Higher-order aberrations in amblyopia:an analysis of pre- and post-wavefront-guided laser refractive correction

For more than a century it has been known that the eye is not a perfect optical system, but rather a system that suffers from aberrations beyond conventional prescriptive descriptions of defocus and astigmatism. Whereas traditional refraction attempts to describe the error of the eye with only two parameters, namely sphere and cylinder, measurements of wavefront aberrations depict the optical error with many more parameters. What remains questionable is the impact these additional parameters have on visual function. Some authors have argued that higher-order aberrations have a considerable effect on visual function and in certain cases this effect is significant enough to induce amblyopia. This has been referred to as ‘higher-order aberration-associated amblyopia’. In such cases, correction of higher-order aberrations would not restore visual function. Others have reported that patients with binocular asymmetric aberrations display an associated unilateral decrease in visual acuity and, if the decline in acuity results from the aberrations alone, such subjects may have been erroneously diagnosed as amblyopes. In these cases, correction of higher-order aberrations would restore visual function. This refractive entity has been termed ‘aberropia’. In order to investigate these hypotheses, the distribution of higher-order aberrations in strabismic, anisometropic and idiopathic amblyopes, and in a group of visual normals, was analysed both before and after wavefront-guided laser refractive correction. The results show: (i) there is no significant asymmetry in higher-order aberrations between amblyopic and fixing eyes prior to laser refractive treatment; (ii) the mean magnitude of higher-order aberrations is similar within the amblyopic and visually normal populations; (iii) a significant improvement in visual acuity can be realised for adult amblyopic patients utilising wavefront-guided laser refractive surgery and a modest increase in contrast sensitivity was observed for the amblyopic eye of anisometropes following treatment (iv) an overall trend towards increased higher-order aberrations following wavefront-guided laser refractive treatment was observed for both visually normal and amblyopic eyes. In conclusion, while the data do not provide any direct evidence for the concepts of either ‘aberropia’ or ‘higher-order aberration-associated amblyopia’, it is clear that gains in visual acuity and contrast sensitivity may be realised following laser refractive treatment of the amblyopic adult eye. Possible mechanisms by which these gains are realised are discussed.

Variation in carotenoid content of kale and other vegetables:a review of pre- and post-harvest effects

Lutein and zeaxanthin are carotenoids that are selectively taken up into the macula of the eye, where they are thought to protect against the development of age-related macular degeneration. They are obtained from dietary sources, with the highest concentrations found in dark green leafy vegetables, such as kale and spinach. In this Review, compositional variations due to variety/cultivar, stage of maturity, climate or season, farming practice, storage, and processing effects are highlighted. Only data from studies which report on lutein and zeaxanthin content in foods are reported. The main focus is kale; however, other predominantly xanthophyll containing vegetables such as spinach and broccoli are included. A small amount of data about exotic fruits is also referenced for comparison. The qualitative and quantitative composition of carotenoids in fruits and vegetables is known to vary with multiple factors. In kale, lutein and zeaxanthin levels are affected by pre-harvest effects such as maturity, climate, and farming practice. Further research is needed to determine the post-harvest processing and storage effects of lutein and zeaxanthin in kale; this will enable precise suggestions for increasing retinal levels of these nutrients.

Resident’s Perceptions on Impacts of Hosting the Guimaraes 2012 European Capital of Culture: Comparisons of the Pre- and Post Periods

