Assessment of diabetic neuropathy using novel corneal markers.

Diabetic peripheral neuropathy is a debilitating condition that affects approximately 50 per cent of diabetic patients. The symptoms of neuropathy include numbness and tingling or pain in the arms and legs. If left untreated, patients with numbness might develop foot ulcers, which might ultimately require foot amputation. Currently the only method of directly examining peripheral nerves is to conduct skin punch biopsies, which are uncomfortable and invasive.

Longitudinal assessment of neuropathy in diabetes using novel ophthalmic markers (LANDMark) : baseline findings

Purpose Over the past decade, corneal nerve morphology and corneal sensation threshold have been explored as potential surrogate markers for the evaluation of diabetic neuropathy. We present the baseline findings of a Longitudinal Assessment of Neuropathy in Diabetes using novel ophthalmic Markers (LANDMark). Methods The LANDMark Study is a 5-year, two-site, natural history (observational) study of individuals with Type 1 diabetes stratified into those with (T1W) and without (T1WO) neuropathy according to the Toronto criteria, and control subjects. All study participants undergo detailed annual assessment of neuropathy including corneal nerve parameters measured using corneal confocal microscopy and corneal sensitivity measured using non-contact corneal esthesiometry. Results 396 eligible individuals (208 in Brisbane and 188 in Manchester) were assessed: 76 T1W, 166 T1WO and 154 controls. Corneal sensation threshold (mbars) was significantly higher in T1W (1.0 ± 1.1) than T1WO (0.7 ± 0.7) and controls (0.6 ± 0.4) (P=0.002); post-hoc analysis (PHA) revealed no difference between T1WO and controls (Tukey HSD, P=0.502). Corneal nerve fiber length (mm/mm2) (CNFL) was lower in T1W (13.8 ± 6.4) than T1WO (19.1 ± 5.8) and controls (23.2 ± 6.3) (P<0.001); PHA revealed CNFL to be lower in T1W than T1WO, and lower in both of these groups than controls (P<0.001). Corneal nerve branch density (branches/mm2) (CNBD) was significantly lower in T1W (40 ± 32) than T1WO (62 ± 37) and controls (83 ± 46) (P<0.001); PHA showed CNBD was lower in T1W than T1WO, and lower in both groups than controls (P<0.001). Alcohol and cigarette consumption did not differ between groups, although age, BMI, BP, waist circumference, HbA1c, albumin-creatinine ratio, and cholesterol were slightly greater in T1W than T1WO (p<0.05). Some site differences were observed. Conclusions The LANDMark baseline findings confirm that corneal sensitivity and corneal nerve morphometry can detect differences in neuropathy status in individuals with Type 1 diabetes and healthy controls. Corneal nerve morphology is significantly abnormal even in diabetic patients ‘without neuropathy’ compared to control participants. Results of the longitudinal trial will assess the capability of these tests for monitoring change in these parameters over time as potential surrogate markers for neuropathy.

Hydrogel microwell arrays allow the assessment of protease-associated enhancement of cancer cell aggregation and survival

Current routine cell culture techniques are only poorly suited to capture the physiological complexity of tumor microenvironments, wherein tumor cell function is affected by intricate three-dimensional (3D), integrin-dependent cell-cell and cell-extracellular matrix (ECM) interactions. 3D cell cultures allow the investigation of cancer-associated proteases like kallikreins as they degrade ECM proteins and alter integrin signaling, promoting malignant cell behaviors. Here, we employed a hydrogel microwell array platform to probe using a high-throughput mode how ovarian cancer cell aggregates of defined size form and survive in response to the expression of kallikreins and treatment with paclitaxel, by performing microscopic, quantitative image, gene and protein analyses dependent on the varying microwell and aggregate sizes. Paclitaxel treatment increased aggregate formation and survival of kallikrein-expressing cancer cells and levels of integrins and integrin-related factors. Cancer cell aggregate formation was improved with increasing aggregate size, thereby reducing cell death and enhancing integrin expression upon paclitaxel treatment. Therefore, hydrogel microwell arrays are a powerful tool to screen the viability of cancer cell aggregates upon modulation of protease expression, integrin engagement and anti-cancer treatment providing a micro-scaled yet high-throughput technique to assess malignant progression and drug-resistance.

