A new method to monitor visual field defects caused by photoreceptor degeneration by quantitative optical coherence tomography

PURPOSE: To correlate the dimension of the visual field (VF) tested by Goldman kinetic perimetry with the extent of visibility of the highly reflective layer between inner and outer segments of photoreceptors (IOS) seen in optical coherence tomography (OCT) images in patients with retinitis pigmentosa (RP). METHODS: In a retrospectively designed cross-sectional study, 18 eyes of 18 patients with RP were examined with OCT and Goldmann perimetry using test target I4e and compared with 18 eyes of 18 control subjects. A-scans of raw scan data of Stratus OCT images (Carl Zeiss Meditec, AG, Oberkochen, Germany) were quantitatively analyzed for the presence of the signal generated by the highly reflective layer between the IOS in OCT images. Starting in the fovea, the distance to which this signal was detectable was measured. Visual fields were analyzed by measuring the distance from the center point to isopter I4e. OCT and visual field data were analyzed in a clockwise fashion every 30 degrees , and corresponding measures were correlated. RESULTS: In corresponding alignments, the distance from the center point to isopter I4e and the distance to which the highly reflective signal from the IOS can be detected correlate significantly (r = 0.75, P < 0.0001). The greater the distance in VF, the greater the distance measured in OCT. CONCLUSIONS: The authors hypothesize that the retinal structure from which the highly reflective layer between the IOS emanates is of critical importance for visual and photoreceptor function. Further research is warranted to determine whether this may be useful as an objective marker of progression of retinal degeneration in patients with RP.

EVALUATION OF INTENSITY MODULATED RADIATION THERAPY (IMRT) DELIVERY ERROR DUE TO IMRT TREATMENT PLAN COMPLEXITY AND IMPROPERLY MATCHED DOSIMETRY DATA

Intensity modulated radiation therapy (IMRT) is a technique that delivers a highly conformal dose distribution to a target volume while attempting to maximally spare the surrounding normal tissues. IMRT is a common treatment modality used for treating head and neck (H&N) cancers, and the presence of many critical structures in this region requires accurate treatment delivery. The Radiological Physics Center (RPC) acts as both a remote and on-site quality assurance agency that credentials institutions participating in clinical trials. To date, about 30% of all IMRT participants have failed the RPC’s remote audit using the IMRT H&N phantom. The purpose of this project is to evaluate possible causes of H&N IMRT delivery errors observed by the RPC, specifically IMRT treatment plan complexity and the use of improper dosimetry data from machines that were thought to be matched but in reality were not. Eight H&N IMRT plans with a range of complexity defined by total MU (1460-3466), number of segments (54-225), and modulation complexity scores (MCS) (0.181-0.609) were created in Pinnacle v.8m. These plans were delivered to the RPC’s H&N phantom on a single Varian Clinac. One of the IMRT plans (1851 MU, 88 segments, and MCS=0.469) was equivalent to the median H&N plan from 130 previous RPC H&N phantom irradiations. This average IMRT plan was also delivered on four matched Varian Clinac machines and the dose distribution calculated using a different 6MV beam model. Radiochromic film and TLD within the phantom were used to analyze the dose profiles and absolute doses, respectively. The measured and calculated were compared to evaluate the dosimetric accuracy. All deliveries met the RPC acceptance criteria of ±7% absolute dose difference and 4 mm distance-to-agreement (DTA). Additionally, gamma index analysis was performed for all deliveries using a ±7%/4mm and ±5%/3mm criteria. Increasing the treatment plan complexity by varying the MU, number of segments, or varying the MCS resulted in no clear trend toward an increase in dosimetric error determined by the absolute dose difference, DTA, or gamma index. Varying the delivery machines as well as the beam model (use of a Clinac 6EX 6MV beam model vs. Clinac 21EX 6MV model), also did not show any clear trend towards an increased dosimetric error using the same criteria indicated above.

