Contact lens use after contact lens-associated infectious ulcers

Purpose: The purpose of this study was to evaluate the outcome of patients with healed moderate to severe contact lens-associated corneal infectious ulcers who were re-fit with contact lenses. Methods: We retrospectively studied patients who were fit with contact lenses on our service and who had had moderate to severe corneal infectious ulcers associated with previous contact lens use. Six patients were included in the study. Results: Gas permeable contact lenses were fit in five patients, and a soft contact lens was fit in one patient. Successful fit was achieved in all cases and visual acuities were equal to or better than 20/30 in all patients. No significant complications were observed after a mean follow-up of 23 months (range, 6-45 months). Conclusion: In this small series of patients with a history of moderate to severe contact-lens related infectious keratitis, no complications were observed after contact lenses were refit. Contact lens wear in patients with a history of infectious keratitis may be safe and useful in order to achieve visual rehabilitation.

'The performative surprise': parody, documentary and critique

Can parody help us to 're-imagine' the organizations and institutions we live with (Du Gay 2007, 13)? Or, like many forms of critique, does parody risk being incorporated: becoming part of the power it aims to make fun of? In this paper, drawing on Judith Butler's work, I argue that certain circumstances enable parody to destabilize hegemonic, taken-for-granted institutions (Butler 1990). I explore these ideas through a reading of the Yes Men documentary (Tartan Video 2005). This film features a series of humorous representations of the World Trade Organization (WTO). I show how these act to denaturalize and effectively critique this dominant force in global trade. This paper discusses the value of parody for helping us to re-think and re-make particular institutions and organizations. In doing so, I point to the importance of creating a spectacle in which parody can travel beyond its immediate location, so that it can reach ever newer audiences with its 'performative surprise' (Butler 1990, xxvi). I suggest that the rise of the Internet and inexpensive documentary techniques offer interesting new ways for achieving this.

Non-Acanthamoeba amebic keratitis

Purpose. To describe the clinical presentation and outcome of two cases with presumed non-Acanthamoeba amebic keratitis. Methods. Case reports. Results. Both patients presented with typical symptoms and signs of Acanthamoeba keratitis. The patients' soft contact lenses, lens cases, open solutions, and conjunctival samples were cultured. Diagnosis of non- Acanthamoeba amebic keratitis was based on the presence of keratitis and amebic growth from patients' contact lenses of the affected eyes. Amebic culture from the contralateral contact lens was negative. Vahlkampfia cysts were identified in case 1, and Naegleria cysts in case 2. Topical treatment with polyhexamethylene biguanide and propamidine resolved the keratitis in case 1. Case 2 was lost to follow-up. Conclusion. Non-Acanthamoeba amebic keratitis was diagnosed in two patients based on the clinical presentation (resembling Acanthamoeba keratitis), culture of the contact lens, and response to antiamebic treatment (in one case). Keratitis associated with Naegleria contamination of contact lenses has not been previously reported.

Successful medical treatment of Acanthamoeba keratitis

Purpose: To describe the outcome of a series of Acanthamoeba keratitis treated with a similar regimen. Methods: All cases diagnosed with Acanthamoeba keratitis in a referral centre from June 1994 through June 1997 were included. Diagnosis of Acanthamoeba keratitis was based in clinical presentation and laboratory results. Positive laboratory identification of Acanthamoeba from corneal scraping or contact lens was required, unless the patient had very characteristic symptoms (severe pain) and signs of the infection, including perineural infiltrates. Initial intensive treatment included topical polyhexamethylene biguanide (PHMB) 0.02%, propamidine isothionate 0.1% and broad-spectrum antibiotics. The treatment was gradually tapered. After documented response to anti-acanthamoeba therapy, topical steroids were introduced; they were discontinued before cessation of the antiAcanthamoeba regimen. Results: Six males and four females, with a mean age of 30.0 ± 7.4 years were included in this study. All cases weared contact lenses. On presentation all cases had severe pain, and epitheliopathy was associated with stromal infiltrate in most (seven of ten) cases. Four patients had anterior uveitis. Perineural infiltrates were present in three cases and ring infiltrate in one patient. Anti-amoebic treatment was started 12.7 ± 7.2 days after beginning of symptoms. The clinical response to therapy was very satisfactory in all patients. Within two to three weeks all patients had remarkable lessening of pain and photophobia, and improvement of clinical signs. At two to three months, visual acuity had improved in all patients. Two patients required penetrating keratoplasty for visual rehabilitation. Conclusion: The use of PHMB and propamidine cured all cases of Acanthamoeba keratitis. Cautious introduction of steroids was associated with expedited resolution of inflammation and provided symptomatic relief.

