ROCK Inhibitors in Corneal Diseases and Glaucoma-A Comprehensive Review of These Emerging Drugs

Rho kinase (ROCK) inhibitors have gained significant attention as emerging novel treatment options in the field of ophthalmology in recent years. The evidence supporting their efficacy in glaucoma and corneal pathology includes both in vitro and clinical studies. Among the available options, ripasudil and netarsudil have emerged as the leading ROCK inhibitors, and some countries have approved these therapeutic options as treatments for glaucoma. Various dosing regimens have been studied, including monotherapy and combination therapy, especially for patients with secondary glaucoma who are already on multiple medications. Another rising application of ROCK inhibitors includes their use as an adjunct in surgical procedures such as Descemetorhexis Without Endothelial Keratoplasty (DWEK), Descemet Stripping Only (DSO) to accelerate visual recovery, glaucoma surgeries to reduce scarring process and allow better intraocular pressure (IOP) control, or after complicated anterior segment surgery to treat corneal oedema. This article provides a comprehensive overview of the existing literature in the field, offering recommendations for prescribing ROCK inhibitors and also discussing patient selection, drug efficacy, and possible adverse effects

Radar array diagnosis from undersampled data using a compressed sensing/sparse recovery technique

A Compressed Sensing/Sparse Recovery approach is adopted in this paper for the accurate diagnosis of fault array elements from undersampled data. Experimental validations on a slotted waveguide test array are discussed to demonstrate the effectiveness of the proposed procedure in the failures retrieval from a small set of measurements with respect to the number of radiating elements. Due to the sparsity feature of the proposed formulation, the method is particularly appealing for the diagnostics of large arrays, typically adopted for radar applications

The growth and erosion of cinder cones in Guatemala and El Salvador: Models and statistics

Morphologic data for 147 cinder cones in southern Guatemala andwestern El Salvador are comparedwith data from the San Francisco volcanic field, Arizona (USA), Cima volcanic field, California (USA), Michoácan–Guanajuato volcanic field, Mexico, and the Lamongan volcanic field, East Java. The Guatemala cones have an average height of 110+/-50 m, an average basal diameter of 660+/-230 m and an average top diameter of 180+/-150 m. The generalmorphology of these cones can be described by their average cone angle of slope (24+/-7), average heightto- radius ratio (0.33+/-0.09) and their flatness (0.24+/-0.18). Although the mean values for the Guatemalan cones are similar to those for other volcanic fields (e.g., San Francisco volcanic field, Arizona; Cima volcanic field, California; Michoácan–Guanajuato volcanic field, Mexico; and Lamongan volcanic field, East Java), the range of morphologies encompasses almost all of those observed worldwide for cinder cones. Three new 40Ar/39Ar age dates are combined with 19 previously published dates for cones in Guatemala and El Salvador. There is no indication that the morphologies of these cones have changed over the last 500–1000 ka. Furthermore, a re-analysis of published data for other volcanic fields suggests that only in the Cima volcanic field (of those studied) is there clear evidence of degradation with age. Preliminary results of a numerical model of cinder cone growth are used to show that the range of morphologies observed in the Guatemalan cinder cones could all be primary, that is, due to processes occurring at the time of eruption

Continuing medical education and evidence-based clinical pathways. Training emergency health workers in Latium, Italy

Background: In recent decades, studies that evaluate training programmes have shown that continuing education for physicians is not very effective in improving performance and behavioural changes. One of our goals was to create a Continuing Medical Education Programme (CMEP) that would result in changing the behaviour of health professionals. In early 2005, a new CMEP was offered to emergency medical services and emergency room professionals to introduce an Emergency Critical Pathway (ECP) for the management of acute stroke patients. This paper illustrates the main characteristics of the educational model and the strategies and activities adopted to realize it. Methods: The training programme was planned and organized applying the concepts and tools of experiential learning, It was organised in three successive phases: 1.) interviews with health professionals to identify their learning ne-eds; 2) training the ECP coordinators/facilitators in a residential setting; and 3) on-site training in small groups of health professionals (6-8), led by a coordinator/facilitator. Results: The CME involved 324 emergency health professionals, Participants positively evaluated both the educational programme and the clinical indications of the protocols. Over six months of the ECP training, health professionals treated 657 stroke patients: 153 (23.3%) were transferred to the stroke unit where 15 (9.8%) were thrombolysed. In the same period of the previous year, the professionals treated 638 patients: 99 (15.5%) were transferred to the stroke unit and no patients were thrombolysed. Conclusion: The application of the new educational methodology has contributed to improved management of stroke patients in Latium.</p

Continuing medical education and evidence-based clinical pathways. Training emergency health workers in Latium, Italy

Background: In recent decades, studies that evaluate training programmes have shown that continuing education for physicians is not very effective in improving performance and behavioural changes. One of our goals was to create a Continuing Medical Education Programme (CMEP) that would result in changing the behaviour of health professionals. In early 2005, a new CMEP was offered to emergency medical services and emergency room professionals to introduce an Emergency Critical Pathway (ECP) for the management of acute stroke patients. This paper illustrates the main characteristics of the educational model and the strategies and activities adopted to realize it. Methods: The training programme was planned and organized applying the concepts and tools of experiential learning, It was organised in three successive phases: 1.) interviews with health professionals to identify their learning ne-eds; 2) training the ECP coordinators/facilitators in a residential setting; and 3) on-site training in small groups of health professionals (6-8), led by a coordinator/facilitator. Results: The CME involved 324 emergency health professionals, Participants positively evaluated both the educational programme and the clinical indications of the protocols. Over six months of the ECP training, health professionals treated 657 stroke patients: 153 (23.3%) were transferred to the stroke unit where 15 (9.8%) were thrombolysed. In the same period of the previous year, the professionals treated 638 patients: 99 (15.5%) were transferred to the stroke unit and no patients were thrombolysed. Conclusion: The application of the new educational methodology has contributed to improved management of stroke patients in Latium.</p

