Nidek OPD-scan analysis of normal, keratoconic, and penetrating keratoplasty eyes

PURPOSE: To determine by wavefront analysis the difference between eyes considered normal, eyes diagnosed with keratoconus, and eyes that have undergone penetrating keratoplasty METHODS: The Nidek OPD-Scan wavefront aberrometer was used to measure ocular aberrations out to the sixth Zernike order. One hundred and thirty eyes that were free of ocular pathology, 41 eyes diagnosed with keratoconus, and 8 eyes that had undergone penetrating keratoplasty were compared for differences in root mean square value. Three and five millimeter root mean square values of the refractive power aberrometry maps of the three classes of eyes were compared. Radially symmetric and irregular higher order aberration values were compared for differences in magnitude. RESULTS: Root mean square values were lower in eyes free of ocular pathology compared to eyes with keratoconus and eyes that had undergone penetrating keratoplasty. The aberrations were larger with the 5-mm pupil. Coma and spherical aberration values were lower in normal eyes. CONCLUSION: Wavefront aberrometry of normal, pathological, and eyes after surgery may help to explain the visual distortions encountered by patients. The ability to measure highly aberrated eyes allows an objective assessment of the optical consequences of ocular pathology and surgery. The Nidek OPD-Scan can be used in areas other than refractive surgery.

Optical quality and visual performance with customised soft contact lenses for keratoconus

Purpose: This study investigated how aberration-controlling, customised soft contact lenses corrected higher-order ocular aberrations and visual performance in keratoconic patients compared to other forms of refractive correction (spectacles and rigid gas-permeable lenses). Methods: Twenty-two patients (16 rigid gas-permeable contact lens wearers and six spectacle wearers) were fitted with standard toric soft lenses and customised lenses (designed to correct 3rd-order coma aberrations). In the rigid gas-permeable lens-wearing patients, ocular aberrations were measured without lenses, with the patient's habitual lenses and with the study lenses (Hartmann-Shack aberrometry). In the spectacle-wearing patients, ocular aberrations were measured both with and without the study lenses. LogMAR visual acuity (high-contrast and low-contrast) was evaluated with the patient wearing their habitual correction (of either spectacles or rigid gas-permeable contact lenses) and with the study lenses. Results: In the contact lens wearers, the habitual rigid gas-permeable lenses and customised lenses provided significant reductions in 3rd-order coma root-mean-square (RMS) error, 3rd-order RMS and higher-order RMS error (p ≤ 0.004). In the spectacle wearers, the standard toric lenses and customised lenses significantly reduced 3rd-order RMS and higher-order RMS errors (p ≤ 0.005). The spectacle wearers showed no significant differences in visual performance measured between their habitual spectacles and the study lenses. However, in the contact lens wearers, the habitual rigid gas-permeable lenses and standard toric lenses provided significantly better high-contrast acuities compared to the customised lenses (p ≤ 0.006). Conclusions: The customised lenses provided substantial reductions in ocular aberrations in these keratoconic patients; however, the poor visual performances achieved with these lenses are most likely to be due to small, on-eye lens decentrations. © 2014 The College of Optometrists.

Visual performance and optical quality with soft lenses in keratoconus patients

Purpose: To assess visual performance and ocular aberrations in keratoconic patients using toric soft contact lenses (SCL), rigid-gas-permeable (RGP) contact lenses and spectacle lens correction. Methods: Twenty-two keratoconus patients (16 RGP lens wearers and six spectacle wearers) were fitted with toric SCL. Ocular aberrations were measured with and without the patient's habitual RGP lenses and with the SCL in place. In the spectacle wearers, aberrations were measured with and without the SCL. Visual performance (high- and low-contrast visual acuity) was evaluated with the patient's habitual correction and with the SCL. Results: In the RGP lens wearers both the habitual lenses and the toric SCL significantly reduced coma, trefoil, 3rd-order, 4th-order cylinder and higher-order root-mean-square (RMS) aberrations (p≤0.015). In the spectacle wearers the toric SCL significantly reduced coma, 3rd-order and higher-order RMS aberrations (p≤0.01). The patients' habitual RGP lenses gave better low-contrast acuity (p≤0.006) compared to the toric SCL; however, no significant difference was found between lens types for high-contrast acuity (p=0.10). In the spectacle wearers no significant differences in visual performance measurements were found between the patients' spectacles and the toric SCL (p≥0.06). Conclusion: The results show that RGP lenses provided superior visual performances and greater reduction of 3rd-order aberrations compared to toric SCL in this group of keratoconic patients. In the spectacle-wearing group, visual performance with the toric SCL was found to be comparable to that measured with spectacles. Nevertheless, with the exception of spherical aberration, the toric SCL were successful in significantly reducing uncorrected higher-order aberrations. Ophthalmic & Physiological Optics © 2012 The College of Optometrists.

