New and emerging technologies for the treatment of inherited retinal diseases: a horizon scanning review.

The horizon scanning review aimed to identify new and emerging technologies in development that have the potential to slow or stop disease progression and/or reverse sight loss in people with inherited retinal diseases (IRDs). Potential treatments were identified using recognized horizon scanning methods. These included a combination of online searches using predetermined search terms, suggestions from clinical experts and patient and carer focus groups, and contact with commercial developers. Twenty-nine relevant technologies were identified. These included 9 gene therapeutic approaches, 10 medical devices, 5 pharmacological agents, and 5 regenerative and cell therapies. A further 11 technologies were identified in very early phases of development (typically phase I or pre-clinical) and were included in the final report to give a complete picture of developments 'on the horizon'. Clinical experts and patient and carer focus groups provided helpful information and insights, such as the availability of specialised services for patients, the potential impacts of individual technologies on people with IRDs and their families, and helped to identify additional relevant technologies. This engagement ensured that important areas of innovation were not missed. Most of the health technologies identified are still at an early stage of development and it is difficult to estimate when treatments might be available. Further, well designed trials that generate data on efficacy, applicability, acceptability, and costs of the technologies, as well as the long-term impacts for various conditions are required before these can be considered for adoption into routine clinical practice

Unsteady separation past moving surfaces

Unsteady boundary-layer development over moving walls in the limit of infinite Reynolds number is investigated using both the Eulerian and Lagrangian formulations. To illustrate general trends, two model problems are considered, namely the translating and rotating circular cylinder and a vortex convected in a uniform flow above an infinite flat plate. To enhance computational speed and accuracy for the Lagrangian formulation, a remeshing algorithm is developed. The calculated results show that unsteady separation is delayed with increasing wall speed and is eventually suppressed when the speed of the separation singularity approaches that of the local mainstream velocity. This suppression is also described analytically. Only 'upstream-slipping' separation is found to occur in the model problems. The changes in the topological features of the flow just prior to the separation that occur with increasing wall speed are discussed

The structure of a three-dimensional turbulent boundary layer

The three-dimensional turbulent boundary layer is shown to have a self-consistent two-layer asymptotic structure in the limit of large Reynolds number. In a streamline coordinate system, the streamwise velocity distribution is similar to that in two-dimensional flows, having a defect-function form in the outer layer which is adjusted to zero at the wall through an inner wall layer. An asymptotic expansion accurate to two orders is required for the cross-stream velocity which is shown to exhibit a logarithmic form in the overlap region. The inner wall-layer flow is collateral to leading order but the influence of the pressure gradient, at large but finite Reynolds numbers, is not negligible and can cause substantial skewing of the velocity profile near the wall. Conditions under which the boundary layer achieves self-similarity and the governing set of ordinary differential equations for the outer layer are derived. The calculated solution of these equations is matched asymptotically to an inner wall-layer solution and the composite profiles so formed describe the flow throughout the entire boundary layer. The effects of Reynolds number and cross-stream pressure gradient on the cross-stream velocity profile are discussed and it is shown that the location of the maximum cross-stream velocity is within the overlap region

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Newsletter of the Boston University School of Medicine, Student American Medical Association (SAMA

The effect of the systemic inflammatory response on plasma vitamin 25 (OH) D concentrations adjusted for albumin

<b>Aim</b><p></p> To examine the relationship between plasma 25(OH)D, CRP and albumin concentrations in two patient cohorts.<p></p> <b>Methods</b><p></p> 5327 patients referred for nutritional assessment and 117 patients with critical illness were examined. Plasma 25 (OH) D concentrations were measured using standard methods. Intra and between assay imprecision was <10%.<p></p> <b>Result</b><p></p> In the large cohort, plasma 25 (OH) D was significantly associated with CRP (rs = −0.113, p<0.001) and albumin (rs = 0.192, p<0.001). 3711 patients had CRP concentrations ≤10 mg/L; with decreasing albumin concentrations ≥35, 25–34 and <25 g/l, median concentrations of 25 (OH) D were significantly lower from 35 to 28 to 14 nmol/l (p<0.001). This decrease was significant when albumin concentrations were reduced between 25–34 g/L (p<0.001) and when albumin <25 g/L (p<0.001). 1271 patients had CRP concentrations between 11–80 mg/L; with decreasing albumin concentrations ≥35, 25–34 and <25 g/l, median concentrations of 25 (OH) D were significantly lower from 31 to 24 to 19 nmol/l (p<0.001). This decrease was significant when albumin concentration were 25–34 g/L (p<0.001) and when albumin <25 g/L (p<0.001). 345 patients had CRP concentrations >80 mg/L; with decreasing albumin concentrations ≥35, 25–34 and <25 g/l, median concentrations of 25 (OH) D were not significantly altered varying from 19 to 23 to 23 nmol/l. Similar relationships were also obtained in the cohort of patients with critical illness.<p></p> <b>Conclusion</b><p></p> Plasma concentrations of 25(OH) D were independently associated with both CRP and albumin and consistent with the systemic inflammatory response as a major confounding factor in determining vitamin D status.<p></p&gt

