Guidance on noncorticosteroid systemic immunomodulatory therapy in noninfectious uveitis: fundamentals of care for uveitis (focus) initiative

Topic: An international, expert-led consensus initiative to develop systematic, evidence-based recommendations for the treatment of noninfectious uveitis in the era of biologics. Clinical Relevance: The availability of biologic agents for the treatment of human eye disease has altered practice patterns for the management of noninfectious uveitis. Current guidelines are insufficient to assure optimal use of noncorticosteroid systemic immunomodulatory agents. Methods: An international expert steering committee comprising 9 uveitis specialists (including both ophthalmologists and rheumatologists) identified clinical questions and, together with 6 bibliographic fellows trained in uveitis, conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol systematic reviewof the literature (English language studies from January 1996 through June 2016; Medline [OVID], the Central Cochrane library, EMBASE,CINAHL,SCOPUS,BIOSIS, andWeb of Science). Publications included randomized controlled trials, prospective and retrospective studies with sufficient follow-up, case series with 15 cases or more, peer-reviewed articles, and hand-searched conference abstracts from key conferences. The proposed statements were circulated among 130 international uveitis experts for review.Atotal of 44 globally representativegroupmembersmet in late 2016 to refine these guidelines using a modified Delphi technique and assigned Oxford levels of evidence. Results: In total, 10 questions were addressed resulting in 21 evidence-based guidance statements covering the following topics: when to start noncorticosteroid immunomodulatory therapy, including both biologic and nonbiologic agents; what data to collect before treatment; when to modify or withdraw treatment; how to select agents based on individual efficacy and safety profiles; and evidence in specific uveitic conditions. Shared decision-making, communication among providers and safety monitoring also were addressed as part of the recommendations. Pharmacoeconomic considerations were not addressed. Conclusions: Consensus guidelines were developed based on published literature, expert opinion, and practical experience to bridge the gap between clinical needs and medical evidence to support the treatment of patients with noninfectious uveitis with noncorticosteroid immunomodulatory agents

JSS Editorial Board & Credits

Jefferson Surgical Solutions is published by Thomas Jefferson University and Thomas Jefferson University Hospital. Jefferson Department of Surgery Curtis Building, Suite 620 1015 Walnut Street Philadelphia, PA 19107 www.JeffersonHospital.org/surgery Barry Gutman, Editor/Writer JeffGraphics, Design Editorial Board: Volume 1, Issue 1 Hwyda Arafat, MD, PhD Adam Berger, MD Cataldo Doria, MD Adam Frank, MD Gerald Isenberg, MD Robert Larson, MD John Moore, MD Scott Silvestry, MD Robert Solit, MD Thomas Tulenko, PhD Charles Yeo, MD Jennifer Brumbaugh Diane Calder Patricia McMorrow Flo Williams Information in Jefferson Surgical Solutions is not intended to provide advice on personal medical matters or to substitute for consultation with a physician

Fabrication of Composite Membranes for Solar-thermal Desalination

With rising human populations, the demand for freshwater is an ever-growing problem. One emerging technology to combat this problem is membrane distillation (MD). MD has several advantages for water desalination such as: •100% rejection of solute (salt, heavy metals, etc.) •Mergeable with other affordable energy sources (solar heat, electric resistance, etc.) However, at the moment the specific energy consumption (SEC) of MD is very high due to low water production rates and large energy inputs to heat water. In a solar-assisted design for MD, the high cost of solar collectors (~$200/m2) inhibits low cost of water production in comparison to reverse osmosis (RO).[1] Low water production rates for MD designs can be addressed with high-performance membranes and distillation modules. Solar-integrated devices will improve MD efficiencies and make it a marketable technology for desalination processes. This research poster shows great improvement upon current MD efficiencies