Residents tend to have high expectations regarding the benefits of hosting a mega- event, in particular the creation of new infrastructure, growth in GDP and employ- ment, image enhancement and the spin-offs of attracting tourists and fostering sustainable growth of the cultural supply (Jeong and Faulkner 1996; Deccio and Baloglu 2002; Gursoy and Kendall 2006; Getz 2008; Langen and Garcia 2009; Ritchie et al. 2009; Gursoy et al. 2011; Palonen 2011). Nevertheless, they normally recognise that some costs will be incurred (Kim and Petrick 2005; Kim et al. 2006; Ritchie et al. 2009; Gursoy et al. 2011; Lee et al. 2013). So, it was not surprising that the nomination of Guimaraes, a small city in the northwest of Portugal, as one of the two European Capitals of Culture in 2012 (2012 ECOC), had raised great expectations in the local community vis- a-vis its socio-economic and cultural benefits. Our research was designed to examine the Guimar~aes residents’ perceptions of the impacts of hosting the 2012 ECOC, approached at two different times: before and after the event, to try and capture the evolution of the residents’ assessment of its impacts. From the empirical literature, we know that residents’ perceived impacts tend to change as time goes by (Kim et al. 2006; Ritchie et al. 2009; Gursoy et al. 2011; Lee et al. 2013). The data were gathered via two surveys applied to Guimaraes residents, one in 2011, before the event, and the other afterwards, in 2013. The Guimaraes residents’ assessment was thought to be essential to get an accurate appraisal of the impact of the mega-event as they were a main part of the hosting process. 2012 ECOC impacts were mainly felt by local people who, in most cases, will go on feeling them in the short and long term. The research was thought to be socially pertinent as the opinions collected through the surveys can help to prevent repeating mistakes when similar mega- events are organised in the future, and to increase the positive impacts derived from hosting them. When we talk about the social pertinence of the empirical results, we want to stress that the expertise acquired can be useful to any host city or country.

Role of pre and post-operative oral calcium and vitamin D supplements in prevention of hypocalcemia after total thyroidectomy

Aim. to evaluate the role of pre and post-operative oral calcium and vitamin D supplements in prevention of hypocalcemia after total thyroidectomy. Patients and methods. 50 consecutive patients, undergoing total thyroidectomy, were enrolled. Oral calcium and vitamin D were administered in the pre and post-operative time. The data concerning symptomatic and laboratoristic hypocalcemia were collected. Results. Incidence of symptomatic hypocalcemia was very low (6%); incidence of laboratoristic hypocalcemia was 10%. No permanent hypocalcemia developed. Conclusions. Implementing oral calcium and vitamin D both before and after total thyroidectomy can reduce the incidence of hypocalcemia related to surgery.

The Influence of Pre-Migration Factors and Post-Migration Climate of the Receiving Community on the Psychological Distress of Latino Immigrants

Over forty million foreign-born residents currently live in the United States. Latinos make up the largest population of immigrants living in the U.S. Previous research suggests that Latino immigrants often experience pre-migration stressors, such as traumatic experiences, political upheaval, and unplanned migration. These stressors may have a negative impact on immigrants’ post-migration mental health. Research also suggests that the post-migration climate of the receiving community may inform the connection between pre-migration experiences and post-migration mental health. The current study examined the relationship between Latino immigrants’ reasons for migration, migration planning, and pre-migration experience of political and/or interpersonal violence, and post-migration symptoms of psychological distress. In addition to examining the effect of these pre-migration factors, the current study also examined the community “climate” experienced by Latino immigrants post-migration by assessing the influence of three post-migration factors: 1) community support and engagement, 2) discrimination, and 3) employment. The study was a secondary analysis of data collected for the National Latino and Asian American Study, which focused on the mental health and service utilization of Latinos and Asian Americans. Participants included 1,629 Latino immigrants from across the United States. Results indicated that pre-migration experience of political and/or interpersonal trauma, post-migration experience of discrimination, and female sex were positively associated with psychological distress. Post-migration employment was negatively associated with psychological distress. In addition, discrimination modified the association between unplanned migration and psychological distress; the relationship between unplanned migration and psychological distress decreased for participants who reported more discrimination. Furthermore, employment modified the association between political and/or interpersonal trauma and psychological distress; the connection between trauma and psychological distress increased among those who reported having less employment. Recommendations for further research were presented. Policy and clinical practice implications were discussed, particularly given the current climate of high anti-immigrant sentiment and hostility in the U.S.