Short- and long-term changes in corneal aberrations and axial length induced by orthokeratology in children are not correlated

PURPOSE: To assess the correlation between changes in corneal aberrations and the 2-year change in axial length in children fitted with orthokeratology (OK) contact lenses. METHODS: Thirty-one subjects 6 to 12 years of age and with myopia −0.75 to −4.00DS and astigmatism ≤1.00DC were fitted with OK. Measurements of axial length and corneal topography were taken at regular intervals over a 2-year period. Corneal topography at baseline and after 3 and 24 months of OK lens wear was used to derive higher-order corneal aberrations (HOA) that were correlated with OK-induced axial length changes at 2 years. RESULTS: Significant changes in C3, C4, C4, root mean square (RMS) secondary astigmatism and fourth and total HOA were found with both 3 and 24 months of OK lens wear in comparison with baseline (all P0.05). Coma angle of orientation changed significantly pre-OK in comparison with 3 and 24 months post-OK as well as secondary astigmatism angle of orientation pre-OK in comparison with 24 months post-OK (all P0.05). DISCUSSION: Short-term and long-term OK lens wear induces significant changes in corneal aberrations that are not significantly correlated with changes in axial elongation after 2-years.

Data compilation on the biological response to ocean acidification: environmental and experimental context of data sets and related literature

The exponential growth of studies on the biological response to ocean acidification over the last few decades has generated a large amount of data. To facilitate data comparison, a data compilation hosted at the data publisher PANGAEA was initiated in 2008 and is updated on a regular basis (doi:10.1594/PANGAEA.149999). By January 2015, a total of 581 data sets (over 4 000 000 data points) from 539 papers had been archived. Here we present the developments of this data compilation five years since its first description by Nisumaa et al. (2010). Most of study sites from which data archived are still in the Northern Hemisphere and the number of archived data from studies from the Southern Hemisphere and polar oceans are still relatively low. Data from 60 studies that investigated the response of a mix of organisms or natural communities were all added after 2010, indicating a welcomed shift from the study of individual organisms to communities and ecosystems. The initial imbalance of considerably more data archived on calcification and primary production than on other processes has improved. There is also a clear tendency towards more data archived from multifactorial studies after 2010. For easier and more effective access to ocean acidification data, the ocean acidification community is strongly encouraged to contribute to the data archiving effort, and help develop standard vocabularies describing the variables and define best practices for archiving ocean acidification data.

Análisis mediante acelerometría del patrón locomotor, tras la administración de morfina con o sin acepromacina, en el caballo

Los opiáceos producen una serie de efectos farmacológicos en los caballos entre los cuales destaca la analgesia, ejercida principalmente sobre el sistema nervioso central. No obstante, también producen otros efectos no deseados como son sedación, excitación, depresión cardio-respiratoria, disminución de la motilidad gastrointestinal, aumento de la actividad motora, leve hipertermia y, en dosis crecientes, sueño profundo y coma. El representante principal de este grupo farmacológico es la morfina, la cual ejerce un efecto analgésico muy potente en esta especie animal, haciendo que su uso sea de gran interés en la clínica equina. Actualmente, uno de los usos clínicos más interesantes de la morfina es el tratamiento del dolor ortopédico severo en el caballo. Sin embargo, el principal inconveniente es que la morfina también da lugar a las reacciones adversas generales de los opiáceos destacando las producidas sobre la actividad motora (marcha compulsiva), por lo que su uso estaría contraindicado en animales con problemas músculo esqueléticos que requieran guardar reposo. Estos efectos adversos indeseados, así como la ausencia relativa de evidencia con respecto a la producción de analgesia en caballos con enfermedades que se producen de manera natural hacen que su utilización sea más limitada y exista controversia en lo que respecta a su eficacia y uso clínico. Para controlar o prevenir los efectos indeseados de los opiáceos, éstos se pueden administrar dentro de un protocolo de neuroleptoanalgesia, es decir, administrar de manera conjunta un neuroléptico (tranquilizante o sedante) y un analgésico opioide. Esta combinación farmacológica permite reducir la excitación que producen los opiáceos, por lo que supone una buena alternativa en aquellos pacientes que requieran un efecto analgésico potente y en los que queramos evitar el riesgo que suponen algunos efectos adversos de los opiáceos...

