Global trends in myopia management attitudes and strategies in clinical practice – 2019 Update

Purpose: A survey in 2015 identified a high level of eye care practitioner concern about myopia with a reported moderately high level of activity, but the vast majority still prescribed single vision interventions to young myopes. This research aimed to update these findings 4 years later. Methods: A self-administrated, internet-based questionnaire was distributed in eight languages, through professional bodies to eye care practitioners globally. The questions examined: awareness of increasing myopia prevalence, perceived efficacy of available strategies and adoption levels of such strategies, and reasons for not adopting specific strategies. Results: Of the 1336 respondents, concern was highest (9.0 ± 1.6; p < 0.001) in Asia and lowest (7.6 ± 2.2; p < 0.001) in Australasia. Practitioners from Asia also considered their clinical practice of myopia control to be the most active (7.7 ± 2.3; p < 0.001), the North American practitioners being the least active (6.3 ± 2.9; p < 0.001). Orthokeratology was perceived to be the most effective method of myopia control, followed by pharmaceutical approaches and approved myopia control soft contact lenses (p < 0.001). Although significant intra-regional differences existed, overall, most practitioners did not consider single-vision distance under-correction to be an effective strategy for attenuating myopia progression (79.6 %), but prescribed single vision spectacles or contact lenses as the primary mode of correction for myopic patients (63.6 ± 21.8 %). The main justifications for their reluctance to prescribe alternatives to single vision refractive corrections were increased cost (20.6 %) and inadequate information (17.6 %). Conclusions: While practitioner concern about myopia and the reported level of activity have increased over the last 4 years, the vast majority of eye care clinicians still prescribe single vision interventions to young myopes. With recent global consensus evidence-based guidelines having been published, it is hoped that this will inform the practice of myopia management in future

Dotation dans les soins aigus: quelles conséquences pour la qualité des soins ?

Ce travail s’intéresse à la relation entre la qualité des soins prodigués aux patients dans un service de soins aigus et la dotation infirmière. La pertinence de cette thématique reste actuelle et très discutée. Chaque infirmière est confrontée un jour ou l’autre à ce questionnement. Pour cette raison, nous avons essayé d’apporter un éclairage et des réponses. En principe, la dotation devrait respecter un équilibre entre la charge de travail et les ressources allouées (ressources humaines, matériel, outils de planification, etc.) par l’institution. Actuellement, la politique de réduction des coûts des hôpitaux tend à s’opposer aux analyses décrites dans la littérature. En effet, de nombreuses études soulignent l’apparition d’évènements indésirables pour les patients en lien avec un niveau de dotation inadéquat. Cette divergence de points de vue nous a interpellées, c’est pourquoi l’envie de comprendre davantage ces mécanismes est survenue. Finalement, l’un ne pourrait-il pas aller de pair avec l’autre ? Cette réflexion nous a amenées au questionnement suivant: «La dotation serait-elle un moyen pour améliorer la qualité des soins ?»

Mont-de-Marsan (40), Les sites Protohistoriques et Médiévaux de Pémégnan 1 et 2

La fouille des sites Pémégnan 1 et Pémégnan 2 anticipe la construction d’un centre pénitentiaire sur la commune de Mont-de-Marsan, suite à un sondage diagnostic qui avait délimité deux zones à fort potentiel archéologique, avec des indices d’occupations protohistoriques et médiévaux. Au nord, le site de Pémégnan 1, avec une surface de 1500 mètres carrés, s’attachait à caractériser les indices d’occupation historiques, matérialisés par la présence de céramique médiévale, des scories associées à des reliquats de four ou torchis et des possibles structures négatives. La fouille a permis de délimiter une couche d’occupation sous la forme d’une vaste lentille de plan plus ou moins quadrangulaire. Elle livre un abondant mobilier céramique et quelques objets métalliques, l’ensemble étant daté entre les VIe et VIIe siècles de notre ère. Sous cette couche ou à ses abords immédiats, les structures sont de deux types : des fosses dépotoirs liées au fonctionnement domestique du site, et une structure de combustion interprétée comme un bas-fourneau très arasé. Au sud, la fouille du site de Pémégnan 2 porte sur près de 9000 m². Trois concentrations, attribuées à la protohistoire ancienne (Néolithique final/ Bronze ancien) rassemblent un corpus composé essentiellement de tessons issus de grands vases de stockages. Ces concentrations sont en outre accompagnées d’éléments de meulerie. Plusieurs indices d’occupations postérieures, du Bronze moyen mais surtout du Bronze final, sont plus dispersés sur l’ensemble de la surface étudiée, sans réelle cohérence. L’industrie lithique demeure elle-aussi hétérogène et diachronique. Enfin et toujours sur le site de Pémégnan 2, deux concentrations et une structure caractérisent l’extension des occupations au haut Moyen-Age déjà abordées avec le site de Pémégnan 1. Il s’agit dans le premier cas de simples concentrations, sans aménagements décelables. La structure consiste là encore en un bas-fourneau dont la fouille a livré en très grande quantité des déchets d’activités métallurgiques. Leur étude permet de préciser les modalités de la chaîne opératoire. Pour assurer une étude la plus complète possible des deux zones, la méthodologie instaurée a consisté à fabriquer de grands tamis opérationnels pour assurer un tamisage mécanisé systématique des sédiments selon une grille orthonormée. Plusieurs dizaines de mètres cubes ont ainsi été traités, assurant une représentativité poussée des matériels récoltés, tout en garantissant la possibilité d’analyses spatiales nécessaire à l’analyse d’une fouille extensive

