Quantitative evaluation of visual function 12 months after bilateral implantation of a diffractive trifocal IOL

PURPOSE: To quantitatively evaluate visual function 12 months after bilateral implantation of the Physiol FineVision® trifocal intraocular lens (IOL) and to compare these results with those obtained in the first postoperative month. METHODS: In this prospective case series, 20 eyes of 10 consecutive patients were included. Monocular and binocular, uncorrected and corrected visual acuities (distance, near, and intermediate) were measured. Metrovision® was used to test contrast sensitivity under static and dynamic conditions, both in photopic and low-mesopic settings. The same software was used for pupillometry and glare evaluation. Motion, achromatic, and chromatic contrast discrimination were tested using 2 innovative psychophysical tests. A complete ophthalmologic examination was performed preoperatively and at 1, 3, 6, and 12 months postoperatively. Psychophysical tests were performed 1 month after surgery and repeated 12 months postoperatively. RESULTS: Final distance uncorrected visual acuity (VA) was 0.00 ± 0.08 and distance corrected VA was 0.00 ± 0.05 logMAR. Distance corrected near VA was 0.00 ± 0.09 and distance corrected intermediate VA was 0.00 ± 0.06 logMAR. Glare testing, pupillometry, contrast sensitivity, motion, and chromatic and achromatic contrast discrimination did not differ significantly between the first and last visit (p>0.05) or when compared to an age-matched control group (p>0.05). CONCLUSIONS: The Physiol FineVision® trifocal IOL provided satisfactory full range of vision and quality of vision parameters 12 months after surgery. Visual acuity and psychophysical tests did not vary significantly between the first and last visit

Contrôle et lutte contre la fraude du patient européen

Il est des chiffres qui donnent le vertige. Incontestablement, ceux concernant les pertes dues à la fraude et la corruption en matière de soins en font partie. Certaines estimations font en effet état de 56 milliards d'euros perdus annuellement en Europe, ce qui représente près de 80 millions de perte chaque jour et plus de 5% de l'ensemble des budgets nationaux consacrés à la santé (Gee et alii, 2010)

Soluble human Suppression of Tumorigenicity 2 is associated with endoscopic activity in patients with moderate-to-severe ulcerative colitis treated with golimumab

Suppressor of Tumorigenicity 2 (ST2) is an IL33 receptor detected in the mucosa and serum of ulcerative colitis (UC) patients. We evaluated soluble ST2 (sST2) as a surrogate biomarker of disease outcome and therapeutic response, in moderate-to-severe UC patients treated with golimumab.Agência financiadora Merck Sharp and Dohme, Lda, Portugal MK8259-22info:eu-repo/semantics/publishedVersio

