A retrospective analysis of visual outcomes in laser vision correction of hyperopic patients using the VISX STAR S4 IR® and the WaveLight® EX500 excimer laser platforms

BACKGROUND: Laser vision correction (LVC) developed as a more permanent alternative to other forms of refractive error correction. In the last several decades, visual outcomes of corneal refractive surgeries like LVC have improved dramatically with the discovery of new technologies and techniques designed to make the patient experience more comfortable and worthwhile. LVC has been shown to safely and effectively treat refractive errors in myopic and hyperopic eyes, with gradually improving outcomes and safety measures. However, it is important to note whether specific excimer lasers impart the same level of safe, effective treatments for patients as technology advances. OBJECTIVE: This study aims to identify whether any statistically significant difference exists in the visual and refractive outcomes of hyperopic laser vision correction using two excimer laser platforms, the VISX STAR S4 IR® and the WaveLight® EX500, and to determine whether either laser shows any statistically significant difference in the rate of repeat surgery within one year post-operatively. METHODS: Using EMR data collected from December 2008 through December 2016, distance and near visual acuity outcomes for hyperopic eyes treated with LASIK, LASEK, or PRK were compared at one month and up to one year post-operatively. Distance eyes were compared separately from monovision (near-targeted) eyes for visual acuity; however, if manifest refraction post-operative data were available, they were used to identify whether any difference existed in the refractive outcomes in either category. The number of enhancements (repeat surgeries) was also tabulated. X2 Tests of Independence were used to determine statistical significance. RESULTS: Visual acuity outcomes in distance eyes at one month post-operatively showed similar trends between the two lasers, with 54% of the 267 VISX- and 60% of the 119 EX500-treated eyes presenting with UCVA of 20/20 or better. Eyes available for follow-up within one year post-operatively kept with this trend; 98 (51%) VISX- and 58 (67%) EX500-treated, eyes had UCVA measured at 20/20 or better. For monovision (treated for reading vision) eyes, 29 (47%) eyes and 19 (54%) of VISX- and EX500-treated eyes, respectively, read J1+ by one month post-operatively. By one year, 16 (39%) and 3 (21%) of available eyes read J1+ after treatment with the VISX and EX500 respectively. The relative enhancement rate was 7.82% (28 eyes) on the VISX and 4.19% (7 eyes) on the EX 500. CONCLUSION: Overall, visual outcomes of laser vision correction for hyperopic patients did not differ consistently between the two lasers. Only distance-treated eyes measured up to one year post-operatively showed a statistically significant difference between the two lasers. The visual and, more importantly, the refractive outcomes were statistically similar at both one month and up to one year post-operatively irrespective of treatment type. Enhancement rate between the two lasers also showed no differences. Both lasers are similarly safe and effective for treating hyperopia and hyperopic astigmatism.2018-01-11T00:00:00

Stability and Change in the Heart of Europe: German Media Perspectives of the 2008 U.S. Presidential Election

Artykuł analizuje treść publikacji prasowych na temat amerykańskich wyborów prezydenckich w 2008 r. jakie ukazały się w niemieckiej prasie. Artykuł posługuje się „pakietowym” (package) podejściem do kontekstu, obejmującego elementy składające się na kontekst bądź struktury kulturowe. Przedstawiono wyniki i płynące z nich wnioski dotyczące roli teorii framingu (kontekstu) w skali międzynarodowej.Artykuł analizuje treść publikacji prasowych na temat amerykańskich wyborów prezydenckich w 2008 r. jakie ukazały się w niemieckiej prasie. Artykuł posługuje się „pakietowym” (package) podejściem do kontekstu, obejmującego elementy składające się na kontekst bądź struktury kulturowe. Przedstawiono wyniki i płynące z nich wnioski dotyczące roli teorii framingu (kontekstu) w skali międzynarodowej

Fire, myth and mankind- An experiment in education

This freshman course is designed to explore our complex and intimate relationships with fire as a cultural symbol. The image of fire as both a creator and destroyer of worlds is deeply rooted in the mythos of almost every culture. It is the stuff of ancient legend and distant myth, and as modern as the yellow kevlar-cloaked heroes who march into the burning hills with Pulaskis over their shoulders. Frequent, often intense wildfires are a natural part of the American northwestern landscape and play a critical role in sustaining and rejuvenating its tall forests

