Minimizing Surgically Induced Astigmatism at the Time of Cataract Surgery Using a Square Posterior Limbal Incision

Purpose. To compare the surgically induced astigmatism from clear corneal and square posterior limbal incisions at the time of cataract surgery. Methods. Surgically induced astigmatism was calculated for a set of eyes after cataract surgery using a temporal 2.2 mm square posterior limbal incision. Results were compared to similar available data from surgeons using clear corneal incisions of similar size. Results. Preoperative corneal astigmatism averaged 1.0 D and was not significantly different between the incision types. Surgically induced astigmatism with the 2.2 mm posterior limbal incision averaged 0.25 ± 0.14 D, significantly lower in magnitude than the aggregate surgically induced astigmatism produced by the 2.2 mm clear corneal incision (0.68 ± 0.49 D). Conclusion. The 2.2 mm square posterior limbal incision induced significantly less, and significantly less variable, surgically induced astigmatism relative to a similar-sized clear corneal incision. This is likely to improve refractive outcomes, particularly important with regard to premium intraocular lenses

Les troubles du comportement, la compétence sociale et la pratique d’activités physiques chez les adolescents

Les problèmes de comportement constituent une préoccupation importante en milieu scolaire. Un des principaux moyens d’intervention utilisés est l’entraînement aux habiletés sociales. L’efficacité de ce type d’initiatives est modeste en ce qui a trait au transfert, au maintien et à la généralisation de l’apprentissage de nouveaux comportements. L’objectif de cette étude est de comparer les profils d’élèves, avec et sans troubles du comportement, autour de différentes variables associées aux habiletés sociales, à l’adaptation psychosociale, à la pratique d’activités physiques et à certaines habitudes de vie à la santé. En partant des résultats de l’analyse, les auteurs proposent de nouvelles pistes d’intervention dans le cadre de programmes d’entraînement aux habiletés sociales s’adressant aux élèves en difficulté de comportement.Behaviour problems are an important concern in the school milieu. One of the principal means of intervention is that of social skills training. These types of initiatives have resulted in only modest efficacy regarding the transfer, the maintenance and the generalization of learning new behaviours. The object of this study is to compare profiles of students with and without behaviour problems with regards to different variables associated with social skills, to psychosocial adaptation, to the practice of physical activities, and to certain healthy life habits. From an analysis of the results, the authors propose new directions for intervention within the frame of social skill training programs for students with behaviour difficulties.Los problemas de comportamiento representan una preocupación importante en el ámbito escolar. Uno de los principales medios de intervención utilizados es la incitación a las habilidades sociales. La eficacia de este tipo de iniciativas es poco significante referente a la transferencia, al mantenimiento y a la generalización del aprendizaje de comportamientos nuevos. Este estudio tiene por objetivo comparar los perfiles de alumnos, con y sin trastornos de comportamiento, en torno a distintas variables asociadas a las habilidades sociales, a la adaptación psicosocial, a la práctica de actividades físicas y a ciertos hábitos de vida relacionados con la salud. A partir de los resultados del análisis, los autores proponen nuevas pistas de intervención a través de programas de entrenamiento a las habilidades sociales, dirigidos a alumnos con problemas de comportamiento

New liver cell mutants defective in the endocytic pathway

AbstractTo isolate mutant liver cells defective in the endocytic pathway, a selection strategy using toxic ligands for two distinct membrane receptors was utilized. Rare survivors termed trafficking mutants (Trf2–Trf7) were stable and more resistant than the parental HuH-7 cells to both toxin conjugates. They differed from the previously isolated Trf1 HuH-7 mutant as they expressed casein kinase 2 α″ (CK2α″) which is missing from Trf1 cells and which corrects the Trf1 trafficking phenotype. Binding of 125I-asialoorosomucoid (ASOR) and cell surface expression of asialoglycoprotein receptor (ASGPR) were reduced approximately 20%–60% in Trf2–Trf7 cells compared to parental HuH-7, without a reduction in total cellular ASGPR. Based on 125I-transferrin binding, cell surface transferrin receptor activity was reduced between 13% and 88% in the various mutant cell lines. Distinctive phenotypic traits were identified in the differential resistance of Trf2–Trf7 to a panel of lectins and toxins and to UV light-induced cell death. By following the endocytic uptake and trafficking of Alexa488-ASOR, significant differences in endosomal fusion between parental HuH-7 and the Trf mutants became apparent. Unlike parental HuH-7 cells in which the fusion of endosomes into larger vesicles was evident as early as 20 min, ASOR endocytosed into the Trf mutants remained within small vesicles for up to 60 min. Identifying the biochemical and genetic mechanisms underlying these phenotypes should uncover novel and unpredicted protein–protein or protein–lipid interactions that orchestrate specific steps in membrane protein trafficking

