Intravitreal Ranibizumab in the Treatment of Predominantly Hemorrhagic Lesions in Exudative Age-Related Macular Degeneration.

BACKGROUND: Submacular hemorrhage is a manifestation of neovascular age-related macular degeneration (AMD) that has a very poor natural history leading to severe visual loss. We have evaluated the safety and efficacy of intravitreal ranibizumab in the treatment of predominantly hemorrhagic AMD. PATIENTS AND METHODS: A retrospective study of patients with predominantly hemorrhagic AMD treated with intravitreal ranibizumab at the Jules Gonin Eye Hospital between December 2006 and December 2008 was undertaken. Baseline and monthly follow-up exams included visual acuity (VA), fundus exam and optical coherence tomography (OCT) while fluorescein and indocyanine green angiography were performed at least every three months. RESULTS: The study included 8 eyes. The mean follow-up was 13 months (SD: 6.3). The mean number of intravitreal injections administered for each patient was 6.4 (SD: 2). 50 % of the patients demonstrated stable or improved VA. The size of hemorrhage at baseline was inversely correlated to the final VA (two-tailed p value = 0.038) and positively correlated to the final central macular thickness (two-tailed p value = 0.021). Anticoagulation treatment was inversely correlated to the time of hemorrhage resolution (two-tailed p value = 0.039). CONCLUSIONS: Intravitreal ranibizumab may be an effective treatment for predominantly hemorrhagic lesions due to neovascular AMD.

Novel ADAM9 homozygous mutation in a consanguineous Egyptian family with severe cone-rod dystrophy and cataract.

OBJECTIVE: To genetically and phenotypically describe a new ADAM9 homozygous mutation in a consanguineous family from Egypt with autosomal recessive cone-rod dystrophy (arCRD), anterior polar and posterior subcapsular cataract. DESIGN, SETTING AND PARTICIPANTS: The parents and their six children were included. They underwent a complete ophthalmic examination with fundus photography and optical coherence tomography (OCT). INTERVENTION: DNA was extracted from peripheral blood from all family members. Screening for mutations in genes known to be implicated in retinal disorders was done with the IROme, an in-solution enrichment array, followed by high-throughput sequencing. Validation of the results was done by bidirectional Sanger sequencing of ADAM9 exon 14, including exon-intron junctions. Screening of normal controls was done by denaturing high-performance liquid chromatography. RESULTS: arCRD was diagnosed in the mother and two of her children. Bilateral anterior polar and posterior subcapsular cataract was observed in the mother and bilateral dot cataract was diagnosed in three of the four children not affected with arCRD, one of whom also had glaucoma. The characteristics of the arCRD were childhood-onset visual impairment, reorganisation of the retinal pigment epithelium with mid-periphery greyish-white discolouration, attenuated retinal vasculatur and optic disc pallor. A coloboma-like macular lesion was observed in one of the arCRD-affected children. IROme analysis identified a c.1396-2A>G homozygous mutation in the splice acceptor site of intron 13 of ADAM9. This mutation was homozygous in the two children affected by arCRD and in their affected mother. This mutation was heterozygous in the unaffected father and the four unaffected children. CONCLUSIONS AND RELEVANCE: We identified a novel autosomal recessive ADAM9 mutation causing arCRD in a consanguineous Egyptian family. The percentage of arCRD cases caused by mutation in ADAM9 remains to be determined. Few families are reported in the literature to date; hence extensive clinical descriptions of families with ADAM9 mutations are of significant importance.

Electro-cortical correlates of motor inhibition : a comparison between selective and non-selective stop tasks

In this study, we compared a selective stop task (transition from a bimanual in-phase to a unimanual index fingers' tapping), with a non-selective stop task (stopping a bimanual in-phase tapping at all), and with a switching task (transition from in-phase to anti-phase bimanual tapping). The aim was twofold: 1) to identify the electro-cortical correlates of selective and non-selective inhibition processes and 2) to investigate which type of inhibition - selective or not - is required when switching between two bimanual motor patterns. The results revealed that all tasks led to enhanced activation (alpha power) of the left sensorimotor and posterior regions which seems to reflect an overall effort to stop the preferred bimanual in-phase tendency. Each task implied specific functional connectivity reorganizations (beta coherence) between cerebral motor areas, probably reflecting engagement in a new unimanual or bimanual movement.

