Classical View on Nonclassical Crystal Growth in a Biological Setting.

Crystallization by amorphous particle attachment, a nonclassical crystal growth mode, is prevalent in minerals formed by living tissues. It allows the organism to intervene at every step of crystal growth, i.e.

Elastic constants of biogenic calcium carbonate.

Living organisms form complex mineralized composite architectures that perform a variety of essential functions. These materials are commonly utilized for load-bearing purposes such as structural stability and mechanical strength in combination with high toughness and deformability, which are well demonstrated in various highly mineralized molluscan shell ultrastructures. Here, the mineral components provide the general stiffness to the composites, and the organic interfaces play a key role in providing these biogenic architectures with mechanical superiority.

The BElfast Retinal Tear and detachment Score (BERT Score) in vitreous haemorrhage.

Objective: To establish if the BElfast Retinal Tear and detachment Score (BERT Score) can be used in triaging patients presenting with vitreous haemorrhage to allow safe differentiation between those with retinal tears and detachments, versus haemorrhagic posterior vitreous detachments.

Methods: Retrospective audit of 122 patients presenting to eye casualty with vitreous haemorrhage excluding trauma and vascular causes. Twenty-two patients were excluded from the study as they had no follow-up.

Crystallization by Amorphous Particle Attachment: On the Evolution of Texture.

Crystallization by particle attachment (CPA) is a gradual process where each step has its own thermodynamic and kinetic constrains defining a unique pathway of crystal growth. An important example is biomineralization of calcium carbonate through amorphous precursors that are morphed into shapes and textural patterns that cannot be envisioned by the classical monomer-by-monomer approach. Here, a mechanistic link between the collective kinetics of mineral deposition and the emergence of crystallographic texture is established.

Natural hybrid silica/protein superstructure at atomic resolution.

Formation of highly symmetric skeletal elements in demosponges, called spicules, follows a unique biomineralization mechanism in which polycondensation of an inherently disordered amorphous silica is guided by a highly ordered proteinaceous scaffold, the axial filament. The enzymatically active proteins, silicateins, are assembled into a slender hybrid silica/protein crystalline superstructure that directs the morphogenesis of the spicules. Furthermore, silicateins are known to catalyze the formation of a large variety of other technologically relevant organic and inorganic materials.

The BElfast Retinal Tear and detachment Score (BERT Score).

Purpose: To establish a scoring system to triage patients presenting with symptoms of flashes and floaters to allow safe differentiation between those with retinal tears and detachments, versus uncomplicated posterior vitreous detachments (PVDs).

Methods: Prospective and retrospective audits of 153 patients presenting to eye casualty and vitreoretinal clinics to ascertain the clinical features most likely to be associated with retinal pathology, rather than simple PVD. We then developed a scoring system, which was applied to 160 patients in a further prospective audit.

Outcome of primary rhegmatogenous retinal detachment surgery in a tertiary referral centre in Northern Ireland - A regional study.

Purpose: To report the primary and final success, functional outcome and complication rates of patients with primary rhegmatogenous retinal detachment (RRD) who underwent retinal detachment surgery in a tertiary referral centre in Northern Ireland.

Venue: Vitreoretinal service, Royal Victoria Hospital, Belfast, Northern Ireland.

Methods: This is a retrospective case series of all patients who underwent primary RRD repair between 1st of January 2013 and 31st of December 2013.

[Psychosocial rehabilitation and care under constraint].

Psychosocial rehabilitation is a theoretical tools used in psychiatry to fight against the marginalization of chronic patients. In Geneva, the "Tilleuls", a rehabilitation unit located in the psychiatric hospital, provides a range of group and individual interventionsfocusing on recovery for patients with criminal or civil constraints but also patient with severe and debilitating forms of psychotic illness. This article addresses the various types of constraints (medical, civil or criminal) and their impact on for the recovery process.

The incidence and rate of rhegmatogenous retinal detachment seven years after cataract surgery in patients with high myopia.

Background: Cataract extraction is the most commonly performed surgery in the National Health Service. Myopia increases the risk of postoperative rhegmatogenous retinal detachment (RRD). The aim of this study was to determine the incidence and rate of RRD seven years after cataract extraction in highly myopic eyes.

P63 expression in conjunctival proliferative diseases: pterygium and laryngo-onycho-cutaneous (LOC) syndrome.

Purpose: Compare expression of p63 in pterygium and laryngo-onycho-cutaneous (LOC) syndrome with normal conjunctiva.

Methods: P63 immunohistochemical detection was carried out in normal, pterygium, and LOC conjunctival tissue. In vitro, growth of normal conjunctival biopsy specimens, pterygium, and LOC in growth tissue was compared.

