Drusen prevalence and pigmentary changes in Caucasians aged 18-54 years

Aims and Purpose The aim of this study was to describe the prevalence and characteristics of drusen and pigmentary changes in a middle-aged population.

Methods Retinal images from 500 individuals aged 18–54 years were included. The source of participants was two UK optometry practices. Retinal images were graded using the Wisconsin Age-Related
Maculopathy Grading System. However, owing to the relatively young age of the population studied, a new category of drusen of smaller size (o31.5mm) was introduced.

Results Drusen were identi?ed within the central macular grid in 91.48% of all gradable eyes and in 444 subjects. Drusen sized o31.5mm were present in 89.7% of eyes, drusen sized 431.5mm and o63mm were present in 45.9% of all eyes and drusen 463mm and o125mm were present in only 1.7% of eyes. No eye had drusen larger or equal to 125mm. Very few eyes (1.2%) showed pigmentary changes within the grid. Drusen load increased with increasing age, P o0.001.

Conclusions The frequency of drusen in a younger Caucasian population aged 18–54 years is high, with 91.48% of all gradable eyes having drusen. The most frequent drusen subtype was hard distinct drusen o31.5mm. No druse greater or equal in size to 125mm was seen. Pigmentary changes are rare. Eye(2012) 26, 1357–1362; doi:10.1038/eye.2012.165; published online 17 August 2012

A cluster randomised controlled trial of “Bookstart+”: a book gifting programme

Purpose – The purpose of this paper is to evaluate the effectiveness of a free book gifting programme, called “Bookstart+”, in improving family reading outcomes.

Design/methodology/approach – Bookstart+ consists of a pack of books and reading materials provided to families at their two-year-old child's statutory health visit. The pack is accompanied by a short priming demonstration, delivered by the health visitor, on shared reading. The evaluation took the form of a randomised controlled trial (RCT) with 460 families from the client lists of 115 health visitors.

Findings – The study found evidence of: a positive significant effect on parents’ attitudes to reading and books (Cohen's d=+0.192, p=0.034); no significant effect on parental attitudes to their child reading (d=+0.085, p=0.279); and a negative effect, approaching significance, on public library usage (d=-0.160, p=0.055).

Research limitations/implications – The attrition rate was high, with only 43.9 per cent of the target families completing all of the research. However, this level of attrition did not lead to any significant differences between the control and intervention groups on their pre-test measures.

Practical implications – The study provides recommendations for free book gifting service provision in relation to pack contents and delivery.

Originality/value – This paper contributes to the limited international RCT evidence on free book gifting programmes.

Arsenic Contents in Spanish Infant Rice, Pureed Infant Foods, and Rice

It seems there is a positive correlation between rice content and arsenic level in foods. This is of extraordinary importance for infants below 1 y of age because their diet is very limited and in some cases is highly dependent on rice-based products; this is particularly true for infants with the celiac disease because they have no other option than consume gluten-free products, such as rice or corn. Arsenic contents were significantly higher (P <0.001) in gluten-free infant rice (0.057 mg kg-1) than in products with gluten, based on a mixture of cereals (0.024 mg kg-1). Besides, especial precaution must be taken when preparing rice-based products at home, because arsenic content in Spanish rice was high, with levels being above 0.3 mg kg-1 in some cases.

Automated versus non-automated weaning for reducing the duration of mechanical ventilation in critically ill adults & children (Review)