. Phenotype/genotype correlation associated with a novel nonsense Glu20stop mutation in the Rp2 gene in a three-generation family with x-linked retinitis pigmentosa

Purpose: To assess the phenotype of patients in a large 3 generation Swiss family with X-linked retinitis pigmentosa (XLRP) due to a novel nonsense mutation Glu20stop in RP2 gene and to correlate with the genotype. Methods: 6 affected patients (1 male, 5 females, age range: 23 - 73 years) were assessed with a complete ophthalmologic examination. All had fundus autofluorescence images, standardised electroretinography, Goldmann visual fields and Optical Coherence Tomography. In addition, medical records of 2 affected male patients were reviewed. Blood sample was taken for molecular analysis. Results: The male patients were severely affected at a young age with early macular involvement. The youngest 23 y old male had also high myopia and vision of less than 0.05 according to Snellen EDTRS chart bilaterally. All 5 female carriers had some degree of rod-cone dystrophy, but no macular involvement. The visual acuity was 1.0 in the younger carriers, while the 73 years old had VA of 0.5. Two females had mild myopia (range -0.75 to -2) and one had anisometropia of 3.5D, with the more severely affected eye being myopic. Three out of 5 female carriers had optic nerve drusen. Conclusions: We report a novel Glu20stop mutation in RP2 gene, which is a rare cause of XLRP. Our description of severe phenotype in male patients with high myopia and early macular atrophy confirms previous reports. Unlike previous reports, all our female carriers had RP, but not macular involvement or high myopia. The identifiable phenotype for RP2-XLRP aids in clinical diagnosis and targeted genetic screening.

Expérimentation générique et dialogisme intertextuel. Perrault, La Fontaine, Apulée, Straparola, Basile

EXPERIMENTATION GENERIQUE ET DIALOGISME INTERTEXTUEL: PERRAULT, LA FONTAINE, APULEIUS, STRAPAROLA AND BASILE. Les contes en vers et en prose de Perrault relèvent, selon l'hypothèse présentée dans cette étude, d'un dialogisme intertextuel très complexe avec les formes génériques du conte déjà existantes dans les littératures européennes. L'académicien s'adonne à une véritable «expérimentation générique » au cours de laquelle il crée de nouvelles formes génériques, de nouvelles intrigues et de nouvelles figures à partir de la fabella de Psyché enchâssée dans les Métamorphoses d'Apulée, et de sa récriture galante par La Fontaine dans Les Amours de Psiché et de Cupidon en 1669. Ce double dialogue intertextuel est encore sous-tendu par le recours aux favole de Straparola (Le Piacevole notti) et aux cunti (Lo cunto de li cunti) de Basile, célèbres narrateurs italiens, qui avaient déjà reconfiguré de façon originale certains épisodes et personnages de la fabella de Psyché. Ce processus dialogique complexe est ici mis en évidence par l'analyse (inter)textuelle successive des trois premiers contes en prose, La Belle au bois dormant, Le Petit Chaperon rouge et La Barbe bleue. L'analyse comparative montre que Perrault les invente à partir des trois moments successifs de l'épreuve la plus difficile que Vénus inflige à Psyché, celle de la descente aux Enfers. En introduisant des différences significatives par rapport aux textes latins, italiens et français, l'académicien parvient à créer une nouvelle variation générique : le conte pseudo-naïf doté d'un sens crypté qui se découvre « plus ou moins selon le degré de pénétration de ceux qui les lisent ».GENERIC EXPERIMENTATION AND INTERTEXTUAL DIALOGISM: PERRAULT, LA FONTAINE, APULEIUS, STRAPAROLA AND BASILEAccording to Ute Heidmann, Perrault's tales have very complex inter- textual relations with other generic forms which already existed in other European literatures. Heidmann demonstrates here how Perrault experi- ments "generically" with the fairy tale and how he creates new generic forms from other tales by Apuleus, Straparola, Basile, or La Fontaine. This dialogic process is here underlined by the analysis of three particular fairy tales, Sleeping Beauty in the Woods, Little Red Riding Hood and Blue Beard. Heidmann shows how, by introducing key differences with the Latin, Italian and French models, Perrault succeeds in creating a new generic variation of the fairy tale: "the pseudo-naïve fairy tale".

