The Relationship between Intraocular Pressure Reduction and Rates of Progressive Visual Field Loss in Eyes with Optic Disc Hemorrhage

Purpose: To evaluate rates of visual field progression in eyes with optic disc hemorrhages and the effect of intraocular pressure (IOP) reduction on these rates. Design: Observational cohort study. Participants: The study included 510 eyes of 348 patients with glaucoma who were recruited from the Diagnostic Innovations in Glaucoma Study (DIGS) and followed for an average of 8.2 years. Methods: Eyes were followed annually with clinical examination, standard automated perimetry visual fields, and optic disc stereophotographs. The presence of optic disc hemorrhages was determined on the basis of masked evaluation of optic disc stereophotographs. Evaluation of rates of visual field change during follow-up was performed using the visual field index (VFI). Main Outcome Measures: The evaluation of the effect of optic disc hemorrhages on rates of visual field progression was performed using random coefficient models. Estimates of rates of change for individual eyes were obtained by best linear unbiased prediction (BLUP). Results: During follow-up, 97 (19%) of the eyes had at least 1 episode of disc hemorrhage. The overall rate of VFI change in eyes with hemorrhages was significantly faster than in eyes without hemorrhages (-0.88%/year vs. -0.38%/year, respectively, P < 0.001). The difference in rates of visual field loss pre- and post-hemorrhage was significantly related to the reduction of IOP in the post-hemorrhage period compared with the pre-hemorrhage period (r = -0.61; P < 0.001). Each 1 mmHg of IOP reduction was associated with a difference of 0.31%/year in the rate of VFI change. Conclusions: There was a beneficial effect of treatment in slowing rates of progressive visual field loss in eyes with optic disc hemorrhage. Further research should elucidate the reasons why some patients with hemorrhages respond well to IOP reduction and others seem to continue to progress despite a significant reduction in IOP levels. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. Ophthalmology 2010; 117: 2061-2066 (C) 2010 by the American Academy of Ophthalmology.

A Comparison of Rates of Change in Neuroretinal Rim Area and Retinal Nerve Fiber Layer Thickness in Progressive Glaucoma

PURPOSE. To evaluate and compare rates of change in neuro-retinal rim area (RA) and retinal nerve fiber layer thickness (RNFLT) measurements in glaucoma patients, those with suspected glaucoma, and normal subjects observed over time. METHODS. In this observational cohort study, patients recruited from two longitudinal studies (Diagnostic Innovations in Glaucoma Study-DIGS and African Descent and Evaluation Study-ADAGES) were observed with standard achromatic perimetry (SAP), optic disc stereophotographs, confocal scanning laser ophthalmoscopy (HRT-3; Heidelberg Engineering, Heidelberg, Germany), and scanning laser polarimetry (GDx-VCC; Carl Zeiss Meditec, Inc., Dublin, CA). Glaucoma progression was determined by the Guided Progression Analysis software for standard automated perimetry [SAP] and by masked assessment of serial optic disc stereophotographs by expert graders. Random-coefficients models were used to evaluate rates of change in average RNFLT and global RA measurements and their relationship with glaucoma progression. RESULTS. At baseline, 194 (31%) eyes were glaucomatous, 347 (55%) had suspected glaucoma, and 88 (14%) were normal. Forty-six (9%) eyes showed progression by SAP and/or stereophotographs, during an average follow-up of 3.3 (+/-0.7) years. The average rate of decline for RNFLT measurements was significantly higher in the progressing group than in the non-progressing group (-0.65 vs. -0.11 mu m/y, respectively; P < 0.001), whereas RA decline was not significantly different between these groups (-0.0058 vs. -0.0073 mm(2)/y, respectively; P = 0.727). The areas under the receiver operating characteristic (ROC) curves used to discriminate progressing versus nonprogressing eyes were 0.811 and 0.507 for the rates of change in the RNFLT and RA, respectively (P < 0.001). CONCLUSIONS. The ability to discriminate eyes with progressing glaucoma by SAP and/or stereophotographs from stable eyes was significantly greater for RNFLT than for RA measurements. (Invest Ophthalmol Vis Sci. 2010;51:3531-3539) DOI: 10.1167/iovs.09-4350

