Posterior lamellar tarsal rotation technique in entropion with upper eyelid trichiasis

Увод: Ентропион на горен клепач е рядко срещана патология. Често се представя като едностранен или двустранен папиларен конюнктивит, причината за който убягва от вниманието на лекаря. Причините са развитие на ентропиона са много, като една от тях е синдрома на отпуснатия горен клепач. Заболяването често остава недиагностицирано, докато не се появят усложнения, затова и броят на регистрираните случаи с тази диагноза е малък. Цел: Да представим техника "задна ламеларна тарзална ротация" за оперативно лечение на случаи с ентропион на горен клепач. Материали и методи: В изследването са включени 5 пациенти с ентропион на горен клепач- 4 мъже и 1 жена на възраст 36-67г. Двама от мъжете са диагностицирани с ентропион и трихиаза вследствие floppy eyelid syndrome, двама са с идиапатична етиология, a жената е с цикатрициален ентропион вследствие химично изгаряне. Представяме оперативна техника тарзална ротация със заден достъп за корекция на ентропион на горен клепач Резултати: Представени са 5 случая с ентропион на горен клепач. При всички оперирани болни се установи много добър ефект - липса на трихиаза и ентропион и липса на субективни оплаквания, които са разделени в тристепенна скала (1- по-добре, 2-без промяна, 3- влошаване) в постоперативния период. Изводи: Предложената оперативна техника е лесно осъществима, с добър функционален и козметичен ефект.Introduction: The upper eyelid entropion is a rare pathology. It is frequently presented as uni- or bilateral papillary conjunctivitis, the cause for which escapes the physician`s attention. The causes for developing an entropion are multiple and one of the most frequent is the floppy upper eyelid syndrome. The disease often remains underdiagnosed while complications emerge, that is why the number of registered cases of this diagnose is small Objective: To present a `posterior lamellar tarsal rotation` technique for operative management of upper eyelid entropion. Material and methods: This study enrolls 5 patients with upper eyelid entropion - 4 men and 1 woman, at the age of 36-67 years. Two of the men were diagnosed with entropion and trichiasis due to floppy eyelid syndrome, two have idiopathic etiology and the woman has a cicatricial entropion due to chemical burn. We present an operative technique with a tarsal rotation with posterior access for the correction of the upper eyelid entropion. Results: This study enrolls 5 patients with upper eyelid entropion. For all operated patients was established a very good effect - lack of trichiasis and entropion and lack of subjective complaints divided into a three-stage scale (1 - better, 2- no change, 3 - worsening) during the postoperative period. Conclusions: The suggested operative technique is easy to perform and has good functional and cosmetic effect

Amniotic membrane transplantation algorithms - outcomes within a period of 7 years

Трансплантацията на амниотична мембрана (АМТ) през последните години се превърна в една от най-често извършваните оперативни процедури при тежки, неподаващи се на медикаментозното лечение заболявания на предния очен сегмент. Познаването на оперативните техники е изключително важно с оглед постигането на добър постоперативен резултат.Цел: Целта на настоящото проучване е да се направи обзор на трансплантациите на амниотична мембрана за периода от 2001 до 2016г. и да се създадат алгоритми за оперативно лечение с цел трайно възстановяване увредената предна очна повърхност.Материали и методи: В проучването са включени 420 пациента, преминали и оперирани в СБОБАЛ за 7 годишен период. На всички пациенти е извършена трансплантация на криосъхранена АМ. Пациентите са разделени в седем групи по диагнози. В зависимост от тежестта на обективната симптоматика (големина и дълбочина на дефекта) и вида на заболяването е извършена трансплантация тип покритие и/ или пълнител в един, два или повече слоя. Оценка на големината и дълбочината на дефекта е извършена по тристепенна скала (големина- 1- до 4mm, 2- 4-7mm, 3- >7mm от диаметъра на роговицата; дълбочина: 1 - 50% от дебелината).Резултати: При 74% от болните е извършена трансплантация тип покритие, a при 26% - техника тип пълнител. Доказана е сигнификантна разлика във вида на трансплантацията при отделните групи диагнози. Повлияване на големината на язвата се наблюдава при всички видове трансплантации, като значително намаляване на размера има при трансплантациите тип- покритие, тип-пълнител (едно слоен) и тип-пълнител (двуслоен) (р 7mm diameter of the cornea, depth (1 - 50% of the thickness of the cornea).Results: 74% of patients received an onlay technique transplantation, and 26% - an inlay one. The result analyses show that there is a significant difference in the type of transplantation in the different groups of diagnoses. With all types of transplantations the size of the ulcer was influenced; a significant reduction in its size was observed in onlay type of transplantations, inlay ones (single layer) and inlay type (dual layer) (p <0.001). On the 25th postoperative day in 98% of the patients who have received an onlay type of transplantation a recovery of corneal defects below 2mm was observed. The same effect (92%) was observed in patients with single-layer combined transplantation. With multi-type inlay transplantation positive influence was observed in 71%. The outcomes that show how much the depth of the ulcer was influenced are similar to the ones associated with size.Conclusion: The amniotic membrane proved to be the tool of choice for refractory, recurrent and severe pathological conditions affecting the anterior segment. The use of appropriate surgical technique according to the type and severity of the objective symptomatology leads to a significant improvement in the post-operative result