IPH response to DSD Urban Regeneration and Community Development Policy Framework Consultation

The Urban Regeneration and Community Development Policy Framework for Northern Ireland sets out for DSD and its partners, clear priorities for urban regeneration and community development programmes, both before and after the operational responsibility for these is transferred to councils under the reform of local government. Four policy objectives have been developed, which will focus on the underlying structural problems in urban areas and also help strengthen community development throughout Northern Ireland. The policy objectives are as follows: Policy Objective 1 – To tackle area-based deprivation: Policy Objective 2 – To strengthen the competitiveness of our towns and cities: Policy Objective 3 – To improve linkages between areas of need and areas of opportunity: and Policy Objective 4 –To develop more cohesive and engaged communities. Key points from IPH response Urban regeneration and community development provide a basis for addressing the social determinants of health and reducing inequalities in health. This policy framework presents an opportunity for coherence and complementarity with ‘Fit and Well - Changing Lives’ as part of government’s overall approach to tackling health inequalities. It is now well established that a focus on early years’ interventions and family support services yields significant returns, so prioritising action in these areas is essential. Defined action plans on child poverty are essential if this policy framework is to make a real and lasting difference in deprived urban areas. Development of the environmental infrastructure to improve health in deprived areas should be supported by well-planned monitoring and evaluation. Linking the policy framework to economic development and local community plans will enhance effectiveness in the areas of education, job creation, commercial investment and access to services, which in turn are critical for the economic growth and stability of urban communities. Community profile data and health intelligence (as available through IPH Health Well) could usefully inform central and local government in terms of resource allocation and targeted service delivery.

Research in psychopathology: epistemologic issues.

Etiologic research in psychiatry relies on an objectivist epistemology positing that human cognition is specified by the "reality" of the outer world, which consists of a totality of mind-independent objects. Truth is considered as some sort of correspondence relation between words and external objects, and mind as a mirror of nature. In our view, this epistemology considerably impedes etiologic research. Objectivist epistemology has been recently confronting a growing critique from diverse scientific fields. Alternative models in neurosciences (neuronal selection), artificial intelligence (connectionism), and developmental psychology (developmental biodynamics) converge in viewing living organisms as self-organizing systems. In this perspective, the organism is not specified by the outer world, but enacts its environment by selecting relevant domains of significance that constitute its world. The distinction between mind and body or organism and environment is a matter of observational perspective. These models from empirical sciences are compatible with fundamental tenets of philosophical phenomenology and hermeneutics. They imply consequences for research in psychopathology: symptoms cannot be viewed as disconnected manifestations of discrete localized brain dysfunctions. Psychopathology should therefore focus on how the person's self-coherence is maintained and on the understanding and empirical investigation of the systemic laws that govern neurodevelopment and the organization of human cognition.

Fonaments i actuacions de lideratge sistèmic d'un equip de bàsquet professional i futures aplicacions

