothers avoided egg and cows' milk and worsened again when these were reintroduced. Two infants suffered gastrointestinal reactions after maternal ingestion of egg and cows' milk, one developing colitis. Maternal dietary exclusion seems to benefit some breast fed babies with eczema. PMID:3089466

IgG-based elimination diet in migraine plus irritable bowel syndrome.

PubMed

Aydinlar, Elif Ilgaz; Dikmen, Pinar Yalinay; Tiftikci, Arzu; Saruc, Murat; Aksu, Muge; Gunsoy, Hulya G; Tozun, Nurdan

2013-03-01

To evaluate therapeutic potential of the immunoglobulin G (IgG)-based elimination diet among migraine patients with irritable bowel syndrome (IBS). Food elimination has been suggested as an effective and inexpensive therapeutic strategy in patients with migraine and concomitant IBS in the past studies. A total of 21 patients (mean [standard deviation] age: 38.0 [11.2] years; 85.7% females) diagnosed with migraine and IBS were included in this double-blind, randomized, controlled, cross-over clinical trial composed of baseline (usual diet), first diet (elimination or provocation diets), and second diet (interchange of elimination or provocations diets) phases and 4 visits. IgG antibody tests against 270 food allergens revealed mean (standard deviation) reaction count to be 23.1 (14.1). Compared with baseline levels, elimination diet per se was associated with significant reductions in attack count (4.8 [2.1] vs 2.7 [2.0]; P < .001), maximum attack duration (2.6 [0.6] vs. 1.4 [1.1] days; P < .001), mean attack duration (1.8 [0.5] vs. 1.1 [0.8] days; P < .01), maximum attack severity (visual analog scale 8.5 [1.4] vs. visual analog scale 6.6 [3.3]; P < .001), and number of attacks with acute medication (4.0 [1.5] vs. 1.9 [1.8]; P < .001). There was a significant reduction in pain-bloating severity (1.8 [1.3] vs. 3.2 [0.8]; P < .05), pain-bloating within the last 10 days (3.2 [2.8] vs. 5.5 [3.1]; P < .05), and improvement obtained in quality of life (3.6 [1.4] vs. 2.9 [1.0]; P < .05) by the elimination diet as compared with provocation diet. Our findings indicate that food elimination based on IgG antibodies in migraine patients who suffer from concomitant IBS may effectively reduce symptoms from both disorders with possible positive impact on the quality of life of the patients as well as potential savings to the health-care system. © 2012 American Headache Society.

Elimination of onchocerciasis from Colombia: first proof of concept of river blindness elimination in the world.

PubMed

Nicholls, Rubén Santiago; Duque, Sofía; Olaya, Luz Adriana; López, Myriam Consuelo; Sánchez, Sol Beatriz; Morales, Alba Lucía; Palma, Gloria Inés

2018-04-11

Onchocerciasis is a chronic parasitic infection originally endemic in 13 discrete regional foci distributed among six countries of Latin America (Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela). In Colombia, this disease was discovered in 1965 in the Pacific Coast of the country. The National Onchocerciasis Elimination Program was established in 1993 with the aim of eliminating disease morbidity and infection transmission. In 2013, the World Health Organization (WHO) verified Colombia as free of onchocerciasis, becoming the first country in the world to reach such a goal. This report provides the empirical evidence of the elimination of Onchocerca volvulus transmission by Simulium exiguum (s.l.) after 12 years of 6-monthly mass drug administration of Mectizan® (ivermectin) to all the eligible residents living in this endemic area. From 1996 onwards, a biannual community-based mass ivermectin administration programme was implemented, complemented by health education and community participation. In-depth parasitological, serological and entomological surveys were conducted periodically between 1998 and 2007 to evaluate the impact of ivermectin treatment according to the 2001 WHO guidelines. When the interruption of parasite transmission was demonstrated, the drug distribution ceased and a three-year post-treatment surveillance (PTS) period (2008-2010) was initiated. After 23 rounds of treatment, parasitological and ophthalmological assessments showed absence of microfilariae in skin and anterior chamber of the eyes. Serological tests proved lack of antibodies against O. volvulus in children under 10 years-old. A total of 10,500 S. exiguum flies tested by PCR had no L3 infection (infectivity rate = 0.0095%; 95% CI: 0.0029-0.049) during 2004, indicating interruption of parasite transmission. However, biannual ivermectin treatments continued until 2007 followed by a 3-year PTS period at the end of which 13,481 flies were analyzed and no infective flies were found (infectivity rate = 0%; 95% CI: 0.0-0.014). These results fulfilled the WHO criteria for onchocerciasis elimination. Consequently, in 2013 Colombia was verified as free of onchocerciasis, demonstrating that elimination of this neglected tropical disease is an achievable goal and paving the way for an elimination agenda to be followed by other endemic countries in Latin America and Africa.

Persons with Mild or Moderate Alzheimer's Disease Learn to Use Urine Alarms and Prompts to Avoid Large Urinary Accidents

ERIC Educational Resources Information Center

Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Bosco, Andrea; Zonno, Nadia; Badagliacca, Francesco

2011-01-01

This study assessed whether three patients with Alzheimer's disease could learn to use urine alarms and caregivers' prompts to eliminate large urinary accidents. As soon as the patient began to release urine, the alarm system presented auditory and vibratory signals. In relation to those signals, the caregiver would prompt/encourage the patient to…

Removing the depth-degeneracy in optical frequency domain imaging with frequency shifting

PubMed Central

Yun, S. H.; Tearney, G. J.; de Boer, J. F.; Bouma, B. E.

2009-01-01

A novel technique using an acousto-optic frequency shifter in optical frequency domain imaging (OFDI) is presented. The frequency shift eliminates the ambiguity between positive and negative differential delays, effectively doubling the interferometric ranging depth while avoiding image cross-talk. A signal processing algorithm is demonstrated to accommodate nonlinearity in the tuning slope of the wavelength-swept OFDI laser source. PMID:19484034

Language and System Support for Concurrent Programming

DTIC Science & Technology

1990-04-01

language. We give suggestions on how to avoid polling programs , and suggest changes to the rendezvous facilities to eliminate the polling bias. The...concerned with support for concurrent pro- Capsule gramming provided to the application programmer by operating Description systems and programming ...of concurrent programming has widened Philosophy from "pure" operating system applications to a multitude of real-time and distributed programs . Since

What a Shock: No Apoptosis without Heat Shock Protein 90α | Center for Cancer Research

Cancer.gov

Apoptosis, also known as programmed cell death, consists of a series of reactions designed to systematically chop up a cell and its contents. The process is used to eliminate specific cells during development or to remove old or damaged cells without harming any surrounding cells. Since cancer cells can develop mechanisms to avoid apoptosis, researchers may be able to identify

IL-27 Found to Play Significant Role in Conferring HIV Resistance | Poster

Cancer.gov

By Nancy Parrish, Staff Writer The human immunodeficiency virus (HIV) targets specific immune cells in the body known as macrophages because these are the cells that eliminate foreign material such as bacteria or viruses. HIV is able to reproduce and spread throughout the body if it can avoid destruction by macrophages. A recent study by Lue Dai, Ph.D., and colleagues revealed

Prevalence and causes of blindness in children in Vietnam.

PubMed

Limburg, Hans; Gilbert, Clare; Hon, Do Nhu; Dung, Nguyen Chi; Hoang, Tran Huy

2012-02-01

To estimate the prevalence of blindness in children in Vietnam and to assess the major causes. A population-based study sampled children from 16 provinces across Vietnam. The second study examined children attending all blind schools in Vietnam. In 16 provinces, 28 800 children aged 0-15 were sampled. In 28 blind schools, 569 children aged 0-15 were examined. In children not seeing well according to the parents, presenting visual acuity (PVA) was assessed. If PVA was <3/60 in one or both eyes, the child was examined by an ophthalmologist. All children in blind schools were examined by a pediatric ophthalmologist. Blindness was defined as PVA <3/60 in the better eye. Causes of visual loss were classified using the World Health Organization classification. In the population-based study, 22 children had a PVA <3/60 in the better eye, a prevalence of 7.6/10 000 children (95% confidence interval [CI], 4.9-11.8/10 000). Fourteen children had a pinhole visual acuity <3/60 in the better eye, a prevalence of 4.9/10 000 (95% CI, 2.8-8.4/10 000). An estimated 16 400 (95% CI, 10 500-25 300), children were blind from all causes, with 36.4% from uncorrected refractive errors. In the blind schools, 411 children had a PVA <3/60 in the better eye and 55.5% were male. Conditions of the retina (24.6%) and cornea (24.0%) predominated. Retinopathy of prematurity (ROP) caused blindness in 32.6% of children younger than 10 years, but in only 6% of older children. The converse was true for corneal scarring and phthisis (14.0% and 27.3%, respectively). All other causes were similar between age groups (53.5% and 66.7%, respectively). More than half of all causes were avoidable. Vietnam is developing very rapidly, and this is impacting health indices. The mortality rate of those younger than 5 years declined from 65/100 live births in 1980 to 14/100 in 2008. The findings of this study show these changes, because the childhood blindness prevalence was relatively low, and the causes show improved control of measles and vitamin A deficiency, as well as increased services for premature babies. Eye care services for children should now focus on refractive errors, cataract, and control of ROP. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Further statistics in dentistry. Part 4: Clinical trials 2.

PubMed

Petrie, A; Bulman, J S; Osborn, J F

2002-11-23

The principles which underlie a well-designed clinical trial were introduced in a previous paper. The trial should be controlled (to ensure that the appropriate comparisons are made), randomised (to avoid allocation bias) and, preferably, blinded (to obviate assessment bias). However, taken in isolation, these concepts will not necessarily ensure that meaningful conclusions can be drawn from the study. It is essential that the sample size is large enough to enable the effects of interest to be estimated precisely, and to detect any real treatment differences.

Robot-assisted thoracoscopic surgery with simple laparoscopy for diaphragm eventration.

PubMed

Ahn, Joong Hyun; Suh, Jong Hui; Jeong, Jin Yong

2013-09-01

Robot-assisted thoracoscopic surgery has been applied for general thoracic operations. Its advantages include not only those of minimally invasive surgery but also those of magnified three-dimensional vision and angulation of the robotic arm. However, there are no direct tactile sensation and force feedback, which can cause unwanted organ damage. We therefore used laparoscopy simultaneously to avoid a blind intraperitoneal area during robotic surgery for diaphragmatic eventration via transthoracic approach and describe the technique herein. Georg Thieme Verlag KG Stuttgart · New York.

Importance of intraocular pressure in glaucoma

NASA Astrophysics Data System (ADS)

Joos, Karen M.

1999-06-01

Glaucoma results in permanent vision loss and affects the peripheral vision initially. It is presented in 22.5 million people worldwide and is the 3rd cause of blindness. Present tonometers are not ideal for intraocular pressure measurements in all eyes. Of concern, PRK and LASIK may result in lower intraocular pressure readings. A challenges now exists for the development of a tonometer which can easily compensate for corneas with many parameters to avoid a future increase in normal-tension glaucoma or glaucoma which is advanced.

Flying Blind at over 7 Kilometers per Second: A Concept for Improving Space Collision Avoidance

DTIC Science & Technology

2010-05-20

gotten crowded, especially in low Earth orbits around the poles. 2 As more and more countries and private organizations have gained access to space...shell around the Earth within two years. 15 Figure 6 depicts the orange and blue fragments moving across the North Pole in comparison to the orbits ... Sun , Moon, Mars, and Jupiter. Because these sources are far away, their influences are not enough to wrest an object out of Earth orbit , but the

Global Vision Impairment and Blindness Due to Uncorrected Refractive Error, 1990-2010.

PubMed

Naidoo, Kovin S; Leasher, Janet; Bourne, Rupert R; Flaxman, Seth R; Jonas, Jost B; Keeffe, Jill; Limburg, Hans; Pesudovs, Konrad; Price, Holly; White, Richard A; Wong, Tien Y; Taylor, Hugh R; Resnikoff, Serge

2016-03-01

The purpose of this systematic review was to estimate worldwide the number of people with moderate and severe visual impairment (MSVI; presenting visual acuity <6/18, ≥3/60) or blindness (presenting visual acuity <3/60) due to uncorrected refractive error (URE), to estimate trends in prevalence from 1990 to 2010, and to analyze regional differences. The review focuses on uncorrected refractive error which is now the most common cause of avoidable visual impairment globally. : The systematic review of 14,908 relevant manuscripts from 1990 to 2010 using Medline, Embase, and WHOLIS yielded 243 high-quality, population-based cross-sectional studies which informed a meta-analysis of trends by region. The results showed that in 2010, 6.8 million (95% confidence interval [CI]: 4.7-8.8 million) people were blind (7.9% increase from 1990) and 101.2 million (95% CI: 87.88-125.5 million) vision impaired due to URE (15% increase since 1990), while the global population increased by 30% (1990-2010). The all-age age-standardized prevalence of URE blindness decreased 33% from 0.2% (95% CI: 0.1-0.2%) in 1990 to 0.1% (95% CI: 0.1-0.1%) in 2010, whereas the prevalence of URE MSVI decreased 25% from 2.1% (95% CI: 1.6-2.4%) in 1990 to 1.5% (95% CI: 1.3-1.9%) in 2010. In 2010, URE contributed 20.9% (95% CI: 15.2-25.9%) of all blindness and 52.9% (95% CI: 47.2-57.3%) of all MSVI worldwide. The contribution of URE to all MSVI ranged from 44.2 to 48.1% in all regions except in South Asia which was at 65.4% (95% CI: 62-72%). : We conclude that in 2010, uncorrected refractive error continues as the leading cause of vision impairment and the second leading cause of blindness worldwide, affecting a total of 108 million people or 1 in 90 persons.

Rapid assessment of avoidable blindness in Papua New Guinea: a nationwide survey.

PubMed

Lee, Ling; D'Esposito, Fabrizio; Garap, Jambi; Wabulembo, Geoffrey; Koim, Samuel Peter; Keys, Drew; Cama, Anaseini T; Limburg, Hans; Burnett, Anthea

2018-05-23

To estimate the prevalence and main causes of blindness and vision impairment in people aged 50 years and older in Papua New Guinea (PNG). National cross-sectional population-based survey in National Capital District (NCD), Highlands, Coastal and Islands regions. Adults aged 50 years and above were recruited from 100 randomly selected clusters. Each participant underwent monocular presenting and pinhole visual acuity (VA) assessment and lens examination. Those with pinhole VA<6/12 in either eye had a dilated fundus examination to determine the primary cause of reduced vision. Those with obvious lens opacity were interviewed on barriers to cataract surgery. A total of 4818 adults were examined. The age-adjusted and sex-adjusted prevalence of blindness (VA <3/60), severe vision impairment (SVI, VA <6/60 but ≥3/60), moderate vision impairment (MVI, VA <6/18 but ≥6/60) and early vision impairment (EVI, VA <6/12 but ≥6/18) was 5.6% (95% CI 4.9% to 6.3%), 2.9% (95% CI 2.5% to 3.4%), 10.9% (95% CI 9.9% to 11.9%) and 7.3% (95% CI 6.6% to 8.0%), respectively. The main cause of blindness, SVI and MVI was cataract, while uncorrected refractive error was the main cause of EVI. A significantly higher prevalence of blindness, SVI and MVI occurred in the Highlands compared with NCD. Across all regions, women had lower cataract surgical coverage and spectacle coverage than men. PNG has one of the highest reported prevalence of blindness globally. Cataract and uncorrected refractive error are the main causes, suggesting a need for increased accessible services with improved resources and advocacy for enhancing eye health literacy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Prevalence of Colour Vision Anomalies Amongst Dental Professionals and its Effect on Shade Matching of Teeth.

PubMed

Khosla, Amrit; Maini, Anuj Paul; Wangoo, Anuj; Singh, Sukhman; Mehar, Damanpreet Kaur

2017-01-01

The success of a restoration is dependent on accurate shade matching of teeth leading to studies evaluating the factors affecting the perception of shades. Colour vision anomalies including colour blindness have been found to exist in the population and it has been thought to be a potential factor affecting the colour perception ability. The present study was done to evaluate the prevalence of colour vision anomalies and its effect on matching of shades of teeth. A total of 147 dental professionals were randomly selected for the study and were first tested for visual acuity using the Snellen's Eye Chart so as to carry on the study with only those operators who had a vision of 6/6. Then, the Ishihara's colour charts were used to test the operators for colour vision handicap. In the last stage of the study, test for accuracy of shade selection was done using the Vitapan Classical shade guide. The shade guide tabs were covered to avoid bias. Percentage was used to calculate the prevalence of colour vision handicap and its effect on matching of shades of teeth as compared to normal vision, which was evaluated using Chi square test. Nineteen operators had colour vision anomalies out of hundred operators and only two operators presented with colour blindness. Colour vision anomaly was more prevalent than colour blindness and it was also found that it was more prevalent in males than females. The difference between the accuracy of shade matching between the operators with normal vision and colour vision defect and operators with normal vision and colour blindness was statistically not significant. Colour blindness and colour vision handicap are rare conditions, with the latter being more common in the population. According to our study, it was concluded that no statistically significant difference existed amongst the operators with normal vision and colour vision anomaly or operators with normal vision and colour blindness during the matching of shades of teeth.

Decentralized control of large-scale systems: Fixed modes, sensitivity and parametric robustness. Ph.D. Thesis - Universite Paul Sabatier, 1985

NASA Technical Reports Server (NTRS)

Tarras, A.

1987-01-01

The problem of stabilization/pole placement under structural constraints of large scale linear systems is discussed. The existence of a solution to this problem is expressed in terms of fixed modes. The aim is to provide a bibliographic survey of the available results concerning the fixed modes (characterization, elimination, control structure selection to avoid them, control design in their absence) and to present the author's contribution to this problem which can be summarized by the use of the mode sensitivity concept to detect or to avoid them, the use of vibrational control to stabilize them, and the addition of parametric robustness considerations to design an optimal decentralized robust control.

CAD scheme for detection of hemorrhages and exudates in ocular fundus images

NASA Astrophysics Data System (ADS)

Hatanaka, Yuji; Nakagawa, Toshiaki; Hayashi, Yoshinori; Mizukusa, Yutaka; Fujita, Akihiro; Kakogawa, Masakatsu; Kawase, Kazuhide; Hara, Takeshi; Fujita, Hiroshi

2007-03-01

This paper describes a method for detecting hemorrhages and exudates in ocular fundus images. The detection of hemorrhages and exudates is important in order to diagnose diabetic retinopathy. Diabetic retinopathy is one of the most significant factors contributing to blindness, and early detection and treatment are important. In this study, hemorrhages and exudates were automatically detected in fundus images without using fluorescein angiograms. Subsequently, the blood vessel regions incorrectly detected as hemorrhages were eliminated by first examining the structure of the blood vessels and then evaluating the length-to-width ratio. Finally, the false positives were eliminated by checking the following features extracted from candidate images: the number of pixels, contrast, 13 features calculated from the co-occurrence matrix, two features based on gray-level difference statistics, and two features calculated from the extrema method. The sensitivity of detecting hemorrhages in the fundus images was 85% and that of detecting exudates was 77%. Our fully automated scheme could accurately detect hemorrhages and exudates.

Image Quality Ranking Method for Microscopy

PubMed Central

Koho, Sami; Fazeli, Elnaz; Eriksson, John E.; Hänninen, Pekka E.

2016-01-01

Automated analysis of microscope images is necessitated by the increased need for high-resolution follow up of events in time. Manually finding the right images to be analyzed, or eliminated from data analysis are common day-to-day problems in microscopy research today, and the constantly growing size of image datasets does not help the matter. We propose a simple method and a software tool for sorting images within a dataset, according to their relative quality. We demonstrate the applicability of our method in finding good quality images in a STED microscope sample preparation optimization image dataset. The results are validated by comparisons to subjective opinion scores, as well as five state-of-the-art blind image quality assessment methods. We also show how our method can be applied to eliminate useless out-of-focus images in a High-Content-Screening experiment. We further evaluate the ability of our image quality ranking method to detect out-of-focus images, by extensive simulations, and by comparing its performance against previously published, well-established microscopy autofocus metrics. PMID:27364703

Effects of allergen and trigger factor avoidance advice in primary care on asthma control: a randomized-controlled trial.

PubMed

Bobb, C; Ritz, T; Rowlands, G; Griffiths, C

2010-01-01

Allergy contributes significantly to asthma exacerbation, yet avoidance of triggers, in particular allergens, is rarely addressed in detail in regular asthma review in primary care. To determine whether structured, individually tailored allergen and trigger avoidance advice, given as part of a primary care asthma review, improves lung function and asthma control. In a randomized-controlled trial 214 adults with asthma in six general practices were either offered usual care during a primary care asthma review or usual care with additional allergen and trigger identification (by skin prick testing and structured allergy assessment) and avoidance advice according to a standardized protocol by trained practice nurses. Main outcome measures were lung function, asthma control, asthma self-efficacy. Both intervention groups were equivalent in demographic and asthma-related variables at baseline. At 3-6-month follow-up, patients receiving the allergen and trigger avoidance review showed significant improvements in lung function (assessed by blinded research nurses) compared with those receiving usual care. Significantly more patients in the intervention group than in the control group showed improvements in forced expiratory volume in 1 s > or =15%. No significant differences were found in self-report measures of asthma control. Asthma-specific self-efficacy improved in both groups but did not differ between groups. Allergen and trigger identification and avoidance advice, given as part of a structured asthma review delivered in primary care by nurses results in clinically important improvements in lung function but not self-report of asthma control. ISRCTN45684820.

The beneficial effect of oxytocin on avoidance-related facial emotion recognition depends on early life stress experience.

PubMed

Feeser, Melanie; Fan, Yan; Weigand, Anne; Hahn, Adam; Gärtner, Matti; Aust, Sabine; Böker, Heinz; Bajbouj, Malek; Grimm, Simone

2014-12-01

Previous studies have shown that oxytocin (OXT) enhances social cognitive processes. It has also been demonstrated that OXT does not uniformly facilitate social cognition. The effects of OXT administration strongly depend on the exposure to stressful experiences in early life. Emotional facial recognition is crucial for social cognition. However, no study has yet examined how the effects of OXT on the ability to identify emotional faces are altered by early life stress (ELS) experiences. Given the role of OXT in modulating social motivational processes, we specifically aimed to investigate its effects on the recognition of approach- and avoidance-related facial emotions. In a double-blind, between-subjects, placebo-controlled design, 82 male participants performed an emotion recognition task with faces taken from the "Karolinska Directed Emotional Faces" set. We clustered the six basic emotions along the dimensions approach (happy, surprise, anger) and avoidance (fear, sadness, disgust). ELS was assessed with the Childhood Trauma Questionnaire (CTQ). Our results showed that OXT improved the ability to recognize avoidance-related emotional faces as compared to approach-related emotional faces. Whereas the performance for avoidance-related emotions in participants with higher ELS scores was comparable in both OXT and placebo condition, OXT enhanced emotion recognition in participants with lower ELS scores. Independent of OXT administration, we observed increased emotion recognition for avoidance-related faces in participants with high ELS scores. Our findings suggest that the investigation of OXT on social recognition requires a broad approach that takes ELS experiences as well as motivational processes into account.

Secure E-Business applications based on the European Citizen Card

NASA Astrophysics Data System (ADS)

Zipfel, Christian; Daum, Henning; Meister, Gisela

The introduction of ID cards enhanced with electronic authentication services opens up the possibility to use these for identification and authentication in e-business applications. To avoid incompatible national solutions, the specification of the European Citizen Card aims at defining interoperable services for such use cases. Especially the given device authentication methods can help to eliminate security problems with current e-business and online banking applications.

Diet and ADHD, Reviewing the Evidence: A Systematic Review of Meta-Analyses of Double-Blind Placebo-Controlled Trials Evaluating the Efficacy of Diet Interventions on the Behavior of Children with ADHD.