MALTS: A Tool to Simulate Lorentz Transmission Electron Microscopy From Micromagnetic Simulations

Here we describe the development of the MALTS software which is a generalized tool that simulates Lorentz Transmission Electron Microscopy (LTEM) contrast of magnetic nanostructures. Complex magnetic nanostructures typically have multiple stable domain structures. MALTS works in conjunction with the open access micromagnetic software Object Oriented Micromagnetic Framework or MuMax. Magnetically stable trial magnetization states of the object of interest are input into MALTS and simulated LTEM images are output. MALTS computes the magnetic and electric phases accrued by the transmitted electrons via the Aharonov-Bohm expressions. Transfer and envelope functions are used to simulate the progression of the electron wave through the microscope lenses. The final contrast image due to these effects is determined by Fourier Optics. Similar approaches have been used previously for simulations of specific cases of LTEM contrast. The novelty here is the integration with micromagnetic codes via a simple user interface enabling the computation of the contrast from any structure. The output from MALTS is in good agreement with both experimental data and published LTEM simulations. A widely-available generalized code for the analysis of Lorentz contrast is a much needed step towards the use of LTEM as a standardized laboratory technique.

Predictive Maintenance for Improved Sustainability - An Ion Beam Etch Endpoint Detection System Use Case

In modern semiconductor manufacturing facilities maintenance strategies are increasingly shifting from traditional preventive maintenance (PM) based approaches to more efficient and sustainable predictive maintenance (PdM) approaches. This paper describes the development of such an online PdM module for the endpoint detection system of an ion beam etch tool in semiconductor manufacturing. The developed system uses optical emission spectroscopy (OES) data from the endpoint detection system to estimate the RUL of lenses, a key detector component that degrades over time. Simulation studies for historical data for the use case demonstrate the effectiveness of the proposed PdM solution and the potential for improved sustainability that it affords.

Dublin’s ephemeral and imaginary architectures

In 1989, the Irish architectural practice O’Donnell and Tuomey were commissioned to build a temporary pavilion to represent Ireland at the 11 Cities/11 Nations exhibition at Leeuwarden in the Netherlands. Citing Peter Smithson, John Tuomey suggested the pavilion, which drew inspirations from the forms and materials of the modern Irish barn, embodied an intention ‘not just to build but to communicate’. Its subsequent reassembly for the inauguration of the Irish Museum of Modern Art in the courtyard of the seventeenth-century Royal Hospital Kilmainham in Dublin in 1991, drew comparisons between the urban sophistication of this colonial building, its svelte new refit, and the rural expression of O’Donnell + Tuomey’s barn. It was, one critic recently noted, as if ‘a wedding had been crashed by a country cousin who had forgotten to clean his boots’.
It has been argued that temporary or ephemeral pieces of architecture, unburdened by the traditional constraints of firmitas or utilitas, have the ability to offer a concise distillation of meaning and intention. Approaching the qualities of rhetoric, such architectures share similarities with the monument and yet differ in fundamental ways. Their rapid construction in lightweight materials can allow for an almost instantaneous negotiation of zeitgeist. And, unlike the monument, from the outset the space and form of these installations is designed to disappear.
This paper analyses the ephemeral architectures of Dublin in the modern period contextualising their qualities and intentions as they manifest themselves across colonial, post-colonial and contemporary epochs. It finds origins in the theatrical sets of the late eighteenth century and traces their movements into the semi-public sphere of the pleasure garden and finally into the theatre of the streets. It is here that temporary architecture in the city has been at its most potent, allowing the amplification or subversion of the meanings of much larger spaces. Historically, much of Dublin’s most conspicuous instances of ephemeral architecture have been realised as a means of articulating mass spectacle in political, religious or nationalistic events. And while much of this has sought to confirm dominant ideologies, it has also been possible to discern moments of opposition.
The contemporary period, however, has arguably witnessed a shift in ephemeral architectures from explicitly representing ‘positive ideologies’ towards something more oblique or nebulous. This turn towards abstraction in form and space has rendered an especially communicative form of architecture particularly elusive. By examining continuities within the apparent disjuncture between historical and contemporary examples, this paper begins to unpick the language of recent ephemeral architecture in Dublin and situate it within wider global trends where political and economic imperatives are often simultaneously obscured and expressed in public space by a vocabulary of universality. As Jurgen Habermas has suggested, the contemporary value given to the transitory and the ephemeral ‘discloses a longing for an undefiled, immaculate and stable present’.

