Bilateral keratoprostheses in a patient with ocular mucous membrane pemphigoid.

Mucous membrane pemphigoid (MMP) with ocular involvement, also referred to as ocular cicatricial pemphigoid, is a rare, autoimmune blistering disease that can have devastating effects for patients. The resulting corneal neovascularization, recurrent corneal abrasions, and ulceration can ultimately result in severe vision loss. We present a 64-year-old man with recalcitrant ocular MMP and consequently advanced corneal involvement that received bilateral keratoprostheses. This case highlights an aggressive but successful placement of bilateral keratoprostheses in recalcitrant ocular MMP, which restored his vision and ultimately his quality of life

Performance And Satisfaction In Adaptive Websites: An Experiment On Searches Within A Task-Adapted Website

Finding information within websites is becoming an increasing challenge as the size and the complexity of websites soar. One possible solution is to adapt the view of the site to the task in hand. Although such a procedure is technically feasible, the effectiveness of such designs is yet to be tested. Assuming user scenarios that involve searches by browsing rather than structured queries, we build on models of searching in text to formulate a task representation of searches within websites. This task representation is used to model the effects of adapted websites on performance and satisfaction. We have, therefore, two main aims: (1) to propose a task representation of website searches, and (2) to use it to explore the effect of adaptive designs on performance and satisfaction. In an experiment with a simulated adaptive website, the impact of an adapted site is compared with that of a non-adapted site in terms of time, accuracy, and perceived complexity of completing a search task and satisfaction with the human-computer interaction. The results indicate that adapted sites improve performance but not overall satisfaction. A breakdown of the components of satisfaction reveals that users are unhappy with the changing menus. Part of the explanation may be their perceptions that adaptive sites are less consistent and, therefore, more complex

Stable Secretaries

We define and study a new variant of the secretary problem. Whereas in the classic setting multiple secretaries compete for a single position, we study the case where the secretaries arrive one at a time and are assigned, in an on-line fashion, to one of multiple positions. Secretaries are ranked according to talent, as in the original formulation, and in addition positions are ranked according to attractiveness. To evaluate an online matching mechanism, we use the notion of blocking pairs from stable matching theory: our goal is to maximize the number of positions (or secretaries) that do not take part in a blocking pair. This is compared with a stable matching in which no blocking pair exists. We consider the case where secretaries arrive randomly, as well as that of an adversarial arrival order, and provide corresponding upper and lower bounds.Comment: Accepted for presentation at the 18th ACM conference on Economics and Computation (EC 2017

Modulational instability in nonlinear periodic structures: Implications for ‘‘gap solitons’’

A nonlinear periodic structure can convert an input continuous wave beam into a train of pulses. This modulational instability implies that the nonlinear spatial resonance (‘‘gap solitons’’) of distributed feedback structures are generally unstable. Stability is assured only for low coupling strengths or large detunings from the Bragg condition.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/70181/2/APPLAB-58-10-1001-1.pd

The \u3ci\u3eChildren and Parents in Focus\u3c/i\u3e Project: A Population-Based Cluster-Randomised Controlled Trial to Prevent Behavioural and Emotional Problems in Children

Background: There is large body of knowledge to support the importance of early interventions to improve child health and development. Nonetheless, it is important to identify cost-effective blends of preventive interventions with adequate coverage and feasible delivery modes. The aim of the Children and Parents in Focus trial is to compare two levels of parenting programme intensity and rate of exposure, with a control condition to address impact and cost-effectiveness of a universally offered evidence-based parenting programme in the Swedish context. Methods/Design: The trial has a cluster randomised controlled design comprising three arms: Universal arm (with access to participation in Triple P - Positive Parenting Program, level 2); Universal Plus arm (with access to participation in Triple P - Positive Parenting Program, level 2 as well as level 3, and level 4 group); and Services as Usual arm. The sampling frame is Uppsala municipality in Sweden. Child health centres consecutively recruit parents of children aged 3 to 5 years before their yearly check-ups (during the years 2013–2017). Outcomes will be measured annually. The primary outcome will be children’s behavioural and emotional problems as rated by three informants: fathers, mothers and preschool teachers. The other outcomes will be parents’ behaviour and parents’ general health. Health economic evaluations will analyse cost-effectiveness of the interventions versus care as usual by comparing the costs and consequences in terms of impact on children’s mental health, parent’s mental health and health-related quality of life. Discussion: This study addresses the need for comprehensive evaluation of the long-term effects, costs and benefits of early parenting interventions embedded within existing systems. In addition, the study will generate population-based data on the mental health and well-being of preschool aged children in Sweden. Trial registration: ISRCTN: ISRCTN16513449

A systematic review of internet-based worksite wellness approaches for cardiovascular disease risk management: outcomes, challenges & opportunities.

ContextThe internet is gaining popularity as a means of delivering employee-based cardiovascular (CV) wellness interventions though little is known about the cardiovascular health outcomes of these programs. In this review, we examined the effectiveness of internet-based employee cardiovascular wellness and prevention programs.Evidence acquisitionWe conducted a systematic review by searching PubMed, Web of Science and Cochrane library for all published studies on internet-based programs aimed at improving CV health among employees up to November 2012. We grouped the outcomes according to the American Heart Association (AHA) indicators of cardiovascular wellbeing--weight, BP, lipids, smoking, physical activity, diet, and blood glucose.Evidence synthesisA total of 18 randomized trials and 11 follow-up studies met our inclusion/exclusion criteria. Follow-up duration ranged from 6-24 months. There were significant differences in intervention types and number of components in each intervention. Modest improvements were observed in more than half of the studies with weight related outcomes while no improvement was seen in virtually all the studies with physical activity outcome. In general, internet-based programs were more successful if the interventions also included some physical contact and environmental modification, and if they were targeted at specific disease entities such as hypertension. Only a few of the studies were conducted in persons at-risk for CVD, none in blue-collar workers or low-income earners.ConclusionInternet based programs hold promise for improving the cardiovascular wellness among employees however much work is required to fully understand its utility and long term impact especially in special/at-risk populations