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Background The association between subclinical atheromatosis and chronic hepatitis C virus (HCV) infection is unknown but is relevant now that antivirals are improving the survival of patients with the infection. Objectives To determine whether HCV is an independent risk factor for subclinical atheromatosis and to analyze the changes in lipid profiles according to viral RNA levels and hepatic fibrosis. Patients and methods We conducted an observational, cross-sectional study that included 102 HCV-positive patients and 102 HCV-negative patients with parity in terms of sex and age, with no history of cardiovascular or kidney disease or diabetes. Atheromatosis (the presence of atheromatous plaques) and the carotid intima-media thickness (CIMT) were assessed using ultrasonography of the carotid and femoral arteries. Results There was a greater presence of atheromatosis in any vascular territory in HCV-positive patients than in the patients without infection (58.8% vs. 28.4%, p Conclusions HCV infection is an independent risk factor for subclinical atheromatosis. Systemic arterial ultrasonography for this population improves the cardiovascular risk assessment beyond lipid profile abnormalities and the risk calculation using SCORE tables.

Resumen Introduccion Se desconoce la asociacion entre ateromatosis subclinica e infeccion cronica por el virus de la hepatitis C (VHC), relevante ahora que los antivirales mejoran la supervivencia en los pacientes infectados. Objetivos Conocer si el VHC es factor de riesgo independiente de ateromatosis subclinica y analizar las modificaciones del perfil lipidico segun niveles de ARN viral y fibrosis hepatica. Pacientes y metodos Estudio observacional y transversal; incluye 102 pacientes VHC positivos y 102 sujetos VHC negativos con paridad de sexo y edad, sin antecedentes de enfermedad cardiovascular, renal ni diabetes. La ateromatosis (presencia de placas de ateroma) y el grosor intima-media carotideo (GIMc) se evaluo mediante ecografia de arterias carotidas y femorales. Resultados La presencia de ateromatosis en cualquier territorio vascular fue mayor en pacientes VHC que en sujetos no infectados (58,8% frente a 28,4%, p Conclusiones La infeccion VHC es factor de riesgo independiente de ateromatosis subclinica. La ecografia arterial sistemica en esta poblacion mejora la evaluacion del riesgo cardiovascular mas alla de las alteraciones del perfil lipidico y del calculo de riesgo por tablas SCORE.

Funding Acknowledgements Type of funding sources: None. BACKGROUND Coronary artery calcifications (CAC) scoring assessed by the Agatston score has shown an excellent prognostic value in large studies, particularly in diabetic patients, with a very low rate of cardiovascular events in patients with a zero Agatston score. Moreover, recent studies have suggested that high-sensitive cardiac troponin I (hs-cTnI) and brain natriuretic peptide (BNP) may be useful for detecting subclinical atherosclerosis, especially in diabetic patients. However, the link between hs-cTnI/BNP and the Agatston score has not been investigated in this population. PURPOSE The aim of this study was to investigate if hs-cTnI and BNP can bring additional value to predict zero Agatston score in patients with diabetes mellitus in addition to usual risk factors. METHODS Between 2015 and 2019, CAC score was prospectively performed in consecutive patients with diabetes mellitus with high cardiovascular risk. Patients with symptoms or known coronary artery disease were excluded. Within 24h from CT exam, peripheral blood samples were taken to measure hs-cTnI and BNP. The relationship between serum hs-cTnI/BNP concentrations and zero Agatston score was evaluated using univariate and multivariate binomial models. 77 variables have been used to build the model. The implication of hs-cTnI and BNP in this multivariate model was evaluated using nested models associated with Chi-squared test of independence. RESULTS A total of 844 patients with diabetes were enrolled (61 ± 7 years, 57% men, mean diabetes duration 18 years). In this population, 294 (35%) had a zero Agatston score, 253 (30%) an Agatston score from 1 to 100, 161 (19%) from 101 to 400, and 136 (16%) higher than 400. In univariate analysis, hs-cTnI and BNP concentrations were associated with a zero Agatston score (respectively OR, 2.63 [95% CI, 1.51-5.01]; p CONCLUSIONS Cardiac biomarkers hs-cTnI and BNP are associated with a zero Agatston score, which is correlated with a very low risk of cardiovascular events in asymptomatic patients with diabetes mellitus. Abstract Figure. ROC curve to predict zero Agatston score

