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Purpose: To offer a comprehensive review of the available data regarding non-arteritic anterior ischaemic optic neuropathy and its phenocopies, focusing on the current evidence to support the different existing aetiopathogenic hypotheses for the development of these conditions. Conclusions and importance: Due to the limited array of responses of the neural tissue and other retinal structures, different aetiopathogenic mechanisms may result in a similar clinical picture. Moreover, when the insult occurs within a confined space, such as the optic nerve or the optic nerve head, in which different tissues (neural, glial, vascular) are highly interconnected and packed together, determining the primary noxa can be challenging and may lead to misdiagnosis. Anterior ischaemic optic neuropathy is a condition most clinicians will face during their everyday work, and it is important to correctly differentiate among resembling pathologies affecting the optic nerve to avoid unnecessary diagnostic procedures. Combining a good clinical history and multimodal imaging can assist diagnosis in most cases. The key remains to combine demographic data (e.g. age), with ophthalmic data (e.g. refractive error), systemic data (e.g. comorbidities and medication), imaging data (e.g. retinal OCT) with topographic signs (e.g. focal neurology). Methodology: Papers relevant for this work were obtained from the MEDLINE and Embase databases by using the PubMed search engine. One author (MPMG) performed the search and selected only publications with relevant information about the aetiology, pathogenic mechanisms, risk factors as well as clinical characteristics of phenocopies (such as vitreopapillary traction, intrapapillary haemorrhage with adjacent peripapillary subretinal haemorrhage or diabetic papillopathy) of non-arteritic anterior ischaemic optic neuropathy (NAION). The terms “non-arteritic ischaemic optic neuropathy/NAION”, “vitreopapillary traction”, “vitreopapillary traction AND non-arteritic ischaemic optic neuropathy/NAION”, “posterior vitreous detachment AND non-arteritic ischaemic optic neuropathy/NAION”, “central retinal vein occlusion AND non-arteritic ischaemic optic neuropathy/NAION”, “disc oedema/disc oedema”, “diabetes mellitus AND non-arteritic ischaemic optic neuropathy/NAION” and “diabetic papillopathy” were searched on PubMed. From each of these searches, publications were selected based on their title, obtaining a total of 115 papers. All papers not written in English were then excluded, and those whose abstracts were not deemed relevant for our review, according to the aforementioned criteria. Subsequent scrutiny of the main text of the remaining publications led us (MPMG, AP, ZS) to include references which had not been selected during our first search, as their titles did not contain the previously mentioned MeSH terms, due to their significantly relevant contents for our work. A total of 62 publications were finally consulted for our review. The literature review was last updated on 24-Aug-2022.

Background: Ophthalmology outpatient attendances have significantly increased recently with rising pressure from backlogs arising from the pandemic. Medical retina digital surveillance clinics for stable follow-up appointments are well established. We present a model for assessing new referrals and evaluating clinical outcomes and long-term sustainability in a complex high-volume medical retina service. Methods: Suitable routine new patient referrals were identified from electronic referrals and referred to this new pathway. Structured history, visual acuities, and intraocular pressures were recorded, and widefield colour fundus and optical coherence tomography imaging were performed at a imaging hub for asynchronous consultant-led review. Results: 1458 patients were invited to attend over four months, with a 13.2% did-not-attend (DNA) rate. Common diagnoses included stable diabetic retinopathy (19.9%), early age-related macular degeneration (6.7%), central serous retinopathy (8.8%), and retinal vein occlusion (6.3%). 7 patients (0.05%) required urgent same-day review. 61 (5.0%) required urgent face-to-face (F2F) assessment within two weeks. A total of 727 (59.0%) were either discharged or remained in the virtual pathway following their first visit. Conclusion: This study encourages the use of a digital model that efficiently assesses suitable newly referred medical retina patients in both complex and local eye unit settings. This decreased the need for F2F clinics and resources. Further patient satisfaction surveys for digital services are currently being evaluated to guide long-term sustainability of this model.

