Medical management of diabetic retinopathy:fenofibrate and ACCORD eye studies

The approach of all ophthalmologists, diabetologists and general practitioners seeing patients with diabetic retinopathy should be that good control of blood glucose, blood pressure and plasma lipids are all essential components of modern medical management. The more recent data on the use of fenofibrate in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) and The Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye studies is reviewed. In FIELD, fenofibrate (200 mg/day) reduced the requirements for laser therapy and prevented disease progression in patients with pre-existing diabetic retinopathy. In ACCORD Eye, fenofibrate (160 mg daily) with simvastatin resulted in a 40% reduction in the odds of retinopathy progressing over 4 years, compared with simvastatin alone. This occurred with an increase in HDL-cholesterol and a decrease in the serum triglyceride level in the fenofibrate group, as compared with the placebo group, and was independent of glycaemic control. We believe fenofibrate is effective in preventing progression of established diabetic retinopathy in type 2 diabetes and should be considered for patients with pre-proliferative diabetic retinopathy and/or diabetic maculopathy, particularly in those with macular oedema requiring laser. © 2011 Macmillan Publishers Limited All rights reserved.

Back from the future:the second chance in the past of aller + infinitive

Typological studies (Bybee et al. 1994, Dahl 2000, Bourdin 2008 among many others) have shown a tendency for spatial elements (such as movement verbs) to grammaticalise into temporal expressions. The periphrasis made of aller + infinitive has been very productive in Romance languages. If in French, Spanish or Portuguese, it refers to future, it refers to a simple past in Catalan. fr.: je vais aller au cinéma esp.: voy a ir al cine pt. Vou ira o cine cat.: vaig anar al cine Barceló & Bres (2005:168) indicate that, In French, «vers le XVIème siècle, […] la périphrase a brièvement fonctionné comme un temps du passé (alors même que l’emploi comme temps du futur émergeait)»: (1) Sur ces propos, firent leur accord et, en regardant le lieu le plus propre pour faire cette belle œuvre, elle va dire qu’elle n’en savait point de meilleure ni plus loin de tout soupçon, qu’une petite maison qui était dedans le parc, où il y avait chambre et lit tout à propos. (Marguerite de Navarre, L’Heptaméron) The future value took over so much so that Damourette & Pichon (1911-1936 :117) claimed the past value had disappeared»: Un second tour, encore plus aberrant, n’a plus, que nous sachions, aucune position en pays d’Oui. Nous voulons parler de l’expression d’un passé au moyen de l’auxiliaire aller, suivi de l’infinitif. Ce tour a eu une grande fortune dans le provençal ancien et le catalan […] En français, on n’en trouve que des traces, notamment du XIVe au XVIe siècles . Ex.:[…] Adoncques s’arrêtèrent le conte et Raimondin soubz un grand arbre ; lors va dire le conte à Raimondin: […]. Et Raimondin va lui dire : Sire, ce qu’il vous plaira. That allegedly extinct use is nonetheless alive and kicking in Contemporary French. Larreya (2005:349)notes that it is « très courant dans les récits – en particulier dans les récits oraux» and it is also found in newspaper language as shown by this except from an obituary for Loulou Gasté (Le Monde 1995): (2) Celle-ci se déroule aux Editions Micro, où il a un bureau. Séduit par la jeune interprète, il commence à lui écrire des chansons sur mesure et leur complicité va mettre cinq ans à se transformer en amour. Au début de leur rencontre, Loulou est neurasthénique parce qu’il vient de divorcer et la future Line, exclusivement préoccupée par son métier, ne songe à rien d’autre. Line et Loulou vont rattraper le temps perdu et créer ensemble un millier de petites chansons dont la plupart sont devenues immortelles. Jusqu’à ces derniers mois, il ne va pas se passer une journée sans que Loulou s’empare de sa guitare pour créer un refrain. Would we be witnessing a linguistic resurrection? The same structure seems therefore to have grammaticalised in diverging and even diametrically opposite ways in different Romance languages. In this talk, we shall try to explain how the phrase aller + infinitive is able to function both as a future and a past. We will especially concentrate on the case of contemporary French where, while the future interpretation has obtained the status of tense as futur proche or périphrastique, a past interpretation is now commonplace. Our reflection will be supported by a personal corpus of authentic examples.

An investigation of the factor-analytic approach to the determination of abilities involved in psychomotor learning

This research began with an attempt to solve a practical problem, namely, the prediction of the rate at which an operator will learn a task. From a review of the literature, communications with researchers in this area and the study of psychomotor learning in factories it was concluded that a more fundamental approach was required which included the development of a task taxonomy. This latter objective had been researched for over twenty years by E. A. Fleishman and his approach was adopted. Three studies were carried out to develop and extend Fleishman's approach to the industrial area. However, the results of these studies were not in accord with FIeishman's conclusions and suggested that a critical re-assessment was required of the arguments, methods and procedures used by Fleishman and his co-workers. It was concluded that Fleishman's findings were to some extent an artifact of the approximate methods and procedures which he used in the original factor analyses and that using the more modern computerised factor analytic methods a reliable ability taxonomy could be developed to describe the abilities involved in the learning of psychomotor tasks. The implications for a changing-task or changing-subject model were drawn and it was concluded that a changing task and subject model needs to be developed.

