Stability of OCT and OCTA in the Intensive Therapy Unit Setting

To assess the stability of retinal structure and blood flow measures over time and in different clinical settings using portable optical coherence tomography angiography (OCTA) as a potential biomarker of central perfusion in critical illness, 18 oesophagectomy patients completed retinal structure and blood flow measurements by portable OCT and OCTA in the eye clinic and intensive therapy unit (ITU) across three timepoints: (1) pre-operation in a clinic setting; (2) 24–48 h post-operation during ITU admission; and (3) seven days post-operation, if the patient was still admitted. Blood flow and macular structural measures were stable between the examination settings, with no consistent variation between pre- and post-operation scans, while retinal nerve fibre layer thickness increased in the post-operative scans (+2.31 µm, p = 0.001). Foveal avascular zone (FAZ) measurements were the most stable, with an intraclass correlation coefficient of up to 0.92 for right eye FAZ area. Blood flow and structural measures were lower in left eyes than right eyes. Retinal blood flow assessed in patients before and during an ITU stay using portable OCTA showed no systematic differences between the clinical settings. The stability of retinal blood flow measures suggests the potential for portable OCTA to provide clinically useful measures in ITU patients.

#3029 HIV-associated neurocognitive disorder: an investigation using structural neuroimaging in a c-ART treated tanzanian cohort

BackgroundThere is a newly emergent ageing population of people living with HIV (PLWH) in Africa. However, there is little research into HIV-associated neurocognitive disorder (HAND) in this population. Existing research suggests HAND is prevalent however the aetiology remains unclear. This study aims to determine whether HAND is truly prevalent and explore potential causes in PLWH on c-ART using objective structural measures.AimsExplore whether substantial atrophy and/or white matter hyperintensities (WMH) is present on the clinical magnetic resonance imaging (MRI) reports and quantitative analysis of people with optimally managed HIV in Northern Tanzania.Explore the aetiology of HAND by assessing whether cerebral atrophy and/or WMH is associated with demographic risk factors, HIV–related factors and/or comorbidities.Investigate whether structural damage is related to objectively measured cognitive impairment, and whether this is a subcortical or cortical impairment.Explore which neurocognitive test is the best predictor of structural damage and therefore most valid diagnostic test for HAND.MethodsA systematic sample of PLWH aged ≥ 50 were recruited from a HIV clinic in Kilimanjaro, Tanzania. Demographic data and comorbidities were self-reported. HIV-disease management data were obtained. Viral load and CD4 count were measured. A neurocognitive battery and informant history of functional impairment identified HAND. Cerebral atrophy (brain and ventricle volume) and WMH were measured using quantitative analysis of 1.5T MRI.Preliminary resultsThis cohort (n=91) had well-managed HIV (75.9% suppressed viral load, median CD4 507 cells/ul). The significant independent predictor (IP) of decreased brain volume was older age at HIV diagnosis (p=.001), and of increased ventricle volume was increased age (p<.0001), male gender (p<.0001) and increased frailty (p<.0001). The significant IPs of increased WMH volume were increased age (p<.0001) and smoking (p=.021). Only memory impairment independently predicted all structural measures.ConclusionsThis is the first MRI study of older c-ART treated PLWH in Africa. Despite c-ART and good disease management, HAND was objectively prevalent and unrelated to measures of HIV. Cerebral atrophy and WMH were associated with factors of neurodegeneration. Cerebral atrophy was associated with male gender and age at diagnosis (legacy effect).

Assessing the societal adoptability of participatory water management: an application of the Motivation and Ability (MOTA) framework

Exploring whether society is sufficiently equipped and motivated to adopt planned interventions is vital for modern plan development trajectories. The Motivation and Ability (MOTA) framework offers a tool to assess the societal adoptability of plans by exploring stakeholders' motivations and abilities. It was originally developed to assess plan implementation feasibility for structural measures of flood management in the Mekong Delta. Further development is necessary before applying the tool in other contexts and for other types of planning interventions. Institutional measures like participatory water management (PWM) have long been recognized as essential elements for water management, but have so far also remained out of the reach of conventional planning assessment tools such as cost–benefit or cost-effectiveness analyses. This research, therefore, aims at extending the MOTA tool in the context of PWM reforms in Bangladesh. It does this by, first, further detailing the MOTA components and identifying indicators for quantification and, second, an expert validation and application of this framework for coastal communities in Bangladesh. Our results suggest that the MOTA framework is capable of informing policymakers and implementing agencies about how to enhance the stakeholders' motivation and ability to ensure an enduring implementation of PWM reforms. HIGHLIGHTS The Motivation and Ability (MOTA) framework appeared recently to capture the societal and institutional dimensions in assessing the implementation feasibility of structural measures. This research further extends the MOTA framework and tests whether this can be applicable in case of assessing the implementation feasibility of soft measures like participatory water management.