PubMed

Pelsser, Lidy M; Frankena, Klaas; Toorman, Jan; Rodrigues Pereira, Rob

2017-01-01

Attention-deficit/hyperactivity disorder (ADHD) is a debilitating mental health problem hampering the child's development. The underlying causes include both genetic and environmental factors and may differ between individuals. The efficacy of diet treatments in ADHD was recently evaluated in three reviews, reporting divergent and confusing conclusions based on heterogeneous studies and subjects. To address this inconsistency we conducted a systematic review of meta-analyses of double-blind placebo-controlled trials evaluating the effect of diet interventions (elimination and supplementation) on ADHD. Our literature search resulted in 14 meta-analyses, six of which confined to double-blind placebo-controlled trials applying homogeneous diet interventions, i.e. artificial food color (AFC) elimination, a few-foods diet (FFD) and poly-unsaturated fatty acid (PUFA) supplementation. Effect sizes (ES) and Confidence intervals (CI) of study outcomes were depicted in a forest plot. I2 was calculated to assess heterogeneity if necessary and additional random effects subgroup meta-regression was conducted if substantial heterogeneity was present. The AFC ESs were 0.44 (95% CI: 0.16-0.72, I2 = 11%) and 0.21 (95% CI: -0.02-0.43, I2 = 68%) [parent ratings], 0.08 (95% CI: -0.07-0.24, I2 = 0%) [teacher ratings] and 0.11 (95% CI: -0.13-0.34, I2 = 12%) [observer ratings]. The FFD ESs were 0.80 (95% CI: 0.41-1.19, I2 = 61%) [parent ratings] and 0.51 (95% CI: -0.02-1.04, I2 = 72%) [other ratings], while the PUFA ESs were 0.17 (95% CI: -0.03-0.38, I2 = 38%) [parent ratings], -0.05 (95% CI: -0.27-0.18, I2 = 0%) [teacher ratings] and 0.16 (95% CI: 0.01-0.31, I2 = 0%) [parent and teacher ratings]. Three meta-analyses (two FFD and one AFC) resulted in high I2 without presenting subgroup results. The FFD meta-analyses provided sufficient data to perform subgroup analyses on intervention type, resulting in a decrease of heterogeneity to 0% (diet design) and 37.8% (challenge design). Considering the small average ESs PUFA supplementation is unlikely to provide a tangible contribution to ADHD treatment, while further research is required for AFC elimination before advising this intervention as ADHD treatment. The average FFD ES is substantial, offering treatment opportunities in subgroups of children with ADHD not responding to or too young for medication. Further FFD research should focus on establishing the underlying mechanisms of food (e.g. incrimination of gut microbiota) to simplify the FFD approach in children with ADHD.

Natural History of Food-Triggered Atopic Dermatitis and Development of Immediate Reactions in Children.

PubMed

Chang, Angela; Robison, Rachel; Cai, Miao; Singh, Anne Marie

2016-01-01

Case reports suggest that children with food-triggered atopic dermatitis (AD) on elimination diets may develop immediate reactions on accidental ingestion or reintroduction of an avoided food. The objective of this study was to systematically study the incidence and risk factors associated with these immediate reactions. A retrospective chart review of 298 patients presenting to a tertiary-care allergy-immunology clinic based on concern for food-triggered AD was performed. Data regarding triggering foods, laboratory testing, and clinical reactions were collected prospectively from the initial visit. Food-triggered AD was diagnosed by an allergist-immunologist with clinical evaluation and laboratory testing. We identified immediate reactions as any reaction to a food for which there was evidence of sIgE and for which patients developed timely allergic signs and symptoms. Differences between children with and without new immediate reactions were determined by a Mann-Whitney, χ(2), or Fisher's exact test as appropriate. A total of 19% of patients with food-triggered AD and no previous history of immediate reactions developed new immediate food reactions after initiation of an elimination diet. Seventy percent of reactions were cutaneous but 30% were anaphylaxis. Cow's milk and egg were the most common foods causing immediate-type reactions. Avoidance of a food was associated with increased risk of developing immediate reactions to that food (P < .01). Risk was not related to specific IgE level nor a specific food. A significant number of patients with food-triggered AD may develop immediate-type reactions. Strict elimination diets need to be thoughtfully prescribed as they may lead to decreased oral tolerance. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Improving utilization of and retention in PMTCT services: can behavioral economics help?

PubMed

Taylor, Nicholas Kenji; Buttenheim, Alison M

2013-10-10

The most recent strategic call to action of the World Health Organization sets the elimination of pediatric HIV as a goal. While recent efforts have focused on building infrastructure and ensuring access to high-quality treatment, we must now turn our focus to the behavior change needed to eliminate vertical transmission. We make the case for the application of concepts from the field of behavioral economics to prevention of mother-to-child transmission (PMTCT) programs to more effectively address demand-side issues of uptake and retention. We introduce five concepts from the field of behavioral economics and discuss their application to PMTCT programs: 1) Mentor mothers who come from similar circumstances as PMTCT patients can serve as social references who provide temporally salient modeling of utilization of services and adherence to treatment. 2) Economic incentives, like cell phone minutes or food vouchers, that reward adherence to PMTCT protocols leverage present bias, the observation that people are generally biased toward immediate versus future awards. 3) Default bias, our preference for the default option, is already being used in many countries in the form of opt-out testing, and could be expanded to all PMTCT programs. 4) We are hardwired to avoid loss more than to pursue an equivalent gain. PMTCT programs can take advantage of loss aversion through the use of commitment contracts that incentivize mothers to return to the clinic in order to avoid both reputational and financial loss. Eliminating vertical transmission of HIV is an ambitious goal. To close the remaining gap, innovations are needed to address demand for PMTCT services. Behavioral economics offers a set of tools that can be engineered into PMTCT programs to increase uptake and improve retention with minimal investment.

Improving utilization of and retention in PMTCT services: Can behavioral economics help?

PubMed Central

2013-01-01

Background The most recent strategic call to action of the World Health Organization sets the elimination of pediatric HIV as a goal. While recent efforts have focused on building infrastructure and ensuring access to high-quality treatment, we must now turn our focus to the behavior change needed to eliminate vertical transmission. We make the case for the application of concepts from the field of behavioral economics to prevention of mother-to-child transmission (PMTCT) programs to more effectively address demand-side issues of uptake and retention. Discussion We introduce five concepts from the field of behavioral economics and discuss their application to PMTCT programs: 1) Mentor mothers who come from similar circumstances as PMTCT patients can serve as social references who provide temporally salient modeling of utilization of services and adherence to treatment. 2) Economic incentives, like cell phone minutes or food vouchers, that reward adherence to PMTCT protocols leverage present bias, the observation that people are generally biased toward immediate versus future awards. 3) Default bias, our preference for the default option, is already being used in many countries in the form of opt-out testing, and could be expanded to all PMTCT programs. 4) We are hardwired to avoid loss more than to pursue an equivalent gain. PMTCT programs can take advantage of loss aversion through the use of commitment contracts that incentivize mothers to return to the clinic in order to avoid both reputational and financial loss. Summary Eliminating vertical transmission of HIV is an ambitious goal. To close the remaining gap, innovations are needed to address demand for PMTCT services. Behavioral economics offers a set of tools that can be engineered into PMTCT programs to increase uptake and improve retention with minimal investment. PMID:24112440

Calibration-independent measurement of complex permittivity of liquids using a coaxial transmission line

NASA Astrophysics Data System (ADS)

Guoxin, Cheng

2015-01-01

In recent years, several calibration-independent transmission/reflection methods have been developed to determine the complex permittivity of liquid materials. However, these methods experience their own respective defects, such as the requirement of multi measurement cells, or the presence of air gap effect. To eliminate these drawbacks, a fast calibration-independent method is proposed in this paper. There are two main advantages of the present method over those in the literature. First, only one measurement cell is required. The cell is measured when it is empty and when it is filled with liquid. This avoids the air gap effect in the approach, in which the structure with two reference ports connected with each other is needed to be measured. Second, it eliminates the effects of uncalibrated coaxial cables, adaptors, and plug sections; systematic errors caused by the experimental setup are avoided by the wave cascading matrix manipulations. Using this method, three dielectric reference liquids, i.e., ethanol, ethanediol, and pure water, and low-loss transformer oil are measured over a wide frequency range to validate the proposed method. Their accuracy is assessed by comparing the results with those obtained from the other well known techniques. It is demonstrated that this proposed method can be used as a robust approach for fast complex permittivity determination of liquid materials.

Behavioral response and kinetics of terrestrial atrazine exposure in American toads (bufo americanus)

USGS Publications Warehouse

Storrs, Mendez S.I.; Tillitt, D.E.; Rittenhouse, T.A.G.; Semlitsch, R.D.

2009-01-01

Amphibians in terrestrial environments obtain water through a highly vascularized pelvic patch of skin. Chemicals can also be exchanged across this patch. Atrazine (ATZ), a widespread herbicide, continues to be a concern among amphibian ecologists based on potential exposure and toxicity. Few studies have examined its impact on the terrestrial juvenile or adult stages of toads. In the current study, we asked the following questions: (1) Will juvenile American toads (Bufo americanus) avoid soils contaminated with ATZ? (2) Can they absorb ATZ across the pelvic patch? (3) If so, how is it distributed among the organs and eventually eliminated? We conducted a behavioral choice test between control soil and soil dosed with ecologically relevant concentrations of ATZ. In addition, we examined the uptake, distribution, and elimination of water dosed with 14C-labeled ATZ. Our data demonstrate that toads do not avoid ATZ-laden soils. ATZ crossed the pelvic patch rapidly and reached an apparent equilibrium within 5 h. The majority of the radiolabeled ATZ ended up in the intestines, whereas the greatest concentrations were observed in the gall bladder. Thus, exposure of adult life stages of amphibians through direct uptake of ATZ from soils and runoff water should be considered in risk evaluations. ?? 2009 Springer Science+Business Media, LLC.

Elimination of Cigarette Smoke-derived Acetaldehyde in Saliva by Slow-release L-Cysteine Lozenge Is a Potential New Method to Assist Smoking Cessation. A Randomised, Double-blind, Placebo-controlled Intervention.

PubMed

Syrjänen, Kari; Salminen, Johanna; Aresvuo, Ulla; Hendolin, Panu; Paloheimo, Lea; Eklund, Carita; Salaspuro, Mikko; Suovaniemi, Osmo

2016-05-01

Harmans are condensation products of acetaldehyde and biogenic amines in saliva. Like other monoamine oxidase inhibitors, harmans help maintain behavioral sensitization to nicotine and mediate the addictive potential of cigarette smoke-derived acetaldehyde. The aim of this study was to test the hypothesis that effective elimination of acetaldehyde in saliva by slow-release L-cysteine (Acetium™ lozenge; Biohit Oyj, Helsinki, Finland) blocks the formation of harmans and eliminates acetaldehyde-enhanced nicotine addiction in smokers. A double-blind, randomized, placebo-controlled trial comparing Acetium lozenges and placebo in smoking intervention was undertaken. A cohort of 423 cigarette smokers were randomly allocated to intervention (n=212) and placebo arms (n=211). Smoking-related data were recorded by questionnaires, together with nicotine dependence testing by Fagerström scale. The participants used a smoking diary to record the daily number of cigarettes, test lozenges and sensations of smoking. The data were analyzed separately for point prevalence of abstinence and prolonged abstinence endpoints. Altogether, 110 study participants completed the trial per protocol, 234 had minor violations, and the rest (n=79) were lost to follow-up. During the 6-month trial, 65 participants quit smoking; 38 (17.9%) in the intervention arm and 27 (12.8%) in the placebo arm [odds ratio (OR)=1.48; 95% confidence intervals (CI)=0.87-2.54; p=0.143]. Success in the per protocol group was better (42.9% vs. 31.1%, respectively; OR=1.65, 95% CI=0.75-3.62; p=0.205) than in the modified intention-to-treat group: 13.5% vs. 7.4% (p=0.128). If the efficacy of Acetium lozenge can be confirmed in an adequately powered study, this new approach would represent a major breakthrough in smoking quit intervention because slow-release L-cysteine is non-toxic with no side-effects or limitations of use. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Will the SAFE Strategy Be Sufficient to Eliminate Trachoma by 2020? Puzzlements and Possible Solutions

PubMed Central

Lavett, Diane K.; Lansingh, Van C.; Carter, Marissa J.; Eckert, Kristen A.; Silva, Juan C.

2013-01-01

Since the inception of (the Global Elimination of Blinding Trachoma) GET 2020 in 1997 and the implementation of the SAFE strategy a year later, much progress has been made toward lowering the prevalence of trachoma worldwide with elimination of the disease in some countries. However, high recurrence of trichiasis after surgery, difficulty in controlling the reemergence of infection after mass distribution of azithromycin in some communities, the incomplete understanding of environment in relation to the disease, and the difficulty in establishing the prevalence of the disease in low endemic areas are some of the issues still facing completion of the GET 2020 goals. In this narrative review, literature was searched from 1998 to January 2013 in PubMed for original studies and reviews. Reasons for these ongoing problems are discussed, and several suggestions are made as avenues for exploration in relation to improving the SAFE strategy with emphasis on improving surgical quality and management of the mass treatment with antibiotics. In addition, more research needs to be done to better understand the approach to improve sanitation, hygiene, and environment. The main conclusion of this review is that scale-up is needed for all SAFE components, and more research should be generated from communities outside of Africa and Asia. PMID:23766701

Treatment of inflammatory dilated cardiomyopathy and (peri)myocarditis with immunosuppression and i.v. immunoglobulins.

PubMed

Maisch, Bernhard; Hufnagel, Günther; Kölsch, Susanne; Funck, Rainer; Richter, Annette; Rupp, Heinz; Herzum, Matthias; Pankuweit, Sabine

2004-09-01

Treatment objectives in inflammatory dilated cardiomyopathy (DCMi), myocarditis (M) and peri(myo)carditis are 1) the elimination of inflammatory cells from the myocardium and pericardium, 2) the elimination or (second best) mitigation of B-cell products such as antibodies and immuncomplexes directed against cardiac epitopes such as sarcolemmal, fibrillary and mitochondrial epitopes, and 3) the eradication of the causative viral or microbial agent, if present. A "non-specific" anti-inflammatory treatment in peri(myo)carditis can be carried out with antiphlogistics (NSAIDs preferably colchicine 1-3 mg/d) independent from the presence of the infective agent. In larger virus and bacteria negative effusions we recommend intrapericardial instillation of cristalloid triamcinolon (Volon A) at a dose of 500 mg/m(2), which should be left in place to have a sustained effect over at least 4 weeks. This will effectively prevent recurrences particularly when colchicine is added over a period of at least 3-6 months. Taking into account the 2004 ESC task force recommendations on the management of pericardial diseases the treatment recommendation for NSAIDs and colchicine can be classified as level of evidence A, indication class I, for intrapericardial triamcinolon instillation as level of evidence B, indication class IIa. In (immuno)histologically validated autoreactive (virus negative) myocarditis and DCMi double-blind randomized trials are lacking to demonstrate the superiority of immunosuppression over conventional heart failure management. The only published randomized and double-blind immunosuppression treatment trial (American Myocarditis Treatment Trial) was underpowered and did not distinguish viral from non-viral disease. It showed neither benefit nor harm of a combination of cyclosporin and prednisone. A number of retrospective analyses of immunosuppression in myocarditis showed some benefit of surrogate parameters (ejection fraction, exercise tolerance) but improvement under conventional heart failure treatment cannot be ruled out completely as the main cause for amelioration. ESETCID (European Study on the Epidemiology and Treatment of Cardiac Inflammatory Disease) is a double-blind, randomized, placebo-controled three-armed trial with prednisolone and azathioprine for autoreactive (virus negative) DCMi, interferon alpha for enterovirus positive DCMi, high-dose immunoglobulin for cytomegalovirus and intermediate dose for adeno- and Parvo B19 DCMi. It has now randomized more than 120 patients to the different treatment arms. Its final result has still to be awaited.-Patients not willing to randomize in the trial were included in a registry follow-up, which shows improvement of hemodynamic parameters and elimination of the inflammation in the majority of patients. This is in concordance with several non-randomized trials. Since evidence is conflicting (level of evidence C, indication class IIb; if negative viral etiology is taken into consideration class IIa) treatment with immunosuppression cannot be generally recommended but should be further evaluated in doubleblind randomized clinical trials or at least in controlled trials and registries. This also applies to treatment with interferon for enteroviral or other viral infections in the heart. : The elimination of anticardiac antibodies, which have been associated with DCMi, is a currently discussed concept, which is supported by published registry data and a few very small controlled investigations but not by a randomized double-blind trial with clinical endpoints of relevance. In some studies immunoglobulins have been substituted, so that an additional immunomodulatory effect has to be taken into account. The current proof of concept can be ranked level of evidence C, indication class IIa only. An even more challenging and still more attractive hypothesis is that cardiac inflammation caused by specific circulating beta-adrenoceptor antibodies can be eradicated with the elimination of the beta-receptor antibody thus healing dilated cardiomyopathy. Application of this approach can be ranked level of evidence C, indication class IIb at present only. Therefore these two pathophysiologically attractive concepts have to await further validation by a double-blind, randomized clinical endpoint trial. It has been shown that immunoglobulins have both an antiviral and an anti-inflammatory effect. They may suppress proinflammatory cytokines and reduce oxidative stress. HIGH-DOSE I.V. In biopsy proven CMVmyocarditis a controlled trial demonstrated eradication of inflammation and of the virus (level of evidence B, indication class IIa), which is in accordance with registry data and case reports. In suspected myocarditis (not biopsy proven, no viral etiology established or excluded) conflicting data exist with respect to the improvement of surrogate markers such as the ejection fraction under high-dose immunoglobulins. More evidence can be weighted in favour of a positive treatment effect (level of evidence B, indication class IIb). Importantly there were no detrimental effects of the ivIG reported in these trials. One has to consider the high costs of this treatment, however. A trial taking into account the different etiologies (different viruses assessed separately vs. non-viral/autoreactive vs. placebo) is still lacking. MODERATE-DOSE I.V. Registry data support a positive effect of 20 g i.v. pentaglobin (IgG and IgM) in adenovirus positive myocarditis for clinical improvement, eradication of both the inflammation and the virus. In Parvo B19 myocarditis our own registry data indicate that clinical improvement can be noted, but only inflammation is successfully eliminated, whereas Parvo B19 persistence remains a problem in the majority of patients. In Parvo B19 associated DCMi therefore dose finding studies and randomized trials are needed.

Medical certification reduces the number of children requiring allergen elimination diets for school lunches.

PubMed

Korematsu, Seigo; Toyokuni, Kenji; Handa, Yousuke; Gotoh, Chika; Wasada, Rieko; Kato, Rie; Kawano, Nanae; Ikeuchi, Mayo; Okamoto, Tomoko; Kiriya, Maki; Takahashi, Mizuho; Takano, Tomoyuki; Haigo, Atsuhiko

2017-04-01

Following the increase in the number of children with food allergies, support systems are now required for school lunches, but a large-scale factual investigation has not been carried out. We evaluated the features of elimination diet due to food allergy and the support system in kindergartens and schools. A prefecture-based questionnaire survey regarding measures for food allergies in school lunches of all kindergartens, public elementary schools, and public junior high schools (631 facilities) was conducted in Oita Prefecture, Japan. The recovery rate of the questionnaire was 99.5%, which included 106,008 students in total. A total of 1,562 children (1.5%) required elimination diets. The rate of children on elimination diets in kindergartens and elementary/junior high schools that required medical certification by a physician was 1.2% (324 among 27,761 children), which was significantly lower than the 1.8% of children (1,227 among 68,576 students) on elimination diets at the request of guardians without the need for medical certification ( p < 0.0001). A total of 43.9% of the kindergartens and schools said that they would contact guardians if symptoms were observed after accidental ingestion, while a low 8.1% stated that they provided support to children themselves, including the administration of adrenaline auto-injectors. Medical certification reduces the number of children requiring elimination diets, but it has not been adequately implemented. Furthermore, waiting to contact guardians after symptoms are observed may lead to the delayed treatment of anaphylaxis. Cooperation between physicians and teachers is desired to avoid the overdiagnosis and undertreatment of children with food allergies.

A brief review of Boston type-1 and osteo-odonto keratoprostheses.

PubMed

Avadhanam, Venkata S; Liu, Christopher S C

2015-07-01

Globally there are ≈4.9 million bilaterally corneal blind and 23 million unilaterally corneal blind. Majority of this blindness exists in the developing countries, where resources for corneal banking and transplant surgery are less than adequate. Survival of corneal grafts gradually declines over the long term. Corneal transplantation has poor prognosis in vascularised corneal beds, ocular surface disease and viral keratitis. Keratoprosthesis (KPro) remains as a final option for end-stage ocular surface disease, multiple corneal transplant failures and high-risk corneal grafts. Boston type-1 KPro and osteo-odonto-keratoprosthesis are the two devices proven useful in recent years. Choice of a keratoprosthetic device is patient specific based on the underlying diagnosis, ocular morbidity and patient suitability. KPro surgery demands a high level of clinical and surgical expertise, lifelong commitment and extensive resources. Improvements in techniques and biomaterials may in the future provide retainable KPros that do not need regular follow-up of patients, have low complications but high retention rates and may be produced at a low cost on a mass scale to be available as 'off the shelf' devices. Because KPros have the potential to effectively address the burden of surgically treatable corneal blindness and may also eliminate the problems of corneal transplantation, more research is required to develop KPros as substitutes for corneal transplantation even in low-risk cases. In those countries where corneal blindness is a major liability, we need a two pronged approach: one to develop eye donation, eye banking and corneal transplantation and the second to establish centres for keratoprostheses, which are affordable and technically not challenging, in a population where default on follow-up visits are high. Until the latter is achieved, KPros should be viewed as a temporary means for visual restoration and be offered in national and supraregional specialised centres only. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Color-Blind Racial Beliefs Among Dental Students and Faculty.

PubMed

Su, Yu; Behar-Horenstein, Linda S

2017-09-01

Providing culturally competent patient care requires an awareness of racial and cultural norms as well as a recognition of racism. Yet, there is a paucity of research devoted to this problem. In dental education, increased attention has focused on eliminating oral health care disparities due to ethnicity and race. Further investigation to determine the relationship between color-blind attitudes (failing to recognize the impact of race and racism on social justice) and dental educators' cultural competence is needed. The aim of this study was to determine dental faculty and student baseline color-blind racial attitudes scale scores, using the color-blind racial attitudes scale (CoBRAS). This 20-item instrument that measures three subscales of color-blind racial attitudes (Unawareness of Racial Privilege, Institutional Discrimination, and Blatant Racial Issues) was administered to student and faculty groups at one U.S. dental school. Out of a total 245 students in three class years, 235 responded to all items, for a response rate of 96%; out of a total 77 faculty members invited to participate, 71 responded to all items, for a response rate of 92%. Underrepresented minority (URM) faculty scored significantly higher on the Institutional Discrimination subscale and lower on Unawareness of Racial Privilege compared to non-URM students. Males scored significantly higher on Institutional Discrimination and Blatant Racial Issues compared to females. Compared to white students, URM students scored lower on all three subscales. The findings were consistent with previous studies indicating that female and URM students were more sensitive to racism compared to male and majority students. The findings that white faculty had higher awareness of racial privilege than white students and that URM faculty were less aware of institutional discrimination than URM students provided new information. These findings suggest that dental faculty members need professional development opportunities that promote becoming color-conscious and understanding privilege and biases, that model instruction on discussing race and racism, and that extend beyond a brief workshop.

Helicase-Dependent Isothermal Amplification of DNA and RNA by Using Self-Avoiding Molecular Recognition Systems.

PubMed

Yang, Zunyi; McLendon, Chris; Hutter, Daniel; Bradley, Kevin M; Hoshika, Shuichi; Frye, Carole B; Benner, Steven A

2015-06-15

Assays that detect DNA or RNA (xNA) are highly sensitive, as small amounts of xNA can be amplified by PCR. Unfortunately, PCR is inconvenient in low-resource environments, and requires equipment and power that might not be available in these environments. Isothermal procedures, which avoid thermal cycling, are often confounded by primer dimers, off-target priming, and other artifacts. Here, we show how a "self avoiding molecular recognition system" (SAMRS) eliminates these artifacts and gives clean amplicons in a helicase-dependent isothermal amplification (SAMRS-HDA). We also show that incorporating SAMRS into the 3'-ends of primers facilitates the design and screening of primers for HDA assays. Finally, we show that SAMRS-HDA can be twofold multiplexed, difficult to achieve with HDA using standard primers. Thus, SAMRS-HDA is a more versatile approach than standard HDA, with a broader applicability for xNA-targeted diagnostics and research. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Helicase Dependent Isothermal Amplification of DNA and RNA using Self-Avoiding Molecular Recognition Systems

PubMed Central

Yang, Zunyi; McLendon, Chris; Hutter, Daniel; Bradley, Kevin M.; Hoshika, Shuichi; Frye, Carole; Benner, Steven A.

