A Case Report Discussing The Options for Placement of Glaucoma Drainage Devices in the Presence of Corneal Decompensation

Purpose: The purpose of this case report is to discuss how the various placements of glaucoma drainage implants relate to corneal decompensation. Method: A 58-year Hispanic female presented for evaluation of decreased vision in the left eye for 2 years. This is a case report of a patient who underwent a secondary surgery to replace the anterior tube shunt implantation with a posterior shunt implantation following development of severe corneal decompensation. Results: Glaucoma tube shunt implants inserted into the ciliary sulcus of pseudophakic eyes shield the cornea offering protection against decompensation and avoid the risk of posterior segment complications. Conclusions: Placement of glaucoma drainage implants into the ciliary sulcus in pseudophakic patients with shallow anterior chambers, abnormal irido-corneal anatomy, or those at risk for corneal decompensation is a safe and effective method of not only lowering the intraocular pressure but also protecting the cornea against decompensation. As primary eye care providers, optometrists need to know the various treatment options and adverse effects associated with each procedure

A Case Report Discussing an Uncommon Peripheral Exudative Hemorrhagic Chorioretinopathy

Purpose: The purpose of this case report is to discuss an uncommon, unique hemorrhagic chorioretinopathy. Method: A 79-year-old-white female presented to clinic with complaints of difficulty reading at close distances and seeing faces at far distances in both eyes. An 85-year old white female presented with no visual complaints but stated redness in the nasal corner of her right eye. This is a case report of two patients that presented with geographic atrophy of the macula as well as midperipheral RPE alterations in both eyes, which resembled intraretinal hemorrhages. Results: The ocular findings associated with peripheral exudative hemorrhagic chorioretinopathy may include midperipheral intraretinal hemorrhages, peripheral RPE mottling, subretinal fluid or hemorrhages, subretinal exudation, pigment epithelial detachments, and/or vitreous hemorrhages. Conclusions: Although this condition is rare, primary eye care providers should be aware of this unique clinical entity, its relationship to age-related macular degeneration, and when these patients require a referral to a retinal specialist

Reducing inconsistencies in point observations of maximum flood inundation level

Flood simulation models and hazard maps are only as good as the underlying data against which they are calibrated and tested. However, extreme flood events are by definition rare, so the observational data of flood inundation extent are limited in both quality and quantity. The relative importance of these observational uncertainties has increased now that computing power and accurate lidar scans make it possible to run high-resolution 2D models to simulate floods in urban areas. However, the value of these simulations is limited by the uncertainty in the true extent of the flood. This paper addresses that challenge by analyzing a point dataset of maximum water extent from a flood event on the River Eden at Carlisle, United Kingdom, in January 2005. The observation dataset is based on a collection of wrack and water marks from two postevent surveys. A smoothing algorithm for identifying, quantifying, and reducing localized inconsistencies in the dataset is proposed and evaluated showing positive results. The proposed smoothing algorithm can be applied in order to improve flood inundation modeling assessment and the determination of risk zones on the floodplain

Conserving socio-ecological landscapes: An analysis of traditional and responsive management practices for floodplain meadows in England

Contemporary practice in the conservation of socio-ecological landscapes draws on both a model of responsive management, and also on ideas about historic management. This study considered what evidence might exist for the exercise of these approaches to management in the conservation of floodplain meadows in England, in order to inform understanding and knowledge of conservation management and assessment practice. Evidence for a model of responsive management was limited, with managing stakeholders often alternating between this model and an alternative approach, called here the ‘traditional management approach’, based on ideas, narratives and prescriptions of long-established land management practices. Limited monitoring and assessment appeared to undermine the former model, whilst uncertainty over past long-standing management practices undermined the latter. As a result of the relative power of conservation actors over farmers delivering site management, and their framings of meadows as ‘natural’ spaces, management tended to oscillate between aspects of these two approaches in a sometimes inconsistent manner. Conservation managers should consider the past motivating drivers and management practices that created the landscapes they wish to conserve, and bear in mind that these are necessarily implicated in aspects of the contemporary landscape value that they wish to maintain. They should ensure that assessment activity captures a broad range of indicators of site value and condition, not only biological composition, and also record data on site management operations in order to ensure management effectiveness