Retrobulbar hemorrhage after sub-Tenon's anesthesia.

We present a case of retrobulbar hemorrhage complicating sub-Tenon's anesthesia in a patient receiving oral anticoagulants. To our knowledge, this has been described only once in the literature.

Surgical removal of subfoveal choroidal neovascular membranes in older patients without age-related macular degeneration.

Purpose: To assess visual and anatomical outcomes following the surgical removal of subfoveal choroidal neovascular membranes (CNVMs) in older patients without clinical evidence of diffuse disease of the retinal pigment epithelium (RPE).

Methods: We retrospectively reviewed records of consecutive patients aged 50 years or older who underwent surgical removal of subfoveal CNVMs. Patients with clinical evidence for age-related macular degeneration (AMD) (>5 small drusen), angioid streaks, and myopic degeneration were excluded.

Are we under-utilizing the talents of primary care personnel? A job analytic examination.

Background: Primary care staffing decisions are often made unsystematically, potentially leading to increased costs, dissatisfaction, turnover, and reduced quality of care. This article aims to (1) catalogue the domain of primary care tasks, (2) explore the complexity associated with these tasks, and (3) examine how tasks performed by different job titles differ in function and complexity, using Functional Job Analysis to develop a new tool for making evidence-based staffing decisions.

Methods: Seventy-seven primary care personnel from six US Department of Veterans Affairs (VA) Medical Centers, representing six job titles, participated in two-day focus groups to generate 243 unique task statements describing the content of VA primary care.

Clinical practice guideline implementation strategy patterns in Veterans Affairs primary care clinics.

Background: The Department of Veterans Affairs (VA) mandated the system-wide implementation of clinical practice guidelines (CPGs) in the mid-1990s, arming all facilities with basic resources to facilitate implementation; despite this resource allocation, significant variability still exists across VA facilities in implementation success.

Objective: This study compares CPG implementation strategy patterns used by high and low performing primary care clinics in the VA.

Research Design: Descriptive, cross-sectional study of a purposeful sample of six Veterans Affairs Medical Centers (VAMCs) with high and low performance on six CPGs.

Task overlap among primary care team members: an opportunity for system redesign?

This article presents the results of research on a systematic approach to the assignment of primary care work in the Veterans Health Administration. Based on a functional job analysis protocol, the study identified overlap in the performance of primary care tasks among multiple occupational groups as prima facie evidence of opportunities to reallocate work responsibilities. Results show that registered nurses, physicians, advanced practitioners, and licensed vocational nurses reported performing 60 percent to 97 percent of the same tasks, while clerks and health technicians appeared to be underutilized.

An in vitro study of human lens epithelial cell adhesion to intraocular lenses with and without a fibronectin coating.

Purpose: To demonstrate differences in human lens epithelial cell adhesion to different intraocular lens biomaterials in vitro and to determine whether these differences can be influenced by coating the intraocular lens surface with commercially available fibronectin.

Methods: A prospective laboratory-based study comparing human lens epithelial cell adhesion to silicone (n=18), polymethylmethacrylate (PMMA; n=18), and acrylic (n=18) intraocular lenses in vitro. The three types of intraocular lenses were then coated with fibronectin: silicone (n=6), PMMA (n=6), and acrylic (n=6).

Audit and feedback and clinical practice guideline adherence: making feedback actionable.

Background: As a strategy for improving clinical practice guideline (CPG) adherence, audit and feedback (A&F) has been found to be variably effective, yet A&F research has not investigated the impact of feedback characteristics on its effectiveness. This paper explores how high performing facilities (HPF) and low performing facilities (LPF) differ in the way they use clinical audit data for feedback purposes.

Method: Descriptive, qualitative, cross-sectional study of a purposeful sample of six Veterans Affairs Medical Centers (VAMCs) with high and low adherence to six CPGs, as measured by external chart review audits.

Diagnosis and treatment of endogenous fungal endophthalmitis.

Endogenous infectious endophthalmitis is rare, and a primary source is usually identified. A case of primary fungal endophthalmitis successfully treated with vitrectomy and systemic antifungal therapy is presented. The aetiology and treatment of the condition are discussed.

Core self-evaluations and job burnout: the test of alternative models.

Research on job burnout has traditionally focused on contextual antecedent conditions, although a theoretically appropriate conception implicates person-environment relationships. The authors tested several models featuring various combinations of personal and contextual influences on burnout and job satisfaction. Measures of core self-evaluations, organizational constraints, burnout, and job satisfaction were collected from 859 health care employees.