Background Automated closed loop systems may improve adaptation of mechanical support for a patient's ventilatory needs and facilitate systematic and early recognition of their ability to breathe spontaneously and the potential for discontinuation of ventilation. This review was originally published in 2013 with an update published in 2014. Objectives The primary objective for this review was to compare the total duration of weaning from mechanical ventilation, defined as the time from study randomization to successful extubation (as defined by study authors), for critically ill ventilated patients managed with an automated weaning system versus no automated weaning system (usual care). Secondary objectives for this review were to determine differences in the duration of ventilation, intensive care unit (ICU) and hospital lengths of stay (LOS), mortality, and adverse events related to early or delayed extubation with the use of automated weaning systems compared to weaning in the absence of an automated weaning system. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 8); MEDLINE (OvidSP) (1948 to September 2013); EMBASE (OvidSP) (1980 to September 2013); CINAHL (EBSCOhost) (1982 to September 2013); and the Latin American and Caribbean Health Sciences Literature (LILACS). Relevant published reviews were sought using the Database of Abstracts of Reviews of Effects (DARE) and the Health Technology Assessment Database (HTA Database). We also searched the Web of Science Proceedings; conference proceedings; trial registration websites; and reference lists of relevant articles. The original search was run in August 2011, with database auto-alerts up to August 2012. Selection criteria We included randomized controlled trials comparing automated closed loop ventilator applications to non-automated weaning strategies including non-protocolized usual care and protocolized weaning in patients over four weeks of age receiving invasive mechanical ventilation in an ICU. Data collection and analysis Two authors independently extracted study data and assessed risk of bias. We combined data in forest plots using random-effects modelling. Subgroup and sensitivity analyses were conducted according to a priori criteria. Main results We included 21 trials (19 adult, two paediatric) totaling 1676 participants (1628 adults, 48 children) in this updated review. Pooled data from 16 eligible trials reporting weaning duration indicated that automated closed loop systems reduced the geometric mean duration of weaning by 30% (95% confidence interval (CI) 13% to 45%), however heterogeneity was substantial (I2 = 87%, P < 0.00001). Reduced weaning duration was found with mixed or medical ICU populations (42%, 95% CI 10% to 63%) and Smartcare/PS™ (28%, 95% CI 7% to 49%) but not in surgical populations or using other systems. Automated closed loop systems reduced the duration of ventilation (10%, 95% CI 3% to 16%) and ICU LOS (8%, 95% CI 0% to 15%). There was no strong evidence of an effect on mortality rates, hospital LOS, reintubation rates, self-extubation and use of non-invasive ventilation following extubation. Prolonged mechanical ventilation > 21 days and tracheostomy were reduced in favour of automated systems (relative risk (RR) 0.51, 95% CI 0.27 to 0.95 and RR 0.67, 95% CI 0.50 to 0.90 respectively). Overall the quality of the evidence was high with the majority of trials rated as low risk. Authors' conclusions Automated closed loop systems may result in reduced duration of weaning, ventilation and ICU stay. Reductions are more likely to occur in mixed or medical ICU populations. Due to the lack of, or limited, evidence on automated systems other than Smartcare/PS™ and Adaptive Support Ventilation no conclusions can be drawn regarding their influence on these outcomes. Due to substantial heterogeneity in trials there is a need for an adequately powered, high quality, multi-centre randomized controlled trial in adults that excludes 'simple to wean' patients. There is a pressing need for further technological development and research in the paediatric population.

Artificial urinary sphincter implantation in the irradiated patient:safety, efficacy and satisfaction

Objective To compare the long-term outcome of artificial urinary sphincter (AUS) implantation in patients after prostatectomy, with and with no history of previous irradiation.

Patients and methods The study included 98 men (mean age 68 years) with urinary incontinence after prostatectomy for prostate cancer (85 radical, 13 transurethral resection) who had an AUS implanted. Twenty-two of the patients had received adjuvant external beam irradiation before AUS implantation. Over a mean (range) follow-up of 46 (5-118) months, the complication and surgical revision rates were recorded and compared between irradiated and unirradiated patients. The two groups were also compared for the resolution of incontinence and satisfaction, assessed using a questionnaire.

Results Overall, surgical revision was equally common in irradiated (36%) and unirradiated (24%) patients. After activating the AUS, urethral atrophy, infection and erosion requiring surgical revision were more common in irradiated patients (41% vs 11%; P <0.05); 70% of patients reported a significant improvement in continence, regardless of previous irradiation. Patient satisfaction remained high, with >80% of patients stating that they would undergo surgery again and/or recommend it to others, despite previous Irradiation and/or the need for surgical revision.