Le délirium aux soins intensifs : identification de facteurs de risque et de conséquences pour les patients

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Peripheral refraction validity of the Shin-Nippon SRW5000 autorefractor

PURPOSE: To investigate the operation of the Shin-Nippon/Grand Seiko autorefractor and whether higher-order aberrations affect its peripheral refraction measurements. METHODS: Information on instrument design, together with parameters and equations used to obtain refraction, was obtained from a patent. A model eye simulating the operating principles was tested with an optical design program. Effects of induced defocus and astigmatism on the retinal image were used to calibrate the model eye to match the patent equations. Coma and trefoil were added to assess their effects on the image. Peripheral refraction of a physical model eye was measured along four visual field meridians with the Shin-Nippon/Grand Seiko autorefractor SRW-5000 and a Hartmann-Shack aberrometer, and simulated autorefractor peripheral refraction was derived using the Zernike coefficients from the aberrometer. RESULTS: In simulation, the autorefractor's square image was changed in size by defocus, into rectangles or parallelograms by astigmatism, and into irregular shapes by coma and trefoil. In the presence of 1.0 D oblique astigmatism, errors in refraction were proportional to the higher-order aberrations, with up to 0.8 D sphere and 1.5 D cylinder for ±0.6 μm of coma or trefoil coefficients with a 5-mm-diameter pupil. For the physical model eye, refraction with the aberrometer was similar in all visual field meridians, but refraction with the autorefractor changed more quickly along one oblique meridian and less quickly along the other oblique meridian than along the horizontal and vertical meridians. Simulations predicted that higher-order aberrations would affect refraction in oblique meridians, and this was supported by the experimental measurements with the physical model eye. CONCLUSIONS: The autorefractor's peripheral refraction measurements are valid for horizontal and vertical field meridians, but not for oblique field meridians. Similar instruments must be validated before being adopted outside their design scope.

Le délirium aux soins intensifs : identification de facteurs de risque et de conséquences pour les patients

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Seawater carbonate chemistry and calcification rate of the corals Oculina patagonica and Cladocora caespitosa in a laboratory experiment

In recent years, some of the ramifications of the ocean acidification problematic derived from the anthropogenic rising of atmospheric CO2 have been widely studied. In particular, the potential effects of a lowering pH on tropical coral reefs have received special attention. However, only a few studies have focused on testing the effects of ocean acidification in corals from the Mediterranean Sea, despite the fact that this basin is especially sensitive to increasing atmospheric CO2. In this context, we investigated the response to ocean acidification of the two zooxanthellate coral species capable of constituting the main framework of the community, the endemic Cladocora caespitosa and the non-native Oculina patagonica. To this end, we examined the response of both species to pCO2 concentrations expected by the end of the century, 800 ppm, vs the present levels. Calcification rate measurements after 92 days of exposure to low pH conditions showed the same negative response in both species, a decrease of 32-35% compared to corals reared under control conditions. In addition, we detected in both species a correlation between the calcification rate of colonies in control conditions and the degree of impairment of the same colonies at low pH. Independent of species, faster growing colonies were more affected by decreased pH. After this period of decreased pH, we conducted a recovery experiment, in which corals reared in the acidic treatment were brought back to control conditions. In this case, normal calcification rates were reached in both species. Overall, our results suggest that O. patagonica and C. caespitosa will both be affected detrimentally by progressive ocean acidification in the near future. They do not display differences in response between native and non-native species but do manifest differential responses depending on calcification rate, pointing to a role of the coral genetics in determining the response of corals to ocean acidification.