Exploring the partial use of the Mo.S.E. system as effective adaptation to rising flood frequency of Venice

In times of climate change the impact of coastal hazards should be mitigated by identifying and implementing effective adaptation strategies, encompassing a balanced mix of structural and non-structural measures based on high level scientific knowledge. Due to its hydro-geological features, the Venice lagoon (Italy) is particularly vulnerable to climate change. Some structural measures have been adopted over time to protect Venice from flooding, among which a system of flap gates (Mo.S.E. system) has been operational under testing phase since October 2020. However, relative sea level rise and wind setup pose relevant management challenges, as a frequent closing of the lagoon would have negative impacts on flushing capacity, fishing industry and port activities. Hence, optimal operation rules for the existing control structure are searched to anticipate and to adapt to a possible acceleration of sea level rise induced by climate change. Here, the focus is on the hydrodynamic effects of a partial closure of the Mo.S.E. barriers that, with respect to closing all the three inlets of the Lagoon, could play a role in reducing the economic and environmental impacts of the Mo.S.E. system. The main goal is to identify the flooding events that can be counteracted by closing only the Lido inlet, which is the closest to the city of Venice. Based on the tidal and meteorological dataset collected in the period 2000–2019, a robust modelling exercise indicates that the closing of the Lido inlet only would protect the Venice lagoon from two third of the flooding events up to a relative sea level rise of +0.4 m.

Fostering Self-Protection against Impacts of Heavy Rain at the Municipal Level

Local governments are highly relevant actors when it comes to mitigating climate change impacts such as flooding. Not only do they need to implement regulatory and infrastructural measures, but they also need to promote complementing self-protective measures at the household level. The individual motivation of municipal actors to pursue climate adaptation can be important for the implementation of such measures, obviously alongside several other factors, such as financial and administrative issues. A questionnaire survey with a non-random sample of 77 local government actors from 15 of the 16 German federal states was conducted, focusing on potential key factors concerning the motivation to implement adaptation measures against hazardous impacts of heavy rain. Additionally, the perceived effectiveness and realizability of selected municipal structural measures and of activation measures promoting self-protective behavior were collected. It can be shown that the perceived realizability of adaptation measures as well as knowledge of risk and adaptation may be key factors in the motivation to implement both activation and structural measures, while motivation and implementation are only partially related. The results imply a need for the evaluation of activation measures and a need for further research on the motivation of municipal actors to implement activation measures.

A climate change adaptation measure through education and citizen science. The project FLOODUP

&lt;p&gt;In this communication, FLOODUP, a strategy that combines a participatory methodology (citizen science) with educational activities, will be presented as a measure of adaptation to floods and their possible increase due to climate change. The adaptation strategies to climate change range from structural measures (building a dam, for example) to non-structural measures (legislation and improvement of risk assessment, for example). In recent years it has become clear that it is necessary to increase the risk awareness of the population in the face of extreme events such as floods, not only when they occur but also before and after (Hyogo Framework). The population's lack of awareness in front of natural hazards makes it difficult to take responsible decisions at the individual and community level. This is especially relevant considering the context of climate change, which also contributes with a perception of uncertainty. In this context, the development of innovative adaptation strategies based on the knowledge are needed. These strategies are also an opportunity to face the challenges associated with SDGs (Sustainable Development Goals).&lt;/p&gt;&lt;p&gt;The objective of FLOODUP project is double: (a) to improve the knowledge, capacitation and empowerment of the population in front of natural hazards and climatic change and (b) to collect information about their impact and management through citizen science. The tools developed in the project as a mobile application, questionnaires or educational materials will be presented. The main campaigns carried out will also be shown. Their aim is to generate spaces for reflection, especially after flood events. On the other hand, the itinerary of citizen science that is developed in secondary schools and its strengths and weaknesses will be presented. Finally, it will analyze how to respond to current challenges, such as those associated with the SDGs, from projects such as FLOODUP.&lt;/p&gt;&lt;p&gt;This work has been done in the framework of the M-CostAdapt (CTM2017-83655-C2-1&amp;2-R) research project, funded by the Spanish Ministry of Science and Innovation (MICINN-AEI/FEDER, UE) and the PIRAGUA project EFA210/16 Interreg V Spain-France-Andorre Programme (POCTEFA 2014-2020, EU).&lt;/p&gt;

SVD Entropy Reveals the High Complexity of Ecological Networks

Quantifying the complexity of ecological networks has remained elusive. Primarily, complexity has been defined on the basis of the structural (or behavioural) complexity of the system. These definitions ignore the notion of “physical complexity,” which can measure the amount of information contained in an ecological network, and how difficult it would be to compress. We present relative rank deficiency and SVD entropy as measures of “external” and “internal” complexity, respectively. Using bipartite ecological networks, we find that they all show a very high, almost maximal, physical complexity. Pollination networks, in particular, are more complex when compared to other types of interactions. In addition, we find that SVD entropy relates to other structural measures of complexity (nestedness, connectance, and spectral radius), but does not inform about the resilience of a network when using simulated extinction cascades, which has previously been reported for structural measures of complexity. We argue that SVD entropy provides a fundamentally more “correct” measure of network complexity and should be added to the toolkit of descriptors of ecological networks moving forward.