2015-01-01

Assays that target DNA or RNA (xNA) are highly sensitive, as small amounts of xNA can be amplified by PCR. Unfortunately, PCR is inconvenient in low resource environments, requiring equipment and power that may not be available in these environments. However, isothermal procedures that avoid thermal cycling are often confounded by primer dimers, off-target priming, and other artifacts. Here, we show how a “self avoiding molecular recognition system” (SAMRS) eliminates these artifacts to give clean amplicons in a helicase-dependent isothermal amplification (SAMRS-HDA). We also show that incorporating SAMRS into the 3′-ends of primers facilitates the design and screening of primers for HDA assays. Finally, we show that SAMRS-HDA can be twofold multiplexed, something difficult to achieve with HDA using standard primers. This shows that SAMRS-HDA is a more versatile approach than standard HDA with a broader applicability for xNA-targeted diagnostics and research. PMID:25953623

Gradient, contact-free volume transfers minimize compound loss in dose-response experiments.

PubMed

Harris, David; Olechno, Joe; Datwani, Sammy; Ellson, Richard

2010-01-01

More accurate dose-response curves can be constructed by eliminating aqueous serial dilution of compounds. Traditional serial dilutions that use aqueous diluents can result in errors in dose-response values of up to 4 orders of magnitude for a significant percentage of a compound library. When DMSO is used as the diluent, the errors are reduced but not eliminated. The authors use acoustic drop ejection (ADE) to transfer different volumes of model library compounds, directly creating a concentration gradient series in the receiver assay plate. Sample losses and contamination associated with compound handling are therefore avoided or minimized, particularly in the case of less water-soluble compounds. ADE is particularly well suited for assay miniaturization, but gradient volume dispensing is not limited to miniaturized applications.

Real time aircraft fly-over noise discrimination

NASA Astrophysics Data System (ADS)

Genescà, M.; Romeu, J.; Pàmies, T.; Sánchez, A.

2009-06-01

A method for measuring aircraft noise time history with automatic elimination of simultaneous urban noise is presented in this paper. A 3 m-long 12-microphone sparse array has been proven to give good performance in a wide range of urban placements. Nowadays, urban placements have to be avoided because their background noise has a great influence on the measurements made by sound level meters or single microphones. Because of the small device size and low number of microphones (that make it so easy to set up), the resolution of the device is not high enough to provide a clean aircraft noise time history by only applying frequency domain beamforming to the spatial cross-correlations of the microphones' signals. Therefore, a new step to the processing algorithm has been added to eliminate this handicap.

Rugged fiber optic probe for raman measurement

DOEpatents

O'Rourke, Patrick E.; Toole, Jr., William R.; Nave, Stanley E.

1998-01-01

An optical probe for conducting light scattering analysis is disclosed. The probe comprises a hollow housing and a probe tip. A fiber assembly made up of a transmitting fiber and a receiving bundle is inserted in the tip. A filter assembly is inserted in the housing and connected to the fiber assembly. A signal line from the light source and to the spectrometer also is connected to the filter assembly and communicates with the fiber assembly. By using a spring-loaded assembly to hold the fiber connectors together with the in-line filters, complex and sensitive alignment procedures are avoided. The close proximity of the filter assembly to the probe tip eliminates or minimizes self-scattering generated by the optical fiber. Also, because the probe can contact the sample directly, sensitive optics can be eliminated.

Quality Assurance in Trichiasis Surgery: a methodology

PubMed Central

Buchan, John C; Limburg, Hans; Burton, Matthew J

2013-01-01

SUMMARY Trachoma remains a significant cause of blindness in many parts of the world. The major route to blindness involves upper lid entropion leading to trachomatous trichiasis (TT) which promotes progressive corneal opacification. The provision of surgery to correct TT in the populations most severely affected is a major challenge for the global effort to eliminate Trachoma blindness by the year 2020. Most attention has been paid to increasing the quantity of TT surgery performed, and large numbers of non-doctor operators have been trained to this end. Surgical audit by those performing TT surgery is not a routine part of any national trachoma control programme, and no effective mechanism exists for identifying surgeons experiencing poor outcomes. We propose a methodology for surgical audit at the level of the individual surgeon based on Lot Quality Assurance. A set number of patients operated on previously for upper eyelid TT are examined to detect the recurrence of TT. The number of recurrent cases found will lead to categorisation of the TT surgeon to either “high recurrence” or “low recurrence” with reasonable confidence. The threshold of unacceptability can be set by individual programmes according to previous local studies of recurrence rates or those from similar settings. Identification of surgeons delivering unacceptably high levels of recurrent TT will guide managers on the need for remedial intervention such as re-training. PMID:20881027

Motorcycle crashes potentially preventable by three crash avoidance technologies on passenger vehicles.

PubMed

Teoh, Eric R

2018-07-04

The objective of this study was to identify and quantify the motorcycle crash population that would be potential beneficiaries of 3 crash avoidance technologies recently available on passenger vehicles. Two-vehicle crashes between a motorcycle and a passenger vehicle that occurred in the United States during 2011-2015 were classified by type, with consideration of the functionality of 3 classes of passenger vehicle crash avoidance technologies: frontal crash prevention, lane maintenance, and blind spot detection. Results were expressed as the percentage of crashes potentially preventable by each type of technology, based on all known types of 2-vehicle crashes and based on all crashes involving motorcycles. Frontal crash prevention had the largest potential to prevent 2-vehicle motorcycle crashes with passenger vehicles. The 3 technologies in sum had the potential to prevent 10% of fatal 2-vehicle crashes and 23% of police-reported crashes. However, because 2-vehicle crashes with a passenger vehicle represent fewer than half of all motorcycle crashes, these technologies represent a potential to avoid 4% of all fatal motorcycle crashes and 10% of all police-reported motorcycle crashes. Refining the ability of passenger vehicle crash avoidance systems to detect motorcycles represents an opportunity to improve motorcycle safety. Expanding the capabilities of these technologies represents an even greater opportunity. However, even fully realizing these opportunities can affect only a minority of motorcycle crashes and does not change the need for other motorcycle safety countermeasures such as helmets, universal helmet laws, and antilock braking systems.

Dehabilitation in the era of elimination and rehabilitation: a study of 100 leprosy patients from a tertiary care hospital in India.

PubMed

Seshadri, Divya; Khaitan, Binod K; Khanna, Neena; Sagar, Rajesh

2015-03-01

To study the clinical profile of leprosy patients; to assess dehabilitation in leprosy patients and to study the factors affecting dehabilitation. A cross-sectional questionnaire-based study was carried out on 100 leprosy patients visiting the All India Institute of Medical Sciences (AIIMS), New Delhi between February 2009 and February 2010. Demographic and clinical data were collected and subjects were administered the 52-item Anandaraj Dehabilitation scale which measures the negative impact of leprosy on family relationships, vocational condition, social interaction and self-esteem. The mean patient age was 30.9 years, 81% were males, 51% were at the lepromatous end of the spectrum, 87% had multibacillary leprosy, 22% each had Type 1 and Type 2 reactions, 22% had Grade 1 disability and 39% had Grade 2 disability. The mean duration of symptoms before diagnosis was 20 months. On the Anandaraj scale, 23% had high levels of dehabilitation; on an average, scores were in the range of medium level dehabilitation. Nearly 80% of patients avoided meeting friends, one-third hid the diagnosis from their families and worried about losing their jobs due to the disease, while around a quarter avoided sexual relations, used separate utensils and avoided touching children. Over 40% of unmarried patients faced matrimonial difficulty due to leprosy. Anxiety and guilt were common and incidence of suicidal ideas was much higher than the lifetime incidence in general population. Lack of education, Type 2 reactions, Grade 2 disability and lower age were predictors of greater dehabilitation. Dehabilitation of leprosy patients continues in this post-elimination era of rehabilitation. A large segment of preventable disability and resultant dehabilitation is likely being missed. There is an urgent need for corrective and preventive measures.

"Safe Foods" or "Fear Foods": the implications of food avoidance in college students from low- and middle-income countries.

PubMed

James, C; Harrison, A; Seixas, A; Powell, M; Pengpid, S; Peltzer, K

2017-09-01

The primary objective of this study was to explore if self-reported food avoidance (fats, carbohydrates and protein) exists among college students in low- and middle-income countries (LMICs) and its relationship with body mass index (BMI), dieting, mood/anxiety symptoms, physical activities and general health knowledge. This study is a subset (N = 6096) of a larger 26 LMICs cross-sectional survey, which consisted of 21,007 college students. We ascertained socio-demographic information, food avoidance, physical activities, dieting behaviours, depressive and PTSD symptoms, and recorded anthropometric measurements. Chi-square analyses assessed the relationship between predictor variables and food categories eliminated from participants' diet. Multiple logistic regression assessed if food avoidance predicts outcome variables such as binge drinking, high physical activity, being underweight, exhibiting significant depressive and PTSD symptoms. Food avoidance exists in as many as one-third of college students in low- and middle-income countries, with this being more likely in persons who are trying to lose weight whether by dieting or otherwise. Food avoidance was associated with higher BMI, depressive symptoms, and high intensity exercises, as well as the level of health knowledge influencing the types of food avoided. A significant difference was noted between lower middle-income and upper middle-income countries with respect to the foods they avoided. Despite being knowledgeable about health-related behaviours, we found that college students in our sample were not that different from those in developed countries and may be influenced by a similar advice given by non-experts about macronutrients. These results hold implications for intervention programmes and policy makers. Level V, descriptive cross-sectional survey.

Removal of micropollutants with coarse-ground activated carbon for enhanced separation with hydrocyclone classifiers.

PubMed

Otto, N; Platz, S; Fink, T; Wutscherk, M; Menzel, U

2016-01-01

One key technology to eliminate organic micropollutants (OMP) from wastewater effluent is adsorption using powdered activated carbon (PAC). To avoid a discharge of highly loaded PAC particles into natural water bodies a separation stage has to be implemented. Commonly large settling tanks and flocculation filters with the application of coagulants and flocculation aids are used. In this study, a multi-hydrocyclone classifier with a downstream cloth filter has been investigated on a pilot plant as a space-saving alternative with no need for a dosing of chemical additives. To improve the separation, a coarser ground PAC type was compared to a standard PAC type with regard to elimination results of OMP as well as separation performance. With a PAC dosing rate of 20 mg/l an average of 64.7 wt% of the standard PAC and 79.5 wt% of the coarse-ground PAC could be separated in the hydrocyclone classifier. A total average separation efficiency of 93-97 wt% could be reached with a combination of both hydrocyclone classifier and cloth filter. Nonetheless, the OMP elimination of the coarse-ground PAC was not sufficient enough to compete with the standard PAC. Further research and development is necessary to find applicable coarse-grained PAC types with adequate OMP elimination capabilities.

Limitations in ROP Programs in 32 Neonatal Intensive Care Units in Five States in Mexico

PubMed Central

Zepeda-Romero, L. Consuelo; Gilbert, Clare

2015-01-01

Retinopathy of prematurity (ROP) is the main cause of avoidable blindness in children in Mexico despite National ROP Guidelines and examination of preterm infants being a legal requirement. Objective. To assess coverage of ROP programs and their compliance with national guidelines. Study Design. Thirty-two neonatal intensive care units (NICUs) in five of the largest states were visited. Staff were interviewed to collect information on their ROP programs which were defined as (1) compliant, if National Guidelines for screening and treatment were followed, (2) noncompliant, if other approaches were used, or (3) no program. Results. Only 10 (31.2%) had fully compliant programs and 11 (34.4%) had no program. In the remaining 11 (34.4%) different screening criteria were used (7 units): screening was undertaken by an ophthalmologist in unsalaried time (4), was not undertaken in the NICU (2), and was undertaken by a neonatologist (1) and/or Avastin was used as first-line treatment (7). Poorer states had poorer programs. Conclusions. Despite legislation mandating eye examination of preterm births, many ROP programs in the largest cities in Mexico require improvement or need to be established. Prevention of blindness due to ROP needs to be prioritized in Mexico to control the epidemic of ROP blindness. PMID:26167494

Toward an understanding of the turbidity measurement of heterocoagulation rate constants of dispersions containing particles of different sizes.

PubMed

Liu, Jie; Xu, Shenghua; Sun, Zhiwei

2007-11-06

Our previous studies have shown that the determination of coagulation rate constants by turbidity measurement becomes impossible for a certain operating wavelength (that is, its blind point) because at this wavelength the change in the turbidity of a dispersion completely loses its response to the coagulation process. Therefore, performing the turbidity measurement in the wavelength range near the blind point should be avoided. In this article, we demonstrate that the turbidity measurement of the rate constant for coagulation of a binary dispersion containing particles of two different sizes (heterocoagulation) presents special difficulties because the blind point shifts with not only particle size but also with the component fraction. Some important aspects of the turbidity measurement for the heterocoagulation rate constant are discussed and experimentally tested. It is emphasized that the T-matrix method can be used to correctly evaluate extinction cross sections of doublets formed during the heterocoagulation process, which is the key data determining the rate constant from the turbidity measurement, and choosing the appropriate operating wavelength and component fraction are important to achieving a more accurate rate constant. Finally, a simple scheme in experimentally determining the sensitivity of the turbidity changes with coagulation over a wavelength range is proposed.

Eye conditions and blindness in children: Priorities for research, programs, and policy with a focus on childhood cataract

PubMed Central

Gilbert, Clare; Muhit, Mohammed

2012-01-01

The major causes of blindness in children encompass intrauterine and acquired infectious diseases, teratogens and developmental and molecular genetics, nutritional factors, the consequences of preterm birth, and tumors. A multidisciplinary approach is therefore needed. In terms of the major avoidable causes (i.e., those that can be prevented or treated) the available evidence shows that these vary in importance from country to country, as well as over time. This is because the underlying causes closely reflect socioeconomic development and the social determinants of health, as well as the provision of preventive and therapeutic programs and services from the community through to tertiary levels of care. The control of blindness in children therefore requires not only strategies that reflect the local epidemiology and the needs and priorities of communities, but also a well functioning, accessible health system which operates within an enabling and conducive policy environment. In this article we use cataract in children as an example and make the case for health financing systems that do not lead to ‘catastrophic health expenditure’ for affected families, and the integration of eye health for children into those elements of the health system that work closely with mothers and their children. PMID:22944758

Modeling error distributions of growth curve models through Bayesian methods.

PubMed

Zhang, Zhiyong

2016-06-01

Growth curve models are widely used in social and behavioral sciences. However, typical growth curve models often assume that the errors are normally distributed although non-normal data may be even more common than normal data. In order to avoid possible statistical inference problems in blindly assuming normality, a general Bayesian framework is proposed to flexibly model normal and non-normal data through the explicit specification of the error distributions. A simulation study shows when the distribution of the error is correctly specified, one can avoid the loss in the efficiency of standard error estimates. A real example on the analysis of mathematical ability growth data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 is used to show the application of the proposed methods. Instructions and code on how to conduct growth curve analysis with both normal and non-normal error distributions using the the MCMC procedure of SAS are provided.

Effect of sugar-sweetened beverages on body weight in children: design and baseline characteristics of the Double-blind, Randomized INtervention study in Kids.

PubMed

de Ruyter, Janne Catharine; Olthof, Margreet Renate; Kuijper, Lothar David Jan; Katan, Martijn Bernard

2012-01-01

Intake of sugar-sweetened beverages is associated with overweight in observational studies. A possible explanation is that liquid sugars do not satiate and that their intake is not compensated by reduced caloric intake from other foods. However, evidence from intervention studies for this hypothesis is inconclusive because previous studies were not blinded. Hence results may have been influenced by expectations and behavioral cues rather than by physiological mechanisms. We designed the Double-blind, Randomized INtervention study in Kids (DRINK) to examine the effect on body weight of covertly replacing sugar-sweetened by sugar-free beverages. Children were only eligible if they habitually drank sugar-sweetened beverages. We recruited 642 healthy children (mean age 8.2, range 4.8-11.9). We designed, tested and produced custom-made beverages containing 10% sugar and sugar-free beverages with the same sweet taste and look. Children receive one 250 mL can of study beverage daily for 18 months. We perform body measurements at 0, 6, 12 and 18 months. The primary outcome is the z-score of BMI for age. The maximum predicted difference in this score between groups is 0.72, which corresponds with a difference in body weight of 2.3 kg. The double-blind design eliminates behavioral factors that affect body weight. If children gain less body fat when drinking sugar-free than when drinking sugar-sweetened beverages that would show that liquid sugar indeed bypasses biological satiation mechanisms. It would also suggest that a reduction in liquid sugars could decrease body fat more effectively than reduction of other calorie sources. Copyright © 2011 Elsevier Inc. All rights reserved.

Dose requirements of alfentanil to eliminate autonomic responses during rapid-sequence induction with thiopental 4 mg/kg and rocuronium 0.6 mg/kg.

PubMed

Abou-Arab, Mohammad H; Rostrup, Morten; Heier, Tom

2016-12-01

Opioids are integral part of anesthesia induction, but information on optimal dosing is limited. We aimed to determine doses of alfentanil needed to eliminate increases in 5 autonomic response variables (plasma concentrations of epinephrine, norepinephrine and vasopressin, arterial blood pressure [ABP], and heart rate) during rapid-sequence induction of anesthesia with thiopental 4 mg/kg and rocuronium 0.6 mg/kg. Prospective, randomized, observer-blinded, interventional clinical study. Large academic institution. Eighty-four healthy patients, aged 18 to 55 years, received 1 of 7 assessor-blinded doses of alfentanil (0, 10, 20, 30, 40, 50, and 60 μg/kg) together with thiopental 4 mg/kg and rocuronium 0.6 mg/kg, administered in rapid succession (15 seconds). Laryngoscopy was initiated 40 seconds after rocuronium, and tracheal intubation was concluded within 15 seconds thereafter. An indwelling radial artery catheter was used for hemodynamic monitoring and blood sampling. Relationships between alfentanil dose and response variables were tested with linear regression, and the influence of covariates (sex, body weight, and age) was determined. Alfentanil dose needed to prevent increases in ABP >10% above baseline with 95% probability was estimated with logistic regression. Significant relationships were determined between alfentanil dose and response variables. Clinically interesting influence of covariates was not found. Alfentanil 55 μg/kg was needed to prevent increases in ABP postintubation >10% above baseline with 95% probability. One individual needed a bolus of vasopressor postintubation. Optimal control of autonomic responses during rapid-sequence induction was achieved with clinically relevant doses of alfentanil in healthy patients anesthetized with thiopental 4 mg/kg and rocuronium 0.6 mg/kg. Copyright © 2016 Elsevier Inc. All rights reserved.

Survey of physicians' approach to food allergy, Part 2: Allergens, diagnosis, treatment, and prevention.

PubMed

Wilson, Brian G; Cruz, Narlito V; Fiocchi, Alessandro; Bahna, Sami L

2008-03-01

Food allergy (FA) practice varies widely. To report differences between allergists and nonallergists regarding diagnosis, treatment, and prevention of FA. A 2-page questionnaire was mailed to 3,000 allergists and 4,000 nonallergists. We previously published the findings on prevalence and manifestations. Herein, we report the findings on food allergens, diagnosis, treatment, and prevention. Responses were received from 584 (19.5%) of the allergists and 77 (1.9%) of the nonallergists. Because of the nonallergists' low response rate, descriptive comparisons were made without emphasis on statistical significance. Allergists and nonallergists differed in their rankings of the 5 most common food allergens. Nonallergists differed markedly from allergists in the diagnostic methods, using more leukocytotoxic tests (10.9% vs 0.3%), specific IgG4 tests (33.8% vs 6.0%), and intradermal tests (40.0% vs 9.5%), but fewer percutaneous skin tests (44.7% vs 98.9%), specific IgE tests (73.4% vs 97.8%), and challenges (61.1% vs 87.6%). They also differed in their use of open, single-blind, and double-blind challenge tests. Allergists were more likely to rely on elimination of proven food allergens and less likely to use conventional elimination diets, rotation diets, and sublingual or subcutaneous hyposensitization. Allergists were more likely to recommend a diet regimen during pregnancy (76.7% vs 35.3%) and lactation (91.1% vs 72.9%), breastfeeding (93.6% vs 84.3%), hydrolysate formulas (83.5% vs 64.3%), and withholding solids until the age of 6 months (89.4% vs 70.0%). Differences were noted between nonallergists and allergists regarding causes, diagnostic methods, treatment, and prevention of FA, indicating the need for more education in this area.

Baclofen add-on to citalopram in treatment of posttraumatic stress disorder.

PubMed

Manteghi, Ali Akhoundpour; Hebrani, Paria; Mortezania, Mohammad; Haghighi, Mehri Baghban; Javanbakht, Arash

2014-04-01

Posttraumatic stress disorder (PTSD) is a chronic disabling illness, resulting from exposure to extreme traumatic event. Although different pharmacologic agents are suggested for treatment of PTSD, none have been completely effective in eliminating symptoms. The purpose of this study was to assess the use of baclofen as an add-on to citalopram in treatment of PTSD. In this double-blind clinical trial, 40 Iranian combat veterans with PTSD were randomly assigned to 2 groups. The first group received a combination treatment of 20 to 60 mg/d citalopram and 40 mg/d baclofen, and the second group received 20 to 60 mg/d citalopram plus placebo. Symptom severity was assessed by Clinician-Administered PTSD Scale at the beginning of the study and after 2, 4, 6, and 8 weeks. Global Assessment of Functioning and Hamilton Rating Scale for Anxiety and Depression were also used at the same periods. Data were analyzed with independent t test and paired t test using SPSS software version 13 (IBM, Armonk, NY). Twenty-three male patients (baclofen group, 13 patients; placebo group, 10 patients) completed the study. Dropout from the treatment was not caused by adverse effects of the new medications in any of the subjects. Baclofen group showed significantly larger improvement in Clinician-Administered PTSD Scale total (P = 0.040), hyperarousal (P = 0.020), and avoidance (0.020) scores, Global Assessment of Functioning score (0.001), depression (P = 0.000), and anxiety (P = 0.000) after 8 weeks of treatment. No intergroup difference was found in improvement of reexperience symptoms (P = 0.740). Baclofen showed to be an effective add-on to selective serotonin reuptake inhibitors in treatment of PTSD for better symptom recovery and functional improvement.

Effects of a cyclic NSAID regimen on levels of gingival crevicular fluid prostaglandin E2and Interleukin-1β: A 6-month randomized controlled clinical trial.

PubMed

Oduncuoglu, B F; Kayar, N A; Haliloglu, S; Serpek, B; Ataoglu, T; Alptekin, N O

2018-05-01

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for inflammation control and pain relief. However, while the adjunct use of NSAIDs is avoided for periodontal therapy because of related side effects, cyclic administration of NSAIDs may reduce or eliminate these effects. We evaluated the effect of a cyclic diclofenac potassium (DP) regimen on clinical parameters and levels of prostaglandin E 2 (PGE 2 ) and interleukin-1β (IL-1β) in the gingival crevicular fluid (GCF) of individuals with periodontitis. The study protocol was approved by the Ethics Committee (2000/071). Forty-one individuals with chronic periodontitis (33 men, 8 women) were divided into two groups (test and control) after initial periodontal therapy. During this 6-month, randomized, double-blind, placebo-controlled study, test (n = 28) and control (n = 13) groups were administered a cyclic regimen of DP (50 mg, twice daily) or placebo. Clinical measurements and GCF sample collections were made at baseline, 2, 4, and 6 months. GCF levels of PGE 2 and IL-1β were determined using enzyme immunoassay and enzyme-linked immunoassay kits, respectively. At baseline, no significant differences existed between groups for plaque indices, gingival indices, bleeding on probing, probing depth (PD), or attachment levels (P > 0.05). Compared with the control group, cyclic regimen in the test group suppressed increased levels of PGE 2 found in GCF at the end of the study (P < 0.05). Significant differences for PD and relative attachment gain were also noted in favor of the test group (P < 0.05). These results suggest that a cyclic regimen of DP may be efficacious in the management of chronic periodontitis in adults.