In vitro assessment of migratory behavior of two cell populations in a simple multichannel microdevice

Recent literature suggests that mesenchymal stem/stromal cells (MSC) could be used as Trojan Horses to deliver “death-signals” to cancer cells. Herein, we describe the development of a novel multichannel cell migration device, and use it to investigate the relative migration rates of bone marrow-derived MSC and breast cancer cells (MCF-7) towards each other. Confluent monolayers of MSC and MCF-7 were established in adjacent chambers separated by an array of 14 microchannels. Initially, culture chambers were isolated by air bubbles (air-valves) contained within each microchannel, and then bubbles were displaced to initiate the assay. The MCF-7 cells migrated preferentially towards MSC, whilst the MSC did not migrate preferentially towards the MCF-7 cells. Our results corroborate previous literature that suggests MSC migration towards cancer cells in vivo is in response to the associated inflammation rather than directly to signals secreted by the cancer cells themselves.

OSCE online : making assessment of clinical competencies transparent, accountable & authentic

Creating an authentic assessment which at once assesses competencies, scene management, communication and overall patient care is challenging in the competitive tertiary education market. Increasing student numbers and the cost of evaluating scenario based competencies serve to ensure the need for consistent objectivity and need for timely feedback to students on their performance. Objective structured clinical examination (OSCE) is currently the most flexible approach to competency based formative and summative assessment and widely used within paramedic degree programs. Students are understandably compelled to perform well and can be frustrated by not receiving timely and appropriate feedback. Increasingly a number of products aimed at providing a more efficient and paperless approach have begun to enter the market. These products, it is suggested are aimed at medicine programs and not at allied health professions and limited to one operating system and therefore ignore issues surrounding equity and accessibility. OSCE Online aims to address this gap in the market and is tailored to these disciplines. The application will provide a service that can be both tailored and standardised from a pre-written bank, depending upon requirement to fit around the needs of clinical competency assessment. Delivering authentic assessments to address student milestones in their training to become paramedics is the cornerstone of OSCE Online. By not being restricted to a specific device it will address issues of functionality, adaptability, accessibility, authenticity and importantly: transparency and accountability by producing contemporaneous data allowing issues to be easily identified and rectified.

Analysis of distance learner value assessment of distance education in engineering

Numerous research studies have evaluated whether distance learning is a viable alternative to traditional learning methods. These studies have generally made use of cross-sectional surveys for collecting data, comparing distance to traditional learners with intent to validate the former as a viable educational tool. Inherent fundamental differences between traditional and distance learning pedagogies, however, reduce the reliability of these comparative studies and constrain the validity of analyses resulting from this analytical approach. This article presents the results of a research project undertaken to analyze expectations and experiences of distance learners with their degree programs. Students were given surveys designed to examine factors expected to affect their overall value assessment of their distance learning program. Multivariate statistical analyses were used to analyze the correlations among variables of interest to support hypothesized relationships among them. Focusing on distance learners overcomes some of the limitations with assessments that compare off- and on-campus student experiences. Evaluation and modeling of distance learner responses on perceived value for money of the distance education they received indicate that the two most important influences are course communication requirements, which had a negative effect, and course logistical simplicity, which revealed a positive effect. Combined, these two factors accounted for approximately 47% of the variability in perceived value for money of the educational program of sampled students. A detailed focus on comparing expectations with outcomes of distance learners complements the existing literature dominated by comparative studies of distance and nondistance learners.

Assessment of polybrominated diphenyl ethers (PBDEs) in samples collected from indoor environments in South East Queensland, Australia

Polybrominated diphenyl ethers (PBDEs) are compounds that are used as flame retardants. Human exposure is suggested to be via food, dust and air. An assessment of PBDE exposure via indoor environments using samples of air, dust and surface wipes from eight sites in South East Queensland, Australia was conducted. For indoor air, ΣPBDEs ranged from 0.5 -179 pg/m3 for homes and 15 - 487 pg/m3 for offices. In dust, ΣPBDEs ranged from 87 - 733 ng/g dust and 583 - 3070 ng/g dust in homes and offices, respectively. PBDEs were detected on 9 out of 10 surfaces sampled and ranged from non-detectable to 5985 pg/cm2. Overall, the congener profiles for air and dust were dominated by BDE-209. This study demonstrated that PBDEs are ubiquitous in the indoor environments of selected buildings in South East Queensland and suggest the need for detailed assessment of PBDE concentrations using more sites to further investigate the factors influencing PBDE exposure in Australia.

Assessment of recycled concrete aggregates as a pavement material

Population increase and economic developments can lead to construction as well as demolition of infrastructures such as buildings, bridges, roads, etc resulting in used concrete as a primary waste product. Recycling of waste concrete to obtain the recycled concrete aggregates (RCA) for base and/or sub-base materials in road construction is a foremost application to be promoted to gain economical and sustainability benefits. As the mortar, bricks, glass and reclaimed asphalt pavement (RAP) present as constituents in RCA, it exhibits inconsistent properties and performance. In this study, six different types of RCA samples were subjected classification tests such as particle size distribution, plasticity, compaction test, unconfined compressive strength (UCS) and California bearing ratio (CBR) tests. Results were compared with those of the standard road materials used in Queensland, Australia. It was found that material type ‘RM1-100/RM3-0’ and ‘RM1-80/RM3-20’ samples are in the margin of the minimum required specifications of base materials used for high volume unbound granular roads while others are lower than that the minimum requirement.