Meet the Interns

The Department has welcomed a dynamic group of categorical interns including one graduate of Sidney Kimmel Medical College at Thomas Jefferson University. The interns were selected from over 1200 applicants to our program. These doctors, who recently matched with Jefferson, started on June 20, 2016. Please welcome: Peter Altshuler, MD Sidney Kimmel Medical College Kashmira Chawla, MD Mayo Medical School Thomas O’Malley, MD Tulane University School of Medicine Arturo Rios Diaz, MD Universidad Central de Venezuela Steven Woodward, MD University of Maryland School of Medicine Alicja Zalewski, MD Rutgers University – New Jersey Medical School We are also pleased to welcome back the following Sidney Kimmel Medical College 2016 graduates as preliminary interns in general surgery: Drs. Raj Patel, Ben Rudnick, and Alex Uhr

Clock reading: an underestimated topic in children with mathematics difficulties

Recent studies have shown that children with mathematics difficulties (MD) have weaknesses in multiple areas of mathematics. Andersson (2008), for example, recently found that children with MD perform significantly worse than other children on clock reading tasks. The present study builds on this recent finding and aims at a more profound understanding of the difficulties that children with MD experience with telling time. Therefore, clock reading abilities of 154 children with MD were compared to the ability of 571 average achieving children and a qualitative error analysis was performed. The results of this study confirm the earlier finding of Andersson (2008) that children with MD perform worse on clock reading than average achieving children, and additionally shows that children with MD are especially struggling the combination of procedural and retrieval strategies that are needed to read complex five minute and one minute clock times. Children with MD make more errors that reflect immature counting strategies and deficits in memory retrieval. This finding is in line with Geary’s (2005) theory of subtypes in MD, that argues that children with MD have problems with mathematical procedures and semantic memory retrieval

Meet the Interns

The Department has welcomed an impressive group of categorical interns including two graduates of Sidney Kimmel Medical College at Thomas Jefferson University. The interns were selected from over 1350 applicants to our program. These doctors, who matched with Jefferson, started on June 20, 2017. Please welcome (from left to right): Ryan Lamm, MD Stony Brook University School of Medicine James Fraser, MD Quinnipiac University School of Medicine Andrew Hallett, MD New York University School of Medicine Keyur Patel, MD Sidney Kimmel Medical College Lindsay Lynch, MD Rutgers University – New Jersey Medical School Adrienne Christopher, MD Sidney Kimmel Medical College We are also pleased to welcome back the following Sidney Kimmel Medical College 2017 graduates as preliminary interns in general surgery: Drs. Gabi Barmettler, Charles McCann, and James Metkus

Multiple Description Coding of Discrete Ergodic Sources

We investigate the problem of Multiple Description (MD) coding of discrete ergodic processes. We introduce the notion of MD stationary coding, and characterize its relationship to the conventional block MD coding. In stationary coding, in addition to the two rate constraints normally considered in the MD problem, we consider another rate constraint which reflects the conditional entropy of the process generated by the third decoder given the reconstructions of the two other decoders. The relationship that we establish between stationary and block MD coding enables us to devise a universal algorithm for MD coding of discrete ergodic sources, based on simulated annealing ideas that were recently proven useful for the standard rate distortion problem.Comment: 6 pages, 3 figures, presented at 2009 Allerton Conference on Communication, Control and Computin

Controllers for imposing continuum-to-molecular boundary conditions in arbitrary fluid flow geometries

We present a new parallelised controller for steering an arbitrary geometric region of a molecular dynamics (MD) simulation towards a desired thermodynamic and hydrodynamic state. We show that the controllers may be applied anywhere in the domain to set accurately an initial MD state, or solely at boundary regions to prescribe non-periodic boundary conditions (PBCs) in MD simulations. The mean molecular structure and velocity autocorrelation function remain unchanged (when sampled a few molecular diameters away from the constrained region) when compared with those distributions measured using PBCs. To demonstrate the capability of our new controllers, we apply them as non-PBCs in parallel to a complex MD mixing nano-channel and in a hybrid MD continuum simulation with a complex coupling region. The controller methodology is easily extendable to polyatomic MD fluids