Development of a Diagnostic Genetic Test for Simplex and Autosomal Recessive Retinitis Pigmentosa

PURPOSE: Retinitis pigmentosa (RP) causes hereditary blindness in adults (prevalence, approximately 1 in 4000). Each of the more than 30 causative genes identified to date are responsible for only a small percentage of cases. Genetic diagnosis via traditional methods is problematic, and a single test with a higher probability of detecting the causative mutation would be very beneficial for the clinician. The goal of this study therefore was to develop a high-throughput screen capable of detecting both known mutations and novel mutations within all genes implicated in autosomal recessive or simplex RP. DESIGN: Evaluation of diagnostic technology. PARTICIPANTS AND CONTROLS: Participants were 56 simplex and autosomal recessive RP patients, with 360 population controls unscreened for ophthalmic disease. METHODS: A custom genechip capable of resequencing all exons containing known mutations in 19 disease-associated genes was developed (RP genechip). A second, commercially available arrayed primer extension (APEX) system was used to screen 501 individual previously reported variants. The ability of these high-throughput approaches to identify pathogenic variants was assessed in a cohort of simplex and autosomal recessive RP patients. MAIN OUTCOME MEASURES: Number of mutations and potentially pathogenic variants identified. RESULTS: The RP genechip identified 44 sequence variants: 5 previously reported mutations; 22 known single nucleotide polymorphisms (SNPs); 11 novel, potentially pathogenic variants; and 6 novel SNPs. There was strong concordance with the APEX array, but only the RP genechip detected novel variants. For example, identification of a novel mutation in CRB1 revealed a patient, who also had a single previously known CRB1 mutation, to be a compound heterozygote. In some individuals, potentially pathogenic variants were discovered in more than one gene, consistent with the existence of disease modifier effects resulting from mutations at a second locus. CONCLUSIONS: The RP genechip provides the significant advantage of detecting novel variants and could be expected to detect at least one pathogenic variant in more than 50% of patients. The APEX array provides a reliable method to detect known pathogenic variants in autosomal recessive RP and simplex RP patients and is commercially available. High-throughput genotyping for RP is evolving into a clinically useful genetic diagnostic tool.

Bit error rate performance enhancement of a retrodirective array over a conventional fixed beam array in a dynamic multipath environment

In this paper, we provide experimental evidence to show that enhanced bit error rate (BER) performance is possible using a retrodirective array operating in a dynamically varying multipath environment. The operation of such a system will be compared to that obtained by a conventional nonretrodirective array. The ability of the array to recover amplitude shift keyed encoded data transmitted from a remote location whose position is not known a priori is described. In addition, its ability to retransmit data inserted at the retrodirective array back to a spatially remote beacon location whose position is also not known beforehand is also demonstrated. Comparison with an equivalent conventional fixed beam antenna array utilizing an identical radiating aperture arrangement to that of the retrodirective array are given. These show that the retrodirective array can effectively exploit the presence of time varying multipath in order to give significant reductions in BER over what can be otherwise achieved. Additionally, the retrodirective system is shown to be able to deliver low BER regardless of whether line of sight is present or absent.

A Diagnostic System Using Broad Categories With Clinicaly Relevant Specifiers: Lessons for ICD-10

A diagnostic system for ICD-11 is proposed which commences with broad reorganization and simplification of the current categories and the use of clinically relevant specifiers. Such changes have implications for the positioning of diagnostic groups and lead to a range of possibilities for improving terminology and the juxtaposition of individual conditions. The development of ICD-11 provides the first opportunity in almost two decades to improve the validity and reliability of the international classification system. Widespread change in broad categories and criteria cannot be justified by research that has emerged since the last revision. It would also be disruptive to clinical practice and might devalue past research work. However, the case for reorganization of the categories is stronger and has recently been made by an eminent international group of researchers (Andrews et al., 2009). A simpler, interlinked diagnostic system is proposed here which is likely to have fewer categories than its predecessor. There are major advantages of such a system for clinical practice and research and it could also produce much needed simplification for primary care (Gask et al., 2008) and the developing world (Wig, 1990; Kohn et al., 2004).

Real-time error detection but not error correction drives automatic visuomotor adaptation

We investigated the role of visual feedback of task performance in visuomotor adaptation. Participants produced novel two degrees of freedom movements (elbow flexion-extension, forearm pronation-supination) to move a cursor towards visual targets. Following trials with no rotation, participants were exposed to a 60A degrees visuomotor rotation, before returning to the non-rotated condition. A colour cue on each trial permitted identification of the rotated/non-rotated contexts. Participants could not see their arm but received continuous and concurrent visual feedback (CF) of a cursor representing limb position or post-trial visual feedback (PF) representing the movement trajectory. Separate groups of participants who received CF were instructed that online modifications of their movements either were, or were not, permissible as a means of improving performance. Feedforward-mediated performance improvements occurred for both CF and PF groups in the rotated environment. Furthermore, for CF participants this adaptation occurred regardless of whether feedback modifications of motor commands were permissible. Upon re-exposure to the non-rotated environment participants in the CF, but not PF, groups exhibited post-training aftereffects, manifested as greater angular deviations from a straight initial trajectory, with respect to the pre-rotation trials. Accordingly, the nature of the performance improvements that occurred was dependent upon the timing of the visual feedback of task performance. Continuous visual feedback of task performance during task execution appears critical in realising automatic visuomotor adaptation through a recalibration of the visuomotor mapping that transforms visual inputs into appropriate motor commands.

Detection of improper installation from the sensor signal of vortex flowmeters

Effects of inappropriate installation can bias the measurements of flowmeters. For vortex flowmeters, a method is proposed to detect inappropriate installation of the flowmeter from the oscillatory signal of the vortex sensor. The method is based on assuming the process of vortex generation to be a generic, noisy, nonlinear oscillation, describable by a noisy Stuart-Landau equation, with a corresponding sensor signal that also contains higher harmonic excitations. By making use of the scaling properties of the Navier-Stokes Equation, the method was designed to be robust with respect to uncertainties in the fluid properties. The diagnostic functionality is demonstrated on measurement data. In the experiments, installation effects that lead to more than 0.5% error in the output of the flowmeter could clearly be detected. (C) 2003 Elsevier Ltd. All rights reserved.

Spectator understanding of error in performance

The development of computer-based devices for music control has created a need to study how spectators understand new performance technologies and practices. As a part of a larger project examining how interactions with technology can be communicated to spectators, we present a model of a spectator's understanding of error by a performer. This model is broadly applicable throughout HCI, as interactions with technology are increasingly public and spectatorship is becoming more common.