Law's Ethical, Global and Theoretical Contexts: Essays in Honour of William Twining

Law's Ethical, Global and Theoretical Contexts examines William Twining's principal contributions to law and jurisprudence in the context of three issues which will receive significant scholarly attention over the coming decades. Part I explores human rights, including torture, the role of evidence in human rights cases, the emerging discourse on 'traditional values', the relevance of 'Southern voices' to human rights debates, and the relationship between human rights and peace agreements. Part II assesses the impact of globalization through the lenses of sociology and comparative constitutionalism, and features an analysis of the development of pluralistic ideas of law in the context of privatization. Finally, Part III addresses issues of legal theory, including whether global legal pluralism needs a concept of law, the importance of context in legal interpretation, the effect of increasing digitalization on legal theory, and the utility of feminist and postmodern approaches to globalization and legal theory.

Characterization of x-ray lens for use in probing high energy density states of matter

By using polycapillary lenses to focus laser-produced x-ray sources to high intensities, an improvement in signal-to-noise ratio can be achieved. Here the He-alpha line emission produced by driving a titanium backlighter target is focused by a polycapillary lens and the output characterized. The x-ray spot is measured to have a peak intensity of 4.5 x 10(7) photons, with a total photon count of 8.8 x 10(8) in 0.13 +/- 0.01 mm(2). This setup is equivalent to placing the backlighter target 3 mm from the sample with a 600 mu m diameter pinhole. The polycapillary lens enables the placement of the backlighter target at a much larger distance from the sample to be studied and therefore has the ability to greatly improve the signal-to-noise ratio on detectors. We demonstrate this with two simple diffraction experiments using pyrolytic graphite and polycrystalline aluminium.

Representing Irishness in Belfast’s Gaeltacht Quarter

This paper examines a place-making project in post-conflict Belfast, analyzing efforts to transform an area which has often been used as a byword for militant Irish nationalism and social deprivation into an inclusive, vibrant tourist destination and cultural hub themed around the Irish language (called the "Gaeltacht Quarter‟). The antagonistic and territorial assumptions about place that characterize divided cities now co-exist with global trends towards the commodification of difference as recreation or spectacle, and longstanding struggles over the representation of contested identities are intertwined with the struggle to compete for international tourism and investment. The proliferation of officially themed quarters in many cities across the world reflects the enthusiasm with which planning authorities have embraced the vision of difference as a benign resource for the creation of tourist revenue. Yet, analysis of „quartering‟ processes reveals that such commodification does not neutralise or evade the political potency of naming, representing and delimiting cultural difference. Indeed, this paper argues that such projects offer a valuable insight into the inseparable roles of physical and representational space as both loci and catalysts of contestation in urban conflicts. Bringing together a wide range of public and private interest groups, projects redefining parts of Belfast as distinctive quarters have been explicitly linked with efforts to deterritorialize the city. The creation of bounded, themed spaces as an attempt to leave behind the ethno-sectarian geographical segregation that parts of Belfast still experience has its particular ironies, but is in many ways typical of contemporary trends in urban planning. The Gaeltacht Quarter exemplifies both the importance and the challenge of representation within cities where culturally distinguishing features have acted as markers of violent division, and where negotiations about how to successfully encompass difference necessarily address multiple local and international audiences simultaneously.

Impact of Free Glasses and a Teacher Incentive on Children's Use of Eyeglasses: A Cluster-Randomized Controlled Trial.