Background Diabetes mellitus is associated with a high risk of heart failure. The predictors of futures heart failure events in diabetic patients are not clearly understood. BNP measurement can be used as a surrogate endpoint for the diagnosis of heart failure. We investigated the determinants of an increase in BNP level in a large cohort of asymptomatic diabetic patients without known cardiac disease Methods This prospective study included consecutive stable diabetic (type 1 or 2) patients coming for yearly check-up between March 2015 and July 2018 in the university center for the study of diabetes and its complications. Patients with an history of cardiac disease (coronary artery disease, atrial fibrillation, cardiomyopathy, previous heart failure ...) were excluded. All patients had a complete clinical exam, blood pressure measurement (3 consecutive times – mean of 2 lasts measurements), ECG, and blood sample including HbA1C, risk factors assessment, renal function (CKD-EPI) and BNP measurement. Data are presented as mean±SD or median - Spearman's rank and multivariate regression were used for analysis. Results 3743 patients (mean age 57±14 y.o. – 57% male – 78% / 18% / 4% of type 2, type 1 or other type of diabetes respectively – Mean duration of diabetes 17 [1–63] y. – 44% treated with insulin) were studied. Mean±SD / median [min-max] BNP level was 25±39 / 12 [4–737] ng/L. BNP was 400 ng/L in 69 / 15 / 6 / 7 / 3 / 0.1% of the population respectively. The parameters most correlated with BNP level in type 1 and type 2 diabetes were age, duration of diabetes, renal function, HbA1C, and pulsed pressure. For multivariate analysis, renal function was removed of the model as it was highly correlated with age (r=−0.68). Multivariate analysis demonstrated that in type 1 diabetes, high BNP level was linked to age (p Conclusion Age, pulsed pressure and duration of diabetes are the main determinants of an increased level of BNP in asymptomatic diabetic patients without any history of cardiac disease. This result could help to select a population who could benefit to a more extensive follow up concerning heart failure.

Up to now, predicting accurately the Fission Gas Release (FGR) from high burn up UO2 and/or MOX (Mixed Oxide) fuels at off-normal conditions, such as power transient, reactivity-initiated accident (RIA) and loss-of-coolant accident (LOCA), is still a significant and very challenging task. For this purpose, different R&D programs have been carried out in France, as well as in other countries. This has been done with a specific emphasis on mechanisms which promote the FGR under accidental conditions. These studies can be performed thanks to dedicated integral experiments conducted in-pile (i.e. in Materials Testing Reactor) with the corresponding cost and constraints, or at the laboratory scale with annealing tests which allow to be representative of specific parameters (thermal history for instance). During these annealing tests under well-known conditions (temperature, atmosphere), both the absolute level and the time dependence of the released gases should be monitored, together with the corresponding fuel micro-structural changes, since experimental knowledge of fission gas release alone is not efficient enough. This approach requires more and more accurate on-line measurements. This corresponds to the driving force of the present work. In this contribution, we will present our progress in developing an experimental platform that can submit nuclear fuel and cladding samples to annealing tests involving very high temperatures (up to 2500°C) and very fast temperature ramp (up to thousands of °C/s) with controlled thermal gradients and temporal dynamics. This new platform implements innovative instrumentation, such as optical diagnostics to measure fuel fragmentation kinetics and infrared pyrometry for temperature monitoring. This experiment is based on a high-power laser (1.5kW) coupled to an experimental chamber with controlled atmosphere (Ar, N2, or vacuum) and specific optical components. Based on the spatial beam profile and temporal power function of the laser, it is possible which such a system to produce complex spatio-temporal temperature gradients, relevant for addressing different research needs. It provides access to extreme conditions that are very difficult to reach with other means. Particularly, one of main objectives of this work is to investigate conditions of Reactivity Initiated Accident (RIA). The first experiments performed on inactive materials, non-irradiated uranium dioxide, is presented in order to highlight the capabilities of this technique.