Conclusions Despite higher complication and surgical revision rates in patients who have an AUS implanted and have a history of previous Irradiation, the long-term continence and patient satisfaction appear not to be adversely affected.

Design of an automated solar concentrator for the pyrolysis of scrap rubber

An automated solar reactor system was designed and built to carry out catalytic pyrolysis of scrap rubber tires at 550°C. To maximize solar energy concentration, a two degrees-of-freedom automated sun tracking system was developed and implemented. Both the azimuth and zenith angles were controlled via feedback from six photo-resistors positioned on a Fresnel lens. The pyrolysis of rubber tires was tested with the presence of two types of acidic catalysts, H-beta and H-USY. Additionally, a photoactive TiO<inf>2</inf> catalyst was used and the products were compared in terms of gas yields and composition. The catalysts were characterized by BET analysis and the pyrolysis gases and liquids were analyzed using GC-MS. The oil and gas yields were relatively high with the highest gas yield reaching 32.8% with H-beta catalyst while TiO<inf>2</inf> gave the same results as thermal pyrolysis without any catalyst. In the presence of zeolites, the dominant gasoline-like components in the gas were propene and cyclobutene. The TiO<inf>2</inf> and non-catalytic experiments produced a gas containing gasoline-like products of mainly isoprene (76.4% and 88.4% respectively). As for the liquids they were composed of numerous components spread over a wide distribution of C<inf>10</inf> to C<inf>29</inf> hydrocarbons of naphthalene and cyclohexane/ene derivatives.

Fish product mislabelling: failings of traceability in the production chain and implications for illegal, unreported and unregulated (IUU) fishing

Increasing consumer demand for seafood, combined with concern over the health of our oceans, has led to many initiatives aimed at tackling destructive fishing practices and promoting the sustainability of fisheries. An important global threat to sustainable fisheries is Illegal, Unreported and Unregulated (IUU) fishing, and there is now an increased emphasis on the use of trade measures to prevent IUU-sourced fish and fish products from entering the international market. Initiatives encompass new legislation in the European Union requiring the inclusion of species names on catch labels throughout the distribution chain. Such certification measures do not, however, guarantee accuracy of species designation. Using two DNA-based methods to compare species descriptions with molecular ID, we examined 386 samples of white fish, or products labelled as primarily containing white fish, from major UK supermarket chains. Species specific real-time PCR probes were used for cod (Gadus morhua) and haddock (Melanogrammus aeglefinus) to provide a highly sensitive and species-specific test for the major species of white fish sold in the UK. Additionally, fish-specific primers were used to sequence the forensically validated barcoding gene, mitochondrial cytochrome oxidase I (COI). Overall levels of congruence between product label and genetic species identification were high, with 94.34% of samples correctly labelled, though a significant proportion in terms of potential volume, were mislabelled. Substitution was usually for a cheaper alternative and, in one case, extended to a tropical species. To our knowledge, this is the first published study encompassing a large-scale assessment of UK retailers, and if representative, indicates a potentially significant incidence of incorrect product designation.

During pregnancy, recreational drug-using women stop taking ecstasy (3,4-methylenedioxy-N-methylamphetamine) and reduce alcohol consumption but continue to smoke tobacco and cannabis

