Cause of Death in Long-Term Substance Use: A Scoping Study and Review of The Implications For End of Life and Palliative Care

Older people who use substances are more likely than general populations to have complex non-cancer pathologies which are under-represented in palliative care services. Our work explores mortality and morbidity relevant to end of life care and reveals discrepancies in provision for people who use substances, identifying possible explanations. We make recommendations for improved governance to inform policy and practice change

Combined tissue excision and corneal tuck for the surgical treatment of extremely advanced pellucid marginal corneal degeneration

Pellucid marginal corneal degeneration (PMCD) is managed surgically in the advanced stages of the disease, but extreme thinning extending over a very wide area in most of the corneal circumference represents a true surgical challenge that makes conventional approaches unsuitable. Here, we present the results of a new procedure (partial excision of the corneal ectasia and tuck of the residual thinned corneal lips left behind) performed in 3 eyes of 2 patients with extremely advanced PMCD, judged unsuitable for undergoing conventional surgical approaches. Preoperatively, uncorrected visual acuity was limited to the perception of hand motion in 1 eye, which presented with hydrops, and to finger counting at 1 m in the other 2 eyes. With a follow-up of 3 to 4 years, a complete, stable resolution of the ectasia was seen in all cases. As early as 1 year postoperatively, the best spectacle-corrected visual acuity was 20/30 to 20/50 with no subsequent substantial changes. Partial excision of the ectasia and tucking was found to work successfully at achieving both a new corneal shape compatible with visual rehabilitation and restoring peripheral corneal thickness in advanced cases of PMCD that were unsuitable for conventional surgery. © 2013 by Lippincott Williams & Wilkins

Higher order aberrations in keratoconus‏

Introduction: Keratoconus is a progressive disorder of the cornea that causes thinning (Sedaghat et al. in Sci Rep 11(1):11971, 2021), ectasia, and irregular astigmatism, resulting in poor visual acuity that cannot be corrected with standard sphero-cylindrical spectacle lenses. One feature distinguishing keratoconic corneas is ocular aberrations, manifesting up to five or six times the amount of higher-order aberrations than a normal, healthy eye. These aberrations can cause visual disturbances even at the very early stages of the disease. Methods: In the past, a diagnosis was derived from clinical symptoms, but technological advances have revealed multiple pre-clinical features, allowing for the differentiation between keratoconic and normal eyes at a much earlier stage. These include anterior and posterior corneal surface elevations, the corneal pachymetry profile, corneal epithelial patterns, wavefront aberration metrics, and corneal biomechanics (Sedaghat et al. in Sci Rep 11(1):11971, 2021).This review discusses the aberrations associated with keratoconus, how to measure them, and treatment methods to minimize their negative influence. Conclusions: Early diagnosis can lead to early treatment and may allow for arresting progression, thereby improving the long-term prognosis. With the acceleration of refractive surgery, it is important to identify patients with keratoconus, as they are usually contraindicated for refractive surgery

Structural asymmetry in the magnesium channel CorA points to sequential allosteric regulation

s 35 References 47 Workshop Call for Position Papers 54 List of Figures 1 Interaction of Conceptual and Representational Data Models : : : : : : : : : : : : 14 iii 1 Introduction Temporal databases has been an active area of research for the last fifteen years, with a corpus nearing 700 papers [KLINE93]. Most database conferences include at least one paper on temporal databases (TDB). Temporal databases are now discussed in several undergraduate database textbooks. There are perhaps one hundred researchers actively studying temporal databases. During that time an astonishing diversity of temporal data models and query languages has arisen. Most applications, whether business, engineering, medical, or scientific, need to store historical data. Surprisingly, in spite of both this substantial activity and this pressing requirements from the user community, there are no widely used commercial temporal database management systems (TDBMS). One view is that there is an embarrassment of ri..