Background Coronary artery calcification score (CACs) has been shown to be useful for assessment of cardiovascular risk in diabetic patients without known coronary artery disease. CACs can be useful to detect high risk patients (CACs > 400) or low risk patients (CACs Purpose To check if CAC is discriminant to stratify the cardiovascular risk whatever the age is. Methods A CACs was prospectively performed in 460 consecutive type 2 diabetic patients with ≥ 2 additional risk factors (age > 50 for men and > 60 for women, hypertension, current smoking, elevated LDL and albuminuria) but without any known coronary artery disease during a yearly check-up between January 2015 and December 2016. Results Mean age was 61 ± 10 [30–87] y.o. and 58% were male. Mean duration of diabetes was 15 ± 10 years and 35% were treated with insulin for a mean duration of 10 ± 8 years. Mean CAC score was 287 ± 30 [0–5983]. CACs = 0 was found in 25%, CACs 400 in 20% and CACs > 1000 in 9% of the population. A significant relationship was found between CACs and duration of diabetes, waist circumference, creatinine level and GFR, albuminuria and LDL levels. CACs level was highly related to age: r = 0.522, P Fig. 1 ). Mean CACs in the different age groups, as proportion of CACs 400 are presented in Table 1 . ROC curve analysis demonstrated that the threshold for detecting a high risk (CACs > 400) with a sensitivity > 95% was 55 y.o. In the other hand, the threshold for detecting a low risk (CACs 95% was 69 y.o. Conclusion From our study, in type 2 diabetic patients without known coronary artery disease, the detection of high risk individuals (CACs > 400) is probably relevant after 55 y.o. and detection of low risk individuals (CACs

Resumen Introduccion y objetivos La hiperhomocisteinemia como un factor de riesgo para el dano auditivo, el dano neuronal y el deterioro cognitivo en los pacientes adultos mayores es controvertido y se encuentra limitado por un pequeno numero de estudios. El objetivo de este trabajo es determinar si los pacientes adultos mayores con hiperhomocisteinemia presentan mayor riesgo de desarrollar alteraciones en los procesos centrales de la audicion frente a un grupo de pacientes con niveles de homocisteina adecuados, y definir el comportamiento de las pruebas psicoacusticas y de potenciales de latencia larga (P300) en estos grupos. Metodo Estudio transversal, comparativo y analitico. Se formo un grupo de pacientes con hiperhomocisteinemia y un grupo control con valores normales de homocisteina. A todos los pacientes se les realizo audiometria tonal, impedanciometria y una seleccion de pruebas psicoacusticas (digitos dicoticos, palabras filtradas pasa bajo, palabra en ruido y diferencia en niveles de enmascaramiento), asi como potenciales evocados auditivos de tallo cerebral y P300. Resultados Los pacientes con hiperhomocisteinemia presentaron valores en la prueba de diferencia en los niveles de enmascaramiento superiores a los del grupo control (p = 0,049), asi como latencias mas prologadas en los P300 (p = 0,000). Conclusiones La hiperhomocisteinemia es un factor que altera las funciones auditivas centrales. Las pruebas psicoacusticas alteradas junto con la alteracion en las pruebas electrofisiologicas sugieren que la porcion central de la via auditiva esta afectada en los pacientes con hiperhomocisteinemia.

Introduction and objectives Hyperhomocysteinemia as a risk factor for hearing impairment, neuronal damage and cognitive impairment in elderly patients is controversial and is limited by the small number of studies. The aim of this work was determine if elderly patients detected with hyperhomocysteinemia have an increased risk of developing abnormalities in the central auditory processes as compared with a group of patients with appropriate homocysteine levels, and to define the behaviour of psychoacoustic tests and long latency potentials (P300) in these patients. Methods This was a cross-sectional, comparative and analytical study. We formed a group of patients with hyperhomocysteinemia and a control group with normal levels of homocysteine. All patients underwent audiometry, tympanometry and a selection of psychoacoustic tests (dichotic digits, low-pass filtered words, speech in noise and masking level difference), auditory evoked brainstem potentials and P300. Results Patients with hyperhomocysteinemia had higher values in the test of masking level difference than did the control group (P=.049) and more protracted latency in P300 (P=.000). Conclusions Hyperhomocysteinemia is a factor that alters the central auditory functions. Alterations in psychoacoustic tests and disturbances in electrophysiological tests suggest that the central portion of the auditory pathway is affected in patients with hyperhomocysteinemia.