Development of a Robust Capillary Electrophoresis–Mass Spectrometer Interface with a Floating Sheath Liquid Feed

The on-line combination of capillary electrophoresis (CE) with electrospray ionisation mass spectrometry (ESI-MS) has attracted major attention for the in-depth analysis of complex samples. However, CE-MS coupling is not straightforward. We present a novel coaxial sheath liquid CE-MS interface, which is robust and can be used for both hyphenated techniques, liquid chromatography-mass spectrometry (LC-MS) and CE-MS, alternatively on the same mass spectrometer. The two separation techniques can be switched within minutes. To obtain a stable ion spray and avoid electrical problems, the CE-power supply is used to produce the potential for the CE separation and the ESI sprayer tip simultaneously. The necessary sheath liquid is delivered by a pump which floats on the ion sprayer potential of the mass spectrometer, avoiding any current flow towards ground. The sole parameter which has to be adjusted to adapt to different CE conditions is a variable resistor. Analytical applications such as peptide mixture analysis and drug screening are presented

In situ measurement of 3D contact angle in sand based on X-ray computed tomography

Soil water repellency is traditionally expressed as contact angle (CA) and measured destructively on exposed surfaces or derived from flow behavior or measured forces. These approaches cannot map local heterogeneities in CA, which typically exist in intact soil. Here, we explore the potential and limitations of in situ measurements of three-dimensional CAs with simplified benchmark tests and in intact sand. The method is based on a protocol for the freely available OpenFOAM software and applied to segmented X-ray computed tomography (X-ray CT) data. This study scrutinizes its suitability under typical vadose zone conditions, as it was originally developed for rock studies in petroleum engineering. The assets of the method are that it allows for accurate measurement of locally varying, equilibrium contact angles and that they can be linked to pore scale features that cause them. This is demonstrated with rehydrated mucilage structures in sand and the associated change in local CAs, where they touch sand grains. In general, the image acquisition time of polychromatic X-ray CT (minutes) precludes the assessments of dynamic CAs that may equilibrate within seconds. Another limitation is that acute CAs are overestimated due to the voxel discretization of interfaces and contact lines in combination with image smoothing. The divergence arises around 60 degrees and is most severe in the limit of vanishing water repellency. In summary, the method enables the mapping of local heterogeneities of equilibrium CAs, though the absolute values should be critically assessed.ISSN:1539-166

Une séquence lœssique, des paléosols et des silex à Saint-Soupplets, au pied des buttes de la Goële (Seine-et-Marne)

Les logiques d’accumulation des lœss sont bien connues dans le nord de la France et en Normandie où cette couverture est quasiment continue. Ces séquences limoneuses dilatées ont permis d’établir un cadre chronoclimatique très précis du dernier cycle glaciaire (Lautridou 1985 ; Antoine et al. 2003). Les sites archéologiques du Paléolithique inférieur, moyen et supérieur ancien sont extrêmement bien conservés dans ces formations et il est possible de les inscrire dans leur environnement (Antoi..

Multimode Ytterbium–Aluminosilicate Core Optical Fibre for Amplification and Laser Applications

Rare-earth-doped optical fibres are widely used in lasers and amplifiers. The incorporation of ytterbium and aluminium oxide in a high doping concentration has led to the fabrication of a multi-mode (MM) optical fibre. Within this research, the design, preparation and calculation for the production of a fibre with a targeted 45 μm core diameter are explored. By Energy Dispersive X-ray (EDX) analysis, the doping concentrations of the elements in the core have been measured as 60.4 at.% Al and 1 at.% Yb. Supporting micrographs are used for confirming the core/cladding ratio. Based on the atomic percentage concentration, the calculated refractive index of the multi-element core has an n = 1.61 and an NA = 0.678. Characterisation of the fibre, including absorption and emission cross-section analysis, was performed in order to prove the ability of the fibre to be used for amplification as well as lasing applications

Le site paléolithique à ossements de mammouth de Changis-sur-Marne (Seine-et-Marne)

International audienc

Hematological safety of metamizole: retrospective analysis of WHO and Swiss spontaneous safety reports

Purpose: Since the 1970s, the use of metamizole is controversial due to the risk of agranulocytosis. The aim of this study was to analyze individual case safety reports (ICSRs) of metamizole-associated hematological adverse drug reactions (ADRs). Methods: International and Swiss metamizole-associated ICSR concerning selected hematological ADR were retrieved from VigiBase™, the World Health Organization Global Database of ICSR, and the Swiss Pharmacovigilance Database. We evaluated demographic data, co-medication, drug administration information, dose and duration of metamizole treatment, as well as the latency time of ADR, their course, and severity. The subgroup analysis of Swiss reports allowed us to analyze cases with fatal outcome more in depth and to estimate a rough minimal incidence rate. Results: A total of 1417 international and 77 Swiss reports were analyzed. Around 52% of the international and 33% of the Swiss metamizole-associated hematological ADR occurred within a latency time of ≤7days. More women were affected. The annual number of hematological reports and those with fatal outcome increased over the last years parallel to metamizole sales figures. In Switzerland, the minimal incidence rate of agranulocytosis was 0.46-1.63 cases per million person-days of use (2006-2012). Female sex, old age, pancytopenia, and co-medication with methotrexate were striking characteristics of the seven Swiss fatal cases. Conclusions: Metamizole-associated hematological ADR remain frequently reported. This is underscored by increasing annual reporting rates, which mainly reflect growing metamizole use. Early detection of myelotoxicity and avoidance of other myelotoxic substances such as methotrexate are important measures for preventing fatalities