The Doctor, the Smoking Patient and the Challenge of Electronic Cigarettes

Apesar dos esforços e das medidas de prevenção e controlo que vêm sendo adotadas desde a década de 80 do século passado, o tabagismo continua a ser, em Portugal e no mundo, um dos mais importantes fatores evitáveis de doença crónica e de mortalidade prematura. 1 A carga da doença atribuível ao tabaco em Portugal foi estimada por Borges et al 2 há mais de uma década. Nesse estudo 11,7% das mortes em Portugal foram atribuídas ao consumo de tabaco. Medida a carga da doença atra- vés dos anos de vida ajustados por incapacidade (disabi- lity adjusted life years — DALY) gerados pela mortalidade, a proporção da carga da doença atribuível ao tabaco foi de 11,2%. Baseados em dados disponíveis para Portugal, em 2005, os autores evidenciaram grande disparidade na análise de género, sendo o tabaco no homem responsável por 15,4% da carga da doença e 17,7% das mortes, e na mulher responsável por 4,9% da carga da doença e 5,2% das mortes. O estudo apresentava ainda estimativas sobre a carga da doença redutível, ou seja, a redução de mortali- dade e DALY que ocorreriam se os fumadores abandonas- sem o tabagismo e passassem a apresentar o risco médio das populações de ex-fumadores, caso em que a carga da doença se reduziria em 5,8% (7,8% dos homens e 2,8% das mulheres) e as mortes em 5,8% (8,5% dos homens e 2,9% das mulheres). Nos anos seguintes, muito foi feito em Portugal para melhorar o controlo do tabagismo. No entan- to, e apesar destes esforços, o consumo de tabaco é ainda crescente na mulher portuguesa 1 . Em 2007, a Direção-Geral de Saúde emitiu o Progra- ma-Tipo de Actuação em Cessação Tabágica 3 e em 2008, a Convenção-Quadro para o Controlo do Tabagismo da Organização Mundial de Saúde (OMS) propôs um conjunto de estratégias concertadas para ajudar os países a contro- lar a epidemia do tabaco e a reduzir o seu rasto mortífero. 4 O acrónimo MPOWER resume as seis políticas com mais impacto: M — Monitorizar a epidemia e as políticas de con- trolo; P — Proteger do fumo ambiental; O — Oferecer ajuda na cessação tabágica; W — (Warn) avisar sobre os male- fícios do tabaco; E — (Enforce bans) Impor a proibição da publicidade, promoção e patrocínio do tabaco; R — (Raise taxes) Aumentar os impostos sobre os produtos do taba- co. Estes pilares viriam a servir de referência para o Plano Nacional para a Prevenção e Controlo do Tabagismo (PNPCT) em Portugal, lançado em 2012. 5 Oferecer ajuda na cessação tabágica é uma das principais estratégias no controlo do tabagismo, mas as restantes medidas preconi- zadas pela OMS necessitam de implementação e desen- volvimento, para que o seu efeito sinérgico se faça sentir. Um enorme desafio surgiu, nos últimos anos, com o aparecimento de novos produtos de tabaco, entre os quais os cigarros electrónicos (CE), que podem colocar em cau- sa os esforços desenvolvidos nas últimas duas décadas. Em Portugal, este fenómeno é ainda menos expressivo do que o observado em muitos países, mas obriga o médico a estar bem informado sobre estes novos produtos e os seus riscos (já conhecidos ou potenciais). Apesar da população portuguesa ter aumentado a per- cepção de risco relacionado com estes produtos, 6 cerca de um terço da população europeia (29,1%) não sabe se são ou não prejudiciais. 6 Consequentemente, tem-se verificado um aumento crescente da sua experimentação e consumo diário, não só em Portugal 6 como na Europa em geral. 7 Habitualmente o médico não aborda o consumo de CE com o seu doente. Uma investigação recente 8 conclui que apenas uma minoria dos médicos o faz de acordo com as recomendações para a melhor prática da cessação tabági- ca. Um dos maiores problemas da ‘discussão sobre cigar- ros eletrónicos’ é o da ambivalência gerada pela incerteza e contradição da informação científica disponível.info:eu-repo/semantics/publishedVersio

Socio-Economic Instability and the Scaling of Energy Use with Population Size

The size of the human population is relevant to the development of a sustainable world, yet the forces setting growth or declines in the human population are poorly understood. Generally, population growth rates depend on whether new individuals compete for the same energy (leading to Malthusian or density-dependent growth) or help to generate new energy (leading to exponential and super-exponential growth). It has been hypothesized that exponential and super-exponential growth in humans has resulted from carrying capacity, which is in part determined by energy availability, keeping pace with or exceeding the rate of population growth. We evaluated the relationship between energy use and population size for countries with long records of both and the world as a whole to assess whether energy yields are consistent with the idea of an increasing carrying capacity. We find that on average energy use has indeed kept pace with population size over long time periods. We also show, however, that the energy-population scaling exponent plummets during, and its temporal variability increases preceding, periods of social, political, technological, and environmental change. We suggest that efforts to increase the reliability of future energy yields may be essential for stabilizing both population growth and the global socio-economic system