Summary Objective This study was designed to estimate the maximum oxygen uptake, muscular strength and flexibility of elite Brazilian Jiu-Jitsu athletes. Methods The sample consisted of eleven Brazilian Jiu-Jitsu athletes (25.8 ± 3.3 years old) who were medallists at national and/or international competitions. The aerobic power was estimated by a treadmill test, according to the Bruce Protocol. The maximal isometric strength (hand, leg and back) was measured by specific dynamometric tests. We used sit-ups and push-ups to evaluate abdominal and upper limb strength endurance, respectively. We applied the sit-and-reach test to determine hip, back and posterior flexibility of the muscles of the lower limbs. Results We observed a VO 2max of 49.4 ± 3.6 mL/kg per minute for the treadmill test. We observed measures of 43.7 ± 4.8 kgf for the right maximal isometric handgrip strength, 40.1 ± 3.8 kgf for the left maximal isometric handgrip strength, 185.5 ± 36.0 kgf for the maximal isometric back strength and 154.3 ± 41.9 kgf for the maximal isometric leg strength. In the strength endurance test, the athletes performed 52 ± 7 repetitions in a 1-min sit-up test, and 40 ± 8 repetitions in the push-up test. In the sit-and-reach test, the athletes had an average score of 36 ± 9 cm. Conclusions The elite Brazilian Jiu-Jitsu athletes had medium aerobic power and flexibility, excellent abdominal and upper body strength endurance and maximal isometric back strength. However, these athletes did not have high maximal isometric handgrip or leg strength.

To study the quality of the cut created by 3 microkeratomes from 2 different generations using corneal confocal microscopy.Department of Refractive Surgery, Instituto Oftalmológico de Alicante, Alicante, Spain.Two different studies were conducted: Study 1 and Study 2. Study 1 was a prospective analysis using confocal microscopy examination data from 2 reference groups: Group A (control) with 20 nonoperated eyes of 20 healthy volunteers, and Group B with 50 eyes of 30 patients operated on with the BauschLomb Automated Corneal Shaper (ACS) microkeratome. Study 2 was a prospective randomized double-masked study in which 40 eyes of 20 patients underwent myopic laser in situ keratomileusis by 1 surgeon. The right and left eyes of each patient were randomly and alternatively assigned to Group C, flap made with the Hansatome microkeratome, or Group D, flap made with the Moria M2. Immediately after surgery, the microscopic appearance of the cut was subjectively evaluated by the surgeon. One month postoperatively, flap thickness, particle density, and the subclinical confocal wound healing opacity (WHO) index were evaluated with the corneal confocal microscope.Surgeon handling comfort was nearly the same with the Hansatome as with the M2 (P =.540). However, the apparent quality of the resulting flap was better with the M2 microkeratome (P =.041). The depth of the cuts made by the 3 microkeratomes were significantly different (P.001), with the ACS flaps being thinner than the flaps made with the Hansatome or the M2. Particle density at the interface was significantly poorer in the eyes operated on with the ACS, but in these cases the WHO index was significantly greater (P.001 in both cases).Confocal microscopy is a very useful tool to evaluate the quality of the cut made by different microkeratomes. Overall, the predictability in flap thickness and the apparent quality of the cut made by the Moria M2 microkeratome are better than those obtained with the Hansatome or the ACS. The thin flap made by the ACS microkeratome produced a significantly greater WHO index than the thicker flaps created with the other 2 microkeratomes.

