Widening use of dexamethasone implant for the treatment of macular edema

Sustained-release intravitreal 0.7 mg dexamethasone (DEX) implant is approved in Europe for the treatment of macular edema related to diabetic retinopathy, branch retinal vein occlusion, central retinal vein occlusion, and non-infectious uveitis. The implant is formulated in a biodegradable copolymer to release the active ingredient within the vitreous chamber for up to 6 months after an intravitreal injection, allowing a prolonged interval of efficacy between injections with a good safety profile. Various other ocular pathologies with inflammatory etio­pathogeneses associated with macular edema have been treated by DEX implant, including neovascular age-related macular degeneration, Irvine–Gass syndrome, vasoproliferative retinal tumors, retinal telangiectasia, Coats’ disease, radiation maculopathy, retinitis pigmentosa, and macular edema secondary to scleral buckling and pars plana vitrectomy. We undertook a review to provide a comprehensive collection of all of the diseases that benefit from the use of the sustained-release DEX implant, alone or in combination with concomitant therapies. A MEDLINE search revealed lack of randomized controlled trials related to these indications. Therefore we included and analyzed all available studies (retrospective and prospective, com­parative and non-comparative, randomized and nonrandomized, single center and multicenter, and case report). There are reports in the literature of the use of DEX implant across a range of macular edema-related pathologies, with their clinical experience supporting the use of DEX implant on a case-by-case basis with the aim of improving patient outcomes in many macular pathologies. As many of the reported macular pathologies are difficult to treat, a new treat­ment option that has a beneficial influence on the clinical course of the disease may be useful in clinical practice

The rationale of development practices for expert systems : an empirical investigation

Practices of expert system development are not widely investigated. In this paper I describe results of case studies on the inhouse deployment of small expert systems in two companies, along with a review of empirical research. The investigation focuses on the underlying rationale of the observed practices during the stages of design, field transfer and use. The examples show the importance of integrative approaches to technical and organizational aspects of development projects. The remaining potential for organizational turbulences is explained with inherent tensions of the rationale

Creating a center for global health at the University of Wisconsin-Madison.

Globalization, migration, and widespread health disparities call for interdisciplinary approaches to improve health care at home and abroad. Health professions students are pursuing study abroad in increasing numbers, and universities are responding with programs to address these needs. The University of Wisconsin (UW)-Madison schools of medicine and public health, nursing, pharmacy, veterinary medicine, and the division of international studies have created an interdisciplinary center for global health (CGH). The CGH provides health professions and graduate students with courses, field experiences, and a new Certificate in Global Health. Educational programs have catalyzed a network of enthusiastic UW global health scholars. Partnerships with colleagues in less economically developed countries provide the foundation for education, research, and service programs. Participants have collaborated to improve the education of health professionals and nutrition in Uganda; explore the interplay between culture, community development, and health in Ecuador; improve animal health and address domestic violence in Mexico; and examine successful public health efforts in Thailand. These programs supply students with opportunities to understand the complex determinants of health and structure of health systems, develop adaptability and cross-cultural communication skills, experience learning and working in interdisciplinary teams, and promote equity and reduce health disparities at home and abroad. Based on the principles of equity, sustainability, and reciprocity, the CGH provides a strong foundation to address global health challenges through networking and collaboration among students, staff, and faculty within the UW and beyond

The Extensive (But Fragile) Authority of the WTO Appellate Body

The authority of an international court (IC) is not necessarily evolutionary and its development unidirectional. This article addresses the authority of the Appellate Body (AB) of the World Trade Organization (WTO) and shows how it rapidly and almost immediately became extensive, but has since exhibited signs of becoming more fragile. The article applies a typology of IC authority developed by Alter, Helfer and Madsen (2014) and explains the transformation from narrow authority (a dispute resolution venue under the GATT based on political negotiations) to extensive authority (a judicialized WTO dispute settlement system with a sophisticated case law) and presents empirical indicators of the rise of the AB’s authority. Such rapid development of extensive authority is arguably a unique case in international politics at the multilateral level. That authority nonetheless remains fragile, and shows signs that it could decline significantly for reasons we explain

How to reduce long-term drift in present-day and deep-time simulations?

Climate models are often affected by long-term drift that is revealed by the evolution of global variables such as the ocean temperature or the surface air temperature. This spurious trend reduces the fidelity to initial conditions and has a great influence on the equilibrium climate after long simulation times. Useful insight on the nature of the climate drift can be obtained using two global metrics, i.e. the energy imbalance at the top of the atmosphere and at the ocean surface. The former is an indicator of the limitations within a given climate model, at the level of both numerical implementation and physical parameterisations, while the latter is an indicator of the goodness of the tuning procedure. Using the MIT general circulation model, we construct different configurations with various degree of complexity (i.e. different parameterisations for the bulk cloud albedo, inclusion or not of friction heating, different bathymetry configurations) to which we apply the same tuning procedure in order to obtain control runs for fixed external forcing where the climate drift is minimised. We find that the interplay between tuning procedure and different configurations of the same climate model provides crucial information on the stability of the control runs and on the goodness of a given parameterisation. This approach is particularly relevant for constructing good-quality control runs of the geological past where huge uncertainties are found in both initial and boundary conditions. We will focus on robust results that can be generally applied to other climate models.Comment: 12 pages, 9 figures, accepted for publication in Climate Dynamic

Wrap-up session

Listening to the case studies that were presented it became quite evident that the best data management systems were the ones where data managers and research scientists worked as a team developed in the early stages of project planning. Examples that were given included WOCE Data Assembly Centres e.g., Drifters, the Global Temperature Salinity Pilot Project (GTSPP) collaboration with Joint Analyses Centres in the U.S. and Australia, and JGOFS/BOFS development of Topical Centres. While each of these has some elements unique to the project, each had brought together 'teams' of Principal Investigators (PI's) and data management experts at an early stage of project development. Conversely, projects which had considered data management as a totally separate activity with lower priority often failed to provide the service required to meet scientific objectives. Therefore, the following actions should be brought to the attention of relevant groups within the IOC and other international organizations: (1) Publicize, at the national and international level, underway data/scientist collaborations that may be used as models in planning for the future. (2) Reduce adversarial situations where data managers and scientists appear to be in competition. (3) Colocation and other forms of collaboration often results in very high quality data sets and more timely data submission. Improved timeliness of data submissions was a common theme throughout the workshop and must be considered an important element in all future plans. Improvements in timely submission of data were noted. In order to continue this trend the advantages of timely submission of data must be stressed to those planning new ocean science projects

Lessons Learned from Developing a New Distance-Learning Masters Course in the Green Economy

It is widely recognised that for the green economy to develop successfully, new educational curricula will be required to help professionals develop appropriate knowledge and skills. Relatively few university courses have been developed to date that explicitly focus on the green economy, reflecting its recent origins. Here we present the lessons learned from developing and implementing a new Masters course in the green economy, at Bournemouth University in the UK. The most significant challenges were institutional barriers, such as different departmental policies and procedures and decentralised budget strategies, which inhibited the cross-departmental collaboration desired for interdisciplinarity. Uncertainty about the future development of the green economy and its value as a concept, among both teaching staff and prospective students, presented a further challenge. In addition, the development of an appropriate curriculum for green economy courses has received little attention previously. Here, we present an overview of the curriculum developed for this Masters-level course, and, based on our experience, we demonstrate how the challenges in developing such a course can successfully be overcome