Genetic population structure of sympatric and allopatric populations of Baltic ciscoes (Coregonus albula complex, Teleostei, Coregonidae)

<p>Abstract</p> <p>Background</p> <p>Teleost fishes of the Coregonidae are good model systems for studying postglacial evolution, adaptive radiation and ecological speciation. Of particular interest is whether the repeated occurrence of sympatric species pairs results from <it>in-situ </it>divergence from a single lineage or from multiple invasions of one or more different lineages. Here, we analysed the genetic structure of Baltic ciscoes (<it>Coregonus albula </it>complex), examining 271 individuals from 8 lakes in northern Germany using 1244 polymorphic AFLP loci. Six lakes had only one population of <it>C. albula </it>while the remaining two lakes had <it>C. albula </it>as well as a sympatric species (<it>C. lucinensis </it>or <it>C. fontanae</it>).</p> <p>Results</p> <p>AFLP demonstrated a significant population structure (Bayesian <it>θ</it>^B= 0.22). Lower differentiation between allopatric (<it>θ</it>^B= 0.028) than sympatric (0.063-0.083) populations contradicts the hypothesis of a sympatric origin of taxa, and there was little evidence for stocking or ongoing hybridization. Genome scans found only three loci that appeared to be under selection in both sympatric population pairs, suggesting a low probability of similar mechanisms of ecological segregation. However, removal of all non-neutral loci decreased the genetic distance between sympatric pairs, suggesting recent adaptive divergence at a few loci. Sympatric pairs in the two lakes were genetically distinct from the six other <it>C. albula </it>populations, suggesting introgression from another lineage may have influenced these two lakes. This was supported by an analysis of isolation-by-distance, where the drift-gene flow equilibrium observed among allopatric populations was disrupted when the sympatric pairs were included.</p> <p>Conclusions</p> <p>While the population genetic data alone can not unambiguously uncover the mode of speciation, our data indicate that multiple lineages may be responsible for the complex patterns typically observed in <it>Coregonus</it>. Relative differences within and among lakes raises the possibility that multiple lineages may be present in northern Germany, thus understanding the postglacial evolution and speciation in the <it>C. albula </it>complex requires a large-scale phylogenetic analysis of several potential founder lineages.</p

Adding epoetin alfa to intense dose-dense adjuvant chemotherapy for breast cancer : randomized clinical trial

BACKGROUND: The AGO-ETC trial compared 5-year relapse-free survival of intense dose-dense (IDD) sequential chemotherapy with epirubicin (E), paclitaxel (T), and cyclophosphamide (C) (IDD-ETC) every 2 weeks vs conventional scheduled epirubicin/cyclophosphamide followed by paclitaxel (EC→T) (every 3 weeks) as adjuvant treatment in high-risk breast cancer patients. The objective of this study was to evaluate the safety and efficacy of epoetin alfa in a second randomization of the intense dose-dense arm. METHODS: One thousand two hundred eighty-four patients were enrolled; 658 patients were randomly assigned to the IDD-ETC treatment group. Within the IDD-ETC group, 324 patients were further randomly assigned to the epoetin alfa group, and 319 were randomly assigned to the non-erythropoiesis-stimulating agent (ESA) control group. Primary efficacy endpoints included change in hemoglobin level from baseline to Cycle 9 and the percentage of subjects requiring red blood cell transfusion. Relapse-free survival, overall survival, and intramammary relapse were secondary endpoints estimated with Kaplan-Meier and Cox regression methods. Except for the primary hypothesis, all statistical tests were two-sided. RESULTS: Epoetin alfa avoided the decrease in hemoglobin level (no decrease in the epoetin alfa group vs -2.20g/dL change for the control group; P < .001) and statistically significantly reduced the percentage of subjects requiring red blood cell transfusion (12.8% vs 28.1%; P < .0001). The incidence of thrombotic events was 7% in the epoetin alfa arm vs 3% in the control arm. After a median follow-up of 62 months, epoetin alfa treatment did not affect overall survival, relapse-free survival, or intramammary relapse. CONCLUSIONS: Epoetin alfa resulted in improved hemoglobin levels and decreased transfusions without an impact on relapse-free or overall survival. However, epoetin alfa had an adverse effect, resulting in increased thrombosis