While recreational drug use in UK women is prevalent, to date there is little prospective data on patterns of drug use in recreational drug-using women immediately before and during pregnancy. A total of 121 participants from a wide range of backgrounds were recruited to take part in the longitudinal Development and Infancy Study (DAISY) study of prenatal drug use and outcomes. Eighty-six of the women were interviewed prospectively while pregnant and/or soon after their infant was born. Participants reported on use immediately before and during pregnancy and on use over their lifetime. Levels of lifetime drug use of the women recruited were high, with women reporting having used at least four different illegal drugs over their lifetime. Most users of cocaine, 3,4-methylenedioxy-N-methylamphetamine (MDMA) and other stimulants stopped using these by the second trimester and levels of use were low. However, in pregnancy, 64% of the sample continued to use alcohol, 46% tobacco and 48% cannabis. While the level of alcohol use reduced substantially, average tobacco and cannabis levels tended to be sustained at pre-pregnancy levels even into the third trimester (50 cigarettes and/or 11 joints per week). In sum, while the use of ‘party drugs’ and alcohol seems to reduce, levels of tobacco and cannabis use are likely to be sustained throughout pregnancy. The data provide polydrug profiles that can form the basis for the development of more realistic animal models.

Recreational shore fishing in southern Portugal: biological and socio-economic aspects and perspectives for management

Although overfishing is a concern for many fish stocks, it was for a long time only associated with commercial fishing exploitation, with less or no attention being given to the recreational fisheries. Recent research has shown however that the impact of recreational fishing on particular species can be considerable, and that the recreational harvest needs to be taken into account if fisheries are to be accurately assessed and effectively managed. In Portugal, the first recreational fishing regulations were only recently implemented. However, mirroring other European countries, regulations lacked scientific support, and specific knowledge of the activity was limited to a few studies with limited coverage. This thesis aimed to characterize the biological and socioeconomic aspects of the recreational shore angling activity in southern Portugal, to investigate whether the regulations in place were adequate and effective, and to provide recommendations for improved management and conservation of the inshore fisheries resources. A combined aerial-roving survey was conducted to gather data on fishing effort, catch, fishing trips and socioeconomic aspects (including anglers’ perceptions of regulations) of the recreational angling activity. The analysis of anglers’ catches suggested that compliance with daily bag limits was high, with less than 0.5% of creels exceeding the 10 kg angler-1 day-1 bag limit. Overall, 11.5% of the retained fishes were undersized, but non-compliance with minimum size limits was found to be high for some species (e.g. seabass, 73% undersized). In terms of the impact of recreational shore angling, the total estimated catches corresponded to less than 1% of the commercial landings for the same period (shared species). However, shore angling catches for white sea bream (Diplodus sargus) were found to be considerable, corresponding to 65% of the commercial landings (39.4% of total catch). In terms of anglers’ perceptions about the recreational fishing regulations in Portugal, the present study has shown that the majority of anglers accepted the existence of some kind of SRF regulations, but in general there was a partial or total disagreement with the recreational fishing restrictions recently put in place. Most anglers perceived themselves as not being involved in the decision-making process and claimed that some restrictions lacked a meaningful rationale (e.g. prohibition of fishing from piers/jetties). Fishers’ awareness with regard to specific aspects of the restrictions (such as the rationale for minimum size limits) was found to be very limited. During the same period, catches from sport fishing competitions were examined to test for differences with the recreational activity in terms of catches, and evaluate long term trends in catch and mean size of fish. Catches of the sport fishing competitions were found to be different from those observed for recreational fishing, being dominated by different species (e.g. garfish, mullets), and suggesting different fishing strategies of the the two types of anglers. High percentages of undersized fish were observed to be captured (and retained) during the competitions (in particular seabass, with 100% undersized), probably as a result of a single allowable minimum size (AMS) of 15 cm for all species in use in competitions. Lastly, catch and release fishing experiments were carried out to assess post-release mortality of three recreationally important species: two banded sea bream Diplodus vulgaris; black sea bream Spondyliosoma cantharus; and gilthead sea bream Sparus aurata. Post-release mortalities were found to be low (0-12%). The main predictor of mortality for Sparus aurata was anatomical hooking location, with 63% of the fishes that died being deeply hooked. The results support the release of fish, either from mandatory (e.g. minimum landing sizes) or voluntary practices. In summary, this thesis has demonstrated that the impact of recreational fishing for particular species is significant and needs to be taken into account for more effective management and stock assessment purposes. It has also highlighted several management issues that should be addressed in order to promote more adequate regulations in the future and prevent noncompliance issues. A periodic monitoring of the recreational fishing activity including all fishing modes (i.e. spear fishing, boat, and shore angling) would also be beneficial to ensure a timely knowledge on the global recreational fishing activity and support future management actions.