PURPOSE: To assess the effectiveness of optical and ultrasonic pachymetry when examining corneas of patients before and after laser in situ keratomileusis (LASIK). METHODS: We conducted a prospective study of 25 patients (50 eyes) who had LASIK for myopia or myopic astigmatism (mean spherical equivalent refraction -4.80 ± 3.60 D; range -1.75 to -12.00 D). Corneal thickness was measured using 1) conventional ultrasonic pachymetry (20 MHz probe) in the central cornea, 2) ASL confocal microscopy (CMTF analysis), 3) Orbscan II Analyzer, and 4) ultrasound biomicroscopy (UBM) (50 MHz probe) preoperatively and 3 months postoperatively. RESULTS: Preoperative pachymetry values measured with the Orbscan II Analyzer (551.3 ± 27.3 µm) were almost identical to those measured with the 20 MHz ultrasonic probe (553.7 ± 25.7 µm; t-test P=.652). The mean preoperative pachymetry for UBM was 566.7 ± 38.8 µm and for CMTF was 553.2 ± 15.5 µm. The optic and ultrasonic system measurements differed in operated eyes; 20 MHz ultrasonic pachymetry yielded an average 478.7 ± 23.5 µm and the UBM, 482.4 ± 40.3 µm. These measurements differed from the Orbscan II (Tukey test; P=.023) measurement of 461.1 ± 37.5 µm but not from the confocal microscopy measurement of 475.2 ± 41.8 µm. UBM registered greater values that were more variable than those obtained with ultrasonic pachymetry. CONCLUSIONS: In non-operated eyes, corneal thickness was similar using conventional ultrasound, Orbscan II, or confocal techniques, with ultrasound biomicroscopy giving thicker readings. [J Refract Surg 2004;20:29-34]

The number of episodes of vascular catheter related bacteraemia (CRB) observed in non-Intensive Care Unit (ICU) patients may be similar or even higher than those observed in ICUs. While we have a lot of information regarding the impact of CRB among ICU patients, there is still lack of information concerning non-ICU patients.

Caroli's disease is characterized by congenital cystic dilatation of the intrahepatic bile ducts. In 7% of casea a malignant tumor develops complicating the course of the disease.We report the case of a 25 year-old woman in whom Caroli's disease was diagnosed at the age of 11. From that time on, she had several episodes of cholangitis. In 1989, the abdominal ultrasound and CT scan showed dilatation of the intrahepatic bile ducts, intracystic lithiasis and a solid mass. FNA cytology showed a papillary adenocarcinoma. At laparotomy a tumor was found occupying both hepatic lobes, and intraoperative US showed another two nodules in the left lobe. The tumor was considered unresectable. Examination of the hilar lymph nodes was tumor-negative. Two weeks later, the patient underwent an ortothopic liver transplantation (OLT). The pathological examination confirmed Caroli's disease with adenocarcinoma. Two years after OLT, the patient is alive with normal liver function and no evidence of disease.To our knowledge this is the first case report of adenocarcinoma in Caroli's disease treated by OLT.

PURPOSE To report a patient with severe and progressive bilateral deafness who suffered recurrent episodes of diffuse lamellar keratitis (DLK) in both eyes ≥4 months after undergoing uneventful LASIK for myopia. METHODS Four months after LASIK, the patient presented with blurred vision in the left eye. Best spectacle-corrected visual acuity was 0.9. Slit-lamp examination revealed aggregates of white cells at the paracentral and mid-peripheral interface without affecting the visual axis. Diffuse lamellar keratitis stage II was diagnosed and intensive corticosteroid treatment was started. Uncorrected visual acuity (UCVA) in the right eye was 1.2 with no signs of DLK. RESULTS One week after initiating corticosteroid treatment, UCVA improved (1.2) in the left eye. Diffuse lamellar keratitis was diagnosed in the left eye again at 9 months and in the right eye at 15 months after LASIK. The patient was later diagnosed with atypical Cogan’s syndrome. CONCLUSIONS Recurrent and late-onset DLK may be due to other patient systemic conditions predisposing to interstitial keratitis, such as Cogan’s syndrome. [J Refract Surg. 2008;24:548-550.] ABOUT THE AUTHORS From the Department of Cornea and Refractive Surgery, VISSUM, Instituto Oftalmológico de Alicante, Miguel Hernández University School of Medicine, Alicante, Spain (Javaloy, Muñoz, Pérez-Santonja, Vidal, Alió); and Otorhino-Laringology Department, Fundación Hospital de Torrevieja, Torrevieja, Spain (Barrera). The authors have no proprietary interest in the materials presented herein. Correspondence: Jaime Javaloy, MD, PhD, Instituto Oftalmológico de Alicante, Avda Denia, sn. Edificio VISSUM, Alicante, Spain. Tel: 34 965 150 025; E-mail: jjavaloy@coma.es; rdioa@vissum.com Received: June 13, 2007 Accepted: November 7, 2007 Posted online: January 31, 2008