[Diagnosis and management of cow's protein milk allergy in infant].

PubMed

Mazigh, Sonia; Yahiaoui, Salem; Ben Rabeh, Rania; Fetni, Ilhem; Sammoud, Azza

2015-04-01

Cow's milk protein allergy (CMPA) can be responsible of a variety of symptoms and can be caused by IgE or non-IgEmediated reactions. The remaining questions concern the diagnosis (what are the most suggestive clinical manifestations, the laboratory evaluations which play a supporting role, and the management of CMPA in breast fed infants and formula-fed infants. Review of the pub med, science direct, Cochrane library, using the key words cow's milk protein allergy, guideline, and child. Evidence was levelled A, B, C. No symptom is pathognomonic. A thorough history and careful clinical examination are necessary to suspect the disease. Skin prick tests, and serum specific IgE are only indicative of sensitivation to CMP. A double-blind placebo-controlled challenge is considered the gold standard in diagnosis, but in practice only an open challenge is performed. The patient with suspected pathology will follow a cow's milk free diet for 2-4 weeks. Formula-fed infants get an extensively hydrolyzed formula .If the allergy is present, clinical manifestations will disappear. If symptoms do not improve, an amino acid based formula should be considered. In severe Cow's milk protein allergy with life-threatening symptoms, an amino-acid formula is recommended. The infant should be maintained on an elimination diet until the infant is between 9-12 months or at least for 6 months. The overall natural evolution of the disease is favorable with most patients achieving tolerance to milk by the age of five years. The importance of defined diagnostic criteria needs to be emphasized. It precludes infants from an unnecessary diet and avoids delay in diagnosis, which can lead to malnutrition.

A beam-splitter-type 3-D endoscope for front view and front-diagonal view images.

PubMed

Kamiuchi, Hiroki; Masamune, Ken; Kuwana, Kenta; Dohi, Takeyoshi; Kim, Keri; Yamashita, Hiromasa; Chiba, Toshio

2013-01-01

In endoscopic surgery, surgeons must manipulate an endoscope inside the body cavity to observe a large field-of-view while estimating the distance between surgical instruments and the affected area by reference to the size or motion of the surgical instruments in 2-D endoscopic images on a monitor. Therefore, there is a risk of the endoscope or surgical instruments physically damaging body tissues. To overcome this problem, we developed a Ø7- mm 3-D endoscope that can switch between providing front and front-diagonal view 3-D images by simply rotating its sleeves. This 3-D endoscope consists of a conventional 3-D endoscope and an outer and inner sleeve with a beam splitter and polarization plates. The beam splitter was used for visualizing both the front and front-diagonal view and was set at 25° to the outer sleeve's distal end in order to eliminate a blind spot common to both views. Polarization plates were used to avoid overlap of the two views. We measured signal-to-noise ratio (SNR), sharpness, chromatic aberration (CA), and viewing angle of this 3-D endoscope and evaluated its feasibility in vivo. Compared to the conventional 3-D endoscope, SNR and sharpness of this 3-D endoscope decreased by 20 and 7 %, respectively. No significant difference was found in CA. The viewing angle for both the front and front-diagonal views was about 50°. In the in vivo experiment, this 3-D endoscope can provide clear 3-D images of both views by simply rotating its inner sleeve. The developed 3-D endoscope can provide the front and front-diagonal view by simply rotating the inner sleeve, therefore the risk of damage to fragile body tissues can be significantly decreased.

Parents' Attitudes to Risk and Injury to Children and Young People on Farms.

PubMed

Nilsson, Kerstin

2016-01-01

Children and young people growing up in a farm environment run a greater risk of being injured or dying in an accident than their non-farming counterparts. This study examines farming parents' attitudes and experiences of having their children grow up on farms, one of the most dangerous work environments as their home, everyday environment and playground. Data were collected using two ethnological methods, a question list and interviews, with a study population of 20 parents. The data were analysed phenomenologically. The analysis pursued four themes: i) the most dangerous places and situations on the farm; ii) children's tasks on the farm; iii) children as a safety risk on the farm; and iv) farm risk education for children. Most parents know the risks on their farm, but are sometimes careless when working under stress or exhaustion. Some parents wanted more information and some wanted compulsory preventative or safety measures by manufacturers, e.g. a safety belt as standard on the extra seat in tractors. Children's friends were described as one of the greatest risks for injury due to peer pressure. Some parents mentioned that people who grow up on farms are sometimes 'blind' to the dangers. Other parents seemed to overlook the risks and had their children carrying out tasks for which they were not mentally or physically equipped. Some of the tasks the children reportedly carried out on farms contravened Swedish legislation. It is thus important for farming parents to be repeatedly reminded of the risks to their children and to increase their awareness of how to prevent and eliminate risks in order to avoid accidents on the farm. The situation for farm children is highlighted in a critical discussion.

The Soviet Union and Iraq Since 1968.

DTIC Science & Technology

1980-07-01

had outlived its usefulness and had itself become a threat to the regime’s authority. Kassem turned on it and attempted to restrict its political ... Kassem had studiously avoided: They began to eliminate the ICP physically as a political force. By one estimate 3,000 party members were killed.IlJ This...ide It mne@*aip and identir by block uwober) USSR Foreign Aid IRAQ Political Science Arms Control Foreign Policy Military Assistance International

Complications in Musculoskeletal Intervention: Important Considerations

PubMed Central

Wang, David T.; Dubois, Melissa; Tutton, Sean M.

2015-01-01

Musculoskeletal (MSK) intervention has proliferated in recent years among various subspecialties in medicine. Despite advancements in image guidance and percutaneous technique, the risk of complication has not been fully eliminated. Overall, complications in MSK interventions are rare, with bleeding and infection the most common encountered. Other complications are even rarer. This article reviews various complications unique to musculoskeletal interventions, assists the reader in understanding where pitfalls lie, and highlights ways to avoid them. PMID:26038623

Strategic defense initiative: critical issues

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nuckolls, J.H.

The objectives of the Strategic Defense Initiative (SDI) as outlined by President Reagan are discussed. The principal objective for SDI is as a defense against ballistic missiles. Soviet objections and a summary of US-USSR dialogue on the subject are reviewed. Most US studies have been critical of SDI. Four critical issues are addressed in depth: are defense weapons technologically feasible which have high economic leverage relative to offensive ballistic missiles; would the defense feasibility and leverage be degraded or enhanced in the technological race between weapons innovation and countermeasures; could stability be achieved during and after the transition to themore » defense dominated world envisioned by SDI proponents; would the deployment of high leverage defensive weapons increase or decrease the security of NATO Europe, and the probability of major conventional or nuclear wars. The issue of SDI may lead to a paradox that contains the seeds of catastrophe. The author concludes by warning that nuclear disarmament may eliminate the highly successful deterrent mechanism for avoiding another major world war. In a world made safe for major conventional wars by the apparent ''elimination'' of nuclear weapons, the leaders in a conventional World War III - involving unimaginable suffering, hatred, terror, and death - would be strongly motivated to introduce nuclear weapons in the crucial decisive battles. Even if diplomacy could ''eliminate'' nuclear weapons, man's knowledge of nuclear weapons can never be eliminated. The paradox is the attempt to eliminate nuclear weapons may maximize the probability of their use. (DMC)« less

Smc5/6-Mms21 Prevents and Eliminates Inappropriate Recombination Intermediates in Meiosis

PubMed Central

Xaver, Martin; Huang, Lingzhi; Chen, Doris; Klein, Franz

2013-01-01

Repairing broken chromosomes via joint molecule (JM) intermediates is hazardous and therefore strictly controlled in most organisms. Also in budding yeast meiosis, where production of enough crossovers via JMs is imperative, only a subset of DNA breaks are repaired via JMs, closely regulated by the ZMM pathway. The other breaks are repaired to non-crossovers, avoiding JM formation, through pathways that require the BLM/Sgs1 helicase. “Rogue” JMs that escape the ZMM pathway and BLM/Sgs1 are eliminated before metaphase by resolvases like Mus81-Mms4 to prevent chromosome nondisjunction. Here, we report the requirement of Smc5/6-Mms21 for antagonizing rogue JMs via two mechanisms; destabilizing early intermediates and resolving JMs. Elimination of the Mms21 SUMO E3-ligase domain leads to transient JM accumulation, depending on Mus81-Mms4 for resolution. Absence of Smc6 leads to persistent rogue JMs accumulation, preventing chromatin separation. We propose that the Smc5/6-Mms21 complex antagonizes toxic JMs by coordinating helicases and resolvases at D-Loops and HJs, respectively. PMID:24385936

Automated EEG artifact elimination by applying machine learning algorithms to ICA-based features.

PubMed

Radüntz, Thea; Scouten, Jon; Hochmuth, Olaf; Meffert, Beate

2017-08-01

Biological and non-biological artifacts cause severe problems when dealing with electroencephalogram (EEG) recordings. Independent component analysis (ICA) is a widely used method for eliminating various artifacts from recordings. However, evaluating and classifying the calculated independent components (IC) as artifact or EEG is not fully automated at present. In this study, we propose a new approach for automated artifact elimination, which applies machine learning algorithms to ICA-based features. We compared the performance of our classifiers with the visual classification results given by experts. The best result with an accuracy rate of 95% was achieved using features obtained by range filtering of the topoplots and IC power spectra combined with an artificial neural network. Compared with the existing automated solutions, our proposed method is not limited to specific types of artifacts, electrode configurations, or number of EEG channels. The main advantages of the proposed method is that it provides an automatic, reliable, real-time capable, and practical tool, which avoids the need for the time-consuming manual selection of ICs during artifact removal.

Spurring enrollment in Medicare savings programs through a substitute for the asset test focused on investment income.

PubMed

Dorn, Stan; Shang, Baoping

2012-02-01

Fewer than one-third of eligible Medicare beneficiaries enroll in Medicare savings programs, which pay premiums and, in some cases, eliminate out-of-pocket cost sharing for poor and near-poor enrollees. Many beneficiaries don't participate in savings programs because they must complete a cumbersome application process, including a burdensome asset test. We demonstrate that a streamlined alternative to the asset test-allowing seniors to qualify for Medicare savings programs by providing evidence of limited assets or showing a lack of investment income-would permit 78 percent of currently eligible seniors to bypass the asset test entirely. This simplified approach would increase the number of beneficiaries who qualify for Medicare savings programs from the current 3.6 million seniors to 4.6 million. Such an alternative would keep benefits targeted to people with low assets, eliminate costly administrative expenses and obstacles to enrollment associated with the asset test, and avoid the much larger influx of seniors that would occur if the asset test were eliminated entirely.

Automated EEG artifact elimination by applying machine learning algorithms to ICA-based features

NASA Astrophysics Data System (ADS)

Radüntz, Thea; Scouten, Jon; Hochmuth, Olaf; Meffert, Beate

2017-08-01

Objective. Biological and non-biological artifacts cause severe problems when dealing with electroencephalogram (EEG) recordings. Independent component analysis (ICA) is a widely used method for eliminating various artifacts from recordings. However, evaluating and classifying the calculated independent components (IC) as artifact or EEG is not fully automated at present. Approach. In this study, we propose a new approach for automated artifact elimination, which applies machine learning algorithms to ICA-based features. Main results. We compared the performance of our classifiers with the visual classification results given by experts. The best result with an accuracy rate of 95% was achieved using features obtained by range filtering of the topoplots and IC power spectra combined with an artificial neural network. Significance. Compared with the existing automated solutions, our proposed method is not limited to specific types of artifacts, electrode configurations, or number of EEG channels. The main advantages of the proposed method is that it provides an automatic, reliable, real-time capable, and practical tool, which avoids the need for the time-consuming manual selection of ICs during artifact removal.

A human-machine cooperation route planning method based on improved A* algorithm

NASA Astrophysics Data System (ADS)

Zhang, Zhengsheng; Cai, Chao

2011-12-01

To avoid the limitation of common route planning method to blindly pursue higher Machine Intelligence and autoimmunization, this paper presents a human-machine cooperation route planning method. The proposed method includes a new A* path searing strategy based on dynamic heuristic searching and a human cooperated decision strategy to prune searching area. It can overcome the shortage of A* algorithm to fall into a local long term searching. Experiments showed that this method can quickly plan a feasible route to meet the macro-policy thinking.

Floating-point scaling technique for sources separation automatic gain control

NASA Astrophysics Data System (ADS)

Fermas, A.; Belouchrani, A.; Ait-Mohamed, O.

2012-07-01

Based on the floating-point representation and taking advantage of scaling factor indetermination in blind source separation (BSS) processing, we propose a scaling technique applied to the separation matrix, to avoid the saturation or the weakness in the recovered source signals. This technique performs an automatic gain control in an on-line BSS environment. We demonstrate the effectiveness of this technique by using the implementation of a division-free BSS algorithm with two inputs, two outputs. The proposed technique is computationally cheaper and efficient for a hardware implementation compared to the Euclidean normalisation.

Using Risk Assessment Methodologies to Meet Management Objectives

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2015-01-01

Corporate and program objectives focus on desired performance and results. ?Management decisions that affect how to meet these objectives now involve a complex mix of: technology, safety issues, operations, process considerations, employee considerations, regulatory requirements, financial concerns and legal issues. ?Risk Assessments are a tool for decision makers to understand potential consequences and be in a position to reduce, mitigate or eliminate costly mistakes or catastrophic failures. Using a risk assessment methodology is only a starting point. ?A risk assessment program provides management with important input in the decision making process. ?A pro-active organization looks to the future to avoid problems, a reactive organization can be blindsided by risks that could have been avoided. ?You get out what you put in, how useful your program is will be up to the individual organization.

Efficient blind search for similar-waveform earthquakes in years of continuous seismic data

NASA Astrophysics Data System (ADS)

Yoon, C. E.; Bergen, K.; Rong, K.; Elezabi, H.; Bailis, P.; Levis, P.; Beroza, G. C.

2017-12-01

Cross-correlating an earthquake waveform template with continuous seismic data has proven to be a sensitive, discriminating detector of small events missing from earthquake catalogs, but a key limitation of this approach is that it requires advance knowledge of the earthquake signals we wish to detect. To overcome this limitation, we can perform a blind search for events with similar waveforms, comparing waveforms from all possible times within the continuous data (Brown et al., 2008). However, the runtime for naive blind search scales quadratically with the duration of continuous data, making it impractical to process years of continuous data. The Fingerprint And Similarity Thresholding (FAST) detection method (Yoon et al., 2015) enables a comprehensive blind search for similar-waveform earthquakes in a fast, scalable manner by adapting data-mining techniques originally developed for audio and image search within massive databases. FAST converts seismic waveforms into compact "fingerprints", which are efficiently organized and searched within a database. In this way, FAST avoids the unnecessary comparison of dissimilar waveforms. To date, the longest duration of continuous data used for event detection with FAST was 3 months at a single station near Guy-Greenbrier, Arkansas, which revealed microearthquakes closely correlated with stages of hydraulic fracturing (Yoon et al., 2017). In this presentation we introduce an optimized, parallel version of the FAST software with improvements to the fingerprinting algorithm and the ability to detect events using continuous data from a network of stations (Bergen et al., 2016). We demonstrate its ability to detect low-magnitude earthquakes within several years of continuous data at locations of interest in California.

Blindness following cosmetic injections of the face.

PubMed

Lazzeri, Davide; Agostini, Tommaso; Figus, Michele; Nardi, Marco; Pantaloni, Marcello; Lazzeri, Stefano

2012-04-01

Complications following facial cosmetic injections have recently heightened awareness of the possibility of iatrogenic blindness. The authors conducted a systematic review of the available literature to provide the best evidence for the prevention and treatment of this serious eye injury. The authors included in the study only the cases in which blindness was a direct consequence of a cosmetic injection procedure of the face. Twenty-nine articles describing 32 patients were identified. In 15 patients, blindness occurred after injections of adipose tissue; in the other 17, it followed injections of various materials, including corticosteroids, paraffin, silicone oil, bovine collagen, polymethylmethacrylate, hyaluronic acid, and calcium hydroxyapatite. Some precautions may minimize the risk of embolization of filler into the ophthalmic artery following facial cosmetic injections. Intravascular placement of the needle or cannula should be demonstrated by aspiration before injection and should be further prevented by application of local vasoconstrictor. Needles, syringes, and cannulas of small size should be preferred to larger ones and be replaced with blunt flexible needles and microcannulas when possible. Low-pressure injections with the release of the least amount of substance possible should be considered safer than bolus injections. The total volume of filler injected during the entire treatment session should be limited, and injections into pretraumatized tissues should be avoided. Actually, no safe, feasible, and reliable treatment exists for iatrogenic retinal embolism. Nonetheless, therapy should theoretically be directed to lowering intraocular pressure to dislodge the embolus into more peripheral vessels of the retinal circulation, increasing retinal perfusion and oxygen delivery to hypoxic tissues. Risk, V.

Prevalence of sensitivity to food and drug additives in patients with chronic idiopathic urticaria.

PubMed

Rajan, Jessica P; Simon, Ronald A; Bosso, John V

2014-01-01

Chronic idiopathic urticaria (CIU) is defined as the presence of urticaria most days of the week for a period of 6 weeks or longer. There have been reports of food additive sensitivity in CIU previously, but the prevalence has not been precisely determined. To determine the prevalence of reactions to food and drug additives in patients with CIU. We challenged 100 patients in our allergy/immunology division with CIU to the 11 additives most commonly associated with reactions: tartrazine (FD&C Yellow 5), potassium metabisulfite, monosodium glutamate, aspartame, sodium benzoate, methyl paraben, butylated hydroxy anisole, butylated hydroxy toluene, FD&C Yellow 6, sodium nitrate, sodium nitrite. All of the patients had a history of CIU for longer than 6 weeks, and 43 reported possible history of food or drug additive sensitivity. Single-blind challenges to all of the additives were performed in the clinic and skin scores were recorded. Subjects with positive challenge tests underwent double-blind placebo controlled challenges. Of 100 subjects, only 2 had a positive urticarial response on single-blind challenge. Neither of these patients had a positive urticarial response on double-blind placebo-controlled challenge. There were no gastrointestinal, respiratory, or other symptom, and no patients reported late reactions. We were able to conclude, with 95% confidence intervals that sensitivity to any of the 11 food and drug additives occurs in fewer than 1% of patients with CIU. Food and drug additives appear to be a rare cause of CIU, and avoidance is not recommended. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Effect of low oral doses of disopyramide and amiodarone on ventricular and atrial arrhythmias of chagasic patients with advanced myocardial damage.

PubMed

Carrasco, H A; Vicuña, A V; Molina, C; Landaeta, A; Reynosa, J; Vicuña, N; Fuenmayor, A; López, F

1985-12-01

Low-dose (7 mg/kg per day) disopyramide administration to arrhythmic chagasic patients decreased the frequency of ventricular extrasystoles in 4 of 17 patients (24%) and suppressed most complex ventricular arrhythmias in 12 of 15 patients (80%). This assessment was made from 72-h continuous Holter monitoring recorded during the course of this double blind, placebo-controlled randomized crossover study. Seven patients (41%) complained of anticholinergic side effects, but no contractile or conduction system depression was seen. Amiodarone (200 mg) given on a single blind, placebo-controlled basis to 9 of these patients reduced the frequency of ventricular extrasystoles in 6 of 9 patients (67%) and suppressed complex ventricular ectopy in 6 of 7 patients (85%). One patient was unable to tolerate this drug (11%). Both drugs seemed less effective in controlling supraventricular arrhythmias, although disopyramide eliminated paroxysms of supraventricular tachycardia in 9 of 13 (69%) and amiodarone in all 6 patients with this arrhythmia. Amiodarone appears to be a better antiarrhythmic drug for chagasic patients, due to its greater effectiveness and lower incidence of side effects.

Barriers to Cataract Surgery in Africa: A Systematic Review.

PubMed

Aboobaker, Shaheer; Courtright, Paul

2016-01-01

Cataract remains the leading cause of blindness in Africa. We performed a systematic literature search of articles reporting barriers to cataract surgery in Africa. PubMed and Google Scholar databases were searched with the terms "barriers, cataract, Africa, cataract surgery, cataract surgical coverage (CSC), and rapid assessment of avoidable blindness (RAAB)." The review covered from 1999 to 2014. In RAAB studies, barriers related to awareness and access were more commonly reported than acceptance. Other type of studies reported cost as the most common barrier. Some qualitative studies tended to report community and family dynamics as barriers to cataract surgery. CSC was lower in females in 88.2% of the studies. The variability in outcomes of studies of barriers to cataract surgery could be due to context and the type of data collection. It is likely that qualitative data will provide a deeper understanding of the complex social, family, community, financial and gender issues relating to barriers to uptake of cataract surgery in Africa.

A wearable multipoint ultrasonic travel aids for visually impaired

NASA Astrophysics Data System (ADS)

Ercoli, Ilaria; Marchionni, Paolo; Scalise, Lorenzo

2013-09-01

In 2010, the World Health Organization estimates that there were about 285 million people in the world with disabling eyesight loss (246 millions are visually impaired (VI) and 39 millions are totally blind). For such users, hits during mobility tasks are the reason of major concerns and can reduce the quality of their life. The white cane is the primary device used by the majority of blind or VI users to explore and possibly avoid obstacles; it can monitor only the ground (< 1m) and it does not provide protection for the legs, the trunk and the head. In this paper, authors propose a novel stand-alone Electronic Travel Aid (ETA) device for obstacle detection based on multi- sensing (by 4 ultrasonic transducers) and a microcontroller. Portability, simplicity, reduced dimensions and cost are among the major pros of the reported system, which can detect and localize (angular position and distance from the user) obstacles eventually present in the volume in front of him and on the ground in front of him.

