Short-term corneal changes with gas-permeable contact lens wear in keratoconus subjects: a comparison of two fitting approaches

Purpose: To evaluate changes in anterior corneal topography and higher-order aberrations (HOA) after 14-days of rigid gas-permeable (RGP) contact lens (CL) wear in keratoconus subjects comparing two different fitting approaches. Methods: Thirty-one keratoconus subjects (50 eyes) without previous history of CL wear were recruited for the study. Subjects were randomly fitted to either an apical-touch or three-pointtouch fitting approach. The lens’ back optic zone radius (BOZR) was 0.4 mm and 0.1 mm flatter than the first definite apical clearance lens, respectively. Differences between the baseline and post-CL wear for steepest, flattest and average corneal power (ACP) readings, central corneal astigmatism (CCA), maximum tangential curvature (KTag), anterior corneal surface asphericity, anterior corneal surface HOA and thinnest corneal thickness measured with Pentacam were compared. Results: A statistically significant flattening was found over time on the flattest and steepest simulated keratometry and ACP in apical-touch group (all p < 0.01). A statistically significant reduction in KTag was found in both groups after contact lens wear (all p < 0.05). Significant reduction was found over time in CCA (p = 0.001) and anterior corneal asphericity in both groups (p < 0.001). Thickness at the thinnest corneal point increased significantly after CL wear (p < 0.0001). Coma-like and total HOA root mean square (RMS) error were significantly reduced following CL wearing in both fitting approaches (all p < 0.05). Conclusion: Short-term rigid gas-permeable CL wear flattens the anterior cornea, increases the thinnest corneal thickness and reduces anterior surface HOA in keratoconus subjects. Apicaltouch was associated with greater corneal flattening in comparison to three-point-touch lens wear.

Cultura, liderança e resultados escolares: uma abordagem a partir das representações dos alunos do ensino secundário

Grande parte dos estudos produzidos sobre a liderança escolar tem incidido na análise da relação entre os processos de liderança, a aprendizagem e o sucesso. Embora esta convergência de enfoque (liderança/sucesso) encubra abordagens teóricas, disciplinares e metodológicas muito diferenciadas, é evidente a presença de uma perspetiva unidirecional, mais focada nas políticas e nas práticas de liderança e menos na forma como estas são entendidas pelos alunos. Neste artigo, propomos um enfoque invertido, focado nas representações dos alunos sobre os processos de liderança. Do ponto de vista metodológico, recorremos aos dados recolhidos no âmbito de quatro estudos de caso realizados em escolas/agrupamentos com ensino secundário, resultantes da administração de um inquérito por questionário e da realização de focus group a alunos com resultados académicos de excelência e a alunos não incluídos neste nível de desempenho. Elegemos como referência analítica um estudo de caso de longa duração, a partir do qual colocamos em confronto os dados recolhidos nos outros três contextos estudados. Os resultados deste estudo apontam para a existência de relações e diferenças significativas entre a cultura organizacional da escola e os estilos de liderança, sendo destacada a importância do papel do Diretor na condução do ideário de excelência da escola.

A VEP study in sleeping and awake one-month-old infants and its relation with social behavior

With the present study we aimed to analyze the relationship between infants' behavior and their visual evoked-potential (VEPs) response. Specifically, we want to verify differences regarding the VEP response in sleeping and awake infants and if an association between VEP components, in both groups, with neurobehavioral outcome could be identified. To do so, thirty-two full-term and healthy infants, approximately 1-month of age, were assessed through a VEP unpatterned flashlight stimuli paradigm, offered in two different intensities, and were assessed using a neurobehavioral scale. However, only 18 infants have both assessments, and therefore, these is the total included in both analysis. Infants displayed a mature neurobehavioral outcome, expected for their age. We observed that P2 and N3 components were present in both sleeping and awake infants. Differences between intensities were found regarding the P2 amplitude, but only in awake infants. Regression analysis showed that N3 amplitude predicted an adequate social interactive and internal regulatory behavior in infants who were awake during the stimuli presentation. Taking into account that social orientation and regulatory behaviors are fundamental keys for social-like behavior in 1-month-old infants, this study provides an important approach for assessing physiological biomarkers (VEPs) and its relation with social behavior, very early in postnatal development. Moreover, we evidence the importance of the infant's state when studying differences regarding visual threshold processing and its association with behavioral outcome.