Purpose: To study the effect of free glasses combined with teacher incentives on in-school glasses wear among Chinese urban migrant children. Design: Cluster-randomized controlled trial. Methods: Children with VA <= 6/12 in either eye due to refractive error in 94 randomly-chosen primary schools underwent randomization by school to receive free glasses, education on their use and a teacher incentive (Intervention), or glasses prescriptions only (Control). Intervention group teachers received a tablet computer if >= 80% of children given glasses wore them during un-announced visits 6 weeks and 6 months (main outcome) after intervention. Results: Among 4376 children, 728 (16.7%, mean age 10.9 years, 51.0% boys) met enrollment criteria and were randomly allocated, 358 (49.2%, 47 schools) to Intervention and 370 (50.8%, 47 schools) to Control. Among these, 693 children (95.2%) completed the study and underwent analysis. Spectacle wear was significantly higher at 6 months among Intervention children (Observed [main outcome]: 68.3% versus 23.9%, Adjusted Odds Ratio [OR]=11.5, 95% Confidence Interval [CI] 5.91-22.5, P<0.001; Self-reported: 90.6% versus 32.1%, OR = 43.7, 95% CI = 21.7-88.5, P < 0.001). Other predictors of observed wear at 6 months included baseline spectacle wear (P<0.001), uncorrected VA<6/18 (P=0.01) and parental spectacle wear (P=0.02). The 6-month observed wear rate was only 41% among similar-aged children provided free glasses in our previous trial without teacher incentives. Conclusions: Free spectacles and teacher incentives maintain classroom wear in the large majority of children needing glasses over a school year. Low wear among Control children demonstrates the need for interventions.

Dublin 1916: theatre of revolt

At Easter 1916, Dublin city centre was one of a series of sites throughout Ireland where a rebellion was staged against British rule. It was a strategic failure, swiftly crushed by superior British forces. The event, however, subsequently took a central role in the mythology of modern Ireland.

The first visual representations were of the conflict’s aftermath: photographic journeys through landscapes of ruin. From the distance of the camera, we see none of the pockmarks of shell bursts, nor the etchings of machine guns. Instead, traces of life in the city seem to have been swept aside by an unseen hand: the passing of millennia or a violent action of nature. Architecture alone has witnessed and recorded its presence. Amongst the fragments, the shell of the General Post Office (G.P.O.) in Sackville Street is one of the few buildings still wholly recognizable. The remnants of its classical form, portico and pediment, columns and entablature seem to transcend its prosaic modern functions and allude to something more ancient. The bewilderment of city’s inhabitants is also recorded. Dubliners have become inquisitive tourists in streets which hitherto were the locus of everyday life. They wander around aimlessly in a landscape as alien and picturesque as Pompeii. This shift in perception was captured by the Irish poet W.B. Yeats who hinted that Dublin, purged of modern commercialism had transcended its petty inadequacies to revive a slumbering heroic past.

‘I have met them at the close of day
Coming with vivid faces
From counter or desk among grey
Eighteenth-century houses [.]’
All is changed, changed utterly:
A terrible beauty is born.’

His comments were prescient. Initially unpopular, the republican leaders, executed by the British, slowly became recast as heroic martyrs. Similarly, the spaces where their heroism was forged became venerated. The G.P.O. and Sackville Street, however, already had a republican history. It was originally conceived in the eighteenth century as part of a series of magnificent urban spaces to provide an arena of spectacle and self-celebration for the colonial Anglo-Irish and their vision of a Protestant republic. O’Connell/Sackville Street became the temporal, geographical and mythical hinge upon which two different versions of Irish republicanism waxed and waned. Its recasting after independence as a space of Catholic Nationalism bore testimony to its consistency in providing a backdrop for the production of ritual and myth. In the 1920s and 30s, as the nascent country, beset with economic stagnation and political tensions, turned to spectacle as a salve for it social problems, O’Connell Street and the G.P.O. provided its most sacred sites. Within the introduction of new myths, however, individual as well as national identities were created and consolidated. The emerging identity of modern Ireland became inextricably linked with that of one ambitious politician. His uses of the G.P.O. in particular revealed a perceptive understanding of the political uses of classical architecture and urban space.

Effect of providing free glasses on children's educational outcomes in China: cluster randomized controlled trial