Self-adjuvanting polymer-peptide conjugates as therapeutic vaccine candidates against cervical cancer

Dendrimers are structurally well-defined, synthetic polymers with sizes and physicochemical properties often resembling those of biomacromolecules (e.g. proteins). As a result they are promising candidates for peptide-based vaccine delivery platforms. Herein, we established a synthetic pathway to conjugate a human papillomavirus (HPV) E7 protein-derived peptide antigen to a star-polymer to create a macromolecular vaccine candidate to treat HPV-related cancers. These conjugates were able to reduce tumor growth and eradicate E7-expressing TC-1 tumors in mice after a single immunization, without the help of any external adjuvant

4-Hydroxy-1-naphthaldehydes: proton transfer or deprotonation

A series of naphthaldehydes, including a Mannich base, have been investigated by UV-Vis spectroscopy, NMR and theoretical methods to explore their potential tautomerism. In the case of 4-hydroxy-1-naphthaldehyde concentration dependent deprotonation has been detected in methanol and acetonitrile. For 4-hydroxy-3-(piperidin-1-ylmethyl)-1-naphthaldehyde (a Mannich base) an intramolecular proton transfer involving the OH group and the piperidine nitrogen occurs. In acetonitrile the equilibrium is predominantly at the OH-form, whereas in methanol the proton transferred tautomer is the preferred form. In chloroform and toluene, the OH form is completely dominant. Both 4-hydroxy-1-naphthaldehyde and 4-methoxy-1-naphthaldehyde (fixed enol form) show dimerization in the investigated solvents and the crystallographic data, obtained for the latter, confirm the existence of a cyclic dimer

Incunabular Immunological Events in Prion Trafficking

While prions probably interact with the innate immune system immediately following infection, little is known about this initial confrontation. Here we investigated incunabular events in lymphotropic and intranodal prion trafficking by following highly enriched, fluorescent prions from infection sites to draining lymph nodes. We detected biphasic lymphotropic transport of prions from the initial entry site upon peripheral prion inoculation. Prions arrived in draining lymph nodes cell autonomously within two hours of intraperitoneal administration. Monocytes and dendritic cells (DCs) required Complement for optimal prion delivery to lymph nodes hours later in a second wave of prion trafficking. B cells constituted the majority of prion-bearing cells in the mediastinal lymph node by six hours, indicating intranodal prion reception from resident DCs or subcapsulary sinus macrophages or directly from follicular conduits. These data reveal novel, cell autonomous prion lymphotropism, and a prominent role for B cells in intranodal prion movement

The Role of Perceived University Support in the Formation of Students' Entrepreneurial Intention

Entrepreneurship education is central to student entrepreneurship. Previous research has attempted to understand the role of entrepreneurship education in the formation of students' entrepreneurial intention and behavior, albeit in an isolated manner. Universities can support entrepreneurship in many ways, but it is important to measure students' perception of the support that they receive in order to understand the extent of such support and its impact on students. The current study proposed and tested an integrative, multiperspective framework. We have hypothesized that the three dimensions of university support, that is, perceived educational support, concept development support, and business development support, together with institutional support, shape students' entrepreneurial self-efficacy. In turn, entrepreneurial self-efficacy and individual motivations constitute the fundamental elements of the intention to start a business. A sample of 805 university students took part in the study and data were analyzed using structural equation modeling. Our findings showed that perceived educational support exerted the highest influence on entrepreneurial self-efficacy, followed by concept development support, business development support, and institutional support. Self-efficacy in turn had a significant effect on entrepreneurial intention. Individual motivations such as self-realization, recognition, and role had an additional impact on intention. However, intention was not related to financial success, innovation, and independence. The findings suggest that a holistic perspective provides a more meaningful understanding of the role of perceived university support in the formation of students' entrepreneurial intention. Theoretical and practical implications are discussed