The growth and erosion of cinder cones in Guatemala and El Salvador: Models and statistics

Morphologic data for 147 cinder cones in southern Guatemala andwestern El Salvador are comparedwith data from the San Francisco volcanic field, Arizona (USA), Cima volcanic field, California (USA), Michoácan–Guanajuato volcanic field, Mexico, and the Lamongan volcanic field, East Java. The Guatemala cones have an average height of 110+/-50 m, an average basal diameter of 660+/-230 m and an average top diameter of 180+/-150 m. The generalmorphology of these cones can be described by their average cone angle of slope (24+/-7), average heightto- radius ratio (0.33+/-0.09) and their flatness (0.24+/-0.18). Although the mean values for the Guatemalan cones are similar to those for other volcanic fields (e.g., San Francisco volcanic field, Arizona; Cima volcanic field, California; Michoácan–Guanajuato volcanic field, Mexico; and Lamongan volcanic field, East Java), the range of morphologies encompasses almost all of those observed worldwide for cinder cones. Three new 40Ar/39Ar age dates are combined with 19 previously published dates for cones in Guatemala and El Salvador. There is no indication that the morphologies of these cones have changed over the last 500–1000 ka. Furthermore, a re-analysis of published data for other volcanic fields suggests that only in the Cima volcanic field (of those studied) is there clear evidence of degradation with age. Preliminary results of a numerical model of cinder cone growth are used to show that the range of morphologies observed in the Guatemalan cinder cones could all be primary, that is, due to processes occurring at the time of eruption

Sustained low influenza vaccination in health care workers after H1N1 pandemic: A cross sectional study in an Italian health care setting for at-risk patients

Background: Despite consistent recommendations by all Public Health Authorities in support of annual influenza vaccination for at-risk categories, there is still a low uptake of influenza vaccine in these groups including health care workers (HCWs). Aim of this observational two-phase study was to estimate the immunization rates for influenza in four subsequent seasons and for pandemic H1N1 influenza in HCWs of a University Hospital, and to investigate its distribution pattern and the main determinants of immunization. Phase 1 data collection was performed in 2009-2010, during the peak of H1N1 pandemic. Phase 2 data collection, aimed to investigate seasonal influenza vaccination coverage in the three seasons after pandemic, was performed in 2012-2013. Methods: The overall H1N1 vaccination rate was derived by the Hospital immunization registry. In 2010, the personnel of three Departments (Infectious Diseases, Pediatrics and Gynecology/Obstetrics) completed a survey on influenza. A second-phase analysis was performed in 2012 to investigate influenza vaccination coverage in three consecutive seasons. Results: The first-phase survey showed a low coverage for influenza in all categories (17 %), with the lowest rate in nurses (8.1 %). A total of 37 % of health care workers received H1N1 vaccine, with the highest rate among physicians and the lowest in nurses. H1N1 vaccination was closely related to the Department, being higher in the Department of Infectious Diseases (53.7 %) and Pediatrics (42.4 %) than in Gynecology/Obstetrics (8.3 %). The second-phase survey showed the lowest rate of influenza vaccination in 2012/13 season. The main reasons for not being vaccinated were "Unsure of the efficacy of vaccine" and "Feel not at-risk of getting influenza or its complications". Despite recommendations, influenza vaccine uptake remains poor. Conclusion: Immunization is largely perceived as a personal protection rather than a measure needed to prevent disease spreading to at-risk patients. Compulsory vaccination against influenza should be considered as a possible strategy, at least in health institutions where at-risk patients are admitted

Theory of mechanical unfolding of homopolymer globule: all-or-none transition in force-clamp mode vs phase coexistence in position-clamp mode

Equilibrium mechanical unfolding of a globule formed by long flexible homopolymer chain collapsed in a poor solvent and subjected to an extensional force f (force-clamp mode) or extensional deformation D (position-clamp mode) is studied theoretically. Our analysis, like all previous analysis of this problem, shows that the globule behaves essentially differently in two modes of extension. In the force-clamp mode, mechanical unfolding of the globule with increasing applied force occurs without intramolecular microphase segregation, and at certain threshold value of the pulling force the globule unfolds as a whole ("all-or-none" transition). The value of the threshold force and the corresponding jump in the distance between the chain ends increase with a deterioration of the solvent quality and/or with an increase in the degree of polymerization. In the position-clamp mode, the globule unfolding occurs via intramolecular microphase coexistence of globular and extended microphases followed by an abrupt unraveling transition. Reaction force in the microphase segregation regime demonstrates an "anomalous" decrease with increasing extension. Comparison of deformation curves in force and position-clamp modes demonstrates that at weak and strong extensions the curves for two modes coincide, differences are observed in the intermediate extension range. Another unfolding scenario is typical for short globules: in both modes of extension they unfold continuously, without jumps or intramolecular microphase coexistence, by passing a sequence of uniformly elongated configurations.Comment: 19 pages, 13 figures, 1 tabl

The Magnetic Distortion Calibration System of the LHCb RICH1 Detector

The LHCb RICH1 detector uses hybrid photon detectors (HPDs) as its optical sensors. A calibration system has been constructed to provide corrections for distortions that are primarily due to external magnetic fields. We describe here the system design, construction, operation and performance.Comment: 9 pages, 14 figure