Best practice eye care models

PubMed Central

Qureshi, Babar M; Mansur, Rabiu; Al-Rajhi, Abdulaziz; Lansingh, Van; Eckert, Kristen; Hassan, Kunle; Ravilla, Thulasiraj; Muhit, Mohammad; Khanna, Rohit C; Ismat, Chaudhry

2012-01-01

Since the launching of Global Initiative, VISION 2020 “the Right to Sight” many innovative, practical and unique comprehensive eye care services provision models have evolved targeting the underserved populations in different parts of the World. At places the rapid assessment of the burden of eye diseases in confined areas or utilizing the key informants for identification of eye diseases in the communities are promoted for better planning and evidence based advocacy for getting / allocation of resources for eye care. Similarly for detection and management of diabetes related blindness, retinopathy of prematurity and avoidable blindness at primary level, the major obstacles are confronted in reaching to them in a cost effective manner and then management of the identified patients accordingly. In this regard, the concept of tele-ophthalmology model sounds to be the best solution. Whereas other models on comprehensive eye care services provision have been emphasizing on surgical output through innovative scales of economy that generate income for the program and ensure its sustainability, while guaranteeing treatment of the poorest of the poor. PMID:22944741

Corneal Nerves in Health and Disease

PubMed Central

Shaheen, Brittany; Bakir, May; Jain, Sandeep

2013-01-01

Corneal nerves are responsible for the sensations of touch, pain, and temperature and play an important role in the blink reflex, wound healing, and tear production and secretion. Corneal nerve dysfunction is a frequent feature of diseases that cause opacities and result in corneal blindness. Corneal opacities rank as the second most frequent cause of blindness. Technological advances in in vivo corneal nerve imaging, such as optical coherence tomography and confocal scanning, have generated new knowledge regarding the phenomenological events that occur during reinnervation of the cornea following disease, injury, or surgery. The recent availability of transgenic neurofluorescent murine models has stimulated the search for molecular modulators of corneal nerve regeneration. New evidence suggests that neuro-regenerative and inflammatory pathways in the cornea are intertwined. Evidence-based treatment of neurotrophic corneal diseases includes using neuro-regenerative (blood component-based and neurotrophic factors), neuroprotective, and ensconcing (bandage contact lens and amniotic membrane) strategies and avoiding anti-inflammatory therapies, such as cyclosporine and corticosteroids. PMID:24461367

Medical certification reduces the number of children requiring allergen elimination diets for school lunches

PubMed Central

Toyokuni, Kenji; Handa, Yousuke; Gotoh, Chika; Wasada, Rieko; Kato, Rie; Kawano, Nanae; Ikeuchi, Mayo; Okamoto, Tomoko; Kiriya, Maki; Takahashi, Mizuho; Takano, Tomoyuki; Haigo, Atsuhiko

2017-01-01

Background Following the increase in the number of children with food allergies, support systems are now required for school lunches, but a large-scale factual investigation has not been carried out. Objective We evaluated the features of elimination diet due to food allergy and the support system in kindergartens and schools. Methods A prefecture-based questionnaire survey regarding measures for food allergies in school lunches of all kindergartens, public elementary schools, and public junior high schools (631 facilities) was conducted in Oita Prefecture, Japan. Results The recovery rate of the questionnaire was 99.5%, which included 106,008 students in total. A total of 1,562 children (1.5%) required elimination diets. The rate of children on elimination diets in kindergartens and elementary/junior high schools that required medical certification by a physician was 1.2% (324 among 27,761 children), which was significantly lower than the 1.8% of children (1,227 among 68,576 students) on elimination diets at the request of guardians without the need for medical certification (p < 0.0001). A total of 43.9% of the kindergartens and schools said that they would contact guardians if symptoms were observed after accidental ingestion, while a low 8.1% stated that they provided support to children themselves, including the administration of adrenaline auto-injectors. Conclusion Medical certification reduces the number of children requiring elimination diets, but it has not been adequately implemented. Furthermore, waiting to contact guardians after symptoms are observed may lead to the delayed treatment of anaphylaxis. Cooperation between physicians and teachers is desired to avoid the overdiagnosis and undertreatment of children with food allergies. PMID:28487840

Examination of the perception of sweet- and bitter-like taste qualities in sucralose preferring and avoiding rats.

PubMed

Torregrossa, A-M; Loney, G C; Smith, J C; Eckel, L A

2015-03-01

Sucralose avoiding rats detect a bitter-like taste quality in concentrations of sucralose that are strongly preferred over water by sucralose preferring rats. Here, we investigated whether sucralose preferrers (SP) also detect a bitter-like quality in sucralose that may be masked by an increased perception of sucralose's sweet-like quality. A microstructural analysis of sucralose intake revealed that, at concentrations they avoided in preference tests, sucralose avoiders (SA) consumed smaller and fewer bouts of sucralose than SP. Interestingly, the concentration-dependent increase in sucralose preference in SP was not associated with larger bouts or increased lick rate, two measures that are expected to increase with increasing perceived sweetness. This suggests that SP can detect an aversive quality in sucralose, but this perception of a presumably bitter-like quality may be masked by increased salience of a sweet-like quality that sustains high levels of intake in SP. Further evidence for increased sweet-taste perception in SP, relative to SA, was obtained in a second study in which SP consumed more of a palatable sweet-milk diet than SA. These are the first data to suggest that SP are not blind to the bitter-like quality in sucralose, and that there may be differences in sweet-taste perception between SP and SA. Copyright © 2014 Elsevier Inc. All rights reserved.

Postural effects on the noninvasive baselines of ventricular performance

NASA Technical Reports Server (NTRS)

Lance, V. Q.; Spodick, D. H.

1977-01-01

The effects of posture on time-based noninvasive measurements were determined utilizing the sequence supine-sitting-standing in a formal protocol in which observer biases were eliminated by blinding the measurement and calculation phases. Compared to the supine posture, the sitting and standing postures produced significant increases in heart rate, isovolumic contraction time, pre-ejection period and pre-ejection period/left-ventricular ejection time and significant decreases in ejection time and ejection time index. The response patterns are consistent with the hemodynamic correlates cited in the literature which show increased adrenergic activity and decreased venous return in the sitting and standing postures, the effect on venous return being dominant.

Development and validation of a questionnaire assessing the quality of life impact of Colour Blindness (CBQoL).

PubMed

Barry, John A; Mollan, Susan; Burdon, Michael A; Jenkins, Michelle; Denniston, Alastair K

2017-10-02

Congenital colour vision deficiency (CVD), commonly called 'colour blindness', affects around 8% of men and 0.4% of women. Although many aspects of health (e.g. change in colour of urine) and healthcare (e.g. coloured medication, colour-coded diagnostic tests), and modern life depend upon colour coding (e.g. graphs, maps, signals), the impact of colour blindness on everyday life is not generally considered a topic of importance. This study is the first to create and validate a questionnaire measuring the quality of life (QoL) impact of being colour blind. This study consisted of two phases. Firstly, the questionnaire design and development phase was led by an expert panel and piloted on a focus group. Secondly, an online sample of 128 men and 291 women filled in the questionnaire, and the psychometric properties of the questionnaire were analysed using principal components analysis (PCA). The scores of colour blind (CB) participants and normal-sighted controls, controlling for age and sex, were compared using matched t-tests. The PCA resulted in a questionnaire with three domains (or subscales): QoL for Health & Lifestyle, QoL for Work, and QoL for Emotions. Controlling for age, there was a significantly greater negative impact on QoL for CB people than normal-sighted controls in regards to confusion over colour in various aspects of their health (p = 5 × 10 -7 ), work (p = 1.3 × 10 -7 ), and emotional life (p = 6 × 10 -5 ). Colour blindness can significantly impact quality of life for health, emotions, and especially careers. The tool developed here could be useful in future clinical studies to measure changes in CBQoL in response to therapy in conditions where colour vision is affected. We also discuss ways in which everyday problems related to colour vision might be reduced, for example, workplaces could avoid colour coding where a non-colour alternative is possible.

Prevalence of Colour Vision Anomalies Amongst Dental Professionals and its Effect on Shade Matching of Teeth

PubMed Central

Maini, Anuj Paul; Wangoo, Anuj; Singh, Sukhman; Mehar, Damanpreet Kaur

2017-01-01

Abstract Introduction The success of a restoration is dependent on accurate shade matching of teeth leading to studies evaluating the factors affecting the perception of shades. Colour vision anomalies including colour blindness have been found to exist in the population and it has been thought to be a potential factor affecting the colour perception ability. Aim The present study was done to evaluate the prevalence of colour vision anomalies and its effect on matching of shades of teeth. Materials and Methods A total of 147 dental professionals were randomly selected for the study and were first tested for visual acuity using the Snellen’s Eye Chart so as to carry on the study with only those operators who had a vision of 6/6. Then, the Ishihara’s colour charts were used to test the operators for colour vision handicap. In the last stage of the study, test for accuracy of shade selection was done using the Vitapan Classical shade guide. The shade guide tabs were covered to avoid bias. Percentage was used to calculate the prevalence of colour vision handicap and its effect on matching of shades of teeth as compared to normal vision, which was evaluated using Chi square test. Results Nineteen operators had colour vision anomalies out of hundred operators and only two operators presented with colour blindness. Colour vision anomaly was more prevalent than colour blindness and it was also found that it was more prevalent in males than females. The difference between the accuracy of shade matching between the operators with normal vision and colour vision defect and operators with normal vision and colour blindness was statistically not significant. Conclusion Colour blindness and colour vision handicap are rare conditions, with the latter being more common in the population. According to our study, it was concluded that no statistically significant difference existed amongst the operators with normal vision and colour vision anomaly or operators with normal vision and colour blindness during the matching of shades of teeth. PMID:28274040

A possibility of avoiding surface roughness due to insects

NASA Technical Reports Server (NTRS)

Wortmann, F. X.

1984-01-01

Discussion of a method for eliminating turbulence caused by the formation of insect roughness upon the leading edges and fuselage, particularly in aircraft using BLC. The proposed technique foresees the use of elastic surfaces on which insect roughness cannot form. The operational characteristics of highly elastic rubber surface fastened to the wing leading edges and fuselage edges are examined. Some preliminary test results are presented. The technique is seen to be advantageous primarily for short-haul operations.

Batch Processing with the Radioiodine Laser Induced-Fluorescence Detector.

DTIC Science & Technology

1980-08-27

out by ourselves and by Burger. (2) Can the poisoning of the Au catalyst be avoided by eliminating the silica tube in which the reaction is run? (3) Can...of alkyl Iodides and HI to 12 have been quantitatively evaluated for use in batch processing. Scrubbing properties of silver zeolites in terms of their...to an apparent poisoning of the gold catalyst after a short period of time. Subsequently, studies by ourselves and conversations with Lee Burger of

Disabler: a game occupational health nurses cannot afford to play.

PubMed

Walker, Jasen M

2003-10-01

The dynamics of the Disabler game are complex, not always recognizable, and less than easily manageable. Awareness of the game and a willingness to avoid direct participation can enhance injured worker rehabilitation and decrease costs associated with lost time and productivity. Not playing the Disabler game can make the role of the occupational health nurse more rewarding. The game requires the field upon which to play, and effectively supported DMPs can help eliminate those playing fields.

Malaria during Pregnancy.

PubMed

Fried, Michal; Duffy, Patrick E

2017-06-01

One hundred and twenty-five million women in malaria-endemic areas become pregnant each year (see Dellicour et al. PLoS Med 7: e1000221 [2010]) and require protection from infection to avoid disease and death for themselves and their offspring. Chloroquine prophylaxis was once a safe approach to prevention but has been abandoned because of drug-resistant parasites, and intermittent presumptive treatment with sulfadoxine-pyrimethamine, which is currently used to protect pregnant women throughout Africa, is rapidly losing its benefits for the same reason. No other drugs have yet been shown to be safe, tolerable, and effective as prevention for pregnant women, although monthly dihydroartemisinin-piperaquine has shown promise for reducing poor pregnancy outcomes. Insecticide-treated nets provide some benefits, such as reducing placental malaria and low birth weight. However, this leaves a heavy burden of maternal, fetal, and infant morbidity and mortality that could be avoided. Women naturally acquire resistance to Plasmodium falciparum over successive pregnancies as they acquire antibodies against parasitized red cells that bind chondroitin sulfate A in the placenta, suggesting that a vaccine is feasible. Pregnant women are an important reservoir of parasites in the community, and women of reproductive age must be included in any elimination effort, but several features of malaria during pregnancy will require special consideration during the implementation of elimination programs. Copyright © 2017 Cold Spring Harbor Laboratory Press; all rights reserved.

Food avoidance and restriction in adults: a cross-sectional pilot study comparing patients from an immunology clinic to a general practice.

PubMed

Fitzgerald, Michael; Frankum, Brad

2017-01-01

With the introduction of avoidant/restrictive food intake disorder (ARFID) in the Diagnostic and Statistical Manual - fifth edition, there is an increased need to understand the prevalence and pattern of food avoidance and restriction in adults. High rates of food allergy and intolerance in immunology clinic populations, and subsequent high rates of elimination diets, place these individuals at a greater risk of developing pathological eating behaviours. This descriptive cross sectional pilot study aims to provide preliminary data on the prevalence and nature of food avoidance and restriction in an adult population, and to explore the reasons for this behaviour. A self-administered questionnaire was designed and distributed to adults presenting to an immunology clinic and a general practice over the course of 6 months to describe the prevalence and nature of avoidant and restrictive eating behaviours in this population. Pearson's chi square test was used to examine the strength of a potential link to a formal diagnosis of avoidant restrictive food intake disorder in these patients. A total of 102 completed questionnaires were used for data analysis. Food avoidance or restriction was detected in 81 respondents (79%), with rates not significantly higher in the immunology clinic group compared to the general practice group ( p  = .242). Food allergy and intolerance were the most common reasons for disturbed eating patterns. Life impact secondary to food avoidance and restriction was reported by 26% of respondents, with significantly higher rates observed in the immunology clinic cohort compared to the general practice ( p  = .011). Eating disturbances similar to those characteristic of ARFID are very common in adults. Food avoidance and restriction due to perceived food allergy and intolerance are significant reasons for such disordered eating patterns, particularly in an immunology clinic population. Further investigation is needed to determine if such eating behaviours are pathological and whether they qualify for a diagnosis of ARFID.

The impact of intranasal oxytocin on attention to social emotional stimuli in patients with anorexia nervosa: a double blind within-subject cross-over experiment.

PubMed

Kim, Youl-Ri; Kim, Chan-Hyung; Park, Jin Hong; Pyo, Jimin; Treasure, Janet

2014-01-01

Social factors may be of importance causally and act as maintenance factors in patients with anorexia nervosa. Oxytocin is a neuromodulatory hormone involved in social emotional processing associated with attentional processes. This study aimed to examine the impact of oxytocin on attentional processes to social faces representing anger, disgust, and happiness in patients with anorexia nervosa. A double-blind, placebo-controlled within-subject crossover design was used. Intranasal oxytocin or placebo followed by a visual probe detection task with faces depicting anger, disgust, and happiness was administered to 64 female subjects: 31 patients with anorexia nervosa and 33 control students. Attentional bias to the disgust stimuli was observed in both groups under the placebo condition. The attentional bias to disgust was reduced under the oxytocin condition (a moderate effect in the patient group). Avoidance of angry faces was observed in the patient group under the placebo condition and vigilance was observed in the healthy comparison group; both of these information processing responses were moderated by oxytocin producing an increase in vigilance in the patients. Happy/smiling faces did not elicit an attentional response in controls or the patients under either the placebo or oxytocin conditions. Oxytocin attenuated attentional vigilance to disgust in patients with anorexia nervosa and healthy controls. On the other hand, oxytocin changed the response to angry faces from avoidance to vigilance in patients but reduced vigilance to anger in healthy controls. We conclude that patients with anorexia nervosa appear to use different strategies/circuits to emotionally process anger from their healthy counterparts.

Systematic evaluation of the methodology of randomized controlled trials of anticoagulation in patients with cancer.

PubMed

Rada, Gabriel; Schünemann, Holger J; Labedi, Nawman; El-Hachem, Pierre; Kairouz, Victor F; Akl, Elie A

2013-02-14

Randomized controlled trials (RCTs) that are inappropriately designed or executed may provide biased findings and mislead clinical practice. In view of recent interest in the treatment and prevention of thrombotic complications in cancer patients we evaluated the characteristics, risk of bias and their time trends in RCTs of anticoagulation in patients with cancer. We conducted a comprehensive search, including a search of four electronic databases (MEDLINE, EMBASE, ISI the Web of Science, and CENTRAL) up to February 2010. We included RCTs in which the intervention and/or comparison consisted of: vitamin K antagonists, unfractionated heparin (UFH), low molecular weight heparin (LMWH), direct thrombin inhibitors or fondaparinux. We performed descriptive analyses and assessed the association between the variables of interest and the year of publication. We included 67 RCTs with 24,071 participants. In twenty one trials (31%) DVT diagnosis was triggered by clinical suspicion; the remaining trials either screened for DVT or were unclear about their approach. 41 (61%), 22 (33%), and 11 (16%) trials respectively reported on major bleeding, minor bleeding, and thrombocytopenia. The percentages of trials satisfying risk of bias criteria were: adequate sequence generation (85%), adequate allocation concealment (61%), participants' blinding (39%), data collectors' blinding (44%), providers' blinding (41%), outcome assessors' blinding (75%), data analysts' blinding (15%), intention to treat analysis (57%), no selective outcome reporting (12%), no stopping early for benefit (97%). The mean follow-up rate was 96%. Adequate allocation concealment and the reporting of intention to treat analysis were the only two quality criteria that improved over time. Many RCTs of anticoagulation in patients with cancer appear to use insufficiently rigorous outcome assessment methods and to have deficiencies in key methodological features. It is not clear whether this reflects a problem in the design, conduct or the reporting of these trials, or both. Future trials should avoid the shortcomings described in this article.

A Direct Examination of the Effect of Intranasal Administration of Oxytocin on Approach-Avoidance Motor Responses to Emotional Stimuli

PubMed Central

Theodoridou, Angeliki; Penton-Voak, Ian S.; Rowe, Angela C.

2013-01-01

Oxytocin has been shown to promote a host of social behaviors in humans but the exact mechanisms by which it exerts its effects are unspecified. One prominent theory suggests that oxytocin increases approach and decreases avoidance to social stimuli. Another dominant theory posits that oxytocin increases the salience of social stimuli. Herein, we report a direct test of these hypotheses. In a double-blind, placebo-controlled study we examined approach-avoidance motor responses to social and non-social emotional stimuli. One hundred and twenty participants self-administered either 24 IU oxytocin or placebo and moved a lever toward or away from pictures of faces depicting emotional expressions or from natural scenes appearing before them on a computer screen. Lever movements toward stimuli decreased and movements away increased stimuli size producing the illusion that stimuli moved away from or approached participants. Reaction time data were recorded. The task produced the effects that were anticipated on the basis of the approach-avoidance literature in relation to emotional stimuli, yet the anticipated speeded approach and slowed avoidance responses to emotional faces by the oxytocin group were not observed. Interestingly, the oxytocin treatment group was faster to approach and avoid faces depicting disgust relative to the placebo group, suggesting a salience of disgust for the former group. Results also showed that within the oxytocin group women's reaction times to all emotional faces were faster than those of men, suggesting sex specific effects of oxytocin. The present findings provide the first direct evidence that intranasal oxytocin administration does not enhance approach/avoidance to social stimuli and does not exert a stronger effect on social vs. non-social stimuli in the context of processing of emotional expressions and scenes. Instead, our data suggest that oxytocin administration increases the salience of certain social stimuli and point to a possible role for oxytocin in behavioral prophylaxis. PMID:23469148

A direct examination of the effect of intranasal administration of oxytocin on approach-avoidance motor responses to emotional stimuli.

PubMed

Theodoridou, Angeliki; Penton-Voak, Ian S; Rowe, Angela C

2013-01-01

Oxytocin has been shown to promote a host of social behaviors in humans but the exact mechanisms by which it exerts its effects are unspecified. One prominent theory suggests that oxytocin increases approach and decreases avoidance to social stimuli. Another dominant theory posits that oxytocin increases the salience of social stimuli. Herein, we report a direct test of these hypotheses. In a double-blind, placebo-controlled study we examined approach-avoidance motor responses to social and non-social emotional stimuli. One hundred and twenty participants self-administered either 24 IU oxytocin or placebo and moved a lever toward or away from pictures of faces depicting emotional expressions or from natural scenes appearing before them on a computer screen. Lever movements toward stimuli decreased and movements away increased stimuli size producing the illusion that stimuli moved away from or approached participants. Reaction time data were recorded. The task produced the effects that were anticipated on the basis of the approach-avoidance literature in relation to emotional stimuli, yet the anticipated speeded approach and slowed avoidance responses to emotional faces by the oxytocin group were not observed. Interestingly, the oxytocin treatment group was faster to approach and avoid faces depicting disgust relative to the placebo group, suggesting a salience of disgust for the former group. Results also showed that within the oxytocin group women's reaction times to all emotional faces were faster than those of men, suggesting sex specific effects of oxytocin. The present findings provide the first direct evidence that intranasal oxytocin administration does not enhance approach/avoidance to social stimuli and does not exert a stronger effect on social vs. non-social stimuli in the context of processing of emotional expressions and scenes. Instead, our data suggest that oxytocin administration increases the salience of certain social stimuli and point to a possible role for oxytocin in behavioral prophylaxis.

An Overview of Randomization and Minimization Programs for Randomized Clinical Trials

PubMed Central

Saghaei, Mahmoud

2011-01-01

Randomization is an essential component of sound clinical trials, which prevents selection biases and helps in blinding the allocations. Randomization is a process by which subsequent subjects are enrolled into trial groups only by chance, which essentially eliminates selection biases. A serious consequence of randomization is severe imbalance among the treatment groups with respect to some prognostic factors, which invalidate the trial results or necessitate complex and usually unreliable secondary analysis to eradicate the source of imbalances. Minimization on the other hand tends to allocate in such a way as to minimize the differences among groups, with respect to prognostic factors. Pure minimization is therefore completely deterministic, that is, one can predict the allocation of the next subject by knowing the factor levels of a previously enrolled subject and having the properties of the next subject. To eliminate the predictability of randomization, it is necessary to include some elements of randomness in the minimization algorithms. In this article brief descriptions of randomization and minimization are presented followed by introducing selected randomization and minimization programs. PMID:22606659

Collision avoidance in space

NASA Technical Reports Server (NTRS)

Kessler, D. J.; Cour-Palais, B. G.; Taylor, R. E.; Landry, P. M.

1980-01-01

Collisions in earth orbital space between operational payloads and various forms of space debris (nonoperational payloads, nonfunctional mission-related objects and fragments resulting from collisions and explosions) are discussed and possible means of avoiding them are considered. From 10,000 to 15,000 objects are estimated to be in earth orbital space, most of which represent spacecraft fragments and debris too small to be detected and tracked by earth-based sensors, and it is considered likely that some of them will be or have already been involved in direct collisions with the ever increasing number of operational satellites and space stations. Means of protecting proposed large space structures and smaller spacecraft from significant damage by larger space objects, particularly in the 400-4000 km altitude range where most debris occurs, include structural redundancy and the double shielding of sensitive components. Other means of collision avoidance are the collection or relocation of satellites, rocket bodies and other objects by the Space Shuttle, the prevention of explosions and the disposal of spent rocket parts by reentry. Finally, a management structure would be required to administer guidelines for the prevention and elimination of space debris.

Role of UV light in photodamage, skin aging, and skin cancer: importance of photoprotection.

PubMed

Gonzaga, Evelyn R

2009-01-01

Solar, and particularly UV, radiation causes molecular and cellular damage with resultant histopathologic and clinical degenerative changes, leading in turn to photosensitivity, photo-aging, and skin cancer. While our bodies have some natural UV defenses, additional protection from the sun is essential, including sun avoidance, physical protection, and sunscreen use. Sun avoidance includes limiting exposure during peak UV times (10am-4pm), avoiding UV-reflective surfaces such as sand, snow and water, and eliminating photosensitizing drugs. Physical protection includes wearing photoprotective clothing such as a broad-brimmed hat and long sleeves and use of UV-blocking films on windows. Sunscreen containing avobenzone, titanium dioxide, zinc oxide or encamsule should be used daily and frequently reapplied. To guard against the UVB spectrum, zinc oxide and titanium dioxide are particularly recommended. Sunscreen is generally under-applied at only 25% of the recommended dose, seriously compromising photoprotection. Dosage guidelines recommend using more than half a teaspoon each on head and neck area and each arm, and more than a teaspoon each on anterior torso, posterior torso, and each leg (approximately 2 mg/cm(2)).

Communicating diabetes in Australian print media: a change in language use between 2010 and 2014?

PubMed

Bailey, Jannine; McCrossin, Timothy

2016-10-01

To assess if language used by Australian print media has changed in accordance with the 2011 Diabetes Australia position statement: a new language for diabetes. Five prominent Australian newspapers were reviewed to retrieve articles from 2010 and 2014 that focused on diabetes or discussed diabetes in detail. Individual terms or phrases used within each article were categorised as preferred language, neutral language or language to avoid. 111 and 79 diabetes-specific articles were retrieved for 2010 and 2014, respectively. A significant decrease (p<0.05) was observed in diabetes articles using language to avoid in 2014 (45.6%) compared to 2010 (70.3%); accompanied by a significant increase (p<0.05) in diabetes articles using preferred language. There was no significant increase in articles that only used preferred language with or without neutral language, indicating that most articles commonly use both preferred language and language to avoid. The Australian print news media has increased use of preferred language when communicating about diabetes, but have not eliminated the use of language to avoid. To realise the goals of the language position statement, continued championing of the recommendations by the health community is needed to ensure awareness and adoption. © 2016 Public Health Association of Australia.

Driving towards malaria elimination in Botswana by 2018: progress on case-based surveillance, 2013–2014

PubMed Central

Edwards, J.; Namboze, J.; Butt, W.; Moakofhi, K.; Obopile, M.; Manzi, M.; Takarinda, K. C.; Zachariah, R.; Owiti, P.; Oumer, N.; Mosweunyane, T.