A rapid assessment of the effects of extreme weather on two Great Barrier Reef industries

In coastal areas, extreme weather events, such as floods and cyclones, can have debilitating effects on the social and economic viability of marine-based industries. In March 2011, the Great Barrier Reef Marine Park Authority implemented an Extreme Weather Response Program, following a period of intense flooding and cyclonic activity between December 2010 and February 2011. In this paper, we discuss the results of a project within the Program, which aimed to: (1) assess the impacts of extreme weather events on regional tourism and commercial fishing industries; and (2) develop and road-test an impact assessment matrix to improve government and industry responses to extreme weather events. Results revealed that extreme weather events both directly and indirectly affected all five of the measured categories, i.e. ecological, personal, social, infrastructure and economic components. The severity of these impacts, combined with their location and the nature of their business, influenced how tourism operators and fishers assessed the impact of the events (low, medium, high or extreme). The impact assessment tool was revised following feedback obtained during stakeholder workshops and may prove useful for managers in responding to potential direct and indirect impacts of future extreme weather events on affected marine industries. © 2013 Planning Institute Australia.

Non-formal techniques for early assessment of design ideas for services

Designing systems for multiple stakeholders requires frequent collaboration with multiple stakeholders from the start. In many cases at least some stakeholders lack a professional habit of formal modeling. We report observations from student design teams as well as two case studies, respectively of a prototype for supporting creative communication to design objects, and of stakeholder-involvement in early design. In all observations and case studies we found that non-formal techniques supported strong collaboration resulting in deep understanding of early design ideas, of their value and of the feasibility of solutions.

A sonographer's guide to the assessment of heart disease

The book is mostly designed for students of echocardiography, teachers of echocardiography and cardiac sonographers working in routine clinical practice, but will also be very useful to echocardiologists and cardiac registrars. The goal of the text is to provide a comprehensive review of transthoracic echocardiography in the assessment of various cardiac pathologies. Refresher notes on cardiac anatomy and the relevant cardiac physiology and pathophysiology are included to expand the cardiac sonographer’s knowledge in this area and further their understanding of various diseases, disease processes and associated findings.

Computational aspects of probabilistic assessment of UAS robust autonomy

As the level of autonomy in Unmanned Aircraft Systems (UAS) increases, there is an imperative need for developing methods to assess robust autonomy. This paper focuses on the computations that lead to a set of measures of robust autonomy. These measures are the probabilities that selected performance indices related to the mission requirements and airframe capabilities remain within regions of acceptable performance.

Assessment of gene expression of intracellular calcium channels, pumps and exchangers with epidermal growth factor-induced epithelial-mesenchymal transition in a breast cancer cell line

Background Epithelial-mesenchymal transition (EMT) is a process implicated in cancer metastasis that involves the conversion of epithelial cells to a more mesenchymal and invasive cell phenotype. In breast cancer cells EMT is associated with altered store-operated calcium influx and changes in calcium signalling mediated by activation of cell surface purinergic receptors. In this study, we investigated whether MDA-MB-468 breast cancer cells induced to undergo EMT exhibit changes in mRNA levels of calcium channels, pumps and exchangers located on intracellular calcium storing organelles, including the Golgi, mitochondria and endoplasmic reticulum (ER). Methods Epidermal growth factor (EGF) was used to induce EMT in MDA-MB-468 breast cancer cells. Serum-deprived cells were treated with EGF (50 ng/mL) for 12 h and gene expression was assessed using quantitative RT-PCR. Results and conclusions These data reveal no significant alterations in mRNA levels of the Golgi calcium pump secretory pathway calcium ATPases (SPCA1 and SPCA2), or the mitochondrial calcium uniporter (MCU) or Na+/Ca2+ exchanger (NCLX). However, EGF-induced EMT was associated with significant alterations in mRNA levels of specific ER calcium channels and pumps, including (sarco)-endoplasmic reticulum calcium ATPases (SERCAs), and inositol 1,4,5-trisphosphate receptor (IP3R) and ryanodine receptor (RYR) calcium channel isoforms. The most prominent change in gene expression between the epithelial and mesenchymal-like states was RYR2, which was enriched 45-fold in EGF-treated MDA-MB-468 cells. These findings indicate that EGF-induced EMT in breast cancer cells may be associated with major alterations in ER calcium homeostasis.