Visual results with the use of prismatic lenses in the treatment of congenital nystagmus: a clinical case

Purpose: It is important to establish a differential diagnosis between the different types of nystagmus, in order to give the appropriate clinical approach to every situation and to improve visual acuity. The nystagmus is normally blocked when the eyes are positioned in a particular way. This makes the child adopt a posture of ocular torticollis that reduces the nistagmiformes movements, improving the vision in this position. A way to promote the blocking of the nystagmic movements is by using prismatic lenses with opposite bases, to block or minimize the oscillatory movements. This results in a vision improvement and it reduces the anomalous head position. There is limited research on the visual results in children with nystagmus after using prisms with opposing bases. Our aim is to describe the impact on the visual acuity (VA ) of theprescription prism lenses in a nystagmus patient starting at 3 months of age. Methods: Case report on thirty month old caucasian male infant, with normal growth and development for their age, with an early onset of horizontal nystagmus at 3 months of age. Ophthalmic examination included slit lamp examination, fundus, refractive study, electrophysiological and magnetic resonance tests, measurement of VA over time with the Teller Acuity Cards (TAC ) in the distance agreed for the age. At age ten months, the mother noted a persistent turn to the right of the child’s head, which became increasingly more severe along the months. There’s no oscillopcia. At 24 months, an atropine refraction showed the following refractive error: 0D.: -1,50, OS: -0,50 and prismatic lens adapting OD 8 Δ nasal base and OE 8 Δ temporal base. Results: Thirty month old child, with adequate development for their age, with onset of idiopatic horizontal nystagmus, at 3 months of age. Normal ocular fundus and magnetic ressoance without alterations, sub-normal results in electrophysiological tests and VA with values below normal for age. At 6 months OD 20/300; OE 20/400; OU 20/300. At 9 months OD 20/250; OE 20/300; OU 20/150 (TAC a 38 cm). At 18 months OD 20/200; OE 20/100; OU 20/80 (TAC at 38 cm), when the head is turned to the right and the eyes in levoversão, the nystagmus decreases in a “neutral” area. At 24 month, with the prismatic glasses, OD 20/200 OE 20/100, OU20/80 (TAC at 54 cm, reference value is 20/30 – 20/100 para OU e 20/40 – 20/100 monocular), there was an increase in the visual acuity. The child did visual stimulation with multimedia devices and using glasses. After adaptation of prisms: at 30 months VA (with Cambridge cards) OD e OE = 6/18. The child improved the VA and reduced the anomalous head position. There is also improvement in mobility and fine motricity. Conclusion: Prisms with opposing bases., were used in the treatment of idiopathic nystagmus. Said prisms were adapted to reduce the skewed position of the head, and to improve VA and binocular function. Monitoring of visual acuity and visual stimulation was done using electronic devices. Following the use of prismatic, the patient improved significantly VA and the anomalous head position was reduced.

Tracing the use of Communication Technologies in Higher Education

This chapter presents a comprehensive view of the main activities and findings of a research project entitled TRACER-Portuguese Public Higher Education Use of Communication Technologies, which focused on how the information about the use of Communication Technologies in Higher Education Institutions  can be collected, systematized, processed, and deployed to stakeholders. The project was carried out between 2011 and 2014 and its main results are a consolidated proposal of an analysis model to address the use of Communication Technologies in Higher Education institutions, as well as the U-TRACER® tool. This Web-based tool provides support to the process of collecting, processing, and deployment of data related with the use of Communication Technologies in a specific Higher Education or in a group of institutions, based on institutional or geographical criteria.