2018-01-01

Background: Reliable information reporting systems ensure that all malaria cases are tested, treated and tracked to avoid further transmission. Botswana aimed to eliminate malaria by 2018, and surveillance is key. This study focused on assessing the uptake of the new malaria case-based surveillance (CBS) system introduced in 2012, which captures information on malaria cases reported in the Integrated Disease Surveillance and Response (IDSR) system. Methods: This was a retrospective descriptive study based on routine data focusing on Ngami, Chobe and Okavango, three high-risk districts in Botswana. Aggregated data variables were extracted from the IDSR and compared with data from the CBS. Results: The IDSR reported 456 malaria cases in 2013 and 1346 in 2014, of which respectively only 305 and 884 were reported by the CBS. The CBS reported 34% fewer cases than the IDSR system, indicating substantial differences between the two systems. The key malaria indicators with the greatest variability among the districts included in the study were case identification number and date of diagnosis. Conclusion: The IDSR and CBS systems are essential for malaria elimination, as shown by the significant gaps in reporting between the two systems. These findings highlight the need for further investigation into these discrepancies. Strengthening the CBS system will help to reach the objective of malaria elimination in Botswana. PMID:29713590

Driving towards malaria elimination in Botswana by 2018: progress on case-based surveillance, 2013-2014.

PubMed

Motlaleng, M; Edwards, J; Namboze, J; Butt, W; Moakofhi, K; Obopile, M; Manzi, M; Takarinda, K C; Zachariah, R; Owiti, P; Oumer, N; Mosweunyane, T

2018-04-25

Background: Reliable information reporting systems ensure that all malaria cases are tested, treated and tracked to avoid further transmission. Botswana aimed to eliminate malaria by 2018, and surveillance is key. This study focused on assessing the uptake of the new malaria case-based surveillance (CBS) system introduced in 2012, which captures information on malaria cases reported in the Integrated Disease Surveillance and Response (IDSR) system. Methods: This was a retrospective descriptive study based on routine data focusing on Ngami, Chobe and Okavango, three high-risk districts in Botswana. Aggregated data variables were extracted from the IDSR and compared with data from the CBS. Results: The IDSR reported 456 malaria cases in 2013 and 1346 in 2014, of which respectively only 305 and 884 were reported by the CBS. The CBS reported 34% fewer cases than the IDSR system, indicating substantial differences between the two systems. The key malaria indicators with the greatest variability among the districts included in the study were case identification number and date of diagnosis. Conclusion: The IDSR and CBS systems are essential for malaria elimination, as shown by the significant gaps in reporting between the two systems. These findings highlight the need for further investigation into these discrepancies. Strengthening the CBS system will help to reach the objective of malaria elimination in Botswana.

Antimicrobial efficiency of ethanol and 2-propanol alcohols used on contaminated storage phosphor plates and impact on durability of the plate

PubMed Central

Wenzel, A; Kornum, F; Knudsen, MR; Lau, E Frandsen

2013-01-01

Objectives: To assess (1) antimicrobial efficiency of wiping intraoral phosphor plates with alcohol tissues based on ethanol or 2-propanol alcohols after contamination with Candida albicans and Streptococcus oralis, (2) a concept for autodisinfection with ultraviolet light of the transport ramp in a scanner for phosphor plates and (3) the impact of wiping with alcohol tissues on durability of the plate. Methods: Suspensions of C. albicans and S. oralis were prepared in concentrations of 109 and 105 organisms per ml, and Digora (Digora® Optime Imaging Plate, size 2; Soredex, PalaDEx Group Brenntag Nordic A/S, Hellerup, Denmark) and Vista (VistaScan® Imaging Plate PLUS, size 2; Dürr Dental AG, Bietigheim-Bissingen, Germany) plates were contaminated. The plates were wiped with ethanol or 2-propanol disinfectant tissues and imprints obtained on agar. Number of microbial colonies after culturing was recorded. The scanner ramp was contaminated with C. albicans or S. oralis, respectively, the ultraviolet light (UV light) disinfection in the scanner was activated and the number of colonies after culturing was recorded. Plates from each system were sequentially wiped (5–60 times) with ethanol and 2-propanol, exposed and scanned. 48 images from each system were scored blind: 1 = no artefact, 2 = small artefacts and 3 = severe artefacts. Results: Ethanol eliminated C. albicans and S. oralis in high and low concentrations from both types of plates, whereas 2-propanol did not eliminate all micro-organisms at high concentrations. The UV light eliminated all micro-organisms from the ramp. Ethanol degraded the plates to a larger extent than did 2-propanol. Images from Vista plates showed severe artefacts after wiping with ethanol; those from Digora plates did not. Conclusions: Ethanol eliminated all micro-organisms but degraded phosphor plates, whereas 2-propanol did not eliminate all micro-organisms and still degraded plates from Vista but not from Digora. PMID:23420856

Antimicrobial efficiency of ethanol and 2-propanol alcohols used on contaminated storage phosphor plates and impact on durability of the plate.

PubMed

Wenzel, A; Kornum, F; Knudsen, Mr; Lau, E Frandsen

2013-01-01

To assess (1) antimicrobial efficiency of wiping intraoral phosphor plates with alcohol tissues based on ethanol or 2-propanol alcohols after contamination with Candida albicans and Streptococcus oralis, (2) a concept for autodisinfection with ultraviolet light of the transport ramp in a scanner for phosphor plates and (3) the impact of wiping with alcohol tissues on durability of the plate. Suspensions of C. albicans and S. oralis were prepared in concentrations of 10(9) and 10(5) organisms per ml, and Digora (Digora(®) Optime Imaging Plate, size 2; Soredex, PalaDEx Group Brenntag Nordic A/S, Hellerup, Denmark) and Vista (VistaScan(®) Imaging Plate PLUS, size 2; Dürr Dental AG, Bietigheim-Bissingen, Germany) plates were contaminated. The plates were wiped with ethanol or 2-propanol disinfectant tissues and imprints obtained on agar. Number of microbial colonies after culturing was recorded. The scanner ramp was contaminated with C. albicans or S. oralis, respectively, the ultraviolet light (UV light) disinfection in the scanner was activated and the number of colonies after culturing was recorded. Plates from each system were sequentially wiped (5-60 times) with ethanol and 2-propanol, exposed and scanned. 48 images from each system were scored blind: 1 = no artefact, 2 = small artefacts and 3 = severe artefacts. Ethanol eliminated C. albicans and S. oralis in high and low concentrations from both types of plates, whereas 2-propanol did not eliminate all micro-organisms at high concentrations. The UV light eliminated all micro-organisms from the ramp. Ethanol degraded the plates to a larger extent than did 2-propanol. Images from Vista plates showed severe artefacts after wiping with ethanol; those from Digora plates did not. Ethanol eliminated all micro-organisms but degraded phosphor plates, whereas 2-propanol did not eliminate all micro-organisms and still degraded plates from Vista but not from Digora.

Elimination of Kalrn Expression in POMC Cells Reduces Anxiety-Like Behavior and Contextual Fear Learning

PubMed Central

Mandela, Prashant; Yan, Yan; LaRese, Taylor; Eipper, Betty A.; Mains, Richard E.

2014-01-01

Kalirin, a Rho GDP/GTP exchange factor for Rac1 and RhoG, is known to play an essential role in the formation and maintenance of excitatory synapses and in the secretion of neuropeptides. Mice unable to express any of the isoforms of Kalrn in cells that produce POMC at any time during development (POMC cells) exhibited reduced anxiety-like behavior and reduced acquisition of passive avoidance behavior, along with sex-specific alteration in the corticosterone response to restraint stress. Strikingly, lack of Kalrn expression in POMC cells closely mimicked the effects of global Kalrn knockout on anxiety-like behavior and passive avoidance conditioning without causing the other deficits noted in Kalrn knockout mice. Our data suggest that deficits in excitatory inputs onto POMC neurons are responsible for the behavioral phenotypes observed. PMID:25014196

Personality traits as risk factors of depression and anxiety among Japanese students.

PubMed

Matsudaira, Tomomi; Kitamura, Toshinori

2006-01-01

The aim of this study is to examine the effects of personality (temperament and character) on specific depression and specific anxiety. A total of 541 Japanese undergraduates were investigated by using the Temperament and Character Inventory (TCI) and the Hospital Anxiety and Depression (HAD) scale. Hierarchical multiple regression analyses demonstrated that specific depression was predicted by lower Reward-Dependence, Persistence, Self-Directedness, Cooperativeness, and Self-Transcendence; specific anxiety was predicted by higher Novelty-Seeking, Harm-Avoidance, Persistence, and Self-Transcendence, and lower Self-Directedness. Immaturity of Self-Directedness is a risk factor for negative affectivity. Immaturity of all character dimensions is a risk factor for specific depression. The relationship between Harm-Avoidance and depression in previous studies may be linked partly to somatic symptoms that were deliberately eliminated in the HAD scale.

Trans-Splenic Portal Vein Embolization: A Technique to Avoid Damage to the Future Liver Remnant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sarwar, Ammar, E-mail: asarwar@bidmc.harvard.edu; Brook, Olga R.; Weinstein, Jeffrey L.

2016-10-15

Portal vein embolization (PVE) induces hypertrophy of the future liver remnant (FLR) in patients undergoing extensive hepatic resection. Portal vein access for PVE via the ipsilateral hepatic lobe (designated for resection) places veins targeted for embolization at acute angles to the access site requiring reverse curve catheters for access. This approach also involves access close to tumors in the ipsilateral lobe and requires care to avoid traversing tumor. Alternatively, a contralateral approach (through the FLR) risks damage to the FLR due to iatrogenic trauma or non-target embolization. Two patients successfully underwent PVE via trans-splenic portal vein access, allowing easy accessmore » to the ipsilateral portal veins and eliminating risk of damage to FLR. Technique and advantages of trans-splenic portal vein access to perform PVE are described.« less

The challenges of control groups, placebos and blinding in clinical trials of dietary interventions.

PubMed

Staudacher, Heidi M; Irving, Peter M; Lomer, Miranda C E; Whelan, Kevin

2017-08-01

High-quality placebo-controlled evidence for food, nutrient or dietary advice interventions is vital for verifying the role of diet in optimising health or for the management of disease. This could be argued to be especially important where the benefits of dietary intervention are coupled with potential risks such as compromising nutrient intake, particularly in the case of exclusion diets. The objective of the present paper is to explore the challenges associated with clinical trials in dietary research, review the types of controls used and present the advantages and disadvantages of each, including issues regarding placebos and blinding. Placebo-controlled trials in nutrient interventions are relatively straightforward, as in general placebos can be easily produced. However, the challenges associated with conducting placebo-controlled food interventions and dietary advice interventions are protean, and this has led to a paucity of placebo-controlled food and dietary advice trials compared with drug trials. This review appraises the types of controls used in dietary intervention trials and provides recommendations and nine essential criteria for the design and development of sham diets for use in studies evaluating the effect of dietary advice, along with practical guidance regarding their evaluation. The rationale for these criteria predominantly relate to avoiding altering the outcome of interest in those delivered the sham intervention in these types of studies, while not compromising blinding.

Blind Compensation of I/Q Impairments in Wireless Transceivers

PubMed Central

Aziz, Mohsin; Ghannouchi, Fadhel M.; Helaoui, Mohamed

2017-01-01

The majority of techniques that deal with the mitigation of in-phase and quadrature-phase (I/Q) imbalance at the transmitter (pre-compensation) require long training sequences, reducing the throughput of the system. These techniques also require a feedback path, which adds more complexity and cost to the transmitter architecture. Blind estimation techniques are attractive for avoiding the use of long training sequences. In this paper, we propose a blind frequency-independent I/Q imbalance compensation method based on the maximum likelihood (ML) estimation of the imbalance parameters of a transceiver. A closed-form joint probability density function (PDF) for the imbalanced I and Q signals is derived and validated. ML estimation is then used to estimate the imbalance parameters using the derived joint PDF of the output I and Q signals. Various figures of merit have been used to evaluate the efficacy of the proposed approach using extensive computer simulations and measurements. Additionally, the bit error rate curves show the effectiveness of the proposed method in the presence of the wireless channel and Additive White Gaussian Noise. Real-world experimental results show an image rejection of greater than 30 dB as compared to the uncompensated system. This method has also been found to be robust in the presence of practical system impairments, such as time and phase delay mismatches. PMID:29257081

Narcolepsy: current treatment options and future approaches

PubMed Central

Billiard, Michel

2008-01-01

The management of narcolepsy is presently at a turning point. Three main avenues are considered in this review: 1) Two tendencies characterize the conventional treatment of narcolepsy. Modafinil has replaced methylphenidate and amphetamine as the first-line treatment of excessive daytime sleepiness (EDS) and sleep attacks, based on randomized, double blind, placebo-controlled clinical trials of modafinil, but on no direct comparison of modafinil versus traditional stimulants. For cataplexy, sleep paralysis, and hypnagogic hallucinations, new antidepressants tend to replace tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) in spite of a lack of randomized, double blind, placebo-controlled clinical trials of these compounds; 2) The conventional treatment of narcolepsy is now challenged by sodium oxybate, the sodium salt of gammahydroxybutyrate, based on a series of randomized, double-blind, placebo-controlled clinical trials and a long-term open label study. This treatment has a fairly good efficacy and is active on all symptoms of narcolepsy. Careful titration up to an adequate level is essential both to obtain positive results and avoid adverse effects; 3) A series of new treatments are currently being tested, either in animal models or in humans, They include novel stimulant and anticataplectic drugs, endocrine therapy, and, more attractively, totally new approaches based on the present state of knowledge of the pathophysiology of narcolepsy with cataplexy, hypocretine-based therapies, and immunotherapy. PMID:18830438

The incidence of congenital syphilis in the United Kingdom: February 2010 to January 2015.

PubMed

Simms, I; Tookey, P A; Goh, B T; Lyall, H; Evans, B; Townsend, C L; Fifer, H; Ison, C

2017-01-01

To estimate the incidence of congenital syphilis in the UK. Prospective study. United Kingdom. Children born between February 2010 and January 2015 with a suspected diagnosis of congenital syphilis were reported through an active surveillance system. Number of congenital syphilis cases and incidence. For all years, reported incidence was below the WHO threshold for elimination (<0.5/1000 live births). Seventeen cases (12 male, five female) were identified. About 50% of infants (8/17) were born preterm (<37 weeks' gestation): median birthweight 2000 g (865-3170 g). Clinical presentation varied from asymptomatic to acute disease, including severe anaemia, hepatosplenomegaly, rhinitis, thrombocytopaenia, skeletal damage, and neurosyphilis. One infant was deaf and blind. Median maternal age was 20 years (17-31) at delivery. Where maternal stage of infection was recorded, 6/10 had primary, 3/10 secondary and 1/10 early latent syphilis. Most mothers were white (13/16). Country of birth was recorded for 12 mothers: UK (n = 6), Eastern Europe (n = 3), Middle East (n = 1), and South East Asia (n = 2). The social circumstances of mothers varied and included drug use and sex work. Some experienced difficulty accessing health care. The incidence of congenital syphilis is controlled and monitored by healthcare services and related surveillance systems, and is now below the WHO elimination threshold. However, reducing the public health impact of this preventable disease in the UK is highly dependent on the successful implementation of WHO elimination standards across Europe. Congenital syphilis incidence in the UK is at a very low level and well below the WHO elimination threshold. © 2016 Royal College of Obstetricians and Gynaecologists.

Balancing game universes for playing without sight or hearing.

PubMed

Westin, Thomas; Furöstam, Malin; Yasasindhu, Roy; Norberg, Lena; Wiklund, Mats; Mozelius, Peter

2015-01-01

Equal access to cultural activities is important for inclusion and computer gaming is one of the most common activities in digital culture. However, many people with impairments are excluded from participating. While parallel game universes (PGUs) provide a method to achieve equal access, the question is: how can a balanced collaborative real-time game be designed with the help of PGU for playing without sight or hearing? Balance is a central concept in game design and is important to avoid perceived cheating or disadvantages due to individual or environmental differences. The question was examined with a design science approach, where a game prototype was created in two iterations with a structured design method and evaluated using interviews and observations. In this first step of a more long-term study, ten experienced gamers without impairments were selected with purposive sampling to provide relevant data through simulation of temporary impairments or environmental issues, which can affect many or all gamers. By sorting out these issues first, later testing with actual blind and deaf gamers can focus on more specific issues for each group. The ten participants played either without sight or hearing. The results confirm the use of PGUs for creating a balanced experience but also finds that while multiplayer feel is not optimal, it is a reasonable trade-off for universal access for blind and deaf being able to play together. The results also show that a help system and equal understanding of the game play between the blind and deaf players are important aspects to achieve game balance. Further research should be done involving actual blind and deaf gamers, and similar evaluations of game balance should be conducted with users having other types of impairments.

Preventing diabetes blindness: cost effectiveness of a screening programme using digital non-mydriatic fundus photography for diabetic retinopathy in a primary health care setting in South Africa.

PubMed

Khan, Taskeen; Bertram, Melanie Y; Jina, Ruxana; Mash, Bob; Levitt, Naomi; Hofman, Karen

2013-08-01

South Africa like many other developing countries is experiencing an epidemiologic transition with a marked increase in the non-communicable disease (NCD) burden. Diabetic retinopathy is the most common cause of incidental blindness in adults. A screening programme using a mobile fundal camera in a primary care setting has been shown to be effective in the country. Information on affordability and cost is essential for policymakers to consider its adoption. Economic evaluation is the comparative analysis of competing alternative interventions in terms of costs and consequences. A cost effectiveness analysis was done using actual costs from the primary care screening programme. A total of 14,541 patients were screened in three primary healthcare facilities in the Western Cape. Photographs were taken by a trained technician with supervision by an ophthalmic nurse. The photographs were then read by a medical officer with ophthalmic experience. A cost effective ratio of $1206 per blindness case averted was obtained. This included costs for screening and treating an individual. The cost just to screen a patient for retinopathy was $22. The costs of screening and treating all incident cases of blindness due to diabetes in South Africa would be 168,000,000 ZAR ($19,310,344) per annum. Non mydriatic digital fundoscopy is a cost effective measure in the screening and diagnosis of diabetic retinopathy in a primary care setting in South Africa. The major savings in the long term are a result of avoiding government disability grant for people who suffer loss of vision. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

What a Shock: No Apoptosis without Heat Shock Protein 90α | Center for Cancer Research

Cancer.gov

Apoptosis, also known as programmed cell death, consists of a series of reactions designed to systematically chop up a cell and its contents. The process is used to eliminate specific cells during development or to remove old or damaged cells without harming any surrounding cells. Since cancer cells can develop mechanisms to avoid apoptosis, researchers may be able to identify new targets to combat cancer by better understanding the details of the apoptotic process.

Avoid Workplace Injury through Ergonomics | Poster

Cancer.gov

Ergonomics is “the scientific study of people at work,” with the goal of reducing stress and eliminating injuries associated with overused muscles, bad posture, and repeated tasks, according to the Centers for Disease Control and Prevention (CDC). The Occupational Safety and Health Administration (OSHA) states that working ergonomically reduces muscle fatigue, increases productivity, and decreases the number and severity of work-related musculoskeletal disorders (MSDs). MSDs affect the muscles, nerves, and tendons, and are a leading cause of lost workdays due to injury or illness.

Purification process for .sup.153Gd produced in natural europium targets

DOEpatents

Johnsen, Amanda M; Soderquist, Chuck Z; McNamara, Bruce K; Risher, Darrell R

2013-04-23

An alteration of the traditional zinc/zinc-amalgam reduction procedure which eliminates both the hazardous mercury and dangerous hydrogen gas generation. In order to avoid the presence of water and hydrated protons in the working solution, which can oxidize Eu.sup.2+ and cause hydrogen gas production, a process utilizing methanol as the process solvent is described. While methanol presents some flammability hazard in a radiological hot cell, it can be better managed and is less of a flammability hazard than hydrogen gas generation.

Impact of NAVSTAR Global Positioning System on Military Plans for Navigation and Position Fixing Systems

DTIC Science & Technology

1975-10-01

There are however significant factors evident in the study , but not amenable to fiscal quantifi- cation that provide impetus for employment of GPS...assumed in this study . (For summary of these factors , see Section A.2.a, page 25, in the. Discussion.) C These ranges of GPS cost, as well as the...this study . However, they may be a major factor in the teasibility of eliminating the single Doppler, which would be a significant added cost avoidance

Elimination of numerical diffusion in 1 - phase and 2 - phase flows

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rajamaeki, M.

1997-07-01

The new hydraulics solution method PLIM (Piecewise Linear Interpolation Method) is capable of avoiding the excessive errors, numerical diffusion and also numerical dispersion. The hydraulics solver CFDPLIM uses PLIM and solves the time-dependent one-dimensional flow equations in network geometry. An example is given for 1-phase flow in the case when thermal-hydraulics and reactor kinetics are strongly coupled. Another example concerns oscillations in 2-phase flow. Both the example computations are not possible with conventional methods.

Improvement of the grid-connect current quality using novel proportional-integral controller for photovoltaic inverters.

PubMed

Cheng, Yuhua; Chen, Kai; Bai, Libing; Yang, Jing

2014-02-01

Precise control of the grid-connected current is a challenge in photovoltaic inverter research. Traditional Proportional-Integral (PI) control technology cannot eliminate steady-state error when tracking the sinusoidal signal from the grid, which results in a very high total harmonic distortion in the grid-connected current. A novel PI controller has been developed in this paper, in which the sinusoidal wave is discretized into an N-step input signal that is decided by the control frequency to eliminate the steady state error of the system. The effect of periodical error caused by the dead zone of the power switch and conduction voltage drop can be avoided; the current tracking accuracy and current harmonic content can also be improved. Based on the proposed PI controller, a 700 W photovoltaic grid-connected inverter is developed and validated. The improvement has been demonstrated through experimental results.

Elimination of the asymmetric modes in a Ka-band super overmoded coaxial Cerenkov oscillator

NASA Astrophysics Data System (ADS)

Bai, Zhen; Zhang, Jun; Zhong, Huihuang; Zhao, Xuelong; Yang, Fuxiang

2017-12-01

The issue of asymmetric modes output of a Ka-band super overmoded coaxial Cerenkov oscillator is analyzed in this paper. Due to serious passband overlapping in a super overmoded coaxial slow wave structure (SWS), the asymmetric competition mode EH11 can hardly be suppressed thoroughly by the methods adopted in moderately overmoded devices, especially in the startup of oscillation. If the output structures reflect the asymmetric modes, the asymmetric mode competition in SWS will be aggravated and the normal operation state will be destroyed. In order to solve this problem, a taper waveguide is inserted at a specific position to achieve the destructive interference of the reflected TM11, and a special support structure is designed to avoid reflection of TE11. With these methods, asymmetric mode competition can be successfully eliminated, and the oscillator is capable of achieving a steady fundamental mode operation performance.

Error-eliminating rapid ultrasonic firing

DOEpatents

Borenstein, Johann; Koren, Yoram

1993-08-24

A system for producing reliable navigation data for a mobile vehicle, such as a robot, combines multiple range samples to increase the "confidence" of the algorithm in the existence of an obstacle. At higher vehicle speed, it is crucial to sample each sensor quickly and repeatedly to gather multiple samples in time to avoid a collision. Erroneous data is rejected by delaying the issuance of an ultrasonic energy pulse by a predetermined wait-period, which may be different during alternate ultrasonic firing cycles. Consecutive readings are compared, and the corresponding data is rejected if the readings differ by more than a predetermined amount. The rejection rate for the data is monitored and the operating speed of the navigation system is reduced if the data rejection rate is increased. This is useful to distinguish and eliminate noise from the data which truly represents the existence of an article in the field of operation of the vehicle.

Error-eliminating rapid ultrasonic firing

DOEpatents

Borenstein, J.; Koren, Y.