Objective: To assess the effect of provision of free glasses on academic performance in rural Chinese children with myopia. Design: Cluster randomized, investigator masked, controlled trial.Setting 252 primary schools in two prefectures in western China, 2012-13. Participants: 3177 of 19 934 children in fourth and fifth grades (mean age 10.5 years) with visual acuity <6/12 in either eye without glasses correctable to >6/12 with glasses. 3052 (96.0%) completed the study.Interventions Children were randomized by school (84 schools per arm) to one of three interventions at the beginning of the school year: prescription for glasses only (control group), vouchers for free glasses at a local facility, or free glasses provided in class. Main outcome measures: Spectacle wear at endline examination and end of year score on a specially designed mathematics test, adjusted for baseline score and expressed in standard deviations. Results: Among 3177 eligible children, 1036 (32.6%) were randomized to control, 988 (31.1%) to vouchers, and 1153 (36.3%) to free glasses in class. All eligible children would benefit from glasses, but only 15% wore them at baseline. At closeout glasses wear was 41% (observed) and 68% (self reported) in the free glasses group, and 26% (observed) and 37% (self reported) in the controls. Effect on test score was 0.11 SD (95% confidence interval 0.01 to 0.21) when the free glasses group was compared with the control group. The adjusted effect of providing free glasses (0.10, 0.002 to 0.19) was greater than parental education (0.03, −0.04 to 0.09) or family wealth (0.01, −0.06 to 0.08). This difference between groups was significant, but was smaller than the prespecified 0.20 SD difference that the study was powered to detect. Conclusions: The provision of free glasses to Chinese children with myopia improves children’s performance on mathematics testing to a statistically significant degree, despite imperfect compliance, although the observed difference between groups was smaller than the study was originally designed to detect. Myopia is common and rarely corrected in this setting. Trial Registration: Current Controlled Trials ISRCTN03252665.

The effect of pantethine and ultraviolet-B radiation on the development of lenticular opacity in the emory mouse.

PURPOSE: Few studies have examined the impact of long-term treatments or exposures on the development of cataract in maturity-onset animal models. We studied the effect of treatment with D-pantethine and exposure to ultraviolet-B (UVB) radiation on the development of lenticular opacity in the Emory mouse. METHODS: A total of 164 Emory mice were randomized by litter at weaning to exposure to UVB light at 12 mJ/cm(2) for 6 hr/day (UV) or usual room light (A), and within litter, were further randomized to bi-weekly intra-peritoneal injections of 0.8 g/kg pantethine (T) or no treatment (C). Retro illumination lens photos were taken at 2, 4, 6, 8, and 10 months after weaning, and graded in masked fashion. The animals were sacrificed at 10 months and the lenses analyzed for total pantethine and total cysteamine. RESULTS: Lens pantethine and cysteamine levels were significantly (P < 0.001) higher for the T as compared to C litters. Mean cataract grade increased monotonically over time for all four groups. Unadjusted mean grade for the AT group at 8 (1.32) and 10 (1.86) months appeared lower than for the other groups (AC: 2.17, 2.39; UVC: 1.77, 2.40; UVT: 1.88, 2.37). However, the mean grade for the pantethine-treated litters did not differ significantly from the untreated litters except at 2 months (when untreated litters had significantly lower grades), when adjusting for UV treatment, gender and litter effect. No significant difference in cataract score existed between UV-exposed and ambient litters. Mortality was higher among pantethine-treated (hazard ratio = 1.8, p = 0.05) and UV-exposed animals (hazard ratio = 1.8, p = 0. 03) than among the untreated and unexposed litters. CONCLUSION: Significantly increased lens levels of pantethine are achieved with long-term intra-peritoneal dosing. The impact of pantethine on the progression of lenticular opacity in the Emory mouse is less than has been reported in other models. This level of chronic UVB exposure appeared to have no effect on the development of cataract in this model.

Rapid, objective detection of cataract-induced blur using a bull's eye photodetector.

PURPOSE: To determine whether optical aberrations caused by cataract can be detected and quantified objectively using a newly described focus detection system (FDS). SETTING: The Wilmer Opthalmological Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. METHODS: The FDS uses a bull's eye photodetector to measure the double-pass blur produced from a point source of light. To determine the range and level of focus, signals are measured with a series of trial lenses in the light path selected to span the point of best focus to generate focus curves. The best corrected visual acuity (BCVA), refractive error, lens photograph grades, and FDS signals were obtained in 18 patients scheduled to have cataract surgery. The tests were repeated 6 weeks after surgery. RESULTS: The mean FDS outcome measures improved after cataract surgery, with increased peak height (P=.001) and decreased peak width (P=.001). Improvement in signal strength (integral of signal within +/-1.5 diopters of the point of best focus) strongly correlated with improvement in peak height (R(2)=.88, P<.0001) and photographic cataract grade (R(2)=.72, P<.0001). The mean BCVA improved from 20/50 to 20/26 (P<.0001). The improvement in BCVA correlated more closely with FDS signal strength (R(2)=.44, P=.001) than with cataract grade (R(2)=.25, P=.06). CONCLUSIONS: Improvement in FDS outcome measures correlated with cataract severity and improvement in visual acuity. This objective approach may be useful in long-term studies of cataract progression.