Coherent pulsed Doppler ultrasonic velocimeters cannot measure large blood velocities in deep vessels. To overcome this limitation, a nonuniform sampling method is proposed. The method is based on adding a delayed sampling sequence interlaced to the conventional one. The time interval between two consecutive samples can be continuously adjusted to avoid undesirable sample volumes. Experimental results are shown, confirming theoretical expectations that the maximum measurable velocity and the maximum measurable velocity width are doubled.

Current studies on African rhythm are characterized by the absence of a formalized theoretical framework for describing rhythm on a conceptually analytical level. This paper offers a formal theoretical framework within which the problem of rhythm can be more systematically studied. During an examination of scores of Yoruba drum music, it was observed that the continuous repetition of ‘rhythmic ostinato' was the structural framework upon which an entire composition is often organized. Some rhythmic ostinato were then extracted from some composition and compared with those of the music of neighboring groups such as the Edo, Fon and Ewe. It was discovered that the so-called ‘standard twelve-beat pattern' exists in various forms which literally speaking are ‘modes'. More important is that other ‘modes' can be generated from a given mode by starting at different points within the “rhythmic cycle” in a way analogous to the derivation of modes in scale construction. A mode can also be generated through a retrograde inversion of the other. A formal table was then constructed showing the number of modes derivable from the ‘standard twelve-beat pattern'. Using this approach, rhythmic patterns that are generically related can be grouped together as modes and given a nomenclature. Nigerian Music Review Vol. 6 2005: pp. 9-26

A femtosecond laser microkeratome is becoming a popular device for performing lamellar cuts before laser ablation during laser-assisted in situ keratomileusis (LASIK) surgery, achieving good refractive outcomes and a low rate of complications.1–5 Inflammatory reactions at the interface after using a femtosecond laser for creating lamellar cuts have been communicated at ophthalmology meetings but not yet published in papers. We present a case of severe diffuse lamellar keratitis (DLK) after using IntraLase (IntraLase Corp, Irvine, CA) for performing LASIK surgery. A 32-year-old Caucasian male patient attended our clinic for refractive surgery. He had non-relevant medical or ocular history. The preoperative cicloplegic refraction was right eye, −1.25 sph, −1 cyl×80° visual acuity = 1 (decimal scale); left eye, −1.25 sph, −1.75 cyl×90° visual acuity = 1. Pachymetry …

PURPOSE: To analyze the quality of LASIK flaps created using a femtosecond laser or a mechanical microkeratome. METHODS: A prospective study of consecutive bilateral LASIK flaps (100 patients) created with a 15 kHz femtosecond laser (IntraLase) or with a mechanical microkeratome (Moria M2) was performed. Outcome measures included visual and refractive outcomes, flap dimensions, and intraoperative complications. The first consecutive ten patients (20 eyes) were examined using confocal microscopy 1 and 3 months following surgery. RESULTS: No significant differences were noted in the visual outcomes between groups (t test, P>.05 for all comparisons). Analysis of superficial measurements revealed more round flaps and greater predictability in surface dimensions for the femtosecond laser group (ttest, P=. 016). Mean deviation of flap thickness from target was the same for both instruments, 10 µm, with greater variability for the mechanical microkeratome. The incidence of diffuse lamellar keratitis was significantly greater in the femtosecond laser group (17%) than in the mechanical group (0%) (chi-square test, P CONCLUSIONS: Although the clinical results are similar, the femtosecond laser produces LASIK flaps with more accurate dimensions compared to the mechanical microkeratome. [J Refract Surg. 2007;23:178-187.]