1993-08-24

A system for producing reliable navigation data for a mobile vehicle, such as a robot, combines multiple range samples to increase the confidence'' of the algorithm in the existence of an obstacle. At higher vehicle speed, it is crucial to sample each sensor quickly and repeatedly to gather multiple samples in time to avoid a collision. Erroneous data is rejected by delaying the issuance of an ultrasonic energy pulse by a predetermined wait-period, which may be different during alternate ultrasonic firing cycles. Consecutive readings are compared, and the corresponding data is rejected if the readings differ by more than a predetermined amount. The rejection rate for the data is monitored and the operating speed of the navigation system is reduced if the data rejection rate is increased. This is useful to distinguish and eliminate noise from the data which truly represents the existence of an article in the field of operation of the vehicle.

HIP OSTEOARTHRITIS AND WORK

PubMed Central

Harris, E Clare; Coggon, David

2016-01-01

Epidemiological evidence points strongly to a hazard of hip osteoarthritis from heavy manual work. Harmful exposures may be reduced by elimination or redesign of processes and use of mechanical aids. Reducing obesity might help to protect workers whose need to perform heavy lifting cannot be eliminated. Particularly high relative risks have been reported in farmers, and hip osteoarthritis is a prescribed occupational disease in the UK for long-term employees in agriculture. Even where it is not attributable to employment, hip osteoarthritis impacts importantly on capacity to work. Factors that may influence work participation include the severity of disease, the physical demands of the job, age, and the size of the employer. Published research does not provide a strong guide to the timing of return to work following hip arthroplasty for osteoarthritis, and it is unclear whether patients should avoid heavy manual tasks in their future employment. PMID:26612242

Bone marrow–derived stem cells preserve cone vision in retinitis pigmentosa

PubMed Central

Smith, Lois E.H.

2004-01-01

Retinitis pigmentosa is a heritable group of blinding diseases resulting from loss of photoreceptors, primarily rods and secondarily cones, that mediate central vision. Loss of retinal vasculature is a presumed metabolic consequence of photoreceptor degeneration. A new study shows that autologous bone marrow–derived lineage-negative hematopoietic stem cells, which incorporate into the degenerating blood vessels in two murine models of retinitis pigmentosa, rd1 and rd10, prevent cone loss. The use of autologous bone marrow might avoid problems with rejection while preserving central cone vision in a wide variety of genetically disparate retinal degenerative diseases. PMID:15372096

Empiric 6-food elimination diet induced and maintained prolonged remission in patients with adult eosinophilic esophagitis: a prospective study on the food cause of the disease.

PubMed

Lucendo, Alfredo J; Arias, Ángel; González-Cervera, Jesús; Yagüe-Compadre, José Luis; Guagnozzi, Danila; Angueira, Teresa; Jiménez-Contreras, Susana; González-Castillo, Sonia; Rodríguez-Domíngez, Benito; De Rezende, Livia C; Tenias, José M

2013-03-01

Although empiric exclusion from the diet of the 6 food groups most likely to trigger allergies achieves eosinophilic esophagitis (EoE) remission in children, data on its prolonged efficacy and effects on adults are lacking. We sought to evaluate the efficacy of a 6-food elimination diet in inducing and maintaining prolonged remission in patients with adult EoE. Sixty-seven consecutive patients with adult EoE were prospectively recruited and treated exclusively with a diet avoiding cereals, milk, eggs, fish/seafood, legumes/peanuts, and soy for 6 weeks. Subsequent challenge was undertaken by sequentially reintroducing all excluded single foods, followed by endoscopy and biopsies, which were developed every 6 weeks in case of response (eosinophil peak count reduction to <15/high-power field [hpf]). A food was considered a trigger for EoE and removed from the diet if pathologic eosinophilic infiltration (≥15 eosinophils/hpf) reappeared. Food-specific serum IgE measurements and skin prick tests were performed before initiating the diet. Forty-nine (73.1%) patients exhibited significantly reduced eosinophil peak counts (<15 eosinophils/hpf) before sequential single-food reintroduction. A single offending food antigen was identified in 35.71% of patients, 2 food triggers were identified in 30.95%, and 3 or more food triggers were identified in 33.3%. Cow's milk was the most common food antigen (61.9%), followed by wheat (28.6%), eggs (26.2%), and legumes (23.8%). Prior allergy tests showed no concordance with food-reintroduction challenge results. All patients who continued to avoid the offending foods maintained histopathologic and clinical EoE remission for up to 3 years. An empiric 6-food elimination diet effectively induced remission of active adult EoE, which was maintained for up to 3 years with individually tailored, limited exclusion diets. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Does previous use affect litter box appeal in multi-cat households?

PubMed

Ellis, J J; McGowan, R T S; Martin, F

2017-08-01

It is commonly assumed that cats actively avoid eliminated materials (especially in multi-cat homes), suggesting regular litter box cleaning as the best defense against out-of-box elimination. The relationship between previous use and litter box appeal to familiar subsequent users is currently unknown. The purpose of this study was to investigate the relationship between previous litter box use and the identity of the previous user, type of elimination, odor, and presence of physical/visual obstructions in a multi-cat household scenario. Cats preferred a clean litter box to a dirty one, but the identity of the previous user had no impact on preferences. While the presence of odor from urine and/or feces did not impact litter box preferences, the presence of odorless faux-urine and/or feces did - with the presence of faux-feces being preferred over faux-urine. Results suggest neither malodor nor chemical communication play a role in litter box preferences, and instead emphasize the importance of regular removal of physical/visual obstructions as the key factor in promoting proper litter box use. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Low frequency noise elimination technique for 24-bit Σ-Δ data acquisition systems.

PubMed

Qu, Shao-Bo; Robert, Olivier; Lognonné, Philippe; Zhou, Ze-Bing; Yang, Shan-Qing

2015-03-01

Low frequency 1/f noise is one of the key limiting factors of high precision measurement instruments. In this paper, digital correlated double sampling is implemented to reduce the offset and low frequency 1/f noise of a data acquisition system with 24-bit sigma delta (Σ-Δ) analog to digital converter (ADC). The input voltage is modulated by cross-coupled switches, which are synchronized to the sampling clock, and converted into digital signal by ADC. By using a proper switch frequency, the unwanted parasitic signal frequencies generated by the switches are avoided. The noise elimination processing is made through the principle of digital correlated double sampling, which is equivalent to a time shifted subtraction for the sampled voltage. The low frequency 1/f noise spectrum density of the data acquisition system is reduced to be flat down to the measurement frequency lower limit, which is about 0.0001 Hz in this paper. The noise spectrum density is eliminated by more than 60 dB at 0.0001 Hz, with a residual noise floor of (9 ± 2) nV/Hz(1/2) which is limited by the intrinsic white noise floor of the ADC above its corner frequency.

Economic considerations for the eradication endgame

PubMed Central

Barrett, Scott

2013-01-01

An infectious disease will be eradicated only if it is eliminated everywhere, including in the hardest-to-reach, most vaccine-wary communities. If eradication is successful, it promises a dividend in the form of avoided infections and vaccinations. However, success is never certain unless and until eradication is achieved, and claiming the dividend means bearing the possibly great risk of re-emergence. Economic analysis of eradication evaluates these risks and rewards relative to the alternative of ‘optimal control’, and also exposes the incentives for achieving and capitalizing on eradication. Eradication is a ‘game’, because some countries may be willing to eliminate the disease within their borders only if assured that all others will eliminate the disease within their borders. International financing is also a game, because each country would rather free ride than contribute. Finally, for diseases such as polio, capitalizing on eradication is a game, for should any country continue to vaccinate in the post-eradication era using the live-attenuated polio vaccine, the countries that stop vaccinating will be exposed to the risk of vaccine-derived polioviruses. In the framework developed in this paper, eradication is a seductive goal, its attainment fraught with peril. PMID:23798697

Gold nanoparticles as efficient antimicrobial agents for Escherichia coli and Salmonella typhi

PubMed Central

2013-01-01

Background It is imperative to eliminate bacteria present in water in order to avoid problems in healthy. Escherichia coli and Salmonella typhi bacteria are two common pollutants and they are developing resistance to some of the most used bactericide. Therefore new biocide materials are being tested. Thus, gold nanoparticles are proposed to inhibit the growth of these two microorganisms. Results Gold nanoparticles were supported onto clinoptilolite, mordenite and faujasite zeolites. Content of gold in materials varied between 2.3 and 2.8 wt%. The size, dispersion and roughness of gold nanoparticles were highly dependent of the zeolite support. The faujasite support was the support where the 5 nm nanoparticles were highly dispersed. The efficiency of gold-zeolites as bactericides of Escherichia coli and Salmonella typhi was determined by the zeolite support. Conclusions Gold nanoparticles dispersed on zeolites eliminate Escherichia coli and Salmonella typhi at short times. The biocidal properties of gold nanoparticles are influenced by the type of support which, indeed, drives key parameters as the size and roughness of nanoparticles. The more actives materials were pointed out Au-faujasite. These materials contained particles sized 5 nm at surface and eliminate 90–95% of Escherichia coli and Salmonella typhi colonies. PMID:23331621

Estimation of distribution algorithm with path relinking for the blocking flow-shop scheduling problem

NASA Astrophysics Data System (ADS)

Shao, Zhongshi; Pi, Dechang; Shao, Weishi

2018-05-01

This article presents an effective estimation of distribution algorithm, named P-EDA, to solve the blocking flow-shop scheduling problem (BFSP) with the makespan criterion. In the P-EDA, a Nawaz-Enscore-Ham (NEH)-based heuristic and the random method are combined to generate the initial population. Based on several superior individuals provided by a modified linear rank selection, a probabilistic model is constructed to describe the probabilistic distribution of the promising solution space. The path relinking technique is incorporated into EDA to avoid blindness of the search and improve the convergence property. A modified referenced local search is designed to enhance the local exploitation. Moreover, a diversity-maintaining scheme is introduced into EDA to avoid deterioration of the population. Finally, the parameters of the proposed P-EDA are calibrated using a design of experiments approach. Simulation results and comparisons with some well-performing algorithms demonstrate the effectiveness of the P-EDA for solving BFSP.

Two-Year Stability and Change of Schizotypal, Borderline, Avoidant, and Obsessive–Compulsive Personality Disorders

PubMed Central

Grilo, Carlos M.; Shea, M. Tracie; Sanislow, Charles A.; Skodol, Andrew E.; Gunderson, John G.; Stout, Robert L.; Pagano, Maria E.; Yen, Shirley; Morey, Leslie C.; Zanarini, Mary C.; McGlashan, Thomas H.

2012-01-01

The authors examined the stability of schizotypal (STPD), borderline (BPD), avoidant (AVPD) and obsessive– compulsive (OCPD) personality disorders (PDs) over 2 years of prospective multiwave follow-up. Six hundred thirty-three participants recruited at 4 collaborating sites who met criteria for 1 or more of the 4 PDs or for major depressive disorder (MDD) without PD were assessed with semistructured interviews at baseline, 6, 12, and 24 months. Lifetable survival analyses revealed that the PD groups had slower time to remission than the MDD group. Categorically, PD remission rates range from 50% (AVPD) to 61% (STPD) for dropping below diagnostic threshold on a blind 24-month reassessment but range from 23% (STPD) to 38% (OCPD) for a more stringent definition of improvement. Dimensionally, these findings suggest that PDs may be characterized by maladaptive trait constellations that are stable in their structure (individual differences) but can change in severity or expression over time. PMID:15482035

An evidence-based information booklet helps reduce fear-avoidance beliefs after first-time discectomy for disc prolapse.

PubMed

Claus, D; Coudeyre, E; Chazal, J; Irthum, B; Mulliez, A; Givron, P

2017-04-01

We aimed to assess the impact of a booklet integrating the biopsychosocial model of chronic pain management on reducing disability among patients undergoing lumbar discetomy. In a prospective, controlled, time-series study with an alternate-month design, we enrolled 129 patients from a tertiary care university hospital after they underwent uncomplicated lumbar discectomy for the first time. The intervention group received the biopsychosocial evidence-based booklet and the control group a biomedical-based booklet; the booklets differed only in information content. Patients were blinded to treatment group. The main outcome was disability at 2 months (measured by the Quebec back-pain disability scale [QBPDS]). Secondary outcomes were fear and avoidance beliefs measured by the Fear-Avoidance Beliefs Questionnaire (FABQ). All data were collected by self-reporting questionnaires. At 2 months, disability did not differ between the 2 groups (QBPDS score 32.4±22.8 vs 36.1±18.7, P=0.36). FABQ physical activity score was lower with the evidenced-based booklet as compared with controls (8.0±7.14 vs 11.2±6.3, P=0.008). Providing an evidence-based booklet had no effect at 2 months after surgery on disability but reduced fear-avoidance beliefs about physical activity. This booklet could be an effective tool for health care professionals in helping with patient education. CLINICALTRIALS. NCT00761111. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Delaying in vivo exposure to a tarantula with very brief exposure to phobic stimuli.

PubMed

Siegel, Paul; Gallagher, Kimberly Alyse

2015-03-01

Research has documented the very brief exposure (VBE) effect: the reduction of phobic fear by continuous presentation of masked phobic pictures. In prior studies, phobic participants approached a live tarantula immediately after the masked stimuli were presented. This study tested the hypothesis that VBE would reduce phobic avoidance of the tarantula 24 h later. 86 spider-phobic participants were identified with a fear questionnaire and Behavioral Avoidance Test (BAT) with a live tarantula indicative of a DSM-IV diagnosis of Specific Phobia. One week later, they were randomly assigned in double-blind fashion to presentation of a continuous series of 25 trials of masked images of either spiders or flowers (33-ms each), i.e., to VBE or control exposure. The participants gave subjective distress ratings just before and after these exposures. Then they engaged in the BAT again either immediately thereafter or 24 h later to measure changes in avoidance of the tarantula. Masked images of spiders reduced avoidance of the tarantula both immediately after exposure and 24 h later without causing subjective distress. The effect sizes at these two time points did not significantly differ from each other. We did not manipulate awareness of the spider images by presenting them unmasked to a third group. Conclusions about the effect of awareness of the stimuli cannot be drawn. VBE induces a process of fear reduction before phobic individuals engage in in vivo exposure, which is more distressing. Thus, VBE may help phobic-resistant individuals start treatment more gradually.

Powerline noise elimination in biomedical signals via blind source separation and wavelet analysis.

PubMed

Akwei-Sekyere, Samuel

2015-01-01

The distortion of biomedical signals by powerline noise from recording biomedical devices has the potential to reduce the quality and convolute the interpretations of the data. Usually, powerline noise in biomedical recordings are extinguished via band-stop filters. However, due to the instability of biomedical signals, the distribution of signals filtered out may not be centered at 50/60 Hz. As a result, self-correction methods are needed to optimize the performance of these filters. Since powerline noise is additive in nature, it is intuitive to model powerline noise in a raw recording and subtract it from the raw data in order to obtain a relatively clean signal. This paper proposes a method that utilizes this approach by decomposing the recorded signal and extracting powerline noise via blind source separation and wavelet analysis. The performance of this algorithm was compared with that of a 4th order band-stop Butterworth filter, empirical mode decomposition, independent component analysis and, a combination of empirical mode decomposition with independent component analysis. The proposed method was able to expel sinusoidal signals within powerline noise frequency range with higher fidelity in comparison with the mentioned techniques, especially at low signal-to-noise ratio.

ANTIPLAQUE AND ANTIGINGIVITIS EFFECT OF LIPPIA SIDOIDES. A DOUBLE-BLIND CLINICAL STUDY IN HUMANS

PubMed Central

Rodrigues, Ítalo Sarto Carvalho; Tavares, Vinícius Nascimento; Pereira, Sérgio Luís da Silva; da Costa, Flávio Nogueira

2009-01-01

Objectives: The antiplaque and antigingivitis effect of Lippia Sidoides (LS) was evaluated in this in vivo investigation. Material and Methods: Twenty-three subjects participated in a cross-over, double-blind clinical study, using 21-day partial-mouth experimental model of gingivitis. A toothshield was constructed for each volunteer, avoiding the brushing of the 4 experimental posterior teeth in the lower left quadrant. The subjects were randomly assigned initially to use either the placebo gel (control group) or the test gel, containing 10% LS (test group). Results: The clinical results showed statistically significant differences for plaque index (PLI) (p<0.01) between days 0 and 21 in both groups, however only the control group showed statistically significant difference (p<0.01) for the bleeding (IB) and gingival (GI) index within the experimental period of 21 days. On day 21, the test group presented significantly better results than the control group with regard to the GI (p<0.05). Conclusions: The test gel containing 10% LS was effective in the control of gingivitis. PMID:19936516

[Focus on popular science education of glaucoma and reduce glaucomatous low vision and blindness].

PubMed

Sun, X H

2017-02-11

The prevention of blindness caused by glaucoma is a difficult task. In order to accomplish the task better, we need the participation of whole society and popularize relevant medical knowledge. Popular science and related knowledge of glaucoma are needed to the people especially for high risk population. If people know glaucoma better and actively join the screening of glaucoma, we can find and diagnose glaucoma earlier, avoid late treatment and reduce the glaucomatous visual function impairment. For patients who had been diagnosed with glaucoma, they should aware and accept new medical concept and technique through systemic popular science education. They should actively participate the whole procedure of the disease management and improve their compliance and confidence. Academic organization of ophthalmology should participate and guide the patient education, improve the individualized comprehensive health care for the diagnosis and treatment and third-order health care system that is suitable for the condition of our country, help improving the prognosis of glaucoma and life quality related to vision for advanced and late glaucoma. (Chin J Ophthalmol, 2017, 53: 81-84) .

[New concepts for pressure-controlled glaucoma implants].

PubMed

Allemann, R; Stachs, O; Falke, K; Schmidt, W; Siewert, S; Sternberg, K; Chichkov, B; Wree, A; Schmitz, K-P; Guthoff, R F

2013-08-01

In industrialized countries glaucoma is one of the most common causes that leads to blindness. It is also the most common cause of irreversible blindness worldwide. In addition to local treatment of intraocular pressure and filtering glaucoma surgery, alloplastic implants are increasingly being used in glaucoma therapy. As long-term results published in the literature of commonly used implants are unsatisfactory, it seems useful to search for new concepts. In order to avoid the well-known short-term and long-term postoperative complications a pressure-controlled microstent with antiproliferative surface modifications was developed. Additionally, the functionality of such a microstent should be investigated using an animal glaucoma model. This paper describes the concept of a microstent which drains aquous humour from the anterior chamber into the suprachoroidal space. In addition, the glaucoma models described in the literature are discussed. Unfortunately, none of the methods could be reproduced permanently. First results show a correct implantation of a coated microstent with valve where the anti-proliferative effect could be demonstrated histologically. The promising results should lead to further investigations and the final goal will be the testing of the stent in the human eye.

Elimination of Kalrn expression in POMC cells reduces anxiety-like behavior and contextual fear learning.

PubMed

Mandela, Prashant; Yan, Yan; LaRese, Taylor; Eipper, Betty A; Mains, Richard E

2014-07-01

Kalirin, a Rho GDP/GTP exchange factor for Rac1 and RhoG, is known to play an essential role in the formation and maintenance of excitatory synapses and in the secretion of neuropeptides. Mice unable to express any of the isoforms of Kalrn in cells that produce POMC at any time during development (POMC cells) exhibited reduced anxiety-like behavior and reduced acquisition of passive avoidance behavior, along with sex-specific alteration in the corticosterone response to restraint stress. Strikingly, lack of Kalrn expression in POMC cells closely mimicked the effects of global Kalrn knockout on anxiety-like behavior and passive avoidance conditioning without causing the other deficits noted in Kalrn knockout mice. Our data suggest that deficits in excitatory inputs onto POMC neurons are responsible for the behavioral phenotypes observed. Copyright © 2014 Elsevier Inc. All rights reserved.

Inequality, communication, and the avoidance of disastrous climate change in a public goods game.

PubMed

Tavoni, Alessandro; Dannenberg, Astrid; Kallis, Giorgos; Löschel, Andreas

2011-07-19

International efforts to provide global public goods often face the challenges of coordinating national contributions and distributing costs equitably in the face of uncertainty, inequality, and free-riding incentives. In an experimental setting, we distribute endowments unequally among a group of people who can reach a fixed target sum through successive money contributions, knowing that if they fail, they will lose all their remaining money with 50% probability. In some treatments, we give players the option to communicate intended contributions. We find that inequality reduces the prospects of reaching the target but that communication increases success dramatically. Successful groups tend to eliminate inequality over the course of the game, with rich players signaling willingness to redistribute early on. Our results suggest that coordination-promoting institutions and early redistribution from richer to poorer nations are both decisive for the avoidance of global calamities, such as disruptive climate change.

What if it is the other way around? Early introduction of peanut and fish seems to be better than avoidance.

PubMed

Wennergren, Göran

2009-07-01

For many years, the advice to prevent food allergy was to postpone the introduction of allergens like egg, fish and peanut. However, elimination of food allergens during pregnancy and infancy failed to prevent food allergy. Instead, several studies indicate that early introduction of food like fish and peanuts may be beneficial. The most compelling illustration of this has been presented for peanuts. The prevalence of peanut allergy is lower in children in Israel than in the UK, despite introduction of peanut during infancy in Israel. Other studies have reported that early introduction of fish reduced the risk of allergic sensitization and allergic diseases like eczema. Early introduction rather than avoidance may be a better strategy for the prevention of food allergy. The mechanism may be that early introduction of food allergens during infancy might induce tolerance, thereby preventing the development of allergy.

Inequality, communication, and the avoidance of disastrous climate change in a public goods game

PubMed Central

Tavoni, Alessandro; Dannenberg, Astrid; Kallis, Giorgos; Löschel, Andreas

2011-01-01

International efforts to provide global public goods often face the challenges of coordinating national contributions and distributing costs equitably in the face of uncertainty, inequality, and free-riding incentives. In an experimental setting, we distribute endowments unequally among a group of people who can reach a fixed target sum through successive money contributions, knowing that if they fail, they will lose all their remaining money with 50% probability. In some treatments, we give players the option to communicate intended contributions. We find that inequality reduces the prospects of reaching the target but that communication increases success dramatically. Successful groups tend to eliminate inequality over the course of the game, with rich players signaling willingness to redistribute early on. Our results suggest that coordination-promoting institutions and early redistribution from richer to poorer nations are both decisive for the avoidance of global calamities, such as disruptive climate change. PMID:21730154

Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis

PubMed Central

Schapowal, Andreas

2002-01-01

Objectives To compare the efficacy and tolerability of butterbur (Petasites hybridus) with cetirizine in patients with seasonal allergic rhinitis (hay fever). Design Randomised, double blind, parallel group comparison. Setting Four outpatient general medicine and allergy clinics in Switzerland and Germany. Participants 131 patients were screened for seasonal allergic rhinitis and 125 patients were randomised (butterbur 61; cetirizine 64). Interventions Butterbur (carbon dioxide extract tablets, ZE 339) one tablet, four times daily, or cetirizine, one tablet in the evening, both given for two consecutive weeks. Main outcome measures Scores on SF-36 questionnaire and clinical global impression scale. Results Improvement in SF-36 score was similar in the two treatment groups for all items tested hierarchically. Butterbur and cetirizine were also similarly effective with regard to global improvement scores on the clinical global impression scale (median score 3 in both groups). Both treatments were well tolerated. In the cetirizine group, two thirds (8/12) of reported adverse events were associated with sedative effects (drowsiness and fatigue) despite the drug being considered a non-sedating antihistamine. Conclusions The effects of butterbur are similar to those of cetirizine in patients with seasonal allergic rhinitis when evaluated blindly by patients and doctors. Butterbur should be considered for treating seasonal allergic rhinitis when the sedative effects of antihistamines need to be avoided. What is already known on this topicSeasonal allergic rhinitis (hay fever) is common in countries with temperate climates.Most patients have their symptoms treated for short periods, particularly during peaks in atmospheric pollen countWhat this study addsAfter two weeks, the effects of butterbur and cetirizine were comparable in patients with hay feverButterbur produced fewer sedating effects than cetirizineButterbur should be considered when the sedating effects of antihistamines must be avoided PMID:11799030

Low-grade inflammation decreases emotion recognition - Evidence from the vaccination model of inflammation.