Exploiting the archive: and the animals came in two by two, 16mm, CD-ROM and BetaSp

This a post-print, author-produced version of an article accepted for publication in Area. Copyright © 1999 Wiley Blackwell. The definitive version is available at www3.interscience.wiley.comUsing an account of the construction and subsequent exploitation of the film archive at the BBC's Natural History Unit, this paper explores the ways in which animals are embedded in the different cultures of care, control and commodification in the zoo and the wildlife film-making unit. Network analysis is used to account for the similarities and tensions between these forms of animal exhibition, as revealed in the electronic zoo at Wildscreen World

Cytomegalovirus induces abnormal chondrogenesis and osteogenesis during embryonic mandibular development

<p>Abstract</p> <p>Background</p> <p>Human clinical studies and mouse models clearly demonstrate that cytomegalovirus (CMV) disrupts normal organ and tissue development. Although CMV is one of the most common causes of major birth defects in humans, little is presently known about the mechanism(s) underlying CMV-induced congenital malformations. Our prior studies have demonstrated that CMV infection of first branchial arch derivatives (salivary glands and teeth) induced severely abnormal phenotypes and that CMV has a particular tropism for neural crest-derived mesenchyme (NCM). Since early embryos are barely susceptible to CMV infection, and the extant evidence suggests that the differentiation program needs to be well underway for embryonic tissues to be susceptible to viral infection and viral-induced pathology, the aim of this study was to determine if first branchial arch NCM cells are susceptible to mCMV infection prior to differentiation of NCM derivatives.</p> <p>Results</p> <p>E11 mouse mandibular processes (MANs) were infected with mouse CMV (mCMV) for up to 16 days <it>in vitr</it>o. mCMV infection of undifferentiated embryonic mouse MANs induced micrognathia consequent to decreased Meckel's cartilage chondrogenesis and mandibular osteogenesis. Specifically, mCMV infection resulted in aberrant stromal cellularity, a smaller, misshapen Meckel's cartilage, and mandibular bone and condylar dysmorphogenesis. Analysis of viral distribution indicates that mCMV primarily infects NCM cells and derivatives. Initial localization studies indicate that mCMV infection changed the cell-specific expression of FN, NF-κB2, RelA, RelB, and Shh and Smad7 proteins.</p> <p>Conclusion</p> <p>Our results indicate that mCMV dysregulation of key signaling pathways in primarily NCM cells and their derivatives severely disrupts mandibular morphogenesis and skeletogenesis. The pathogenesis appears to be centered around the canonical and noncanonical NF-κB pathways, and there is unusual juxtaposition of abnormal stromal cells and surrounding matrix. Moreover, since it is critically important that signaling molecules are expressed in appropriate cell populations during development, the aberrant localization of components of relevant signaling pathways may reveal the pathogenic mechanism underlying mandibular malformations.</p

The social and scientific values that shape national climate scenarios: a comparison of the Netherlands, Switzerland and the UK

This paper seeks to understand why climate information is produced differently from country to country. To do this, we critically examined and compared the social and scientific values that shaped the production of three national climate scenarios in the Netherlands, Switzerland and the UK. A comparative analysis of documentary materials and expert interviews linked to the climate scenarios was performed. Our findings reveal a new typology of use-inspired research in climate science for decision-making: (i) innovators, where the advancement of science is the main objective; (ii) consolidators, where knowledge exchanges and networks are prioritised; and (iii) collaborators, where the needs of users are put first and foremost. These different values over what constitutes ‘good’ science for decision-making are mirrored in the way users were involved in the production process: (i) elicitation, where scientists have privileged decision-making power; (ii) representation, where multiple organisations mediate on behalf of individual users; and (iii) participation, where a multitude of users interact with scientists in an equal partnership. These differences help explain why climate knowledge gains its credibility and legitimacy differently even when the information itself might not be judged as salient and usable. If the push to deliberately co-produce climate knowledge is not sensitive to the national civic epistemology at play in each country, scientist–user interactions may fail to deliver more ‘usable’ climate information

Joint stakeholder decision-making on the management of the Silao-Romita aquifer using AHP