From planetesimals to planets: volatile molecules

Context. Solar and extrasolar planets are the subject of numerous studies aiming to determine their chemical composition and internal structure. In the case of extrasolar planets, the composition is important as it partly governs their potential habitability. Moreover, observational determination of chemical composition of planetary atmospheres are becoming available, especially for transiting planets. Aims. The present works aims at determining the chemical composition of planets formed in stellar systems of solar chemical composition. The main objective of this work is to provide valuable theoretical data for models of planet formation and evolution, and future interpretation of chemical composition of solar and extrasolar planets. Methods. We have developed a model that computes the composition of ices in planets in different stellar systems with the use of models of ice and planetary formation. Results. We provide the chemical composition, ice/rock mass ratio and C:O molar ratio for planets in stellar systems of solar chemical composition. From an initial homogeneous composition of the nebula, we produce a wide variety of planetary chemical compositions as a function of the mass of the disk and distance to the star. The volatile species incorporated in planets are mainly composed of H2O, CO, CO2, CH3OH, and NH3. Icy or ocean planets have systematically higher values of molecular abundances compared to giant and rocky planets. Gas giant planets are depleted in highly volatile molecules such as CH4, CO, and N2 compared to icy or ocean planets. The ice/rock mass ratio in icy or ocean and gas giant planets is, respectively, equal at maximum to 1.01 ± 0.33 and 0.8 ± 0.5, and is different from the usual assumptions made in planet formation models, which suggested this ratio to be 2–3. The C:O molar ratio in the atmosphere of gas giant planets is depleted by at least 30% compared to solar value.

From stellar nebula to planetesimals

Context. Solar and extrasolar comets and extrasolar planets are the subject of numerous studies in order to determine their chemical composition and internal structure. In the case of planetesimals, their compositions are important as they govern in part the composition of future planets. Aims. The present works aims at determining the chemical composition of icy planetesimals, believed to be similar to present day comets, formed in stellar systems of solar chemical composition. The main objective of this work is to provide valuable theoretical data on chemical composition for models of planetesimals and comets, and models of planet formation and evolution. Methods. We have developed a model that calculates the composition of ices formed during the cooling of the stellar nebula. Coupled with a model of refractory element formation, it allows us to determine the chemical composition and mass ratio of ices to rocks in icy planetesimals throughout in the protoplanetary disc. Results. We provide relationships for ice line positions (for different volatile species) in the disc, and chemical compositions and mass ratios of ice relative to rock for icy planetesimals in stellar systems of solar chemical composition. From an initial homogeneous composition of the nebula, a wide variety of chemical compositions of planetesimals were produced as a function of the mass of the disc and distance to the star. Ices incorporated in planetesimals are mainly composed of H2O, CO, CO2, CH3OH, and NH3. The ice/rock mass ratio is equal to 1 ± 0.5 in icy planetesimals following assumptions. This last value is in good agreement with observations of solar system comets, but remains lower than usual assumptions made in planet formation models, taking this ratio to be of 2–3.

FACTORS INFLUENCING ACCESS TO HEALTH CARE AMONG MEXICAN AMERICAN ELDERLY IN TEXAS

Differential access to health care services has been observed among various groups in the United States. Minorities and low-income groups have been especially notable in their decreased access to regular providers of care. This is believed by many to account for some of the higher rates of morbidity and mortality and shorter life expectancies of these groups.^ This research delineated the factors associated with health care access for a particular subset of a minority group, the Mexican American elderly in Texas. Hospital admission and evidence of a regular source of medical care and dental care were chosen as the indicators of access to health care.^ This study analyzed survey interview data from the Texas Study on Aging, 1976. The 597 Mexican American elderly included in this study were representative of the non-institutionalized Mexican American elderly in Texas aged 55 or older.^ The results indicate that hospital admission is not a question of discretion and that common barriers to access, such as income, health insurance, and distance to the nearest facility, are not important in determining hospital admission. Mexican American elderly who need to be hospitalized, as indicated by self-perception of health and disability days, will be hospitalized.^ The results also indicate that having a regular source of medical care is influenced by many factors, some mutable and some immutable. The well-established and immutable factors of age, sex, and need were confirmed. However, the mutable factors such as area of residence and income were also found to have a significant influence. Mexican American elderly living in urban areas had significantly less access to a regular source of medical care as did those who were near the poverty level (as opposed to those who were well below the poverty level). In general, persons claiming a regular source of medical care were more likely to be women, persons who had many health needs, were near the poverty level, lived in urban areas, and had extensive social support systems.^ Persons claiming a regular source of dental care tended to be more advantaged. They had more education, a more extensive informal social support network, higher income, and were generally younger and in better health. They were also more likely to have private health insurance. . . . (Author's abstract exceeds stipulated maximum length. Discontinued here with permission of author.) UMI ^