Use of closed systems in the Hospital Pharmacy

Objective: In the setting of the increasing use of closed systems for reconstitution and preparation of these drugs, we intend to analyze the correct use of these systems in the Hospital Pharmacy, with the objective to minimize the risks of exposure not only for those professionals directly involved, but also for all the staff in the unit, taking also into account efficiency criteria. Method: Since some systems protect against aerosol formation but not from vapours, we decided to review which cytostatics should be prepared using an awl with an air inlet valve, in order to implement a new working procedure. We reviewed the formulations available in our hospital, with the following criteria: method of administration, excipients, and potential hazard for the staff handling them. We measured the diameters of the vials. We selected drugs with Level 1 Risk and also those including alcohol-based excipients, which could generate vapours. Outcomes: Out of the 66 reviewed formulations, we concluded that 11 drugs should be reconstituted with this type of awl: busulfan, cabazitaxel, carmustine, cyclophosphamide, eribulin, etoposide, fotemustine, melphalan, paclitaxel, temsirolimus and thiotepa; these represented an 18% of the total volume of formulations. Conclusions: The selection of healthcare products must be done at the Hospital Pharmacy, because the use of a system with an air valve inlet only for those drugs selected led to an outcome of savings and a more efficient use of materials. In our experience, we confirmed that the use of the needle could only be avoided when the awl could adapt to the different formulations of cytostatics, and this is only possible when different types of awls are available. Besides, connections were only really closed when a single awl was used for each vial. The change in working methodology when handling these drugs, as a result of this study, will allow us to start different studies about environmental contamination as a future line of work.

Use of sulfuryl fluoride in the management of strongly phosphine-resistant insect pest populations in bulk grain storages in Australia

Sulfuryl fluoride (SF), an effective structural fumigant, is registered recently as Profume™ for controlling insect pests of stored grains and processed commodities. Information on its effectiveness in disinfestation of bulk grain, however, is limited. The ongoing problem with the strong level of resistance to phosphine has been addressed recently through deployment of SF as a ‘resistance breaker’ in bulk storages in Australia. This paper discusses important results on the efficacy of SF against key phosphine- resistant insect pests, lesser grain borer, Rhyzopertha dominca, red flour beetle, Tribolium castaneum, rice weevil, Sitophilus oryzae and the rusty grain beetle, Cryptolestes ferrugineus. We have established CT (g-hm3) profiles for SF against these insect pests at two temperature regimes 25 and 30°C, that showed that both temperature and exposure period (t) has significant influence on the effectiveness of SF than the concentration. Over a seven days fumigation period, CTs of 800 and 400 g-hm3 achieved complete control of all the target pests, including the most strongly phosphine - resistant species, C. ferrugineus at 25 and 30°C, respectively. Results from four industry scale field trials involving currently registered rate of SF (1500 g-hm3) over 2–14 d exposure period, confirmed its effectiveness in achieving complete control of the target pest species. The assessment of postfumigation grain samples across all the test storages indicated that the reinfestation occurs after three months. Monitoring resistance to phosphine in C. ferrugineus over a six year period (2009–2015), showed a significant reduction in resistant populations after the introduction of SF into the fumigation strategy at problematic storage sites. Overall our research concludes that SF is a good candidate to be used as a ‘resistance breaker’ where phosphine resistance is prevalent.

Use of business analysis in beef businesses to direct management practice change for climate adaptation outcomes

Beef businesses in northern Australia are facing increased pressure to be productive and profitable with challenges such as climate variability and poor financial performance over the past decade. Declining terms of trade, limited recent gains in on-farm productivity, low profit margins under current management systems and current climatic conditions will leave little capacity for businesses to absorb climate change-induced losses. In order to generate a whole-of-business focus towards management change, the Climate Clever Beef project in the Maranoa-Balonne region of Queensland trialled the use of business analysis with beef producers to improve financial literacy, provide a greater understanding of current business performance and initiate changes to current management practices. Demonstration properties were engaged and a systematic approach was used to assess current business performance, evaluate impacts of management changes on the business and to trial practices and promote successful outcomes to the wider industry. Focus was concentrated on improving financial literacy skills, understanding the business’ key performance indicators and modifying practices to improve both business productivity and profitability. To best achieve the desired outcomes, several extension models were employed: the ‘group facilitation/empowerment model’, the ‘individual consultant/mentor model’ and the ‘technology development model’. Providing producers with a whole-of-business approach and using business analysis in conjunction with on-farm trials and various extension methods proved to be a successful way to encourage producers in the region to adopt new practices into their business, in the areas of greatest impact. The areas targeted for development within businesses generally led to improvements in animal performance and grazing land management further improving the prospects for climate resilience.