Modulation of Auditory and Visual Processing by Delta-9-Tetrahydrocannabinol and Cannabidiol: an fMRI Study

Although the effects of cannabis on perception are well documented, little is known about their neural basis or how these may contribute to the formation of psychotic symptoms. We used functional magnetic resonance imaging (fMRI) to assess the effects of Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) during visual and auditory processing in healthy volunteers. In total, 14 healthy volunteers were scanned on three occasions. Identical 10mg THC, 600mg CBD, and placebo capsules were allocated in a balanced double-blinded pseudo-randomized crossover design. Plasma levels of each substance, physiological parameters, and measures of psychopathology were taken at baseline and at regular intervals following ingestion of substances. Volunteers listened passively to words read and viewed a radial visual checkerboard in alternating blocks during fMRI scanning. Administration of THC was associated with increases in anxiety, intoxication, and positive psychotic symptoms, whereas CBD had no significant symptomatic effects. THC decreased activation relative to placebo in bilateral temporal cortices during auditory processing, and increased and decreased activation in different visual areas during visual processing. CBD was associated with activation in right temporal cortex during auditory processing, and when contrasted, THC and CBD had opposite effects in the right posterior superior temporal gyrus, the right-sided homolog to Wernicke`s area. Moreover, the attenuation of activation in this area (maximum 61, -15, -2) by THC during auditory processing was correlated with its acute effect on psychotic symptoms. Single doses of THC and CBD differently modulate brain function in areas that process auditory and visual stimuli and relate to induced psychotic symptoms. Neuropsychopharmacology (2011) 36, 1340-1348; doi:10.1038/npp.2011.17; published online 16 March 2011

A genomewide survey of developmentally relevant genes in Ciona intestinalis - V. Genes for receptor tyrosine kinase pathway and Notch signaling pathway

In the present survey, we identified most of the genes involved in the receptor tyrosine kinase (RTK), mitogen activated protein kinase (MAPK) and Notch signaling pathways in the draft genome sequence of Ciona intestinalis, a basal chordate. Compared to vertebrates, most of the genes found in the Ciona genome had fewer paralogues, although several genes including ephrin, Eph and fringe appeared to have multiplied or duplicated independently in the ascidian genome. In contrast, some genes including kit/flt, PDGF and Trk receptor tyrosine kinases were not found in the present survey, suggesting that these genes are innovations in the vertebrate lineage or lost in the ascidian lineage. The gene set identified in the present analysis provides an insight into genes for the RTK, MAPK and Notch signaling pathways in the ancient chordate genome and thereby how chordates evolved these signaling pathway.

Knowledge and technologies in innovative information systems

7th Mediterranean Conference on Information Systems, MCIS 2012, Guimaraes, Portugal, September 8-10, 2012, Proceedings Series: Lecture Notes in Business Information Processing, Vol. 129

Action, reaction and protest by publishers in 1960s Portugal: books and other publications in the Catholic opposition

The authoritarian regime of the Portuguese Estado Novo (New State), the longest dictatorship in twentieth-century Western Europe, suffered one of its most serious threats during the late 1950s and the whole of the following decade. An array of events and dynamics of opposition to the regime and condemnation of the political and social situation in Portugal appeared at that time. One of the core groups that displayed their dissidence in the 1960s, with the awakening of their critical conscience, originated in Catholic sectors that rallied the laity and the clergy to express their disagreement or even break with the government of Salazar (and, later, Marcelo Caetano). This article aims to establish the role of print culture and, in particular, publishing in the opposition’s mobilisation of Catholics who criticised the Estado Novo. It will also closely examine the contribution of certain publishers to the formulation of the terms of this mobilisation, in publishing new authors and topics and creating new printed forums (e.g. periodicals) for discussion and reflection. The most detailed case will be that of the publishing house Livraria Moraes Editora, under the command of the publisher António Alçada Baptista.

Farm 2.0 Using Wordpress to Manage Geocontent and Promote Regional Food Products

Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies.