PubMed

Balter, Leonie J T; Hulsken, Sasha; Aldred, Sarah; Drayson, Mark T; Higgs, Suzanne; Veldhuijzen van Zanten, Jet J C S; Raymond, Jane E; Bosch, Jos A

2018-05-06

The ability to adequately interpret the mental state of another person is key to complex human social interaction. Recent evidence suggests that this ability, considered a hallmark of 'theory of mind' (ToM), becomes impaired by inflammation. However, extant supportive empirical evidence is based on experiments that induce not only inflammation but also induce discomfort and sickness, factors that could also account for temporary social impairment. Hence, an experimental inflammation manipulation was applied that avoided this confound, isolating effects of inflammation and social interaction. Forty healthy male participants (mean age = 25, SD = 5 years) participated in this double-blind placebo-controlled crossover trial. Inflammation was induced using Salmonella Typhi vaccination (0.025 mg; Typhim Vi, Sanofi Pasteur, UK); saline-injection was used as a control. About 6 h 30 m after injection in each condition, participants completed the Reading the Mind in the Eyes Test (RMET), a validated test for assessing how well the mental states of others can be inferred through observation of the eyes region of the face. Vaccination induced systemic inflammation, elevating IL-6 by +419% (p < .001), without fever, sickness symptoms (e.g., nausea, light-headedness), or mood changes (all p's > .21). Importantly, compared to placebo, vaccination significantly reduced RMET accuracy (p < .05). RMET stimuli selected on valence (positive, negative, neutral) provided no evidence of a selective impact of treatment. By utilizing an inflammation-induction procedure that avoided concurrent sicknesses or symptoms in a double-blinded design, the present study provides further support for the hypothesis that immune activation impairs ToM. Such impairment may provide a mechanistic link explaining social-cognitive deficits in psychopathologies that exhibit low-grade inflammation, such as major depression. Copyright © 2018 Elsevier Inc. All rights reserved.

Phasing out of the Universal Mega Dose of Vitamin-A Prophylaxis to Avoid Toxicity.

PubMed

Bhattacharya, Sudip; Singh, Amarjeet

2017-01-01

Childhood blindness due to corneal ulceration was prevalent among poor Indian children. To tackle this situation, the National Institute of Nutrition (NIN), Hyderabad, India, Vitamin-A (Vit-A) prophylaxis programme was launched nationally in 1970 after field testing. Research of Indian Council for Medical Research (ICMR) documented that prevalence of Vit-A deficiency signs such as Bitot's spot decreased among children, over a period of time. However, this decrease cannot be ascertained is due to mass Vit-A prophylaxis programme. This is because coverage was low and patchy. Improved nutrition status, wider vaccination coverage, increased rate in breast feeding and improvement of healthcare services played a crucial role. Rather many studies revealed that (mass prophylaxis to the child who is having adequate Vit-A level) it may be harmful to certain group of children as a result of acute toxic symptoms. High dose of Vit-A is capable of loss of bone density-hence retarded growth may be observed in susceptible individuals. To tackle this issue food based approach should be promoted (which includes breast feeding) along with timely measles vaccination. The children who have signs of Vit-A deficiency (e.g. night blindness, xeropthalmia, Bitot's spot) or post measles children should receive Vit-A in age specific daily doses for two weeks along with Vit-A rich food, like green leafy vegetables, red palm oil, liver etc. Public spirited citizens, together with scientific community in India, should discourage this "one size fit to all" approach. It will not only avoid the ill effects of high dose of Vit-A but also it will help us optimal utilization of health resources in a resource poor country like India.

Growth hormone distribution kinetics are markedly reduced in adults with growth hormone deficiency.

PubMed

Catalina, Pablo F; Páramo, Concepción; Andrade, Maria Amalia; Mallo, Federico

2007-03-01

Growth hormone (GH) circulating levels are highly dependent not only on GH secretion rate from the pituitary, but also on the hormone distribution in the compartments of the body and elimination phenomena. In adult GH-deficient patients these factors become critical nowadays, especially when recombinant human GH (rhGH) is available for replacement therapy. In the present study, we assess the influence of both distribution and elimination phenomena on GH pharmacokinetics in adult GH-deficient patients. We used a four-step methodology following a compartmental approach after an intravenous bolus of recombinant GH in adult GH-deficient patients. We found that GH kinetics are clearly explained by a bi-exponential, two-compartmental model in GH-deficient patients, similarly than in normal or diabetic subjects, as previously shown. We have also observed a marked delay in the whole GH elimination process in GH-deficient patients compared to normal adult subjects, as revealed by metabolic clearance ratio (MCR), elimination constant from central compartment (k(10)), and mean resident time in the body (MRT). Interestingly, such a delay appear to be caused by deep changes in the distribution phase (Mtt(1)- mean transit time-1; T(1/2alpha)- GH half-life at distribution phase), while the elimination phenomenon remains unaltered. Our results emphasize the relevance of distribution phenomena in GH pharmacokinetics, and indicates that studies avoiding data from the GH distribution phase, such as those carried out in steady-state conditions, or those using noncompartmental models, could easily miss relevant information. Our data should be taken into consideration when establishing the appropriate dosage for GH replacement treatments in GH-deficient patients, and calculations should include GH distribution kinetics.

Travel and implications for the elimination of trachoma in ethiopia.

PubMed

Shah, Neelima A; House, Jenafir; Lakew, Takele; Alemayehu, Wondu; Halfpenny, Colleen; Hong, Kevin C; Keenan, Jeremy D; Porco, Travis C; Whitcher, John P; Lietman, Thomas M; Gaynor, Bruce D

2010-03-01

Trachoma is the leading infectious cause of blindness. The World Health Organization has set a goal of reducing the trachoma disease burden to a level where it is no longer a public health concern by the year 2020. Some investigators feel that local elimination of ocular chlamydia infection is possible, but little has been done to study the likelihood of reintroduction of infection from neighboring areas. Mass administration of azithromycin has been shown to dramatically reduce the prevalence of infection in many villages in central Ethiopia. However, after treatment is discontinued, infection returns. Reintroduction of infection could occur from the few remaining infected cases in a treated community or from outside the community. People traveling between villages might be responsible thus complicating the elimination of trachoma. We conducted a survey to assess the travel pattern of the Gurage zone residents in Ethiopia. Seven hundred and seventeen households with at least one child aged 1-5 years in 48 villages were surveyed to collect the details of travel in 1 month prior to the survey. Seventy-eight percent of the surveyed households had at least one traveler, with the majority being women. Pre-school children, the main reservoir of clinically active infection, rarely traveled. Most travel was to the market or to school, and most for less than 1 day. Travel routinely takes place in these villages. Trachoma control programs in this area might consider treating areas with the same markets and schools in the same period to increase the efficacy of mass treatment.

Evaluating the Pros and Cons of Different Peer Review Policies via Simulation.

PubMed

Zhu, Jia; Fung, Gabriel; Wong, Wai Hung; Li, Zhixu; Xu, Chuanhua

2016-08-01

In the academic world, peer review is one of the major processes in evaluating a scholars contribution. In this study, we are interested in quantifying the merits of different policies in a peer review process, such as single-blind review, double-blind review, and obtaining authors feedback. Currently, insufficient work has been undertaken to evaluate the benefits of different peer review policies. One of the major reasons for this situation is the inability to conduct any empirical study because data are presently unavailable. In this case, a computer simulation is one of the best ways to conduct a study. We perform a series of simulations to study the effects of different policies on a peer review process. In this study, we focus on the peer review process of a typical computer science conference. Our results point to the crucial role of program chairs in determining the quality and diversity of the articles to be accepted for publication. We demonstrate the importance of discussion among reviewers, suggest circumstances in which the double-blind review policy should be adopted, and question the credibility of the authors feedback mechanism. Finally, we stress that randomness plays an important role in the peer review process, and this role cannot be eliminated. Although our model may not capture every component of a peer review process, it covers some of the most essential elements. Thus, even the simulation results clearly cannot be taken as literal descriptions of an actual peer review process. However, we can at least still use them to identify alternative directions for future study.

Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: The 2-4-6 study.

PubMed

Molina-Infante, Javier; Arias, Ángel; Alcedo, Javier; Garcia-Romero, Ruth; Casabona-Frances, Sergio; Prieto-Garcia, Alicia; Modolell, Ines; Gonzalez-Cordero, Pedro L; Perez-Martinez, Isabel; Martin-Lorente, Jose Luis; Guarner-Argente, Carlos; Masiques, Maria L; Vila-Miravet, Victor; Garcia-Puig, Roger; Savarino, Edoardo; Sanchez-Vegazo, Carlos Teruel; Santander, Cecilio; Lucendo, Alfredo J

2018-04-01

Numerous dietary restrictions and endoscopies limit the implementation of empiric elimination diets in patients with eosinophilic esophagitis (EoE). Milk and wheat/gluten are the most common food triggers. We sought to assess the effectiveness of a step-up dietary strategy for EoE. We performed a prospective study conducted in 14 centers. Patients underwent a 6-week 2-food-group elimination diet (TFGED; milk and gluten-containing cereals). Remission was defined by symptom improvement and less than 15 eosinophils/high-power field. Nonresponders were gradually offered a 4-food-group elimination diet (FFGED; TFGED plus egg and legumes) and a 6-food-group elimination diet (SFGED; FFGED plus nuts and fish/seafood). In responders eliminated food groups were reintroduced individually, followed by endoscopy. One hundred thirty patients (25 pediatric patients) were enrolled, with 97 completing all phases of the study. A TFGED achieved EoE remission in 56 (43%) patients, with no differences between ages. Food triggers in TFGED responders were milk (52%), gluten-containing grains (16%), and both (28%). EoE induced only by milk was present in 18% and 33% of adults and children, respectively. Remission rates with FFGEDs and SFGEDs were 60% and 79%, with increasing food triggers, especially after an SFGED. Overall, 55 (91.6%) of 60 of the TFGED/FFGED responders had 1 or 2 food triggers. Compared with the initial SFGED, a step-up strategy reduced endoscopic procedures and diagnostic process time by 20%. A TFGED diet achieves EoE remission in 43% of children and adults. A step-up approach results in early identification of a majority of responders to an empiric diet with few food triggers, avoiding unnecessary dietary restrictions, saving endoscopies, and shortening the diagnostic process. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Evidence for negative feature guidance in visual search is explained by spatial recoding.

PubMed

Beck, Valerie M; Hollingworth, Andrew

2015-10-01

Theories of attention and visual search explain how attention is guided toward objects with known target features. But can attention be directed away from objects with a feature known to be associated only with distractors? Most studies have found that the demand to maintain the to-be-avoided feature in visual working memory biases attention toward matching objects rather than away from them. In contrast, Arita, Carlisle, and Woodman (2012) claimed that attention can be configured to selectively avoid objects that match a cued distractor color, and they reported evidence that this type of negative cue generates search benefits. However, the colors of the search array items in Arita et al. (2012) were segregated by hemifield (e.g., blue items on the left, red on the right), which allowed for a strategy of translating the feature-cue information into a simple spatial template (e.g., avoid right, or attend left). In the present study, we replicated the negative cue benefit using the Arita et al. (2012), method (albeit within a subset of participants who reliably used the color cues to guide attention). Then, we eliminated the benefit by using search arrays that could not be grouped by hemifield. Our results suggest that feature-guided avoidance is implemented only indirectly, in this case by translating feature-cue information into a spatial template. (c) 2015 APA, all rights reserved).

Active Trachoma and Ocular Chlamydia trachomatis Infection in Two Gambian Regions: On Course for Elimination by 2020?

PubMed Central

Harding-Esch, Emma M.; Edwards, Tansy; Sillah, Ansumana; Sarr, Isatou; Roberts, Chrissy H.; Snell, Paul; Aryee, Esther; Molina, Sandra; Holland, Martin J.; Mabey, David C. W.; Bailey, Robin L.

2009-01-01

Background Trachoma has been endemic in The Gambia for decades. National trachoma control activities have been in place since the mid-1980's, but with no mass antibiotic treatment campaign. We aimed to assess the prevalence of active trachoma and of actual ocular Chlamydia trachomatis infection as measured by polymerase chain reaction (PCR) in the two Gambian regions that had had the highest prevalence of trachoma in the last national survey in 1996 prior to planned national mass antibiotic treatment distribution in 2006. Methodology/Principal Findings Two stage random sampling survey in 61 randomly selected Enumeration Areas (EAs) in North Bank Region (NBR) and Lower River Region (LRR). Fifty randomly selected children aged under 10 years were examined per EA for clinical signs of trachoma. In LRR, swabs were taken to test for ocular C. trachomatis infection. Unadjusted prevalences of active trachoma were calculated, as would be done in a trachoma control programme. The prevalence of trachomatous inflammation, follicular (TF) in the 2777 children aged 1–9 years was 12.3% (95% CI 8.8%–17.0%) in LRR and 10.0% (95% CI 7.7%–13.0%) in NBR, with significant variation within divisions (p<0.01), and a design effect of 3.474. Infection with C. trachomatis was found in only 0.3% (3/940) of children in LRR. Conclusions/Significance This study shows a large discrepancy between the prevalence of trachoma clinical signs and ocular C. trachomatis infection in two Gambian regions. Assessment of trachoma based on clinical signs alone may lead to unnecessary treatment, since the prevalence of active trachoma remains high but C. trachomatis infection has all but disappeared. Assuming that repeated infection is required for progression to blinding sequelae, blinding trachoma is on course for elimination by 2020 in The Gambia. PMID:20027217

Study protocol for a randomised controlled double-blinded trial of the dose-dependent efficacy and safety of primaquine for clearance of gametocytes in children with uncomplicated falciparum malaria in Uganda.

PubMed

Eziefula, Alice Chijioke; Staedke, Sarah G; Yeung, Shunmay; Webb, Emily; Kamya, Moses; White, Nicholas J; Bousema, Teun; Drakeley, Chris

2013-03-26

For the purpose of blocking transmission of Plasmodium falciparum malaria from humans to mosquitoes, a single dose of primaquine is recommended by the WHO as an addition to artemisinin combination therapy. Primaquine clears gametocytes but causes dose-dependent haemolysis in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Evidence is needed to inform the optimal dosing of primaquine for malaria elimination programmes and for the purpose of interrupting the spread of artemisinin-resistant malaria. This study investigates the efficacy and safety of reducing doses of primaquine for clearance of gametocytes in participants with normal G6PD status. In this prospective, four-armed randomised placebo-controlled double-blinded trial, children aged 1-10 years, weighing over 10 kg, with haemoglobin ≥8 g/dl and uncomplicated P falciparum malaria are treated with artemether lumefantrine and randomised to receive a dose of primaquine (0.1, 0.4 or 0.75 mg base/kg) or placebo on the third day of treatment. Participants are followed up for 28 days. Gametocytaemia is measured by quantitative nucleic acid sequence-based analysis on days 0, 2, 3, 7, 10 and 14 with a primary endpoint of the number of days to gametocyte clearance in each treatment arm and secondarily the area under the curve of gametocyte density over time. Analysis is for non-inferiority of efficacy compared to the reference dose, 0.75 mg base/kg. Safety is assessed by pair-wise comparisons of the arithmetic mean (±SD) change in haemoglobin concentration per treatment arm and analysed for superiority to placebo and incidence of adverse events. Ethics and dissemination Approval was obtained from the ethical committees of Makerere University School of Medicine, the Ugandan National Council of Science and Technology and the London School of Hygiene and Tropical Medicine. These will be disseminated to inform malaria elimination policy, through peer-reviewed publication and academic presentations.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lewis, M.S.

The Barnwell Waste Management Facility (BWMF) is scheduled to restrict access to waste generators outside of the Atlantic Compact (SC, CT, NJ) on July 1, 2008. South Carolina, authorized under the Low-Level Waste Policy Act of 1980 and Amendments Act of 1985, and in agreement with the other Atlantic Compact states, will only accept Class A, B, and C low-level radioactive waste (LLRW) generated within compact. For many years, the BWMF has been the only LLRW disposal facility to accept Class B and C waste from LLRW generators throughout the country, except those that have access to the Northwest Compactmore » Site. Many Class B/C waste generators consider this to be a national crisis situation requiring interim or possible permanent storage, changes in operation, significant cost impacts, and/or elimination of services, especially in the health care and non-power generation industries. With proper in-house waste management practices and utilization of commercial processor services, a national crisis can be avoided, although some generators with specific waste forms or radionuclides will remain without options. In summary: It is unknown what the future will bring for commercial LLRW disposal. Could the anticipated post Barnwell Class B/C crisis be avoided by any of the following? - Barnwell Site remains open for the nation's commercial Class B/C waste; - Richland Site opens back up to the nation for commercial Class B/C waste; - Texas Site opens up to the nation for commercial Class B/C waste; - Federal Government intervenes by keeping a commercial Class B/C site open for the nation's commercial Class B/C waste; - Federal Government makes a DOE site available for commercial Class B/C waste; - Federal Government revisits the LLRW Policy Act of 1980 and Amendments Act of 1985. Without a future LLRW site capable of accepting Class B/C currently on the horizon, commercial LLRW generators are faced with waste volume elimination, reduction, or storage. With proper in-house waste management practices, utilization of commercial processor services and regulatory relief, a national crisis can be avoided. Waste volumes for storage can be reduced to as little as 10% of the current Class B/C volume. Although a national LLRW crisis can be avoided, some generators with specific waste forms or radionuclides will have a significant financial and/or operational impact due to a lack of commercial LLRW management options. (authors)« less

Improving services for glaucoma care in Nigeria: implications for policy and programmes to achieve universal health coverage.

PubMed

Kyari, Fatima; Gilbert, Clare; Blanchet, Karl; Wormald, Richard

2017-05-01

Glaucoma in Africa is sometimes referred to as the silent thief of sight. In Nigeria, glaucoma is common, it is serious, ophthalmologists face many constraints in managing it, people do not even know they have it until it is advanced, patients do not understand or comply with treatment after they are diagnosed and the poor are more likely to be glaucoma blind. Available evidence indicates that the health system in Nigeria is failing to meet the needs of patients with glaucoma. Based on evidence, we propose future directions for improving services for glaucoma care in Nigeria, and the implications for policy and programmes to control glaucoma blindness, using a health system-oriented approach. Three complementary strategies are required: (i) strengthening clinical services for glaucoma-by developing models of glaucoma care, improving clinical treatment options, making medicines and equipment available, financing glaucoma care and training eye care workers; (ii) introducing initiatives for earlier detection of glaucoma in the clinic and approaches in the community and (iii) strengthening health system governance. Glaucoma is a complex disease to manage and addressing it as a public health problem is challenging. However, we need to change the paradigm to recognise that glaucoma is a potentially avoidable cause of blindness in Africa. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Corneal refractive surgery: Is intracorneal the way to go and what are the needs for technology?

NASA Astrophysics Data System (ADS)

Hjortdal, Jesper; Ivarsen, Anders

2014-02-01

Corneal refractive surgery aims to reduce or eliminate refractive errors of the eye by changing the refractive power of the cornea. For the last 20 years controlled excimer laser ablation of corneal tissue, either directly from the corneal stromal surface or from the corneal interior after creation of a superficial corneal flap has become widely used to correct myopia, hyperopia, and astigmatism. Recently, an intrastromal refractive procedure whereby a tissue lenticule is cut free in the corneal stroma by a femtosecond laser and removed through a small peripheral incision has been introduced. This procedure avoids creation of a corneal flap and the potential associated risks while avoiding the slow visual recovery of surface ablation procedures. Precise intrastromal femtosecond laser cutting of the fine lenticule requires very controlled laser energy delivery in order to avoid lenticule irregularities, which would compromise the refractive result and visual acuity. This newly introduced all-femtosecond based flap-free intracorneal refractive procedure has been documented to be a predictable, efficient, and safe procedure for correction of myopia and astigmatism. Technological developments related to further improved cutting quality, hyperopic and individualized treatments are desirable.

Improved normal tissue sparing in head and neck radiotherapy using biological cost function based-IMRT.

PubMed

Anderson, N; Lawford, C; Khoo, V; Rolfo, M; Joon, D L; Wada, M

2011-12-01

Intensity-modulated radiotherapy (IMRT) has reduced the impact of acute and late toxicities associated with head and neck radiotherapy. Treatment planning system (TPS) advances in biological cost function based optimization (BBO) and improved segmentation techniques have increased organ at risk (OAR) sparing compared to conventional dose-based optimization (DBO). A planning study was undertaken to compare OAR avoidance in DBO and BBO treatment planning. Simultaneous integrated boost treatment plans were produced for 10 head and neck patients using both planning systems. Plans were compared for tar get coverage and OAR avoidance. Comparisons were made using the BBO TPS Monte Carlo dose engine to eliminate differences due to inherent algorithms. Target coverage (V95%) was maintained for both solutions. BBO produced lower OAR doses, with statistically significant improvement to left (12.3%, p = 0.005) and right parotid mean dose (16.9%, p = 0.004), larynx V50_Gy (71.0%, p = 0.005), spinal cord (21.9%, p < 0.001) and brain stem dose maximums (31.5%, p = 0.002). This study observed improved OAR avoidance with BBO planning. Further investigations will be undertaken to review any clinical benefit of this improved planned dosimetry.

Improved Normal Tissue Sparing in Head and Neck Radiotherapy Using Biological Cost Function Based-IMRT

PubMed Central

Anderson, N.; Lawford, C.; Khoo, V.; Rolfo, M.; Joon, D. Lim; Wada, M.

2011-01-01

Intensity-modulated radiotherapy (IMRT) has reduced the impact of acute and late toxicities associated with head and neck radiotherapy. Treatment planning system (TPS) advances in biological cost function based optimization (BBO) and improved segmentation techniques have increased organ at risk (OAR) sparing compared to conventional dose-based optimization (DBO). A planning study was undertaken to compare OAR avoidance in DBO and BBO treatment planning. Simultaneous integrated boost treatment plans were produced for 10 head and neck patients using both planning systems. Plans were compared for tar get coverage and OAR avoidance. Comparisons were made using the BBO TPS Monte Carlo dose engine to eliminate differences due to inherent algorithms. Target coverage (V95%) was maintained for both solutions. BBO produced lower OAR doses, with statistically significant improvement to left (12.3%, p = 0.005) and right parotid mean dose (16.9%, p = 0.004), larynx V50 Gy (71.0%, p = 0.005), spinal cord (21.9%, p < 0.001) and brain stem dose maximums (31.5%, p = 0.002). This study observed improved OAR avoidance with BBO planning. Further investigations will be undertaken to review any clinical benefit of this improved planned dosimetry. PMID:22066597

Population and behavioural responses of native prey to alien predation.

PubMed

Kovacs, Eszter Krasznai; Crowther, Mathew S; Webb, Jonathan K; Dickman, Christopher R

2012-04-01

The introduction of invasive alien predators often has catastrophic effects on populations of naïve native prey, but in situations where prey survive the initial impact a predator may act as a strong selective agent for prey that can discriminate and avoid it. Using two common species of Australian small mammals that have persisted in the presence of an alien predator, the European red fox Vulpes vulpes, for over a century, we hypothesised that populations of both would perform better where the activity of the predator was low than where it was high and that prey individuals would avoid signs of the predator's presence. We found no difference in prey abundance in sites with high and low fox activity, but survival of one species-the bush rat Rattus fuscipes-was almost twofold higher where fox activity was low. Juvenile, but not adult rats, avoided fox odour on traps, as did individuals of the second prey species, the brown antechinus, Antechinus stuartii. Both species also showed reduced activity at foraging trays bearing fox odour in giving-up density (GUD) experiments, although GUDs and avoidance of fox odour declined over time. Young rats avoided fox odour more strongly where fox activity was high than where it was low, but neither adult R. fuscipes nor A. stuartii responded differently to different levels of fox activity. Conservation managers often attempt to eliminate alien predators or to protect predator-naïve prey in protected reserves. Our results suggest that, if predator pressure can be reduced, otherwise susceptible prey may survive the initial impact of an alien predator, and experience selection to discriminate cues to its presence and avoid it over the longer term. Although predator reduction is often feasible, identifying the level of reduction that will conserve prey and allow selection for avoidance remains an important challenge.