SPKI/SDSI is a flexible and extensible decentralized security model that provides authentication, confidentiality, and access control. However, SPKI/SDSI certification chains are not suitable for large scale, highly dynamic environments such as computational grids. This work extends the SPKI/SDSI model by including an opinion model based on subjective logic. A simulation is performed to evaluate the effectiveness of the proposal.

PURPOSE: To study the quality of the flap obtained with two different heads, disposable and nondisposable, and two different speeds, low and high, using the same Moria M 2 microkeratome (Moria, Antony, France). METHODS: In a prospective randomized study, 51 consecutive eyes (28 patients) underwent myopic LASIK (-4.3 9 ±2. 15 diopters). The eyes were randomly assigned to four groups related to cutting head model (disposable and nondisposable) and cut speed (low and high). In all cases, the intended cut was 160 ¿m and the same M2 unit was used. During surgery, superficial measurements of the flap and the surgeon's opinion about the quality of the cut were recorded. One month after LASIK, the cut depth, interface particle density, and transparency of the cornea (confocal wound healing opacity index) were measured with a confocal microscope. RESULTS: Flaps performed with a disposable cutting head and high speed were statistically significantly larger than the flaps created in the other groups (Kruskal-Wallis test; P=. 041). No statistical differences were noted in cut depth, number of particles, and wound healing opacity index. The surgeon's opinion parameters were similar in all groups. CONCLUSIONS: The Moria M2 microkeratome is safe and provided reproducible results, regardless of cutting head and speed. Disposable and nondisposable head models were similar in their outcome in the quality control model used in this study. [J Refract Surg. 2006;22:28-33.]

Aims: To ascertain the prevalence of acute trachoma as a supposed endemic disease among infants in the Saharan refugee camps of Tindouf (Algeria) and to evaluate the efficacy of treatment with a single dose of azithromycin. Methods: 527 children aged between 3 and 17 were evaluated in the camp schools in October 2001. All the children were clinically and microbiologically examined, including slit lamp checks of anterior segment and two conjunctival swabs, one for the detection of membrane lipopolysaccharide by quick immunoassay test Clearview Chlamydia MF and the other for the detection of specific DNA by chlamydia plasmid specific polymerase chain reaction (PCR) assay. After examination, a single dose of azithromycin was administered to each child. One month later samples from positive children and 12 random negative children by the first PCR were taken to perform a new PCR assay. Results: Chlamydia trachomatis was suspected in 2.47% of the children, papillary hypertrophy being the most frequently seen clinical sign. Scarring changes secondary to trachoma were detected in 11.7% of the children. Only four cases (0.8%) were positive to the immunoassay test and 12 cases (2.27%) were positive by PCR. After treatment a second PCR was performed on positive children and they were negative of chlamydia DNA amplification. However, one child who was negative and received the treatment was positive in the second PCR assay. Conclusion: Acute trachoma prevalence is much lower than expected among infants in this Saharan population. The possible reasons could be the recent improvements in hygiene and health care. Cicatricial trachoma is more frequent. The Clearview immunoassay test has very low sensitivity in the detection of this disease. A single dose of azithromycin is sufficient to treat chlamydial conjunctivitis. However, a programme of improvement in hygiene and health care is necessary to prevent re-infection.

Applications such as aircraft combat simulation require both dynamic supervision and real-time decision-making: actions and observations interact in a reactive way, and durations between two events must be accounted for. We start from a decision-tree model, which owns strong context handling capabilities, but provides only static decision-making. We improve it by matching possible temporal chronicles, accounting for dynamic evolutions, to the context. A decision in this framework is activated upon complete recognition of such a chronicle, whereas our highly reactive application domain requires anticipated decisions, comparing possible evolutions to take the best decision in real-time. We choose to dynamically compute a timed game automaton synthesizing the predicted possible next steps, and propose an algorithm that computes the best decision from this simple controller model.

