Signs and Symptoms of Dry Eye in Keratoconus Patients: A Pilot Study

Purpose: To compare signs and symptoms of dry eye in keratoconus (KC) patients versus healthy subjects. Methods: A total of 15 KC patients (KC group, n = 15 eyes) and 16 healthy subjects (control group, 16 eyes) were enrolled in this study. The Schirmer I test with no anesthetic, tear break-up time (TBUT), corneal staining characteristics, and ocular surface disease index (OSDI) scores were evaluated for both groups. Impression cytology, combined with/scanning laser confocal microscopy (LCM), was performed to evaluate goblet cell density, mucin cloud height (MCH), and goblet cell layer thickness (CLT). Finally, tear concentrations of di-adenosine tetraphosphate (Ap4A) were assessed. Results were statistically analyzed using Shapiro–Wilk and non-parametric Wilcoxon rank sum tests. Statistical significance was set at p < 0.05. Results: KC patients had lower tear volumes and greater corneal staining than did healthy subjects (p < 0.05). OSDI scores were 44.96 ± 8.65 and 17.78 ± 6.50 for the KC and control groups, respectively (p < 0.05). We found no statistically significant differences in TBUT between groups. Impression cytology revealed lower goblet cell densities in KC group patients versus control group subjects (84.88 ± 32.98 and 128.88 ± 50.60 cells/mm,2 respectively, p < 0.05). There was a statistically significant reduction in MCH and CLT in KC group patients compared with control group subjects. Ap4A tear concentrations were higher in KC group patients than in control group subjects (2.56 ± 1.10 and 0.15 ± 0.12 µM, respectively, p < 0.05). Conclusions: The parameters evaluated in this study indicate that KC patients suffer greater symptoms of dry eye and greater tear instability, primarily due to the decreased mucin production in their tears, than do healthy patients with no KC.

Best Alternatives to Cronbach's Alpha Reliability in Realistic Conditions: Congeneric and Asymmetrical Measurements

The Cronbach's alpha is the most widely used method for estimating internal consistency reliability. This procedure has proved very resistant to the passage of time, even if its limitations are well documented and although there are better options as omega coefficient or the different versions of glb, with obvious advantages especially for applied research in which the ítems differ in quality or have skewed distributions. In this paper, using Monte Carlo simulation, the performance of these reliability coefficients under a one-dimensional model is evaluated in terms of skewness and no tau-equivalence. The results show that omega coefficient is always better choice than alpha and in the presence of skew items is preferable to use omega and glb coefficients even in small samples.

Variation in the expression of migratory activity in blackcap (Sylvia atricapilla); effects of the origin, environmental conditions, dominance and personalities

La migración es una respuesta a cambios estacionales del clima generando desplazamientos periódicos entre hábitats de cría y de invernada, permitiendo así el uso temporal de los recursos disponibles. La migración implica unos costes energéticos muy elevados, un aumento de la depredación potencial, variaciones ambientales y una disponibilidad de alimento impredecible a lo largo de la ruta migratoria; por lo que es una de las actividades más desafiantes de su ciclo vital. A pesar de ello, los beneficios de la migración compensan sus costes. La migración está programada genéticamente, siendo relativamente constante en su momento, distancia y dirección. Por otro lado, ambiente juega un papel predominante en algunas poblaciones, pudiendo modificar el comportamiento migratorio de una estrategia parcial o facultativa a un modo de vida sedentario. Con el fin de describir el origen y evolución del comportamiento migratorio en aves, se ha propuesto un “modelo de umbral” genético para determinar si un ave es migrante o sedentaria. Dentro de una variable continua (p.ej. la concentración de proteínas u hormonas), este modelo asume que existe una actividad migratoria subyacente implicada en su expresión génica. Este umbral divide cada variable en categorías dicotómicas que definen el fenotipo de un individuo. Los ejemplares sin actividad migratoria muestran valores por debajo de este umbral, siendo clasificados como sedentarios, mientras que los ejemplares migrantes muestran valores por encima del umbral definido. Los cambios de estrategia vital no dependen únicamente de la posición del umbral determinado genéticamente sino también de las variables ambientales, por lo que dichas variaciones deben ser añadidas al modelo. Este modelo de umbral ambiental predice que el carácter migratorio de los individuos situados en los extremos de distribución no se encuentra afectado por los factores ambientales, mientras que aquellos más próximos al umbral pueden más fácilmente cambiar su estrategia migratoria...

Discovery and validation of serologic biomarkers for the diagnosis and prognosis of invasive candidiasis by computational immunomics

Invasive candidiasis (IC) is an opportunistic systemic mycosis caused by Candida species (commonly Candida albicans) that continues to pose a significant public health problem worldwide. Despite great advances in antifungal therapy and changes in clinical practices, IC remains a major infectious cause of morbidity and mortality in severely immunocompromised or critically ill patients, and further accounts for substantial healthcare costs. Its impact on patient clinical outcome and economic burden could be ameliorated by timely initiation of appropriate antifungal therapy. However, early detection of IC is extremely difficult because of its unspecific clinical signs and symptoms, and the inadequate accuracy and time delay of the currently available diagnostic or risk stratification methods. In consequence, the diagnosis of IC is often attained in advanced stages of infection (leading to delayed therapeutic interventions and ensuing poor clinical outcomes) or, unfortunately, at autopsy. In addition to the difficulties encountered in diagnosing IC at an early stage, the initial therapeutic decision-making process is also hindered by the insufficient accuracy of the currently available tools for predicting clinical outcomes in individual IC patients at presentation. Therefore, it is not surprising that clinicians are generally unable to early detect IC, and identify those IC patients who are most likely to suffer fatal clinical outcomes and may benefit from more personalized therapeutic strategies at presentation. Better diagnostic and prognostic biomarkers for IC are thus needed to improve the clinical management of this life-threatening and costly opportunistic fungal infection...