The use of animal models in multiple myeloma

International audience

Requirements for the use of virtual worlds in corporate training : perspectives from the post-mortem of a corporate e-learning provider approach of Second Life and OpenSimulator

Between 2009 and 2011, a joint academia-industry effort took place to integrate Second Life and OpenSimulator platforms into a corporate elearning provider’s learning management platform. The process involved managers and lead developers at the provider and an academic engineering research team. We performed content analysis on the documents produced in this process, seeking data on the corporate perspective of requirements for virtual world platforms to be usable in everyday practice. In this paper, we present the requirements found in the documents, and detail how they emerged and evolved throughout the process.

Use of ordinal outcomes in vascular prevention trials: comparison with binary outcomes in published trials

Background and Purpose—Vascular prevention trials mostly count “yes/no” (binary) outcome events, eg, stroke/no stroke. Analysis of ordered categorical vascular events (eg, fatal stroke/nonfatal stroke/no stroke) is clinically relevant and could be more powerful statistically. Although this is not a novel idea in the statistical community, ordinal outcomes have not been applied to stroke prevention trials in the past. Methods—Summary data on stroke, myocardial infarction, combined vascular events, and bleeding were obtained by treatment group from published vascular prevention trials. Data were analyzed using 10 statistical approaches which allow comparison of 2 ordinal or binary treatment groups. The results for each statistical test for each trial were then compared using Friedman 2-way analysis of variance with multiple comparison procedures. Results—Across 85 trials (335 305 subjects) the test results differed substantially so that approaches which used the ordinal nature of stroke events (fatal/nonfatal/no stroke) were more efficient than those which combined the data to form 2 groups (P0.0001). The most efficient tests were bootstrapping the difference in mean rank, Mann–Whitney U test, and ordinal logistic regression; 4- and 5-level data were more efficient still. Similar findings were obtained for myocardial infarction, combined vascular outcomes, and bleeding. The findings were consistent across different types, designs and sizes of trial, and for the different types of intervention. Conclusions—When analyzing vascular events from prevention trials, statistical tests which use ordered categorical data are more efficient and are more likely to yield reliable results than binary tests. This approach gives additional information on treatment effects by severity of event and will allow trials to be smaller. (Stroke. 2008;39:000-000.)

Extended use of gamma irradiation in wild mushrooms conservation: validation of 2 kGy dose to preserve their chemical characteristics

Irradiation is recognized by international organizations as a conservation technology, and its application to wild mushrooms has been tested in some species. Our research group evaluated the effectiveness of gamma irradiation to conserve different samples of highly appreciated species, particularly, Lactarius deliciosus, Macrolepiota procera, Boletus edulis and Hydnum repandum. From those results and considering also international recommendations on this subject, the 2 kGy dose was chosen for further studies. Therefore, the application of gamma irradiation at 2 kGy dose was extended to Boletus pinophilus Pilát & Dermek and Clitocybe subconnexa Murrill to validate the proposed technology. Considering the obtained results, some of the analysed chemical parameters (specially sugars and fatty acids), as well as the antioxidant activity, showed significant changes after irradiation treatment, particularly in B. pinophillus, probably due to its higher water content. Nevertheless, the obtained differences did not seem to be sufficient to change the organoleptic characteristics of these mushrooms. Furthermore, the antioxidant activity was generally higher in irradiated samples. In conclusion, the detected chemical changes might be considered as acceptable, when considering the high advantages of gamma irradiation at decontamination and/or disinfestation level.

