Importance of anterior segment tomography for the diagnosis of corneal ectasia

Purpose: The methodology currently used for interpretation of the cornea and anterior segment tomography for the diagnosis of corneal ectasia and its susceptibility. Methods: Description of the methodology and clinical interpretation of corneal and anterior segment tomography indexes; report of three cases demonstrating the importance of this new diagnostic tool (Pentacam HR (R)) in ophthalmological practice. Conclusion: The use of corneal and anterior segment tomography seems to be an effective method to increase the sensitivity and specificity for the diagnosis and early detection of corneal ectasia.

New-onset epilepsy: considerations for initial and follow-up MRI to detect brain tumor

Seizures are often the presenting symptoms of a cerebral tumor and may precede its diagnosis by many years. The article under evaluation searched two large English registries for patients admitted for new-onset epilepsy. The risk of subsequently being diagnosed with a malignant brain tumor was found to be 26-fold higher compared with controls, persisted over many years and was accentuated in young patients. Recently, surgical advances have led to a significant decrease in surgical morbidities, making surgery the first treatment option for gliomas, especially low-grade gliomas. This paradigm shift warrants a consequent diagnostic workup (MRI) in patients at risk for low-grade glioma - that is, patients with new-onset epilepsy. The study is discussed in the context of the ongoing debate on neuroimaging after new-onset epilepsy.

Impact of the early use of immunomodulators or TNF antagonists on bowel damage and surgery in Crohn's disease.

BACKGROUND The impact of early treatment with immunomodulators (IM) and/or TNF antagonists on bowel damage in Crohn's disease (CD) patients is unknown. AIM To assess whether 'early treatment' with IM and/or TNF antagonists, defined as treatment within a 2-year period from the date of CD diagnosis, was associated with development of lesser number of disease complications when compared to 'late treatment', which was defined as treatment initiation after >2 years from the time of CD diagnosis. METHODS Data from the Swiss IBD Cohort Study were analysed. The following outcomes were assessed using Cox proportional hazard modelling: bowel strictures, perianal fistulas, internal fistulas, intestinal surgery, perianal surgery and any of the aforementioned complications. RESULTS The 'early treatment' group of 292 CD patients was compared to the 'late treatment' group of 248 CD patients. We found that 'early treatment' with IM or TNF antagonists alone was associated with reduced risk of bowel strictures [hazard ratio (HR) 0.496, P = 0.004 for IM; HR 0.276, P = 0.018 for TNF antagonists]. Furthermore, 'early treatment' with IM was associated with reduced risk of undergoing intestinal surgery (HR 0.322, P = 0.005), and perianal surgery (HR 0.361, P = 0.042), as well as developing any complication (HR 0.567, P = 0.006). CONCLUSIONS Treatment with immunomodulators or TNF antagonists within the first 2 years of CD diagnosis was associated with reduced risk of developing bowel strictures, when compared to initiating these drugs >2 years after diagnosis. Furthermore, early immunomodulators treatment was associated with reduced risk of intestinal surgery, perianal surgery and any complication.

Factors governing late-recurrence of disease in a cohort of early-stage breast cancer survivors

Purpose. To determine the risk of late breast cancer recurrence (5 years after treatment) in a population of women diagnosed with early-stage breast cancer at The University of Texas M.D. Anderson Cancer Center (MDACC) between 1985-2000 and to examine the effect of this population’s BMI, smoking history, reproductive history, hormone use, and alcohol intake at the time of diagnosis on risk of late recurrence.^ Methods. Patients included 1,913 members of the Early Stage Breast Cancer Repository recruited at MDACC who had survived without a recurrence for at least five years after their initial diagnosis of early stage breast cancer. Clinical and epidemiological information was ascertained twice on participants during the study—first by medical record abstraction then by patient interview at least five years after receipt of adjuvant treatment. A total of 223 late breast cancer recurrences were captured, with an average follow-up of 10.6 years. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). ^

A user-focused integrated system for sustainable refurbishment.