Simulation of cholinergic and noradrenergic modulation of behavior in uncertain environments

Attention is a complex neurobiological process that involves rapidly and flexibly balancing sensory input and goal-directed predictions in response to environmental changes. The cholinergic and noradrenergic systems, which have been proposed to respond to expected and unexpected environmental uncertainty, respectively, play an important role in attention by differentially modulating activity in a multitude of cortical targets. Here we develop a model of an attention task that involves expected and unexpected uncertainty. The cholinergic and noradrenergic systems track this uncertainty and, in turn, influence cortical processing in five different, experimentally verified ways: (1) nicotinic enhancement of thalamocortical input, (2) muscarinic regulation of corticocortical feedback, (3) noradrenergic mediation of a network reset, (4) locus coeruleus (LC) activation of the basal forebrain (BF), and (5) cholinergic and noradrenergic balance between sensory input and frontal cortex predictions. Our results shed light on how the noradrenergic and cholinergic systems interact with each other and a distributed set of neural areas, and how this could lead to behavioral adaptation in the face of uncertainty

Muscle Activity during Maximal Isometric Forearm Rotation Using a Power Grip

This study aimed to provide quantitative activation data for muscles of the forearm during pronation and supination while using a power grip. Electromyographic data was collected from 15 forearm muscles in 11 subjects while they performed maximal isometric pronating and supinating efforts in nine positions of forearm rotation. Biceps brachii was the only muscle with substantial activation in only one effort direction. It was significantly more active when supinating (µ = 52.1%, SD = 17.5%) than pronating (µ = 5.1%, SD = 4.8%, p \u3c .001). All other muscles showed considerable muscle activity during both pronation and supination. Brachioradialis, flexor carpi radialis, palmaris longus, pronator quadratus and pronator teres were significantly more active when pronating the forearm. Abductor pollicis longus and biceps brachii were significantly more active when supinating. This data highlights the importance of including muscles additional to the primary forearm rotators in a biomechanical analysis of forearm rotation. Doing so will further our understanding of forearm function and lead to the improved treatment of forearm fractures, trauma-induced muscle dysfunction and joint replacements

The prototype HIV-1 maturation inhibitor, bevirimat, binds to the CA-SP1 cleavage site in immature Gag particles

<p>Abstract</p> <p>Background</p> <p>Bevirimat, the prototype Human Immunodeficiency Virus type 1 (HIV-1) maturation inhibitor, is highly potent in cell culture and efficacious in HIV-1 infected patients. In contrast to inhibitors that target the active site of the viral protease, bevirimat specifically inhibits a single cleavage event, the final processing step for the Gag precursor where p25 (CA-SP1) is cleaved to p24 (CA) and SP1.</p> <p>Results</p> <p>In this study, photoaffinity analogs of bevirimat and mass spectrometry were employed to map the binding site of bevirimat to Gag within immature virus-like particles. Bevirimat analogs were found to crosslink to sequences overlapping, or proximal to, the CA-SP1 cleavage site, consistent with previous biochemical data on the effect of bevirimat on Gag processing and with genetic data from resistance mutations, in a region predicted by NMR and mutational studies to have α-helical character. Unexpectedly, a second region of interaction was found within the Major Homology Region (MHR). Extensive prior genetic evidence suggests that the MHR is critical for virus assembly.</p> <p>Conclusions</p> <p>This is the first demonstration of a direct interaction between the maturation inhibitor, bevirimat, and its target, Gag. Information gained from this study sheds light on the mechanisms by which the virus develops resistance to this class of drug and may aid in the design of next-generation maturation inhibitors.</p

Flexible Office: Assignment of Office Space to Enhance Knowledge Work Productivity

Abstract: Even though knowledge management has been around for more than a decade, so far concrete instruments that can be systematically deployed are still rare. This paper presents an optimization solution targeted at flexible management of office space considering knowledge management criteria in order to enhance knowledge work productivity. The paper presents the Flexible Office conceptual model and optimization solution and discusses the theoretical foundation, assumptions and reasoning. A corresponding prototype was field-tested, successfully introduced, evaluated with the help of a series of interviews with users and improved according to their requirements. The paper also reflects on the organisational impact and lessons learned from field test and practical experience