Age-related macular degeneration and modification of systemic complement factor H production through liver transplantation

Purpose: To investigate whether modification of liver complement factor H (CFH) production, by alteration of liver CFH Y402H genotype through liver transplantation (LT), influences the development of age-related macular degeneration (AMD). Design: Multicenter, cross-sectional study. Participants: We recruited 223 Western European patients ≥55 years old who had undergone LT ≥5 years previously. Methods: We determined AMD status using a standard grading system. Recipient CFH Y402H genotype was obtained from DNA extracted from recipient blood samples. Donor CFH Y402H genotype was inferred from recipient plasma CFH Y402H protein allotype, measured using enzyme-linked immunosorbent assays. This approach was verified by genotyping donor tissue from a subgroup of patients. Systemic complement activity was ascertained by measuring levels of plasma complement proteins using an enzyme-linked immunosorbent assay, including substrates (C3, C4), activation products (C3a, C4a, and terminal complement complex), and regulators (total CFH, C1 inhibitor). Main Outcome Measures: We evaluated AMD status and recipient and donor CFH Y402H genotype. Results: In LT patients, AMD was associated with recipient CFH Y402H genotype (P = 0.036; odds ratio [OR], 1.6; 95% confidence interval [CI], 1.0-2.4) but not with donor CFH Y402H genotype (P = 0.626), after controlling for age, sex, smoking status, and body mass index. Recipient plasma CFH Y402H protein allotype predicted donor CFH Y402H genotype with 100% accuracy (n = 49). Plasma complement protein or activation product levels were similar in LT patients with and without AMD. Compared with previously reported prevalence figures (Rotterdam Study), LT patients demonstrated a high prevalence of both AMD (64.6% vs 37.1%; OR, 3.09; P<0.001) and the CFH Y402H sequence variation (41.9% vs 36.2%; OR, 1.27; P = 0.014). Conclusions: Presence of AMD is not associated with modification of hepatic CFH production. In addition, AMD is not associated with systemic complement activity in LT patients. These findings suggest that local intraocular complement activity is of greater importance in AMD pathogenesis. The high AMD prevalence observed in LT patients may be associated with the increased frequency of the CFH Y402H sequence variation. © 2013 by the American Academy of Ophthalmology Published by Elsevier Inc.

Climate change and construction sector SMEs:vulnerability, consequences and resilience

Climate change has become one of the prime challenges the society has to face in the future. As far as businesses are concerned, it also has added one other important issue that they have to consider as part of their business planning. Climate change is of significant importance particularly to the Small and Medium-sized enterprises (SMEs), which are considered as the most vulnerable among the business community to the effects of climate change. This paper presents the findings of a literature review conducted with the aim of identifying the specific importance of climate change to the construction sector SMEs. The objectives of the paper are to identify the vulnerability of construction sector SMEs to the effects of climate change, their consequences and also to identify the importance of improving resilience and implementing adaptive measures to manage these issues. The paper also outlines the directions of a study undertaken to address these issues as part of an EPSRC funded research project titled “Community Resilience to Extreme Weather Events – CREW”. The paper concludes by stressing the importance of improving the resilience of construction sector SMEs to climate change effects and also the importance of collective action in this regard.

Utilising Intranet technologies in construction sector SMEs:building up knowledge bases for extreme weather event risk management

Intranet technologies accessible through a web based platform are used to share and build knowledge bases in many industries. Previous research suggests that intranets are capable of providing a useful means to share, collaborate and transact information within an organization. To compete and survive successfully, business organisations are required to effectively manage various risks affecting their businesses. In the construction industry too this is increasingly becoming an important element in business planning. The ability of businesses, especially of SMEs which represent a significant portion in most economies, to manage various risks is often hindered by fragmented knowledge across a large number of businesses. As a solution, this paper argues that Intranet technologies can be used as an effective means of building and sharing knowledge and building up effective knowledge bases for risk management in SMEs, by specifically considering the risks of extreme weather events. The paper discusses and evaluates relevant literature in this regard and identifies the potential for further research to explore this concept.

Multimodal field data entry:performance and usability issues

Mobile technologies have yet to be widely adopted by the Architectural, Engineering, and Construction (AEC) industry despite being one of the major growth areas in computing in recent years. This lack of uptake in the AEC industry is likely due, in large part, to the combination of small screen size and inappropriate interaction demands of current mobile technologies. This paper discusses the scope for multimodal interaction design with a specific focus on speech-based interaction to enhance the suitability of mobile technology use within the AEC industry by broadening the field data input capabilities of such technologies. To investigate the appropriateness of using multimodal technology for field data collection in the AEC industry, we have developed a prototype Multimodal Field Data Entry (MFDE) application. This application, which allows concrete testing technicians to record quality control data in the field, has been designed to support two different modalities of data input speech-based data entry and stylus-based data entry. To compare the effectiveness or usability of, and user preference for, the different input options, we have designed a comprehensive lab-based evaluation of the application. To appropriately reflect the anticipated context of use within the study design, careful consideration had to be given to the key elements of a construction site that would potentially influence a test technician's ability to use the input techniques. These considerations and the resultant evaluation design are discussed in detail in this paper.