Quantitative analysis of pre- and post-operative valvular annulus deformations following valvular insufficiency

Valvular insufficiency is a growingly common valvular heart disease that frequently is associated with regurgitation. Atrioventricular incompetency can lead to overall ventricular and atrial enlargement, volume overload, heart impairment and, if not treated, can culminate in heart failure. With the advances in technology and the increasing interest in devices that have lower post-operative burden on patients, transcatheter mitral and tricuspid valve repair systems are going through a phase of rapid development and growing use. In this work, we aimed to quantitatively assess the morphology of mitral and tricuspid annuli in patients who underwent transcatheter valve repair with MitraClip/TriClip, before and after the intervention, using three-dimensional transoesophageal echocardiography images, in order to evaluate the geometrical changes of the annulus following the intervention. For our purposes, firstly, we implemented a tool for the visualization and navigation of the volumetric data across the cardiac cycle. Then, in order to track the annulus over the cardiac cycle, we extracted five rotational slices from the volume data, selected two initial points on each slice, and tracked these points across the cardiac cycle using KLT algorithm. In a first stage we led a parameters optimization for the tracking method, and we studied the sensitivity of the KLT algorithm to the initialization points, that are manually chosen by the user. In a second stage, we analysed 10 subjects (5 for mitral regurgitation and 5 for tricuspid regurgitation), tracking their annulus before and after valve repairment. In conclusion, we found in all our 10 subjects that immediately after the intervention there is a shortening of the major diameters of the valves, mainly the shortest diameter, due to the clip application, that leads to a reduction of the perimeter and the area of the annulus.

The institutions of archaic post-modernity and their organizational and managerial consequences: The case of Portugal

The long march of modernization of the Western societies tends to be presented as following a regular sequence: societies and institutions were pre-modern, and then they were modernized, eventually becoming post-modern. Such teleology may provide an incomplete or distorted narrative of societal evolution in many parts of the world, even in the ‘post-modern heartland’ of Western Europe, with Portugal being a case in point. The concept of archaic post-modernity has been developed by a philosopher, José Gil, to show how Portuguese institutions and organizations combine elements of pre-modernity and post-modernity. The notion of an archaic post-modernity is advanced in order to provide an alternative account of the modernization process, which enriches discussion of the varieties of capitalism. Differences in historical experiences create singularities that may be considered in the analysis of culture, management and organization.

Bariatric and Post-Bariatric Surgery: from Metabolic Surgery to Plastic Surgery Indications

Background: Controversy exists concerning indications and outcomes of major bariatric surgery procedures. Massive weight loss after bariatric surgery leads to excess skin with functional and aesthetic impairments. The aim of this study was to investigate the major bariatric surgery procedures and their outcomes in two specific subgroups of morbidly obese patients, ≥55-year-olds and the superobese. Further aims were to evaluate whether the preoperative weight loss correlates with laparoscopic gastric bypass complications. The prevalence and impact of excess skin and the desire for body contouring after bariatric surgery were also studied. Patients and Methods: Data from patients who underwent Laparoscopic Adjustable Gastric Banding (LAGB) and Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) at Vaasa Central Hospital were collected and postoperative outcomes were evaluated according to the BMI, age and preoperative weight loss. Patients who had undergone bariatric surgery procedures were asked to complete a questionnaire to estimate any impairment due to redundant skin and to analyse each patient’s desire for body contouring by area. Results: No significant difference was found in operative time, hospital stay, or overall early postoperative morbidity between LAGB and LRYGB. Mean excess weight loss percents (EWL%) at 6 and 12 months after LRYGB were significantly higher. A significant difference was found in operative time favouring patients <55 years. Intraoperative complications were significantly more frequent in the group aged >55 years. No significant difference was detected in overall postoperative morbidity rates. A significant difference was found in operative time and hospital stay favouring all patients who lost weight preoperatively. Most patients reported problems with redundant skin, especially on the abdomen, upper arms and rear/buttocks, which impaired daily physical activity in half of them. Excess skin was significantly associated with female gender, weight loss and ΔBMI. Patients with a WL >20 kg, ΔBMI ≥10 kg/m2 and an EWL % > 50 showed a significantly surplus skin discomfort (p < 0.001). Most patients desired body contouring surgery, with high or very high desire for waist/abdomen (62.2%), upper arm (37.6%), chest/breast (28.3%), and rear/buttock (35.6%) contouring. Conclusions: LRYGB is effective and safe in superobese (BMI >50) and elderly (>55 years) patients. A preoperative weight loss >5% is recommended to improve the outcomes and reduce complications. A WL >20 kg, ΔBMI ≥10 kg/m2 and an EWL % > 50 are associated with a higher functional discomfort due to redundant skin and to a stronger desire for body contouring plastic surgery.