"A noite branca", between the Documentary and Fictional: the Silenced Account of the Blue Division

The article explores the ambiguous phenomenological status of the novel A noite branca (The White Night) by Francisco Fernández Naval, published in Galician in 2012. This ambiguity is produced by the discursive hybridity of the novel and by the vague ontological status of facts narrated and by several characters. The clarification of the strategies of the said ambiguity, and the originality of the subject, in the whole of Galician narrative about the memory of Civil War and Postwar can tightly evaluate the literary merits of the novel.

Reassembled, Slightly Askew:Composition & Sound Design

Reassembled, Slightly Askew is an autobiographical, immersive audio-based artwork based on Shannon Sickels’ experience of falling critically ill with a rare brain infection and her journey of rehabilitation with an acquired brain injury. Audience members experience Reassembled individually, listening to the audio via headphones while lying on a bed. The piece makes use of binaural microphone technology and spatial sound design techniques, causing listeners to feel they are inside Shannon’s head, viscerally experiencing her descent into coma, brain surgeries, early days in the hospital, and re-integration into the world with a hidden disability. It is a new kind of storytelling, never done before about this topic, that places the listener safely in the first-person perspective with the aim of increasing empathy and understanding. Reassembled… was made through a 5-year collaboration with an interdisciplinary team of artists led by Shannon Sickels (writer & performer), Paul Stapleton (composer & sound designer), Anna Newell (director), Hanna Slattne (dramaturgy), Stevie Prickett (choreography), and Shannon’s consultant neurosurgeon and head injury nurse. It’s development and production has been made possible with the support of a Wellcome Trust Arts Award, the Arts Council NI, Sonic Arts Research Centre, Belfast's Metropolitan Arts Centre, and grants from the Arts & Disability Award Ireland scheme. In its 2015 premiere year, Reassembled had 99 shows across Northern Ireland, including at the Cathedral Quarter Arts Festival (the MAC, Belfast) and BOUNCE Arts & Disability Forum Festival (Lyric Theatre, Belfast). It was awarded 5 stars in the Stage, a Hospital Club h100 Theatre & Performance Award, and been shared at medical conferences and trainings across the UK. It continues to be presented in diverse artistic and educational contexts, including as part of A Nation’s Theatre Festival in 2016 at Battersea Arts Centre in London where it was given 4 star reviews in the Guardian, Time Out London and the Evening Standard. "A real-life ordeal, captured by a daring, disorientating artistic collaboration, which works brilliantly on so many levels…It should be available on prescription.” — The Stage ★★★★★ www.reassembled.co.uk Audio clips and documentary footage available here: http://www.paulstapleton.net/portfolio/reassembled-slightly-askew

Análise microestrutural de misturas cerâmicas de grês porcelanato com adição de chamote de telhas cerâmicas

MELO, Maxymme Mendes de ; PINHEIRO, Andrea Santos ; NASCIMENTO, R. M. ; MARTINELLI, Antonio Eduardo ; DUTRA, Ricardo Peixoto Suassuna ; MELO, Marcus Antônio de Freitas . Análise microestrutural de misturas cerâmicas de grês Porcelanato com adição de chamote de telhas cerâmicas. Cerâmica (São Paulo. Impresso), v. 55, p. 356-364, 2009

Análise microestrutural de misturas cerâmicas de grês porcelanato com adição de chamote de telhas cerâmicas

MELO, Maxymme Mendes de ; PINHEIRO, Andrea Santos ; NASCIMENTO, R. M. ; MARTINELLI, Antonio Eduardo ; DUTRA, Ricardo Peixoto Suassuna ; MELO, Marcus Antônio de Freitas . Análise microestrutural de misturas cerâmicas de grês Porcelanato com adição de chamote de telhas cerâmicas. Cerâmica (São Paulo. Impresso), v. 55, p. 356-364, 2009

An Unusual Case of Cerebral Oedema

Hereditary angioedema (HAE) is a rare genetic disorder transmitted as an autosomal dominant trait, characterized by reduced plasma concentration or by the presence of non-functional C1 esterase inhibitor. Oedema caused by HAE mostly affects the skin and bowel and can induce swelling of genitalia. Oedema can be life threatening if it causes swelling of the larynx with obstruction of the airways. We describe the case of a 52-year-old man who presented a neurological emergency (coma), where the remarkable localization of the clinical manifestation and the unusual symptomatology hindered the correct diagnosis.