Implantation of a diffractive trifocal intraocular lens: One-year follow-up

Purpose: To evaluate the visual, refractive, contrast-sensitivity, and aberrometric outcomes during a 1-year follow-up after implantation of a trifocal intraocular lens (IOL). Setting: Premium Clinic, Teplice, Czech Republic. Design: Prospective case series. Methods: This study included eyes of patients having cataract surgery with implantation of the trifocal IOL model AT Lisa tri 839MP. Distance, intermediate (66 and 80 cm), and near (33 and 40 cm) vision; contrast sensitivity; aberrometric outcomes; and the defocus curve were evaluated during a 12-month follow-up. The level of posterior capsule opacification (PCO) was also evaluated. Results: In 120 eyes (60 patients), 1 month postoperatively, an improvement was observed in all visual parameters (P ≤ .03) except corrected near and intermediate visual acuities (both P ≥ .05). From 1 month to 12 months postoperatively, small but statistically significant changes were observed in uncorrected and corrected distance and near visual acuities (all P ≤ .03) and in uncorrected intermediate visual acuity (P = .01). In the defocus curve, no significant differences were found between visual acuities corresponding to defocus levels of −1.0 diopter (D) and −2.0 D (P = .22). The level of ocular spherical aberration decreased statistically significantly at 6 months (P < .001). Ocular and internal higher-order aberrations increased minimally but significantly from 6 to 12 months postoperatively (P < .001). The mean 12-month PCO score was 0.32 ± 0.44 (SD). Four eyes (3.3%) required neodymium:YAG capsulotomy. Conclusion: The trifocal IOL provided complete and stable visual restoration after cataract surgery during a 12-month follow-up, with good levels of visual quality.

Annotated almanac, 1769

Almanac with one laid-in folded leaf and annotations made by John and Hannah Winthrop. The calendar pages are minimally annotated with a note about household activities such as bringing the horse to pasture. The laid-in leaf contains entries on firing the household chimneys, baptisms and deaths in the community, and a bill of mortality for 1769 in John Winthrop's hand.

Analysis of Hyporheic Flow Induced by a Bar in a Gravel Stream: an Experimental Study

Thesis (Master, Civil Engineering) -- Queen's University, 2016-06-01 00:03:02.939

The Knowledge of High-Performance Gymnastic Coaches : Competition and Training Considerations

The purpose of this study is to report the knowledge used in training and competition by 17 expert high-performance gymnastic coaches. A qualitative research methodology was used to collect and inductively analyze the data. The knowledge elicited for the competition component was categorized as competition site, competition floor, and trial competitions. These categories indicated that the coaches are minimally involved with the gymnasts in competition. The knowledge of the coaches elicited within the training component were categorized as coach involvement in training, intervention style, technical skills, mental skills, and simulation. Properties of these categories that were extensively discussed by the expert coaches, such as teaching progressions, being supportive, and helping athletes to deal with stress,are consistent with the literature on coaching and on sport psychology. Other aspects considered important in the sport psychology literature, such as developing concentration skills, were not discussed as thoroughly by the expert coaches.

Desnervação simpática renal e sua utilização no tratamento da hipertensão resistente : caso clínico

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Hiperparatiroidismo primário em doentes jovens

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Hiperparatiroidismo primário assintomático : caso clínico

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

The sutureless aortic valve at 1 year: A large multicenter cohort study

OBJECTIVE Sutureless aortic valve replacement (AVR) offers an alternative to standard AVR in aortic stenosis. This prospective, single-arm study aimed to demonstrate safety and effectiveness of a bovine pericardial sutureless aortic valve at 1 year. METHODS From February 2010 to September 2013, 658 patients (mean age 78.3 ± 5.6 years; 40.0% octogenarian; 64.4% female; mean Society of Thoracic Surgeons score 7.2 ± 7.4) underwent sutureless AVR in 25 European centers. Concomitant cardiac procedures were performed in 29.5% and minimally invasive cardiac surgery in 33.3%. RESULTS One-year site-reported event rates were 8.1% for all-cause mortality, 4.5% for cardiac mortality, 3.0% for stroke, 1.9% for valve-related reoperation, 1.4% for endocarditis, and 0.6% for major paravalvular leak. No valve thrombosis, migration, or structural valve deterioration occurred. New York Heart Association class improved at least 1 level in 77.5% and remained stable (70.4% New York Heart Association class I or II at 1 year). Mean effective orifice area was 1.5 ± 0.4 cm(2); pressure gradient was 9.2 ± 5.0 mm Hg. Left ventricular mass decreased from 138.5 g/m(2) before surgery to 115.3 g/m(2) at 1 year (P < .001). Echocardiographic core laboratory findings confirmed that paravalvular leak was rare and remained stable during follow-up. CONCLUSIONS The Perceval sutureless valve resulted in low 1-year event rates in intermediate-risk patients undergoing AVR. New York Heart Association class improved in more than three-quarters of patients and remained stable. These data support the safety and efficacy to 1 year of the Perceval sutureless valve in this intermediate-risk population.