El treball de recerca “Fonaments i actuacions de lideratge sistèmic d’un equip de bàsquet professional i futures aplicacions” fa l’anàlisi d’una experiència real vinculada al món de l’esport professional. Es pretén donar a conèixer com l’estructuració del coneixement de l’entrenador pot afavorir el bon funcionament de l’equip. L’estructuració ens genera criteri i coherència a l’hora de prendre decisions.Es reconeix a l’entrenador com una persona treballadora, apassionada per la seva feina i en constant creixement individual. Valors com la humilitat, l’entusiasme, el compromís, la generositat i l’autoexigència es converteixen en adjectius fonamentals del nostre entrenador.L’estudi en l’autoconeixement en conceptes com lideratge, nivells neurològics, talent i motivació esdevenen el pal de paller en la construcció de l’equip. Un equip amb identitat pròpia, on el benefici pel bé comú (equip) està per sobre de tot, cooperatiu, compromès, i on la figura de l’entrenador intuïtiu amb coneixement influeix més per convenciment que per autoritat.El treball del dia a dia de l’entrenador i de l´equip es fonamenta en l’organització dels pilars de l’entrenador: flexibilitat, creixement de l’entrenador, equip, marges col·lectiu i individual són els motors del bon funcionament del col·lectiu. En el treball presentat, es destaca la importància de saber diferenciar, en el rendiment d’un equip, dues vessants: una més objectiva (tècnica, tàctica, estratègia i física) i l’altra on el factor humà és determinant. La investigació aprofundeix en aquest segon factor i el reconeix com a preferent. Per acabar es presenten tot un seguit d’actuacions utilitzades al llarg de la investigació amb la finalitat de generar, mantenir i millorar l’equip al mateix temps que es mostren diferents eines per tal d’optimitzar l’eficiència de les actuacions. La investigació pretén ser una experiència útil i enriquidora a l’hora d’estructurar el coneixement per tal de poder ser utilitzat en futures aplicacions.

Coevolutionary networks: a novel approach to understanding the relationships of humans with the infectious agents

Human organism is interpenetrated by the world of microorganisms, from the conception until the death. This interpenetration involves different levels of interactions between the partners including trophic exchanges, bi-directional cell signaling and gene activation, besides genetic and epigenetic phenomena, and tends towards mutual adaptation and coevolution. Since these processes are critical for the survival of individuals and species, they rely on the existence of a complex organization of adaptive systems aiming at two apparently conflicting purposes: the maintenance of the internal coherence of each partner, and a mutually advantageous coexistence and progressive adaptation between them. Humans possess three adaptive systems: the nervous, the endocrine and the immune system, each internally organized into subsystems functionally connected by intraconnections, to maintain the internal coherence of the system. The three adaptive systems aim at the maintenance of the internal coherence of the organism and are functionally linked by interconnections, in such way that what happens to one is immediately sensed by the others. The different communities of infectious agents that live within the organism are also organized into functional networks. The members of each community are linked by intraconnections, represented by the mutual trophic, metabolic and other influences, while the different infectious communities affect each other through interconnections. Furthermore, by means of its adaptive systems, the organism influences and is influenced by the microbial communities through the existence of transconnections. It is proposed that these highly complex and dynamic networks, involving gene exchange and epigenetic phenomena, represent major coevolutionary forces for humans and microorganisms.

Narrative Diagrammatik. Mit einer Modellanalyse: Die Diagrammatik des "Decameron"

Taking as a starting point the seeming inconsistency of late-medieval romances notoriously 'run wild' (verwildert), this article is concerned with the description of an abstract form of narrative coherence that is based on the notion of the diagrammatic. In a first section, this concept is illustrated in a simplified manner by an analysis of Boccaccio's Decameron based on two levels of spatial structure: that of the autograph Berlin manuscript (Codex Hamilton 90) and that of the recipient's mental visualisation of the relations between the frame and the tales of the work. It is argued that the connectivity of the work as a whole depends on the perception of those two spatial representations of the plot. A second section develops this concept in a more theoretical fashion, drawing on Charles Sanders Peirce's notion of diagrammatic reasoning as a way of perceiving relations through mental and material topological representations. Correspondingly, a view of narrative is proposed that does not depend on the traditional perspective of temporal sequence but emphasizes the spatial structure of literary narrative. It is argued that these conditions form the primary ontological mode of narrative, whereas the temporal development of a story is an aesthetic illusion that has been specifically stimulated by the narrative conventions of approximately the past three centuries and must thus be considered a secondary effect. To conclude, an interpretation in miniature of an aspect of Heinrich von Neustadt's Apollonius von Tyrland that seems to have 'run wild' is undertaken from a diagrammatic perspective.