In flexible manufacturing cells, scheduling has to take into account multiple cells in charge of distinct manufacturing orders sharing common flexible machines, and frequent disturbances must be accounted for efficiently. That suggests a multiagent model distributing decisions between manufacturing order agents and machine agents. The solving process is achieved by alternating infinite capacity scheduling processes performed by the former and several finite capacity scheduling processes performed by the latter. The resulting chronological greedy search is shown to be robust to sudden changes and is able to tackle overconstrained problems. To make the heuristics more effective, we add negotiation processes between manufacturing order agents through forward checking techniques inspired by the constraint-based scheduling community.

In animal models of epilepsy, calcium entry blockers have shown anticonvulsant properties. We studied the antiepileptic effects of nimodipine and two novel dihydropyridines, a calcium antagonist (PCA 50922) and a calcium agonist (PCA 50941), on pentylenetetrazole seizure and maximal electroshock seizure (MES) in mice. Anticonvulsant profile of nimodipine and PCA 50922 was similar to that of clonazepam, but markedly different from that of phenytoin. None of the doses of the PCA 50941 showed anticonvulsant effect., Alter.

Finding a lymphangioma in the upper digestive tract is a rather infrequent event. A case of a 64-year-old man is reported. Diagnosis was made in the course of an endoscopic oesophagogastroduodenal examination and tumor excision with a diathermy snare at the same time. Two years after resection there was no sign of recidivation of the tumor.

For lupus nephritis (LN) management, it is very important to detect fibrosis at an early stage. Urinary exosomal miRNAs profiling can be used as a potential multi-marker phenotyping tool to identify early fibrosis. We isolated and characterised urinary exosomes and cellular pellets from patients with biopsy-proven LN (n = 45) and healthy controls (n = 20). LN chronicity index (CI) correlated with urinary exosomal miR-21, miR-150, and miR-29c (r = 0.565, 0.840, &minus, 0.559, respectively). This miRNA profile distinguished low CI from moderate-high CI in LN patients with a high sensitivity and specificity (94.4% and 99.8%). Furthermore, this multimarker panel predicted an increased risk of progression to end-stage renal disease (ESRD). Pathway analysis identified VEGFA and SP1 as common target genes for the three miRNAs. Immunohistochemistry in LN renal biopsies revealed a significant increase of COL1A1 and COL4A1 correlated with renal chronicity. SP1 decreased significantly in the high-CI group (p = 0.002). VEGFA levels showed no differences. In vitro experiments suggest that these miRNA combinations promote renal fibrosis by increasing profibrotic molecules through SP1 and Smad3/TGF&beta, pathways. In conclusion, a urinary exosomal multimarker panel composed of miR-21, miR-150, and miR-29c provides a non-invasive method to detect early renal fibrosis and predict disease progression in LN.

At present, Lupus Nephritis (LN) is still awaiting a biomarker to better monitor disease activity, guide clinical treatment, and predict a patient’s long-term outcome. In the last decade, novel biomarkers have been identified to monitor the disease, but none have been incorporated into clinical practice. The transmembrane receptor neuropilin-1 (NRP-1) is highly expressed by mesangial cells and its genetic deletion results in proteinuric disease and glomerulosclerosis. NRP-1 is increased in kidney biopsies of LN. In this work we were interested in determining whether urinary NRP-1 levels could be a biomarker of clinical response in LN. Our results show that patients with active LN have increased levels of urinary NRP-1. When patients were divided according to clinical response, responders displayed higher urinary and tissue NRP-1 levels at the time of renal biopsy. Areas under the receiver operating characteristic curve, comparing baseline creatinine, proteinuria, urinary NRP-1, and VEGFA protein levels, showed NRP-1 to be an independent predictor for clinical response. In addition, in vitro studies suggest that NRP-1could promote renal recovery through endothelial proliferation and migration, mesangial migration and local T cell cytotoxicity. Based on these results, NRP-1 may be used as an early prognostic biomarker in LN., This work was supported by grants from the Spain Government (Instituto de Salud Carlos III). This research also received donations from Catalan Lupus Foundation and A.Bosch Foundation.