The Use of Cryogenic Air in Supplied Air Respiratory Protection

The Mine Improvement and New Emergency Response (MINER) Act of 2006 implemented new regulations in the underground coal mining industry that allow for the certification of non-compressed gas equipment for respiratory protection in underground coal mines. NASA’s Kennedy Space Center (KSC) Biomedical Research and Engineering Laboratory (BRL) is investigating the potential to expand cryogenic air supply systems into the mining and general industries. These investigations have, so far, resulted in four separate comparison and hardware development programs. The Propellant Handlers Ensemble (PHE) and Level “A” Ensemble Comparison (LAE): This study compared worker thermal stress while using the industry standard Level A hazardous material handling ensemble as opposed to using the similarly protective Propellant Handler’s Ensemble (PHE) that utilizes a cryogenic air supply pack, known as an Environmental Control Unit (ECU) as opposed to the compressed air Self Contained Breathing Apparatus (SCBA) used in the LAE. The research found that, in a 102°F environment, test subjects experienced significantly decreased body temperature increases, significantly decreased heart rate increases, and decreased sweat loss while performing a standard work routine while using the PHE, compared to the same test subjects performing the same routine while using the LAE. The Cryogenic Refuge Alternative Supply System (CryoRASS) project: The MINER Act of 2006 requires the operators of underground coal mines to provide refuge alternatives that can provide a safe atmosphere for workers for up to 96 hours in the event of a mine emergency. The CryoRASS project retrofitted an existing refuge chamber with a liquid air supply instead of the standard compressed air supply system and performed a 96 hour test. The CryoRASS system demonstrated that it provided a larger air supply in a significantly smaller footprint area, provided humidity and temperature control, and maintained acceptable oxygen and carbon dioxide levels in the chamber for the required amount of time. SCBA and Mine Rescue System (CryoBA/CryoASFS) Another requirement of the MINER Act is that additional emergency breathing equipment must be staged along evacuation routes to supplement the Self Contained/Self Rescue (SCSR) devices that are now required. The BRL has developed an SCBA known as the Cryogenic Breathing Apparatus (CryoBA), that has the ability to provide 2 hours of breathing air, a refill capability, and some cooling for the user. Cryogenic Air Storage and Filling Stations (CryoASFS) would be positioned in critical areas to extend evacuation time. The CryoASFS stations have a significantly smaller footprint and larger air storage capacity to similar compressed air systems. The CryoBA pack is currently undergoing NIOSH certification testing. Technical challenges associated with liquid breathing air systems: Research done by the BRL has also addressed three major technical challenges involved with the widespread use of liquid breathing air. The BRL developed a storage Dewar fitted with a Cryorefrigerator that has stored liquid air for four months with no appreciable oxygen enrichment due to differential evaporation. Testing of liquid breathing air was material and time intensive. A BRL contract developed a system that only required 1 liter of air and five minutes of time compared to the 10 liters of air and 75 minutes of time required by the old method. The BRL also developed a simple and cost effective method of manufacturing liquid air that joins a liquid oxygen tanker with a liquid nitrogen tanker through an orifice controlled “Y” fitting, mixing the two components, and depositing the mixed breathing air in a separate tanker.

Researching the Use of Communication Technologies in Higher Education Institutions in Portugal

This paper describes a research which main purpose was identifying and characterizing the use of Communication Technologies by Portuguese Public Higher Education Institutions to support learning activities. An analysis model was created and used to develop a nationwide online survey used to collect data from students, teachers and institutional managers. The results show that institutional policies and resources are in place and being used to support learning; learning management systems and interpersonal communication technologies are intensely used and widely adopted; and that there are gender differences as far as the students' use of Communication Technologies is concerned. The results of this project provide a useful insight on the use of Communication Technologies by Portuguese Public Higher Education Institutions and give valuable information for ongoing decision making processes regarding the institutional adoption and development of learning models that take advantage of these technologies.

Quarantine facilities and legal issues of the use of biocontrol agents in Brazil.

The objective of this work was to address the classical biological control of pests in Brazil, regarding procedures to import and export native biological material. A brief introduction will be given on the current legal issues on the use of biocontrol agents, as well as some considerations on the existing quarantine pests and actions already carried out in the country. The safety in the introduction of exotic organisms is important for Brazilian phytosanitary defense and for a higher adoption of classical biocontrol, making it available for integrated pest management (IPM). Legal and normative aspects establish the procedures that must to be adopted, not only to protect bioprospecting and native organisms, but also to minimize risks to the national genetic patrimony associated with the introduction of exotic organisms. Furthermore, the import/export procedures adopted for vegetal and useful organisms for pest biological control and for other genetic material must be subjected to phytosanitary measures performed in government?certified quarantine facilities and diagnostic laboratories. Finally, the quarantine activities listed here are strategic for safeguarding the country from potential problems arising from border transit of living organisms.