Essays on Entrepreneurship and Founder Pre-entry Knowledge

Thesis (Ph.D.)--University of Washington, 2016-06

Pre-Service Teachers’ Mathematics Language and Reflection in the Context of an Early Childhood Mathematics Methods Course

Thesis (Ph.D.)--University of Washington, 2016-06

Emergency Provider Use of Plain Radiographs in the Evaluation of Pediatric Constipation

Thesis (Master's)--University of Washington, 2016-06

How peripheral a phenomenon is it?: On the interaction of DP-internal ellipsis, degree inversion, and islands

Thesis (Ph.D.)--University of Washington, 2016-06

Perceptual and instrumental analysis of laryngeal function after traumatic brain injury in childhood

Objective: To investigate laryngeal function and phonatory disturbance in children with traumatic brain injury (TBI), using both perceptual and instrumental techniques. Design and participants: The performance of 16 individuals with moderate to severe TBI acquired in childhood and 16 nonneurologicatly impaired control subjects was compared on a battery of perceptual (Frenchay Dysarthria Assessment, speech sample analysis) and instrumental (Aerophone II, laryngograph) assessments. Results and conclusions: As a group, the children with TBI demonstrated normal, or only minimally impaired laryngeal function, when compared with the control group, which contrasts with the significant laryngeal impairment noted in adults after TBI. Several reasons for the different findings in relation to laryngeal function in adults and children after TBI are postulated: (1) differing types of injury usually incurred by adults and children may result in a relatively decreased degree of neurologic impairment in these children, (2) differences in recovery potential between adults and children, and (3) the pediatric larynx is still developing, hence it may be better able to compensate for any impairment incurred.

The source of the Great Dyke, Zimbabwe, and its tectonic significance: Evidence from Re-Os isotopes

Re-Os data for chromite separates from 10 massive chromitite seams sampled along the 550-km length of the 2.58-Ga Great Dyke layered igneous complex, Zimbabwe, record initial 187Os/188Os ratios in the relatively narrow range between 0.1106 and 0.1126. This range of initial 187Os/188Os values is only slightly higher than the value for the coeval primitive upper mantle (0.1107) as modeled from the Re-Os evolution of chondrites and data of modern mantle melts and mantle derived xenoliths. Analyses of Archean granitoid and gneiss samples from the Zimbabwe Craton show extremely low Os concentrations (3-9 ppt) with surprisingly unradiogenic present-day 187Os/188Os signatures between 0.167 and 0.297. Only one sample yields an elevated 187Os/188Os ratio of 1.008. Using these data, the range of crustal contamination of the Great Dyke magma would be minimally 0%-33% if the magma source was the primitive upper mantle, whereas the range estimated from Nd and Pb isotope systematics is 5%-25%. If it is assumed that the primary Great Dyke magma derived from an enriched deep mantle reservoir (via a plume), a better agreement can be obtained. A significant contribution from a long-lived subcontinental lithospheric mantle (SCLM) reservoir with subchondritic Re/Os to the Great Dyke melts cannot be reconciled with the Os isotope results at all. However, Os isotope data on pre-Great Dyke ultramafic complexes of the Zimbabwe Craton and thermal modeling show that such an SCLM existed below the Zimbabwe Craton at the time of the Great Dyke intrusion. It is therefore concluded that large melt volumes such as that giving rise to the Great Dyke were able to pass lithospheric mantle keels without significant contamination in the late Archean. Because the ultramafic-mafic melts forming the Great Dyke must have originated below the SCLM (which extends to at least a 200-km depth ), the absence of an SCLM signature precludes a subduction-related magma-generation process.

Dog peritoneal and pleural cavities as bioreactors to grow autologous vascular grafts

Objective: The purpose of this study was to grow artificial blood vessels for autologous transplantation as arterial interposition grafts in a large animal model (dog). Method and results: Tubing up to 250 mm long, either bare or wrapped in biodegradable polyglycolic acid (Dexon) or nonbiodegradable polypropylene (Prolene) mesh, was inserted in the peritoneal or pleural cavity of dogs, using minimally invasive techniques, and tethered at one end to the wall with a loose suture. After 3 weeks the tubes and their tissue capsules were harvested, and the inert tubing was discarded. The wall of living tissue was uniformly 1-1.5 mm thick throughout its length, and consisted of multiple layers of myofibroblasts and matrix overlaid with a single layer of mesothelium. The myofibroblasts stained for a-smooth muscle actin, vimentin, and desmin. The bursting strength of tissue tubes with no biodegradable mesh scaffolds was in excess of 2500 mm Hg, and the suture holding strength was 11.5 N, both similar to that in dog carotid and femoral arteries. Eleven tissue tubes were transplanted as interposition grafts into the femoral artery of the same dog in which they were grown, and were harvested after 3 to 6.5 months. Eight remained patent during this time. At harvest, their lumens were lined with endothelium-like cells, and wall cells stained for alpha-actin, smooth muscle myosin, desmin and smoothelin; there was also a thick adventitia containing vasa vasorum. Conclusion: Peritoneal and pleural cavities of large animals can function as bioreactors to grow myofibroblast tubes for use as autologous vascular grafts.