Evaluation and Potential Cost-Effectiveness of Active Surveillance Pharmacovigilance for First-Line HAART in Namibia

Thesis (Ph.D.)--University of Washington, 2016-02

Relatório de estágio

I (Prática Pedagógica) - O estágio foi realizado na Academia de Música de Almada (AMA) com três alunos de níveis diferentes: Aluno x, Iniciação Musical; Aluna y, 2º grau; e Aluna z, 5º grau. A planificação do trabalho foi feita com a colaboração do professor Vasco Broco e sob a supervisão do professor Pedro Saglimbeni Muñoz, tendo por base o programa da AMA e procurando corresponder às necessidades individuais de cada aluno, bem como respeitar os diferentes ritmos de aprendizagem. Dadas as diferenças de idade e de nível, os objectivos que procurei atingir com cada aluno durante o ano lectivo são naturalmente díspares, bem como a perspectiva de cada um em relação ao próprio instrumento e ao ensino da música. Enquanto que os mais novos encaram a aprendizagem musical como uma actividade meramente recreativa, pelo menos por enquanto, a Aluna z ambiciona fazer uma carreira como instrumentista. Mesmo entre os mais novos há diferenças, pois apesar de o Aluno x ainda estar a frequentar a Iniciação Musical, já iniciou a sua aprendizagem há mais tempo do que a Aluna y, encarando o ensino com mais seriedade. A AMA tem a vantagem de ter um pianista acompanhador disponível para cada dia da semana, o que tornou possível desenvolver um trabalho consistente com os alunos em termos de ensaios e audições. As audições e momentos de avaliação foram marcados em reuniões de Departamento Curricular, à excepção da calendarização das Provas Globais que foi feita em reunião de Conselho Pedagógico. O aproveitamento foi positivo para os três alunos no final do estágio, tendo todos transitado para o nível de ensino seguinte.

Trois compositions, trois genres musicaux et une démarche programmatique : Le chat noir, La nébuleuse de la tour, Le livre de Thot

La version intégrale de ce mémoire est disponible uniquement pour consultation individuelle à la Bibliothèque de musique de l'Université de Montréal (www.bib.umontreal.ca/MU).

Diversité et structure du zooplancton : importance pour la conservation de la biodiversité aquatique en zone urbaine