La construcción social de las emociones en las sociedades occidentales: el amor materno en la Catalunya del siglo XXI

El objetivo principal de esta investigación es analizar la forma cómo se construye socialmente el amor materno en el marco de las sociedades occidentales, y para ello partiremos del estudio del caso de las maternidades en la Catalunya actual. El amor materno, como emoción, aparece como una codificación cultural que responde a la canalización de la vida que cada cultura establece. En las sociedades occidentales el amor materno se revela como uno de los ejes vertebradores y legitimadores de la esfera reproductiva y del papel de la mujer dentro de ésta, definiéndose en consonancia y dando coherencia al resto de aspectos del sistema social. Dada su importancia los discursos hegemónicos de la sociedad que lo define tienden a naturalizar esta emoción en favor del mantenimiento y el no cuestionamiento del orden social dado, a pesar de que abundante evidencia empírica en ciencias sociales demuestra que se trata de una construcción social que responde a las necesidades del sistema social en cuestión. Actualmente los discursos tradicionales que contenían y definían la concepción de amor materno en Occidente se han ampliado y diversificado debido a cambios sociales como el ingreso de la mujer en la esfera pública; el logro de igualdad jurídica entre géneros; cambios en los modelos familiares; nuevas situaciones en torno a la infancia y la juventud; la intensificación de los flujos migratorios; la creciente urbanización; la expansión de los servicios públicos (escuela y salud); el alargamiento de la esperanza de vida, los métodos anticonceptivos modernos..., de manera tal que muchos de ellos entran en contraposición con las definiciones tradicionales. Es decir, nuevos y viejos discursos alrededor de la maternidad se encuentran enfrentados en su redefinición a otros que lo cuestionan, y a prácticas y cambios en ciertas instituciones que llevan en otra dirección la construcción de esta emoción. Esta nueva situación, aún en fase de conformación, reclama una explicación que pasa por conocer las causas, las formas y la definición del amor materno, en nuestro actual contexto.

Inhabitants' and professionals' social representations of health determinants in a disadvantaged urban area in France: a qualitative analysis = représentations sociales des déterminants de santé dans une zone urbaine défavorisée en France : analyse qualitative auprès d'habitants et de professionnels

Background and objective. - Access to care in French disadvantaged urban areas remains an issue despite the implementation of local healthcare structures. To understand this contradiction, we investigated social representations held by inhabitants of such areas, as well as those of social and healthcare professionals, regarding events or behaviours that can impact low-income individuals' health. Method. - In the context of a health diagnosis, 288 inhabitants living in five disadvantaged districts of Aix-les-Bains, as well as 28 professionals working in these districts, completed an open-ended questionnaire. The two groups of respondents were asked to describe what could have an impact on health status from the inhabitants' point of view. The textual responses were analyzed using the Alceste method. Results. - We observed a number of differences in the way the inhabitants and professionals represented determinants of health in disadvantaged urban areas: the former proposed a representation mixing personal responsibility with physiological, social, familial, and professional aspects, whereas the latter associated health issues with marginalization (financial, drug, or alcohol problems) and personal responsibility. Both inhabitants and professionals mentioned control over events and lifestyle as determinants of health. Discussion. - The results are discussed regarding the consequences of these different representations on the beneficiary - healthcare-provider relationship in terms of communication and trust.