Post-occupancy evaluation studies in recently refurbished office building: energy performance and employees' satisfaction

Existing buildings contribute greatly to global energy use and greenhouse gas emissions. In the UK, about 18% of carbon emissions are generated by non-domestic buildings; sustainable building refurbishment can play an important role in reducing carbon emissions. This paper looks at the performance of a recently refurbished 5-storey office building in London, in terms of energy consumption as well as occupants’ satisfaction. Pre- and post-occupancy evaluation studies were conducted using online questionnaire surveys and energy consumption evaluation. Results from pre-occupancy and post-occupancy evaluation studies showed that employees, in general, were more satisfied with their work environment at the refurbished building than with that of their previous office. Employees’ self-reported productivity improved after the move to Elms House. These surveys showed a positive relationship between employees’ satisfaction with their work environment and their self-reported productivity, well-being and enjoyment at work. The factor that contributed to increasing employee satisfaction the most was: better use of interior space. Although the refurbishment was a success in terms of reducing energy consumption per m2, the performance gap was almost 3 times greater than that estimated. Unregulated loads, problems with building control, ineffective use of space and occupants’ behaviour are argued to be reasons for this gap.

Towards the main sequence: detailed analysis of weak line and post-T Tauri stars

A detailed study was performed for a sample of low-mass pre-main-sequence (PMS) stars, previously identified as weak-line T Tauri stars, which are compared to members of the Tucanae and Horologium Associations. Aiming to verify if there is any pattern of abundances when comparing the young stars at different phases, we selected objects in the range from 1 to 100 Myr, which covers most of PMS evolution. High-resolution optical spectra were acquired at European Southern Observatory and Observatorio do Pico dos Dias. The stellar fundamental parameters effective temperature and gravity were calculated by excitation and ionization equilibria of iron absorption lines. Chemical abundances were obtained via equivalent width calculations and spectral synthesis for 44 per cent of the sample, which shows metallicities within 0.5 dex solar. A classification was developed based on equivalent width of Li I 6708 angstrom and Ha lines and spectral types of the studied stars. This classification allowed a separation of the sample into categories that correspond to different evolutive stages in the PMS. The position of these stars in the Hertzsprung-Russell diagram was also inspected in order to estimate their ages and masses. Among the studied objects, it was verified that our sample actually contains seven weak-line T Tauri stars, three are Classical T Tauri, 12 are Fe/Ge PMS stars and 21 are post-T Tauri or young main-sequence stars. An estimation of circumstellar luminosity was obtained using a disc model to reproduce the observed spectral energy distribution. Most of the stars show low levels of circumstellar emission, corresponding to less than 30 per cent of the total emission.

Estudos sedimentológicos e o contexto estrutural da formação Serra do Martins, nos platôs de Portalegre, Martins e Santana/RN

This dissertation deals with sedimentological and structural framework of the siliciclastic rock of the Serra do Martins Formation (FSM) in the Portalegre, Martins and Santana plateau, located to the south of Potiguar Basin, in the southwest and central Rio Grande do Norte state. This formation, regarded as of Oligo-Miocene age based on intrusive relations of the Miocene Macau volcanics, has a still disputable age due to the lack of appropriate bio and/or chronostratigraphic markers. The FSSM deposits crop out along 650 to 750 m high plateau, as a remanescent sedimentary cover directly overlying topographically uplifted pre-cambrian crystalline rocks. During the last decades, these deposits were interpreted according to a Tertiary paleoclimatic evolutionary model, associated to pedogenetic processes. The sedimentological characterization of the FSM was done through a detailed study of its facies, petrography and diagenetic features. The facies study was based on description of field relations, textures and structures, the piling up of the strata and their lateral variations. The FSM was deposited by an anastomosing to coarse-meandering fluvial system, including deposits of lag, cannel-fill, ouver-bank and flood plain. The petrographic composition of the sediments, coupled to their facies and paleocurrent directions, suggest a rather distal sourcearea, to the south of the present plateau. The diagenetic study identified an incipient grain mechanical compaction, pronounced dissolution of the framework, matrix and/or cement components, intense precipitation of kaolinite, silic and, eventually, iron oxides, besides mechanical infiltration of the clays. Most of these events, regarded in the literature as associated to near-surface conditions (eo or telodiagenesis), indicate the FSM sediments were never deeply buried. Topographic relations along longitudinal and transversal sections reaching the Potiguar Basin to the north identified regional dips that allow to discuss stratigraphic correlations between the FSM and the basin formations. The sedimentological features of the different units and the intrusive relations of the Macau volcanics were also considered in these correlations,which support the Oligo-Miocene age previously accepted for the FSM. Concerning the tectonic framework of the FSM, this work investigated the pre-cambrian to cretaceous heritage and the cenozoic deformation, allowing the recognition of pre-, sin and post-FSM structures. The crystalline basement, belonging to the Seridó Belt, displays NE and WNW foliation trends related to the Brasiliano-age ductile shear zones. In this terrain, brittle-ductile and brittle NE- and NW-trending structures, associated with extensional joints filled with pegmatites and quartz veins, are related to an E-W compression by the end of Brasiliano Cycle. The E-W joints and NE-trending fractures were reactivated by N-S to N-S to NW extension during late Jurassic to Cretaceous times, controlling the emplacement of the Rio Ceará-Mirim basic dyke swarm and the opening of the Potiguar rift basin

