The effect of systematic lens parameter variation on the fitting characteristics of RGP lenses

In the art of rigid contact lens fitting, practitioners must be able to make judgements to obtain the desired fit and to overcome wearing problems for the contact lens patient. The new rigid gas permable (RGP) lens materials offer the practitioner opportunity to optimize contact lens design for use in fitting and patient management. Successful fitting techniques using RGP lenses demand careful patient selection, understanding of design principles, and proper material selection. The use of diagnostic fitting and flourescein examination can be powerful tools in reaching a successful fit and management evaluation for your patients. This paper/video will discuss and illustrate the effects of variations in base curve, diameter, power, center thickness, and edge profile. Through use of high resolution biomicroscopy we will demonstrate how varying these parameters will clinically alter the lens-cornea fitting relationship

Diagnostic and prognostic value of bone biomarkers in progressive knee osteoarthritis: a 6-year follow-up study in middle-aged subjects

SummaryObjectiveTo determine the value of bone markers in early-stage progressive knee osteoarthritis (OA), a population-based cohort of middle-aged subjects with chronic knee complaints was followed over 6 years (two consecutive two 3-year periods).MethodsTibiofemoral (TF) and patellofemoral (PF) radiographs were graded in 128 subjects (mean age at baseline 45 ± 6.2 years) in 2002, 2005 and 2008. Bone formation was assessed by the serum concentration of procollagen type I amino-terminal propeptide (sPINP); bone resorption by the level of the C-terminal cross-linked telopeptides of type I collagen (sCTx-I); and bone mineralization by the values of osteocalcin (sOC) by electrochemiluminescence immunoassay. A novel marker of bone resorption, urinary osteocalcin midfragments (uMidOC), was assayed using enzyme linked immunosorbent assay (ELISA).ResultsSeveral diagnostic associations were found between the bone markers (PINP, OC, MidOC) and progressive OA expressed by TF osteophytosis. The increasing output of MidOC demonstrated several-fold higher risk for progressive TF osteophytosis [odds ratio (OR) 5.32; 95% confidence interval (CI) 1.41–20.06, P = 0.014] than other bone markers. The values of PINP had prognostic value for subsequent more severely expressed knee OA progression [r(s) = 0.460, P = 0.005].ConclusionsBone metabolism is activated in early-stage knee OA. OA progression was preceded by the enhanced bone formation (by PINP) and accompanied by the activation of bone formation (by PINP), non-collagenous bone resorption (by MidOC), as well as by changes in mineralization (by OC). All three bone markers had diagnostic value, and one of them, PINP, had also a predictive value for knee OA progression, especially for progressive osteophytosis

Theorising Global Governance Inside Out: A Response to Professor Ladeur

Professor Ladeur argues that administrative law’s postmodernism (and by extension Global Administrative Law) necessitates that we move beyond relying on ideas of delegation, account- ability and legitimacy. Global Governance, particularly Global Administrative Law and Global Constitutionalism, should try to adapt and experiment with the changing nature of the postmod- ern legality and support the creation of norms that will adapt to the complexities of globalisation. Ladeur’s contestation, similar to GAL’s propositions, can be challenged. By taking the International Criminal Tribunal for Rwanda, a significant contributor to the field of international criminal law, as an example, it is suggested that the creation of networks that Ladeur makes visible may not account for ‘regulatory capture’. This paper will argue that from the outside, the proliferation of networks may suggest that spontaneous accountability is possible. A closer look, however, drawing on anthropological insights from the ICTR, reveals that international institutions are suscepti- ble to capture by special interests. Furthermore, there are two central themes that animate the response to Professor Ladeur: the political nature of international institutions and the history of international law, and the role of institutions in this history

Mending a Broken Heart: Treatment of Stress-Induced Heart Failure after Solid Organ Transplantation

Stress-induced heart failure, also known as Broken Heart Syndrome or Takotsubo Syndrome, is a phenomenon characterized as rare but well described in the literature, with increasing incidence. While more commonly associated with postmenopausal women with psychiatric disorders, this entity is found in the postoperative patient. The nonischemic cardiogenic shock manifests as biventricular failure with significant decreases in ejection fraction and cardiac function. In a review of over 3000 kidney and liver transplantations over the course of 17 years within two transplant centers, we describe a series of 7 patients with Takotsubo Syndrome after solid organ transplantation. Furthermore, we describe a novel approach of successfully treating the transient, though potentially fatal, cardiogenic shock with a percutaneous ventricular assistance device in two liver transplant patients, while treating one kidney transplant patient medically and the remaining four liver transplant patients with an intra-aortic balloon pump. We describe our experience with Takotsubo’s Syndrome and compare the three modalities of treatment and cardiac augmentation. Our series is novel in introducing the percutaneous ventricular assist device as a more minimally invasive intervention in treating nonischemic heart failure in the solid organ transplant patient, while serving as a comprehensive overview of treatment modalities for stress-induced heart failure

Widespread Treponema pallidum Infection in Nonhuman Primates, Tanzania

We investigated Treponema pallidum infection in 8 nonhuman primate species (289 animals) in Tanzania during 2015–2017. We used a serologic treponemal test to detect antibodies against the bacterium. Infection was further confirmed from tissue samples of skin-ulcerated animals by 3 independent PCRs (polA, tp47, and TP_0619). Our findings indicate that T. pallidum infection is geographically widespread in Tanzania and occurs in several species (olive baboons, yellow baboons, vervet monkeys, and blue monkeys). We found the bacterium at 11 of 14 investigated geographic locations. Anogenital ulceration was the most common clinical manifestation; orofacial lesions also were observed. Molecular data show that nonhuman primates in Tanzania are most likely infected with T. pallidum subsp. pertenue–like strains, which could have implications for human yaws eradication

Review of battery electric vehicle propulsion systems incorporating flywheel energy storage

The development of battery electric vehicles (BEV) must continue since this can lead us towards a zero emission transport system. There has been an advent of the production BEVs in recent years; however their low range and high cost still remain the two important drawbacks. The battery is the element which strongly affects the cost and range of the BEV. The batteries offer either high specific power or high specific energy but not both. To provide the BEVs with the characteristic to compete with conventional vehicles it is beneficial to hybridize the energy storage combining a high energy battery with a high power source. This shields the battery from peak currents and improves its capacity and life. There are various devices which could qualify as a secondary storage system for the BEV such as high power battery, supercapacitor and high speed flywheel (FW). This paper aims to review a specific type of hybridisation of energy storage which combines batteries and high speed flywheels. The flywheel has been used as a secondary energy system in BEVs from the early 1970s when the oil crises triggered an interest in BEVs. Since the last decade the interest in flywheels has strengthened and their application in the kinetic energy recovery system (KERS) in Formula 1 has further bolstered the case for flywheels. With a number of automotive manufacturers getting involved in developing flywheels for road applications, the authors believe commercial flywheel based powertrains are likely to be seen in the near future. It is hence timely to produce a review of research and development in the area of flywheel assisted BEVs