The Effects of Fire Fighting and On-Scene Rehabilitation on Hemostatis

Fire fighting is a dangerous occupation – in part because firefighters are called upon to perform strenuous physical activity in hot, hostile environments. Each year, approximately 100 firefighters lose their lives in the line of duty and tens of thousands are injured. Over the past 15 years, approximately 45% of line of duty deaths have been attributed to heart attacks and another 650-1,000 firefighters suffer non-fatal heart attacks in the line of duty each year. From 1990 to 2004, the total number of fireground injuries has declined, yet during this same period, the number of cases related to the leading cause of injury - overexertion/strain – remained relatively constant. It is well recognized that fire fighting leads to increased cardiovascular and thermal strain. However, the time course of recovery from fire fighting is not well documented, despite the fact that a large percentage of fire fighting fatalities occur after fire fighting activity. Furthermore, on scene rehabilitation (OSR) has been broadly recommended to mitigate the cardiovascular and thermal strain associated with performing strenuous fire fighting activity, yet the efficacy of different rehabilitation interventions has not been documented. Twenty-five firefighters were recruited to participate in a “within-subjects, repeated measures” study designed to describe the acute effects of fire fighting on a broad array of physiological and psychological measures and several key cardiovascular variables. This study provided the first detailed documentation of the time course of recovery during 2½ hours post-fire fighting. Additionally, we compared two OSR strategies (standard and enhanced) to determine their effectiveness.published or submitted for publicationnot peer reviewe

Patients' management of type 2 diabetes in Middle Eastern countries: review of studies

The increased prevalence of diabetes in Middle Eastern countries is a health policy priority. Important risk factors for diabetes have been identified. Lifestyle interventions and adherence to medications are central to disease prevention and management. This review focuses on the management of type 2 diabetes mellitus in Middle Eastern countries. The aim is to identify the ways in which knowledge, health beliefs, and social and cultural factors influence adherence to medication and lifestyle measures. Thirty-four studies were identified following a systematic search of the literature. The studies describe the influence of knowledge, health beliefs, culture, and lifestyle on the management of type 2 diabetes mellitus in the Middle East. Findings indicate a lack of health knowledge about diabetes among populations, which has implications for health behaviors, medication adherence, and treatment outcomes. Many identified health beliefs and cultural lifestyle factors, such as religious beliefs, beliefs about fasting during Ramadan, and sedentary lifestyles played a role in patients’ decisions. For better management of this disease, a collaborative approach between patients, their families, health care professionals, and governments should be adopted. Implementing behavioral strategies and psychological interventions that incorporate all health care professionals in the management process have been shown to be effective methods. Such services help patients change their behavior. However, the utilization of such services and interventions is still limited in Arabian countries. Physicians in the Middle East are the health care professionals most involved in the care process

Sympathetic and swap cooling of trapped ions by cold atoms in a MOT

A mixed system of cooled and trapped, ions and atoms, paves the way for ion assisted cold chemistry and novel many body studies. Due to the different individual trapping mechanisms, trapped atoms are significantly colder than trapped ions, therefore in the combined system, the strong binary ion$-$atom interaction results in heat flow from ions to atoms. Conversely, trapped ions can also get collisionally heated by the cold atoms, making the resulting equilibrium between ions and atoms intriguing. Here we experimentally demonstrate, Rubidium ions (Rb$^+$) cool in contact with magneto-optically trapped (MOT) Rb atoms, contrary to the general expectation of ion heating for equal ion and atom masses. The cooling mechanism is explained theoretically and substantiated with numerical simulations. The importance of resonant charge exchange (RCx) collisions, which allows swap cooling of ions with atoms, wherein a single glancing collision event brings a fast ion to rest, is discussed.Comment: 10 pages, 3 figure

Gestational age at delivery and special educational need: retrospective cohort study of 407,503 schoolchildren

<STRONG>Background</STRONG> Previous studies have demonstrated an association between preterm delivery and increased risk of special educational need (SEN). The aim of our study was to examine the risk of SEN across the full range of gestation. <STRONG>Methods and Findings</STRONG> We conducted a population-based, retrospective study by linking school census data on the 407,503 eligible school-aged children resident in 19 Scottish Local Authority areas (total population 3.8 million) to their routine birth data. SEN was recorded in 17,784 (4.9%) children; 1,565 (8.4%) of those born preterm and 16,219 (4.7%) of those born at term. The risk of SEN increased across the whole range of gestation from 40 to 24 wk: 37–39 wk adjusted odds ratio (OR) 1.16, 95% confidence interval (CI) 1.12–1.20; 33–36 wk adjusted OR 1.53, 95% CI 1.43–1.63; 28–32 wk adjusted OR 2.66, 95% CI 2.38–2.97; 24–27 wk adjusted OR 6.92, 95% CI 5.58–8.58. There was no interaction between elective versus spontaneous delivery. Overall, gestation at delivery accounted for 10% of the adjusted population attributable fraction of SEN. Because of their high frequency, early term deliveries (37–39 wk) accounted for 5.5% of cases of SEN compared with preterm deliveries (<37 wk), which accounted for only 3.6% of cases. <STRONG>Conclusions</STRONG> Gestation at delivery had a strong, dose-dependent relationship with SEN that was apparent across the whole range of gestation. Because early term delivery is more common than preterm delivery, the former accounts for a higher percentage of SEN cases. Our findings have important implications for clinical practice in relation to the timing of elective delivery