Evaluation of radial distribution of cartilage degeneration and necessity of pre-contrast measurements using radial dGEMRIC in adults with acetabular dysplasia

Background The purpose of the present study was to investigate the radial distribution patterns of cartilage degeneration in dysplastic hips at different stages of secondary osteoarthritis (OA) by using radial delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), and to assess whether pre-contrast measurements are necessary. Methods Thirty-five hips in 21 subjects (mean age ± SD, 27.6 ± 10.8 years) with acetabular dysplasia (lateral CE angle < 25°) were studied. Severity of OA was assessed on radiographs using Tönnis grading. Pre- (T1pre) and post-contrast T1 (T1Gd) values were measured at 7 sub-regions on radial reformatted slices acquired from a 3-dimensional (3D) T1 mapping sequence using a 1.5 T MR scanner. Values of radial T1pre, T1Gd and ΔR1 (1/T1Gd - 1/T1pre) of subgroups with different severity of OA were compared to those of the subgroup without OA using nonparametric tests, and bivariate linear Pearson correlations between radial T1Gd and ΔR1 were analyzed for each subgroup. Results Compared to the subgroup without OA, the subgroup with mild OA was observed with a significant decrease in T1Gd in the anterosuperior to superior sub-regions (mean, 476 ~ 507 ms, p = 0.026 ~ 0.042) and a significant increase in ΔR1 in the anterosuperior to superoposterior and posterior sub-regions (mean, 0.93 ~ 1.37 s-1, p = 0.012 ~ 0.042). The subgroup with moderate to severe OA was observed with a significant overall decrease in T1Gd (mean, 404 ~ 452 ms, p = 0.001 ~ 0.020) and an increase in ΔR1 (mean, 1.17 ~1.69 s-1, p = 0.001 ~ 0.020). High correlations were observed between radial T1Gd and ΔR1 for all subgroups (r = −0.869 ~ −0.944, p < 0.001). Conclusions Radial dGEMRIC without pre-contrast measurements is useful for evaluating different patterns of cartilage degeneration in the entire hip joint of patients with hip dysplasia, particularly for those in early stages of secondary OA.

The Genesis Solar Wind Concentrator: Flight and Post-Flight Conditions and Modeling of Instrumental Fractionation