L'écologie urbaine est un nouveau champ de recherche qui cherche à comprendre les structures et les patrons des communautés et des écosystèmes situés dans des paysages urbains. Les petits plans d’eau sont connus comme des écosystèmes aquatiques qui peuvent contenir une biodiversité considérable pour plusieurs groupes taxonomiques (oiseaux, amphibiens, macroinvertébrés), ce qui en fait des écosystèmes intéressants pour les études de conservation. Cependant, la biodiversité du zooplancton, un élément central des réseaux trophiques aquatiques, n’est pas entièrement connue pour les plans d’eaux urbains et devrait être mieux décrite et comprise. Cette étude a évalué les patrons de biodiversité des communautés zooplanctoniques dans des plans d’eau urbains sur l’Ile de Montréal et leurs sources de variation. Des suggestions pour l’évaluation et la conservation de la biodiversité sont aussi discutées. La biodiversité zooplanctonique des plans d’eaux urbains s’est avérée être assez élevée, avec les cladocères et les rotifères montrant les contributions à la diversité gamma et bêta les plus élevées. Sur l’ensemble des plans d’eau, il y avait une corrélation négative entre les contributions à la bêta diversité des cladocères et des rotifères. Au niveau de chaque plan d'eau, la zone littorale colonisée par des macrophytes s'est avérée être un habitat important pour la biodiversité zooplactonique, contribuant considérablement à la richesse en taxons, souvent avec une différente composition en espèces. Les communautés zooplanctoniques répondaient aux facteurs ascendants et descendants, mais aussi aux pratiques d’entretien, car le fait de vider les plans d’eau en hiver affecte la composition des communautés zooplanctoniques. Les communautés de cladocères dans ces plans d’eau possédaient des quantités variables de diversité phylogénétique, ce qui permet de les classer afin de prioriser les sites à préserver par rapport à la diversité phylogénétique. Le choix des sites à préserver afin de maximiser la diversité phylogénétique devrait être correctement établi, afin d’eviter de faire des choix sous-optimaux. Cependant, pour des taxons tels que les cladocères, pour lesquels les relations phylogénétiques demeurent difficiles à établir, placer une confiance absolue dans un seul arbre est une procédure dangereuse. L’incorporation de l’incertitude phylogénétique a démontré que, lorsqu’elle est prise en compte, plusieurs différences potentielles entre la diversité phylogenétique ne sont plus supportées. Les patrons de composition des communautés différaient entre les plans d’eau, les mois et les zones d’échantillonnage. Etant donné les intéractions sont significatives entres ces facters; ceci indique que tous ces facteurs devraient êtres considérés. L’urbanisation ne semblait pas sélectionner pour un type unique de composition des groupes alimentaires, étant donné que les communautés pouvaient changer entres des assemblages de types alimentaires différents. Les variables environnementales, surtout la couverture du plan d’eau en macrophytes, étaient des facteurs importants pour la biodiversité zooplanctonique, affectant la richesse spécifique de divers groupes taxonomiques et alimentaires. Ces variables affectaient aussi la composition des communautés, mais dans une moindre mesure, étant des variables explicatives modestes, ce qui indiquerait le besoin de considérer d’autres processus.

Black yeasts from the slope sediments of Bay of Bengal: phylogenetic and functional characterization

Occurrence of black yeasts in the slope sediments of Bay of Bengal was investigated during FORV Sagar Sampada cruises 236 and 245. The black yeast population was found to be very scanty in the area and the isolates could be obtained from 200m to 1000m depth regions in the slope sediments. The isolates were identified as Hortaea werneckii by Internal Transcribed Spacer (ITS) sequencing. The biodegradation potential of these strains was found to be very high with all the strains exhibiting protease, lipase and amylase production. The optimum growth conditions were pH 8, salinity 30 ppt and temperature 30oC. The pigment melanin, in these organisms was identified to be of dihydroxynaphthalene type by NMR. The melanin was found to exhibit inhibitory activity against different human and fish pathogens. Melanin degrading enzyme could also be extracted from these organisms

Irrigation performance and gross water productivity in furrow-irrigated ornamental tree production

In the ornamental plant production region of Girona (Spain), which is one of the largest of its kind in southern Europe, most of the surface is irrigated using wide blocked-end furrows. The objectives of this paper were: (1) to evaluate the irrigation scheduling methods used by ornamental plant producers; (2) to analyse different scenarios in order to assess how they affect irrigation performance; (3) to evaluate the risk of deep percolation; and (4) to calculate gross water productivity. A two-year study in a representative commercial field, planted with Prunus cerasifera ‘Nigra’, was carried out. The irrigation dose applied by the farmers was slightly smaller than the required water dose estimated by the use of two different methods: the first based on soil water content, and the second based on evapotranspiration. Distribution uniformity and application efficiency were high, with mean values above 87%. Soil water content measurements revealed that even at the end of the furrow, where the infiltrated water depth was greatest, more than 90% of the infiltrated water was retained in the shallowest 40 cm of the soil; accordingly, the risk of water loss due to deep percolation was minimal. Gross water productivity for ornamental tree production was € 11.70 m–3, approximately 20 times higher than that obtained with maize in the same region