Errors Associated to Keratoconus Grading using Systems based on Corneal Power

Purpose: To analyze and define the possible errors that may be introduced in keratoconus classification when the keratometric corneal power is used in such classification. Materials and methods: Retrospective study including a total of 44 keratoconus eyes. A comprehensive ophthalmologic examination was performed in all cases, which included a corneal analysis with the Pentacam system (Oculus). Classical keratometric corneal power (Pk), Gaussian corneal power (Pc Gauss), True Net Power (TNP) (Gaussian power neglecting the corneal thickness effect), and an adjusted keratometric corneal power (Pkadj) (keratometric power considering a variable keratometric index) were calculated. All cases included in the study were classified according to five different classification systems: Alió-Shabayek, Amsler-Krumeich, Rabinowitz-McDonnell, collaborative longitudinal evaluation of keratoconus (CLEK), and McMahon. Results: When Pk and Pkadj were compared, differences in the type of grading of keratoconus cases was found in 13.6% of eyes when the Alió-Shabayek or the Amsler-Krumeich systems were used. Likewise, grading differences were observed in 22.7% of eyes with the Rabinowitz-McDonnell and McMahon classification systems and in 31.8% of eyes with the CLEK classification system. All reclassified cases using Pkadj were done in a less severe stage, indicating that the use of Pk may lead to the classification of a cornea as keratoconus, being normal. In general, the results obtained using Pkadj, Pc Gauss or the TNP were equivalent. Differences between Pkadj and Pc Gauss were within ± 0.7D. Conclusion: The use of classical keratometric corneal power may lead to incorrect grading of the severity of keratoconus, with a trend to a more severe grading.

Compressive behaviour of a tire recycled steel and textil fiber concrete subjected to fire

The use of rubber aggregates, steel and textile fibres recycled from tires in concrete is a solution that it is being studied by several authors around the world. A few works have been carried out at room temperature but very scarce at high temperatures. This paper presents the results of a research with the aim to evaluate the behaviour at high temperatures of a concrete made with different amounts of recycled textile and steel fibres from tires. The study considered five concrete compositions, with the same water/cement ratio (W/C=0.43), differing only in the type and quantity of fibers incorporated in the mixture. Thus, a reference composition (0% fiber), two compositions with 30 and 70kg/m3 of steel fibers and a composition with 2 and 4kg/m3 of textile fibers from tires were tested. The concrete was tested for a load level of 0.5fcd and different maximum temperature levels (20, 300, 500 and 700ºC).

Carte de la coste d'Arabie, Mer Rouge et Golfe de Perse: tirée de la Carte de l'Océan Oriental publiée en 1740 par Ordre de Mgr le Comte de Maurepas augmentée sur des remarques particulières et dressée sur des observations astronomiques = Kaart van de Kust van Arabië, de Roode-Zee en de Gulf van Persië Gemaakt na de Fransse-Kaart van den Ooster-Ocean uitgegeven A. 1740 op Bevel van den Hre Grave de Maurepas Vermeederd op byzondere Aanmerkingen, en geschikt volgens Sterrekundige-Waarnemingen

J. V. Schley.

Carte des trois Arabies: tirée en partie de l'Arabe de Nubie, en partie de diuers autres autheurs

par le S. N. Sanson d'Abbeville Geographe ordinaire du Roy ; J. Somer sculp.

Predictors of Nasal Obstruction: Quantification and Assessment Using Multiple Grading Scales

Objective. To evaluate the association between nasal obstruction and (1) demographic factors, (2) medical history, (3) physical tests, and (4) nasal exam findings. Study Design. CASE SERIES: Methods. Chart review at a tertiary medical center. Results. Two hundred-forty consecutive patients (52.1 ± 17.5 years old, with a Nasal Obstruction Symptom Evaluation (NOSE) score of 32.0 ± 24.1) were included. Demographic factors and inferior turbinate sizes were not associated with NOSE score or Nasal Obstruction Visual Analog Scale (NO-VAS). A significant association was found between higher NOSE score on univariate analysis and positive history of nasal trauma (p = 0.0136), allergic rhinitis (p < 0.0001), use of nasal steroids (p = 0.0108), higher grade of external nasal deformity (p = 0.0149), higher internal nasal septal deviation grade (p = 0.0024), and narrow internal nasal valve angle (p < 0.0001). Multivariate analysis identified the following as independent predictors of high NOSE score: NO-VAS: ≥50 (Odds Ratio (OR) = 17.6 (95% CI 5.83-61.6), p < 0.0001), external nasal deformity: grades 2-4 (OR = 4.63 (95% CI 1.14-19.9), p = 0.0339), and allergic rhinitis: yes (OR = 5.5 (95% CI 1.77-18.7), p = 0.0041). Conclusion. Allergic rhinitis, NO-VAS score ≥ 50, and external nasal deformity (grades 2-4) were statistically significant independent predictors of high NOSE scores on multivariate analysis. Inferior turbinate size was not associated with NOSE scores or NO-VAS.