Gastric adenocarcinoma: contribute of computed tomography in preoperative T nad N staging

RESUMO:Os recentes progressos na imagiologia médica possibilitaram um papel de destaque para a Tomografia Axial Computorizada Multicorte no estadiamento do carcinoma do estômago (GA). Foi objetivo deste estudo avaliar a acuidade desta técnica no estadiamento T (invasão mural) e N (ganglionar) e avaliar fatores de prognóstico como fatores de representação/substituição para melhorar a referida acuidade. Sessenta e nove pacientes operados a carcinoma gástrico (GA) entre Janeiro de 2010 e Julho de 2012 e avaliados por Tomografia Computorizada, a maioria recorrendo a técnica de multicorte com distensão gástrica, foram estadiados retrospetivamente por três imagiologistas. Utilizaram-se critérios de avaliação referidos na literatura especializada e fatores de substituição/representação nos estadios menos eficazes. O estadiamento T revelou acuidade de 66,7% e sensibilidade de 92% e a acuidade, sensibilidade e especificidade obtidas para o estadiamento N foram respetivamente 49%, 40,9% e 64%. Usando um fator de substituição de estadiamento diagnóstico T4/N2 para mudar o estadiamento N2 obtido por MDCT para estadiamento N3A aumentaria a acuidade do estadiamento N para 59% e a sensibilidade para 58,1% e baixaria a especificidade para 61,5%, embora essa mudança não fosse estatisticamente significativa (Teste exato de Fisher 0,159). Em conclusão a acuidade de uma técnica simples de MDCT com distensão gástrica no estadiamento T e N do GA está dentro dos valores citados na literatura e fatores de substituição/representação como o estadiamento T4 e o tipo Difuso da classificação de Lauren podem melhorar a acuidade do estadiamento N.-------------- ABSTRACT: Recent innovations in medical sectional imaging have allowed a major role of multi-detector computed tomography (MDCT) in staging of gastric adenocarcinoma (GA). The purpose of this study was to evaluate the accuracy of this technique in depth of mural invasion (T) and nodal (N) staging of GA and to evaluate prognostic factors as surrogate factors to improve such accuracy. Sixty nine patients operated to GA between January 2010 and July 2012 that underwent Computed Tomography, the majority through Multidetector Computed Tomography (MDCT) with gastric distention, were staged retrospectively by three imagiologists with state-of-the-art criteria and surrogate prognostic factors were analyzed for less accurate stages. MDCT T-staging was 66,7 % accurate with a sensibility of 92 % and there was a 49 % accuracy, 40,9 % sensibility and 64 % specificity for N Staging. Using a surrogate factor of T4/N2 diagnostic staging to change diagnostic MDCT N2 disease to N3A disease would increase accuracy of N staging to 59% and sensibility to 58,1% and would decrease specificity to 61,5 %, although that change was not statistically significant (Fisher´s Exact Test 0,159)In conclusion the accuracy of a simple hydro-MDCT technique in T and N staging of GA is in the range of values cited in the literature and surrogate factors as diagnostic T4 disease and diffuse type of Lauren´s Classification may improve the accuracy of N staging.

ISO 9001:2000 - advantages and obstacles in the portuguese construction business

Innovations in Structural Engineering and Construction - ISEC, 2008

Recommendations on quality control and quality assurance in cervical cytology

Objective: We aimed to critically evaluate the importance of quality control (QC) and quality assurance (QA) strategies in the routine work of uterine cervix cytology. Study Design: We revised all the main principles of QC and QA that are already being implemented worldwide and then discussed the positive aspects and limitations of these as well as proposing alternatives when pertinent. Results: A literature review was introduced after highlighting the main historical revisions, and then a critical evaluation of the principal innovations in screening programmes was conducted, with recommendations being postulated. Conclusions: Based on the analysed data, QC and QA are two essential arms that support the quality of a screening programme.

Oligocene CO2 decline promoted C4 photosynthesis in grasses.