Patchwork Gridshells::Using Modularity to Facilitate Prefabrication and Simplify Construction

Modern architectural design has seen a shift towards iconic doubly-curved envelopes enclosing large column-free spaces. Gridshells have long been considered an efficient solution to such designs, but their actual use in practice has not spread worldwide. For elastic gridshells, their advantages in terms of substantial material savings can often be overshadowed by the significant challenges associated with their construction. Similarly, for rigid gridshells, the manufacture of a large number of different members and nodal connections is often a barrier to their implementation. This paper proposes an effective way of designing, fabricating and erecting gridshells. The “Patchwork Gridshell” consists of a number of efficient elastic gridshell patches assembled using rigid gridshell frames. It can easily generate a number of different configurations, use a wide range of materials, and allows more architectural expression of practical long-span forms. The benefits of combining the ingenuously simple efficiency of elastic lattices and the power of digital fabrication are demonstrated by digitally rebuilding four alternative configurations of the Japan Pavilion of the Hanover Expo 2000 as a case study. The result is a flexible digital workflow which creates large column-free spaces that are capable of being constructed efficiently by nonspecialist contractors.</p

Patchwork Gridshells::Using Modularity to Facilitate Prefabrication and Simplify Construction

Modern architectural design has seen a shift towards iconic doubly-curved envelopes enclosing large column-free spaces. Gridshells have long been considered an efficient solution to such designs, but their actual use in practice has not spread worldwide. For elastic gridshells, their advantages in terms of substantial material savings can often be overshadowed by the significant challenges associated with their construction. Similarly, for rigid gridshells, the manufacture of a large number of different members and nodal connections is often a barrier to their implementation. This paper proposes an effective way of designing, fabricating and erecting gridshells. The “Patchwork Gridshell” consists of a number of efficient elastic gridshell patches assembled using rigid gridshell frames. It can easily generate a number of different configurations, use a wide range of materials, and allows more architectural expression of practical long-span forms. The benefits of combining the ingenuously simple efficiency of elastic lattices and the power of digital fabrication are demonstrated by digitally rebuilding four alternative configurations of the Japan Pavilion of the Hanover Expo 2000 as a case study. The result is a flexible digital workflow which creates large column-free spaces that are capable of being constructed efficiently by nonspecialist contractors.</p

Enseigner des valeurs à l'ordre collégial

Dans le contexte social et scolaire actuel, il existe une volonté de plus en plus grande des cégeps de donner un sens à la formation technique en enseignant les valeurs rattachées au métier, tout en faisant de la réussite des études une entreprise personnelle. À cet égard, un partenariat entre le Cégep Limoilou et l’Université Laval a permis de développer des activités pédagogiques concrètes pour l’enseignement de valeurs entrepreneuriales dans la formation technique. Cet article présente Ça me tient à cœur !, une activité élaborée en vue de l’acquisition de valeurs entrepreneuriales dans une perspective de développement durable. On y expose les visées de l’activité, les modalités de son déroulement et les résultats de son expérimentation en classe. Réalisée dans un programme technique spécifique, à savoir le programme de Technologie de la mécanique du bâtiment, l’activité présentée est néanmoins transférable à tout programme collégial dont les buts recouvrent le développement de valeurs ou la formation citoyenne. L’article évoque enfin trois autres activités visant le développement d’un système de valeur par les étudiants

Mocetinostat for patients with previously treated, locally advanced/metastatic urothelial carcinoma and inactivating alterations of acetyltransferase genes