Over-exploitation and pollution have been identified as the main problems facing the Silao-Romita aquifer in Guanajuato, Mexico. The objective of this paper is to analyze the current situation, characterized by a clear lack of legislative enforcement, dispersion of competences, and scarcity of economic resources, in order to establish a new prioritization of action plans, and choose from among three specific management options. One of the main challenges when addressing these problems in a holistic manner is the conflicting viewpoints of the sectors involved. As each stakeholder has a different perception, there is a clear need for appropriate mechanisms to reach a consensus in decision-making. To achieve the objective, we use the Analytic Hierarchy Process (AHP), because of its flexibility and the availability of mathematical axiomatic principles and techniques to obtain group preferences and priorities. In addition, we use several tools developed by the authors to obtain consistency, streamline the trade-off between stakeholder know-how and synthetic consistency, and consistently complete partial judgments given by some of the stakeholders. The problem of obtaining a consensus among the actors involved regarding criteria and alternatives is also considered. The obtained results are intended to serve as guidelines for conducting priority actions to help solve the general problem of the study area, and to identify the management model that best meets the needs of the aquifer, according to the actors involved. (C) 2013 Elsevier Ltd. All rights reserved.This work has been supported by project IDAWAS, DPI2009-11591 of the Spanish Ministry of Science and Innovation; with supplementary support from ACOMP/2011/188 of the education department of the Generalitat Valenciana. The first author wishes to thank CONACYT for the 10007-2011-01 scholarship program. The use of English in this paper was revised by John Rawlins.Delgado Galván, XV.; Izquierdo Sebastián, J.; Benítez López, J.; Pérez García, R. (2014). Joint stakeholder decision-making on the management of the Silao-Romita aquifer using AHP. Environmental Modelling & Software. 51:310-322. https://doi.org/10.1016/j.envsoft.2013.10.008S3103225

Prostatic Artery Embolization as a Primary Treatment for Benign Prostatic Hyperplasia: Preliminary Results in Two Patients

Symptomatic benign prostatic hyperplasia (BPH) typically occurs in the sixth and seventh decades, and the most frequent obstructive urinary symptoms are hesitancy, decreased urinary stream, sensation of incomplete emptying, nocturia, frequency, and urgency. Various medications, specifically 5-α-reductase inhibitors and selective α-blockers, can decrease the severity of the symptoms secondary to BPH, but prostatectomy is still considered to be the traditional method of management. We report the preliminary results for two patients with acute urinary retention due to BPH, successfully treated by prostate artery embolization (PAE). The patients were investigated using the International Prostate Symptom Score, by digital rectal examination, urodynamic testing, prostate biopsy, transrectal ultrasound (US), and magnetic resonance imaging (MRI). Uroflowmetry and postvoid residual urine volume complemented the investigation at 30, 90, and 180 days after PAE. The procedure was performed under local anesthesia; embolization of the prostate arteries was performed with a microcatheter and 300- to 500-μm microspheres using complete stasis as the end point. One patient was subjected to bilateral PAE and the other to unilateral PAE; they urinated spontaneously after removal of the urethral catheter, 15 and 10 days after the procedure, respectively. At 6-month follow-up, US and MRI revealed a prostate reduction of 39.7% and 47.8%, respectively, for the bilateral PAE and 25.5 and 27.8%, respectively, for the patient submitted to unilateral PAE. The early results, at 6-month follow-up, for the two patients with BPH show a promising potential alternative for treatment with PAE

Discovery of 4,6-disubstituted pyrimidines as potent inhibitors of the heat shock factor 1 (HSF1) stress pathway and CDK9.

Heat shock factor 1 (HSF1) is a transcription factor that plays key roles in cancer, including providing a mechanism for cell survival under proteotoxic stress. Therefore, inhibition of the HSF1-stress pathway represents an exciting new opportunity in cancer treatment. We employed an unbiased phenotypic screen to discover inhibitors of the HSF1-stress pathway. Using this approach we identified an initial hit (1) based on a 4,6-pyrimidine scaffold (2.00 μM). Optimisation of cellular SAR led to an inhibitor with improved potency (25, 15 nM) in the HSF1 phenotypic assay. The 4,6-pyrimidine 25 was also shown to have high potency against the CDK9 enzyme (3 nM)