C4 photosynthesis is an adaptation derived from the more common C3 photosynthetic pathway that confers a higher productivity under warm temperature and low atmospheric CO2 concentration [1, 2]. C4 evolution has been seen as a consequence of past atmospheric CO2 decline, such as the abrupt CO2 fall 32-25 million years ago (Mya) [3-6]. This relationship has never been tested rigorously, mainly because of a lack of accurate estimates of divergence times for the different C4 lineages [3]. In this study, we inferred a large phylogenetic tree for the grass family and estimated, through Bayesian molecular dating, the ages of the 17 to 18 independent grass C4 lineages. The first transition from C3 to C4 photosynthesis occurred in the Chloridoideae subfamily, 32.0-25.0 Mya. The link between CO2 decrease and transition to C4 photosynthesis was tested by a novel maximum likelihood approach. We showed that the model incorporating the atmospheric CO2 levels was significantly better than the null model, supporting the importance of CO2 decline on C4 photosynthesis evolvability. This finding is relevant for understanding the origin of C4 photosynthesis in grasses, which is one of the most successful ecological and evolutionary innovations in plant history.

Analysing the innovation process in the EU Integrated Programme, ISAFRUIT

ISAFRUIT is an integrated European Union Project focussed on increasing fruit consumption as a means to improve human health, through evaluating the fruit chain and addressing bottlenecks therein.The innovations which are being developed throughout the ISAFRUIT Project have been analysed to determine both the success factors and the obstacles in reaching the commercialisation stage. Only 9.58% of the deliverables planned within the Project were focussed on developing technological innovations.There is evidence, however, of successes in the development of new innovations arising from the ISAFRUIT Project, with several other potential innovations in the pipeline. Of the technologies identified, 67% are still at the “invention stage”; that is, the stage prior to bridging the so-called “valley of death”, the stage between an invention and an innovation. Those which are considered to have moved over the “valley of death” either had industry partners included in the Project, or had consulted with industry to ensure that the technology was relevant, or met a recognised industry need. Many of the technologies which made less progress did not have the same interactions with industry. A number of other issues were identified which prevented further progress towards innovation. The need for scientists to publish scientific papers, both for their career pathways and to increase their chances of future funding, was identified as one issue, although the filing of patents is now becoming more accepted and recognised. The patenting system is considered complex by many scientists and is not well-understood. Finally, agreements between partners on the sharing of intellectual property rights can cause a delay in the innovation process.

Technology, business models and network structure in the airline industry

Network airlines have been increasingly focusing their operations on hub airports through the exploitation of connecting traffic, allowing them to take advantage of economies of traffic density, which are unequivocal in the airline industry. Less attention has been devoted to airlines? decisions on point-to-point thin routes, which could be served using different aircraft technologies and different business models. This paper examines, both theoretically and empirically, the impact on airlines ?networks of the two major innovations in the airline industry in the last two decades: the regional jet technology and the low-cost business model. We show that, under certain circumstances, direct services on point-to-point thin routes can be viable and thus airlines may be interested in deviating passengers out of the hub.

Technology, business models and network structure in the airline industry

Network airlines have been increasingly focusing their operations on hub airports through the exploitation of connecting traffic, allowing them to take advantage of economies of traffic density, which are unequivocal in the airline industry. Less attention has been devoted to airlines' decisions on point-to-point thin routes, which could be served using different aircraft technologies and different business models. This paper examines, both theoretically and empirically, the impact on airlines' networks of the two major innovations in the airline industry in the last two decades: the regional jet technology and the low-cost business model. We show that, under certain circumstances, direct services on point-to-point thin routes can be viable and thus airlines may be interested in deviating passengers out of the hub. Keywords: regional jet technology; low-cost business model; point-to-point network; hub-and-spoke network JEL Classi…fication Numbers: L13; L2; L93

'Greek' and 'Roman' in Latin Medical Texts. Studies in Cultural Change and Exchange in Ancient Medicine : [Proceedings of the 10th International Conference "Ancient Latin Medical Texts", Lausanne, 2010, November 3rd-6th November]

Latin medical texts transmit medical theories and practices that originated mainly in Greece. This interaction took place through juxtaposition, assimilation and transformation of ideas. 'Greek' and 'Roman' in Latin Medical Texts studies the ways in which this cultural interaction influenced the development of the medical profession and the growth of knowledge of human and animal bodies, and especially how it provided the foundations for innovations in the areas of anatomy, pathology and pharmacology, from the earliest Latin medical texts until well into the medieval world.