Environmental Costs of Government-Sponsored Agrarian Settlements in Brazilian Amazonia

Brazil has presided over the most comprehensive agrarian reform frontier colonization program on Earth, in which ~1.2 million settlers have been translocated by successive governments since the 1970's, mostly into forested hinterlands of Brazilian Amazonia. These settlements encompass 5.3% of this ~5 million km2 region, but have contributed with 13.5% of all land conversion into agropastoral land uses. The Brazilian Federal Agrarian Agency (INCRA) has repeatedly claimed that deforestation in these areas largely predates the sanctioned arrival of new settlers. Here, we quantify rates of natural vegetation conversion across 1911 agrarian settlements allocated to 568 Amazonian counties and compare fire incidence and deforestation rates before and after the official occupation of settlements by migrant farmers. The timing and spatial distribution of deforestation and fires in our analysis provides irrefutable chronological and spatially explicit evidence of agropastoral conversion both inside and immediately outside agrarian settlements over the last decade. Deforestation rates are strongly related to local human population density and road access to regional markets. Agrarian settlements consistently accelerated rates of deforestation and fires, compared to neighboring areas outside settlements, but within the same counties. Relocated smallholders allocated to forest areas undoubtedly operate as pivotal agents of deforestation, and most of the forest clearance occurs in the aftermath of government-induced migration

Novel mutations in TARDBP (TDP-43) in patients with familial amyotrophic lateral sclerosis.

The TAR DNA-binding protein 43 (TDP-43) has been identified as the major disease protein in amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration with ubiquitin inclusions (FTLD-U), defining a novel class of neurodegenerative conditions: the TDP-43 proteinopathies. The first pathogenic mutations in the gene encoding TDP-43 (TARDBP) were recently reported in familial and sporadic ALS patients, supporting a direct role for TDP-43 in neurodegeneration. In this study, we report the identification and functional analyses of two novel and one known mutation in TARDBP that we identified as a result of extensive mutation analyses in a cohort of 296 patients with variable neurodegenerative diseases associated with TDP-43 histopathology. Three different heterozygous missense mutations in exon 6 of TARDBP (p.M337V, p.N345K, and p.I383V) were identified in the analysis of 92 familial ALS patients (3.3%), while no mutations were detected in 24 patients with sporadic ALS or 180 patients with other TDP-43-positive neurodegenerative diseases. The presence of p.M337V, p.N345K, and p.I383V was excluded in 825 controls and 652 additional sporadic ALS patients. All three mutations affect highly conserved amino acid residues in the C-terminal part of TDP-43 known to be involved in protein-protein interactions. Biochemical analysis of TDP-43 in ALS patient cell lines revealed a substantial increase in caspase cleaved fragments, including the approximately 25 kDa fragment, compared to control cell lines. Our findings support TARDBP mutations as a cause of ALS. Based on the specific C-terminal location of the mutations and the accumulation of a smaller C-terminal fragment, we speculate that TARDBP mutations may cause a toxic gain of function through novel protein interactions or intracellular accumulation of TDP-43 fragments leading to apoptosis

Effects of university affiliation and “school spirit” on color preferences: Berkeley versus Stanford

The ecological valence theory (EVT) posits that preference for a color is determined by people’s average affective response to everything associated with it (Palmer & Schloss, Proceedings of the National Academy of Sciences, 107, 8877–8882, 2010). The EVT thus implies the existence of sociocultural effects: Color preference should increase with positive feelings (or decrease with negative feelings) toward an institution strongly associated with a color. We tested this prediction by measuring undergraduates’ color preferences at two rival universities, Berkeley and Stanford, to determine whether students liked their university’s colors better than their rivals did. Students not only preferred their own colors more than their rivals did, but the degree of their preference increased with self-rated positive affect (“school spirit”) for their university. These results support the EVT’s claim that color preference is caused by learned affective responses to associated objects and institutions, because it is unlikely that students choose their university or develop their degree of school spirit on the basis of preexisting color preferences