Nowadays, it is urgent to renovate a great number of residential buildings. The necessity of improving energy efficiency must also be considered as an opportunity to improve indoor comfort. To achieve this goal, it is essential to develop tools to be used in the decision-making process, aiming to refurbish buildings in an integrated, efficient and sustainable way. The integrated system developed is based on a set of indicators. Sustainability indicators are useful to synthesize and organize complex information. They can provide data to evaluate a process in different stages: evaluation, diagnosis, comparison and tracing. The set of proposed indicators aims to accomplish the holistic approach pursued by sustainable development. So, these indicators are divided into three groups: environmental, social and economic. However, the main innovation of the system of indicators is the social ones. The sustainable refurbishment system aims to be a user-focused one. Therefore, the starting point is the needs of the user and social indicators are developed around this. The system tackles the sustainable refurbishment of buildings beyond energy problems. It proposes incorporating users in the decision-making process involving them in the refurbishment and so, contributing to the success of the renovation. In order to achieve this target, three social indicators are used, divided into 10 sub-indicators, and a ?Questionnaire about Sustainable Refurbishment? is drawn up. This research has been carried out in the framework of ?Sustainable Refurbishment? Research and Development Project, an integrated project under the supervision of the Centro para el Desarrollo Tecnológico e Industrial (CDTI) from the Spanish Government, in which University and the Construction Industry collaborate. This research project aims to develop an integrated system for the retrofitting of existing buildings to improve their energy efficiency. Accordingly, an additional objective of the project is to improve quality of life of residents.

Detección precoz de dificultades en el aprendizaje. Herramienta para la predicción del rendimiento de los estudiantes

Inspirados por las estrategias de detección precoz aplicadas en medicina, proponemos el diseño y construcción de un sistema de predicción que permita detectar los problemas de aprendizaje de los estudiantes de forma temprana. Partimos de un sistema gamificado para el aprendizaje de Lógica Computacional, del que se recolectan masivamente datos de uso y, sobre todo, resultados de aprendizaje de los estudiantes en la resolución de problemas. Todos estos datos se analizan utilizando técnicas de Machine Learning que ofrecen, como resultado, una predicción del rendimiento de cada alumno. La información se presenta semanalmente en forma de un gráfico de progresión, de fácil interpretación pero con información muy valiosa. El sistema resultante tiene un alto grado de automatización, es progresivo, ofrece resultados desde el principio del curso con predicciones cada vez más precisas, utiliza resultados de aprendizaje y no solo datos de uso, permite evaluar y hacer predicciones sobre las competencias y habilidades adquiridas y contribuye a una evaluación realmente formativa. En definitiva, permite a los profesores guiar a los estudiantes en una mejora de su rendimiento desde etapas muy tempranas, pudiendo reconducir a tiempo los posibles fracasos y motivando a los estudiantes.

The Wheatley manuscript : a collection of Middle English verse and prose contained in a ms. now in the British museum. Add. mss. 39574 /

Fifteenth century manuscript named in honor of Dr. H.B. Wheatley.

The Old English version of the enlarged rule of Chrodegang together with the Latin original. An Old English version of the Capitula of Theodulf together with the Latin original. An interlinear Old English rendering of the Epitome of Benedict of Aniane.

"A fuller introduction, together with notes and a glossary, is in preparation."--Temporary pref.

Seynt Graal, or The Sank Ryal.: The history of the Holy Graal, partly in English verse,

Vol. I, Rev. John Stuart Hippisley Horner's copy (name in red in list of members).

Vices and virtues, being a soul's confession of its sins with reason's description of the virtues. A middle-English dialogue of about 1200 A.D.

Includes index.

The earliest English translation of the first three books of the De imitatione Christi, now first printed from a ms. in the library of Trinity college, Dublin, with various readings from a ms. in the University library, Cambridge. Also the earliest printed translation of the whole work from a copy in the British museum (Books I-III by William Atkynson, D. D., book IV by the Lady Margaret, mother of K. Henry VII, and countess of Richmond and Derby).

Mode of access: Internet.

Essays introductory to the study of English constitutional history,

Henson, H. The early English constitution.--Ashley, W.J. Feudalism.--Oman, C.W.C. The Anglo-Norman and Angevin administrative system (1100-1265)--Medley, D.J. Parliament.--Hassall, A. Constitutional kingship (1399-1485)--Wakeman, H.O. The influence of the church upon the development of the state.

English fragments from Latin medieval service-books;

Mode of access: Internet.

History of the holy rood-tree, a twelfth century version of the cross legend, with Notes on the orthography of the Ormulum (with a facsimile) and a Middle English Compassio Mariae.

Bibliography: p. x-xi.

The lay folks' Mass book : or, Manner of hearing Mass : with rubric and devations for the people; in four texts ; and, Offices in English according to the use of York : from MSS. of the Xth to the XVth century /

Includes glossary and index