BackgroundThe authors evaluated mocetinostat (a class I/IV histone deacetylase inhibitor) in patients with urothelial carcinoma harboring inactivating mutations or deletions in CREB binding protein [CREBBP] and/or E1A binding protein p300 [EP300] histone acetyltransferase genes in a singleâ arm, openâ label phase 2 study.MethodsEligible patients with platinumâ treated, advanced/metastatic disease received oral mocetinostat (at a dose of 70 mg 3 times per week [TIW] escalating to 90 mg TIW) in 28â day cycles in a 3â stage study (ClinicalTrials.gov identifier NCT02236195). The primary endpoint was the objective response rate.ResultsGenomic testing was feasible in 155 of 175 patients (89%). Qualifying tumor mutations were CREBBP (15%), EP300 (8%), and both CREBBP and EP300 (1%). A total of 17 patients were enrolled into stage 1 (the intentâ toâ treat population); no patients were enrolled in subsequent stages. One partial response was observed (11% [1 of 9 patients; the population that was evaluable for efficacy comprised 9 of the 15 planned patients]); activity was deemed insufficient to progress to stage 2 (null hypothesis: objective response rate of â ¤15%). All patients experienced â ¥1 adverse event, most commonly nausea (13 of 17 patients; 77%) and fatigue (12 of 17 patients; 71%). The median duration of treatment was 46 days; treatment interruptions (14 of 17 patients; 82%) and dose reductions (5 of 17 patients; 29%) were common. Mocetinostat exposure was lower than anticipated (doseâ normalized maximum serum concentration [Cmax] after TIW dosing of 0.2 ng/mL/mg).ConclusionsTo the authorsâ knowledge, the current study represents the first clinical trial using genomicâ based selection to identify patients with urothelial cancer who are likely to benefit from selective histone deacetylase inhibition. Mocetinostat was associated with significant toxicities that impacted drug exposure and may have contributed to modest clinical activity in these pretreated patients. The efficacy observed was considered insufficient to warrant further investigation of mocetinostat as a single agent in this setting.After the genomicâ based selection of patients with urothelial cancer with inactivating mutations/deletions in the histone acetyltransferase genes CREBBP and/or EP300, singleâ agent mocetinostat appears to be associated with significant toxicities that limit drug exposure. This may have contributed to the limited activity noted in the current phase 2 study (response rate of 11%) among heavily pretreated patients with platinumâ refractory disease.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147860/1/cncr31817_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147860/2/cncr31817.pd

Monte Carlo simulation of expected outcomes with the AcrySof® toric intraocular lens

<p>Abstract</p> <p>Background</p> <p>To use a Monte Carlo simulation to predict postoperative results with the AcrySof^®Toric lens, evaluating the likelihood of over- or under-correction using various toric lens selection criteria.</p> <p>Methods</p> <p>Keratometric data were obtained from a large patient population with preoperative corneal astigmatism <= 2.50D (2,000 eyes). The probability distributions for toric marking accuracy, surgically induced astigmatism and lens rotation were estimated using available data. Anticipated residual astigmatism was calculated using a Monte Carlo simulation under two different lens selection scenarios.</p> <p>Results</p> <p>This simulation demonstrated that random errors in alignment, surgically induced astigmatism and lens rotation slightly reduced the overall effect of the toric lens. Residual astigmatism was statistically significantly higher under the simulation of surgery relative to an exact calculation (p < 0.05). The simulation also demonstrated that more aggressive lens selection criteria could produce clinically significant reductions in residual astigmatism in a high percentage of patients.</p> <p>Conclusion</p> <p>Monte Carlo simulation suggests that surgical variability and lens orientation/rotation variability may combine to produce small reductions in the correction achieved with the AcrySof^®Toric^®IOL. Adopting more aggressive lens selection criteria may yield significantly lower residual astigmatism values for many patients, with negligible overcorrections. Surgeons are encouraged to evaluate their AcrySof^®Toric^®outcomes to determine if they should modify their individual lens selection criteria, or their default surgically induced astigmatism value, to benefit their patients.</p