VLPs and particle strategies for cancer vaccines

n/

Synthetic Nanoparticles for Vaccines and Immunotherapy

The immune system plays a critical role in our health. No other component of human physiology plays a decisive role in as diverse an array of maladies, from deadly diseases with which we are all familiar to equally terrible esoteric conditions: HIV, malaria, pneumococcal and influenza infections; cancer; atherosclerosis; autoimmune diseases such as lupus, diabetes, and multiple sclerosis. The importance of understanding the function of the immune system and learning how to modulate immunity to protect against or treat disease thus cannot be overstated. Fortunately, we are entering an exciting era where the science of immunology is defining pathways for the rational manipulation of the immune system at the cellular and molecular level, and this understanding is leading to dramatic advances in the clinic that are transforming the future of medicine.1,2 These initial advances are being made primarily through biologic drugs– recombinant proteins (especially antibodies) or patient-derived cell therapies– but exciting data from preclinical studies suggest that a marriage of approaches based in biotechnology with the materials science and chemistry of nanomaterials, especially nanoparticles, could enable more effective and safer immune engineering strategies. This review will examine these nanoparticle-based strategies to immune modulation in detail, and discuss the promise and outstanding challenges facing the field of immune engineering from a chemical biology/materials engineering perspectiveNational Institutes of Health (U.S.) (Grants AI111860, CA174795, CA172164, AI091693, and AI095109)United States. Department of Defense (W911NF-13-D-0001 and Awards W911NF-07-D-0004

Drivers of diversification and pluriactivity among smallholder farmers—evidence from Nigeria

Diversification and pluriactivity have become a norm among farm business owners (FBOs) due to persistent low farm income. This study applies the resource-based theory to examine drivers of diversification and livelihood income-oriented towards a sustainable livelihood. Our framework develops hypotheses about the impact of internal and external resources on livelihood choices at the household level. We use a survey of 480 rural Nigerian farmers (agripreneurs), applying a Multivariate Tobit to test our framework. We find that education plays the most significant role in all types of employment options. The more FBOs are educated, the more the likelihood that they will choose non-farm or wage employment. This study revealed that while the agriculture sector’s share of rural employment is declining, non-farm is on the increase. More so, there is a decline in farming among the young generation, marital status bias and gender influence in resource allocation. The socioeconomic (income and food security) and socio-cultural (employment and rural-urban migration) implications of rural sustainability linked to UN Development Goals have been highlighted and analysed in this article

Baseline characteristics of patients in the reduction of events with darbepoetin alfa in heart failure trial (RED-HF)

&lt;p&gt;Aims: This report describes the baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF) which is testing the hypothesis that anaemia correction with darbepoetin alfa will reduce the composite endpoint of death from any cause or hospital admission for worsening heart failure, and improve other outcomes.&lt;/p&gt; &lt;p&gt;Methods and results: Key demographic, clinical, and laboratory findings, along with baseline treatment, are reported and compared with those of patients in other recent clinical trials in heart failure. Compared with other recent trials, RED-HF enrolled more elderly [mean age 70 (SD 11.4) years], female (41%), and black (9%) patients. RED-HF patients more often had diabetes (46%) and renal impairment (72% had an estimated glomerular filtration rate &#60;60 mL/min/1.73 m2). Patients in RED-HF had heart failure of longer duration [5.3 (5.4) years], worse NYHA class (35% II, 63% III, and 2% IV), and more signs of congestion. Mean EF was 30% (6.8%). RED-HF patients were well treated at randomization, and pharmacological therapy at baseline was broadly similar to that of other recent trials, taking account of study-specific inclusion/exclusion criteria. Median (interquartile range) haemoglobin at baseline was 112 (106–117) g/L.&lt;/p&gt; &lt;p&gt;Conclusion: The anaemic patients enrolled in RED-HF were older, moderately to markedly symptomatic, and had extensive co-morbidity.&lt;/p&gt