Shape of the posterior vitreous chamber in human emmetropia and myopia

PURPOSE - To compare posterior vitreous chamber shape in myopia to that in emmetropia. METHODS - Both eyes of 55 adult subjects were studied, 27 with emmetropia (MSE =-0.55; <+0.75D; mean +0.09 ±0.36D) and 28 with myopia (MSE -5.87 ±2.31D). Cycloplegic refraction was measured with a Shin Nippon autorefractor and anterior chamber depth and axial length with a Zeiss IOLMaster. Posterior vitreous chamber shapes were determined from T2-weighted MRI (3-Tesla) using procedures previously reported by our laboratory. 3-D surface model coordinates were assigned to nasal, temporal, superior and inferior quadrants and plotted in 2-D to illustrate the composite shape of respective quadrants posterior to the second nodal point. Spherical analogues of chamber shape were constructed to compare relative sphericity between refractive groups and quadrants. RESULTS - Differences in shape occurred in the region posterior to points of maximum globe width and were thus in general accord with an equatorial model of myopic expansion. Shape in emmetropia is categorised distinctly as that of an oblate ellipse and in myopia as an oblate ellipse of significantly less degree such that it approximates to a sphere. There was concordance between shape and retinotopic projection of respective quadrants into right, left, superior and inferior visual fields. CONCLUSIONS - The transition in shape from oblate ellipse to sphere with axial elongation supports the hypothesis that myopia may be a consequence of equatorial restriction associated with biomechanical anomalies of the ciliary apparatus. The synchronisation of quadrant shapes with retinotopic projection suggests that binocular growth is coordinated by processes that operate beyond the optic chiasm.

Un phénix linguistique? Le tour narratif va + infinitif renaîtrait-il, en français contemporain, de ses cendres médiévales?

Les études typologiques (Hagège 1993, Bybee et al.1994, Dahl 2000, Bourdin 2008 notamment) ont montré de façon consistante que les indications spatiales (notamment les verbes de mouvement) tendaient à se grammaticaliser en expressions temporelles. La forme itive (en français aller) dans les langues romanes a fait l’objet de ce processus linguistique , et avec succès, puisque, en tant qu’auxiliaire d’un verbe à l’infinitif ou au participe présent (et moins fréquemment au participe passé), elle est à même d’offrir, au cours de son histoire, pas moins de onze emplois grammaticalisés (Bres et Labeau à paraître). Nous nous intéresserons dans cet article, qui ne portera que sur le français, à l’emploi que nous nommerons, avec Larreya (2005) et Lansari (2009), narratif: il apparaît en textualité narrative, dont les propositions du premier plan sont régies par la relation de progression (Labov 1972/1978). Cet emploi que le français a connu jusqu’au début du XVIIème (1) tend, sur des bases peut-être différentes, à se répandre aujourd’hui (2): (1) Sur ces propos, feirent leur accord, et, en regardant le lieu le plus propre pour faire ceste belle oeuvre, elle vat dire qu'elle n'en sçavoit poinct de meilleure ne plus loing de tout soupson, que une petite maison qui estoit dedans le parc, où il y avoit chambre et lict tout à propos. Le gentil homme, qui n'eust trouvé nul lieu mauvais, se contenta de cestuy-là. (Navarre M. de, L'Heptaméron, 1550) (2) (…) Teddy Pendergrass est remarqué par Harold Melvin, leader du quintette vocal The Blue Notes. Il rejoint alors la formation, qui va enchaîner une succession de tubes. En 1976, Teddy Pendergrass décide de mener une carrière solo et quitte les Blue Notes . Il va régulièrement occuper les premières places des meilleures ventes de disques aux USA. (Le Monde, Obituaire de T. Pendergrass, 27 .1. 2010)

Hypoglycaemia:a limiting factor

Recent trials of intensive glucose control (for example ACCORD, ADVANCE and VADT) have re-focussed attention on the problem of hypoglycaemia. Definitions of hypoglycaemia and gradings of intensity vary between studies, making direct comparisons difficult. This in turn has contributed to continued debate over the prevalence, impact and costs of hypoglycaemia.

Influence of alkyl chain length on sulfated zirconia catalysed batch and continuous esterification of carboxylic acids by light alcohols

The impact of alkyl chain length on the esterification of C2–C16 organic acids with C1–C4 alcohols has been systematically investigated over bulk and SBA-15 supported sulfated zirconias (SZs). Rates of catalytic esterification for methanol with acetic acid are directly proportional to the sulfur content for both SZ and SZ/SBA-15, with the high dispersion of SZ achievable in conformal coatings over mesoporous SBA-15 confering significant rate-enhancements. Esterification over the most active 0.24 mmol gcat−1 bulk SZ and 0.29 mmol gcat−1 SZ/SBA-15 materials was inversely proportional to the alkyl chain length of alcohol and acid reactants; being most sensitive to changes from methanol to ethanol and acetic to hexanoic acids respectively. Kinetic analyses reveal that these alkyl chain dependencies are in excellent accord with the Taft relationship for polar and steric effects in aliphatic systems and the enthalpy of alcohol adsorption, implicating a Langmuir–Hinshelwood mechanism. The first continuous production of methyl propionate over a SZ fixed-bed is also demonstrated.