ABSTRACT A patented self-tensioning system for long-span wooden structural floors is described that increases the performance of the deflected sections in terms of both resistance and deformation. The system is [...]

The extent of capillary nonperfusion measure in seven fields ETDRS and widefield angiography follows a near-perfect, linear correlation in patients with CRVO. The average amount of nonperfusion in total retina exceeds by over three-fold the amount measured on seven fields.

Aim: We present the case of a 72-year-old male with advanced choroideremia and a left chronic rhegmatogenous retinal detachment, which to our knowledge is the first formal report of a retinal detachment in this disease.Background: Choroideremia is a rare X-linked inherited retinal dystrophy, caused by mutations in the CHMgene which encodes Rab escort protein 1 (REP1), and affected males typically experience a progressive centripetal loss of vision. The disease pathology is caused by a primary retinal pigment epithelium degeneration, which leads to secondary loss of photoreceptors and choriocapillaris. This in turn leads to fusion of the degenerate outer retinal layers resulting in a retinopexy that is known to make subretinal gene therapy particularly challenging in these patients.Conclusion: Although retinal gene therapy is commonly targeted to the macular area in choroideremia, the observation of a rhegmatogenous retinal detachment indicates that the peripheral retina may not fuse with the residual choroid as occurs in the equatorial and macular regions. If this hypothesis is correct, targeting gene therapy to the retinal periphery even in advanced cases may be feasible and could potentially be used to preserve navigational vision.

Inherited retinal disease (IRD) is a leading cause of blindness. Recent advances in gene-directed therapies highlight the importance of understanding the genetic basis of these disorders. This study details the molecular spectrum in a large United Kingdom (UK) IRD patient cohort.

Social polarization is a growing concern worldwide, as it strains social relations, erodes trust in institutions, and thus hurts democratic societies. Polarization has been traditionally studied in binary conflicts where two groups support opposite ideas. However, in many social systems, such as multi-party democracies, political conflicts involve multiple dissenting factions. Despite the prevalence of multipolar systems, there is still a lack of suitable analytical tools to study their polarization patterns. In this work, we introduce new polarization metrics for multidimensional scenarios and develop a methodology that extracts the ideological structure of multipolar contexts from social networks. We propose the trace of the covariance matrix (the total variation) of the multipolar opinion distribution as a measure of global polarization, and its eigendecomposition to identify the directions of maximum polarization. Instead of using a pre-conceived opinion space (conservative vs progressive, liberal vs authoritarian, etc.), our framework reveals the natural ideological axes of the system. We apply our methodology to quadripolar and pentapolar real-world democratic processes, finding non-trivial ideological structures with clear connections to the underlying social context. Our framework opens new avenues for understanding multilateral social tensions and facing the challenges of polarization in a unified way. • We propose a new methodology to measure polarization in multipolar systems. • We model the opinion space as a regular simplex, with the poles at its vertices. • We apply our method to two elections, inferring opinions from retweet networks. • We compute the direction of maximum polarization from the opinion's covariance. • The parties' order in the direction of maximum polarization matches their ideology. [ABSTRACT FROM AUTHOR]

In this paper we propose a complementary activity for the practical sessions which belong to the academic syllabus. The aim is offering to mechanical engineering students an insight into the work undertaken in the engineering profession through a graphic project guided by the teacher who plays an active role as monitor. The activity consists in drawing diagrams from a given mechanism and making a multimedia presentation of the work performed. For teachers, this activity is a methodological innovation which had excellent results for fulfilling the teaching objectives in engineering graphics subjects. For students, it develops as the combination of the most elemental traditional methods with cutting-edge technology for drawing their engineering projects. As a result of this activity, the dropout rate for practical sessions became lower than in previous academic years.