The Genesis mission Solar Wind Concentrator was built to enhance fluences of solar wind by an average of 20x over the 2.3 years that the mission exposed substrates to the solar wind. The Concentrator targets survived the hard landing upon return to Earth and were used to determine the isotopic composition of solar-wind—and hence solar—oxygen and nitrogen. Here we report on the flight operation of the instrument and on simulations of its performance. Concentration and fractionation patterns obtained from simulations are given for He, Li, N, O, Ne, Mg, Si, S, and Ar in SiC targets, and are compared with measured concentrations and isotope ratios for the noble gases. Carbon is also modeled for a Si target. Predicted differences in instrumental fractionation between elements are discussed. Additionally, as the Concentrator was designed only for ions ≤22 AMU, implications of analyzing elements as heavy as argon are discussed. Post-flight simulations of instrumental fractionation as a function of radial position on the targets incorporate solar-wind velocity and angular distributions measured in flight, and predict fractionation patterns for various elements and isotopes of interest. A tighter angular distribution, mostly due to better spacecraft spin stability than assumed in pre-flight modeling, results in a steeper isotopic fractionation gradient between the center and the perimeter of the targets. Using the distribution of solar-wind velocities encountered during flight, which are higher than those used in pre-flight modeling, results in elemental abundance patterns slightly less peaked at the center. Mean fractionations trend with atomic mass, with differences relative to the measured isotopes of neon of +4.1±0.9 ‰/amu for Li, between -0.4 and +2.8 ‰/amu for C, +1.9±0.7‰/amu for N, +1.3±0.4 ‰/amu for O, -7.5±0.4 ‰/amu for Mg, -8.9±0.6 ‰/amu for Si, and -22.0±0.7 ‰/amu for S (uncertainties reflect Monte Carlo statistics). The slopes of the fractionation trends depend to first order only on the relative differential mass ratio, Δ m/ m. This article and a companion paper (Reisenfeld et al. 2012, this issue) provide post-flight information necessary for the analysis of the Genesis solar wind samples, and thus serve to complement the Space Science Review volume, The Genesis Mission (v. 105, 2003).

NOVEL PHANTOMS AND POST-PROCESSING FOR DIFFUSION SPECTRUM IMAGING

High Angular Resolution Diffusion Imaging (HARDI) techniques, including Diffusion Spectrum Imaging (DSI), have been proposed to resolve crossing and other complex fiber architecture in the human brain white matter. In these methods, directional information of diffusion is inferred from the peaks in the orientation distribution function (ODF). Extensive studies using histology on macaque brain, cat cerebellum, rat hippocampus and optic tracts, and bovine tongue are qualitatively in agreement with the DSI-derived ODFs and tractography. However, there are only two studies in the literature which validated the DSI results using physical phantoms and both these studies were not performed on a clinical MRI scanner. Also, the limited studies which optimized DSI in a clinical setting, did not involve a comparison against physical phantoms. Finally, there is lack of consensus on the necessary pre- and post-processing steps in DSI; and ground truth diffusion fiber phantoms are not yet standardized. Therefore, the aims of this dissertation were to design and construct novel diffusion phantoms, employ post-processing techniques in order to systematically validate and optimize (DSI)-derived fiber ODFs in the crossing regions on a clinical 3T MR scanner, and develop user-friendly software for DSI data reconstruction and analysis. Phantoms with a fixed crossing fiber configuration of two crossing fibers at 90° and 45° respectively along with a phantom with three crossing fibers at 60°, using novel hollow plastic capillaries and novel placeholders, were constructed. T2-weighted MRI results on these phantoms demonstrated high SNR, homogeneous signal, and absence of air bubbles. Also, a technique to deconvolve the response function of an individual peak from the overall ODF was implemented, in addition to other DSI post-processing steps. This technique greatly improved the angular resolution of the otherwise unresolvable peaks in a crossing fiber ODF. The effects of DSI acquisition parameters and SNR on the resultant angular accuracy of DSI on the clinical scanner were studied and quantified using the developed phantoms. With a high angular direction sampling and reasonable levels of SNR, quantification of a crossing region in the 90°, 45° and 60° phantoms resulted in a successful detection of angular information with mean ± SD of 86.93°±2.65°, 44.61°±1.6° and 60.03°±2.21° respectively, while simultaneously enhancing the ODFs in regions containing single fibers. For the applicability of these validated methodologies in DSI, improvement in ODFs and fiber tracking from known crossing fiber regions in normal human subjects were demonstrated; and an in-house software package in MATLAB which streamlines the data reconstruction and post-processing for DSI, with easy to use graphical user interface was developed. In conclusion, the phantoms developed in this dissertation offer a means of providing ground truth for validation of reconstruction and tractography algorithms of various diffusion models (including DSI). Also, the deconvolution methodology (when applied as an additional DSI post-processing step) significantly improved the angular accuracy of the ODFs obtained from DSI, and should be applicable to ODFs obtained from the other high angular resolution diffusion imaging techniques.