A multi-perspective approach to performance anxiety in music students

AbstractPerforming publicly has become increasingly important in a variety of professions. This condition is associated with performance anxiety in almost all performers. Whereas some performers successfully cope with this anxiety, for others it represents a major problem and even threatens their career. Musicians and especially music students were shown to be particularly affected by performance anxiety.Therefore, the goal of this PhD thesis was to gain a better understanding of performance anxiety in university music students. More precisely, the first part of this thesis aimed at increasing knowledge on the occurrence, the experience, and the management of performance anxiety (Article 1). The second part aimed at investigating the hypothesis that there is an underlying hyperventilation problem in musicians with a high level of anxiety before a performance. This hypothesis was addressed in two ways: firstly, by investigating the association between the negative affective dimension of music performance anxiety (MPA) and self-perceived physiological symptoms that are known to co-occur with hyperventilation (Article 2) and secondly, by analyzing this association on the physiological level before a private (audience-free) and a public performance (Article 3). Article 4 places some key variables of Article 3 in a larger context by jointly analyzing the phases before, during, and after performing.The main results of the self-report data show (a) that stage fright is experienced as a problem by one-third of the surveyed students, (b) that the students express a considerable need for more help to better cope with it, and (c) that there is a positive association between negative feelings of MPA and the self-reported hyperventilation complaints before performing. This latter finding was confirmed on the physiological level in a tendency of particularly high performance-anxious musicians to hyperventilate. Furthermore, the psycho-physiological activation increased from a private to a public performance, and was higher during the performances than before or after them. The physiological activation was mainly independent of the MPA score. Finally, there was a low response coherence between the actual physiological activation and the self-reports on the instantaneous anxiety, tension, and perceived physiological activation.Given the high proportion of music students who consider stage fright as a problem and given the need for more help to better cope with it, a better understanding of this phenomenon and its inclusion in the educational process is fundamental to prevent future occupational problems. On the physiological level, breathing exercises might be a good means to decrease - but also to increase - the arousal associated with a public performance in order to meet an optimal level of arousal needed for a good performance.

Saponins from Swartzia langsdorffii: biological activities

The presence of saponins and the molluscicidal activity of the roots, leaves, seeds and fruits of Swartzia langsdorffii Raddi (Leguminosae) against Biomphalaria glabrata adults and eggs were investigated. The roots, seeds and fruits were macerated in 95% ethanol. These extracts exerted a significant molluscicidal activity against B. glabrata, up to a dilution of 100 mg/l. Four mixtures (A2, B2, C and D) of triterpenoid oleanane type saponins were chromatographically isolated from the seed and fruit extracts. Two known saponins (1 and 2) were identified as beta-D-glucopyranosyl-[alpha-L-rhamnopyranosyl-(1->3)- beta-D-glucuronopyranosyl-(1->3)]-3beta-hydroxyolean-12-ene-28 -oate, and beta-D-glucopyranosyl-(1->3)-beta-D-glucuronopyranosyl-(1 ->3)]-3beta-hydroxyolean-12-ene-28-oate, respectively. These two saponins were present in all the mixtures, together with other triterpenoid oleane type saponins, which were shown to be less polar, by reversed-phase HPLC. The saponin identifications were based on spectral evidence, including ¹H-¹H two-dimensional correlation spectroscopy, nuclear Overhauser and exchange spectroscopy, heteronuclear multiple quantum coherence, and heteronuclear multiple-bond connectivity experiments. The toxicity of S. langsdorffii saponins to non-target organisms was prescreened by the brine shrimp lethality test.

Modular analysis of gene expression data with R.

SUMMARY: Large sets of data, such as expression profiles from many samples, require analytic tools to reduce their complexity. The Iterative Signature Algorithm (ISA) is a biclustering algorithm. It was designed to decompose a large set of data into so-called 'modules'. In the context of gene expression data, these modules consist of subsets of genes that exhibit a coherent expression profile only over a subset of microarray experiments. Genes and arrays may be attributed to multiple modules and the level of required coherence can be varied resulting in different 'resolutions' of the modular mapping. In this short note, we introduce two BioConductor software packages written in GNU R: The isa2 package includes an optimized implementation of the ISA and the eisa package provides a convenient interface to run the ISA, visualize its output and put the biclusters into biological context. Potential users of these packages are all R and BioConductor users dealing with tabular (e.g. gene expression) data. AVAILABILITY: http://www.unil.ch/cbg/ISA CONTACT: sven.bergmann@unil.ch