OBJECTIVE To evaluate differences in the initial prognosis of patients with cutaneous melanoma managed by teledermatology (TD) vs other non-TD referral systems. DESIGN Descriptive and longitudinal study of a store-and-forward TD system aimed at the triage of patients with suspicious pigmented lesions. SETTING In 2003, a store-and-forward TD triage system aimed at the selection of patients with skin growths suggestive of cancer was implemented at a skin cancer clinic. This system has been shown to be accurate and reliable and able to significantly shorten waiting periods for consultation with a dermatologist. PARTICIPANTS Patients with primary cutaneous melanoma referred to the Melanoma Clinic of the Dermatology Unit, Hospital Universitario Virgen Macarena, Seville, Spain, by TD or non-TD tracks were included in the study. MAIN OUTCOME MEASURES Decisions on the referral of patients with suspicious skin lesions by store-and-forward TD vs by a conventional referral system. Breslow thickness and tumor stage were recorded in each study group (TD and non-TD) and were compared. RESULTS Two hundred one patients with primary cutaneous melanoma were enrolled in the study. In total, 33.3% were managed at their primary care center by teleconsultation, whereas 66.7% were managed by a conventional referral system. The mean Breslow thickness was significantly lower among patients in the TD group than among patients in the non-TD group (1.06 vs 1.64 mm, P = .03). The frequency of melanoma with a favorable initial prognosis (tumor stages Tis and T1a) was significantly higher in the TD group (70.1% vs 56.9%, P = .03). The odds ratio of having a cutaneous melanoma with a favorable initial prognosis in the TD group was 1.96 (95% CI, 1.14-3.50; P = .04). CONCLUSION Teledermatology as a screening system for cutaneous melanoma has a favorable effect on the initial prognosis of patients with melanoma.

This paper introduces an Augmented Reality application for teaching practice of electrical engineering. In order to improve the student«s autonomy and self-ability we have developed new practical AR-manuals for being used in the Electric Machines Laboratory. We have used these AR-manuals and the classical ones observing an improvement in both learning and students« motivation. The augmented information consists in 3D models, animations and sound which are superimposed over real objects helping the students in specific tasks’ training. The user provided with a tablet PC or HMD with webcam will be able to visualize on screen the virtual objects added to the real scene.

In the actual curriculums of engineering degrees in the framework of the European Higher Education Area (EHEA), the spatial vision skill is considered as a competence that should be developed by students. The teachers of Graphic Design are struggling to achieve that students develop those tasks which require spatial visualization and reasoning abilities. This is the source of interest for developing and validating applications and procedures which might be included in the curriculum of Graphic Engineering for providing the students with good levels of spatial skill. This paper presents a satisfaction study about the tools and didactic material designed to evaluate the effect of attending several intensive remedial courses based on three different methodologies: Virtual Reality (VR), Augmented Reality (AR) and Portable Document Format 3D (PDF3D) intended to improve the spatial ability of freshmen engineering students.

Non-alcoholic fatty liver disease (NAFLD) is a very common indication for liver transplantation. How fat-rich diets promote progression from fatty liver to more damaging inflammatory and fibrotic stages is poorly understood. Here, we show that disrupting phosphorylation at Ser196 (S196A) in the liver X receptor alpha (LXRα, NR1H3) retards NAFLD progression in mice on a high-fat-high-cholesterol diet. Mechanistically, this is explained by key histone acetylation (H3K27) and transcriptional changes in pro-fibrotic and pro-inflammatory genes. Furthermore, S196A-LXRα expression reveals the regulation of novel diet-specific LXRα-responsive genes, including the induction of Ces1f, implicated in the breakdown of hepatic lipids. This involves induced H3K27 acetylation and altered LXR and TBLR1 cofactor occupancy at the Ces1f gene in S196A fatty livers. Overall, impaired Ser196-LXRα phosphorylation acts as a novel nutritional molecular sensor that profoundly alters the hepatic H3K27 acetylome and transcriptome during NAFLD progression placing LXRα phosphorylation as an alternative anti-inflammatory or anti-fibrotic therapeutic target.